Six Days of Low Carbohydrate, Not Energy Availability, Alters the Iron and Immune Response to Exercise in Elite Athletes.
Journal
Medicine and science in sports and exercise
ISSN: 1530-0315
Titre abrégé: Med Sci Sports Exerc
Pays: United States
ID NLM: 8005433
Informations de publication
Date de publication:
01 03 2022
01 03 2022
Historique:
pubmed:
26
10
2021
medline:
8
3
2022
entrez:
25
10
2021
Statut:
ppublish
Résumé
To quantify the effects of a short-term (6-d) low carbohydrate (CHO) high fat (LCHF), and low energy availability (LEA) diet on immune, inflammatory, and iron-regulatory responses to exercise in endurance athletes. Twenty-eight elite male race walkers completed two 6-d diet/training phases. During phase 1 (Baseline), all athletes consumed a high CHO/energy availability (CON) diet (65% CHO and ~40 kcal·kg-1 fat-free mass (FFM)·d-1). In phase 2 (Adaptation), athletes were allocated to either a CON (n = 10), LCHF (n = 8; <50 g·d-1 CHO and ~40 kcal·kg-1·FFM-1·d-1), or LEA diet (n = 10; 60% CHO and 15 kcal·kg-1·FFM-1·d-1). At the end of each phase, athletes completed a 25-km race walk protocol at ~75% V˙O2max. On each occasion, venous blood was collected before and after exercise for interleukin-6, hepcidin, cortisol, and glucose concentrations, as well as white blood cell counts. The LCHF athletes displayed a greater IL-6 (P = 0.019) and hepcidin (P = 0.011) response to exercise after Adaptation, compared with Baseline. Similarly, postexercise increases in total white blood cell counts (P = 0.026) and cortisol levels (P < 0.001) were larger compared with Baseline after LCHF Adaptation. Decreases in blood glucose concentrations were evident postexercise during Adaptation in LCHF (P = 0.049), whereas no change occurred in CON or LEA (P > 0.05). No differences between CON and LEA were evident for any of the measured biological markers (all P > 0.05). Short-term adherence to a LCHF diet elicited small yet unfavorable iron, immune, and stress responses to exercise. In contrast, no substantial alterations to athlete health were observed when athletes restricted energy availability compared with athletes with adequate energy availability. Therefore, short-term restriction of CHO, rather than energy, may have greater negative impacts on athlete health.
Identifiants
pubmed: 34690285
doi: 10.1249/MSS.0000000000002819
pii: 00005768-202203000-00002
doi:
Substances chimiques
Biomarkers
0
Iron
E1UOL152H7
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
377-387Informations de copyright
Copyright © 2021 by the American College of Sports Medicine.
Références
Loucks AB, Kiens B, Wright HH. Energy availability in athletes. J Sports Sci . 2011;29(1 Suppl):S7–15.
Burke LM, Close GL, Lundy B, Mooses M, Morton JP, Tenforde AS. Relative energy deficiency in sport in male athletes: a commentary on its presentation among selected groups of male athletes. Int J Sport Nutr Exerc Metab . 2018;28(4):364–74.
Mountjoy M, Sundgot-Borgen J, Burke L, et al. International Olympic Committee (IOC) consensus statement on Relative Energy Deficiency in Sport (RED-S): 2018 update. Int J Sport Nutr Exerc Metab . 2018;28(4):316–31.
Logue D, Madigan SM, Delahunt E, Heinen M, Mc Donnell SJ, Corish CA. Low energy availability in athletes: a review of prevalence, dietary patterns, physiological health, and sports performance. Sports Med . 2018;48(1):73–96.
Melin A, Tornberg ÅB, Skouby S, et al. The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad. Br J Sports Med . 2014;48(7):540–5.
Drew M, Vlahovich N, Hughes D, et al. Prevalence of illness, poor mental health and sleep quality and low energy availability prior to the 2016 Summer Olympic Games. Br J Sports Med . 2018;52(1):47–53.
Ackerman KE, Holtzman B, Cooper KM, et al. Low energy availability surrogates correlate with health and performance consequences of relative energy deficiency in sport. Br J Sports Med . 2019;53(10):628–33.
Walsh NP. Nutrition and athlete immune health: new perspectives on an old paradigm. Sports Med . 2019;49(2 Suppl):153–68.
Sim M, Garvican-Lewis LA, Cox GR, et al. Iron considerations for the athlete: a narrative review. Eur J Appl Physiol . 2019;119(7):1463–78.
McKay AKA, Pyne DB, Burke LM, Peeling P. Iron metabolism: interactions with energy and carbohydrate availability. Nutrients . 2020;12(12):3692.
McKay AKA, Peeling P, Pyne DB, et al. Chronic adherence to a ketogenic diet modifies iron metabolism in elite athletes. Med Sci Sports Exerc . 2019;51(3):548–55.
McKay AKA, Peeling P, Pyne DB, et al. Acute carbohydrate ingestion does not influence the post-exercise iron-regulatory response in elite keto-adapted race walkers. J Sci Med Sport . 2019;22(6):635–40.
McKay AKA, Pyne DB, Peeling P, Sharma AP, Ross MLR, Burke LM. The impact of chronic carbohydrate manipulation on mucosal immunity in elite endurance athletes. J Sports Sci . 2019;37(5):553–9.
Weir JB. New methods for calculating metabolic rate with special reference to protein metabolism. J Physiol . 1949;109(1–2):1–9.
Burke LM, Ross ML, Garvican-Lewis LA, et al. Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers. J Physiol . 2017;595(9):2785–807.
Burke LM, Sharma AP, Heikura IA, et al. Crisis of confidence averted: impairment of exercise economy and performance in elite race walkers by ketogenic low carbohydrate, high fat (LCHF) diet is reproducible. PLoS One . 2020;15(6):e0234027.
Peeling P, McKay AKA, Pyne DB, et al. Factors influencing the post-exercise hepcidin-25 response in elite athletes. Eur J Appl Physiol . 2017;117(6):1233–9.
McKay AKA, Peeling P, Pyne DB, et al. Sustained exposure to high carbohydrate availability does not influence iron-regulatory responses in elite endurance athletes. Int J Sport Nutr Exerc Metab . 2021;31(2):101–8.
Peeling P, Dawson B, Goodman C, et al. Effects of exercise on hepcidin response and iron metabolism during recovery. Int J Sport Nutr Exerc Metab . 2009;19(6):583–97.
Domínguez R, Sánchez-Oliver AJ, Mata-Ordoñez F, et al. Effects of an acute exercise bout on serum hepcidin levels. Nutrients . 2018;10(2):209.
Badenhorst CE, Dawson B, Cox GR, Laarakkers CM, Swinkels DW, Peeling P. Acute dietary carbohydrate manipulation and the subsequent inflammatory and hepcidin responses to exercise. Eur J Appl Physiol . 2015;115(12):2521–30.
Whitfield J, Burke LM, McKay AKA, et al. Acute ketogenic diet and ketone ester supplementation impairs race walk performance. Med Sci Sports Exerc . 2021;53(4):776–84.
Burke LM, Whitfield J, Heikura IA, et al. Adaptation to a low carbohydrate high fat diet is rapid but impairs endurance exercise metabolism and performance despite enhanced glycogen availability. J Physiol . 2021;599(3):771–90.
Dill DB, Costill DL. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol . 1974;37(2):247–8.
Frigolet ME, Ramos Barragan VE, Tamez Gonzalez M. Low-carbohydrate diets: a matter of love or hate. Ann Nutr Metab . 2011;58(4):320–34.
Gore CJ, Parisotto R, Ashenden MJ, et al. Second-generation blood tests to detect erythropoietin abuse by athletes. Haematologica . 2003;88(3):333–44.
Chen YJ, Wong SH, Wong CK, Lam CW, Huang YJ, Siu PM. The effect of a pre-exercise carbohydrate meal on immune responses to an endurance performance run. Br J Nutr . 2008;100(6):1260–8.
Henson DA, Nieman DC, Parker JC, et al. Carbohydrate supplementation and the lymphocyte proliferative response to long endurance running. Int J Sports Med . 1998;19(8):574–80.
Bermon S, Castell LM, Calder PC, et al. Consensus statement immunonutrition and exercise. Exerc Immunol Rev . 2017;23:8–50.
Shaw DM, Merien F, Braakhuis A, Keaney L, Dulson DK. Adaptation to a ketogenic diet modulates adaptive and mucosal immune markers in trained male endurance athletes. Scand J Med Sci Sports . 2021;31(1):140–52.
Pyne DB. Exercise, training, and the immune system. Sports Med Tr Rehab . 1994;5(1):47–64.
Heikura IA, Uusitalo ALT, Stellingwerff T, Bergland D, Mero AA, Burke LM. Low energy availability is difficult to assess but outcomes have large impact on bone injury rates in elite distance athletes. Int J Sport Nutr Exerc Metab . 2018;28(4):403–11.
Koehler K, Hoerner NR, Gibbs JC, et al. Low energy availability in exercising men is associated with reduced leptin and insulin but not with changes in other metabolic hormones. J Sports Sci . 2016;34(20):1921–9.
Papageorgiou M, Martin D, Colgan H, et al. Bone metabolic responses to low energy availability achieved by diet or exercise in active eumenorrheic women. Bone . 2018;114:181–8.
Burke LM, Lundy B, Fahrenholtz IL, Melin AK. Pitfalls of conducting and interpreting estimates of energy availability in free-living athletes. Int J Sport Nutr Exerc Metab . 2018;28(4):350–63.
Heikura IA, Stellingwerff T, Areta JL. Low energy availability in female athletes: from the lab to the field. Eur J Sport Sci . 2021;1–11.
Capling L, Beck KL, Gifford JA, Slater G, Flood VM, O’Connor H. Validity of dietary assessment in athletes: a systematic review. Nutrients . 2017;9(12):1313.
Phillips SM, Van Loon LJ. Dietary protein for athletes: from requirements to optimum adaptation. J Sports Sci . 2011;29(1 Suppl):S29–38.
Thomas DT, Erdman KA, Burke LM. Position of the academy of nutrition and dietetics, dietitians of Canada, and the American College of Sports Medicine: nutrition and athletic performance. J Acad Nutr Diet . 2016;116(3):501–28.
Nova E, Samartin S, Gomez S, Morande G, Marcos A. The adaptive response of the immune system to the particular malnutrition of eating disorders. Eur J Clin Nutr . 2002;56(3 Suppl):S34–7.
França TGD, Ishikawa LLW, Zorzella-Pezavento SFG, Chiuso-Minicucci F, da Cunha MLRS, Sartori A. Impact of malnutrition on immunity and infection. J Venom Anim Toxins incl Trop Dis . 2009;15(3):374–90.
Hadigan CM, Anderson EJ, Miller KK, et al. Assessment of macronutrient and micronutrient intake in women with anorexia nervosa. Int J Eat Disord . 2000;28(3):284–92.
Ishibashi A, Kojima C, Tanabe Y, et al. Effect of low energy availability during three consecutive days of endurance training on iron metabolism in male long distance runners. Phys Rep . 2020;8(12):e14494.
Hennigar SR, McClung JP, Hatch-McChesney A, et al. Energy deficit increases hepcidin and exacerbates declines in dietary iron absorption following strenuous physical activity: a randomized-controlled cross-over trial. Am J Clin Nutr . 2021;113(2):359–69.
Vecchi C, Montosi G, Garuti C, et al. Gluconeogenic signals regulate iron homeostasis via hepcidin in mice. Gastroenterology . 2014;146(4):1060–9.
Nova E, Lopez-Vidriero I, Varela P, Toro O, Casas JJ, Marcos AA. Indicators of nutritional status in restricting-type anorexia nervosa patients: a 1-year follow-up study. Clin Nutr . 2004;23(6):1353–9.
Papillard-Marechal S, Sznajder M, Hurtado-Nedelec M, et al. Iron metabolism in patients with anorexia nervosa: elevated serum hepcidin concentrations in the absence of inflammation. Am J Clin Nutr . 2012;95(3):548–54.
Creighton BC, Hyde PN, Maresh CM, Kraemer WJ, Phinney SD, Volek JS. Paradox of hypercholesterolaemia in highly trained, keto-adapted athletes. BMJ Open Sport Exerc Med . 2018;4(1):e000429.
Lee HS, Lee J. Influences of ketogenic diet on body fat percentage, respiratory exchange rate, and total cholesterol in athletes: a systematic review and meta-analysis. Int J Environ Res Public Health . 2021;18(6):2912.
Practitioners RACoG. Guidelines for preventive activities in general practice . 9th ed. East Melbourne, Vic: RACGP; 2016.