Search

Background The aim of this study was to review, systematically, evidence concerning the link between the ACTN3 R577X polymorphism and the rates and severity of non-contact injuries and exercise-induced muscle damage in athletes and individuals enrolled in exercise training programs. Methods A computerized literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus, from inception until November 2020. All included studies compared the epidemiological characteristics of non-contact injury between the different genotypes of the ACTN3 R577X polymorphism. Results Our search identified 492 records. After the screening of titles, abstracts, and full texts, 13 studies examining the association between the ACTN3 genotypes and the rate and severity of non-contact injury were included in the analysis. These studies were performed in 6 different countries (Spain, Japan, Brazil, China, Republic of Korea, and Italy) and involved a total participant pool of 1093 participants. Of the studies, 2 studies involved only women, 5 studies involved only men, and 6 studies involved both men and women. All the studies included were classified as high-quality studies (≥6 points in the Physiotherapy Evidence Database (PEDro) scale score). Overall, evidence suggests there is an association between the ACTN3 R577X genotype and non-contact injury in 12 investigations. Six studies observed a significant association between ACTN3 R577X polymorphism and exercise induced muscle damage: two with non-contact ankle injury, three with non-contact muscle injury, and one with overall non-contact injury. Conclusion The present findings support the premise that possessing the ACTN3 XX genotype may predispose athletes to a higher probability of some non-contact injuries, such as muscle injury, ankle sprains, and higher levels of exercise-induced muscle damage.

The authors present opinions based on their applied experiences of working with female athletes in combination with the existing evidence-based literature. Most of the existing menstrual cycle research focuses on a few steady-state time points within the pre-defined menstrual cycle phases, yet this disregards the day-to-day hormonal changes that women have to accommodate to perform optimally and consistently. The traditional research models are inadequate for studying symptoms and symptom management, and ultimately for supporting athletes to perform well throughout the entirety of their cycle. As such, the monitoring of the day-to-day variation, particularly during the transitions between menstrual cycle phases appears to be an important “overlooked” consideration. This is particularly pertinent considering the known intra-individual and inter-individual variation in menstrual cycle characteristics. Anecdotal and research evidence supports the idea that athletes can use non-pharmacological solutions to mitigate negative menstrual cycle symptoms and do not need to “grit their teeth and roll with it”. However, further research (including case studies) is needed in this important research area. Such knowledge should be and needs to be widespread amongst practitioners and athletes as they should not have to figure this out alone. As such, researchers and practitioners need to put more work into understanding symptom aetiology, symptom clusters and their relationship with hormonal changes, menstrual cycle phases and transitions, with potential for a profound impact on individual athlete health and well-being. In so doing, those working with female athletes need to continue building on the recent progress made in educating athletes and practitioners; for example, normalising the discussion of and about the menstrual cycle and all of its implications.

Purpose: Most women during their lifetime experience a combination of premenstrual syndrome (PMS) symptoms (eg, menstrual cramps) before and often to the end of menstruation. However, the impact of these symptoms on sport routines (eg, performance, training absence) during phases around menstruation is still unclear. Therefore, we investigated the impact of PMS symptoms on sport routines among nonelite athletes over 3 phases related to menstruation. Methods: An online questionnaire was developed to recruit nonelite female athletes who participate in summer Olympic sports. Participants were allocated into 2 groups: those who experienced mild to moderate PMS symptoms (no-PMS) and those with severe PMS symptoms (p-PMS). Two hundred thirty-four responses from eumenorrheic women (p-PMS = 78%) were considered valid. An unpaired Student t test was conducted to compare demographic characteristics between groups and chi-square test to evaluate the impact of PMS status on sport routines between groups. Results: A significant (P P = .01) and competitive (P P Conclusion: The presence of PMS symptoms reduces training and competitive performance, primarily during and before menstruation, respectively. Severity of PMS symptoms was significantly associated with alterations in training schedule but not with competitive schedule.

We examined whether endurance training for a standard marathon (42.2 km) had a greater influence on male libido than more generalized endurance exercise training. We surveyed adult men (>1000) who regularly engaged in endurance running to evaluate exercise training histories-patterns and libido characteristics. Our participants were primarily recruited from North America and Europe. Results indicate men conducting marathon training had lower libido scores (p

PURPOSE This study examined and compared select Triad-RED-S components/risk factors in high-level Kenyan male and female distance runners to corresponding control groups; focusing on examining energy intake (EI), bone indices, and hormonal markers. METHODS A cross-sectional, observational design was used in which Kenyan male and female (n = 30 and n = 26, respectively) middle- and long-distance runners and corresponding male and female control groups (n = 29 and n = 29, respectively) were examined. The participant's bone mineral density (BMD) at the lumbar spine, right femur, and total body were measured using a dual-energy X-ray absorptiometry analysis. Complete blood counts (CBC) were done on the whole blood specimens and hormonal measurements were performed on plasma specimens. In addition, athletes completed metabolic testing to determine maximal oxygen uptakes and 7-day dietary diaries. RESULTS Overall daily EI across runners and controls within each sex were low, but not significantly different (p > 0.05). Prevalence of low BMD values (Z score 0.05). CBC measures suggested that both runners and controls were healthy. Finally, slight hormonal differences between runners and their respective controls existed (p

Research should equitably reflect responses in men and women. Including women in research, however, necessitates an understanding of the ovarian hormones and menstrual phase variations in both cellular and systems physiology. This review outlines recent advances in the multiplicity of ovarian hormone molecular signaling that elucidates the mechanisms for menstrual phase variability in exercise metabolism. The prominent endogenous estrogen, 17-β-estradiol (E2), molecular structure is bioactive in stabilizing plasma membranes and quenching free radicals and both E2 and progesterone (P4) promote the expression of antioxidant enzymes attenuating exercise-induced muscle damage in the late follicular (LF) and mid-luteal (ML) phases. E2 and P4 bind nuclear hormone receptors and membrane-bound receptors to regulate gene expression directly or indirectly, which importantly includes cross-regulated expression of their own receptors. Activation of membrane-bound receptors also regulates kinases causing rapid cellular responses. Careful analysis of these signaling pathways explains menstrual phase-specific differences. Namely, E2-promoted plasma glucose uptake during exercise, via GLUT4 expression and kinases, is nullified by E2-dominant suppression of gluconeogenic gene expression in LF and ML phases, ameliorated by carbohydrate ingestion. E2 signaling maximizes fat oxidation capacity in LF and ML phases, pending low-moderate exercise intensities, restricted nutrient availability, and high E2:P4 ratios. P4 increases protein catabolism during the luteal phase by indeterminate mechanisms. Satellite cell function supported by E2-targeted gene expression is countered by P4, explaining greater muscle strengthening from follicular phase-based training. In totality, this integrative review provides causative effects, supported by meta-analyses for quantitative actuality, highlighting research opportunities and evidence-based relevance for female athletes.

We examined whether endurance training for a standard marathon (42.2 km) had a greater influence on male libido than more generalized endurance exercise training. We surveyed adult men (1000) who regularly engaged in endurance running to evaluate exercise training histories-patterns and libido characteristics. Our participants were primarily recruited from North America and Europe. Results indicate men conducting marathon training had lower libido scores (p0.05; ~20%, d=0.44) than those not doing such specific training. Factors most related to libido were: 1) the number of years of training, and 2) the proportion of high-intensity effort conducted in training (inverse relationships); regardless of whether marathon training was performed or not. Our survey approach did not allow us to determine the cause of the reduced libido, but we speculate it could relate to: 1) chronic physical fatigue from high volumes of exercise training, 2) behavioral accommodations in energy expenditure, or else

International audience; Background Knowledge of the long-term effects of soccer training on hematological, hormonal, inflammatory, and muscle damage markers and physical performance may help to better design strength and conditioning programs for performance development and injury prevention for the individual player and the team. Objectives The aim of this systematic review was to summarize and discuss evidence on the long-term effects of soccer training on selected hematological, hormonal, inflammatory, and muscle damage markers and physical performance in elite and professional soccer players. A second goal was to investigate associations between selected physiological markers and measures of performance. Methods Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature search was conducted in four electronic databases (PubMed, ISI Web of Knowledge, Web of Science, and SPORTDiscus) from inception until August 2020 to identify articles related to soccer training effects. To be included in this systematic review, studies had to examine male elite (national level) and/or professional (international level) soccer players aged > 17 years and a soccer training period > 4 weeks, and report outcomes related to hematological, hormonal, inflammatory, muscle damage, and performance markers. Results The search syntax initially identified 2420 records. After screening titles, abstracts, and full texts, 20 eligible studies were included in this systematic review, with training durations lasting between 4 and 18 weeks in 15 studies, around 6 months in four studies, and around 1 year in one study. Effects of long-term soccer training revealed parameter-specific increases or decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance. Two studies showed a moderate increase in hematological markers such as hemoglobin (effect size [ES] = 0.67-0.93). Parameter-specific changes were noted for hormonal markers in the form of increases for total testosterone (ES = 0.20-0.67) and free testosterone (FT) (ES = 0.20-0.65) and decreases for cortisol (ES = - 0.28 to - 1.31). Finally, moderate to very large increases were found for muscle damage markers such as creatine kinase (ES = 0.94-6.80) and physical performance such as countermovement jump (CMJ) height (ES = 0.50-1.11) and squat jump (SJ) height (ES = 0.65-1.28). After long-term periods of soccer training, significant positive correlations were found between percentage change (Delta%) in FT and Delta% in CMJ height (r = 0.94; p = 0.04) and between Delta% in total testosterone/cortisol (TT/C) ratio and Delta% in SJ (r = 0.89; p = 0.03). Conclusions Findings suggest that long-term soccer training induces increases/decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance in male elite and professional soccer players. These fluctuations can be explained by different contextual factors (e.g., training load, duration of training, psychological factors, mood state). Interestingly, the observed changes in hormonal parameters (FT and TT/C) were related to vertical jump performance changes (e.g., CMJ and SJ). Anabolic hormones and TT/C can possibly be used as a tool to identify physical performance alteration after long-term soccer training.

Energy Availability and RED-S Risk Factors in Competitive, Non-elite Male Endurance Athletes Amy R Lane1, Anthony C Hackney()1, Abbie E Smith-Ryan1, Kristen Kucera1, Johna K Register-Mihalik1 and Kristin Ondrak1 1Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA © The Authors Abstract Relative Energy Deficiency in Sport (RED-S) is predicated on the assumption that low energy availability (EA) induces deficiencies-dysfunction in multiple physiologic systems. However, research on RED-S and EA in male athletes is limited in comparison to women. The aim of this study is to investigate EA and the risk factors for RED-S, and their potential associations in non-elite male endurance athletes. Laboratory assessments for resting metabolic rate (RMR), bone mineral density (BMD), blood hormonal biomarkers and maximal aerobic capacity were conducted on 60 competitive, recreationally trained male endurance athletes (age=43.4±11.6 years [mean±SD], training=10.9±2.7 h/wk, 7.1±8.8 years). Participants provided 7-days of training logs and 4-days of diet records. Diet and training records were used to calculate EA. Correlations were used to examine associations between EA and RMR, BMD, stress fractures and reproductive, metabolic and bone biomarkers. Mean EA was 28.7±13.4 kcal/kg fat free mass (FFM), which categorized our sample as low EA (based upon published criterion, < 30 kcal/kg FFM) and at a high risk for RED-S. Hormonal and bone biomarkers were in normal clinical ranges, even though EA was low. The only interesting significant association was EA being negatively associated with total body BMD (r=–0.360, P=0.005), opposite of expectations. On average our subjects displayed a state of low EA based upon the criterion which has been primarily developed from female-based research. Nonetheless, our participants displayed no major hormonal or bone health disturbances found in athletes diagnosed with RED-S. A value of < 30 kcal/kg FFM to diagnose low EA may not be appropriate for non-elite endurance trained men.

This study aimed to examine the effects of two high-intensity interval training programs (HIIT) on maximal aerobic velocity (MAV), hematological variations and muscle damage markers in young healthy adults. Twenty-nine male physical education students, aged 20.3 ± 3.3 years, volunteered to participate in this study, and were randomly assigned to a control group (CG, n = 9) or two intervention groups (group 1 or 2). Intervention group 1 (n = 10) exercised at 100% of their MAV (EG100) while group 2 (n = 10) exercised at 110% MAV (EG110). Before and after the eight week training program, blood samples were drawn at rest, before, and after an intermittent exercise. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), C reactive protein (CRP), creatine kinase (CK) concentrations and hematological parameters (white blood cells [WBC], monocytes [MO], lymphocytes [LY], neutrophil [NE]) and lactate dehydrogenase (LDH) were measured. Post-hoc tests showed that MAV was significantly higher in EG110 compared to EG100 after HIIT (p p2 = 0.05), whilst ALAT, ASAT, and CPR were significantly lower (p p2 110 compared to EG100. Moreover, post-hoc tests indicated that LY decreased significantly (p p2 = 0.21) only for EG110. Furthermore, there were significant positive correlations for both EG100 and EG110 between MAV and ALAT (r = 0.66, p = 0.044 and r = 0.64, p = 0.041 respectively), CK (r = 0.67, p = 0.031 and r = 0.86, p = 0.030, respectively), LDH (r = 0.74, p = 0.014, and r = 0.071, p = 0.021, respectively). In addition, there was a significant positive correlation for both, EG100 and EG110 between MAV and LY (r = 0.79, p p p 110. Findings from this study revealed that HIIT at 110% MAV was more efficient to improve MAV and reduce muscle damage. In addition, we observed significant associations between performance improvements (MAV) and markers of muscle damage.

ObjectiveTo determine the effects of different intensities of interval resistance training (IRT) protocols on the levels of select myokines (decorin, follistatin, myostatin, activin A, transforming growth factor beta-1 [TGF-β1]), and cardiometabolic and anthropometric measures in males with obesity.MethodsForty-four obese males (age: 27.5 ± 9.4 yr.; height: 165.4 ± 2.8 cm; weight: 97.9 ± 2.6 kg and BMI: 35.7 ± 4.3 kg/m2) were randomly assigned to one of four groups (n=11 per group): low-intensity interval resistance training (LIIRT), moderate-intensity interval resistance training (MIIRT), high-intensity interval resistance training (HIIRT) or control (C). The LIIRT group performed 10 exercises in 3 sets of 40% (20 repetitions), the MIIRT group performed 10 exercises in three sets of 60% (13 repetitions), and the HIIRT group performed 10 exercises in three sets of 80% (10 repetitions) of one maximum repetition (1RM), which were followed with active rest of 20% of 1RM and 15 repetitions. The resistance training groups exercised ~70 min per session, 3 days per week, for 12 weeks. Measurements were taken at baseline and after 12 weeks of exercise training.ResultsBaseline levels of myokines, cardiovascular risk factors, anthropometry, body composition, and cardio-respiratory fitness were not different between the four groups (p>0.05). The group x time interactions for decorin, activin A, follistatin, myostatin, and TGF-β1, total cholesterol (TC), triglyceride (TG), high-density cholesterol (HDL), low-density cholesterol (LDL), anthropometry, body composition, and cardio-respiratory fitness were statistically significant (p2peak, HDL, TG, glucose, activin A, decorin were not significant in LIIRT compared to the control group, while changes in activin A, follistatin, and TFG-β1 levels were greater in HIIRT and MIIRT groups compared to the LIIRT group (pConclusionThe LIIRT, MIIRT, and HIIRT protocols all produced beneficial changes in decorin, activin A, follistatin, myostatin, and TGF-β1 levels, and cardiometabolic risk factors, with greater effects from the MIIRT and HIIRT protocols compared to LIIRT.

Mooses, M, Haile, DW, Ojiambo, R, Sang, M, Mooses, K, Lane, AR, and Hackney, AC. Shorter ground contact time and better running economy: evidence from female Kenyan runners. J Strength Cond Res 35(2): 481-486, 2021-Previously, it has been concluded that the improvement in running economy (RE) might be considered as a key to the continued improvement in performance when no further increase in V̇o2max is observed. To date, RE has been extensively studied among male East African distance runners. By contrast, there is a paucity of data on the RE of female East African runners. A total of 10 female Kenyan runners performed 3 × 1,600-m steady-state run trials on a flat outdoor clay track (400-m lap) at the intensities that corresponded to their everyday training intensities for easy, moderate, and fast running. Running economy together with gait characteristics was determined. Subjects showed moderate to very good RE at the first (202 ± 26 ml·kg-1·km-1) and second (188 ± 12 ml·kg-1·km-1) run trials, respectively. Correlation analysis revealed significant relationship between ground contact time (GCT) and RE at the second run (r = 0.782; p = 0.022), which represented the intensity of anaerobic threshold. This study is the first to report the RE and gait characteristics of East African female athletes measured under everyday training settings. We provided the evidence that GCT is associated with the superior RE of the female Kenyan runners.

BACKGROUND: Androgen deprivation therapy (ADT) for prostate cancer (PC) has detrimental effects on physical function and quality of life (QoL), but the addition of androgen receptor signaling inhibitors (ARSI) on these outcomes is unclear. PURPOSE: To compare body composition, physical function, and QoL across progressive stages of PC and non-cancer controls (CON). METHODS: In men with hormone sensitive PC (HSPC, n=43) or metastatic castration-resistant PC (mCRPC, n=22) or CON (n=37), relative and absolute lean and fat mass, physical function (6m walk, chair stands, timed up and go [TUG], stair climb), and QoL were determined. RESULTS: Relative body composition differed amongst all groups, along with ~39% greater absolute fat mass in mCRPC vs. CON. TUG and chair stands were ~71% and ~33% slower in mCRPC compared to both CON and HSPC, whereas stair climb was ~29% and 6m walk was ~18% slower in mCRPC vs. CON. Relative body composition was correlated with physical function (r=0.259–0.385). Clinically relevant differences for mCRPC were observed for overall QoL and several subscales vs. CON, although body composition and physical function did not influence QoL. CONCLUSIONS: PC progression is associated with deteriorations in body composition and physical function. As ADT length was similar between groups, ARSI use for mCRPC likely contributed in part to these changes. Given the difficulties of improving lean mass during ADT, interventions that reduce adiposity may lessen the side effects of hormone therapy.

Context Field-based, portable motion-capture systems can be used to help identify individuals at greater risk of lower extremity injury. Microsoft Kinect-based markerless motion-capture systems meet these requirements; however, until recently, these systems were generally not automated, required substantial data postprocessing, and were not commercially available. Objective To validate the kinematic measures of a commercially available markerless motion-capture system. Design Descriptive laboratory study. Setting Laboratory. Patients or Other Participants A total of 20 healthy, physically active university students (10 males, 10 females; age = 20.50 ± 2.78 years, height = 170.36 ± 9.82 cm, mass = 68.38 ± 10.07 kg, body mass index = 23.50 ± 2.40 kg/m2). Intervention(s) Participants completed 5 jump-landing trials. Kinematic data were simultaneously recorded using Kinect-based markerless and stereophotogrammetric motion-capture systems. Main Outcome Measure(s) Sagittal- and frontal-plane trunk, hip-joint, and knee-joint angles were identified at initial ground contact of the jump landing (IC), for the maximum joint angle during the landing phase of the initial landing (MAX), and for the joint-angle displacement from IC to MAX (DSP). Outliers were removed, and data were averaged across trials. We used intraclass correlation coefficients (ICCs [2,1]) to assess intersystem reliability and the paired-samples t test to examine mean differences (α ≤ .05). Results Agreement existed between the systems (ICC range = −1.52 to 0.96; ICC average = 0.58), with 75.00% (n = 24/32) of the measures being validated (P ≤ .05). Agreement was better for sagittal- (ICC average = 0.84) than frontal- (ICC average = 0.35) plane measures. Agreement was best for MAX (ICC average = 0.77) compared with IC (ICC average = 0.56) and DSP (ICC average = 0.41) measures. Pairwise comparisons identified differences for 18.75% (6/32) of the measures. Fewer differences were observed for sagittal- (0.00%; 0/15) than for frontal- (35.29%; 6/17) plane measures. Between-systems differences were equivalent for MAX (18.18%; 2/11), DSP (18.18%; 2/11), and IC (20.00%; 2/10) measures. The markerless system underestimated sagittal-plane measures (86.67%; 13/15) and overestimated frontal-plane measures (76.47%; 13/17). No trends were observed for overestimating or underestimating IC, MAX, or DSP measures. Conclusions Moderate agreement existed between markerless and stereophotogrammetric motion-capture systems. Better agreement existed for larger (eg, sagittal-plane, MAX) than for smaller (eg, frontal-plane, IC) joint angles. The DSP angles had the worst agreement. Markerless motion-capture systems may help clinicians identify individuals at greater risk of lower extremity injury.

International audience; OBJECTIVE: This study aimed to determine how different resistance training protocols affect gremlin 1, macrophage migration inhibitory factor (MIF), cardiometabolic, and anthropometric measures in obese men. METHODS: Forty-four males with obesity (weight: 93.2 ± 2.2 kg, BMI: 32.9 ± 1.2 kg/m(2), age: 27.5 ± 9.4 years) were randomly assigned to traditional resistance training (TRT, n = 11), circuit resistance training (CRT, n = 11), interval resistance training (IRT, n = 11) or control (C, n = 11) groups. TRT group performed ten exercises at 50% of 1RM with 14 repetitions for three sets and 30 seconds rest interval between exercises and 1.5 min rest between sets, the CRT protocol included three circuits of 10 exercises, at an intensity of 50% of 1-RM, 14 repetitions with a minimum rest (< 15 s) between exercises and 3 min rest between sets, and the IRT group performed two sets of the same exercises with 50% of 1 RM, and 14 repetitions were followed with active rest of 25% of 1RM and 14 repetitions. All resistance training groups performed 60 min per session resistance exercises, 3 days per week, for 12 weeks. Measurements were taken at baseline and after 12 weeks of exercise training. RESULTS: Resistance training (TRT, CRT, and IRT) significantly decreased plasma levels of gremlin (TRT from 231.0 ± 5.8 to 210.0 ± 11.6 ng/ml, CRT from 226.0 ± 7.6 to 188.0 ± 7.7 ng/ml and, IRT from 227.0 ± 6.3 to 183.0 ± 9.0 ng/ml, effect size (ES): 0.50), MIF (TRT from 251.0 ± 7.4 to 260.0 ± 6.5 ng/ml, CRT from 248.0 ± 10.9 to 214.0 ± 9.0 ng/ml and, IRT from 247.0 ± 8.9 to 196.0 ± 6.9 ng/ml, ES: 0.55) and CRP (TRT from 28.4 ± 1.7 to 23.3 ± 2.1 nmol/l, CRT from 28.5 ± 2.2 to 21.1 ± 1.8 nmol/l, IRT from 28.1 ± 1.3 to 20.8 ± 1.3 nmol/l, ES: 0.49) compared to the control group (p

Introduction: Low testosterone and its symptoms is a condition affecting many males with severe repercussions on health. Testosterone affects metabolism, bones, joints, and ligaments, the cardiovascular system, liver, sexual functions, muscle mass, and the nervous system. Nowadays, due to recent research showing the benefits of testosterone replacement therapy, this treatment is gaining in popularity among aging men. However, testosterone replacement can increase the risk of infertility. Areas covered: Human chorionic gonadotropin (HCG) is used in the treatment of male infertility due to its luteinizing hormone (LH)-like action triggering testosterone and sperm production. Due to these positive effects on testosterone production, HCG has also been used to treat secondary hypogonadism. In this review, based on a literature review for the years 1977-2020 via Google Scholar, we summarize the current research on HCG as treatment for patients suffering from low testosterone and provide an overview of the pros and contras for HCG therapy as compared to testosterone replacement therapy for the treatment of secondary hypogonadism. Expert opinion: The testosterone and sperm production triggering effects of HCG without the side effects on fertility seen in testosterone replacement therapy make HCG therapy a prime candidate for patients suffering from secondary hypogonadism.

This pilot study assessed the feasibility and combined effect of aerobic exercise (AE) and mindfulness meditation (MM), compared with MM alone and a control (CON) condition, on stress, anxiety, and depression in high-stress college-based young adults. Thirty-two participants (84.4% F, 20.5 ± 2.7 years, 23.9 ± 5.0 kg/m

The purpose of this study was to compare three types of resistance training including traditional, circular and interval in non-athletic men with obesity in comparison to a control group for neuregulin 4, adiponectin and leptin responses.The sample of the study included 44 non-athletic men with obesity, who were randomly divided into the 4 equal groups (10 per each group): traditional, circular, and interval resistance training as well as a control group. Neuregulin 4, leptin and adiponectin were analyzed using ELISA commercial kits.The results of mixed-design ANOVA with repeated measures showed that there was a significant interaction between the type of resistance training used and time on neuregulin 4 (F (3, 40) = 80.22, P= 0.005, ES = 0.85), leptin (F (3, 40) = 27.53, P= 0.005, ES = 0.67) and adiponectin (F (3, 40) = 12.44, P= 0.005, ES = 0.48). Considering the main effect of groups, results indicated that there was a significant difference between types of resistance training and control group in neuregulin 4 (F (1, 40) =41.31, P=0.005, ES = 0.75), adiponectin (F (1, 40) =15.08, P=0.005, ES = 0.53) and leptin (F (1, 40) =32.05, P = 0.005, ES = 0.70).Findings suggest that resistance training, especially interval resistance training can lead to increase the plasma level of neuregulin 4, adiponectin and decrease leptin in non-athletic men with obesity. Interval training showed superior effects on all study outcomes followed by circular and traditional training, respectively.El propósito de este estudio fue comparar tres tipos de entrenamiento de resistencia, incluido el tradicional, el circular y el intervalo en hombres no atléticos con obesidad, en comparación con un grupo de control para las respuestas de neuregulin 4, adiponectin y leptin.La muestra del estudio incluyó a 44 hombres no deportistas con obesidad, que fueron divididos alea-toriamente en 4 grupos iguales (10 por cada grupo): entrenamiento de resistencia tradicional, circular e intervalado, así como un grupo de control. Se analizaron neuregulin 4, leptin y adiponectin utilizando kits comerciales de ELISA.Los resultados del ANOVA de diseño mixto con medidas repetidas mostraron que hubo una interacción significativa entre el tipo de entrenamiento de resistencia utilizado y el tiempo con neuregulin 4 (F (3, 40) = 80,22, p = 0,005, ES = 0,85), leptin (F (3, 40) = 27,53, p = 0,005, ES = 0,67) y adiponectin (F (3, 40) = 12,44, p = 0,005, ES = 0,48). Considerando el efecto principal de los grupos, los resultados indicaron que hubo una diferencia significativa entre los tipos de entrenamiento de resistencia y el grupo de control en neuregulin 4 (F (1, 40) = 41,31, p = 0,005, ES = 0,75), adiponectin (F (1, 40) = 15,08, p = 0,005, ES = 0,53) y leptin (F (1, 40) = 32,05, p = 0,005, ES = 0,70).Los resultados sugieren que el entrenamiento de resistencia, especialmente el entrenamiento de resistencia a intervalos, puede aumentar el nivel plasmático de neuregulin 4, adiponectin y disminuir leptin en hombres obesos no atléticos. El entrenamiento por intervalos mostró efectos superiores en todos los resultados del estudio seguido del entrenamiento circular y tradicional, respectivamente.

The authors present opinions based on their applied experiences of working with female athletes in combination with the existing evidence-based literature. Most of the existing menstrual cycle research focuses on a few steady-state time points within the pre-defined menstrual cycle phases, yet this disregards the day-to-day hormonal changes that women have to accommodate to perform optimally and consistently. The traditional research models are inadequate for studying symptoms and symptom management, and ultimately for supporting athletes to perform well throughout the entirety of their cycle. As such, the monitoring of the day-to-day variation, particularly during the transitions between menstrual cycle phases appears to be an important "overlooked" consideration. This is particularly pertinent considering the known intra-individual and inter-individual variation in menstrual cycle characteristics. Anecdotal and research evidence supports the idea that athletes can use non-pharmacological solutions to mitigate negative menstrual cycle symptoms and do not need to "grit their teeth and roll with it". However, further research (including case studies) is needed in this important research area. Such knowledge should be and needs to be widespread amongst practitioners and athletes as they should not have to figure this out alone. As such, researchers and practitioners need to put more work into understanding symptom aetiology, symptom clusters and their relationship with hormonal changes, menstrual cycle phases and transitions, with potential for a profound impact on individual athlete health and well-being. In so doing, those working with female athletes need to continue building on the recent progress made in educating athletes and practitioners; for example, normalising the discussion of and about the menstrual cycle and all of its implications.

This study aimed to examine the effects of fatiguing power loading on neuromuscular properties, force production, and metabolic capacities during four phases of the menstrual cycle (MC): menstruation (M), midfollicular (mid FOL), ovulation (OV), and midluteal (mid LUT).Sixteen eumenorrheic women performed sessions of maximal explosive leg press (2 × 10 at 60% one-repetition maximum load with 2-min recovery between sets). Serum hormones and neuromuscular responses were measured.The loading protocol significantly decreased power (between -14.2% and -12.5%; P0.001) and maximal force production (between maximum voluntary force (MVC); -15.0% and -7.8%; P0.001-0.05), while decreasing activation level (between AL; -6.9% and -2.2%; P0.001-0.05) in all MC phases. The decreases in AL were greater during mid LUT (P0.01) compared with OV. Changes in MVC and AL were associated (r2 = 0.53; P0.01) at all MC phases. The decrease in EMG during MVC did not differ between the MC phases; however, mean power frequency was higher during M (+7.7%; P0.05) and mid LUT (+3.1%; P0.05) compared with OV (-7.5%). Resting twitch force decreased during mid FOL (-6.9%; P0.05) and mid LUT (-16.2%; P0.001), and these values were significantly decreased (P0.05) compared with OV. In addition, resting twitch force at mid LUT was lower (P0.01) compared with M. Blood lactate levels increased more (P0.05) during M compared with mid LUT. Some serum hormone concentrations were associated with fatigue-induced changes in neuromuscular properties and force production, but these correlations behaved differently between the MC phases.OV may offer a more favorable hormonal milieu for acute neural responses, whereas mid FOL and mid LUT seem to be superior for acute muscular responses.

Context Gait biomechanics are linked to biochemical changes that contribute to the development of posttraumatic knee osteoarthritis in individuals with anterior cruciate ligament reconstruction (ACLR). It remains unknown if modifying peak loading during gait using real-time biofeedback will result in acute biochemical changes related to cartilage metabolism. Objective To determine if acutely manipulating peak vertical ground reaction force (vGRF) during gait influences acute changes in serum cartilage oligomeric matrix protein concentration (sCOMP) among individuals with ACLR. Design Crossover study. Patients or Other Participants Thirty individuals with unilateral ACLR participated (70% female, age = 20.43 ± 2.91 years old, body mass index = 24.42 ± 4.25, months post-ACLR = 47.83 ± 26.97). Additionally, we identified a subgroup of participants who demonstrated an increase in sCOMP after the control or natural loading condition (sCOMPCHANGE > 0 ng/mL, n = 22, 70% female, age = 20.32 ± 3.00 years old, body mass index = 24.73 ± 4.33, months post-ACLR = 47.27 ± 29.32). Main Outcome Measure(s) Serum was collected both prior to and immediately after each condition to determine sCOMPchange. Intervention(s) All participants attended 4 sessions that involved 20 minutes of walking on a force-measuring treadmill consisting of a control condition (natural loading) followed by random ordering of 3 loading conditions with real-time biofeedback: (1) symmetric vGRF between limbs, (2) a 5% increase in vGRF (high loading) and (3) a 5% decrease in vGRF (low loading). A general linear mixed model was used to determine differences in sCOMPCHANGE between altered loading conditions and the control group in the entire cohort and the subgroup. Results The sCOMPCHANGE was not different across loading conditions for the entire cohort (F3,29 = 1.34, P = .282). Within the subgroup, sCOMPCHANGE was less during high loading (1.95 ± 24.22 ng/mL, t21 = −3.53, P = .005) and symmetric loading (9.93 ± 21.45 ng/mL, t21 = −2.86, P = .025) compared with the control condition (25.79 ± 21.40 ng/mL). Conclusions Increasing peak vGRF during gait decreased sCOMP in individuals with ACLR who naturally demonstrated an increase in sCOMP after 20 minutes of walking. Trial Registry ClinicalTrials.gov (NCT03035994)

Context Military service members commonly sustain lower extremity stress fractures (SFx). How SFx risk factors influence bone metabolism is unknown. Understanding how SFx risk factors influence bone metabolism may help to optimize risk-mitigation strategies. Objective To determine how SFx risk factors influence bone metabolism. Design Cross-sectional study. Setting Military service academy. Patients or Other Participants Forty-five men (agepre = 18.56 ± 1.39 years, heightpre = 176.95 ± 7.29 cm, masspre = 77.20 ± 9.40 kg; body mass indexpre = 24.68 ± 2.87) who completed Cadet Basic Training (CBT). Individuals with neurologic or metabolic disorders were excluded. Intervention(s) We assessed SFx risk factors (independent variables) with (1) the Landing Error Scoring System (LESS), (2) self-reported injury and physical activity questionnaires, and (3) physical fitness tests. We assessed bone biomarkers (dependent variables; procollagen type I amino-terminal propeptide [PINP] and cross-linked collagen telopeptide [CTx-1]) via serum. Main Outcome Measure(s) A markerless motion-capture system was used to analyze trunk and lower extremity biomechanics via the LESS. Serum samples were collected post-CBT; enzyme-linked immunosorbent assays determined PINP and CTx-1 concentrations, and PINP : CTx-1 ratios were calculated. Linear regression models demonstrated associations between SFx risk factors and PINP and CTx-1 concentrations and PINP : CTx-1 ratio. Biomarker concentration mean differences with 95% confidence intervals were calculated. Significance was set a priori using α ≤ .10 for simple and α ≤ .05 for multiple regression analyses. Results The multiple regression models incorporating LESS and SFx risk factor data predicted the PINP concentration (R2 = 0.47, P = .02) and PINP : CTx-1 ratio (R2 = 0.66, P = .01). The PINP concentration was increased by foot internal rotation, trunk flexion, CBT injury, sit-up score, and pre- to post-CBT mass changes. The CTx-1 concentration was increased by heel-to-toe landing and post-CBT mass. The PINP : CTx-1 ratio was increased by foot internal rotation, lower extremity sagittal-plane displacement (inversely), CBT injury, sit-up score, and pre- to post-CBT mass changes. Conclusions Stress fracture risk factors accounted for 66% of the PINP : CTx-1 ratio variability, a potential surrogate for bone health. Our findings provide insight into how SFx risk factors influence bone health. This information can help guide SFx risk-mitigation strategies.

The purpose of this review is to present a different perspective of the relative energy deficiency syndrome, to improve understanding of associated endocrine alterations, and to highlight the need for further research in this area. The term "female athlete triad" was coined over 25 years ago to describe three interrelated components: disordered eating, menstrual dysfunction, and low bone mass. The syndrome's etiology is attributed to energy intake deficiency relative to energy expenditure required for health, function, and daily living. Recently, it became clear that there was a need to broaden the term, as the disorder is not an issue of only three interrelated problems but of a whole spectrum of insults resulting from low energy availability (LEA; i.e., insufficient energy availability to cover basic physiological demands) that can potentially affect any exerciser, irrespective of gender. The new model, termed relative energy deficiency in sport (RED-S), has received greater scrutiny in sports medicine due to its effects on both health and performance in athletes of both sexes. RED-S results from low-energy diets (intentional or unintentional) and/or excessive exercise. Energy deficiency reduces hypothalamic pulsatile release of gonadotropin-releasing hormone, this impairing anterior pituitary release of gonadotropins. In women, reduced FSH and LH pulsatility produces hypoestrogenism, causing functional hypothalamic amenorrhea and decreased bone mass. In men, it reduces testosterone and negatively affects bone health. Moreover, LEA alters other hormonal pathways, causing physiological consequences, such as alteration of the thyroid hormone signaling pathways, leptin levels, carbohydrate metabolism, the growth hormone/insulin-like growth factor-1 axis, and sympathetic/parasympathetic tone. This review explains and clarifies the effects of RED-S in both sexes.

Context: Individuals who undergo anterior cruciate ligament reconstruction (ACLR) are at higher risk of posttraumatic osteoarthritis (PTOA). Altered joint tissue loading caused by aberrant gait biomechanics leads to deleterious changes in joint health linked to PTOA onset. Knee braces have been used to modify joint tissue loading in individuals with joint injury; yet, the effects of walking with a brace following ACLR on biomechanical, biological, and structural cartilage outcomes are unknown. Objective: To compare biomechanical, biochemical, and structural outcomes between braced and non-braced walking in ACLR individuals. Design: Cross-over study. Setting: Research laboratory. Participants: 34 individuals with unilateral ACLR (time since ACLR = 50±37 months; 18 females, 16 males). Interventions: Gait bioemchanics were assessed during braced (Rebound Cartilage; Ossur, Reykavik, Iceland) and unbraced conditions on separate days. Main Outcome Measures: Vertical ground reaction force (vGRF), knee flexion angle (KFA), and internal knee extension moment (KEM) waveforms were evaluated throughout the stance phase and compared between conditions. Percent changes of serum cartilage oligomeric matrix protein (%ΔCOMP) and femoral cartilage cross sectional area (%ΔCSA) measured via ultrasound were calculated following a 3000-step walking protocol. Results: Braced walking increased KFA (largest difference: 3.56°; effect size: d=1.72) and increased KEM (largest difference: 0.48 %Body Weight×Height; effect size: d=1.14) compared to non-braced walking but did not influence vGRF. While there was no significant difference (p=0.196) in %ΔCOMP between the braced and non-braced conditions in the entire cohort(n=30), there was a larger increase (p=0.036) in %ΔCOMP during non-braced compared to braced walking in individuals who demonstrated increased COMP during non-braced walking. There was no difference (p=0.86) in %ΔCSA between the braced and non-braced conditions. Conclusions: Braced walking may improve sagittal plane gait biomechanics and %ΔCOMP in a subset of individuals who demonstrate a typical increased COMP response to load (i.e., increase in COMP) following non-braced walking.

The energy costs of athletic training can be substantial, and deficits arising from costs unmet by adequate energy intake, leading to a state of low energy availability, may adversely impact athlete health and performance. Life history theory is a branch of evolutionary theory that recognizes that the way the body uses energy-and responds to low energy availability-is an evolved trait. Energy is a finite resource that must be distributed throughout the body to simultaneously fuel all biological processes. When energy availability is low, insufficient energy may be available to equally support all processes. As energy used for one function cannot be used for others, energetic "trade-offs" will arise. Biological processes offering the greatest immediate survival value will be protected, even if this results in energy being diverted away from others, potentially leading to their downregulation. Athletes with low energy availability provide a useful model for anthropologists investigating the biological trade-offs that occur when energy is scarce, while the broader conceptual framework provided by life history theory may be useful to sport and exercise researchers who investigate the influence of low energy availability on athlete health and performance. The goals of this review are: (1) to describe the core tenets of life history theory; (2) consider trade-offs that might occur in athletes with low energy availability in the context of four broad biological areas: reproduction, somatic maintenance, growth, and immunity; and (3) use this evolutionary perspective to consider potential directions for future research.

This study examined the effects of creatine (Cr) loading on body mass (BM) and fluid markers of total body water (TBW), extra-cellular fluid (ECF), and intra-cellular fluid (ICF) across the menstrual cycle (MC). Thirty moderately active females, either naturally-menstruating (NM) or using hormonal contraceptives (HC), were randomized to Cr (Cr; 4 × 5 g/day of creatine monohydrate for 5 days; n = 15) or a non-caloric placebo (PL; n = 15) using a double-blind, placebo-controlled design, with a menstrual phase crossover. BM, TBW, ECF, and ICF were measured at pre- and post-supplementation in randomized order of follicular phase (FP; NM: MC days 0–8, HC: inactive pill days) or luteal phase (LP; NM: ≤15 days from next projected cycle start date, HC: active pill days) using bioelectrical impedance spectroscopy. Acute hydration status and salivary estrogen were used as covariates. Change in BM was not different between groups across MC ([PL-Cr] Δ 0.40 ± 0.50 kg; p = 0.427) or between MC phase across groups ([FP-LP] Δ 0.31 ± 0.48 kg; p = 0.528). TBW (p = 0.802), ECF (p = 0.373), and ICF (p = 0.795) were not different between supplement groups at pre-supplementation/FP time points. There were no significant differences between the NM and HC subjects at any time point, for any outcome (p > 0.05). Following LP supplementation, significant changes were observed in TBW (Cr: Δ 0.83 ± 0.38 L, PL: Δ −0.62 ± 0.38 L; p = 0.021), ECF (Cr: Δ 0.46 ± 0.15 L, PL: Δ −0.19 ± 0.15 L; p = 0.013), and ICF (Cr: Δ 0.74 ± 0.23 L, PL: Δ −0.02 ± 0.23 L; p = 0.041). These data demonstrate an increase in all fluid compartments in the LP following Cr loading, without observed alterations in body weight for females.

The primary aim of this study was to compare the effects of 12 weeks of 3 resistance training methods (traditional, circular and interval) compared with no exercise on the plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in nonathletic men with obesity.The study sample included 44 nonathletic men with obesity who were randomly assigned to one of four groups: traditional, circular, and interval resistance training or a control group. IL-6 and TNF-α cytokines were analyzed using commercial ELISA kits.The results of mixed-design ANOVA with repeated measures showed that there was significant correspondence between the type of training used and time on TNF-α (F(1,40) = 2212.35; P = .001; estimates (ES) = 0.98) and IL-6 (F(1,40) = 2423.69; P = .001; ES = 0.98) levels. Results indicated that there was a significant difference between the resistance training groups and the control group in both TNF-α (F(3, 40) = 11.39; P = .001; ES = 0.46) and IL-6 (F(3, 40) = 4.65; P = .007; ES = 0.25) levels.All types of resistance training decreased biomarker outcomes compared with the control group. However, interval resistance training showed a significant difference from circular resistance training in IL-6 level, while there was no significant difference between the effects of the 3 types of resistance training on TNF-α levels.

AIM OF THE STUDY: This study examined the response of the free testosterone and cortisol ratio (fTC) to prolonged endurance exercise. METHODS: A trained sportsman performed treadmill exercise at 70% of maximal oxygen uptake to volitional fatigue. Frequent blood samples were collected over 24 hours and analyzed to determine changes in the fTC ratio. RESULTS: Exercise caused an initial increase in the ratio followed by a rapid decline in the immediate recovery from exercise. Approximately 8 hours into recovery from exercise, there was a pronounced and persistent (~6 hours) secondary increase in the ratio. CONCLUSIONS: Results suggest that the fTC ratio responds to intensive exercise, but that aspects of the response can be of a delayed nature occurring many hours into recovery. Exercise scientists who wish to monitor this parameter should be aware that the time course by which they choose to conduct their blood sampling could impact upon the interpretation of their data.

Purpose: To determine the relationship between gastrointestinal hormones (leptin, glucagon-like peptide-1), ghrelin, cholecystokinin, peptide YY, morphological characteristics, and physical performances in elite soccer players. Methods: Q2 Twenty-two elite male soccer players (age = 23.1 [2.7] y, height = 177.0 [0.1] cm, weight = 70.2 [2.9] kg, body mass index = 22.1 [1.8] kg/m2) completed 3-day food records each week during the 5-week training period. Blood samples were drawn after an overnight fast before and after preseason training to assess gastrointestinal hormones (leptin, glucagon-like peptide-1, ghrelin, cholecystokinin, and peptide YY). Continuous analysis of the training load was used during the training period. Preintervention and postintervention tests assessed jumping (countermovement jump), sprinting (10, 20, and 30 m), and endurance fitness (the Yo-Yo Intermittent Recovery Test Level 1 [YYIRT1]) levels. Results: Preseason training decreased body mass index (P = .001; effect size [ES] = 0.183) and body fat percentage (P = .001; ES = 0.516). There were increases in countermovement jump (P = .032; ES = 0.215), 20- (P = .016; ES = 0.195) and 30-m sprints (P = .001; ES = 0.188), and YYIRT1 performance (P = .001; ES = 0.9). Levels of cholecystokinin, peptide YY, and ghrelin did not change during preseason training, although changes in leptin (P = .001; ES = 0.41) and glucagon-like peptide-1 levels (P = .039; ES = 0.606) were recorded. Leptinemia correlated with anthropometric parameters (body mass index, r = .77, P = .001; percentage of body fat,r = .67, P = .006) and the total distance covered during the YYIRT1 (r = −.54; P = .03). Conclusion: Changes in morphological parameters and physical performance in elite-level male soccer players are related to variations in selected gastrointestinal hormones.

To evaluate body composition, fat distribution, and metabolism at rest and during exercise in premenopausal, perimenopausal, and postmenopausal women.This cross-sectional study in 72 women ages 35 to 60 years evaluated body composition via a fourcompartment model, fat distribution using dual-energy x-ray absorptiometry-derived android to gynoid ratio, metabolic measures via indirect calorimetry, and lifestyle factors using surveys. One-way analyses of variance and one-way analyses of covariance covaried for age and hormone levels (estrogen and progesterone) were used to compare groups.Body fat percent was significantly lower in premenopausal than perimenopausal women (mean difference ± standard error: - 10.29 ± 2.73%, P = 0.026) despite similarities in fat mass and fat-free mass between groups (P≥0.217). Android to gynoid ratio was significantly lower in premenopausal than perimenopausal women (MD ± SE: -0.16 ± 0.05 a.u., P = 0.031). Resting energy expenditure was similar between groups (P = 0.999). Fat oxidation during moderate intensity cycle ergometer exercise was significantly greater in premenopausal than postmenopausal women (MD ± SE: 0.09 ± 0.03 g/min, P = 0.045). The change in respiratory exchange ratio between rest and moderate intensity exercise was significantly lower in premenopausal women than peri- (MD ± SE: -0.05 ± 0.03 a.u., P = 0.035) and postmenopausal women (MD ± SE: -0.06 ± 0.03 a.u., P = 0.040). Premenopausal women reported significantly fewer menopause symptoms than peri- (MD ± SE: -6.58 ± 1.52 symptoms, P = 0.002) and postmenopausal participants (MD ± SE: -4.63 ± 1.52 symptoms, P = 0.044), while similarities between groups were observed for lifestyle factors including diet and physical activity (P0.999).Perimenopause may be the most opportune window for lifestyle intervention, as this group experienced the onset of unfavorable body composition and metabolic characteristics.http://links.lww.com/MENO/A932.

Aberrant joint loading contributes to the development of posttraumatic knee osteoarthritis (PTOA) following anterior cruciate ligament reconstruction (ACLR); yet little is known about the association between joint loading due to daily walking and cartilage health post-ACLR. Accelerometer-based measures of daily steps and cadence (i.e., rate of steps/min) provide information regarding daily walking in a real-world setting. The purpose of this study was to determine the association between changes in serum cartilage oligomeric matrix protein (COMP; %∆COMP), a mechanosensitive biomarker that is associated with osteoarthritis progression, following a standardized walking protocol and daily walking in individuals with ACLR and uninjured controls. Daily walking was assessed over 7 days using an accelerometer worn on the right hip in 31 individuals with ACLR and 21 controls and quantified as mean steps/day and time spent in ≥100 steps/min. Serum COMP was measured before and following a 3000-step walking protocol at a preferred speed. %∆COMP was calculated as a change in COMP relative to the prewalking value. Linear regressions were used to examine associations between daily walking and %∆COMP after adjusting for preferred speed. Fewer daily steps (ΔR

We investigated the effects of 12 weeks of high-intensity interval training (HIIT) on selected circulating adipokines and other cardiovascular diseases risks factors in men with obesity. Thirty men with obesity (age: 24.96±3.11 year, BMI: 30.92±1.04 kg/m2) were randomly assigned to HIIT and control groups. The HIIT group participated in a 12-week HIIT program (5×2 min interval bout at an intensity of 85–95% HRmax interspersed by 1 min passive recovery, three times per week), while the control group maintained their usual lifestyles. Blood lipids, insulin resistance, and select serum adipokines were assessed before and after 12 weeks of the intervention period. HIIT improved body composition and lipid profiles (p

Relative Energy Deficiency in Sport (RED-S) is predicated on the assumption that low energy availability (EA) induces deficiencies—dysfunction in multiple physiologic systems. However, research on RED-S and EA in male athletes is limited in comparison to women. The aim of this study is to investigate EA and the risk factors for RED-S, and their potential associations in non-elite male endurance athletes. Laboratory assessments for resting metabolic rate (RMR), bone mineral density (BMD), blood hormonal biomarkers and maximal aerobic capacity were conducted on 60 competitive, recreationally trained male endurance athletes (age=43.4±11.6 years [mean±SD], training=10.9±2.7 h/wk, 7.1±8.8 years). Participants provided 7–days of training logs and 4-days of diet records. Diet and training records were used to calculate EA. Correlations were used to examine associations between EA and RMR, BMD, stress fractures and reproductive, metabolic and bone biomarkers. Mean EA was 28.7±13.4 kcal/kg fat free mass (FFM), which categorized our sample as low EA (based upon published criterion, < 30 kcal/kg FFM) and at a high risk for RED-S. Hormonal and bone biomarkers were in normal clinical ranges, even though EA was low. The only interesting significant association was EA being negatively associated with total body BMD (r = –0.360, P =0.005), opposite of expectations. On average our subjects displayed a state of low EA based upon the criterion which has been primarily developed from female-based research. Nonetheless, our participants displayed no major hormonal or bone health disturbances found in athletes diagnosed with RED-S. A value of < 30 kcal/kg FFM to diagnose low EA may not be appropriate for non-elite endurance trained men.

Beta-alanine, caffeine, and nitrate are dietary supplements generally recognized by the sport and exercise science community as evidence-based ergogenic performance aids. Evidence supporting the efficacy of these supplements, however, is greatly skewed due to research being conducted primarily in men. The physiological differences between men and women, most notably in sex hormones and menstrual cycle fluctuations, make generalizing male data to the female athlete inappropriate, and potentially harmful to women. This narrative review outlines the studies conducted in women regarding the efficacy of beta-alanine, caffeine, and nitrate supplementation for performance enhancement. Only nine studies on beta-alanine, 15 on caffeine, and 10 on nitrate in healthy women under the age of 40 years conducted in normoxia conditions were identified as relevant to this research question. Evidence suggests that beta-alanine may lower the rate of perceived exertion and extend training bouts in women, leading to greater functional adaptations. Studies of caffeine in women suggest the physiological responder status and caffeine habituation may contribute to caffeine’s efficacy, with a potential plateau in the dose–response relationship of performance enhancement. Nitrate appears to vary in influence based on activity type and primary muscle group examined. However, the results summarized in the limited literature for each of these three supplements provide no consensus on dosage, timing, or efficacy for women. Furthermore, the literature lacks considerations for hormonal status and its role in metabolism. This gap in sex-based knowledge necessitates further research on these ergogenic supplements in women with greater considerations for the effects of hormonal status.

Objectives The influence of hormonal contraceptives (HC) on inflammation and body composition after high-intensity combined strength and endurance training was investigated. Design Active healthy women formed two training groups: HC users (HCU, n = 9) and those who had never used HC (NHC, n = 9). Training included two strength training sessions and two high-intensity interval training sessions per week for 10 weeks. Methods Before (PRE) and after (POST) the training intervention, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1beta (IL-1β) concentrations were measured. Dual-energy X-ray absorptiometry was used to estimate fat mass (FM), abdominal fat mass (aFM), and lean mass (LM). Results Circulating concentrations of hs-CRP decreased significantly in the NHC from pre to post with −0.46 mg l−1 (95% CI: −0.78, −0.14, p = 0.009, ES = 0.434), whereas a significant increase was observed in HCU from pre to post with 0.89 mg l−1 (95% CI: 1.66, 0.12, p = 0.048, ES = 1.988) with a significant between-group difference (p = 0.015). In addition, hs-CRP concentration was significantly higher in HCU than in NHC after training (p = 0.036) at post. Lean mass increased significantly more in NHC than in HCU (p = 0.049). Conclusions High-intensity combined strength and endurance training can modify inflammation and body composition of women. The present study showed that inflammation, in terms of hs-CRP was higher post training in HCU than NHC, which may be associated with smaller gains in lean mass in response to training.

Introduction: Evidence suggests that hypoxia and high-intensity exercise training can increase apoptosis of lung cells and Adiantum capillus-veneris (Ac-v) extract can have anti-apoptotic effects. Thus, the aim of the present study was to investigate the effect of chronic hypoxia and the (Ac-v) extraction as a supplement on TNF-a and P53 protein expression as well as the respiratory surface. Material and methods: 24 healthy Wistar rats (age = 4 weeks, weight = 72 = 9 gr) were trained using interval training for 6 weeks followed by a 3-week stay in hypoxia conditions. Half of the hypoxia samples received 500 ml/gr/per body weight daily (Ac-v) within 3 weeks of hypoxia. At the end, the lung tissue was removed for histological and immunohistological analysis. Results: After 3 weeks of hypoxia exposure following 6 weeks of exercise, expression of P53 and TNF-a increased and the respiratory surface decreased (p ≤ 0.05). After 3 weeks of taking the Ac-v extract during hypoxia exposure, reduced P53 and TNF-a expression and the increased respiratory surface were observed (p ≤ 0.05). Conclusions: Chronic hypoxia may be considered as a strong stimulus leading to the expression of proteins involved in apoptosis and tissue disruption. However, our findings suggest that the antioxidative properties of Ac-v extract could decrease the destructive structural and molecular events that happen along with hypoxia exposure or intense exercise training.