Tanja Oosthuyse

The effect of the menstrual cycle on exercise metabolism: implications for exercise performance in eumenorrhoeic women.

The female hormones, oestrogen and progesterone, fluctuate predictably across the menstrual cycle in naturally cycling eumenorrhoeic women. Other than reproductive function, these hormones influence many other physiological systems, and their action during exercise may have implications for exercise performance. Although a number of studies have found exercise performance — and in particular, endurance performance — to vary between menstrual phases, there is an equal number of such studies reporting no differences. However, a comparison of the increase in the oestrogen concentration (E) relative to progesterone concentration (P) as the E/P ratio (pmol/ nmol) in the luteal phase in these studies reveals that endurance performance may only be improved in the mid-luteal phase compared with the early follicular phase when the E/P ratio is high in the mid-luteal phase. Furthermore, the late follicular phase, characterized by the pre-ovulatory surge in oestrogen and suppressed progesterone concentrations, tends to promote improved performance in a cycling time trial and future studies should include this menstrual phase. Menstrual phase variations in endurance performance may largely be a consequence of changes to exercise metabolism stimulated by the fluctuations in ovarian hormone concentrations. The literature suggests that oestrogen may promote endurance performance by altering carbohydrate, fat and protein metabolism, with progesterone often appearing to act antagonistically. Details of the ovarian hormone influences on the metabolism of these macronutrients are no longer only limited to evidence from animal research and indirect calorimetry but have been verified by substrate kinetics determined with stable tracer methodology in eumenorrhoeic women. This review thoroughly examines the metabolic perturbations induced by the ovarian hormones and, by detailed comparison, proposes reasons for many of the inconsistent reports in menstrual phase comparative research. Often the magnitude of increase in the ovarian hormones between menstrual phases and the E/P ratio appear to be important factors determining an effect on metabolism. However, energy demand and nutritional status may be confounding variables, particularly in carbohydrate metabolism. The review specifically considers how changes in metabolic responses due to the ovarian hormones may influence exercise performance. For example, oestrogen promotes glucose availability and uptake into type I muscle fibres providing the fuel of choice during short duration exercise; an action that can be inhibited by progesterone. A high oestrogen concentration in the luteal phase augments muscle glycogen storage capacity compared with the low oestrogen environment of the early follicular phase. However, following a carbo-loading diet will super-compensate muscle glycogen stores in the early follicular phase to values attained in the luteal phase. Oestrogen concentrations of the luteal phase reduce reliance on muscle glycogen during exercise and although not as yet supported by human tracer studies, oestrogen increases free fatty acid availability and oxidative capacity in exercise, favouring endurance performance. Evidence of oestrogen’s stimulation of 50-AMPactivated protein kinase may explain many of the metabolic actions of oestrogen. However, both oestrogen and progesterone suppress gluconeogenic output during exercise and this may compromise performance in the latter stages of ultra-long events if energy replacement supplements are inadequate. Moreover, supplementing energy intake during exercise with protein may be more relevant when progesterone concentration is elevated compared with menstrual phases favouring a higher relative oestrogen concentration, as progesterone promotes protein catabolism while oestrogen suppresses protein catabolism. Furthermore, prospective research ideas for furthering the understanding of the impact of the menstrual cycle on metabolism and exercise performance are highlighted.

Oestrogen's regulation of fat metabolism during exercise and gender specific effects

Early animal, menstrual phase and gender comparative studies inconsistently support an oestrogen-induced increase in fat oxidation during exercise. Recent advances from studies of cellular signalling and gene expression provide evidence for inter-tissue and intramuscular mechanisms that demonstrate oestrogens promotion of skeletal muscle fat oxidative capacity. Oestrogen or oestrogen-analogues act mainly through oestrogen receptor-alpha in skeletal muscle to stimulate the genomic expression of certain other nuclear hormone receptors and downstream targets to promote long chain fatty acid (LCFA) uptake, mitochondrial shuttling and β oxidation. Oestrogen increases the availability of LCFA substrate by enhancing adipocyte lipolysis and expression of genes promoting intramyocellular lipid storage. Oestrogen acts by non-genomic means to increase the activation of AMPK that may reinforce some direct genomic actions.

Reduced cardiac stiffness following exercise is associated with preserved myocardial collagen characteristics in the rat.

Abstract We determined whether the increment in cardiac end-diastolic compliance (a reduced diastolic stiffness constant) following endurance training is related to alterations in myocardial collagen characteristics. Sixteen weeks of habitual exercise (Ex) in rats, which produced left ventricular (LV) hypertrophy (LVH) [LV weight in g: Ex=1.01 (0.04), sedentary control = 0.89 (0.04); P<0.05], resulted in a reduced LV end-diastolic (LVED) chamber stiffness [slope of the linearised LVED pressure versus LVED internal diameter relation in kPa · mm−1: Ex=0.67 (0.03), control=0.80 (0.03); P<0.05]. The increased LVED chamber distensibility was associated with an attenuated myocardial stiffness [slope of the linearised LVED stress versus strain relation in g · cm−2; Ex=15 (3), control=25 (2); P<0.05]. Although LV total collagen content (mg) was increased in the exercised rats [Ex=5.0 (0.3), control=4.1 (0.2); P<0.05], this was a reflection of the presence of LVH, as the myocardial collagen concentration (μg · mg−1 LV wet weight) was unaltered [Ex=4.9 (0.2), control=4.6 (0.2)]. Furthermore, habitual exercise did not influence the percentage of myocardial collagen extracted following cyanogen bromide digestion (an index of collagen cross-linking), [i.e. Ex=38 (3), control=38 (3)], nor the proportion of myocardial collagen phenotypes I and III [I/III; Ex=3.04 (0.20), control=2.85 (0.22)]. In conclusion, exercise-induced increments in end-diastolic myocardial distensibility are unlikely to be a consequence of alterations in the properties of myocardial collagen.

Evaluation of miniature data loggers for body temperature measurement during sporting activities

Abstract We recorded body temperatures in four runners, two squash players and one swimmer at 1-min intervals using miniature data loggers. These single-channel loggers are small and light (25 g), and were easily carried by the athletes during their sporting activities. Wide-range loggers (−37°C to +46°C), which had a temperature resolution of 0.4°C, were used to measure thigh skin temperature. Auditory canal temperature and rectal temperature were measured with narrow-range loggers (+34°C to +46°C) which had a considerably higher resolution (0.04°C). With the aid of visual analogue scales subjects reported that the thermometric equipment caused very little discomfort or impairment of exercise performance. Loggers connected to uncoated bead thermistors (used for skin and auditory canal temperatures) had a thermal time constant of 0.4 s, and that of the coated thermistors (rectal probes) was 6 s. We were able to waterproof the equipment and measure rectal temperature in a swimmer. Hot (35°C) or cold (5°C) ambient temperatures had an insignificant effect on the intrinsic accuracy of the data loggers, even when used without recalibration at those temperatures. We believe that miniature temperature loggers are convenient and accurate thermometers for use during sporting activities and may provide new insights into thermoregulation during exercise.

Whole body vibration increases hip bone mineral density in road cyclists.

This study aimed to determine the effects of 10 weeks of whole body vibration training on the bone density of well-trained road cyclists. 15 road cyclists were assigned to either a vibrating group (n=8), who undertook 15 min of intermittent whole body vibration at 30 Hz, 3 times per week while continuing with their normal cycling training; or a control group (n=7), who continued with their normal cycling training for the 10-week period. Cyclists were age, body mass and height matched with 15 sedentary participants. At baseline, all participants underwent regional dual x-ray absorptiometry scans, where both cycling groups had lower pelvic (p<0.050) and higher head bone mineral density (p<0.050) than the sedentary participants with no other differences observed. After 10 weeks of training, vibrating cyclists showed a significantly greater increase in hip bone mineral density (0.020±0.010 g.cm - 2 (1.65%), p=0.024) while the control cyclists ( - 0.004±0.001 g.cm - 2 (0%)) showed no change (p>0.050). The control group had a significantly lower spine bone mineral density (1.027±0.140 g.cm - 2, p=0.020) compared to baseline (1.039±0.140 g.cm - 2). This loss was not observed in the vibrating group. 10 weeks of whole body vibration training increased hip and preserved spine bone mineral density in road cyclists.

Bone resorption is suppressed immediately after the third and fourth days of multiday cycling but persistently increased following overnight recovery

Previous studies suggest that seasoned cyclists may incur a low bone mineral density. This study investigated the effect of multiday cycling on bone turnover. Ten male cyclists completed 4 consecutive days of cycling for 3 h·day(-1). Sweat calcium excretion during exercise and serum calcium, cortisol, bone formation marker (bone alkaline phosphotase (bone-ALP)), bone resorptive marker (C-terminal telopeptide of type I collagen (β-CTX)), and parathyroid hormone concentration were measured before and immediately postexercise each day. Serum β-CTX concentration increased from pre- to postcycling on days 1 and 2 (p = 0.01) (day 1: 0.31 ± 0.14 to 0.60 ± 0.4 ng·mL(-1); day 2: 0.58 ± 0.26 to 0.87 ± 0.42 ng·mL(-1)), while serum bone-ALP concentration remained unchanged. Conversely, on days 3 and 4 both serum β-CTX (day 3: 0.60 ± 0.26 to 0.43 ± 0.26 ng·mL(-1), p < 0.05; day 4: 0.63 ± 0.21 to 0.43 ± 0.22 ng·mL(-1), p < 0.001) and bone-ALP (p < 0.01) response to exercise was suppressed. Interestingly, calcium lost to sweat and postexercise serum cortisol concentration were also significantly lower on days 3 and 4 than on day 1 (p < 0.05). However, both serum β-CTX (102%-124%) and bone-ALP (25%-29%) remained persistently elevated after 21 h of overnight recovery on all successive days compared with day 1 pre-exercise, where the percentage increase was greater for β-CTX (p < 0.05). Bone resorption, immediately following prolonged cycling, is acutely reduced by the third and fourth consecutive days and is coincident to reduced sweat calcium excretion and cortisol concentration. However, multiday cycling imposes a persistent increase in bone resorption following overnight recovery.

Radial bone size and strength indices in male road cyclists, mountain bikers and controls

Abstract Mountain biking (MB), unlike road cycling (RC) involves exposure to ground impact bone strain and requires upper-body muscle forces to maintain stability over uneven terrain and therefore may have differential effects on radial bone structure and strength. This study aimed to compare serum bone turnover marker concentration, 1-repetition maximum muscle strength and the radial proximal (diaphysis) and distal (metaphysis) bone structure [bone mineral content, total and cortical area (CoA), density and thickness, diameter and circumference], strength strain indices and muscle cross-sectional area (MCSA) using peripheral quantitative computed tomography (pQCT) between 30 male cyclists (18–34 years) MB (n = 10), RC (n = 10) and non-athletes controls (CON, n = 10). Differences were assessed by ANOVA and an ANCOVA (adjusting for body mass and height) where appropriate. MB radii were characterised by significantly stronger (14–16%), denser (9–27%) and larger (10%) metaphyses and stronger (22–23%) and larger (11–13%) diaphyses compared to RC and CON. RC had significantly 7% higher strength indices and 4% greater CoA and thickness than CON at the diaphysis, with no differences for other bone measurements. Serum C-terminal telopeptides of type-1 collagen concentration (bone resorption marker) was higher in RC than MB (p < 0.05) and above the age-reference range. MCSA and strength were greater in MB than RC (p < 0.05). Muscle forces generated during RC appear to produce an osteogenic stimulus to increase radial bone strength indices with minimal improvement in bone structure. However greater resorptive activity in RC suggests inadequate loading to support bone maintenance. In conclusion, bone loading, muscle size and strength of MB are superior to RC.

Anaerobic Power in Road Cyclists Is Improved After 10 Weeks of Whole-body Vibration Training

Abstract Oosthuyse, T, Viedge, A, McVeigh, J, and Avidon, I. Anaerobic power in road cyclists is improved after 10 weeks of whole-body vibration training. J Strength Cond Res 27(2): 485–494, 2013—Whole-body vibration (WBV) training has previously improved muscle power in various athletic groups requiring explosive muscle contractions. To evaluate the benefit of including WBV as a training adjunct for improving aerobic and anaerobic cycling performance, road cyclists (n = 9) performed 3 weekly, 10-minute sessions of intermittent WBV on synchronous vertical plates (30 Hz) while standing in a static posture. A control group of cyclists (n = 8) received no WBV training. Before and after the 10-week intervention period, lean body mass (LBM), cycling aerobic peak power (Wmax), 4 mM lactate concentration (OBLA), V[Combining Dot Above]O2peak, and Wingate anaerobic peak and mean power output were determined. The WBV group successfully completed all WBV sessions but reported a significant 30% decrease in the weekly cycling training time (pre: 9.4 ± 3.3 h·wk−1; post: 6.7 ± 3.7 h·wk−1; p = 0.01) that resulted in a 6% decrease in V[Combining Dot Above]O2peak and a 4% decrease in OBLA. The control group reported a nonsignificant 6% decrease in cycling training volume (pre: 9.5 ± 3.6 h·wk−1; 8.6 ± 2.9 h·wk−1; p = 0.13), and all measured variables were maintained. Despite the evidence of detraining in the WBV group, Wmax was maintained (pre: 258 ± 53 W; post: 254 ± 57 W; p = 0.43). Furthermore, Wingate peak power increased by 6% (668 ± 189 to 708 ± 220 W; p = 0.055), and Wingate mean power increased by 2% (553 ± 157 to 565 ± 157 W; p = 0.006) in the WBV group from preintervention to postintervention, respectively, without any change to LBM. The WBV training is an attractive training supplement for improving anaerobic power without increasing muscle mass in road cyclists.

The Effect of Gender and Menstrual Phase on Serum Creatine Kinase Activity and Muscle Soreness Following Downhill Running

Serum creatine kinase (CK) activity reflects muscle membrane disruption. Oestrogen has antioxidant and membrane stabilising properties, yet no study has compared the CK and muscle soreness (DOMS) response to unaccustomed exercise between genders when all menstrual phases are represented in women. Fifteen eumenorrhoeic women (early follicular, EF (n = 5); late follicular, LF (n = 5); mid-luteal, ML (n = 5) phase) and six men performed 20 min of downhill running (−10% gradient) at 9 km/h. Serum CK activity and visual analogue scale rating of perceived muscle soreness were measured before, immediately, 24-h, 48-h and 72-h after exercise. The 24-h peak CK response (relative to pre-exercise) was similar between women and men (mean change (95% confidence interval): 58.5 (25.2 to 91.7) IU/L; 68.8 (31.3 to 106.3) IU/L, respectively). However, serum CK activity was restored to pre-exercise levels quicker in women (regardless of menstrual phase) than men; after 48-h post exercise in women (16.3 (−4.4 to 37.0) IU/L; 56.3 (37.0 to 75.6) IU/L, respectively) but only after 72-h in men (14.9 (−14.8 to 44.6) IU/L). Parallel to the CK response, muscle soreness recovered by 72-h in men. Conversely, the women still reported muscle soreness at 72-h despite CK levels being restored by 48-h; delayed recovery of muscle soreness appeared mainly in EF and LF. The CK and DOMS response to downhill running is gender-specific. The CK response recovers quicker in women than men. The CK and DOMS response occur in concert in men but not in women. The DOMS response in women is prolonged and may be influenced by menstrual phase.

Changes in substrate utilisation and protein catabolism during multiday cycling in well-trained cyclists

Abstract There is a paucity of studies that have evaluated substrate utilisation and protein catabolism during multiday strenuous exercise in athletes. Eleven well-trained male cyclists completed 3 h of race-simulated cycling on 4 consecutive days. Cyclist exercised 2 h postprandially and with carbohydrate supplementation (~50 g · h−1) during exercise. Whole body substrate utilisation was measured by indirect calorimetry, protein catabolism from sweat and urine urea excretion, and blood metabolite concentration was evaluated. Protein catabolism during exercise was significantly greater on days 2–4 (29.9 ± 8.8; 34.0 ± 11.2; 32.0 ± 7.3 g for days 2, 3, and 4, respectively) compared to day 1 (23.3 ± 7.6 g), P < 0.05. Fat oxidation was greater at 21 km (~45 min) on days 2–4 (1.06 ± 0.23; 1.08 ± 0.25; 1.12 ± 0.29 g · min−1) compared to day 1 (0.74 ± 0.23 g · min−1, P < 0.05), but the rate of carbohydrate and fat oxidation was similar between days at 50 and 80 km. Whole body substrate utilisation is altered on subsequent days of multiday prolonged strenuous cycling that includes a quicker transition to greater fat utilisation from exercise onset and a 28–46% greater reliance on endogenous protein catabolism on all successive days.