Immunosurveillance associated with upper respiratory symptoms in elite swimmers: The 8-month period leading into Commonwealth Games.

OBJECTIVES: To monitor individual mucosal immunity and identify potential risk factors of upper respiratory symptoms in elite swimmers over a competitive season. DESIGN: Eight-month longitudinal study, observing mucosal immunity, Epstein-Barr virus status, training loads and illness symptoms of elite international swimmers, leading into the Commonwealth Games 2018. METHODS: Participants were fourteen elite swimmers (age ±â€¯standard deviation = 19.9 ±â€¯0.8 years, height = 178.9 ±â€¯6.3 cm, and mass = 75.0 ±â€¯7.7 kg). Self-reported upper respiratory symptoms, training load and saliva samples were collected weekly. Venous blood samples were taken at study commencement to determine Epstein-Barr virus status. RESULTS: Throughout the study, 70 episodes of upper respiratory symptoms were recorded resulting in 34 days of missed training. Incidence (p = 0.001), severity (p = 0.022), and duration of upper respiratory symptoms (p = 0.001) were significantly higher during high training loads, compared to low. Eight swimmers (61 %) had evidence of past infection with Epstein-Barr virus, but this had no relationship with incidence, severity, or duration of upper respiratory symptoms (p > 0.05). Relative individual salivary immunoglobulin A concentration was 12 % lower when upper respiratory symptoms were present but was not statistically significant (p = 0.101). CONCLUSIONS: This study highlights the importance of individual athlete monitoring, to identify swimmers at increased illness risk. Identification of possible risk factors for upper respiratory symptoms, such as increased training load, may allow for modifications in training or other illness preventative strategies for elite swimmers.

Health Benefits of Montmorency Tart Cherry Juice Supplementation in Adults with Mild to Moderate Ulcerative Colitis: A Protocol for a Placebo Randomized Controlled Trial.

Ulcerative colitis, characterized by its relapsing and remissive nature, negatively affects perception, body image, and overall quality of life. The associated financial burden underscores the need for alternative treatment approaches with fewer side effects, alongside pharmaceutical interventions. Montmorency tart cherries, rich in anthocyanins, have emerged as a potential natural anti-inflammatory agent for ulcerative colitis. This manuscript outlines the study protocol for a randomized placebo-controlled trial investigating the effects of Montmorency tart cherry in individuals with ulcerative colitis. The trial aims to recruit 40 participants with mild to moderate disease activity randomly assign them to either a Montmorency tart cherry or placebo group. The intervention will span 6 weeks, with baseline and 6-week assessments. The primary outcome measure is the Inflammatory Bowel Disease Quality of Life Questionnaire. Secondary outcomes include other health-related questionnaires and biological indices. Statistical analysis will adhere to an intention-to-treat approach using linear mixed effect models. Ethical approval has been obtained from the University of Hertfordshire (cLMS/SF/UH/05240), and the trial has been registered as a clinical trial (NCT05486507). The trial findings will be disseminated through a peer-reviewed publication in a scientific journal.

Heart Rate Recovery Assessed by Cardiopulmonary Exercise Testing in Patients with Cardiovascular Disease: Relationship with Prognosis.

BACKGROUND: The use of exercise testing has expanded in recent decades and there is a wealth of information examining the prognostic significance of exercise variables, such as peak oxygen consumption or ventilatory measures whilst exercising. However, a paucity of research has investigated the use of recovery-derived parameters after exercise cessation. Heart rate recovery (HRR) has been considered a measure of the function of the autonomic nervous system and its dysfunction is associated with cardiovascular risk. OBJECTIVES: We aim to provide an overview of the literature surrounding HRR and its prognostic significance in patients with cardiovascular disease undertaking an exercise test. DATA SOURCES: In December 2020, searches of PubMed, Scopus, and ScienceDirect were performed using key search terms and Boolean operators. STUDY SELECTION: Articles were manually screened and selected as per the inclusion criteria. RESULTS: Nineteen articles met inclusion criteria and were reviewed. Disagreement exists in methodologies used for measuring and assessing HRR. However, HRR provides prognostic mortality information for use in clinical practice. CONCLUSIONS: HRR is a simple, non-invasive measure which independently predicts mortality in patients with heart failure and coronary artery disease; HRR should be routinely incorporated into clinical exercise testing.

Ultra-Endurance Participation and Acute Kidney Injury: A Narrative Review.

Increasingly popular, ultra-endurance participation exposes athletes to extremely high levels of functional and structural damage. Ultra-endurance athletes commonly develop acute kidney injury (AKI) and other pathologies harmful to kidney health. There is strong evidence that non-steroidal anti-inflammatory drugs, common amongst ultra-athletes, is linked to increased risk and severity of AKI and potentially ischaemic renal injury, i.e., acute tubular necrosis. Ultra-endurance participation also increases the risk of exertional rhabdomyolysis, exercise-associated hyponatremia, and gastrointestinal symptoms, interlinked pathologies all with potential to increase the risk of AKI. Hydration and fuelling both also play a role with the development of multiple pathologies and ultimately AKI, highlighting the need for individualised nutritional and hydration plans to promote athlete health. Faster athletes, supplementing nitrates, and being female also increase the risk of developing AKI in this setting. Serum creatinine criteria do not provide the best indicator for AKI for ultra-athletes therefore further investigations are needed to assess the practicality and accuracy of new renal biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL). The potential of recurring episodes of AKI provide need for further research to assess the longitudinal renal health impact of ultra-participation to provide appropriate advice to athletes, coaches, medical staff, and event organisers.

Physical activity and sitting time changes in response to the COVID-19 lockdown in England.

To reduce the spread of the novel coronavirus disease 2019 (COVID-19), national governments implemented measures to limit contact between citizens. This study evaluated changes in physical activity and sitting in response to the first COVID-19 lockdown in England and factors associated with these changes. A cross-sectional online survey-based study collected data from 818 adults between 29 April and 13 May 2020. Participants self-reported demographic information, physical activity and sitting for a 'typical' week before and during lockdown. Participants were grouped into low, moderate and high physical activity, and low and high (≥8 hours/day) sitting. Paired samples t-tests compared physical activity (MET-min/week) before and during lockdown. Pearson's Chi-squared evaluated the proportion of participants in the physical activity and sitting categories. Logistic regression explored associations of demographic and behavioural factors with physical activity and sitting during lockdown. Walking and total physical activity significantly increased during lockdown by 241 (95% confidence interval [CI]: 176, 304) MET-min/week and 302 (CI: 155, 457) MET-min/week, respectively (P < 0.001). There was a 4% decrease in participants engaging in low physical activity and a 4% increase in those engaging in high physical activity from before to during lockdown (P < 0.001). The proportion engaging in high sitting increased from 29% to 41% during lockdown (P < 0.001). Lower education level (odds ratio [OR] = 1.65, P = 0.045) and higher BMI (OR = 1.05, P = 0.020) were associated with increased odds of low physical activity during lockdown, whereas non-White ethnicity (OR = 0.24, P = 0.001) was associated with reduced odds. Younger age was associated with increased odds of high sitting (OR = 2.28, P = 0.008). These findings suggest that physical activity and sitting both increased during lockdown. Demographic and behavioural factors associated with low physical activity and high sitting have been identified that could inform intervention strategies during situations of home confinement.

The relationship between the elevation of haemoglobin A1c level, sleep quality and sleep duration in clinically diagnosed pre-diabetic patients in a nationally representative sample.

BACKGROUND/OBJECTIVES: Type 2 diabetes mellitus (T2DM) is one of the most common chronic illnesses in the United Kingdom accounting for approximately 15% of deaths per year. Growing evidence suggests that sleep duration and quality contributes towards this. This study aimed to determine whether there was a significant relationship between the elevation of haemoglobin A1c (HbA1c) level, sleep quality (SQ) and sleep duration (SD) in clinically diagnosed pre-diabetic patients. SUBJECTS/METHODS: Following referral from a relevant healthcare professional, participants (n = 40) were registered on the National Health Service England, funded Healthier You: National Diabetes Prevention Programme and completed a Pittsburgh Sleep Quality Index questionnaire to evaluate SQ and SD. RESULTS: A Spearman's correlation showed an association between HbA1c, SQ and SD measures. A simple linear regression showed a significant large positive association (rs = 0.913, p < 0.001) and significant regression (F (1) = 39, p < 0.001) with an R2 of 0.842 between HbA1c level and SQ. Additionally, a significant large negative association (rs = 0.757, p < 0.001) and significant regression was found (F (1) = 39, p < 0.001) with an R2 of 0.570 between HbA1c and SD. CONCLUSIONS: This study suggests a relationship between SQ, SD and the elevation of HbA1c which may contribute towards prevalence of T2DM and may help to increase adherence to diabetes prevention programmes.

Changes to Physical Activity, Sitting Time, Eating Behaviours and Barriers to Exercise during the First COVID-19 'Lockdown' in an English Cohort.

This study aimed to determine the effect of the first English national COVID-19 lockdown on physical activity (PA), sitting time, eating behaviours and body mass in an adult cohort. This was further examined to determine whether conforming to recommended guidelines on PA and sedentary behaviour was improved. Based on an online survey (n = 818) incorporating the International Physical Activity Questionnaire Short Form (IPAQ-SF), self-reported body mass change showed that in 32.2% of participants body mass increased, with 39.1% reporting an increase in food intake. Never exercising at the gym or undertaking an exercise class (online or live), increased by 50.8% during lockdown, with 53.5% changing from exercising frequently to never exercising, suggesting a lack of engagement with online and home workouts. However, outdoor running and cycling >2 times/week increased by 38% during lockdown. Walking at least 30 min continuously on >2 occasions/week increased by 70% during lockdown with minimum 10-min walks on 7 days per week increasing by 23%. The lockdown had a negative impact on sitting time (>8 h a day), which increased by 43.6% on weekdays and 121% at weekends. Furthermore, sitting <4 h/day decreased during lockdown (46.5% and 25.6% for weekdays and weekends, respectively). Those citing tiredness or lack of time as a barrier to exercise reduced by 16% and 60%, respectively, from pre-lockdown to during lockdown. More of the sedentary group met the Public Health England PA recommendations, however most participants still did not meet the UK Government guidelines for PA. Improvements in health per additional minutes of physical activity will be proportionately greater in those previously doing <30 min/week, the area where most improvements were found although, conversely sitting time was greatly increased. This study may assist in informing whether future lifestyle changes could improve the health of the population.

Effects of short-term continuous Montmorency tart cherry juice supplementation in participants with metabolic syndrome.

PURPOSE: Metabolic Syndrome (MetS) augments the incidence of cardiovascular disease by two-fold and type II diabetes mellitus by five-fold. Montmorency tart cherries are rich in phytochemicals shown to improve biomarkers related to cardio-metabolic health in humans. This study aimed to examine cardio-metabolic responses after 7-days Montmorency tart cherry juice (MTCJ) supplementation and also acute on short-term supplementation responses to a single bolus, in humans with MetS. METHODS: In a randomised, single-blind, placebo-controlled, crossover trial, 12 participants with MetS (50 ± 10 years; 6M/6F), consumed MTCJ or placebo (PLA) for 7 days. Blood-based and functional cardio-metabolic biomarkers were measured pre- and post-supplementation, and acute responses measured pre-bolus and up to 5 h post-bolus on the 7th day. RESULTS: 24-h ambulatory systolic (P = 0.016), diastolic (P = 0.009) blood pressure and mean arterial pressure (P = 0.041) were significantly lower after 7-days MTCJ supplementation compared to PLA. Glucose (P = 0.038), total cholesterol (P = 0.036), LDL (P = 0.023) concentrations, total cholesterol:HDL ratio (P = 0.004) and respiratory exchange ratio values (P = 0.009) were significantly lower after 6-days MTCJ consumption compared to PLA. CONCLUSIONS: This study revealed for the first time in humans that MTCJ significantly improved 24-h BP, fasting glucose, total cholesterol and total cholesterol:HDL ratio, and also lowered resting respiratory exchange ratio compared to a control group. Responses demonstrated clinically relevant improvements on aspects of cardio-metabolic function, emphasising the potential efficacy of MTCJ in preventing further cardio-metabolic dysregulation in participants with MetS. Registered at clinicaltrials.gov (NCT03619941).

The effects of Montmorency tart cherry juice supplementation and FATMAX exercise on fat oxidation rates and cardio-metabolic markers in healthy humans.

Montmorency tart cherries (Prunus cerasus L.) are rich in anthocyanins, compounds capable of augmenting fat oxidation and regulating metabolic dysfunction. The present study examined whether Montmorency tart cherry juice (MTCJ) supplementation could augment fat oxidation rates at rest and during FATMAX exercise, thus improve cardio-metabolic health. Eleven, healthy participants consumed MTCJ or placebo (PLA) twice daily, in a randomised, counterbalanced order for 20 days. Participants cycled at FATMAX for 1-h pre-, mid- (10 days) and post-supplementation whilst substrate oxidation rates were measured. Before exercise anthropometrics and resting metabolic rate were measured. Blood pressure, serum triglycerides, cholesterol, HDL, total antioxidant status (TAS) and glucose were measured immediately before and after exercise. No significant differences between conditions or interactions were observed for any functional and blood-based cardio-metabolic markers or fat oxidation during exercise or rest (P > 0.05). Pre-exercise TAS (P = 0.036) and HDL (P = 0.001) were significantly reduced from mid- to post-supplementation with MTCJ only. Twenty days' MTCJ supplementation had no effect on fat oxidation; therefore, it is unnecessary for individuals in this participant cohort to consume MTCJ with exercise to improve cardio-metabolic biomarkers.

Neck Cooling Improves Table Tennis Performance amongst Young National Level Players.

This study aimed to examine the effects of neck cooling on table tennis performance. Eight young, National level, male table tennis players (age 16 ± 2 years, height 1.77 ± 0.08 m, body mass 67.54 ± 10.66 kg) were recruited. Participants attended four testing sessions separated by a week. Session one determined fitness levels, and session two was a familiarisation trial. The final two sessions involved completing the table tennis-specific protocol either with (ICE) or without (CON) neck cooling for 1 min before each exercise period (bout: 80⁻90 shots), which represented an individual game. The exercise protocol required completing three bouts to represent a match, each simulating a different skill (forehand, backhand, alternate forehand and backhand), against a mechanical ball thrower. Performance was measured by the number of balls hitting two pre-determined targets. Heart rate, ratings of perceived exertion (RPE), and thermal sensation (TS) were measured. Total performance scores (shots on target) were significantly greater during ICE (136 ± 26), compared to CON (120 ± 25; p = 0.006) with a 15 (±12)% improvement. Effects for time (p < 0.05) but not condition (p > 0.05) were found for RPE and all other physiological variables. TS significantly decreased with cooling throughout the protocol (p = 0.03). Neck cooling appears to be beneficial for table tennis performance by lowering thermal sensation.