Glucose pulse. A simple method to estimate the amount of glucose oxidized during exercise in type 1 diabetic patients

In type 1 diabetic patients, exercise contributes to enhance insulin sensitivity and may help, together with diet and insulin therapy, to achieve and maintain better metabolic control. Fat and carbohydrates are the main substrates for energy production in skeletal muscle during aerobic exercise in well-fed humans, with their relative contribution to total energy production being a function of exercise intensity. Below the anaerobic threshold, both oxygen consumption and heart rate during exercise increase linearly as a function of exercise intensity. On the basis of these relationships, the aim of the present study was to verify the possibility of using heart rate to estimate the amount of glucose oxidized during exercise in type 1 diabetic patients as well as in a control group of healthy subjects. This study shows that heart rate can be a useful physiological parameter to be used to estimate the amount of glucose oxidized during exercise

Positive energy balance is associated with accelerated muscle atrophy and increased erythrocyte glutathione turnover during 5 wk of bed rest

Background: Physical inactivity is often associated with positive energy balance and fat gain. Objective: We aimed to assess whether energy intake in excess of requirement activates systemic inflammation and antioxidant defenses and accelerates muscle atrophy induced by inactivity. Design: Nineteen healthy male volunteers were studied before and at the end of 5 wk of bed rest. Subjects were allowed to spontaneously adapt to decreased energy requirement (study A, n = 10) or were provided with an activity-matched diet (study B, n = 9). Groups with higher (HEB) or lower (LEB) energy balance were identified according to median values of inactivity-induced changes in fat mass (\u394FM, assessed by bioelectrical impedance analysis). Results: In pooled subjects (n = 19; median \u394FM: 1.4 kg), bed rest-mediated decreases in fat-free mass (bioelectrical impedance analysis) and vastus lateralis thickness (ultrasound imaging) were significantly greater (P < 0.03) in HEBAB (-3.8 \ub1 0.4kg and -0.32 \ub1 0.04 cm, respectively) than in LEBab (-2.3 \ub1 0.5 kg and -0.09 \ub1 0.04 cm, respectively) subjects. In study A (median \u394FM: 1.8 kg), bed rest-mediated increases in plasma leptin, C-reactive protein, and myeloperoxidase were greater (P < 0.04) in HEBA than in LEBA subjects. Bed rest-mediated changes of glutathione synthesis rate in eythrocytes (L-[3,3-2H2]cysteine incorporation) were greater (P = 0.03) in HEBA (from 70 \ub1 19 to 164 \ub1 29%/d) than in LEBA (from 103 \ub1 23 to 84 \ub1 27%/d) subjects. Conclusions: Positive energy balance during inactivity is associated with greater muscle atrophy and with activation of systemic inflammation and of antioxidant defenses. Optimizing caloric intake may be a useful strategy for mitigating muscle loss during period of chronic inactivity

Pilot investigation of the oxygen demands and metabolic cost of incremental shuttle walking and treadmill walking in patients with cardiovascular disease

Objective: To determine if the metabolic cost of the incremental shuttle-walking test protocol is the same as treadmill walking or predicted values of walking-speed equations. Setting: Primary care (community-based cardiac rehabilitation). Participants: Eight Caucasian cardiac rehabilitation patients (7 males) with a mean age of 67±5.2 years. Primary and secondary outcome measures: Oxygen consumption, metabolic power and energy cost of walking during treadmill and shuttle walking performed in a balanced order with 1 week between trials. Results: Average overall energy cost per metre was higher during treadmill walking (3.22±0.55 J kg/m) than during shuttle walking (3.00±0.41 J kg/m). There were significant post hoc effects at 0.67 m/s (p<0.004) and 0.84 m/s (p<0.001), where the energy cost of treadmill walking was significantly higher than that of shuttle walking. This pattern was reversed at walking speeds 1.52 m/s (p<0.042) and 1.69 m/s (p<0.007) where shuttle walking had a greater energy cost per metre than treadmill walking. At all walking speeds, the energy cost of shuttle walking was higher than that predicted using the American College of Sports Medicine walking equations. Conclusions: The energetic demands of shuttle walking were fundamentally different from those of treadmill walking and should not be directly compared. We warn against estimating the metabolic cost of the incremental shuttle-walking test using the current walking-speed equations

Sarcopenia parameters in active older adults - an eight-year longitudinal study

BACKGROUD: Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population. METHODS: The 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants' overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements. RESULTS: In the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and - 48.5%; p < .001, respectively). CONCLUSIONS: Despite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature. TRIAL REGISTRATION: The clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531

Quantifying The External And Internal Loads Of Professional Rugby League Training Modes: Consideration For Concurrent Field-Based Training Prescription.

Practitioners prescribe numerous training modes to develop the varied physical qualities professional rugby league players must express during competition. The aim of the current study was to determine how the magnitude of external and internal training load per minute of time differs between modes in professional rugby league players. This data were collected from 17 players across 716 individual sessions (mean (SD) sessions: 42 (13) per player) which were categorised by mode (conditioning, small sided games, skills and sprint training). Derived from global positioning systems (5Hz with 15Hz interpolation), the distances covered within arbitrary speed- and metabolic-power-thresholds were determined to represent the external load. Session rating of perceived exertion (sRPE) and individualised training impulse (iTRIMP) represented the internal load. All data were made relative to session duration. The differences in time-relative load methods between each mode were assessed using magnitude based inferences. Small-sided-games and conditioning very likely to almost certainly produced the greatest relative internal and external loads. Sprint training provided players with the greatest sprinting and maximal-power distances without a concomitant increase in internal load. The metabolic-power method complements speed-based quantification of the external load, particularly during smallsided-games and skills training. In practice, establishing normative loads per minute of time for each mode can be useful to plan future training by multiplying this value by the planned session duration

Metabolic Factors Limiting Performance in Marathon Runners

Each year in the past three decades has seen hundreds of thousands of runners register to run a major marathon. Of those who attempt to race over the marathon distance of 26 miles and 385 yards (42.195 kilometers), more than two-fifths experience severe and performance-limiting depletion of physiologic carbohydrate reserves (a phenomenon known as ‘hitting the wall’), and thousands drop out before reaching the finish lines (approximately 1–2% of those who start). Analyses of endurance physiology have often either used coarse approximations to suggest that human glycogen reserves are insufficient to fuel a marathon (making ‘hitting the wall’ seem inevitable), or implied that maximal glycogen loading is required in order to complete a marathon without ‘hitting the wall.’ The present computational study demonstrates that the energetic constraints on endurance runners are more subtle, and depend on several physiologic variables including the muscle mass distribution, liver and muscle glycogen densities, and running speed (exercise intensity as a fraction of aerobic capacity) of individual runners, in personalized but nevertheless quantifiable and predictable ways. The analytic approach presented here is used to estimate the distance at which runners will exhaust their glycogen stores as a function of running intensity. In so doing it also provides a basis for guidelines ensuring the safety and optimizing the performance of endurance runners, both by setting personally appropriate paces and by prescribing midrace fueling requirements for avoiding ‘the wall.’ The present analysis also sheds physiologically principled light on important standards in marathon running that until now have remained empirically defined: The qualifying times for the Boston Marathon

The application of differential ratings of perceived exertion to Australian Football League matches

Objectives: To investigate the application of differential ratings of perceived exertion for the examination of internal load during Australian Football League (AFL) matches. Design: Single cohort, observational study. Methods: Using the centiMax rating of perceived exertion (RPE) scale, 26 professional AFL players provided ratings for match exertion (RPE-M), along with differential ratings for breathlessness (RPE-B), leg exertion (RPE-L), and technical demand (RPE-T) following 129 matches (5.0 ± 1.6 matches per player). Global positioning satellite (GPS) and accelerometer measures were also collected. Data were analysed using magnitude-based inferences. Results: RPE scores were 93.0 ± 8.2 AU (RPE-M), 89.0 ± 11.0 AU (RPE-B), 91.5 ± 9.8 AU (RPE-L), and 87.0 ± 10.0 AU (RPE-T). There was a most likely small difference between RPE-L and RPE-T (5.5%; ±90% confidence limits 1.9%), a likely small difference between RPE-L and RPE-B (3.5%; ±1.5%) and a possibly small difference between RPE-B and RPE-T (1.9%; ±1.9%). Within-player correlations between RPE and GPS measures were small for RPE-M (r = 0.14–0.28), unclear to small for RPE-B (r = 0.06–0.24) and unclear to moderate for RPE-L (r = 0.06–0.37). Differential RPE's combined to explain 76% of the variance in RPE-M. For all RPE scores, within-player variability was moderate to high (typical error: 7.9–12.4%), and the thresholds for a likely between-match change were 8.8–13.7%. Conclusions: As differential RPE's represent distinct sensory inputs, the collection of these scores facilitate the interpretation of internal match loads and therefore represent a valuable addition to match data collection procedures. Moderate to high within-player variability should be considered when interpreting between-match changes in all RPE scores