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BACKGROUND: Myonectin is a myokine with potential effects on the lipid metabolism; however, its regulation by exercise in humans remains unclear. We aimed to compare the efficacy of high-intensity interval training low-volume (HIIT) versus moderate-intensity continuous training (MICT) on serum myonectin, serum lipids, appendicular fat and lean mass, and intramuscular lipids in humans. METHODS: Secondary analysis of a controlled, randomized, clinical trial in adults of both sexes with metabolic syndrome, who underwent a supervised, three-times/week, 12-week treadmill program. HIIT (n = 29) consisted of six intervals with one-minute, high-intensity phases at 90% of peak oxygen consumption (VO2peak) for a total of 22 min. MICT (n = 31) trained at 60% of VO2peak for 36 min. Serum myonectin was measured using a human enzyme-linked immunosorbent assay. Lipid profile was determined by enzymatic methods and free fatty acids (FFA) were measured by gas chromatography. Fat and lean mass were assessed by dual-energy X-ray absorptiometry. Intramuscular lipids were measured through proton magnetic resonance spectroscopy. RESULTS: Subjects had a mean age of 50.8±6.0 years and body mass index of 30.6±4.0 kg/m2. Compared to MICT, HIIT was not superior at increasing serum myonectin (p = 0.661) or linoleic acid (p = 0.263), reducing palmitic (p = 0.286) or stearic acid (p = 0.350), or improving lipid profile (all p>0.05), appendicular fat mass index -AFMI- (p = 0.713) or appendicular lean mass percentage -ALM- (p = 0.810). Compared to baseline, only HIIT significantly increased myonectin (p = 0.042), with a large effect size, although both interventions reduced AFMI and increased ALM with a large effect size. Lipid profile, FFA and intramuscular lipids did not change in any intervention group (p>0.05). CONCLUSIONS: Compared to MICT, HIIT low volume did not demonstrate superiority in improving serum lipids. The fact that both training types reduced AFMI without paralleled significant changes in serum myonectin suggests that this myokine may have a minor effect on short-middle-term exercise-induced fat mobilization.

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CONTEXT: Movement velocity (MV) may be a valid tool to evaluate and control the load in resistance training (RT). The rating of perceived exertion (RPE) also enables practical load management. The relationship between RPE and MV may be used to monitor RT intensity. OBJECTIVE: To evaluate the validity and practicality of RPE scales related to MV and training intensity in resistance exercise. We hypothesize a positive correlation among RPE, MV, and load intensity in RT. Therefore, RPE may serve as a supplementary indicator in monitoring RT load. DATA SOURCES: Boolean algorithms were used to search several databases (SPORTDiscus, EBSCO, PubMed, Scopus, and Google Scholar). STUDY SELECTION: Studies published from 2009 to 2023 included clinical trials (randomized or not) in healthy female and male subjects that analyzed the relationship between different RPE scales and MV in basic RT exercises. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 3. RESULTS: A total of 18 studies were selected using different RPE scales with reported MV training loads. Participants included RT and untrained male and female subjects (15-31 years old). Two RPE scales (OMNI-RES and repetitions in reserve) were used. The selected studies showed moderate positive correlations among these RPE scales, MV, and training load (eg, percentage of 1-repetition maximum [%1-RM]). In addition, equations have been developed to estimate %1-RM and MV loss based on the OMNI-RES scale. CONCLUSION: Studies show that RPE scales and MV constitute a valid, economic, and practical tool for assessing RT load progression and complementing other training monitoring variables. Exercise professionals should consider familiarizing participants with RPE scales and factors that might influence the perception of exertion (eg, level of training, motivation, and environmental conditions).

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Mexico City is the location with the largest number of boxers in Mexico; in fact, it is the first city in the country to open a Technological Baccalaureate in Education and Sports Promotion with a pugilism orientation. This cross-sectional study aimed to determine the physical-functional profile of applicants for admission to the baccalaureate in sports. A total of 227 young athletes (44F; 183M; 15.65 (1.79) years; 63.66 (14.98) kg; >3 years of boxing experience) participated in this study. Body mass (BM), maximal isometric handgrip (HG) strength, the height of the countermovement jump (CMJ), the velocity of straight boxing punches (PV), and the rear hand punch impact force (PIF) were measured. The young boxers were profiled using unsupervised machine learning algorithms, and the probability of superiority (ρ) was calculated as the effect size of the differences. K-Medoids clustering resulted in two sex-independent significantly different groups: Profile 1 (n = 118) and Profile 2 (n = 109). Except for BM, Profile 2 was statistically higher (p < 0.001) with a clear distinction in terms of superiority on PIF (ρ = 0.118), the PIF-to-BM ratio (ρ = 0.017), the PIF-to-HG ratio (ρ = 0.079) and the PIF-to-BM+HG ratio (ρ = 0.008). In general, strength levels explained most of the data variation; therefore, it is reasonable to recommend the implementation of tests aimed at assessing the levels of isometric and applied strength in boxing gestures. The identification of these physical-functional profiles might help to differentiate training programs during sports specialization of young boxing athletes.

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Myonectin has shown beneficial effects on lipid regulation in murine models; therefore, it may have implications in the pathophysiology of metabolic syndrome (MS). We evaluated the relationship between serum myonectin and serum lipids, global and regional fat mass, intramuscular lipid content, and insulin resistance (IR) in adults with metabolic risk factors. This was a cross-sectional study in sedentary adults who were diagnosed with MS or without MS (NMS). Serum myonectin was quantified by enzyme-linked immunosorbent assay, lipid profile by conventional techniques, and free fatty acids (FFA) by gas chromatography. Body composition was assessed by dual-energy X-ray absorptiometry and intramuscular lipid content through proton nuclear magnetic resonance spectroscopy in the right vastus lateralis muscle. IR was estimated with the homeostatic model assessment (HOMA-IR). The MS (n = 61) and NMS (n = 29) groups were comparable in age (median (interquartile range): 51.0 (46.0-56.0) vs. 53.0 (45.5-57.5) years, p > 0.05) and sex (70.5% men vs. 72.4% women). MS subjects had lower serum levels of myonectin than NMS subjects (1.08 (0.87-1.35) vs. 1.09 (0.93-4.05) ng·mL-1, p < 0.05). Multiple linear regression models adjusted for age, sex, fat mass index and lean mass index showed that serum myonectin was negatively correlated with the android/gynoid fat mass ratio (R2 = 0.48, p < 0.01), but not with the lipid profile, FFA, intramuscular lipid content or HOMA-IR. In conclusion, serum myonectin is lower in subjects with MS. Myonectin negatively correlates with a component relevant to the pathophysiology of MS, such as the android/gynoid fat mass ratio, but not with other components such as FFA, intramuscular fat or IR.

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Non-exercise physical activity (NEPA), also called unstructured or informal physical activity, refers to those daily activities that require movement of the human body without planning or strict control of the physical effort made. Due to new technologies and motorized transportation devices, the general population has significantly decreased its NEPA. This increase in sedentary lifestyles, physical inactivity, and excessive energy intake is considered a risk factor for obesity, non-communicable diseases (NCDs), and all-cause mortality. Searching in PubMed/MEDLINE and Web of Science databases, a narrative review of NEPA was carried out to address its conceptualization, promotion strategies for the general population, and monitoring through wearable devices. It is strongly recommended that governmental entities, health practitioners, and the construction industry adhere to "The Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World" and implement different salutogenic urban strategies. These strategies aim to generate environments that motivate increases in NEPA, such as cycling and walking transportation (between 5000-12,500 steps per day), and the progression to physical exercise. There is a wide variety of electronic devices for personal use, such as accelerometers, smartphone apps, or "smart clothes", that allow for the monitoring of NEPA, some with a wide range of analysis variables contributing to the estimation of total daily energy expenditure and the promotion of healthy habits. In general, the further promotion and monitoring of NEPA is required as part of a strategy to promote healthy habits sustainable over time for the prevention and control of obesity and NCDs.

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Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) Hypericum perforatum (St. John's Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by Crocus sativus L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John's Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression.

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It is estimated that three to five million sports injuries occur worldwide each year. The highest incidence is reported during competition periods with mainly affectation of the musculoskeletal tissue. For appropriate nutritional management and correct use of nutritional supplements, it is important to individualize based on clinical effects and know the adaptive response during the rehabilitation phase after a sports injury in athletes. Therefore, the aim of this PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science PERSiST-based systematic integrative review was to perform an update on nutritional strategies during the rehabilitation phase of musculoskeletal injuries in elite athletes. After searching the following databases: PubMed/Medline, Scopus, PEDro, and Google Scholar, a total of 18 studies met the inclusion criteria (Price Index: 66.6%). The risk of bias assessment for randomized controlled trials was performed using the RoB 2.0 tool while review articles were evaluated using the AMSTAR 2.0 items. Based on the main findings of the selected studies, nutritional strategies that benefit the rehabilitation process in injured athletes include balanced energy intake, and a high-protein and carbohydrate-rich diet. Supportive supervision should be provided to avoid low energy availability. The potential of supplementation with collagen, creatine monohydrate, omega-3 (fish oils), and vitamin D requires further research although the effects are quite promising. It is worth noting the lack of clinical research in injured athletes and the higher number of reviews in the last 10 years. After analyzing the current quantitative and non-quantitative evidence, we encourage researchers to conduct further clinical research studies evaluating doses of the discussed nutrients during the rehabilitation process to confirm findings, but also follow international guidelines at the time to review scientific literature.

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The estimation of body fat percentage (%BF) from anthropometry-related data requires population-specific equations to avoid incorrect interpretations in young athletes. Waist girth (WG) has been described as potential predictor of fat mass (FM) in several populations; however, there are no valid WG-based equations to estimate body composition in young Colombian athletes. The aim of this STandardisierte BerichtsROutine für Sekundärdaten Analysen STROSA-based study was twofold: i) to validate the relative fat mass (RFM) and its pediatric version (RFMp) compared to dual-energy x-ray absorptiometry (DXA) and ii) to develop a new equation (F20CA) to estimate the fat mass in Colombian children and adolescent elite athletes. A total of 114 young athletes that belong to the 'Team Medellín' program (58F, 56M; 51 children, 63 adolescents; 14.85 [2.38] years; 55.09 [12.16] kg; 162.38 [11.53] cm) participated in this cross-sectional study. The statistical analysis revealed a poor correlation, agreement and concordance of RFMp and RFM estimations with DXA measurements. After model specification using both Ordinary Least Square method and Bayesian analysis, the regression output revealed that sex, body mass-to-waist ratio, and waist-to-stature ratio were the statistically significant predictor variables that account for variability in FM. The new F20CA equation is expressed as FM (kg) = 5.46 ∗ (Sex) + 0.21 ∗ (BM/W [kg/m]) + 81.7 ∗ (W/Stature [cm/cm]) - 41.8 (R2 = 0.683; SEE = 2.468 kg), where sex is 0 for males and 1 for females. A moderate-to-high correlation and agreement of the F20CA was confirmed within the internal validation data set (R2 = 0.689; ICC [95%CI] = 0.805 [0.615, 0.904]; RMSE = 2.613 kg). The Bland-Altman analysis corroborated the high concordance between the reference method (DXA) and the F20CA-estimated FM (bias [95% LoA] = 1.02 [-3.77, 5.81] kg), indicating the two methods could be considered interchangeable. Even though external validation is needed, practitioners are advised to use the F20CA in young Colombian athletes with similar characteristics to those who participated in this study.

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Weight resistance training (RT) is an essential component of physical conditioning programs to improve the quality of life and physical fitness in different ages and populations. This integrative review aimed to analyze the scientific evidence on the relationship between exercise selection and the appearance of musculoskeletal injuries in physical fitness centers (PFC). The PubMed or Medline, EMBASE or Science Direct, Google Scholar and PEDro databases were selected to examine the available literature using a Boolean algorithm with search terms. The review process was performed using the five-stage approach for an integrative review and it was reported according to the PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science (PERSiST) guidelines. A total of 39 peer-reviewed articles (Price index = 71.7%) met the inclusion criteria and evaluated the link between exercise selection and the incidence of injuries in exercisers who regularly attend PFC. Most injuries occur to the shoulders, elbows, vertebrae of the spine, and knees. Although the injury etiologies are multifactorial, the findings of the reviewed articles include the impacts of overuse, short post-exercise recovery periods, poor conditioning in the exercised body areas, frequent use of heavy loads, improper technique in certain exercises, and the abuse of performance- and image-enhancing drugs. Practical recommendations addressed to clinical exercise physiologists, exercise professionals, and health professionals are given in this paper. The exercise selection in RT programs requires professional supervision and adhering to proper lifting techniques and training habits that consider the anatomical and biomechanical patterns of the musculoskeletal structures, as well as genetic, pedagogical, and methodological aspects directly related to the stimulus-response process to mitigate the occurrence of RT-related injuries in PFC.

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Waist girth (WG) represents a quick, simple, and inexpensive tool that correlates with excess of fat mass in humans; however, this measurement does not provide information on body composition. The evaluation of body composition is one of the main components in the assessment of nutritional status. Indeed, the use of anthropometry-based equations to estimate body fat and fat-free mass is a frequent strategy. Considering the lack of validation in the Colombian population, the aim of this research study (the F20 Project) is to externally validate WG-based equations (e.g., relative fat mass), and also to develop and validate new models that include WG to estimate body composition in Colombian adults compared to DXA. This cross-sectional study will be carried out following the guidelines for Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut). Using stratified probabilistic sampling, the study population will be adults with different levels of physical activity residing in Medellín and its metropolitan area. The results of this study will not only validate the estimation performance of the current WG-based equations, but they will also develop new equations to estimate body composition in the Colombian population. This will improve professional practice in health, exercise, and sports sciences (ClinicalTrials.gov ID #NCT05450588).

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The immune function is closely related to iron (Fe) homeostasis and allostasis. The aim of this bioinformatics-assisted review was twofold; (i) to update the current knowledge of Fe metabolism and its relationship to the immune system, and (ii) to perform a prediction analysis of regulatory network hubs that might serve as potential biomarkers during stress-induced immunosuppression. Several literature and bioinformatics databases/repositories were utilized to review Fe metabolism and complement the molecular description of prioritized proteins. The Search Tool for the Retrieval of Interacting Genes (STRING) was used to build a protein-protein interactions network for subsequent network topology analysis. Importantly, Fe is a sensitive double-edged sword where two extremes of its nutritional status may have harmful effects on innate and adaptive immunity. We identified clearly connected important hubs that belong to two clusters: (i) presentation of peptide antigens to the immune system with the involvement of redox reactions of Fe, heme, and Fe trafficking/transport; and (ii) ubiquitination, endocytosis, and degradation processes of proteins related to Fe metabolism in immune cells (e.g., macrophages). The identified potential biomarkers were in agreement with the current experimental evidence, are included in several immunological/biomarkers databases, and/or are emerging genetic markers for different stressful conditions. Although further validation is warranted, this hybrid method (human-machine collaboration) to extract meaningful biological applications using available data in literature and bioinformatics tools should be highlighted.

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Weight resistance training (RT) has been shown to positively influence physical performance. Within the last two decades, a methodology based on monitoring RT through movement velocity (also called velocity-based resistance training, VBRT) has emerged. The aim of this PRISMA-based systematic review was to evaluate the effect of VBRT programs on variables related to muscle strength (one-repetition maximum, 1-RM), and high-speed actions (vertical jump, and sprint performance) in trained subjects. The search for published articles was performed in PubMed/MEDLINE, SPORT Discus/EBSCO, OVID, Web of Science, Scopus, and EMBASE databases using Boolean algorithms independently. A total of 22 studies met the inclusion criteria of this systematic review (a low-to-moderate overall risk of bias of the analyzed studies was detected). VBRT is an effective method to improve 1-RM, vertical jump and sprint. According to the results of the analyzed studies, it is not necessary to reach high muscle failure in order to achieve the best training results. These findings reinforce the fact that it is possible to optimize exercise adaptations with less fatigue. Future studies should corroborate these findings in female population.

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The academic curriculum has shown to promote sedentary behavior in college students. This study aimed to profile the physical fitness of physical education majors using unsupervised machine learning and to identify the differences between sexes, academic years, socioeconomic strata, and the generated profiles. A total of 542 healthy and physically active students (445 males, 97 females; 19.8 [2.2] years; 66.0 [10.3] kg; 169.5 [7.8] cm) participated in this cross-sectional study. Their indirect VO2max (Cooper and Shuttle-Run 20 m tests), lower-limb power (horizontal jump), sprint (30 m), agility (shuttle run), and flexibility (sit-and-reach) were assessed. The participants were profiled using clustering algorithms after setting the optimal number of clusters through an internal validation using R packages. Non-parametric tests were used to identify the differences (p < 0.05). The higher percentage of the population were freshmen (51.4%) and middle-income (64.0%) students. Seniors and juniors showed a better physical fitness than first-year students. No significant differences were found between their socioeconomic strata (p > 0.05). Two profiles were identified using hierarchical clustering (Cluster 1 = 318 vs. Cluster 2 = 224). The matching analysis revealed that physical fitness explained the variation in the data, with Cluster 2 as a sex-independent and more physically fit group. All variables differed significantly between the sexes (except the body mass index [p = 0.218]) and the generated profiles (except stature [p = 0.559] and flexibility [p = 0.115]). A multidimensional analysis showed that the body mass, cardiorespiratory fitness, and agility contributed the most to the data variation so that they can be used as profiling variables. This profiling method accurately identified the relevant variables to reinforce exercise recommendations in a low physical performance and overweight majors.

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BACKGROUND: Kinanthropometry offers to exercise and health professionals a standardized procedure of acquiring surface anatomical measurements that might be used to track changes in body composition. AIM: To describe simple anthropometric indices to monitor body composition changes in amateur and elite athletes, and to provide reference values during the competition phase. METHODS: A search of articles indexed in PubMed/MEDLINE, ScienceDirect, Cochrane, and SciELO databases using the string body composition AND (anthropometric OR skinfolds OR circumferences OR girth OR estimation equation) AND "body fat". Inclusion criteria were: quantitative and/or qualitative research published between 2009 and 2020, written in English or Spanish, reporting simple anthropometric indices that included skinfolds, girths, or basic measures in amateur and elite athletes. RESULTS: A total of 51 studies (Price's index = 66.4%) met all the inclusion criteria and were included in this scoping review. Contrary to the frequent practice, the use of a regression equation might not be accurate to evaluate body composition. To avoid this, anthropometrists should base their analysis on the absolute values of the sum of skinfolds (∑S) and related variables, such as skinfold-corrected girths and lean mass index. While not definitive, because further research is required, the practical recommendations and updated reference values in competition phase provided by this review would contribute to the accurate identification of body composition changes. CONCLUSIONS: ∑S and lean mass index have been shown to be valid for monitoring changes in fat mass and fat-free mass, respectively. More research is needed to derive the lean mass index-specific coefficient for each sports population.

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Creatine monohydrate (CrM) supplementation has been shown to improve body composition and muscle strength when combined with resistance training (RT); however, no study has evaluated the combination of this nutritional strategy with cluster-set resistance training (CS-RT). The purpose of this pilot study was to evaluate the effects of CrM supplementation during a high-protein diet and a CS-RT program on lower-limb fat-free mass (LL-FFM) and muscular strength. Twenty-three resistance-trained men (>2 years of training experience, 26.6 ± 8.1 years, 176.3 ± 6.8 cm, 75.6 ± 8.9 kg) participated in this study. Subjects were randomly allocated to a CS-RT+CrM (n = 8), a CS-RT (n = 8), or a control group (n = 7). The CS-RT+CrM group followed a CrM supplementation protocol with 0.1 g·kg-1·day-1 over eight weeks. Two sessions per week of lower-limb CS-RT were performed. LL-FFM corrected for fat-free adipose tissue (dual-energy X-ray absorptiometry) and muscle strength (back squat 1 repetition maximum (SQ-1RM) and countermovement jump (CMJ)) were measured pre- and post-intervention. Significant improvements were found in whole-body fat mass, fat percentage, LL-fat mass, LL-FFM, and SQ-1RM in the CS-RT+CrM and CS-RT groups; however, larger effect sizes were obtained in the CS-RT+CrM group regarding whole body FFM (0.64 versus 0.16), lower-limb FFM (0.62 versus 0.18), and SQ-1RM (1.23 versus 0.75) when compared to the CS-RT group. CMJ showed a significant improvement in the CS-RT+CrM group with no significant changes in CS-RT or control groups. No significant differences were found between groups. Eight weeks of CrM supplementation plus a high-protein diet during a CS-RT program has a higher clinical meaningfulness on lower-limb body composition and strength-related variables in trained males than CS-RT alone. Further research might study the potential health and therapeutic effects of this nutrition and exercise strategy.

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Ashwagandha (Withania somnifera) is considered a potent adaptogen and anti-stress agent that could have some potential to improve physical performance. This preferred reporting items for systematic reviews and meta-analyses (PRISMA)-based comprehensive systematic review and Bayesian meta-analysis aimed to evaluate clinical trials up to 2020 from PubMed, ScienceDirect, and Google Scholar databases regarding the effect of Ashwagandha supplementation on physical performance in healthy individuals. Besides implementing estimation statistics analysis, we developed Bayesian hierarchical models for a pre-specified subgroup meta-analysis on strength/power, cardiorespiratory fitness and fatigue/recovery variables. A total of 13 studies met the requirements of this systematic review, although only 12 were included in the quantitative analysis. A low-to-moderate overall risk of bias of the trials included in this study was detected. All Bayesian hierarchical models converged to a target distribution (Ȓ = 1) for both meta-analytic effect size (µ) and between-study standard deviation (τ). The meta-analytic approaches of the included studies revealed that Ashwagandha supplementation was more efficacious than placebo for improving variables related to physical performance in healthy men and female. In fact, the Bayesian models showed that future interventions might be at least in some way beneficial on the analyzed outcomes considering the 95% credible intervals for the meta-analytic effect size. Several practical applications and future directions are discussed, although more comparable studies are needed in exercise training, and athletic populations are needed to derive a more stable estimate of the true underlying effect.

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The objective of this research was to compare the effect of Post-Activation Performance Enhancement (PAPE) exerted on the back squat (BS) versus the barbell hip thrust (HT) on the sprint performance (5- and 10-m). 17 male amateur rugby players participated in the study (age 22.14 ± 2.52 years; body mass 81.06 ± 9.6 kg; height 1.78 ± 0.05 m). All participants performed a dynamic maximum strength test (3RM) in BS and HT at maximum speed. Two randomized sessions were performed inducing PAPE using BS or HT trough three series with three repetitions at 85% 1RM eight minutes before the sprint tests. An ANOVA of repeated measurement, found no differences in the time for 5-m (F = 0.398, P = 0.537, η2p = 0.024) or 10-m (F = 2.589, P = 0.127, η2p = 0.139). There were no significant differences in the Protocol effect between HT and BS in 5-m or 10-m (F = 2.963, P = 0.104, η2p = 0.156 and F = 1.472, P = 0.243 η2p = 0.084, respectively). There were also no differences in the Time x Protocol interaction at 5-m (F = 0.001, P = 0.976, η2p < 0.001) or 10-m (F = 4.174, P = 0.058, η2p = 0.207). The effect size obtained in the results of the sprint tests was small in both exercises (ES < 0.2). None of the BS or HT exercises performed with heavy load induced a significant PAPE phenomenon on the ability to sprint in rugby players.

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According to current therapeutic approaches, a nitrate-dietary supplementation with beetroot juice (BRJ) is postulated as a nutritional strategy that might help to control arterial blood pressure in healthy subjects, pre-hypertensive population, and even patients diagnosed and treated with drugs. In this sense, a systematic review of random clinical trials (RCTs) published from 2008 to 2018 from PubMed/MEDLINE, ScienceDirect, and manual searches was conducted to identify studies examining the relationship between BRJ and blood pressure. The specific inclusion criteria were: (1) RCTs; (2) trials that assessed only the BRJ intake with control group; and (3) trials that reported the effects of this intervention on blood pressure. The search identified 11 studies that met the inclusion criteria. This review was able to demonstrate that BRJ supplementation is a cost-effective strategy that might reduce blood pressure in different populations, probably through the nitrate/nitrite/nitric oxide (NO3-/NO2-/NO) pathway and secondary metabolites found in Beta vulgaris. This easily found and cheap dietary intervention could significantly decrease the risk of suffering cardiovascular events and, in doing so, would help to diminish the mortality rate associated to this pathology. Hence, BRJ supplementation should be promoted as a key component of a healthy lifestyle to control blood pressure in healthy and hypertensive individuals. However, several factors related to BRJ intake (e.g., gender, secondary metabolites present in B. vulgaris, etc.) should be studied more deeply.

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