RESEARCH: Studies reviewed this week: 20 September 2021 to 26 September 2021

NUTRITION: Athletes’ and Coaches’ Perceptions of Nutritional Advice: Eating More Food for Health and Performance

Last week I shared an article about RED-S and prevalent it is. The importance of eating enough and fueling to perform is therefore something that athletes and coaches should be mindful of. This study set out "to explore athletes’ and coaches’ perceptions towards advice to athletes to eat larger than their current quantities of food and to explore how nutritionists could deliver this advice". The authors found that through semi-structured interviews and offering good nutritional advice:

Athletes reported improved training consistency, fewer injuries and illnesses, and improved resilience when consuming adequate energy and nutrients to meet their needs.
Lack of time and meal preparation difficulties were the main challenges faced to fuelling.

This led to the conclusion that:

Although education about under-fuelling is important, motivating, enabling, and supporting athletes to change behaviour is pivotal to increasing athlete self-awareness and to make long-term nutritional changes.

PRACTICAL TAKEAWAY - even if we're aware of the cost of under-fuelling it may take more than just that knowledge to take action and make meaningful improvements in our nutrition. Take the time to set up effective checks and balances to ensure you are fuelling enough.

NUTRITION: Beta-alanine did not improve high-intensity performance throughout simulated road cycling

This study set out to test beta-alanine supplementation. It is a particularly interesting study due to the protocol used by the authors who tried to replicate a race to test the real world application of the supplment:

Cyclists undertook a prolonged intermittent cycling protocol lasting 125 min, with a 10-s sprint every 20 min, finishing with a 4-km time-trial at 5% simulated incline. Participants completed two familiarization sessions, and two main sessions, one pre-supplementation and one post-supplementation following 28 days of 6.4 g·day−1 of beta-alanine (N=11) or placebo (N=6; maltodextrin).

The results were that:

There were no main effects on sprint performance throughout the intermittent cycling test. There was no group, time or group x time interaction on time-to-complete the 4-km time-trial.
Beta-alanine supplementation increased muscle carnosine content from pre- to post-supplementation but was not related to performance changes.

PRACTICAL TAKEAWAY - beta-alanine supplementation does not appear to improve sprint performance.

SLEEP: Associations between sleep and in-race gastrointestinal symptoms: an observational study of running and triathlon race competitors

How are sleep and GI issues related? In this study the author set out to test triathlon and duathlon participants' GI symptoms and compared these to their sleep from the night before the race. The author found that:

It appears as though upper GI symptoms experienced by race competitors may, to a modest extent, result from chronic sleep problems.
These findings have implications for athletes who experience disturbed sleep over a period of several days or weeks due to travel, stress and other factors known to impact sleep.

However, they also found:

That adjustment for anxiety scores, as measured by the STICSA, significantly attenuated the association between chronic sleep problems and upper GI symptoms during races.

PRACTICAL TAKEAWAY - pre-race sleep is important in many ways and good sleep may also reduce upper GI issues on race day.

PHYSIOLOGY: Athletes with exercise-associated fatigue have abnormally short muscle DNA telomeres

This study looked into the impact of heavy training and racing on skeletal muscles. The authors hypothesized that 'this damage is repaired by satellite cells that can undergo a finite number of cell divisions" and therefore can mean a limited athletic career for endurance athletes. The study:

Compared a marker of skeletal muscle regeneration of athletes with exercise-associated chronic fatigue, a condition labeled the "fatigued athlete myopathic syndrome" (FAMS), with healthy asymptomatic age- and mileage-matched control endurance athletes.

With the authors finding that:

All 13 symptomatic athletes reported a progressive decline in athletic performance, decreased ability to tolerate high mileage training, and excessive muscular fatigue during exercise.
The minimum value of TRF lengths measured on the DNA from vastus lateralis biopsies from these athletes were significantly shorter than those from 13 age- and mileage-matched control athletes. Three of the FAMS patients had extremely short telomeres.

PRACTICAL TAKEAWAY - there can be significant impacts from large volumes of training that result in muscular damage. I believe this suggests that intensity control and volume management are important.

TRAINING: Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review

In the study above I shard the potential negative impacts on muscle damage from multiple years of training and racing. This study investigated the potential "long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems".

A few highlights from the study include:

Atrial arrhythmia, mainly atrial fibrillation (AF), can be encountered in highly trained endurance male athletes, and this abnormality may typically occur after several years of training, with a risk multiplied three- to fivefold when compared to sedentary individuals.
Competitors in a 100-mile (161-km) footrace were shown to exhibit a mean increase in the frequency of echocardiographic “comet tails” (indicative of extravascular lung water) congruent with decreased lung diffusing capacity and alveolar-capillary membrane conductance. While pulmonary edema may be a normal response to strenuous endurance exercise, the short- or long-term consequences of repeated occurrences are currently unknown.
In athletic populations, periods of overreaching may result in longer lasting immune alterations and dysfunction. Importantly, physiological/psychological overload evoked from training and racing that is disproportionate to recovery may lead to non-functional overreaching, contributing to a long-term performance deficit known as under-performance syndrome.

PRACTICAL TAKEAWAY - it is very important to consider both your training volume and the stress of racing and making good decisions to ensure your long-term health.

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