Effect of breakfast omission and consumption on energy intake and physical activity in adolescent girls: a randomised controlled trial

It is not known if breakfast consumption is an effective intervention for altering daily energy balance in adolescents when compared with breakfast omission. This study examined the acute effect of breakfast consumption and omission on free-living energy intake (EI) and physical activity (PA) in adolescent girls. Using an acute randomised crossover design, forty girls (age 13.3 ± 0.8 y, body mass index 21.5 ± 5.0 kg∙m-2) completed two, 3-day conditions in a randomised, counter-balanced order: no breakfast (NB) and standardised (~1962 kJ) breakfast (SB). Dietary intakes were assessed using food diaries combined with digital photographic records and PA was measured via accelerometry throughout each condition. Statistical analyses were completed using repeated measures analysis of variance. Post-breakfast EI was 483 ± 1309 kJ/d higher in NB vs. SB (P=0.025), but total daily EI was 1479 ± 1311 kJ/d higher in SB vs. NB (P<0.0005). Daily carbohydrate, fibre and protein intakes were higher in SB vs. NB (P<0.0005), whereas daily fat intake was not different (P=0.405). Effect sizes met the minimum important difference of ≥0.20 for all significant effects. Breakfast manipulation did not affect post-breakfast macronutrient intakes (P≥0.451) or time spent sedentary or in PA (P≥0.657). In this sample of adolescent girls, breakfast omission increased post-breakfast free-living EI, but total daily EI was greater when a standardised breakfast was consumed. We found no evidence that breakfast consumption induces compensatory changes in PA. Further experimental research is required to determine the effects of extended periods of breakfast manipulation in young people

Carbohydrate needs of the young athlete

Carbohydrate (CHO) typically provides the majority of energy in the athlete’s diet and is essential to fuel high intensity exercise. Ensuring adequate energy is available to meet the demands of high energy expenditures is important in the young athlete to ensure proper growth, development, and maturation. Physiological and metabolic changes that accompany the transition from childhood to adolescence and to adulthood, combined with the additional energy expenditure arising from exercise, mean that the dietary needs of young athletes require special consideration. However, in contrast to the well-documented literature in adults, little research attention has been given to child and adolescent populations. Thus, the development of specific recommendations for CHO intake in young athletes is difficult. Nevertheless, it is possible to make some general recommendations. Both the total daily CHO intake and the timing of CHO consumption in relation to exercise can determine whether adequate CHO substrate is available for muscles and the central nervous system or whether CHO fuel sources might limit exercise performance. In terms of the overall diet, CHO should contribute to the majority of energy intake, which must be high enough to support growth and maturation whilst fuelling the additional physical activity, and consequently elevated energy expenditure, in young athletes. In particular, CHO is an important fuel for high intensity exercise in young athletes. Decrements in exercise performance, fatigue and changes in body composition may serve as useful indicators that CHO intake may not be adequate, particularly in female adolescent athletes. During exercise, drinks containing CHO could be considered for young athletes engaged in endurance exercise due to the preferential use of exogenous CHO in younger athletes in the pre- or early- pubertal stages. However, evidence on CHO loading and CHO for post-exercise recovery does not appear to be available in children or adolescents. This chapter provides an overview of the available evidence that can be used to inform recommendations for CHO intake and timing in young athletes. Where no direct evidence in young athletes is available, we have relied on the relevant adult-based literature whilst emphasising that the direct translation and application of these findings to children and adolescents must be viewed cautiously

Supporting Paralympic wheelchair sport performance through technological, physiological and environmental considerations

This is an Accepted Manuscript of an article published by Taylor & Francis in Annals of Human Biology on 25 Sep 2016, available online: http://www.tandfonline.com/10.1080/03014460.2016.1234644

Effect of low-compression balls on wheelchair tennis match-play

The purpose of this study was to compare court-movement variables and physiological responses to wheelchair tennis match-play when using low versus standard compression tennis balls. Eleven wheelchair basketball players were monitored during repeated bouts of tennis (20-minutes) using both ball types. Graded and peak exercise tests were completed. For match-play, a data logger was used to record distance and speed. Individual linear heart rate oxygen consumption relationships were used to estimate match-play oxygen uptake. Significant main effects for ball type revealed that total distance (P<0.05), forwards distance (P<0.05), and average speed (P<0.05) were higher for play using a low compression ball. A lower percentage of total time was spent stationary (P<0.001), with significantly more time spent at speeds of 1 to 1.49 (P<0.05), 1.5 to 1.99 (P<0.05) and 2.0 to 2.49 (P<0.05) m∙sec-1 when using the low compression ball. Main effects for physiological variables were not significant. Greater total and forwards distance, and higher average speeds are achieved using a low compression ball. No difference in measured HR and estimated physiological responses indicates that players move further and faster at no additional mean physiological cost. This type of ball will be useful for novice players in the early phases of skill development

Metabolism and exercise during youth — The year that was 2017

Two publications were selected because they are excellent representations of studies examining different ends of the exercise-sedentary behavior continuum in young people. The first study is an acute response study with 13 mixed-sex, mid to late adolescents presenting complete data from 4 different randomized experimental crossover conditions for analyses. Continuous glucose monitoring showed that interrupting prolonged continuous sitting with body-weight resistance exercises reduced the postprandial glucose concentration compared with a time-matched uninterrupted period of sitting. Furthermore, the effects of the breaks in sitting time were independent of the energy content of the standardized meals, but variations in the area under the glucose time curves expression were important. The second study adopted a chronic 12-week exercise training intervention design with a large sample of obese children and adolescents who were allocated randomly to high-intensity interval training (HIIT), moderate-intensity continuous training, or nutritional advice groups. HIIT was the most efficacious for improving cardiorespiratory fitness compared with the other interventions; however, cardiometabolic biomarkers and visceral/subcutaneous adipose tissue did not change meaningfully in any group over the 12 weeks. Attrition rates from both HIIT and moderate-intensity continuous training groups reduce the validity of the exercise training comparison, yet this still provides a solid platform for future research comparisons using HIIT in young people

Alterations in shoulder kinematics are associated with shoulder pain during wheelchair propulsion sprints

The study purpose was to examine the biomechanical characteristics of sports wheelchair propulsion and determine biomechanical associations with shoulder pain in wheelchair athletes. Twenty wheelchair court-sport athletes (age: 32 +/- 11 years old) performed one submaximal propulsion trial in their sports-specific wheelchair at 1.67 m/s for 3 min and two 10 s sprints on a dual-roller ergometer. The Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI) assessed shoulder pain. During the acceleration phase of wheelchair sprinting, participants propelled with significantly longer push times, larger forces, and thorax flexion range of motion (ROM) than both the maximal velocity phase of sprinting and submaximal propulsion. Participants displayed significantly greater peak glenohumeral abduction and scapular internal rotation during the acceleration phase (20 +/- 9 degrees and 45 +/- 7 degrees) and maximal velocity phase (14 +/- 4 degrees and 44 +/- 7 degrees) of sprinting, compared to submaximal propulsion (12 +/- 6 degrees and 39 +/- 8 degrees). Greater shoulder pain severity was associated with larger glenohumeral abduction ROM (r = 0.59, p = 0.007) and scapular internal rotation ROM (r = 0.53, p = 0.017) during the acceleration phase of wheelchair sprinting, but with lower peak glenohumeral flexion (r = -0.49, p = 0.030), peak abduction (r = -0.48, p = 0.034), and abduction ROM (r = -0.44, p = 0.049) during the maximal velocity phase. Biomechanical characteristics of wheelchair sprinting suggest this activity imposes greater mechanical stress than submaximal propulsion. Kinematic associations with shoulder pain during acceleration are in shoulder orientations linked to a reduced subacromial space, potentially increasing tissue stress

Propulsion biomechanics do not differ between athletic and nonathletic manual wheelchair users in their daily wheelchairs

The purpose of this study was to investigate whether athletic and nonathletic manual wheelchair users (MWU) display differences in kinetic and kinematic variables during daily wheelchair propulsion. Thirty-nine manual wheelchair users (athletic n = 25; nonathletic n = 14) propelled their own daily living wheelchair on a roller ergometer at two submaximal speeds for three minutes (1.11 m s−1 and 1.67 m s−1). A 10 camera Vicon motion capture system (Vicon, Motion Systems Ltd. Oxford, United Kingdom) collected three-dimensional kinematics of the upper limbs and thorax at 200 Hz during the final minute of each propulsion trial. Kinetics, kinematics and kinematic variability were compared between athletic and nonathletic groups. Kinematic differences were investigated using statistical parametric mapping. Athletic MWU performed significantly greater physical activity per week compared to nonathletic MWU (920 ± 601 mins vs 380 ± 147 mins, respectively). However, no significant biomechanical differences between athletic and nonathletic MWU were observed during either propulsion speed. During the 1.11 m s−1 trial wheelchair users displayed a stroke frequency of 53 ± 12 pushes/min and a contact angle of 92.5 ± 16.2°. During the 1.67 m s−1 trial the mean stroke frequency was 64 ± 22 pushes/min and contact angle was 85.4 ± 13.6°. Despite the hand being unconstrained during the recovery phase the magnitude of joint kinematic variability was similar across both glenohumeral and scapulothoracic joints during recovery and push phases. To conclude, although athletic MWU participate in more physical activity per week they adopt similar strategies to propel their daily living wheelchair. Investigations of shoulder pain and dailywheelchair propulsion do not need to distinguish between athletic and nonathletic MWU

The longitudinal relationship between shoulder pain and altered wheelchair propulsion biomechanics of manual wheelchair users

The purpose of this study was to investigate the longitudinal association between within-subject changes in shoulder pain and alterations in wheelchair propulsion biomechanics in manual wheelchair users. Eighteen (age 33 ± 11 years) manual wheelchair users propelled their own daily living wheelchair at 1.11 m.s-1 for three minutes on a dual-roller ergometer during two laboratory visits (T1 and T2) between 4 and 6 months apart. Shoulder pain was assessed using the Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI). Between visits mean PC-WUSPI scores increased by 5.4 points and varied from - 13.5 to + 20.9 points. Of the eighteen participants, nine (50%) experienced increased shoulder pain, seven (39%) no change in pain, and two (11%) decreased pain. Increasing shoulder pain severity correlated with increased contact angle (r = 0.59, P = 0.010), thorax range of motion (r = 0.60, P = 0.009) and kinetic and kinematic variability. Additionally, increasing shoulder pain was associated with reductions in peak torque (r = -0.56, P = 0.016), peak glenohumeral abduction (r = -0.69, P = 0.002), peak scapular downward rotation (r = -0.68, P = 0.002), and range of motion in glenohumeral flexion/extension and scapular angles. Group comparisons revealed that these biomechanical alterations were exhibited by individuals who experienced increased shoulder pain, whereas, propulsion biomechanics of those with no change/decreased pain remained unaltered. These findings indicate that wheelchair users exhibit a protective short-term wheelchair propulsion biomechanical response to increases in shoulder pain which may temporarily help maintain functional independence

Scapular kinematic variability during wheelchair propulsion is associated with shoulder pain in wheelchair users

The purpose of this study was to investigate whether wheelchair propulsion biomechanics differ between individuals with different magnitudes of shoulder pain. Forty (age 36 11 years) manual wheelchair users propelled their own daily living wheelchair at 1.11 m.s(-1) for three minutes on a dual-roller ergometer. Shoulder pain was evaluated using the Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI). Correlation analyses between spatio-temporal, kinetic and upper limb kinematic variables during wheelchair propulsion and PC-WUSPI scores were assessed. Furthermore, kinematic differences between wheelchair users with no or mild shoulder pain (n = 33) and moderate pain (n = 7) were investigated using statistical parametric mapping. Participant mean PC-WUSPI scores were 20.3 +/- 26.3 points and varied from zero up to 104 points. No significant correlations were observed between kinetic or spatio-temporal parameters of wheelchair propulsion and shoulder pain. However, lower inter-cycle variability of scapular internal/external rotation was associated with greater levels of shoulder pain (r = 0.35, P = 0.03). Wheelchair users with moderate pain displayed significantly lower scapular kinematic variability compared to those with mild or no pain between 17 and 51% of the push phase for internal rotation, between 31-42% and 77-100% of the push phase for downward rotation and between 28-36% and 53-65% of the push phase for posterior tilt. Lower scapular variability displayed by wheelchair users with moderate shoulder pain may reflect a more uniform distribution of repeated subacromial tissue stress imposed by propulsion. This suggests that lower scapular kinematic variability during propulsion may contribute towards the development of chronic shoulder pain. (C) 2020 Elsevier Ltd. All rights reserved