Philip Cordery

A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index

BACKGROUND The identification of beverages that promote longer-term fluid retention and maintenance of fluid balance is of real clinical and practical benefit in situations in which free access to fluids is limited or when frequent breaks for urination are not desirable. The postingestion diuretic response is likely to be influenced by several beverage characteristics, including the volume ingested, energy density, electrolyte content, and the presence of diuretic agents. OBJECTIVE This study investigated the effects of 13 different commonly consumed drinks on urine output and fluid balance when ingested in a euhydrated state, with a view to establishing a beverage hydration index (BHI), i.e., the volume of urine produced after drinking expressed relative to a standard treatment (still water) for each beverage. DESIGN Each subject (n = 72, euhydrated and fasted male subjects) ingested 1 L still water or 1 of 3 other commercially available beverages over a period of 30 min. Urine output was then collected for the subsequent 4 h. The BHI was corrected for the water content of drinks and was calculated as the amount of water retained at 2 h after ingestion relative to that observed after the ingestion of still water. RESULTS Total urine masses (mean ± SD) over 4 h were smaller than the still-water control (1337 ± 330 g) after an oral rehydration solution (ORS) (1038 ± 333 g, P < 0.001), full-fat milk (1052 ± 267 g, P < 0.001), and skimmed milk (1049 ± 334 g, P < 0.001). Cumulative urine output at 4 h after ingestion of cola, diet cola, hot tea, iced tea, coffee, lager, orange juice, sparkling water, and a sports drink were not different from the response to water ingestion. The mean BHI at 2 h was 1.54 ± 0.74 for the ORS, 1.50 ± 0.58 for full-fat milk, and 1.58 ± 0.60 for skimmed milk. CONCLUSIONS BHI may be a useful measure to identify the short-term hydration potential of different beverages when ingested in a euhydrated state. This trial was registered at www.isrctn.com as ISRCTN13014105.

Chronic ingestion of a low dose of caffeine induces tolerance to the performance benefits of caffeine

ABSTRACT This study examined effects of 4 weeks of caffeine supplementation on endurance performance. Eighteen low-habitual caffeine consumers (<75 mg · day−1) were randomly assigned to ingest caffeine (1.5–3.0 mg · kg−1day−1; titrated) or placebo for 28 days. Groups were matched for age, body mass, V̇O2peak and Wmax (P > 0.05). Before supplementation, all participants completed one V̇O2peak test, one practice trial and 2 experimental trials (acute 3 mg · kg−1 caffeine [precaf] and placebo [testpla]). During the supplementation period a second V̇O2peak test was completed on day 21 before a final, acute 3 mg · kg−1 caffeine trial (postcaf) on day 29. Trials consisted of 60 min cycle exercise at 60% V̇O2peak followed by a 30 min performance task. All participants produced more external work during the precaf trial than testpla, with increases in the caffeine (383.3 ± 75 kJ vs. 344.9 ± 80.3 kJ; Cohen’s d effect size [ES] = 0.49; P = 0.001) and placebo (354.5 ± 55.2 kJ vs. 333.1 ± 56.4 kJ; ES = 0.38; P = 0.004) supplementation group, respectively. This performance benefit was no longer apparent after 4 weeks of caffeine supplementation (precaf: 383.3 ± 75.0 kJ vs. postcaf: 358.0 ± 89.8 kJ; ES = 0.31; P = 0.025), but was retained in the placebo group (precaf: 354.5 ± 55.2 kJ vs. postcaf: 351.8 ± 49.4 kJ; ES = 0.05; P > 0.05). Circulating caffeine, hormonal concentrations and substrate oxidation did not differ between groups (all P > 0.05). Chronic ingestion of a low dose of caffeine develops tolerance in low-caffeine consumers. Therefore, individuals with low-habitual intakes should refrain from chronic caffeine supplementation to maximise performance benefits from acute caffeine ingestion.

Mouth rinsing with a carbohydrate solution does not influence cycle time trial performance in the heat.

Ten endurance-trained males were recruited to examine the possible role of carbohydrate (CHO) receptors in the mouth influencing exercise performance in the heat. Volunteers completed an incremental test to exhaustion to determine peak oxygen uptake, a familiarisation trial, followed by 2 experimental trials. Trials consisted of a 1-h time trial undertaken in a climatic chamber maintained at 30 °C, 60% relative humidity. Immediately before, and at regular intervals throughout exercise, subjects ingested a bolus of water and then were provided with either a placebo (PLA) or a 6.4% glucose (CHO) solution to rinse in the mouth for 10 s before being expectorated. There was no difference in total work done between the PLA and CHO trials (758.8 ± 149.0 kJ; 762.6 ± 141.1 kJ; P = 0.951). Pacing was also similar, with no differences in power output apparent during the experimental trials (P = 0.546). Core temperature (P = 0.615), heart rate (P = 0.505), ratings of perceived exertion (P = 0.181), and perceived thermal stress (P = 0.416) were not influenced by the nature of the intervention. Blood glucose concentrations were similar during the CHO and PLA trials (P = 0.117). In contrast to the findings of several studies undertaken in temperate conditions, the present investigation failed to support role of oral sensing of CHO in influencing performance during prolonged exercise in warm conditions.

Dopamine/noradrenaline reuptake inhibition in women improves endurance exercise performance in the heat

Catecholamine reuptake inhibition improves the performance of male volunteers exercising in warm conditions, but sex differences in thermoregulation, circulating hormones, and central neurotransmission may alter this response. With local ethics committee approval, nine physically active women (mean ± SD age 21 ± 2 years; height 1.68 ± 0.08 m; body mass 64.1 ± 6.0 kg; VO2peak 51 ± 7 mL/kg/min) were recruited to examine the effect of pre‐exercise administration of Bupropion (BUP; 4 × 150 mg) on prolonged exercise performance in a warm environment. Participants completed a VO2peak test, two familiarization trials, and two randomized, double‐blind experimental trials. All trials took place during the first 10 days of the follicular phase of the menstrual cycle. Participants cycled for 1 h at 60% VO2peak followed by a 30‐min performance test. Total work done was greater during the BUP trial (291 ± 48 kJ) than the placebo trial (269 ± 46 kJ, P = 0.042, d = 0.497). At the end of the performance test, core temperature was higher on the BUP trial (39.5 ± 0.4 °C) than on the placebo trial (39.2 ± 0.6 °C, P = 0.021; d = 0.588), as was heart rate (185 ± 9 vs 179 ± 13, P = 0.043; d = 0.537). The results indicate that during the follicular phase of the menstrual cycle, an acute dosing protocol of BUP can improve self‐regulated performance in warm conditions.

Individual variation in hunger, energy intake and ghrelin responses to acute exercise

Purpose This study aimed to characterize the immediate and extended effect of acute exercise on hunger, energy intake, and circulating acylated ghrelin concentrations using a large data set of homogenous experimental trials and to describe the variation in responses between individuals. Methods Data from 17 of our groups experimental crossover trials were aggregated yielding a total sample of 192 young, healthy males. In these studies, single bouts of moderate to high-intensity aerobic exercise (69% ± 5% V˙O2 peak; mean ± SD) were completed with detailed participant assessments occurring during and for several hours postexercise. Mean hunger ratings were determined during (n = 178) and after (n = 118) exercise from visual analog scales completed at 30-min intervals, whereas ad libitum energy intake was measured within the first hour after exercise (n = 60) and at multiple meals (n = 128) during the remainder of trials. Venous concentrations of acylated ghrelin were determined at strategic time points during (n = 118) and after (n = 89) exercise. Results At group level, exercise transiently suppressed hunger (P < 0.010, Cohens d = 0.77) but did not affect energy intake. Acylated ghrelin was suppressed during exercise (P < 0.001, Cohens d = 0.10) and remained significantly lower than control (no exercise) afterward (P < 0.024, Cohens d = 0.61). Between participants, there were notable differences in responses; however, a large proportion of this spread lay within the boundaries of normal variation associated with biological and technical assessment error. Conclusion In young men, acute exercise suppresses hunger and circulating acylated ghrelin concentrations with notable diversity between individuals. Care must be taken to distinguish true interindividual variation from random differences within normal limits.

A Catecholamine Precursor Does Not Influence Exercise Performance in Warm Conditions

PURPOSE Acute doses of Sinemet® (L-DOPA combined with carbidopa) previously failed to influence prolonged exercise performance in a temperate environment, but it is not known whether acute doses of L-DOPA timed to reach maximum plasma concentrations (Cmax) during exercise will improve prolonged cycling performance in warm conditions (30.2°C ± 0.2°C, 50% ± 1%). METHODS Ten physically active men (age, 26 ± 4 yr; height, 1.76 ± 0.08 m; body mass, 76.3 ± 10.6 kg; V˙O2peak, 57 ± 8 mL·kg(-1)·min(-1)) were recruited for this study. Participants cycled for 1 h at 60% V˙O2peak followed by a 30-min exercise test, during which they were instructed to complete as much work as possible. Heart rate, skin and core temperatures, as well as RPE and thermal stress were recorded throughout the exercise, and blood samples were collected at rest, at 15-min intervals during the first hour of exercise, and at the end of the exercise test. Finger tapping tests at the beginning and end of the exercise were conducted to examine fine motor control. RESULTS There was no significant difference in the work done on the placebo (314 ± 43 kJ) and L-DOPA trials (326 ± 48 kJ, P = 0.276). Prolactin concentrations were increased at the end of the exercise in all trials (P < 0.001), but this response was attenuated at the end of the exercise for the L-DOPA trial (11.4 ± 5.5 ng·mL(-1)) and placebo trials (20.8 ± 3.3 ng·mL(-1), P = 0.003). No differences between trials were found for any other measure. CONCLUSIONS The results suggest that increasing central catecholamine availability inhibits the normal prolactin response to exercise in the heat but does not alter performance, thermoregulation, or sympathetic outflow.

Development of a hydration index: a randomized trial to assess the potential of different beverages to affect hydration status.

Background: The water content of ingested beverages enters the body water pool at a rate dictated by the rates of gastric emptying and intestinal absorption. Water is subsequently lost from the body by various routes, primarily urine in the absence of sweating. The post-ingestion diuretic response following prior hypohydration is influenced by several characteristics of the drink, including primarily volume, energy density, electrolyte content, and the presence of diuretic agents. Objective: This study investigated the effects of 13 different commonly-consumed drinks on urine output and fluid balance when ingested in a euhydrated state, with a view to establishing a Hydration Index (HI; i.e. volume of urine produced after drinking expressed relative to a standard treatment [still water]). Design: Each subject (n = 72, euhydrated and fasted males) ingested 1 L of still water or one of three other commercially-available beverages over a period of 30 minutes. Urine output was then collected for the subsequent 4 h. HI was corrected for water content of drinks and was calculated as the amount of water retained at 2 h after ingestion, relative to that observed following ingestion of still water. Results: Total urine masses (mean (SD)) over 4 h were smaller than the still water control (1337(330) g) after oral rehydration solution (ORS, 1038(333) g, P=0.004), full-fat milk (1052(267) g, P=0.006) and skimmed milk (1049(334) g, P=0.005). Cumulative urine output at 4h after ingestion of cola, diet cola, tea, cold tea, coffee, lager, orange juice, sparkling water and a sports drink were not different from the response to water ingestion. The mean HI at 2 h was 1.53(0.74) for ORS, 1.32(0.51) for full-fat milk, and 1.44(0.54) for skimmed milk. Conclusions: An HI may be a useful measure to identify the short-term hydration potential of different beverages when ingested in a euhydrated state.

Spinal Cord Injury Level Influences Acute Plasma Caffeine Responses.

Purpose This study aimed to investigate the absorption curve and acute effects of caffeine at rest in individuals with no spinal cord injury (SCI), paraplegia (PARA), and tetraplegia (TETRA). Methods Twenty-four healthy males (eight able-bodied [AB], eight PARA, and eight TETRA) consumed 3 mg·kg−1 caffeine anhydrous (CAF) in a fasted state. Plasma caffeine [CAF], glucose, lactate, free fatty acid, and catecholamine concentrations were measured during a 150-min rest period. Results Peak [CAF] was greater in TETRA (21.5 &mgr;M) compared with AB (12.2 &mgr;M) and PARA (15.1 &mgr;M), and mean peak [CAF] occurred at 70, 80, and 80 min, respectively. Moderate and large effect sizes were revealed for TETRA compared with PARA and AB (−0.55 and −1.14, respectively) for the total area under the [CAF] versus time curve. Large interindividual responses were apparent in SCI groups. The change in plasma catecholamine concentrations after CAF did not reach significance (P > 0.05); however, both adrenaline and noradrenaline concentrations were lowest in TETRA. Significant increases in free fatty acid were seen over time (P < 0.0005), but there was no significant influence of SCI level. Blood lactate concentration reduced over time (P = 0.022), whereas blood glucose concentration decreased modestly (P = 0.695), and no difference between groups was seen (P > 0.05). Conclusion The level of SCI influenced the caffeine absorption curve, and there was large interindividual variation within and between groups. Individual curves should be considered when using caffeine as an ergogenic aid in athletes with an SCI. The results indicate TETRA should trial low doses in training and PARA may consider consuming caffeine greater than 60 min before exercise performance. The study also supports caffeines direct effect on adipose tissue, which is not secondary to catecholamine release.

Supplementation with a low-dose of octopamine does not influence endurance cycling performance in recreationally active men

OBJECTIVES The aim of this study was to examine the influence of octopamine supplementation on endurance performance and exercise metabolism. DESIGN Double-blind cross-over study. METHODS Ten healthy, recreationally active men (Mean±SD; age: 24±2 years; body mass: 78.4±8.7kg; VO2peak: 50.5±6.8 mLkg-1min-1) completed one VO2peak test, one familiarisation trial and two experimental trials. After an overnight fast, participants ingested either a placebo or 150mg of octopamine 60min prior to exercise. Trials consisted of 30min of cycle exercise at 55% peak power output, followed by a 30min performance task whereby participants completed as much work (kJ) as possible. RESULTS Performance was similar between the experimental trials (placebo: 352.8±39kJ; octopamine: 350.9±38.3kJ; Cohens d effect size=0.05; p=0.380). Substrate oxidation and circulating concentrations of free fatty acids, prolactin and cortisol were similar between trial conditions (all p>0.05). There were also no differences across trials for heart rate or perceived exertion during exercise (both p>0.05). CONCLUSIONS Acute supplementation with a low dose of octopamine did not influence endurance cycle performance, substrate oxidation or circulating hormonal concentrations, which could be due to the low serum octopamine concentrations observed. Future studies should investigate the influence of larger doses of octopamine in recreationally active and well-trained individuals during prolonged exercise in temperate and high ambient conditions.

OC13 The effect of a catecholamine precursor on prolonged exercise performance in warm conditions

Acute doses of Sinemet® (L-DOPA combined with carbidopa) previously failed to change prolonged exercise performance in a temperate environment, but it is not known whether acute doses of L-DOPA timed to reach Cmax during exercise will improve prolonged cycling performance in warm conditions. 10 physically active men (age 26 ± 4 y; height 1.76 ± 0.08 m; body mass 76.3 ± 10.6 kg; VO2peak 57 ± 8 ml/kg/min) were recruited for this study. Participants cycled for 1 h at 60% VO2peak followed by a 30 min exercise test, during which they were instructed to complete as much work as possible. Heart rate, skin and core temperature, as well as ratings of perceived exertion and thermal comfort were recorded throughout exercise and blood samples were collected at rest, 15 min intervals during the first hour of exercise and the end of the exercise test. Finger tap tests at the beginning and end of exercise were employed to examine fine motor control. There was no significant difference in the work done on placebo (314 ± 43 kJ) and L-DOPA trials (326 ± 48 kJ; p = 0.08). Prolactin concentrations were increased at the end of exercise in all trials (p < 0.001) but this response was attenuated at the end of exercise for the L-DOPA trial (11.4 ± 5.5 ng/ml) compared to single-blind (23.6 ± 5.6 ng/ml) and double-blind placebo trials (20.8 ± 3.3 ng/ml; p = 0.024). No differences between trials were found for any other measure. The results suggest that increasing central catecholamineavailability inhibits the normal prolactin response to exercise in the heat, but does not alter performance, thermoregulation or sympathetic outflow.