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

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

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

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

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

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

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

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

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

This study compared the effects of varying aerobic training programs on pulmonary diffusing capacity (TLCO), pulmonary diffusing capacity for nitric oxide (TLNO), lung capillary blood volume (Vc) and alveolar–capillary membrane diffusing capacity (DM) of gases at rest and just after maximal exercise in young athletes. Sixteen healthy young runners (16–18 years) were randomly assigned to an intense endurance training program (IET, n = 8) or to a moderate endurance training program (MET, n = 8). The training volume was similar in IET and MET but with different work intensities, and each lasted for 8 weeks. Participants performed a maximal graded cycle bicycle ergometer test to measure maximal oxygen consumption (VO2max) and maximal aerobic power (MAP) before and after the training programs. Moreover, TLCO, TLNO and Vc were measured during a single breath maneuver. After eight weeks of training, all pulmonary parameters with the exception of alveolar volume (VA) and inspiratory volume (VI) (0.104 < p < 0889; 0.001 < ES < 0.091), measured at rest and at the end of maximal exercise, showed significant group × time interactions (p < 0.05, 0.2 < ES < 4.0). Post hoc analyses revealed significant pre-to-post decreases for maximal heart rates (p < 0.0001, ES = 3.1) and improvements for VO2max (p = 0.006, ES = 2.22) in the IET group. Moreover, post hoc analyses revealed significant pre-to-post improvements in the IET for DM, TLNO, TLCO and Vc (0.001 < p < 0.0022; 2.68 < ES < 6.45). In addition, there were increases in Vc at rest, VO2max, TLNO and DM in the IET but not in the MET participants after eight weeks of training with varying exercise intensities. Our findings suggest that the intensity of training may represent the most important factor in increasing pulmonary vascular function in young athletes.

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

Background: This study aimed to evaluate the effects of a combination of aerobic-resistance training (CARET) and broccoli supplementation on dectin-1 levels and insulin resistance in men with type 2 diabetes mellitus (T2D). Methods: Forty-four males with T2D were randomly allocated to four groups (n = 11 each group): CARET + broccoli supplement (TS), CARET + placebo (TP), control + broccoli supplement (S), and control + placebo (CP). CARET was performed three days per week for 12 weeks. TS and S groups received 10 g of broccoli supplement per day for 12 weeks. All variables were assessed at baseline and 12 weeks. Results: Plasma dectin-1 levels were decreased in TS and TP groups compared with the CP group (p &lt, 0.05). Cardiometabolic risk factors showed significant reductions in TP and TS groups compared to S and CP groups (p &lt, 0.05). Conclusion: The combination of CARET and broccoli supplementation produced the largest improvements in insulin resistance and dectin-1 and other complications of T2D.

This article discusses the research supporting that the hormonal changes across the menstrual cycle phases affect a woman’s physiology during exercise, specifically addressing aspects of energy substrate metabolism and macro-nutrient utilization and oxidation. The overarching aim is to provide a perspective on what are the limitations of earlier research studies that have concluded such hormonal changes do not affect energy metabolism. Furthermore, suggestions are made concerning research approaches in future studies to increase the likelihood of providing evidence-based data in support of the perspective that menstrual cycle hormonal changes do affect energy metabolism in exercising women.

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

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

Context Better knee function is linked to psychological readiness to return to sport after anterior cruciate ligament reconstruction (ACLR). Individuals with ACLR participate in less physical activity than matched uninjured control individuals, yet the association between knee function and physical activity post–ACLR remains unclear. Objective To determine the associations between (1) patient-reported knee function measured using the Knee Injury and Osteoarthritis Outcome Score Knee-Related Quality of Life (KOOS-QOL), daily steps, and minutes spent in moderate-to-vigorous physical activity (MVPA) of individuals with ACLR and (2) KOOS-QOL and daily steps and MVPA in individuals with ACLR who presented with (ie, symptomatic) or without (ie, asymptomatic) clinically meaningful knee-related symptoms. Design Cross-sectional study. Setting Laboratory, free-living conditions. Patients or Other Participants A total of 66 individuals with primary unilateral ACLR (36 women, 30 men; age = 22 ± 4 years, height = 1.71 ± 0.1 m, mass = 71.3 ± 12.6 kg, body mass index = 24.2 ± 2.9, time post–ACLR = 28 ± 33 months). Main Outcome Measure(s) We collected KOOS data and retrospectively stratified participants into those with (symptomatic group, n = 30) or without (asymptomatic group, n = 36) clinically meaningful knee-related symptoms based on previously defined KOOS cutoffs. We assessed daily steps and MVPA using accelerometers that participants wore on the right hip for 7 days. We conducted linear regressions to determine associations between KOOS-QOL and daily steps and MVPA. Results In the entire sample, no associations existed between KOOS-QOL and daily steps (ΔR2 = 0.01, P = .50) or MVPA (ΔR2 = 0.01, P = .36). In the symptomatic group, a greater KOOS-QOL was associated with more time in MVPA (ΔR2 = 0.12, P = .05). In the asymptomatic group, no associations were identified between the KOOS-QOL and daily steps and MVPA. Conclusions Individuals with symptoms post–ACLR who spent more time in MVPA reported higher QOL.

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

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

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

Context Individuals with an anterior cruciate ligament reconstruction (ACLR) are at an increased risk of developing posttraumatic osteoarthritis. How osteoarthritis risk factors, such as increased body mass index (BMI), may influence early changes in joint tissue metabolism is unknown. Objective To determine the association between BMI and type 2 cartilage turnover in individuals with an ACLR. Design Cross-sectional study. Setting Research laboratory. Patients or Other Participants Forty-five individuals (31 women, 14 men) with unilateral ACLR at least 6 months earlier who were cleared for unrestricted physical activity. Main Outcome Measure(s) Body mass index (kg/m2) and type 2 collagen turnover were the primary outcomes. Body mass index was calculated from objectively measured height and mass. Serum was obtained to measure type 2 collagen turnover, quantified as the ratio of degradation (collagen type 2 cleavage product [C2C]) to synthesis (collagen type 2 C-propeptide [CP2]; C2C : CP2). Covariate measures were physical activity level before ACLR (Tegner score) and current level of disability (International Knee Documentation Committee Index score). Associations of primary outcomes were analyzed for the group as a whole and then separately for males and females. Results Overall, greater BMI was associated with greater C2C : CP2 (r = 0.32, P = .030). After controlling for covariates (Tegner and International Knee Documentation Committee Index scores), we identified a similar association between BMI and C2C : CP2 (partial r = 0.42, P = .009). Among women, greater BMI was associated with greater C2C : CP2 before (r = 0.47, P = .008) and after (partial r = 0.50, P = .008) controlling for covariates. No such association occurred in men. Conclusions Greater BMI may influence greater type 2 collagen turnover in those with ACLR. Individuals, especially women, who maintain or reduce BMI may be less likely to demonstrate greater type 2 collagen turnover ratios after ACLR.

International audience; Purpose:We studied the effect of two interval training programs of varying intensities (100% vs. 110% of maximal aerobic velocity [MAV]) on hematocrit (Ht), hemoglobin (Hb), and plasma volume variations (PVV) in young men.Methods: Thirty-nine male volunteered were assigned to two control groups (CG100, n = 9 and CG110, n = 10), and two training groups (one with 100% MAV [EG100, n = 10] and one with 110% MAV [EG110, n = 10]). All participants performed a maximal graded exercise test and an intermittent exercise (IE) protocol. Blood was collected at rest, at the end of the IE and after 15 min of recovery, before and after 8-weeks-training. Interval training (IT) sessions consist of 30s IE run at 100% or 110% MAV with 30s recovery at 50% MAV.Results: After training, time to exhaustion (TTE) was improved in EG110 (+613.7) and EG100 (+397.5). This improvement was greater in EG110 than EG100 (p

The purpose of this case series was to evaluate the presence of low Energy Availability (EA) and its impact on components of Relative Energy Deficiency in Sport (RED-S) in a population of female collegiate runners. Seven female NCAA Division I athletes (age: 22.3 ± 1.5 yrs; height: 169.7 ± 5.7 cm; weight: 58.3 ± 4.1 kg) were tracked from August until February, covering the beginning (Pre XC), end (Post XC) of their competitive cross country season, and beginning of the following track season (Pre Track). The athletes were assessed for female athlete triad (Triad) risk, energy availability, body composition, resting metabolic rate (RMR), nutritional intake, and blood markers (including vitamin D, ferritin, and triiodothyronine (T3)). From Pre XC to Post XC there were no significant differences in body mass, fat free mass or body fat percentage. At Pre XC, mean EA was 31.6 ± 13.3 kcal/kg FFM∙d-1. From Post XC to Pre Track, there was a significant increase in body mass (59.1 ± 5.1 to 60.6 ± 5.7 kg, p-1, pvs 39.5 ± 12.2 ng·mL-1, p=0.047,d=-0.4), and a significant increase from Post XC to Pre Track (39.5 ± 12.2 vs. 48.1 ± 10.4 ng·mL-1, p=0.014,d=0.75). For ferritin, there was a trend towards a decrease from Pre XC to Post XC (24.2 ± 13.2 vs. 15.7 ± 8.8 ng·mL-1, p=0.07, d=-0.75), as well as a trend toward an increase from Post XC to Pre Track (15.7 ± 8.8 vs. 34.1 ± 18.0 ng·mL-1, p=0.08, d=1.3). No differences in T3 were observed across time points. Average Triad risk score was 2.3 ± 1.4. Notably, 5 of 7 athletes met criteria for moderate risk. Despite many athletes meeting criteria for low EA and having elevated Triad risk assessment scores, most were able to maintain body mass and RMR. One athlete suffered severe performance decline and a reduced RMR. Surprisingly, she was the only athlete above the recommended value for ferritin. Following increased nutritional intake and reduced training volume, her performance and RMR recovered. Changes in body mass and body composition were not indicative of the presence of other concerns associated with RED-S. This exploratory work serves as a guide for future, larger studies for tracking athletes, using RMR and nutritional biomarkers to assess RED-S.

This study examined the effect of estradiol-β-17 across the menstrual cycle (MC) during aerobic exercise on energy substrate utilization and oxidation. Thirty-two eumenorrheic (age = 22.4 ± 3.8 y (mean ± SD)), physically active women participated in two steady-state running sessions at 65% of VO2max, one during the early follicular and one during the luteal phase of the MC. Blood samples were collected at rest before each exercise session and analyzed for Estradiol-β-17 to confirm the MC phase. Carbohydrate (CHO) utilization and oxidation values were significantly lower (p < 0.05) in the luteal (utilization: 51.6 ± 16.7%; oxidation: 1.22 ± 0.56 g/min; effect size (ES) = 0.45, 0.27) than follicular phase (utilization: 58.2 ± 15.1%; oxidation: 1.38 ± 0.60 g/min) exercise sessions. Conversely, fat utilization and oxidation values were significantly (p < 0.05) higher in the luteal (utilization: 48.4 ± 16.7%; oxidation: 0.49 ± 0.19 g/min; ES = 0.45,0.28) than follicular phase (utilization: 41.8 ± 15.1%; oxidation: 0.41 ± 0.14 g/min). Estradiol-β-17 concentrations were significantly (p < 0.01) greater during the luteal (518.5 ± 285.4 pmol/L; ES = 0.75) than follicular phase (243.8 ± 143.2 pmol/L). Results suggest a greater use of fat and reduced amount of CHO usage during the luteal versus follicular phase, directly related to the change in resting estradiol-β-17. Future research should investigate the role these changes may play in female athletic performance.

International audience; We review the effects of acute and long-term physical activity on adipokine levels in individuals with type 2 diabetes (T2D). Three electronic databases were searched. Studies made in animal models were excluded, while studies based on participants with and without T2D, and also studies with type 1 diabetes were included. Of the 2,450 citations, 63 trials, including randomised control trials, cross-sectional and longitudinal studies, met our inclusion criteria. Seventy and five percent of studies reported the effects of physical activity on tumor necrosis factor-alpha (TNFα), interleukin 6 (IL-6), adiponectin, visfatin, omentin-1, and leptin levels. There are no robust results due to variations in exercise modality, intensity, duration, and also differences in cohort characteristics in the literature. Only four studies described the effects of an acute session of physical activity on adipokine levels. Overall, physical activity improves diabetes status by regulating adipokine levels. However, long-term aerobic + resistance training combined with dietary modifications is likely to be a more effective strategy for improving adipokines profiles in patients with type 2 diabetes.

Until recently, there has been less demand for and interest in female-specific sport and exercise science data. As a result, the vast majority of high-quality sport and exercise science data have been derived from studies with men as participants, which reduces the application of these data due to the known physiological differences between the sexes, specifically with regard to reproductive endocrinology. Furthermore, a shortage of specialist knowledge on female physiology in the sport science community, coupled with a reluctance to effectively adapt experimental designs to incorporate female-specific considerations, such as the menstrual cycle, hormonal contraceptive use, pregnancy and the menopause, has slowed the pursuit of knowledge in this field of research. In addition, a lack of agreement on the terminology and methodological approaches (i.e., gold-standard techniques) used within this research area has further hindered the ability of researchers to adequately develop evidenced-based guidelines for female exercisers. The purpose of this paper was to highlight the specific considerations needed when employing women (i.e., from athletes to non-athletes) as participants in sport and exercise science-based research. These considerations relate to participant selection criteria and adaptations for experimental design and address the diversity and complexities associated with female reproductive endocrinology across the lifespan. This statement intends to promote an increase in the inclusion of women as participants in studies related to sport and exercise science and an enhanced execution of these studies resulting in more high-quality female-specific data.

International audience; The objective of present study is to investigate the effects of walk training with and without blood flow restriction (BFR and no-BFR) on lipid profiles, inflammatory and haematological factors in over-weighed men. Participants were divided into BFR (n = 9) or no-BFR (n = 9) groups. Both groups were exposed to 8-week walk training on a treadmill: 3 sessions/week at a speed of 50 m/min, 5 sets × 2 min/session. There were differences in pre- to post-levels of (TG) and fibrinogen in the BFR group (p ≤ 0.05) that were accompanied by changes in red blood cells (RBC), haemoglobin (HGB) and haematocrit (HCT) levels (p ≤ 0.05). RBC levels were increased in the BFR group (p ≤ 0.05). The groups differed in their mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC). These findings suggest the efficiency of BFR walk training in individuals exposed to chronic diseases associated with overweight, such as metabolic syndrome.

Umlauff, L, Weil, P, Zimmer, P, Hackney, AC, Bloch, W, and Schumann, M. Oral contraceptives do not affect physiological responses to strength exercise. J Strength Cond Res 35(4): 894-901, 2021-This study investigated the effect of oral contraceptive (OC) use on acute changes in steroid hormone concentrations and tryptophan (TRP) metabolites in response to strength exercise. Twenty-one women (age: 23 ± 3 years), 8 combined OC users (OC group) and 13 naturally cycling women (menstrual cycle [MC] group), participated. Testing was performed during the pill-free interval for the OC group and the follicular phase for the MC group. Subjects completed an intense strength exercise protocol (4 × 10 repetitions back squat). Blood samples were taken at baseline (T0), post-exercise (T1), and after 24 hours (T2) to determine serum concentrations of cortisol, estradiol, testosterone, TRP, and kynurenine (KYN). Statistical significance was defined as p ≤ 0.05. At T0, the OC group showed higher cortisol (OC: 493.7 ± 47.1 ng·mL-1, MC: 299.1 ± 62.7 ng·mL-1, p0.001) and blood lactate (OC: 1.81 ± 0.61 mmol·L-1, MC: 1.06 ± 0.30 mmol·L-1, p = 0.001) and lower estradiol (OC: 31.12 ± 4.24 pg·mL-1, MC: 38.34 ± 7.50 pg·mL-1, p = 0.023) and KYN (OC: 1.15 ± 0.23 µmol·L-1, MC: 1.75 ± 0.50 µmol·L-1, p = 0.005). No significant interactions (group × time, p0.05) were found for the hormones and TRP metabolites assessed. Oral contraceptive use did not affect the physiological response of steroid hormones and TRP metabolites to acute strength exercise during the low hormone phase of the contraceptive or MC in healthy young women, even when some baseline concentrations differed between groups. Consequently, these findings provide important implications for practitioners testing heterogeneous groups of female athletes.

The effects of acute consumption of L-Arginine (L-Arg) in healthy young individuals are not clearly defined, and no studies on the effects of L-Arg in individuals with abnormal body mass index undertaking strenuous exercise exist. Thus, we examined whether supplementation with L-Arg diminishes cardiopulmonary exercise testing responses, such as ventilation (VE), VE/VCO2, oxygen uptake (VO2), and heart rate, in response to an acute session of high-intensity interval exercise (HIIE) in overweight men. A double-blind, randomized crossover design was used to study 30 overweight men (age, 26.5 ± 2.2 years; body weight, 88.2 ± 5.3 kilogram; body mass index, 28.0 ± 1.4 kg/m2). Participants first completed a ramped-treadmill exercise protocol to determine VO2max velocity (vVO2max), after which they participated in two sessions of HIIE. Participants were randomly assigned to receive either 6 g of L-Arg or placebo supplements. The HIIE treadmill running protocol consisted of 12 trials, including exercise at 100% of vVO2max for 1 min interspersed with recovery intervals of 40% of vVO2max for 2 min. Measurements of VO2 (ml·kg−1·min−1), VE (L/min), heart rate (beat per min), and VE/VCO2 were obtained. Supplementation with L-Arg significantly decreased all cardiorespiratory responses during HIIE (placebo+HIIE vs. L-Arg+HIIE for each measurement: VE [80.9 ± 4.3 L/min vs. 74.6 ± 3.5 L/min, p 2 [26.4 ± 1.3 vs. 24.4 ± 1.0, p 2 [26.4 ± 0.8 ml·kg−1·min−1 vs. 24.4 ± 0.9 ml·kg−1·min−1, p p d = 0.89]). The authors conclude consuming L-Arg before HIIE can alleviate the excessive physiological strain resulting from HIIE and help to increase exercise tolerance in participants with a higher body mass index who may need to exercise on a regular basis for extended periods to improve their health.

Myllyaho, MM, Ihalainen, JK, Hackney, AC, Valtonen, M, Nummela, A, Vaara, E, Häkkinen, K, Kyröläinen, H, and Taipale, RS. Hormonal contraceptive use does not affect strength, endurance, or body composition adaptations to combined strength and endurance training in women. J Strength Cond Res 35(2): 449-457, 2021-This study examined the effects of a 10-week period of high-intensity combined strength and endurance training on strength, endurance, body composition, and serum hormone concentrations in physically active women using hormonal contraceptives (HCs, n = 9) compared with those who had never used hormonal contraceptives (NHCs, n = 9). Training consisted of 2 strength training sessions and 2 high-intensity running interval sessions per week. Maximal bilateral isometric leg press (Isom), maximal bilateral dynamic leg press (one repetition maximum [1RM]), countermovement jump (CMJ), a 3,000-m running test (3,000 m), body composition, and serum hormone levels were measured before and after training between days 1-5 of each subject's menstrual cycle. Both groups increased 1RM and CMJ: HC = 13.2% (p0.001) and 9.6% (p0.05), and NHC = 8.3% (p0.01) and 8.5% (p0.001). Hormonal contraceptive improved 3,000 m by 3.5% (p0.05) and NHC by 1% (n.s.). Never used hormonal contraceptive increased lean mass by 2.1% (p0.001), whereas body fat percentage decreased from 23.9 ± 6.7 to 22.4 ± 6.0 (-6.0%, p0.05). No significant changes were observed in body composition in HC. No significant between-group differences were observed in any of the performance variables. Luteinizing hormone concentrations decreased significantly (p0.05) over 10 weeks in NHC, whereas other hormone levels remained statistically unaltered in both groups. It seems that the present training is equally appropriate for improving strength, endurance, and body composition in women using HC as those not using HC without disrupting hypothalamic-pituitary-gonadal axis function.

COVID-19 has spread rapidly around the world and reached pandemic proportions. With no definitive treatment to date, prevention is critical, and strengthening the immune system is a valuable tool in reducing the risk of infection. While the aging process can weaken the immune system, physical activity may boost it.The review intended to examine the interaction between the changes in the immune system during aging and the development of a COVID-19 infection, focusing on pathophysiological factors, and to evaluate whether regular physical activity can strengthen the immune system in older adults.The research team performed a narrative review by searching databases.During the COVID-19 pandemic, older people can stay active and healthy through playing sports such as yoga, walking, jogging, and cycling. Also, they can use online or virtual yoga and Pilates classes and videos, perform resistance exercises with minimal facilities at home, and do daily housework, such as gardening.In general, due to the positive role of regular exercise training on the immune system of the older adults as well as the involvement of the immune system in COVID-19, it's necessary to guide and implement home-based exercises for older adults.

Multidirectional repeated sprints with quick changes-of-direction (CoD) are considered a key performance determinant in basketball. The objective of this study was to investigate the effects of a 12-week CoD sprint training program compared to regular basketball training on selected measures of physical fitness and physiological adaptations in male basketball players. Sixteen professional basketball players were randomly assigned to an intervention group (INT = 8) or an active control group (CON = 8). INT completed a 12-week CoD sprint training program with two sessions per week while CON continued their regular training. Training volume was similar between groups. Before and after the intervention, the two groups were evaluated for the repeated sprint ability test with CoD (IRSA5COD), the squat jump (SJ) and countermovement jump (CMJ) test, the five time-jump test (FJT) and change of direction T-test. Blood samples were taken before the beginning of the experimental protocol, after 4, 8 and 12 weeks to monitor the testosterone/cortisol ratio (T/C). For T-test, post-hoc tests revealed significant pre-to-post improvements for INT (3.4%, p = 0.001, ES = 0.91). For CMJ, post-hoc tests revealed a significant pre-to-post decrease for INT (&minus, 11.6%, p = 0.001, ES = 0.94), and a significant improvement for CON (4.96%, p = 0.014, ES = 0.60). For T/C ratio, post-hoc tests revealed a significant decrease after 12 weeks of training for INT (52.3%, p &lt, 0.001, ES = 0.63). In conclusion, twelve weeks of CoD sprint training enhanced CoD performance but negatively affected vertical jump capacity in male basketball players. T/C ratio indicated that the physiological demands associated with INT were well-balanced.

Our objective was to examine the relationship between change of direction (CoD) performance, with (CoDb), and without the ball (CoDwb), and selected measures of physical fitness (jump performance, speed, balance) in elite soccer players, according to players&rsquo, positions. Forty elite male soccer players performed the change-of-direction and acceleration test (CODAT) with (CODATb), and without the ball (CODATwb), 5- and 20-m sprint tests, the 5-jump test (5JT), and the Y-balance test (YBT). Analyses of the whole sample showed significant correlations between all CODAT measures (CODATwb and CODATb, respectively) and sprint 5-m (r = 0.72, p &lt, 0.001, r = 0.52, p &lt, 0.01), sprint 20-m (r = 0.54, p &lt, 0.03, r = 0.45, p &lt, 0.05), jump (r = &minus, 0.62, p &lt, 0.01, r = &minus, 0.64, p &lt, 0.01) and balance (r = &minus, 0.50, p &lt, 0.83, p &lt, 0.001) performances. Correlations were significantly different between player positions (defender, midfielder and striker). When examining the entire sample, the single best predictor of CODATwb was performance in the 5-m test with an explained variance of 52% (p &lt, 0.001). For CODATb, the Y-balance performance explained 68% of the variance of performance (p &lt, 0.001). In conclusion, soccer coaches and fitness trainers are advised to improve players&rsquo, CoD using neuromuscular training that mimic crucial match actions. Meanwhile, CoD testing and training should be designed in line with the demands of playing position.

Objective Cartilage health is thought to be dependent on the relationship between mechanics, structure, and metabolism, rather than these individual components in isolation. Due to sex differences in cartilage health, there is need to determine if the relationships between these cartilage components separately for males and females. Therefore, we sought to determine the sex-specific associations between cartilage structure and metabolism at rest and their acute response following walking and drop-landing in healthy individuals. Design A cartilage ultrasound assessment and an ante-cubital blood draw were performed before and after walking and drop-landing conditions in 20 males and 20 females. Cartilage structure was assessed via medial and lateral femoral cartilage cross-sectional area. Cartilage metabolism was quantified with serum cartilage oligomeric matrix protein (COMP) concentration. Percent change scores from pre- to postloading were used to calculate acute alterations in cross-sectional area and COMP. Correlational analyses were used to assess the association between cartilage structure and metabolism measures separately for males and females. Results In females, greater resting COMP concentration was associated with less cartilage cross-sectional area in the medial(ρ = −0.50, P = 0.03) and lateral (ρ = −0.69, P = 0.001) femur. Resting cartilage measures were not associated among males. Following walking and drop-landing, percent change scores in cartilage structure and metabolism were not associated. Conclusions This study highlights that, in females, thinner anterior femoral cartilage is associated with greater resting serum COMP concentrations, a biomarker often linked to cartilage breakdown. Future studies into the relationships between various cartilage components should consider sex-specific analyses as these relationships are sex dependent.

Background Special Operations Forces (SOF) combat soldiers are frequently exposed to blast and blunt neurotrauma, most often classified as mild traumatic brain injury (mTBI). Repetitive mTBI may increase the risk of developing long-term neurological sequelae. Identifying changes in neuroinflammatory biomarkers before chronic conditions emerge could serve as preliminary evidence of developing neuropathology. Objective To determine the effects of mTBI history, lifetime mTBI incidence, and recency on blood biomarker concentrations of axonal protein neurofilament light (NfL), glycolytic enzyme neuron-specific enolase (NSE), astrocyte-expressed S100 calcium-binding protein B (S100B), and neurotrophic cytokine interleukin-6 (IL-6) in healthy, active duty SOF combat soldiers. Methods Self-reported mTBI history/recency and fasted blood samples were collected in this cross-sectional study of 104 asymptomatic SOF combat soldiers. Biomarker concentrations were quantified using commercial enzyme-linked immunosorbent assays. Mann-Whitney U and Kruskal-Wallis tests were used to compare groups. Post hoc tests with appropriate corrections were conducted as warranted. Results Soldiers with mTBI history had higher NSE concentrations than those without (z = -2.60, P = .01). We also observed significant main effects of lifetime mTBI incidence on NSE (χ(3) = 9.52, P = .02) and S100B (χ(3) = 8.21, P = .04) concentrations and a significant main effect of mTBI recency on NfL concentration (χ(2) = 6.02, P = .049). Conclusion The SOF combat soldiers with mTBI history had increased NSE. Longitudinal studies in this population are needed due to between-subject heterogeneity in biomarker concentrations. The NfL concentrations in our SOF combat soldiers-regardless of mTBI history or recency-were similar to values previously reported in civilian acute TBI patients.

We studied the effects of Ramadan intermittent fasting (RIF) on gut hormones (leptin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), and ghrelin) in males with obesity. Thirty sedentary males were randomly allocated to either an experimental group (EG, n = 15) or a control group (CG, n = 15). The EG group completed their Ramadan fasting rituals (30 days), whereas the CG continued with their normal daily habits. Blood samples were collected at four time points: 24 h before the start of Ramadan (T0), on the 15th day of Ramadan (T1), the day after the end of Ramadan (T2) and 21 days after Ramadan (T3). There were significant pre-to-post improvements for leptin (p = 0.01, d = 1.52), GLP-1 (p = 0.022, d = 0.75), PYY (p = 0.031, d = 0.69) and CCK (p = 0.027, d = 0.81) in the EG, with no interaction effect for ghrelin (p = 0.74, d = 0.008). No significant changes (p &gt, 0.05) occurred in plasma volume variations (&Delta, PV) after RIF in both EG (&minus, 0.03 &plusmn, 0.01%) and CG (0.06 &plusmn, 0.07%). RIF represents an effective strategy to modify appetite-regulating hormones, leading to improved body composition indices and reduced obesity.

Purpose: To determine body composition, energy availability, training load, and menstrual status in young elite endurance running athletes (ATH) over 1 year, and in a secondary analysis, to investigate how these factors differ between nonrunning controls (CON), and amenorrheic (AME) and eumenorrheic (EUM) ATH. Correlations to injury, illness, and performance were also examined. Methods: Altogether 13 ATH and 8 CON completed the Low Energy Availability in Females Questionnaire. Anthropometric, energy intake, and peak oxygen uptake assessments were made at 4 time points throughout the year: at baseline post competition season, post general preparation, post specific preparation, and post competition season the following year. Logs of physical activity, menstrual cycle, illness, and injury were kept by all participants. Performance was defined using the highest International Association of Athletics Federations points prior to and after the study. Results: ATH had significantly lower body mass (P P P P P P r P Conclusions: More than half of this group of runners was AME, and they were injured more and ran less than their EUM counterparts. Furthermore, only the EUM runners increased their performance over the course of the year.

Purpose: To examine the potential impact of fluctuations in sex steroid hormones across the menstrual cycle (MC) on marathon running performance of recreational female athletes. Methods: A survey questionnaire was administered to recreational, nonelite runners who had completed multiple marathons within the last 18 months. Results: A total of 599 questionnaires were returned and deemed viable for review. From these, 185 survey participants were found to have complete information and eligibility to have their surveys used in the statistical analysis. A total of 106 women had their best marathon performance in the luteal phase (high sex steroid hormones) of the MC, and 79 had their best performance in the follicular phase (low sex steroid hormones) of the MC (responses were significantly different; z-score value = 1.11; P Conclusion: Recreational female runners have varying performances in the marathon across their MC phases, specifically performing better in the luteal phase of the cycle.

International audience; Increasing the amount of physical activity is an important strategy for weight loss. This systematic review summarizes recent findings on the effects of physical training on anthropometric characteristics, physical performances and physiological capacities in individuals with overweight and obesity. A systematic literature search strategy was conducted from inception until June 2019 using four electronic databases that identified 2,708 records. After screening for titles, abstracts and full texts, 116 studies were included in our final analysis. Both aerobic (e.g., endurance training) and anaerobic training (e.g., high-intensity training, resistance training) improved body composition and physical fitness indicators in adults, adolescents and children with obesity (effect size 0.08 < d < 2.67, trivial to very large). This systematic review suggests that both low- and high-intensity training significantly reduced body weight and fat mass while increasing fat-free mass in individuals with obesity (effect size 0.04

For decades researchers have reported men who engaged in intensive exercise training can develop low resting testosterone levels, alterations in their hypothalamic-pituitary-gonadal (HPG) axis, and display hypogonadism. Recently there is renewed interest in this topic since the International Olympic Committee (IOC) Medical Commission coined the term "Relative Energy Deficiency in Sports" (RED-S) as clinical terminology to address both the female-male occurrences of reproductive system health disruptions associated with exercise. This IOC Commission action attempted to move beyond the sex-specific terminology of the "Female Athlete Triad" (Triad) and heighten awareness/realization that some athletic men do have reproductive related physiologic disturbances such as lowered sex hormone levels, HPG regulatory axis alterations, and low bone mineral density similar to Triad women. There are elements in the development and symptomology of exercise-related male hypogonadism that mirror closely that of women experiencing the Triad/RED-S, but evidence also exists that dissimilarities exist between the sexes on this issue. Our research group postulates that the inconsistency and differences in the male findings in relation to women with Triad/RED-S are not just due to sex dimorphism, but that there are varying forms of exercise-related reproductive disruptions existing in athletic men resulting in them displaying a relative hypogonadism condition. Specifically, such conditions in men may derive acutely and be associated with low energy availability (Triad/RED-S) or excessive training load (overtraining) and appear transient in nature, and resolve with appropriate clinical interventions. However, manifestations of a more chronic based hypogonadism that persists on a more permanent basis (years) exist and is termed the "Exercise Hypogonadal Male Condition." This article presents an up-to-date overview of the various types of acute and chronic relative hypogonadism found in athletic, exercising men and proposes mechanistic models of how these various forms of exercise relative hypogonadism develop.

International audience; Background - To determine the effects of Ramadan intermittent fasting (RIF) on inflammatory (C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α)) and biochemical markers of liver-renal function (aspartate aminotransferase (AST), alanine amino transferase (ALT), bilirubin, lactate dehydrogenase (LDH), urea and creatinine) in males with obesity. Materials and methods - Twenty-eight males with obesity were randomly allocated to an experimental group (EG, n = 14) or a control group (CG, n = 14). The EG group completed their fasting rituals for the entire month of Ramadan (30 days) whereas the CG group continued with their normal daily habits. Blood samples were collected 24 h before the start of Ramadan (T0), on the 15th day of Ramadan (T1), the day after the end of Ramadan (T2), and 21 days after the end of Ramadan (T3). Resting plasma volume variation between pre and post-RIF (ΔPV) was calculated. Results - Decreases were noted for interleukin-6 (p = 0.02, d = 1.4) and tumor necrosis factor-alpha (p = 0.01, d = 0.7), with no changes for C-reactive protein (p = 0.3; d = 0.1) in the EG compared to CG group. There were no changes (P > 0.05) in ΔPV recorded after RIF for either EG (-0.035 ± 0.02%) and CG (0.055 ± 0.06%). Conclusion - This study demonstrates that RIF improves systemic inflammation biomarkers in males with obesity. Moreover, RIF did not negatively affect biomarkers of liver and renal function.

International audience; Background The diffusing capacity, which measures gas-exchange, uses reference values based on data from American or European studies. There are currently no reference values of pulmonary diffusing capacity (TL) and its components, such as the conductance of the membrane (Dm) and capillary lung volume (Vc) for healthy North African children. Objectives We determined the prediction equations-reference values for TL, Dm, Vc and the alveolar volume (VA) in healthy Tunisian boys. Methods Values of Vc, Dm, TL, and VA were measured by the NO/CO transfer method, using a single breath maneuver in 118 Tunisian boys (8-14 years old) at rest. We performed linear regression analysis of the pulmonary parameters and independent variables, such as height, weight, and age. Results The reference equations for pulmonary diffusing capacity for carbon monoxide (TLCO) was 0.201 x weight (kg) + 8.979; for TL(NO)was 0.76 x height (cm)-24.383; for Dm was 0.388 x height (cm)- 12.555 and for VA was 0.34 x height (cm)-3.951. Vc increased significantly with weight (P < .05) but not with age (P > .05). Conclusions References norms for TL(CO)and TL for nitric oxide and its components in young Tunisian boys are similar to data from other countries. The prediction equations we developed can be extended to clinical practice in Tunisia and can be considered for use in neighboring North African countries.

Performance enhancing substances are becoming increasingly popular amongst bodybuilders and people who want to enhance their physiques. However, due to the rise of the Internet and laws prohibiting sales of these substances without prescription, the route of procurement and administration practices have become more and more dangerous. Prior to the mid-1970's, anabolic steroids were not regulated and easily available from physicians and pharmacies in several countries. In 1990, the United States enacted the Anabolic Steroid Control Act, leading to the proliferation of black markets and underground laboratories. The shift from pharmacy to underground online sites for the procurement of anabolic steroids led to an increase of fake products with low purity and the ability to potentially endanger the health of anabolic steroid users. Underground laboratories emerged both locally and in countries with lax legal regulations. 'Anabolic steroid tourism' and large networks of online resellers emerged, leading to the banalisation of the illegal procurement of anabolic steroids. Furthermore, the increase of anecdotal information spreading on the internet among anabolic steroid user forums nourishes the rampant misinformation and dangerous practices that currently exist. The dosages and ways of administration recommended on these forums can be false and misleading to those who lack a medical background and cannot go to their physician to seek advice because of the fear of repercussions. This review aims to elucidate and describe current practices of the anabolic-androgenic steroids black market and draw attention to potential dangers for users.

The cortisol awakening response (CAR) is commonly used as a marker of psychological stress; however, it is unknown whether CAR is affected by regular physical-exercise-induced stress. Purpose: To assess the relationship between training load and CAR. Methods: Recreational endurance athletes were recruited from local running clubs. Subjects (n = 15) completed training logs for 2 wk, with various training loads, including psychometric analysis (Recovery-Stress Questionnaire for Athletes). Subjects provided saliva samples each day immediately after waking and 30 min postwaking. Samples were analyzed for cortisol concentration via enzyme-linked immunosorbent assay and subsequently were analyzed for CAR and CAR%. Daily training load was calculated and analyzed as training impulse. Simple linear regression was used to assess the relationship between CAR and training impulse. Results: CAR (r2 = .352, P = .025) and CAR% (r2 = .373, P = .012) both showed a significant negative relationship with training load. Conclusions: These results suggest that CAR is affected by regular exercise training loads in recreational athletes. It is recommended that future CAR research control for fitness level and exercise training load in physically active populations.

In the current aging society, the occurrence of the locomotive syndrome, a condition in which the locomotive organs are impaired, is increasing. The locomotive system includes support (bones), mobility and impact absorption (joints and intervertebral disks), drive and control (muscles, nerves), and network (blood vessels). The impairment of any of those systems can lead to a major decrease in quality of life. In recent years, several studies on methods to improve and prevent conditions impairing the locomotive syndrome have been conducted. Almost in parallel with the structure supporting mobility and body functions, testosterone levels decrease with age. Testosterone is a hormone-regulating several pathways affecting each aspect of the locomotive syndrome. Testosterone is regulated by the pituitary gland triggering several processes in the body through genomic and non-genomic pathways, affecting muscles, bones, nerves, joints, intervertebral discs, and blood vessels. The purpose of this review is to investigate the role of testosterone in each of the systems involved in the locomotive syndrome.

INTRODUCTION An in-depth understanding of the healthy cartilage response to activities of daily living is needed to better understand the complex relationship between cartilage health and loading. The purpose was to assess the role of loading on the acute serum cartilage oligomeric matrix protein (COMP) response in recreationally active individuals. METHODS Forty individuals without previous lower extremity injury participated in this repeated-measures study in which each participant completed all conditions during independent data collection sessions separated by at least 1 wk. An antecubital blood draw was performed before and after walking, drop-landing, and control (i.e., sitting) conditions. Commercially available enzyme-linked immunosorbent assays measured COMP concentration. The acute COMP response was quantified as the percent change of COMP concentration from before to after each condition. A one-way, repeated-measures ANOVA compared the acute COMP response between conditions. Post hoc Pearson product-moment correlation and chi-square analysis determined the relationship between the walking and drop-landing acute COMP response within individuals. RESULTS Acute COMP response was greater after walking (+4.2, P = 0.008) and drop landing (+4.6%, P = 0.002) compared with control (-2.3%), but did not differ between the walking and drop-landing conditions (P = 0.596). The magnitudes of the acute COMP response during walking and drop landing were correlated (r = 0.56, P < 0.001). However, the direction (i.e., either increase or decrease) of COMP was not the same after the walking and drop-landing conditions (χ1 = 0.870, P = 0.351). CONCLUSIONS Walking and drop landing produced a greater acute COMP response when compared with a control condition in healthy individuals, but the acute COMP response was similar between the two physical activity conditions, although the conditions differed in magnitude and frequency of loading.

Individuals with anterior cruciate ligament reconstruction (ACLR) often exhibit a "stiffened knee strategy" or an excessively extended knee during gait, characterized by lesser knee flexion excursion and peak internal knee extension moment (KEM). The purpose of this study was to determine the effect of real-time biofeedback (RTBF) cuing an acute change in peak vertical ground reaction force (vGRF) during the first 50% of the stance phase of walking gait on: (1) root mean square error (RMSE) between actual vGRF and RTBF target vGRF; (2) perceived difficulty; and (3) knee biomechanics. Acquisition and short-term recall of these outcomes were evaluated. Thirty individuals with unilateral ACLR completed 4 separate walking sessions on a force-measuring treadmill that consisted of a control (no RTBF) and 3 experimental loading conditions using RTBF including: (1) 5% vGRF increase (high-loading), (2) 5% vGRF decrease (low-loading) and (3) symmetric vGRF between limbs. Bilateral biomechanical outcomes were analyzed during the first 50% of the stance phase, and included KEM, knee flexion excursion, peak vGRF, and instantaneous vGRF loading rate (vGRF-LR) for each loading condition. Peak vGRF significantly increased and decreased during high-loading and low-loading, respectively compared to control loading. Instantaneous vGRF-LR, peak KEM and knee flexion excursion significantly increased during the high-loading condition compared to low-loading. Perceived difficultly and RMSE were lower during the symmetrical loading condition compared to the low-loading condition. Cuing an increase in peak vGRF may be beneficial for increasing KEM, knee flexion excursion, peak vGRF, and vGRF-LR in individuals with ACLR. Clinical Trials Number: NCT03035994.

Background/Objective:Adipokines are involved in the etiology of diabetes, insulin resistance, and the development of atherosclerosis and other latent-onset complications. The objective of this meta-analysis was to determine the effectiveness of exercise interventions on adipokines in pediatric obesity.Subjects/Methods:A computerized search was made using three databases. The analysis was restricted to studies that examined the effect of exercise interventions on adipokines (adiponectin, leptin, resistin and visfatin) in pediatric obesity (6-18 years old). Fourteen randomized controlled trials (347 youths) were included. Weighted mean difference (WMD) and 95% confidence intervals were calculated.Results:Exercise was associated with a significant increase in adiponectin (WMD=0.882 ?g ml -1, 95% CI, 0.271-1.493) but did not alter leptin and resistin level. Likewise, exercise intensity and change in body fat; as well as total exercise program duration, duration of the sessions, and change in body fat all significantly influenced the effect of exercise on adiponectin and leptin, respectively.Conclusions:Exercise seems to increase adiponectin levels in childhood obesity. Our results also suggested that exercise on its own, without the concomitant presence of changes in body composition levels, does not affect leptin levels. © 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.

This is the first report of the psychobiology of stress in BASE jumpers, one of the most dangerous forms of extreme sport. We tested the hypotheses that indicators of emotional style (temperament) predict salivary cortisol reactivity, whereas indicators of intentional goal-setting (persistence and character) predict salivary alpha-amylase reactivity during BASE jumping. Ninety-eight subjects completed the Temperament and Character Inventory (TCI) the day before the jump, and 77 also gave salivary samples at baseline, pre-jump on the bridge over the New River Gorge, and post-jump upon landing. Overall BASE jumpers are highly resilient individuals who are highly self-directed, persistent, and risk-taking, but they are heterogeneous in their motives and stress reactivity in the Hypothalamic-Pituitary-Adrenal (HPA) stress system (cortisol reactivity) and the sympathetic arousal system (alpha-amylase reactivity). Three classes of jumpers were identified using latent class analysis based on their personality profiles, prior jumping experience, and levels of cortisol and alpha-amylase at all three time points. “Masterful” jumpers (class 1) had a strong sense of self-directedness and mastery, extensive prior experience, and had little alpha-amylase reactivity and average cortisol reactivity. “Trustful” jumpers (class 2) were highly cooperative and trustful individuals who had little cortisol reactivity coincident with the social support they experienced prior to jumping. “Courageous” jumpers (class 3) were determined despite anxiety and inexperience, and they had high sympathetic reactivity but average cortisol activation. We conclude that trusting social attachment (Reward Dependence) and not jumping experience predicted low cortisol reactivity, whereas persistence (determination) and not jumping experience predicted high alpha-amylase reactivity.