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Social determinants of health (SDoH), the conditions in which we live, learn, work, and play, have a profound impact on health and lead to health disparities in our communities. The Centers for Disease Control and Prevention (CDC) created an interactive SDoH module within the US Diabetes Surveillance System to explore these disparities in the context of diabetes burden and risk factors (Figure). The module was launched with the CDC Social Vulnerability Index (SVI), which was created to identify communities needing support during hazardous events. The index is composed of Census Bureau data on 15 variables, grouped into 4 themes: socioeconomic status, household composition and disability, minority status and language, and housing and transportation. Percentile ranks are used to score areas from 0-1 on social vulnerability with 1 being the most vulnerable. SVI is available at the national level to compare counties across states and at the state level to compare counties within a state. In addition to SVI, CDC will scale this module to include other SDoH such as food insecurity, community walkability, and crime. Local, state, and federal public health practitioners may find this application useful for identifying disparities in SDoH and chronic disease and designing targeted interventions to reduce these disparities in the communities of greatest need. Disclosure S. R. Benoit: None. D. C. Shelton: None. Y. Wang: None. K. Batchu: None. K. M. Bullard: None. P. Cho: None. I. A. Hora: None. D. King: None. J. W. Reynolds: None. H. Xie: None. Y. Zhang: None. M. Aboneaaj: None.

Amylomaize-7 is classified as a resistant corn starch and is 68% digestible. When modified by partial hydrolysis in ethanol and hydrochloric acid its digestibility is 92%, yet retains its low glycemic and insulinemic properties. The purpose of this study was to characterize the metabolic response when modified amylomaize-7 or dextrose is consumed in the hour before exercise, and to compare the effect on performance of a brief high-intensity cycling trial. Ten male, trained cyclists were given 1 g/kg body mass of dextrose (DEX) or modified amylomaize-7 (AMY-7) or a flavored water placebo (PL) 45 min prior to exercise on a cycle ergometer. A 15-min ride at 60% Wmaxwas immediately followed by a self-paced time trial (TT) equivalent to 15 min at 80% Wmax. When cyclists consumed DEX, mean serum glucose concentration increased by 3.3 ± 2.1 mmol/L before exercise, compared to stable serum glucose observed for AMY-7 or PL. Glucose concentrations returned to baseline by pre-TT in all treatments. However, the mean post-TT glucose concentration of the DEX group was significantly lower than baseline, AMY-7, or PL. Serum insulin concentration increased nine-fold from baseline to preexercise in the DEX trial, whereas PL or AMY-7 remained unchanged. Time required to complete the performance trial was not significantly different between DEX, AMY-7 or PL. Preexercise ingestion of modified amylomaize-7 compared to dextrose resulted in a more stable serum glucose concentration, but did not offer a performance advantage in this high-intensity cycling trial.

Purpose:To determine whether chicken noodle soup before exercise increases ad libitum water intake, fluid balance, and physical and cognitive performance compared with water.Methods:Nine trained men (age 25 ± 3 yr, VO2peak 54.2 ± 5.1 ml · kg−1 · min−1; M ± SD) performed cycle exercise in the heat (wet bulb globe temperature = 25.9 ± 0.4 °C) for 90 min at 50% VO2peak, 45 min after ingesting 355 ml of either commercially available bottled water (WATER) or chicken noodle soup (SOUP). The same bottled water was allowed ad libitum throughout both trials. Participants then completed a time trial to finish a given amount of work (10 min at 90% VO2peak; n = 8). Cognitive performance was evaluated by the Stroop color–word task before, every 30 min during, and immediately after the time trial.Results:Ad libitum water intake throughout steady-state exercise was greater in SOUP than with WATER (1,435 ± 593 vs. 1,163 ± 427 g, respectively; p < .03). Total urine volume was similar in both trials (p = .13), resulting in a trend for greater water retention in SOUP than in WATER (87.7% ± 7.6% vs. 74.9% ± 21.7%, respectively; p = .09), possibly due to a change in free water clearance (–0.32 ± 1.22 vs. 0.51 ± 1.06 ml/min, respectively; p = .07). Fluid balance tended to be improved with SOUP (–106 ± 603 vs. –478 ± 594 g, p = .05). Likewise, change in plasma volume tended to be reduced in SOUP compared with WATER (p = .06). Only mild dehydration was achieved (p = .77). The number of errors in the Stroop color–word task was lower in SOUP throughout the entire trial (treatment effect; p = .04).Conclusion:SOUP before exercise increased ad libitum water intake and may alter kidney function.

In brief: Seventeen male collegiate swimmers were studied before, during, and after 14 days of reduced training (tapering). Maximal arm power was measured using a bio- kinetic swim bench and during a tethered (power) swim test, and each swimmer also swam 200 yards (182.9 meters) at an evenly paced velocity corresponding to 90% of his best performance of the season. Tapering had no influence on postexercise acid-base balance, but there was a significant increase (p

Testosterone prohormones such as androstenedione, androstenediol, and dehydroepiandrosterone (DHEA) have been heavily marketed as testosterone-enhancing and muscle-building nutritional supplements for the past decade. Concerns over the safety of prohormone supplement use prompted the United States Food and Drug Administration to call for a ban on androstenedione sales, and Congress passed the Anabolic Steroid Control Act of 2004, which classifies androstenedione and 17 other steroids as controlled substances. As of January 2005, these substances cannot be sold without prescription. Here, we summarize the current scientific knowledge regarding the efficacy and safety of prohormone supplementation in humans. We focus primarily on androstenedione, but we also discuss DHEA, androstenediol, 19-nor androstenedione, and 19-nor androstenediol supplements. Contrary to marketing claims, research to date indicates that the use of prohormone nutritional supplements (DHEA, androstenedione, androstenediol, and other steroid hormone supplements) does not produce either anabolic or ergogenic effects in men. Moreover, the use of prohormone nutritional supplements may raise the risk for negative health consequences.

The effectiveness of an androgenic nutritional supplement designed to enhance serum testosterone concentrations and prevent the formation of dihydrotestosterone and estrogen was investigated in healthy 3 to 58 year old men.Subjects were randomly assigned to consume a nutritional supplement (AND-HB) containing 300-mg androstenediol, 480-mg saw palmetto, 450-mg indole-3-carbinol, 300-mg chrysin, 1,500 mg gamma-linolenic acid and 1.350-mg Tribulus terrestris per day (n = 28), or placebo (n = 27) for 28 days. Subjects were stratified into age groups to represent the fourth (30 year olds, n = 20), fifth (40 year olds, n = 20) and sixth (50 year olds, n = 16) decades of life.Serum free testosterone, total testosterone, androstenedione, dihydrotestosterone, estradiol, prostate specific antigen and lipid concentrations were measured before supplementation and weekly for four weeks.Basal serum total testosterone, estradiol, and prostate specific antigen (PSA) concentrations were not different between age groups. Basal serum free testosterone concentrations were higher (p0.05) in the 30- (70.5 +/- 3.6 pmol/L) than in the 50 year olds (50.8 +/- 4.5 pmol/L). Basal serum androstenedione and dihydrotestosterone (DHT) concentrations were significantly higher in the 30- (for androstenedione and DHT, respectively, 10.4 +/- 0.6 nmol/L and 2198.2 +/- 166.5 pmol/L) than in the 40- (6.8 +/- 0.5 nmol/L and 1736.8 +/- 152.0 pmol/L) or 50 year olds (6.0 +/- 0.7 nmol/L and 1983.7 +/- 147.8 pmol/L). Basal serum hormone concentrations did not differ between the treatment groups. Serum concentrations of total testosterone and PSA were unchanged by supplementation. Ingestion of AND-HB resulted in increased (p0.05) serum androstenedione (174%), free testosterone (37%), DHT (57%) and estradiol (86%) throughout the four weeks. There was no relationship between the increases in serum free testosterone, androstenedione, DHT, or estradiol and age (r2 = 0.08, 0.03, 0.05 and 0.02, respectively). Serum HDL-C concentrations were reduced (p0.05) by 0.14 mmol/L in AND-HB.These data indicate that ingestion of androstenediol combined with herbal products does not prevent the formation of estradiol and dihydrotestosterone.

The purpose of the present study was to determine whether resistance training alters the cardiovascular responses to submaximal lower body negative pressure (LBNP) in the elderly. Twenty-one subjects were randomized into a control (C: n = 10; 70 ± 3 years. mean ± SD) or a resistance training (TR: n = 11; 67 ± 7 years) group. Subjects in the TR underwent 12 weeks of training consisting of three sets of 8-12 contractions at ∼60-80% of their initial maximal one repetition, three times per week, on 10 different machines. Before (Pre) and after (Post) training, all subjects underwent exposures of LBNP of -10, -20 and -40 Torr and muscle biopsy sampling at the vastus lateralis. TR increased (P≤0.05) knee extension (Pre = 379 ± 140 N, Post = 534 ± 182 N) and chest press (Pre = 349 ± 137 N, Post = 480 ± 192 N) strength. Neither body weight nor percentage body fat were altered (P>0.05) by training. Resistance training increased (P≤0.05) cross-sectional area in both Type I (4203 ± 1196 to 5248 ± 1728 μm 2 ) and Type II (3375 ± 1027 to 4286 ± 1892 μm 2 ) muscle fibres. Forearm blood flow, forearm vascular conductance, mean arterial pressure, and heart-rate responses to LBNP were not altered by the training. These data suggest that the cardiovascular responses of elderly to LBNP are unaffected by 12 weeks of whole-body resistance training despite increases in muscle strength and size.

The effectiveness of a nutritional supplement designed to enhance serum testosterone concentrations and prevent the formation of dihydrotestosterone and estrogens from the ingested androgens was investigated in healthy 30- to 59-year old men. Subjects were randomly assigned to consume DION (300 mg androstenedione, 150 mg dehydroepiandrosterone, 540 mg saw palmetto, 300 mg indole-3-carbinol, 625 mg chrysin, and 750 mg Tribulus terrestris per day; n = 28) or placebo (n = 27) for 28 days. Serum free testosterone, total testosterone, androstenedione, dihydrotestosterone, estradiol, prostate-specific antigen (PSA), and lipid concentrations were measured before and throughout the 4-week supplementation period. Serum concentrations of total testosterone and PSA were unchanged by supplementation. DION increased (p < 0.05) serum androstenedione (342%), free testosterone (38%), dihydrotestosterone (71%), and estradiol (103%) concentrations. Serum HDL-C concentrations were reduced by 5.0 mg/dL in DION (p < 0.05). Increases in serum free testosterone (r2 = 0.01), androstenedione (r2 = 0.01), dihydrotestosterone (r2 = 0.03), or estradiol (r2 = 0.07) concentrations in DION were not related to age. While the ingestion of androstenedione combined with herbal products increased serum free testosterone concentrations in older men, these herbal products did not prevent the conversion of ingested androstenedione to estradiol and dihydrotestosterone.

This part of our A–Z series contains five articles on a wide variety of topics. For the sake of continuity, some topics in the alphabetical listing have been moved further down: curcumin, which will appear collectively with flavonoids; docosahexanoic acid and eicosapentanoic acid, which will now come under the umbrella of fatty acids. The compounds covered in part 12 range considerably in their composition and their physiological roles in the body. However, they do share some common characteristics, which might be seen as a generic description of most of the supplements marketed to athletes. Each has a mechanism by which it is proposed that supplementation might improve sports performance, based on the enhancement of an existing biochemical or hormonal pathway that is considered limiting. The marketing credibility of each of these supplements, and others, is boosted from time to time by anecdotal reports of use by a successful athlete or popularity within a certain sporting population. For example, dehydroepiandrosterone achieved notoriety in sporting circles when American baseball player, Mark McGwire, provided testimonials regarding its use during the 1998 season in which he broke the league record for hitting home runs. Alternatively, dimethylglycine has enjoyed the mystique among Western athletes of being used by athletes from Eastern Bloc countries. However, the most important characteristic is that each product has received only minor attention from sports scientists, in terms of involvement in well-conducted, randomised, controlled trials, specific to sport. ### K Currell, A Syed Cysteine is a non-essential amino acid and, together with glycine and glutamate, is an important precursor of the tripeptide glutathione. Glycine and glutamate are readily available within the body and it is thought that the limiting step in the synthesis of glutathione is the availability of cysteine.1 Glutathione is one of the key antioxidants within the body2 and is an essential …

In young men, chronic ingestion of 100 mg androstenedione (ASD), three times per day, does not increase serum total testosterone but does increase serum estrogen and ASD concentrations. We investigated the effects of ASD ingestion in healthy 30- to 56-yr-old men. In a double-blind, randomly assigned manner, subjects consumed 100 mg ASD three times daily (n = 28), or placebo (n = 27) for 28 days. Serum ASD, dihydrotestosterone (DHT), free and total testosterone, estradiol, prostate-specific antigen (PSA), and lipid concentrations were measured at week 0 and each week throughout the supplementation period. Serum total testosterone and PSA concentrations did not change with supplementation. Elevated serum concentrations of ASD (300%), free testosterone (45%), DHT (83%), and estradiol (68%) were observed during weeks 1-4 in ASD (P < 0.05). There was no relationship between age and changes in serum ASD (r2 = 0.024), free testosterone (r2 = 0.00), or estradiol (r2 = 0.029) concentrations with ASD, whereas the serum DHT response to ASD ingestion was related to age (r2 = 0.244; P < 0.05). Serum concentrations of high-density lipoprotein cholesterol were decreased by 10% during the supplementation period (P < 0.05). These results suggest that the ingestion of 100 mg ASD, three times per day, does not increase serum total testosterone or PSA concentrations but does elicit increases in ASD, free testosterone, estradiol, and DHT and decreases serum high-density lipoprotein cholesterol concentrations.

The effects of androgen precursors, combined with herbal extracts designed to enhance testosterone formation and reduce conversion of androgens to estrogens was studied in young men. Subjects performed 3 days of resistance training per week for 8 weeks. Each day during Weeks 1,2,4,5,7, and 8, subjects consumed either placebo (PL; n = 10) or a supplement (ANDRO-6; n = 10), which contained daily doses of 300 mg androstenedione, 150 mg DHEA, 750 mg Tribulus terrestris, 625 mg Chrysin, 300 mg Indole-3-carbinol, and 540 mg Saw palmetto. Serum androstenedione concentrations were higher in ANDRO-6 after 2,5, and 8 weeks (p < .05), while serum concentrations of free and total testosterone were unchanged in both groups. Serum estradiol was elevated at Weeks 2, 5, and 8 in ANDRO-6 (p < .05), and serum estrone was elevated at Weeks 5 and 8 (p < .05). Muscle strength increased (p < .05) similarly from Weeks 0 to 4, and again from Weeks 4 to 8 in both treatment groups. The acute effect of one third of the daily dose, of ANDRO-6 and PL was studied in 10 men (23±4years). Serum androstenedione concentrations were elevated (p < .05) in ANDRO-6 from 150 to 360 min after ingestion, while serum free or total testosterone concentrations were unchanged. These data provide evidence that the addition of these herbal extracts to androstenedione does not result in increased serum testosterone concentrations, reduce the estrogenic effect of androstenedione, and does not augment the adaptations to resistance training.

This study examined the effects of acute dehydroepiandrosterone (DHEA) ingestion on serum steroid hormones and the effect of chronic DHEA intake on the adaptations to resistance training. In 10 young men (23 ± 4 yr old), ingestion of 50 mg of DHEA increased serum androstenedione concentrations 150% within 60 min ( P < 0.05) but did not affect serum testosterone and estrogen concentrations. An additional 19 men (23 ± 1 yr old) participated in an 8-wk whole body resistance-training program and ingested DHEA (150 mg/day, n = 9) or placebo ( n = 10) during weeks 1, 2, 4, 5, 7, and 8. Serum androstenedione concentrations were significantly ( P < 0.05) increased in the DHEA-treated group after 2 and 5 wk. Serum concentrations of free and total testosterone, estrone, estradiol, estriol, lipids, and liver transaminases were unaffected by supplementation and training, while strength and lean body mass increased significantly and similarly ( P < 0.05) in the men treated with placebo and DHEA. These results suggest that DHEA ingestion does not enhance serum testosterone concentrations or adaptations associated with resistance training in young men.

Previous investigations have reported that soluble fiber reduces the plasma glucose and insulin changes after an oral glucose load. To improve the payability of a soluble-fiber feeding, this study addressed how a combined, soluble fiber (delivered in capsule form) and a preexercise CHO feeding would affect metabolic responses during exercise. On 3 different days, participants ingested a placebo (CON), 75 g liquid CHO (GLU), or 75 g liquid CHO with 14.5 g encapsulated guar gum (FIB) 45 min before cycling for 60 min at 70% VO2peak. Peak concentrations of plasma glucose and insulin were similar and significantly greater than CON preexercise (p < .05). Similarities in carbohydrate reliance were observed in GLU and FIB. Muscle glycogen use did not differ significantly among trials. These results demonstrate that encapsulated soluble fiber delivered with a liquid CHO feeding does not affect plasma glucose, insulin, or muscle glycogen utilization during exercise.

To investigate the impact of fluid composition on rehydration effectiveness, 30 subjects (15 men and 15 women) were studied during 2 h of rehydration after a 2.5% body weight loss. In a randomized crossover design, subjects rehydrated with water (H2O), chicken broth (CB: 109.5 mmol/l Na, 25.3 mmol/l K), a carbohydrate-electrolyte drink (CE: 16.0 mmol/l Na, 3.3 mmol/l K), and chicken noodle soup (Soup: 333.8 mmol/l Na, 13.7 mmol/l K). Subjects ingested 175 ml at the start of rehydration and 20 min later; H2O was given every 20 min thereafter for a total volume equal to body weight loss during dehydration. At the end of the rehydration period, plasma volume was not significantly different from predehydration values in the CB (−1.6 ± 1.1%) and Soup (−1.4 ± 0.9%) trials. In contrast, plasma volume remained significantly ( P < 0.01) below predehydration values in the H2O (−5.6 ± 1.1%) and CE (−4.2 ± 1.0%) trials after the rehydration period. Urine volume was greater in the CE (310 ± 30 ml) than in the CB (188 ± 20 ml) trial. Urine osmolality was higher in the CB and Soup trials than in the CE trial. Urinary sodium concentration was higher in the Soup and CB trials than in the CE and H2O trials. These results provide evidence that the inclusion of sodium in rehydration beverages, as well as consumption of a sodium-containing liquid meal, increases fluid retention and improves plasma volume restoration.

The purpose of this study was to determine if amino acid supplementation influences blood and muscle lactate response to exercise and the time course of the metabolic adaptations to training. Two groups of untrained males (n = 7 each) were given (double-blind) a daily supplement (2.9 g.day-1) containing a mixture of leucine, isoleucine, valine, glutamine, and carnitine (EXP) or 3 g.day-1 of lactose (CON). Following 7 days of supplementation there was no significant change in VO2peak, time to exhaustion (TTX) at 120% VO2peak, or muscle and blood lactate in either EXP or CON. Subjects then initiated 6 weeks of combined aerobic and anaerobic training on a Monark cycle ergometer. It was found that amino acid supplementation had no effect on either blood or muscle lactate accumulation during exercise, while supplementation resulted in a faster adaptation in buffer capacity. Performance during intense exercise was not improved with amino acid supplementation.

The purposes of this study were 1) to investigate glucose tolerance and insulin action immediately after exercise and 2) to determine how long the improved glucose homeostatic mechanisms observed 12–16 h after exercise persist. Nine (seven men, two women) moderately trained middle-aged (51 +/- 3 yr) subjects performed 45 min of exercise at 73 +/- 2% of peak O2 uptake for 5 days, followed by 7 days of inactivity. Oral glucose tolerance tests (OGTT; 75 g) were performed immediately postexercise (IPE; approximately 30 min) after the final exercise bout and 1, 3, 5, and 7 days after exercise. The incremental area under the plasma glucose curve was markedly higher IPE (355 +/- 82 mM.min) compared with those on days 1 (136 +/- 57 mM.min; P < 0.05) and 3 (173 +/- 62 mM.min; P < 0.05). The glucose area was significantly higher on days 5 (213 +/- 80 mM.min) and 7 (225 +/- 84 mM.min) compared with those on days 1 and 3 (P < 0.05). The incremental insulin area IPE (3,729 +/- 1,104 microU.ml–1.min) was 43% higher compared with that on day 1 (2,603 +/- 635 microU.ml–1.min; P < 0.05) and 66% higher compared with that on day 3 (2,240 +/- 517 microU.ml–1.min; P < 0.05). The insulin area increased to 3,616 +/- 617 microU.ml–1.min after 5 days of inactivity (P < 0.05). An additional 48 h of inactivity did not result in any further increase in the plasma insulin response.(ABSTRACT TRUNCATED AT 250 WORDS)

Part 34 is dominated by a review of prohormones, or more specifically, testosterone prohormones, which cause concern in sports nutrition related to their direct use or inadvertent intake as contaminants in other supplements. When taken specifically for their alleged effects as testosterone alternatives, they may give rise to health problems while failing to achieve the claimed benefits of enhanced strength and muscle mass. Prohormones are a Prohibited Substance on the World Anti-Doping Agency (WADA) list and, even in minute concentrations (as occurs in contaminated supplements) these products can lead to a positive doping outcome. This part also contains brief summaries of ribose and smilax, two supplements which have not lived up to any claims related to benefits to athletic performance. ### D S King, R Baskerville The term prohormone strictly refers to a post-translational peptide that is cleaved by convertases into a variety of bioactive hormones .In the supplement context, prohormones refer to androgenic precursors which, when ingested, become enzymatically activated to testosterone derivatives. An understanding of the biochemical pathways emphasises the similarity between testosterone and its precursors. Users see prohormones as a natural means to improve muscle strength, body composition and general well-being with fewer side effects than testosterone or synthetic androgenic steroids and a more practical (capsule) form of intake. The marketing strategy of commercial websites is to promote prohormones as ‘legal alternatives’ to testosterone with similar anabolic effects. Of course, many consumers are unaware that these prohormones are included on the WADA list of prohibited substances as well as being illegal for sale or importation in many countries. Prohormones have another concerning role in sports nutrition as contaminants in other sports supplements which account for a large proportion of inadvertent doping offences. From cholesterol, pregnenolone is produced which converts to testosterone via dihydroepiandosterone (DHEA). The path via DHEA …

Studies have shown that insulin resistance increases with age, independent of changes in total adiposity. However, there is growing evidence that the development of insulin resistance may be more closely related to abdominal adiposity. To evaluate the independent effects of aging and regional and total adiposity on insulin resistance, we performed hyperinsulinemic euglycemic clamps on 17 young (21–33 yr) and 67 older (60–72 yr) men and women. We assessed FFM and total and regional adiposity by hydrodensitometry and anthropometry. Insulin-stimulated GORs at a plasma insulin concentration of ∼450 pM averaged 45.6 ± 3.3 μmol · kg FFM−1 · min−1 (mean ± SE) in the young subjects, 45.6 ± 10.0 μmol · kg FFM−1 · min−1 in 24 older subjects who were insulin sensitive, and 23.9 ± 11.7 μmol · kg FFM−1 · min−1 in 43 older subjects who were insulin resistant. Few significant differences were apparent in skin-fold and circumference measurements between young and insulin-sensitive older subjects, but measurements at most central body sites were significantly larger in the insulin-resistant older subjects. Waist girth accounted for >40% of the variance in insulin action, whereas age explained only 10–20% of the total variance and

Purpose: This article aimed to study the effect of preexercise ingestion of an electrolyte-containing beverage and meal on fluid balance during exercise in men and women. Methods: Twenty healthy, college-aged people (10 males, 10 females; mean +/- SD = 51.2 +/- 9.8 mL[middle dot]kg-1[middle dot]min-1) exercised at 58 +/- 4% V[spacing dot above]O2peak for 90 min, 45 min after ingesting 355 mL of chicken noodle soup (SOUP; 167 mmol[middle dot]L-1 Na+), carbohydrate-electrolyte beverage (CE; 16 mmol[middle dot]L-1 Na+), or water (WATER). After 90 min of exercise, participants completed a physical performance task (PPT) consisting of the calculated work that would be completed in 30 min at 60% V[spacing dot above]O2peak (n = 19). Water was allowed ad libitum throughout all trials. -Results: Fluid balance was improved in SOUP compared with WATER (-251 +/- 418 vs -657 +/- 593 g, respectively; P = 0.002) because of greater water intake and retention throughout the trial. Water intake was also greater in CE compared with WATER mostly because of an increase during the PPT. Plasma osmolality increased after ingestion of SOUP and remained elevated throughout exercise compared with both CE and WATER. Men and women had similar fluid balance results, with women having lower relative water intake and evaporative water losses compared with men. Physical performance was similar in all trials. Conclusions: SOUP ingested before exercise improves fluid balance because of increased ad libitum water intake and reduced proportional urinary water loss. The increase in water intake and, subsequently, the improved fluid balance may be because of a greater plasma osmolality before and throughout exercise.

We used the euglycemic clamp to assess the effects of exercise on maximally insulin-stimulated glucose disposal. In 11 young men, a 60-min bout of exercise had no significant effect on the rate of glucose disposal during a euglycemic clamp performed approximately 30 min postexercise in which plasma insulin was raised to approximately 2,500 microU/ml (a maximal insulin stimulus). The maximal rate of glucose disposal attained during the clamp averaged 15.7 +/- 1.0 mg.kg lean body mass-1.min-1 after exercise vs. a control value of 15.4 mg.kg lean body mass-1.min-1. In a second experiment, eight men performed supine cycle exercise during the 3rd h of a 4-h euglycemic clamp with a plasma insulin concentration of approximately 2,500 microU/ml. Exercise during the hyperinsulinemic clamp resulted in a 70% increase in glucose disposal rate. There was no measurable increase in glucose 6-phosphate in the quadriceps muscle during the insulin infusion at rest. We conclude that prior exercise does not enhance maximally insulin-stimulated glucose disposal in young healthy men. Our results are compatible with the interpretations that glucose availability rather than glucose metabolism limits the rate of glucose disposal in response to a maximal insulin stimulus in resting subjects and that the increase in glucose uptake in response to superimposed exercise is primarily due to an increase in glucose availability.

Electrical stimulation to augment or maintain muscle performance has been well documented. The purpose of this preliminary report is to present the results of a single-case study conducted to determine the order of activation of skeletal muscle fibers as a result of electrical stimulation. The subject's quadriceps femoris muscles were electrically stimulated at 80% of maximal isometric torque. Pre-stimulation and immediate post-stimulation muscle biopsy samples were obtained, and a modification of the glucogen-depletion method was used to determine activation of muscle fibers. The pre-stimulation muscle biopsy sample demonstrated uniform periodic acid-Schiff (PAS)-positive staining in all fiber types, whereas the post-stimulation muscle biopsy sample showed glycogen depletion of type II muscle fibers. The most PAS-negative muscle fibers were type IIa skeletal muscle fibers. The results of this single-case study provide evidence that electrical stimulation, as described, selectively activates type II skeletal muscle fibers. The implication of this finding is that, in many chronic diseases, type II fibers are selectively and preferentially affected. Electrical stimulation may be a clinically viable technique to use in patients with type II fiber involvement.

Leucine, a branched chain amino acid, can be an energy source for muscle, and thus may contribute to muscle energy needs during exercise. However, the contribution of leucine to energy metabolism o...

The effect of androstenedione intake on serum hormone concentrations in women is equivocal. Therefore, we examined the hormonal response to androstenedione intake in healthy young (22.1 +/- 0.4 y) women for 4 hours. On day 3 of the follicular phase, subjects ingested placebo, 100, or 300 mg androstenedione in a random, double-blind, cross-over manner. Blood samples were collected before and every 30 min for 240 min after intake. Serum androstenedione concentrations (means +/- SE) increased above basal (6.2 +/- 0.8 nmol/l) from 60-240 min for both 100 mg (22.6 +/- 1.0 nmol/l at 240 min) and 300 mg (28.1 +/- 1.3 nmol/l at 210 min). Androstenedione intake increased serum total testosterone concentrations above basal (1.2 +/- 0.2 nmol/l) from 120-240 min (5.5 +/- 0.9 nmol/l at 210 min) with 100 mg and from 60-240 with 300 mg (10.2 +/- 1.6 nmol/l at 210 min). Androstenedione intake also increased serum estradiol concentrations (basal 191 +/- 24 pmol/l) at 150 min with 100 mg (237 +/- 35 pmol/l) and from 150-240 min with 300 mg (reaching 260 +/- 32 pmol/l at 240 min). These data indicate that, in contrast to men, androstenedione intake in women increases serum testosterone concentrations.

Menopause-induced estrogen deficiency increases the risk of cardiovascular disease, which is related to a shift in regional fat distribution. We tested the hypothesis that estrogen-like isoflavones in soy protein isolate (SPI+) would lessen both regional fat gain and lean loss compared with isoflavone-poor soy (SPI-).Perimenopausal participants (N = 69) were randomly assigned (double-blind) to 24 weeks of treatment (40 g soy or whey protein per day): SPI+ (n = 24), SPI- (n = 24), or whey control (n = 21); each participant had blood drawn in the fasted (12 hours) state, had physical activity assessed, and kept a 5-day food diary. Dual-energy x-ray absorptiometry was used to examine the effects of SPI+ on regional fat and lean tissue distribution changes in the waist, hip, and thigh regions.Mean body mass increased (P0.01) in each group, but treatment had no effect on gain in overall body mass, fat mass, or lean mass using analysis of variance. In all treatment groups combined, lean mass increased in each region; fat mass increased only in the waist region. Treatment had an effect (P = 0.039) on hip lean mass and a marginal effect (P = 0.077) on thigh fat. Regression analyses revealed that SPI+ diminished the increase in thigh fat (P = 0.018) and heightened the increase in hip lean (P = 0.035) mass. Carbohydrate intake (P = 0.006) and cohort (reflective of season; P = 0.011) contributed to the gain in thigh fat. Total protein intake (P = 0.0012), plasma insulin (P = 0.0034), and physical activity (P = 0.047) contributed to the gain in hip lean mass.Gain in hip lean mass was greater (P = 0.014) in SPI+ than other groups, but SPI+ did not reduce the disease-promoting menopausal shift in regional fat mass.

ContextAndrostenedione, a precursor to testosterone, is marketed to increase blood testosterone concentrations as a natural alternative to anabolic steroid use. However, whether androstenedione actually increases blood testosterone levels or produces anabolic androgenic effects is not known.ObjectivesTo determine if short- and long-term oral androstenedione supplementation in men increases serum testosterone levels and skeletal muscle fiber size and strength and to examine its effect on blood lipids and markers of liver function.Design and SettingEight-week randomized controlled trial conducted between February and June 1998.ParticipantsThirty healthy, normotestosterogenic men (aged 19-29 years) not taking any nutritional supplements or androgenic-anabolic steroids or engaged in resistance training.InterventionsTwenty subjects performed 8 weeks of whole-body resistance training. During weeks 1, 2, 4, 5, 7, and 8, the men were randomized to either androstenedione, 300 mg/d (n=10), or placebo (n=10). The effect of a single 100-mg androstenedione dose on serum testosterone and estrogen concentrations was determined in 10 men.Main Outcome MeasuresChanges in serum testosterone and estrogen concentrations, muscle strength, muscle fiber cross-sectional area, body composition, blood lipids, and liver transaminase activities based on assessments before and after short- and long-term androstenedione administration.ResultsSerum free and total testosterone concentrations were not affected by short- or long-term androstenedione administration. Serum estradiol concentration (mean [SEM]) was higher (P

Plasma free fatty acid (FFA) levels tend to be lower and the plasma lipolytic hormone response to prolonged exercise of the same intensity is blunted after endurance exercise training. To determine whether training elicits a corresponding decrease in plasma FFA turnover and metabolism during prolonged exercise, we measured plasma [1-13C]palmitate kinetics and oxidation and respiratory gas exchange in 13 subjects during the latter portion of a 90- to 120-min bout of cycle ergometer work performed before and after 12 wk of alternate-day cycling and running. Training increased total fat oxidation during prolonged exercise by 41% (P < 0.005). However, for the final 30-60 min of the cycle ergometer protocol, the rate of 13CO2 production from [1-13C]palmitate oxidation was 27% lower (P < 0.05), the rate of palmitate turnover was 33% less (P < 0.05), and plasma FFA and glycerol concentrations were 32 and 20% lower (P < 0.05), respectively, than in the untrained state. Thus endurance exercise training results in decreased plasma FFA turnover and oxidation during a 90- to 120-min bout of submaximal exercise because of a slower rate of FFA release from adipose tissue.

BACKGROUND Decreased insulin secretion may contribute to the deterioration of glucose tolerance associated with aging. METHODS We studied the insulin response to a 3-hour hyperglycemic clamp (10 mM) of 19 young (24 +/- 1 y) subjects with normal glucose tolerance and 60 older (65 +/- 1 y) subjects with various levels of glucose tolerance. RESULTS The noninsulin dependent diabetic (NIDDM) group had a diminished first phase immunoreactive (IR)-insulin response compared to young and nondiabetic older groups (p < .05). The older groups had a lower rate of change in IR insulin concentration during the third hour of hyperglycemia compared to the young group (p < .05). This was not, however, a universal finding, because a decreased third hour response was not seen in a subgroup of older subjects whose glucose tolerance was similar to that of the young group. Another subgroup of older subjects with a decrease in glucose tolerance mild enough to be considered normal by the National Diabetes Group Criteria tended to have both an increase in the early insulin response and a decrease in the third hour response. More severe decreases in glucose tolerance were associated with blunting of the early response. CONCLUSION Aberrations in early and late phase glucose-stimulated insulin responses appear to be present in older subjects with even mildly decreased glucose tolerance. Some individuals, however, show no evidence of deterioration of glucose tolerance or insulin response to glucose with aging, at least up to age 70 years.

Eleven subjects performed a graded exercise test after 1 week of protein supplementation (PRO) or glucose polymer placebo (CON), randomly assigned in a double blind fashion. The exercise consisted of 3-min graded exercise bouts separated by 10 min of active recovery at zero pedal resistance. Subjects then performed a 30-sec Wingate test (WIN) to assess performance during supramaximal exercise. Blood samples were obtained in the last 15 sec of each exercise and recovery period. PRO resulted in a decrease in blood lactate following 120%and WIN, an increase in blood alanine at all time points, and lower postexercise muscle lactate and glycogen. Resting muscle GPT activity was 47% higher during the PRO trial. Mean power output during the WIN did not differ between PRO and CON. The WIN fatigue index was not significantly different between PRO and CON. The increased alanine may reflect increased transamination of pyruvate, thereby reducing the accumulation of lactate, which in turn had a marginal effect on performance during supramaximal exercise.

Previous studies of endurance exercise training in older men and women generally have found only minimal skeletal muscle adaptations to training. To evaluate the possibility that this may have been due to an inadequate training stimulus, we studied 23 healthy older (64 +/- 3 yr) men and women before and after they had trained by walking/jogging at 80% of maximal heart rate for 45 min/day 4 days/wk for 9–12 mo. This training program resulted in a 23% increase in maximal O2 consumption. Needle biopsy samples of the lateral gastrocnemius muscle were obtained before and after training and analyzed for selected histochemical and enzymatic characteristics. The percentage of type I muscle fibers did not change with training. The percentage of type IIb fibers, however, decreased from 19.1 +/- 9.1 to 15.1 +/- 8.1% (P less than 0.001), whereas the percentage of type IIa fibers increased from 22.1 +/- 7.7 to 29.6 +/- 9.1% (P less than 0.05). Training also induced increases in the cross-sectional area of both type I (12%; P less than 0.001) and type IIa fibers (10%; P less than 0.05). Capillary density increased from 257 +/- 43 capillaries/mm2 before training to 310 +/- 48 capillaries/mm2 after training (P less than 0.001) because of increases in the capillary-to-fiber ratio and in the number of capillaries in contact with each fiber. Lactate dehydrogenase activity decreased by 21% (P less than 0.001), whereas the activities of the mitochondrial enzymes succinate dehydrogenase, citrate synthase, and beta-hydroxyacyl-CoA dehydrogenase increased by 24–55% in response to training (P less than 0.001–0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

The purpose of this study was to determine the effectiveness of two rehydration beverages on fluid restoration and metabolism on subsequent exercise following exerciseand heat-induced dehydration. Twelve male subjects were dehydrated by ~3 % of body mass with exercise and heat exposure. In a randomly assigned, counterbalanced design, subjects were rehydrated at room temperature with either 175 ml of chicken noodle soup (SOUP: Campbell Soup Company, Camden, NJ) or an artificially sweetened placebo (CON) at the beginning of the 120 min rehydration period and 20 min later. Water was ingested every 20 min during the remaining 100 min of rehydration. Soup contained 161.0 mmol/l Na, 5.3 mmol/l K, and 32.6 g total carbohydrate. CON contained 14.4 mmol/l Na, 16.0 mmol/l K, and no carbohydrate. Total fluid ingestion was matched with body fluid loss during dehydration. After rehydration, subjects performed 30 min of steady state exercise at 68% VO2peak. Subjects then performed a time trial in which they accumulated as rapidly as possible the amount of work equal to 30 min of exercise at 70% VO2peak in a thermo-neutral environment (25 C and 40% relative humidity). There was no significant difference in percent recovery of body mass during rehydration (CON: 79.4 ± 3.3%; SOUP: 80.9 ± 3.4%). Time trial performance was significantly improved in SOUP (30.6 ± 0.8 min) compared with CON (33.2 ± 1.4 min; p=0.031). The rate of carbohydrate oxidation tended to be higher in SOUP (2.33 ± 0.09 g/min) compared with CON (2.18 ± 0.11 g/min; p=0.076). No differences in heart rate or ratings of perceived exercise were found during post-rehydration exercise. These results

The purpose of this study was to investigate the effects of the use of toeclips on the ventilatory threshold (VT) of cyclists and runners during cycle ergometry. Ten competitive cyclists and ten well-trained runners performed two continuous maximal cycle ergometer tests, once with toeclips and once without toeclips. Respiratory data were collected every 20 s and used to determine VT and VO2 max. For cyclists, the mean (congruent to SEM) oxygen uptake at VT (VO2, VT) was greater during the trial with toeclips (48.8 +/- 1.9 ml kg-1 min-1 and 46.9 +/- 1.9 ml kg-1 min-1 during cycle ergometry with and without toeclips, respectively; p less than 0.05). No significant difference in VO2, VT was noted between trials for runners. The cyclists also demonstrated a higher VO2 max during the trial with toeclips (58.8 +/- 3.0 ml kg-1 min-1) compared to the trial without toeclips (54.4 +/- 2.0 ml kg-1 min-1; p less than 0.05). When expressed relative to VO2 max (%VO2 max) the VT during the toeclip trial for cyclists was significantly decreased (p less than 0.05). These data suggest that the cyclists in this study developed specific adaptations related to the use of toeclips, and the use of toeclips during cycle ergometry is therefore recommended. We recommend that future studies report results with VT expressed in both absolute (VO2) and relative (%VO2 max) terms.

Insulin secretion in response to glucose stimulation is reduced in endurance-trained humans. In this study, a modified hyperglycemic clamp, with a superimposed arginine infusion and fat meal, was performed on eight endurance-trained and nine untrained men to determine whether insulin secretory capacity is reduced by exercise training. Raising the plasma glucose concentration to approximately 450 mg/dl resulted in a plasma insulin response in the trained men that was approximately 64% lower than that of the untrained (peak values: 54 +/- 8 vs. 149 +/- 35 microU/ml; P less than 0.001). When a primed continuous infusion of arginine was superimposed on the hyperglycemia, the plasma insulin response was also markedly lower (66%) in the trained subjects, reaching peak values of 333 +/- 68 and 974 +/- 188 microU/ml for trained and untrained subjects, respectively (P less than 0.005). When insulin secretion was further stimulated during the arginine-infused hyperglycemia by the ingestion of a high-fat meal, peak insulin concentrations averaged 989 +/- 205 microU/ml in the trained compared with 2,232 +/- 455 microU/ml in the untrained subjects (P less than 0.01). The response of gastric inhibitory polypeptide (GIP) to the fat meal was delayed and blunted, suggesting that some enteric factor(s) other than GIP mediated the insulinotropic effect of the fat meal. The reduced plasma insulin response in trained people to the stimuli investigated suggests that regular exercise produces either several adaptations within the beta-cell or a single alteration of the beta-cell that results in an attenuation of the insulin secretory response to glucose, arginine, and fat ingestion.

Many older athletes are capable of endurance performances equal to those of young runners who have higher maximal O2 uptakes (VO2max). To determine whether this is a result of differences in skeletal muscle characteristics, gastrocnemius muscle biopsy samples were obtained from eight master athletes [aged 63 +/- 6 (SD) yr] and eight young (aged 26 +/- 3 yr) runners. The young runners were matched with the master athletes for 10-km running performance and for their volume, pace, and type of training. Despite similar 10-km run times, VO2max was 11% lower (P less than 0.05) in the master athletes. Fiber type distribution did not differ between groups, with both groups having 60% type I and very few type IIb fibers. Succinate dehydrogenase and beta-hydroxyacyl-CoA dehydrogenase activities, however, were 31 and 24% higher in the master athletes compared with the matched young runners, whereas lactate dehydrogenase activity was 46% lower (all P less than 0.05). The capillary-to-fiber ratio was also greater in the master athletes; however, capillary density was similar in the two groups, because of the master athletes' 34% larger (P less than 0.05) type I fibers. These differences in skeletal muscle characteristics may explain the master athletes' ability to perform as well as some young runners despite having a lower VO2max.

Master athletes who exercise regularly appear to avoid the development of insulin resistance and deterioration of glucose tolerance (GT) commonly seen with aging. To evaluate the possibility that exercise prevents rather than masks the aging-related changes responsible for development of insulin resistance, we investigated the effects of 10 days of physical inactivity in 14 master athletes aged 61 +/- 2 (SE) yr. The response of 10 of these men to inactivity was similar to that of young athletes, with an unchanged plasma glucose response and a significantly greater insulin response to an oral glucose tolerance test (OGTT) after 10 days of inactivity. These 10 athletes appeared to have been protected against the aging-related changes in GT because their plasma glucose and insulin levels during the OGTT after 10 days of inactivity were not significantly different from those of young lean sedentary men. In contrast, a deterioration in GT occurred in four of the master athletes during 10 days of inactivity; this was sufficiently marked in two of them to be classified as impaired GT. We conclude that regular exercise may 1) protect against the development of insulin resistance and decline in GT with aging in individuals with normal GT and 2) normalize GT by means of short-term effects of exercise in some individuals with abnormal GT.

This study was designed to determine whether patients with McArdle's disease, who do not increase their blood lactate levels during and after maximal exercise, have a slow “lactacid” component to their recovery O2 consumption (VO2) response after high-intensity exercise. VO2 was measured breath by breath during 6 min of rest before exercise, a progressive maximal cycle ergometer test, and 15 min of recovery in five McArdle's patients, six age-matched control subjects, and six maximal O2 consumption- (VO2 max) matched control subjects. The McArdle's patients' ventilatory threshold occurred at the same relative exercise intensity [71 +/- 7% (SD) VO2max] as in the control groups (60 +/- 13 and 70 +/- 10% VO2max) despite no increase and a 20% decrease in the McArdle's patients' arterialized blood lactate and H+ levels, respectively. The recovery VO2 responses of all three groups were better fit by a two-, than a one-, component exponential model, and the parameters of the slow component of the recovery VO2 response were the same in the three groups. The presence of the same slow component of the recovery VO2 response in the McArdle's patients and the control subjects, despite the lack of an increase in blood lactate or H+ levels during maximal exercise and recovery in the patients, provides evidence that this portion of the recovery VO2 response is not the result of a lactacid mechanism. In addition, it appears that the hyperventilation that accompanies high-intensity exercise may be the result of some mechanism other than acidosis or lung CO2 flux.