Research Update 2005 Chiropractic Sports Sciences Symposium Sports Nutrition With Strength and Conditioning Exercise Physiology and Spine/General Studies with Practical Application - PowerPoint PPT Presentation

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Research Update 2005 Chiropractic Sports Sciences Symposium Sports Nutrition With Strength and Conditioning Exercise Physiology and Spine/General Studies with Practical Application


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Title: Research Update 2005 Chiropractic Sports Sciences Symposium Sports Nutrition With Strength and Conditioning Exercise Physiology and Spine/General Studies with Practical Application

Research Update2005 Chiropractic Sports Sciences
Symposium Sports NutritionWith Strength and
ConditioningExercise Physiology
andSpine/General Studies with Practical
  • G. Douglas Andersen, DC, DACBSP, CCN

Sugar Utilization During Exercise
  • Sucrose (S), fructose (F), maltodextrin (MD), and
    glucose (G) are, in part, absorbed by different
    transport mechanisms
  • CHO oxidation during cycling exercise peaks at 1
    gr/min for G1 and MD2
  • SG or FG peak at 1.25 g/min1
  • MD F (67-33) reached 1.5 g/ min during
  • A GSF mix (50 25 25) reached 1.7 g/min
    during exercise1
  • Endogenous CHO oxidation 25 lower with 3 sugar
  • 1Jentjens, R.L., Achten, J., Jeukendrup, A.E.
    High Oxidation Rates from a Mixture of Glucose,
    Sucrose and Fructose Ingested During Prolonged
    Exercise. Med. Sci. Sp. Ex. 2004 36(5) S19
  • 2Wallis, G.A., Rowlands, D.S., Shaw, C. et al.
    Oxidation of Comined Ingestion of Maltodextrins
    and Fructose during Exercise. Med. Sci. Sp. Ex.
    2004 37(3) 426-432

CHO in Simulated Team Sport Conditions
  • No debate on CHOs ability to improve endurance
  • Growing evidence that CHOs help intermit high
    intensity exercise as well
  • This study showed 6 CHO solution superior to
    placebo after 4-15 minute quarters of shuttle
    drills ranging from running, sprinting, repeated
    jumps, to walk/jog, stops/starts, and skill test
  • Compared to placebo, CHO drink resulted in faster
    20m sprint time, higher average jump height,
    better motor skills and improved mood in the 4th
  • This study showed 6 CHO drink preserves both
    physical and central nervous system function late
    in the game
  • Winnick, J.J., Davis, J.M., Welsh, R.S., et al.
    Carbohydrate Feedings during Team Sport Exercise
    Preserve Physical and CNS Function. Med. Sci. Sp.
    Ex. 2005 37(2) 306-315

Carbo Mouthwash
  • 9 endurance cyclists (7 M, 2 F) completed 2 set
    workloads as fast as possible
  • On 8 occasions during the ride, subjects rinsed
    for 5 seconds with a 6.4 maltodextrin carb drink
    (C) or a zero carb placebo (P)
  • They were not allowed to swallow either solution
  • 7 days later they rode again with the opposite
  • Results
  • Power output was greater in 8/9 subjects when
    they gargled with CHO drink versus the placebo
  • Ave power output C-259 W P-252 W
  • Performance times C 59.571.50 min vs. P
    61.371.56 min
  • Are there oral C receptors that stimulate reward
    or pleasure centers in the brain?
  • Carter, J. M., Jeukendrop, A.E., Jones, D.A. The
    Effect of Carbohydrate Mouth Rinse on 1-h Cycle
    Time Trail Performance. Med. Sci. Sp. Ex. 2004
    36(12) 2107-2111

Placebo Sports Drink
  • 16 runners randomly ran 5k time trials
  • They consumed water or water falsely labeled as a
    new ergogenic aid sports drink. They also viewed
    a video about how great the product was..
  • 12/16 ran faster with the placebo. (2140 248
    vs. 2154 320) although statistical
    significance was not achieved
  • The final 400 meters were run 2.5 seconds faster
    with the placebo
  • Foster, C., Felker, H., Porcari, J.P, et al The
    Placebo Effect on Exercise Performance. Med. Sci.
    Sp. Ex. 2004 36(5) S171

CHO/Protein Fluid Replacement Drink Improves
Speed Reaction in Ice Hockey
  • Methods
  • 1 goalie and 4 skaters were NCAA Div 1 hockey
  • Blinded/counter balanced treatment
  • Consumed 1 quart during two 90 minute practices
  • Placebo and 8 CHO/P drinks were reversed 1 wk
  • Shooting drills, sprints, and reaction times were
  • Results
  • Skating speed improved 8 (23 vs. 25 seconds)
  • Scoring improved from 3.25 to 3.5 goals
  • Goalie skate time was faster (4.34 vs. 4.38
  • Goalie reaction time was faster (R L) .126/.126
    vs. .138/.146
  • Olson, B., Seifert, J. The Effects of a
    Carbohydrate/Protein Dink on Skating Performance
    in Collegiate Hockey Players. Med. Sci. Sp. Ex.
    2004 36(5) S13

CHO Protein drink vs. CHO drink on time to
Fatigue Muscle Damage
  • 15 cyclists rode exercise bike to exhaustion at
    70 VO2 max and repeated ride 12-15 hr later at
    85 VO2 max
  • They consumed either 7.3 CHO drink or 7.3 CHO
    drink with 1.8 whey protein at a rate of 4oz
    per 15 min
  • 14 days later the test was repeated with the
    other solution
  • Results CHO CHO P longer CHO P
  • Ride 1 82 min 106 min 29
  • Ride 2 31 min 44 min 40
  • Adding P to CHO beverage improved performance in
    both rides regardless of what order the subjects
    got the CHO P drink

CHO/P drink vs. CHO drink Cont
  • Time of exhaustion with CHO drink was 82 min.
  • At 82 min., CHO calories ingested were 186 CHO
    P calories ingested were 232
  • At 106 min. total caloric intake for CHO P
    riders was 325 kcal
  • Total calories expended at end of CHO P ride
    were an additional 318 kcal more than the CHO
    ride - but only 139 more calories were ingested
  • Previous studies have shown CHO P accelerates
    glycogen resynthesis1 and storage2 - Thus, ride
    one improvement may be explained via increased
    resynthesis while the ride two benefit is likely
    due to greater storage of glycogen
  • 1Lvy, et al. J Appl. Physiol. 93 1337-44, 2002
  • 2Willaims, et al. J Strength Cond. Res. 1712-19,

CHO/P drink vs. CHO drinkcont on Muscle Damage
  • Creatine phosphokinase (CPK) is a good indicator
    of muscle damage
  • CPK was measured 30 min prior to the 1st ride to
    exhaustion and again 12-15 hrs later
  • Pre ride CPK levels were the same in both groups.
    Post ride levels averaged 1318 u/L for CHO and
    216 u/L for CHO P were 83 less
  • This indicates 1.8 P added to a 7.3 CHO drink
    reduced post exercise muscle damage and increased
    time to exhaustion (in both rested and recovering
    rides) when compared to a 7.3 CHO only drink.
  • Saunders, M.J., Kane, M.D., Todd, M.K. Effects of
    a Carbohydrate-Protein Beverage on Cycling
    Endurance and Muscle Damage. Med. Sci. Sp. Ex.
    2004 36(7) 1233-1238

Glycemic Index Meals Low vs. High
  • 8 21 23 yr old males preformed a treadmill run
    for 90 minutes at 70 VO2 max
  • 8 g/kg/bw CHO for 24 hrs was either low or high
    GI Index
  • Following overnight fast, 70 VO2 max run to
  • Average time to exhaustion, Low GI 108 min. Hi
    GI 96 min.
  • Comments
  • - Results suggest improvement was due to greater
    fat oxidation during the run to exhaustion on an
    empty stomach 24 hrs later
  • - Pearl Hi GI carbs for 1st 2-4 hrs post
    exercise, then low GI foods for the next 20-22
  • Stevenson, E.J., Willaims, C., McComb, G., et al.
    Improved Recovery from Prolonged Exercise
    Following the Consumption of Low Glycaemic Index
    Carbohydrate Meals. Med. Sci. Sp. Ex. 2004
    36(5) S21

Omega 3 Fatty Acids
  • 7 men (23-24 years old) participated in 4
    treatment conditions and then were tested with a
    glucose challenge 15 hours later
  • 1. 3 days of rest
  • 2. 3 days of a brisk 1 hour walk
  • 3. 3 days of rest after 5-6 weeks of 4.5 gr/d of
    omega 3 fatty acid supplements
  • 4. 3 days of brisk 1 hour walk after 5-6 weeks of
    4.5 gr/d of omega 3 fatty acid supplements

Omega 3 Fatty Acids Cont
  • Insulin (uU/ml) response to glucose challenge (15
    hrs post ex)
  • Rest Rest Sup. Walk Walk Sup
  • 5805 4961 4403 4194
  • Exercise reduced insulin levels 24 vs. rest
  • Rest and Omega 3s reduced insulin 14.5 vs. rest
  • Exercise and Omega 3s reduced insulin 15.5 vs.
  • Ben-Ezra, V., Clark, S.J., Wooten, J.S., et al.
    The Independent and Combined Effects of n-3
    Polyunsaturated Fatty Acids and Exercise on
    Insulin Responses. Med. Sci. Sp. Ex. 2004 36(5)

Protein Strength
  • 51 subjects, 18-25 yrs. old (28 M, 23 F) were in
    a 6 month strength and conditioning program
  • They received either a - 42 gr protein, 24 gr
    carb, 2 gr fat drink twice daily or a 70 gr carb
    drink twice a day for 6 months. The calories,
    vitamins and minerals were the same in both
  • Training was 3 d/wk weight training and 3 d/wk
  • Diet records done at baseline, 3 and 6 months
    indicated no difference in calories between the
  • Protein intake was 2.2 g/kg/bw in protein group
    and 1.1 g/kg/bw in carb group

Protein Strength Cont
  • Baseline 3M 6M
  • Placebo
  • Bench Press, kg 55.8 7.2 70.0 8.4
    75.2 7.8
  • Hip Sled, kg 156.2 14.9 205.9 18.8
    231.4 18.8
  • Protein
  • Bench Press, kg 53.5 5.9 71.8 6.9
    80.8 7.1
  • Hip Sled, kg 141.0 12.8 194.9 12.8
    216.2 12.4
  • Protein improved bench press but not the hip sled
  • (GDA Study should be repeated with more
  • Vukovich, M.D., Tausz, S.M., Ballard, T.L., et
    al. Effect of Protein Supplementation During a
    6-month Strength and Conditioning Program on
    Muscular Strength. Med. Sci. Sp. Ex. 2004 36(5)

Raisins vs. Sports Gels
  • 8 trained cyclists did a 45 minute exercise bike
    ride followed immediately by a 15 minute
    performance trail
  • 45 minutes before the ride, 1 g/kg/bw of a sports
    gel or raisins were consumed
  • The experiment was repeated with the opposite CHO
  • Raisins are considered to be a moderate glycemic
    index (GI) food sports gels are high GI index
  • There was no difference in performance
  • Following exercise, free fatty acids were
    elevated in the raisin group but not the gel
  • This study was funded by the California Raisin
    Marketing Board
  • Kern, M., Heslin, C.J., Rezende, R.S. Metabolic
    and Performance Effects of Raisions Versus Sports
    Gel as Preexercise Feedings in Cyclists. Med.
    Sci. Sp. Ex. 2004 36(5) S174

Ergogenic Aids TCA Intermediates
  • 3 Tricarboxylic-Acid-Cycle intermediates
    (pyridoxine-alpha-ketogluterate, malate and
    succinate) with low dose vitamins, minerals,
    amino acid, and accessory nutrients (L-Carnitine,
    CoQ10, lipoic acid, inosine, TMG, glutathione)
  • Cyclists took the supplement or placebo 2x/d for
    3 weeks
  • Following 1 week break, cyclists took the
    opposite treatment for 3 weeks
  • Placebo time to exhaustion was longer (but not
    statistically significant)
  • Brown, A.C., MacRae, H.SH., Turner, N.S.,
    Tricarboxylic-Acid-Cycle Intermediates and Cycle
    Endurance Capacity. Int. J. Sport Nutr. Ex. Meta.
    2004 14(6) 720-729

  • Endurox is standardized ciwujia extract
    (pronounced su-wah-ja)
  • Ciwujia comes from a root grown in NE China
  • Product claims include studies that show
  • Up to 43 in fat metabolism
  • Up to 33 reduction in lactic acid
  • Heart rate during recovery is 20
  • does not reference the studies

Endurox vs. PowerAde vs. Water
  • 18 subjects (20-40 9 male 9 female)
  • 45 minute ride at 65 followed by 2 minute sprint
    increments to fatigue
  • After 15 minutes of rest, a second incremental
    ride to fatigue was done
  • 1st bout E 50.8 minutes PA 51.9 minutes W
    52.0 minutes
  • 2nd bout differences were non-significant
  • Bergen, J.L., McDaniel, K.O., Willhoit, K., et
    al. Effect of Endurox on Exercise Time to
    Fatigue, Recovery, and Recovery Exercise
    Performance. Med. Sci. Sp. Ex. 2004 36(5) S174

Iron Deficiency in Female Athletes vs. Non
  • 55 High school seniors in sports and 92 non
    participants were tested
  • 29/55 athletes (53) and 43/92 general population
    (47) were iron deficient
  • Authors state no statistical difference between
    athletes and non athletes
  • The percent of iron deficient women in studies
    does vary
  • Pearl low energy, sleepy after workouts, cant
    get in shape, little or no red meat think iron!
  • Landahl, G., Börjesson, M., Rödjer, S. Iron
    Deficiency-More Common among Female Athletes than
    Non-athletes? Med. Sci. Sp. Ex. 2004 36(5) S120

High Dose Vitamin E Triathlon
  • 38 athletes got either 800 IU of Vitamin E (d
    alpha tocopherol) or placebo for 8 weeks prior to
    competing in a 3.9 km swim, 180 km bike, and 42
    km run
  • The hypothesis was with severe exertion, Vitamin
    E would attenuate exercise induced increases in
    inflammation, oxidative stress and post race
    immune suppression
  • Plasma alpha tocopherol was 75 higher in the
    Vitamin E group
  • Plasma oxidative stress markers were 181 higher
    than pre race baseline after the race in the
    Vitamin E group but only 97 higher in the
    placebo group
  • Vitamin E neither helped or harmed performance.
    To the authors surprise, high dose E appeared to
    increase oxidative insult
  • Nieman, D.C., Henson, D.A., McAnulty, S.R., et
    al. Vitamin E and Immunity after the Kona
    Triathlon World Championship. Med. Sci. Sp. Ex.
    2004 36(8) 1325-1335

Antioxidant Food
  • Athletes underwent two high intensity run to
    exhaustion (40 min) treadmill tests
  • The exercise test were done after 2 weeks of a
    diet high in antioxidants (HAD) and (after
    washout) repeated the test, following 2 weeks of
    a low antioxidant diet (LAD)
  • Blood tests revealed increased markers of oxidant
    stress after the LAD following sub maximal (38)
    exhaustion (45) and 1 hr of recovery (31)
  • Authors Conclusion
  • These deficiencies in antioxidant capacity can be
    resolved with food alone
  • There is no need for supplements if the diet is
  • Watson, T.A., Callister, R., Taylor, R.D., et al.
    Antioxidant Restriction and Oxidative Stress in
    Short-Duration Exhaustive Exercise. Med. Sci. Sp.
    Ex. 2005 37(1) 63-71

Antioxidants Post Exercise Oxygen Stress
  • 18 obese untrained women ages 19-31 were enrolled
    in a dbl blind study
  • 9 took 400 IU E, 1000 mg C, 90 mcg Se for 14
    days prior and 2 days following eccentric tricep
    exercise, 9 took placebo
  • Eccentric exercise increased the biomarkers of
    protein oxidation 200 from baseline in the
    placebo group but only 50 with antioxidants
  • This protection was maintained at 2, 6, 24, and
    48 hours following the workout
  • Goldfarb, A.H., Bloomer, R.J., McKenzie, M.J.
    Combined Antioxidant Treatment Effects on Blood
    Oxidative Stress after Eccentric Exercise. Med.
    Sci. Sp. Ex. 2005 37(2) 234-239

  • A dipeptide synthesized from lysine and
  • 20 mildly overweight college students took 1 gram
    TID of carnitine (C) for one month or placebo (P)
  • They were further divided into exercise (Ex) and
    non exercise groups
  • Comparison of C, C Ex, P Ex and P, revealed
    that C did lower cholesterol, triglycerides and
    LDL but had no effect on body fat, endurance,
    anaerobic threshold or peak VO2
  • Choi, E.S., Bae, Y.J., Kim, C.K. Effects of
    Carnitine Intake and Aerobic Exercise on Blood
    Lipid Levelsand Physical Performance. Med. Sci.
    Sp. Ex. 2004 36(5) S176

  • Conjugated Linoleic Acid (CLA) research has been
    quite successful in reducing fat and increasing
    lean mass in animals
  • Human research has been generally unimpressive
  • 77 young (average age 25) subjects (37 M, 40 F)
    took 5 grams of CLA/d or placebo for 7 weeks
  • Both groups followed the same strength program
    (3d/wk 12 exercises 3-4 sets)

CLA Cont
  • Results
  • CLA Placebo
  • Lean mass 1.4 kg 0.2 kg
  • Fat mass -0.8 kg -0.4 kg
  • No differences in leg press, knee extension or
    bench press in women
  • Males on CLA increased bench press 31 kg vs. 22
    kg for placebo
  • 17 subjects volunteered to crossover for 7 more
  • The CLA had greater loss of fat mass 0.2 kg vs.
    1.5 kg fat gain
  • Males who crossed over did not duplicate bench
    press gains seen in the initial phase
  • Pinkoski, C., Chilibeck, P.D., Candow, D.G., et
    al. Conjugated Linoleic Acid Supplementation
    During Strength Training. Med. Sci. Sp. Ex. 2004
    36(5) S284

Glutamine Endurance
  • Glutamine is used for the critically ill and
    immune suppressed to maintain muscle mass and/or
    slow muscle loss in these groups
  • Glutamine is the most abundant AA in the human
  • It regulates protein balance in skeletal muscle
    (high levels increase protein synthesis low
    levels cause proteolysis)
  • Endogenous levels are depressed in cases of
  • Glutamine sales are based on extrapolation of the
  • The limited studies on athletic use have been
    generally unimpressive

Glutamine Endurance Cont
  • 12 male cyclists aged 19 - 31
  • Protocol Wingate test - exercise to exhaustion
    - wingate test 2 - 24 hrs rest -wingate test 3
  • Following exercise they were divided into 2
    groups CHO glutamine (.3 g/kg/bw) or CHO drink
    for 6 days
  • On the 7th day, a wingate test and exercise to
    exhaustion was repeated.
  • Results Time to exhaustion increased 3 minutes
    in glutamine group after one week use.
  • Piattoly, T., Welsch, M.A. L-Glutamine
    Supplementation Effects on Recovery from
    Exercise. Med. Sci. Sp. Ex. 2004 36(5) S127

Rhodiola Rosea Endurance
  • AKA Golden Root
  • Grown in the mountains of Europe, Asia, and
  • Claims include CNS stimulation, increased work
    performance, increase muscle strength, also anti
    cancer cardio protective
  • Dbl. Blind study compared one acute dose (200 mg
    1 hr prior to exercise) with 30 days of 200 mg
    doses and retested
  • Results- time to exhaustion increased 24 seconds
    16.8-17.2 min with a single pre event dose, all
    other tests - ability to sustain attention,
    visual reaction time, speed of limb movement, and
    muscular strength were negative. After 30 days,
    retesting the results were unchanged.
  • Conclusion 4 weeks of 200 mg/d was no different
    than a single dose
  • De Bock, K., Eijinde, B.O., Ramaekers, M., et al.
    Acute Rhodiola Rosea Intake Can Improve Endurance
    Exercise Performance. Int. J. Sport Nutr. Ex.
    Meta. 2004 14(3) 298-307

Cordyceps Sinensis Rhodiola Rosea
  • 17 competitive cyclists were tested, randomized
    and given either 3 capsules containing 1000 mg
    CS, 300mg RR, and 800 mg of a blend of pyruvate,
    Na and K phosphate, chromium, ribose and
  • No difference in Peak VO2, time to exhaustion,
    peak power, or peak heart rate
  • Blood lactate, ventilatory threshold and
    respiratory compensation were also unaffected in
    either a positive or negative way
  • Earnest, C.P., Wyatt, F., Lucia, A. Effects of a
    Cordyceps Sensis and Rhodiol Rosea Based Formula
    on Exercise Performance in Cyclists. Med. Sci.
    Sp. Ex. 2004 36(5) S171

Oral ATP
  • 27 males who lift weights completed a dbl. blind
  • Randomly they received 150 mg ATP, 225 mg ATP, or
  • Testing was done at
  • 1. Baseline
  • 2. 7 days later -75 minutes after the first dose
  • 3. Following 14 days of dosing
  • No change in total work, average power or peak
    power output in Wingate testing
  • Authors conclusion may provide small ergogenic
    effect on muscular strength under some treatment
    conditions is based on a 1.5 rep bench press
    increase from baseline in the 1st of 3 sets. This
    followed a 1 rep max which declined 2 kg and
    preceded the 2nd and 3rd sets which were
  • Jordan, A.N., Jurca, R., Abraham, E.H., et al.
    Effects of Oral ATP Supplementation on Anaerobic
    Power and Muscular Strength. Med. Sci. Sp. Ex.
    2004 36(6) 983-990

Creatine, Endurance Exercise Followed by
Resistance Exercise
  • 14 College age women (age 19-23) took Creatine or
  • Creatine 20g/d x 5 then 3g/d x 7 (12 days total)
  • Baseline Leg Press
  • Pre Creatine Pre Placebo
  • 1 rep max 190 kg 179 kg
  • 3 sets (reps) 9.4 - 10.0 - 9.3 8.9 - 8.4 - 8.6
  • reps 80 of 1RM, 2.5 minute rest between sets
  • Then 12 days of creatine or placebo

Creatine, Endurance Exercise Followed by
Resistance Exercise Cont
  • An aerobic task (maximum distance in 20 minutes)
    was preformed followed by a one rep maximum test
    in leg press and then 3 sets
  • 12d Creatine 12d Placebo
  • Aerobic task 3140 244 meters 3420 394 meters
  • 1 rep max 191 kg 181 kg
  • 3 sets (reps) 10.1 - 9.6 - 9.9 7.1 - 4.7 - 4.4
  • Creatine reduced the effect of fatigue on
    strength loss
  • Aoki, M.S., Gomes, R.V., Raso, V. Creatine
    Supplementation Attenuates the Adverse Effect of
    Endurance Exercise on Subsequent Resistance
    Exercise Performance. Med. Sci. Sp. Ex. 2004
    36(5) S334

Acid Buffers
  • Energy from continuous high intensity activity
    causes intra muscular acidity leading to fatigue
  • Hydrogen ions, not lactate ions, cause acidosis
  • Improving the capacity to buffer will retard acid
  • Theoretically this will delay fatigue and
    lengthen time to exhaustion
  • The most common substances are Na bicarbonate, Na
    citrate, and Na lactate
  • 16 trained runners compared these buffers and a
    placebo (Na chloride)

Acid Buffers Cont
  • Na bicarbonate was dosed at 300 mg/kg/bw
  • The other substances were dosed at an equal
    osmotic strength to Na bicarbonate to control for
    nausea or GI discomfort
  • Na citrate 525 mg/kg/bw, lactate 400 mg/kg/bw,
    chloride 209 mg/kg/bw
  • Subjects ingested 20 to 60 capsules depending on
    bw over a 90 minute period
  • 90 minutes later a performance test was done
  • The protocol was repeated every 2-5 days until
    treadmill runs were complete (one with each
  • Time to exhaustion bicarbonate 82.3 seconds,
    lactate 80.2 seconds, citrate 78.2 seconds,
    chloride (placebo) 77.4 seconds
  • 12/16 runners best time was with Na bicarbonate
  • Van Montfoort, M.C.E., Van Dieren, L., Hopkins,
    W.G., et al. Effects of Ingestion of Bicarbonate,
    Citrate, Lactate, and Chloride on Sprint Running.
    Med. Sci. Sp. Ex. 2004 36(7) 1239-1243

  • Dehydroepiandrostevone (DHEA) and DHEA-Sulfate
    are cursors to both testosterone and estrogen.
  • 15 men (ages 20-45) took 100 mg DHEA or placebo
    for 1 month. Following a 3 week washout,
    treatments were reversed for another month
  • No differences were found on stair climbing,
    treadmill, pull-ups, or grip strength
  • Testosterone was not elevated
  • Exercise induced blood glucose was significantly
    increased- it was a completely unexpected
    finding that needs more research
  • Deuster, P.A., Sutton, E., Criqui, M., et al.
    DHEA Effects on Metabolism and Exercise
    Performance in Men. Med. Sci. Sp. Ex. 2004
    36(5) S176

Nandrolone Excretion
  • Nandrolone (19 nor-testosterone) AKA Deca or
    Deca Durobolin is statistically the most common
    positive found by doping labs
  • It has been used for decades and has been banned
    by the IOC since 1976
  • Positive tests are declared when its metabolite,
    19-norandrosterone (19-NA) exceeds 2000 pg. ml in
    the urine
  • 32 males consented to be studied they all denied
    steroid use
  • Within 3 hours of severe musculoskeletal injury
    urine was analyzed for 19-NA
  • 19-NA levels ranged from 2 pg. ml to 2800
  • 6 weeks after injury subjects underwent a second
  • 19-NA ranged from 0-540
  • Kohler, R.M., Lambert, M., Hall, K. et al. The
    Effect of Musculoskeletal Injury on Endogenous
    Nandrolone Metabolism. Med. Sci. Sp. Ex. 2004
    36(5) S171

Nandrolone Elimination
  • 24 subjects received 50 mg radio-labelled
    C13-Nandrolone 12 get a placebo
  • Participants then exercised to exhaustion
  • The pattern of the radio-labelled steroid showed
    commonly measured metabolities are not accurate
    due to a large individual variation from exercise
    induced synthesis
  • Along with the previous study it appears both
    exercise and injury can cause a wide range of
    endogenous production
  • In some people markers of exogenous nandrolone
    (juicing) may exceed IOC levels without
  • Baume, N., Avois, L., Cauderay, M., et al.
    C13-Labelled Nandrolone Excretion in Trained
    Athletes Effect of Exercise. Med. Sci. Sp. Ex.
    2004 36(5) S170

Second Day Effect of Exercise in Heat
  • Over 2000 cases of exertional heat illness (EHI)
    from 1979-1997 were retrospectively analyzed from
    U.S. Marine Corps records
  • In addition to heat at the time of the event,
    analysis yielded many cases of EHI on days with
    temperatures well below the 80F and above,
    classified as high risk conditions
  • Further research reveled that the hotter the
    previous day was, the greater the risk of EHI,
    even with moderate temperatures on the following
  • An odds ratio was published. For example the
    risk of EHI on an 85 day is the same as a 75
    day if the previous day was 90
  • Wallace, R.F., Kriebel, D., Punnett, L., et al.
    The Effects of Continuous Hot Weather Training on
    Risk of Exertional Heat Illness. Med. Sci. Sp.
    Ex. 2005 37(1) 84-90

Heat Stress Football Helmets
  • Football players were studied in preseason hot
  • Sensors were placed on the head
  • Esophageal probe measured core temp
  • Heart rate monitors were worn
  • Intermittent sprints in the heat were preformed
    on consecutive days with and without helmets
  • Helmets significantly increased thermal load
    including core temp and heart rate
  • Pearl in hot conditions remove helmets when not
  • Brothers, R.M., Mitchell, J.B., Smith, M.L.
    Wearing a Football Helmet Exacerbates Thermal
    Load During Exercise in Hyperthermic Conditions.
    Med. Sci. Sp. Ex. 2004 36(5) S48

Kids Dehydration
  • 58 12 year olds (34 boys, 24 girls) were
    monitored during a 4 day summer soccer camp
  • Boys had three 2 hour sessions a day Girls had
    three 1.5 hour practices per day
  • Fluids were available at all times. Coaches
    encouraged kids to drink both during frequent
    breaks or anytime during practice
  • Hydration status was measured by urine specific
    gravity (USG)

Kids Dehydration Cont
  • Boys () Girls ()
  • Hydration Status Day 2 Day 3 Day 4
    Day 2 Day 3 Day 4
  • Minimal DHY 15 24 16 9 18 13
  • Significant DHY 44 43 37 26 37 40
  • Serious DHY 25 24 22 52 18 30
  • Total 84 91 75 87 73 83
  • Urine Specific Gravity tests (USG) were done in
    the AM before practice.
  • Minimal Dehydration USG 1.020 1.024
  • Significant Dehydration 1.025 1.029
  • Serious Dehydration 1.030 or greater
  • Walker, S.M., Casa, D.J., Levresult, M.L., et al.
    Children Participating in Summer Soccer Camps are
    Chronically Dehydrated. Med. Sci. Sp. Ex. 2004
    36(5) S180

Obesity Research
  • Fitness reduces the rates of coronary artery
    disease and cardiovascular event1
  • The longer immigrants live in the US the fatter
    they get. By 15 years or more they exceed US
    natives classified as overweight and are within
    3 of obese US natives (19 vs. 22)2
  • Higher consumption of sugar sweetened beverages
    is associated with weight gain and type 2
  • 1.Wessel, T.R., Arant, C.B., Olson, M.B., et al.
    Relationship of Physical Fitness vs Body Mass
    Index With Coronary Artery Disease and
    Cardiovascular Events in Women. JAMA 2004
    292(10) 1179-1187
  • 2 Goel, M.S., McCarthy, E.P., Phillips, R.S., et
    al. Obesity Among US Immigrant Subgroups by
    Duration of Residence. JAMA 2004 292(23) 2860
  • 3Schulze, M.B., Manson, J.E., Ludwig, D.S., et
    al. Sugar-Sweetened Beverages, Weight Gain, and
    Incidence of Type 2 Diabetes in Young and
    Middle-Aged Women. JAMA 2004 292(8) 927-934

Obesity Research Cont
  • Even with CDC obesity deaths overestimated, at
    current rates of weight gain, mathematical
    demographers expect a potential lifespan decline
    within the next 50 years unless the population
    can find the discipline to reduce consumption and
    increase activity or a significant medical
    breakthrough occurs1
  • The 2005 USDA dietary guidelines for exercise
    have changed from the 2000 guide. Rather than
    attempt to accumulate 30 min. of activity per
    day, the 2005 recommendations state 60 min. of
    moderate to vigorous exercise on most days while
    not exceeding calorie requirements is the amount
    needed to lose weight.2
  • 1Olshansky, S.J., Passaro, D.J., Hershow, R.C.,
    et al. A Potertial Decline in Life Expectancy in
    the United States in the 21st Century. N. Engl.
    J. Med. 2005 352(11) 1139 1145
  • 2Kuehn, B.M. Experts Charge New US Dietary
    Guidelines Pose Daunting Challenges for the
    Public. JAMA 2005 293(8) 918 - 921

Diet, Exercise Kids
  • 10 kids ages 10-14 spent 2 weeks in a Pritikin
    residential program
  • Foods were high fiber, very low fat, low
    cholesterol and consumed ad libitum
  • Aerobic exercise daily
  • Results Pre Two weeks later
  • Total Cholesterol 164 mg/dl 117 mg/dl
  • LDL 124 mg/dl 79 mg/dl
  • Triglycerides 141 mg/dl 80 mg/dl
  • CRP 4.15 mg/L 1.90 mg/L
  • Insulin 22.6 uU/ml 15.5 uU/ml
  • Chen, A., Roberts, C., Barnard, R.J., Effect of a
    Short-term Diet and Exercise Intervention on
    Serum Insulin, Lipids, Oxidative Stress,
    Inflammation, and Adhesion Molecules in Children.
    Med. Sci. Sp. Ex. 2004 36(5) S82

Protein Weight Loss Bone Mineral Density
  • 52 (21 M, 31 F) middle aged (mean 48) overweight
    (BMI 33.7 4.5) subjects
  • 4 months - 1700 cal/d F - 1900 cal/d M Active
  • HI PRO 1.6 g/kg 30 P 40 C 30 F
  • CHO 0.8 g/kg 15 P 55 C 30 F
  • Results PRO CHO
  • Ave Wt loss -19 lbs -16 lbs
  • Fat loss -13 lbs -10 lbs
  • BMD 3.0 0.9
  • BMC 3.7 1.5
  • in lumbar spine
  • Evans, E.M., Heinrichs, K.L., Layman, D.K. Does
    Protein Intake During Weight Loss affect Bone
    Mineral Content and Density? Med. Sci. Sp. Ex.
    2004 36(5) S96

High Carb, Low Protein Beats High Protein, Low
  • 164 women average age 37 BMI 32.5 4
  • 1 year - 1200-1500 cal/d - Group sessions and
    phone calls to maintain compliance were preformed
  • Questionnaires on food and activity were done
    throughout the year
  • Divided into High PRO P 20 C 45 F 35 1437 583
  • High CHO P 13 C61 F26 1305 604 cal/d
  • Exercise High CHO 220 100 min/wk High PRO
    160 116 min/wk
  • Wt loss High CHO 22 lbs High PRO 13.4 lbs
  • Authors state no statistical difference in
    energy intake or activity
  • Mohr, C.R., Jakicic, J.M., Gallagher, K.I., et
    al. Effect of Macronutrient Composition on
    12-Month Weight Loss in Overweight Women. Med.
    Sci. Sp. Ex. 2004 36(5) S97

Fitness Bodyweight Disease
  • Results of 24 year follow-up of The Nurses Health
    Study, 116,500 women between 30 and 55 in 1976
  • Modest adult weight gain increases risk of
    reduced lifespan
  • Physical inactivity (less than 3.5 hr/wk a.k.a.
    30 min/d) reduces lifespan
  • Adiposity predicted higher death rate regardless
    of activity
  • Activity was beneficial at all levels of
    adiposity but could only reduce, not reverse, the
    increased risk of death with obesity
  • Hu, F.B., Willett, W.C., Li, T., et al. Adiposity
    as Compared with Physical Activity in Predicting
    Mortality among Women. N. Engl. J. Med. 2004
    351(26) 2695-2703

Parents Obese Children
  • 947 surveys to parents of 2nd, 3rd, and 4th
    graders in 5 NY schools
  • 127 surveys were completed
  • 79 of overweight parents had overweight kids
  • 88 of parents correctly classified their
    children as normal or overweight
  • Of the 12 who misclassified their kids, 15/16
    said their overweight child was normal weight
  • Pearl It is not normal to be overweight
  • Keller, B.A., Miner, J.K., Wigglesworth, J.K. The
    Role of Parents in Factors that Contribute to
    obesity in Children. Med. Sci. Sp. Ex. 2004
    36(5) S51

Could the Obesity Problem be Caused by Food?
  • 13 subjects (9 M, 4 F) mean age (23) BMI 23.2
    were deceived into thinking they were in a taste
    and food perception study
  • The study began with subjects getting a buffet
    lunch which researchers then weighed and analyzed
    for amount of energy they self selected. When
    they finished lunch, any leftovers were again
  • Monday Wednesday Friday
  • Week 1 Buffet lunch Buffet lunch Buffet
  • Week2 Group A (100) Group A (150) Group A
  • Group B (125) Group B (100) Group B (150)
  • Group C (150) Group C (125) Group C (100)
  • Percentages refer to the average amount consumed
    in the first week

Could the Obesity Problem be Caused by Food?
  • In week 2 they were divided into 3 groups
  • The self selected buffet meal was referred to as
  • The self selected meals averaged 698 kcal
  • The 863 kcal were consumed from the 125 plate
  • The 971 kcal were consumed from the 150 plate
  • Results
  • The amount of food consumed was not associated
    with hunger
  • The amount of food consumed was directly
    associated with the amount served
  • Levitsky, D.A., Youn, T. The More Food Young
    Adults Are Served, the More They Overeat. J Nutr.
    2004 134 2546-2549

Single vs. Multiple Sets
  • 1 set of 10 reps of 10 different exercises was
    compared to 3 sets ( same reps, same lifts)
  • Energy Expendative (EE) during and following was
  • 1 set 3 sets
  • During 75 kcal 208 kcal
  • Post Ex 36 kcal 51 kcal
  • Total 111 kcal 259 kcal
  • kcal in 120 min post exercise. After 2 hours
    both groups resting EE returned to baseline.
  • Henley, M.O., Irving, B.A., Gaesser, G.A. Effect
    of Singles- and Multiple-Set Resistance Exercise
    on Postexercise Energy Expenditure. Med. Sci. Sp.
    Ex. 2004 36(5) S277

EPOC, TRIMPS Intensity
  • EPOC Excess Post-exercise Oxygen consumption
  • TRIMPS The index of training load (calculated
    from the relative duration and intensity
    multiplied by a factor describing blood lactate
    vs. relative intensity relation)
  • 8 men (28 yrs old 4) ran an inclined treadmill
    on 3 occasions
  • 1.21 min at 68 VO2 max 58 ml/kg 39 arb.
    units 165
  • 2.40 min at 68 VO2 max 115 ml/kg 48 arb.
    units 177
  • 3.21 min at 79 VO2 max 121 ml/kg 57 arb.
    units 182
  • Intensity increased training load more than
    duration did
  • Rusko, H.K., Pulkkinen, A., Martinmaki, K. et al.
    Influence of Increased Duration or Intensity on
    Training Load as evaluated by EPOC and TRIMPS.
    Med. Sci. Sp. Ex. 2004 36(5) S144

Low Back Pain in Wrestlers
  • This study begins with 3 references to support
    this statement
  • 85 of male gymnasts, 80 of weightlifters, 69
    of wrestlers, 58 soccer players, 50 of tennis
    players, 30 golfers, and 40-60 of general
    population were reported to have low back pain

Low Back Pain in Wrestlers Cont
  • 53 Collegiate wrestlers got x-rays, MRIs, and
    then had trunk flexor and extensor muscle
    strength tested at 3 angular velocities
  • Based on imaging, wrestlers were divided into a
    radiological abnormality (RA) and non RA (NRA)
  • 35/53 had RA (66) 18/53 (34) had normal
  • 14/35 in RA group (40) had LBP 8/18 (44) in
    NRA group had LBP
  • There was no correlation between trunk flexor
    strength and LBP in either group
  • Weak extensors correlated to LBP in the NRA group
    but not the RA group
  • Iwai, K., Nakazto, K., Irie, K., et al. Trunk
    Muscle Strength and Disability Level of Low Back
    Pain in Collegiate Wrestlers. Med. Sci. Sp. Ex.
    2004 36(8) 1296-1300

Low Back Braces
  • Many companies advocate low back braces to
    prevent injuries in repetitive lifting
  • 12 subjects (average 50 yrs old) lifted a 25 lb
    milk crate 4x per minute for 15 minutes on two
    occasions with and without a back brace. They
    also did a no load, no brace set.
  • 3 sets of fluoroscopic images were obtained no
    load, load without brace, load with brace
  • Images were analyzed for joint angles and disc
  • Conclusion Compressive and shear disc
    deformation was reduced with back braces in the
    upright position. The reduction of forces in
    flexed postures was insignificant.
  • Debeliso, M., O'Shea, P., Harris, C., et al. The
    Effects of a Back-Belt on Lumbar Disc Deformation
    During Stoop Type Lifting. Med. Sci. Sp. Ex.
    2004 36(5) S348

Chronic LBP Brain Atrophy
  • 26 chronic low back (LBP) patients were compared
    to matched controls
  • LBP were subdivided into neuropathic (sciatic
    nerve damage) and non-neuropathic groups
  • MRI brain scan data, automated analysis
    techniques voxel-based morphometry and non
    parametric statistics technique were employed

Chronic LBP Brain Atrophy Cont
  • Results
  • LBP patients shared 5-11 less neocortical gray
    matter volume than control
  • This is equivalent to what is lost in 10-20 yrs
    of normal ageing
  • Each year of chronic pain reduced 1.3 cm3 of gray
  • The gray matter lost occurred in the dorsolateral
    prefrontal cortex bilaterally and right thalamus
  • There were distinct patterns for neuropathic and
    non-neuropathic LBP patients
  • Apkarian A.V., Sosa, Y., Sonty, S., et al.
    Chronic Back Pain is Associated with Decreased
    Prefrontal and Thalmic Gray Matter Density. J
    Neuroscience. 2004 24(46)10410-10415

Magnets Negative for DOMs
  • 10 males 10 females aged 18 32
  • Dbl blind placebo control
  • 2 sets of 25 reps eccentric elbow flexion to
    induce soreness
  • After exercise they were given armbands with
    magnets or placebo and were worn 7 days
  • Magnets had no effect on reducing pain and
    swelling, nor did they prevent strength loss
  • Mikesky, A.E., Hayden, M.W. Effect of Static
    Magnetic Therapy on Recovery from Delayed Onset
    Muscle Soreness (DOMS). Med. Sci. Sp. Ex. 2004
    36(5) S16

Testosterone Works!
  • 60 young men (average age 26, range 18-36) and 60
    old men (average age 66, range 60-75) were
    involved in a 20 week study and were randomly
    assigned to one of five doses (20,50, 125, 300 or
    600 mg/wk) of testosterone enanthate.
  • Results
  • In both young and old men, there was a dose
    dependant correlation between the amount of
    steroid and the amount of muscle growth.
  • Pearl More roids bigger buff.duh
  • Magliano, L., Woodhouse, L.J., Bhasin, S., et al.
    Testosterone Dose-Dependently Increases Skeletal
    Muscle Mass (SMM) in Healthy Men. Med. Sci. Sp.
    Ex. 2004 36(5) S238

American College of Sports Medicine Position
Stand Physical activity and Bone Health
  • Exercise Rx
  • Mode weight-Bearing endurance activities
    (tennis stair climbing jogging at least
    intermittently during walking), activities that
    involve jumping (volleyball, basketball), and
    resistance exercise (weight lifting)
  • Intensity moderate to high, in terms of
    bone-loading forces (60 of 1 rep max)
  • Frequency weight-bearing endurance activities
    3-5 times per week resistance exercise 2-3
    times per week
  • Duration 30-60 mind-1 of a combination of
    weight-bearing endurance activities,
    activities that involve jumping, and resistance
    exercise that targets all major muscle groups
  • NOTE Exercise programs for elderly women and men
    should include not only weight-bearing endurance
    and resistance activities aimed at preserving
    bone mass, but also activities designed to
    improve balance and prevent falls
  • Kohrt, W.M., Bloomfield, S.A., Little, K.D., et
    al. Physical Activity and Bone Health. Med. Sci.
    Sp. Ex. 2004 36(11) 1985 -1996

Asplund, C.A., Brown, D.L. The Running Shoe
Prescription. Phys Sportsmed 2005 33(1) 17-24
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