Effekte einer schnellen Gewichtsreduktion zum Start in niedriger Gewichtsklasse auf den Flüssigkeits-, Elektrolyt- und Vitaminhaushalt bei Boxern der deutschen Spitzenklasse

Viele Boxer bestreiten ihre Wettkämpfe in einer Gewichtsklasse, die deutlich unter ihrem üblichen Körpergewicht liegt, da sie sich dadurch Vorteile im Kampf gegen einen vermeintlich körperlich unterlegenen Gegner versprechen. Die Gewichtsreduktion erfolgt dabei meist innerhalb weniger Tage durch eine Restriktion der Nahrungs- und Flüssigkeitsaufnahme und die Induktion großer Schweißverluste (mittels wiederholten Saunagängen, Dauerläufen in speziellen Schwitzanzügen, etc.). In dem vorliegenden Dissertationsprojekt wurden die Effekte eines solchen „Gewichtmachens“ auf den Flüssigkeits-, Elektrolyt- und Vitaminhaushalt und den oxidativen Stressstatus bei Boxern der deutschen Spitzenklasse untersucht. Zudem erfolgte eine Evaluation der Nährstoffzufuhr und der Energiebalance der Athleten. Insgesamt wurden 10 Boxer (19.7 ± 3.2 Jahre; 175.5 ± 7.0 cm; 67.4 ± 9.4 kg), die ihr Gewicht regelmäßig um ≥ 5% vor Wettkämpfen reduzierten (Gewichtsreduktionsgruppe, GRG), während einer normalen Trainingsphase mit konstantem Körpergewicht (t-1), 2 Tage vor einem Wettkampf (nach 5 Tagen Gewichtsreduktion, t-2) und 7 Tage nach dem Wettkampf (t-3) untersucht. Dabei wurden Gesamtkörperwasser (GKW), intrazelluläres (IZW) und extrazelluläres Wasser (EZW) mittels Bioelektrischer Impedanzanalyse (BIA) objektiviert sowie die Gesamthämoglobinmasse (tHb) und hieraus abgeleitet das Blut (BV)- und Plasmavolumen (PV) mithilfe der optimierten CO-Rückatmungsmethode bestimmt. Ferner wurden Blutkonzentrationen ausgewählter Elektrolyte und Vitamine sowie die Spiegel an Gesamt-, reduziertem und oxidiertem Glutathion im Blutplasma und in peripheren mononukleären Blutzellen (PBMCs) bestimmt. Zur Abschätzung der Nährstoffzufuhr und der Energiebalance wurden jeweils eine Woche vor den Messzeitpunkten 7-tägige Ernährungs- und Aktivitätsprotokolle geführt. Sämtliche Untersuchungen erfolgten zudem bei einer Kontrollgruppe von 7 Boxern (18.4 ± 2.2 Jahre; 174.6 ± 7.4 cm; 64.8 ± 8.9 kg), die ihr Gewicht zum Wettkampf nicht reduzierten. In der GRG nahm das Körpergewicht zwischen t-1 und t-2 signifikant (P < 0.001) um 5.6 ± 1.7% ab. Gleichzeitig kam es zu einer signifikanten (P < 0.001) Reduktion von GKW (–6.0 ± 0.9%), EZW (–12.4 ± 7.6%), tHb (–5.3 ± 3.8%), BV (–7.6 ± 2.1%) und PV (–8.6 ± 3.9%). Das IZW änderte sich nicht signifikant. Während das Körpergewicht sowie GKW, EZW und PV an t-3 wieder signifikant angestiegen waren und nahezu den Ausgangswert erreichten, waren BV und tHb noch signifikant (P < 0.05) um ~3% bzw. ~2% gegenüber t-1 verringert. Die Elektrolytkonzentrationen im Blut blieben zwischen den drei Messzeitpunkten unverändert und innerhalb des normalen Referenzbereiches, was bei den gleichzeitig festgestellten Flüssigkeitsverlusten eine isotone Dehydratation anzeigt. In der KG wurden keine signifikanten Änderungen dieser Parameter beobachtet. In beiden Gruppen lag die Zufuhr an Kalorien, Kohlenhydraten und Wasser sowie die Aufnahme der Vitamine A, E und Folsäure während des gesamten Untersuchungszeitraumes unter den empfohlenen Referenzwerten. Während der Gewichtsreduktionsphase wurde die Zufuhr an Kohlenhydraten, Eiweiß, Fett und Wasser zudem signifikant reduziert (P < 0.001) und ein signifikantes Energiedefizit induziert. Die Vitaminkonzentrationen im Blut sowie die im Plasma und in den PBMCs gemessenen Glutathionspiegel lagen in beiden Gruppen zu jedem Messzeitpunkt jedoch im Referenzbereich für gesunde Erwachsene und zeigten keine Veränderung mit Bedeutung. Daraus lässt sich mit Blick auf den Flüssigkeitshaushalt folgern, dass die innerhalb von 5 Tagen erzielte Körpergewichtsreduktion um ~6% eine Hypohydratation induzierte, die sich eine Woche nach Beendigung des Gewichtmachens wieder regeneriert hatte. Die im Rahmen des Gewichtmachens festgestellte, signifikante Abnahme der tHb stellt einen überraschenden Befund dar, der weiterer Abklärung bedarf. Die Daten aus den Ernährungsprotokollen weisen auf einen inadäquaten und verbesserungsbedürftigen Ernährungszustand der deutschen Spitzenboxer hin – unabhängig davon, ob Gewicht vor dem Wettkampf gemacht wurde oder nicht. Trotz einer zum Teil deutlich unter den Referenzwerten liegenden Nährstoffaufnahme wurden jedoch keine Anzeichen für Vitamindefizite oder einen erhöhten oxidativen Stress bei den Boxern festgestellt, so dass auch hier weiterer Untersuchungsbedarf – möglicherweise auch hinsichtlich einer Überarbeitung der in der Literatur für Sportler veröffentlichten Richtwerte besteht

Whole-Body Electromyostimulation Combined With Individualized Nutritional Support Improves Body Composition in Patients With Hematological Malignancies – A Pilot Study

Patients undergoing the complex treatment for hematological malignancies are exposed to a high physiological and psychological distress inducing fatigue and physical inactivity. In line with cancer-related metabolic changes patients are predisposed for skeletal muscle mass loss that leads to a functional decline, affects therapeutic success, and quality of life. Benefits of physical exercise and nutritional interventions on muscle maintenance are observed in solid cancer patients, but marginally investigated in patients with hematological cancer. We here studied the effects of a combined supportive exercise and nutrition intervention using whole-body electromyostimulation (WB-EMS) training and individualized nutritional support in patients actively treated for hematological malignancy. In a controlled pilot trial, 31 patients (67.7% male; 58.0 ± 16.7 years) with various hematological cancers were allocated to a control group (n = 9) receiving nutritional support of usual care regarding a high protein intake (&gt;1.0 g/kg/d) or to a physical exercise group (n = 22) additionally performing WB-EMS training twice weekly for 12 weeks. Bodyweight and body composition assessed by bioelectrical impedance analysis were measured every 4 weeks. Physical function, blood parameters, quality of life and fatigue were assessed at baseline and after 12 weeks. No WB-EMS-related adverse effects occurred. Patients attending the exercise program presented a higher skeletal muscle mass than controls after 12-weeks (1.51 kg [0.41, 2.60]; p = 0.008). In contrast, patients of the control group showed a higher fat mass percentage than patients of the WB-EMS group (-4.46% [-7.15, -1.77]; p = 0.001) that was accompanied by an increase in serum triglycerides in contrast to a decrease in the WB-EMS group (change ± SD, control 36.3 ± 50.6 mg/dl; WB-EMS -31.8 ± 68.7 mg/dl; p = 0.064). No significant group differences for lower limb strength, quality of life, and fatigue were detected. However, compared to controls the WB-EMS group significantly improved in physical functioning indicated by a higher increase in the 6-min-walking distance (p = 0.046). A combined therapeutic intervention of WB-EMS and protein-rich nutritional support seems to be safe and effective in improving skeletal muscle mass and body composition in hematological cancer patients during active oncological treatment.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02293239

Is Increased Susceptibility to Balkan Endemic Nephropathy in Carriers of Common GSTA1 (*A/*B) Polymorphism Linked with the Catalytic Role of GSTA1 in Ochratoxin A Biotransformation? Serbian Case Control Study and In Silico Analysis

Although recent data suggest aristolochic acid as a putative cause of Balkan endemic nephropathy (BEN), evidence also exists in favor of ochratoxin A (OTA) exposure as risk factor for the disease. The potential role of xenobiotic metabolizing enzymes, such as the glutathione transferases (GSTs), in OTA biotransformation is based on OTA glutathione adducts (OTHQ-SG and OTB-SG) in blood and urine of BEN patients. We aimed to analyze the association between common GSTA1, GSTM1, GSTT1, and GSTP1 polymorphisms and BEN susceptibility, and thereafter performed an in silico simulation of particular GST enzymes potentially involved in OTA transformations. GSTA1, GSTM1, GSTT1 and GSTP1 genotypes were determined in 207 BEN patients and 138 non-BEN healthy individuals from endemic regions by polymerase chain reaction (PCR). Molecular modeling in silico was performed for GSTA1 protein. Among the GST polymorphisms tested, only GSTA1 was significantly associated with a higher risk of BEN. Namely, carriers of the GSTA1*B gene variant, associated with lower transcriptional activation, were at a 1.6-fold higher BEN risk than those carrying the homozygous GSTA1*A/*A genotype (OR = 1.6; p = 0.037). In in silico modeling, we found four structures, two OTB-SG and two OTHQ-SG, bound in a GSTA1 monomer. We found that GSTA1 polymorphism was associated with increased risk of BEN, and suggested, according to the in silico simulation, that GSTA1-1 might be involved in catalyzing the formation of OTHQ-SG and OTB-SG conjugates

Muscle-derived cytokines reduce growth, viability and migratory activity of pancreatic cancer cells

The evidence that regular physical exercise reduces the risk of developing cancer is well described. However, the interaction between physical exercise and cancer is not fully clarified yet. Several myokines released by skeletal muscle appear to have a direct anti-tumour function. There are few data on myokine secretion after exercise in patients with advanced tumours. Pancreatic cancer (PC) is a very aggressive and usually fatal cancer. To investigate the effects of exercise in PC, the blood of advanced-stage PC patients was analysed after 12 weeks of resistance training using whole-body electromyostimulation. After the 12-week training period, the patient serum inhibited the proliferation and the motility of PC cells and enhanced PC cell apoptosis. The impact of exercise training was also investigated in an exercise-mimicking in vitro model using electric pulse stimulation of human myotubes and revealed similar anti-tumour effects on PC cells, clearly indicating direct cancer-protective properties of activated skeletal muscle. Protein and gene expression analyses in plasma from exercise-trained patients and in myotube cultures after in vitro exercise showed that interleukin 10 (IL10), C-X-C motif ligand 1 (CXCL1) and C-C motif chemokine ligand 4 (CCL4) are myokines released from activated skeletal muscle. In accordance with the effects of serum from exercise-trained patients, the supplementation with recombinant IL10, CXCL1 and CCL4 impaired growth and migration of PC cells. Treatment of PC cells with these myokines upregulated caspase 3/7 expression and the cleavage of poly(ADP-ribose) polymerase, leading to enhanced PC cell death. The identification of myokines with anti-tumour properties in advanced-stage PC patients after exercise opens a new perspective in supportive therapy with sports and exercise for cancer patients

Gastrointestinal complaints in runners are not due to small intestinal bacterial overgrowth

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal complaints are common among long distance runners. We hypothesised that small intestinal bacterial overgrowth (SIBO) is present in long distance runners frequently afflicted with gastrointestinal complaints.</p> <p>Findings</p> <p>Seven long distance runners (5 female, mean age 29.1 years) with gastrointestinal complaints during and immediately after exercise without known gastrointestinal diseases performed Glucose hydrogen breath tests for detection of SIBO one week after a lactose hydrogen breath test checking for lactose intolerance. The most frequent symptoms were diarrhea (5/7, 71%) and flatulence (6/7, 86%). The study was conducted at a laboratory.</p> <p>In none of the subjects a pathological hydrogen production was observed after the intake of glucose. Only in one athlete a pathological hydrogen production was measured after the intake of lactose suggesting lactose intolerance.</p> <p>Conclusions</p> <p>Gastrointestinal disorders in the examined long distance runners were not associated with small intestinal bacterial overgrowth.</p

&ldquo;HIIT the Inflammation&rdquo;: Comparative Effects of Low-Volume Interval Training and Resistance Exercises on Inflammatory Indices in Obese Metabolic Syndrome Patients Undergoing Caloric Restriction

Exercise is a cornerstone in metabolic syndrome (MetS) treatment. However, the effects of low-volume exercise modalities on MetS-associated low-grade inflammation are unclear. A total of 106 MetS patients (53.7 &plusmn; 11.4 years) were randomized to low-volume high-intensity interval training (LOW-HIIT, 14 min/session), single-set resistance training (1-RT, ~15 min/session), whole-body electromyostimulation (WB-EMS, 20 min/session), three-set resistance training (3-RT, ~50 min/session), each performed 2 &times;/week for 12 weeks, or a control group (CON). All groups received nutritional counseling for weight loss. Inflammatory and cardiometabolic indices were analyzed pre- and post-intervention. All groups significantly reduced body weight by an average of 3.6%. Only LOW-HIIT reduced C-reactive protein (CRP) (&minus;1.6 mg/L, p = 0.001) and interleukin-6 (&minus;1.1 pg/mL, p = 0.020). High-sensitivity CRP and lipopolysaccharide-binding protein decreased following LOW-HIIT (&minus;1.4 mg/L, p = 0.001 and &minus;2.1 ng/mL, p = 0.004) and 3-RT (&minus;0.6 mg/L, p = 0.044 and &minus;2.0 ng/mL, p &lt; 0.001). MetS severity score improved with LOW-HIIT (&minus;1.8 units, p &lt; 0.001), 1-RT (&minus;1.6 units, p = 0.005), and 3-RT (&minus;2.3 units, p &lt; 0.001). Despite similar effects on body weight, low-volume exercise modalities have different impact on inflammatory and cardiometabolic outcomes in MetS patients. LOW-HIIT has superior efficacy for improving inflammation compared to 1-RT and WB-EMS. Resistance-based exercise appears to require a higher volume to promote beneficial impact on inflammation

Dietary Effects on Microbiota—New Trends with Gluten-Free or Paleo Diet

A well-balanced diet is the basis for a healthy life. Both the western diet and special diets can have a relevant impact on the microbiome and promote the development of various diseases. There has been an increase in food-related disorders in recent years, largely associated with dramatic changes in food consumption trends and main nutrients. A major response to food intolerances has been the adoption of new dietary trends involving the reduction or exclusion of specific food ingredients. Especially gluten-containing, but also gluten-free cereals are in the cross-fire. Supporters of the gluten-free diet argue that gluten triggers inflammation and related diseases, while followers of the Paleo diet drastically impeach all cereals as dangerous for human health. To date, no controlled studies support or reject a positive health effect of a gluten-free or cereal-free diet. Future large-scale studies need to evaluate the effect of gluten-containing and gluten-free cereals and the various diets on human health, inflammatory parameters, clinical symptoms, and the gut microbiota (including the bacteria, fungi, and viruses). Dietary-associated changes in compositional and functional microbiota traits should be correlated with the health status for the future development of dietary recommendations and potential clinical interventions

Low-volume high-intensity interval training improves cardiometabolic health, work ability and well-being in severely obese individuals: a randomized-controlled trial sub-study

Background!#!Obesity is associated with impaired health and lower work ability. Increased physical activity is a cornerstone in the treatment of obesity and related risk factors. Recently, high-intensity interval training (HIIT) has emerged as a popular exercise option. However, data regarding the effects on cardiometabolic health, perceived work ability and well-being in severely obese individuals are lacking.!##!Methods!#!Sixty-five obese individuals with sedentary occupation (48.7 ± 9.9 years, BMI: 39.6 ± 7.1 kg/m!##!Results!#!Mean body weight reduction was 5.3 kg [95% confidence interval (95% CI) - 7.3 to - 3.3 kg] in the HIIT group (P &amp;lt; 0.001) and 3.7 kg (95% CI - 5.3 to - 2.1 kg) in CON (P &amp;lt; 0.001), respectively. Only the HIIT group showed significant (P &amp;lt; 0.001) changes in VO!##!Conclusions!#!Low-volume HIIT may induce significant improvements in cardiometabolic health, especially VO!##!Trial registration!#!ClinicalTrials.gov Id: NCT03306069. Registered 10 October 2017, https://clinicaltrials.gov/ct2/show/NCT03306069

Protein Supplementation Does Not Maximize Adaptations to Low-Volume High-Intensity Interval Training in Sedentary, Healthy Adults: A Placebo-Controlled Double-Blind Randomized Study

There is ample evidence that specific nutritional strategies can enhance adaptions to resistance and endurance training. However, it is still unclear whether post-session protein supplementation may increase the effects of low-volume high-intensity interval training (LOW-HIIT). We examined the impact of LOW-HIIT combined with protein vs. placebo supplementation on cardiometabolic health indices in sedentary healthy individuals. Forty-seven participants (31.1 ± 8.0 yrs) performed cycle ergometer LOW-HIIT (5–10x1 min at 80–95% maximum heart rate) for eight weeks and randomly received double-blinded 40 g of whey protein (PRO-HIIT, N = 24) or an isocaloric placebo (maltodextrin, PLA-HIIT, N = 23) after each session. The maximum oxygen uptake (VO2max, primary outcome) and several secondary cardiometabolic outcomes were determined pre-/post-intervention. VO2max increased in PRO-HIIT (+2.8 mL/kg/min, p = 0.003) and PLA-HIIT (+3.5 mL/kg/min, p p p p = 0.003) decreased in PRO-HIIT and alanine aminotransferase (−3 U/L, p = 0.014) in PLA-HIIT. There were no significant between-group differences in any of the outcome changes. In conclusion, LOW-HIIT improved VO2max and other cardiometabolic markers irrespective of the supplementation condition. Post-session protein supplementation does not seem to provide any additional benefit to LOW-HIIT in improving cardiometabolic health in sedentary healthy individuals