Thorn in Your Side or Thorn in Your Head? Anxiety and Stress as Correlates of Exercise-Related Transient Abdominal Pain.

OBJECTIVES: The etiology of exercise-related transient abdominal pain (ETAP) is not congruent among researchers notwithstanding numerous studies on the matter. No pursuit has sought to correlate ETAP with factors such as anxiety, stress, sleep dysfunction, and pain sensitivity that are linked to other gastrointestinal (GI) disturbances in athletes. DESIGN: Cross-sectional observational study involving an anonymous survey. SETTING: Online. PARTICIPANTS: One hundred sixty-eight male and female adults running at least 10 miles/wk. ASSESSMENTS OF RISK FACTORS: Age, body mass index, years of running experience, GI symptoms, the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA), Perceived Stress Scale (PSS)-14, Sleep Problems Index-I, and Pain Sensitivity Questionnaire. MAIN OUTCOMES: Exercise-related transient abdominal pain prevalence over the past month as well as ETAP severity and frequency. RESULTS: Exercise-related transient abdominal pain occurred in 39.9% of participants at least once in the past month. Exercise-related transient abdominal pain-positive runners were significantly younger and less experienced than ETAP-negative runners. Exercise-related transient abdominal pain-positive runners demonstrated higher resting and running-related GI symptoms, PSS-14, and STICSA scores compared with ETAP-negative runners. After accounting for age and experience, the ETAP-positive group had STICSA and PSS-14 scores that were 3.4 [95% confidence interval (CI), 1.0-5.8] and 4.1 (95% CI, 1.2-6.0) points higher, respectively, than the ETAP-negative group. State-Trait Inventory for Cognitive and Somatic Anxiety scores were significantly, modestly correlated (ρ = 0.27, P = 0.03) with ETAP frequency but not severity in runners who were ETAP-positive. CONCLUSIONS: In runners, this is the first investigation to reveal that anxiety and stress are associated with the presence of ETAP.

Got Beer? A Systematic Review of Beer and Exercise.

Beer is used to socialize postexercise, celebrate sport victory, and commiserate postdefeat. Rich in polyphenols, beer has antioxidant effects when consumed in moderation, but its alcohol content may confer some negative effects. Despite beer's popularity, no review has explored its effects on exercise performance, recovery, and adaptation. Thus, a systematic literature search of three databases (PubMed, SPORTDiscus, and Web of Science) was conducted by two reviewers. The search resulted in 16 studies that were appraised and reviewed. The mean PEDro score was 5.1. When individuals are looking to rehydrate postexercise, a low-alcohol beer (<4%) may be more effective. If choosing a beer higher in alcoholic content (>4%), it is advised to pair this with a nonalcoholic option to limit diuresis, particularly when relatively large volumes of fluid (>700 ml) are consumed. Adding Na+ to alcoholic beer may improve rehydration by decreasing fluid losses, but palatability may decrease. These conclusions are largely based on studies that standardized beverage volume, and the results may not apply equally to situations where people ingest fluids and food ad libitum. Ingesting nonalcoholic, polyphenol-rich beer could be an effective strategy for preventing respiratory infections during heavy training. If consumed in moderation, body composition and strength qualities seem largely unaffected by beer. Mixed results that limit sweeping conclusions are owed to variations in study design (i.e., hydration and exercise protocols). Future research should incorporate exercise protocols with higher ecological validity, recruit more women, prioritize chronic study designs, and use ad libitum fluid replacement protocols for more robust conclusions.

Effects of high-carbohydrate versus mixed-macronutrient meals on female soccer physiology and performance.

PURPOSE: Athletes are often told to minimize intakes of fiber, fat, and protein in pre-competition meals to avoid gut distress, but this guidance is based on scant direct evidence. This study evaluated the physiological and perceptual effects of pre-competition mixed-macronutrient (MM) and high-carbohydrate (HCHO) meals in collegiate female soccer players. METHODS: Fifteen players participated in this randomized, investigator-blinded, crossover study involving two ~ 1000-kcal meals (HCHO and MM) consumed 4 h prior to 70-min scrimmages. Assessments included global positioning system (GPS) tracking, heart rate (HR), perceived exertion (RPE), ratings of fatigue (ROF), gut symptoms, and perceptions of satiety, hunger, and fullness. Differences between conditions for HR, RPE, ROF, and gut symptoms were evaluated with Wilcoxon signed-rank tests. GPS data and hunger, satiety, and fullness scores were compared using within-subjects repeated measures ANOVAs. RESULTS: No statistically significant differences were found between the conditions at any time point for HR, RPE, ROF, or gut symptoms. Significant time effects were found for two GPS variables (total distance covered and high-speed running), indicating that participants covered less distance during the second half of the scrimmages in comparison to the first half. However, there were no significant condition or condition × time interactions for GPS data. Finally, there were no condition or condition × time interactions for hunger, fullness, and satiety, though significant time effects were observed. CONCLUSION: A MM meal consumed 4 h prior to 70 min of soccer competition does not increase gut symptoms and can be similarly ergogenic as a HCHO meal.

Life stress and background anxiety are not associated with resting metabolic rate in healthy adults.

This study examined associations between anxiety, stress, and resting metabolic rate (RMR). Thirty women and 23 men had RMR measured at two visits. Participants also had body composition assessed and completed several questionnaires: State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA), Anxiety Sensitivity Index (ASI)-3, and Perceived Stress Scale (PSS)-14. The state version of the STICSA was completed at both visits, while the other questionnaires were completed at visit one. RMR was expressed in kilocalories per day and relative to lean mass (RMRrelative). Participants were divided into low-, medium-, and high-anxiety groups based on STICSA trait scores, and RMR was compared among groups using one-way ANOVA. Changes between visits were evaluated using paired t tests and Wilcoxon signed-rank tests. RMR did not change from visit one to visit two (1589 to 1586 kcal/day, p = 0.86) even though STICSA state scores slightly declined (Z-statistic = -2.39, p = 0.017). RMRrelative values were 30.3 ± 3.7, 29.0 ± 1.9, and 29.9 ± 3.6 kcal/kg of lean mass among low, medium, and high trait anxiety groups, respectively (F = 0.70, p = 0.50). No RMR variable significantly correlated with PSS-14, ASI-3, or STICSA scores. This study provides evidence that trait anxiety and life stress do not impact RMR. Whether an association between these factors exists in anxiety disorders remains to be evaluated. Novelty Contrary to previous research, this study found no associations between anxiety and RMR. It is doubtful whether practitioners need to account for healthy subjects' trait anxiety and stress when analyzing RMR data.

Aerobic Recovery after Radical Prostatectomy: A Case Study.

PURPOSE: This case study examined the recovery after radical prostatectomy (RP) of an endurance-trained 65-yr-old man. METHODS: A maximal incremental exercise test and a 1-h steady-state test were performed just before and 3 months after robotic RP to determine maximal oxygen consumption (V˙O2max) and other cardiorespiratory variables. The patient recorded his training as he prepared for an endurance event that was to occur 3 months after RP, the Norwegian Foot March, a 30-km road march carrying 11.4 kg. RESULTS: In the month before RP, the patient performed 2 to 3 h of vigorous-intensity aerobic exercise per week, fast walking carrying an 11.4-kg pack, with the longest individual session being a 16-km road march. Just before surgery, V˙O2max was 36.7 mL·min·kg, HR during 30 min at 7.2 km·h and 0% grade was 77% of HR reserve (HRR), and during 30 min at 5.3 km·h and 10% grade was 92% HRR. On postsurgery day 44, he did a 19-km road march carrying 11.4 kg, exceeding the training level of the month presurgery. Three months postsurgery, V˙O2max was 42.7 mL·min·kg, and HR during the flat and uphill 30-min sessions at the same absolute intensity as presurgery were 70% and 83% HRR, respectively. He completed the Norwegian Foot March 93 d postsurgery in 4:24:37, with an average HR of 72% HRR. CONCLUSIONS: This case study demonstrates that an aerobically trained prostate cancer patient can return to high-level aerobic training in as little as 7 wk post-RP, and even exceed presurgery fitness. This finding has implications for prognosis given the beneficial effect of vigorous-intensity exercise on prostate cancer progression.