Search

Aging is associated with a decline in physiological function and exercise performance. These effects are mediated, at least in part, by an age-related decrease in the bioavailability of nitric oxide (NO), a ubiquitous gasotransmitter and regulator of myriad physiological processes. The decrease in NO bioavailability with aging is especially apparent in sedentary individuals, whereas older, physically active individuals maintain higher levels of NO with advancing age. Strategies which enhance NO bioavailability (including nutritional supplementation) have been proposed as a potential means of reducing the age-related decrease in physiological function and enhancing exercise performance and may be of interest to a range of older individuals including those taking part in competitive sport. In this brief review we discuss the effects of aging on physiological function and endurance exercise performance, and the potential role of changes in NO bioavailability in these processes. We also provide a summary of current evidence for dietary supplementation with substrates for NO production - including inorganic nitrate and nitrite, l-arginine and l-citrulline - for improving exercise capacity/performance in older adults. Additionally, we discuss the (limited) evidence on the effects of (poly)phenols and other dietary antioxidants on NO bioavailability in older individuals. Finally, we provide suggestions for future research.

This systematic review analyzed whether carbohydrate source (food vs. supplement) influenced performance and gastrointestinal (GI) symptoms during endurance exercise. Medline, SPORTDiscus, and citations were searched from inception to July 2021. Inclusion criteria were healthy, active males and females aged >18 years, investigating endurance performance, and GI symptoms after ingestion of carbohydrate from a food or supplement, n = 1) or cycling (n = 13) performance/capacity between food and supplemental sources. Greater GI symptoms were reported with food compared with supplemental sources. Highly heterogenous study designs for carbohydrate dose and timing, as well as exercise protocol and duration, make it difficult to compare findings between studies. A further limitation results from only one study assessing running performance. Food choices of carbohydrate consumed immediately before and during endurance exercise result in similar exercise performance/capacity responses to supplemental carbohydrate sources, but may slightly increase GI symptoms in some athletes, particularly with exercise >2 hr.

Beetroot (BR) is a rich source of nitrate (NO3-) that has been shown to reduce blood pressure (BP). Yet, no studies have examined the vascular benefits of BR in whole-food form and whether the effects are modified by age. This study was a four-arm, randomised, open-label, cross-over design in twenty-four healthy adults (young n 12, age 27 ± 4 years, old n 12, age 64 ± 5 years). Participants consumed whole-cooked BR at portions of (NO3- content in brackets) 100 g (272 mg), 200 g (544 mg) and 300 g (816 mg) and a 200-ml solution containing 1000 mg of potassium nitrate (KNO3) on four separate occasions over a 4-week period (≥7-d washout period). BP, plasma NO3- and nitrite (NO2-) concentrations, and post-occlusion reactive hyperaemia via laser Doppler, were measured pre- and up to 5-h post-intervention. Data were analysed by repeated-measures ANOVA. Plasma NO2- concentrations were higher in the young v. old at baseline and post-intervention (P < 0·05). All NO3- interventions decreased systolic and diastolic BP in young participants (P < 0·05), whereas only KNO3 (at 240–300 min post-intake) significantly decreased systolic (–4·8 mmHg, −3·5 %, P = 0·024) and diastolic (–5·4 mmHg, −6·5 %, P = 0·007) BP in older participants. In conclusion, incremental doses of dietary NO3- reduced systolic and diastolic BP in healthy young adults whereas in the older group a significant decrease was only observed with the highest dose. The lower plasma NO2- concentrations in older participants suggest that there may be mechanistic differences in the production of NO from dietary NO3- in young and older populations.

Background: Dietary nitrate consumption can increase concentrations of nitrate and nitrite in blood, saliva, and urine. Whether the change in concentrations is influenced by age is currently unknown. Objectives: We aimed to measure changes in nitrate and nitrite concentrations in plasma, urine, and saliva and exhaled NO concentrations after single incremental doses of dietary nitrate in young and older healthy adults. Methods: Twelve young (18–35 y old) and 12 older (60–75 y old) healthy, nonsmoking participants consumed single doses of 100 g, 200 g, 300 g whole beetroot (BR) and 1000 mg potassium nitrate (positive control) ≥7 d apart in a crossover, randomized clinical trial. Plasma nitrate and nitrite concentrations and exhaled NO concentrations were measured over a 5-h period. Salivary nitrate and nitrite concentrations were measured over a 12-h period and urinary nitrate over a 24-h period. Time, intervention, age, and interaction effects were measured with repeated-measures ANOVAs. Results: Dose-dependent increases were seen in plasma, salivary, and urinary nitrate after BR ingestion (all P ≤ 0.002) but there were no differences between age groups at baseline (all P ≥ 0.56) or postintervention (all P ≥ 0.12). Plasma nitrite concentrations were higher in young than older participants at baseline (P = 0.04) and after consumption of 200 g (P = 0.04; +25.7 nmol/L; 95% CI: 0.97, 50.3 nmol/L) and 300 g BR (P = 0.02; +50.3 nmol/L; 95% CI: 8.57, 92.1 nmol/L). Baseline fractional exhaled NO (FeNO) concentrations were higher in the younger group [P = 0.03; +8.60 parts per billion (ppb); 95% CI: 0.80, 16.3 ppb], and rose significantly over the 5-h period, peaking 5 h after KNO3 consumption (39.4 ± 4.5 ppb; P < 0.001); however, changes in FeNO were not influenced by age (P = 0.276). Conclusions: BR is a source of bioavailable dietary nitrate in both young and older adults and can effectively raise nitrite and nitrate concentrations. Lower plasma nitrite and FeNO concentrations were found in older subjects, confirming the impact of ageing on NO bioavailability across different systems. This trial was registered at www.isrctn.com as ISRCTN86706442.

Purpose We examined the effects of collagen peptides (CP) supplementation on exercise-induced gastrointestinal (GI) stress. Methods In a randomized, crossover design, 20 volunteers (16 males: $$\dot{V}$$ V ˙ O2max, 53.4 ± 5.9 ml·kg−1) completed 3 trials: a non-exercise rest trial, with no supplement (REST) and then an exercise trial with CP (10 g·day−1) or placebo control (CON) supplements, which were consumed for 7 days prior to, and 45 min before, a 70 min run at 70–90% of $$\dot{V}$$ V ˙ O2max. Outcome measures included urinary lactulose and rhamnose (L/R), intestinal fatty acid binding protein (I-FABP), lipopolysaccharide (LPS), anti-LPS antibody, monocyte-chemoattractant protein-1 (MCP-1), interleukin (IL) 6 and 8, cortisol, alkaline phosphatase (ALP) (measured pre, 10 min post and 2 h post) and subjective GI symptoms. Results There were no differences in heart rate, perceived exertion, thermal comfort, or core temperature during exercise in the CP and CON trials (all P > 0.05). I-FABP was higher in CP (2538 ± 1221 pg/ml) and CON (2541 ± 766 pg/ml) vs. REST 2 h post (1893 ± 1941 pg/ml) (both P P P P > 0.05), and no differences in L/R or GI symptoms between CON and CP (all P > 0.05). Conclusion Collagen peptides did not modify exercise-induced changes in inflammation, GI integrity or subjective GI symptoms but LPS was higher in CON 2 h post-exercise and thus future studies may be warranted.

Exercise-induced muscle damage (EIMD) is associated with oxidative stress and inflammation, muscle soreness, and reductions in muscle function. Cocoa flavanols (CF) are (poly)phenols with antioxidant and anti-inflammatory effects and thus may attenuate symptoms of EIMD. The purpose of this narrative review was to collate and evaluate the current literature investigating the effect of CF supplementation on markers of exercise-induced oxidative stress and inflammation, as well as changes in muscle function, perceived soreness, and exercise performance. Acute and sub-chronic intake of CF reduces oxidative stress resulting from exercise. Evidence for the effect of CF on exercise-induced inflammation is lacking and the impact on muscle function, perceived soreness and exercise performance is inconsistent across studies. Supplementation of CF may reduce exercise-induced oxidative stress, with potential for delaying fatigue, but more evidence is required for any definitive conclusions on the impact of CF on markers of EIMD.Graphic abstract

The current investigation examined professional academy soccer players' perceived experiences of loan environments, compared to their previous academy experiences. Fifteen professional soccer players completed season-long loans at various European soccer clubs. Individual semi-structured interviews were conducted following the loans to determine the physical, technical, tactical, psychological, and psychosocial differences between their loan, and existing academy environments. Inductive content analysis was conducted on the interviews to build a system of categories explaining the holistic experiences of player’s loan experiences. Key themes that emerged were greater perceived physical demands on loan, but similar or lower technical demands. Players were exposed to a wider range of playing styles on loan. Some players struggled with the reduced feedback and communication surrounding their performances on loan compared to the academy, and had difficulty interacting with peers. The current investigation highlights areas for consideration to ensure a smooth transition between academy and loan environments.

This systematic review and meta-analysis of randomized controlled trials examined whether dietary nitrate supplementation attenuates exercise-induced muscle damage (EIMD) and is reported according to the PRISMA guidelines. Medline and SPORTDiscus databases were searched from inception to June 2020. Inclusion criteria were studies in adult humans consuming inorganic nitrate before and after exercise and that measured markers implicated in the etiology of EIMD (muscle function, muscle soreness, inflammation, myocellular protein efflux, oxidative stress, range of motion) p = 0.01) and countermovement jump performance 24–72 h post-exercise (SMD range: 0.75-1.32, p < 0.03). Pressure pain threshold was greater with beetroot juice 48 (SMD: 0.58, p = 0.03) and 72 h post-exercise (SMD: 0.61, p = 0.02). Beetroot juice had no effect on markers of oxidative stress and creatine kinase (p > 0.05), but c-reactive protein was higher vs. placebo at 48 h post-exercise (SMD: 0.55, p = 0.03). These findings suggest that nitrate-rich beetroot juice may attenuate some markers of EIMD, but more large-scale controlled trials in elite athletes are needed.

This systematic review and meta-analysis examined the effects of creatine supplementation on recovery from exercise-induced muscle damage, and is reported according to the PRISMA guidelines. MEDLINE and SPORTDiscus were searched for articles from inception until April 2020. Inclusion criteria were adult participants (≥18 years); creatine provided before and/or after exercise versus a noncreatine comparator; measurement of muscle function recovery, muscle soreness, inflammation, myocellular protein efflux, oxidative stress; range of motion; randomized controlled trials in humans. Thirteen studies (totaling 278 participants; 235 males and 43 females; age range 20–60 years) were deemed eligible for analysis. Data extraction was performed independently by both authors. The Cochrane Collaboration Risk of Bias Tool was used to critically appraise the studies; forest plots were generated with random-effects model and standardized mean differences. Creatine supplementation did not alter muscle strength, muscle soreness, range of motion, or inflammation at each of the five follow-up times after exercise (p > .05). Creatine attenuated creatine kinase activity at 48-hr postexercise (standardized mean difference: −1.06; 95% confidence interval [−1.97, −0.14]; p = .02) but at no other time points. High (I2; >75%) and significant (Chi2; p

Purpose To examine the prevalence of disordered eating (DE) in elite male and female soccer players and the influence of perfectionism. Methods Using a cross-sectional design, elite male (n = 137) and female (n = 70) soccer players and non-athlete controls (n = 179) completed the clinical perfectionism questionnaire (CPQ-12) and the eating attitudes test (EAT-26) to assess perfectionism and DE risk, respectively. Results Male soccer players had higher EAT-26 scores than controls (10.4 ± 9.9 vs. 6.8 ± 6.7; P = 0.001), but there were no differences in the prevalence of clinical levels of DE (EAT-26 score ≥ 20) (15 vs. 5%, respectively; X2 = 0.079) The proportion of females with DE risk was higher in controls [EAT-26: 13.9 ± 11.6 (25% of population)] than female players [EAT-26: 10.0 ± 9.0% (11% of population)] (X2 = 0.001). With linear regression, perfectionism explained 20% of the variation in DE risk in males (P = 0.001); in females, athletic status (player vs. control) and perfectionism were significant predictors of DE risk, explaining 21% of the variation (P = 0.001). Male reserve team players had higher EAT-26 (+ 3.5) and perfectionism (+ 2.7) scores than first-team players (P X2 = 0.595). Conclusions The prevalence of DE risk was not different in elite male and female soccer players; in fact, the prevalence was greatest in non-athlete female controls. Perfectionism is a significant predictor of DE risk in males and females. Level of evidence III, case–control study.

Introduction Dietary inorganic nitrate is a popular nutritional supplement, which increases nitric oxide bioavailability and may improve exercise performance. Despite over a decade of research into the effects of dietary nitrate supplementation during exercise there is currently no expert consensus on how, when and for whom this compound could be recommended as an ergogenic aid. Moreover, there is no consensus on the safe administration of dietary nitrate as an ergogenic aid. This study aimed to address these research gaps. Methods The modified Delphi technique was used to establish the views of 12 expert panel members on the use of dietary nitrate as an ergogenic aid. Over three iterative rounds (two via questionnaire and one via videoconferencing), the expert panel members voted on 222 statements relating to dietary nitrate as an ergogenic aid. Consensus was reached when > 80% of the panel provided the same answer (i.e. yes or no). Statements for which > 80% of the panel cast a vote of insufficient evidence were categorised as such and removed from further voting. These statements were subsequently used to identify directions for future research. Results The 12 panel members contributed to voting in all three rounds. A total of 39 statements (17.6%) reached consensus across the three rounds (20 yes, 19 no). In round one, 21 statements reached consensus (11 yes, 10 no). In round two, seven further statements reached consensus (4 yes, 3 no). In round three, an additional 11 statements reached consensus (5 yes, 6 no). The panel agreed that there was insufficient evidence for 134 (60.4%) of the statements, and were unable to agree on the outcome of the remaining statements. Conclusions This study provides information on the current expert consensus on dietary nitrate, which may be of value to athletes, coaches, practitioners and researchers. The effects of dietary nitrate appear to be diminished in individuals with a higher aerobic fitness (peak oxygen consumption [V̇O2peak] > 60 ml/kg/min), and therefore, aerobic fitness should be taken into account when considering use of dietary nitrate as an ergogenic aid. It is recommended that athletes looking to benefit from dietary nitrate supplementation should consume 8–16 mmol nitrate acutely or 4–16 mmol/day nitrate chronically (with the final dose ingested 2–4 h pre-exercise) to maximise ergogenic effects, taking into consideration that, from a safety perspective, athletes may be best advised to increase their intake of nitrate via vegetables and vegetable juices. Acute nitrate supplementation up to ~ 16 mmol is believed to be safe, although the safety of chronic nitrate supplementation requires further investigation. The expert panel agreed that there was insufficient evidence for most of the appraised statements, highlighting the need for future research in this area. Graphical Abstract

Penile cancer is a rare but debilitating condition, which often requires aggressive treatment. Partial penectomy is considered as a treatment option when a sufficient portion of the penile shaft can be maintained to preserve functionality. This systematic review, which followed the PRIMSA guidelines, aimed to evaluate the effects of partial penectomy for penile cancer on sexual function—the maintenance of which is often a priority in patient groups—and to identify potential factors which may moderate these effects. A systematic search of PubMed, The Cochrane Library, and Open Grey as well as MEDLINE, CINAHL and Open Dissertations via EBSCOhost was conducted from inception through to 24thMarch, 2022. Studies were required to include adults aged ≥18 years who had undergone partial penectomy for the treatment of penile cancer, with a quantitative measure of sexual function available pre- and post-surgery. Four eligible articles were identified for inclusion in this review, three of which reported a decrease in sexual function pre- to post-surgery across all domains of the International Index of Erectile Function (IIEF) questionnaire (erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction). Conversely, one study reported an increase in sexual function across IIEF domains, except for orgasmic function, which decreased, pre- to post-surgery. Greater penile length was associated with higher post-operative sexual function, whilst increasing age and higher anxiety levels were associated with lower post-operative sexual function levels in one study. Despite the overall drop in sexual function, many patients were still able to maintain satisfactory sex lives following partial penectomy. Given the limited research in this area and small sample sizes across studies, additional well-controlled investigations are warranted to provide further evidence on the effects of partial penectomy for penile cancer on sexual function.

Although physical activity is a health-promoting, popular global pastime, regular engagement in strenuous exercises, such as long-distance endurance running races, has been associated with a variety of detrimental physiological and immunological health effects. The resulting altered physiological state has previously been associated with fluctuations in various key metabolite concentrations, however, limited literature exists pertaining to the global/holistic metabolic changes that are induced by such. This investigation subsequently aims at elucidating the metabolic changes induced by a marathon by employing an untargeted proton nuclear magnetic resonance (1H-NMR) spectrometry metabolomics approach. A principal component analysis (PCA) plot revealed a natural differentiation between pre- and post-marathon metabolic profiles of the 30-athlete cohort, where 17 metabolite fluctuations were deemed to be statistically significant. These included reduced concentrations of various amino acids (AA) along with elevated concentrations of ketone bodies, glycolysis, tricarboxylic acid (TCA) cycle, and AA catabolism intermediates. Moreover, elevated concentrations of creatinine and creatine in the post-marathon group supports previous findings of marathon-induced muscle damage. Collectively, the results of this investigation characterize the strenuous metabolic load induced by a marathon and the consequential regulation of main energy-producing pathways to accommodate this, and a better description of the cause of the physiological changes seen after the completion of a marathon.

Nutrition plays a key role in training for, and competing in, competitive sport, and is essential for reducing risk of injury and illness, recovering and adapting between bouts of activity, and enhancing performance. Consumption of a Mediterranean diet (MedDiet) has been demonstrated to reduce risk of various non-communicable diseases and increase longevity. Following the key principles of a MedDiet could also represent a useful framework for good nutrition in competitive athletes under most circumstances, with potential benefits for health and performance parameters. In this review, we discuss the potential effects of a MedDiet, or individual foods and compounds readily available in this dietary pattern, on oxidative stress and inflammation, injury and illness risk, vascular and cognitive function, and exercise performance in competitive athletes. We also highlight potential modifications which could be made to the MedDiet (whilst otherwise adhering to the key principles of this dietary pattern) in accordance with contemporary sports nutrition practices, to maximise health and performance effects. In addition, we discuss potential directions for future research.

Background Dietary inorganic nitrate (NO3−) is a polyatomic ion, which is present in large quantities in green leafy vegetables and beetroot, and has attracted considerable attention in recent years as a potential health-promoting dietary compound. Numerous small, well-controlled laboratory studies have reported beneficial health effects of inorganic NO3− consumption on blood pressure, endothelial function, cerebrovascular blood flow, cognitive function, and exercise performance. Translating the findings from small laboratory studies into ‘real-world’ applications requires careful consideration. Main body This article provides a brief overview of the existing empirical evidence basis for the purported health-promoting effects of dietary NO3− consumption. Key areas for future research are then proposed to evaluate whether promising findings observed in small animal and human laboratory studies can effectively translate into clinically relevant improvements in population health. These proposals include: 1) conducting large-scale, longer duration trials with hard clinical endpoints (e.g. cardiovascular disease incidence); 2) exploring the feasibility and acceptability of different strategies to facilitate a prolonged increase in dietary NO3− intake; 3) exploitation of existing cohort studies to explore associations between NO3− intake and health outcomes, a research approach allowing larger samples sizes and longer duration follow up than is feasible in randomised controlled trials; 4) identifying factors which might account for individual differences in the response to inorganic NO3− (e.g. sex, genetics, habitual diet) and could assist with targeted/personalised nutritional interventions; 5) exploring the influence of oral health and medication on the therapeutic potential of NO3− supplementation; and 6) examining potential risk of adverse events with long term high- NO3− diets. Conclusion The salutary effects of dietary NO3− are well established in small, well-controlled laboratory studies. Much less is known about the feasibility and efficacy of long-term dietary NO3− enrichment for promoting health, and the factors which might explain the variable responsiveness to dietary NO3− supplementation between individuals. Future research focussing on the translation of laboratory data will provide valuable insight into the potential applications of dietary NO3− supplementation to improve population health.

The aim of this study was to investigate amateur runners’ knowledge and practices of the current sports nutrition guidelines for pre and post-event carbohydrate (CHO) and protein (PRO) intakes. Data was collected from 100 amateur runners using an online survey. Participants provided demographic information, a dietary recall of their intake 24 (n = 49) and 1–4 h before and immediately after a long-distance run (≥ 60–90 min in duration) for analysis of CHO and PRO contents (n = 82). They also answered questions about their knowledge of the current CHO and PRO recommendations and their primary sources of nutrition information. CHO intake 24-h pre-exercise (3.3 ± 1.7 g kg day−1) was lower than the currently recommended intakes of 10–12 g kg−1 for effective CHO loading (P = 0.001). Average CHO intake 1–4 h pre-exercise (1.2 ± 0.6 g kg−1) were within the recommended amounts > 1.0 g kg-1 (P > 0.05); however, only 60% of participants consumed ≥ 1.0 g kg−1. Post-exercise CHO intakes (1.1 ± 0.8 g kg−1) were not different from the recommended guidelines ≥ 1.0 g kg−1 (P = 0.190) but only ~ 48% of participants achieved this target. Average PRO intake post-exercise exceeded the minimum recommended guidelines (≥ 0.25 g kg−1) by ~ 0.15 g kg−1 (P = 0.001); however, only ~ 75% of participants consumed ≥ 0.25 g kg−1. Overall, knowledge of the current CHO and PRO intakes pre and post-exercise were poor, with

We conducted a systematic review of human trials examining the effects of dietary phytochemicals on Nrf2 activation. In accordance with the PRISMA guidelines, Medline, Embase and CAB abstracts were searched for articles from inception until March 2020. Studies in adult humans that measured Nrf2 activation (gene or protein expression changes) following ingestion of a phytochemical, either alone or in combination were included. The study was pre-registered on the Prospero database (Registration Number: CRD42020176121). Twenty-nine full-texts were retrieved and reviewed for analysis; of these, eighteen were included in the systematic review. Most of the included participants were healthy, obese or type 2 diabetics. Study quality was assessed using the Cochrane Collaboration Risk of Bias Assessment tool. Twelve different compounds were examined in the included studies: curcumin, resveratrol and sulforaphane were the most common (n = 3 each). Approximately half of the studies reported increases in Nrf2 activation (n = 10); however, many were of poor quality and had an unclear or high risk of bias. There is currently limited evidence that phytochemicals activate Nrf2 in humans. Well controlled human intervention trials are needed to corroborate the findings from in vitro and animal studies. Supplementary information The online version of this article (10.1007/s11033-020-06041-x) contains supplementary material, which is available to authorized users.

We performed a systematic review and meta-analysis to determine whether (poly)phenol supplementation augments the physiological adaptations to exercise training. Eligible studies administered a (poly)phenol supplement alongside ≥2 weeks of supervised exercise in adult humans. After screening, 22 studies were included in the analysis. Isoflavones and green tea (poly)phenols were administered most frequently. Quality assessments suggested most studies were free from bias. (Poly)phenols had no effect on training-induced adaptations in muscle strength, peak power output, and V̇O2max, but enhanced exercise capacity (SMD: 0.67, 95% CI: 0.25 to 1.09, p < 0.01). (Poly)phenols had no overall effect on fat loss (SMD: 0.10, 95% CI: −0.10 to 0.29; p = 0.97) or lean mass gains (SMD: 0.06, 95% CI: −0.18 to 0.30, p = 0.62) but sub-analysis suggested that isoflavones increased lean mass (SMD: 0.25, 95 CI%: −0.00 to 0.50, p = 0.05). Resveratrol impaired adaptations in two studies, although this was a non-statistically significant finding (SMD: −0.54, 95% CI: −1.15 to 0.07, p = 0.08). Our results suggest that isoflavones may augment aspects of the adaptive response to exercise training, while resveratrol may compromise training adaptations. More high-quality research is needed to resolve the effects of (poly)phenols on exercise training adaptations.

Purpose: To investigate the cognitive, physical, and perceptual effects of sleep restriction (SR) in soccer players following a night match. Methods: In a crossover design, nine male soccer players...

Purpose: This study examined whether a higher protein diet following strenuous exercise can alter markers of muscle damage and inflammation in older adults. Methods: Using a double-blind, independent group design, 10 males and eight females (age 57 ± 4 years; mass 72.3 ± 5.6 kg; height 1.7 ± 6.5 m) were supplied with a higher protein (2.50 g·kg−1·day−1) or moderate protein (1.25 g·kg−1·day−1) diet for 48 hr after 140 squats with 25% of their body mass. Maximal isometric voluntary contractions, muscle soreness, creatine kinase, Brief Assessment of Mood Adapted, and inflammatory markers were measured preexercise, and 24 hr and 48 hr postexercise. Results: The maximal isometric voluntary contractions decreased postexercise (p = .001, ), but did not differ between groups (p = .822, ). Muscle soreness peaked at 24 hr post in moderate protein (44 ± 30 mm) and 48 hr post in higher protein (70 ± 46 mm; p = .005; ); however, no group differences were found (p = .585; ). Monocytes and lymphocytes significantly decreased postexercise, and eosinophils increased 24 hr postexercise (p p > .05). Conclusion: In conclusion, 2.50 g·kg−1·day−1 of protein is not more effective than 1.25 g·kg−1·day−1 for attenuating indirect markers of muscle damage and inflammation following strenuous exercise in older adults.

Background Chronic wounds continue to be a burden to healthcare systems, with ageing linked to increased prevalence of chronic wound development. Nutraceutical collagen peptides have been shown to reduce signs of skin ageing, but their therapeutic potential for cutaneous wound healing remains undefined. Aim To determine the potential for nutraceutical collagen peptides to promote cutaneous wound healing in vitro in the context of age. Methods The potential for bovine- or porcine-derived nutraceutical collagen peptides to promote wound healing of primary cutaneous fibroblasts and keratinocytes derived from young and aged individuals in vitro was assessed by two-dimensional scratch and cell-viability assays and by immunofluorescence for the cell proliferation marker, Ki67. The achievement of peptide concentrations in vivo, equivalent to those exerting a beneficial effect on wound healing in vitro, was confirmed by pharmacokinetic studies of hydroxyproline, a biomarker for collagen peptide absorption, following peptide ingestion by healthy individuals over a wide age range. Results Results demonstrated significant nutraceutical collagen peptide-induced wound closure of both young and aged fibroblasts and keratinocytes, mediated by enhanced cellular proliferation and migration. Analysis of blood levels of hydroxyproline in young and aged individuals following porcine collagen peptide ingestion revealed peak serum/plasma levels after 2 h at similar concentrations to those exerting beneficial effects on wound healing in vitro. Conclusion These data demonstrate the capacity for nutraceutical collagen peptides to promote cutaneous wound closure in vitro, at pharmacologically achievable concentrations in vivo, thereby offering a potential novel therapeutic strategy for the management of cutaneous wounds in young and aged individuals.

Endurance athlete performance is greatly dependent on sufficient post-race system recovery, as endurance races have substantial physiological, immunological and metabolic effects on these athletes. To date, the effects of numerous recovery modalities have been investigated, however, very limited literature exists pertaining to metabolic recovery of athletes after endurance races without the utilisation of recovery modalities. As such, this investigation is aimed at identifying the metabolic recovery trend of athletes within 48 h after a marathon. Serum samples of 16 athletes collected 24 h before, immediately after, as well as 24 h and 48 h post-marathon were analysed using an untargeted two-dimensional gas chromatography time-of-flight mass spectrometry metabolomics approach. The metabolic profiles of these comparative time-points indicated a metabolic shift from the overall post-marathon perturbed state back to the pre-marathon metabolic state during the recovery period. Statistical analyses of the data identified 61 significantly altered metabolites including amino acids, fatty acids, tricarboxylic acid cycle, carbohydrates and associated intermediates. These intermediates recovered to pre-marathon related concentrations within 24 h post-marathon, except for xylose which only recovered within 48 h. Furthermore, fluctuations in cholesterol and pyrimidine intermediates indicated the activation of alternative recovery mechanisms. Metabolic recovery of the athletes was attained within 48 h post-marathon, most likely due to reduced need for fuel substrate catabolism. This may result in the activation of glycogenesis, uridine-dependent nucleotide synthesis, protein synthesis, and the inactivation of cellular autophagy. These results may be beneficial in identifying more efficient, targeted recovery approaches to improve athletic performance.

The present study assessed changes in academy soccer players’ perception of mental fatigue (MF) across a competitive season, investigating the relationship between MF and other subjective measures of wellness. Ten players completed a modified Brief Assessment of Mood (BAM+) questionnaire that included the question: ‘How mentally fatigued do you feel’? on match-day (MD) and one (MD+1), two (MD+2) and three (MD+3) days post-match (35 matches). Players reported their MF, along with other subjective measures (sleep, muscle soreness, fatigue and motivation). Results found MF was elevated on MD+1 (43±1 mm) compared to all other days (all P≤0.001). Players reported lower MF on MD+1 in the late-season phase (34±2 mm) compared to both early- (50±2 mm, P≤0.001) and mid-season (46±2 mm, P≤0.001). This coincided with an 80%-win rate in the late-season phase versus the early- (33%) and mid-season (50%). There were very strong repeated-measures correlations between changes in MF and sleep (r=-0.77), muscle soreness (r=0.94), fatigue (r=0.92) and motivation (r =-0.89; all P≤0.0005). In conclusion, MF was closely aligned to match success and other wellness variables. This data suggests a potential lack of sensitivity for identifying MF using a subjective questionnaire. Therefore, researchers and practitioners could work together to identify other ways of practically assessing MF.

Polyphenol consumption has become a popular method of trying to temper muscle damage. Cocoa flavanols (CF) have attracted attention due to their high polyphenol content and palatability. As such, this study will investigate whether an acute dose of CF can aid recovery following exercise-induced muscle damage. The study was a laboratory-based, randomized, single-blind, nutrient-controlled trial involving 23 participants (13 females and 10 males). Participants were randomized into either control ∼0 mg CF (n = 8, four females); high dose of 830 mg CF (CF830, n = 8, five females); or supra dose of 1,245 mg CF (CF1245, n = 7, four females). The exercise-induced muscle damage protocol consisted of five sets of 10 maximal concentric/eccentric hamstring curls and immediately consumed their assigned drink following completion. To measure muscle recovery, maximal voluntary isometric contraction (MVIC) of the knee flexors at 60° and 30°, a visual analog scale (VAS), and lower-extremity function scale were taken at baseline, immediately, 24-, 48-, and 72-hr postexercise-induced muscle damage. There was a main effect for time for all variables (p p ≥ .17). At 48 hr, there were large effect sizes between control and CF1245 for MVIC60 (p = .17, d = 0.8); MVIC30 (p = .26, d = 0.8); MVIC30 percentage change (p = .24 d = 0.9); and visual analog scale (p = .25, d = 0.9). As no significant differences were observed following the consumption of CF, there is reason to believe that CF offer no benefit for muscle recovery when ingested acutely.

Purpose Orthorexia nervosa (ON) is a pattern of eating characterized by a pathological fixation on restricting foods based on their perceived health. Like many eating disorders, ON is thought to be more prevalent in athletes. This was a preliminary study to explore the prevalence of ON in University students to determine whether those who compete in University sports have higher orthorexic tendencies. Methods 116 male and female student athletes (age 21 ± 1 years) and 99 non-athlete controls (21 ± 2) from Universities in the North East of the UK completed the ORTO-15 test (≤ 40 being the cutoff) used to screen individuals for ON. Results ON symptoms were high in all students (76%); there was no difference in ORTO-15 scores between the athletes (36.6 ± 3.9) and non-athlete controls (37.2 ± 3.8; P = 0.279). There was a difference in scores between those who completed ≥ 10 h of exercise per week (36.65 ± 4.38) and those who do ≤ 10 h a week (37.38 ± 3.65) (P = 0.008; ES = 0.43). ORTO-15 scores were not higher in athletes competing in aesthetic and weight dependent sports (P > 0.05). Conclusions Being a student athlete for a University sports team did not affect ON prevalence; however, there appears to be a greater risk for students in general, and for athletes who undertake high volumes of exercise. Nonetheless, the high prevalence of ON symptoms may be attributed to flaws in the ORTO-15 questionnaire, and therefore, future studies should focus on developing a more valid method for ON diagnosis. Level of evidence III, case-control study.

We conducted a systematic review and meta-analysis of randomized controlled trials examining the effect of vitamin C and/or E on exercise-induced training adaptations. Medline, Embase and SPORTDiscus databases were searched for articles from inception until June 2019. Inclusion criteria was studies in adult humans where vitamin C and/or E had to be consumed alongside a supervised exercise training program of ≥4 weeks. Nine trials were included in the analysis of aerobic exercise adaptations and nine for resistance training (RT) adaptations. Vitamin C and/or E did not attenuate aerobic exercise induced improvements in maximal aerobic capacity (V̇O2max) (SMD −0.14, 95% CI: −0.43 to 0.15, P = 0.35) or endurance performance (SMD −0.01, 95% CI: −0.38 to 0.36, P = 0.97). There were also no effects of these supplements on lean mass and muscle strength following RT (SMD −0.07, 95% CI: −0.36 to 0.23, P = 0.67) and (SMD −0.15, 95% CI: −0.16 to 0.46, P = 0.35), respectively. There was also no influence of age on any of these outcomes (P > 0.05). These findings suggest that vitamin C and/or E does not inhibit exercise-induced changes in physiological function. Studies with larger sample sizes and adequate power are still required.