Physiological Responses to Combat Sports in Metabolic Diseases: A Systematic Review.

The aim of this systematic review was to investigate how individuals with metabolic diseases respond to combat sports and if they are feasible, safe, and applicable. A systematic literature search was conducted in PubMed, from inception until 22 January 2021. Studies were included if combat sport exercise sessions were clearly defined and participants had the following types of metabolic disease: type 1 or 2 diabetes mellitus, metabolic syndrome, overweight, and obesity. Eleven studies, involving 472 participants of all age groups with type 1 diabetes mellitus, metabolic syndrome, overweight, or obesity were included in this systematic review. No studies involving combat sports and individuals with type 2 diabetes were found. Combat sports showed improved HbA1c levels over time in individuals with type 1 diabetes mellitus, which was not significantly different compared to the control group (p = 0.57). During the follow-up period, glycaemic variability decreased in those actively participating in combat sports. Fat-mass was higher in athletes performing combat sports with metabolic syndrome, compared to athletes without an increased cardiometabolic risk. In overweight/obese adolescents, combat sports showed improved parameters of physical fitness, cardio autonomic control, strength, and body composition compared to control groups. In all studies included in this systematic review, no adverse event associated with combat sports was reported. In conclusion, combat sports are safe and feasible in individuals with diabetes and/or obesity. For individuals with type 2 diabetes mellitus, no recommendations can be made, due to the lack of evidence in this cohort. Future studies investigating combat sports and metabolic diseases should aim for a structured exercise regimen and acknowledge the experience of the participants prior to starting an exercise intervention involving combat sports.

Acute Changes in Heart Rate Variability to Glucose and Fructose Supplementation in Healthy Individuals: A Double-Blind Randomized Crossover Placebo-Controlled Trial.

BACKGROUND: It is unknown how different types of carbohydrates alter the cardio-autonomic system in healthy individuals. Therefore, the aim of this study was to investigate how heart-rate variability changes to single dose ingestion of glucose, fructose, glucose and fructose, and an artificial sweetener (sucralose). METHODS: In a double-blind randomized crossover placebo-controlled setting, 15 participants received all study-specific substances in liquid form. During each 2-h visit, venous blood glucose was measured in a 5-min interval while heart-rate variability was measured continuously via Holter-electrocardiograph. RESULTS: Ingestion of different types of carbohydrates and sucralose showed significant differences for heart rate (p < 0.001), SDNN (p < 0.008), RMSSD (p < 0.001), pNN50 (p < 0.001) and blood pressure (p < 0.001). Different glucose levels significantly altered parameters of heart-rate variability and blood pressure (all p < 0.001), while the rate of change in blood glucose led to changes in heart rate variability, but not in heart rate (p = 0.25) or blood pressure (p = 0.99). CONCLUSIONS: Ingestion of different types of carbohydrates lead to reductions in heart-rate variability compared to a placebo. Blood glucose values above or below 70-90 mg/dL decreased heart rate variability while this was also seen for rapid glucose changes, yet not as pronounced. Healthy individuals should be conscious about carbohydrate intake while maintaining blood glucose levels between 70-90 mg/dL.

The Impact of Sodium Bicarbonate on Performance in Response to Exercise Duration in Athletes: A Systematic Review.

According to recent literature sodium bicarbonate (NaHCO3) has been proposed as a performance enhancing aid by reducing acidosis during exercise. The aim of the current review is to investigate if the duration of exercise is an essential factor for the effect of NaHCO3. To collect the latest studies from electronic database of PubMed, study publication time was restricted from December 2006 to December 2016. The search was updated in July 2018. The studies were divided into exercise durations of > 4 or ≤ 4 minutes for easier comparability of their effects in different exercises. Only randomized controlled trials were included in this review. Of the 775 studies, 35 met the inclusion criteria. Study design, subjects, effects as well as outcome criteria were inconsistent throughout the studies. Seventeen of these studies reported performance enhancing effects after supplementing NaHCO3. Eleven of twenty studies with exercise duration of ≤ 4 minutes showed positive and four diverse results after supplementing NaHCO3. On the other hand six of fifteen studies with an exercise duration of >4 minutes showed performance enhancing and two studies showed diverse results. Consequently, the duration of exercise might be influential for inducing a performance enhancing effect when supplementing NaHCO3, but to which extent, remains unclear due to the inconsistencies in the study results.

Impairments of postural control, functional performance and strength in morbidly obese patients awaiting bariatric surgery in comparison to healthy individuals.

[Purpose] There is a lack of information evaluating specific markers of performance in patients awaiting bariatric surgery. We aimed to assess the postural control, functional performance, strength and endurance performance for morbidly obese patients awaiting bariatric surgery compared to lean controls. [Subjects and Methods] All parameters were assessed by modified Y-balance test, timed-up-and-go-test, maximum strength testing on resistance exercise equipment and cardio-pulmonary exercise testing on a cycle ergometer in 10 morbidly obese patients awaiting bariatric surgery and 10 age- and sex-matched lean controls. [Results] It was found that significant differences existed for overall modified Y-balance test in morbidly obese patients awaiting bariatric surgery versus lean controls (0.37 ± 0.03 vs. 0.47 ± 0.02 cm.cm-1), timed-up-and-go-test (9.33 ± 1.23 vs. 7.85 ± 1.73 sec) and several variables of cardio-pulmonary exercise testing. Overall absolute strength expressed in kilogram was similar, yet when relativized to body weight strength differences were notable (0.4 ± 0.17 vs. 0.83 ± 0.32 kg.kg-1). [Conclusion] The results of this study demonstrate the need for comprehensive functional assessment prior to surgery with an identified demand for subsequent tailored physical training prescription that should begin before surgery.