Carbohydrate (CHO) supplementation during prolonged exercise postpones fatigue. However, the optimum administration timing, dosage, type of CHO intake, and possible interaction of the ergogenic effect with athletes’ cardiorespiratory fitness (CRF) are not clear. Ninety-six studies (from relevant databases based on predefined eligibility criteria) were selected for meta-analysis to investigate the acute effect of ≤20% CHO solutions on prolonged exercise performance. The between-subject standardized mean difference [SMD = ([mean post-value treatment group–mean post-value control group]/pooled variance)] was assessed. Overall, SMD [95% CI] of 0.43 [0.35, 0.51] was significant (p < 0.001). Subgroup analysis showed that SMD was reduced as the subjects’ CRF level increased, with a 6–8% CHO solution composed of GL:FRU improving performance (exercise: 1–4 h); administration during the event led to a superior performance compared to administration before the exercise, with a 6–8% single-source CHO solution increasing performance in intermittent and ‘stop and start’ sports and an ~6% CHO solution appearing beneficial for 45–60 min exercises, but there were no significant differences between subjects’ gender and age groups, varied CHO concentrations, doses, or types in the effect measurement. The evidence found was sound enough to support the hypothesis that CHO solutions, when ingested during endurance exercise, have ergogenic action and a possible crossover interaction with the subject’s CRF.

Medical and technology development have drastically the improved quality of life and, consequently, life expectancy. Nevertheless, the more people who enter the third-age, the more geriatric syndromes expand in the elderly. Sarcopenia and Type 2 diabetes mellitus (T2DM) are common diseases among the elderly and the literature has extensively studied these two diseases separately. Recent evidence, however, revealed that there is a bidirectional relationship between sarcopenia and T2DM. The aims of the present review were: (1) to present diet and exercise interventions for the management of sarcopenia and T2DM and (2) identify which diet and exercise interventions can be used simultaneously in order to effectively deal with these two disorders. Exercise and a balanced diet are used as effective countermeasures for combating sarcopenia and T2DM in older adults based on their bidirectional relationship. Lifestyle changes such as exercise and a balanced diet seem to play an important role in the remission of the diseases. Results showed that chronic exercise can help towards glycemic regulation as well as decrease the incidence rate of muscle degradation, while diet interventions which focus on protein or amino acids seem to successfully treat both disorders. Despite the fact that there are limited studies that deal with both disorders, it seems that a combined exercise regime (aerobic and resistance) along with protein intake > 1gr/kg/d is the safest strategy to follow in order to manage sarcopenia and T2DM concurrently.

The present study aimed to investigate whether acute L-citrulline supplementation would affect inspiratory muscle oxygenation and respiratory performance. Twelve healthy males received 6 g of L-citrulline or placebo in a double-blind crossover design. Pulmonary function (i.e., forced expired volume in 1 s, forced vital capacity and their ratio), maximal inspiratory pressure (MIP), fractional exhaled nitric oxide (NO^•), and sternocleidomastoid muscle oxygenation were measured at baseline, one hour post supplementation, and after an incremental resistive breathing protocol to task failure of the respiratory muscles. The resistive breathing task consisted of 30 inspirations at 70% and 80% of MIP followed by continuous inspirations at 90% of MIP until task failure. Sternocleidomastoid muscle oxygenation was assessed using near-infrared spectroscopy. One-hour post-L-citrulline supplementation, exhaled NO^• was significantly increased (19.2%; p < 0.05), and this increase was preserved until the end of the resistive breathing (16.4%; p < 0.05). In contrast, no difference was observed in the placebo condition. Pulmonary function and MIP were not affected by the L-citrulline supplementation. During resistive breathing, sternocleidomastoid muscle oxygenation was significantly reduced, with no difference noted between the two supplementation conditions. In conclusion, a single ingestion of 6 g L-citrulline increased NO^• bioavailability but not the respiratory performance and inspiratory muscle oxygenation.

The aim of the present study was to evaluate two different intervention programs applied during a 4-week pre-season period. Twenty-nine players participated in this study and were divided into two groups. One group (Ball_Train, n = 12, age: 17.8 ± 0.4 years, body mass: 73.9 ± 7.6 kg, height: 178 ± 0.1 cm, body fat: 9.6 ± 5.3%) performed a higher percentage of aerobic training with ball and strength training using plyometrics and exercises with body weight. The other group (HIIT_Train, n = 17, age: 17.8 ± 0.7 years, body mass: 73.3 ± 5.0 kg, height: 179 ± 0.1 cm, body fat: 8.0 ± 2.3%) trained with high-intensity interval training (HIIT) without the ball and performed resistance training with weights in the same session. Both groups trained for strength (two times/week) and performed aerobic–anaerobic fitness without the ball, passing games, and tactical and small-sided games. Lower limb power (CMJ) and aerobic fitness (Yo-Yo intermittent recovery test level 1-IR1) were evaluated before and after the four-week training program. Yo-Yo IR1 performance was improved in both groups, but the improvement was greater for the HIIT_Train than Ball_Train group (468 ± 180 vs. 183 ± 177 m, p = 0.07). CMJ showed a non-significant improvement in the Ball_Train group (5.8 ± 8.8%, p = 0.16), but it decreased by 8.1 ± 9% (p = 0.001), in the HIIT_Train group. In conclusion, we have shown that a short pre-season period of training results in improvements in aerobic fitness in both groups, with high-intensity interval training showing superior adaptations than training with the ball. However, CMJ performance was reduced in this group, possibly suggesting higher fatigue levels and overload, and/or showing the effects of concurrent HIIT_Train and strength training in soccer.

This study aimed to elucidate whether muscle blood flow restriction during maximal exercise is associated with alterations in hemodynamics, cerebral oxygenation, cerebral activation, and deterioration of exercise performance in male participants. Thirteen healthy males, cyclists (age 33 ± 2 yrs., body mass: 78.6 ± 2.5 kg, and body mass index: 25.57 ± 0.91 kg·m⁻¹), performed a maximal incremental exercise test on a bicycle ergometer in two experimental conditions: (a) with muscle blood flow restriction through the application of thigh cuffs inflated at 120 mmHg (with cuffs, WC) and (b) without restriction (no cuffs, NC). Exercise performance significantly deteriorated with muscle blood flow restriction, as evidenced by the reductions in $\dot{V}$O_2max (−17 ± 2%, p < 0.001), peak power output (−28 ± 2%, p < 0.001), and time to exhaustion (−28 ± 2%, p < 0.001). Muscle oxygenated hemoglobin (Δ[O₂Hb]) during exercise declined more in the NC condition (p < 0.01); however, at exhaustion, the magnitude of muscle oxygenation and muscle deoxygenation were similar between conditions (p > 0.05). At maximal effort, lower cerebral deoxygenated hemoglobin (Δ[HHb]) and cerebral total hemoglobin (Δ[THb]) were observed in WC (p < 0.001), accompanied by a lower cardiac output, heart rate, and stroke volume vs. the NC condition (p < 0.01), whereas systolic blood pressure, rating of perceived exertion, and cerebral activation (as assessed by electroencephalography (EEG) activity) were similar (p > 0.05) between conditions at task failure, despite marked differences in exercise duration, maximal aerobic power output, and $\dot{V}$O_2max. In conclusion, in trained cyclists, muscle blood flow restriction during an incremental cycling exercise test significantly limited exercise performance. Exercise intolerance with muscle blood flow restriction was mainly associated with attenuated cardiac responses, despite cerebral activation reaching similar maximal levels as without muscle blood flow restriction.