Altered Sympathoadrenal Activity Following Cold-Water Diving.

INTRODUCTION: Little data exist on the effect of extremely cold-water diving on thermo-metabolic hormone secretion. Moreover, the impact of repetitive dives on the stress response is unknown. The purpose of this study was to determine the effects of two daily bouts of cold-water diving on the hormonal and metabolic profile of elite military personnel and to measure the stress response. METHODS: Healthy, male, Norwegian Special Forces operators (n = 5) volunteered for this study. Physiological and hormone data were analyzed prior to and following twice-daily Arctic dives (3.3°C). RESULTS: Core temperature was maintained (p > .05), whereas skin temperature was significantly reduced over the course of each dive (p < .01). Pairwise comparisons revealed adrenocorticotropic hormone (ACTH) and cortisol concentration significantly decreased across both dives and days (p < .001). Adrenaline and noradrenaline significantly increased across both time and day (p < .001). Leptin, testosterone, and IGF-1 significantly decreased over time but recovered between days. CONCLUSION: The main findings of this effort are that there is a rapid sympathetic-adreno-medullary (SAM/SNS) response to cold-water diving and a suppression of the hypothalamic-pituitary-adrenal (HPA) axis and hormones related to repair and recovery. While the sample size was too small to determine the role of SAM/SNS, HPA, and thyroid hormone effect on thermoregulation, it addresses a gap in our understanding of physiological adaptions that occurs in extreme environments.

Efficacy of closed cell wet-suit at various depths and gas mixtures for thermoprotection during military training dives.

Purpose: To evaluate a closed-cell wet-suit for thermal protective capability during extreme cold water exposure at various depths. Methods: Thirteen (n = 13) elite military divers who were tasked with cold-water training, participated in this study. To mimic various depths, the Ocean Simulation Facility (OSF) at the Navy Experimental Diving Unit (NEDU) was pressurized to simulate dive depths of 30, 50, and 75fsw. Water temperature remained at 1.8-2.0°C for all dives. Four divers dove each day and used the MK16 underwater breathing apparatus with gas mixes of either N202 (79:21) or HeO2 (88:12). Mean skin temperature (TSK) (Ramanathan, 1964), core temperature (Tc), hand and foot readings were obtained every 30 min for 30 and 50fsw and every 15 min during the 75fsw dive. Results: TC was significantly reduced across all dives (p = 0.004); however, was preserved above the threshold for hypothermia (post dive Tc = 36.5 ± 0.4). There was no effect of gas mix on TC. TSK significantly decreased (p < 0.001) across all dives independent of depth and gas. Hand and foot temperatures resulted in the termination of three of the dives. There were no significant main effects for depth or gas, but there were significant main effects for time on hand temperature (p < 0.001) and foot temperature (p < 0.001). Conclusion: Core temperature is maintained above threshold for hypothermia. Variatioins in TC and TSK are a function of dive duration independent of depth or gas for a closed-cell wet-suit in cold water at various depths. However, both hand and foot temperatures reached values at which dexterity is compromised.

Don't Shoot Me: Potential Consequences of Force-on-Force Training Modulate the Human Stress Response.

ABSTRACT: Jensen, AE, Bernards, JR, Hamilton, JA, Markwald, RR, Kelly, KR, and Biggs, AT. Do not shoot me: potential consequences of force-on-force training modulate the human stress response. J Strength Cond Res 37(9): 1761-1769, 2023-Close-quarters combat (CQC) engagements trigger the "fight-or-flight" response, activating the sympathetic nervous system and hypothalamic-pituitary-adrenal axis in response to perceived threats. However, it has yet to be shown if a force-on-force (FoF) CQC training environment will lead to adaptations in the physiological stress response or performance. United States Marines and Army infantry personnel participated in a 15-day CQC training program. The CQC program focused heavily on FoF training with the use of nonlethal training ammunition (NLTA). Data collections occurred on training days 1 and 15, during a simulated FoF-hostage rescue (HR) scenario and photorealistic target drill. For the FoF-HR, subjects were instructed to clear the shoot house, rescue the hostage, and only shoot hostile threat(s) with NLTA. The photorealistic target drills were similar, but replaced the role players in the FoF-HR with paper targets. Salivary alpha-amylase (sAA) and salivary cortisol were obtained immediately before entering and exiting the shoot house. Time to completion significantly decreased, between days 1 and 15, for both the FoF-HR and the photorealistic drills by 67.7 and 54.4%, respectively ( p < 0.05). Analyses revealed that the change in sAA, nonsignificantly, doubled from day 1 to 15 during FoF-HR ( p > 0.05), whereas the change in sAA decreased during the photorealistic drills across days ( p < 0.05). Cortisol was significantly higher during the FoF-HR in comparison to the photorealistic drills ( p < 0.05). These data suggest that potential consequences of FoF training heighten the stress response in conjunction with enhanced performance.

Prolonged Extreme Cold Water Diving and the Acute Stress Response During Military Dive Training.

Introduction: Cold water exposure poses a unique physiological challenge to the human body. Normally, water submersion increases activation of parasympathetic tone to induce bradycardia in order to compensate for hemodynamic shifts and reduce oxygen consumption by peripheral tissues. However, elevated stress, such as that which may occur due to prolonged cold exposure, may shift the sympatho-vagal balance towards sympathetic activation which may potentially negate the dive reflex and impact thermoregulation. Objective: To quantify the acute stress response during prolonged extreme cold water diving and to determine the influence of acute stress on thermoregulation. Materials and Methods: Twenty-one (n = 21) subjects tasked with cold water dive training participated. Divers donned standard diving equipment and fully submerged to a depth of ≈20 feet, in a pool chilled to 4°C, for a 9-h training exercise. Pre- and post-training measures included: core and skin temperature; salivary alpha amylase (AA), cortisol (CORT), osteocalcin (OCN), testosterone (TEST) and dehydroepiandosterone (DHEA); body weight; blood glucose, lactate, and ketones. Results: Core, skin, and extremity temperature decreased (p < 0.001) over the 9-h dive; however, core temperature was maintained above the clinical threshold for hypothermia and was not correlated to body size (p = 0.595). There was a significant increase in AA (p < 0.001) and OCN (p = 0.021) and a significant decrease in TEST (p = 0.003) over the duration of the dive. An indirect correlation between changes in cortisol concentrations and changes in foot temperature (ρ = -0.5,p = 0.042) were observed. There was a significant positive correlation between baseline OCN and change in hand temperature (ρ = 0.66, p = 0.044) and significant indirect correlation between changes in OCN concentrations and changes in hand temperature (ρ = -0.59, p = 0.043). Conclusion: These data suggest that long-duration, cold water diving initiates a stress response-as measurable by salivary stress biomarkers-and that peripheral skin temperature decreases over the course of these dives. Cumulatively, these data suggest that there is a relationship between the acute stress response and peripheral thermoregulation.

Perception during use of force and the likelihood of firing upon an unarmed person.

Stress can impact perception, especially during use-of-force. Research efforts can thus advance both theory and practice by examining how perception during use-of-force might drive behavior. The current study explored the relationship between perceptual judgments and performance during novel close-combat training. Analyses included perceptual judgments from close-combat assessments conducted pre-training and post-training that required realistic use-of-force decisions in addition to an artificially construed stress-inoculation event used as a training exercise. Participants demonstrated significant reductions in situational awareness while under direct fire, which correlated to increased physiological stress. The initial likelihood of firing upon an unarmed person predicted the perceptual shortcomings of later stress-inoculation training. Subsequently, likelihood of firing upon an unarmed person was reduced following the stress-inoculation training. These preliminary findings have several implications for low or zero-cost solutions that might help trainers identify individuals who are underprepared for field responsibilities.

Regulation of metabolism during hibernation in brown bears (Ursus arctos): Involvement of cortisol, PGC-1α and AMPK in adipose tissue and skeletal muscle.

The purpose of this study was to investigate changes in expression of known cellular regulators of metabolism during hyperphagia (Sept) and hibernation (Jan) in skeletal muscle and adipose tissue of brown bears and determine whether signaling molecules and transcription factors known to respond to changes in cellular energy state are involved in the regulation of these metabolic adaptations. During hibernation, serum levels of cortisol, glycerol, and triglycerides were elevated, and protein expression and activation of AMPK in skeletal muscle and adipose tissue were reduced. mRNA expression of the co-activator PGC-1α was reduced in all tissues in hibernation whereas mRNA expression of the transcription factor PPAR-α was reduced in the vastus lateralis muscle and adipose tissue only. During hibernation, gene expression of ATGL and CD36 was not altered; however, HSL gene expression was reduced in adipose tissue. During hibernation gene expression of the lipogenic enzyme DGAT in all tissues and the expression of the FA oxidative enzyme LCAD in the vastus lateralis muscle were reduced. Gene and protein expression of the glucose transporter GLUT4 was decreased in adipose tissue in hibernation. Our data suggest that high cortisol levels are a key adaptation during hibernation and link cortisol to a reduced activation of the AMPK/PGC-1α/PPAR-α axis in the regulation of metabolism in skeletal muscle and adipose tissue. Moreover, our results indicate that during this phase of hibernation at a time when metabolic rate is significantly reduced metabolic adaptations in peripheral tissues seek to limit the detrimental effects of unduly large energy dissipation.

Hormonal balance and nutritional intake in elite tactical athletes.

Chronic exposure to multifactorial stress, such as that endured by elite military operators, may lead to overtraining syndrome and negatively impact hormonal regulation. In acute settings (<6 mos), military training has been shown to lead to hormonal dysfunction; however, less is known about the consequences of long-term military training. Thus, the purpose of this study was to determine the chronic effects of military operations and training on the hormone profile of elite military operators. A cross-sectional, random sample of active duty elite US military operators (n = 65, age = 29.8 ±â€¯1.0 yrs, height = 178.4 ±â€¯0.7 cm, weight = 85.1 ±â€¯2.0 kg) concomitantly engaged in rigorous physical training were recruited to participate in the study. Following an overnight fast, waking plasma concentrations of luteinizing hormone, total testosterone (TT), free testosterone, sex-hormone binding globulin, cortisol, thyroid stimulating hormone, triiodothyronine, and thyroxine were obtained. Data were analyzed for correlations and compared against normative reference values. There was a significant positive correlation between TT and cortisol (R2 = 0.07; P = 0.038). In addition, 43% of the participants (n = 28) had TT below age-based normative reference ranges. These results indicate that long-term military operations and training may place a large burden on the operators and depress or alter the hypothalamic pituitary, adrenal, gonadal, and thyroid axes.

Prevalence of Musculoskeletal Injuries Sustained During Marine Corps Recruit Training.

Musculoskeletal injuries cost the U.S. Marine Corps approximately $111 million and 356,000 lost duty days annually. Information identifying the most common types of injuries and events leading to their cause would help target mitigation efforts. The purpose of this effort was to conduct an archival data review of injuries and events leading to injury during recruit training. An archival dataset of Marine recruits from 2011 to 2016 was reviewed and included 43,004 observations from 28,829 unique individuals. Injuries were classified as mild, moderate, and severe and categorized into new overuse, preexisting overuse, and traumatic. Injury classification and categorization were stratified by event in which the injury occurred. The majority of injuries were due to overuse, and the most common types were sprains, strains, iliotibial band syndrome, and stress fractures, which constituted over 40% of all injuries. Conditioning hikes were the primary event leading to injury, with 31% of all injuries occurring during this training; running claimed 12%. Most injuries sustained during basic training comprised sprains and strains. Marines who remained uninjured during basic training outperformed those who reported at least one injury on fitness tests. These results point to enhanced conditioning as a potential entry point to target future intervention efforts.

The Benefit of Mental Skills Training on Performance and Stress Response in Military Personnel.

Mental skills training (MST) has been suggested to reduce stress in civilian and athletic populations, however, whether these techniques and practices transfer to a military population are unknown. Therefore, the purpose of this study was to evaluate two MST programs against a baseline condition, training-as-usual (TAU), during an intense, active-duty, military training environment. Two hundred and three Marines enrolled in the United States Marine Corps' Basic Reconnaissance Course participated in this effort (n = 203; age = 22.7 ± 3.3 years; height = 178 ± 6.35 cm; weight = 97.7 ± 8.3 kg; Mean ± SD). Each Marine was assigned to one of three groups, Mindfulness-Based Mind Fitness Training (MMFT), General Mental Skills Training (GMST), or TAU. Operational and cognitive performance measures, as well as, physiological metrics were obtained across three training phases (phase 1-3). Furthermore, phase 3 was sub-divided into pre-ambush, ambush and post-ambush time points. Significant group × time interactions were found for the total number of errors committed on the sustained attention response task (p = 0.004); as well as, plasma cortisol (p < 0.0001) and insulin-like growth factor-1 (IGF-1; p < 0.0001). There were mixed results between groups on operational performance tasks with the MST groups tending to perform better than TAU the more time participants had with MST instruction. During ambush, the differences among groups were especially pronounced for measures of information processing that one would expect MST to enhance: coordinates recall, plot time, and plot accuracy (p < 0.001), with improvements ranging from 24.7 to 87.9% for the MST conditions when compared to TAU. These data demonstrate that independent of the specific type of MST program, the fundamental characteristics of stress regulation embedded within each MST program may enhance performance and cognitive function during time of heightened stress.

Exercise training with blood flow restriction has little effect on muscular strength and does not change IGF-1 in fit military warfighters.

OBJECTIVE: Aerobic exercise with blood flow restriction (aBFR) has been proposed as an adjunctive modality in numerous populations, potentially via an enhanced growth factor response. However, the effects of aBFR on highly trained warfighters have yet to be examined. The purpose of this study was to determine if adjunctive aBFR as part of a regular physical training regimen would increase markers of aerobic fitness and muscle strength in elite warfighters. In addition, we sought to determine whether the changes in blood lactate concentration induced by aBFR would be associated with alterations in the insulin-like growth factor (IGF) axis. DESIGN: Active-duty US Naval Special Warfare Operators (n=18, age=36.8 ± 2.2 years, weight=89.1 ± 1.2 kg, height=181.5 ± 1.4 cm) from Naval Amphibious Base Coronado were recruited to participate in 20 days of adjunctive aBFR training. Peak oxygen consumption (VO2 peak), ventilatory threshold (VT), and 1-repetition max (1-RM) bench press and squat were assessed pre- and post-aBFR training. Blood lactate and plasma IGF-1 and IGF-binding protein-3 (IGFBP-3) were assessed pre-, 2 min post-, and 30 min post-aBFR on days 1, 9, and 20 of aBFR training. RESULTS: Following aBFR training there were no changes in VO2 peak or VT, but there was an increase in the 1-RM for the bench press and the squat (5.0 and 3.9%, respectively, P<0.05). Blood lactate concentration at the 2-min post-exercise time point was 4.5-7.2-fold higher than pre-exercise levels on all days (P<0.001). At the 30-min post-exercise time point, blood lactate was still 1.6-2.6-fold higher than pre-exercise levels (P<0.001), but had decreased by 49-56% from the 2-min post-exercise time point (P<0.001). Plasma IGF-1 concentrations did not change over the course of the study. On day 9, plasma IGFBP-3 concentration was 4-22% lower than on day 1 (P<0.01) and 22% lower on day 9 than on day 20 at the 30-min post-exercise time point (P<0.001). CONCLUSIONS: Our data suggest that aBFR training does not lead to practical strength adaptations or alterations in the IGF axis in a population of highly trained warfighters.