Sleep, Diet Quality, and Lipid Profile Assessment in NCAA Division I Acrobatics and Tumbling Student-Athletes: A Cross-Sectional Study.

OBJECTIVE: Acrobatics and Tumbling (A&T), an emerging National Collegiate Athletics Association (NCAA) sport, involves athletes with rigorous training backgrounds, usually extending from youth through early adulthood. This study examines the sleep health, diet quality, and lipid profile of A&T athletes clustered by their performance position. METHODS: Forty-two A&T athletes, clustered as tops (n = 19; age = 19.6 ± 1.0 years; body mass index [BMI] = 22.3 ± 1.7 kg/m2) and bases (n = 23; age = 19.6 ± 1.3 years; BMI = 25.7 ± 2.5 kg/m2), completed preseason sleep and diet quality (Rapid Eating Assessment for Participants-Shortened [REAP-S]) surveys. Fasting blood samples were collected for lipid analysis. Body composition was assessed via dual-energy X-ray absorptiometry. RESULTS: Most athletes (71.4%; base n = 14, top n = 16) reported insufficient sleep (≤7 hours) and "good" sleep quality (90.4%, n = 38; base n = 18, top n = 20). Average REAP-S score was 29.24 ± 3.74. Approximately 31% (n = 13) displayed at least one undesirable lipid concentration according to medical guidelines for normal levels (total cholesterol [TC] < 200 mg/dL, triglycerides [TG] < 150 mg/dL, high-density lipoprotein cholesterol [HDL-C] > 40 mg/dL, low-density lipoprotein cholesterol [LDL-C] < 130 mg/dL). Approximately 20% exhibited elevated TC (top n = 4, base n = 4), 12.5% had elevated TG (base n = 5), 2.5% showed low HDL-C (base n = 1), and 10% presented elevated LDL-C (top n = 2, base n = 2). CONCLUSIONS: Most athletes experienced suboptimal sleep (≤7 hours/night) and 31% displayed at least one undesirable lipid concentration (elevated TC, TG, or LDL-C or reduced HDL-C). Tailoring interventions with sports dietitians is recommended, focused on increasing monounsaturated and polyunsaturated fat intake while reducing saturated fat consumption. These interventions could mitigate cardiovascular risks, improve recovery, and possibly enhance athletic performance.

Dietary Intake and Menstrual Health among Acrobatics and Tumbling NCAA Division I Student-Athletes.

OBJECTIVE: Acrobatics & Tumbling (A&T) is an emerging sport in the National Collegiate Athletic Association that lacks research regarding the dietary intake and health of A&T student-athletes (A&Tsa). This study assessed the dietary intake adequacy, estimated energy availability (EA), self-reported menstrual health, and body composition of A&Tsa. METHODS: Twenty-four female A&Tsa participated during week 8 of the preseason (11 top: Age= 20.1 ± 0.9 years; BMI= 22.1 ± 1.7 kg/m2; 13 base: Age= 19.5 ± 1.3 years; BMI= 26.2 ± 2.7 kg/m2). Total energy intake (TEI) and macronutrient intakes were assessed via a paper-based 3-day dietary recall. Resting Metabolic Rate [RMR = 500 + 22 * fat-free mass (FFM)] and energy availability [EA = (TEI - exercise energy expenditure)/FFM)] were estimated; and LEAF-Q assessed menstrual health. Body composition was measured using Dual-Energy X-Ray Absorptiometry. Macronutrient intakes and EA were compared to sports nutrition recommendations (carbohydrate: 6-10 g/kg; protein: 1.2-2.0 g/kg) and the Acceptable Macronutrient Distribution Range (carbohydrate: 45-65%; protein: 10-35%; fat: 20-35%). RESULTS: TEI was 1753 ± 467 kcal (top) and 1980 ± 473.8 kcal (base). A total of 20.8% of A&Tsa failed to meet RMR with TEI, with a higher prevalence in the top (-266 ± 219.2 kcal, n = 3) vs. base (-414.3 ± 534.4 kcal, n = 2) A&Tsa. Top and base A&Tsa had both low EA (28.8 ± 13.4 kcals·FFM-1; 23.8 ± 9.5 kcals·FFM-1) and inadequate carbohydrate intake averages (4.2 ± 1.3 g/kg; 3.5 ± 1.1 g/kg, p < 0.001), respectively. A total of 17% of A&Tsa reported secondary amenorrhea, with a higher prevalence in the top (27.3%, n = 3) vs. the base (7.7%, n = 1). CONCLUSION: TEI and carbohydrate intake of the majority of A&Tsa were below recommendations. Sports dietitians should encourage and educate A&Tsa about following an adequate diet that meets energy and sports-specific macronutrient needs.

Long-Chain Omega-3 Fatty Acid Supplementation and Exercise-Induced Muscle Damage: EPA or DHA?

PURPOSE: Long-chain omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) may enhance recovery from exercise-induced muscle damage (EIMD). However, it is unclear if the effects are due to EPA, DHA, or both. The purpose of this investigation was to examine the effect of EPA + DHA, EPA, and DHA compared with placebo (PL) on muscular recovery. METHODS: Thirty males were randomized to 4 g·d -1 EPA + DHA ( n = 8), EPA ( n = 8), DHA ( n = 7), or PL ( n = 7). After 7-wk supplementation, a downhill running (20 min, 70% V̇O 2max , -16% gradient) plus jumping lunges (5 × 20 reps, 2-min rest intervals) muscle damage protocol was performed. Indices of muscle damage, soreness, muscle function, and inflammation were measured at baseline and throughout recovery. The omega-3 index (O3i; %EPA + %DHA in erythrocytes) was used to track tissue EPA and DHA status. RESULTS: After supplementation, the O3i was significantly higher than PL in all experimental groups ( P < 0.001). Leg press performance was lower in the PL group at 24 h compared with EPA ( P = 0 .019) and at 72 h for EPA ( P = 0.004) and DHA ( P = 0 .046). Compared with PL, muscle soreness was lower in the DHA ( P = 0.015) and EPA ( P = 0.027) groups at 48 h. Albeit nonsignificant, EPA + DHA tended to attenuate muscle soreness ( d = 1.37) and leg strength decrements ( d = 0.75) compared with PL. Jump performance and power metrics improved more rapidly in the EPA and DHA groups (time effects: P < 0.001). Measures of inflammation, range of motion, and muscle swelling were similar between groups ( P > 0.05). CONCLUSIONS: Compared with PL, 4 g·d -1 of EPA or DHA for 52 d improves certain aspects of recovery from EIMD. EPA + DHA did not clearly enhance recovery. Equivalent dosing of EPA + DHA may blunt the performance effects observed in EPA or DHA alone.

Effects of L-Leucine Supplementation and Resistance Training on Adipokine Markers in Untrained Perimenopausal and Postmenopausal Women.

ABSTRACT: Chapman-Lopez, TJ, Funderburk, LK, Heileson, JL, Wilburn, DT, Koutakis, P, Gallucci, AR, and Forsse, JS. Effects of L-leucine supplementation and resistance training on adipokine markers in untrained perimenopausal and postmenopausal women. J Strength Cond Res 38(3): 526-532, 2024-This study examined the effects of supplementing 5 g of leucine compared with a placebo during a 10-week resistance training program on body composition parameters and adipokine concentrations in untrained, perimenopausal and postmenopausal women. Thirty-five women were randomly assigned to 2 groups-leucine (LEU, n = 17) and placebo (PLC, n = 18)-in a double-blind, placebo-controlled trial. Each group consumed the supplement or placebo every day and completed a resistance training program for 10 weeks. Using 3-day food records, a diet was assessed before the intervention and after its cessation. Body composition was assessed preintervention and postintervention using dual-energy x-ray absorptiometry. Moreover, the concentrations of adipokines, such as adiponectin, visfatin, leptin, and monocyte chemoattractant protein-1 (MCP-1), were assessed preintervention and postintervention. Both groups showed an increase in visceral adipose tissue (VAT) area ( p = 0.030) and fat-free mass (FFM; p = 0.023). There were significant group differences in concentrations of visfatin ( p = 0.020) and leptin ( p = 0.038) between the PLC and LEU groups. Visfatin displayed higher concentrations in the PLC group and leptin displayed higher concentrations in the LEU group. In addition, there were significant decreases in adiponectin concentrations for both groups (LEU: 652 ± 513 to 292 ± 447 pg·ml -1 ; PLC: 584 ± 572 to 245 ± 356 pg·ml -1 , p = 0.002) and MCP-1 only decreased in the PLC group (253 ± 119 to 206 ± 106 pg·ml -1 , p = 0.004). There were significant decreases in adiponectin concentrations in both groups and a decrease in MCP-1 concentrations in the PLC group. These decreases may be due to both adipokines possible relationship with VAT area. However, it is not known whether leucine has underlying properties that hinder changes in MCP-1 concentrations.

The impact of omega-3 polyunsaturated fatty acid supplementation on singing training in vocal performers: A non-randomized double-blind placebo-controlled study.

INTRODUCTION: Vocal performers often seek natural treatments to improve their vocal capability. Omega-3 polyunsaturated fatty acid (PUFA) supplementation may reduce inflammation and cause changes in body composition, such as loss of fat mass. The purpose of this study was to determine if omega-3 PUFA supplementation in combination with a singer's training regimen enhances singing training and body composition. METHODS: This was a non-randomized, double-blind, placebo-controlled trial. Forty-three college-level students were recruited and volunteered to serve as study participants. 3.0 grams of omega-3 PUFA per day or 3.0 grams of placebo per day were provided over a 10-week intervention. Participants completed Singing Voice Handicap Index (SVHI), Reflux Symptom Index (RSI), Evaluation of Ability to Sing Easily (EASE), Voice Range Profile (VRP), food records and body composition measures at baseline and study end. RESULTS: Thirty-five participants completed the study. SVHI was significantly different between groups (p = 0.0152; ƞ2 = 0.153). A minor third was added to the bottom of the range in 50% of males in the supplement group (placebo = 0%). Body composition measures were not statistically significant, although those in the supplement group lost more fat mass than placebo, p = 0.101. DISCUSSION/CONCLUSION: Omega-3 PUFA supplementation may be beneficial to improve how active singers feel about their voice and could potentially improve voice range in conjunction with voice lessons, however more research is necessary to confirm the latter. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05141045.

The effect of fish oil supplementation on resistance training-induced adaptations.

BACKGROUND: Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults. METHODS: A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3 days·week-1). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RMSQT) and bench press (1RMBP) at PRE (week 0) and POST (10 weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α-level of 0.05 was used to determine statistical significance and Cohen's d was used to quantify effect sizes (ES). RESULTS: Twenty-one of 28 male and female participants (FOS, n = 10 [4 withdrawals]; PL, n = 11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p< .001) and did not change in the PL group (+1.3%, p = .938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p = .457), FM (FOS: -5.2%, PL: 0.0%, p = .092), and %BF (FOS: -5.9%, PL: -2.5%, p = .136) were observed, although, the between-group ES was considered large for FM (d = 0.84). Absolute and relative (kg·kg [body mass]-1) 1RMBP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p = .047; FOS: +17.6% vs. PL: +7.3%, p = .011; respectively), whereas absolute 1RMSQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p = .191). Relative 1RMSQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p = .045). CONCLUSIONS: When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.

The Effectiveness of Utilizing HRV Indices as a Predictor of ACFT Performance Outcomes.

BACKGROUND: The Army Combat Fitness Test (ACFT) is a performance assessment used by the U.S. Army to assess a cadet's strength, endurance, and agility with a series of six events to ensure that cadets are combat ready. Heart rate variability (HRV) is an instrument that measures cardiac autonomic modulation and has been incorporated to predict the performance of athletes in daily training and competition since acute bouts of exercise alter HRV variables. PURPOSE: To assess the applicability of using HRV to predict ACFT score performance outcomes in cadets. METHODS: Fifty army cadets (n = 36 male; n = 14 female; age = 20.60 ± 3.61 years; height = 173.34 ± 10.39 cm; body mass = 76.33 ± 14.68 kg; body fat percentage = 17.58 ± 5.26%) completed the ACFT and reported for HRV assessment. HRV assessment had the participant lay supine for 5 minutes, and traditional time and frequency domain variables were assessed. A Pearson's correlation and multiple linear regressions were run. RESULTS: HRV time and frequency domains were not significantly correlated in linear regression models except the stress index (SI) and the 2-mile run (2MR). The standing power throw and sprint drag carry were significantly correlated with traditional HRV variables. CONCLUSIONS: HRV was not a predictor of ACFT performance for individual events or overall ACFT. The SI presented predictive properties only for 2MR, with no other significant correlations between HRV variables with standing power throw and sprint drag carry. The SI ability to predict 2MR performance outcome via HRV is a promising tool to assess army cadet performance and recovery.

A Cross-Sectional Analysis of Whole Blood Long-Chain ω-3 Polyunsaturated Fatty Acids and Its Relationship with Dietary Intake, Body Composition, and Measures of Strength and Power in Collegiate Athletes.

ObjectiveLong-chain omega-3 polyunsaturated fatty acids (LC ω-3 PUFAs), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), have received widespread interest from the athletic community for their potential roles in physical performance and recovery. The purpose of this cross-sectional analysis was to evaluate the dietary intake and whole blood ω-3 PUFAs and their relationship with body composition, strength, and power in collegiate athletes.MethodThirty-six athletes completed a dual energy x-ray absorptiometry scan for body composition analysis (n = 35), ω-3 PUFAs food frequency questionnaire (n = 27), provided dried blood spot samples (n = 30) to quantify the Omega-3 Index (O3I) and total ω-3 PUFAs content, handgrip strength (n = 17), and countermovement jump (n = 26) testing.ResultsThe mean daily intake of LC ω-3 PUFAs and O3I was 140 mg and 4.6% ± 0.96, respectively, for all athletes. Dietary LC ω-3 PUFAs were positively correlated with the O3I (r = 0.635, p < .01), whole blood EPA (r = 0.778, p < .01), and DHA (r = 0.515, p < .01). Dietary LC ω-3 PUFA intake, whole blood EPA (%), and the EPA:AA ratio was positively associated with HGS (p < .05). Dietary or blood LC ω-3 PUFAs were not correlated with any other measures.Conclusions:Collegiate athletes consume low amounts of LC ω-3 PUFAs and have sub-optimal O3I status. Sports dietitians should encourage the intake of fatty fish and educate athletes about ω-3 PUFAs potential role on performance- and recovery-based outcomes.

Body Composition, Eicosapentaenoic Acid, and Vitamin D are Associated with Army Combat Fitness Test Performance.

Background: The Army Combat Fitness Test (ACFT), an updated and newly developed metric to assess combat readiness, may require specialized exercise and nutritional interventions. The purpose of this cross-sectional study was to investigate the relationship between body composition, erythrocyte long-chain omega-3 polyunsaturated fatty acids (LC n-3 PUFA), serum vitamin D (VITD) and ACFT performance. Methods: Sixty cadets (43 males, 17 females; 20.9 ± 3.8 years; 173.6 ± 10.2 cm; 75.6 ± 13.7 kg) completed the 6-event ACFT (3-repetition maximum trap-bar deadlift [3DL], standing power toss [SPT], hand-release pushups [HRPU], sprint-drag-carry shuttle run [SDC], leg tuck [LTK], or plank [PLK], and 2-mile run [2MR]), body composition analysis via dual-energy x-ray absorptiometry (percent body fat [%BF], lean body mass [LBM], fat-free mass index [FFMI (LBM+bone mineral content)]), and an omega-3 questionnaire. A sub-sample (n = 50) completed blood draws for fatty acid (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and VITD analysis. Significance was set at p < .05. Results: Lower %BF predicted better performance on all ACFT events (p < .05), except the PLK. Higher LBM was predictive of better performance on the 3DL, SPT, and SDC (p < .05), but no other events. Adjusted FFMI was positively correlated with the 3DL, SPT, HRPU, SDC, and ACFT scores (p < .01 for all). Cadet EPA and DHA dietary intake and omega-3 erythrocyte status was well below established recommendations (25.6 ± 33.9 mg, 58.3 ± 78.1 mg, respectively) and an omega-3 index (O3i = %EPA+%DHA in erythrocytes) of 3.96 ± 1.36%, respectively. EPA was associated with better performance on the 3DL (r = 0.280, p = .049), SPT (r = 0.314, p = .027), LTK (r = 0.316, p = .047), and PLK (r = 0.837, p = .003). After adjusting for body composition, erythrocyte EPA only remained predictive of PLK scores (p = .006). Every 0.1% increase in EPA translated into 5.4 (95% CI: 2.1, 8.8) better PLK score. The O3i or DHA were not associated with any performance variables. Cadets' average serum VITD status was 38.0 ± 14.9 ng∙ml-1. VITD was associated with 3DL (r = 0.305, p = .031), HRPU (r = 0.355, p = .011), 2MR (r = 0.326, p = .021), and total ACFT score (r = 0.359, p = .011). VITD remained predictive of each event after adjustment for body composition. Every 10 ng∙ml-1 increase in VITD was associated with 3-point increase in 3DL, HRPU, 2MR scores, and a 13-point increase in the total ACFT score. Conclusions: Our data highlight the importance of measures of muscularity, LBM and FFMI, on ACFT performance. Additionally, EPA and VITD status is associated with various strength, power, and muscular and aerobic endurance components of the ACFT. While these results could help professionals better assess and train military personnel, especially since these measures are modifiable through exercise and dietary interventions, they are ultimately hypothesis generating and warrant further exploration.

Comparison of a Sucrose-Based and Rice-Based Sports Beverage on Hydration Status During a 19.3-km Foot March in ROTC Cadets.

ABSTRACT: Heileson, JL, Peterson, M, Adair, KE, and Funderburk, LK. Comparison of a sucrose-based and rice-based sports beverage on hydration status during a 19.3-km foot march in ROTC cadets. J Strength Cond Res 36(4): 1105-1110, 2022-The purpose of this field study was to determine whether a rice-based sport beverage (RB) maintains hydration status compared to a sucrose-based sports beverage (SB) during a load-bearing 19.3-km foot march. Eighteen Reserve Officer Training Corps (ROTC) cadets (male, n = 11; female, n = 7) were randomly assigned to consume either 2.84 L of an RB (carbohydrate, 114 g; sodium, 1306 mg) or SB (carbohydrate, 170 g; sodium, 1136 mg) throughout the duration of the foot march (temperature 14.44° C, humidity 50%). The sports beverages were distributed once before the event and then every 3.2 km for a total of 6 servings (0.47 L each). Pre- and post-urine specific gravity (USG) and body mass were used to assess hydration status. A survey was used to determine subjective ratings of perceived exertion and gastrointestinal (GI) discomfort. The level of significance was set at p < 0.05 for all analyses. Sixteen cadets completed the study. Based on USG, both beverages significantly improved hydration status (USG = 1.017 ± 0.010 pre-march vs. 1.011 ± 0.008 post-march, p = 0.04); however, there was no difference between groups (change in USG = -0.009 ± 0.012 for RB group vs. -0.003 ± 0.008 for SB group, p = 0.92). Ratings for perceived exertion and GI discomfort scores were similar between groups. In conclusion, the RB was as effective as the SB at maintaining hydration status and could potentially reduce GI discomfort. Athletes and military personnel concerned with ensuring appropriate hydration during moderate-intensity endurance events can achieve similar fluid balance from a rice-based sports beverage that is lower in calories, carbohydrate, and sugar.

The Impact of Fish Oil Supplementation on Self-Perception of the Voice in Vocal Performers: A Randomized, Single-Blind, Placebo-Controlled Study.

PURPOSE: Physically active adults have experienced training benefits from fish oil-derived omega-3 fatty acid (FO n3), which may also be of benefit to singers. The purpose of this research study was to determine if self-reported vocal adaptations and body composition changes occur in singers following FO n3 supplementation in conjunction with a singer's normal training regimen. METHOD: Twenty college students, currently enrolled in vocal lessons at a university, were randomized to receive either 3.0 g of FO n3 or placebo, which they took during a 10-week study period. Participants were blinded to group assignment. Participants completed the Reflux Symptom Index (RSI), Singing Voice Handicap Index-10 (SVHI-10), and the Evaluation of Ability to Sing Easily (EASE) and submitted to body composition measures (weight, skeletal mass, and body fat mass) before and after the study period. RESULTS: Sixteen participants completed all parts of the study protocol. Mean compliance for the placebo group (83.9%) and the supplement group (75.2%) was similar. There were no significant differences in body composition measures, RSI scores, and EASE scores between groups. Scores on the SVHI-10 decreased significantly over time for all participants. CONCLUSIONS: Improvements seen in the SVHI-10 were not meaningfully different between the supplement and placebo group, pointing to the benefit of weekly lessons. The lack of changes in the questionnaire scores in the supplement group are partially attributed to the low compliance rate and low sample size, which is supported by the lack of change in the body composition measures.

Metabolic Health, Obesity, and Renal Function: 2013-2018 National Health and Nutrition Examination Surveys.

Rising rates of metabolic syndrome, obesity, and mortality from chronic kidney disease (CKD) have prompted further investigation into the association between metabolic phenotypes and CKD. Purpose: To report the frequency of strictly defined metabolic phenotypes, renal function within each phenotype, and individual risk factors associated with reduced renal function. We utilized the 2013-2018 National Health and Nutrition Examination Surveys (NHANES) and complex survey sample weighting techniques to represent 220 million non-institutionalized U.S. civilians. Metabolic health was defined as having zero of the risk factors defined by the National Cholesterol Education Program with the exception of obesity, which was defined as BMI ≥ 30 kg/m2 in non-Asians and BMI ≥ 25 kg/m2 in Asians. The metabolically healthy normal (MUN) phenotype comprised the highest proportion of the population (38.40%), whereas the metabolically healthy obese (MHO) was the smallest (5.59%). Compared to the MHN reference group, renal function was lowest in the strictly defined MUN (B = -9.60, p < 0.001) and highest in the MHO (B = 2.50, p > 0.05), and this persisted when an increased number of risk factors were used to define metabolic syndrome. Systolic blood pressure had the strongest correlation with overall eGFR (r = -0.25, p < 0.001), and individuals with low HDL had higher renal function compared to the overall sample. The MUN phenotype had the greatest association with poor renal function. While the MHO had higher renal function, this may be due to a transient state caused by renal hyperfiltration. Further research should be done to investigate the association between dyslipidemia and CKD.

Metabolic Constellations, Clusters, and Renal Function: Findings from the 2013-2018 National Health and Nutrition Examination Surveys.

Metabolic syndrome (MetS) is associated with decreased renal function and chronic kidney disease (CKD). To date, no research regarding the sixteen possible constellations resulting in the diagnosis of MetS has been elucidated. The purpose of this study is to report renal function in sixteen metabolic constellations grouped into four metabolic clusters. Individuals (n = 2767; representing 86,652,073 individuals) from the 2013-2018 National Health and Nutrition Examination Surveys who met the criteria for MetS were included. Sixteen possible constellations of three or more risk factors were analyzed for renal function. Four metabolic clusters representing MetS with hyperglycemia (Cluster I), MetS with hypertension (Cluster II), MetS with hyperglycemia and hypertension (Cluster III), or MetS with normoglycemia and normotension (Cluster IV) were assessed for renal function and CKD status. Cluster III had the highest odds of CKD (OR = 2.57, 95% CL = 1.79, 3.68). Clusters II and III had the lowest renal function and were not different from one another (87.82 and 87.28 mL/min/1.73 m2, p = 0.71). The constellation with the lowest renal function consisted of hypertension, high triglycerides, and a large waist circumference (82.86 mL/min/1.73 m2), whereas the constellation with the highest renal function consisted of hyperglycemia, low HDL, and a large waist circumference (107.46 mL/min/1.73 m2). The sixteen constellations of MetS do not have the same effects on renal function. More research is needed to understand the relationship between the various iterations of MetS and renal function.

Applications of Fish Oil Supplementation for Special Operators.

Fish oil supplementation (FOS) is beneficial for human health and various disease states. FOS has recently received attention related to its anabolic and anti-catabolic effects on skeletal muscle and cognitive performance. Since Special Operations Forces (SOF) personnel endure rigorous combat and training environments that are mentally and physically demanding, FOS may have important applications for the SOF Warfighter. The purpose of this narrative review is to explore the evidence for FOS and its application to multiple physiological and psychological contexts experienced by SOF personnel. For physical performance, FOS may promote lean body mass (LBM) accretion; however, there seems to be minimal impact on strength, power, or endurance. During physiological stress, FOS may preserve strength, power, LBM (during muscle disuse, not weight loss) and enhance recovery. For cognition, FOS likely improves reaction time, mental fatigue, and may reduce the incidence and severity of mild traumatic brain injury; however, FOS has minimal impact on attentional control and mood states. No safety concerns were evident. In conclusion, there are multiple applications of FOS for SOF personnel. Due to the minimal safety concerns and potential anabolic, anti-catabolic and cognitive benefits, FOS is a viable method to promote and sustain SOF Warfighter physical and cognitive performance. Although promising, the FOS trials to date have not been conducted in the context of the multi-stressor environments experienced by SOF personnel, thus, future studies should be conducted in a SOF population.

The effect of fish oil supplementation on the promotion and preservation of lean body mass, strength, and recovery from physiological stress in young, healthy adults: a systematic review.

CONTEXT: Military personnel are subjected to physiologically stressful environments during combat and its associated training. Evidence suggests that fish oil-derived n-3 polyunsaturated fatty acids (FO n-3 PUFAs) may affect military personnel's performance by promoting or preserving lean body mass, strength, and power, while enhancing recovery from training-associated muscle damage. OBJECTIVE: Following PRISMA guidelines, this systematic review assessed the evidence for FO n-3 PUFA supplementation across various military-relevant outcomes related to physical performance in healthy adult populations. DATA SOURCES: The PubMed, Embase, and the CINAHL databases were searched along with references lists of selected articles and reviews. DATA EXTRACTION: Eighteen trials were assessed for bias, and descriptive data were extracted. DATA ANALYSIS: Of the 18 studies included, 12 trials favored FO n-3 PUFA supplementation in ≥ 1 of the performance outcomes. CONCLUSION: Overall, FO n-3 PUFA supplementation likely preserves strength and very likely enhances recovery from physiological stress in young, healthy adults. However, FO n-3 PUFAs' role in promoting or preserving lean body mass or promoting strength is unclear and warrants additional investigation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020152786.

Efficacy of L-leucine Supplementation Coupled With Resistance Training in Untrained Midlife Women.

Objective: This study investigated the effects of leucine supplementation with resistance training (RT) in untrained peri- and postmenopausal women on fat free mass, strength, and select anabolic-related hormones.Method: This was a randomized, double-blind, placebo-controlled trial, in which 36 untrained women were randomly assigned to either a leucine or placebo supplement group coupled with 10 weeks of RT, performed thrice weekly, while ingesting either 5 g of placebo or leucine. Before and after RT, body composition and muscle strength were assessed and venous blood samples obtained to determine the levels of estradiol, testosterone, insulin-like growth factor-1, growth hormone, and cortisol. Data were analyzed by utilizing separate 2 × 2 [group × time (pretest and posttest)] factorial analyses of variance with repeated measures (p ≤ .05).Results: There were no significant changes or differences between groups in fat free mass or with any of the serum hormones assessed in response to supplementation. However, there were significant increases in strength in both groups in response to RT, but not supplementation.Conclusions: Peri- and postmenopausal women had significant increases in strength following 10 weeks of RT, with no additional effects from supplementing with leucine. There were no significant changes in either group regarding fat free mass or serum hormones.

Decreased Serum Levels of C-Terminal Agrin in Postmenopausal Women Following Resistance Training.

Elevated circulating C-terminal agrin fragment (CAF) is a marker of neuromuscular junction degradation and sarcopenia. This study sought to determine if resistance training (RT) impacted the serum levels of CAF in perimenopausal (PERI-M) and postmenopausal (POST-M) women. A total of 35 women, either PERI-M or POST-M, participated in 10 weeks of RT. Body composition, muscle strength, and serum estradiol and CAF were determined before and after the RT. The data were analyzed with two-way analysis of variance (p ≤ .05). Upper body and lower body strength was significantly increased, by 81% and 73% and 86% and 79% for the PERI-M and POST-M participants, respectively; however, there were no significant changes in body composition. Estradiol was significantly less for the POST-M participants at pretraining compared with the PERI-M participants. CAF moderately increased by 22% for the PERI-M participants in response to RT, whereas it significantly decreased by 49% for the POST-M participants. Ten weeks of RT reduced the circulating CAF in the POST-M women and might play a role in attenuating degenerative neuromuscular junction changes.

US Military Dietetic Internship and Graduate Program: Retrospective Analysis of Selection Criteria and Student Success.

BACKGROUND: The US Military-Baylor Graduate Program in Nutrition (GPN) has a 10% 7-year attrition rate representing wasted military resources. Evidence-based selection criteria for dietetics masters of science (MS) programs do not exist, nor does descriptive information of successful students. OBJECTIVE: Identify GPN student characteristics predicting program success in the didactic and internship phases. DESIGN: Retrospective study using demographic, academic, and nonacademic data extracted from existing files. PARTICIPANTS AND SETTING: There were 72 GPN students enrolled from 2006 to 2013 in San Antonio, TX. MAIN OUTCOME MEASURES: Categorization by optimal performance (no course grade <3.0, no internship rotation delays, first attempt pass registered dietitian nutritionist examination) and GPN completion. RESULTS: The average GPN student was female (65%), in the US Army (94%), and single (64%), with a mean age of 26 years. Mean Quantitative, Verbal Reasoning, and Analytical Writing Graduate Record Examination (GRE) scores were 149, 153, and 4.2 points, respectively. Odds of GPN failure increased 1.3 times with each year increase in age at GPN program start (95% CI=1.089 to 1.612; P=0.005). Odds of attaining optimal performance decreased 4.5 times with each additional year increase between GRE completion and GPN start (95% CI=1.623 to 16.236; P=0.005) and 0.157 times with each grade point average point decrease in Biochemistry (95% CI=0.49 to 0.430; P=0.002). CONCLUSIONS: Modification of selection criteria based on time between GRE and GPN start and undergraduate Biochemistry grades could improve GPN success. However, identification and mitigation of potential student weaknesses is a more realistic approach to promote student success. Intentional development of students with optimal characteristics will strengthen the dietetics profession during the transition to an MS degree requirement.

Fatty Acid Blood Levels, Vitamin D Status, Physical Performance, Activity, and Resiliency: A Novel Potential Screening Tool for Depressed Mood in Active Duty Soldiers.

This study examined whether blood fatty acid levels, vitamin D status, and/or physical activity are associated with physical fitness scores; a measure of mood, Patient Health Questionnaire-9; and a measure of resiliency, Dispositional Resiliency Scale-15 in active duty Soldiers. 100 active duty males at Fort Hood, Texas, underwent a battery of psychometric tests, anthropometric measurements, and fitness tests, and they also provided fasting blood samples for fatty acid and vitamin D analysis. Pearson bivariate correlation analysis revealed significant correlations among psychometric tests, anthropometric measurements, physical performance, reported physical inactivity (sitting time), and fatty acid and vitamin D blood levels. On the basis of these findings, a regression equation was developed to predict a depressed mood status as determined by the Patient Health Questionnaire-9. The equation accurately predicted depressed mood status in 80% of our participants with a sensitivity of 76.9% and a specificity of 80.5%. Results indicate that the use of a regression equation may be helpful in identifying Soldiers at higher risk for mental health issues. Future studies should evaluate the impact of exercise and diet as a means of improving resiliency and reducing depressed mood in Soldiers.

Vitamin D status among overweight and obese soldiers.

Vitamin D is a nutrient with emerging roles in cardiovascular, immune, and musculoskeletal function. Vitamin D (VITD) levels are inversely correlated with weight status in adults. This study was designed to determine the prevalence of vitamin D deficiency and insufficiency in a retrospective sample of overweight or obese Soldiers who had attended weight management classes at Fort Bliss, Texas. The study design was a cross-sectional, retrospective review of electronic outpatient medical records of 314 active duty Soldiers. The mean age of the Soldiers was 31, mean body mass index was 32, and 69% were classified as obese. Twenty-one percent of Soldiers were classified VITD-deficient based on having serum 25-hydroxy VITD concentrations < 20 ng/mL, and 51% were classified as insufficient (20-29 ng/mL). In a multivariate logistic regression model, non-Hispanic Black and Hispanic race were significant predictors of both VITD deficiency and insufficiency. The high rate of vitamin D deficiency and insufficiency in this sample of Soldiers is concerning. Given the important roles of VITD in the body, it is imperative that further study of both normal and overweight Soldiers be conducted in order to determine prevalence.