Background Neurocognitive impairment linked to head impact exposure in otherwise healthy, non-concussed athletes may be associated with adverse long-term outcomes. The primary purpose of this study was to evaluate whether a dietary supplement, Synaquell™, supports brain function and structure in male Junior A ice hockey players over the course of a season. Methods Players underwent pre-season testing, were randomized into a placebo or dietary supplement group, then were retested after the season. Objective tests included: NeuroCatch® portable evoked potential platform, King-Devick Test of rapid number naming, and blood biomarker assay for neurofilament light chain (NfL). Results Multivariate analysis revealed significant differences in neurocognitive changes between groups from pre to postseason after controlling for covariates related to head impact exposure. Post-hoc tests showed significant within-subject differences between groups from pre- to post-season in both N100 latency (p = 0.005) and King-Devick score (p = 0.043). Univariate tests of the NeuroCatch results replicated prior findings of a N400 amplitude decrease (p = 0.017) and N100 latency increase (p = 0.049) in the placebo group, but not in the dietary supplement group. Conclusions This prospective, randomized trial showed that, compared to the placebo group, a multi-ingredient dietary supplement significantly affected objective measures of brain function and structure in Junior A ice hockey players from pre- to post-season. Further investigation into the effects of dietary supplementation on the contact athletes brain is warranted.

No abstract

Introduction: Physical activity is protective against cardiovascular (CV) disease and mortality, yet more than 25% of adults do not perform any regular exercise. Whole body electronic muscle stimulation (WB-EMS) is a novel FDA-approved device used for physical training that simultaneously stimulates all major muscle groups using percutaneous electrical impulse transmission during exercise. Preliminary studies demonstrated increased muscle mass, reduced fat mass, and improved functional capacity in elderly individuals who trained with WB-EMS. We evaluated the effects of training with WB-EMS on measures of CV health. Methods: Healthy adults were randomized to physical training with versus without WB-EMS for one 20-minute session each week for 16 weeks. Participants wore a specifically designed vest and arm and leg straps connected to the WB-EMS device (Miha Bodytec, Germany). Biphasic electrical stimulation was delivered through the vest and straps (4 sec on, 4 sec off) at a frequency that elicited a score of 5-6 on the Borg perceived exertion scale when each major muscle group was stimulated. Individuals randomized to no WB-EMS wore the same equipment but received no stimulation. Sessions were provided by trainers certified in WB-EMS training and consisted of a fixed protocol of simple exercises such as squats and lunges. Temporal changes in measures of CV health were compared between groups. Results: Forty-one individuals were recruited between 02/2021 and 02/2022 (n=24 WB-EMS, n=17 no WB-EMS; mean age 35.9±11.2 yrs; 61.3% females; median BMI 24.3 (21.8, 28.1) kg/m 2 . After 16 weeks there were significant and favorable differences in the intervention group compared to controls in waist: hip ratio (-1.2 cm vs. 0.9, p=0.05); total cholesterol (-1.1 mg/kg vs. 14.2 mg/kg, p=0.02); anaerobic threshold (68.2% vs. 30.8%, p=0.03); breathing efficiency (VE/VCO2: -10.36 vs -7.38, p=0.01); and peripheral endothelial function, measured with reactive hyperemia peripheral arterial tonometry (-0.009 vs. -0.29, p=0.06). Conclusions: Once weekly training with WB-EMS yielded more favorable changes in CV biomarkers compared to conventional training alone in healthy adults, and thus may offer an effective and time-efficient method of physical training.

Objective:To compare the validity indices of the King-Devick (KD) test in hockey players using any increase in test time over baseline to a 6-second increase as a positive concussion test. We hypothesized the KD test using the 6-second change would yield greater validity indices.Design:Prospective observational cohort study.Setting:Sports complex.Participants:Sixty-five male hockey players aged 13 to 20 years.Independent Variable:Concussion diagnosis.Main Outcome Measures:Time to complete the KD test. Sensitivity (SN), specificity (SP), and the positive likelihood ratios (LRs+) were calculated using 2 thresholds for a positive test: (1) any increase in time and (2) an increase of 6 seconds or greater.Results:Eighteen players (27.7%) were diagnosed with a concussion. Using any increase in time as a positive test yielded the following: SN 72.2%, SP 78.7%, LR+ 3.4, and LR− 0.4. Using the 6-second threshold yielded the following: SN 44.4%, SP 93.6%, LR+ 7.0, and LR− 0.6. A receiver operator curve analysis confirmed 6.40 seconds or greater maximized the LR+.Conclusions:A 6-second or greater increase in the KD test performance provides greater validity in diagnosing concussion as compared with any increase in performance time.

Low energy availability (LEA) is defined as a mismatch between an individual's energy intake (EI) and energy expenditure (EE) in exercise, leaving insufficient energy to support normal physiological function and maintain metabolic homeostasis. Periods of LEA are common amongst endurance athletes and may occur due to increased EE, reduced EI, or both. While chronic exposure to LEA is associated with negative health outcomes, to date the effects of acute LEA on parameters of endurance performance have not been characterized. PURPOSE: to determine if short-term LEA exposure negatively impacts factors contributing to endurance performance. METHODS: elite race walkers (n=21, 18 male, 3 female; VO 2peak 63 ± 5 mL/min/kg) underwent a 4-stage exercise economy test and competed in a 10,000 m race prior to and following 8-d of a high energy (HEA; ~ 40 kcal/kg fat free mass (FFM); n=11) or LEA (15 kcal/kg FFM, n=10) diet during a 4-week intensified training camp. DXA and resting metabolic rate were measured to calculate energy availability, while a subset of participants also had DXA measured post intervention to assess changes in body composition. RESULTS: fat oxidation rates during the economy test increased across the training camp (n=21; p<0.001), with a reciprocal decrease in carbohydrate (CHO) oxidation (p<0.001), however there were no differences between dietary treatments. The oxygen cost of exercise (relative VO 2 , mL/min/kg) decreased across all 4 stages in both groups (p<0.001), indicating an increase in exercise economy, while there was no change in VO 2max . Athletes in the LEA intervention (n=7) displayed a decrease in body mass (68.1 ± 6.4 vs. 66.6 ± 6.3 kg, p<0.05) and fat mass (9.0 ± 2.7 vs. 7.9 ± 2.6 kg, p<0.05), but maintained total FFM. Athletes in the HEA group (n=5) displayed no changes in body mass or composition. Race performance was improved in both groups (LEA; 3 ± 2%, HEA 4 ± 2%, p<0.001) with no difference between dietary treatments. CONCLUSION: long-term performance preparation involves integration of strategies to alternatively manage training support, physique management and fuel availability. Acute 8-d exposure to LEA resulted in a decrease in total body and fat mass, but reduced training quality. However, with acute replenishment of CHO availability, there was no short-term impairment in race performance.