-
1.
Regulation of plasma volume in male lowlanders during 4 days of exposure to hypobaric hypoxia equivalent to 3500 m altitude.
Schlittler, M, Gatterer, H, Turner, R, Regli, IB, Woyke, S, Strapazzon, G, Rasmussen, P, Kob, M, Mueller, T, Goetze, JP, et al
The Journal of physiology. 2021;(4):1083-1096
-
-
Free full text
-
Abstract
KEY POINTS Acclimatization to hypoxia leads to a reduction in plasma volume (PV) that restores arterial O2 content. Findings from studies investigating the mechanisms underlying this PV contraction have been controversial, possibly as experimental conditions were inadequately controlled. We examined the mechanisms underlying the PV contraction evoked by 4 days of exposure to hypobaric hypoxia (HH) in 11 healthy lowlanders, while strictly controlling water intake, diet, temperature and physical activity. Exposure to HH-induced an ∼10% PV contraction that was accompanied by a reduction in total circulating protein mass, whereas diuretic fluid loss and total body water remained unchanged. Our data support an oncotically driven fluid redistribution from the intra- to the extravascular space, rather than fluid loss, as the mechanism underlying HH-induced PV contraction. ABSTRACT Extended hypoxic exposure reduces plasma volume (PV). The mechanisms underlying this effect are controversial, possibly as previous studies have been confounded by inconsistent experimental conditions. Here, we investigated the effect of hypobaric hypoxia (HH) on PV in a cross-over study that strictly controlled for diet, water intake, physical activity and temperature. Eleven males completed two 4-day sojourns in a hypobaric chamber, one in normoxia (NX) and one in HH equivalent to 3500 m altitude. PV, urine output, volume-regulating hormones and plasma protein concentration were determined daily. Total body water (TBW) was determined at the end of both sojourns by deuterium dilution. Although PV was 8.1 ± 5.8% lower in HH than in NX after 24 h and remained ∼10% lower thereafter (all P < 0.002), no differences were detected in TBW (P = 0.17) or in 24 h urine volumes (all P > 0.23). Plasma renin activity and circulating aldosterone were suppressed in HH during the first half of the sojourn (all P < 0.05) but thereafter similar to NX, whereas no differences were detected for copeptin between sojourns (all P > 0.05). Markers for atrial natriuretic peptide were higher in HH than NX after 30 min (P = 0.001) but lower during the last 2 days (P < 0.001). While plasma protein concentration was similar between sojourns, total circulating protein mass (TCP) was reduced in HH at the same time points as PV (all P < 0.03). Despite transient hormonal changes favouring increased diuresis, HH did not enhance urine output. Instead, the maintained TBW and reduced TCP support an oncotically driven fluid redistribution into the extravascular compartment as the mechanism underlying PV contraction.
-
2.
Modulation of Hb-O2 affinity to improve hypoxemia in COVID-19 patients.
Woyke, S, Rauch, S, Ströhle, M, Gatterer, H
Clinical nutrition (Edinburgh, Scotland). 2021;(1):38-39
-
-
Free full text
-
Abstract
This opinion paper aims at discussing the potential impact of modulating the Hb-O2 affinity by the nutritional supplement 5-HMF on patients affected by COVID-19. The paper describes the critical role of the oxygen affinity in hypoxemic COVID-19 patients and the potential positive effect of 5-HMF, a compound shown to increase the Hb-O2 affinity.
-
3.
Bioelectrical Impedance Vector Analysis: A Valuable Tool to Monitor Daily Body Hydration Dynamics at Altitude.
Regli, IB, Turner, R, Woyke, S, Rauch, S, Brugger, H, Gatterer, H
International journal of environmental research and public health. 2021;(10)
Abstract
Bioelectrical impedance vector analysis (BIVA) is a method used to estimate variation in body hydration. We assessed the potential of BIVA for monitoring daily body hydration fluctuations in nine healthy, normally active males under matching normoxic (NX) and hypobaric hypoxic (HH) experimental conditions. Furthermore, we aimed to investigate whether changes in BIVA may correspond with the development of acute mountain sickness (AMS). Subjects were exposed in a hypobaric chamber to both NX (corresponding to an altitude of 262 m) and HH conditions corresponding to an altitude of 3500 m during two four-day sojourns within which food, water intake and physical activity were controlled. Bioimpedance and body weight measurements were performed three times a day and medical symptoms were assessed every morning using the Lake Louise score (LLS). Total body water (TBW) was also assessed on the last day of both sojourns using the deuterium dilution technique. We detected circadian changes in vector length, indicating circadian body water variations that did not differ between NX and HH conditions (ANOVA effects: time: p = 0.018, eta2 = 0.149; interaction: p = 0.214, eta2 = 0.083; condition: p = 0.920, eta2 = 0.001). Even though none of the subjects developed AMS, four subjects showed clinical symptoms according to the LLS during the first 24 hours of HH conditions. These subjects showed a pronounced (Cohen's d: 1.09), yet not statistically significant (p = 0.206) decrease in phase angle 6 hours after exposure, which may indicate fluid shift from the intracellular to the extracellular compartment. At the end of each sojourn, vector length correlated with deuterium dilution TBW "gold standard" measurements (linear regression: NX: p = 0.002 and r2 = 0.756, HH: p < 0.001 and r2 = 0.84). BIVA can be considered a valuable method for monitoring body hydration changes at altitude. Whether such changes are related to the development of clinical symptoms associated with AMS, as indicated in the present investigation, must be confirmed in future studies.
-
4.
5-Hydroxymethylfurfural and α-ketoglutaric acid supplementation increases oxygen saturation during prolonged exercise in normobaric hypoxia.
Kössler, F, Mair, L, Burtscher, M, Gatterer, H
International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition. 2021;(1-2):63-68
Abstract
This double-blinded, randomized and placebo-controlled, crossover study investigated whether α-ketoglutaric-acid (α-KG) and 5-hydroxymethylfurfural (5-HMF) supplementation improves exercise performance in hypoxia and affects physiological responses during the exercise task. Eight moderately trained male participants (age: 25.3 ± 2.0 y, VO2max: 48.0 ± 8.3 ml/min/kg) performed an incremental exercise test to exhaustion in normoxia and two 2-hour cycle time trial (TT) tests in hypoxia (3,500 m) each separated by 1-week. Prior to the TT, participants supplemented with either α-KG and 5-HMF or placebo (random order). Supplementation did not improve TT performance at altitude and did not affect heart rate, effort perception and oxidative stress levels (p > 0.05). Oxygen saturation (SpO2) was enhanced during the α-KG and 5-HMF supplementation trial (79.5 ± 3.3 vs. 78.2 ± 3.7%, p = 0.026). Even though TT performance was unaffected, the enhanced SpO2 - possibly originated from changed O2-affinity - deserves further consideration as the exercise performance decline at altitude is strongly linked to the SpO2 decline. The inclusion of moderately fit participants, not specifically cycle trained, might have prevented any visible performance enhancement.
-
5.
5-Hydroxymethylfurfural and Alpha-Ketoglutaric Acid as an Ergogenic Aid During Intensified Soccer Training: A Placebo Controlled Randomized Study.
Gatterer, H, Böcksteiner, T, Müller, A, Simi, H, Krasser, C, Djukic, R, Schroth, R, Wallner, D
Journal of dietary supplements. 2020;(2):161-172
Abstract
Intensified training may lead to fatigue or even a state of overreaching with temporary reductions in performance. Any aid helping to prevent these consequences and to better tolerate such a training regime would be of great importance. 5-hydroxymethylfurfural (5-HMF) and α-ketoglutaric acid (α-KG) supplementation has been suggested to support favorable training outcomes but its effectiveness to facilitate adaptations during an intensified training period has never been investigated. During an in-season competition break (2 weeks), seventeen young outfield soccer players (age:14.7 ± 0.4 yr) performed a 9-day lasting shock microcyle including 5-7 repeated sprint exercise sessions in addition to the regular training (∼6 sessions/wk) and match (1-2 matches/wk) schedule. Before the training period a treadmill test to exhaustion, a YOYO intermittent recovery level 2 (YYIR2) and a repeated sprint ability (RSA) test were performed. The treadmill test was repeated 3 days after the shock microcycle whereas the YYIR2 and the RSA test on day 10 after the training. Magnitude based inference analysis showed likely positive effects of the 5-HMF/α-KG compared to the control group for changes in the maximal running velocity (+0.3 ± 0.7 vs. -0.3 ± 0.8 km/h) and running velocity at lactate turn-point 1 (+0.2 ± 0.4 vs. -0.2 ± 0.6) and lactate turn-point 2 (+0.4 ± 0.4 vs. -0.2 ± 0.6 km/h, for the 5-HMF/α-KG and placebo group, respectively). Training improved YYIR2 performance (+180 ± 67 vs. +200 ± 168m) and RSA (mean time: -0.1 ± 0.1 vs. -0.1 ± 0.1s, for the 5-HMF/α-KG and placebo group, respectively) in both groups and to the same extent. In conclusion, an in-season shock microcyle including repeated sprint training improves YYIR2 performance and RSA in youth soccer players. Supplementation with 5-HMF/α-KG did not modify training adaptations but led to likely positive exercise performance responses shortly after the intensified training regime.
-
6.
Classic Bioelectrical Impedance Vector Reference Values for Assessing Body Composition in Male and Female Athletes.
Campa, F, Matias, C, Gatterer, H, Toselli, S, Koury, JC, Andreoli, A, Melchiorri, G, Sardinha, LB, Silva, AM
International journal of environmental research and public health. 2019;(24)
Abstract
Bioimpedance standards are well established for the normal healthy population and in clinical settings, but they are not available for many sports categories. The aim of this study was to develop reference values for male and female athletes using classic bioimpedance vector analysis (BIVA). In this study, 1556 athletes engaged in different sports were evaluated during their off-season period. A tetrapolar bioelectrical impedance analyzer was used to determine measurements of resistance (R) and reactance (Xc). The classic BIVA procedure, which corrects bioelectrical values for body height, was applied, and fat-free mass, fat mass, and total body water were estimated. In order to verify the need for specific references, classic bioelectrical values were compared to the reference values for the general male and female populations. Additionally, athletes were divided into three groups: endurance, velocity/power, and team sports. In comparison with the general healthy male and female populations, the mean vectors of the athletes showed a shift to the left on the R-Xc graph. Considering the same set of modalities, BIVA confidence graphs showed that male and female endurance athletes presented lower body fluids, fat mass, and fat-free mass than other sets of modalities. This study provides BIVA reference values for an athletic population that can be used as a standard for assessing body composition in male and female athletes.
-
7.
Are Pre-Ascent Low-Altitude Saliva Cortisol Levels Related to the Subsequent Acute Mountain Sickness Score? Observations from a Field Study.
Gatterer, H, Bernatzky, G, Burtscher, J, Rainer, M, Kayser, B, Burtscher, M
High altitude medicine & biology. 2019;(4):337-343
Abstract
Background: The associations among cortisol levels, body water status, and acute mountain sickness (AMS) remain unclear. We investigated associations between AMS prevalence and severity with resting saliva cortisol levels at low altitude (LA) and high altitude (HA) and with fluid balance during a HA stay. Methods: Twenty-two physically fit and healthy participants (12 women, 10 men) were transported to HA (Testa Grigia, 3480 m). In the late afternoon at LA, on the next day 3-4 hours after arrival at HA and in the morning after an overnight stay, heart rate, oxygen saturation, and systolic and diastolic blood pressures were measured in a sitting position after 10 minutes of rest; cortisol levels were quantified in saliva samples taken pre-ascent and 3-4 hours after arrival at HA. AMS was scored with the 1993 Lake Louise Score (LLS, cut-off ≥3). Urine volume and fluid and food intake were recorded during the altitude stay. Results: Pre-ascent cortisol levels were associated with fluid retention during the altitude stay (r2 = 0.33, p < 0.05) and both were positively related to the LLS (r2 = 0.49 and r2 = 0.26, p < 0.05, respectively). Conclusions: In conclusion, resting LA cortisol levels and fluid retention upon rapid exposure to altitude seem to be associated with AMS. This suggests a potential link among cortisol homeostasis, fluid balance, and AMS risk.
-
8.
Body Composition and Body Weight Changes at Different Altitude Levels: A Systematic Review and Meta-Analysis.
Dünnwald, T, Gatterer, H, Faulhaber, M, Arvandi, M, Schobersberger, W
Frontiers in physiology. 2019;:430
Abstract
Changes in body composition and weight loss frequently occur when humans are exposed to hypoxic environments. The mechanisms thought to be responsible for these changes are increased energy expenditure resulting from increased basal metabolic rate and/or high levels of physical activity, inadequate energy intake, fluid loss as well as gastrointestinal malabsorption. The severity of hypoxia, the duration of exposure as well as the level of physical activity also seem to play crucial roles in the final outcome. On one hand, excessive weight loss in mountaineers exercising at high altitudes may affect performance and climbing success. On the other, hypoxic conditioning is presumed to have an important therapeutic potential in weight management programs in overweight/obese people, especially in combination with exercise. In this regard, it is important to define the hypoxia effect on both body composition and weight change. The purpose of this study is to define, through the use of meta-analysis, the extent of bodyweight -and body composition changes within the three internationally classified altitude levels (moderate altitude: 1500-3500 m; high altitude: 3500-5300 m; extreme altitude: >5300 m), with emphasis on physical activity, nutrition, duration of stay and type of exposure.
-
9.
Exercise physiology and nutritional perspectives of elite soccer refereeing.
Schenk, K, Bizzini, M, Gatterer, H
Scandinavian journal of medicine & science in sports. 2018;(3):782-793
Abstract
Referees are an integral part of soccer, and their performance is fundamental for regular match flow, irrespective of the competition level or age classes. So far, scientific interest was mainly limited to aspects of exercise physiology and match performance of soccer referees, whereas recommendations for nutrition were adopted from active professional soccer. In contrast to elite soccer players, most referees are non-professional and engaged in different occupations. Furthermore, elite referees and soccer players differ in regard to age, body composition, aerobic capacity, and training load. Thus, referees' caloric needs and recommended daily carbohydrate intake may generally be lower compared to active soccer players, with higher intakes limited to periods of increased training load and match days or for referees engaged in physical demanding occupations. With respect to fluid intake, pre-match and in-match hydration strategies generally valid in sports are recommended also for referees to avoid cognitive and physical performance loss, especially when officiating in extreme climates and altitude. In contrast to elite soccer, professional assistance concerning nutrition and training is rarely available for national elite referees of most countries. Therefore, special attention on education about adequate nutrition and fluid intake, about the dietary prevention of deficiencies (iron in female referees, vitamin D irrespective of sex and age), and basic precautions for travels abroad is warranted. In conclusion, the simple adoption of nutritional considerations from active soccer for referees may not be appropriate. Recommendations should respect gender differences, population-specific physical characteristics, and demands just as well as individual characteristics and special needs.
-
10.
Probiotic Supplements Beneficially Affect Tryptophan-Kynurenine Metabolism and Reduce the Incidence of Upper Respiratory Tract Infections in Trained Athletes: A Randomized, Double-Blinded, Placebo-Controlled Trial.
Strasser, B, Geiger, D, Schauer, M, Gostner, JM, Gatterer, H, Burtscher, M, Fuchs, D
Nutrients. 2016;8(11)
-
-
-
Free full text
Plain language summary
Moderate physical exercise benefits the immune system. Intensive exercise however, has the opposite effect leading to an increased risk of Upper Respiratory Tract Infections (URTIs). Studies have shown that supplementing probiotics can enhance resistance to URTIs in athletes. During physical exercise, the amino acid tryptophan (Trp) is broken down and may play an important role in the development of infections. Thirty-three athletes took part in this randomized, double-blinded, placebo-controlled trial. One group took a probiotic supplement daily for 12 weeks and the other took a placebo. Serum Trp levels were measured and symptoms of URTIs recorded before and after intensive exercise, at week 1 and week 12. The placebo group had more URTI symptoms during the study and Trp levels decreased. Trp levels remained stable in the probiotics group. Daily supplementation with probiotics was associated with a lower frequency of URTIs in athletes who underwent endurance training. Further investigation is needed to determine the mechanisms involved and to be able to specify how much exercise affects the gut flora.
Abstract
BACKGROUND Prolonged intense exercise has been associated with transient suppression of immune function and an increased risk of infections. In this context, the catabolism of amino acid tryptophan via kynurenine may play an important role. The present study examined the effect of a probiotic supplement on the incidence of upper respiratory tract infections (URTI) and the metabolism of aromatic amino acids after exhaustive aerobic exercise in trained athletes during three months of winter training. METHODS Thirty-three highly trained individuals were randomly assigned to probiotic (PRO, n = 17) or placebo (PLA, n = 16) groups using double blind procedures, receiving either 1 × 1010 colony forming units (CFU) of a multi-species probiotic (Bifidobacterium bifidum W23, Bifidobacterium lactis W51, Enterococcus faecium W54, Lactobacillus acidophilus W22, Lactobacillus brevis W63, and Lactococcus lactis W58) or placebo once per day for 12 weeks. The serum concentrations of tryptophan, phenylalanine and their primary catabolites kynurenine and tyrosine, as well as the concentration of the immune activation marker neopterin were determined at baseline and after 12 weeks, both at rest and immediately after exercise. Participants completed a daily diary to identify any infectious symptoms. RESULTS After 12 weeks of treatment, post-exercise tryptophan levels were lowered by 11% (a significant change) in the PLA group compared to the concentrations measured before the intervention (p = 0.02), but remained unchanged in the PRO group. The ratio of subjects taking the placebo who experienced one or more URTI symptoms was increased 2.2-fold compared to those on probiotics (PLA 0.79, PRO 0.35; p = 0.02). CONCLUSION Data indicate reduced exercise-induced tryptophan degradation rates in the PRO group. Daily supplementation with probiotics limited exercise-induced drops in tryptophan levels and reduced the incidence of URTI, however, did not benefit athletic performance.