UNASSIGNED: Ketogenic diets and ketone supplements have gained popularity among endurance runners given their purported effects: potentially delaying the onset of fatigue by enabling the increased utilization of the body\'s fat reserve or external ketone bodies during prolonged running.
UNASSIGNED: This systematic review was conducted to evaluate the effects of ketogenic diets (>60% fat and <10% carbohydrates/<50 g carbohydrates per day) or ketone supplements (ketone esters or ketone salts, medium-chain triglycerides or 1,3-butadiol) on the aerobic performance of endurance runners.
UNASSIGNED: A systematic search was conducted in PubMed, Web of Science, Pro Quest, and Science Direct for publications up to October 2023.
UNASSIGNED: Human studies on the effects of ketogenic diets or ketone supplements on the aerobic performance of adult endurance runners were included after independent screening by 2 reviewers.
UNASSIGNED: Systematic review.
UNASSIGNED: Level 3.
UNASSIGNED: Primary outcomes were markers of aerobic performance (maximal oxygen uptake [VO2max], race time, time to exhaustion and rate of perceived exertion).
UNASSIGNED: VO2max was assessed by incremental test to exhaustion. Endurance performance was assessed by time trials, 180-minute running trials, or run-to-exhaustion trials; 5 studies on ketogenic diets and 7 studies on ketone supplements involving a total of 132 endurance runners were included. Despite the heterogeneity in study design and protocol, none reported benefits of ketogenic diets or ketone supplements on selected markers of aerobic performance compared with controls. Reduction in bodyweight and fat while preserving lean mass and improved glycemic control were reported in some included studies on ketogenic diets.
UNASSIGNED: This review did not identify any significant advantages or disadvantages of ketogenic diets or ketone supplements for the aerobic performance of endurance runners. Further trials with larger sample sizes, more gender-balanced participants, longer ketogenic diet interventions, and follow-up on metabolic health are warranted.

Probiotics are increasingly used to treat conditions associated with gastrointestinal injury and permeability, including exercise-induced gastrointestinal discomfort. This study assessed safety and efficacy of a probiotic in altering the intestinal milieu and mitigating gastrointestinal symptoms (GIS) in endurance runners. In a double blind, crossover study, 16 runners were randomized to 4 weeks of daily supplementation with a probiotic cocktail containing Pediococcus acidilactici bacteria and Lactobacillus plantarum or placebo. Fasting blood and stool samples were collected for measurement of gut permeability markers, immune parameters, and microbiome analyses. Treadmill run tests were performed before and after treatment; participants ran at 65%-70% of VO2max at 27 °C for a maximum of 90 min or until fatigue/GIS developed. A blood sample was collected after the treadmill run test. In healthy individuals, 4 weeks of probiotic supplementation did not alter health parameters, although a marginal reduction in aspartate aminotransferase levels was observed with probiotic treatment only (p = 0.05). GIS, gut permeability-associated parameters (intestinal fatty acid binding protein, lipopolysaccharide binding protein, zonulin, and cytokines), and intestinal microbial content were not altered by the probiotic supplementation. Post-run measurements of GIS and gut-associated parameters did not differ between groups; however, the observed lack of differences is confounded by an absence of measurable functional outcome as GIS was not sufficiently induced during the run. Under the current study conditions, the probiotic was safe to use, and did not affect gut- or immune-associated parameters, or intestinal symptoms in a healthy population. The probiotic might reduce tissue damage, but more studies are warranted.

Purpose: In the last decades, the energy cost assessment provided new insight on shuttle or constant running as training modalities. No study, though, quantified the benefit of constant/shuttle running in soccer-players and runners. Therefore, the aim of this study was to clarify if marathon runners and soccer players present specific energy cost values related to their training experience performing constant and shuttle running. Methods: To this aim, eight runners (age 34 ± 7.30y; training experience 5.70 ± 0.84y) and eight soccer-players (age 18.38 ± 0.52y; training experience 5.75 ± 1.84y) were assessed randomly for 6\' on shuttle-running or constant-running with 3 days of recovery in-between. For each condition, the blood lactate (BL) and the energy cost of constant (Cr) and shuttle running (CSh) was determined. To assess differences for metabolic demand in terms of Cr, CSh and BL over the two running conditions on the two groups a MANOVA was used. Results: V·O2max were 67.9 ± 4.5 and 56.8 ± 4.3 ml·min-1 kg-1 (p = 0.0002) for marathon runners and soccer players, respectively. On constant running, the runners had a lower Cr compared to soccer players (3.86 ± 0.16 J kg-1m-1 vs. 4.19 ± 0.26 J kg-1 m-1; F = 9.759, respectively; p = 0.007). On shuttle running, runners had a higher CSh compared to soccer players (8.66 ± 0.60 J kg-1 m-1 vs. 7.86 ± 0.51 J kg-1 m-1; F = 8.282, respectively; with p = 0.012). BL on constant running was lower in runners compared to soccer players (1.06 ± 0.07 mmol L-1 vs. 1.56 ± 0.42 mmol L-1, respectively; with p = 0.005). Conversely, BL on shuttle running was higher in runners compared to soccer players 7.99 ± 1.49 mmol L-1 vs. 6.04 ± 1.69 mmol L-1, respectively; with p = 0.028). Conclusion: The energy cost optimization on constant or shuttle running is strictly related to the sport practiced.

Few studies in the literature have illustrated cold hypoalgesia induced by strength training. Objectives of this contribution were to compare the ratings of perceived pain in endurance running (n = 22) and powerlifting (n = 22) male athletes and controls (n = 22) at baseline and after two bouts of 40 min aerobic/strength training respectively, using the Cold Pressor Test (CPT) and simultaneously monitoring changes in blood pressure (BP), heart rate (HR), and body temperature. A two-way repeated measures ANOVA was conducted to examine the effects of training sessions in endurance runners vs. powerlifting athletes vs. controls on the intensity of perceived pain at CPT. A statistically significant two-way interaction between the group and training resulted in p < 0.001, ηp2 = 0.513. A simple main effects analysis showed that as the participants went through the strength training session, pain perception at CPT was significantly lower in powerlifters compared to runners and controls. Considering the physiological parameters, powerlifters reported significantly higher values of BP and HR. This difference was present at baseline but after training as well, and before and after CPT, despite a slight hypotensive effect. The differences reported after CPT at baseline, but very significantly after the strength activation session in the powerlifters, provide interesting insights into the hypoalgesic effect of high-intensity strength training.

It is not fully understood how supplementation with omega-3 fatty acids affects the metabolism of amino acids required for the bioavailability/synthesis of NO, i.e., L-arginine (L-arg), asymmetric dimethylarginine (ADMA), their metabolites, and the L-arg/ADMA ratio and their impact on running economy (RE) in runners. Thus, 26 male amateur endurance runners completed a twelve-week study in which they were divided into two supplemented groups: the OMEGA group (n = 14; 2234 mg and 916 mg of eicosapentaenoic and docosahexaenoic acid daily) or the MCT group (n = 12; 4000 mg of medium-chain triglycerides daily). At the same time, all participants followed an endurance training program. Before and after the 12-week intervention, blood was collected from participants at two time points (at rest and immediately post-exercise) to determine EPA and DHA in red blood cells (RBCs) and plasma levels of L-arg, ADMA, and their metabolites. RBC EPA and DHA significantly increased in the OMEGA group (p < 0.001), which was related to the resting increase in L-arg (p = 0.001) and in the L-arg/ADMA ratio (p = 0.005) with no changes in the MCT group. No differences were found in post-exercise amino acid levels. A total of 12 weeks of omega-3 fatty acid supplementation at a dose of 2234 mg of EPA and 916 mg of DHA daily increased levels of L-arg and the L-arg/ADMA ratio, which indirectly indicates increased bioavailability/NO synthesis. However, these changes were not associated with improved RE in male amateur endurance runners.

Peak oxygen uptake (VO2peak) is one of the most reliable parameters of exercise capacity; however, maximum effort is required to achieve this. Therefore, alternative, and repeatable submaximal parameters, such as running economy (RE), are needed. Thus, we evaluated the suitability of oxygen uptake efficiency (OUE), oxygen uptake efficiency plateau (OUEP) and oxygen uptake efficiency at the ventilatory anaerobic threshold (OUE@VAT) as alternatives for VO2peak and RE. Moreover, we evaluated how these parameters are affected by endurance training and supplementation with omega-3 fatty acids. A total of 26 amateur male runners completed a 12-week endurance program combined with omega-3 fatty acid supplementation or medium-chain triglycerides as a placebo. Before and after the intervention, the participants were subjected to a treadmill test to determine VO2peak, RE, OUE, OUEP and OUE@VAT. Blood was collected at the same timepoints to determine eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes. OUE correlated moderately or weakly with VO2peak (R2 = 0.338, p = 0.002) and (R2 = 0.226, p = 0.014) before and after the intervention, respectively. There was a weak or no correlation between OUEP, OUE@VAT, VO2peak and RE despite steeper OUE, increased OUEP and OUE@VAT values in all participants. OUE parameters cannot be treated as alternative parameters for VO2peak or RE and did not show changes following supplementation with omega-3 fatty acids in male amateur endurance runners.

Regular physical activity, recommended by the WHO, is crucial in maintaining a good physical fitness level and health status and slows down the effects of aging. However, there is a lack of knowledge of whether lifelong endurance running, with a volume and frequency above the WHO limits, still brings the same benefits, or several negative effects too. The present study aims to examine the protentional benefits and risks of lifelong endurance running training in Master male athletes, as this level of physical activity is above the WHO recommendations. Within the study, four main groups of participants will be included: (1) endurance-trained master athletes, (2) endurance-trained young athletes, (3) young sedentary adults, and (4) elderly sedentary. Both groups of athletes are strictly marathon runners, who are still actively running. The broad spectrum of the diagnostic tests, from the questionnaires, physical fitness testing, and blood sampling to muscle biopsy, will be performed to obtain the possibility of complexly analyzing the effects of lifelong endurance physical activity on the human body and aging. Moreover, the study will try to discover and explain new relationships between endurance running and diagnostic parameters, not only within aging.

BACKGROUND: The use of normobaric hypoxia can bring benefits to sports performance because it improves haematological parameters and/or physical activity tests. Our objective was to conduct a systematic review so as to analyse the methods used in hypoxia and to detect its effects on middle- and/or long-distance runners.
METHODS: Research was conducted using five electronic databases (PubMed, SportDiscus, Cochrane Library, Scopus and PEDro) until December 2021. The methodological quality of the included studies was assessed using the PEDro scale.
RESULTS: Having analysed 158 studies, 12 were chosen for the qualitative and quantitative synthesis. A significant improvement on time until exhaustion was detected, and oxygen saturation decreased after the intervention. There were no significant changes in the 3000-metre time trial or in the haematocrit percentage. The changes in percentage of reticulocytes, heart rate, maximal heart rate, lactate concentration and erythropoietin were heterogeneous between the different research studies.
CONCLUSIONS: short exposure (less than 3 h to normobaric hypoxia significantly increases the time to exhaustion). However, longer exposure times are necessary to increase haemoglobin. Altitude and exposure time are highly heterogeneous in the included studies.

UNASSIGNED: The aim of this study was to investigate the effects of gradient and speed on running variability (RV) and local dynamic stability (LDS) during uphill running.
UNASSIGNED: (1) Both gradient and speed increase metabolic effort, in terms of heart rate (HR) and perceived exertion (CR10), in line with the contemporary literature, and (2) gradient increases RV and impairs LDS.
UNASSIGNED: \"Crossover\" observational design.
UNASSIGNED: Level 3.
UNASSIGNED: A total of 25 runners completed 10-minute running trials in 3 different conditions and in a randomized order: gradient at 0% (0CON), 2% (2CON), and 2% at isoefficiency speed (2IES). 0CON and 2CON speeds were calculated as the \"best 10-km race performance\" minus 1 km·h-1, whereas 2IES speed was adjusted to induce the same metabolic expenditure as 0CON. HR and perceived exertion as well as running kinematic variables were collected across all trials and conditions. Running variability was calculated as the standard deviation of the mean stride-to-stride intervals over 100 strides, while LDS was expressed by the Lyapunov exponent (LyE) determined on running cycle time over different running conditions.
UNASSIGNED: Increases in HR and CR10 were observed between 0CON and 2CON (P < 0.001) and between 2IES and 2CON (P < 0.01). Higher RV was found in 2CON compared with 0CON and 2IES (both P < 0.001). Finally, the largest LyE was observed in 2IES compared with 0CON and 2CON (P = 0.02 and P = 0.01, respectively).
UNASSIGNED: Whereas RV seems to be dependent more on metabolic effort, LDS is affected by gradient to a greater extent.
UNASSIGNED: Running variability could be used to monitor external training load in marathon runners.

The objective of this review was to identify studies that report the pre-exercise effects of isometric exercise versus static stretching on performance and injury rates of running athletes in comparison to their outcomes. Seven electronic databases were searched: Cochrane, PEDro, CINAHL, PubMed, MEDLINE, SportDiscus, and GoogleScholar. Data was collected using an established PICO question, and assembled logic grid. The included articles were required to (1) assess running performance or injury prevention and (2) include isometric exercises/muscle activation and/or static stretching. Articles published prior to the year 2000, non-English, and non-human studies were excluded. Quality was assessed using the PEDro quality appraisal tool for RCTs, and NIH-NHLBI appraisal tool for others. The Cochrane collaboration tool for risk of bias as well as the PRISMA 2020 statement were also used in this review. In the nine articles appraised in the study, variables assessed included running economy, injury rate, soreness levels, sprint times, and countermovement and drop jump height. Static stretching demonstrated a significant negative effect on sprint performance and countermovement/drop jump height. It also demonstrated a decrease in variables associated with injury over extended periods and no impact on running economy. Isometric holds demonstrated no significant effect on sprint performance or countermovement/drop jump height. It also demonstrated decreases in soreness levels and no impact on running economy. Isometric holds have positive effects/fewer negative results on running athletes when compared to static stretching for pre-exercise performance. Research with decreased risk of bias is needed to determine maximal benefits from timing/dosage of isometric hold in warm-up.