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Biomedical subjects

Louise M Burke

Publications and source records attributed to Louise M Burke.

At least 19 recordsLinked to original sources

4. The use and misuse of performance-enhancing substances in sport.

Doctors need to know if a patient is an athlete subject to drug testing, and to be aware of the legal situation surrounding drugs they prescribe such patients. Antidoping laws generally exist in order to provide a safe and fair environment for participation in sport. These laws should prevent and protect athletes from subjecting themselves to health risks through the use of unsafe, but performance-enhancing drugs. Because of difficulties in proving intent to cheat, the World Anti-Doping Agency enforces a principle of strict liability for positive test results for banned substances. An area of major controversy with respect to liability is the "sports supplement" industry, which is poorly regulated when compared with prescription drugs yet is a potential source of doping violations. Medical practitioners can be found guilty of anti-doping violations if they traffic banned drugs, prescribe these to athletes or otherwise assist athletes in taking banned substances. Medical practitioners are also now required to complete paperwork (therapeutic use exemption forms) to enable athletes to take banned substances which are required on medical grounds for specific illnesses.

Doping in Sports↗

Energy and carbohydrate for training and recovery.

Soccer players should achieve an energy intake that provides sufficient carbohydrate to fuel the training and competition programme, supplies all nutrient requirements, and allows manipulation of energy or nutrient balance to achieve changes in lean body mass, body fat or growth. Although the traditional culture of soccer has focused on carbohydrate intake for immediate match preparation, top players should adapt their carbohydrate intake on a daily basis to ensure adequate fuel for training and recovery between matches. For players with a mobile playing style, there is sound evidence that dietary programmes that restore and even super-compensate muscle glycogen levels can enhance activity patterns during matches. This will presumably also benefit intensive training, such as twice daily practices. As well as achieving a total intake of carbohydrate commensurate with fuel needs, the everyday diet should promote strategic intake of carbohydrate and protein before and after key training sessions to optimize the adaptations and enhance recovery. The achievement of the ideal physique for soccer is a long-term goal that should be undertaken over successive years, and particularly during the off-season and pre-season. An increase in lean body mass or a decrease in body fat is the product of a targeted training and eating programme. Consultation with a sports nutrition expert can assist soccer players to manipulate energy and nutrient intake to meet such goals. Players should be warned against the accidental or deliberate mismatch of energy intake and energy expenditure, such that energy availability (intake minus the cost of exercise) falls below 125 kJ (30 kcal) per kilogram of fat-free mass per day. Such low energy availability causes disturbances to hormonal, metabolic, and immune function.

Adult↗

Fat and carbohydrate for exercise.

PURPOSE OF REVIEW: To examine the results of new investigations that look at the efficacy of nutrient/training strategies on metabolism and athletic performance. RECENT FINDINGS: 'Dietary periodization' involves the manipulation of macronutrient intake in association with changes in physical training. Such interventions have a major effect on altering patterns of fuel utilization during exercise; however, they often fail to enhance performance capacity. In contrast, the ingestion of a combination of different types of carbohydrate during exercise results in high rates of muscle glucose oxidation (1.5 g/min) and can improve intense, short-duration (approximately 60 min), and prolonged (>90 min) submaximal steady-state exercise, either by metabolic or neural mechanisms. SUMMARY: Further investigation into the responses of specific nutrient/training strategies on metabolic and cellular signaling pathways is warranted to determine the underlying mechanisms by which such interventions exert their effect. Such studies, however, should be coupled with investigations that assess the outcomes of these responses on the 'real life' training adaptations in athletes.

Adaptation, Physiological↗

Decreased PDH activation and glycogenolysis during exercise following fat adaptation with carbohydrate restoration.

Five days of a high-fat diet while training, followed by 1 day of carbohydrate (CHO) restoration, increases rates of whole body fat oxidation and decreases CHO oxidation during aerobic cycling. The mechanisms responsible for these shifts in fuel oxidation are unknown but involve up- and downregulation of key regulatory enzymes in the pathways of skeletal muscle fat and CHO metabolism, respectively. This study measured muscle PDH and HSL activities before and after 20 min of cycling at 70% VO2peak and 1 min of sprinting at 150% peak power output (PPO). Estimations of muscle glycogenolysis were made during the initial minute of exercise at 70% VO2peak and during the 1-min sprint. Seven male cyclists undertook this exercise protocol on two occasions. For 5 days, subjects consumed in random order either a high-CHO (HCHO) diet (10.3 g x kg(-1) x day(-1) CHO, or approximately 70% of total energy intake) or an isoenergetic high-fat (FAT-adapt) diet (4.6 g x kg(-1) x day(-1) FAT, or 67% of total energy) while undertaking supervised aerobic endurance training. On day 6 for both treatments, subjects ingested an HCHO diet and rested before their experimental trials on day 7. This CHO restoration resulted in similar resting glycogen contents (FAT-adapt 873 +/- 121 vs. HCHO 868 +/- 120 micromol glucosyl units/g dry wt). However, the respiratory exchange ratio was lower during cycling at 70% VO2peak in the FAT-adapt trial, which resulted in an approximately 45% increase and an approximately 30% decrease in fat and CHO oxidation, respectively. PDH activity was lower at rest and throughout exercise at 70% VO2peak (1.69 +/- 0.25 vs. 2.39 +/- 0.19 mmol x kg wet wt(-1) x min(-1)) and the 1-min sprint in the FAT-adapt vs. the HCHO trial. Estimates of glycogenolysis during the 1st min of exercise at 70% VO2peak and the 1-min sprint were also lower after FAT-adapt (9.1 +/- 1.1 vs. 13.4 +/- 2.1 and 37.3 +/- 5.1 vs. 50.5 +/- 2.7 glucosyl units x kg dry wt(-1) x min(-1)). HSL activity was approximately 20% higher (P = 0.12) during exercise at 70% VO2peak after FAT-adapt. Results indicate that previously reported decreases in whole body CHO oxidation and increases in fat oxidation after the FAT-adapt protocol are a function of metabolic changes within skeletal muscle. The metabolic signals responsible for the shift in muscle substrate use during cycling at 70% VO2peak remain unclear, but lower accumulation of free ADP and AMP after the FAT-adapt trial may be responsible for the decreased glycogenolysis and PDH activation during sprinting.

Adaptation, Physiological↗

Effect of carbohydrate intake on half-marathon performance of well-trained runners.

Eighteen highly-trained runners ran two half marathons in mild environmental conditions, 3 wk apart, consuming either 426 +/- 227 mL of a flavored placebo drink (PLACEBO) or an equivalent volume of water (386 +/- 185 mL) and a commercial gel (GEL) supplying 1.1 +/- 0.2 g/kg body mass (BM) carbohydrate (CHO). Voluntary consumption of this fluid was associated with a mean BM change of approximately 2.4%. Runners performed better in their second race by 0.9% or 40 s (P = 0.03). Three runners complained of gastrointestinal discomfort in GEL trial, which produced a clear impairment of half-marathon performance by 2.4% or 105 s (P=0.03). The effect of GEL on performance was trivial: time was improvedby 0.3% or 14 s compared with PLACEBO (P = 0.52). Consuming the gel was associated with a 2.4% slower time through the 2 x 200 m feed zone; adding a trivial approximately 2 s to race time. Although benefits to half marathon performance were not detected, the theoretical improvement during 1-h exercise with CHO intake merits further investigation.

Abdominal Pain↗

Failure to repeatedly supercompensate muscle glycogen stores in highly trained men.

PURPOSE: It is not known whether it is possible to repeatedly supercompensate muscle glycogen stores after exhaustive exercise bouts undertaken within several days. METHODS: We evaluated the effect of repeated exercise-diet manipulation on muscle glycogen and triacylglycerol (IMTG) metabolism and exercise capacity in six well-trained subjects who completed an intermittent, exhaustive cycling protocol (EX) on three occasions separated by 48 h (i.e., days 1, 3, and 5) in a 5-d period. Twenty-four hours before day 1, subjects consumed a moderate (6 g.kg)-carbohydrate (CHO) diet, followed by 5 d of a high (12 g.kg.d)-CHO diet. Muscle biopsies were taken at rest, immediately post-EX on days 1, 3, and 5, and after 3 h of recovery on days 1 and 3. RESULTS: Compared with day 1, resting muscle [glycogen] was elevated on day 3 but not day 5 (435+/-57 vs 713+/-60 vs 409+/-40 mmol.kg, P<0.001). [IMTG] was reduced by 28% (P<0.05) after EX on day 1, but post-EX levels on days 3 and 5 were similar to rest. EX was enhanced on days 3 and 5 compared with day 1 (31.9+/-2.5 and 35.4+/-3.8 vs 24.1+/-1.4 kJ.kg, P<0.05). Glycogen synthase activity at rest and immediately post-EX was similar between trials. Additionally, the rates of muscle glycogen accumulation were similar during the 3-h recovery period on days 1 and 3. CONCLUSION: We show that well-trained men cannot repeatedly supercompensate muscle [glycogen] after glycogen-depleting exercise and 2 d of a high-CHO diet, suggesting that the mechanisms responsible for glycogen accumulation are attenuated as a consequence of successive days of glycogen-depleting exercise.

Adult↗

Regulation of fuel metabolism by preexercise muscle glycogen content and exercise intensity.

To date, the results of studies that have examined the effects of altering preexercise muscle glycogen content and exercise intensity on endogenous carbohydrate oxidation are equivocal. Differences in the training status of subjects between investigations may, in part, explain these inconsistent findings. Accordingly, we determined the relative effects of exercise intensity and carbohydrate availability on patterns of fuel utilization in the same subjects who performed a random order of four 60-min rides, two at 45% and two at 70% of peak O(2) uptake (Vo(2 peak)), after exercise-diet intervention to manipulate muscle glycogen content. Preexercise muscle glycogen content was 596 +/- 43 and 202 +/- 21 mmol/kg dry mass (P < 0.001) for high-glycogen (HG) and low-glycogen (LG) conditions, respectively. Respiratory exchange ratio was higher for HG than LG during exercise at both 45% (0.85 +/- 0.01 vs. 0.74 +/- 0.01; P < 0.001) and 70% (0.90 +/- 0.01 vs. 0.79 +/- 0.01; P < 0.001) of Vo(2 peak). The contribution of whole body muscle glycogen oxidation to energy expenditure differed between LG and HG for exercise at both 45% (5 +/- 2 vs. 45 +/- 5%; P < 0.001) and 70% (25 +/- 3 vs. 60 +/- 3%; P < 0.001) of Vo(2 peak). Yet, despite marked differences in preexercise muscle glycogen content and its subsequent utilization, rates of plasma glucose disappearance were similar under all conditions. We conclude that, in moderately trained individuals, muscle glycogen availability (low vs. high) does not influence rates of plasma glucose disposal during either low- or moderate-intensity exercise.

Adult↗

Carbohydrates and fat for training and recovery.

An important goal of the athlete's everyday diet is to provide the muscle with substrates to fuel the training programme that will achieve optimal adaptation for performance enhancements. In reviewing the scientific literature on post-exercise glycogen storage since 1991, the following guidelines for the training diet are proposed. Athletes should aim to achieve carbohydrate intakes to meet the fuel requirements of their training programme and to optimize restoration of muscle glycogen stores between workouts. General recommendations can be provided, preferably in terms of grams of carbohydrate per kilogram of the athlete's body mass, but should be fine-tuned with individual consideration of total energy needs, specific training needs and feedback from training performance. It is valuable to choose nutrient-rich carbohydrate foods and to add other foods to recovery meals and snacks to provide a good source of protein and other nutrients. These nutrients may assist in other recovery processes and, in the case of protein, may promote additional glycogen recovery when carbohydrate intake is suboptimal or when frequent snacking is not possible. When the period between exercise sessions is < 8 h, the athlete should begin carbohydrate intake as soon as practical after the first workout to maximize the effective recovery time between sessions. There may be some advantages in meeting carbohydrate intake targets as a series of snacks during the early recovery phase, but during longer recovery periods (24 h) the athlete should organize the pattern and timing of carbohydrate-rich meals and snacks according to what is practical and comfortable for their individual situation. Carbohydrate-rich foods with a moderate to high glycaemic index provide a readily available source of carbohydrate for muscle glycogen synthesis, and should be the major carbohydrate choices in recovery meals. Although there is new interest in the recovery of intramuscular triglyceride stores between training sessions, there is no evidence that diets which are high in fat and restricted in carbohydrate enhance training.

Dietary Carbohydrates↗

Effect of alcohol intake on muscle glycogen storage after prolonged exercise.

We studied the effects of alcohol intake on postexercise muscle glycogen restoration with samples from vastus lateralis being collected immediately after glycogen-depleting cycling and after a set recovery period. Six well-trained cyclists undertook a study of 8-h recovery (2 meals), and another nine cyclists undertook a separate 24-h protocol (4 meals). In each study, subjects completed three trials in crossover order: control (C) diet [meals providing carbohydrate (CHO) of 1.75 g/kg]; alcohol-displacement (A) diet (1.5 g/kg alcohol displacing CHO energy from C) and alcohol + CHO (AC) diet (C + 1.5 g/kg alcohol). Alcohol intake reduced postmeal glycemia especially in A trial and 24-h study, although insulin responses were maintained. Alcohol intake increased serum triglycerides, particularly in the 24-h study and AC trial. Glycogen storage was decreased in A diets compared with C at 8 h (24.4 +/- 7 vs. 44.6 +/- 6 mmol/kg wet wt, means +/- SE, P < 0.05) and 24 h (68 +/- 5 vs. 82 +/- 5 mmol/kg wet wt, P < 0.05). There was a trend to reduced glycogen storage with AC in 8 h (36.2 +/- 8 mmol/kg wet wt, P = 0.1) but no difference in 24 h (85 +/- 9 mmol/kg wet wt). We conclude that 1). the direct effect of alcohol on postexercise glycogen synthesis is unclear, and 2). the main effect of alcohol intake is indirect, by displacing CHO intake from optimal recovery nutrition practices.

Adult↗

A short-term, high-fat diet up-regulates lipid metabolism and gene expression in human skeletal muscle.

BACKGROUND: Dietary fatty acids may be important in regulating gene expression. However, little is known about the effect of changes in dietary fatty acids on gene regulation in human skeletal muscle. OBJECTIVE: The objective was to determine the effect of altered dietary fat intake on the expression of genes encoding proteins necessary for fatty acid transport and beta-oxidation in skeletal muscle. DESIGN: Fourteen well-trained male cyclists and triathletes with a mean (+/- SE) age of 26.9 +/- 1.7 y, weight of 73.7 +/- 1.7 kg, and peak oxygen uptake of 67.0 +/- 1.3 mL x kg(-1) x min(-1) consumed either a high-fat diet (HFat: > 65% of energy as lipids) or an isoenergetic high-carbohydrate diet (HCho: 70-75% of energy as carbohydrate) for 5 d in a crossover design. On day 1 (baseline) and again after 5 d of dietary intervention, resting muscle and blood samples were taken. Muscle samples were analyzed for gene expression [fatty acid translocase (FAT/CD36), plasma membrane fatty acid binding protein (FABPpm), carnitine palmitoyltransferase I (CPT I), beta-hydroxyacyl-CoA dehydrogenase (beta-HAD), and uncoupling protein 3 (UCP3)] and concentrations of the proteins FAT/CD36 and FABPpm. RESULTS: The gene expression of FAT/CD36 and beta -HAD and the gene abundance of FAT/CD36 were greater after the HFat than after the HCho diet (P < 0.05). Messenger RNA expression of FABPpm, CPT I, and UCP-3 did not change significantly with either diet. CONCLUSIONS: A rapid and marked capacity for changes in dietary fatty acid availability to modulate the expression of mRNA-encoding proteins is necessary for fatty acid transport and oxidative metabolism. This finding is evidence of nutrient-gene interactions in human skeletal muscle.

3-Hydroxyacyl CoA Dehydrogenases↗

Variability in estimation of self-reported dietary intake data from elite athletes resulting from coding by different sports dietitians.

A routine activity for a sports dietitian is to estimate energy and nutrient intake from an athlete's self-reported food intake. Decisions made by the dietitian when coding a food record are a source of variability in the data. The aim of the present study was to determine the variability in estimation of the daily energy and key nutrient intakes of elite athletes, when experienced coders analyzed the same food record using the same database and software package. Seven-day food records from a dietary survey of athletes in the 1996 Australian Olympic team were randomly selected to provide 13 sets of records, each set representing the self-reported food intake of an endurance, team, weight restricted, and sprint/power athlete. Each set was coded by 3-5 members of Sports Dietitians Australia, making a total of 52 athletes, 53 dietitians, and 1456 athlete-days of data. We estimated within- and between- athlete and dietitian variances for each dietary nutrient using mixed modeling, and we combined the variances to express variability as a coefficient of variation (typical variation as a percent of the mean). Variability in the mean of 7-day estimates of a nutrient was 2- to 3-fold less than that of a single day. The variability contributed by the coder was less than the true athlete variability for a 1-day record but was of similar magnitude for a 7-day record. The most variable nutrients (e.g., vitamin C, vitamin A, cholesterol) had approximately 3-fold more variability than least variable nutrients (e.g., energy, carbohydrate, magnesium). These athlete and coder variabilities need to be taken into account in dietary assessment of athletes for counseling and research.

Diet Records↗

Eating patterns and meal frequency of elite Australian athletes.

We undertook a dietary survey of 167 Australian Olympic team athletes (80 females and 87 males) competing in endurance sports (n = 41), team sports (n = 31), sprint- or skill-based sports (n = 67), and sports in which athletes are weight-conscious (n = 28). Analysis of their 7-day food diaries provided mean energy intakes, nutrient intakes, and eating patterns. Higher energy intakes relative to body mass were reported by male athletes compared with females, and by endurance athletes compared with other athletes. Endurance athletes reported substantially higher intakes of carbohydrate (CHO) than other athletes, and were among the athletes most likely to consume CHO during and after training sessions. Athletes undertaking weight-conscious sports reported relatively low energy intakes and were least likely to consume CHO during a training session or in the first hour of recovery. On average, athletes reported eating on approximately 5 separate occasions each day, with a moderate relationship between the number of daily eating occasions and total energy intake. Snacks, defined as food or drink consumed between main meals, provided 23% of daily energy intake and were chosen from sources higher in CHO and lower in fat and protein than foods chosen at meals. The dietary behaviors of these elite athletes were generally consistent with guidelines for sports nutrition, but intakes during and after training sessions were often sub-optimal. Although it is of interest to study the periodicity of fluid and food intake by athletes, it is difficult to compare across studies due to a lack of standardized terminology.

Adult↗

Adaptations to short-term high-fat diet persist during exercise despite high carbohydrate availability.

PURPOSE: Five days of a high-fat diet produce metabolic adaptations that increase the rate of fat oxidation during prolonged exercise. We investigated whether enhanced rates of fat oxidation during submaximal exercise after 5 d of a high-fat diet would persist in the face of increased carbohydrate (CHO) availability before and during exercise. METHODS: Eight well-trained subjects consumed either a high-CHO (9.3 g x kg(-1) x d(-1) CHO, 1.1 g x kg(-1) x d(-1) fat; HCHO) or an isoenergetic high-fat diet (2.5 g x kg(-1) x d(-1) CHO, 4.3 g x kg(-1) x d(-1) fat; FAT-adapt) for 5 d followed by a high-CHO diet and rest on day 6. On day 7, performance testing (2 h steady-state (SS) cycling at 70% peak O(2) uptake [VO(2peak)] + time trial [TT]) of 7 kJ x kg(-1)) was undertaken after a CHO breakfast (CHO 2 g x kg(-1)) and intake of CHO during cycling (0.8 g x kg(-1) x h(-1)). RESULTS: FAT-adapt reduced respiratory exchange ratio (RER) values before and during cycling at 70% VO(2peak); RER was restored by 1 d CHO and CHO intake during cycling (0.90 +/- 0.01, 0.80 +/- 0.01, 0.91 +/- 0.01, for days 1, 6, and 7, respectively). RER values were higher with HCHO (0.90 +/- 0.01, 0.88 +/- 0.01 (HCHO > FAT-adapt, P < 0.05), 0.95 +/- 0.01 (HCHO > FAT-adapt, P < 0.05)). On day 7, fat oxidation remained elevated (73 +/- 4 g vs 45 +/- 3 g, P < 0.05), whereas CHO oxidation was reduced (354 +/- 11 g vs 419 +/- 13 g, P < 0.05) throughout SS in FAT-adapt versus HCHO. TT performance was similar for both trials (25.53 +/- 0.67 min vs 25.45 +/- 0.96 min, NS). CONCLUSION: Adaptations to a short-term high-fat diet persisted in the face of high CHO availability before and during exercise, but failed to confer a performance advantage during a TT lasting approximately 25 min undertaken after 2 h of submaximal cycling.

Adaptation, Physiological↗

Effect of short-term fat adaptation on high-intensity training.

PURPOSE: To determine the effect of short-term (3-d) fat adaptation on high-intensity exercise training in seven competitive endurance athletes (maximal O2 uptake 5.0 +/- 0.5 L x min(-1), mean +/-SD). METHODS: Subjects consumed a standardized diet on d-0 then, in a randomized cross-over design, either 3-d of high-CHO (11 g x kg(-1)d(-1) CHO, 1 g x kg(-1) x d(-1) fat; HICHO) or an isoenergetic high-fat (2.6 g CHO x kg(-1) x d(-1), 4.6 g FAT x kg(-1) x d(-1); HIFAT) diet separated by an 18-d wash out. On the 1st (d-1) and 4th (d-4) day of each treatment, subjects completed a standardized laboratory training session consisting of a 20-min warm-up at 65% of VO2peak (232 +/- 23W) immediately followed by 8 x 5 min work bouts at 86 +/- 2% of VO2peak (323 +/- 32 W) with 60-s recovery. RESULTS: Respiratory exchange ratio (mean for bouts 1, 4, and 8) was similar on d-1 for HIFAT and HICHO (0.91 +/- 0.04 vs 0.92 +/- 0.03) and on d-4 after HICHO (0.92 +/- 0.03) but fell to 0.85 +/- 0.03 (P < 0.05) on d-4 after HIFAT. Accordingly, the rate of fat oxidation increased from 31 +/- 13 on d-1 to 61 +/- 25 micromol x kg(-1) x min(-1) on d-4 after HIFAT (P < 0.05). Blood lactate concentration was similar on d-1 and d-4 of HICHO and on d-1 of HIFAT (3.5 +/- 0.9 and 3.2 +/- 1.0 vs 3.7 +/- 1.2 mM) but declined to 2.4 +/- 0.5 mM on d-4 after HIFAT (P < 0.05). Ratings of perception of effort (legs) were similar on d-1 for HIFAT and HICHO (14.8 +/- 1.5 vs 14.1 +/- 1.4) and on d-4 after HICHO (13.8 +/- 1.8) but increased to 16.0 +/- 1.3 on d-4 after HIFAT (P < 0.05). CONCLUSIONS: 1) competitive endurance athletes can perform intense interval training during 3-d exposure to a high-fat diet, 2) such exercise elicited high rates of fat oxidation, but 3) compared with a high-carbohydrate diet, training sessions were associated with increased ratings of perceived exertion.

Adaptation, Physiological↗

Effects of short-term fat adaptation on metabolism and performance of prolonged exercise.

The concept of manipulating an individuals habitual diet before an exercise bout in an attempt to modify patterns of fuel substrate utilization and enhance subsequent exercise capacity is not new. Modern studies have focused on nutritional and training strategies aimed to optimize endogenous carbohydrate (CHO) stores while simultaneously maximizing the capacity for fat oxidation during continuous, submaximal (60-70% of maximal O(2) uptake [(.)VO(2max)] exercise. Such "nutritional periodization" typically encompasses 5-6 d of a high-fat diet (60-70% E) followed by 1-2 d of high-CHO intake (70-80% E; CHO restoration). Despite the brevity of the adaptation period, ingestion of a high-fat diet by endurance-trained athletes results in substantially higher rates of fat oxidation and concomitant muscle glycogen sparing during submaximal exercise compared with an isoenergetic high-CHO diet. Higher rates of fat oxidation during exercise persist even under conditions in which CHO availability is increased, either by having athletes consume a high-CHO meal before exercise and/or ingest glucose solutions during exercise. Yet, despite marked changes in the patterns of fuel utilization that favor fat oxidation, fat-adaptation/CHO restoration strategies do not provide clear benefits to the performance of prolonged endurance exercise.

Adaptation, Physiological↗