Nicholas M. Beltz

Graded Exercise Testing Protocols for the Determination of VO2max: Historical Perspectives, Progress, and Future Considerations

Graded exercise testing (GXT) is the most widely used assessment to examine the dynamic relationship between exercise and integrated physiological systems. The information from GXT can be applied across the spectrum of sport performance, occupational safety screening, research, and clinical diagnostics. The suitability of GXT to determine a valid maximal oxygen consumption (VO2max) has been under investigation for decades. Although a set of recommended criteria exists to verify attainment of VO2max, the methods that originally established these criteria have been scrutinized. Many studies do not apply identical criteria or fail to consider individual variability in physiological responses. As an alternative to using traditional criteria, recent research efforts have been directed toward using a supramaximal verification protocol performed after a GXT to confirm attainment of VO2max. Furthermore, the emergence of self-paced protocols has provided a simple, yet reliable approach to designing and administering GXT. In order to develop a standardized GXT protocol, additional research should further examine the utility of self-paced protocols used in conjunction with verification protocols to elicit and confirm attainment of VO2max.

Effect of Acute Dietary Nitrate Consumption on Oxygen Consumption During Submaximal Exercise in Hypobaric Hypoxia

Reduced partial pressure of oxygen impairs exercise performance at altitude. Acute nitrate supplementation, at sea level, may reduce oxygen cost during submaximal exercise in hypobaric hypoxia. Therefore, we investigated the metabolic response during exercise at altitude following acute nitrate consumption. Ten well-trained (61.0 ± 7.4 ml/kg/min) males (age 28 ± 7 yr) completed 3 experimental trials (T1, T2, T3). T1 included baseline demographics, a maximal aerobic capacity test (VO2max) and five submaximal intensity cycling determination bouts at an elevation of 1600 m. A 4-day dietary washout, minimizing consumption of nitrate-rich foods, preceded T2 and T3. In a randomized, double-blind, placebo-controlled, crossover fashion, subjects consumed either a nitrate-depleted beetroot juice (PL) or ~12.8 mmol nitrate rich (NR) beverage 2.5 hr before T2 and T3. Exercise at 3500 m (T2 and T3) via hypobaric hypoxia consisted of a 5-min warm-up (25% of normobaric VO2max) and four 5-min cycling bouts (40, 50, 60, 70% of normobaric VO2max) each separated by a 4-min rest period. Cycling RPM and watts for each submaximal bout during T2 and T3 were determined during T1. Preexercise plasma nitrite was elevated following NR consumption compared with PL (1.4 ± 1.2 and 0.7 ± 0.3 uM respectively; p < .05). There was no difference in oxygen consumption (-0.5 ± 1.8, 0.1 ± 1.7, 0.7 ± 2.1, and 1.0 ± 3.0 ml/kg/min) at any intensity (40, 50, 60, 70% of VO2max, respectively) between NR and PL. Further, respiratory exchange ratio, oxygen saturation, heart rate and rating of perceived exertion were not different at any submaximal intensity between NR and PL either. Blood lactate, however, was reduced following NR consumption compared with PL at 40 and 60% of VO2max (p < .0.05). Our findings suggest that acute nitrate supplementation before exercise at 3500 m does not reduce oxygen cost but may reduce blood lactate accumulation at lower intensity workloads.

Hemodynamic and metabolic responses to self-paced and ramp-graded exercise testing protocols

Recent examinations have shown lower maximal oxygen consumption during traditional ramp (RAMP) compared with self-paced (SPV) graded exercise testing (GXT) attributed to differences in cardiac output. The current study examined the differences in hemodynamic and metabolic responses between RAMP and SPV during treadmill exercise. Sixteen recreationally trained men (aged23.7 ± 3.0 years) completed 2 separate treadmill GXT protocols. SPV consisted of five 2-min stages (10 min total) of increasing speed clamped by the Borg RPE6-20 scale. RAMP increased speed by 0.16 km/h every 15 s until volitional exhaustion. All testing was performed at 3% incline. Oxygen consumption was measured via indirect calorimetry; hemodynamic function was measured via thoracic impedance and blood lactate (BLa-) was measured via portable lactate analyzer. Differences between SPV and RAMP protocols were analyzed as group means by using paired-samples t tests (R Core Team 2017). Maximal values for SPV and RAMP were similar (p > 0.05) for oxygen uptake (47.1 ± 3.4 vs. 47.4 ± 3.4 mL·kg-1·min-1), heart rate (198 ± 5 vs. 200 ± 6 beats·min-1), ventilation (158.8 ± 20.7 vs. 159.3 ± 19.0 L·min-1), cardiac output (26.9 ± 5.5 vs. 27.9 ± 4.2 L·min-1), stroke volume (SV) (145.9 ± 29.2 vs. 149.8 ± 25.3 mL·beat-1), arteriovenous oxygen difference (18.5 ± 3.1 vs. 19.7 ± 3.1 mL·dL-1), ventilatory threshold (VT) (78.2 ± 7.2 vs. 79.0% ± 7.6%), and peak BLa- (11.7 ± 2.3 vs. 11.5 ± 2.4 mmol·L-1), respectively. In conclusion, SPV elicits similar maximal hemodynamic responses in comparison to RAMP; however, SV kinetics exhibited unique characteristics based on protocol. These results support SPV as a feasible GXT protocol to identify useful fitness parameters (maximal oxygen uptake, oxygen uptake kinetics, and VT).

Nitrate-Containing Beetroot Juice Reduces Oxygen Consumption During Submaximal Exercise in Low but Not High Aerobically Fit Male Runners

[Purpose] To examine the effect of a 4-day NO3- loading protocol on the submaximal oxygen cost of both low fit and high fit participants at five different exercise intensities. [Methods] Eleven (6 high fit, VO2max 60.1 ± 4.6ml/kg/min; 5 low fit, VO2max 42.4 ± 3.2ml/ kg/min) participants were initially assigned to a placebo (PL; negligible NO3-) or inorganic nitrate-rich (NR; 6.2 mmol nitrate/day) group using a double-blind, placebo-controlled, crossover design. Participants completed three trials (T1, T2 and T3). T1 included a maximal aerobic capacity (VO2max) treadmill test. A 6-day washout, minimizing nitrate consumption, preceded T2. Each of the four days prior to T2 and T3, participants consumed either PL or NR with the final dose 2.5 hours prior to exercise. A 14-day washout followed T2. T2 and T3 consisted of 5-minute submaximal treadmill bouts (45, 60, 70, 80 and 85% VO2max) determined during T1. [Results] Low fit nitrate-supplemented participants consumed less oxygen (p<0.05) at lower workloads (45% and 60% VO2max) compared to placebo trials; changes were not observed in high fit participants. The two lowest intensity workloads of 45 and 60% VO2max revealed the greatest correlation (r=0.54, p=0.09 and r=0.79, p<0.05; respectively) between VO2max and change in oxygen consumption. No differences were found between conditions for heart rate, respiratory exchange ratio or rating of perceived exertion for either fitness group. [Conclusion] Nitrate consumption promotes reduced oxygen consumption at lower exercise intensities in low fit, but not high fit males. Lesser fit individuals may receive greater benefit than higher fit participants exercising at intensities <60% VO2max.