A Framework for Periodized Nutrition for Athletics.

Over the last decade, in support of training periodization there has been an emergence around the concept of nutritional periodization. Within athletics (track and field), the science and art of periodization is a cornerstone concept with recent commentaries emphasizing the underappreciated complexity associated with predictable performance on demand. Nevertheless, there are numerous training, with varying levels of evidence, that feature sport and event specific purposeful sequencing of different training units [long (macro-cycle; months), medium (meso-cycle; weeks) and short (micro-cycle; days and within-day duration] training cycles and sessions. Indeed, implementation of strategic temporal nutrition interventions (macro, meso and micro) can support and enhance training prescription and adaptation, as well as acute event specific performance. However, a general framework on how, why and when nutritional periodization could be implemented has not yet been established. It is beyond the scope of this review to highlight every potential nutritional periodization application. Instead, this review will focus on a generalized framework, with specific examples of macro-, meso- and micro-periodization for the macronutrients of carbohydrate (CHO), and by extension fat. More specifically, we establish the evidence and rationale for situations of acute high CHO availability, as well as the evidence for more chronic manipulation of CHO coupled with training. The topic of periodized nutrition has made considerable gains over the last decade, but is ripe for further scientific progress and field application

Dose-response of sodium bicarbonate ingestion highlights individuality in time course of blood analyte responses

To defend against hydrogen cation accumulation and muscle fatigue during exercise, sodium 20 bicarbonate (NaHCO3) ingestion is commonplace. The individualised dose-response relationship 21 between NaHCO3 ingestion and blood biochemistry is unclear. The present study investigated the 22 bicarbonate, pH, base excess and sodium responses to NaHCO3 ingestion. Sixteen healthy males (23±2 23 years; 78.6±15.1 kg) attended three randomised order-balanced, non-blinded sessions, ingesting a single 24 dose of either 0.1, 0.2 or 0.3 g.kg-1BM of NaHCO3 (Intralabs, UK). Fingertip capillary blood was 25 obtained at baseline and every 10 min for 1 h, then every 15 min for a further 2 h. There was a significant 26 main effect of both time and condition for all assessed blood analytes (P≤0.001). Blood analyte 27 responses were significantly lower following 0.1 g.kg-1BM compared with 0.2 g.kg-1BM; bicarbonate 28 concentrations and base excess were highest following ingestion of 0.3 g.kg-1BM (P≤0.01). Bicarbonate 29 concentrations and pH significantly increased from baseline following all doses; the higher the dose the 30 greater the increase. Large inter-individual variability was shown in the magnitude of the increase in 31 bicarbonate concentrations following each dose (+2.0-5; +5.1-8.1; and +6.0-12.3 mmol·L-1 for 0.1, 0.2 32 and 0.3 g.kg-1BM) and in the range of time to peak concentrations (30-150; 40-165; and 75-180 min for 33 0.1, 0.2 and 0.3 g.kg-1BM). The variability in bicarbonate responses was not affected by normalisation 34 to body mass. These results challenge current practices relating to NaHCO3 supplementation and clearly 35 show the need for athletes to individualise their ingestion protocol and trial varying dosages prior to 36 competition

Nutrition Strategies for Triathlon

Contemporary sports nutrition guidelines recommend that each athlete develop a personalised, periodised and practical approach to eating that allows him or her to train hard, recover and adapt optimally, stay free of illness and injury and compete at their best at peak races. Competitive triathletes undertake a heavy training programme to prepare for three different sports while undertaking races varying in duration from 20 min to 10 h. The everyday diet should be adequate in energy availability, provide CHO in varying amounts and timing around workouts according to the benefits of training with low or high CHO availability and spread high-quality protein over the day to maximise the adaptive response to each session. Race nutrition requires a targeted and well-practised plan that maintains fuel and hydration goals over the duration of the specific event, according to the opportunities provided by the race and other challenges, such as a hot environment. Supplements and sports foods can make a small contribution to a sports nutrition plan, when medical supplements are used under supervision to prevent/treat nutrient deficiencies (e.g. iron or vitamin D) or when sports foods provide a convenient source of nutrients when it is impractical to eat whole foods. Finally, a few evidence-based performance supplements may contribute to optimal race performance when used according to best practice protocols to suit the triathlete’s goals and individual responsiveness

New Opportunities to Advance Sport Nutrition

Sports nutrition is a relatively new discipline; with ~100 published papers/year in the 1990s to ~3,500+ papers/year today. Historically, sports nutrition research was primarily initiated by university-based exercise physiologists who developed new methodologies that could be impacted by nutrition interventions (e.g., carbohydrate/fat oxidation by whole body calorimetry and muscle glycogen by muscle biopsies). Application of these methods in seminal studies helped develop current sports nutrition guidelines as compiled in several expert consensus statements. Despite this wealth of knowledge, a limitation of the current evidence is the lack of appropriate intervention studies (e.g., randomized controlled clinical trials) in elite athlete populations that are ecologically valid (e.g., in real-life training and competition settings). Over the last decade, there has been an explosion of sports science technologies, methodologies, and innovations. Some of these recent advances are field-based, thus, providing the opportunity to accelerate the application of ecologically valid personalized sports nutrition interventions. Conversely, the acceleration of novel technologies and commercial solutions, especially in the field of biotechnology and software/app development, has far outstripped the scientific communities' ability to validate the effectiveness and utility of the vast majority of these new commercial technologies. This mini-review will highlight historical and present innovations with particular focus on technological innovations in sports nutrition that are expected to advance the field into the future. Indeed, the development and sharing of more “big data,” integrating field-based measurements, resulting in more ecologically valid evidence for efficacy and personalized prescriptions, are all future key opportunities to further advance the field of sports nutrition

Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers

We investigated the effects of adaptation to a ketogenic low carbohydrate (CHO), high fat diet (LCHF) during 3 weeks of intensified training on metabolism and performance of world-class endurance athletes. We controlled three isoenergetic diets in elite race walkers: high CHO availability (g kg−1 day−1: 8.6 CHO, 2.1 protein, 1.2 fat) consumed before, during and after training (HCHO, n = 9); identical macronutrient intake, periodised within or between days to alternate between low and high CHO availability (PCHO, n = 10); LCHF (< 50 g day−1 CHO; 78% energy as fat; 2.1 g kg−1 day−1 protein; LCHF, n = 10). Post-intervention, ˙V O2peak during race walking increased in all groups (P < 0.001, 90% CI: 2.55, 5.20%). LCHF was associated with markedly increased rates of whole-body fat oxidation, attaining peak rates of 1.57±0.32 gmin−1 during 2 h of walking at 80% ˙V O2peak.However, LCHFalso increased the oxygen (O2) cost of race walking at velocities relevant to real-life race performance: O2 uptake (expressed as a percentage of new ˙V O2peak) at a speed approximating 20 km race pace was reduced in HCHO and PCHO (90% CI:−7.047,−2.55 and−5.18,−0.86, respectively), but was maintained at pre-intervention levels in LCHF. HCHO and PCHO groups improved times for 10 km race walk: 6.6% (90% CI: 4.1, 9.1%) and 5.3% (3.4, 7.2%), with no improvement (−1.6% (−8.5, 5.3%)) for the LCHF group. In contrast to training with diets providing chronic or periodised high-CHO availability, and despite a significant improvement in ˙V O2peak, adaptation to the topical LCHF diet negated performance benefits in elite endurance athletes, in part due to reduced exercise economy

Quantitative MRI in leukodystrophies

Leukodystrophies constitute a large and heterogeneous group of genetic diseases primarily affecting the white matter of the central nervous system. Different disorders target different white matter structural components. Leukodystrophies are most often progressive and fatal. In recent years, novel therapies are emerging and for an increasing number of leukodystrophies trials are being developed. Objective and quantitative metrics are needed to serve as outcome measures in trials. Quantitative MRI yields information on microstructural properties, such as myelin or axonal content and condition, and on the chemical composition of white matter, in a noninvasive fashion. By providing information on white matter microstructural involvement, quantitative MRI may contribute to the evaluation and monitoring of leukodystrophies. Many distinct MR techniques are available at different stages of development. While some are already clinically applicable, others are less far developed and have only or mainly been applied in healthy subjects. In this review, we explore the background, current status, potential and challenges of available quantitative MR techniques in the context of leukodystrophies

Carbohydrate supplementation during prolonged cycling exercise spares muscle glycogen but does not affect intramyocellular lipid use

Using contemporary stable-isotope methodology and fluorescence microscopy, we assessed the impact of carbohydrate supplementation on whole-body and fiber-type-specific intramyocellular triacylglycerol (IMTG) and glycogen use during prolonged endurance exercise. Ten endurance-trained male subjects were studied twice during 3 h of cycling at 63 ± 4% of maximal O2 uptake with either glucose ingestion (CHO trial; 0.7 g CHO kg−1 h−1) or without (CON placebo trial; water only). Continuous infusions with [U-13C] palmitate and [6,6-2H2] glucose were applied to quantify plasma free fatty acids (FFA) and glucose oxidation rates and to estimate intramyocellular lipid and glycogen use. Before and after exercise, muscle biopsy samples were taken to quantify fiber-type-specific IMTG and glycogen content. Plasma glucose rate of appearance (Ra) and carbohydrate oxidation rates were substantially greater in the CHO vs CON trial. Carbohydrate supplementation resulted in a lower muscle glycogen use during the first hour of exercise in the CHO vs CON trial, resulting in a 38 ± 19 and 57 ± 22% decreased utilization in type I and II muscle-fiber glycogen content, respectively. In the CHO trial, both plasma FFA Ra and subsequent plasma FFA concentrations were lower, resulting in a 34 ± 12% reduction in plasma FFA oxidation rates during exercise (P < 0.05). Carbohydrate intake did not augment IMTG utilization, as fluorescence microscopy revealed a 76 ± 21 and 78 ± 22% reduction in type I muscle-fiber lipid content in the CHO and CON trial, respectively. We conclude that carbohydrate supplementation during prolonged cycling exercise does not modulate IMTG use but spares muscle glycogen use during the initial stages of exercise in endurance-trained men

Feminae: an international multi-site innovative project for female athletes.

Sufficient high-quality studies in sport science using women as participants are lacking, meaning that our knowledge and understanding of female athletes in relation to their ovarian hormone profiles is limited. Consortia can be used to pool talent, expertise, and data, thus accelerating our learning on a given topic and reducing research waste through collaboration. To this end, we have assembled an international multi-site team, described herein, to investigate the effects of the menstrual cycle and oral contraceptive pill phase on aspects of exercise physiology and sports performance in female athletes. We intend to produce an adequately powered, high-quality dataset which can be used to inform the practices of female athletes. Our approach will also employ research transparency – through the inclusion of a process evaluation - and reproducibility – through a standardised study protocol