Dr Meghan Brown

Important topical issues and contemporary practices related to health and performance are also addressed. This book is an essential addition to the library of any distance runner, coach or sport scientist.

Reducing Risk and Maximizing Performance Jeffrey A. Russell. Insufficient sleep or overtraining occasionally may not have a serious impact on your health, so it may be tempting to minimize these. Eventually, however, your body will ...

BACKGROUND: There is a paucity of studies investigating exercise-induced muscle damage (EIMD) in females and only one in response to dance-type exercise. This study sought to firstly elucidate the physiological profile of EIMD following a dance-specific protocol, and second to compare the magnitude of damage to that experienced following a sport-specific protocol in physically active females. METHODS: Twenty-nine female recreational dancers (19±1 years) were recruited. Participants completed either a dance-specific protocol (DPFT; N.=15) or sport-specific repeated sprint protocol (SSRS; N.=14). Muscle soreness, limb girths, creatine kinase (CK), countermovement jump height (CMJ), reactive strength index (RSI), maximal voluntary contraction (MVC) and 30 m sprint time were recorded pre, 0-, 24-, 48-, and 72 h post exercise. RESULTS: The DPFT induced muscle damage, with significant time effects for all variables except RSI. However the response was acute, and muscle function returned to near-baseline levels by 48 h. Although no group differences existed, there were significant interaction effects; notably in CMJ (P=0.038) where the decline at 0 h (-6.9%) was smaller and recovery was greater at 72 h (which exceeded pre-exercise levels by 3.7%) post DPFT compared to post SSRS. CONCLUSIONS: The results offer new information showing that dance-specific activity results in EIMD in females. In addition, the magnitude of damage was similar to repeated sprint exercise and demonstrated that, in this population, recovery from these strenuous activities takes several days. These data have important implications for understanding the consequences of dance activity and other strenuous exercise in females.

BACKGROUND: Prior evidence suggests that high-calcium intake influences postprandial appetite and insulinemia, possibly due to elevated incretins. In vitro and ex vivo models demonstrate that extracellular calcium and protein synergistically enhance secretion of incretins. This is yet to be shown in humans. OBJECTIVE: This study was designed to assess energy intake compensation in response to protein and calcium ingestion. METHODS: Twenty healthy adults (13 men; 7 women) completed 4 trials in a randomized, double-blind crossover design separated by ≥48 h. During the trials, each participant consumed a low-calcium and low-protein control preload [(CON); 4 g and 104 mg, respectively], a high-protein preload (PRO; 29 g), a high-calcium preload (CAL; 1170 mg), or a high-protein and high-calcium preload (PROCAL). Blood samples were collected at baseline and 15, 30, 45, and 60 min after preload ingestion to determine insulin and incretin hormone concentrations. Energy intake was assessed by a homogenous test meal 60 min after the preload. Visual analog scales were completed immediately before blood sampling to assess subjective appetite sensations. RESULTS: Relative to the CON, the PRO produced 100% (95% CI: 85%, 115%) energy compensation, whereas the CAL produced significant overcompensation [118% (95% CI: 104%, 133%)], which was significantly more positive than with the PRO (P < 0.05). The PROCAL resulted in energy compensation of 109% (95% CI: 95%, 123%), which tended to be greater than with the PRO (P = 0.06). The mean difference in appetite sensations relative to the CON was not significantly different between the PRO (-3 mm; 95% CI: -8, 3 mm), CAL (-5 mm; 95% CI: -9, 0 mm), and PROCAL (-5 mm; 95% CI: -10, -1 mm) (P > 0.05). CONCLUSIONS: The addition of protein to a preload results in almost perfect energy compensation, whereas the addition of calcium, with or without protein, suppresses appetite and produces overcompensation of subsequent energy intake. The role of circulating insulin and incretin concentrations in these responses, however, remains unclear. This trial was registered at clinicaltrials.gov as NCT01986036.

Many athletes in aesthetic and weight dependent sports are at risk of energy imbalance. However little is known about the exercise and eating behaviours of highly trained dance populations. This investigation sought to determine the energy intake and energy expenditure of pre-professional female contemporary dancers. Twenty-five female contemporary dance students completed the study. Over a 7-day period, including five week days (with scheduled dance training at a conservatoire) and two weekend days (with no scheduled dance training at the conservatoire), energy intake (self-reported weighed food diary and 24 h dietary recall) and expenditure (tri-axial accelerometry) were recorded. Mean daily energy intake and expenditure were different over the 7-day period (P = 0.014) equating to an energy deficit of -356 ± 668 kcal·day-1 (or -1.5 ± 2.8 MJ·day-1). Energy expenditure was not different when comparing week and weekend days (P = 0.297). However daily energy intake (P = 0.002), energy availability (P = 0.003), and energy balance (P = 0.004) were lower during the week compared to the weekend, where energy balance became positive. The percentage contribution of macronutrients to total energy intake also differed; with higher fat (P = 0.022) and alcohol (P = 0.020), and lower carbohydrate (P = 0.001) and a trend for lower protein (P = 0.051) at the weekend. Energy balance and appropriate macronutrient intake are essential for maintaining the demands of training, performance and recovery. Whilst aesthetics are important, female contemporary dancers may be at risk of the numerous health and performance impairments associated with negative energy balance, particularly during periods of scheduled training.

This study was designed to assess the effect of a dairy-based recovery beverage on post-exercise appetite and energy intake in active females. Thirteen active females completed three trials in a crossover design. Participants completed 60 min of cycling at 65% V̇O2peak, before a 120 min recovery period. On completion of cycling, participants consumed a commercially available dairy-based beverage (DBB), a commercially available carbohydrate beverage (CHO), or a water control (H2O). Non-esterified fatty acids, glucose, and appetite-related peptides alongside measures of subjective appetite were sampled at baseline and at 30 min intervals during recovery. At 120 min, energy intake was assessed in the laboratory by ad libitum assessment, and in the free-living environment by weighed food record for the remainder of the study day. Energy intake at the ad libitum lunch was lower after DBB compared to H2O (4.43 ± 0.20, 5.58 ± 0.41 MJ, respectively; p = 0.046; (95% CI: −2.28, −0.20 MJ)), but was not different to CHO (5.21 ± 0.46 MJ), with no difference between trials thereafter. Insulin and GLP-17-36 were higher following DBB compared to H2O (p = 0.015 and p = 0.001, respectively) but not to CHO (p = 1.00 and p = 0.146, respectively). In addition, glucagon was higher following DBB compared to CHO (p = 0.008) but not to H2O (p = 0.074). The results demonstrate that where DBB consumption may manifest in accelerated recovery, this may be possible without significantly affecting total energy intake and subsequent appetite-related responses relative to a CHO beverage.

BACKGROUND: Tart cherries contain numerous polyphenolic compounds that could potentially improve endothelial function and reduce cardiovascular disease risk. OBJECTIVE: We sought to examine the acute effects of Montmorency tart cherry (MC) juice on vascular function in subjects with early hypertension. DESIGN: A placebo-controlled, blinded, crossover, randomized Latin square design study with a washout period of ≥14 d was conducted. Fifteen men with early hypertension [systolic blood pressure (SBP) ≥130 mm Hg, diastolic blood pressure ≥80 mm Hg, or both] received either a 60-mL dose of MC concentrate or placebo. Microvascular reactivity (laser Doppler imaging with iontophoresis), arterial stiffness (pulse wave velocity and analysis), blood pressure, and phenolic acid absorption were assessed at baseline and at 1, 2, 3, 5, and 8 h postconsumption. RESULTS: MC consumption significantly lowered SBP (P < 0.05) over a period of 3 h, with peak reductions of mean ± SEM 7 ± 3 mm Hg 2 h after MC consumption relative to the placebo. Improvements in cardiovascular disease risk factors were closely linked to increases in circulating protocatechuic and vanillic acid at 1-2 h. CONCLUSIONS: MC intake acutely reduces SBP in men with early hypertension. These benefits may be mechanistically linked to the actions of circulating phenolic acids. This study provides information on a new application of MCs in health maintenance, particularly in positively modulating SBP. This trial was registered at clinicaltrials.gov as NCT02234648.

Abstract

Brown, MA, Howatson, G, Keane, KM, and Stevenson, EJ. Adaptation to damaging dance and repeated-sprint activity in women. J Strength Cond Res 30(9): 2574–2581, 2016—The repeated bout effect (RBE) refers to the prophylactic effect from damaging exercise after a single previous bout of exercise. There is a paucity of data examining the RBE in women, and investigations using exercise paradigms beyond isolated eccentric contractions are scarce. In light of the limited literature, this investigation aimed to determine whether 2 different sport-specific exercise bouts would elicit a RBE in women. Twenty-one female dancers (19 ± 1 years) completed either a dance-specific protocol (n = 10) or sport-specific repeated-sprint protocol (n = 11). Delayed-onset muscle soreness (DOMS), limb girths, creatine kinase (CK), countermovement jump height, reactive strength index, maximal voluntary contraction, and 30-meter sprint time were recorded before and 0, 24, 48, and 72 hours after exercise. An identical exercise bout was conducted approximately 4 weeks after the initial bout, during which time the subjects maintained habitual training and dietary behaviors. DOMS and 30-meter sprint time decreased after a second bout of both activities (p = 0.003; JOURNAL/jscr/04.03/00124278-201609000-00027/inline-formula1/v/2023-08-19T002706Z/r/image-tiff = 0.38 and p = 0.008; and JOURNAL/jscr/04.03/00124278-201609000-00027/inline-formula2/v/2023-08-19T002706Z/r/image-tiff = 0.31, respectively). Circulating CK was also lower at 24, 48, and 72 hours after the second bout, independent of group (p = 0.010 and JOURNAL/jscr/04.03/00124278-201609000-00027/inline-formula3/v/2023-08-19T002706Z/r/image-tiff = 0.23). Compared with the repeated-sprint protocol, the magnitude of change in DOMS was greater after a subsequent bout of the dance protocol (p = 0.010 and JOURNAL/jscr/04.03/00124278-201609000-00027/inline-formula4/v/2023-08-19T002706Z/r/image-tiff = 0.19). These data are the first to demonstrate that dance and repeated-sprint activity resulting in muscle damage in women confers a protective effect against muscle damage after a subsequent bout.

Independently, prolonged uninterrupted sitting and the consumption of a meal high in saturated fats acutely disrupt normal cardiovascular function. Currently, the acute effects of these behaviors performed in combination on arterial stiffness, a marker of cardiovascular health, are unknown. This study sought to determine the effect of consuming a high-fat meal (Δ = 51 g fat) in conjunction with prolonged uninterrupted sitting (180 min) on measures of central and peripheral arterial stiffness. Using a randomized crossover design, 13 young healthy males consumed a high-fat (61 g) or low-fat (10 g) meal before 180 min of uninterrupted sitting. Carotid-femoral (cf) and femoral-ankle (fa) pulse wave velocity (PWV), aortic-femoral stiffness gradient (af-SG), superficial femoral PWV beta (β), and oscillometric pulse wave analysis outcomes were assessed pre and post sitting. cfPWV increased significantly more following the high-fat (mean difference [MD] = 0.59 m·s−1) meal than following the low-fat (MD = 0.2 m·s−1) meal, with no change in faPWV in either condition. The af-SG significantly decreased (worsened) (ηp2 = 0.569) over time in the high- and low-fat conditions (ratio = 0.1 and 0.1, respectively). Superficial femoral PWVβ significantly increased over time in the high- and low-fat conditions (ηp2 = 0.321; 0.8 and 0.4 m·s−1, respectively). Triglycerides increased over time in the high-fat trial only (ηp2 = 0.761). There were no significant changes in blood pressure. Consuming a high-fat meal prior to 180 min of uninterrupted sitting augments markers of cardiovascular disease risk more than consuming a low-fat meal prior to sitting.

The purpose of this research was two-fold: (a) to observe whether highly trained adolescent swimmers abide to vitamin D supplement recommendations; and (b) to monitor changes in circulating 25-hydroxyvitamin D (25(OH)D) that occur between the autumn and winter months. Twenty swimmers (age: 17 ± 2 years) from a UK high-performance swimming club volunteered to complete two blood spot cards to determine their 25(OH)D concentration: the first in an autumn training phase (October) and the second during winter training (January). All swimmers were advised to consume vitamin D3 supplements across the assessment period; however, only 50% of swimmers adhered to this recommendation. Resultantly, a winter decline in 25(OH)D was observed in non-supplementing swimmers (79.6 ± 25.2 to 52.6 ± 15.1 nmol·L−1, p = 0.005), with swimmers either displaying an ‘insufficient’ (60%) or ‘deficient’ (40%) vitamin D status. In comparison, a greater maintenance of 25(OH)D occurred in supplementing swimmers (92.0 ± 25.5 to 97.2 ± 38.3 nmol·L−1, p = 0.544), although variable outcomes occurred at the individual level (four increased, three maintained, three declined). These findings highlight the possible risks of vitamin D insufficiency during the winter for swimmers in the UK, possibly requiring standardised supplement practices. Moreover, alternative educational strategies may be required for swimmers to transfer knowledge to practice in order to improve supplement adherence in future.

Elite ballet dancers are at risk of health issues associated with Relative Energy Deficiency in Sport (RED-S). This study determined the nutritional status, estimated energy status, and assessed factors related to RED-S in vocational female ballet students. Using a cross-sectional study design, we measured dietary intake (food diaries and 24 h dietary-recall) and energy expenditure (accelerometry) in vocational female ballet students (n = 20; age: 18.1 ± 1.1 years; body mass index: 19.0 ± 1.6 kg·m2; body fat: 22.8 ± 3.4%) over 7 days, including 5 weekdays (with dance training) and 2 weekend days (without scheduled dance training). Furthermore, we assessed eating behaviors, menstrual function, risk of RED-S (questionnaires), and body composition (dual x-ray absorptiometry). Energy and macronutrient intakes of vocational ballet students were similar during weekdays and weekend days (P > 0.050), whereas total energy expenditure was greater on weekdays than weekend days (P < 0.010; 95% CI: 212, 379). Energy balance was lower on weekdays (-425 ± 465 kcal·day-1) than weekend days (-6 ± 506 kcal·day-1, P = 0.015; 95% CI: -748, -92). Exercise energy expenditure was greater on weekdays (393 ± 103 kcal·day-1) than weekend days (213 ± 129 kcal·day-1; P < 0.010; 95% CI: 114, 246), but energy availability was similar between time periods (weekdays 38 ± 13 kcal·kg FFM·day-1; weekend days 44 ± 13 kcal·kg FFM·day-1; P = 0.110). Overall, 35% of participants had an energy intake <1,800 kcal·day-1, 44% had reduced energy availability (30-45 kcal·kg FFM·day-1), and 22% had low energy availability (<30 kcal·kg FFM·day-1). Menstrual dysfunctions were reported in 40% of participants; 15 and 25% reported oligomenorrhea and secondary amenorrhea, respectively; while 65% were classified at risk of RED-S (based on the Low Energy Availability in Females Questionnaire). All participants had adequate bone health (bone mineral density Z-score: 1.1 ± 0.9 SD), but 20% had <85% expected body weight. The observation of an energy deficit in vocational female ballet students was primarily attributed to an inability to plan energy intake and thereby meet higher energy requirements during ballet training weekdays. Screening for factors associated with RED-S and tailoring education programs to inform energy and nutrition requirements for health and training are recommended in elite young ballet students.

This study examined whether consuming casein protein (CP) pre-sleep could accelerate acute recovery following muscle-damaging exercise. Thirty-nine active males and females performed 100 drop jumps in the morning, consumed their habitual diet during the day, and then within 30 min pre-bed consumed either ~40 g of CP (n = 19) or ~40 g of a carbohydrate-only control (CON) (n = 20). Maximal isometric voluntary contractions (MIVC), countermovement jumps (CMJ), pressure-pain threshold (PPT), subjective muscle soreness and the brief assessment of mood adapted (BAM+) were measured pre, 24 and 48 h following the drop jumps. MIVC decreased in CP and CON post-exercise, peaking at 24 h post (CP: −8.5 ± 3.5 vs. CON: −13.0 ± 2.9%, respectively); however, no between-group differences were observed (p = 0.486; ηp2 =0.02). There were also no group differences in the recovery of CMJ height, PPT and BAM+ (p > 0.05). Subjective muscle soreness increased post-exercise, but no group differences were present at 24 h (CP: 92 ± 31 mm vs. CON: 90 ± 46 mm) or 48 h (CP: 90 ± 44 mm vs. CON: 80 ± 58 mm) (p > 0.05). These data suggest that pre-bed supplementation with ~40 g of CP is no more beneficial than CON for accelerating the recovery following muscle-damaging exercise.

Background Spastic cerebral palsy (CP) is characterized by muscle weakness owing, in part, to a blunted muscle protein synthetic response. This might be normalized by long-term leucine supplementation. Objectives The study assessed the effects of 10 wk leucine supplementation in adolescents and adults with CP. Methods The study was a single-center randomized controlled trial. Twenty-four participants were randomly assigned to a control group (n = 12) or a leucine group (n = 12). L-Leucine (192 mg/kg body mass) was dissolved in water and administered daily for 10 wk. The primary outcome measures of elbow flexor muscle strength and muscle volume (measured by 3D ultrasound technique) and inflammation [C-reactive protein (CRP) concentration] were assessed before and after the 10 wk, alongside the secondary outcomes of body composition (measured by CP-specific skinfold assessment), metabolic rate (measured by indirect calorimetry), and wellbeing (measured by a self-reported daily questionnaire). Data were compared via a series of 2-factor mixed ANOVAs. Results Twenty-one participants completed the intervention (control group: n = 11, mean ± SD age: 18.3 ± 2.8 y, body mass: 48.8 ± 11.9 kg, 45% male; leucine group: n = 10, age: 18.6 ± 1.7 y, body mass: 58.3 ± 20.2 kg, 70% male). After 10 wk, there was a 25.4% increase in strength (P = 0.019) and a 3.6% increase in muscle volume (P = 0.001) in the leucine group, with no changes in the control group. This was accompanied by a 59.1% reduction in CRP (P = 0.045) and improved perceptions of wellbeing (P = 0.006) in the leucine group. No changes in metabolism or body composition were observed in either group (P > 0.05). Conclusions Improvements in muscle strength and volume with leucine supplementation might provide important functional changes for adults and adolescents with CP and could be partly explained by reduced inflammation. The improved wellbeing highlights its capacity to improve the quality of daily living. This trial was registered at clinicaltrials.gov as NCT03668548.

A number of different forms of protein and their analogues have been investigated for their efficacy in ameliorating exercise-induced muscle damage (EIMD) and recovery. Preliminary data regarding whey protein hydrolysate (WPH) supplementation are promising. However, its efficacy beyond acute eccentric/resistance exercise bouts or longer term training programmes are limited and all investigations have been conducted in male or mixed-sex groups. This study sought to elucidate whether the benefits of WPH previously reported can be demonstrated in females following repeated-sprint exercise. Twenty physically active females were assigned to consume 2 doses of 70 mL WPH or isoenergetic carbohydrate (CHO) for 4 days post-EIMD. Measures of muscle soreness, limb girth, flexibility, muscle function, and creatine kinase were collected before, immediately after, and 24, 48, and 72 h postexercise. Time effects were observed for all variables (p < 0.05) except limb girth, which is indicative of EIMD. Flexibility improved beyond baseline measures following WPH by 72 h, but had failed to recover in the CHO group (p = 0.011). Reactive strength index was higher throughout recovery in the WPH group compared with CHO (p = 0.016). Reductions in creatine kinase were greater following WPH compared with CHO at 48 h post-EIMD (p = 0.031). The findings suggest that 4-day supplementation of WPH is beneficial for reducing symptoms of EIMD and improving recovery of muscle function in physically active females.

This study examined whether beetroot juice (BTJ) would attenuate inflammation and muscle damage following a marathon. Using a double blind, independent group design, 34 runners (each having completed ca. ∼16 previous marathons) consumed either BTJ or an isocaloric placebo (PLA) for 3 days following a marathon. Maximal isometric voluntary contractions (MIVC), countermovement jumps (CMJ), muscle soreness, serum cytokines, leucocytosis, creatine kinase (CK), high sensitivity C-reactive protein (hs-CRP), and aspartate aminotransferase (AST) were measured pre, post, and 2 days after the marathon. CMJ and MIVC were reduced after the marathon (P < 0.05), but no group differences were observed (P > 0.05). Muscle soreness was increased in the day after the marathon (BTJ; 45 ± 48 vs. PLA; 46 ± 39 mm) and had returned to baseline by day 2, irrespective of supplementation (P = 0.694). Cytokines (interleukin-6; IL-6, interleukin-8, tumour necrosis factor-α) were increased immediately post-marathon but apart from IL-6 had returned to baseline values by day 1 post. No interaction effects were evident for IL-6 (P = 0.213). Leucocytes increased 1.7-fold after the race and remained elevated 2 days post, irrespective of supplement (P < 0.0001). CK peaked at 1 day post marathon (BTJ: 965 ± 967, and PLA: 1141 ± 979 IU·L−1) and like AST and hs-CRP, was still elevated 2 days after the marathon (P < 0.05); however, no group differences were present for these variables. Beetroot juice did not attenuate inflammation or reduce muscle damage following a marathon, possibly because most of these indices were not markedly different from baseline values in the days after the marathon.

Abstract

Tart Montmorency cherry concentrate (MC) has been reported to attenuate the symptoms of exercise‐induced muscle damage (EIMD) and to accelerate exercise recovery, which has been attributed to its high anti‐inflammatory and antioxidant properties. Although these data are promising, there are no data regarding exclusively female populations. Therefore, the aim of this investigation was to examine the efficacy of MC on recovery following EIMD in females. In a randomised, double‐blind, placebo‐controlled study, twenty physically active females (mean ± SD age 19 ± 1 y; stature 167 ± 6 cm; body mass 61.4 ± 5.7 kg) consumed MC or a placebo (PL) for eight days (30 mL twice per day). Following four days of supplementation, participants completed a repeated‐sprint protocol and measures of muscle soreness (DOMS), pain pressure threshold (PPT), limb girth, flexibility, muscle function, and systemic indices of muscle damage and inflammation were collected pre, immediately post (0 h) and 24, 48 and 72 h post‐exercise. Time effects were observed for all dependent variables (p < 0.05) except limb girth and high sensitivity C‐reactive protein. Recovery of countermovement jump height was improved in the MC group compared to PL (p = 0.016). There was also a trend for lower DOMS (p = 0.070) and for higher PPT at the rectus femoris (p = 0.071) in the MC group. The data demonstrate that MC supplementation may be a practical nutritional intervention to help attenuate the symptoms of muscle damage and improve recovery on subsequent days in females.

Prolonged uninterrupted sitting and a typical Western meal, high in fat and refined sugar, can additively impair cognitive and cerebrovascular functions. However, it is unknown whether interrupting these behaviours, with a simple desk-based activity, can attenuate the impairment. The aim of this study was to determine whether regular leg fidgeting can off-set the detrimental effects of prolonged sitting following the consumption of a typical Western meal, on executive and cerebrovascular function. Using a randomized cross-over design, 13 healthy males consumed a Western meal and completed 180-min of prolonged sitting with leg fidgeting of 1 min on/4 min off (intervention [INT]) and without (control [CON]). Cognitive function was assessed pre and post sitting using the Trail Maker Test (TMT) parts A and B. Common carotid artery (CCA) blood flow, as an index of brain flow, was measured pre and post, and cerebral (FP1) perfusion was measured continuously. For TMT B the CON trial significantly increased (worsened) completion time (mean difference [MD] = 5.2 s, d = 0.38), the number of errors (MD = 3.33, d = 0.68) and cognitive fatigue (MD = 0.73, d = 0.92). Compared to CON, the INT trial significantly improved completion time (MD = 2.3 s, d = 0.97), and prevented declines in cognitive fatigue and a reduction in the number of errors. No significant changes in cerebral perfusion or CCA blood flow were found. Leg fidgeting for 1-min on/4-min off following a meal high in fats and refined sugars attenuated the impairment in executive function. This attenuation in executive function may not be caused by alterations in CCA blood flow or cerebral perfusion.

Background/Objectives: Ingestion of galactooligosaccharides (GOSs) or GOS mixtures has been purported to improve exercise-induced gastrointestinal (GI) distress and post-exercise recovery. However, the effects have not been explored in recreationally trained endurance athletes. This triple-blind randomised controlled trial, therefore, investigated whether 12 weeks of B-GOS® supplementation affects gastrointestinal comfort and psychological wellbeing in recreational athletes. Methods: Eighteen physically active individuals (12 males, 8 females, 44 ± 14 years, 1.7 ± 0.1 m and 73 ± 14 kg) volunteered for this study. Participants were assigned to independent groups in a placebo-controlled, triple-blind manner via stratified randomisation. A 20 min run at 80% VO2max was completed, with measures for GI distress and Competitive State Anxiety Inventory-2 questionnaire (CSAI-2) pre- and post-exercise. A 12-week supplementation period then ensued, where participants ingested either 3.65 g of B-GOS or an appearance-matched maltodextrin placebo. During this time, physical activity levels (IPAQ-7), general stress (REST-Q), mental wellbeing (WEMWBS), and sleep (core consensus sleep diary) were measured at regular time points. Results: There were no significant differences in VO2max (p = 0.437), GI discomfort (p = 0.227), or CSAI-2 (p = 0.739–0.954) from pre- to post-exercise at any time point or between conditions. Over the 12 weeks there were no significant differences between B-GOS and placebo in IPAQ-7 (p = 0.144–0.723), REST-Q (p = 0.282–0.954), WEMWBS (B-GOS pre = 51 ± 10, post = 53 ± 7; PLA pre = 51 ± 4, post 54; p = 0.862), or sleep (p = 0.065–0.992). The linear mixed model suggests that some may benefit on an individual level in terms of WEMWBS, general stress score, recovery-related scores, sleep, and sport-specific recovery score. Conclusions: There were no group benefits of B-GOS supplementation compared with placebo, although the individual variation may warrant further research in larger sample sizes and longer-duration studies.

Purpose: To (a) quantify the internal and external training load (TL) demands of professional ballet dancers; (b) explore the influence of session type, and sex on TL. Methods: Twenty-nine professional ballet dancers (men = 14; women = 15) were monitored over two weeks. Internal TL data was measured using heart rate-derived TRIMP, and external TL using PlayerLoad (PL). TL data from 303 sessions were categorised and analysed according to session type (rehearsal, class, and conditioning), and sex. Results: Dancers averaged ~4.62 per day (~ 26.1 hours/week) comprised of daily (PL: 539 AU; HR TRIMP: 314 arbitrary units (AU)) and weekly (PL: 2608 AU; HR TRIMP: 1503 AU) TL. Rehearsals had the longest duration (197 ± 66 min) but lowest load per minute. Conditioning produced the highest PL (140.1 AU, 95% CI: 120.2-160.0), while class elicited the greatest HR TRIMP (89.4 AU, 95% CI: 72.1-106.7). Session type significantly influenced TL (P = 0.004, η2 = 0.68) with small to moderate differences between rehearsal and conditioning (PL ES = 0.38; TRIMP ES = 0.49). No significant differences were observed by sex (PL, P = 0.57; TRIMP, P = 0.18). Conclusions: Conditioning sessions produced the greatest TL response and should play a key role in professional ballet dancer’s schedules. Although TL did not significantly differ by sex, the study suggests that a uniform training model may not meet individual dancer needs. These findings support the implementation of personalised monitoring and periodised scheduling strategies to optimise both artistic and physical performance in professional ballet.

This narrative review examines the mechanisms underlying the development of cardiovascular (CVD) and metabolic diseases (MDs), along with their association with sarcopenia. Furthermore, non-pharmacological interventions to address sarcopenia in patients with these conditions are being suggested. The significance of combined training in managing metabolic disease and secondary sarcopenia in type II diabetes mellitus is emphasized. Additionally, the potential benefits of resistance and aerobic training are being explored. This review emphasises the role of nutrition in addressing sarcopenia in patients with CVD or MDs, focusing on strategies such as optimising protein intake, promoting plant-based protein sources, incorporating antioxidant-rich foods and omega-3 fatty acids, and ensuring sufficient vitamin D levels. Moreover, the potential benefits of targeting gut microbiota through probiotics and prebiotic fibres in sarcopenic individuals are being considered. Multidisciplinary approaches that integrate behavioural science are explored to enhance the uptake and sustainability of behaviour-based sarcopenia interventions. Future research should prioritise high-quality randomized controlled trials to refine exercise and nutritional interventions and investigate the incorporation of behavioural science into routine practices. Ultimately, a comprehensive and multifaceted approach is essential to improve health outcomes, well-being, and quality of life in older adults with sarcopenia and coexisting cardio-vascular and metabolic diseases.