Patrick B. Wilson

Psoriasis and physical activity: a review.

Psoriasis is a common, chronic inflammatory skin disease that can cause significant discomfort and impairment to quality of life. Recent research indicates that individuals with moderate‐to‐severe psoriasis are likely at greater risk for chronic cardiometabolic co‐morbidities such as cardiovascular disease, type 2 diabetes, obesity and metabolic syndrome. Physical activity can be an effective primary and adjunctive treatment for these maladies in other populations. Unfortunately, only a limited number of studies have examined physical activity in psoriasis, which are limited by poor design and lack of validated physical activity assessment methodologies. A variety of data suggest shared physiologic pathways between physical activity, psoriasis, and psoriasis cardiometabolic co‐morbidities. Increased adiposity, inflammation, oxidative stress, adhesion molecules and lipids are physiologically linked to psoriasis, the risk of psoriasis cardiometabolic co‐morbidities, and low levels of physical activity. In addition, epigenetic pathways are involved in psoriasis and could be influenced by physical activity. The physical and psychosocial impairments common in psoriasis may make it difficult to participate in regular physical activity, and future studies should aim to determine if physical activity interventions improve functioning and reduce co‐morbidities in psoriasis.

Psoriasis and physical activity

Psoriasis is a common, chronic inflammatory skin disease that can cause significant discomfort and impairment to quality of life. Recent research indicates that individuals with moderate‐to‐severe psoriasis are likely at greater risk for chronic cardiometabolic co‐morbidities such as cardiovascular disease, type 2 diabetes, obesity and metabolic syndrome. Physical activity can be an effective primary and adjunctive treatment for these maladies in other populations. Unfortunately, only a limited number of studies have examined physical activity in psoriasis, which are limited by poor design and lack of validated physical activity assessment methodologies. A variety of data suggest shared physiologic pathways between physical activity, psoriasis, and psoriasis cardiometabolic co‐morbidities. Increased adiposity, inflammation, oxidative stress, adhesion molecules and lipids are physiologically linked to psoriasis, the risk of psoriasis cardiometabolic co‐morbidities, and low levels of physical activity. In addition, epigenetic pathways are involved in psoriasis and could be influenced by physical activity. The physical and psychosocial impairments common in psoriasis may make it difficult to participate in regular physical activity, and future studies should aim to determine if physical activity interventions improve functioning and reduce co‐morbidities in psoriasis.

Glucose‐fructose likely improves gastrointestinal comfort and endurance running performance relative to glucose‐only

This study aimed to determine whether glucose‐fructose (GF) ingestion, relative to glucose‐only, would alter performance, metabolism, gastrointestinal (GI) symptoms, and psychological affect during prolonged running. On two occasions, 20 runners (14 men) completed a 120‐min submaximal run followed by a 4‐mile time trial (TT). Participants consumed glucose‐only (G) or GF (1.2:1 ratio) beverages, which supplied ∼ 1.3 g/min of carbohydrate. Substrate use, blood lactate, psychological affect [Feeling Scale (FS)], and GI distress were measured. Differences between conditions were assessed using magnitude‐based inferential statistics. Participants completed the TT 1.9% (−1.9; −4.2, 0.4) faster with GF, representing a likely benefit. FS ratings were possibly higher and GI symptoms were possibly‐to‐likely lower with GF during the submaximal period and TT. Effect sizes for GI distress and FS ratings were relatively small (Cohens d = ∼0.2 to 0.4). GF resulted in possibly higher fat oxidation during the submaximal period. No clear differences in lactate were observed. In conclusion, GF ingestion – compared with glucose‐only – likely improves TT performance after 2 h of submaximal running, and GI distress and psychological affect are likely mechanisms. These results apply to runners consuming fluid at 500–600 mL/h and carbohydrate at 1.0–1.3 g/min during running at 60–70% VO2peak.

Ginger (Zingiber officinale) as an Analgesic and Ergogenic Aid in Sport: A Systemic Review

Ginger is a popular spice used to treat a variety of maladies, including pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used by athletes to manage and prevent pain; unfortunately, NSAIDs contribute to substantial adverse effects, including gastrointestinal (GI) dysfunction, exercise-induced bronchoconstriction, hyponatremia, impairment of connective tissue remodeling, endurance competition withdrawal, and cardiovascular disease. Ginger, however, may act as a promoter of GI integrity and as a bronchodilator. Given these potentially positive effects of ginger, a systematic review of randomized trials was performed to assess the evidence for ginger as an analgesic and ergogenic aid for exercise training and sport. Among 7 studies examining ginger as an analgesic, the evidence indicates that roughly 2 g·d(-1) of ginger may modestly reduce muscle pain stemming from eccentric resistance exercise and prolonged running, particularly if taken for a minimum of 5 days. Among 9 studies examining ginger as an ergogenic aid, no discernable effects on body composition, metabolic rate, oxygen consumption, isometric force generation, or perceived exertion were observed. Limited data suggest that ginger may accelerate recovery of maximal strength after eccentric resistance exercise and reduce the inflammatory response to cardiorespiratory exercise. Major limitations to the research include the use of untrained individuals, insufficient reporting on adverse events, and no direct comparisons with NSAID ingestion. While ginger taken over 1-2 weeks may reduce pain from eccentric resistance exercise and prolonged running, more research is needed to evaluate its safety and efficacy as an analgesic for a wide range of athletic endeavors.

Multiple Transportable Carbohydrates During Exercise: Current Limitations and Directions for Future Research.

Abstract Wilson, PB. Multiple transportable carbohydrates during exercise: Current limitations and directions for future research. J Strength Cond Res 29(7): 2056–2070, 2015—The concept of multiple transportable carbohydrates (MTC) refers to a combination of saccharides that rely on distinct transporters for intestinal absorption. Ingestion of MTC during prolonged exercise has been purported to increase carbohydrate absorption efficiency, increase exogenous carbohydrate oxidation, reduce gastrointestinal (GI) distress, and improve athletic performance when carbohydrate intake is high (>50–60 g·h−1). Although reviews of MTC research have been published previously, a comprehensive literature evaluation underscoring methodological limitations has not been conducted to guide future work. Accordingly, this review outlined the plausible mechanisms of MTC and subsequently evaluated MTC research based on several factors, including participant characteristics, exercise modality, exercise task, treatment formulation, treatment blinding, and pre-exercise nutrition status. A total of 27 articles examining MTC during exercise were identified and reviewed. Overall, ingestion of MTC led to increased exogenous carbohydrate oxidation, reduced GI distress, and improved performance during cycling lasting ≥2.5 hours, particularly when carbohydrate was ingested at ≥1.2 g·min−1. Despite the apparent benefits, several limitations in the literature were apparent, including that only 3 studies used running, only 2 studies were conducted in the field, most participants were fasted, and women and adolescents were underrepresented. In addition, the majority of the studies fed carbohydrate at ≥1.2 g·min−1, which may have inflated levels of GI distress and exaggerated performance decrements with single-saccharide feedings. Based on these limitations, future MTC investigations should consider focusing on running, examining team-based sports, including women and adolescents, conducting experiments under field conditions, examining the modifying effects of pre-exercise nutrition, and using modest feeding protocols (1.0–1.2 g·min−1).

Does Carbohydrate Intake During Endurance Running Improve Performance? A Critical Review.

Abstract Wilson, PB. Does carbohydrate intake during endurance running improve performance? A critical review. J Strength Cond Res 30(12): 3539–3559, 2016—Previous review articles assessing the effects of carbohydrate ingestion during prolonged exercise have not focused on running. Given the popularity of distance running and the widespread use of carbohydrate supplements, this article reviewed the evidence for carbohydrate ingestion during endurance running. The criteria for inclusion were (a) experimental studies reported in English language including a performance task, (b) moderate-to-high intensity exercise >60 minutes (intermittent excluded), and (c) carbohydrate ingestion (mouth rinsing excluded). Thirty studies were identified with 76 women and 505 men. Thirteen of the 17 studies comparing a carbohydrate beverage(s) with water or a placebo found a between-condition performance benefit with carbohydrate, although heterogeneity in protocols precludes clear generalizations about the expected effect sizes. Additional evidence suggests that (a) performance benefits are most likely to occur during events >2 hours, although several studies showed benefits for tasks lasting 90–120 minutes; (b) consuming carbohydrate beverages above ad libitum levels increases gastrointestinal discomfort without improving performance; (c) carbohydrate gels do not influence performance for events lasting 16–21 km; and (d) multiple saccharides may benefit events >2 hours if intake is ≥1.3 g·min−1 Given that most participants were fasted young men, inferences regarding women, adolescents, older runners, and those competing in fed conditions are hampered. Future studies should address these limitations to further elucidate the role of carbohydrate ingestion during endurance running.

Vitamin D status is associated with adiposity in male ice hockey players.

UNLABELLED The prevalence of insufficient vitamin D status is of concern and may negatively affect health and physical performance. PURPOSE The purpose of this study was twofold, as follows: to assess the prevalence of 25-hydroxyvitamin D (25(OH)D) insufficiency among young hockey players and evaluate the association between 25(OH)D concentration and fat mass (FM) after adjusting for covariates. METHODS Data were collected for 53 junior and collegiate ice hockey players residing near Minneapolis, MN (44.9° N) during the off-season (May 16 to June 28). Liquid chromatography-tandem mass spectrometry was used to assess 25(OH)D concentration, and hydrostatic weighing was used to determine FM. Dietary intake and endogenous synthesis of vitamin D were evaluated via a questionnaire. RESULTS Twenty (37.7%) athletes possessed insufficient 25(OH)D concentrations (<32 ng·mL(-1)). Log-transformed 25(OH)D concentration was inversely associated with FM in the athletes (r = -0.52, n = 51, P = 0.001). After controlling for measured covariates using sequential linear regression, the adjusted R2 change value indicated that 8.1% of the variability in (log of) 25(OH)D concentration was predicted by FM (P = 0.005). CONCLUSIONS The findings of this study demonstrate an inverse association between FM and vitamin D status after adjusting for environmental, dietary, and anthropometric predictors in a sample population of athletes. Athletes with higher levels of adiposity may be at increased risk of poor vitamin D status.

Is dietary supplementation more common among adults with psoriasis? Results from the National Health and Nutrition Examination Survey.

OBJECTIVES Individuals with psoriasis are often unsatisfied with traditional medical treatments and may be more likely to use dietary supplements as alternative or complementary treatment. Limited data is available on the prevalence of dietary supplement use amongst individuals with psoriasis in the general population. The aim was to utilize a representative sample of the United States to estimate the prevalence of dietary supplement use among adults self-reporting psoriasis. DESIGN AND SETTING Cross-sectional data analysis from the 2009 to 2010 National Health and Nutrition Examination Survey. Dietary supplementation over the past 30 days was ascertained and population weights were used to obtain estimates representative of the general population. Logistic regression was used to determine whether psoriasis was associated with higher odds of supplement use. RESULTS This study consisted of 6211 participants aged ≥20 years (representing 219 million Americans). Among the 184 participants reporting psoriasis (representing 6.9 million Americans), 53% reported using at least one dietary supplement, which was not different from participants without psoriasis (49.5%, P=0.416). Participants with psoriasis did not have higher odds of supplement use after adjusting for covariates. Multivitamin/mineral supplements were the most common dietary supplements used by participants with psoriasis (29.6%), and the most common reasons for taking them were to maintain and improve health. Only 12 supplements taken by participants with psoriasis were intended to improve skin health. CONCLUSIONS Dietary supplementation over the past 30 days was reported by half of adults with psoriasis amongst the United States general population. Few individuals with psoriasis took dietary supplements specifically to improve skin health.

Dietary and non-dietary correlates of gastrointestinal distress during the cycle and run of a triathlon

Abstract The purpose of this investigation was to assess whether pre-race dietary and non-dietary factors were associated with gastrointestinal (GI) distress during the cycle and run of a 70.3-mile triathlon. Fifty three participants recorded dietary details the day before and morning of the triathlon and retrospectively reported GI symptoms from the cycle and run. Occurrence and severity of nausea, regurgitation and fullness were combined into an upper GI (UGI) category, while lower abdominal cramps, flatulence and urge to defecate were combined into a lower GI (LGI) category. Spearmans rho coefficients were used to examine whether UGI and LGI were associated with: (1) pre-race diet (kilocalories, carbohydrate, fibre, fat, protein, caffeine); and (2) non-dietary factors (age, body mass index, experience, weight change, GI distress history, finishing time). Of non-dietary factors, only a history of GI distress showed significant associations with GI symptoms during the triathlon (ρ = .32–.36; P < .05). Morning kilocalorie (ρ = .28, P = .04) and carbohydrate (ρ = .36, P < .01) intakes were modestly, positively associated with UGI during the cycle, while morning caffeine intake (ρ = .30, P = .03) showed a modest positive association with LGI during the run. The associations between diet and GI distress variables remained significant after adjusting for non-dietary factors. Competitors of 70.3-mile triathlons should carefully weigh the benefits of higher race-morning energy, carbohydrate and caffeine intakes against their potential to increase GI distress.

Saccharide Composition of Carbohydrates Consumed during an Ultra-endurance Triathlon.

Objective: Ingesting a mix of glucose and fructose during exercise increases exogenous carbohydrate oxidation while minimizing gastrointestinal (GI) distress. Several studies have suggested that a glucose-to-fructose ratio of 1.2:1 to 1:1 is optimal. No studies have quantified saccharides consumed during a nonsimulated endurance event. The aim of this investigation was to quantify saccharide sources used during an ultra-endurance triathlon and provide a resource for athletes desiring to manipulate the saccharide content of carbohydrate consumed during training and competition. Methods: Participant self-report and direct measurement were used to assess foods and beverages consumed during an ultra-endurance (70.3-mile) triathlon. Manufacturer-supplied information, high-performance liquid chromatography, and the US Department of Agriculture Food Database were used to quantify saccharide profiles of foods and beverages. Participants reported GI distress during the run on a 0–10 scale. A subanalysis examined associations between saccharides and GI distress among participants consuming ≥ 50 g·h−1 of carbohydrate during the swim and cycle. Results: Fifty-four participants (43 men) used 80 foods and beverages with a unique saccharide profile. Of total carbohydrate, median proportions as glucose, fructose, and sucrose were 64%, 5%, and 10%, and only 7 foods (8.8%) had a glucose-to-fructose ratio of 1.2:1 to 1:1. The median glucose-to-fructose ratio of carbohydrate ingested was 2.9:1 (2.2:1–5.3:1). Twenty participants consumed ≥ 50 g·h−1 of carbohydrate during the swim and cycle, and significant correlations with incident GI distress at mile 1 of the run were found for glucose (r = 0.480, p = 0.032) and fructose (r = −0.454, p = 0.044). Conclusions: The majority of foods and beverages consumed during an ultra-endurance triathlon did not contain an optimal saccharide profile. Furthermore, glucose intake was associated with greater GI distress among participants consuming a high rate of carbohydrate.