Phillip Watson

Acute dopamine/noradrenaline reuptake inhibition enhances human exercise performance in warm, but not temperate conditions

Nine healthy endurance‐trained males were recruited to examine the effect of a dual dopamine/noradrenaline reuptake inhibitor on performance, thermoregulation and the hormonal responses to exercise. Subjects performed four trials, ingesting either a placebo (pla) or 2 × 300 mg bupropion (bup), prior to exercise in temperate (18°C) or warm (30°C) conditions. Trials consisted of 60 min cycle exercise at 55%Wmax immediately followed by a time trial (TT). TT performance in the heat was significantly improved by bupropion (pla: 39.8 ± 3.9 min, bup: 36.4 ± 5.7 min; P= 0.046), but no difference between treatments was apparent in temperate conditions (pla: 30.6 ± 2.2 min, bup: 30.6 ± 1.9 min; P= 0.954). While TT power output was consistently lower in the heat when compared to temperate conditions, this decrement was attenuated by bupropion. At the end of the TT in the heat, both core temperature (pla 39.7 ± 0.3°C, bup 40.0 ± 0.3°C; P= 0.017) and HR (pla 178 ± 7 beats min−1, bup 183 ± 12 beats min−1; P= 0.039), were higher in the bupropion trial than in the placebo. Circulating pituitary and adrenal hormone concentrations increased throughout exercise in all trials. Circulating serum prolactin was elevated above temperate levels during exercise in a warm environment (P < 0.001). These data indicate that performance in warm conditions is enhanced by acute administration of a dual dopamine/noradrenaline reuptake inhibitor. No such effect was apparent under temperate conditions. It appears that bupropion enabled subjects to maintain a greater TT power output in the heat with the same perception of effort and thermal stress reported during the placebo trial, despite the attainment of a higher core temperature.

The effects of acute dopamine reuptake inhibition on performance.

INTRODUCTION Acute bupropion (dopamine/noradrenaline reuptake inhibitor) administration significantly improved time trial performance and increased core temperature in the heat (30 degrees C). PURPOSE The present study was performed to examine the effect of a dopaminergic reuptake inhibitor on exercise capacity and thermoregulation during prolonged exercise in temperate and warm conditions. METHODS Eight healthy well-trained male cyclists participated in this study. Subjects ingested either placebo (PLA; 20 mg) or methylphenidate (MPH; Ritalin; 20 mg) 1 h before the start of exercise in temperate (18 degrees C) or warm (30 degrees C) conditions and cycled for 60 min at 55% Wmax, immediately followed by a time trial (TT; PLA18 and MPH18; PLA30 and MPH30) to measure exercise performance. RESULTS MPH did not influence TT performance at 18 degrees C (P = 0.397). TT was completed 16% faster in MPH30 (38.1 +/- 6.4 min) than in PLA30 (45.4 +/- 7.3 min; P = 0.049). In the heat Tcore was significantly higher at rest (P = 0.009), and throughout the TT in MPH30 (P < 0.018), reaching values above 40 degrees C. Throughout MPH30, heart rates were significantly higher (P < 0.05). CONCLUSIONS These results show that MPH has a clear ergogenic effect that was not apparent in 18 degrees C. The combination of a dopamine reuptake inhibitor and exercise in the heat clearly improved performance and caused hyperthermia without any change in the perception of effort or thermal stress compared with the PLA trial. This response may potentially increase the risk of developing heat illness during exercise in individuals taking drugs of this nature.

Milk as an effective post-exercise rehydration drink

The effectiveness of low-fat milk, alone and with an additional 20 mmol/l NaCl, at restoring fluid balance after exercise-induced hypohydration was compared to a sports drink and water. After losing 1.8 (sd 0.1) % of their body mass during intermittent exercise in a warm environment, eleven subjects consumed a drink volume equivalent to 150 % of their sweat loss. Urine samples were collected before and for 5 h after exercise to assess fluid balance. Urine excretion over the recovery period did not change during the milk trials whereas there was a marked increase in output between 1 and 2 h after drinking water and the sports drink. Cumulative urine output was less after the milk drinks were consumed (611 (sd 207) and 550 (sd 141) ml for milk and milk with added sodium, respectively, compared to 1184 (sd 321) and 1205 (sd 142) ml for the water and sports drink; P < 0.001). Subjects remained in net positive fluid balance or euhydrated throughout the recovery period after drinking the milk drinks but returned to net negative fluid balance 1 h after drinking the other drinks. The results of the present study suggest that milk can be an effective post-exercise rehydration drink and can be considered for use after exercise by everyone except those individuals who have lactose intolerance.

Hydration and outcome in older patients admitted to hospital (The HOOP prospective cohort study)

Background: older adults are susceptible to dehydration due to age-related pathophysiological changes. We aimed to investigate the prevalence of hyperosmolar dehydration (HD) in hospitalised older adults, aged ≥65 years, admitted as an emergency and to assess the impact on short-term and long-term outcome. Methods: this prospective cohort study was performed on older adult participants who were admitted acutely to a large UK teaching hospital. Data collected included the Charlson comorbidity index (CCI), national early warning score (NEWS), Canadian Study of Health and Aging (CSHA) clinical frailty scale and Nutrition Risk Screening Tool (NRS) 2002. Admission bloods were used to measure serum osmolality. HD was defined as serum osmolality >300 mOsmol/kg. Participants who were still in hospital 48 h after admission were reviewed, and the same measurements were repeated. Results: a total of 200 participants were recruited at admission to hospital, 37% of whom were dehydrated. Of those dehydrated, 62% were still dehydrated when reviewed at 48 h after admission. Overall, 7% of the participants died in hospital, 79% of whom were dehydrated at admission (P = 0.001). Cox regression analysis adjusted for age, gender, CCI, NEWS, CSHA and NRS demonstrated that participants dehydrated at admission were 6 times more likely to die in hospital than those euhydrated, hazards ratio (HR) 6.04 (1.64–22.25); P = 0.007. Conclusions: HD is common in hospitalised older adults and is associated with poor outcome. Coordinated efforts are necessary to develop comprehensive hydration assessment tools to implement and monitor a real change in culture and attitude towards hydration in hospitalised older adults.

Exercise capacity in the heat is greater in the morning than in the evening in man.

PURPOSE This study investigated the effect of time of day on endurance exercise capacity in a warm environment. METHODS Nine males cycled to exhaustion at 65% .VO2peak in an ambient temperature of 35 degrees C (60% relative humidity) at 0645 h (AM) and 1845 h (PM). Rectal temperature (Tc), skin temperature (Tsk), and heart rate (HR) were recorded and blood and expired air samples collected at rest every 5 min during exercise and during recovery. RESULTS Time to exhaustion was longer in the AM trial (45.8 +/- 10.7 min) than in the PM trial (40.5 +/- 9.0 min; P = 0.009). Resting Tc was lower in the AM trial and remained lower for the first 25 min of exercise (P < 0.001). Tc was not different between trials at the point of exhaustion (AM = 38.7 +/- 0.9 degrees C, PM = 38.8 +/- 0.6 degrees C; P = 0.847). Tsk followed a similar pattern, being lower at rest (P = 0.003) and during the initial stages of exercise (P < 0.05) in the AM trial but not different at exhaustion (P = 0.896). The rate of rise of Tc tended to be greater in the AM trial (P = 0.052), and the rate of rise of Tsk (P = 0.032) and of body heat content (P = 0.009) was also greater in the AM trial. HR was initially higher in the PM trial, but there was no difference at exhaustion. There were no differences between trials in blood glucose concentration or plasma volume change. CONCLUSION The results of this study suggest that endurance exercise capacity in the heat was significantly greater in the morning than the evening, possibly due to a lower initial Tc.

Effect of exercise and heat-induced hypohydration on brain volume.

PURPOSE The aim of this study was to quantify changes in brain volume after exercise/heat-induced hypohydration in man. METHODS Eight active men completed intermittent exercise in a warm environment, until 2.9% ± 0.1% of body mass was lost. Subjects remained hypohydrated for 2 h after the end of exercise. Brain volume was measured before, immediately after, and 1 and 2 h after exercise using magnetic resonance imaging (Philips 3T Achieva, AE Eindhoven, The Netherlands). Measures of subjective feelings and core body temperature were also monitored. Blood samples were drawn to determine serum electrolyte concentrations and osmolality and to allow calculation of changes in blood and plasma volumes. RESULTS Brain volume was not influenced by hypohydration (0.2% ± 0.4%; effect size (ES) = 0.2, P = 0.310). Reductions in ventricular (4.0% ± 1.8%; ES = 4.6, P < 0.001) and cerebrospinal fluid (3.1% ± 1.9%; ES = 3.3, P = 0.003) volumes were observed after exercise. Compared with preexercise levels, serum osmolality was elevated throughout the 2-h postexercise period (+10 ± 2 mOsm·kg, P < 0.001). Core temperature increased from 37.1°C ± 0.3°C at rest to 39.3°C ± 0.5°C at the end of exercise (P = 0.001). CONCLUSIONS These data demonstrate that brain volume remains unchanged in response to moderate hypohydration and presence of serum hyperosmolality, suggesting that mechanisms are in place to defend brain volume.

Effects of milk ingestion on prolonged exercise capacity in young, healthy men

OBJECTIVE The effects of fluid intake during prolonged exercise have been extensively studied but at present there exists little information on the effects of milk-based drinks on the response to prolonged exercise. Thus, the purpose of this study was to investigate the effects of milk-based drinks on exercise capacity. METHODS Eight healthy males (age 24 +/- 4 y, height 1.76 +/- 0.04 m, mass 68.9 +/- 9.5 kg, body fat 12.5 +/- 2.4%, peak oxygen consumption 4.3 +/- 0.6 L/min) exercised to volitional exhaustion at 70% peak oxygen consumption on four occasions. Subjects ingested 1.5 mL/kg body mass of plain water, a carbohydrate-electrolyte solution, low-fat (0.1%) milk, or low-fat (0.1%) milk with added glucose before and every 10 min during exercise. The effect of the drink on exercise capacity and the cardiovascular, metabolic, and thermoregulatory responses to prolonged exercise were examined. RESULTS Exercise time to exhaustion was not significantly influenced by the drink ingested (P = 0.19), but there was a tendency for subjects to exercise longer when the carbohydrate-electrolyte (110.6, range 82.0-222.7 min), milk (103.3, range 85.7-228.5 min), or milk plus glucose (102.8, range 74.3-167.1 min) was ingested compared with water (93.3, range 82.4-192.3 min). The solution ingested did not influence the cardiovascular, metabolic, or thermoregulatory response to exercise. CONCLUSION The results of this study suggest that although the low-fat milk-based fluids did not enhance exercise capacity over that seen with the ingestion of plain water, the effect was comparable to that observed with a carbohydrate-electrolyte beverage.

Urinary Nandrolone Metabolite Detection after Ingestion of a Nandrolone Precursor

INTRODUCTION Quantities of various anabolic/androgenic steroids have been found in dietary supplements without their presence being disclosed on the label. The aim of this study was to quantify the excretion patterns of the diagnostic metabolites, 19-norandrosterone (19-NA), and 19-noretiocholanolone (19-NE) after ingestion of small doses of 19-nor-4-androstene-3,17-dione (19-norandrostenedione). METHODS Eleven males and nine females entered the laboratory in the morning after an overnight fast. An initial urine sample was collected, and volunteers then ingested 500 mL of water containing 5 g of creatine monohydrate and 1.0, 2.5, or 5.0 microg of 19-norandrostenedione. The volume of each urine void was measured, and an aliquot was taken. Samples were analyzed for the metabolites 19-NA and 19-NE by GCMS. RESULTS Baseline urinary 19-NA concentrations were 0.19 +/- 0.14 ng x mL. Ingestion of the supplement resulted in peak mean urinary 19-NA concentrations of 0.68 +/- 0.36, 1.56 +/- 0.86, and 3.89 +/- 3.11 ng.mL in the 1.0-, 2.5-, or 5.0-microg trials, respectively. Under current WADA regulations, ingestion of the 1.0-microg dose produced 0 positive doping tests, 5 subjects (20%) tested positive in the 2.5-microg trial, and 15 subjects (75%) had urinary 19-NA concentrations exceeding 2 ng x mL after ingesting creatine containing 5.0 microg of the steroid. The recovery of the ingested dose was highly variable between individuals, with values ranging from 11% to 84% (mean +/- SD = 47% +/- 18%). CONCLUSIONS Ingestion of trace amounts of 19-norandrostenedione can result in transient elevations of urinary 19-NA and 19-NE concentrations. The addition of as little as 2.5 microg of 19-norandrostenedione to a supplement (0.00005% contamination) appears sufficient to result in a doping violation in some individuals.

Mild hypohydration increases the frequency of driver errors during a prolonged, monotonous driving task.

UNLABELLED The aim of the present study was to examine the effect of mild hypohydration on performance during a prolonged, monotonous driving task. METHODS Eleven healthy males (age 22±4y) were instructed to consume a volume of fluid in line with published guidelines (HYD trial) or 25% of this intake (FR trial) in a crossover manner. Participants came to the laboratory the following morning after an overnight fast. One hour following a standard breakfast, a 120min driving simulation task began. Driver errors, including instances of lane drifting or late breaking, EEG and heart rate were recorded throughout the driving task RESULTS Pre-trial body mass (P=0.692), urine osmolality (P=0.838) and serum osmolality (P=0.574) were the same on both trials. FR resulted in a 1.1±0.7% reduction in body mass, compared to -0.1±0.6% in the HYD trial (P=0.002). Urine and serum osmolality were both increased following FR (P<0.05). There was a progressive increase in the total number of driver errors observed during both the HYD and FR trials, but significantly more incidents were recorded throughout the FR trial (HYD 47±44, FR 101±84; ES=0.81; P=0.006) CONCLUSIONS: The results of the present study suggest that mild hypohydration, produced a significant increase in minor driving errors during a prolonged, monotonous drive, compared to that observed while performing the same task in a hydrated condition. The magnitude of decrement reported, was similar to that observed following the ingestion of an alcoholic beverage resulting in a blood alcohol content of approximately 0.08% (the current UK legal driving limit), or while sleep deprived.

The effect of post-exercise drink macronutrient content on appetite and energy intake ☆

Carbohydrate and protein ingestion post-exercise are known to facilitate muscle glycogen resynthesis and protein synthesis, respectively, but the effects of post-exercise nutrient intake on subsequent appetite are unknown. This study aimed to investigate whether protein induced satiety that has been reported at rest was still evident when pre-loads were consumed in a post-exercise context. Using a randomised, double blind, crossover design, 12 unrestrained healthy males completed 30 min of continuous cycling exercise at ~60% VO2peak, followed by five, 3 min intervals at ~85% VO2peak. Ten min post-exercise, subjects consumed 500 ml of either a low energy placebo (15 kJ) (PLA); a 6% whey protein isolate drink (528 kJ) (PRO); or a 6% sucrose drink (528 kJ) (CHO). Sixty min after drink ingestion, a homogenous ad-libitum pasta lunch was provided and energy intake at this lunch was quantified. Subjective appetite ratings were measured at various stages of the protocol. Energy consumed at the ad-libitum lunch was lower after PRO (5831 ± 960 kJ) than PLA (6406 ± 492 kJ) (P<0.05), but not different between CHO (6111 ± 901 kJ) and the other trials (P>0.315). Considering the post-exercise drink, total energy intake was not different between trials (P=0.383). There were no differences between trials for any of the subjective appetite ratings. The results demonstrate that where post-exercise liquid protein ingestion may enhance the adaptive response of skeletal muscle, this may be possible without affecting gross energy intake relative to consuming a low energy drink.