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Daily (circadian) rhythms coordinate our physiology and behaviour with regular environmental changes. Molecular clocks in peripheral tissues (e.g. liver, skeletal muscle and adipose) give rise to rhythms in macronutrient metabolism, appetite regulation and the components of energy balance such that our bodies can align the periodic delivery of nutrients with ongoing metabolic requirements. The timing of meals both in absolute terms (i.e. relative to clock time) and in relative terms (i.e. relative to other daily events) is therefore relevant to metabolism and health. Experimental manipulation of feeding–fasting cycles can advance understanding of the effect of absolute and relative timing of meals on metabolism and health. Such studies have extended the overnight fast by regular breakfast omission and revealed that morning fasting can alter the metabolic response to subsequent meals later in the day, whilst also eliciting compensatory behavioural responses (i.e. reduced physical activity). Similarly, restricting energy intake via alternate‐day fasting also has the potential to elicit a compensatory reduction in physical activity, and so can undermine weight‐loss efforts (i.e. to preserve body fat stores). Interrupting the usual overnight fast (and therefore also the usual sleep cycle) by nocturnal feeding has also been examined and further research is needed to understand the importance of this period for either nutritional intervention or nutritional withdrawal. In summary, it is important for dietary guidelines for human health to consider nutrient timing (i.e. when we eat) alongside the conventional focus on nutrient quantity and nutrient quality (i.e. how much we eat and what we eat). [ABSTRACT FROM AUTHOR]

Nocturnal endocrine responses to exercise performed in the evening and the potential role of nutrition are poorly understood. To gain novel insight, 10 healthy men ingested carbohydrate with (C+P) and without (C) protein in a randomized order and double-blind manner during 2 hr of interval cycling followed by resistance-type exercise and into early postexercise recovery. Blood samples were obtained hourly throughout 9 hr of postexercise overnight recovery for analysis of key hormones. Muscle samples were taken from the vastus lateralis before and after exercise and then again the next morning (7 a.m.) to calculate mixed-muscle protein fractional synthetic rate (FSR). Overnight plasma hormone concentrations were converted into overall responses (expressed as area under the concentration curve) and did not differ between treatments for either growth hormone (1,464 ± 257 vs. 1,432 ± 164 pg/ml · 540 min) or total testosterone (18.3 ± 1.2 vs. 17.9 ± 1.2 nmol/L · 540 min, C and C+P, respectively). In contrast, the overnight cortisol response was higher with C+P (102 ± 11 nmol/L · 540 min) than with C (81 ± 8 nmol/L · 540 min; p = .02). Mixed-muscle FSR did not differ between C and C+P during overnight recovery (0.062% ± 0.006% and 0.062% ± 0.009%/hr, respectively) and correlated significantly with the plasma total testosterone response (r = .7, p < .01). No correlations with FSR were apparent for the response of growth hormone (r = -.2, p = .4), cortisol (r = .1, p = .6), or the ratio of testosterone to cortisol (r = .2, p = .5). In conclusion, protein ingestion during and shortly after exercise does not modulate the endocrine response or muscle protein synthesis during overnight recovery. [ABSTRACT FROM AUTHOR]

Nocturnal endocrine responses to exercise performed in the evening and the potential role of nutrition are poorly understood. To gain novel insight, 10 healthy men ingested carbohydrate with (C+P) and without (C) protein in a randomized order and double-blind manner during 2 hr of interval cycling followed by resistance-type exercise and into early postexercise recovery. Blood samples were obtained hourly throughout 9 hr of postexercise overnight recovery for analysis of key hormones. Muscle samples were taken from the vastus lateralis before and after exercise and then again the next morning (7 a.m.) to calculate mixed-muscle protein fractional synthetic rate (FSR). Overnight plasma hormone concentrations were converted into overall responses (expressed as area under the concentration curve) and did not differ between treatments for either growth hormone (1,464 ± 257 vs. 1,432 ± 164 pg/ml · 540 min) or total testosterone (18.3 ± 1.2 vs. 17.9 ± 1.2 nmol/L · 540 min, C and C+P, respectively). In contrast, the overnight cortisol response was higher with C+P (102 ± 11 nmol/L · 540 min) than with C (81 ± 8 nmol/L · 540 min; p = .02). Mixed-muscle FSR did not differ between C and C+P during overnight recovery (0.062% ± 0.006% and 0.062% ± 0.009%/hr, respectively) and correlated significantly with the plasma total testosterone response (r = .7, p < .01). No correlations with FSR were apparent for the response of growth hormone (r = -.2, p = .4), cortisol (r = .1, p = .6), or the ratio of testosterone to cortisol (r = .2, p = .5). In conclusion, protein ingestion during and shortly after exercise does not modulate the endocrine response or muscle protein synthesis during overnight recovery. [ABSTRACT FROM AUTHOR]

This study was designed to compare the effects of energy-matched carbohydrate (CHO) and carbohydrateprotein (CHO-PRO) supplements on cycling time-trial performance. Twelve competitive male cyclists and triathletes each completed 2 trials in a randomized and counterbalanced order that were separated by 5-10 d and applied in a double-blind manner. Participants performed a 45-min variable-intensity exercise protocol on a cycle ergometer while ingesting either a 9% CHO solution or a mixture of 6.8% CHO plus 2.2% protein in volumes providing 22 kJ/kg body mass. Participants were then asked to cycle 6 km in the shortest time possible. Blood glucose and lactate concentrations were measured every 15 min during exercise, along with measures of substrate oxidation via indirect calorimetry, heart rate, and ratings of perceived exertion. Mean time to complete the 6-km time trial was 433 ± 21 s in CHO trials and 438 ± 22 s in CHO-PRO trials, which represents a 0.94% (CI: 0.01, 1.86) decrement in performance with the inclusion of protein (p = .048). However, no other variable measured in this study was significantly different between trials. Reducing the quantity of CHO included in a supplement and replacing it with protein may not represent an effective nutritional strategy when the supplement is ingested during exercise. This may reflect the central ergogenic influence of exogenous CHO during such activity. [ABSTRACT FROM AUTHOR]

Including protein in a carbohydrate solution may accelerate both the rate of glycogen storage and the restoration of exercise capacity following prolonged activity. Two studies were undertaken with nine active men in study A and seven in study B. All participants performed 2 trials, each involving a 90 min run at 70% VO2max followed by a 4 h recovery. During recovery, either a 9.3% carbohydrate solution (CHO) or the same solution plus 1.5% protein (CHO-PRO) was ingested every 30 min in volumes providing either 1.2 g CHO · kg-1 · h-1 (study A) or 0.8 g CHO · kg-1 · h-1 (study B). Exercise capacity was then assessed by run time to exhaustion at 85% VO2max. Ingestion of CHO-PRO elicited greater insulinemic responses than CHO (P ≤ 0.05) but with no differences in run times to exhaustion. Within the context of this experimental design, CHO and CHO-PRO restored running capacity with equal effect. [ABSTRACT FROM AUTHOR]

The premise of research in human physiology is to explore a multifaceted system whilst identifying one or a few outcomes of interest. Therefore, the control of potentially confounding variables requires careful thought regarding the extent of control and complexity of standardisation. One common factor to control prior to testing is diet, as food and fluid provision may deviate from participants' habitual diets, yet a self-report and replication method can be flawed by under-reporting. Researchers may also need to consider standardisation of physical activity, whether it be through familiarisation trials, wash-out periods, or guidance on levels of physical activity to be achieved before trials. In terms of pharmacological agents, the ethical implications of standardisation require researchers to carefully consider how medications, caffeine consumption and oral contraceptive prescriptions may affect the study. For research in females, it should be considered whether standardisation between- or within-participants in regards to menstrual cycle phase is most relevant. The timing of measurements relative to various other daily events is relevant to all physiological research and so it can be important to standardise when measurements are made. This review summarises the areas of standardisation which we hope will be considered useful to anyone involved in human physiology research, including when and how one can apply standardisation to various contexts. [ABSTRACT FROM AUTHOR]

Purpose: Prolonged sitting is a major health concern, targeted via government policy and the proliferation of height-adjustable workstations and wearable technologies to encourage standing. Such interventions have the potential to influence energy balance and thus facilitate effective management of body/fat mass. It is therefore remarkable that the energy cost of sitting versus standing naturally remains unknown. Methods: Metabolic requirements were quantified via indirect calorimetry from expired gases in 46 healthy men and women (age, 27 ± 12 yr; mass, 79.3 ± 14.7 kg; body mass index, 24.7 ± 3.1 kg·m−2, waist/hip, 0.81 ± 0.06) under basal conditions (i.e., resting metabolic rate) and then, in a randomized and counterbalanced sequence, during lying, sitting and standing. Critically, no restrictions were placed on natural/spontaneous bodily movements (i.e., fidgeting) to reveal the fundamental contrast between sitting and standing in situ while maintaining a comfortable posture. Results: The mean (95% confidence interval [CI]) increment in energy expenditure was 0.18 (95% CI, 0.06–0.31 kJ·min−1) from resting metabolic rate to lying was 0.15 (95% CI, 0.03–0.27 kJ·min−1) from lying to sitting and 0.65 (95% CI, 0.53–0.77 kJ·min−1) from sitting to standing. An ancillary observation was that the energy cost of each posture above basal metabolic requirements exhibited marked interindividual variance, which was inversely correlated with resting heart rate for all postures (r = −0.5; −0.7 to −0.1) and positively correlated with self-reported physical activity levels for lying (r = 0.4; 0.1 to 0.7) and standing (r = 0.6; 0.3–0.8). Conclusions: Interventions designed to reduce sitting typically encourage 30 to 120 min·d−1 more standing in situ (rather than perambulation), so the 12% difference from sitting to standing reported here does not represent an effective strategy for the treatment of obesity (i.e., weight loss) but could potentially attenuate any continued escalation of the ongoing obesity epidemic at a population level. [ABSTRACT FROM AUTHOR]

Purpose: Breaking prolonged sitting reduces postprandial glucose and insulin concentrations and influences skeletal muscle molecular signaling pathways, but it is unknown whether breaking sitting also affects adipose tissue. Methods: Eleven central overweight participants (seven men and four postmenopausal women) 50 ± 5 yr old (mean ± SD) completed two mixed-meal feeding trials (prolonged sitting vs breaking sitting) in a randomized, counterbalanced design. The breaking sitting intervention comprised walking for 2 min every 20 min over 5.5 h. Blood samples were collected at regular intervals to examine metabolic biomarkers and adipokine concentrations. Adipose tissue samples were collected at baseline and at 5.5 h to examine changes in mRNA expression and secretion of selected adipokines ex vivo. Results: Postprandial glycemia and insulinemia were attenuated by approximately 50% and 40% in breaking sitting compared with prolonged sitting (iAUC: 359 ± 117 vs 697 ± 218 mmol per 330 min·L−1, P = 0.001, and 202 ± 71 vs 346 ± 150 nmol per 330 min·L−1, P = 0.001, respectively). Despite these pronounced and sustained differences in postprandial glucose and insulin concentrations, adipose tissue mRNA expression for various genes (interleukin 6, leptin, adiponectin, pyruvate dehydrogenase kinase isozyme 4, insulin receptor substrates 1 and 2, phosphoinositide 3-kinase, and RAC-alpha serine/threonine-protein kinase) and ex vivo adipose tissue secretion of interleukin 6, leptin, and adiponectin were not different between trials. Conclusions: This study demonstrates that breaking sitting with short bouts of physical activity has very pronounced effects on systemic postprandial glucose and insulin concentrations, but this does not translate into corresponding effects within adipose tissue. [ABSTRACT FROM AUTHOR]

Purpose: Most of what we know about adipose tissue is restricted to observations derived after an overnight fast. However, humans spend the majority of waking hours in a postprandial (fed) state, and it is unclear whether increasing adiposity impacts adipose tissue responses to feeding. The aim of this research was to investigate postprandial responses in adipose tissue across varying degrees of adiposity. Methods: Thirty males aged 35-55 years with waist circumference 81-118 cm were divided equally into groups categorized as either lean, overweight or obese. Participants consumed a meal and insulinaemic, glycaemic and lipidaemic responses were monitored over 6 h. Subcutaneous adipose tissue samples were obtained at baseline and after 6 h to examine changes in gene expression and adipose tissue secretion of various adipokines. Results: Following consumption of the meal, insulin and glucose responses were higher with increased adiposity (total AUC effects of group; p = 0.058 and p = 0.027, respectively). At 6 h, significant time effects reflected increases in IL-6 ( F = 14.7 , p = 0.001) and MCP-1 ( F = 10.7, p = 0.003) and reduction in IRS2 adipose tissue gene expression ( F = 24.6, p < 0.001), all independent of adiposity. Ex vivo adipokine secretion from adipose tissue explants remained largely unchanged after feeding. Conclusions: Increased systemic measures of postprandial metabolism with greater adiposity do not translate into increased inflammatory responses within adipose tissue. Instead, postprandial adipose tissue changes may represent a normal response to feeding or a (relatively) normalized response with increased adiposity due to either similar net exposure (i.e. per g of adipose) or reduced adipose tissue responsiveness. [ABSTRACT FROM AUTHOR]

During short-term recovery, postexercise glucose--fructose coingestion can accelerate total glycogen repletion and augment recovery of running capacity. It is unknown if this advantage translates to cycling, or to a longer (e.g., overnight) recovery. Using two experiments, the present research investigated if postexercise glucose--fructose coingestion augments exercise capacity following 4-hr (short experiment; n = 8) and 15-hr (overnight experiment; n = 8) recoveries from exhaustive exercise in trained cyclists, compared with isocaloric glucose alone. In each experiment, a glycogen depleting exercise protocol was followed by a 4-hr recovery, with ingestion of 1.5 or 1.2 g⋅kg-1⋅hr-1 carbohydrate in the short experiment (double blind) and the overnight experiment (single blind), respectively. Treatments were provided in a randomized order using a crossover design. Four or fifteen hours after the glycogen depletion protocol, participants cycled to exhaustion at 70% Wmax or 65% Wmax in the short experiment and the overnight experiment, respectively. In both experiments there was no difference in substrate oxidation or blood glucose and lactate concentrations between treatments during the exercise capacity test (trial effect, p > .05). Nevertheless, cycling capacity was greater in glucose + fructose versus glucose only in the short experiment (28.0 ± 8.4 vs. 22.8 ± 7.3 min, d = 0.65, p = .039) and the overnight experiment (35.9 ± 10.7 vs. 30.6 ± 9.2 min, d = 0.53, p = .026). This is the first study to demonstrate that postexercise glucose--fructose coingestion enhances cycling capacity following short-term (4 hr) and overnight (15 hr) recovery durations. Therefore, if multistage endurance athletes are ingesting glucose for rapid postexercise recovery then fructose containing carbohydrates may be advisable. [ABSTRACT FROM AUTHOR]

Abstract: Background: Consensus guidelines have indicated that postoperative parenteral nutrition (PN) might provide benefit when patients are expected to be nil per os (NPO) ≥7 d and when PN is administered ≥5 d. We hypothesized that most children receiving PN after appendectomy do not satisfy these criteria. Methods: The medical records of the patients who had undergone appendectomy for perforated appendicitis from 2006–2011 were analyzed, and the proportion meeting the criteria for beneficial PN was determined. The clinical parameters independently associated with the criteria for beneficial PN (PN therapy ≥5 d, ileus ≥5 d, NPO ≥7 d) were identified using multiple regression analysis. Results: A total of 1612 patients were treated for appendicitis. Of these, 587 met the inclusion criteria (age <16 y, perforated appendicitis, appendectomy within 24 h, no previous indication for PN). Of the 587 patients, 12.1% received PN; 43.8% of these received PN for ≥5 d. The predictors of PN duration of ≥5 d included preoperative symptoms for ≥3 d (P < 0.01) and initiation of PN by postoperative day 3 (P = 0.047). Preoperative symptoms for ≥3 d, imaging showing a discrete abscess or bowel obstruction, and operative findings of diffuse peritonitis predicted ileus of ≥5 d and NPO of ≥7 d (P < 0.01 for all). Major complications were more common in patients with ileus lasting ≥5 d. Conclusions: Fewer than one-half of patients receiving PN in the present cohort met the consensus-based guidelines for postoperative PN. The preoperative symptom duration, preoperative imaging findings demonstrating abscess and/or bowel obstruction, and intraoperative findings of diffuse peritonitis might predict prolonged ileus and longer recovery periods for children undergoing surgery for perforated appendicitis. [Copyright &y& Elsevier]

Letters are presented in response to several articles including "Forty years of sports performance research and little insight gained," by C. Heneghan and colleagues, and "How valid is the European Food Safety Authority's assessment of sports drinks," by C. Cohen and colleagues, in the July 2012 issue; responses to few of these letters are also presented.

In this article the authors reflect upon whether protein be included in carbohydrate (CHO)-based dietary supplements for athletes. One of the author comments that lack of scientific evidence indicates that protein is not an essential addition to CHO-based sports supplements and should be consumed through whole foods in a balanced diet. Other author stresses on the benefits of including protein to CHO-based supplements for athletes making it a more nutritional product.

Objectives: To report the breadth of ovarian conditions that pediatric urologists may encounter through diverse referral patterns. Methods: Two regional pediatric centers reviewed cases from 2000 to 2010, yielding 13 females with gonad-related conditions. Results: Six of 13 patients (46%) were referred for a presumed urological condition that was later discovered to be of ovarian origin or were already known to the urology clinic for a congenital urological anomaly. Six patients had tumor markers drawn, all of which were normal. Median age was 11.2 years. The most common presenting symptoms were pain (6/13), emesis (5/13), and precocious puberty (2/13). Median mass diameter was 7.5 cm with 2 patients having masses greater than 20 cm. Histologic diagnosis was mature teratoma (4/13), streak gonad (3/13), and hemorrhagic cyst (2/13). Two patients had potentially malignant tumors (immature teratoma and juvenile granulosa cell tumor). Conclusions: At our centers, an ovarian condition is encountered an average of 1.3 times per year. As management of pediatric ovarian cysts and masses is controversial, pediatric urologists should be familiar with the diagnosis and treatment of such conditions. [ABSTRACT FROM AUTHOR]

Background: Current guidance regarding the role of daily breakfast in human health is largely grounded in cross-sectional observations. However, the causal nature of these relationships has not been fully explored and what limited information is emerging from controlled laboratory-based experiments appears inconsistent with much existing data. Further progress in our understanding therefore requires a direct examination of how daily breakfast impacts human health under free-living conditions.Methods/design: The Bath Breakfast Project (BBP) is a randomised controlled trial comparing the effects of daily breakfast consumption relative to extended fasting on energy balance and human health. Approximately 70 men and women will undergo extensive laboratory-based assessments of their acute metabolic responses under fasted and post-prandial conditions, to include: resting metabolic rate, substrate oxidation, dietary-induced thermogenesis and systemic concentrations of key metabolites/hormones. Physiological and psychological indices of appetite will also be monitored both over the first few hours of the day (i.e. whether fed or fasted) and also following a standardised test lunch used to assess voluntary energy intake under controlled conditions. Baseline measurements of participants' anthropometric characteristics (e.g. DEXA) will be recorded prior to intervention, along with an oral glucose tolerance test and acquisition of adipose tissue samples to determine expression of key genes and estimates of tissue-specific insulin action. Participants will then be randomly assigned either to a group prescribed an energy intake of ≥3000 kJ before 1100 each day or a group to extend their overnight fast by abstaining from ingestion of energy-providing nutrients until 1200 each day, with all laboratory-based measurements followed-up 6 weeks later. Free-living assessments of energy intake (via direct weighed food diaries) and energy expenditure (via combined heart-rate/accelerometry) will be made during the first and last week of intervention, with continuous glucose monitors worn both to document chronic glycaemic responses to the intervention and to verify compliance. [ABSTRACT FROM AUTHOR]

This review considers aspects of the optimal nutritional strategy for recovery from prolonged moderate to high intensity exercise. Dietary carbohydrate represents a central component of post-exercise nutrition. Therefore, carbohydrate should be ingested as early as possible in the post-exercise period and at frequent (i.e. 15- to 30-minute) intervals throughout recovery to maximize the rate of muscle glycogen resynthesis. Solid and liquid carbohydrate supplements or whole foods can achieve this aim with equal effect but should be of high glycaemic index and ingested following the feeding schedule described above at a rate of at least 1 g/kg/h in order to rapidly and sufficiently increase both blood glucose and insulin concentrations throughout recovery. Adding ≥0.3 g/kg/h of protein to a carbohydrate supplement results in a synergistic increase in insulin secretion that can, in some circumstances, accelerate muscle glycogen resynthesis. Specifically, if carbohydrate has not been ingested in quantities sufficient to maximize the rate of muscle glycogen resynthesis, the inclusion of protein may at least partially compensate for the limited availability of ingested carbohydrate. Some studies have reported improved physical performance with ingestion of carbohydrate-protein mixtures, both during exercise and during recovery prior to a subsequent exercise test. While not all of the evidence supports these ergogenic benefits, there is clearly the potential for improved performance under certain conditions, e.g. if the additional protein increases the energy content of a supplement and/or the carbohydrate fraction is ingested at below the recommended rate. The underlying mechanism for such effects may be partly due to increased muscle glycogen resynthesis during recovery, although there is varied support for other factors such as an increased central drive to exercise, a blunting of exercise-induced muscle damage, altered metabolism during exercise subsequent to recovery, or a combination of these mechanisms. [ABSTRACT FROM AUTHOR]

Previous studies indicate that exercise-induced muscle damage may be attenuated when protein is included in a carbohydrate recovery supplement. This study was designed to examine systemic indices of muscle damage, inflammation, and recovery of muscle function, following strenuous exercise, with ingestion of either carbohydrate alone or a carbohydrate-protein mixture. Seventeen highly trained volunteers participated in 2 trials in a randomized order, separated by approximately 9 weeks. Each trial involved 90 min of intermittent shuttle-running, either with ingestion of a 9% sucrose solution during and for 4 h after (1.2 g·kg-1 body mass·h-1) or with the same solution plus 3% whey protein isolate (0.4 g·kg-1 body mass·h-1). Blood was sampled throughout and 24 h after each trial to determinate the systemic indices of muscle damage and inflammation. An isokinetic dynamometer was used to establish reliable baseline measurements of peak isometric torque for knee and hip flexors and extensors, which were then followed-up at 4-, 24-, 48-, and 168-h postexercise. The exercise protocol resulted in significantly elevated variables indicative of muscle damage and inflammation, while peak isometric torque was immediately reduced by 10%-20% relative to baseline, across all muscle groups tested. However, none of these responses varied in magnitude or time-course between the treatments, or between participants’ first and second trials. The addition of whey protein isolate to a dietary carbohydrate supplement ingested during and for 4 h following strenuous exercise did not attenuate systemic indices of muscle damage or inflammation, nor did it restore muscle function more rapidly than when the carbohydrate fraction was ingested alone. [ABSTRACT FROM AUTHOR]

The article reports on the study which examines the metabolic impact of including protein in a postexercise carbohydrate supplement when ingested between two bouts of prolonged running performed within the same day. According to the authors of the study, six healthy men have participated in two trials separated by 14-d, each involving a 90 minute treadmill run at 70% VO2max followed by 4 hour of recovery and a subsequent 60-minute run at the same intensity. The results of the study showed that the inclusion of protein in a carbohydrate-recovery supplement can hike the oxidation of extramuscular carbohydrate sources during subsequent exercise without altering the rate of muscle glycogen degradation.

Ingesting carbohydrate plus protein following prolonged exercise may restore exercise capacity more effectively than ingestion of carbohydrate alone. The objective of the present study was to determine whether this potential benefit is a consequence of the protein fraction per se or simply due to the additional energy it provides. Six active males participated in three trials, each involving a 90-min treadmill run at 70% maximal oxygen uptake (run 1) followed by a 4-h recovery. At 30-min intervals during recovery, participants ingested solutions containing: (1) 0.8 g carbohydrate · kg body mass (BM)-1 · h-1 plus 0.3 g · kg-1 · h-1 of whey protein isolate (CHO-PRO); (2) 0.8 g carbohydrate · kg BM-1 · h-1 (CHO); or (3) 1.1 g carbohydrate · kg BM-1 · h-1 (CHO-CHO). The latter two solutions matched the CHO-PRO solution for carbohydrate and for energy, respectively. Following recovery, participants ran to exhaustion at 70% maximal oxygen uptake (run 2). Exercise capacity during run 2 was greater following ingestion of CHO-PRO and CHO-CHO than following ingestion of CHO (P ≤ 0.05) with no significant difference between the CHO-PRO and CHO-CHO treatments. In conclusion, increasing the energy content of these recovery solutions extended run time to exhaustion, irrespective of whether the additional energy originated from sucrose or whey protein isolate. [ABSTRACT FROM AUTHOR]

The premise of research in human physiology is to explore a multifaceted system whilst identifying one or a few outcomes of interest. Therefore, the control of potentially confounding variables requires careful thought regarding the extent of control and complexity of standardisation. One common factor to control prior to testing is diet, as food and fluid provision may deviate from participants' habitual diets, yet a self‐report and replication method can be flawed by under‐reporting. Researchers may also need to consider standardisation of physical activity, whether it be through familiarisation trials, wash‐out periods, or guidance on levels of physical activity to be achieved before trials. In terms of pharmacological agents, the ethical implications of standardisation require researchers to carefully consider how medications, caffeine consumption and oral contraceptive prescriptions may affect the study. For research in females, it should be considered whether standardisation between‐ or within‐participants in regards to menstrual cycle phase is most relevant. The timing of measurements relative to various other daily events is relevant to all physiological research and so it can be important to standardise when measurements are made. This review summarises the areas of standardisation which we hope will be considered useful to anyone involved in human physiology research, including when and how one can apply standardisation to various contexts. [ABSTRACT FROM AUTHOR]

Phosphate is integral to numerous metabolic processes, several of which strongly predict exercise performance (i.e., cardiac function, oxygen transport, and oxidative metabolism). Evidence regarding phosphate loading is limited and equivocal, at least partly because studies have examined sodium phosphate supplements of varied molar mass (e.g., mono/di/tribasic, dodecahydrate), thus delivering highly variable absolute quantities of phosphate. Within a randomized cross-over design and in a single-blind manner, 16 well-trained cyclists (age 38 ± 16 years, mass 74.3 ± 10.8 kg, training 340 ± 171 min/week; mean ± SD) ingested either 3.5 g/day of dibasic sodium phosphate (Na2HPO4: 24.7 mmol/day phosphate; 49.4 mmol/day sodium) or a sodium chloride placebo (NaCl: 49.4 mmol/day sodium and chloride) for 4 days prior to each of two 30-km time trials, separated by a washout interval of 14 days. There was no evidence of any ergogenic benefit associated with phosphate loading. Time to complete the 30-km time trial did not differ following ingestion of sodium phosphate and sodium chloride (3,059 ± 531 s vs. 2,995 ± 467 s). Accordingly, neither absolute mean power output (221 ± 48 W vs. 226 ± 48 W) nor relative mean power output (3.02 ± 0.78 W/kg vs. 3.08 ± 0.71 W/kg) differed meaningfully between the respective intervention and placebo conditions. Measures of cardiovascular strain and ratings of perceived exertion were very closely matched between treatments (i.e., average heart rate 161 ± 11 beats per minute vs. 159 ± 12 beats per minute; Δ2 beats per minute; and ratings of perceived exertion 18 [14–20] units vs. 17 [14–20] units). In conclusion, supplementing with relatively high absolute doses of phosphate (i.e., >10 mmol daily for 4 days) exerted no ergogenic effects on trained cyclists completing 30-km time trials. [ABSTRACT FROM AUTHOR]

The use of a silo for temporary coverage of exposed viscera for newborns with gastroschisis has allowed gradual reduction of the externalized intestine into the abdominal cavity. However, there has not been an easy way to monitor blood perfusion to the intestine within the silo other than with visual examination. In addition, visual examination of bowel through the silo is sometimes difficult for medical staff due to serositis and peel over the bowel. We have adopted an approach to monitor oxygen saturation of silo-contained intestine by placing a pulse oximeter sensor on the surface of the transparent silo to detect intestinal ischemia. Pulse oximeter sensors were applied on both a patient's distal extremity and the silo on five consecutive patients who were born with gastroschisis. The sensor was left on the silo during the entire period of gradual reduction. Perfusion index, pulse and oxygen saturation were observed and checked against the sensor placed on a peripheral extremity. The silo-placed pulse oximeter and peripheral pulse oximeter sensors showed a similar pulse and oxygen saturation throughout the reduction period in all five patients. In general, perfusion index was higher from the silo pulse oximeter compared to the peripheral pulse oximeter reading. A pulse oximeter can be used to monitor intestinal oxygen saturation contained within a silo and help modulate the rate of manual reduction of intestine. [ABSTRACT FROM AUTHOR]

The article presents introduction that discusses about impact on appetite due to acute exercising and inter individual differences with relation to exercising and impact of Genotype on individual variability in response.

Background: Fructose ingestion with a high-fat beverage increases postprandial lipemia when compared with glucose. It is unknown whether other sugars, such as galactose, also increase postprandial lipemia.Objectives: The objective was to assess whether galactose ingestion within a high-fat beverage increases postprandial lipemia relative to glucose or fructose.Methods: Two experiments were conducted, which contrasted different test drinks under otherwise standardized conditions. In Experiment 1, 10 nonobese men (age: 22 ± 1 y; BMI, 23.5 ± 2.2 kg/2) ingested either galactose or glucose (0.75 g supplemented carbohydrate per⋅kilogram body mass) within a high-fat test drink (0.94 g fat per kilogram body mass). In Experiment 2, a separate group of 9 nonobese men (age: 26 ± 6 y; BMI: 23.5 ± 2.6 kg/m2) ingested either galactose or fructose (identical doses as those in Experiment 1) within the same high-fat test drink. Capillary blood was sampled before and at frequent intervals after ingestion of the test drinks for a 300-min period to determine plasma triacylglycerol, glucose, lactate, nonesterified fatty acid, and insulin concentrations. Paired t tests and 2-way, repeated-measures ANOVA were used to compare conditions within each experiment.Results: The incremental AUC for triacylglycerol was greater following galactose ingestion compared with glucose (127 ± 59 compared with 80 ± 48 mmol⋅L-1 × 300 min, respectively; P = 0.04) but not compared with fructose (136 ± 74 compared with 133 ± 63 mmol⋅L-1 ×300 min, respectively; P = 0.91). Plasma lactate concentrations also increased to a greater extent with galactose compared with glucose ingestion (time-condition interaction: P < 0.001) but not fructose ingestion (time-condition interaction: P = 0.17).Conclusions: Galactose ingestion within a high-fat beverage exacerbates postprandial lipemia and plasma lactate concentrations compared with glucose but not fructose in nonobese men. These data suggest that galactose metabolism may be more similar to fructose than to glucose, providing a rationale to reassess the metabolic fate of galactose ingestion in humans. This trial was registered at clinicaltrials.gov as NCT03439878. [ABSTRACT FROM AUTHOR]

Exploring individual responses to exercise training is a growing area of interest. Understanding reasons behind true observed inter-individual responses may help personalise exercise training to maximise the benefits received. While numerous factors have been explored, an often underappreciated consideration in the sport and exercise science field is the influence intra-individual variation, both in a single measurement and in response to an intervention, may have on training outcomes. Several study designs and statistical approaches are available to incorporate intra-individual variation into interventions and accordingly provide information on whether 'true' inter-individual responses are present or if they are an artefact of intra-individual variation. However, such approaches are sparingly applied. Moreover, intra-individual variation may also be important when true inter-individual response differences are present. In this perspective piece, the concept of intra-individual variation is described before briefly summarising study designs and statistical practices to account for intra-individual variation. We then outline two examples of physiological practices (stratified randomisation and prescribing exercise programmes upon training parameters) to demonstrate why sport and exercise scientists should acknowledge intra-individual variation prior to the implementation of an intervention, which potentially offers an additional explanation behind observed true inter-individual responses to training. Repeated testing pre-implementation of exercise training would conceptually provide more confident estimates of training parameters, which if utilised in a study design will help attenuate biases that may dictate inter-individual differences. Moreover, the incorporation of intra-individual differences will facilitate insights into alternative factors that may predict and/or explain true observed individual responses to an exercise training programme. [ABSTRACT FROM AUTHOR]

This study explored lifestyle and biological determinants of peak fat oxidation (PFO) during cycle ergometry, using duplicate measures to account for day-to-day variation. Seventy-three healthy adults (age range: 19–63 years; peak oxygen consumption [ V ˙ O 2 peak ] : 42.4 [ 10.1 ] ml · kg BM − 1 · min − 1 ; n = 32 women]) completed trials 7–28 days apart that assessed resting metabolic rate, a resting venous blood sample, and PFO by indirect calorimetry during an incremental cycling test. Habitual physical activity (combined heart rate accelerometer) and dietary intake (weighed record) were assessed before the first trial. Body composition was assessed 2–7 days after the second identical trial by dual-energy X-ray absorptiometry scan. Multiple linear regressions were performed to identify determinants of PFO (mean of two cycle tests). A total variance of 79% in absolute PFO (g·min−1) was explained with positive coefficients for V ˙ O 2 peak (strongest predictor), FATmax (i.e the % of V ˙ O 2 peak that PFO occurred at), and resting fat oxidation rate (g·min−1), and negative coefficients for body fat mass (kg) and habitual physical activity level. When expressed relative to fat-free mass, 64% of variance in PFO was explained: positive coefficients for FATmax (strongest predictor), V ˙ O 2 peak , and resting fat oxidation rate, and negative coefficients for male sex and fat mass. This duplicate design revealed that biological and lifestyle factors explain a large proportion of variance in PFO during incremental cycling. After accounting for day-to-day variation in PFO, V ˙ O 2 peak and FATmax were strong and consistent predictors of PFO. [ABSTRACT FROM AUTHOR]

The maximal capacity to utilise fat (peak fat oxidation, PFO) may have implications for health and ultra-endurance performance and is commonly determined by incremental exercise tests employing 3-min stages. However, 3-min stages may be insufficient to attain steady-state gas kinetics, compromising test validity. We assessed whether 4-min stages produce steady-state gas exchange and reliable PFO estimates in adults with peak oxygen consumption < 40 mL·kg−1·min−1. Fifteen participants (9 females) completed a graded test to determine PFO and the intensity at which this occurred (FATMAX). Three short continuous exercise sessions (SCE) were then completed in a randomised order, involving completion of the graded test to the stage (i) preceding, (ii) equal to (SCEequal), or (iii) after the stage at which PFO was previously attained, whereupon participants then continued to cycle for 10 min at that respective intensity. Expired gases were sampled at minutes 3–4, 5–6, 7–8, and 9–10. Individual data showed steady-state gas exchange was achieved within 4 min during SCEequal. Mean fat oxidation rates were not different across time within SCEequal nor compared with the graded test at FATMAX (both p > 0.05). However, the graded test displayed poor surrogate validity (SCEequal, minutes 3–4 vs. 5–6, 7–8, and 9–10) and day-to-day reliability (minutes 3–4, SCEequal vs. graded test) to determine PFO, as evident by correlations (range: 0.47–0.83) and typical errors and 95% limits of agreement (ranges: 0.03–0.05 and ±0.09–0.15 g·min−1, respectively). In conclusion, intraindividual variation in PFO is substantial despite 4-min stages establishing steady-state gas exchange in individuals with low fitness. Individual assessment of PFO may require multiple assessments. [ABSTRACT FROM AUTHOR]

The analysis of time series data is common in nutrition and metabolism research for quantifying the physiological responses to various stimuli. The reduction of many data from a time series into a summary statistic(s) can help quantify and communicate the overall response in amore straightforward way and in line with a specific hypothesis. Nevertheless, many summary statistics have been selected by various researchers, and some approaches are still complex. The time-intensive nature of such calculations can be a burden for especially large data sets and may, therefore, introduce computational errors, which are difficult to recognize and correct. In this short commentary, the authors introduce a newly developed tool that automates many of the processes commonly used by researchers for discrete time series analysis, with particular emphasis on how the tool may be implemented within nutrition and exercise science research. [ABSTRACT FROM AUTHOR]

The timing of carbohydrate ingestion and how this influences net muscle glycogen utilization and fatigue has only been investigated in prolonged cycling. Past findings may not translate to running because each exercise mode is distinct both in the metabolic response to carbohydrate ingestion and in the practicalities of carbohydrate ingestion. To this end, a randomized, cross-over design was employed to contrast ingestion of the same sucrose dose either at frequent intervals (15 x 5 g every 5min) or at a late bolus (1 x 75 g after 75 min) during prolonged treadmill running to exhaustion in six well-trained runners (...O2max 61 ± 4 ml⋅kg-1⋅min-1). The muscle glycogen utilization rate was lower in every participant over the first 75 min of running (Δ 0.51 mmol⋅kg dm-1⋅min-1; 95% confidence interval [-0.02, 1.04] mmol⋅kg dm-1⋅min-1) and, subsequently, all were able to run for longer when carbohydrate had been ingested frequently from the start of exercise compared with when carbohydrate was ingested as a single bolus toward the end of exercise (105.6 ± 3.0 vs. 96.4 ± 5.0 min, respectively; Δ 9.3 min, 95% confidence interval [2.8, 15.8] min). A moderate positive correlation was apparent between the magnitude of glycogen sparing over the first 75min and the improvement in running capacity (r = .58), with no significant difference in muscle glycogen concentrations at the point of exhaustion. This study indicates that failure to ingest carbohydrates from the outset of prolonged running increases reliance on limited endogenous muscle glycogen stores--the ergolytic effects of which cannot be rectified by subsequent carbohydrate ingestion late in exercise. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death worldwide. Physical activity interventions improve almost all modifiable CVD risk factors, but the effect of physical activity on low density lipoprotein cholesterol (LDL‐C) is uncertain. This may be due to lack of research on the feeding status in which the physical activity is performed. The aim of this study is to investigate the effect of fasted versus fed exercise on LDL‐C concentrations in males and females. One hundred healthy participants, equal males and females, aged between 25 and 60 years will be recruited and will undergo a home‐based 12‐week exercise intervention. After baseline testing, participants will be randomized to a fasted exercise (exercise after an 8‐h fast) or fed exercise (exercise 90–180 min after ingestion of 1 g kg−1 CHO) group and will perform 50 min of moderate intensity exercise (e.g., 95% heart rate of lactate threshold 1) three times a week either before or after a high carbohydrate (1 g kg−1) meal. Participants will visit the laboratory again at week 4 and week 12 and measurements will be taken for body composition, resting blood pressure, fasting blood glucose, lipid profiles and systemic inflammation, lactate threshold, and 14‐day blood glucose control. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effects of dietary sugar or carbohydrate restriction on physical activity energy expenditure, energy intake, and physiological outcomes across 24 h. Methods: In a randomized, open-label crossover design, twenty-five healthy men (n = 10) and women (n = 15) consumed three diets over a 24-h period: moderate carbohydrate and sugar content (MODSUG = 50% carbohydrate [20% sugars], 15% protein, 35% fat); low sugar content (LOWSUG = 50% carbohydrate [< 5% sugars], 15% protein, 35% fat); and low carbohydrate content (LOWCHO = 8% carbohydrate [< 5% sugars], 15% protein, 77% fat). Postprandial metabolic responses to a prescribed breakfast (20% EI) were monitored under laboratory conditions before an ad libitum test lunch, with subsequent diet and physical activity monitoring under free-living conditions until blood sample collection the following morning. Results: The MODSUG, LOWSUG and LOWCHO diets resulted in similar mean [95%CI] rates of both physical activity energy expenditure (771 [624, 919] vs. 677 [565, 789] vs. 802 [614, 991] kcal·d−1; p = 0.29] and energy intake (2071 [1794, 2347] vs. 2195 [1918, 2473] vs. 2194 [1890, 2498] kcal·d−1; P = 0.34), respectively. The LOWCHO condition elicited the lowest glycaemic and insulinaemic responses to breakfast (P < 0.01) but the highest 24-h increase in LDL-cholesterol concentrations (P < 0.001), with no differences between the MODSUG and LOWSUG treatments. Leptin concentrations decreased over 24-h of consuming LOWCHO relative to LOWSUG (p < 0.01). Conclusion: When energy density is controlled for, restricting either sugar or total dietary carbohydrate does not modulate physical activity level or energy intake over a 24-h period (~ 19-h free-living) despite substantial metabolic changes. Clinical trials registration ID: NCT03509610, https://clinicaltrials.gov/show/NCT03509610 [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Who Needs a Bag?" by L. B. Gladden, J. W. Yates and E. T. Howley, which appeared in a previous issue and was concerned with the Douglas bag technique for indirect calorimetry.

Carbohydrate and fat are the main substrates utilized during prolonged endurance-type exercise. The relative contribution of each is determined primarily by the intensity and duration of exercise, along with individual training and nutritional status. During moderate- to high-intensity exercise, carbohydrate represents the main substrate source. Because endogenous carbohydrate stores (primarily in liver and muscle) are relatively small, endurancetype exercise performance/capacity is often limited by endogenous carbohydrate availability. Much exercise metabolism research to date has focused on muscle glycogen utilization, with little attention paid to the contribution of liver glycogen. 13C magnetic resonance spectroscopy permits direct, noninvasive measurements of liver glycogen content and has increased understanding of the relevance of liver glycogen during exercise. In contrast to muscle, endurance-trained athletes do not exhibit elevated basal liver glycogen concentrations. However, there is evidence that liver glycogenolysis may be lower in endurance-trained athletes compared with untrained controls during moderate- to high-intensity exercise. Therefore, liver glycogen sparing in an endurance-trained state may account partly for traininginduced performance/capacity adaptations during prolonged (>90 min) exercise. Ingestion of carbohydrate at a relatively high rate (>1.5 g/min) can prevent liver glycogen depletion during moderate-intensity exercise independent of the type of carbohydrate (e.g., glucose vs. sucrose) ingested. To minimize gastrointestinal discomfort, it is recommended to ingest specific combinations or types of carbohydrates (glucose plus fructose and/or sucrose). By coingesting glucose with either galactose or fructose, postexercise liver glycogen repletion rates can be doubled. There are currently no guidelines for carbohydrate ingestion to maximize liver glycogen repletion. [ABSTRACT FROM AUTHOR]

Intravenous ketone body infusion can increase erythropoietin (EPO) concentrations, but responses to ketone monoester ingestion postexercise are currently unknown. The purpose of this study was to assess the effect of ketone monoester ingestion on postexercise erythropoietin (EPO) concentrations. Nine healthy men completed two trials in a randomized, crossover design (1-wk washout). During trials, participants performed 1 h of cycling (initially alternating between 50% and 90% of maximal aerobic capacity for 2 min each interval, and then 50% and 80%, and 50% and 70% when the higher intensity was unsustainable). Participants ingested 0.8 g·kg-1 sucrose with 0.4 g·kg-1 protein immediately after exercise, and at 1, 2, and 3 h postexercise. During the control trial (CONTROL), no further nutrition was provided, whereas on the ketone monoester trial (KETONE), participants also ingested 0.29 g·kg-1 of the ketone monoester (R)-3-hydroxybutyl (R)-3-hydroxybutyrate immediately postexercise and at 1 and 2 h postexercise. Blood was sampled immediately postexercise, every 15 min in the first hour and hourly thereafter for 4 h. Serum EPO concentrations increased to a greater extent in KETONE than in CONTROL (time x condition interaction: P = 0.046). Peak serum EPO concentrations were higher with KETONE (means ± SD: 9.0 ± 2.3 IU·L-1) compared with CONTROL (7.5 ± 1.5 IU·L-1, P < 0.01). Serum b-hydroxybutyrate concentrations were also higher, and glucose concentrations lower, with KETONE versus CONTROL (both P < 0.01). In conclusion, ketone monoester ingestion increases postexercise erythropoietin concentrations, revealing a new avenue for orally ingestible ketone monoesters to potentially alter hemoglobin mass. [ABSTRACT FROM AUTHOR]

Introduction: Continuous exercise can increase postprandial gut hormone such as glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) responses, but it is unknown whether interrupting prolonged sitting with intermittent walking elicits this effect. Method: Ten participants with central overweight/obesity (7 men and 3 postmenopausal women, 51 ± 5 yr; mean ± SD) completed a randomized crossover study in which they consumed breakfast and lunch in the laboratory while either sitting continuously for the entire 5.5-h period (SIT) or the prolonged sitting interrupted every 20 min by walking briskly (6.4 km·h−1) for 2 min (BREAKS). Blood samples were collected at regular intervals to examine postprandial plasma GLP-1, PYY, and glucose-dependent insulinotropic polypeptide concentrations. Adipose tissue samples were collected at baseline and at the end of the trials to examine changes in net dipeptidyl peptidase 4 secretion from primary explants. Results: Mean (95% confidence interval) postprandial GLP-1 and PYY incremental area under curve values were elevated by 26% and 31% in the BREAKS trial versus SIT (8.4 [0.7, 16.1] vs 6.7 [−0.8, 14.2], P = 0.001, and 26.9 [8.1, 45.6] vs 20.4 [5.1, 35.8] nmol·330 min·L−1, P = 0.024, respectively) but without any such effect on glucose-dependent insulinotropic polypeptide (P = 0.076) or net adipose tissue dipeptidyl peptidase 4 secretion (P > 0.05). Conclusions: Interrupting prolonged sitting with regular short bouts of brisk walking increases postprandial GLP-1 and PYY concentrations in healthy middle-age men and women with central adiposity. [ABSTRACT FROM AUTHOR]

Caffeine is a psycho-active stimulant that can improve physical and cognitive performance. We systematically reviewed the evidence on the effects of acute caffeine ingestion on physiological parameters, physical and technical-skill performance during high-performance team-sport match-play. Following PRISMA guidelines, studies were identified using scientific databases (PubMed, Web-of-Science, Scopus, and SPORTDiscus) in February 2021. Of 281 results, 13 studies met inclusion, totalling 213 participants. Included studies adopted the randomised double-blinded cross-over design, involving caffeine and control conditions. In studies reporting physiological variables, responses to caffeine included higher peak (n=6/ 8 [n/ total studies measuring the variable]) and mean (n=7/ 9) heart rates, increased blood glucose (n=2/ 2) and lactate (n=2/ 2) concentrations. Improvements in physical performance were widely documented with caffeine, including greater distance coverage (n=7/ 7), high-speed distance coverage (n=5/ 7) and impact frequencies (n=6/ 8). From three studies that assessed technical-skills, it appears caffeine may benefit gross-skill performance, but have no effect, or negatively confound finer technical-skill outcomes. There is compelling evidence that ingesting moderate caffeine doses (~3 to 6 mg·kg−1) ~60 minutes before exercise may improve physical performance in team-sports, whereas evidence is presently too scarce to draw confident conclusions regarding sport-specific skill performance. [ABSTRACT FROM AUTHOR]

Achondroplasia, the most common skeletal dysplasia, is characterized by a variety of medical, functional and psychosocial challenges across the lifespan. The condition is caused by a common, recurring, gain-of-function mutation in FGFR3, the gene that encodes fibroblast growth factor receptor 3. This mutation leads to impaired endochondral ossification of the human skeleton. The clinical and radiographic hallmarks of achondroplasia make accurate diagnosis possible in most patients. However, marked variability exists in the clinical care pathways and protocols practised by clinicians who manage children and adults with this condition. A group of 55 international experts from 16 countries and 5 continents have developed consensus statements and recommendations that aim to capture the key challenges and optimal management of achondroplasia across each major life stage and sub-specialty area, using a modified Delphi process. The primary purpose of this first International Consensus Statement is to facilitate the improvement and standardization of care for children and adults with achondroplasia worldwide in order to optimize their clinical outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Key points Physical exercise significantly improves health but to what extent these benefits depend on altered energy balance remains unclear., In a human experimental model, we investigated whether daily exercise could counteract the effects of short-term overfeeding and under-activity independent of its impact on energy imbalance in healthy young men., Short-term positive energy balance from overfeeding and under-activity resulted in impaired metabolic outcomes and alterations in the expression of several key genes within adipose tissue involved in nutritional balance, metabolism and insulin action., These changes were mostly prevented by the addition of a daily vigorous-intensity exercise bout even in the face of a standardised energy surplus., Abstract Physical activity can affect many aspects of metabolism but it is unclear to what extent this relies on manipulation of energy balance. Twenty-six active men age 25 ± 7 years (mean ± SD) were randomly assigned either to consume 50% more energy than normal by over-consuming their habitual diet for 7 days whilst simultaneously restricting their physical activity below 4000 steps day−1 to induce an energy surplus (SUR group; n= 14) or to the same regimen but with 45 min of daily treadmill running at 70% of maximum oxygen uptake (SUR+EX group; n= 12). Critically, the SUR+EX group received additional dietary energy intake to account for the energy expended by exercise, thus maintaining a matched energy surplus. At baseline and follow-up, fasted blood samples and abdominal subcutaneous adipose tissue biopsies were obtained and oral glucose tolerance tests conducted. Insulinaemic responses to a standard glucose load increased 2-fold from baseline to follow-up in the SUR group (Δ17 ± 16 nmol (120 min) l−1; P= 0.002) whereas there was no change in the SUR+EX group (Δ1 ± 6 nmol (120 min) l−1). Seven of 17 genes within adipose tissue were differentially expressed in the SUR group; expression of SREBP-1c, FAS and GLUT4 was significantly up-regulated and expression of PDK4, IRS2, HSL and visfatin was significantly down-regulated ( P≤ 0.05). The pAMPK/AMPK protein ratio in adipose tissue was significantly down-regulated in the SUR group ( P= 0.005). Vigorous-intensity exercise counteracted most of the effects of short-term overfeeding and under-activity at the whole-body level and in adipose tissue, even in the face of a standardised energy surplus. [ABSTRACT FROM AUTHOR]

We examined whether carbohydrate-protein ingestion influences muscle glycogen metabolism during shortterm recovery from exhaustive treadmill running and subsequent exercise. Six endurance-trained individuals underwent two trials in a randomized double-blind design, each involving an initial run-to-exhaustion at 70% VO2max (Run-1) followed by 4-h recovery (REC) and subsequent run-to-exhaustion at 70% VO2max (Run-2). Carbohydrate-protein (CHO-P; 0.8 g carbohydrate·kg body mass [BM-1]·h-1 plus 0.4 g protein·kg BM-1⋅h-1) or isocaloric carbohydrate (CHO; 1.2 g carbohydrate·kg BM-1⋅h-1) beverages were ingested at 30-min intervals during recovery. Muscle biopsies were taken upon cessation of Run-1, postrecovery and fatigue in Run-2. Time-to-exhaustion in Run-1 was similar with CHO and CHO-P (81 ± 17 and 84 ± 19 min, respectively). Muscle glycogen concentrations were similar between treatments after Run-1 (99 ± 3 mmol⋅kg dry mass [dm-1]). During REC, muscle glycogen concentrations increased to 252 ± 45 mmol·kg dm-1 in CHO and 266 ± 30 mmol⋅kg dm-1 in CHO-P (p = .44). Muscle glycogen degradation during Run-2 was similar between trials (3.3 ± 1.4 versus 3.5 ± 1.9 mmol·kg dm-1·min-1 in CHO and CHO-P, respectively) and no differences were observed at the respective points of exhaustion (93 ± 21 versus 100 ± 11 mmol⋅kg dm-1; CHO and CHO-P, respectively). Similarly, time-to-exhaustion was not different between treatments in Run-2 (51 ± 13 and 49 ± 15 min in CHO and CHO-P, respectively). Carbohydrate-protein ingestion equally accelerates muscle glycogen resynthesis during short-term recovery from exhaustive running as when 1.2 g carbohydrate·kg BM-1·h-1 are ingested. The addition of protein did not alter muscle glycogen utilization or time to fatigue during repeated exhaustive running. [ABSTRACT FROM AUTHOR]

It is unclear whether neuromuscular electrical stimulation (NMES) has meaningful metabolic effects when users have the opportunity to self-select the intensity to one that can be comfortably tolerated. Nine healthy men aged 28 ± 9 y (mean ± SD) with a body mass index 22.3 ± 2.3 kg/m2 completed 3 trials involving a 2-h oral glucose tolerance test whilst, in a randomised counterbalanced order, (1) sitting motionless (SIT), (2) standing motionless (STAND); and (3) sitting motionless with NMES of quadriceps and calves at a self-selected tolerable intensity. The mean (95% confidence interval [CI]) total energy expenditure was greater in the NMES trial (221 [180–262] kcal/2 h) and STAND trial (178 [164–191] kcal/2 h) than during SIT (159 [150–167] kcal/2 h) (both, p < 0.05). This was primarily driven by an increase in carbohydrate oxidation in the NMES and STAND trials compared with the SIT trial (p < 0.05). Postprandial insulin iAUC was lower in both NMES and STAND compared with SIT (16.4 [7.7–25.1], 17 [7–27] and 22.6 [10.8–34.4] nmol·120 min/L, respectively; both, p < 0.05). Compared with sitting, both NMES and STAND increased energy expenditure and whole-body carbohydrate oxidation and reduced postprandial insulin concentrations in healthy men, with more pronounced effects seen with NMES. Self-selected NMES is a potential strategy for improving metabolic health. This trial is registered at ClinicalTrials.gov (ID: NCT04389736). Novelty: NMES at a comfortable intensity enhances energy expenditure and carbohydrate oxidation, and reduces postprandial insulinemia. Thus, self-selected NMES represents a potential strategy to improve metabolic health. [ABSTRACT FROM AUTHOR]