Gymnastik- och idrottshögskolan, GIH

This protocol describes the simultaneous use of a broad span of methods to examine muscle aerobic capacity, glucose tolerance, strength, and power in elderly people performing short-term resistance training (RET). Supervised progressive resistance training for 1 h three times a week over 8 weeks was performed by RET participants (71±1 years, range 65-80). Compared to a control group without training, the RET showed improvements on the measures used to indicate strength, power, glucose tolerance, and several parameters of muscle aerobic capacity. Strength training was performed in a gym with only robust fitness equipment. An isokinetic dynamometer for knee extensor strength permitted the measurement of concentric, eccentric, and static strength, which increased for the RET group (8-12% post- versus pre-test). The power (rate of force development, RFD) at the initial 0-30 ms also showed an increase for the RET group (52%). A glucose tolerance test with frequent blood glucose measurements showed improvements only for the RET group in terms of blood glucose values after 2 h (14%) and the area under the curve (21%). The blood lipid profile also improved (8%). From muscle biopsy samples prepared using histochemistry, the amount of fiber type IIa increased, and a trend towards a decrease in IIx in the RET group reflected a change to a more oxidative profile in terms of fiber composition. Western blot (to determine the protein content related to the signaling for muscle protein synthesis) showed a rise of 69% in both Akt and mTOR in the RET group; this also showed an increase in mitochondrial proteins for OXPHOS complex II and citrate synthase (both ~30%) and for complex IV (90%), in only the RET group. We demonstrate that this type of progressive resistance training offers various improvements (e.g., strength, power, aerobic capacity, glucose tolerance, and plasma lipid profile).

The aim of the present study was to examine the movement patterns, ball skills, and the impressions of Swedish elite football players during competitive games on artificial turf and natural grass. Time - motion analyses (36 observations) and technical analyses (16 team observations) were performed and 72 male and 21 female players completed a questionnaire. No differences were observed between artificial turf and natural grass in terms of total distance covered (mean 10.19 km, s = 0.19 vs. 10.33 km, s = 0.23), high-intensity running (1.86 km, s = 0.10 vs. 1.87 km, s = 0.14), number of sprints (21, s = 1 vs. 22, s = 2), standing tackles (10, s = 1 vs. 11, s = 1) or headers per game (8, s = 1 vs. 8, s = 1), whereas there were fewer sliding tackles (P < 0.05) on artificial turf than natural grass (2.1, s = 0.5 vs. 4.3, s = 0.6). There were more short passes (218, s = 14 vs. 167, s = 12) and midfield-to-midfield passes (148, s = 11 vs. 107, s = 8) (both P < 0.05) on artificial turf than natural grass. On a scale of 0-10, where 0 = "better than", 5 = "equal to", and 10 = "worse than", the male players reported a negative overall impression (8.3, s = 0.2), poorer ball control (7.3, s = 0.3), and greater physical effort (7.2, s = 0.2) on artificial turf than natural grass. In conclusion, the running activities and technical standard were similar during games on artificial turf and natural grass. However, fewer sliding tackles and more short passes were performed during games on artificial turf. The observed change in playing style could partly explain the male players' negative impression of artificial turf.

We examined how the stimulatory effect of leucine on the mechanistic target of rapamycin complex 1 (mTORC1) pathway is affected by the presence of the remaining essential amino acids. Nine male subjects performed resistance exercise on 4 occasions and were randomly supplied essential amino acids (EAAs) with or without leucine (EAA-Leu), leucine alone, or flavored water (placebo; control). Muscle biopsies were taken from the vastus lateralis before and 60 and 90 min after exercise. Biopsies were analyzed for protein phosphorylation, kinase activity, protein-protein interactions, amino acid concentrations, and tracer incorporation. Leucine alone stimulated ribosomal protein s6 kinase 1 (S6K1) phosphorylation ∼280% more than placebo and EAA-Leu after exercise. Moreover, this response was enhanced by 60-75% after intake of EAAs compared with that of leucine alone (P < 0.05). Kinase activity of S6K1 reflected that of S6K1 phosphorylation; 60 min after exercise, the activity was elevated 3.3- and 4.2-fold with intake of leucine alone and with EAAs, respectively (P < 0.05). The interaction between mammalian target of rapamycin and regulatory-associated protein of mammalian target of rapamycin was unaltered in response to both resistance exercise and amino acid provision. Leucine alone stimulates mTORC1 signaling, although this response is enhanced by other EAA and does not appear to be caused by alterations in mTORC1 assembly.-Apró, W., Moberg, M., Hamilton, D. L., Ekblom, B., Rooyackers, O., Holmberg, H.-C., Blomstrand, E. Leucine does not affect mechanistic target of rapamycin complex 1 assembly but is required for maximal ribosomal protein s6 kinase 1 activity in human skeletal muscle following resistance exercise.

Combining endurance and strength training in the same session has been reported to reduce the anabolic response to the latter form of exercise. The underlying mechanism, based primarily on results from rodent muscle, is proposed to involve AMPK-dependent inhibition of mTORC1 signaling. This hypothesis was tested in eight trained male subjects who in a randomized order performed either resistance exercise only (R) or interval cycling followed by resistance exercise (ER). Biopsies taken from the vastus lateralis before and after endurance exercise and repeatedly after resistance exercise were assessed for glycogen content, kinase activity, protein phosphorylation and gene expression. Mixed muscle fractional synthetic rate was measured at rest and during 3h of recovery using the stable isotope technique. In ER, AMPK activity was elevated immediately after both endurance and resistance exercise (~90%, P<0.05) but was unchanged in R. Thr389 phosphorylation of S6K1 was increased several-fold immediately after exercise (P<0.05) in both trials and increased further throughout recovery. After 90 and 180 min recovery, S6K1 activity was elevated (~55% and ~110%, respectively, P<0.05) and eEF2 phosphorylation was reduced (~55%, P<0.05) with no difference between trials. In contrast, markers for protein catabolism were differently influenced by the two modes of exercise; ER induced a significant increase in gene and protein expression of MuRF1 (P<0.05), which was not observed following R exercise only. In conclusion, cycling-induced elevation in AMPK activity does not inhibit mTORC1 signaling after subsequent resistance exercise, but may instead interfere with the hypertrophic response by influencing key components in protein breakdown.

This study investigated the effects of muscle glycogen availability on performance and selected physiological and metabolic responses during high-intensity intermittent exercise. Seven male subjects completed a regimen of exercise and dietary intake (48 h) to either lower and keep low (LOW-CHO) or lower and then increase (HIGH-CHO) muscle glycogen stores, on two separate occasions at least a week apart. On each occasion the subjects completed a short-term (<10 min) and prolonged (>30 min) intermittent exercise (IEX) protocol, 24 h apart, which consisted of 6-s bouts of high-intensity exercise performed at 30-s intervals on a cycle ergometer. Glycogen concentration (mean +/- SEM) in m. vastus lateralis before both IEx(short) and IEx(long) was significantly lower following LOW-CHO [180 (14), 181 (17) mmol kg (dw)(-1)] compared with HIGH-CHO [397 (35), 540 (25) mmol kg (dw)(-1)]. In both IEx(short) and IEx(long), significantly less work was performed following LOW-CHO compared with HIGH-CHO. In IEx(long), the number of exercise bouts that could be completed at a pre-determined target exercise intensity increased by 265% from 111 (14) following LOW-CHO to 294 (29) following HIGH-CHO (P < 0.05). At the point of fatigue in IEx(long), glycogen concentration was significantly lower with the LOW-CHO compared with HIGH-CHO [58 (25) vs. 181 (46) mmol kg (dw)(-1), respectively]. The plasma concentrations of adrenaline and nor-adrenaline (in IEx(short) and IEx(long)), and FFAand glycerol (in IEx(long)), increased several-fold above resting values with both experimental conditions. Oxygen uptake during the exercise periods in IEx(long), approached 70% of Vo2max. These results suggest that muscle glycogen availability can affect performance during both short-term and more prolonged high-intensity intermittent exercise and that with repeated exercise periods as short as 6 s, there can be a relatively high aerobic contribution.

Seven male subjects performed 15 x 40m sprints, on three occasions, with rest periods of either 120 s (R120), 60 s (R60) or 30 s (R30) between each sprint. Sprint times were recorded with four photo cells placed at 0, 15, 30 and 40 m. The performance data indicated that whereas running speed over the last 10 m of each sprint decreased in all three protocols (after 11 sprints in R120, 7 sprints in R60 and 3 sprints in R30), performance during the initial acceleration period from 0-15 m was only affected with the shortest rest periods increasing from (mean +/- SEM) 2.58 +/- .03 (sprint 1) to 2.78 +/- .04 s (spring 15) (p < .05). Post-exercise blood lactate concentration was not significantly different in R120 (12.1 +/- 1.3 mmol.l-1) and R60 (13.9 +/- 1.2 mmol.l-1), but a higher concentration was found in R30 (17.2 +/- .7 mmol.l-1) (p < .05). After 6 sprints there was no significant difference in blood lactate concentration with the different recovery durations, however, there were significant differences in sprint times at this point, suggesting that blood lactate is a poor predictor of performance during this type of exercise. Although the work bouts could be classified primarily as anaerobic exercise, oxygen uptake measured during rest periods increased to 52, 57 and 66% of maximum oxygen uptake in R120, R60 and R30, respectively. Evidence of adenine nucleotide degradation was provided by plasma hypoxanthine and uric acid concentrations elevated post-exercise in all three protocols. Post-exercise uric acid concentration was not significantly affected by recovery duration.(ABSTRACT TRUNCATED AT 250 WORDS)

Physiological responses to repeated bouts of short duration maximal-intensity exercise were evaluated. Seven male subjects performed three exercise protocols, on separate days, with either 15 (S15), 30 (S30) or 40 (S40) m sprints repeated every 30 s. Plasma hypoxanthine (HX) and uric acid (UA), and blood lactate concentrations were evaluated pre- and postexercise. Oxygen uptake was measured immediately after the last sprint in each protocol. Sprint times were recorded to analyse changes in performance over the trials. Mean plasma concentrations of HX and UA increased during S30 and S40 (P less than 0.05), HX increasing from 2.9 (SEM 1.0) and 4.1 (SEM 0.9), to 25.4 (SEM 7.8) and 42.7 (SEM 7.5) mumol.l-1, and UA from 372.8 (SEM 19) and 382.8 (SEM 26), to 458.7 (SEM 40) and 534.6 (SEM 37) mumol.l-1, respectively. Postexercise blood lactate concentrations were higher than pretest values in all three protocols (P less than 0.05), increasing to 6.8 (SEM 1.5), 13.9 (SEM 1.7) and 16.8 (SEM 1.1) mmol.l-1 in S15, S30 and S40, respectively. There was no significant difference between oxygen uptake immediately after S30 [3.2 (SEM 0.1) l.min-1] and S40 [3.3 (SEM 0.4) l.min-1], but a lower value [2.6 (SEM 0.1) l.min-1] was found after S15 (P less than 0.05). The time of the last sprint [2.63 (SEM 0.04) s] in S15 was not significantly different from that of the first [2.62 (SEM 0.02) s]. However, in S30 and S40 sprint times increased from 4.46 (SEM 0.04) and 5.61 (SEM 0.07) s (first) to 4.66 (SEM 0.05) and 6.19 (SEM 0.09) s (last), respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS

The insulin-like growth factor (IGF)-IGF binding proteins (BP) and the pituitary-gonadal axes were investigated during ultra endurance exercise in 16 endurance-trained athletes (seven women). Median duration of the race was 6.3 days. Although food and drink were ad libitum, energy balance was negative. Blood samples were drawn before (PRE), at the end of (END) and 24 h after (POST24h) the race. Serum concentrations of total IGF-I (t-IGF-I) and free IGF-I (f-IGF-I) decreased by 33 (SD 38)% and 54 (19)%, respectively. The decrease in t-IGF-I appeared to be associated to the total energy deficit during the race. At END, the IGFBP-3 fragmentation and IGFBP-1 were increased but these changes did not predict changes in f-IGF-I. An increase in POST24h IGFBP-2 levels in women was the only sex difference. Testosterone was decreased by 67 (12)% in the men and estradiol became undetectable in the women without any detectable increase in LH and/or FSH. In conclusion ultra endurance exercise results in similar IGF-IGFBP responses in men and women reflecting a catabolic state. IGFBP-2 was the only exception, with increased levels in women after exercise. A concomitant decrease in gonadal hormones was not related to endocrine changes in the IGF-IGFBP axis but may be related to local changes in IGF-I expression.

In two articles Timothy Noakes proposes a new physiological model in which skeletal muscle recruitment is regulated by a central "govenor," specifically to prevent the development of a progressive myocardial ischemia that would precede the development of skeletal muscle anaerobiosis during maximal exercise. In this rebuttal to the Noakes' papers, we argue that Noakes has ignored data supporting the existing hypothesis that under normal conditions cardiac output is limiting maximal aerobic power during dynamic exercise engaging large muscle groups.

Manipulation of the blood's oxygen carrying capacity (CaO(2)) through reinfusion of red blood cells, injections of recombinant erythropoietin or by other means results in an increased maximal oxygen uptake and concomitantly enhanced endurance performance. Therefore, there is a need to establish a system--"A Blood Pass"--through which such illegal and unethical methods can be detected. Venous blood samples were taken under standardized conditions from 47 male and female Swedish national and international elite endurance athletes four times during the athletic year of the individual sport (beginning and end of the preparation period and at the beginning and during peak performance in the competition period). In these samples, different hematological values were determined. ON(hes) and OFF(hre) values were calculated according to the formula of Gore et al. A questionnaire regarding training at altitude, alcohol use and other important factors for hematological status was answered by the athletes. There were some individual variations comparing hematological values obtained at different times of the athletic year or at the same time in the athletic year but in different years. However, the median values of all individual hematological, ON(hes) and OFF(hre), values taken at the beginning and the end of the preparation or at the beginning and the end of the competition period, respectively, as well as median values for the preparation and competition periods in the respective sport, were all within the 95% confidence limit (CI) of each comparison. It must be mentioned that there was no gender difference in this respect. This study shows that even if there are some individual variations in different hematological values between different sampling times in the athletic year, median values of important hematological factors are stable over time. It must be emphasized that for each blood sample, the 95% CI in each athlete will be increasingly narrower. The conclusion is that there is a physiological basis for establishing an individual-based "Blood Pass" system, mainly for athletes competing at the international level. On indications of manipulations of hemoglobin concentration and red cell mass by deviations from established "Blood Pass" data, more specific methods can be applied.

Physiological and medical effects of snuff have previously been obtained either in cross-sectional studies or after snuff administration to non-tobacco users. The effects of snuff cessation after several years of daily use are unknown. 24 participants with >2 years of daily snuff-use were tested before and after >6 weeks snuff cessation (SCG). A control group (CO) of 11 snuff users kept their normal habits. Resting heart rate (HR) and blood pressure (BP) were significantly lower in SCG after snuff cessation, and body mass was increased by 1.4 ± 1.7 kg. Total cholesterol increased from 4.12 ± 0.54 (95% CI 3.89-4.35) to 4.46 ± 0.70 (95% CI 4.16-4.75) mM L-1 in SCG, due to increased LDL, and this change was significantly different from CO. Resting values of HDL, C-reactive protein, and free fatty acids (FFA) remained unchanged in both groups. In SCG group, both HR and BP were reduced during a four-stage incremental cycling test (from 50 to 80% of VO2max) and a prolonged cycling test (60 min at 50% of VO2max). Oxygen uptake (VO2), respiratory exchange ratio, blood lactate (bLa) and blood glucose (bGlu) concentration, and rate of perceived exertion (RPE) were unchanged. In CO group, all measurements were unchanged. During the prolonged cycling test, FFA was reduced, but with no significant difference between groups. During the maximal treadmill running test peak values of VO2, pulmonary ventilation (VE), time to exhaustion and bLa were unchanged in both groups. In conclusion, endurance exercise performance (VO2max and maximal endurance time) does not seem to be affected by prolonged snuff use, while effects on cardiovascular risk factors are contradictory. HR and BP during rest and submaximal exercise are reduced after cessation of regular use of snuff. Evidently, the long-time adrenergic stress on circulation is reversible.

AIM: This study assessed the validity and reliability of the Ekblom-Bak (EB) submaximal cycle test in adolescents and identified any sex- or maturity-related factors for prediction errors.

METHODS: We recruited 50 healthy subjects through a public announcement in Stockholm, Sweden, in 2016. The 27 boys and 23 girls were aged 10-15 years and in Tanner stages I-IV. They performed an EB test and incremental treadmill running test for direct measurement of maximal oxygen uptake (VO2 max).

RESULTS: The estimation error of VO2 max was 0.09 L/min. The correlation (r) was 0.86, and the standard error of the estimate (SEE) was 0.29 L/min. The largest overestimation was seen in prepubertal boys (0.49 L/min). The best precision of the EB test was achieved when boys in Tanner stages I and II were re-calculated using the prediction equation developed for adult women. This yielded a mean difference of -0.05 L/min, r = 0.92 and SEE 0.23 L/min, in the entire sample. The prediction error was lowered in boys, but not girls, with increasing pubertal maturity.

CONCLUSION: The EB test was reasonably valid in adolescents, seemed to be related to sex and maturity status, and our findings support its use.

PURPOSE: To further develop the Ekblom Bak-test prediction equation for estimation of VO2max from submaximal cycle ergometry.

METHODS: The model group (117 men and 100 women, aged 48.3 ± 15.7 and 46.1 ± 16.8 years, VO2max 46.6 ± 11.1 and 40.4 ± 9.6 mL kg(-1) min(-1), respectively) and the cross-validation group (60 men and 55 women, aged 40.6 ± 17.1 and 41.6 ± 16.7 years, VO2max 49.0 ± 12.1 and 43.2 ± 8.9 mL min(-1) kg(-1), respectively) performed 4 min of cycling on a standard work rate (30 W) directly followed by 4 min on a higher work rate. Heart rate (HR) at each work rate was recorded. Thereafter, participants completed a graded maximal treadmill test for direct measurement of oxygen uptake. The new prediction equation was cross-validated and accuracy compared with the original Ekblom Bak equation as well as by the Åstrand test method.

RESULTS: The final sex-specific regression models included age, change in HR per-unit change in power (ΔHR/ΔPO), the difference in work rates (ΔPO), and HR at standard work rate as independent variables. The adjusted R (2) for the final models were 0.86 in men and 0.83 in women. The coefficient of variation (CV) was 8.7 % and SEE 0.28 L min(-1). The corresponding CV and SEE values for the EB-test2012 and the Åstrand tests were 10.9 and 18.1 % and 0.35 and 0.48 L min(-1), respectively.

CONCLUSION: The new EB-test prediction equation provides an easy administered and valid estimation of VO2max for a wide variety of ages (20-86 years) and fitness levels (19-76 mL kg(-1) min(-1)).

The prevalence of poor health, in particular stress-related mental ill-health, is increasing over time and birth cohorts. As rapid societal changes have occurred in the last decade and still are occurring, there is an interest in investigating the trends in health-related factors. The aim of the present study was to investigate trends in self-reported general health, overall stress, work-related stress, feelings of loneliness, and sleeping problems in 335,625 Swedish adults across categories of gender, geographic regions, length of education, and age from 2000 to 2016. On population level, sleeping problems and poor general health have increased markedly and significantly, while experiences of work stress decreased between 2000 and 2016 (p < 0.05). Overall stress and level of loneliness were unchanged (p > 0.05). The risk of having ≥3 symptoms (any of poor or very poor general health, often or very often perceived overall stress, loneliness, or sleeping problems) has increased significantly from 2000 to 2016 (ß = 1034 (1027-1040)). This increase was significantly higher in young (ß = 1052 (1038-1065)) and individuals with lower education (ß = 1056 (1037-1076)) compared to older and high length of education.

The COVID-19 pandemic has become a public health emergency of international concern, which may have affected lifestyle habits and mental health. Based on national health profile assessments, this study investigated perceived changes of lifestyle habits in response to the COVID-19 pandemic and associations between perceived lifestyle changes and mental health in Swedish working adults. Among 5599 individuals (50% women, 46.3 years), the majority reported no change (sitting 77%, daily physical activity 71%, exercise 69%, diet 87%, alcohol 90%, and smoking 97%) due to the pandemic. Changes were more pronounced during the first wave (April–June) compared to the second (October–December). Women, individuals &lt;60 years, those with a university degree, white-collar workers, and those with unhealthy lifestyle habits at baseline had higher odds of changing lifestyle habits compared to their counterparts. Negative changes in lifestyle habits and more time in a mentally passive state sitting at home were associated with higher odds of mental ill-health (including health anxiety regarding one’s own and relatives’ health, generalized anxiety and depression symptoms, and concerns regarding employment and economy). The results emphasize the need to support healthy lifestyle habits to strengthen the resilience in vulnerable groups of individuals to future viral pandemics and prevent health inequalities in society.

On two occasions, seven male endurance-trained cyclists performed exhaustive exercise on a cycle ergometer in the morning after they had performed a bout of exercise the preceding evening in an attempt to lower the muscle glycogen stores. The subjects exercised at a work rate corresponding to approximately 70% of their maximal oxygen uptake for 60 min, followed by another 20 min of maximal exercise. During exercise the subjects were given either a solution of branched-chain amino acids (BCAAs) or flavoured water (placebo). Every 10 min during exercise the subjects rated their perceived exertion and mental fatigue on two different Borg scales. During the 60 min exercise at a given work rate the subjects ratings of perceived exertion when they were given BCAAs were 7% lower, and their ratings of mental fatigue were 15% lower than when they were given placebo. In addition, the performance in the colour task of Stroops Colour Word Test performed after exercise was improved when BCAAs had been ingested during exercise, compared with the results from the placebo trial. There was no difference in the physical performance between the two trials measured as the amount of work done during the last 20 min of exercise when the subjects performed at their maximum. The plasma concentration ratio of free tryptophan/BCAAs, which increased by 45% during exercise and by 150% 5 min after exercise in the placebo trial, remained unchanged or even decreased when BCAAs were ingested.

This investigation was designed to evaluate changes in plasma and muscle levels of free amino acids during an ultra-endurance exercise and following recovery. Nine male ultra-endurance trained athletes participated in a 24-h standardized endurance trial with controlled energy intake. The participants performed 12 sessions of running, kayaking and cycling (4 x each discipline). Blood samples were collected before, during and after exercise, as well as after 28 h of recovery. Muscle biopsies were taken 1 week before the test and after exercise, as well as after 28 h of recovery. During the 24-h exercise, plasma levels of branched-chain (BCAA), essential amino acids (EAA) and glutamine fell 13%, 14% and 19% (P<0.05) respectively, whereas their concentrations in muscle were unaltered. Simultaneously, tyrosine and phenylalanine levels rose 38% and 50% (P<0.05) in the plasma and 66% and 46% (P<0.05) in muscle, respectively. After the 24-h exercise, plasma levels of BCAA were positively correlated with muscle levels of glycogen (r2=0.73, P<0.05), as was the combined concentrations of muscle tyrosine and phenylalanine with plasma creatine kinase (r2=0.55, P<0.05). Following 28-h of recovery, plasma and muscle levels of amino acids had either returned to their initial levels or were elevated. In conclusion, ultra-endurance exercise caused significant changes elevations in plasma and muscle levels of tyrosine and phenylalanine, which suggest an increase in net muscle protein breakdown during exercise. There was a reduction in plasma concentrations of EAA and glutamine during exercise, whereas no changes were detected in their muscle concentration after exercise.

Cardiopulmonary kinetics and electromyographic activity (EMG) during exhausting exercise were measured in 8 males performing three maximal combined arm+leg exercises (cA+L). These exercises were performed at different rates of work (mean+/-SD; 373+/-48, 429+/-55 and 521+/-102 W) leading to different average exercise work times in all tests and subjects. VO2 reached a plateau versus work rate in every maximal cA+L exercise (range 6 min 33 s to 3 min 13 s). The three different exercise protocols gave a maximal oxygen consumption (VO2MAX) of 4.67+/-0.57, 4.58+/-0.52 and 4.66+/-0.53 l min(-1) (P=0.081), and a maximal heart rate (HRmax) of 190+/-6, 189+/-4 and 189+/-6 beats min(-1) (P=0.673), respectively. Root mean square EMG (EMGRMS) of the vastus lateralis and the triceps brachii muscles increased with increasing rate of work and time in all three cA+L protocols. The study demonstrates that despite different maximal rates of work, leading to different times to exhaustion, the circulatory adaptation to maximal exercise was almost identical in all three protocols that led to a VO2 plateau. The EMG(RMS) data showed increased muscle recruitment with increasing work rate, even though the HRmax and VO2MAX was the same in all three cA+L protocols. In conclusion, these findings do not support the theory of the existence of a central governor (CG) that regulates circulation and neuronal output of skeletal muscles during maximal exercise.

We tested the hypothesis that the work of the heart was not a limiting factor in the attainment of maximal oxygen uptake (VO2 max). We measured cardiac output (Q) and blood pressures (BP) during exercise at two different rates of maximal work to estimate the work of the heart through calculation of the rate-pressure product, as a part of the ongoing discussion regarding factors limiting VO2 max. Eight well-trained men (age 24.4 +/- 2.8 yr, weight 81.3 +/- 7.8 kg, and VO2 max 59.1 +/- 2.0 ml x min(-1) x kg(-1)) performed two maximal combined arm and leg exercises, differing 10% in watts, with average duration of time to exhaustion of 4 min 50 s and 3 min 40 s, respectively. There were no differences between work rates in measured VO2 max, maximal Q, and peak heart rate between work rates (0.02 l/min, 0.3 l/min, and 0.8 beats/min, respectively), but the systolic, diastolic, and calculated mean BP were significantly higher (19, 5, and 10 mmHg, respectively) in the higher than in the lower maximal work rate. The products of heart rate times systolic or mean BP and Q times systolic or mean BP were significantly higher (3,715, 1,780, 569, and 1,780, respectively) during the higher than the lower work rate. Differences in these four products indicate a higher mechanical work of the heart on higher than lower maximal work rate. Therefore, this study does not support the theory, which states that the work of the heart, and consequently VO2 max, during maximal exercise is hindered by a command from the central nervous system aiming at protecting the heart from being ischemic.

Recent technological developments have made it possible to use hyperoxia as an enhancement aid during training. Athletes wearing a mask can breathe a higher fraction of oxygen from a stationary or portable apparatus while exercising. A large body of evidence indicates that the oxygen transport capacity, lactate metabolism, power output and work tolerance (endurance) are improved when breathing hyperoxia. The physiological mechanisms underlying these performance improvements, although still not fully elucidated, are based on higher oxygen delivery and reduced central fatigue. Although much is known about the acute effects of hyperoxia, the effect of hyperoxic-supplemented endurance training on performance and the mechanisms beneath training adaptations are not very well understood, especially in well-trained endurance athletes. The few studies on the physiological effects of hyperoxia training have been conducted with conflicting results, discussed in this paper. Potential detrimental effects have not yet been shown experimentally and warrant further investigation.

The purpose was to assess the impact of various factors on methodological errors associated with measurement of maximal oxidative phosphorylation (OXPHOS) in human skeletal muscle determined by high-resolution respirometry in saponin-permeabilized fibers. Biopsies were collected from 25 men to assess differences in OXPHOS between two muscle bundles and to assess the correlation between OXPHOS and the wet weight of the muscle bundle. Biopsies from left and right thighs of another five subjects were collected on two occasions to compare limbs and time-points. A single muscle specimen was used to assess effects of the anesthetic carbocaine and the influence of technician. The difference in OXPHOS between two fiber-bundles from the same biopsy exhibited a standard error of measurement (SEM) of 10.5 pmol · s-1  · mg-1 and a coefficient of variation (CV) of 15.2%. The differences between left and right thighs and between two different time-points had SEMs of 9.4 and 15.2 pmol · s-1  · mg-1 and CVs of 23.9% and 33.1%, respectively. The average (±SD) values obtained by two technicians monitoring different bundles of fibers from the same biopsy were 31.3 ± 7.1 and 26.3 ± 8.1 pmol · s-1  · mg-1 . The time that elapsed after collection of the biopsy (up to a least 5 h in preservation medium), wet weight of the bundle (from 0.5 to 4.5 mg) and presence of an anesthetic did not influence OXPHOS. The major source of variation in OXPHOS measurements is the sample preparation. The thigh involved, time-point of collection, size of fiber bundles, and time that elapsed after biopsy had minor or no effect.

Background: Recently, it was shown that exogenously administered testosterone enhances endurance capacity in women. In this study, our understanding on the effects of exogenous testosterone on key determinants of oxygen transport and utilization in skeletal muscle is expanded.Methods: In a double-blinded, randomized, placebo-controlled trial, 48 healthy active women were randomized to 10 weeks of daily application of 10 mg of testosterone cream or placebo. Before and after the intervention, VO₂ max, body composition, total hemoglobin (Hb) mass and blood volumes were assessed. Biopsies from the vastus lateralis muscle were obtained before and after the intervention to assess mitochondrial protein abundance, capillary density, capillary-to-fiber (C/F) ratio, and skeletal muscle oxidative capacity.Results: Maximal oxygen consumption per muscle mass, Hb mass, blood, plasma and red blood cell volumes, capillary density, and the abundance of mitochondrial protein levels (i.e., citrate synthase, complexes I, II, III, IV-subunit 2, IV-subunit 4, and V) were unchanged by the intervention. However, the C/F ratio, specific mitochondrial respiratory flux activating complex I and linked complex I and II, uncoupled respiration and electron transport system capacity, but not leak respiration or fat respiration, were significantly increased following testosterone administration compared to placebo.Conclusion: This study provides novel insights into physiological actions of increased testosterone exposure on key determinants of oxygen diffusion and utilization in skeletal muscle of women. Our findings show that higher skeletal muscle oxidative capacity coupled to higher C/F ratio could be major contributing factors that improve endurance performance following moderately increased testosterone exposure.

AIM:We examined the Fick components together with mitochondrial O2 affinity (p50mito ) in defining O2 extraction and O2 uptake during exercise with large and small muscle mass during normoxia (NORM) and hyperoxia (HYPER).

METHODS:Seven individuals performed two incremental exercise tests to exhaustion on a bicycle ergometer (BIKE) and two on a one-legged knee extension ergometer (KE) in NORM or HYPER. Leg blood flow and VO2 were determined by thermodilution and the Fick method. Maximal ADP-stimulated mitochondrial respiration (OXPHOS) and p50mito were measured ex vivo in isolated mitochondria. Mitochondrial excess capacity in the leg was determined from OXPHOS in permeabilized fibers and muscle mass measured with magnetic resonance imaging in relation to peak leg O2 delivery.

RESULTS:The ex vivo p50mito increased from 0.06±0.02 to 0.17±0.04 kPa with varying substrate supply and O2 flux rates from 9.84±2.91 to 16.34±4.07 pmol O2 ·s-1 ·μg-1 respectively. O2 extraction decreased from 83% in BIKE to 67% in KE as a function of a higher O2 delivery, and lower mitochondrial excess capacity. There was a significant relationship between O2 extraction and mitochondrial excess capacity and p50mito that was unrelated to blood flow and mean transit time.

CONCLUSION:O2 extraction varies with mitochondrial respiration rate, p50mito and O2 delivery. Mitochondrial excess capacity maintains a low p50mito which enhances O2 diffusion from microvessels to mitochondria during exercise. This article is protected by copyright. All rights reserved.

Background: Hyperoxia (HYPER) increases O₂ carrying capacity resulting in a higher O₂ delivery to the working muscles during exercise. Several lines of evidence indicate that lactate metabolism, power output, and endurance are improved by HYPER compared to normoxia (NORM). Since HYPER enables a higher exercise power output compared to NORM and considering the O₂ delivery limitation at exercise intensities near to maximum, we hypothesized that hyperoxic-supplemented high-intensity interval training (HIIT) would upregulate muscle mitochondrial oxidative capacity and enhance endurance cycling performance compared to training in normoxia. Methods: 23 trained cyclists, age 35.3 ± 6.4 years, body mass 75.2 ± 9.6 kg, height 179.8 ± 7.9 m, and VO₂max 4.5 ± 0.7 L min^-1 performed 6 weeks polarized and periodized endurance training on a cycle ergometer consisting of supervised HIIT sessions 3 days/week and additional low-intensity training 2 days/week. Participants were randomly assigned to either HYPER (F_IO₂ 0.30; n = 12) or NORM (F_IO₂ 0.21; n = 11) breathing condition during HIIT. Mitochondrial respiration in permeabilized fibers and isolated mitochondria together with maximal and submaximal VO₂, hematological parameters, and self-paced endurance cycling performance were tested pre- and posttraining intervention. Results: Hyperoxic training led to a small, non-significant change in performance compared to normoxic training (HYPER 6.0 ± 3.7%, NORM 2.4 ± 5.0%; p = 0.073, ES = 0.32). This small, beneficial effect on the self-paced endurance cycling performance was not explained by the change in VO₂max (HYPER 1.1 ± 3.8%, NORM 0.0 ± 3.7%; p = 0.55, ES = 0.08), blood volume and hemoglobin mass, mitochondrial oxidative phosphorylation capacity (permeabilized fibers: HYPER 27.3 ± 46.0%, NORM 16.5 ± 49.1%; p = 0.37, ES = 3.24 and in isolated mitochondria: HYPER 26.1 ± 80.1%, NORM 15.9 ± 73.3%; p = 0.66, ES = 0.51), or markers of mitochondrial content which were similar between groups post intervention. Conclusions: This study showed that 6 weeks hyperoxic-supplemented HIIT led to marginal gain in cycle performance in already trained cyclists without change in VO₂max, blood volume, hemoglobin mass, mitochondrial oxidative phosphorylation capacity, or exercise efficiency. The underlying mechanisms for the potentially meaningful performance effects of hyperoxia training remain unexplained and may raise ethical questions for elite sport.

Sexual dimorphism is apparent in humans, however, to date no studies have investigated mitochondrial function focusing on intrinsic mitochondrial respiration (i.e., mitochondrial respiration for a given amount of mitochondrial protein) and mitochondrial oxygen affinity (p50_mito) in relation to biological sex in human. A skeletal muscle biopsy was donated by nine active women, and ten men matched for maximal oxygen consumption (VO_2max) and by nine endurance trained men. Intrinsic mitochondrial respiration, assessed in isolated mitochondria, was higher in women compared to men when activating complex I (CI_P) and complex I+II (CI+II_P) (p < 0.05), and was similar to trained men (CI_P, p = 0.053; CI+II_P, p = 0.066). Proton leak and p50_mito were higher in women compared to men independent of VO_2max. In conclusion, significant novel differences in mitochondrial oxidative function, intrinsic mitochondrial respiration and p50_mito exist between women and men. These findings may represent an adaptation in the oxygen cascade in women to optimize muscle oxygen uptake to compensate for a lower oxygen delivery during exercise.

The influence of chronic iron deficiency anaemia on myoglobin content, maximal enzyme activities and capillarization in the human skeletal muscle was investigated. Muscle samples from musculus vastus lateralis were screened in an Indonesian population. The causes of iron deficiency were chronic intestinal bleeding or repeated pregnancy combined with low iron intake. The maximal activities of iron-dependent and non-iron-dependent glycolytic and oxidative enzymes as well as myoglobin showed similar values in the iron-deficient group and the matched control group. The activities of the oxidative enzymes in both the iron-deficient group and the controls were lower, however, compared even to untrained Swedish subjects. The capillary density was essentially within a normal range in both groups. It is concluded that chronic iron deficiency anaemia of a moderate or severe degree, with Hb concentrations of about 80-100 g.1(-1), does not cause an impaired biochemical function of the human skeletal muscle.

Blood flow restriction (BFR) with low-load resistance exercise (RE) is often used as a surrogate to traditional high-load RE to stimulate muscular adaptations, such as hypertrophy and strength. However, it is not clear whether such adaptations are achieved through similar cellular and molecular processes. We compared changes in muscle function, morphology and signaling pathways between these differing training protocols. Twenty-one males and females (mean ± SD: 24.3 ± 3.1 years) experienced with resistance training (4.9 ± 2.6 years) performed nine weeks of resistance training (three times per week) with either high-loads (75-80% 1RM; HL-RT), or low-loads with BFR (30-40% 1RM; LL-BFR). Before and after the training intervention, resting muscle biopsies were collected, and quadricep cross-sectional area (CSA), muscular strength and power were measured. Approximately 5 days following the intervention, the same individuals performed an additional 'acute' exercise session under the same conditions, and serial muscle biopsies were collected to assess hypertrophic- and ribosomal-based signaling stimuli. Quadricep CSA increased with both LL-BFR (7.4±4.3%) and HL-RT (4.6±2.9%), with no significant differences between training groups (p=0.37). Muscular strength also increased in both training groups, but with superior gains in squat 1RM occurring with HL-RT (p<0.01). Acute phosphorylation of several key proteins involved in hypertrophy signaling pathways, and expression of ribosomal RNA transcription factors occurred to a similar degree with LL-BFR and HL-RT (all p>0.05 for between-group comparisons). Together, these findings validate low-load resistance training with continuous BFR as an effective alternative to traditional high-load resistance training for increasing muscle hypertrophy in trained individuals.

På Åstrandslaboratoriet vid Gymnastik- och idrotthögskolan i Stockholm finns tradition och erfarenhet av att göra populationsundersökningar. För närvarande finns tre pågående projekt av populationskaraktär; Skola-Idrott-Hälsa (SIH), SCAPIS-undersökningen samt LIV-studierna.

För den som betraktar svenskarna som ett aktivt folk är det dags att tänka om. Bara sju procent av 50-65 åringarna är tillräckligt fysiskt aktiva, visar  resultat från den stora SCAPIS-studien.

Stillasittande innebär en hälsorisk som är skiljd från den risk som otillräcklig fysisk aktivitet utgör. Långvarig inaktivitet är alltså ett eget område med tidigare endast delvis kända riskfaktorer som kräver egna insatser för att motverka ohälsa.

En stor grupp av arbetsföra svenskar har haft en negativ utveckling av såväl kondition, förekomst av övervikt och fetma samt mående och upplevd hälsa under de senaste 30 åren. Det visar flera studier som baserats på en unik databas med hälsoprofiler.

The aim was to investigate sex- and age-specific associations between cardiorespiratory fitness, all-cause and cause-specific mortality, and cardiovascular disease (CVD) morbidity. 266.109 participants (47% women, 18-74 years) free from CVD, participating in occupational health service screenings in 1995-2015 were included. CRF was assessed as estimated maximal oxygen consumption (estVO₂max) using a submaximal cycle test. Incident cases of first-time CVD event and death from any cause were ascertained through national registers. There were 4244 CVD events and 2750 cases of all-cause mortality during mean 7.6 years follow-up. Male gender, higher age and lower estVO₂max were associated with higher all-cause mortality and CVD morbidity incidence rates. Risk reductions with increasing estVO₂max were present in all age-groups of men and women. No obvious levelling off in risk was identified in the total cohort. However, women and older age-groups showed no further reduction in higher aggregated estVO₂max levels. CVD specific mortality was more associated with estVO₂max compared to tumor specific mortality. The risk for all-cause mortality and CVD morbidity decreased by 2.3% and 2.6% per increase in 1 ml·min^-1·kg^-1 with no significant sex-differences but more pronounced in the three lower estVO₂max categories for all-cause mortality (9.1%, 3.8% and 3.3%, respectively). High compared to lower levels of estVO₂max was not related to a significantly elevated mortality or morbidity. In this large cohort study, CVD morbidity and all-cause mortality were inversely related to estVO₂max in both men and women of all age-groups. Increasing cardiorespiratory fitness is a clear public health priority.

Background: The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated. Methods: A total of 258,146 participants (49% women), aged 19–70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VO_2max) were obtained. Results: Women participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81–0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17–1.23) for exercising regularly and a normal/high VO_2max in adulthood. For men, the ORs were significantly lower (range: 0.66–0.86) for poor perceived overall health, general, and abdominal obesity. These associations were seen for participants up to 70 years. Increased PA outside school hours revealed even stronger beneficial associations. In joint analyses, both youth and current PA were important for lower OR of poor health and being obese in adulthood. Conclusions: Physical education class participation and additional PA after school hours were both important for perceived health, PA, VO_2max, and metabolic health in adulthood up to 70 years.

BACKGROUND: Long-term trend analyses of cardiorespiratory fitness (VO₂ max) in the general population are limited.

OBJECTIVES: To describe trends in VO₂ max from 1995 to 2017 in the Swedish working force and to study developments across categories of sex, age, education, and geographic regions.

METHODS: 354.277 participants (44% women, 18-74 years) who participated in a nationwide occupational health service screening between 1995 and 2017 were included. Changes in standardized mean values of absolute (L·min^-1 ) and relative (ml·min^-1 ·kg^-1 ) VO₂ max, and the proportion with low (<32) relative VO₂ max are reported. VO₂ max was estimated using a submaximal cycle test.

RESULTS: Absolute VO₂ max decreased by -6.7% (-0.19 L·min^-1 ) in the total population. Relative VO₂ max decreased by -10.8% (-4.2 ml·min^-1 ·kg^-1 ) with approximately one-third explained by a simultaneous increase in body mass. Decreases in absolute fitness were more pronounced in men vs. women (8.7% vs. 5.3%), in younger vs. older (6.5% vs 2.3%), in short (11.4%) vs. long (4.5%) education, and in rural vs. urban regions (6.5% vs 3.5%), all p<0.001. The proportions with low VO₂ max increased from 27% to 46% (p<0.001).

CONCLUSION: Between 1995 and 2017, there was a steady and pronounced decline in mean cardiorespiratory fitness in Swedish adults. Male gender, young age, short education and living in a rural area were predictive of greater reductions. The proportion with low cardiorespiratory fitness almost doubled. Given the strong associations between cardiorespiratory fitness and multiple morbidities and mortality, preventing further decreases is a clear public health priority, especially for vulnerable groups. This article is protected by copyright. All rights reserved.

På uppdrag av Försvarsmakten genomförde Militärmedicinska forskningsgruppen vid Åstandlaboratoriet vid Gymnastik- och idrottshögskolan Stockholm (GIH), en observationsstudie gällande fysiologisk/medicinsk belastning på 14 flygplatsjägare under en fältövning med beteckningen "F 17 - Flygvapenövning 2014".

Övningen var indelad i tre etapper, varav den första (c:a 42 tim) och sista (c:a 59 tim) planerades vara mer fysiskt och psykiskt krävande än den mellersta (c:a 114 tim). Registrering av hjärtfrekvens gjordes under hela övningen. Fysiologiska mätningar samt blodprov togs före och efter varje etapp samt efter c:a 12 timmars vila med sedvanliga kost efter övningens avslutande.

Beräkningar av energiomsättningen för de tre etapperna inklusive viloperioder var c:a 308, 185 respektive 369 kcal/tim, resulterande i totalt c:a 13 000, 21 100 respektive 21 600 kcal per etapp eller totalt c:a 55 700 kcal för hela övningen. De höga fysiska belastningarna i etapp ett och tre är klart högre än tidigare uppmätta data i svenska och utländska militära operationer. Vissa delar av etapp tre resulterade i fysiska belastningar som var på ungefär samma nivå som vid tävlingar i längre uthållighetsidrotter.

Den höga belastningen resulterade i stora förändringar i fysiologiska parametrar och medicinska markörer. Vissa mätningar av muskelstyrka i armar och ben liksom maximal syreupptagning försämrades. Testosteron sjönk under hela övningen kraftigt. Dessa och andra uppmätta data talar för att fysiska arbetsförmågan – i förlängningen "stridsvärdet" – blev klart försämrat under övningen.

Mätningen 12 timmar efter övningens avslut visade oväntade resultat. Den subjektiva ansträngningskänslan under standardiserat cykelarbete var klart förbättrat av 12-timmarsvilan efter övningen. Däremot var flertalet medicinska och fysiologiska värden oförändrade jämfört med värden vid testerna 12 timmar tidigare och därmed var de klart lägre än vid testet innan övningens start. Det är uppenbart att återhämtning av stridsvärdet inte kan bedömas subjektivt utan måste avgöras genom reliabla psykologiska och fysiologiska mätningar.

Undersökningen har gett underlag för fortsatta studier rörande bland annat typer av energitillskott under övning, olika strategier för snabb återhämtning samt försök att finna markörer för individuella reaktionsmönster på "stridsvärde" under långvariga militära operationer.

AIM: To identify and describe the characteristics of naturally occurring patterns of exercise, sitting in leisure time and at work and cardiorespiratory fitness, and the association of such profiles with metabolic risk factors, perceived health, and perceived symptoms.

METHODS: 64,970 participants (42% women, 18-75 years) participating in an occupational health service screening in 2014-2018 were included. Exercise and sitting were self-reported. Cardiorespiratory fitness was estimated using a submaximal cycle test. Latent profile analysis was used to identify profiles. BMI and blood pressure were assessed through physical examination. Perceived back/neck pain, overall stress, global health, and sleeping problems were self-reported.

RESULTS: Six profiles based on exercise, sitting in leisure time and at work and cardiorespiratory fitness were identified and labelled; Profile 1 "Inactive, low fit and average sitting in leisure, with less sitting at work"; Profile 2 "Inactive, low fit and sedentary"; Profile 3 "Active and average fit, with less sitting at work"; Profile 4 "Active, average fit and sedentary in leisure, with a sedentary work" (the most common profile, 35% of the population); Profile 5 "Active and fit, with a sedentary work"; Profile 6 "Active and fit, with less sitting at work". Some pairwise similarities were found between profiles (1 and 2, 3 and 4, 5 and 6), mainly based on similar levels of exercise, leisure time sitting and fitness, which translated into similar dose-response associations with the outcomes. In general, profile 1 and 2 demonstrated most adverse metabolic and perceived health, profile 4 had a more beneficial health than profile 3, as did profile 6 compared to profile 5.

CONCLUSIONS: The present results implies a large variation in exercise, sitting, and fitness when studying naturally occurring patterns, and emphasize the possibility to target exercise, sitting time, and/or fitness in health enhancing promotion intervention and strategies.

BACKGROUND: The impact of cardiorespiratory fitness (CRF) and other lifestyle-related factors on severe COVID-19 risk is understudied. The present study aims to investigate lifestyle-related and socioeconomic factors as possible predictors of COVID-19, with special focus on CRF, and to further study whether these factors may attenuate obesity- and hypertension-related risks, as well as mediate associations between socioeconomic factors and severe COVID-19 risk.

METHODS: Out of initially 407,131 participants who participated in nationwide occupational health service screening between 1992 and 2020, n = 857 cases (70% men, mean age 49.9 years) of severe COVID-19 were identified. CRF was estimated using a sub-maximum cycle test, and other lifestyle variables were self-reported. Analyses were performed including both unmatched, n = 278,598, and sex-and age-matched, n = 3426, controls. Severe COVID-19 included hospitalization, intensive care or death due to COVID-19.

RESULTS: Patients with more severe COVID-19 had significantly lower CRF, higher BMI, a greater presence of comorbidities and were more often daily smokers. In matched analyses, there was a graded decrease in odds for severe COVID-19 with each ml in CRF (OR = 0.98, 95% CI 0.970 to 0.998), and a two-fold increase in odds between the lowest and highest (< 32 vs. ≥ 46 ml·min^-1·kg^-1) CRF group. Higher BMI (per unit increase, OR = 1.09, 1.06 to 1.12), larger waist circumference (per cm, OR = 1.04, 1.02 to 1.06), daily smoking (OR = 0.60, 0.41 to 0.89) and high overall stress (OR = 1.36, 1.001 to 1.84) also remained significantly associated with severe COVID-19 risk. Obesity- and blood pressure-related risks were attenuated by adjustment for CRF and lifestyle variables. Mediation through CRF, BMI and smoking accounted for 9% to 54% of the associations between low education, low income and blue collar/low skilled occupations and severe COVID-19 risk. The results were consistent using either matched or unmatched controls.

CONCLUSIONS: Both lifestyle-related and socioeconomic factors were associated with risk of severe COVID-19. However, higher CRF attenuated the risk associated with obesity and high blood pressure, and mediated the risk associated with various socioeconomic factors. This emphasises the importance of interventions to maintain or increase CRF in the general population to strengthen the resilience to severe COVID-19, especially in high-risk individuals.