Female RNA concussion (FeRNAC) study: assessing hormone profiles and salivary RNA in females with concussion by emergency departments in New Zealand: a study protocol.

BACKGROUND: Females of reproductive age with concussion report a greater number of symptoms that can be more severe and continue for longer than age matched males. Underlying mechanisms for sex differences are not well understood. Short non-coding Ribonucleic Acids (sncRNAs) are candidate salivary biomarkers for concussion and have been studied primarily in male athletes. Female sex hormones influence expression of these biomarkers, and it remains unclear whether a similar pattern of sncRNA expression would be observed in females following concussion. This study aims to evaluate recovery time, the ratio of salivary sncRNAs and symptom severity across different hormone profiles in females presenting to emergency departments (ED) with concussion and, to investigate the presence of low energy availability (LEA) as a potential modifier of concussion symptoms. METHODS: This prospective cohort study recruits participants from New Zealand EDs who are biologically female, of reproductive age (16-50 years) and with a confirmed diagnosis of concussion from an ED healthcare professional. Participants are excluded by ED healthcare professionals from study recruitment as part of initial routine assessment if they have a pre-diagnosed psychiatric condition, neurological condition (i.e., epilepsy, cerebral palsy) or more than three previously diagnosed concussions. Participants provide a saliva sample for measurement of sncRNA's, and online survey responses relating to hormone profile and symptom recovery at 7-day intervals after injury until they report a full return to work/study. The study is being performed in accordance with ethical standards of the Declaration of Helsinki with ethics approval obtained from the Health and Disability Ethics Committee (HDEC #2021 EXP 11655), Auckland University of Technology Ethics Committee (AUTEC #22/110) and locality consent through Wellington hospital research office. DISCUSSION: If saliva samples confirm presence of sncRNAs in females with concussion, it will provide evidence of the potential of saliva sampling as an objective tool to aid in diagnosis of, and confirmation of recovery from, concussion. Findings will determine whether expression of sncRNAs is influenced by steroid hormones in females and may outline the need for sex specific application and interpretation of sncRNAs as a clinical and/or research tool. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) registration number ACTRN12623001129673.

Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis.

BACKGROUND: Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries. OBJECTIVE: The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework. METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation, Sport medicine and SporTs science'(PERSiST) guidance. The databases PubMed, CINAHL, Web of Science, SPORTDiscus, Medline, Scopus, Cochrane Library and EBSCO were searched from database inception to 24 April 2023. Longitudinal, prospective and retrospective cohort studies and cross-sectional and descriptive epidemiology studies that used standard injury data collection were included. Studies were excluded if injuries were not medically diagnosed and if injuries were not reported and/or analysed by sex. Two reviewers independently extracted data and assessed study quality using the Downs and Black checklist. RESULTS: Overall, 180 studies were included (8 tier-5, 40 tier-4, 98 tier-3, 30 tier-2, 5 tier-1 studies; one study included data in two tiers). Of those, 174 studies were of moderate quality and six studies were of limited quality. In sex-comparable sports, there was moderate evidence that female athletes had greater risk of knee injury (relative risk (RR) 2.7; 95% CI 1.4-5.5), foot/ankle injuries (RR 1.25; 95% CI 1.17-1.34), bone stress injury (RR 3.4; 95% CI 2.1-5.4) and concussion (RR 8.46; 95% CI 1.04-68.77) than male athletes. Male athletes were at increased risk of hip/groin injuries (RR 2.26; 95% CI 1.31-3.88) and hamstring injuries (RR 2.4; 95% CI 1.8-3.2) compared with females, particularly in dynamic sports. Male athletes were 1.8 (1.37-2.7) to 2.8 (2.45-3.24) times more likely to sustain acute fractures than female athletes, with the highest risk in competition. DISCUSSION: Most studies in all cohorts were of moderate quality (mean/range of scores tier-5: 17 ± 2.2 [14-20], tier-4: 16.9 ± 1.9 [11-21], tier-3: 16.9 ± 1.5 [11-20], tier-2: 16.3 ± 2.2 [11-20], tier-1 studies: 15.6 ± 1.3 [14-17] out of 28 on the Downs and Black checklist), with only six studies of limited quality. Female athletes' propensity for bone stress injuries highlights opportunities to reinforce development of optimal bone health during adolescence and to outline the effects of energy availability. Earlier strength development and exposure to neuromuscular training programmes and modification of skill development in female athletes may be effective strategies for reducing lower limb injury risk. Key components of neuromuscular training programmes could be beneficial for reducing hip/groin and hamstring injury risk in male athletes. There may be a need for sex-specific prevention and return-to-sport protocols for sports-related concussion in female athletes. CONCLUSIONS: Female sex was a key determinant of sports-related injuries beyond ACL injury including foot/ankle injury, bone stress injury and sports-related concussion. Male sex was a key determinant of hip/groin, hamstring injury and upper limb injury. TRIAL REGISTRY: PROSPERO registration number: CRD42017058806 (last updated on 7th June 2023).

Pre-sleep feeding, sleep quality, and markers of recovery in division I NCAA female soccer players.

Pre-sleep nutrition habits in elite female athletes have yet to be evaluated. A retrospective analysis was performed with 14 NCAA Division I female soccer players who wore a WHOOP, Inc. band - a wearable device that quantifies recovery by measuring sleep, activity, and heart rate metrics through actigraphy and photoplethysmography, respectively - 24 h a day for an entire competitive season to measure sleep and recovery. Pre-sleep food consumption data were collected via surveys every 3 days. Average pre-sleep nutritional intake (mean ± sd: kcals 330 ± 284; cho 46.2 ± 40.5 g; pro 7.6 ± 7.3 g; fat 12 ± 10.5 g) was recorded. Macronutrients and kcals were grouped into high and low categories based upon the 50th percentile of the mean to compare the impact of a high versus low pre-sleep intake on sleep and recovery variables. Sleep duration (p = 0.10, 0.69, 0.16, 0.17) and sleep disturbances (p = 0.42, 0.65, 0.81, 0.81) were not affected by high versus low kcal, PRO, fat, CHO intake, respectively. Recovery (p = 0.81, 0.06, 0.81, 0.92), RHR (p = 0.84, 0.64, 0.26, 0.66), or HRV (p = 0.84, 0.70, 0.76, 0.93) were also not affected by high versus low kcal, PRO, fat, or CHO consumption, respectively. Consuming a small meal before bed may have no impact on sleep or recovery.

International society of sports nutrition position stand: nutritional concerns of the female athlete.

Based on a comprehensive review and critical analysis of the literature regarding the nutritional concerns of female athletes, conducted by experts in the field and selected members of the International Society of Sports Nutrition (ISSN), the following conclusions represent the official Position of the Society: 1. Female athletes have unique and unpredictable hormone profiles, which influence their physiology and nutritional needs across their lifespan. To understand how perturbations in these hormones affect the individual, we recommend that female athletes of reproductive age should track their hormonal status (natural, hormone driven) against training and recovery to determine their individual patterns and needs and peri and post-menopausal athletes should track against training and recovery metrics to determine the individuals' unique patterns. 2. The primary nutritional consideration for all athletes, and in particular, female athletes, should be achieving adequate energy intake to meet their energy requirements and to achieve an optimal energy availability (EA); with a focus on the timing of meals in relation to exercise to improve training adaptations, performance, and athlete health. 3. Significant sex differences and sex hormone influences on carbohydrate and lipid metabolism are apparent, therefore we recommend first ensuring athletes meet their carbohydrate needs across all phases of the menstrual cycle. Secondly, tailoring carbohydrate intake to hormonal status with an emphasis on greater carbohydrate intake and availability during the active pill weeks of oral contraceptive users and during the luteal phase of the menstrual cycle where there is a greater effect of sex hormone suppression on gluconogenesis output during exercise. 4. Based upon the limited research available, we recommend that pre-menopausal, eumenorrheic, and oral contraceptives using female athletes should aim to consume a source of high-quality protein as close to beginning and/or after completion of exercise as possible to reduce exercise-induced amino acid oxidative losses and initiate muscle protein remodeling and repair at a dose of 0.32-0.38 g·kg-1. For eumenorrheic women, ingestion during the luteal phase should aim for the upper end of the range due to the catabolic actions of progesterone and greater need for amino acids. 5. Close to the beginning and/or after completion of exercise, peri- and post-menopausal athletes should aim for a bolus of high EAA-containing (~10 g) intact protein sources or supplements to overcome anabolic resistance. 6. Daily protein intake should fall within the mid- to upper ranges of current sport nutrition guidelines (1.4-2.2 g·kg-1·day-1) for women at all stages of menstrual function (pre-, peri-, post-menopausal, and contraceptive users) with protein doses evenly distributed, every 3-4 h, across the day. Eumenorrheic athletes in the luteal phase and peri/post-menopausal athletes, regardless of sport, should aim for the upper end of the range. 7. Female sex hormones affect fluid dynamics and electrolyte handling. A greater predisposition to hyponatremia occurs in times of elevated progesterone, and in menopausal women, who are slower to excrete water. Additionally, females have less absolute and relative fluid available to lose via sweating than males, making the physiological consequences of fluid loss more severe, particularly in the luteal phase. 8. Evidence for sex-specific supplementation is lacking due to the paucity of female-specific research and any differential effects in females. Caffeine, iron, and creatine have the most evidence for use in females. Both iron and creatine are highly efficacious for female athletes. Creatine supplementation of 3 to 5 g per day is recommended for the mechanistic support of creatine supplementation with regard to muscle protein kinetics, growth factors, satellite cells, myogenic transcription factors, glycogen and calcium regulation, oxidative stress, and inflammation. Post-menopausal females benefit from bone health, mental health, and skeletal muscle size and function when consuming higher doses of creatine (0.3 g·kg-1·d-1). 9. To foster and promote high-quality research investigations involving female athletes, researchers are first encouraged to stop excluding females unless the primary endpoints are directly influenced by sex-specific mechanisms. In all investigative scenarios, researchers across the globe are encouraged to inquire and report upon more detailed information surrounding the athlete's hormonal status, including menstrual status (days since menses, length of period, duration of cycle, etc.) and/or hormonal contraceptive details and/or menopausal status.

Heating Up to Keep Cool: Benefits and Persistence of a Practical Heat Acclimation Protocol in Elite Female Olympic Team-Sport Athletes.

PURPOSE: Although recommendations for effective heat acclimation (HA) strategies for many circumstances exist, best-practice HA protocols specific to elite female team-sport athletes are yet to be established. Therefore, the authors aimed to investigate the effectiveness and retention of a passive HA protocol integrated in a female Olympic rugby sevens team training program. METHODS: Twelve elite female rugby sevens athletes undertook 10 days of passive HA across 2 training weeks. Tympanic temperature (TTymp), sweat loss, heart rate, and repeated 6-second cycling sprint performance were assessed using a sport-specific heat stress test Pre-HA, after 3 days (Mid-HA), after 10 days (Post-HA), and 15 days post-HA (Decay). RESULTS: Compared with Pre-HA, submaximal TTymp was lower Mid-HA and Post-HA (both by -0.2 [0.7] °C; d ≥ 0.71), while resting TTymp was lower Post-HA (by -0.3 [0.2] °C; d = 0.81). There were no differences in TTymp at Decay compared with Pre-HA, nor were there any differences in heart rate or sweat loss at any time points. Mean peak 6-second power output improved Mid-HA and Post-HA (76 [36] W; 75 [34] W, respectively; d ≥ 0.45) compared with Pre-HA. The observed performance improvement persisted at Decay by 65 (45) W (d = 0.41). CONCLUSIONS: Ten days of passive HA can elicit some thermoregulatory and performance benefits when integrated into a training program in elite female team-sport athletes. However, such a protocol does not provide a sufficient thermal impulse for thermoregulatory adaptations to be retained after 15 days with no further heat stimulus.

High Prevalence of Iron Deficiency Exhibited in Internationally Competitive, Non-Professional Female Endurance Athletes-A Case Study.

BACKGROUND: While iron deficiency is commonly discussed in populations of professional female athletes, less is known about highly trained, sub-elite female athletes (e.g., those winning international age-group competitions) who generally have less access to medical and allied health support. METHODS: Thirteen non-professional highly trained female endurance athletes provided training diaries and completed a blood test, where iron markers of haemoglobin (Hb), haematocrit (Hct), C-reactive protein (Crp), serum iron, serum ferritin, and transferrin were assessed. Resting metabolic rate (RMR) and body composition using dual-energy X-ray absorptiometry (DXA) were also obtained. Participants were classified as iron deficient (ID) if serum ferritin was <30 ug/L serum ferritin. RESULTS: Six of the 13 females were classified as ID. Serum iron, ferritin, Hb, Hct, and ferrin were greater in the ID group (p < 0.05). Crp resulted in large to very large correlations with serum iron (r = -0.72), serum ferritin (r = -0.66), and transferrin (r = 0.70). CONCLUSIONS: In this population of highly trained female athletes, 46% were diagnosed with sub-optimal iron levels, which could have lasting health effects and impair athletic performance. The need for more education and support in non-professional athletes regarding iron deficiency is strongly advised.

The transdisciplinary health research apparatus: A Baradian account of knowledge boundaries and beyond.

This paper engages with new materialist theory to reimagine transdisciplinary health research. In particular, we draw upon Karen Barad's theory of agential realism and concept of apparatus to rethink the processes of doing transdisciplinary research. A Baradian inspired approach to transdisciplinarity encourages us to not only explore ways of knowing health phenomena differently by working across disciplines, but also to pay close attention to the politics and practices in such research. We offer a case study based on a two-year transdisciplinary research project focused on the health condition known as Low Energy Availability (LEA) in sportswomen. Through this case we highlight three key ways that Barad's concept of apparatus helped us know transdisciplinarity differently: (1) Reading disciplines through each other, (2) Intra-actions and the everyday performativity of disciplinary boundaries, and (3) Troubling the boundaries of the apparatus. Ultimately this paper illustrates the value in feminist new materialist conceptual tools for encouraging different questions of transdisciplinary research as ethico-onto-epistemological practices, processes, and politics of knowledge production.

Case Study: Energy Availability and Endocrine Markers in Elite Male Track Cyclists.

AIM: To highlight energy availability status, resting metabolic rate measures, dietary protein intake, and testosterone concentration in 4 elite male track cycling athletes (mean [SD]: age: 20.8 [1.5] y, body mass: 76.3 [3.6] kg, height: 181.8 [2.9] cm). METHOD: A cross-sectional observation included measures of energy availability (energy intake minus exercise energy expenditure, divided by fat-free mass), resting metabolic rate from indirect calorimetry, dietary protein intake from food records, blood analysis to assess sex hormone status, and performance markers. RESULTS: Midrange testosterone (16.9-19.8 nmol/L), lowered resting metabolic rate ratio (0.76-0.98), varied luteinizing hormone (4-10 U/L), and suboptimal energy availability (26-41 kcal/kg fat-free mass/d, range) were observed in the male track cyclists. Protein intakes ranged from 2.0 g to 2.8 g protein/kg/d. CONCLUSION: The current cohort may have within-day energy deficiency, putting them in a catabolic state.

The Influence of Full-Time Holistic Support Delivered by a Sports Nutritionist on Within-Day Macronutrient Distribution in New Zealand Provincial Academy Rugby Union Players.

Dietary intake is an important consideration for rugby union ('rugby') players to ensure substrate provision for optimal performance and facilitate recovery. Within-day meal distribution is especially important for athletes, particularly those with congested schedules and multiple daily training sessions. In the present study, 10 provincial academy rugby players engaged in a holistic support protocol informed by behaviour-change techniques led by a full-time sports nutritionist. Dietary intake was estimated during a 4-week monitoring and 4-week intervention period using the remote food photography method on one high-volume training day (two training sessions) and two low-volume training days (≤1 training session) per week. Lean body mass did not change significantly in response to the intervention. Significant increases were observed for protein on both low-volume (breakfast, AM snack, evening snack) and high-volume (post-gym, AM snack, evening snack) training days. Carbohydrate intake post-intervention was significantly greater at the pre-gym eating occasion but lower at PM snack and dinner eating occasions on high-volume days. These data suggest that incorporating a holistic support protocol led by a sports nutritionist can influence within-day nutrient intake in rugby players; however, no change to lean body mass was observed, and the influence of these changes in nutrient intake on performance and recovery warrants further investigation.

Advancing feminist innovation in sport studies: A transdisciplinary dialogue on gender, health and wellbeing.

Athlete health and wellbeing requires a holistic, multidimensional approach to understanding, supporting, and treating individual athletes. Building more supportive, inclusive, and equitable environments for the health and wellbeing of women and gender expansive people further requires gender-responsive approaches that promote broader cultural change. Feminist sport and exercise medicine practitioners, sports scientists, and social science researchers are increasingly coming together in their efforts to do this work. However, working across disciplines inevitably includes an array of ontological, epistemological, and political challenges. In this paper, we offer a curated 'dialogue' with a group of feminist scholars engaged in research and practice across disciplines, bringing them together to discuss some of the most pressing gendered issues in sport today (i.e., ACL injury, concussion, menstruation in sport, mental health, gender categories). In so doing, we amplify the voices of those working (empirically and clinically) at the disciplinary intersections of gender, sport and health, and learn about some of the current and future possibilities for transdisciplinary innovations and strategies for building (responsiveness to) cultural change.

Patterns of endogenous and exogenous ovarian hormone modulation on recovery metrics across the menstrual cycle.

INTRODUCTION: As the number of female athletes competing rises globally, training methodologies should reflect sex differences across critical metrics of adaptation to training. Surrogate markers of the autonomic nervous system (ANS) used for monitoring training load are heart rate variability (HRV) and resting heart rate (RHR). The aim was to investigate ovarian hormone effects on standard recovery metrics (HRV, RHR, respiratory rate (RR) and sleep duration) across a large population of female athletes. METHODS: A retrospective study analysed 362 852 days of data representing 13 535 menstrual cycles (MC) from 4594 respondents (natural MC n=3870, BC n=455, progestin-only n=269) for relationships and/or differences between endogenous and exogenous ovarian hormones on ANS. RESULTS: HRV and return to baseline (recovery) decreased as resting HR and RR increased (p<0.001) from the early follicular to the late luteal phase of the MC. Patterning was paradoxical across phases for users of combined hormonal contraception (BC) as compared with the patterning of the MC. HRV and recovery start elevated and drop off quickly during the withdrawal bleed, rising through the active pill weeks (p<0.001). Progestin-only users had similar patterning as the MC. The relationship between normalised recovery and previous day strain is modulated by birth control type. BC exhibited steeper declines in recovery with additional strain-normalised recovery decreases by an additional 0.0055±0.00135 (p<0.001) per unit of strain; with no significant difference between MC and progestin-only (p=0.19). CONCLUSION: The patterning of ANS modulation from ovarian hormones is significantly different between naturally cycling women and those on BC, with the patterning dependent on the type of contraception used.

Biological and Socio-Cultural Factors Have the Potential to Influence the Health and Performance of Elite Female Athletes: A Cross Sectional Survey of 219 Elite Female Athletes in Aotearoa New Zealand.

Health is a pre-requisite for optimal performance yet the parameters which govern health and performance of elite female athletes are little understood. The aim of this study was to quantify the health status of elite female athletes, and understand sociocultural factors influencing that status. The survey addressed demographic, health and athletic performance history, training load, contraceptive use, sport-specific appearance and performance pressures, and communication barriers. Three hundred and fifty-seven elite New Zealand female athletes were recruited to complete an on-line survey. Two hundred and nineteen athletes completed the survey. Oligomenorrhea/amenorrhea had been diagnosed in only 12% of athletes compared with 50% of athletes not on hormonal contraception who reported symptoms consistent with this diagnosis. Stress fractures and iron deficiency were common and associated with oligomenorrhoea/amenorrhea (P = 0.002), disordered eating (P = 0.009) or menorrhagia (P = 0.026). Athletes involved in individual sports (P = 0.047) and with higher training volumes (P < 0.001) were more likely to report a medical illness. Seventy-three percent of athletes felt pressured by their sport to alter their physical appearance to conform to gender ideals with 15% engaging in disordered eating practices. Barriers to communicating female health issues included male coaches and support staff, and lack of quality information pertaining to health. Elite female athletes may fail to reach peak performance due to specific health issues and undiagnosed pathology. Sociocultural factors influence the effectiveness of support of female's health and performance. Organizational and cultural change is required if elite female athletes are to combine optimal health with best performance.

Iron status in athletic females, a shift in perspective on an old paradigm.

Iron deficiency is a common nutrient deficiency within athletes, with sport scientists and medical professionals recognizing that athletes require regular monitoring of their iron status during intense training periods. Revised considerations for athlete iron screening and monitoring have suggested that males get screened biannually during heavy training periods and females require screening biannually or quarterly, depending on their previous history of iron deficiency. The prevalence of iron deficiency in female athletes is higher than their male counterparts and is often cited as being a result of the presence of a menstrual cycle in the premenopausal years. This review has sought to revise our current understanding of female physiology and the interaction between primary reproductive hormones (oestrogen and progesterone) and iron homoeostasis in females. The review highlights an apparent symbiotic relationship between iron metabolism and the menstrual cycle that requires additional research as well as identifying areas of the menstrual cycle that may be primed for nutritional iron supplementation.

Where are all the men? Low energy availability in male cyclists: A review.

Most of the low energy availability (LEA) research has been conducted in female populations. The occurrence of LEA in male athletes is not well known, even with an understanding of the components involved in and contributing to LEA. Cycling is a major risk factor for LEA due to inherent sports characteristics: low impact, high energy demands, and a common perception that leanness is a performance advantage. The purpose of this review is to discuss the cycling-specific studies that have documented components of RED-S. The review demonstrates male cyclists (1) experience energy deficits daily, weekly and throughout a season; (2) exhibit lower bone mineral density at the spine compared to the hip, and low bone mineral density correlating with LEA and; (3) demonstrate downregulation of the endocrine system with elevated cortisol, reduced testosterone and insulin-like growth factor 1. The complexity of LEA is further explored by the socio-psychological contribution that may impact eating behaviours, and therefore increase the risk of developing LEA. Future research directions include applying multifaceted research methods to gain a greater understanding of this syndrome and the effect of LEA on male cyclists.

The Influence of COVID-19 Lockdown Restrictions on Perceived Nutrition Habits in Rugby Union Players.

The global outbreak of COVID-19 has led to governments and local authorities implementing nationwide lockdowns in an attempt to encourage social distancing and minimize the spread of the virus. Only essential businesses have been able to remain open, with non-essential businesses and activities either closing or restricting services. With no group training sessions allowed, canceled matches, an inability to work and the closure of eating establishments, Rugby Union players have experienced disruption to their daily lives. Two surveys were distributed among Rugby Union athletes to explore (1) the influence of COVID-19 lockdown restrictions on Rugby Union players' nutrition and training habits and (2) how nutrition habits in New Zealand Rugby Union players change after lockdown restrictions were lifted. In total, 258 respondents completed Survey 1 (84.1% male, 26.4% professional/semi-professional). Of the respondents, 58% indicated they lived with family during lockdown. Total food intake was reported to be higher in 36% of respondents. Fruit and vegetable intake was lower (17%) and packaged/convenience food intake higher (26%) in a minority of respondents. In total, 106 respondents completed Survey 2 (84.9% male, 34.0% professional/semi-professional). Of the respondents, 72% prepared and 67% purchased their own food. Less than half of respondents consumed high-protein food more than twice daily either during or following lockdown. Compared to during lockdown, motivation to train and exercise was greater in 58% of respondents following lockdown. Dieticians and nutritionists within clubs provided most of the nutrition knowledge to athletes however other unreliable sources were identified, such as social media and family members. The ongoing pandemic has presented significant challenges for athletes concerning training and nutrition habits and the current study provides some insight into these. Coaches and performance staff should ensure athletes receive appropriate nutritional and training support whilst being aware of the unique demands the individuals' may face.

Menstrual cycle and thermoregulation during exercise in the heat: A systematic review and meta-analysis.

Research conducted on exercise in the heat has been largely conducted in males, leaving women understudied. Of research including women, results are inconsistent on the impact of menstrual cycle phase on thermoregulation. OBJECTIVES: The purpose of this systematic review is to quantify published investigations in thermal physiology that include menstrual cycle comparisons and assess aggregate data of investigations that include menstrual cycle variation and aerobic exercise in the heat. METHODS: 367 research articles were identified via systematic review and inclusion criteria and yielded 9 papers included in this analysis for a total number of 83 research subjects. Effect size estimates (Hedge's g) were utilized for initial (pre-exercise) and post-exercise internal body temperature (rectal or esophageal, Tint), sweat rate, mean skin temperature, and exercise heart rate. RESULTS: Pooled effect size showed significantly greater initial Tint (1.231±0.186, p<0.01) and post-exercise Tint (0.455±0.153, p<0.01) in the luteal compared to follicular phases. No significant differences were present in mean skin temperature, sweat rate, or exercise heart rate across menstrual phases in analyses of aggregate data. CONCLUSIONS: The limited available data suggest that observed increases in initial Tint in the luteal phase are maintained throughout and post-exercise without an observed impact in sweat rate or mean skin temperature.

Hepcidin and iron: novel findings for elite female rugby Sevens players.

BACKGROUND: Iron deficiency is a common deficiency disease worldwide with athletes at increased risk. METHODS: A proposed new mechanism of exercise-induced iron deficiency in athletes involves the iron-regulatory hormone hepcidin, however, there is limited information on this amongst elite athletes. This study describes iron status in elite female rugby Sevens players. RESULTS: Blood samples were collected at the start and mid-season and analyzed for serum iron, serum ferritin (SF), soluble transferring receptor (sTfR), high sensitivity C-reactive Protein (hsCRP) and hepcidin. Of the 17 players 18% were iron deficient (SF<30 µg/L) with 29-35% of players with sub-optimal iron stores at some point during the study (SF<45 µg/L). Serum hepcidin was strongly correlated with SF (r=0.61, P=0.0001). CONCLUSIONS: Some elite female rugby Sevens players have sub-optimal iron stores over the course of a season.

The Validity of Resting Metabolic Rate-Prediction Equations and Reliability of Measured RMR in Female Athletes.

The aim of the current study was to; 1) assess the test-retest reliability of an indirect calorimetry analyzer (Parvo Medics TrueOne), and 2) compare measured RMR with three RMR-predictive (pRMR) equations in female athletes. In part one, 12 recreationally-exercising women (mean ± SD; age 27.5 ± 12.3 y) performed two RMR assessments, on separate days, utilising the Parvo Medics TrueOne analyser. In part two, 25 recreationally-exercising women to sub-elite athletes (mean ± SD; age 30.1 ± 10.2 y) underwent an RMR assessment using the Parvo Medics TrueOne analyser, which was compared to three calculated pRMR equations (Harris-Benedict (H-B), Mifflin-St Jeor (M), World Health Organisation (WHO)). eTest-retest reliability for the TrueOne analyser was deemed acceptable (CV = 5.3%, ICC = 0.92). The validity of pRMR when compared to measured RMR showed low levels of agreement in all 3 predictive equations (M: CV = 21.4%, TEE = 269 kcal.day-1, r = 0.16, WHO: CV = 21.5%, TEE = 270 kcal.day-1, r = 0.13 H-B: CV = 21.6%, TEE = 270 kcal.day-1, r = 0.13). The Parvo Medics TrueOne analyser is a reliable tool for measuring RMR. Caution should be taken when using pRMR equations in female athletes as they do not take into account the likely differences in fat free mass in these populations.

Practical Hydration Solutions for Sports.

Personalized hydration strategies play a key role in optimizing the performance and safety of athletes during sporting activities. Clinicians should be aware of the many physiological, behavioral, logistical and psychological issues that determine both the athlete's fluid needs during sport and his/her opportunity to address them; these are often specific to the environment, the event and the individual athlete. In this paper we address the major considerations for assessing hydration status in athletes and practical solutions to overcome obstacles of a given sport. Based on these solutions, practitioners can better advise athletes to develop practices that optimize hydration for their sports.