Purpose: To investigate changes in self-reported physical fitness, performance, and side effects across the menstrual cycle (MC) phases among competitive endurance athletes and to describe their knowledge and communication with coaches about the MC. Methods: The responses of 140 participants (older than 18 y) competing in biathlon or cross-country skiing at the (inter)national level were analyzed. Data were collected via an online questionnaire addressing participants’ competitive level, training volume, MC history, physical fitness, and performance during the MC, MC-related side effects, and knowledge and communication with coaches about the MC and its effects on training and performance. Results: About 50% and 71% of participants reported improved and reduced fitness, respectively, during specific MC phases, while 42% and 49% reported improved and reduced performance, respectively. Most athletes reported their worst fitness (47%) and performance (30%) and the highest number of side effects during bleeding (P < .01; compared with all other phases). The phase following bleeding was considered the best phase for perceived fitness (24%, P < .01) and performance (18%, P < .01). Only 8% of participants reported having sufficient knowledge about the MC in relation to training, and 27% of participants communicated about it with their coach. Conclusions: A high proportion of athletes perceived distinct changes in fitness, performance, and side effects across the MC phases, with their worst perceived fitness and performance during the bleeding phase. Because most athletes indicate a lack of knowledge about the MC’s effect on training and performance and few communicate with coaches on the topic, the authors recommend that more time be devoted to educating athletes and coaches.

ObjectiveTo evaluate the effect of five years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (70-77 years).DesignRandomised controlled trial.SettingGeneral population of older adults in Trondheim, Norway.Participants1567 of 6966 individuals born between 1936 and 1942.InterventionParticipants were randomised to two sessions weekly of high intensity interval training at about 90% of peak heart rate (HIIT, n=400), moderate intensity continuous training at about 70% of peak heart rate (MICT, n=387), or to follow the national guidelines for physical activity (n=780; control group); all for five years.Main outcome measureAll cause mortality. An exploratory hypothesis was that HIIT lowers mortality more than MICT.ResultsMean age of the 1567 participants (790 women) was 72.8 (SD 2.1) years. Overall, 87.5% of participants reported to have overall good health, with 80% reporting medium or high physical activity levels at baseline. All cause mortality did not differ between the control group and combined MICT and HIIT group. When MICT and HIIT were analysed separately, with the control group as reference (observed mortality of 4.7%), an absolute risk reduction of 1.7 percentage points was observed after HIIT (hazard ratio 0.63, 95% confidence interval 0.33 to 1.20) and an absolute increased risk of 1.2 percentage points after MICT (1.24, 0.73 to 2.10). When HIIT was compared with MICT as reference group an absolute risk reduction of 2.9 percentage points was observed (0.51, 0.25 to 1.02) for all cause mortality. Control participants chose to perform more of their physical activity as HIIT than the physical activity undertaken by participants in the MICT group. This meant that the controls achieved an exercise dose at an intensity between the MICT and HIIT groups.ConclusionThis study suggests that combined MICT and HIIT has no effect on all cause mortality compared with recommended physical activity levels. However, we observed a lower all cause mortality trend after HIIT compared with controls and MICT.Trial registrationClinicalTrials.gov NCT01666340.

The purpose of this study was to test whether a long duration of aerobic high-intensity interval training is more effective than shorter intervals at a higher intensity in highly trained endurance athletes. The sample comprised of 12 male and 9 female, national-level, junior cross-country skiers (age, 17.5 ± 0.4 years, maximal oxygen uptake (V[Combining Dot Above]O2max): 67.4 ± 7.7 ml min kg), who performed 8-week baseline and 8-week intervention training periods on dry land. During the intervention period, a short-interval group (SIG, n = 7) added 2 weekly sessions with short duration intervals (2- to 4-minute bouts, total duration of 15-20 minutes), a long-interval group (LIG; n = 7) added 2 weekly sessions with long duration intervals (5- to 10-minute bouts, total duration of 40-45 minutes). The interval sessions were performed with the athletes' maximal sustainable intensity. A control group (CG; n = 7) added 2 weekly sessions with low-intensity endurance training at 65-74% of maximal heart rate. Before and after the intervention period, the skiers were tested for time-trial performance on 12-km roller-ski skating and 7-km hill run. V[Combining Dot Above]O2max and oxygen uptake at the ventilatory threshold (V[Combining Dot Above]O2VT) were measured during treadmill running. After the intervention training period, the LIG-improved 12-km roller ski, 7-km hill run, V[Combining Dot Above]O2max, and V[Combining Dot Above]O2VT by 6.8 ± 4.0%, 4.8 ± 2.6%, 3.7 ± 1.6%, and 5.8 ± 3.3%, respectively, from pre- to posttesting, and improved both performance tests and V[Combining Dot Above]O2VT when compared with the SIG and the CG (all p < 0.05). The SIG improved V[Combining Dot Above]O2max by 3.5 ± 3.2% from pre- to posttesting (p < 0.05), whereas the CG remained unchanged. As hypothesized, a long duration of aerobic high-intensity interval training improved endurance performance and oxygen uptake at the ventilatory threshold more than shorter intervals at a higher intensity.

Purpose: Sedentary behaviour (SB) and low physical activity (PA) are independently associated with non-alcoholic fatty liver disease (NAFLD). Compared to PA, high cardiorespiratory fitness (CRF) has been associated with a higher protection against all-cause mortality and a number of specific diseases. However, this relationship has not been investigated in NAFLD. This study examined the roles of SB and CRF on: i) the likelihood of having NAFLD in the general population, and ii) the risk of mortality over 9 years within individuals having NAFLD. Methods: A cross-sectional analysis of 15,781 adults (52% female; age range 19-95 years) was conducted. Selfreported SB was divided into tertiles. CRF was estimated using validated non-exercise models, and the presence of NAFLD from the Fatty Liver Index. Adjusted Odds Ratios and 95% Confidence Intervals for NAFLD were estimated using logistic regression analyses. Hazard Ratios for all-cause mortality were estimated using Cox proportional hazard regression in individuals with NAFLD. Results: For each additional 1h/d of SB, the likelihood of having NAFLD was significantly increased by 4% (CI, 3-6%). In combined analyses, compared with the reference group high CRF and low (4h/d) SB, individuals with low CRF had a markedly higher likelihood of having NAFLD (OR, 16.9; CI 12.9-22.3), even if they had SB4h/d. High CRF attenuated the negative role of SB up to 7h/d on NAFLD. Over 9.41.3 years of follow-up, individuals with NAFLD and low CRF had the risk of mortality increased by 52% (CI, 10-106%) compared to those with high CRF, regardless of SB or meeting PA guidelines. Conclusions: Low CRF increases the risk of premature death in individuals with NAFLD, and is strongly associated with higher likelihood of having NAFLD, outweighing the influence of SB.

This study examined the effects of acute supplementation with L-arginine and nitrate on running economy, endurance and sprint performance in endurance-trained athletes. In a randomised cross-over, double-blinded design we compared the effects of combined supplementation with 6 g L-arginine and 614 mg nitrate against 614 mg nitrate alone and placebo in nine male elite cross-country skiers (age 18 ± 0 years, VO2max 69.3 ± 5.8 ml ⋅ min(-1) ⋅ kg(-1)). After a 48-hour standardisation of nutrition and exercise the athletes were tested for plasma nitrate and nitrite concentrations, blood pressure, submaximal running economy at 10 km ⋅ h(-1) and 14 km ⋅ h(-1) at 1% incline and 180 m as well as 5-km time-trial running performances. Plasma nitrite concentration following L-arginine + nitrate supplementation (319 ± 54 nmol ⋅ L(-1)) did not differ from nitrate alone (328 ± 107 nmol ⋅ L(-1)), and both were higher than placebo (149 ± 64 nmol ⋅ L(-1), p < 0.01). There were no differences in physiological responses during submaximal running or in 5-km performance between treatments. The plasma nitrite concentrations indicate greater nitric oxide availability both following acute supplementation of L-arginine + nitrate and with nitrate alone compared to placebo, but no additional effect was revealed when L-arginine was added to nitrate. Still, there were no effects of supplementation on exercise economy or endurance running performance in endurance-trained cross-country skiers.