No impact of combining multi-ingredient supplementation with exercise on body composition and physical performance, in healthy middle-aged and older adults: A systematic review and meta-analysis.

BACKGROUND: Protein-based multi-ingredient (MTN) supplements have been suggested as a safe and effective way of enhancing exercise outcomes. However, their effectiveness remains controversial when compared to isocaloric and single-nutrient supplements. This review aims to systematically summarise the current knowledge of multi-ingredient supplementation to optimise body composition and physical performance in middle-aged and older adults. MATERIAL AND METHODS: A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search of the literature was conducted using PubMed, EBSCOhost, Google Scholar, Web of Science, and SPORTDiscus from June to October 2021. Every publication identified from the outset to October 2021 was considered. The main inclusion criteria comprised randomized controlled trial (RCT) studies conducted in adults (≥45 years old), following resistance- or endurance-based training programmes for a period of 6 weeks or longer, combined with MTN supplementation and a calorie equivalent comparator (COMP) supplement (e.g., carbohydrates). Continuous data on body composition [fat-free mass (FFM) or lean body mass], strength, and functional capacity as markers of physical performance were pooled using a random-effects model. RESULTS: Initially, 3329 publications were identified. Data from nine RCTs were ultimately included, involving 476 participants. The overall quality of the included studies was high, demonstrating a low risk of bias. Compared to COMP, no significant further benefits of ingesting MTN were identified for FFM (kg) (g = 0.044, 95 % CI -0.14 to 0.22), upper-body strength (kg) (g = 0.046, 95 % CI -0.24 to 0.33), lower-body strength, leg press exercise (kg) (g = 0.025, 95 % CI -0.26 to 0.31), leg extension exercise (kg) (g = 0.106, 95 % CI -0.15 to 0.36) and functional capacity (time in seconds) (g = 0.079, 95 % CI -0.12 to 0.27). CONCLUSIONS: No additional benefits of ingesting MTN vs. COMP to maximise exercise-induced outcomes on body composition and physical performance in healthy physically active middle-aged and older adults have been identified.

Effects of Multi-Ingredient Preworkout Supplementation across a Five-Day Resistance and Endurance Training Microcycle in Middle-Aged Adults.

Preworkout multi-ingredient admixtures are used to maximise exercise performance. The present double-blind, cross-over study compared the acute effects of ingesting a preworkout multi-ingredient (PREW) admixture vs. carbohydrate (CHO) over a week (microcycle) comprising three resistance training (RT) workouts alternated with two 30-min low-intensity endurance sessions (END) on RT volume (kg lifted) and END substrate oxidation. Additionally, postworkout decreases of muscle function and subjective responses were analysed. Following a baseline assessment, fourteen recreationally trained, middle-aged adults (seven females, 48.8 ± 4.7 years old) completed two identical microcycles separated by a two-week washout period while receiving either PREW or CHO (15 min prior to workout). The RT volume, per session (SVOL) and for the entire week (WVOL), was calculated. Fatty acid oxidation (FAO) during 30-min cycling corresponding to their individually determined maximal fat oxidation was measured using expired gasses and indirect calorimetry. Assessments of performance and tensiomyography were conducted within 20 min after each RT. Higher (p = 0.001) SVOL and WVOL along with a larger proportion of FAO (p = 0.05) during the second END workout were determined under the PREW treatment. No other statistically significant differences were observed between conditions. Compared to CHO, a preworkout multi-ingredient appears to increase resistance volume and favour fat oxidation during low-intensity endurance exercises.

Efficacy and acceptability of pharmacological and non-pharmacological interventions for non-specific chronic low back pain: a protocol for a systematic review and network meta-analysis.

BACKGROUND: Despite the enormous financial and humanistic burden of chronic low back pain (CLBP), there is little consensus on what constitutes the best treatment options from a multitude of competing interventions. The objective of this network meta-analysis (NMA) is to determine the relative efficacy and acceptability of primary care treatments for non-specific CLBP, with the overarching aim of providing a comprehensive evidence base for informing treatment decisions. METHODS: We will perform a systematic search to identify randomised controlled trials of interventions endorsed in primary care guidelines for the treatment of non-specific CLBP in adults. Information sources searched will include major bibliographic databases (MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO and LILACS) and clinical trial registries. Our primary outcomes will be patient-reported pain ratings and treatment acceptability (all-cause discontinuation), and secondary outcomes will be functional ability, quality of life and patient/physician ratings of overall improvement. A hierarchical Bayesian class-based NMA will be performed to determine the relative effects of different classes of pharmacological (NSAIDs, opioids, paracetamol, anti-depressants, muscle relaxants) and non-pharmacological (exercise, patient education, manual therapies, psychological therapy, multidisciplinary approaches, massage, acupuncture, mindfulness) interventions and individual treatments within a class (e.g. NSAIDs: diclofenac, ibuprofen, naproxen). We will conduct risk of bias assessments and threshold analysis to assess the robustness of the findings to potential bias. We will compute the effect of different interventions relative to placebo/no treatment for both short- and long-term efficacy and acceptability. DISCUSSION: While many factors are important in selecting an appropriate intervention for an individual patient, evidence for the analgesic effects and acceptability of a treatment are key factors in guiding this selection. Thus, this NMA will provide an important source of evidence to inform treatment decisions and future clinical guidelines. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registry number: CRD42019138115.

Challenge and Threat: A Critical Review of the Literature and an Alternative Conceptualization.

In this article, the authors describe a new theory, the Evaluative Space Approach to Challenge and Threat (ESACT). Prompted by the Biopsychosocial model of challenge and threat (BPS: Blascovich and Tomaka, 1996) and the development of the Theory of Challenge and Threat States in Athletes (Jones et al., 2009), recent years have witnessed a considerable increase in research examining challenge and threat in sport. This manuscript provides a critical review of the literature examining challenge and threat in sport, tracing its historical development and some of the current empirical ambiguities. To reconcile some of these ambiguities, and utilizing neurobiological evidence associated with approach and avoidance motivation (c.f. Elliot and Covington, 2001), this paper draws upon the Evaluative Space Model (ESM; Cacioppo et al., 1997) and considers the implications for understanding challenge and threat in sport. For example, rather than see challenge and threat as opposite ends of a single bipolar continuum, the ESM implies that individuals could be (1) challenged, (2) threatened, (3) challenged and threatened, or (4) neither challenged or threatened by a particular stimulus. From this perspective, it could be argued that the appraisal of some sport situations as both challenging and threatening could be advantageous, whereas the current literature seems to imply that the appraisal of stress as a threat is maladaptive for performance. The ESACT provides several testable hypotheses for advancing understanding of challenge and threat (in sport) and we describe a number of measures that can be used to examine these hypotheses. In sum, this paper provides a significant theoretical, empirical, and practical contribution to our understanding of challenge and threat (in sport).

Reconceptualising workplace resilience - A cross-disciplinary perspective / Reconceptualización de la resiliencia en el lugar de trabajo - Una perspectiva interdisciplinar

Stressful situations, performance pressure, and setbacks are part of contemporary organizational life. The dynamic nature of technological advances and globalisation of business leads to tougher competitive pressures and constant change. People‘s responses to these challenging circumstances vary widely. Some bounce back and adapt to increasing challenges and adversity, others‘ healthy functioning is significantly impaired. Even though resilience is recognised as a crucial issue in the workplace, the rates of new cases of work-related stress and depression have remained broadly flat for more than 10 years. Resilience research within Applied Psychology typically focuses on the psychological domain of a person‘s functioning. This means that also resilience trainings or interventions focus on only one area. The present paper aims to build a comprehensive conceptualization of workplace resilience ultimately to assist in informing targeted intervention and in developing a model to move the research area forward as a whole. A cross-disciplinary understanding of and approach to individual resilience in the workplace would allow to better understand the mechanism of why some people bounce back from adverse events whereas others‘ well-being declines. We propose a resilience framework with antecedents considering psychological (cognitive and emotional) and physiological correlates (cardiovascular, gastrointestinal and metabolic)

Las situaciones estresantes, la presión laboral y los contratiempos son parte de la organización de la vida contemporánea. La naturaleza dinámica de los avances tecnológicos y la globalización del comercio conduce a mayores presiones competitivas y a un cambio constante. Las respuestas de las personas a estas complejas circunstancias son muy diferentes. Algunos se recuperan y se adaptan a los nuevos retos y adversidades, mientras que otros ven su salud seriamente afectada. Aunque la resiliencia es reconocida como un asunto crucial en el lugar de trabajo, la prevalencia de casos de estrés laboral y depresión se ha mantenido constante durante más de diez años. La investigación en resiliencia dentro de la Psicología Aplicada normalmente se ha centrado en el aspecto psicológico del funcionamiento de la persona. Por tanto, los entrenamientos o intervenciones para mejorar la resiliencia se han centrado solo en un área. El objetivo de este artículo es construir una conceptualización comprensiva de la resiliencia en el lugar de trabajo, a fin de ayudar al diseño de intervenciones específicas y desarrollar un modelo para avanzar en el área de investigación en su conjunto. Una comprensión y un enfoque interdisciplinar de la resiliencia individual en el lugar de trabajo permitiría comprender mejor el mecanismo de por qué algunas personas se recuperan de eventos adversos, mientras que el bienestar de otros disminuye. Proponemos un enfoque de la resiliencia que tenga en cuenta aspectos psicológicos (cognitivos y emocionales) y fisiológicos (cardiovasculares, gastrointestinales y metabólicos)

The prognostic value of dobutamine stress echocardiography amongst British Indian Asian and Afro-Caribbean patients: a comparison with European white patients.

BACKGROUND: The incidence of cardiovascular disease is considerably disparate among different racial and ethnic populations. While dobutamine stress echocardiography (DSE) has been shown to be useful in Caucasian patients, its role among ethnic minority groups remains unclear. This study aimed to investigate the prognostic importance of DSE in three ethnic groups in the UK. METHODS: DSE was performed on 6231 consecutive patients. After exclusions, 5329 patients formed the study (2676 [50.2%] Indian Asian, 2219 [41.6%] European white and 434 [8.1%] Afro-Caribbean). Study outcome measures were non-fatal cardiac events (NFCE) and all-cause mortality. RESULTS: There were 849 (15.9%) NFCE and 1365 (25.6%) deaths over a median follow-up period of 4.6 years. In total 1174 (22%) patients had inducible myocardial ischaemia during DSE, 859 (16.1%) had fixed wall motion abnormalities and 3645 (68.4%) patients had a normal study. Ethnicity did not predict events. Among the three ethnic groups, ischaemia on DSE was associated with 2 to 2.5 times the risk of non-fatal cardiac events and 1.2 to 1.4 times the risk of all-cause mortality. Peak wall motion score index was the strongest independent predictor of non-fatal cardiac events and all-cause mortality in all groups. The C statistic for the prediction of NFCE and all-cause mortality were significantly higher when DSE parameters were added to the standard risk factors for all ethnic groups. CONCLUSIONS: DSE is a strong predictor of NFCE and all-cause mortality and provides predictive information beyond that provided by standard risk factors in three major racial and ethnic groups. No major differences among racial and ethnic groups in the predictive value of DSE was detected.