John R. Stofan

Physical activity patterns associated with cardiorespiratory fitness and reduced mortality : The aerobics center longitudinal study

OBJECTIVES This study examined cross sectionally the physical activity patterns associated with low, moderate, and high levels of cardiorespiratory fitness. METHODS Physical activity was assessed by questionnaire in a clinic population of 13,444 men and 3972 women 20 to 87 years of age. Estimated energy expenditure (kcal.wk-1) and volume (min.wk-1) of reported activities were calculated among individuals at low, moderate, and high fitness levels (assessed by maximal exercise tests). RESULTS Average leisure time energy expenditures of 525 to 1650 kcal.wk-1 for men and 420 to 1260 kcal.wk-1 for women were associated with moderate to high levels of fitness. These levels of energy expenditure can be achieved with a brisk walk of approximately 30 minutes on most days of the week. In fact, men in the moderate and high fitness categories walked between 130 and 138 min.wk-1, and women in these categories walked between 148 and 167 min.wk-1. CONCLUSIONS Most individuals should be able to achieve these physical activity goals and thus attain a cardiorespiratory fitness level sufficient to result in substantial health benefits.

Comparison of regional patch collection vs. whole body washdown for measuring sweat sodium and potassium loss during exercise

This study compared simultaneous whole body washdown (WBW) and regional skin surface (REG) sweat collections to generate regression equations to predict WBW sweat Na(+) concentration ([Na(+)]) and K(+) concentration ([K(+)]) from single- and five-site REG sweat patch collections. Athletes (10 men, 10 women) cycled in a plastic chamber for 90 min in the heat. Before exercise, the subject and bike were washed with deionized water. After the onset of sweating, sterile patches were attached to the forearm, back, chest, forehead, and thigh and removed on saturation. After exercise, the subject and bike were washed with ammonium sulfate solution to collect all sweat electrolyte loss and determine the volume of unevaporated sweat. All individual patch sites and five-site REG (weighted for local sweat rate and body surface area) were significantly (P = 0.000) correlated with WBW sweat [Na(+)]. The equation for predicting WBW sweat [Na(+)] from five-site REG was y = 0.68x + 0.44 [r = 0.97, intraclass correlation coefficient (ICC) = 0.70] and did not differ between sexes. There were sex differences in the regression results between five-site REG and WBW sweat [K(+)] (men: y = 0.74x + 0.30, r = 0.89, ICC = 0.73; women: y = 0.04x + 3.18, r = 0.03, ICC = 0.00). Five-site REG sweat [Na(+)] and [K(+)] significantly overestimated that of WBW sweat (59 +/- 27 vs. 41 +/- 19 meq/l, P = 0.000 and 4.4 +/- 0.7 vs. 3.6 +/- 0.7 meq/l, P = 0.000, respectively). For both sexes, the best sites for predicting WBW sweat [Na(+)] and [K(+)] were the thigh (1 +/- 8 meq/l < WBW, P = 1.000, y = 0.75x + 11.37, r = 0.96, ICC = 0.93) and chest (0.2 +/- 0.3 meq/l > WBW, P = 1.000, y = 0.76x + 0.55, r = 0.89, ICC = 0.87), respectively. In conclusion, regression equations can be used to accurately and reliably predict WBW sweat [Na(+)] and [K(+)] from REG sweat collections when study conditions and techniques are similar to that of the present protocol.

Sodium balance during u.s. football training in the heat: Cramp-prone vs. reference players

U. S. football players with a history of heat cramps were evaluated for the effect of physical training, sodium intake, and loss of sweat sodium on whole blood sodium concentration (BNa). Athletes (n=14 males, 24+/-1 y) were recruited and studied based on medical history, age, and position. The reference group (R, n=8 without a cramping history) and cramp-prone group (C, n=6, history of whole-body cramps associated with extensive sweat loss during exercise in the heat) were measured for body mass and BNa (ISTAT) before and after team training of 2.2 h in hot conditions (WBGT=29-32 degrees C). Intake and loss of fluid and sodium were also measured to determine respective acute balance. In R, BNa was stable pre- to post-training (138.9+/-1.8 to 139.0+/-2.0 mmol/L) while it tended to decline in C (137.8+/-2.3 to 135.7+/-4.9 mmol/L), and three subjects in C had BNa values below 135 mmol/L (131.7+/-2.9 mmol/L). C consumed a greater percentage of total fluid as water (p<0.05). Mean sweat sodium concentration was (52.6+/-29.2 mmol/L for C and 38.3+/-18.3 mmol/L for R (p>0.05). Compared to R, C tended to experience a decline in BNa and greater acute sodium imbalance. These changes may place cramp-prone players at greater risks for developing acute sodium deficits during training.

Core temperature and sweat responses in professional women's tennis players during tournament play in the heat

CONTEXT Tennis is often played in hot, humid environments, intensifying the thermoregulatory strain placed on the athletes. As a safety measure, some tennis organizations allow for a 10-minute break in play between the second and third sets when environmental conditions are extreme. However, the actual effect of these breaks in reducing core temperature is unknown. OBJECTIVE To determine change in core temperature after a 10-minute break in play and assess fluid balance in professional female tennis players during tournament matches in the heat. DESIGN Cross-sectional study. SETTING A Womens Tennis Association Tour-sanctioned outdoor tournament on hard courts under hot conditions (30.3°C ± 2.3°C). PATIENTS OR OTHER PARTICIPANTS Seven professional tennis players. MAIN OUTCOME MEASURE(S) Change in core temperature after a 10-minute break in tournament play, fluid intake, and sweat losses during match play. RESULTS Core temperature was reduced from 38.92°C to 38.67°C (change of -0.25°C ± 0.20°C) when a break was taken (P  =  .02). Mean sweat rate during match play was 2.0 ± 0.5 L/h. During that time, mean fluid intake was 1.5 ± 0.5 L/h, resulting in a 1.2% ± 1.0% reduction in body mass. CONCLUSIONS Female professional tennis players are subjected to high heat loads during match play in hot environments. However, a 10-minute break in play decreased core temperature in 6 of 7 players by an average of 0.25°C, indicating that the break provides practical benefits in the field. Furthermore, although mean sweat rate in this group of female tennis players was high, most athletes were still able to minimize mass loss to less than 2% of their prematch weight.

Normative data for regional sweat sodium concentration and whole-body sweating rate in athletes

Abstract The purpose of this study was to establish normative data for regional sweat sodium concentration ([Na+]) and whole-body sweating rate in athletes. Data from 506 athletes (367 adults, 139 youth; 404 male, 102 female) were compiled from observational athlete testing for a retrospective analysis. The participants were skill/team-sport (including American football, baseball, basketball, soccer and tennis) and endurance (including cycling, running and triathlon) athletes exercising in cool to hot environmental conditions (15–50°C) during training or competition in the laboratory or field. A standardised regional absorbent patch technique was used to determine sweat [Na+] on the dorsal mid-forearm. Whole-body sweat [Na+] was predicted using a published regression equation (y = 0.57x+11.05). Whole-body sweating rate was calculated from pre- to post-exercise change in body mass, corrected for fluid/food intake (ad libitum) and urine output. Data are expressed as mean ± SD (range). Forearm sweat [Na+] and predicted whole-body sweat [Na+] were 43.6 ± 18.2 (12.6–104.8) mmol · L–1 and 35.9 ± 10.4 (18.2–70.8) mmol · L–1, respectively. Absolute and relative whole-body sweating rates were 1.21 ± 0.68 (0.26–5.73) L · h–1 and 15.3 ± 6.8 (3.3–69.7) ml · kg–1 · h–1, respectively. This retrospective analysis provides normative data for athletes’ forearm and predicted whole-body sweat [Na+] as well as absolute and relative whole-body sweating rate across a range of sports and environmental conditions.

Core Temperature and Metabolic Responses After Carbohydrate Intake During Exercise at 30°C

CONTEXT Carbohydrate ingestion has recently been associated with elevated core temperature during exercise in the heat when testing for ergogenic effects. Whether the association holds when metabolic rate is controlled is unclear. Such an effect would have undesirable consequences for the safety of the athlete. OBJECTIVE To examine whether ingesting fluids containing carbohydrate contributed to an accelerated rise in core temperature and greater overall body heat production during 1 hour of exercise at 30 degrees C when the effort was maintained at steady state. DESIGN Crossover design (repeated measures) in randomized order of treatments of drinking fluids with carbohydrate and electrolytes (CHO) or flavored-water placebo with electrolytes (PLA). The beverages were identical except for the carbohydrate content: CHO = 93.7 +/- 11.2 g, PLA = 0 g. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Nine physically fit, endurance-trained adult males. INTERVENTION(S) Using rectal temperature sensors, we measured core temperature during 30 minutes of rest and 60 minutes of exercise at 65% of maximal oxygen uptake (Vo(2) max) in the heat (30.6 degrees C, 51.8% relative humidity). Participants drank equal volumes (1.6 L) of 2 beverages in aliquots 30 minutes before and every 15 minutes during exercise. Volumes were fixed to approximate sweat rates and minimize dehydration. MAIN OUTCOME MEASURE(S) Rectal temperature and metabolic response (Vo(2), heart rate). RESULTS Peak temperature, rate of temperature increase, and metabolic responses did not differ between beverage treatments. Initial hydration status, sweat rate, and fluid replacement were also not different between trials, as planned. CONCLUSIONS Ingestion of carbohydrate in fluid volumes that minimized dehydration during 1 hour of steady-state exercise at 30 degrees C did not elicit an increase in metabolic rate or core temperature.

Serum Sodium Concentration Changes Are Related to Fluid Balance and Sweat Sodium Loss

PURPOSE This study determined if changes in serum sodium concentration are related to fluid balance as well as sweat sodium losses in triathletes competing in the Hawaii Ironman triathlon. METHODS Endurance trained athletes (N = 46, age = 24-67 yr) were studied during 30 min of stationary cycling at 70%-75% of HRmax in a warm outdoor laboratory (26.4 degrees C +/- 1.7 degrees C wet bulb globe temperature [WBGT], 28.3 degrees C +/- 1.2 degrees C dry bulb [DB]) 3-7 d before race day. Sweat sodium concentration was measured from absorbent patches on the forearm and scapula, and sweating rate was derived from changes in body mass. Before and after the race, serum sodium concentration, body mass, and nutritional intake during the race were also measured (N = 46). Sweating and race day comparisons and changes in serum sodium concentration were analyzed via Students t-test, correlation, and multiple regression. RESULTS In men, the change in serum sodium concentration during the race was correlated with relative sweating rate (mL.kg.h; r = -0.49, P = 0.012), rate of sweat sodium loss (mEq.kg.h; r = -0.44, P = 0.023), and body mass change (kg; r = -0.54, P = 0.005). Together, the rate of sweat sodium loss and body mass change accounted for 46% of the change in serum sodium concentration in men (R = 0.46). In women, body mass change alone was significantly correlated with the change in serum sodium concentration (r = 0.31). The rate of sodium intake (mEq.kg.h) was related to the rate of sweat sodium loss in women (mEq.kg.h; r = 0.64, P = 0.035) but not in men (r = 0.27, P = 0.486). CONCLUSION Changes in serum sodium concentration during an ultraendurance triathlon are significantly related to interactions of fluid balance, sweat sodium loss, and sodium ingestion.

Validity and reliability of a field technique for sweat Na+ and K+ analysis during exercise in a hot‐humid environment

This study compared a field versus reference laboratory technique for extracting (syringe vs. centrifuge) and analyzing sweat [Na+] and [K+] (compact Horiba B‐722 and B‐731, HORIBA vs. ion chromatography, HPLC) collected with regional absorbent patches during exercise in a hot‐humid environment. Sweat samples were collected from seven anatomical sites on 30 athletes during 1‐h cycling in a heat chamber (33°C, 67% rh). Ten minutes into exercise, skin was cleaned/dried and two sweat patches were applied per anatomical site. After removal, one patch per site was centrifuged and sweat was analyzed with HORIBA in the heat chamber (CENTRIFUGE HORIBA) versus HPLC (CENTRIFUGE HPLC). Sweat from the second patch per site was extracted using a 5‐mL syringe and analyzed with HORIBA in the heat chamber (SYRINGE HORIBA) versus HPLC (SYRINGE HPLC). CENTRIFUGE HORIBA, SYRINGE HPLC, and SYRINGE HORIBA were highly related to CENTRIFUGE HPLC ([Na+]: ICC = 0.96, 0.94, and 0.93, respectively; [K+]: ICC = 0.87, 0.92, and 0.84, respectively), while mean differences from CENTRIFUGE HPLC were small but usually significant ([Na+]: 4.7 ± 7.9 mEql/L, −2.5 ± 9.3 mEq/L, 4.0 ± 10.9 mEq/L (all P < 0.001), respectively; [K+]: 0.44 ± 0.52 mEq/L (P < 0.001), 0.01 ± 0.49 mEq/L (P = 0.77), 0.50 ± 0.48 mEq/L (P < 0.001), respectively). On the basis of typical error of the measurement results, sweat [Na+] and [K+] obtained with SYRINGE HORIBA falls within ±15.4 mEq/L and ±0.68 mEq/L, respectively, of CENTRIFUGE HPLC 95% of the time. The field (SYRINGE HORIBA) method of extracting and analyzing sweat from regional absorbent patches may be useful in obtaining sweat [Na+] when rapid estimates in a hot‐humid field setting are needed.

Body map of regional vs. whole body sweating rate and sweat electrolyte concentrations in men and women during moderate exercise-heat stress

This study determined the relations between regional (REG) and whole body (WB) sweating rate (RSR and WBSR, respectively) as well as REG and WB sweat Na+ concentration ([Na+]) during exercise. Twenty-six recreational athletes (17 men, 9 women) cycled for 90 min while WB sweat [Na+] was measured using the washdown technique. RSR and REG sweat [Na+] were measured from nine regions using absorbent patches. RSR and REG sweat [Na+] from all regions were significantly ( P < 0.05) correlated with WBSR ( r = 0.58-0.83) and WB sweat [Na+] ( r = 0.74-0.88), respectively. However, the slope and y-intercept of the regression lines for most models were significantly different than 1 and 0, respectively. The coefficients of determination ( r2) were 0.44-0.69 for RSR predicting WBSR [best predictors: dorsal forearm ( r2 = 0.62) and triceps ( r2 = 0.69)] and 0.55-0.77 for REG predicting WB sweat [Na+] [best predictors: ventral forearm ( r2 = 0.73) and thigh ( r2 = 0.77)]. There was a significant ( P < 0.05) effect of day-to-day variability on the regression model predicting WBSR from RSR at most regions but no effect on predictions of WB sweat [Na+] from REG. Results suggest that REG cannot be used as a direct surrogate for WB sweating responses. Nonetheless, the use of regression equations to predict WB sweat [Na+] from REG can provide an estimation of WB sweat [Na+] with an acceptable level of accuracy, especially using the forearm or thigh. However, the best practice for measuring WBSR remains conventional WB mass balance calculations since prediction of WBSR from RSR using absorbent patches does not meet the accuracy or reliability required to inform fluid intake recommendations. NEW & NOTEWORTHY This study developed a body map of regional sweating rate and regional (REG) sweat electrolyte concentrations and determined the effect of within-subject (bilateral and day-to-day) and between-subject (sex) factors on the relations between REG and the whole body (WB). Regression equations can be used to predict WB sweat Na+ concentration from REG, especially using the forearm or thigh. However, prediction of WB sweating rate from REG sweating rate using absorbent patches does not reach the accuracy or reliability required to inform fluid intake recommendations.

Trapped sweat in basketball uniforms and the effect on sweat loss estimates

The aims of this study were to determine: (1) trapped sweat (TS) in basketball uniforms and the effect on sweat loss (SL) estimates during a laboratory‐based basketball simulation protocol; (2) the impact of exercise intensity, body mass, age, and SL on TS; and (3) TS during on‐court training to assess the ecological validity of the laboratory‐based results. Twenty‐four recreational/competitive male basketball players (23 ± 10 years, 77.0 ± 16.7 kg) completed three randomized laboratory‐based trials (Low, Moderate, and High intensity) consisting of 150‐min intermittent exercise. Eighteen elite male players (23 ± 4 years, 92.0 ± 20.6 kg) were observed during coach‐led, on‐court training. Nude and clothed body mass were measured pre and postexercise to determine TS. Data are mean ± SD. There was a significant effect of intensity on SL and TS (P < 0.001, Low