Patient perceived need for clear communication of health information.

<p>Patient perceived need for clear communication of health information.</p

Study flowchart.

<p>Study flowchart.</p

Patient perceived need to obtain health information from a variety of sources.

<p>Patient perceived need to obtain health information from a variety of sources.</p

Overview of studies.

<p>Overview of studies.</p

Characteristics of study participants.

<p>Data presented as mean (SD) or number (%)</p><p>Characteristics of study participants.</p

Flow chart of subject recruitment, group allocation and analysis.

<p>Flow chart of subject recruitment, group allocation and analysis.</p

The Effects of a Calcium-Rich Pre-Exercise Meal on Biomarkers of Calcium Homeostasis in Competitive Female Cyclists: A Randomised Crossover Trial

<div><p>Cycling is recognised as a sport in which there is a high incidence of poor bone health. Sweat calcium losses may contribute to this.</p><p>Purpose</p><p>To examine whether a calcium-rich pre-exercise meal attenuates exercise-induced perturbations of bone calcium homeostasis caused by maintenance of sweat calcium losses.</p><p>Methods</p><p>Using a randomized, counterbalanced crossover design, 32 well-trained female cyclists completed two 90 min cycling trials separated by 1 day. Exercise trials were preceded 2 hours by either a calcium-rich (1352 ± 53 mg calcium) dairy based meal (CAL) or a control meal (CON; 46 ± 7 mg calcium). Blood was sampled pre-trial; pre-exercise; and immediately, 40 min, 100 min and 190 min post-exercise. Blood was analysed for ionized calcium and biomarkers of bone resorption (Cross Linked C-Telopeptide of Type I Collagen (CTX-I), Cross Linked C-Telopeptide of Type II Collagen (CTX-II), Parathyroid Hormone (PTH), and bone formation (Procollagen I N-Terminal Propeptide (PINP)) using the established enzyme-linked immunosorbent assay technique.</p><p>Results</p><p>PTH and CTX-I increased from pre-exercise to post-exercise in both conditions but was attenuated in CAL (p < 0.001). PTH was 1.55 [1.20, 2.01] times lower in CAL immediately post-exercise and 1.45 [1.12, 1.88] times lower at 40 min post-exercise. CTX-I was 1.40 [1.15, 1.70] times lower in CAL at immediately post-exercise, 1.30 [1.07, 1.57] times lower at 40 min post-exercise and 1.22 [1.00, 1.48] times lower at 190 min post-exercise (p < 0.05). There was no significant interaction between pre-exercise meal condition and time point for CTX-II (p = 0.732) or PINP (p = 0.819).</p><p>Conclusion</p><p>This study showed that a calcium-rich pre-exercise breakfast meal containing ~1350 mg of calcium consumed ~90 min before a prolonged and high intensity bout of stationary cycling attenuates the exercise induced rise in markers of bone resorption – PTH and CTX-I.</p><p>Trial Registration</p><p>Australian New Zealand Clinical Trials Registry <a href="https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366558" target="_blank">ACTRN12614000675628</a></p></div

PRISMA diagram.

<p><i>From</i>: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). <i>P</i>referred <i>R</i>eporting <i>I</i>terns for <i>S</i>ystematic Reviews and <i>M</i>eta-<i>A</i>nalyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:<a href="https://doi.org/10.1371/journal.pmed1000097" target="_blank">10.1371/journal.pmed1000097</a>. <b>For more information, visit</b><a href="http://www.prisma-statement.org" target="_blank">www.prisma-statement.org</a>.</p

Serum concentrations of biomarkers for bone turn over, calcium homeostasis and haematocrit before and after control (CON) and calcium-rich (CAL) meal conditions and exercise.

<p>Mean ± 95% CI Haematocrit (Hct; A); ionized cacium (iCa: B); and concentrations of <i>parathyroid hormone</i> (PTH: C); <i>cross linked C-telopeptide of type I collagen</i> (CTX-I: D); <i>cross linked C-telopeptide of type II collagen</i> (CTX-II: E); <i>procollagen I N-terminal propeptide</i> (PINP: F); and at each time point for control (CON: open circles) and calcium (CAL: solid squares) trials. Blood samples were taken pre-trial at T = -15 min; pre-exercise at T = 115 min; and post-exercise at all subsequent time points. *Significant difference (p < 0.05) between trial meal conditions at the indicated time point</p

Patient perceived needs of health information content.

<p>Patient perceived needs of health information content.</p