Plasma Acidosis and Peak Power after a Supramaximal Trial in Elite Sprint and Endurance Cyclists: Effect of Bicarbonate.

PURPOSE: This study aimed to determine whether (i) a plasma acidosis contributes to a reduction of mechanical performance and (ii) bicarbonate supplementation blunts plasma acidosis and arterial oxygen desaturation to resist fatigue during the end spurt of a supramaximal trial in elite sprint and endurance cyclists. METHODS: Elite/world-class cyclists ( n = 6 sprint, n = 6 endurance) completed two randomized, double-blind, crossover trials at 105%V̇O 2peak simulating 3 min of a 4-km individual pursuit, 90 min after ingestion of 0.3 g·kg -1 BM sodium bicarbonate (BIC) or placebo (PLA). Peak power output (PPO), optimal cadence and optimal peak torque, and fatigue were assessed using a 6-s "all-out sprint" before (PPO1) and after (PPO2) each trial. Plasma pH, bicarbonate, lactate - , K + , Na + , Ca 2+ , and arterial hemoglobin saturation (SpO 2 (%)), were measured. RESULTS: Sprint cyclists exhibited a higher PPO, optimal pedal torque, and anaerobic power reserve (APR) than endurance cyclists. The trial reduced PPO (PLA) more for sprint (to 47% initial) than endurance cyclists (to 61% initial). Optimal cadence fell from ~151 to 92 rpm and cyclists with higher APR exhibited a reduced optimal peak torque. Plasma pH fell from 7.35 to 7.13 and plasma [lactate - ] increased from 1.2 to 19.6 mM (PLA), yet neither correlated with PPO loss. Sprint cyclists displayed a lesser plasma acidosis but greater fatigue than endurance cyclists. BIC increased plasma [HCO 3- ] (+6.8 mM) and plasma pH after PPO1 (+0.09) and PPO2 (+0.07) yet failed to influence mechanical performance. SpO 2 fell from 99% to 96% but was unrelated to the plasma acidosis and unaltered with BIC. CONCLUSIONS: Plasma acidosis was not associated with the decline of PPO in a supramaximal trial with elite cyclists. BIC attenuated acid-base disturbances yet did not improve arterial oxygen desaturation or mechanical performance at the end-spurt stage.

Exercise intensity regulates the effect of heat stress on substrate oxidation rates during exercise.

Hyperthermia stimulates endogenous carbohydrate metabolism during exercise; however, it is not known if exercise intensity impacts the metabolic effect of heat stress. In the first study of this two-part investigation, endurance-trained male cyclists performed incremental exercise assessments in 18 and 35°C (60% rH). The stimulatory effect of heat stress on carbohydrate oxidation rates was greater at high vs. moderate vs. low relative intensity (P < 0.05). In agreement, no effects of heat stress on carbohydrate oxidation rates were observed during 60-min of subsequent low-intensity cycling. In study two, endurance-trained male cyclists performed 20-min of moderate-intensity (power at the first ventilatory threshold) and 5-min of high-intensity (power at the second ventilatory threshold) cycling in 18, 28, 34, and 40°C (60% rH). At moderate-intensity, carbohydrate oxidation rates were significantly elevated by heat stress in 40°C (P < 0.05), whereas at high-intensity carbohydrate oxidation rates were significantly elevated by heat stress in 34 and 40°C (P < 0.05). This exercise intensity-mediated regulation of the effect of heat stress on carbohydrate oxidation may be partially attributable to observed plasma adrenaline responses. Our data suggest that under moderate environmental heat stress (34-35°C, 60% rH), heat stress-induced changes in CHO oxidation rates are unlikely to occur unless the relative exercise intensity is high (81 ± 8%⩒O2max), whereas under more extreme environmental heat stress (40°C, 60% rH), these changes occur at lower relative intensities (69 ± 8%⩒O2max). This provides indication of when heat stress-induced metabolic changes during exercise are likely to occur.

Effect of a Ketogenic Diet on Submaximal Exercise Capacity and Efficiency in Runners.

PURPOSE: We investigated the effect of a 31-d ketogenic diet (KD) on submaximal exercise capacity and efficiency. METHODS: A randomized, repeated-measures, crossover study was conducted in eight trained male endurance athletes (V˙O2max, 59.4 ± 5.2 mL⋅kg⋅min). Participants ingested their habitual diet (HD) (13.1 MJ, 43% [4.6 g⋅kg⋅d] carbohydrate and 38% [1.8 g⋅kg⋅d] fat) or an isoenergetic KD (13.7 MJ, 4% [0.5 g·kg⋅d] carbohydrate and 78% [4 g⋅kg⋅d] fat) from days 0 to 31 (P < 0.001). Participants performed a fasted metabolic test on days -2 and 29 (~25 min) and a run-to-exhaustion trial at 70% V˙O2max on days 0 and 31 following the ingestion of a high-carbohydrate meal (2 g⋅kg) or an isoenergetic low-carbohydrate, high-fat meal (<10 g CHO), with carbohydrate (~55 g⋅h) or isoenergetic fat (0 g CHO⋅h) supplementation during exercise. RESULTS: Training loads were similar between trials and V˙O2max was unchanged (all, P > 0.05). The KD impaired exercise efficiency, particularly at >70% V˙O2max, as evidenced by increased energy expenditure and oxygen uptake that could not be explained by shifts in respiratory exchange ratio (RER) (all, P < 0.05). However, exercise efficiency was maintained on a KD when exercising at <60% V˙O2max (all, P > 0.05). Time-to-exhaustion (TTE) was similar for each dietary adaptation (pre-HD, 237 ± 44 vs post-HD, 231 ± 35 min; P = 0.44 and pre-KD, 239 ± 27 vs post-KD, 219 ± 53 min; P = 0.36). Following keto-adaptation, RER >1.0 vs <1.0 at V˙O2max coincided with the preservation and reduction in TTE, respectively. CONCLUSION: A 31-d KD preserved mean submaximal exercise capacity in trained endurance athletes without necessitating acute carbohydrate fuelling strategies. However, there was a greater risk of an endurance decrement at an individual level.

Dietary Intake and Metabolic Control of Children with Type 1 Diabetes Mellitus Aged 6-10 Years in KwaZulu-Natal

Objectives: The objective of this study was to assess the dietary intake and metabolic control of children with type 1 diabetes. Design: A cross-sectional observational study was carried out. Subjects: A total of 30 subjects whose ages ranged from six to ten years were included in the study. Setting: The study was conducted at the Paediatric Diabetic Clinics at Grey's Hospital; Pietermaritzburg and Inkosi Albert Luthuli Central Hospital (IALCH); Durban; in KwaZulu-Natal. Outcome measures: Dietary intake was assessed using a three-day dietary record. Metabolic control was assessed using glycosylated haemoglobin (HbA1c). Results: The mean percentage contributions of macronutrients to total energy as determined by the three-day dietary records were as follows: carbohydrate - 52; added sucrose - 2; protein - 16; fat - 32. The mean intakes were similar to the recommendations of the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). Micronutrient intake was generally adequate. The mean latest glycosylated haemoglobin (HbA1c) for the sample as at the time of the study was 9.7. Five of the thirty subjects had HbA1c values that were within the recommended levels for children with type 1 diabetes. Conclusions: The macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while micronutrient intake was adequate in most cases. Overall the sample had poor metabolic control

Are South African Women Willing and Able to Apply the New Food-Based Dietary Guidelines? Lessons for Nutrition Educators

"Background :Consumer testing was a prime consideration in developing specific South African food-based dietary guidelines (FBDGs) which were nationally adopted in 2003.Objectives This study aimed to determine the consumer's ability to apply the FBDGs appropriately; in terms of identifying foods/drinks according to the FBDG food categories; perceived importance of and barriers to applying each FBDG; and planning a typical day's meals to reflect the FBDGs. Design A cross-sectional study of 333 women from different cultural and socio-economic backgrounds. Setting KwaZulu-Natal; South Africa. Methods Data collection comprised focus-group discussions (n = 103) and structured individual interviews (n = 230). Results The identification of foods/drinks according to the FBDG food categories reflected a high level of comprehension by participants of these food categories. Participants from all study samples endorsed the importance of applying the FBDGs; predominantly for health reasons. Participants cited barriers to the application of the FBDGs as affordability; availability; household taste preferences; routine food-purchasing habits; time constraints; traditional/ habitual food-preparation methods; and persistent attitudes. Only three FBDGs were mentioned as difficult to apply; namely; ""fruits/ vegetables""; ""foods from animals"" and ""legumes"". Meal plans did reflect the FBDGs; illustrating the flexibility of their use across cultural and socio-economic differences. Conclusions Consumer testing of the FBDGs was mainly positive. The study has highlighted areas of confusion regarding certain concepts; terminology and misconceptions; and has identified barriers to application. These concerns can be addressed through the reformulation and retesting of certain dietary guidelines; and the provision of explanatory consumer information and health-worker training materials."

The National Food Consumption Survey (NFCS): South Africa, 1999.

OBJECTIVE: The aim of the National Food Consumption Survey (NFCS) in South Africa was to determine the nutrient intakes and anthropometric status of children (1-9 years old), as well as factors that influence their dietary intake. DESIGN: This was a cross-sectional survey of a nationally representative sample of all children aged 1-9 years in South Africa. A nationally representative sample with provincial representation was selected using 1996 Census information. SUBJECTS: Of the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%. METHODS: The sociodemographic status of each household was assessed by a questionnaire. Dietary intake was assessed by means of a 24-hour recall and a food-frequency questionnaire from the caregivers of the children. Food purchasing practices were determined by means of a food procurement questionnaire. Hunger was assessed by a modified hunger scale questionnaire. Nutritional status was determined by means of anthropometric measurements: height, weight, head circumference and arm circumference. RESULTS: At the national level, stunting (height-for-age below minus two standard deviations (< -2SD) from the reference median) was by far the most common nutritional disorder, affecting nearly one in five children. The children least affected (17%) were those living in urban areas. Even with regard to the latter, however, children living in informal urban areas were more severely affected (20%) compared with those living in formal urban areas (16%). A similar pattern emerged for the prevalence of underweight (weight-for-age < -2SD), with one in 10 children being affected at the national level. Furthermore, one in 10 (13%) and one in four (26%) children aged 1-3 years had an energy intake less than half and less than two-thirds of their daily energy needs, respectively. For South African children as a whole, the intakes of energy, calcium, iron, zinc, selenium, vitamins A, D, C and E, riboflavin, niacin, vitamin B6 and folic acid were below two-thirds of the Recommended Dietary Allowances. At the national level, data from the 24-hour recalls indicated that the most commonly consumed food items were maize, sugar, tea, whole milk and brown bread. For South African children overall, one in two households (52%) experienced hunger, one in four (23%) were at risk of hunger and only one in four households (25%) appeared food-secure. CONCLUSION: The NFCS indicated that a large majority of households were food-insecure and that energy deficit and micronutrient deficiencies were common, resulting in a high prevalence of stunting. These results were used as motivation for the introduction of mandatory fortification in South Africa.

Secondary anthropometric data analysis of the National Food Consumption Survey in South Africa: the double burden.

OBJECTIVE: There is an increase in the prevalence of overweight and obesity in children worldwide, including South Africa. We investigated the prevalences of overweight, obesity, and stunting in a current generation of children (ages 12 to 108 mo), which has a high prevalence of stunting, and evaluated the determinants of both nutritional disorders. METHODS: Secondary data analysis of the weight and height measurements of 12- to 108-mo-old children (weighted n = 2200, non-weighted n = 2894) during the 1999 National Food Consumption Survey in South Africa is reported. The body mass index reference percentiles recommended for use in children by the International Obesity Task Force were used to determine the prevalence of overweight and obesity, and the National Center for Health Statistics (NCHS) percentiles were used to determine the prevalence of stunting. RESULTS: Nationally, the prevalence of stunting (height-for-age < or = -2 standard deviations, NCHS 50th percentile) in these children was 19.3% (95% confidence interval [CI] = 17.49 to 21.16) and was highest in 1- to 3-y-old children (24.4%) and in children of farm workers on commercial farms (25.6%). The prevalence of combined overweight and obesity (body mass index > or = 25 kg/m(2) in 17.1%, 95% CI = 15.00 to 19.23) at the national level was nearly as high as that for stunting. Further, the types of determinants for stunting and overweight were generally similar (although directionally opposite in degree of risk conferred) and included type of housing, type of toilet in the home, fuel used in cooking, presence of a refrigerator or stove, presence of a television in the house, educational level of the caregiver, and maternal education level. An example of the directionally opposite degree of risk is exemplified by the use of paraffin as a fuel being protective against being overweight (odds ratio = 0.78, 95% CI = 0.63 to 0.97) but predictive of an increased risk for stunting (odds ratio = 1.24, 95% CI = 1.04 to 1.48). Stunting itself conferred an increased risk (odds ratio = 1.80, 95% CI = 1.48 to 2.20) of being overweight. CONCLUSION: Certain defined determinants appear to play important roles in children's nutritional outcomes in relation to stunting and to overweight and obesity.

Effect of 1,25-dihydroxyvitamin D3 on plasma concentrations of calcium-binding protein in normal and rachitic (vitamin D-dependent rickets type I) pigs.

An i.v. injection of calcitriol (1,25-(OH)2D3) had no effect within 2.5 h on plasma concentrations of calbindin-D9K (vitamin D-induced calcium-binding protein; CaBP) in hypocalcaemic pigs with inherited vitamin D-dependent rickets type I or in their normocalcaemic siblings or half-siblings. Three days later the plasma concentration of CaBP had doubled in the hypocalcaemic pigs, but was unaltered in the normocalcaemic siblings and half-siblings. Following daily i.v. injections of 1,25-(OH)2D3 for a further 5 days (days 4-8) plasma concentrations of CaBP increased in both the hypocalcaemic (days 4-8) and normocalcaemic (day 8) pigs, the effect being more rapid and greater in the hypocalcaemic 1,25-(OH)2D3-deficient animals. An i.v. injection of 1,25-(OH)2D3 to pure Yucatan pigs also had no effect on plasma concentrations of CaBP within 1.5 h, but in the following 1 h there was some indication of an increase in plasma CaBP levels. In contrast to the normal pigs, insulin-induced hypoglycaemia did not lead to a peak in plasma CaBP concentrations in the hypocalcaemic pigs. There was also no change in the plasma concentrations of 1,25-(OH)2D3 associated with the peak in plasma CaBP following insulin-induced hypoglycaemia in normocalcaemic pigs. These results suggest that changes in plasma concentrations of 1,25-(OH)2D3 are not directly involved in mediating the increase in plasma CaBP which follows hypoglycaemia induced by insulin in normal pigs, although 1,25-(OH)2D3 probably plays a permissive role.

Endocrine control of plasma concentrations of calcium-binding protein in the pig.

The aetiology of the rise in plasma calbindin-D9K (vitamin D-induced calcium-binding protein; CaBP), following insulin-induced hypoglycaemia, was studied in the pig. ACTH led to a rise in plasma concentrations of both CaBP and cortisol. Metyrapone, which blocks cortisol synthesis, abolished the increases in plasma concentrations of CaBP and cortisol normally observed in response to insulin-induced hypoglycaemia. However, there was no significant rise in plasma concentrations of CaBP in response to pharmacological or physiological doses of cortisol. Injection of clonidine, an alpha 2-adrenergic agonist, led to a rise in plasma concentrations of CaBP, whereas phenylephrine, an alpha 1-adrenergic agonist, tended to exert an inhibitory effect. Also, administration of phentolamine (an alpha-adrenergic blocker) before injection of insulin abolished the usual increase in plasma concentrations of CaBP, whereas propranolol (a beta-adrenergic blocker) enhanced the normal increase in plasma concentrations of CaBP in response to insulin-induced hypoglycaemia. Isoproterenol, a beta-adrenergic agonist, was without effect on plasma CaBP. Neither GH nor glucagon appear to be involved in the rise in plasma CaBP following insulin-induced hypoglycaemia. Although atropine abolished the effect of acute hypoglycaemia on plasma CaBP, carbamylcholine was without effect on plasma CaBP concentration. It is concluded that the increases in plasma CaBP induced by either ACTH or alpha 2-adrenergic stimulation may be interrelated since the administration of ACTH can lead to raised plasma concentrations of catecholamines.

Hypophosphataemia and vitamin D metabolism in sheep.

The effect of dietary induced hypophosphataemia on vitamin D metabolism was studied in four conscious sheep. No change in the plasma concentrations of 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) were found during hypophosphataemia when compared with normophosphataemia. In addition both the metabolic clearance rate and the production rate of plasma 1,25(OH)2D3 were unaltered during hypophosphataemia. This suggests that changes in circulating levels of 1,25(OH)2D3 were not necessary for the increased efficiency of intestinal phosphorus absorption seen in phosphorus-depleted hypophosphataemic sheep, and may explain why there is no increase in efficiency of intestinal calcium absorption in phosphorus depleted sheep. Increases in phosphataemia induced acutely by intravenous phosphate infusion for 3 h also had no effect on plasma 1,25(OH)2D3 concentration. It is concluded that in the sheep, unlike non-ruminant animals, chronic hypophosphataemia does not increase plasma 1,25(OH)2D3 concentrations and plays no physiological role in regulating its production or metabolism.

Raised levels of calcium-binding protein in plasma following insulin-induced hypoglycaemia in the pig.

Insulin-induced hypoglycaemia in the pig elicited sharp increases in the plasma concentrations of vitamin D-dependent calcium-binding protein (CaBP) and cortisol and a decrease in plasma inorganic phosphate. Glucose infusion following insulin administration abolished the increases in plasma CaBP and cortisol in response to insulin and reduced the hypophosphataemia. The percentage increases in plasma CaBP and cortisol in response to insulin-induced hypoglycaemia were reduced when the pigs were fed a low-calcium diet, but the hypophosphataemic response was similar. We conclude that insulin-induced hypoglycaemia leads to increased plasma CaBP in pigs fed a normal calcium diet, which is associated with the hypoglycaemia rather than being a direct effect of insulin. We therefore suggest that plasma CaBP may represent more than a mere uncontrolled leak from its sites of storage.

The effects of betamethasone on plasma and intestinal calcium binding protein and on 25-hydroxyvitamin D3 metabolism in the pig.

Betamethasone (50 micrograms/kg body weight/day) given to young pigs reduced calcium absorption, growth and plasma vitamin D dependent calcium binding protein (CaBP) concentration. No changes occurred in plasma 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and intestinal CaBP concentrations. 1,25(OH)2D3 (0.1 microgram/kg body weight/day) given with betamethasone increased calcium absorption although growth and plasma CaBP concentrations remained low. Intestinal CaBP levels remained unchanged. Plasma CaBP concentrations were not consistently related to intestinal CaBP or calcium absorption in the presence of betamethasone. We conclude that betamethasone-induced depression of calcium absorption was not mediated by alterations in intestinal CaBP, but the mechanism remains obscure.

Vitamin D-dependent rickets type I in pigs.

We have bred a strain of pigs with an inherited condition of hypocalcaemic rickets, transmitted by an autosomal-recessive mechanism. Homozygous (affected) piglets grew at half the rate of their heterozygous (clinically normal) littermates, and developed profound hypocalcaemia with severe secondary hyperparathyroidism and hypophosphataemia by 8 weeks of age. In the hypocalcaemic piglets, plasma 1,25-dihydroxyvitamin D levels were low or undetectable, and 24,25-dihydroxyvitamin D3 levels were also reduced despite 25-hydroxyvitamin D3 levels being 2-fold higher. There was no detectable 25-hydroxyvitamin D3-1- or -24-hydroxylase enzyme activity in renal homogenates prepared from affected animals. Plasma and intestinal calcium-binding protein levels were reduced in the hypocalcaemic piglets. Sucrose density gradient analysis of intestinal cytosol, prepared in high-salt buffer, revealed the presence of a similar amount of a specific less than 4.2S 1,25-dihydroxyvitamin D3 binder in both groups of piglets. Administration of pharmacological doses of vitamin D3 to affected animals reversed the hypocalcaemia. We conclude that this strain of pigs has vitamin D-dependent rickets type I.

Effect of dietary calcium and phosphorus depletion on vitamin D metabolism and calcium binding protein in the growing pig.

Twenty-four young pigs were divided into three groups and each fed a replete, low calcium (Ca) or low phosphorus (P) diet. It was found that the deficient diets induced rises in renal 25 hydroxy-vitamin D 1,hydroxylase (1-hydroxylase) activity, circulating 1,25 dihydroxy-vitamin D3 (1,25 (OH)2-D3) and Ca binding protein (CaBP) and intestinal 1,25(OH)2D3 and CaBP. All these rises were statistically significant in the low Ca group but only the rises in the 1-hydroxylase activity and intestinal 1,25(OH)2D3 were significant in the low P group. A high degree of correlation existed between the parameters. There was no enhancement of intestinal 1,25(OH)2D3 or CaBP concentration relative to the 1-hydroxylase activity in the low P pigs as occurs in the chick. The low-P-induced rise in 1-hydroxylase activity was independent of parathyroid hormone.