Prevalence of dietary supplement consumption among CrossFit practitioners.

Purpose: We aimed to verify the prevalence of dietary supplements among CrossFit practitioners (CFPs), considering gender and training status. Still, we aimed to determine the type, reasons, and associated factors of dietary supplement utilization among CFPs. Methods: This is a cross-sectional, exploratory, and descriptive study with the snowball sampling method. Data were collected through online questionnaires using the Google Forms® tool. We included CFPs aged 18-64 years, from Aug 1, 2020, to Sept 31, 2020. The questionnaire contained questions to assess the prevalence, type, and reasons for supplement use; also, we assessed information about sociodemographic variables and the prevalence of the main chronic morbidities. To analyze aspects of eating behavior and sleep-related parameters, we applied the three-factor eating questionnaire (TFEQ)-R21 and the Pittsburgh Sleep Quality Index questionnaire (PSQI), respectively. Results: We assessed one hundred twelve (n = 112; 57 men; 55 women) CFPs (28.9 ± 7.64 years old; body mass index (BMI), 25.5 ± 4.83 kg/m2). Eighty-seven (50 men; 37 women; 28.2 ± 6.66 years old; BMI, 25.4 ± 4.55 kg/m2) reported using dietary supplements. Whey protein was the most used supplement (n = 70), followed by creatine (n = 54). Cognitive restraint (a dimension of eating behavior) score was higher in supplement users than in non-users (51.7 ± 18.6 vs. 42.6 ± 20.5; p = 0.040). Sleep-related parameters did not differ between supplement users and non-users. The most associated factors to supplement use were sex (being man; OR, 7.99; p = 0.007), sleep quality (poor; OR, 5.27; p = 0.045), CrossFit level (as prescribed (RX); OR, 4.51; p = 0.031), and cognitive restraint (OR, 1.03; p = 0.029). Conclusion: The CFPs, especially RX and Elite ones, showed a higher prevalence of supplement utilization. Anabolic-related supplements (i.e., whey protein and creatine) were the most used; moreover, several CFPs used supplements not supported by scientific evidence. Cognitive restraint score was higher in supplement users than in non-users. RX level, being men, and poor sleep quality were associated with supplement utilization. These data draw attention to the necessity of nutritional education for CrossFit coaches and athletes. Broader studies are necessary to confirm our findings.

Emotional eating, binge eating, physical inactivity, and vespertine chronotype are negative predictors of dietary practices during COVID-19 social isolation: A cross-sectional study.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) emerged and rapidly spread worldwide. Several countries have imposed lockdown and isolation in attempt to mitigate viral spread. However, social isolation has a negative effect on psychological aspects, increasing stress, fear, anxiety, anger and emotional disturbance, as well as affecting sleep pattern and the practice of physical activity. Negative emotions and lifestyle changes trigger overeating, consequently affecting dietary practices. The aim of this study was to verify the prevalence of lifestyle factors (i.e., sleep time/quality and practice of physical exercise), eating behavior dimensions, chronotype, and association with dietary practices (planning, domestic organization, food choice, ways of eating) in home confinement during the COVID-19 pandemic in São Paulo, Brazil. METHODS: This cross-sectional study was conducted between April 27 and May 25, 2020. An anonymous online questionnaire (Microsoft Forms) was used for data collection by the snowball method. We verified dietary practices (outcome), eating behavior, physical exercise practice, sleep quality and duration, and chronotype (exposure variables). Sex, age, educational and social status were assessed as covariates and confounders. We evaluated 724 adults (585 women and 139 men). Mean age was 32.6 y (±11.3) for women and 33.5 y (±10.5) for men. RESULTS: Emotional eating (EE) and binge eating (BE) were positively correlated (r = 0.66; P <0.001). Dietary practices were negatively correlated with BE (r = -0.41; P <0.001), EE (r = -0.33; P <0.001) and body mass index (r = -0.24; P <0.001). Linear regression demonstrated that EE (ß = -0.1351; t = -2.841; P = 0.005; ηp2 = 0.013), BE (ß = -0.2580; t = -5.612; P < 0.001; ηp2 = 0.050), no practice of physical exercise at home (ß = -0.4271; t = -5.933; P < 0.001; ηp2 = 0.055), being vespertine (ß = -0.3435; t = 2.076; P = 0.038; ηp2 = 0.019), and age (ß = -0.082; t = -2.210; P = 0.027; ηp2 = 0.008) are negative predictors of dietary practices. Finally, cognitive restraint (ß = 0.1407; t = 3.858; P < 0.001; ηp2 = 0.024), better sleep quality (ß = 0.1768; t = 2.506; P = 0.012; ηp2 = 0.010), receiving 4-10 wages per month (according to a minimum wage in Brazil that corresponds to US $ 183.01) (ß = 0.2568; t = 2.573; P = 0.10; ηp2 = 0.027) and 10 - 20 wages per month (ß = 0.4490; t = 3.726; P < 0.001; ηp2 = 0.027) are positive predictors of dietary practices. CONCLUSION: Eating behavior, physical exercise, sleep, and social factors can be important predictors for dietary practices during COVID-19 social confinement. Longitudinal studies in Brazil are needed to confirm these findings.

Anti-inflammatory response to acute exercise is related with intensity and physical fitness.

PURPOSE: The relationship between inflammatory markers and energetic metabolism has been explored. However, the relationship between exercise intensity and fitness status is unclear, and it is necessary to understand this relationship to apply specific exercise guidance. The purpose of the study was to analyze metabolic and inflammatory responses imposed by acute exercise sessions performed at moderate, heavy, and severe intensities and their relationship with the physical fitness status. METHODS: Nineteen healthy male volunteers performed three acute exercise sessions until exhaustion or up to 60 minutes on a cycle ergometer at moderate (90% of first ventilatory threshold [VT1]), heavy (midpoint between VT1 and second ventilatory threshold [VT2]), and severe (midpoint between VT2 and maximal aerobic power) intensities. Blood lactate, glucose, NEFA, endotoxin, and cytokines were determined for each exercise session. Peripheral and lipopolysaccharide (LPS)-stimulated release of tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, and IL-10 was analyzed before, after, and 60 minutes after sessions. RESULTS: In peripheral blood, severe intensity increased lactate, endotoxin, and TNF-α immediately after exercise and glucose at 60 min after exercise. There was a trend for IL-10 increase at 60 minutes after exercise in peripheral blood. Immediately after exercise, LPS-stimulated TNF-α, IL-6, IL-6/IL-10 ratio, and lactate levels were higher in the severe intensity while nonester fatty acid levels decreased at this time. At 60 minute after exercise, higher concentrations of glucose and a trend for increased IL-10 were observed in severe intensity. A positive correlation was observed between maximal aerobic power and IL-10 ( r = 0.513; P = 0.042), and negative correlations between maximal aerobic power and endotoxin ( r = -0.531; P = 0.034) and lactate ( r = -0.538; P = 0.031) in heavy intensity. CONCLUSION: Our data show a novel finding that higher cytokine responses occur at higher intensities, mainly in severe intensity. However, the anti-inflammatory (IL-10) response was physical fitness-dependent.

Melatonin and sleep responses to normobaric hypoxia and aerobic physical exercise: A randomized controlled trial.

This work evaluated the effects of moderate physical exercise performed under hypoxic conditions on melatonin and sleep. Forty healthy men were randomized into four groups: Normoxia (N) (n = 10); Hypoxia (H) (n = 10); Exercise under Normoxia (EN) (n = 10); and Exercise under Hypoxia (EH) (n = 10). The observation period for all groups was approximately 36 h, beginning with a first night devoid of any intervention. Aerobic exercise was performed by the EN and EH groups on a treadmill at 50% of the ventilatory threshold intensity for 60 min. Sleep evaluation was performed on the 1st and 2nd nights. Venous blood samples for the melatonin measurement were obtained on the 1st and 2nd days at 7:30 AM as well as on the 1st and 2nd nights at 10:30 PM. On the 2nd night, melatonin was higher in the H group than in the N group, but both were lower than values of the EH group. The nocturnal increase in melatonin was inversely correlated with the oxygen saturation of hemoglobin (SaO2%) on the 2nd night in the H group and on the 2nd day in the EH group. Diurnal remission of nocturnal melatonin appeared to be postponed in the H group and even more so in the EH group. Thus, normobaric hypoxia, which is equivalent to oxygen availability at an altitude of 4500 m, acutely increases melatonin. Moreover, diurnal remission of the nocturnal increase in melatonin seems to be delayed by hypoxia alone but even more so when acting together with exercise.

Physical activity as a moderator for obstructive sleep apnoea and cardiometabolic risk in the EPISONO study.

Obstructive sleep apnoea (OSA) is positively associated with cardiometabolic diseases; however, high levels of physical activity could decrease the incidence of OSA and associated comorbidities.In this study we aimed to examine the incidence of OSA in relation to physical activity, and its role as a protective factor in individuals with OSA on the incidence of cardiometabolic diseases, in an 8-9-year follow-up study. We analysed data of 658 volunteers from the São Paulo Epidemiologic Sleep Study (EPISONO), a cohort study of individuals aged 20-80 years, collected through polysomnography, the International Physical Activity Questionnaire and an assessment of cardiometabolic profile.Active subjects had a lower risk of developing OSA compared with nonactive subjects (relative risk 0.877, 95% CI 0.296-0.855) and there was a reduced risk of developing type 2 diabetes mellitus in active/apnoeic subjects (relative risk 0.493, 95% CI 0.252-0.961) compared with nonactive subjects. Metabolic equivalent was negatively associated to cardiometabolic markers, such as C-reactive protein (exp(B)=0.720; p=0.001), interleukin-6 (exp(B)=0.991; p=0.03), insulin (exp(B)=0.982; p=0.03), triglycerides (exp(B)=0.997; p<0.001), homeostasis model assessment for insulin resistance (exp(B)≤0.946; p<0.024), quantitative insulin sensitivity check index (exp(B)=992.4; p<0.001) and mean arterial pressure (exp(B)=0.987; p=0.001).Physical activity was a protective factor against type 2 diabetes mellitus in apnoeic individuals; moreover, being active reduced the risk of developing OSA and was associated with a better cardiometabolic profile.

The Secretory Leukocyte Protease Inhibitor mRNA expression is involved with inflammatory control after downhill exercise in the triceps brachii intermediary head in Wistar rats.

After severe skeletal muscle damage, communication between inflammatory macrophages, myogenic cells, and modulatory secretion factors is essential to induce re-establishment of skeletal muscle structure. To analyze when characteristic gene expression of macrophages, myogenic cells, and SLPI are modulated after an exercise-induced muscle damage (EIMD) downhill protocol. Twenty-six rats were exposed to an experimental protocol of exercise and euthanized before (CTRL), immediately after (G0), and 24 (G24) and 48 (G48) hours after the exercise. After euthanasia, the Triceps brachii were dissected and analyzed by enzyme-linked immunosorbent assay and real time polymerase chain reaction. The CD68 expression was higher in the G24 when compared with all groups (p value < 0.05), whereas the CD163 was inhibited compared with G0 (p value < 0.05). MyoD and Myogenin were higher in the G24 when compared with G0 and G48 (p value < 0.05). The mRNA Secretory Leukocyte Protease Inhibitor (SLPI) was higher in the G48 when compared with the CTRL and G0 (p value < 0.05). IL-6 and TNF-α cytokines did not significantly change, but IL-10 presented a trend to be lower in the G0 when compared with G24 (p value = 0.054). A significant negative correlation was observed between CD68/CD163 (C.C = -0.71) and positive correlations between CD68/Myogenin (C.C = 0.65); MyoD/Myogenin (C.C = 0.72); IL-10/MyoD (C.C = 0.46), IL-10/MYOGENIN (C.C = 0.59); and IL-6/IL-10 (C.C = 0.64). A higher expression of CD68, concomitant with an elevation in MyoD and Myogenin 24 h after exercise, along with some correlations, suggests macrophage communication with myogenic cells independent of CD163 elevation. Additionally, the reestablishment of IL-10 in 24 h with the SLPI increased until 48 h indicate that these molecules are involved with anti-inflammatory transition after downhill exercise in the TBIH of Wistar rats.

Effects of Carbohydrate and Glutamine Supplementation on Oral Mucosa Immunity after Strenuous Exercise at High Altitude: A Double-Blind Randomized Trial.

This study analyzed the effects of carbohydrate and glutamine supplementation on salivary immunity after exercise at a simulated altitude of 4500 m. Fifteen volunteers performed exercise of 70% of VO2peak until exhaustion and were divided into three groups: hypoxia placebo, hypoxia 8% maltodextrin (200 mL/20 min), and hypoxia after six days glutamine (20 g/day) and 8% maltodextrin (200 mL/20 min). All procedures were randomized and double-blind. Saliva was collected at rest (basal), before exercise (pre-exercise), immediately after exercise (post-exercise), and two hours after exercise. Analysis of Variance (ANOVA) for repeated measures and Tukey post hoc test were performed. Statistical significance was set at p < 0.05. SaO2% reduced when comparing baseline vs. pre-exercise, post-exercise, and after recovery for all three groups. There was also a reduction of SaO2% in pre-exercise vs. post-exercise for the hypoxia group and an increase was observed in pre-exercise vs. recovery for both supplementation groups, and between post-exercise and for the three groups studied. There was an increase of salivary flow in post-exercise vs. recovery in Hypoxia + Carbohydrate group. Immunoglobulin A (IgA) decreased from baseline vs. post-exercise for Hypoxia + Glutamine group. Interleukin 10 (IL-10) increased from post-exercise vs. after recovery in Hypoxia + Carbohydrate group. Reduction of tumor necrosis factor alpha (TNF-α) was observed from baseline vs. post-exercise and after recovery for the Hypoxia + Carbohydrate group; a lower concentration was observed in pre-exercise vs. post-exercise and recovery. TNF-α had a reduction from baseline vs. post-exercise for both supplementation groups, and a lower secretion between baseline vs. recovery, and pre-exercise vs. post-exercise for Hypoxia + Carbohydrate group. Five hours of hypoxia and exercise did not change IgA. Carbohydrates, with greater efficiency than glutamine, induced anti-inflammatory responses.

Carbohydrate Supplementation Influences Serum Cytokines after Exercise under Hypoxic Conditions.

INTRODUCTION: Exercise performed at the hypoxia equivalent of an altitude of 4200 m is associated with elevated inflammatory mediators and changes in the Th1/Th2 response. By contrast, supplementation with carbohydrates has an anti-inflammatory effect when exercise is performed under normoxic conditions. The objective of this study was to evaluate the effect of carbohydrate supplementation on cytokines and cellular damage markers after exercise under hypoxic conditions at a simulated altitude of 4200 m. METHODS: Seven adult male volunteers who exercised for 60 min at an intensity of 50% VO2Peak were randomly evaluated under three distinct conditions; normoxia, hypoxia and hypoxia + carbohydrate supplementation. Blood samples were collected at rest, at the end of exercise and after 60 min of recovery. To evaluate hypoxia + carbohydrate supplementation, volunteers received a solution of 6% carbohydrate (maltodextrin) or a placebo (strawberry-flavored Crystal Light®; Kraft Foods, Northfield, IL, USA) every 20 min during exercise and recovery. Statistical analyses comprised analysis of variance, with a one-way ANOVA followed by the Tukey post hoc test with a significance level of p < 0.05. RESULTS: Under normoxic and hypoxic conditions, there was a significant increase in the concentration of IL-6 after exercise and after recovery compared to at rest (p < 0.05), while in the hypoxia + carbohydrate group, there was a significant increase in the concentration of IL-6 and TNF-α after exercise compared to at rest (p < 0.05). Furthermore, under this condition, TNF-α, IL-2 and the balance of IL-2/IL-4 were increased after recovery compared to at rest (p < 0.05). CONCLUSION: We conclude that carbohydrate supplementation modified the IL-6 and TNF-α serum concentrations and shifted the IL-2/IL-4 balance towards Th1 in response without glycemic, glutaminemia and cell damage effects.

Downhill exercise-induced changes in gene expression related with macrophage polarization and myogenic cells in the triceps long head of rats.

Macrophages are one of the most heterogenic immune cells involved in skeletal muscle regeneration. After skeletal muscle damage, M1 phenotypes exhibit pro-inflammatory reaction. In a later stage, they are converted to M2 phenotypes with anti-inflammatory properties. To study when gene expressions of macrophage polarization are changed after damage induced by downhill exercise to exhaustion is the objective of this paper. Before (CTRL) and 0 h (G0), 24 h (G24), 48 h (G48) and 72 h (G72) after 18 bouts of downhill exercise, the animals were euthanised, and the triceps were dissected. We measured gene expression of macrophages (CD68 and CD163), myogenic cells (MyoD and myogenin) and quantified cytokine secretion (interleukin (IL)-6, IL-10 and tumour necrosis factor alpha (TNF-α)). The CD68 expression was lower in G72 compared with G24 (P = 0.005) while CD163 was higher in G48 compared with G24 (P = 0.04). The MyoD expression was higher in G72 compared with G0 (P = 0.04). The myogenin expression was lower in G24 compared with CTRL (P = 0.01) and restored in G72 compared with G24 (P = 0.007). The TNF-α was significantly higher at all times after 24 h (all compared with CTRL, with P = 0.03). The CD68 and CD163 expressions behaved distinctly after exercise, which indicates macrophage polarization between 24 and 48 h. The distinct expression of myogenin, concomitantly with MyoD elevation in G72, indicates that myogenic cell differentiation and the significant change of TNF-α level show an important role of this cytokine in these processes.

Exercise improves immune function, antidepressive response, and sleep quality in patients with chronic primary insomnia.

The aim of this study was to evaluate the effects of moderate aerobic exercise training on sleep, depression, cortisol, and markers of immune function in patients with chronic primary insomnia. Twenty-one sedentary participants (16 women aged 44.7 ± 9 years) with chronic primary insomnia completed a 4-month intervention of moderate aerobic exercise. Compared with baseline, polysomnographic data showed improvements following exercise training. Also observed were reductions in depression symptoms and plasma cortisol. Immunologic assays revealed a significant increase in plasma apolipoprotein A (140.9 ± 22 to 151.2 ± 22 mg/dL) and decreases in CD4 (915.6 ± 361 to 789.6 ± 310 mm(3)) and CD8 (532.4 ± 259 to 435.7 ± 204 mm(3)). Decreases in cortisol were significantly correlated with increases in total sleep time (r = -0.51) and REM sleep (r = -0.52). In summary, long-term moderate aerobic exercise training improved sleep, reduced depression and cortisol, and promoted significant changes in immunologic variables.

Can high altitude influence cytokines and sleep?

The number of persons who relocate to regions of high altitude for work, pleasure, sport, or residence increases every year. It is known that the reduced supply of oxygen (O2) induced by acute or chronic increases in altitude stimulates the body to adapt to new metabolic challenges imposed by hypoxia. Sleep can suffer partial fragmentation because of the exposure to high altitudes, and these changes have been described as one of the responsible factors for the many consequences at high altitudes. We conducted a review of the literature during the period from 1987 to 2012. This work explored the relationships among inflammation, hypoxia and sleep in the period of adaptation and examined a novel mechanism that might explain the harmful effects of altitude on sleep, involving increased Interleukin-1 beta (IL-1 ß ), Interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF- α ) production from several tissues and cells, such as leukocytes and cells from skeletal muscle and brain.

High altitude exposure impairs sleep patterns, mood, and cognitive functions.

This work evaluated the importance of sleep on mood and cognition after 24 h of exposure to hypoxia. Ten males, aged 23-30 years, were placed in a normobaric chamber simulating an altitude of 4,500 m. Sleep assessments were conducted from 22:00-6:00; all mood and cognitive assessments were performed 20 min after awakening. The assessments were conducted in normoxic conditions and after 24 h of hypoxia. Sleep was reevaluated 14 h after the start of exposure to hypoxic conditions, and mood state and cognitive functions were reevaluated 24 h after the start of exposure to hypoxic conditions. Hypoxia reduced total sleep time, sleep efficiency, slow-wave sleep, and rapid eye movement. Depressive mood, anger, and fatigue increased under hypoxic conditions. Vigor, attention, visual and working memory, concentration, executive functions, inhibitory control, and speed of mental processing worsened. Changes in sleep patterns can modulate mood and cognition after 24 h.

Effect of exercise on glutamine metabolism in macrophages of trained rats.

This study investigated the effect of exercise on glutamine metabolism in macrophages of trained rats. Rats were divided into three groups: sedentary (SED); moderately trained (MOD) rats that were swim trained 1 h/day, 5 days/week for 6 weeks; and exhaustively trained (EXT) rats that were similarly trained as MOD for 5 weeks and, in the 6th week, trained in three 1-h sessions/day with 150 min of rest between sessions. The animals swam with a load equivalent to 5.5% of their body weight and were killed 1 h after the last exercise session. Cells were collected, and glutamine metabolism in macrophage and function were assayed. Exercise increased phagocytosis in MOD when compared to SED (34.48 +/- 1.79 vs 15.21 +/- 2.91%, P < 0.05); however, H(2)O(2) production was higher in MOD (75.40 +/- 3.48 nmol h x 10(5) cell(-1)) and EXT (79.20 +/- 1.18 nmol h x 10(5) cell(-1)) in relation to SED (32.60 +/- 2.51 nmol h x 10(5) cell(-1), P < 0.05). Glutamine consumption increased in MOD and EXT (26.53 +/- 3.62 and 19.82 +/- 2.62 nmol h x 10(5) cell(-1), respectively) relative to SED (6.72 +/- 0.57 nmol h x 10(5) cell(-1), P < 0.05). Aspartate increased in EXT (9.72 +/- 1.14 nmol h x 10(5) cell(-1)) as compared to SED (1.10 +/- 0.19 nmol h x 10(5) cell(-1), P < 0.05). Glutamine decarboxylation was increased in MOD (12.10 +/- 0.27 nmol h x 10(5) cell(-1)) and EXT (16.40 +/- 2.17 nmol h x 10(5) cell(-1)) relative to SED (1.10 +/- 0.06 nmol h x 10(5) cell(-1), P < 0.05). This study suggests an increase in macrophage function post-exercise, which was supported by enhanced glutamine consumption and metabolism, and highlights the importance for glutamine after exercise.

Reduced maximal oxygen consumption and overproduction of proinflammatory cytokines in athletes.

OBJECTIVE: It was the aim of this study to evaluate whether chronic pain in athletes is related to performance, measured by the maximum oxygen consumption and production of hormones and cytokines. METHODS: Fifty-five athletes with a mean age of 31.9 +/- 4.2 years engaged in regular competition and showing no symptoms of acute inflammation, particularly fever, were studied. They were divided into 2 subgroups according to the occurrence of pain. Plasma concentrations of adrenaline, noradrenaline, cortisol, prolactin, growth hormone and dopamine were measured by radioimmunoassay, and the production of the cytokines interleukin (IL)-1, IL-2, IL-4, IL-6, tumor necrosis factor-alpha, interferon-alpha and prostaglandin E(2) by whole-blood culture. Maximal oxygen consumption was determined during an incremental treadmill test. RESULTS: There was no change in the concentration of stress hormones, but the athletes with chronic pain showed a reduction in maximum oxygen consumption (22%) and total consumption at the anaerobic threshold (25%), as well as increased cytokine production. Increases of 2.7-, 8.1-, 1.7- and 3.7-fold were observed for IL-1, IL-2, tumor necrosis factor-alpha and interferon-alpha, respectively. CONCLUSIONS: Our data show that athletes with chronic pain have enhanced production of proinflammatory cytokines and lipid mediators and reduced performance in the ergospirometric test.