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

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

Research conducted on exercise in the heat has been largely conducted in males, leaving women understudied. Of research including women, results are inconsistent on the impact of menstrual cycle phase on thermoregulation. Objectives The purpose of this systematic review is to quantify published investigations in thermal physiology that include menstrual cycle comparisons and assess aggregate data of investigations that include menstrual cycle variation and aerobic exercise in the heat. Methods 367 research articles were identified via systematic review and inclusion criteria and yielded 9 papers included in this analysis for a total number of 83 research subjects. Effect size estimates (Hedge's g) were utilized for initial (pre-exercise) and post-exercise internal body temperature (rectal or esophageal, Tint), sweat rate, mean skin temperature, and exercise heart rate. Results Pooled effect size showed significantly greater initial Tint (1.231 ± 0.186, p Conclusions The limited available data suggest that observed increases in initial Tint in the luteal phase are maintained throughout and post-exercise without an observed impact in sweat rate or mean skin temperature.

To date most of the research surrounding low energy availability (LEA) and female athletes has focused on the high prevalence rates (2-77%). Despite the severe negative health and performance consequences, awareness of this issue is low. There are potentially a multitude of factors which con

Background: Muscle adaptations are potentially enhanced through resistance training in elevated environmental temperatures (>30°C) due to upregulated anabolic hormonal responses. Method: Eighteen p...

Menstrual disorders are frequent in female athletes, especially those participating at the elite level. Factors which may contribute to impaired ovarian function in athletes include high training volumes, eating disorders and/or low body weight, which in turn may interrupt GnRH signaling. Hormonal contraception may disguise underlying menstrual disorders, and athlete use of such approaches is common, despite limited data on whether hormonal control has positive, neutral or negative effects on athletic performance. To determine the prevalence of hormonal contraceptive use, as well as the prevalence of menstrual disorders, in New Zealand elite female athletes, we completed a national internet-based survey of 219 participants being supported by High Performance Sport New Zealand. The survey aimed to characterize the demographics, health and athletic performance history, the training load and contraceptive use. We found that athletes were training intensely, with 38% reporting training volumes of >70 hours/month. At the youngest age represented (15-19 years), 72% had been in competitive sports for more than 5 years, suggesting a young gynecological age is represented by the cohort. More than half (58%, 127/219) of the surveyed athletes reported diagnosed illness or injuries. Stress fractures (39% 50/127), concussion (31%, 39/127) and asthma (26%, 33/127) were the most common diagnoses, followed by oligo/amenorrhea (20%, 26/127), reduced energy deficit syndrome (9%, 17/194), endometriosis (8%, 16/194), and polycystic ovary syndrome (5%, 9/194). Oligomenorrhea was significantly associated with stress fracture (p=0.018) and disordered eating (p=0.009). More than 50% of athletes tracked their menstrual cycle, and self-reporting showed even higher rates of oligo/amenorrhea 37% (29/79) in athletes not using hormonal contraception. Self-reporting also indicated a high prevalence of other menstrual disorders including delayed menarche (21%,43/207), menorrhagia (30%, 60/203), and dysmenorrhea (32%, 66/203). In athletes reporting menorrhagia, there was a significant association with iron deficiency (p=0.026). Of the 219 athletes, 37% were currently using hormonal contraception, of which the oral combined pill was the most popular (64%). The most commonly cited reason for hormonal contraception was birth control, however athletes used hormonal control to manipulate either the frequency (38%) or the symptoms (29%) of menstruation, particularly around competition. The data clearly suggests that there is likely to be significant undiagnosed gynecological pathology in elite female athletes. Hormonal contraception can mask gynecological health issues and themselves can lead to side effects that affect performance. It remains that health issues, especially those related to gynecological health, need to be considered by athletes, their coaches and medical support staff.

BACKGROUND Iron deficiency is a common deficiency disease worldwide with athletes at increased risk. METHODS A proposed new mechanism of exercise-induced iron deficiency in athletes involves the iron-regulatory hormone hepcidin, however, there is limited information on this amongst elite athletes. This study describes iron status in elite female rugby Sevens players. RESULTS Blood samples were collected at the start and mid-season and analyzed for serum iron, serum ferritin (SF), soluble transferring receptor (sTfR), high sensitivity C-reactive Protein (hsCRP) and hepcidin. Of the 17 players 18% were iron deficient (SF

IntroductionAs the number of female athletes competing rises globally, training methodologies should reflect sex differences across critical metrics of adaptation to training. Surrogate markers of the autonomic nervous system (ANS) used for monitoring training load are heart rate variability (HRV) and resting heart rate (RHR). The aim was to investigate ovarian hormone effects on standard recovery metrics (HRV, RHR, respiratory rate (RR) and sleep duration) across a large population of female athletes.MethodsA retrospective study analysed 362 852 days of data representing 13 535 menstrual cycles (MC) from 4594 respondents (natural MC n=3870, BC n=455, progestin-only n=269) for relationships and/or differences between endogenous and exogenous ovarian hormones on ANS.ResultsHRV and return to baseline (recovery) decreased as resting HR and RR increased (pConclusionThe patterning of ANS modulation from ovarian hormones is significantly different between naturally cycling women and those on BC, with the patterning dependent on the type of contraception used.

Mayo, Brad, Cory Miles, Stacy Sims, and Matthew Driller. The effect of resistance training in a hypoxic chamber on physical performance in elite rugby athletes. High Alt Med Biol 19:28-34, 2018.-Limited research suggests that muscle adaptations may be enhanced through resistance training in a hypoxic environment. Seventeen professional rugby union athletes (age [mean ± SD], 24 ± 3 years; body mass, 98.7 ± 12.8 kg; and height, 188.9 ± 7.9 cm), performed 12 resistance training sessions over a 3-week period. Participants were randomly divided into two groups: HYP (n = 8), where resistance training sessions were performed in an environmental chamber with O

Moderate-intensity physical activity is recommended for individuals with diabetes to control glucose and prevent diabetes-related complications. The extent to which a diabetes diagnosis motivates patients to increase physical activity is unclear. This study used data from the Women's Health Initiative Observational Study (baseline data collected from 1993 to 1998) to examine change in physical activity and sedentary behavior in women who reported a diabetes diagnosis compared with women who did not report diabetes during 7 yr of follow-up (up to 2005).Participants (n = 84,300) were postmenopausal women who did not report diabetes at baseline (mean ± SD; age = 63.49 ± 7.34 yr; body mass index = 26.98 ± 5.67 kg·m). Linear mixed-model analyses were conducted adjusting for study year, age, race/ethnicity, body mass index, education, family history of diabetes, physical functioning, pain, energy/fatigue, social functioning, depression, number of chronic diseases, and vigorous exercise at age 18 yr. Analyses were completed in August 2012.Participants who reported a diabetes diagnosis during follow-up were more likely to report increasing their total physical activity (P = 0.002), walking (P0.001), and number of physical activity episodes (P0.001) compared with participants who did not report a diabetes diagnosis. On average, participants reporting a diabetes diagnosis reported increasing their total physical activity by 0.49 MET·h·wk, their walking by 0.033 MET·h·wk, and their number of physical activity episodes by 0.19 MET·h·wk. No differences in reported sedentary behavior change were observed (P = 0.48).A diabetes diagnosis may prompt patients to increase physical activity. Healthcare professionals should consider how best to capitalize on this opportunity to encourage increased physical activity and maintenance.

A number of nutrients, foods and supplements have the potential to augment health, exercise performance and/or recovery, particularly in women, due to fluctuation of sex hormones, or reductions thereof. Some of these for which significant amounts of research have provided evidence include

Objective To evaluate the association between self-reported daily sitting time and the incidence of type 2 diabetes in a cohort of postmenopausal women. Methods Women (N=88,829) without diagnosed diabetes reported the number of hours spent sitting over a typical day. Incident cases of diabetes were identified annually by self-reported initiation of using oral medications or insulin for diabetes > 14.4 years follow-up. Results Each hour of sitting time was positively associated with increased risk of diabetes [risk ratio (RR): 1.05; 95% confidence interval (CI): 1.02–1.08]. However, sitting time was only positively associated with incident diabetes in obese women. Obese women reporting sitting 8–11 (RR: 1.08; 95% CI 1.0–1.1), 12–15 (OR: 1.13; 95% CI 1.0–1.2), and ≥16 hours (OR: 1.25; 95% CI 1.0–1.5) hours per day had an increased risk of diabetes compared to women sitting ≤7 hours per day. These associations were adjusted for demographics, health conditions, behaviors (smoking, diet, and alcohol intake), and family history of diabetes. Time performing moderate to vigorous intensity physical activity did not modify these associations. Conclusions Time spent sitting was independently associated with increased risk of diabetes diagnosis among obese women—a population already at high risk of the disease.

The unclear relationship of obesity to incident melanoma and nonmelanoma skin cancer (NMSC) risks was evaluated in the large, geographically diverse longitudinal, prospective Women's Health Initiative (WHI) observational study. Risks of melanoma and NMSC in normal weight women were compared with risks in overweight [body mass index (BMI) = 25–29.0 kg/m2] and obese (BMI ≥ 30 kg/m2) women, using Cox proportional hazards models for melanoma and logistic regression for NMSC. Over a mean 9.4 years of follow-up, there were 386 melanoma and 9,870 NSMC cases. Risk of melanoma did not differ across weight categories (P = 0.86), whereas in fully adjusted models, NMSC risk was lower in overweight [OR, 0.93; 95% confidence interval (CI), 0.89–0.99] and obese (OR, 0.85; 95% CI, 0.80–0.91) women (P < 0.001). Excess body weight was not associated with melanoma risk in postmenopausal women but was inversely associated with NMSC risk, possibly due to lower sun exposure in overweight and obese women. This supports previous work demonstrating the relationship between excess body weight and skin cancer risk. Cancer Epidemiol Biomarkers Prev; 22(12); 2412–5. ©2013 AACR.

Background: Large cohort studies have reported no relationship between dietary fat and nonmelanoma skin cancer (NMSC), although a low-fat diet intervention reduced NMSC risk in a small clinical trial. In animal studies, skin tumor development has been reduced by low-fat diet. We evaluated the effect of a low-fat dietary pattern on NMSC and melanoma in the Women's Health Initiative Dietary Modification trial. Methods: Postmenopausal women aged 50 to 79 years (n = 48,835) were randomly assigned to the low-fat dietary pattern intervention (n = 19,541) or comparison group (n = 29,294). The intervention goals included decreasing fat intake to 20% or less of calories, increasing vegetable and fruit intake, and increasing grain intake. Self-reported incident NMSC (n = 4,907) and physician-adjudicated incident melanoma (n = 279) were ascertained every 6 months. Results: Over 8.1 years of follow-up, the low-fat diet intervention did not affect overall incidence of NMSC [HR 0.98; 95% confidence interval (CI), 0.92–1.04] or melanoma (HR, 1.04; 95% CI, 0.82–1.32). In subgroup analyses of melanoma risk, baseline fat intake interacted significantly with group assignment (Pinteraction = 0.006). Among women with higher baseline fat intake, the dietary intervention significantly increased risk (HR, 1.48; 95% CI, 1.06–2.07), whereas, among women with lower baseline fat intake, the intervention tended to reduce melanoma risk (HR, 0.72; 95% CI, 0.50–1.02). Conclusions: In this large randomized trial, a low-fat dietary pattern did not affect overall incidence of NMSC or melanoma. Impact: A low-fat diet does not reduce incidence of NMSC, but an interaction between baseline fat intake and dietary intervention on melanoma risk warrants further investigation. Cancer Epidemiol Biomarkers Prev; 22(9); 1509–19. ©2013 AACR.

Objectives: The aim of this study was to examine the independent and joint associations of sitting time and physical activity with risk of incident cardiovascular disease (CVD).Background: Sedentar...

We used a biomarker of activity-related energy expenditure (AREE) to assess measurement properties of self-reported physical activity and to determine the usefulness of AREE regression calibration equations in the Women's Health Initiative. Biomarker AREE, calculated as the total energy expenditure from doubly labeled water minus the resting energy expenditure from indirect calorimetry, was assessed in 450 Women's Health Initiative participants (2007-2009). Self-reported AREE was obtained from the Arizona Activity Frequency Questionnaire (AAFQ), the 7-Day Physical Activity Recall (PAR), and the Women's Health Initiative Personal Habits Questionnaire (PHQ). Eighty-eight participants repeated the protocol 6 months later. Reporting error, measured as log(self-report AREE) minus log(biomarker AREE), was regressed on participant characteristics for each instrument. Body mass index was associated with underreporting on the AAFQ and PHQ but overreporting on PAR. Blacks and Hispanics underreported physical activity levels on the AAFQ and PAR, respectively. Underreporting decreased with age for the PAR and PHQ. Regressing logbiomarker AREE on logself-reported AREE revealed that self-report alone explained minimal biomarker variance (R(2) = 7.6, 4.8, and 3.4 for AAFQ, PAR, and PHQ, respectively). R(2) increased to 25.2, 21.5, and 21.8, respectively, when participant characteristics were included. Six-month repeatability data adjusted for temporal biomarker variation, improving R(2) to 79.4, 67.8, and 68.7 for AAFQ, PAR, and PHQ, respectively. Calibration equations "recover" substantial variation in average AREE and valuably enhance AREE self-assessment.

While low physical activity and high body mass index (BMI) have been associated with higher endometrial cancer incidence, no previous studies have evaluated the association between physical activity and survival after endometrial cancer diagnosis, and studies on BMI and survival have not been performed in a prospective cohort.We examined pre-diagnosis BMI and moderate- to vigorous-intensity physical activity in relation to overall and disease-specific survival among 983 postmenopausal women who were diagnosed with endometrial cancer in the Women's Health Initiative Observational Study and Clinical Trials.Over a median 5.2 (max 14.1) years from diagnosis to death or end of follow-up, 163 total deaths were observed, 66 of which were due to endometrial cancer. We observed a higher all-cause mortality hazard ratio (HR) = 1.85 (95% CI 1.19-2.88) comparing women with a BMI ≥ 35 kg/m(2) to women with BMI25 kg/m(2). For endometrial cancer-specific mortality the HR = 2.23 (95% CI 1.09-4.54) comparing extreme BMI categories. To examine histologic subtypes we analyzed type I endometrial tumors separately and found an HR = 1.20 (95% CI 1.07-1.35) associated with all-cause mortality for each 5-unit change in BMI. Moderate- to vigorous-intensity physical activity was not associated with all-cause or endometrial cancer-specific mortality.Pre-diagnosis BMI, but not physical activity, was associated with survival among women with endometrial cancer. Future studies should investigate mechanisms and timing of BMI onset to better understand the burden of disease attributable to BMI.

Telephone-based interactive voice response (IVR) systems could be an effective tool for promotion of physical activity among older women. To test IVR feasibility, we enrolled 30 older women in a 10-week physical activity intervention designed around National Institute on Aging (NIA) Go4Life® educational materials with IVR coaching. Participants (mean age = 76 years) significantly increased physical activity by a mean 79 ± 116 (SD) minutes/week (p

Purpose: The study�s purpose was to investigate the relationship of sedentary (=100 MET·min·wk-1), low (>100�500 MET·min·wk-1), moderate (>500�1200 MET·min·wk-1), and high (>1200 MET·min·wk-1) habitual physical activity with body weight, body mass index, and measures of fat distribution (waist-to-hip ratio) in postmenopausal women by age decades. Methods: A prospective cohort study of 58,610 postmenopausal women age 50�79 yr weighed annually during 8 yr at one of 40 US clinical centers was analyzed to determine the relationship of high versus low habitual physical activity with changes in body weight and fat distribution by age group. Results: Among women age 50�59 yr, there was significant weight loss in those expending >500�1200 MET·min·wk-1 (coefficient = -0.30, 95% confidence interval = -0.53 to -0.07) compared with the group expending =100 MET·min·wk-1. Among women age 70�79 yr, higher physical activity was associated with less weight loss (coefficient = 0.34, 95% confidence interval = 0.04�0.63). Age at baseline significantly modified the association between physical activity and total weight change, whereas baseline body mass index did not. Conclusions: High habitual physical activity is associated with less weight gain in younger postmenopausal women and less weight loss in older postmenopausal women. These findings suggest that promoting physical activity among postmenopausal women may be important for managing body weight changes that accompany aging.

The performance of garments for outdoor activity was compared. Three fabrics, each in garments for the upper body, matched garment/wearer dimensions, were worn by 10 athletically 'well-trained' males under controlled conditions (hot 32 +/- 2 degrees C, 20 +/- 2% relative humidity (RH); cold 8 +/- 2 degrees C, 40 +/- 2% RH) with physical (instrumental) and sensory responses obtained during the trials. Differences in human responses to the fabrics/garments included heart rate, core temperature during run (hot, cold), rest (hot) and walk (cold), heat content of the body, humidity under garments during rest and run and time to onset of sweating. No such differences were identified for change in body mass, core temperature during walk (hot) and rest (cold), skin temperature, temperature of skin covered by the garment, humidity under the garments during walk or for any perceptions (thermal sensations, thermal comfort of torso, exertion, wetness). The garment in single jersey wool fabric performed best in both hot and cold conditions. Effects of garments on wearers are often related to properties of the fabrics from which the garments are made. This study shows that only some differences in fabric properties result in measurable thermophysiological and perceptual responses of the garment wearers and underlines the difficulty in predicting performance of garments/persons from laboratory tests on fabrics.

SIMS, S. T., L. van VLIET, J. D. COTTER, and N. J. REHRER. Sodium Loading Aids Fluid Balance and Reduces Physiological Strain of Trained Men Exercising in the Heat. Med. Sci. Sports Exerc., Vol. 39, No. 1, pp. 123–130, 2007. Purpose: This study was conducted to determine whether preexercise ingestion of a highly concentrated sodium beverage would increase plasma volume (PV) and reduce the physiological strain of moderately trained males running in the heat. Methods: Eight endurance-trained (V u O2max :5 8 mLIkg j1 Imin j1 (SD 5); 36 yr (SD 11)) runners completed this double-blind, crossover experiment. Runners ingested a high-sodium (High Na + : 164 mmol Na + IL j1 ) or low-sodium (Low Na + : 10 mmol Na + IL j1 ) beverage (10 mLIkg j1 ) before running to exhaustion at 70% V u O2max in warm conditions (32-C, 50% RH, Va $ 1.5 mIs j1 ). Beverages (~757 mL) were ingested in seven portions across 60 min beginning 105 min before exercise. Trials were separated by 1–3 wk. Heart rate and core and skin temperatures were measured throughout exercise. Urine and venous blood were sampled before and after drinking and exercise. Results: High Na + increased PV before exercise (4.5% (SD 3.7)), calculated from Hct and [Hb]), whereas Low Na + did not (0.0% (SD 0.5); P = 0.04), and involved greater time to exercise termination in the six who stopped because of an ethical end point (core temperature 39.5-C: 57.9 min (SD 6) vs 46.4 min (SD 4); P = 0.04) and those who were exhausted (96.1 min (SD 22) vs 75.3 min (SD 21); P = 0.03; High Na + vs Low Na + , respectively). At equivalent times before exercise termination, High Na + also resulted in lower core temperature (38.9 vs 39.3-C; P = 0.00) and perceived exertion (P = 0.01) and a tendency for lower heart rate (164 vs 174 bpm; P = 0.08). Conclusions: Preexercise

AB Purpose: Higher physical activity (PA) has been associated with greater attenuation of body fat gain and preservation of lean mass across the lifespan. These analyses aimed to determine relationships of change in PA to changes in fat and lean body mass in a longitudinal prospective study of postmenopausal women. Methods: Among 11,491 women enrolled at three Women's Health Initiative clinical centers who were selected to undergo dual-energy x-ray absorptiometry, 8352 had baseline body composition measurements, with at least one repeated measure at years 1, 3, and 6. PA data were obtained by self-report at baseline and 3 and 6 yr of follow-up. Time-varying PA effect on change in lean and fat mass during the 6-yr study period for age groups (50-59 yr, 60-69 yr, and 70-79 yr) was estimated using mixed effects linear regression. Results: Baseline PA and body composition differed significantly among the three age groups. The association of change in fat mass from baseline and time-varying PA differed across the three age groups (P = 0.0006). In women age 50-59 yr, gain in fat mass from baseline was attenuated with higher levels of PA. Women age 70-79 yr lost fat mass at all PA levels. In contrast, change in lean mass from baseline and time-varying PA did not differ by age group (P = 0.1935). Conclusions: The association between PA and change in fat mass varies by age group, with younger, but not older, women benefiting from higher levels of aerobic PA. Higher levels of aerobic activity are not associated with changes in lean mass, which tends to decrease in older women regardless of activity level. Greater attention to resistance training exercises may be needed to prevent lean mass loss as women age. (C) 2013 American College of Sports Medicine

To examine the association of dietary quality and risk of incident diabetes overall and by race/ethnicity among postmenopausal women enrolled in the Women's Health Initiative (WHI).The WHI recruited 161,808 postmenopausal women between 1993 and 1998, and followed them until 2005. Incident diabetes was determined annually over an average of 7.6 years from enrollment. At baseline, all participants completed a Food Frequency Questionnaire (FFQ). Dietary quality was assessed by the Alternate Healthy Eating Index (AHEI), calculated from the baseline FFQ responses.There were 10,307 incident cases of self-reported treated diabetes over 1,172,761 person-years of follow-up. Most participants did not meet the AHEI dietary goals; that is, only 0.1% of women met or exceeded the recommended consumption of vegetables, and few (17.3%) met or exceeded the recommended level for total fiber. After adjusting for potential confounders, women in the highest quintile of the AHEI score were 24% less likely to develop diabetes relative to women in the lowest quintile of AHEI [hazard ratio (HR)=0.76 (95% CI: 0.70-0.82)]. This association was observed in Whites [HR=0.74 (95% CI: 0.68-0.82)] and Hispanics [HR=0.68 (95% CI: 0.46-0.99)], but not in Blacks [HR=0.85 (95% CI: 0.69-1.05)] or Asians [HR=0.88 (95% CI: 0.57-1.38)].These findings support a protective role of healthful eating choices in reducing the risk of developing diabetes, after adjusting for other lifestyle factors, in White and Hispanic postmenopausal women. Future studies are needed to investigate the relationship between dietary quality and risk of diabetes among Blacks and Asians in relationship to other lifestyle factors.

The aim of this study was to determine whether a dietary intervention designed to reduce fat intake and increase intake of fruit, vegetables, and whole grains, and weight loss, reduces vasomotor symptoms (VMS; ie, hot flashes or night sweats) in postmenopausal women.We included 17,473 postmenopausal US women, ages 50 to 79 years, at baseline who participated in the Women's Health Initiative Dietary Modification trial and were not taking menopausal hormone therapy. Logistic regression was used to evaluate associations.In multivariate-adjusted analyses, with simultaneous adjustment for the intervention and weight change, assignment to the dietary intervention versus the control arm was significantly (odds ratio [OR], 1.14; 95% CI, 1.01-1.28) related to a higher likelihood of symptom elimination among women with VMS at baseline. In addition, women with symptoms at baseline who lost 10 lb or more (OR, 1.23; 95% CI, 1.05-1.46) or lost 10% or more of their baseline body weight (OR, 1.56; 95% CI, 1.21-2.02) between baseline and year 1 were significantly more likely to eliminate VMS compared with those who maintained weight. Upon examining the joint effect of the dietary modification and weight loss, compared with women in the control arm who maintained weight, women who lost substantial weight (≥ 10%) as a part of the intervention (OR, 1.89; 95% CI, 1.39-2.57) but not as part of the control arm (OR, 1.40; 95% CI, 0.92-2.13) were significantly more likely to end VMS, although these two groups did not differ significantly from each other. Large weight loss (22 lb), but not dietary changes, was related to the elimination of moderate/severe VMS.Weight loss as part of a healthy dietary modification may help eliminate VMS among postmenopausal women.

Background Although studies have investigated the effects of hydration on performance measures, few studies have investigated how the temperature of the ingested liquid affects performance and core temperature during an exercise session. The hypothesis of the present study was that cold water would improve thermoregulation and performance as measured by bench repetitions to fatigue, broad jump for force and power and total time to exhaustion for cardiovascular fitness Methods Forty-five, physically fit, adult males (30.28 ± 5.4 yr, 1.77 ± 7.8 m, 83.46 ± 11.5 kg; 13.7 ± 4.8 %BF; 49.8 ± 6.3 ml/kg/min V02) completed two 60-minute exercise sessions. Subjects consumed either COLD (4°C) or room temperature (RT) water (22°C) in randomized order. Core temperature was measured every 15 minutes throughout each trial using a digestible thermometer. Three performance tests were performed upon completion of the exercise session: bench press to fatigue, standing broad jump, and bicycle time to exhaustion Results Although both groups significantly increased their core temperature (p Conclusion Drinking cold water can significantly mediate and delay the increase in core body temperature during an exercise session in a moderate climate with euhydrated subjects. The ingestion of COLD improved performance for 49% and 51% of the participants in the broad jump and TTE performance tests respectively, but did not reach statistical significance. Moreover, although minimal, subjects experienced a decrease in performance on the bench press during the COLD.

Background: Barriers to physical activity for obese women include overheating, sweating, fatigue, exhaustion, and rapid heart rate. Adipose tissue acts as a thermal insulator, promoting a greater heat load on the nonfat tissues, reducing heat tolerance; exercise causes a rise in body temperature with an inability to dissipate heat contributing to reduced exercise tolerance. With difficulties of thermoregulation in the sedentary obese population, the aspect of attenuating the discomfort thus associated may encourage continuation of exercise. A heat sink applied to palmar surfaces extracts heat and cools the venous blood, reducing thermal strain by enhancing the volume of cooled venous return. We hypothesized that palmar cooling using a rapid thermal exchange device (RTX) during exercise would attenuate the thermal discomfort of exercise of sedentary obese women, improving exercise tolerance. Methods: To examine whether palmar cooling would impact exercise tolerance in obese women, 24 healthy women aged 30–45 years, with no history of long term structured exercise, a body mass of 120–135% above ideal and/or BMI between 30 and 34.9 were recruited. Women were randomized into a cooling (RXT with 16°C water circulating) or a control (RTX with 37°C water circulating) group and attended 3 exercise sessions a week for 3-months (12 weeks). Each session was comprised of 10 min body weight exercises, 25–45 min treadmill walking at 70–85% HRR with the RTX device, and 10 min of core strengthening exercises. The performance marker was a 1.5 mi walk for time; conducted on the first and last days of the intervention. Mixed models were used to model each of the outcomes as a function of thermal strain, time and treatment with covariates of speed, heart rate, distance, and the interaction of the main effects included in the model. Results: Groups were matched at baseline for key variables (time for 1.5 mile walk test, resting and exercising heart rate [HR], blood pressure [BP], waist circumference [WC], body weight, body mass index [BMI]). Among the cooling group, time to complete the 1.5mile walk test was significantly faster (31.6 ± 2.3 vs. 24.6 ± 2.5 min, pre vs. post, P< 0.01). A greater average exercising HR was observed (136 vs. 154 bpm, pre vs. post, P P< 0.01) and resting BP (139/84 ± 124/70 mmHg, pre vs. post, P < 0.025). There were no significant differences observed in the control group. Conclusion: Results indicate that exercise tolerance in obese women improved with cooling during exercise, more so than those women who did not have cooling. An improvement in blood pressure, heart rate, waist circumference, and overall aerobic fitness was observed. These findings suggest that by reducing thermal discomfort during exercise, tolerance increases, thus improving cardiovascular parameters of obese women.

Considerable sex and gender bias has been recognized within the field of medicine. Investigators have used sex and gender analysis to reevaluate studies and outcomes and generate new perspectives and new questions regarding differential diagnoses and treatments of men and women. Sex and gender analysis acts as an experimental control to provide critical scientific rigor; researchers who ignore it risk ignoring a possible source of error in past, current, and future science. In this article, the authors introduce some tools of sex and gender analysis and illustrate the concept of gendered innovations by demonstrating through examples how this type of analysis has profoundly enhanced human knowledge in health and disease. The authors also provide recommendations for incorporating the concepts of sex and gender analysis into nursing education and research.

This study was conducted to investigate effects of an acute sodium load on resting plasma volume (PV) and renal mechanisms across the menstrual cycle of endurance-trained women with natural (NAT) or oral contraceptive pill (OCP) controlled cycles. Twelve women were assigned to one of two groups, according to their usage status: 1) OCP [ n = 6, 29 yr (SD 6), 59.4 kg (SD 3.2)], or 2) NAT [ n = 6, 24 yr (SD 5), 61.3 kg (SD 3.6)]. The sodium load was administered as a concentrated sodium chloride/citrate beverage (164 mmol Na+/l, 253 mosmol/kgH2O, 10 ml/kg body mass) during the last high-hormone week of the OCP cycle (OCPhigh) or late luteal phase of the NAT cycle (NAThigh) and during the low-hormone sugar pill week of OCP (OCPlow) or early follicular phase of the NAT cycle (NATlow). The beverage (∼628 ml) was ingested in seven portions across 60 min. Over the next 4 h, PV expanded more in the low-hormone phase for both groups (time-averaged change): OCPlow 6.1% (SD 1.1) and NATlow 5.4% (SD 1.2) vs. OCPhigh 3.9% (SD 0.9) and NAThigh 3.5% (SD 0.8) ( P = 0.02). The arginine vasopressin increased less in the low-hormone phase [1.63 (SD 0.2) and 1.30 pg/ml (SD 0.2) vs. 1.82 (SD 0.3) and 1.57 pg/ml (SD 0.5), P = 0.0001], as did plasma aldosterone concentration (∼64% lower, P = 0.0001). Thus PV increased more and renal hormone sensitivity was decreased in the low-hormone menstrual phase following sodium/fluid ingestion, irrespective of OCP usage.