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BACKGROUND: Palmitoylethanolamide (PEA) is an endocannabinoid-like lipid mediator which is naturally produced in the body and found in certain foods. The aim of this study was to assess the effect of a bioavailable formulated form of PEA (Levagen+®) on serum BDNF levels and parameters of cognitive function in healthy adults. METHODS: A randomised double-blinded placebo-controlled cross-over trial was implemented to measure the effects of a 6-week 700 mg/day course of formulated PEA supplementation versus a placebo. Participants (n = 39) completed pre- and post-assessments of a lab-based cognitive test. Serum samples were collected to measure BDNF concentrations using an immunoassay. RESULTS: A significant increase in serum BDNF levels was found following PEA supplementation compared with the placebo (p = 0. 0057, d = 0.62). The cognition test battery demonstrated improved memory with PEA supplementation through better first success (p = 0.142, d = 0.54) and fewer errors (p = 0.0287; d = -0.47) on the Paired Associates Learning test. CONCLUSION: This was the first study to report a direct beneficial effect of Levagen+® PEA supplementation on memory improvement as well as corresponding increases in circulating neurotrophic marker levels. This suggests that formulated PEA holds promise as an innovative and practical intervention for cognitive health enhancement.

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Police officers are at high risk of developing obesity and cardiometabolic health conditions. Their job presents challenges that contribute to this, predominantly shift work, which causes circadian misalignment and can impair metabolism. Food consumption plays a critical role in the synchronisation of the circadian system. Thus, the aim of this study was to understand the barriers and the impact that different shift types have on the dietary habits of police officers in the UK. A concurrent mixed-methods design was used through an online survey that was open to all police officers who were currently working shifts in the UK. One hundred and twenty-seven police officers were included in the analysis. Diet quality was significantly worse on all shift types than on rest days (P < 0·001) and was negatively correlated with BMI on all shifts: early shift (= -0·29, P = 0·001), late shift (rs(105) = -0·25, P = 0·009), nightshift (rs(104) = -0·24, P = 0·013) and rest days (rs(117) = -0·31, P = 0·001). Participants reported that shift work had altered their frequency and timing of food consumption and had increased their reliance on convenience and poor-quality food. Barriers to healthy eating included lacking time (87 %), motivation (65 %) and cost (48 %). Convenience was ranked the highest influence on food choice (49 %), followed by price (41·5 %). Police officers are faced with unavoidable challenges when it comes to eating healthily. Future police-specific dietary interventions are required, providing practical solutions to these barriers so that behaviour change is more likely to be implemented.

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BACKGROUND: Digital health interventions are efficacious in health-promoting behaviors (eg, healthy eating and regular physical activity) that mitigate health risks and menopausal symptoms in midlife. However, integrated evidence-based knowledge about the mechanisms of change in these interventions is unclear. OBJECTIVE: This systematic review aimed to evaluate studies on behavior change techniques (BCTs) and mechanisms of change in digital health interventions aimed at promoting health-enhancing behaviors in midlife women (aged 40-65 years). METHODS: A systematic literature search of the electronic databases PubMed, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials in the Cochrane Library was conducted. In total, 2 independent reviewers selected the studies for inclusion, extracted data, and completed BCT mapping of eligible studies. The mechanism of action and intervention functions of eligible studies were evaluated using the behavior change wheel framework. Reporting of psychological theory use within these interventions was explored using the Theory Coding Scheme. Mode of delivery, psychological theory, and BCTs were presented as descriptive statistics. RESULTS: In total, 13 interventions (including 1315 women) reviewed used 13 (SD 4.30, range 6-21) BCTs per intervention on average. The "Shaping knowledge" and "Repetition and substitution" behavior change categories were used most frequently, with 92% (12/13) of the interventions implementing at least one of the BCTs from these 2 categories. Only 13.98% (169/1209) of the 93 available BCTs were used, with "Instructions on behaviour" most frequently used (12/13, 92%). The behavior change wheel mapping suggests that half of the intervention content aimed to increase "Capability" (49/98, 50% of the intervention strategies), "Motivation" (41/98, 42%), and "Opportunity" (8/98, 8%). "Behavioural Regulation" was the most frequently used mechanism of action (15/98, 15%), followed by increasing "Knowledge" (13/98, 13%) and "Cognitive and Interpersonal skills" (10/98, 10%). A total of 78% (7/9) of the intervention functions were used in the studies to change behavior, primarily through "Enablement" (60/169, 35.5%), whereas no study used "Restriction" or "Modelling" functions. Although 69% (9/13) of the interventions mentioned a psychological theory or model, most (10/13, 77%) stated or suggested rather than demonstrated the use of a theoretical base, and none reported explicit links between all BCTs within the intervention and the targeted theoretical constructs. Technological components were primarily based on web-based (9/13, 69%) modes of delivery, followed by phone or SMS text message (8/13, 62%) and wearables (7/13, 54%). CONCLUSIONS: The findings of this review indicate an overall weak use of theory, low levels of treatment fidelity, insignificant outcomes, and insufficient description of several interventions to support the assessment of how specific BCTs were activated. Thus, the identified limitations in the current literature provide an opportunity to improve the design of lifestyle health-enhancing interventions for women in midlife. TRIAL REGISTRATION: PROSPERO CRD42021259246; https://tinyurl.com/4ph74a9u.

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Commercial saturation divers are exposed to unique environmental conditions and are required to conduct work activity underwater. Consequently, divers' physiological status is shown to be perturbed and therefore, appropriate strategies and guidance are required to manage the stress and adaptive response. This study aimed to evaluate the daily energy expenditure (DEE) of commercial saturation divers during a 21-day diving operation in the North Sea. Ten saturation divers were recruited during a diving operation with a living depth of 72 metres seawater (msw) and a maximum working dive depth of 81 msw. Doubly labelled water (DLW) was used to calculate DEE during a 10-day measurement period. Energy intake was also recorded during this period by maintaining a dietary log. The mean DEE calculated was 3030.9 ± 513.0 kcal/day, which was significantly greater than the mean energy intake (1875.3 ± 487.4 kcal; p = 0.005). There was also a strong positive correction correlation between DEE and total time spent performing underwater work (r = 0.7, p = 0.026). The results suggested saturation divers were in a negative energy balance during the measurement period with an intraindividual variability in the energy cost present that may be influenced by time spent underwater.

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Purpose: The purpose of this study was to investigate whether mouth rinsing with a pink non-caloric, artificially sweetened solution can improve self-selected running speed and distance covered during a 30 min running protocol. Methods: Ten healthy and habitually active individuals (six males, four females) completed two experimental trials in a randomised, single-blind, crossover design. Each experimental trial consisted of a 30 min treadmill run at a self-selected speed equivalent to 15 (hard/heavy) on the rating of perceived exertion scale. During exercise, participants mouth rinsed with either a pink or a clear non-caloric, artificially sweetened solution, with performance, perceptual and physiological measures obtained throughout. Results: Self-selected running speed (+0.4 ± 0.5 km·h-1, p = 0.024, g = 0.25) and distance covered (+213 ± 247 m, p = 0.023, g = 0.25) during the 30 min running protocol were both improved by 4.4 ± 5.1% when participants mouth rinsed with the pink solution when compared to the clear solution. Feelings of pleasure were also enhanced during the 30 min treadmill run when participants mouth rinsed with the pink solution, with ratings increased from 3.4 ± 0.7 in the clear condition to 3.8 ± 0.6 in the pink condition (+0.4 ± 0.5, p = 0.046, g = 0.54). Conclusion: Mouth rinsing with a pink non-caloric, artificially sweetened solution improved self-selected running speed, total distance covered, and feelings of pleasure obtained during a 30 min running protocol when compared to an isocaloric and taste-matched clear solution.

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OBJECTIVES: This study aimed to investigate whether supplementation with 12 mg⋅day-1 astaxanthin for 7 days can improve exercise performance and metabolism during a 40 km cycling time trial. DESIGN: A randomised, double-blind, crossover design was employed. METHODS: Twelve recreationally trained male cyclists (VO2peak: 56.5 ± 5.5 mL⋅kg-1⋅min-1, Wmax: 346.8  ± 38.4 W) were recruited. Prior to each experimental trial, participants were supplemented with either 12 mg⋅day-1 astaxanthin or an appearance-matched placebo for 7 days (separated by 14 days of washout). On day 7 of supplementation, participants completed a 40 km cycling time trial on a cycle ergometer, with indices of exercise metabolism measured throughout. RESULTS: Time to complete the 40 km cycling time trial was improved by 1.2 ± 1.7% following astaxanthin supplementation, from 70.76 ± 3.93 min in the placebo condition to 69.90 ± 3.78 min in the astaxanthin condition (mean improvement = 51 ± 71 s, p = 0.029, g = 0.21). Whole-body fat oxidation rates were also greater (+0.09 ± 0.13 g⋅min-1, p = 0.044, g = 0.52), and the respiratory exchange ratio lower (-0.03 ± 0.04, p = 0.024, g = 0.60) between 39-40 km in the astaxanthin condition. CONCLUSIONS: Supplementation with 12 mg⋅day-1 astaxanthin for 7 days provided an ergogenic benefit to 40 km cycling time trial performance in recreationally trained male cyclists and enhanced whole-body fat oxidation rates in the final stages of this endurance-type performance event.

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This study investigated the effects of two separate doses of sodium bicarbonate (NaHCO3) on 4 km time trial (TT) cycling performance and post-exercise acid base balance recovery in hypoxia. Fourteen club-level cyclists completed four cycling TT's, followed by a 40 min passive recovery in normobaric hypoxic conditions (FiO2 = 14.5%) following one of either: two doses of NaHCO3 (0.2 g.kg-1 BM; SBC2, or 0.3 g.kg-1 BM; SBC3), a taste-matched placebo (0.07 g.kg-1 BM sodium chloride; PLA), or a control trial in a double-blind, randomized, repeated-measures and crossover design study. Compared to PLA, TT performance was improved following SBC2 (p = 0.04, g = 0.16, very likely beneficial), but was improved to a greater extent following SBC3 (p = 0.01, g = 0.24, very likely beneficial). Furthermore, a likely benefit of ingesting SBC3 over SBC2 was observed (p = 0.13, g = 0.10), although there was a large inter-individual variation. Both SBC treatments achieved full recovery within 40 min, which was not observed in either PLA or CON following the TT. In conclusion, NaHCO3 improves 4 km TT performance and acid base balance recovery in acute moderate hypoxic conditions, however the optimal dose warrants an individual approach.

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PURPOSE: Exacerbated hydrogen cation (H+) production is suggested to be a key determinant of fatigue in acute hypoxic conditions. This study, therefore, investigated the effects of NaHCO3 ingestion on repeated 4 km TT cycling performance and post-exercise acid-base balance recovery in acute moderate hypoxic conditions. METHODS: Ten male trained cyclists completed four repeats of 2 × 4 km cycling time trials (TT1 and TT2) with 40 min passive recovery, each on different days. Each TT series was preceded by supplementation of one of the 0.2 g kg-1 BM NaHCO3 (SBC2), 0.3 g kg-1 BM NaHCO3 (SBC3), or a taste-matched placebo (0.07 g kg-1 BM sodium chloride; PLA), administered in a randomized order. Supplements were administered at a pre-determined individual time to peak capillary blood bicarbonate concentration ([HCO3-]). Each TT series was also completed in a normobaric hypoxic chamber set at 14.5% FiO2 (~ 3000 m). RESULTS: Performance was improved following SBC3 in both TT1 (400.2 ± 24.1 vs. 405.9 ± 26.0 s; p = 0.03) and TT2 (407.2 ± 29.2 vs. 413.2 ± 30.8 s; p = 0.01) compared to PLA, displaying a very likely benefit in each bout. Compared to SBC2, a likely and possible benefit was also observed following SBC3 in TT1 (402.3 ± 26.5 s; p = 0.15) and TT2 (410.3 ± 30.8 s; p = 0.44), respectively. One participant displayed an ergolytic effect following SBC3, likely because of severe gastrointestinal discomfort, as SBC2 still provided ergogenic effects. CONCLUSION: NaHCO3 ingestion improves repeated exercise performance in acute hypoxic conditions, although the optimal dose is likely to be 0.3 g kg-1 BM.

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Acute moderate hypoxic exposure can substantially impair exercise performance, which occurs with a concurrent exacerbated rise in hydrogen cation (H+) production. The purpose of this study was therefore, to alleviate this acidic stress through sodium bicarbonate (NaHCO3) supplementation and determine the corresponding effects on severe-intensity intermittent exercise performance. Eleven recreationally active individuals participated in this randomised, double-blind, crossover study performed under acute normobaric hypoxic conditions (FiO2% = 14.5%). Pre-experimental trials involved the determination of time to attain peak bicarbonate anion concentrations ([HCO3-]) following NaHCO3 ingestion. The intermittent exercise tests involved repeated 60-s work in their severe-intensity domain and 30-s recovery at 20 W to exhaustion. Participants ingested either 0.3 g kg bm-1 of NaHCO3 or a matched placebo of 0.21 g kg bm-1 of sodium chloride prior to exercise. Exercise tolerance (+ 110.9 ± 100.6 s; 95% CI 43.3-178 s; g = 1.0) and work performed in the severe-intensity domain (+ 5.8 ± 6.6 kJ; 95% CI 1.3-9.9 kJ; g = 0.8) were enhanced with NaHCO3 supplementation. Furthermore, a larger post-exercise blood lactate concentration was reported in the experimental group (+ 4 ± 2.4 mmol l-1; 95% CI 2.2-5.9; g = 1.8), while blood [HCO3-] and pH remained elevated in the NaHCO3 condition throughout experimentation. In conclusion, this study reported a positive effect of NaHCO3 under acute moderate hypoxic conditions during intermittent exercise and therefore, may offer an ergogenic strategy to mitigate hypoxic induced declines in exercise performance.

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OBJECTIVE: To quantify the effects of acute hypoxic exposure on exercise capacity and performance, which includes continuous and intermittent forms of exercise. DESIGN: A systematic review was conducted with a three-level mixed effects meta-regression. The ratio of means method was used to evaluate main effects and moderators providing practical interpretations with percentage change. DATA SOURCES: A systemic search was performed using three databases (Google scholar, PubMed and SPORTDiscus). Eligibility criteria for selecting studies: Inclusion was restricted to investigations that assessed exercise performance (time trials (TTs), sprint and intermittent exercise tests) and capacity (time to exhaustion test, TTE) with acute hypoxic (<24 h) exposure and a normoxic comparator. RESULTS: Eighty-two outcomes from 53 studies (N = 798) were included in this review. The results show an overall reduction in exercise performance/capacity -17.8 ± 3.9% (95% CI -22.8% to -11.0%), which was significantly moderated by -6.5 ± 0.9% per 1000 m altitude elevation (95% CI -8.2% to -4.8%) and oxygen saturation (-2.0 ± 0.4%; 95% CI -2.9% to -1.2%). TT (-16.2 ± 4.3%; 95% CI -22.9% to -9%) and TTE (-44.5 ± 6.9%; 95% CI -51.3% to -36.7%) elicited a negative effect, whilst indicating a quadratic relationship between hypoxic magnitude and both TTE and TT performance. Furthermore, exercise less than 2 min exhibited no ergolytic effect from acute hypoxia. Summary/Conclusion: This review highlights the ergolytic effect of acute hypoxic exposure, which is curvilinear for TTE and TT performance with increasing hypoxic levels, but short duration intermittent and sprint exercise seem to be unaffected.

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The aim of this study was to investigate the effects of sodium bicarbonate (NaHCO3) on 4 km cycling time trial (TT) performance when individualised to a predetermined time to peak blood bicarbonate (HCO3-). Eleven male trained cyclists volunteered for this study (height 1.82 ± 0.80 m, body mass (BM) 86.4 ± 12.9 kg, age 32 ± 9 years, peak power output (PPO) 382 ± 22 W). Two trials were initially conducted to identify time to peak HCO3- following both 0.2 g.kg-1 BM (SBC2) and 0.3 g.kg-1 BM (SBC3) NaHCO3. Thereafter, on three separate occasions using a randomised, double-blind, crossover design, participants completed a 4 km TT following ingestion of either SBC2, SBC3, or a taste-matched placebo (PLA) containing 0.07 g.kg-1 BM sodium chloride (NaCl) at the predetermined individual time to peak HCO3-. Both SBC2 (-8.3 ± 3.5 s; p < 0.001, d = 0.64) and SBC3 (-8.6 ± 5.4 s; p = 0.003, d = 0.66) reduced the time to complete the 4 km TT, with no difference between SBC conditions (mean difference = 0.2 ± 0.2 s; p = 0.87, d = 0.02). These findings suggest trained cyclists may benefit from individualising NaHCO3 ingestion to time to peak HCO3- to enhance 4 km TT performance.

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PURPOSE: This study investigated the effect of induced alkalosis on the curvature constant (W') of the power-duration relationship under normoxic and hypoxic conditions. METHODS: Eleven trained cyclists (mean ± SD) Age: 32 ± 7.2 years; body mass (bm): 77.0 ± 9.2 kg; VO2peak: 59.2 ± 6.8 ml·kg-1·min-1 completed seven laboratory visits which involved the determination of individual time to peak alkalosis following sodium bicarbonate (NaHCO3) ingestion, an environment specific ramp test (e.g. normoxia and hypoxia) and four x 3 min critical power (CP) tests under different experimental conditions. Participants completed four trials: alkalosis normoxia (ALN); placebo normoxia (PLN); alkalosis hypoxia (ALH); and placebo hypoxia (PLH). Pre-exercise administration of 0.3 g.kg-1 BM of NaHCO3 was used to induce alkalosis. Environmental conditions were set at either normobaric hypoxia (FiO2: 14.5%) or normoxia (FiO2: 20.93%). RESULTS: An increase in W' was observed with pre-exercise alkalosis under both normoxic (PLN: 15.1 ± 6.2 kJ vs. ALN: 17.4 ± 5.1 kJ; P = 0.006) and hypoxic conditions (ALN: 15.2 ± 4.9 kJ vs. ALN: 17.9 ± 5.2 kJ; P < 0.001). Pre-exercise alkalosis resulted in a larger reduction in bicarbonate ion (HCO3-) concentrations during exercise in both environmental conditions (p < 0.001) and a greater blood lactate accumulation under hypoxia (P = 0.012). CONCLUSION: Pre-exercise alkalosis substantially increased W' and, therefore, may determine tolerance to exercise above CP under normoxic and hypoxic conditions. This may be due to NaHCO3 increasing HCO3- buffering capacity to delay exercise-induced acidosis, which may, therefore, enhance anaerobic energy contribution.

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BACKGROUND: Current evidence suggests sodium bicarbonate (NaHCO3) should be ingested based upon the individualised alkalotic peak of either blood pH or bicarbonate (HCO3-) because of large inter-individual variations (10-180 min). If such a strategy is to be practical, the blood analyte response needs to be reproducible. OBJECTIVE: This study aimed to evaluate the degree of reproducibility of both time to peak (TTP) and absolute change in blood pH, HCO3- and sodium (Na+) following acute NaHCO3 ingestion. METHODS: Male participants (n = 15) with backgrounds in rugby, football or sprinting completed six randomised treatments entailing ingestion of two doses of 0.2 g·kg-1 body mass (BM) NaHCO3 (SBC2a and b), two doses of 0.3 g·kg-1 BM NaHCO3 (SBC3a and b) or two control treatments (CON1a and b) on separate days. Blood analysis included pH, HCO3- and Na+ prior to and at regular time points following NaHCO3 ingestion over a 3-h period. RESULTS: HCO3- displayed greater reproducibility than pH in intraclass correlation coefficient (ICC) analysis for both TTP (HCO3- SBC2 r = 0.77, P = 0.003; SBC3 r = 0.94, P < 0.001; pH SBC2 r = 0.62, P = 0.044; SBC3 r = 0.71, P = 0.016) and absolute change (HCO3- SBC2 r = 0.89, P < 0.001; SBC3 r = 0.76, P = 0.008; pH SBC2 r = 0.84, P = 0.001; SBC3 r = 0.62, P = 0.041). CONCLUSION: Our results indicate that both TTP and absolute change in HCO3- is more reliable than pH. As such, these data provide support for an individualised NaHCO3 ingestion strategy to consistently elicit peak alkalosis before exercise. Future work should utilise an individualised NaHCO3 ingestion strategy based on HCO3- responses and evaluate effects on exercise performance.

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During periods of heavy exercise training and competition, lipid, protein, and nucleic molecules can become damaged due to an overproduction of reactive oxygen and nitrogen species (RONS) within the exercising organism. As antioxidants can prevent and delay cellular oxidative damage through removing, deactivating, and preventing the formation of RONS, supplementation with exogenous antioxidant compounds has become a commercialized nutritional strategy commonly adopted by recreationally active individuals and athletes. The following review is written as a critical appraisal of the current literature surrounding astaxanthin and its potential application as a dietary supplement in exercising humans. Astaxanthin is a lipid-soluble antioxidant carotenoid available to supplement through the intake of Haematococcus pluvialis-derived antioxidant products. Based upon in vitro and in vivo research conducted in mice exercise models, evidence would suggest that astaxanthin supplementation could potentially improve indices of exercise metabolism, performance, and recovery because of its potent antioxidant capacity. In exercising humans, however, these observations have yet to be consistently realized, with equivocal data reported. Implicated, in part, by the scarcity of well-controlled, scientifically rigorous research, future investigation is necessary to enable a more robust conclusion in regard to the efficacy of astaxanthin supplementation and its potential role in substrate utilization, endurance performance, and acute recovery in exercising humans.