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Along with digestion and absorption of nutrients, the gastrointestinal epithelium acts as a primary intestinal defense layer, preventing luminal pathogens from entering the circulation. During exercise in the heat, epithelial integrity can become compromised, allowing bacteria and bacterial endotoxins to translocate into circulation, triggering a systemic inflammatory response and exacerbating gastrointestinal damage. While this relationship seems clear in the general population in endurance/ultraendurance exercise, the aim of this systematic review was to evaluate the effect of exercise in the heat on blood markers of gastrointestinal epithelial disturbance in well-trained individuals. Following the 2009 Preferred Reporting Items for Systematic Reviewed and Meta-Analyses guidelines, five electronic databases were searched for appropriate research, and 1,885 studies were identified. Five studies met the inclusion criteria and were subject to full methodological appraisal by two reviewers. Critical appraisal of the studies was conducted using the McMasters Critical Review Form. The studies investigated changes in markers of gastrointestinal damage (intestinal fatty acid–binding protein, endotoxin, and/or lipopolysaccharide-binding protein) following acute exercise in warm to hot conditions (≥ 30 °C) and included trained or well-trained participants with direct comparisons to a control temperate condition (≤ 22 °C). The studies found that prolonged submaximal and strenuous exercise in hot environmental conditions can acutely increase epithelial disturbance compared with exercise in cooler conditions, with disturbances not being clinically relevant. However, trained and well-trained populations appear to tolerate exercise-induced gastrointestinal disturbance in the heat. Whether this is an acquired tolerance related to regular training remains to be investigated.

Background Hypertension is a major contributor to cardiovascular diseases and premature death, therefore determining factors that contribute to such a high burden of disease is critically important. This study examined anthropometric and physical measurements, as well as blood and saliva biomarkers, as predictors for hypertension using datasets from the 2008 Health and Retirement Study. Methods A total of 2,924 participants (aged 74.84 ± 6.45 years) were included. Binary logistic regression was performed to ascertain the effects of sex, age, telomere length, C-reactive protein (CRP), body mass index (BMI), and additional markers on the odds of developing hypertension. Results Males had 2.3 times the odds (odds ratio (OR) = 2.313, confidence interval (CI) 95% (1.391, 3.845); P = 0.001) of being hypertensive if they were obese, females had 1.7 times the odds (OR = 1.788, CI 95% (1.260, 2.536); P = 0.001) if overweight, and 2.4 times (OR = 2.479, CI 95% (1.693, 3.630); P < 0.001) if obese. Age in females was an independent predictor where every 1-year increase in age was tied to a 5.1% increase in being hypertensive (OR = 1.051, CI 95% (1.027, 1.075); P 3 mg/l) had 1.4 times the odds (OR = 1.447, CI 95% (1.079, 1.942); P = 0.014). Conclusions This study provides verification for BMI as a predictor for hypertension and proposes age and CRP as predictors for females. Specific sex differences and life stage should be considered when evaluating hypertension risk to improve clinical outcomes and promote healthy aging.

Probiotic supplementation may offer team sport athletes a range of benefits beyond the immune and gastrointestinal systems.To examine the effects of a probiotic formulation on perceptual markers of sleep quality and quantity, and muscle soreness, leg heaviness and motivation in elite rugby union athletes.A double-blind randomised controlled trial involving 19 elite male rugby athletes was conducted over 17 weeks encompassing both domestic and international competition. Psychometric variables and salivary biomarkers were assessed twice a week. Athletes were assigned either a daily probiotic (Ultrabiotic 60™) and Saccharomyces boulardii (during international competition) or a placebo. Associations between psychometric scores for perceptual and salivary biomarkers of sleep (melatonin) and inflammation C-reactive protein (CRP) were investigated.Muscle soreness was ∼0.5 units lower (F(1, 343)=42.646, p0.0001) and leg heaviness scores ∼0.7 units lower (F(1, 334)=28.990, p0.0001) in the probiotic group compared to the placebo group. Across both groups, as self-reported muscle soreness scores and salivary CRP concentrations increased, sleep quantity, quality and motivation scores decreased. Conversely as muscle soreness scores and CRP decreased, sleep quantity and quality, and motivation scores improved.A long-term programme of probiotic supplementation in international-level rugby union players may yield favourable effects on self-reported muscle soreness and sleep quality associated with muscle soreness during training and competitions.

The use of exercise as a priming strategy to enhance sport performance is becoming increasingly popular in professional sports and as an area of research interest. Early research suggests that the acute physiological responses to exercise can positively influence performance for up to 48 h. There is yet to be a comprehensive review of exercise strategies which could be implemented specifically on the day of competition. The aim of this systematic review was to provide a synthesis of research investigating acute exercise interventions as game day priming strategies for team-sport athletes to improve physical performance and athlete readiness when implemented in the 1–12 h prior to competition. A literature search of SPORTDiscus, PubMed and Cochrane Central Register for Controlled Trials was conducted. A total of 6428 studies were retrieved and assessed against the following inclusion criteria: (1) randomised controlled trials and non-randomised comparative studies with reported pre–post intervention outcomes; (2) exercise interventions were applied 1–12 h prior to the assessment of outcome measures. Studies were excluded if they used nutrition, supplementation, pre-heating, pre-cooling, stretching, massage or vibration training as the priming strategies, or if interventions were performed at altitude or in hypoxic environments. Studies were assessed for methodological quality at the study level using the Physiotherapy Evidence Database (PEDro) scale. Twenty-nine studies satisfied the eligibility criteria and were included in this review. Studies were categorised as resistance training; cycling; running; and other strategies. Resistance training using heavy loads at low volumes increased strength and power measures following a 4–6 h recovery, with limited improvements observed following shorter (1–3 h) and longer (6–12 h) recovery periods. Running-based sprint priming led to improvements in subsequent sprint and repeat sprint performance following a 5–6 h recovery, whereas cycling improved counter-movement jump height in a single study only. No significant differences were reported in any performance measures following endurance-based running or cycling strategies. Physiological markers, such a hormone and blood lactate responses, showed mixed results between studies. High-intensity low-volume resistance training leads to a greater physiological and performance response than high-volume resistance training. Maximal running sprints may be more effective than maximal cycling sprints due to an increased physiological demand; however, loading protocols must also be considered in conjunction with exercise volume and movement specificity to achieve a beneficial response for subsequent performance. There is limited evidence to suggest endurance cycling or running exercise is beneficial as a priming strategy.

Arthritis is a significant cause of chronic pain and disability, affecting around 3.5 million Australians. However, little is known regarding the overall diet quality of those living with arthritis. This study aimed to assess the dietary quality of Australians living in the Australian Capital Territory region with arthritis. This cross-sectional study analysed dietary intake data of individuals living with arthritis using a validated food frequency questionnaire. Dietary quality was assessed using the Healthy Eating Index-2015 (HEI-2015) to examine associations between diet composition, age, income and arthritis impact using the short form of the Arthritis Impact Measurement Scales 2 (AIMS2-SF). Participants, predominantly female (82.6%), were grouped by age: 18–50 years (n = 32), 50–64 years (n = 31), and 65 + years (n = 23). Significant correlations were observed between age and HEI-2015 (rs = 0.337, p = 0.002) and income and AIMS2-SF (rs = − 0.353, p

The proportion of adults living with hypertension increases significantly with advancing age. It is therefore important to consider how health and vitality can be maintained by the aging population until end of life. A primary risk factor for the progression of cardiovascular diseases (CVD) is hypertension, so exploring the factors and processes central to this burden of disease is essential for healthy aging. A loss of skeletal muscle quantity and quality is characteristic in normal aging, with a reduction of vasodilatory capacity caused by endothelial dysfunction, and subsequent increase in peripheral resistance and risk for hypertension. Reactive Oxygen and Nitrogen Species (RONS) encompass the reactive derivatives of NO and superoxide, which are continuously generated in contracting skeletal muscle and are essential mediators for cellular metabolism. They act together as intra and intercellular messengers, gene expression regulators, and induce programmed cell death. In excessive amounts RONS can inflict damage to endothelial and skeletal muscle cells, alter signaling pathways or prematurely promote stress responses and potentially speed up the aging process. The age-related increase in RONS by skeletal muscle and endothelial mitochondria leads to impaired production of NO, resulting in vascular changes and endothelial dysfunction. Changes in vascular morphology is an early occurrence in the etiology of CVDs and, while this is also a normal characteristic of aging, whether it is a cause or a consequence of aging in hypertension remains unclear. This review serves to focus on the roles and mechanisms of biological processes central to hypertension and CVD, with a specific focus on the effects of aging muscle and RONS production, as well as the influence of established and more novel interventions to mediate the increasing risk for hypertension and CVD and improve health outcomes as we age.

Heart rate variability (HRV) is an accepted method for determining autonomic nervous system activity and cardiovascular risk in various populations. This study assessed the validity and reliability of a commercially available finger photoplethysmography (PPG) system for measuring pediatric HRV in a real-world setting. Sixteen healthy children (4.06 ± 0.58 years) were recruited. The PPG system was compared to the Polar H10 heart rate (HR) sensor validated against ECG (gold standard) for HRV measurement. Seated short-term resting R-R intervals were recorded simultaneously using both systems. Recordings were performed on 3 days at the participants’ school. Paired t-tests, effect sizes and Bland–Altman analyses determined the validity of the PPG system. The relative and absolute reliability of both systems were calculated. No HRV parameters were valid for the PPG system. Polar H10 yielded moderate (0.50–0.75) to good (0.75–0.90) relative reliability with R-R intervals and the standard deviation of instantaneous and continuous R-R variability ratio showing the best results (ICCs = 0.84). Polar H10 displayed better absolute reliability with the root mean square of successive differences, R-R intervals and HR showing the lowest values (TEM% &lt, 12%). The use of the Polar H10 and not the PPG system is encouraged for HRV measurement of young children in an educational real-world setting.

The primary purpose of this study was to assess the reliability of 3 methods estimating energy expenditure (EE) during and in response to resistance exercise. Ten males (aged 29.4 ± 10.2 years) with ≥2 months resistance training (RT) experience performed 3 training sessions incorporating the bench press and back-squat; sessions were separated by 48 to 72 h. Total energy expenditure (TEE) was estimated using a Suunto T6D Heart Rate Monitor and 2 methods (named “Scott” and “Magosso”) that used oxygen uptake and blood lactate measurements to determine aerobic and anaerobic energy expenditure (AnEE). For TEE, relative reliability for both the Scott and Magosso methods remained “nearly perfect” across all testing days for the bench press and back-squat; with interclass correlations (ICC) > 0.93 and percentage of the typical error measurement (TEM%) below 5.8%. The heart rate method showed moderate variability between testing days for both exercises; ICCs ranged between 0.66–0.92 with TEM% between 18%–37% during the bench press and 11%–17% during the back-squat. The estimation of AnEE showed that the Scott and Magosso methods had “strong” to “very strong” relative reliability for both exercises; however, a low absolute reliability was observed. Mean EE was significantly higher in the Scott and Magosso methods during the bench press >912 kJ and back-squat >1170 kJ, with the heart rate method estimating 358 kJ and 416 kJ. The Scott and Magosso methods showed a high degree of reliability between testing days when measuring EE. Heart rate methods may significantly underestimate EE during and in response to RT.

Testing of performance-associated parameters is a routine requirement in high-performance sports. Limited information is available regarding the anthropometrical, physiological and biomechanical characteristics of deaf soccer players. The primary purpose of this cross-sectional, descriptive study was to investigate possible performance-associated differences between the deaf Czech Republic national team soccer players and hearing counterparts from the Czech Republic First League. Seventy-four male soccer players (31 deaf and 43 hearing, ≥ 17 years of age) underwent laboratory testing that included measurement of autonomic cardiac activity, anthropometrical parameters, vertical jump performance, and maximal aerobic capacity via an incremental running test. Compared with the hearing players, deaf players were shorter (p = 0.012), had more body fat (p

Functional beverages can be a valuable component of the human diet with the ability to not only provide essential hydration but to deliver important bioactive compounds that can contribute to chronic disease treatment and prevention. One area of the functional beverage market that has seen an increase in demand in recent years are beverages that promote relaxation and sleep. Sleep is an essential biological process, with optimal sleep being defined as one of adequate duration, quality and timing. It is regulated by a number of neurotransmitters which are, in turn, regulated by dietary intake of essential bioactive compounds. This narrative review aimed to evaluate the latest evidence of the sleep promoting properties of a selection of bioactive compounds (such as L-theanine and L-tryptophan) for the development of a functional beverage to improve sleep quality; and the effectiveness of traditional sleep promoting beverages (such as milk and chamomile). Overall, the bioactive compounds identified in this review, play essential roles in the synthesis and regulation of important neurotransmitters involved in the sleep-wake cycle. There is also significant potential for their inclusion in a number of functional beverages as the main ingredient on their own or in combination. Future studies should consider dosage; interactions with the beverage matrix, medications and other nutraceuticals; bioavailability during storage and following ingestion; as well as the sensory profile of the developed beverages, among others, when determining their effectiveness in a functional beverage to improve sleep quality.

Objective: This review sought to synthesize evidence examining the effect of exercise on prostate cancer patients undergoing androgen deprivation therapy (ADT).Data Sources: A systematic literature search was conducted in electronic databases (CINAHL, MEDLINE, APAPsychINFO, Scopus, SPORTDiscus, and Cochrane Library) from their inception to March 31, 2020. Inclusion criteria were randomized controlled trials (RCTs) testing the effect of exercise on body composition, muscle strength and physical performance. Fourteen RCTs were included. Participant numbers within the individual RCTs ranged from 19 to 163 with heterogeneity in prostate cancer stage (localized and locally advanced diagnoses) with age of participants ranging from 43 to 90 years. The length of the interventions ranged from 12 weeks to 12 months, with the number of sessions per week ranging from 2 to 5. Resistance training intensity ranged from 60% to 90% 1RM and the aerobic training ranged from 60% to 90% HRmax. Conclusions: Resistance training and sport (football) in the form of small sided games (SSGs) played an important role in preserving bone mineral density and lean mass as well as improving muscle strength and physical performance outcomes in men affected by prostate cancer undergoing ADT. Implications for Nursing Practice: Multimodal exercise, including resistance exercise and activity that includes repeated sprints (SSGs), benefit the maintenance of bone mineral density and lean mass as well as increase strength and physical performance in men affected by prostate cancer undergoing ADT. Based on this evidence, nurses should coordinate timely referrals to qualified exercise physiologists or physiotherapist with expertise in cancer care. Refereed/Peer-reviewed

Social isolation and sedentary behaviour are common in residential aged care facilities (also known as nursing homes or long-term care). Use of new technologies such as virtual and augmented reality are currently under investigation for their potential to provide exciting and engaging activities for older people in residential aged care facilities. However, there is limited evidence on whether these technologies can promote physical activity in a small group setting for people with cognitive impairment. Using mixed methods, we examined the use of a virtual cycling experience in a sample of 10 participants with cognitive impairment living in residential aged care facilities. In a randomised crossover design, participants engaged in a 25-minute, self-paced, facilitated seated virtual cycling experience and a time-matched seated physical activity session in groups of five. All participants completed a brief pre- and post-intervention mood questionnaire. Video analysis was used for both conditions to compare levels of environmental stimulation, apathy and engagement using both the Person–Environment Apathy Rating Scale and the Engagement of a Person with Dementia Scale. A thematic analysis of semi-structured interviews following the virtual cycling experience was also performed. No differences were observed between conditions for all outcomes except for environmental stimulation, where there was a lower response in the intervention than the control condition ( p = 0.032). This was primarily driven by lower scores for the virtual cycling experience than control in physical accessibility ( p = 0.012). Participants reported the virtual cycling experience to be immersive and challenging and reminisced about cycling earlier in life. The activity manager observed that the virtual cycling experience was an overall positive experience and emphasised benefits of safety screening and preparation prior to the activities. The findings of this study support the use of the virtual cycling experience as an immersive and engaging alternative to usual activities, which might encourage higher levels of physical activity in residential aged care facilities.

Background Cardiovascular disease (CVD) remains the largest cause of death in breast cancer survivors. The aim of this study was to explore the impact of exercise intensity on aerobic fitness and autonomic cardiac regulation (heart rate variability (HRV)) and salivary biomarkers of the stress systems (HPA-axis, cortisol; sympathetic nervous system, α-amylase) and mucosal immunity (secretory(s)-IgA), markers of increased risk of CVD in breast cancer survivors. Methods Participants were randomly assigned to; 1) high intensity interval training (HIIT); 2) moderate-intensity, continuous aerobic training (CMIT); or 3) a wait-list control (CON) for a 12-week (36 session) stationary cycling intervention. Cardiorespiratory fitness (VO2peak), resting HRV and salivary biomarkers were measured at baseline 2–4 d pre-intervention and 2–4 d post the last exercise session. Results Seventeen participants were included in this study (62 ± 8 years, HIIT; n = 6, CMIT; n = 5, CON; n = 6). A significant improvement (p ≤ 0.05) was observed for VO2peak in the HIIT group; 19.3% (B = 3.98, 95%CI = [1.89; 4.02]) and a non-significant increase in the CMIT group; 5.6% (B = 1.96, 95%CI = [− 0.11; 4.03]), compared with a 2.6% (B = − 0.64, 95%CI = [− 2.10; 0.82]) decrease in the CON group. Post intervention improvements in HRV markers of vagal activity (log (ln)LF/HF, LnRMSSD) and sympathetic nervous system (α-amylase waking response) occurred for individuals exhibiting outlying (> 95% CI) levels at baseline compared to general population. Conclusion High intensity interval training improved cardiovascular fitness in breast cancer survivors and improved cardiac regulation, and sympathetic nervous system (stress) responses in some individuals. High-intensity interval training was safe and effective for breast cancer survivors to participate in with promising results as a time efficient intensity to improve physical health and stress, reducing CVD risk. Trial registration This pilot study was retrospectively registered through the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12620000684921.

l-Theanine (l-THE) is a nonproteinogenic amino acid derived from green tea (Camellia sinensis), which exhibits strong antioxidant-like properties and contributes to the favourable umami taste sensation. Several studies have reported that the consumption of this amino acid has many therapeutic effects, including improvements in brain and gastrointestinal function, cancer drug therapeutic efficacies, antihypertensive effects, and improved immune function. Considering the recent Western commercialisation and popularity of green tea consumption as a nootropic agent in humans, the aims of this review were to consolidate the existing knowledge from ex vivo and in vitro animal models and attempt to highlight the applicability of l-THE towards the human clinical trials. Considering the anti-inflammatory and antioxidants effects of l-THE presented in the current review, further research must translate the existing knowledge gained from animal and cell models to exploring the potential metabolic health benefits and moderating effects on the pathogenesis of conditions such as obesity, arthritis, depression, and type 2 diabetes in human trials. This will bridge the gap in literature and provide more insights into the mechanisms driving pathologies characterised by the inflammatory response and oxidative stress.

Background Evidence regarding stress, team structure and decision-making has been used to inform efficacious team composition and deployment. There have been limited attempts to establish the relationship between psychological stress with physiological data within professional environments. The current study explored measures of psychological and physiological stress in Australian emergency practitioners. Methods Thirty-seven staff in an Australian emergency department completed an online survey assessing freedom to make decisions, social support, and psychological job demands. Seven participants provided saliva samples three times daily for seven days (valid n = 141 samples). Cortisol levels of the samples were analysed using competitive enzyme immunoassay kits, and α-amylase using kinetic enzyme assay kits. Results Years of emergency experience was positively associated with freedom to make decisions, and social support was negatively correlated with psychological demand. No consistent pattern was observed between cortisol level and reported psychological demand, decision freedom or social support. Physical activity was not reflected in elevated α-amylase. Diurnal variation of cortisol and α-amylase was not affected by shiftwork. Conclusions The data supports the case for using multiple assessments to measure stress. While the psychological data is consistent with previous findings, there are possible disparities between psychological reports and physical indicators of stress.

Consumption of L-Theanine (L-THE) has been associated with a sensation of relaxation, as well as a reduction of stress. However, these physiological responses have yet to be elucidated in humans where L-THE is compared alongside food or as a functional ingredient within the food matrix. The aim of this study was to determine the physiological responses of a single intake of a potential functional food product (mango sorbet) containing L-THE (ms-L-THE, 200 mgw/w) in comparison to a flavour and colour-matched placebo (ms). Eighteen healthy male participants were recruited in this randomised, double-blind, placebo-controlled trial. The participants were required to consume ms-L-THE or placebo and their blood pressure (BP) (systolic and diastolic), heart rate (HR), and heart rate variability (HRV) were monitored continuously over 90 minutes. Eleven males (age 27.7 ± 10.8 years) completed the study. Changes in area under the curve for systolic and diastolic blood pressure and HRV over the 90 minute observation period indicated no differences between the three conditions (all p &gt, 0.05) or within individual groups (all p &gt, 0.05). The values for heart rate were also not different in the placebo group (p = 0.996) and treatment group (p = 0.066), while there was a difference seen at the baseline (p = 0.003). Based on the findings of this study, L-THE incorporated in a food matrix (mango sorbet) demonstrated no reduction in BP or HR and showed no significant parasympathetic interaction as determined by HRV high-frequency band and low-frequency/high-frequency ratio. Further studies should be focussed towards the comparison of pure L-THE and incorporation within the food matrix to warrant recommendations of L-THE alongside food consumption.

To explore the impact of short-term exercise of varying intensity on traditional risk factors for cardiometabolic disease.A total of 109 children (mean age, 11.1 ± 0.8 years) were conveniently assigned to 5 weeks of moderate-intensity continuous training (MICT; n = 29) set at 65%-70% of maximum heart rate, high-intensity interval training (HIIT; n = 29;80% maximum heart rate), combined training (HIIT + MICT; n = 27), or no training (control; n = 24). Two-way ANOVA (group × time) was used to evaluate the effects of training on all cardiometabolic disease risk factors. Effect sizes were calculated to assess the magnitude of difference.MICT, HIIT, and HIIT + MICT were associated with significantly improved resting heart rate (effect size, -0.4, -1.1, and -1.1, respectively; P .0001), fasting glucose (effect size, -0.6, -0.9, and -0.1, respectively; P = .0004), peak oxygen consumption (effect size, 0.5, 0.9, and 0.5, respectively; P .0001), and c-reactive protein (effect size, -0.2, -1.0, and -0.5, respectively; P = .0016). HIIT + MICT was significantly associated with reduced waist circumference (-5.4%; P .0001) and waist-to-hip ratio (-2.5%; P .0002) compared with MICT (7.0% and 6.3%, respectively) and HIIT (-0.5% and -1.3%, respectively).Short-term HIIT and MICT interventions are useful for improving cardiometabolic health in children. HIIT + MICT may provide superior reductions in central obesity indicators.

Studies examining post-traumatic stress disorder (PTSD) have either emphasized a relationship between PTSD and a systemically pro-inflammatory state or identified a link between PTSD and chronic disease. The aim of this study was to evaluate the evidence for a relationship between individuals with PTSD and systemic low-grade inflammation that has been proposed to underlie chronic disease development in this population. The authors conducted a systematic review of the literature (January 2006 to April 2017) in accordance with the PRISMA statement in the following four databases: PubMed, MEDLINE, PsycINFO, and SPORTDiscus with Full Text. The search strategy was limited to articles published in peer-reviewed journals and to human studies. Nine studies measuring systemic inflammation and discussing its role in chronic disease development were selected for inclusion in this review. The association between markers of systemic inflammation and PTSD was evaluated by the measurement of a variety of systemic inflammatory markers including acute-phase proteins, complement proteins, pro- and anti-inflammatory cytokines, natural killer cells, and white blood cells. In general, systemic inflammatory biomarkers were elevated across the studies in the PTSD groups. There is evidence that PTSD is underpinned by the presence of a systemic low-grade inflammatory state. This inflammation may be the mechanism associated with increased risk for chronic disease in the PTSD population. From this, future research should focus on interventions that help to reduce inflammation, such as exercise.

AIM To determine the impact of low volume high-intensity interval training (LVHIIT) and continuous low to moderate-intensity exercise training (CLMIT) on cardiovascular disease (CVD) risk and health outcomes in cancer survivors. METHODS Sedentary cancer survivors (n = 75, aged 51 ± 12 year) within 24 months of diagnosis, were randomised into three groups for 12 wk of LVHIIT (n = 25), CLMIT (n = 25) or control group (n = 25). The exercise intervention involved 36 sessions (three sessions per week). The LVHIIT group performed 7 x 30 s intervals (≥ 85% predicted maximal heart rate) with a 60 s rest between intervals, and the CLMIT group performed continuous aerobic training for 20 min (≤ 55% predicted maximal heart rate) on a stationary bike. Outcome variables were measured at baseline and at 12 weeks and analysed using a 3 x 2 (group x time) repeated measures ANCOVA to evaluate main and interaction effects. RESULTS Significant improvements (time) were observed for seven of the 22 variables (ES 0.35-0.97, P ≤ 0.05). There was an interaction effect (P < 0.01) after 12 wk in the LVHIIT group for six-minute walk test (P < 0.01; d = 0.97; 95%CI: 0.36, 1.56; large), sit to stand test (P < 0.01; d = -0.83; 95%CI: -1.40, -0.22; large ) and waist circumference reduction (P = 0.01; d = -0.48; 95%CI: -1.10, 0.10; medium). An interaction effect (P < 0.01) was also observed for quality of life in both the LVHIIT (d = 1.11; 95%CI: 0.50, 1.72; large) and CLMIT (d = 0.57; 95%CI: -0.00, 1.20; moderate) compared with the control group (d = -0.15; 95%CI: -0.95, 0.65; trivial). CONCLUSION Low-volume high-intensity training shows promise as an effective exercise prescription within the cancer population, showing greater improvements in cardio-respiratory fitness, lower body strength and waist circumference compared with traditional CLMIT and control groups. Both LVHIIT and CLMIT improved quality of life. A proposed benefit of LVHIIT is the short duration (3 min) of exercise required, which may entice more cancer survivors to participate in exercise, improving health outcomes and lowing the risk of CVD.

Background: It is well known that vigorous physical activity induces functional changes in cardiac autonomic nervous system (ANS) activity that is sustained several hours after exercise. However, data related to ANS recovery after more extreme endurance events, such as skyrunning marathons, are still lacking. Objective: The aims of this prospective cohort study were firstly, to determine the ANS response to a SkyMarathon, and secondly, to examine correlates of run performance. Methods: Ten male skyrunners aged 37.2 ± 9.2 years were recruited. The race was performed at a mean intensity 85.4 ± 3.7% of heart rate reserve, and lasted for 338 ± 38 min. Morning supine heart rate variability was measured at 10, 2 and 1 days before race, on the race day, at 5 min intervals for 30 min immediately post-race and then at 5 h and 30 h post. High-frequency power (HF, 0.15-0.50 Hz), low-frequency power (LF, 0.05-0.15 Hz), and square root of the mean of the squares of the successive differences (RMSSD) were calculated and transformed by natural logarithm (Ln). Results: Sympathovagal balance (Ln LF/HF) was most likely increased above baseline during the 30 min post-race and returned to baseline by 5 h. Vagal activity (Ln RMSSD and Ln HF) was most likely decreased below baseline during the 30 min post-race and 5 h of post-race, and recovered to baseline by 30 h. Race time correlated with resting heart rate (r = .81), body mass index (r = .73), maximal power output (r = -.70), and maximal oxygen uptake (r = -.61). Conclusions: The SkyMarathon elicited disturbances in ANS activity, with relative sympathetic activity increased up to 5 h post-race and vagal activity recovering by 30 h. Resting heart rate, body mass index, maximal power output, and maximal oxygen uptake were associated with SkyMarathon performance prediction.

Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of neural tube defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p > 0.05). The single L-MTHF trial that explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton depression rating scale from adjunctive treatment with 15 mg/day of L-MTHF compared with placebo (−6.8 ± 7.2 vs. −3.7 ± 6.5; p = 0.017) and improvement with L-MTHF for most genetic markers. Currently, there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.

Background: A reduction in the inspired oxygen fraction (FiO2) induces a decline in arterial oxygen saturation (SpO2) and changes of heart rate variability (HRV). It has been shown that SpO2 and HRV responses to similar levels of acute normobaric hypoxia are inter-individual variable. Variable response may be influenced by normoxia reached maximal oxygen uptake (VO2max) value. Objective: The primary aim was to assess HRV and the SpO2 response to hypoxia, and examine the association with normoxic VO2max. Methods: Supine HRV and SpO2 were monitored during normobaric hypoxia (FiO2 = 9.6%) for 10 minutes in 28 subjects, aged 23.7 ± 1.7 years. HRV was evaluated by using both spectral and time domain HRV analysis. Low frequency (LF, 0.05-0.15 Hz) and high frequency (HF, 0.15-0.50 Hz) power together with square root of the mean of the squares of the successive differences (rMSSD) were calculated and transformed by natural logarithm (Ln). Based on the SpO2 in hypoxia, subjects were divided into Resistant (RG, SpO2 ≥ 70.9%, n = 14) and Sensitive (SG, SpO2 2max was higher in SG (62.4 ± 7.2 ml ⋅ kg-1 ⋅ min-1) compared with RG (55.5 ± 7.1 ml ⋅ kg-1 ⋅ min-1, p = .017, d = 0.97). A significant relationship (r = -.45, p = .017) between hypoxic-normoxic difference in SpO2 and normoxic VO2max level was found. Vagal activity (Ln rMSSD) was significantly decreased (SG: p 2, accompanied by greater autonomic cardiac disturbances during hypoxia. The SpO2 reduction was associated with perceived hypoxia comfort/discomfort. The hypoxia discomfort state was accompanied by a greater withdrawal in cardiac vagal activity.

There is a significant body of research undertaken in order to elucidate the mechanisms underlying the pathology of Alzheimer's disease (AD), as well as to discover early detection biomarkers and potential therapeutic strategies. One such proposed biomarker is the calcium binding protein S100β, which, depending on its local concentration, is known to exhibit both neurotrophic and neuroinflammatory properties in the central nervous system. At present, relatively little is known regarding the effect of chronic S100β disruption in AD. Dietary intake has been identified as a modifiable risk factor for AD. Preliminary in vitro and animal studies have demonstrated an association between S100β expression and dietary intake which links to AD pathophysiology. This review describes the association of S100β to fatty acids, ketone bodies, insulin, and botanicals as well as the potential impact of physical activity as a lifestyle factor. We also discuss the prospective implications of these findings, including support of the use of a Mediterranean dietary pattern and/or the ketogenic diet as an approach to modify AD risk.

The study assessed the effects of different weekly training frequencies performed over a 12 week exercise programme (strength, endurance, balance) on autonomic cardiac activity, blood pressure and cardiorespiratory fitness (CRF) in elderly individuals.Fifty-eight individuals participated in the study: 2TG (N=24, 71.1±6.4 yrs; 19 females, 5 males) performing two, 60min sessions/week; and 3TG (N=34, 72.3±7.9 yrs; 25 females, 9 males) performing three, 60min sessions/week. Time domain and spectral analysis of heart rate variability (HRV) quantified autonomic cardiac regulation.Natural logarithm (Ln) transformation was applied to all HRV parameters. There were significant reductions in total power (Ln TP) (p=0.006), low frequency (Ln LF) (p=0.013), high frequency (Ln HF) (p=0.013) and root mean square of successive differences (Ln rMSSD) (p=0.014) post training in 3TG after intervention. Diastolic BP (DBP) decreased significantly in both groups (2TG: P0.001; 3TG: P0.001). Both groups showed significant improvements in six-minute walk distance (2TG: P=0.003, 3TG: P=0.001). However, there were significant HRV differences between 2TG and 3TG for Ln TP (P=0.018), Ln LF (P=0.049), Ln HF (P=0.039) and Ln rMSSD (P=0.049).A combined exercise programme resulted in improved DBP and CRF irrespective of training two or three 60min sessions/week. However, training three, sessions/week induced negative health-related changes in autonomic cardiac activity through reducing HRV parasympathetic function, while HRV was maintained in the group training twice a week.

The effects of sleep deprivation on physical performance are well documented, but data on the consequence of sleep deprivation on recovery from exercise are limited. The aim was to compare cyclists' recovery from a single bout of high-intensity interval training (HIIT) after which they were given either a normal night of sleep (CON, 7.56 ± 0.63 h) or half of their usual time in bed (DEP, 3.83 ± 0.33 h).In this randomized cross-over intervention study, 16 trained male cyclists (age 32 ± 7 years), relative peak power output (PPO 4.6 ± 0.7 W kgPPO was reduced more 24 h after the HIIT session in the DEP (ΔPPO -0.22 ± 0.22 W kgOne night of partial sleep deprivation impairs recovery from a single HIIT session in cyclists. Further research is needed to understand the mechanisms behind this observation.

Background Performance analysis in rugby union has become an integral part of the coaching process. Although performance analysis research in rugby and data collection has progressed, the utility of the insights is not well understood. The primary objective of this review is to consider the current state of performance analysis research in professional rugby union and consider the utility of common methods of analysing performance and the applicability of these methods within professional coaching practice. Methods SPORTDiscus electronic database was searched for relevant articles published between 1 January 1997 and 7 March 2019. Professional, male 15-a-side rugby union studies that included relevant data on tactical and performance evaluation, and statistical compilation of time-motion analysis were included. Studies were categorised based on the main focus and each study was reviewed by assessing a number of factors such as context, opposition analysis, competition and sample size. Results Forty-one studies met the inclusion criteria. The majority of these studies measured performance through the collection and analysis of performance indicators. The majority did not provide context relating to multiple confounding factors such as field location, match location and opposition information. Twenty-nine performance indicators differentiated between successful match outcomes; however, only eight were commonly shared across some studies. Five studies considered rugby union as a dynamical system; however, these studies were limited in analysing lower or national-level competitions. Conclusions The review highlighted the issues associated with assessing isolated measures of performance, lacking contextual information such as the opposition, match location, period within match and field location. A small number of studies have assessed rugby union performance through a dynamical systems lens, identifying successful characteristics in collective behaviour patterns in attacking phases. Performance analysis in international rugby union can be advanced by adopting these approaches in addition to methods currently adopted in other team sports.

Decreased physical activity (PA) is a global concern contributing to the rise in cardiometabolic diseases. One potential mechanism linking insufficient PA and poor health is dysregulated autonomic nervous system (ANS) activity. This relationship is established in adults and PA recommendations, with specific exercise prescription guidelines, have been proposed to overcome this societal health burden. However, research on the benefits and underlying mechanisms of exercise on ANS activity in children

The use of existing public spaces by people living with dementia, such as museums and art galleries, are becoming popular due to their ability to facilitate programs which promote social engagement and inclusion. However, few studies have investigated physiological outcomes of art gallery-based programs. Using a quasi-experimental design, the present study aimed to investigate the levels of salivary biomarkers of cortisol and interleukin-6, quality of life (QoL), depressive symptoms, cognition, and wellbeing, after attending the National Gallery of Australia (NGA) Art and Dementia program. Twenty-eight people living with dementia, each supported by a carer or family member, were recruited for a six-week program and were followed up at twelve weeks. In total, 25 participants (17 female; mean age 84.6±7.27 years) completed the study, and 22 provided viable saliva samples. The waking to evening salivary cortisol ratio was higher post-intervention (p = 0.033), and returned to baseline levels at follow-up (p = 1.00), indicating a more dynamic salivary cortisol rhythm in response to the six-week program. Interleukin-6 levels remained unchanged (p = 0.664). No improvements in QoL (DEMQOL-Carer) were observed between baseline and post-intervention (p = 0.076). However, self-reported depressive symptoms decreased post-intervention compared with baseline (p = 0.015), and memory (immediate recall) (p = 0.009) and verbal fluency (p = 0.027) improved between the same timepoints. The NGA Art and Dementia program appears to have quantifiable benefits, including improved hypothalamic-pituitary-adrenal axis function, justifying a need for longer controlled trial inclusive of physiological outcomes.

The potential anti-fatigue and performance benefits of hydrogen rich water (HRW) have resulted in increased research interest over the past 5 years. The aim of this study was to assess physiological and perceptual responses to an incremental exercise protocol after administration of 600 ml HRW within 30 min before exercise. This randomized, double blinded placebo-controlled cross over study included twelve healthy males aged 27.1±4.9 years. The exercise protocol consisted of a 10 min warm-up at 1.0 W.kg−1, followed by 8 min at 2.0, 3.0, and 4.0 W.kg−1, respectively. Cardio-respiratory variables, lactate and ratings of perceived exertion (RPE) were assessed in the last minute of each step. A significantly lower blood lactate was found with HRW (4.0±1.6 and 8.9±2.2 mmol.l−1) compared to Placebo (5.1±1.9 and 10.6±3.0 mmol.l−1) at 3.0, and 4.0 W.kg−1, respectively. Ventilatory equivalent for oxygen and RPE exhibited significantly lower values with HRW (32.3±7.2, and 17.8±1.2 points, respectively) compared to Placebo (35.0±8.4, and 18.5±0.8 points, respectively) at 4 W.kg−1. To conclude, acute pre-exercise supplementation with HRW reduced blood lactate at higher exercise intensities, improved exercise-induced perception of effort, and ventilatory efficiency.

The prevalence of cardiovascular disease (CVD) is rising worldwide, remaining the major cause of death in developed countries. Polyphenols have been shown to have cardioprotective properties; however, their impact on iron bioavailability and potential impact on other aspects of health is unclear. A systematic review was undertaken to evaluate the current status of the relationship between habitual polyphenol consumption, iron status, and circulating biomarkers of CVD. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2009 guidelines, searches were performed across 5 electronic databases (PubMed, Cochrane Library, Scopus, Web of Science, and CINAHL) to identify randomized controlled trials which investigated the effects of polyphenol consumption on inflammatory markers, serum lipid profile, and iron absorption and bioavailability. In total, 1174 records were identified, with only 7 studies meeting the inclusion criteria. The selected studies involved 133 participants and used a variety of foods and supplements, including olive oil and cherries, rich in polyphenols including hydroxytyrosol, quercetin, and resveratrol, as well as catechin enriched drinks. The duration of the studies ranged from between 56 and 145 days, with total polyphenolic content of the food items and supplements ranging from 45 to 1015 mg (per 100 g). Polyphenols did not appear to interfere with iron status, and most studies reported improvements in inflammatory markers and lipid profile. While these results are promising, the limited number of studies and considerable heterogeneity across the interventions support the need for more extensive trials assessing the relationship between polyphenol intake, iron bioavailability, and CVD risk.

The potential for B-vitamins to reduce plasma homocysteine (Hcy) and reduce the risk of Alzheimer's disease (AD) has been described previously. However, the role of Apolipoprotein E є4 (APOE4) in this relationship has not been adequately addressed. This case-control study explored APOE4 genotype in an Australian sample of 63 healthy individuals (female = 38; age = 76.9 ± 4.7 y) and 63 individuals with AD (female = 35, age = 77.1 ± 5.3 y). Findings revealed 55 of 126 participants expressed the APOE4 genotype with 37 of 126 having both AD and the APOE4 genotype. Analysis revealed an increased likelihood of AD when Hcy levels are11.0 µmol/L (p = 0.012), cysteine levels were255 µmol/L (p = 0.033) and serum folate was22.0 nmol/L (p = 0.003; in males only). In females, dietary intake of total folate336 µg/day (p=0.001), natural folate270 µg/day (p = 0.011), and vitamin B2 1.12 mg/day (p = 0.028) was associated with an increased AD risk. These results support Hcy, Cys, and SF as useful biomarkers for AD, irrespective of APOE4 genotype and as such should be considered as part of screening and managing risk of AD.

This cross-sectional study compared somatic, endurance performance determinants and heart rate variability (HRV) profiles of professional soccer players divided into different age groups: GI (17–19.9 years; n = 23), GII (20–24.9 years; n = 45), GIII (25–29.9 years; n = 30), and GIV (30–39 years; n = 26). Players underwent somatic and HRV assessment and maximal exercise testing. HRV was analyzed by spectral analysis of HRV, and high (HF) and low (LF) frequency power was transformed by a natural logarithm (Ln). Players in GIV (83 ± 7 kg) were heavier (p < 0.05) compared to both GI (73 ± 6 kg), and GII (78 ± 6 kg). Significantly lower maximal oxygen uptake (VO2max, ml•kg-1•min-1) was observed for GIV (56.6 ± 3.8) compared to GI (59.6 ± 3.9), GII (59.4 ± 4.2) and GIV (59.7 ± 4.1). All agegroups, except for GII, demonstrated comparable relative maximal power output (Pmax). For supine HRV, significantly lower Ln HF (ms2) was identified in both GIII (7.1 ± 0.8) and GIV (6.9 ± 1.0) compared to GI (7.9 ± 0.6) and GII (7.7 ± 0.9). In conclusion, soccer players aged >25 years showed negligible differences in Pmax unlike the age group differences demonstrated in VO2max. A shift towards relative sympathetic dominance, particularly due to reduced vagal activity, was apparent after approximately 8 years of competing at the professional level.

Background: In order to optimize training in soccer, knowledge about the specific position fitness demands and characteristics is required. Objective: The aim of the study was to determine whether there are position specific differences in somatic, cardiorespiratory and autonomic cardiac profiles of professional senior Czech soccer players. Methods: All players (N = 120) were divided into six groups according to field positions: goalkeeper (GK; n = 11), external defenders (ED; n = 15), central defenders (CD; n = 18), external midfielders (EM; n = 18), central midfielders (CM; n = 24) and forwards (F; n = 34). Players underwent anthropometrical and heart rate variability (HRV) assessment, and a maximal incremental running test in order to obtain maximal oxygen uptake (VO2max) and heart rate. HRV variables were transformed using the natural logarithm (Ln). Results: GK and CD were significantly (p = .005) heavier than ED, EM, CM, and F; while F were significantly (p = .026) heavier than CM and EM. GK and CD were significantly (p = .008) taller than ED, EM, CM, F; and EM were significantly (p = .041) shorter than CM and F. The only significant (p = .043) difference in percentage of body fat was observed in CD compared with CM. A significantly (p = .021) lower VO2max was observed for GK compared with ED, CD, EM, CM, and F. Supine HRV was significantly (p = .039) lower for Ln LF/HF in GK compared with F. Standing HRV was significantly (p = .03) lower for Ln LF in CD compared with both ED and F, significantly (p = .028) higher for Ln LF/HF in ED compared with CD and EM. Conclusions: In soccer, specific positions are associated with different height, body mass and aerobic capacity. A lower VO2max and vagal activity in GK compared with other playing positions may not be considered as disadvantage for performance in this specific playing position.

The primary aim of this study was to determine the levels of salivary secretory IgA (sIgA) and salivary alpha-amylase (sAA) in young, black male soccer players, before and after 12 weeks of soccer-specific training. Thirty-four children (11–13 years) who were part of a youth soccer development training academy, participated in the study. The participants underwent 12 weeks of soccer-specific training. Resting saliva samples were collected 48 h before the commencement, and 48 h after the completion, of the training program. Samples were taken between 07:30 and 08:30, 90 min after waking. Body fat percentage (BF %), lean body mass (LBM) and cardiorespiratory fitness (CRF) were also measured. Significant differences were found between pre- and post-training for body mass index (BMI) (P 0.05), sAA secretion rate (P > 0.05) or sIgA concentration (P > 0.05). The magnitude of differences from pre- to post-training applying Cohen’s d effect sizes (ES) were moderate (>0.5) for estimated VO2max, sAA, sAA secretion rate, sIgA and sIgA secretion rate. These findings suggest that, 12 weeks of soccer-specific training enhances mucosal immunity and body composition and may have an effect on the sympathetic nervous system in black, male youths.

Objective: Prostate cancer continues to be one of the highest-incident cancers among men. Reducing serum testosterone with androgen deprivation therapy (ADT) is a common effective treatment. While well-demonstrated for cancer suppression, there are numerous adverse effects caused by ADT that can contribute to short- and long-term prognosis. Increased levels of physical activity (PA) during treatment may reduce these side effects. However, uptake of PA is low. The purpose of this review is to identify and evaluate the current literature on strategies to promote and increase the levels of PA in patients with prostate cancer undergoing ADT. Data Sources: Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, and grey literature were searched using Google Scholar up until April 2020. Conclusion: At present the most appropriate modes and dosages of PA for specific ADT toxicities is not known. It is established that some PA in the form of exercise, whether aerobic or resistance, is better than being sedentary for improvements in physical health, but beyond this prescription specifics have not been established. Further research is required to understand the impact of PA on the mental and physical health of men with prostate cancer undergoing ADT. Implications for Nursing Practice: Being physically active and avoiding sedentary behaviour is important for men with prostate cancer undergoing ADT, especially the implementation of strength training. PA in the form of exercise can assist in reducing the adverse physical side effects in the short- and long-term, with limited understanding of the effects on mental health. PA improves mental health outcomes across populations, which may also translate to men with prostate cancer, although further research is required. An important strategy to improve PA within the prostate cancer population is to provide an early referral to an exercise professional, such as an accredited exercise physiologist/clinical exercise physiologist or physical therapist/physiotherapist, and is supported by research as best practice for people affected by cancer undergoing active treatment. Refereed/Peer-reviewed

The current dietary recommendations for cardiovascular disease (CVD) risk reduction include increased fruit and vegetable consumption. The Opuntia spp., Prickly Pear (PP) fruit is rich in dietary fiber and may have lipid-lowering effects but it is often confused with the PP stem/leaf (Cladode (CLD)), or not identified. The efficacy of the PP fruit and CLD in reducing CVD risk is a growing area of research.This systematic review (PROSPERO: CRD42018110643), examined the effects of consuming the Opuntia spp. components (PP or CLD) on CVD risk factors, specifically total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). The review, performed from February through September 2019, used resources available through Food Science and Technology Abstracts (EBSCO), Medline, Scopus, CINAHL, Web of Science and Cochrane databases.Eleven articles met the inclusion criteria, which characterised Opuntia spp. products as either PP (n = 6), CLD (n = 4) or commercial products' (n=1). Effects were investigated in healthy and obese populations as well as those with metabolic illnesses, specifically type 2 diabetes and metabolic syndrome. PP consumption was associated with significant reductions in TC (p 0.05) in all but one included study, whereas in the remaining studies (n=6), LDL-C levels decreased (p 0.05). Separately, the effect of CLD consumption on lipids was small with one study reporting a significant increase in plasma HDL-C in a subgroup of participants (45 years of age) following consumption of a patented CLD powder product. It is plausible, that differences in overall effect may be due to compositional distinctions between CLD and PP, such as fiber composition. Care must be taken in future studies to accurately report the identity of the selected components of Opuntia spp.

Background An unhealthy lifestyle negatively alters autonomic nervous system (ANS) activity as reflected by decreased heart rate variability (HRV), increasing cardiovascular disease (CVD) risk. Research investigating the effect of modifiable lifestyle factors on ANS activity in young children is limited. Early identification of these risk factors is vital to improving long-term individual and public health outcomes. A systematic review was conducted to assess the effect of maternal or child modifiable lifestyle factors on child ANS activity. Methods Following the 2009 PRISMA guidelines, three electronic databases were searched from February 2018 – July 2019 for articles describing human trials between 1996 – 2019. Included studies examined ANS activity of children between 28 weeks gestational age – 6 years in relation to modifiable lifestyle CVD risk factors. Results Twenty-six studies fulfilled inclusion criteria. Sixteen studies reported that modifiable lifestyle factors significantly influenced the HRV of children. Increased HRV was significantly associated with higher maternal zinc and omega-3 fatty acid intake, regular maternal aerobic exercise and a non-smoking environment. Child diet and body composition demonstrated some support for an association between these modifiable lifestyle factors and child HRV. Conclusion There is cross-sectional evidence supporting an association between maternal lifestyle factors and child HRV. Evidence is less supportive of a relationship between child modifiable lifestyle factors and child HRV. Monitoring the effects of lifestyle interventions on the ANS via HRV measurements of both mother and child may identify child CVD risk.

Nutritional and ergogenic aid supplementation is prevalent within athletic or general fitness populations, and is only continuing to gain momentum. Taken in isolation or as a combination, amino acid (AA) supplementation has the potential to increase endurance performance among other benefits. L-Arginine (L-Arg) and L-Citrulline (L-Cit) are two AAs proposed to increase endothelial nitric oxide (NO) synthesis, with potential additional physiological benefits, and therefore may contribute to enhanced performance outcomes such as increased power output, or time to exhaustion. However, the appropriate dose for promoting physiological and performance benefits of these AAs, and their potential synergistic effects remains to be determined. Therefore, the aim of this review was to evaluate the varied concentrations used in the current literature, assess the effects of L-Arg and L-Cit in combination on physiological responses and endurance performance, and consider if there is a fundamental basis for providing these supplements in the form of a beverage. A total of six studies were considered eligible for the review which utilized a range of 3–8 g of the AA constituents. The findings support the notion that supplementing with a combination of L-Arg and L-Cit may increase NO production, enhance vasodilation, and therefore increase performance capacity in athletes. A beverage as a carrier for the two AAs is worth considering; however, there remains limited research assessing these outcomes across a consistent range of concentrations in order to see their full potential.

Post-traumatic stress disorder (PTSD) is a prevalent and debilitating condition associated with psychological conditions and chronic diseases that may be underpinned by dysfunction in the autonomic nervous system (ANS), the hypothalamic-pituitary-adrenal (HPA) axis and chronic systemic low-grade inflammation. The objective of this pilot study was to determine psychological, ANS [heart rate variability (HRV)], HPA (salivary cortisol) and inflammatory (salivary C-Reactive Protein) responses to a bout of vigorous exercise in male first responders, military veterans and active duty personnel with (n = 4) and without (n = 4) PTSD. Participants (50.1 &plusmn, 14.8 years) performed a thirteen-minute, vigorous intensity (70%&ndash, 80% of heart rate max), one-on-one boxing session with a certified coach. Physiological and psychological parameters were measured before, during, immediately after to 30 min post-exercise, and then at 24 h and 48 h post. The effect sizes demonstrated large to very large reductions in HRV that lasted up to 48 h post-exercise in the PTSD group compared with unclear effects in the trauma-exposed control (TEC) group. There were unclear effects for depression, anxiety and stress as well as salivary biomarkers for both groups at all time-points. Findings may reflect stress-induced changes to the ANS for PTSD sufferers.

To examine the effects of a probiotic protocol on the incidence and severity of respiratory and gastrointestinal infections in elite rugby union athletes across an international competition season. Associations were also investigated between salivary biomarkers of stress (cortisol, alpha-amylase) and mucosal immunity (secretory(s)-IgA).A double-blind RCT was conducted over 27-weeks, divided into three stages: (1) control period; (2) domestic competition; and (3) international competition.Athletes were assigned a probiotic (n = 9) or placebo (n = 10) supplement. Ultrabiotic 60™ or placebo was taken with food twice daily for 17 weeks and SB Floractiv™ 250 mg added twice daily during stage three.Five infections were diagnosed by the team sports physician across the 27-weeks, three within the intervention period in athletes randomised to the placebo group. No significant group x time interaction effects for salivary cortisol, alpha-amylase or s-IgA were identified over the 27-week time period, although a significant main effect for group and time was identified for salivary cortisol, alpha-amylase, and s-IgA (p 0.05 for all). When considering stage, significant differences were identified in stage one with s-IgA lower in the probiotic group (p = 0.015). In stage two and three, salivary cortisol was higher in the probiotic group (p = 0.016 and p = 0.001 respectively), and salivary alpha-amylase was higher in the probiotic group in stage three (p = 0.007).The probiotic protocol used in this study was associated with an increase in salivary alpha-amylase supporting its possible role as a host defence peptide.

Purpose To find the shortest, acceptable stabilization period before recording resting, supine ultra-short-term Ln RMSSD and heart rate (HR). Method Thirty endurance-trained male athletes (age 24.1 ± 2.3 years, maximal oxygen consumption (VO2max) 64.1 ± 6.6 ml·kg-1·min-1) and 30 male students (age 23.3 ± 1.8 years, VO2max 52.8 ± 5.1 ml·kg-1·min-1) were recruited. Upon awaking at home, resting, supine RR intervals were measured continuously for 10 min using a Polar V800 HR monitor. Ultra-short-term Ln RMSSD and HR values were calculated from 1-min RR interval segments after stabilization periods from 0 to 4 min in 0.5 min increments and were compared with reference values calculated from 5-min segment after 5-min stabilization. Systematic bias and intraclass correlation coefficients (ICC) including 90% confidence intervals (CI) were calculated and magnitude based inference was conducted. Results The stabilization periods of up to 30 s for athletes and up to 60 s for students showed positive (possibly to most likely) biases for ultra-short-term Ln RMSSD compared with reference values. Stabilization periods of 60 s for athletes and 90 s for students showed trivial biases and ICCs were 0.84; 90% CI 0.72 to 0.91, and 0.88; 0.79 to 0.94, respectively. For HR, biases were trivial and ICCs were 0.93; 0.88 to 0.96, and 0.93; 0.88 to 0.96, respectively. Conclusion The shortest stabilization period required to stabilize Ln RMSSD and HR was set at 60 s for endurance-trained athletes and 90 s for university students.

Cycle training is an important training modality of elite rowers. Cycling is the preferred alternative to on-water and ergometer rowing as it provides a reduction in compressive forces on the thoracic cage and upper extremities while still creating a local and central acclimation to endurance training. It is hypothesised, however, that there will be differences in physiological characteristics between Concept II (CII) rowing and WattBike (WB) cycling due to the principle regarding the specificity of training that elite rowers undertake. Understanding these differences will ensure more accurate training prescription when cycling. Twenty international level male rowers, [ V ˙ O2PEAK 5.85 ± 0.58 L.min-1 (CI ± 0.26 L.min-1)] participated in two identical discontinuous incremental exercise tests on a CII rowing and WB cycle ergometer. Ergometer modalities were randomised and counterbalanced among the group and tests occurred 7 days apart. V ˙ O2, V ˙ CO2, V ˙ E(STPD) and HR were significantly higher for every submaximal power output on the CII compared with the WB. Maximal power output on the WB was higher than on the CII [42 ± 33 W (CI ± 14 W) p V ˙ O2PEAK was similar between modalities. Minute ventilation at maximal exercise was 11 L.min-1 lower on CII than on WB. When data were expressed relative to modality specific V ˙ O2PEAK, power output was consistently lower on the CII as was submaximal V ˙ CO2, RER, RPE, mechanical efficiency and BLa concentration at 75% V ˙ O2PEAK. Across all power outputs and exercise modalities, 77% of the variance in RPE could be explained by the variance in BLa. These results demonstrate that elite rowers can attain similar V ˙ O2PEAK scores regardless of modality. Substantial physiological and metabolic differences are evident between CII rowing and WB cycling when power output is the independent variable with the latter being over 40 W higher. The difference in displayed power output between the ergometer modalities is attributed to differences in mechanical efficiency and a degree of power output not being accounted for on the CII ergometer. Given the lack of consistency between CII and WB power output, other physiological measures, such as HR, are better suited to prescribe WB ergometer sessions.

Objective: To examine the effect of a physical treatment (speed, power, and strength [SPS] training) and psychosocial treatment (group motivational presentation) on salivary testosterone (sal-T), salivary cortisol (sal-C), and sal-T-to-sal-C ratio (T:C) in professional rugby. Methods: Fourteen male rugby players (age = 25.9 [2.5] y, height = 186.1 [6.7] cm, and body mass = 104.1 [12.7] kg) participated in this study. Testing occurred across 2 d on 2 separate occasions (week 1 and week 2). On day 1 of both weeks, participants completed an SPS training session. On day 2 of both weeks, participants undertook a field-based rugby training session. In week 2, participants underwent an additional treatment in the form of a motivational presentation given by a respected former player before the rugby session. Saliva was collected before and after SPS training and before and after the rugby session and was assayed for testosterone and cortisol. Results: No differences were found between weeks for sal-T at any time point, but sal-C was higher in week 2 before and after SPS and before rugby on day 2 (P P 0.91 [0.13, 1.69]). T:C increased when the motivational presentation accompanied rugby training (P = .07, ES = 1.06 [0.27, 1.85]). Sal-C, not sal-T, drove changes in T:C (P Conclusions: Physical or psychosocial treatments may affect sal-T, sal-C, and T:C, and individual variation in responses to treatments may exist.

Objective This study evaluated the associations between cardiac autonomic nervous system (ANS) activity and cardiometabolic disease (CMD) risk factors among black South African children. Design The participants included 34 black South African children (11.85 ± 0.89 y). CMD risk factors included waist circumference (WC), hip circumference (HC), body mass index z-score (BMI z-score), blood pressure (SBP, DBP), total cholesterol (TC), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), fasting glucose (FG), fasting insulin (FINS), and vessel stiffness index (SI). Heart rate variability was used to quantify cardiac ANS activity. Results lnRMSSD, pNN50 and lnSD1 were inversely associated with FINS (r = −0.33, p = 0.05; r = −0.36, p = 0.03; r = −0.41, p = 0.01), WC (r = −0.45, p = 0.01; r = −0.39, p = 0.02; r = −0.45, p = 0.01), and HC (r = −0.41, p = 0.01; r = −0.36, p = 0.03; r = −0.43, p = 0.01). HDL was positively associated with lnRMSSD (r = 0.37; p = 0.03) and lnSD1 (r = 0.37; p = 0.03) while, LDL was negatively associated with HF (r = −0.41; p = 0.01). Regression analysis identified WC as the primary predictor for parasympathetic modulation in time domain (lnRMSSD: r2 = 0.21, p = 0.01; pNN50: r2 = 0.18, p = 0.01) and non-linear domain (lnSD1: r2 = 0.21, p = 0.01). Conclusion Elevated resting parasympathetic activity in children is associated with lower CMD risk factors and an elevation in the protective HDL.

Humans appear to have innate energy regulation mechanisms that manifest in sensations of satiation during a meal and satiety post ingestion. Interactions between these mechanisms and the macronutrient profile of their contemporary food environment could be responsible for the dysregulation of this mechanism, resulting in a higher energy intake. The aim of this systematic review was to determine the impact of dietary fibre and fat both in isolation and combination on satiation and satiety. A systematic review of the literature was undertaken, from inception until end December 2017, in accordance with the PRISMA guidelines, in: Scopus, Food Science and Tech, CINAHL, and Medline databases. The search strategy was limited to articles in English language, published in peer-reviewed journals and human studies. Studies were selected based on inclusion/exclusion criteria. A total of 1490 studies were found initially using the selected search terms that were reduced to 12 studies suitable for inclusion. Following on from this, a meta-analysis was also conducted to determine any satiety effects from any potential interaction between dietary fat and fibre on satiety, no significant effects were found. Owing to high energy density, fat (per kJ) had a weak effect on satiation as determined by the effect per gram for each unit of energy. The addition of fibre theoretically improves satiety by slowing the absorption of various nutrients including fat, although the meta-analysis as part of this review was unable to demonstrate an effect, perhaps reflecting a lack of sensitivity in research design. The potential to improve satiation and satiety responses by consuming fat together with carbohydrates containing fibre warrants further investigation.

Nutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults. The aim of this systematic review was to determine the evidence for these claims from the scientific literature in randomised, double-blinded, controlled trials (duration: ≥1 year; participants:n≥100; age(mean): ≥65 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, CINAHL and Web of Science) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016. Interventions included B-vitamins,n-3 fatty acids, antioxidant vitamins and herbs. Of the B-vitamin studies, four found benefits to cognition with supplementation. The first of these B-vitamin studies, in individuals with mild cognitive impairment (n266; duration=2 years), included benefit to executive function (P=0·015) and improvements in the Mini-Mental State Examination (MMSE) among participants with baseline homocysteine above 11·3 µmol/l (Pn-3 fatty acid status. The third B-vitamin study (n900; duration=2 years) reported improved performance in immediate (P=0·046) and delayed recall (P=0·013), whereas the fourth study (n856; duration=2 years) reported slower rate of cognitive decline in the MMSE (P=0·05). One study investigating DHA treatment (n402; duration=1·5 years) revealed the slower rate of cognitive change inapoE e4non-carriers (P=0·03). As only five included studies revealed notable benefits, presently based on the specific compounds explored here, there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly. Future long-term trials of nutraceuticals should investigate interactions with lifestyle, blood biomarkers and genetic risk factors.

Background: Chronic exercise training is associated with improvements in body composition and/aerobic fitness. This presents a challenge to study effects of exercise in isolation. Metabolic effects of short-term exercise training (≤ 12 weeks) are unclear, with studies reporting improvements or no change in insulin sensitivity and/or glucose control. This review systemically examined randomized controlled trials (RCTs) to establish whether short-term exercise training improves insulin resistance and type 2 diabetes (diabetes). Methods: Following the PRISMA guidelines, a systematic review was conducted on nine electronic databases (BMC Endocrine Disorders, Clinical Key, Cochrane Library, EBSChost, PubMed, Scopus, Sabinet_SA Publications, The Lancet and Web of Science) to identify randomized controlled human trials (2005-2018) examining effects of short-term exercise training (≤ 12 weeks) in overweight/obese adults with insulin resistance or diabetes. Search terms included: insulin resistance, type 2 diabetes, short-term, exercise or energy expenditure and randomized controlled trial. Studies were only included if they provided sufficient data on: insulin sensitivity, glycemic control, body composition and aerobic fitness. Results: From 374 articles, three met the inclusion criteria. Of these, two prescribed moderate intensity training (MIT); rate of perceived exertion (RPE) 12-13 and 60% lactic threshold (LT) for four and twelve weeks, respectively while one prescribed vigorous exercise training at 70% VO2max for seven days. Duration of exercise sessions was 40-60 minutes. Twelve weeks of MIT was associated with improved glycemic control vs. no change in the 7-d and four weeks studies. Seven days of vigorous training was associated with greater improvement in insulin sensitivity, 44.4% vs. no change in the four- and twelve-weeks studies. Conclusion: Short-term exercise appears to improve insulin sensitivity and glucose control independent of body fat loss or gains in aerobic fitness. Vigorous exercise training was associated with superior improvements in insulin sensitivity. More RCTs are needed to confirm these findings.

Strahorn, J, Serpell, BG, McKune, A, and Pumpa, KL. Effect of physical and psychosocial interventions on hormone and performance outcomes in professional rugby union players: a systematic review. J Strength Cond Res 31(11): 3158-3169, 2017-This systematic review investigates the acute effects of physical or psychosocial interventions on testosterone and cortisol responses in elite male rugby union players, and the subsequent association with physical performance areas (e.g., strength, power, sprint performance) or key performance indicators (e.g., coach-identified skills). Medline (via EBSCO), SPORTDiscus, Web of Science, InformIT, ProQuest, Cochrane, and Scopus were searched for relevant articles. Nine articles met the inclusion criteria, with 6 articles examining the effect of speed, strength or power training, and the remaining 3 psychosocial interventions. Quality assessment of the articles as determined by their PEDro score was either 6 or 7 out of 11. This review found that both physical and psychosocial interventions can alter testosterone and cortisol, and physical performance areas important for rugby union are affected by these changes. The limited literature in the field supports the notion that physical interventions of short duration and high intensity, and psychosocial interventions that create a positive environment may elicit a hormonal response that is associated with favorable performance outcomes. Studies that reported psychosocial interventions suggest that testosterone and cortisol may be altered in elite rugby players without metabolic stress, something of great interest to elite athletes and coaches who are looking to elicit a performance advantage without increasing athlete load. Overall, this review identified that when the testosterone responses to an intervention are notably greater than that of cortisol, favorable outcomes are likely. Further research is required to improve our understanding on how to best manipulate training to induce these favorable changes.

There is an increasing body of evidence underpinning high-intensity exercise as an effective and time-efficient intervention for improving health in cancer survivors. The aim of this study was to, (1) evaluate the efficacy and (2) the safety of high-intensity exercise interventions in improving selected health outcomes in cancer survivors. Design Systematic review. Data sources Google Scholar and EBSCO, CINAHL Plus, Computers and Applied Sciences Complete, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition, MEDLINE, Web of Science and SPORTDiscuss from inception up until August 2017. Eligibility criteria Randomized controlled trials of high-intensity exercise interventions in cancer survivors (all cancer types) with health-related outcome measures. The guidelines adopted for this review were the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The search returned 447 articles, of which nine articles (n = 531 participants mean, age 58 ± 9.5 years) met the eligibility criteria. Exercise interventions of between 4 and 18 weeks consisting of high-intensity interval bouts of up to 4-min were compared with a continuous moderate intensity (CMIT) intervention or a control group. High-intensity exercise interventions elicited significant improvements in VO2 max, strength, body mass, body fat and hip and waist circumference compared with CMIT and/or control groups. The studies reviewed showed low risk in participating in supervised high-intensity exercise interventions. Mixed mode high-intensity interventions which included both aerobic and resistance exercises were most effective improving the aerobic fitness levels of cancer survivors by 12.45–21.35%, from baseline to post-intervention. High-intensity exercise interventions improved physical and physiological health-related outcome measures such as cardiovascular fitness and strength in cancer survivors. Given that high-intensity exercise sessions require a shorter time commitment, it may be a useful modality to improve health outcomes in those who are time poor. The risk of adverse events associated with high-intensity exercise was low.

Background There is inconsistency in the literature regarding the nature of hypothalamic-pituitary-adrenal (HPA) axis functionality in post-traumatic stress disorder (PTSD). Purpose The review aimed to investigate HPA axis functionality via the diurnal profile of cortisol as it relates to PTSD. Methods The authors conducted a systematic review of the literature from June 2017 – March 2019 in accordance with The PRISMA Statement in the following four databases: PubMed, MEDLINE, ScienceDirect and PsycINFO with Full Text. The search strategy was limited to articles in English language, published in peer-reviewed journals within the last decade and human studies. Search terms included “post-traumatic stress disorder” OR “PTSD”, AND “hypothalamic pituitary adrenal axis” OR “HPA axis” AND “diurnal cortisol” OR “cortisol”. PTSD sufferers of all trauma types, genders and socioeconomic statuses were included provided there was a “healthy” control group and an inclusion of reporting on inter-group measurements of diurnal cortisol profiles as a portrayal of HPA axis functionality. Results A total of 10 studies met the criteria for inclusion in this review. The association between HPA axis functionality and PTSD was evaluated by the measurement of salivary and/or plasma cortisol concentrations. Only two studies demonstrated an association between PTSD and diurnal cortisol when compared with respective control groups while three studies found no associations. The remaining five studies found partial, mostly negative associations between PTSD and diurnal cortisol. Conclusion Despite some indications of an association between PTSD and dysregulated HPA axis functionality as demonstrated by diurnal cortisol output, the current review has revealed mixed findings. As such, a complete understanding of HPA axis dysregulation as it relates to PTSD remains unestablished. Given the findings, further investigation into the relationship between PTSD trauma-exposed and non-PTSD trauma-exposed individuals and diurnal cortisol is warranted.