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Biomedical subjects

Stavros A Kavouras

Publications and source records attributed to Stavros A Kavouras.

11 recordsLinked to original sources

Water polo is associated with an apparent redistribution of bone mass and density from the lower to the upper limbs.

The bone response to exercise is site-specific and load-dependent. Recent evidence suggests that an inverse relationship may exist between loaded and unloaded sites, such that the former may benefit at the expense of the latter. The present study examined this possibility in 48 males (21 water polo players, 12 handball players, and 15 sedentary controls). Water polo and handball are alike with respect to the active loading of the upper limbs during overhead throwing; however, the weight-supporting environment of water polo removes the weight-bearing effect from the lower limbs. Bone mineral content (BMC), bone projected area (Ap), and areal bone mineral density (aBMD) of the total body and of various subregions were determined by dual-energy X-ray absorptiometry. After adjusting for age, height, and weight, water polo players had higher arms BMC, Ap, and aBMD (by 22.2, 11.1, and 10.5%, respectively; P<0.05), but lower legs aBMD (-6.3%; P<0.05) relative to controls. On the contrary, compared to controls, handball players had higher BMC (from 11.8 to 24.3%), Ap (from 5.2 to 11.7%), and aBMD (from 6.4 to 11.9%) for the total body at all sites. Water polo athletes had increased arms and decreased legs aBMD ratios (regional-to-total) than either handball players or sedentary subjects (P<0.001). Water polo is associated with an apparent redistribution of bone mass and density from the lower to the upper limbs, with no major effects on the rest of the body.

Adolescent↗

Exertional Rhabdomyolysis during a 246-km continuous running race.

BACKGROUND: To evaluate the effect of continuous, moderate-intensity ultra-endurance running exercise on skeletal muscle and hepatic damage, as indicated by serum enzyme activity measured immediately following the race. METHODS: Thirty-nine runners of the Spartathlon race (a 246-km continuous race from Athens to Sparta, Greece) who managed to complete the race within the 36-h limit participated in this study. Mean finishing time of the study participants was 33.3+/-0.5 h and their average age, height, and body mass were 41+/-1 yr, 174+/-1 cm, and 67.5+/-1.1 kg, respectively. Blood samples, taken a day before and immediately after completion of the race, were assayed for the following variables: creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (gamma-GT). RESULTS: A dramatic increase in most of muscle and liver damage indicators was observed. The mean values for CK, LDH, AST, and ALT after the race were 43,763+/-6,764, 2,300+/-285, 1,182+/-165, and 264+/-37 IU.L, respectively. These values were 29,384+/-4,327, 585+/-89, 5,615+/-902, and 1,606+/-331% higher than the corresponding values before the race (P<0.001) for CK, LDH, AST, and ALT, respectively. However, there was not a significant increase in gamma-GT levels. CONCLUSION: Muscle and liver damage indicators were elevated at the highest level ever reported as a result of prolonged exercise, although no severe symptoms that required hospitalization were observed in any of the participants. The data suggest that even moderate-intensity exercise of prolonged duration can induce asymptomatic exertional rhabdomyolysis.

Adult↗

No effect of 5% hypohydration on running economy of competitive runners at 23 degrees C.

PURPOSE: Although running economy (RE) is recognized as an integral component of successful endurance performance and is affected by numerous factors, little is known about the influence of body water loss on RE. This investigation examined the effects of hypohydration (HY) on RE and associated physiological responses. METHODS: Ten highly trained collegiate distance runners (mean +/- SD; age, 20 +/- 3 yr; height, 178.5 +/- 6.3 cm; body mass, 66.7 +/- 5.4 kg; VO2max, 66.5 +/- 4.1 mL x kg(-1) x min(-1)) participated in four experiments on separate days, twice in a euhydrated (EU) and twice in a HY state (-5.5 and -5.7% body mass loss achieved during 24 h). At each hydration level, subjects performed one 10-min treadmill run per day (23 degrees C environment), at either 70% VO2max (EU 70% or HY 70%) or 85% VO2max (EU 85% or HY 85%) in a randomized, repeated-measures design. Cardiopulmonary, metabolic, thermal, hormonal, and perceptual variables were measured. RESULTS: No between-treatment differences existed for RE (EU 70%, 46.3 +/- 3.2; HY 70%, 47.2 +/- 3.8; EU 85%, 58.6 +/- 2.8; HY 85%, 58.9 +/- 4.1 mL x kg(-1) x min(-1)), postexercise plasma lactate concentration (EU 70%, 1.9 +/- 0.6; HY 70%, 1.8 +/- 0.6; EU 85%, 6.5 +/- 3.5; HY 85%, 6.4 +/- 3.5 mmol x L(-1)), or rating of perceived exertion. HY resulted in a greater (P < 0.05 to 0.001) heart rate (HR), rectal temperature, and plasma norepinephrine concentration (NE), concurrent with reduced cardiac output, stroke volume, and respiratory exchange ratio. CONCLUSION: HY did not alter the RE or lactate accumulation of endurance athletes during 10 min of exercise at 70 and 85% VO2max. These findings indicate that HY had no effect on RE, but that it increased physiological strain in a 23 degrees C environment.

Adolescent↗

Rehydration with glycerol: endocrine, cardiovascular, and thermoregulatory responses during exercise in the heat.

The impact of rehydration with glycerol on cardiovascular and thermoregulatory responses during exercise in the heat was studied in eight highly trained male cyclists. Each subject completed three dehydration-rehydration experimental trials that differed only in the rehydration treatment, each separated by 7 days. Before each experimental day, subjects dehydrated to -4% of their body weight by exercise and water restriction. The experimental treatments were as follows: no fluid (NF), glycerol bolus (1 g/kg body wt) followed by water (G), and water alone (W). Rehydration (3% body weight) was given over an 80-min period. After rehydration, subjects cycled (74% peak O2 uptake) to exhaustion in a hot and wet (37 degrees C and 48% relative humidity) environment. For G, plasma volume was expanded (P < 0.05) during rehydration and remained higher than W (P < 0.05) during exercise. Exercise time to exhaustion during G (33 +/- 4 min) was longer (P < 0.05) compared with both W (27 +/- 3 min) and NF (19 +/- 3 min). Cutaneous vascular conductance was significantly elevated (P < 0.05) during G, but G provided no other thermoregulatory or cardiovascular benefits compared with W and NF. Fluid-regulating hormones (vasopressin, aldosterone, atriopeptin, and plasma renin activity) decreased during rehydration and increased during exercise (except atriopeptin), but there were no differences between G and W. These data indicated that glycerol had little or no major effect on fluid-regulating factors during rehydration or exercise, and the improved exercise capacity in G was likely due to a greater plasma volume during exercise.

Adult↗

The anthropometrical and physiological characteristics of elite water polo players.

In order to examine the physical and physiological demands of water polo, we assessed the profile of elite water polo players. Nineteen male professional water polo players (age: 25.5+/-5.0 years, height: 184.5+/-4.3 cm body mass: 90.7+/-6.4 kg) underwent body composition assessment by dual-energy X-ray absorptiometry. We also evaluated peak oxygen consumption VO2peak, lactate threshold (LT), energy cost of swimming (C s), anaerobic capacity and isokinetic shoulder strength. Body fat (%) was 16.8+/-4.4, lean mass (LM) 75.1+/-4.9 kg and bone mineral density (BMD) 1.37+/-0.07 g.cm(-2) . VO2peak was 57.9+/-7 ml.kg(-1). min(-1) . LT was identified at 3.9+/-0.7 mmol.l(-1) at a swimming velocity (v) of 1.33+/-0.05 m.s(-1) with a heart rate of 154+/-7 bpm, corresponding to an intensity of 83+/-9 of VO2peak. The average C s of swimming at the LT was 1.08+/-0.04 kJ.m(-1).C s at LT was correlated to body mass index (BMI) (r=0.22, P=0.04) and to swimming performance at 400 m (r=0.86, P=0.01) and 4 x 50 m (r=0.84, P<0.01). Internal rotator muscles were stronger compared to the external rotators by a 2:1 ratio. This study provides a quantitative representation of both physical and physiological demands of water polo and proposes a comprehensive battery of tests that can be used for assessing the status of a team.

Adult↗

Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls.

The aim of this study was to examine the effect of aerobic exercise training on insulin sensitivity in overweight and obese girls. Nineteen overweight and obese girls (mean +/- SD: age, 13.1+/-1.8 years; body mass index, 26.8+/-3.9 kg/m(2)) volunteered for this study. Body composition (dual-energy x-ray absorptiometry), insulin sensitivity (oral glucose tolerance test and homeostasis model assessment estimate of insulin resistance; n=15), adiponectin, C-reactive protein (CRP), interleukin (IL) 6, insulin-like growth factor-1, soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1 serum levels, and blood lipids and lipoproteins were assessed before and after 12 weeks of aerobic training. Cardiorespiratory fitness increased by 18.8% (P<.05) as a result of training. The area under the insulin concentration curve (insulin area under the curve) decreased by 23.3% (12781.7+/-7454.2 vs 9799.0+/-4918.6 microU.min/mL before and after intervention, respectively; P=.03). Insulin sensitivity was improved without changes in body weight (pre-intervention, 67.9+/-14.5 kg; post-intervention, 68.3+/-14.0 kg) or percent body fat (pre-intervention, 41.4% +/- 4.8%; post-intervention, 40.7%+/-5.2%). The lower limb fat-free mass increased by 6.2% (P<.01) as a result of training, and changes in lower limb fat-free mass were correlated with changes in the insulin area under the curve (r= -.68; P< .01). Serum adiponectin, IL-6, and CRP concentrations did not change (pre-intervention vs post-intervention: adiponectin, 9.57+/-3.01 vs 9.08+/-2.32 microg/mL; IL-6, 1.67+/-1.29 vs 1.65+/-1.25 pg/mL, CRP, 3.21+/-2.48 vs 2.73+/-1.88 mg/L) whereas insulin-like growth factor-1 was lower after training (pre-intervention, 453.8 +/- 159.3 ng/mL; post-intervention, 403.2+/- 155.1 ng/mL; P<.05). In conclusion, 12 weeks of aerobic training improved insulin sensitivity in overweight and obese girls without change in body weight, percent body fat, and circulating concentrations of adiponectin, IL-6, CRP, and other inflammatory markers. These findings suggest that increased physical activity may ameliorate the metabolic abnormalities associated with obesity in children with a mechanism other than the parameters cited earlier.

Adiponectin↗

Caffeine use in sports, pharmacokinetics in man, and cellular mechanisms of action.

Caffeine is the most widely consumed psychoactive 'drug' in the world and probably one of the most commonly used stimulants in sports. This is not surprising, since it is one of the few ergogenic aids with documented efficiency and minimal side effects. Caffeine is rapidly and completely absorbed by the gastrointestinal tract and is readily distributed throughout all tissues of the body. Peak plasma concentrations after normal consumption are usually around 50 microM, and half-lives for elimination range between 2.5-10 h. The parent compound is extensively metabolized in the liver microsomes to more than 25 derivatives, while considerably less than 5% of the ingested dose is excreted unchanged in the urine. There is, however, considerable inter-individual variability in the handling of caffeine by the body, due to both environmental and genetic factors. Evidence from in vitro studies provides a wealth of different cellular actions that could potentially contribute to the observed effects of caffeine in humans in vivo. These include potentiation of muscle contractility via induction of sarcoplasmic reticulum calcium release, inhibition of phosphodiesterase isoenzymes and concomitant cyclic monophosphate accumulation, inhibition of glycogen phosphorylase enzymes in liver and muscle, non-selective adenosine receptor antagonism, stimulation of the cellular membrane sodium/potassium pump, impairment of phosphoinositide metabolism, as well as other, less thoroughly characterized actions. Not all, however, seem to account for the observed effects in vivo, although a variable degree of contribution cannot be readily discounted on the basis of experimental data. The most physiologically relevant mechanism of action is probably the blockade of adenosine receptors, but evidence suggests that, at least under certain conditions, other biochemical mechanisms may also be operational.

Caffeine↗

The influence of low versus high carbohydrate diet on a 45-min strenuous cycling exercise.

To examine the effects of a 3-day high carbohydrate (H-CHO) and low carbohydrate (L-CHO) diet on 45 min of cycling exercise, 12 endurance-trained cyclists performed a 45-min cycling exercise at 82 +/- 2% VO2peak following an overnight fast, after a 6-day diet and exercise control. The 7-day protocol was repeated under 2 randomly assigned dietary trials H-CHO and L-CHO. On days 1-3, subjects consumed a mixed diet for both trials and for days 4-6 consumed isocaloric diets that contained either 600 g or 100 g of carbohydrates, for the H-CHO and the L-CHO trials, respectively. Muscle biopsy samples, taken from the vastus lateralis prior to the beginning of the 45-min cycling test, indicated that muscle glycogen levels were significantly higher (p < .05) for the H-CHO trial (104.5 +/- 9.4 mmol/kg wet wt) when compared to the L-CHO trial (72.2 +/- 5.6 mmol/kg wet wt). Heart rate, ratings of perceived exertion, oxygen uptake, and respiratory quotient during exercise were not significantly different between the 2 trials. Serum glucose during exercise for the H-CHO trial significantly increased (p < .05) from 4.5 +/- 0.1 mmol x L(-1) (pre) to 6.7 +/- 0.6 mmol x L(-1) (post), while no changes were found for the L-CHO trial. In addition, post-exercise serum glucose was significantly greater (p < .05) for the H-CHO trial when compared to the L-CHO trial (H-CHO, 6.7 +/- 0.6 mmol x L(-1); L-CHO, 5.2 +/- 0.2 mmol x L(-1)). No significant changes were observed in serum free fatty acid, triglycerides, or insulin concentration in either trial. The findings suggest that L-CHO had no major effect on 45-min cycling exercise that was not observed with H-CHO when the total energy intake was adequate.

Adult↗

Effect of maltose-containing sports drinks on exercise performance.

This study examined the effect of maltose-containing sports drinks on exercise performance. Ten subjects completed 4 trials. Each trial consisted of a glycogen depletion protocol, followed by a 15-min refueling, after which subjects performed an 1-h performance test while consuming one of the experimental drinks (HGlu, glucose; HMal, maltose; MalMix, sucrose, maltose, and maltodextrin; Plac, placebo). Drinks provided 0.65 g/kg body weight carbohydrates during refueling and 0.2 g/kg every 15 min during the performance test. Although no significant differences were found in performance (HGlu: 67.2 +/- 2.0; HMal: 68.6 +/- 1.7; MalMix: 66.7 +/- 2.0; Plac: 69.4 +/- 3.0 min, P> 0.05), subjects completed the MalMix trial 3.9%; faster than the Plac. Carbohydrate drinks caused comparable plasma glucose values that were significantly higher during refueling and at the end of exercise, compared to Plac. The data suggest that although carbohydrate drinks help to maintain plasma glucose at a higher level, no differences in performance could be detected after glycogen-depleting exercise.

Adult↗

Caffeine and ephedrine: physiological, metabolic and performance-enhancing effects.

Preparations containing caffeine and ephedrine have become increasingly popular among sportspersons in recent years as a means to enhance athletic performance. This is due to a slowly accumulating body of evidence suggesting that combination of the two drugs may be more efficacious than each one alone. Caffeine is a compound with documented ergogenicity in various exercise modalities, while ephedrine and related alkaloids have not been shown, as yet, to result in any significant performance improvements. Caffeine-ephedrine mixtures, however, have been reported in several instances to confer a greater ergogenic benefit than either drug by itself. Although data are limited and heterogeneous in nature to allow for reaching consensus, the increase in performance is a rather uniform finding as it has been observed during submaximal steady-state aerobic exercise, short- and long-distance running, maximal and supramaximal anaerobic cycling, as well as weight lifting. From the metabolic point of view, combined ingestion of caffeine and ephedrine has been observed to increase blood glucose and lactate concentrations during exercise, wheareas qualitatively similar effects on lipid fuels (free fatty acids and glycerol) are less pronounced. In parallel, epinephrine and dopamine concentrations are significantly increased, wheareas the effects on norepinephrine are less clear. With respect to pulmonary gas exchange during short-term intense exercise, no physiologically significant effects have been reported following ingestion of caffeine, ephedrine or their combination. Yet, during longer and/or more demanding efforts, some sporadic enhancements have indeed been shown. On the other hand, a relatively consistent cardiovascular manifestation of the latter preparation is an increase in heart rate, in addition to that caused by exercise alone. Finally, evidence to date strongly suggests that caffeine and ephedrine combined are quite effective in decreasing the rating of perceived exertion and this seems to be independent of the type of activity being performed. In general, our knowledge and understanding of the physiological, metabolic and performance-enhancing effects of caffeine-ephedrine mixtures are still in their infancy. Research in this field is probably hampered by sound ethical concerns that preclude administration of potentially hazardous substances to human volunteers. In contrast, while it is certainly true that caffeine and especially ephedrine have been associated with several acute adverse effects on health, athletes do not seem to be concerned with these, as long as they perceive that their performance will improve. In light of the fact that caffeine and ephedra alkaloids, but not ephedrine itself, have been removed from the list of banned substances, their use in sports can be expected to rise considerably in the foreseeable future. Caffeine-ephedra mixtures may thus become one of most popular ergogenic aids in the years to come and while they may indeed prove to be one of the most effective ones, and probably one of the few legal ones, whether they also turn out to be one of the most dangerous ones awaits to be witnessed.

Adrenergic Agents↗

Assessing hydration status.

PURPOSE: Understanding the importance of euhydration in humans in order to ensure good health in various situations, the purpose of this review is to examine the available techniques in assessing hydration status. RECENT FINDINGS: During the past 20 years, many indices have been developed to assess hydration levels accurately in humans. Changes in body weight, haematological and urine parameters, bioelectrical impedance, skinfold thickness, heart rate and blood pressure changes are among these indices. Plasma osmolality, urine osmolality and urine specific gravity are the most widely used markers of hydration. However, urine colour has also been used with reasonable accuracy when laboratory analysis is not available or when a quick estimate of hydration is necessary. Some data indicate that urine colour is as good indicator of hydration as plasma or urine osmolality or urine specific gravity. SUMMARY: Although there is no 'gold standard' for assessment of hydration status, it appears that changes in body weight, along with urine osmolality, specific gravity, conductivity and colour are among the most widely used indices. Furthermore, they provide reasonable results, especially when the analysis is based on the first morning urine sample.

Blood Chemical Analysis↗