Adaptation to an MCFA-rich diet : effect on gastric tolerance, the capacity for MCFA oxidation, and performance while ingesting exogenous carbohydrate and structured oils during endurance exercise : a thesis presented in partial fulfilment of the requirements for the degree of Master of Sport Science at Massey University

Introduction: Elevating the availability of fatty-acids to the muscle can potentially benefit endurance exercise performance by reducing intramuscular-glycogen utilisation. Digestion of triglycerides containing long-chain fatty acids (LCFAs) is slow, and fatty acids must pass through the carnitine palmityl transferase (CPT) transport system to enter the mitochondria, which potentially limits fat oxidation during prolonged-heavy exercise. Conversely, medium-chain triglycerides (MCTs) are rapidly digested and their constituent fatty acids (MCFAs) by-pass the CPT transport system. Ingestion of MCFAs may therefore supply mitochondrial acetyl-CoA, potentially reducing the requirement for glycolytic flux during exercise. However, studies comparing carbohydrate (CHO) with CHO-containing MCFA-rich exercise supplements have revealed inconsistent results, probably because of the variation in gastrointestinal (GI) distress suffered by participants associated with MCT ingestion. Purpose: To investigate whether 2-weeks of dietary adaptation to MCFA-rich supplements reduces the severity of gastrointestinal (Gl) distress, or increases the rate of MCFA oxidation during endurance exercise. A decrease in ratings of GI distress, or an increase in MCFA oxidation was anticipated to lead to performance benefits. Method: Nine well-trained male endurance cyclists participated in a double-blind, pseudo-randomised. triple-crossover protocol. Participants were 37 ± 7.26 years, 81.36 ± 7.67 kg. training at least 8-10 h per week and riding competitively. Mean VO2 max and peak power output (PPO) were 4.84 ± 0.46 L-min-1 and 357.33 ± 20.55 W respectively. The effects of a 2-week MCFA-rich diet +13 C-enriched MCFA+CHO exercise supplement (MC-MC) on GI distress, MCFA-oxidation rate and sprint performance variables were compared against a 2-week LCFA-rich diet with either: (a) a13 C-enriched MCFA+CHO exercise supplement (LC-MC), or (b) a CMO-only supplement (LC-CHO). Dietary and exercise MCFA-rich supplements were consumed in the form of randomised-structured triacylglycerols made with a 3:1 molar ratio of MC- and LCFAs randomly esterified to glycerol backbones. Participants followed a controlled training regime whilst on the diets. The performance test consisted of a 3-h ride at 50% PPO followed by 10 maximal sprints. At rest and every 20-min throughout the ride, participant ratings of GI and exertion sensations were recorded, followed by external respiratory-gas analysis, collection of a breath sample for breathl3 C-enrichment analysis, a venous blood sample and ingestion of a supplement. Similarly, after sprints 1, 4, 7 and 10 participants recorded their GI ratings followed by a blood sample. Results: Peak MCFA-oxidation rates were 0.38 g-min-1(95% Cl 0.31-0.47) and 0.43 g-min-1(0.30-0.61, p-value = 0.21) in the MC-MC and LC-MC conditions respectively, but there was no evidence for CHO sparing following MCFA adaptation. Participant ratings of GI distress decreased slightly during exercise with 2-weeks of a diet high in MCFAs relative to LCFAs. Ratings of reflux, bloatedness, nausea, and urge to vomit were, respectively, 1.34 (0.88-3.14), 1.03 (0.74-2.27), 0.81 (0.62-1.69) and 0.93 (0.64-245) scale units lower in the MC-MC condition relative to LC-MC. The attenuation in GI distress corresponded with a tendency toward increased sprint mean power, which was 3.4% (± 5.9%, 0.25) higher in the MC-MC condition relative to LC-MC. However, sprint mean power was still lower in both the MC-MC (6.8% ± 2.8%, <0.0001) and LC-MC (10.4% ± 5.5%, 0.0004) conditions relative to LC-CHO. Mechanism covariate analysis illustrated a negative effect of the GI distress marker nausea on sprint performance. For every 1 unit increase in nausea for the MC-MC and LC- MC conditions, sprint power decreased by 6 W (± 3.8,0.004) relative to LC-CHO. Conclusion: No clear metabolic adaptation was evident with high dietary MCFA relative to LCFA. In addition, MCFA-rich exercise supplements caused a decrement in performance relative to CHO ingestion in both MC-MC and LC-MC conditions, suggesting that light- moderate GI distress still causes substantial performance detriments. There was little evidence to support the ingestion of randomised structured triglycerides high in MCFA with the intention of enhancing endurance performance

British birds.

v. 11 June 1917/May 191

Insurers : too many, too few, or"just right"? initial observations on a cross-country dataset of concentration and competition measures

In many markets, industry and policymakers agree that there may be too many insurers. In others, the consensus is that there could be benefit from more competition. But this broad consensus is often supported by evidence that is more qualitative, anecdotal, or judgmental despite being unanimous.What is less clear, however, is how far consolidation or liberalization will go, how fast, and when it will end. This paper presents some initial observations from a cross-country data set and proposes that individual country results can be interpreted against this data set to inform expectations regarding trends in competition, concentration and consolidation, to inform analysis of the sector, for individual firm strategic planning and wider market risk assessments. A"natural level"for measures is suggested as a starting hypothesis. Further consideration is then made of the role of absolute market size, stage of market development, and differentials between life and non life segments. Analysis of the natural level, adjusted for market conditions, can then be used to develop preliminary views on current and expected market dynamics, strategic planning, and to inform policy, regulatory and supervisory priorities.Debt Markets,Markets and Market Access,Emerging Markets,Microfinance,Insurance&Risk Mitigation

A mixed methods sequential explanatory study of the utilisation and practice of traditional Chinese medicine by Chinese people in Hong Kong and Guangzhou

Little is known about why traditional Chinese (TCM) continues to be used and practised by Chinese people despite the existence of evidence-based Western medicine (WM). This study aims to explore Chinese patients and TCM practitioners’ attitudes and beliefs towards the utilisation and practice of TCM and to determine if there are any differences in the way in which Chinese people use and practice TCM in different regions of China, in this study, Hong Kong and Guangzhou. A mixed-method, sequential explanatory study was undertaken that involved two phases. In the first phase, a structured questionnaire translated into Chinese was used to collect data from a convenience sample of Chinese patients attending outpatient clinics in Hong Kong and Guangzhou. A Chinese research assistant who could speak Cantonese and Mandarin distributed the questionnaires to patients attending the TCM outpatient clinics in Hong Kong and Guangzhou. Also, a random sample of Chinese medicine practitioners in Hong Kong was sent a questionnaire by post, as a list of Chinese medicine practitioners names, and clinic addresses in Hong Kong are available on the Chinese Medical Council’s Internet website. For TCM practitioners in Guangzhou, a Chinese research assistant distributed the questionnaire in-person to a random sample of TCM doctors working at the Guangzhou University of Traditional Chinese medicine in Guangzhou. In the second phase of the study, semi-structured interviews were conducted with patients and Chinese medicine practitioners in Hong Kong and patients and TCM practitioners in Guangzhou. Patients and TCM practitioners who took part in an interview were randomly selected from a list of patients and TCM practitioners who had previously filled out a questionnaire in the first phase of the study. A total of 1,200 patients and 400 TCM practitioners took part in the study, which comprised of 600 patients attending an out-patient TCM clinic in Hong Kong and 600 attending an out-patient TCM clinic in Guangzhou. The response rate for patients who took part was 81.4% (n= 505) and for Guangzhou 91.6% (n=550). For TCM practitioners, the response rate was 55% (n=110) for practitioners in Hong Kong and 61.5% (n= 123) for practitioners in Guangzhou. Patients’ mean age was 44.6 years, and the sample consisted of 41.2% males and 58.8% females. For TCM practitioners, the mean age was 45.4 years and the sample consisting of 66.1% males and 33.9% females. In the second phase of the study, semi-structured interviews were conducted with 16 patients and 16 TCM practitioners in Hong Kong and Guangzhou, respectively. The results showed that for patients in Hong Kong and Guangzhou the most common use of TCM was for the treatment of acute medical conditions, such as colds and flu and also for chronic medical conditions, such as rheumatism and diabetes. Also, patients in Guangzhou were found to use TCM to “recuperate” the body after taking Western medicines prescribed by WM doctors, or after suffering a chronic illness. Concurrent use of TCM and WM was found to be more common in patients in Guangzhou, than in patients in Hong Kong. The integration of TCM services in hospitals in Hong Kong is notably different from that of China. Unlike China, where TCM practitioners are permitted to treat in-patients inside state-run hospitals, in Hong Kong, TCM practitioners are only permitted to treat patients on an outpatient basis and not as in-patients. The results of this study contribute to the existing body of literature about the utilisation and practice of TCM by Chinese people in Hong Kong and Guangzhou. The study also provides unique information about the practice of TCM in Hong Kong since the implementation of the Chinese medicine Ordinance and the establishment of the Chinese Medicine Council of Hong Kong. Although the study contributes to the existing body of literature concerning the utilisation and practice of TCM by Chinese people and TCM practitioners ‘respectively, it does have several inherent limitations. Among the significant limitations is the fact that, as a cross-sectional survey design was used, therefore no “cause and effect” relationships can be drawn from the results. Furthermore, because statistical tests, in general, require a large sample size to ensure a representative distribution of the population being studied, the total number of patients and TCM practitioners who participated in the study is relatively small

The market for retirement products in Australia

Australia introduced a mandatory retirement savings scheme in 1992. This built on pre-existing voluntary occupational plans. The new scheme has been very successful in expanding coverage and mobilizing large financial savings that are equal to close to 100 percent of GDP. However, Australia does not impose restrictions on payout options. The payout phase used to be dominated by lump sum withdrawals, which accounted for 80 percent of benefit payments as recently as 2002. But pension payments increased in recent years and now represent 45 percent of total payments. The vast majority of these pension payments take the form of term annuities and allocated annuities. The latter are similar to phased withdrawals in Chile but run for fixed terms of up to 25 years rather than for lifetime terms. The demand for life annuities and lifetime phased withdrawals is very limited. The paper discusses the factors that have shaped the pattern of demand for retirement products, including the availability of the universal age pension and the effect of clawback provisions, the impact of the high level of home ownership, and the widespread preference of retiring workers for reliance on self-annuitization. The paper also reviews the prudential regulation of superannuation funds and life insurance companies.,Debt Markets,Emerging Markets,Pensions&Retirement Systems,Economic Theory&Research

An empirical analysis of the annuity rate in Chile

Empirical analyses of annuities markets have been limited to a few industrial countries and restricted by data limitations. Chile provides excellent conditions for research on annuities because of the depth of its market and the availability of data. The authors use a panel of life insurance company data to examine econometrically the main determinants of the annuity rate, defined as the internal rate ofreturn on annuities. The results indicate that the annuity rate is determined by the risk-free interest rate, the share of privately-issued higher yield securities in the portfolio of providers as a proxy for the spread over the risk-free rate, the leverage of providers, the level of broker's commissions, the market share of individual providers, the level of the premium, and the degree of market competition. The results also show that efforts to improve market transparency produced structural shifts in the parameters of the annuity rate equation. The results are consistent with separate research on money's worth ratios, and indicate the need to develop appropriate financial instruments, allowing providers to hedge their risks while extracting higher returns, and also to ensure competition and transparency in annuities markets, in order to ensure good outcomes for annuitants.Insurance&Risk Mitigation,Pensions&Retirement Systems,Economic Theory&Research,Investment and Investment Climate,Non Bank Financial Institutions