Tuesday, 5 July 2011

Interesting things at the ACSM

I promised to write something about the ACSM conference in Denver and then lack of time did the rest….and never got around writing anything.

So, with a bit of time available I will write few reflections about the conference.

The topics covered in the sessions were quite diverse as usual, ranging from obesity to military medicine to sport performance and there were loads of parallel sessions which makes it impossible to follow everything happening. I will provide few notes on the ones I attended, but my overall impression of the conference was that sport performance research is becoming more and more rare and there is a lot of emphasis on exercise science clearly due to funding opportunities. Also, I sense a bit of staleness in the scientific community as I keep seeing a lot of experiments repeated over and over again and few innovative approaches/ideas. I have discussed this topic on my article on “the Leader” newsletter, and will not replicate it here, but I sense that the disconnect between the lab and the field is getting bigger.

Nutrition in rehabilitation

Professor Kevin Tipton from Stirling University (http://www.sports.stir.ac.uk/staff/kevin-tipton.php) provided a good overview for the use of protein for muscle remodelling. Kevin wrote a great chapter in my book on strength and conditioning and presented his work in a very elegant manner.

Some good evidence was provided on the negative effects of a reduction in energy intake when injured. This in fact, may be bad news as it might slow down muscle recovery. So nutritional advice for athletes in rehab should be carefully planned as while it is true that excess energy intake will lead to weight gain and alterations in body composition, it is also true that reducing energy intake too much might slow down muscle remodelling.

He also suggested the use of Omega 3 Fatty acids to facilitate recovery as indicated in recent papers from Bettina Mittendofer’s Lab (http://www.ncbi.nlm.nih.gov/pubmed/21501117)

Professor Stuart Phillips gave also a good talk on protein metabolism and suggested the Omega 3 FA approach as well (4g of FDA approved Lovaza http://www.lovaza.com/). I am sure more research will be published soon on the use of Mega 3 FAs for muscle remodelling.

Dr. Ferrando talked about a “Cocktail” of supplements showing great promise (so not a single product) in his very-applied talk on how to speed up recovery following hip replacement. He suggested that in the real world we want to use all we know from research and apply it for our patients/clients. Showed some data of reduced day in hospital using a drink made of all compounds suggested to have beneficial effects on muscle remodelling (e.g. creatine, proteins, Omega 3, etc etc).

New Techniques

Some very interesting work was presented by Dr. Minoru Shinonara’s Lab. Dr. Shinonara is doing some work with a new ultrasound technique able to quantify muscle stiffness http://www.ncbi.nlm.nih.gov/pubmed?term=%22Shinohara%20M%22%5BAuthor%5D%20and%20muscle%20stiffness

A very interesting technique as you can see here: http://www.supersonicimagine.fr/product_0_1_shearwave-elastography,en.htm

Overtraining

There was an entire afternoon session on overtraining.Consensus is that there is not a single marker, but a variety of things which can be measured to assess if an individual is at risk of overtraining or already overtrained. It was pretty much a series of presentations of data already available in the literature.

The most interesting talk was from Dr. Bradley Nindl. In particular some new techniques and some data recently published:

Some practical data showing the effects of extreme physical training in army recruits. This  interesting transdermal method to measure IGF-1 following exercise. As well as blood spots technique to measure IGF-1.

Dr.Nindl talked about the concept of “fit to fight” which is very similar to the sport concept of readiness to train or compete.

image

Creatine

There was a good update on the status of research on creatine, which still is perceived to be a “bad supplement” in the media. However, the recent work from Kley et al 2011 clearly showed there are no issues with creatine supplementation.

Recent data show also a reduction in pain in muscle dystrophy with creatine and also that brain creatine can be increased from 4 to 9% with supplementation.

We do not know well if it works in older adults; however basal brain creatine seems to be inversely related to uptake. So the more you have, the less you are likely to gain with supplementation. Recent work suggests the potential use of creatine supplementation for a variety of pathological conditions indicating that more work on its effects on the central nervous system will shed more light on other potential uses.

Very interesting recent work from my dear colleague and friend Dr. Christian Cook has shown the potential for creatine to counteract the negative effects of sleep deprivation.

Recent work on creatine safety from Dr. Gualano was also mentioned here.

One of the speakers in this session mentioned the IOWA accident (http://www.businessinsider.com/exertional-rhabdomyolysis-iowa-football-players-hospitalized-after-their-workout-2011-1), with reference to the public health report showing that Creatine had nothing to do with what happened to the athletes. However, creatine was mentioned causing the media to then speculate about the possible influence of creatine intake on the health of the athletes.

Muscle atrophy and sarcopenia

Good tutorial lecture from Professor Marco Narici from Manchester Met. University (http://www.shs.mmu.ac.uk/staff_list/staffbiog/?StaffID=740). Marco gave a good overview of what happens to muscle and tendon with immobilisation. He also showed data on concentric vs. eccentric loading and the effects on muscle fascicles and tendon stiffness.

He showed that with immobilisation, muscle size decreased 0.4% per day! And you can lose about 2700 sarcomeres after 10 days of immobilisation. Some good data to keep in mind next time an athlete is in a cast!

Barefoot running

Possibly the most interesting session of the conference. Some great speakers and great arguments/data to support barefoot running.

It was all generated by recent work from Lieberman (http://www.ncbi.nlm.nih.gov/pubmed/20111000). However when you look at the data carefully the obvious conclusions is that it needs to be introduced slowly with athletes as there are some risks of injury. But, if the technique is mastered could potentially be a great methods to strengthen the muscles controlling the foot and the ankle and eventually also lead to performance as well as reduction of injuries.

One of the most interesting data was the actual lack of evidence of effectiveness of running shoes in reducing injury risk. That is, there is not a single study that has shown that shoes reduce the risk of injury. In fact, there is now evidence that the risk of injury is unchanged, maybe even higher in the expensive shoes. Injury rates haven't come down even a little bit since the 1970s, the period which has seen the explosion in the running shoe industry. Back in the 70s, the shoes resemble today's minimalist shoes, but about 70% of runners were getting injured, the same rate as today.

Russ Tucker has written a good review of the session on his blog if you want to know more about this issue:

http://www.sportsscientists.com/2011/06/barefoot-running-shoes-and-born-to-run.html

Pacing and fatigue

Dr. Ross Tucker gave an elegant talk on how the brain controls how hard you go during a time trial and how it controls your pacing. More details on www.sportsscientists.com

I really enjoyed the excellent work done by Dr. Markus Amman. I really like his model to study fatigue and if you want to know more you should really read some recent work published from his lab:

Amann M, Secher NH. (2010). Afferent feedback from fatigued locomotor muscles is an important determinant of endurance exercise performance. J Appl Physiol, 108, 452-454.

Amann M, Secher NH. (2010). Point: Afferent feedback from fatigued locomotor muscles is an important determinant of endurance exercise performance. J Appl Physiol, 108(2), 452-4; discussion 457; author reply 470

Prof. Romain Meeusen provided a good overview of the central aspects of fatigue using human and animal models.

However the highlight for me was Dr. Schneider from Germany.He presented some interesting data on a new approach to EEG to study human performance in a variety of settings. His recent work on music and exercise is quite amusing http://www.ncbi.nlm.nih.gov/pubmed/20845211 as well as the link between exercising and neurocognitive function with astronauts http://www.ncbi.nlm.nih.gov/pubmed/21654620.

There was a lot more going on with more than 6000 delegates attending the conference. But the above is what made it interesting for me. It was of course a great opportunity to catch up with old colleagues and friends as well as meet new people and learn more about the fascinating work they are doing and the challenges currently faced by academics in this field struggling to attract significant funding to conduct research projects.

Unfortunately I will not be able to attend next years’ conference in San Francisco, but I hope to be able to make the 2013 annual conference in Indianapolis.

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