John W. Castellani

Bioimpedance spectroscopy technique: intra-, extracellular, and total body water

The purpose of this study was to test the validity of a multiple frequency bioimpedance spectroscopy (BIS) technique that estimates extracellular fluid volume (ECV), intracellular fluid volume (ICV), and total body water (TBW). Thirteen healthy males (mean +/- SD: age, 23 +/- 3 yr; body mass, 80.6 +/- 14.7 kg) had their TBW and ECV measured by ingesting dilution tracers (7.27 g deuterium oxide, 1.70 g sodium bromide; blood samples at 0 and 4 h). ICV was calculated as TBW minus ECV. Impedance was measured (50-500 kHz) at rest, on a nonconducting surface, with a BIS analyzer. Electrode placement, posture, exercise, food/fluid intake, and ambient temperature were controlled. Dilution measures (TBW, 51.00 +/- 9.30; ECV, 19.88 +/- 3.14; ICV, 31.12 +/- 6.80 L) and BIS volumes (TBW, 50.03 +/- 7.67; ECV, 20.95 +/- 3.33; ICV, 29.04 +/- 4.51 L) were significantly different for ECV (P < 0.01) and ICV (P < 0.05); some individual differences were large. The correlation coefficients of dilution versus BIS volumes (r = 0.93 to 0.96) were significant at P < 0.0001; SEEs were: TBW, 2.23 L; ECV, 1.26 L; and ICV, 1.71 L. We concluded that BIS is valid for between-subject comparisons of body fluid compartments, is appropriate in clinical settings where change in ECV/ICV ratio is important, and should be used by comparing the required level of accuracy to the inherent technique error/variance.

Effects of hydration state on plasma testosterone, cortisol and catecholamine concentrations before and during mild exercise at elevated temperature.

This investigation examined the influence of pre-exercise hydration status, and water intake during low intensity exercise (5.6 km · h−1 at 5% gradient) in the heat (33° C), on plasma testosterone (TEST), cortisol (CORT), adrenaline (A), and noradrenaline (NA) concentrations at baseline (BL), pre-exercise (PRE), and immediately (IP), 24 h (24 P), and 48 h postexercise (48 P). Ten active men participated in four experimental treatments. These treatments differed in preexercise hydration status [euhydrated or hypohydrated (HY, −3.8 (SD 0.7)% body mass)] and water intake during exercise (water ad libitum or no water intake during exercise, NW). There were no significant changes in TEST, CORT, or A concentrations with time (BL, PRE, IP, 24 P, and 48 P), or among treatments. However, significant increases from BL and PRE plasma NA concentrations were observed at IP during all four treatment conditions. In addition, HY + NW resulted in significantly higher plasma NA concentrations at IP compared to all other treatments. These results suggest that moderate levels of hypohydration during prolonged, low intensity exercise in the heat do not influence plasma TEST, CORT, or A concentrations. However, plasma NA appears to respond in a sensitive manner to these hydration and exercise stresses.

Hydration effects on cognitive performance during military tasks in temperate and cold environments

Body water deficits or hypohydration (HYP) may degrade cognitive performance during heat exposure and perhaps temperate conditions. Cold exposure often induces HYP, but the combined effects of cold and HYP on cognitive performance are unknown. This study investigated whether HYP degrades cognitive performance during cold exposure and if physical exercise could mitigate any cold-induced performance decline. On four occasions, eight volunteers completed one hour of militarily-relevant cognitive testing: 30 min of simulated sentry duty/marksmanship, 20 min of a visual vigilance task, a self-report workload assessment, and a mood questionnaire. Testing was conducted in a cold (2 degrees C) or temperate (20 degrees C) environment before and after cycle ergometer (60 min at 60% of VO(2peak)) exercise. Each trial was preceded by 3 h of passive heat stress (45 degrees C) in the early morning with (euhydration, EUH) or without (hypohydration, HYP; 3% body mass) fluid replacement followed by prolonged recovery. HYP did not alter any cognitive, psychomotor, or self-report parameter in either environment before or after exercise. Cold exposure increased (p<0.05) target detection latency in the sentry duty task, adversely affected mood and workload ratings, but had no impact on any other cognitive or psychomotor measure. After completing the exercise bout, there were modest improvements in friend-foe discrimination and total response latency in the sentry duty task, but not on any other performance measures. Moderate HYP had no effect on cognitive and psychomotor performance in either environment, cold exposure produced equivocal effects, and aerobic exercise improved some aspects of military task performance.

Physiological Employment Standards III: physiological challenges and consequences encountered during international military deployments

Modern international military deployments in austere environments (i.e., Iraq and Afghanistan) place considerable physiological demands on soldiers. Significant physiological challenges exist: maintenance of physical fitness and body composition, rigors of external load carriage, environmental extremes (heat, cold, and altitude), medical illnesses, musculoskeletal injuries, traumatic brain injuries, post-traumatic stress disorder, and environmental exposure hazards (i.e., burn pits, vehicle exhaust, etc.). To date there is very little published research and no comprehensive reviews on the physiological effects of deployments. The purpose of this paper is to overview what is currently known from the literature related mainly to current military conflicts with regard to the challenges and consequences from deployments. Summary findings include: (1) aerobic capacity declines while muscle strength, power and muscular endurance appear to be maintained, (2) load carriage continues to tax the physical capacities of the Soldier, (3) musculoskeletal injuries comprise the highest proportion of all injury categories, (4) environmental insults occur from both terrestrial extremes and pollutant exposure, and (5) post-deployment concerns linger for traumatic brain injury and post-traumatic stress disorder. A full understanding of these responses will assist in identifying the most effective risk mitigation strategies to ensure deployment readiness and to assist in establishment of military employment standards.

Reliability assessment of ballistic jump squats and bench throws.

The purpose of this investigation was to determine the test-retest reliability and coefficient of variation of 2 novel physical performance tests. Ten healthy men (22.0 ± 3.0 years, 87.0 ± 8.0 kg, 20.0 ± 5.0% body fat) performed 30 continuous and dynamic jump squats (JS) and bench throws (BT) on 4 separate occasions. The movements were performed under loaded conditions utilizing 30% of subjects predetermined 1 repetition maximum in the back squat and bench press. Mean power (MP; W), peak power (PP; W), mean velocity (MV; m·s-1), peak velocity (PV; m·s-1), and total work (TW; J) were assessed using a ballistic measurement system (Innervations Inc., Muncie, IN). Data were analyzed using repeated measures analysis of variance with Duncans post hoc test when mean differences were p ≤ 0.05. Intraclass correlation coefficient (ICC) and within-subject coefficient of variation (CV%) were also calculated. All values are presented as mean 6 SE. BT variables were statistically similar across the 4 sessions: MP (350.0 ± 13.9 W), PP (431.4 ± 18.5 W) MV (1.6 6 0.03 m·s-1), PV (2.0 ± 0.03 m·s-1), and TW (199.1 ± 7.2 J). For JS, session 3 PP (1,669.8 ± 111.2 W) was significantly greater vs. sessions 1, 2, and 4 (1,601.2 ± 58.4 W). Session 4 MP (1,403.2 ± 88.6 W) and MV (1.9 6 0.1 m·s-1) for JS were significantly lower during sessions 1, 2, and 3 (MP: 1,479.4.5 ± 44.8 W, MV: 2.0 ± 0.05 m·s-1). TW (834.7 ± 24.3 J) and PV (2.2 ± 0.04 m·s-1) were staistically similar during all sessions for JS. The CVs ranged from 3.0 to 7.6% for the BT and 3.2 to 5.7% for the JS. ICCs for MP, PP, MV, PV, and TW were 0.92, 0.95, 0.94, 0.91, and 0.95, respectively, during BT. ICCs during JS for MP, PP, MV, PV, and TW were 0.96, 0.98, 0.94, 0.94, and 0.89, respectively. The results of the current study support the use of a 30 continuous and dynamic BT protocol as a reliable upper-body physical performance test, which can be administered with minimal practice. Slightly greater variability for JS was observed, although the test had high reliability.

Effects of oral and intravenous rehydration on ratings of perceived exertion and thirst

The purpose of this investigation was to compare the effects of oral and intravenous saline rehydration on differentiated ratings of perceived exertion (RPE) and thirst. Eight men underwent three randomly assigned rehydration treatments following a 2- to 4-h exercise-induced dehydration bout to reduce body weight by 4%. Treatments included 0.45% saline infusion (i.v.), 0.45% saline oral ingestion (ORAL), and no fluid (NF). Following rehydration and rest (2 h total), subjects walked at 50% VO2max for 90 min at 36 degrees C (EX). Central RPE during ORAL was lower (P < 0.05) than i.v. and NF throughout EX. Local RPE during NF was higher (P < 0.05) than i.v. and ORAL at minutes 20 and 40 of EX and overall RPE during NF was higher (P < 0.05) than ORAL at minutes 20 and 40 of EX. Significant correlations were found between overall RPE and mean skin temperature for i.v. (r = 0.72) and NF (r = 0.75), and between overall RPE and thirst ratings for i.v. (r = 0.70). Thirst ratings were not different among trials at postdehydration. Following rehydration, thirst was higher (P < 0.05) during NF than i.v. and ORAL and lower (P < 0.05) during ORAL than i.v. at all subsequent time points. Results suggest that oral rehydration is likely to elicit lower RPE and thirst ratings compared with intravenous rehydration.

Human physiological responses to cold exposure: Acute responses and acclimatization to prolonged exposure

Cold exposure in humans causes specific acute and chronic physiological responses. This paper will review both the acute and long-term physiological responses and external factors that impact these physiological responses. Acute physiological responses to cold exposure include cutaneous vasoconstriction and shivering thermogenesis which, respectively, decrease heat loss and increase metabolic heat production. Vasoconstriction is elicited through reflex and local cooling. In combination, vasoconstriction and shivering operate to maintain thermal balance when the body is losing heat. Factors (anthropometry, sex, race, fitness, thermoregulatory fatigue) that influence the acute physiological responses to cold exposure are also reviewed. The physiological responses to chronic cold exposure, also known as cold acclimation/acclimatization, are also presented. Three primary patterns of cold acclimatization have been observed, a) habituation, b) metabolic adjustment, and c) insulative adjustment. Habituation is characterized by physiological adjustments in which the response is attenuated compared to an unacclimatized state. Metabolic acclimatization is characterized by an increased thermogenesis, whereas insulative acclimatization is characterized by enhancing the mechanisms that conserve body heat. The pattern of acclimatization is dependent on changes in skin and core temperature and the exposure duration.

Effect of hypohydration and altitude exposure on aerobic exercise performance and acute mountain sickness

Hypoxia often causes body water deficits (hypohydration, HYPO); however, the effects of HYPO on aerobic exercise performance and prevalence of acute mountain sickness (AMS) at high altitude (ALT) have not been reported. We hypothesized that 1) HYPO and ALT would each degrade aerobic performance relative to sea level (SL)-euhydrated (EUH) conditions, and combining HYPO and ALT would further degrade performance more than one stressor alone; and 2) HYPO would increase the prevalence and severity of AMS symptoms. Seven lowlander men (25 ± 7 yr old; 82 ± 11 kg; mean ± SD) completed four separate experimental trials. Trials were 1) SL-EUH, 2) SL-HYPO, 3) ALT-EUH, and 4) ALT-HYPO. In HYPO, subjects were dehydrated by 4% of body mass. Subjects maintained hydration status overnight and the following morning entered a hypobaric chamber (at SL or 3,048 m, 27°C) where they completed 30 min of submaximal exercise immediately followed by a 30-min performance time trial (TT). AMS was measured with the Environmental Symptoms Questionnaire-Cerebral Score (AMS-C) and the Lake Louise Scoring System (LLS). The percent change in TT performance, relative to SL-EUH, was -19 ± 12% (334 ± 64 to 278 ± 87 kJ), -11 ± 10% (334 ± 64 to 293 ± 33 kJ), and -34 ± 22% (334 ± 64 to 227 ± 95 kJ), for SL-HYPO, ALT-EUH, and ALT-HYPO, respectively. AMS symptom prevalence was 2/7 subjects at ALT-EUH for AMS-C and LLS and 5/7 and 4/7 at ALT-HYPO for AMS-C and LLS, respectively. The AMS-C symptom severity score (AMS-C score) tended to increase from ALT-EUH to ALT-HYPO but was not significant (P = 0.07). In conclusion, hypohydration at 3,048 m 1) degrades aerobic performance in an additive manner with that induced by ALT; and 2) did not appear to increase the prevalence/severity of AMS symptoms.

Exertion-induced fatigue and thermoregulation in the cold

Cold exposure facilitates body heat loss which can reduce body temperature, unless mitigated by enhanced heat conservation or increased heat production. When behavioral strategies inadequately defend body temperature, vasomotor and thermogenic responses are elicited, both of which are modulated if not mediated by sympathetic nervous activation. Both exercise and shivering increase metabolic heat production which helps offset body heat losses in the cold. However, exercise also increases peripheral blood flow, in turn facilitating heat loss, an effect that can persist for some time after exercise ceases. Whether exercise alleviates or exacerbates heat debt during cold exposure depends on the heat transfer coefficient of the environment, mode of activity and exercise intensity. Prolonged exhaustive exercise leading to energy substrate depletion could compromise maintenance of thermal balance in the cold simply by precluding continuation of further exercise and the associated thermogenesis. Hypoglycemia impairs shivering, but this appears to be centrally mediated, rather than a limitation to peripheral energy metabolism. Research is equivocal regarding the importance of muscle glycogen depletion in explaining shivering impairments. Recent research suggests that when acute exercise leads to fatigue without depleting energy stores, vasoconstrictor responses to cold are impaired, thus body heat conservation becomes degraded. Fatigue that was induced by chronic overexertion sustained over many weeks, appeared to delay the onset of shivering until body temperature fell lower than when subjects were rested, as well as impair vasoconstrictor responses. When heavy physical activity is coupled with underfeeding for prolonged periods, the resulting negative energy balance leads to loss of body mass, and the corresponding reduction in tissue insulation, in turn, compromises thermal balance by facilitating conductive transfer of body heat from core to shell. The possibility that impairments in thermoregulatory responses to cold associated with exertional fatigue are mediated by blunted sympathetic nervous responsiveness to cold is suggested by some experimental observations and merits further study.

Cognitive function and mood during acute cold stress after extended military training and recovery.

INTRODUCTION Acute cold stress is often accompanied by exposure to other adverse factors, such as sleep loss, under-nutrition, and psychological stress that singly and together may affect cognitive function. METHODS The effect of moderate cold stress on cognitive function was investigated in 15 male volunteers exposed to cold air (10 degrees C) for 4 h after they had completed an intense, 61-d regimen (U.S. Army Ranger training). The single cohort of volunteers was tested on three separate occasions: (1) immediately after completing Ranger training; (2) 2 d later when they had partially recovered from training; (3) 108 d later after full recovery. Documented training stressors included limited sleep (approximately 4 h sleep/night), caloric deficit (approximately 850 kcal x d(-1), intense physical activity, and psychological stress. RESULTS Baseline rectal temperature fell significantly due to training alone (from 36.6 degrees C +/- 0.1 to 36.3 degrees C +/- 0.1) and was lower still with acute cold exposure (35.9 degrees C +/- 0.2). Cognitive function was affected by training alone, as indicated by significant decreases in vigilance, four-choice reaction time, pattern recognition, symbol-digit substitution, word-list learning, grammatical reasoning, and mood prior to exposure to acute cold stress. Mood states were also adversely affected, including tension, depression, anger, fatigue, confusion, and vigor. Acute cold exposure itself significantly degraded vigilance, overall mood, and increased tension. DISCUSSION Chronic multifactorial stress impaired cognitive function and mood; the addition of moderate, acute cold stress further degraded vigilance and mood. When such circumstances occur, such as during disasters or military operations, measures to prevent adverse cognitive and physiological outcomes are recommended.