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Author: Neil P Walsh (51)


Dec
1969

In this consensus statement on immunonutrition and exercise, a panel of knowledgeable contributors from across the globe provides a consensus of updated science, including the background, the aspects for which a consensus actually exists, the controversies and, when possible, suggested directions for future research.

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May
2017

Recovery of the immune system after exercise.

J Appl Physiol (1985) 2017 May 1;122(5):1077-1087. Epub 2016 Dec 1.
Jonathan M Peake, Oliver Neubauer, Neil P Walsh, Richard J Simpson
The notion that prolonged, intense exercise causes an "open window" of immunodepression during recovery after exercise is well accepted. Repeated exercise bouts or intensified training without sufficient recovery may increase the risk of illness. However, except for salivary IgA, clear and consistent markers of this immunodepression remain elusive.

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Nov
2016

The purpose of the review is to provide recommendations to improve clinical decision-making based on the strengths and weaknesses of commonly used hydration biomarkers and clinical assessment methods.
There is widespread consensus regarding treatment, but not the diagnosis of dehydration. Even though it is generally accepted that a proper clinical diagnosis of dehydration can only be made biochemically rather than relying upon clinical signs and symptoms, no gold standard biochemical hydration index exists.

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Mar
2016

To compare the effectiveness of a single-layered polyethylene survival bag (P), a single-layered polyethylene survival bag with a hot drink (P+HD), a multi-layered metalized plastic sheeting survival bag (MPS: Blizzard Survival), and a multi-layered MPS survival bag with 4 large chemical heat pads (MPS+HP: Blizzard Heat) to treat cold casualties.
Portable cold casualty treatment methods were compared by examining core and skin temperature, metabolic heat production, and thermal comfort during a 3-hour, 0°C cold air exposure in 7 shivering, near-hypothermic men (35.4°C).

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Dec
1969

Vitamin D is mainly obtained through sunlight ultraviolet-B (UVB) exposure of the skin, with a small amount typically coming from the diet.It is now clear that vitamin D has important roles beyond its well-known effects on calcium and bone homeostasis. Immune cells express the vitamin D receptor, including antigen presenting cells, T cells and B cells, and these cells are all capable of synthesizing the biologically active vitamin D metabolite, 1, 25 hydroxy vitamin D.

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Mar
2016

The identification of beverages that promote longer-term fluid retention and maintenance of fluid balance is of real clinical and practical benefit in situations in which free access to fluids is limited or when frequent breaks for urination are not desirable. The postingestion diuretic response is likely to be influenced by several beverage characteristics, including the volume ingested, energy density, electrolyte content, and the presence of diuretic agents.
This study investigated the effects of 13 different commonly consumed drinks on urine output and fluid balance when ingested in a euhydrated state, with a view to establishing a beverage hydration index (BHI), i.

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Feb
2016

This review outlines recent advancements in the understanding of athlete immune health. Controversies discussed include whether high levels of athletic training and environmental stress (for example, heat acclimation, cryotherapy and hypoxic training) compromise immunity and increase upper respiratory tract infection (URTI). Recent findings challenge early exercise immunology doctrine by showing that international athletes performing high-volume training suffer fewer, not greater, URTI episodes than lower-level performers and URTI incidence decreases, not increases, around the time of competition compared with heavy training.

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Mar
2016

Research has not convincingly demonstrated the utility of saliva secretory immunoglobulin-A (SIgA) as a biomarker of upper respiratory tract infection (URTI) risk, and disagreement exists about the influence of heavy exercise ("open-window theory") and dehydration on saliva SIgA. Prompted by the search for viable alternatives, we compared the utility of tear and saliva SIgA to predict URTI prospectively (study 1) and assessed the influence of exercise (study 2) and dehydration (study 3) using a repeated-measures crossover design.
In study 1, 40 subjects were recruited during the common-cold season.

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Oct
2015

To assess which osmolarity equation best predicts directly measured serum/plasma osmolality and whether its use could add value to routine blood test results through screening for dehydration in older people.
Diagnostic accuracy study.
Older people (≥65 years) in 5 cohorts: Dietary Strategies for Healthy Ageing in Europe (NU-AGE, living in the community), Dehydration Recognition In our Elders (DRIE, living in residential care), Fortes (admitted to acute medical care), Sjöstrand (emergency room) or Pfortmueller cohorts (hospitalised with liver cirrhosis).

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Jun
2016

Carbohydrate (CHO) supplementation during prolonged exercise is widely acknowledged to blunt in vitro immunoendocrine responses, but no study has investigated in vivo immunity.
To determine the effect of CHO supplementation during prolonged exercise on in vivo immune induction using experimental contact hypersensitivity with the novel antigen diphenylcyclopropenone (DPCP).
In a double-blind design, 32 subjects were randomly assigned to 120 min of treadmill exercise at 60 % [Formula: see text] with CHO (Ex-CHO) or placebo (Ex-PLA) supplementation.

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Oct
2015

In persons completing exhaustive daily exercise, sleep and energy restriction have been highlighted as risk factors for hypothermia in cold environments. The present study therefore sought to determine the effect of sleep deprivation (SDEP), with and without energy restriction, on the thermal response to cold.
In a random order, ten recreationally active men (mean ± SD: age 25 ± 6 years, body fat 17 ± 5 %) completed three 53 h trials: a control (CON: 436 min/night sleep), SDEP (0 min sleep), and sleep deprivation and energy restriction (SDEP + ER: 0 min sleep and 10% daily energy requirements).

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Apr
2015

There is evidence that water-loss dehydration is common in older people and associated with many causes of morbidity and mortality. However, it is unclear what clinical symptoms, signs and tests may be used to identify early dehydration in older people, so that support can be mobilised to improve hydration before health and well-being are compromised.
To determine the diagnostic accuracy of state (one time), minimally invasive clinical symptoms, signs and tests to be used as screening tests for detecting water-loss dehydration in older people by systematically reviewing studies that have measured a reference standard and at least one index test in people aged 65 years and over.

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Mar
2015

Dehydration in older adults contributes to increased morbidity and mortality during hospitalization. As such, early diagnosis of dehydration may improve patient outcome and reduce the burden on healthcare. This prospective study investigated the diagnostic accuracy of routinely used physical signs, and noninvasive markers of hydration in urine and saliva.

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Jul
2015

To examine the effects of intensity and duration of exercise stress on induction of in vivo immunity in humans using experimental contact hypersensitivity (CHS) with the novel antigen diphenylcyclopropenone (DPCP).
Sixty-four healthy males completed either 30 min running at 60% V˙O2peak (30MI), 30 min running at 80% V˙O2peak (30HI), 120 min running at 60% V˙O2peak (120MI), or seated rest (CON). Twenty min later, the subjects received a sensitizing dose of DPCP; and 4 wk later, the strength of immune reactivity was quantified by measuring the cutaneous responses to a low dose-series challenge with DPCP on the upper inner arm.

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Dec
1969

Heat acclimation induces adaptations that improve exercise tolerance in hot conditions. Here we report novel findings into the effects of ultra-marathon specific exercise load in increasing hot ambient conditions on indices of heat acclimation. Six male ultra-endurance runners completed a standard pre-acclimation protocol at 20°C ambient temperature (T amb), followed by a heat acclimation protocol consisting of six 2 h running exercise-heat exposures (EH) at 60% VO2max on a motorised treadmill in an environmental chamber.

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Jan
2014

This study aimed to investigate the effects of multi-strain probiotics supplementation on gastrointestinal permeability, systemic markers of inflammation and running performance when exercising in the heat.
Ten male runners were randomized to 4 weeks of daily supplementation with a probiotics capsule (45 billion CFU of Lactobacillus, Bifidobacterium and Streptococcus strains) or placebo, separated by a washout period (double-blind, cross-over trial). After each treatment, the runners exercised to fatigue at 80% of their ventilatory threshold at 35 °C and 40% humidity.

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Jan
2014

When substantial solute losses accompany body water an isotonic hypovolemia (extracellular dehydration) results. The potential for using blood or urine to assess extracellular dehydration is generally poor, but saliva is not a simple ultra-filtrate of plasma and the autonomic regulation of salivary gland function suggests the possibility that saliva osmolality (Sosm) may afford detection of extracellular dehydration via the influence of volume-mediated factors.
This study aimed to evaluate the assessment of extracellular dehydration using Sosm.

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Sep
2013

Unaccustomed strenuous physical exertion in hot environments can result in heat stroke and acute kidney injury (AKI). Both exercise-induced muscle damage and AKI are associated with the release of interleukin-6, but whether muscle damage causes AKI in the heat is unknown. We hypothesized that muscle-damaging exercise, before exercise in the heat, would increase kidney stress.

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Jun
2013

The aim was to assess the effect of high altitude on the development of new immune memory (induction) using a contact sensitization model of in vivo immunity. We hypothesized that high-altitude exposure would impair induction of the in vivo immune response to a novel antigen, diphenylcyclopropenone (DPCP). DPCP was applied (sensitization) to the lower back of 27 rested controls at sea level and to ten rested mountaineers 28 hours after passive ascent to 3777 m.

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Sep
2013

Individuals exposed to total sleep deprivation may experience an increased risk of impaired thermoregulation and physiological strain during prolonged physical activity in the heat. However, little is known of the impact of more relevant partial sleep deprivation (PSD). This randomized counterbalanced study investigated the effect of PSD on thermal strain during an exercise-heat stress.

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Sep
2012

To identify if whole-body hydration plays an important role in dry eye (DE). We hypothesized that individuals classified as DE have higher plasma osmolality (Posm), indicating suboptimal hydration, compared with those classified as non-DE.
Using a hospital-based observational cross-sectional design, assessment of DE and hydration was performed upon admission in 111 participants (N = 56 males and 55 females; mean ± SD age 77 ± 8 years).

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Jun
2012

The purpose was to determine the effects of a carbohydrate (CHO)-protein (PRO) drink, consumed immediately after endurance exercise on saliva anti-microbial proteins known to be important for host defence. Eleven male runners ran for 2 h at 75% VO2max on two occasions, and immediately post-exercise were provided, in randomised order, either a placebo solution (CON), or a CHO-PRO solution containing 1.2 gCHO·kg-1BM and 0.

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Jun
2012

The purpose of this study was to determine the effects of a carbohydrate (CHO) and protein (PRO) drink consumed immediately after endurance exercise on saliva antimicrobial proteins known to be important for host defense. Eleven male runners ran for 2 hr at 75% VO2max on 2 occasions and immediately postexercise were provided, in randomized order, either a placebo solution (CON) or a CHO-PRO solution containing 1.2 g CHO/kg body mass (BM) and 0.

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Oct
2012

The aim of the study was to investigate the effect of exercise-induced dehydration and subsequent overnight fluid restriction on saliva antimicrobial proteins important for host defence (secretory IgA (SIgA), α-amylase, and lysozyme). On two randomized occasions, 13 participants exercised in the heat, either without fluid intake to evoke progressive body mass losses (BML) of 1%, 2%, and 3% with subsequent overnight fluid restriction until 0800 h in the following morning (DEH) or with fluids to offset losses (CON). Participants in the DEH trial rehydrated from 0800 h until 1100 h on day 2.

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Dec
1969

An individual's level of physical activity influences their risk of infection, most likely by affecting immune function. Regular moderate exercise reduces the risk of infection compared with a sedentary lifestyle, but very prolonged bouts of exercise and periods of intensified training are associated with an increased risk of infection. There are several lifestyle, nutritional, and training strategies that can be adopted to limit the extent of exercise-induced immunodepression and minimize the risk of infection.

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Dec
2011

The aim of this work was to investigate the effect of a daily mixed nutritional supplement upon body composition, physical performance, and circulating anabolic hormones in soldiers undergoing arduous training. Thirty males received either a habitual diet alone (CON, n = 15) or with the addition of a daily mixed supplement (SUP, n = 15) of ∼5.1 MJ·d⁻¹ during 8 weeks of training.

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Apr
2012

The aim was to investigate the influence of a daily mixed nutritional supplement during an 8-week arduous training programme on immune indices and mediators including circulating leucocyte counts; bacterially stimulated neutrophil degranulation; interleukin-6 (IL-6), cortisol and saliva secretory immunoglobulin-A (SIgA). Thirty men (mean (SD): age 25 (3) years; body mass, 80.9 (7.

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Jun
2011

The purpose of the study was to determine the effects of carbohydrate (CHO) intake, with and without protein (PRO), immediately after prolonged strenuous exercise on circulating bacterially stimulated neutrophil degranulation. Twelve male runners completed 3 feeding interventions, 1 week apart, in randomized order after 2 hr of running at 75% VO2max. The feeding interventions included a placebo solution, a CHO solution equal to 1.

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Dec
1969

The physical training undertaken by athletes is one of a set of lifestyle or behavioural factors that can influence immune function, health and ultimately exercise performance. Others factors including potential exposure to pathogens, health status, lifestyle behaviours, sleep and recovery, nutrition and psychosocial issues, need to be considered alongside the physical demands of an athlete's training programme. The general consensus on managing training to maintain immune health is to start with a programme of low to moderate volume and intensity; employ a gradual and periodised increase in training volumes and loads; add variety to limit training monotony and stress; avoid excessively heavy training loads that could lead to exhaustion, illness or injury; include non-specific cross-training to offset staleness; ensure sufficient rest and recovery; and instigate a testing programme for identifying signs of performance deterioration and manifestations of physical stress.

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Dec
1969

An ever-growing volume of peer-reviewed publications speaks to the recent and rapid growth in both scope and understanding of exercise immunology. Indeed, more than 95% of all peer-reviewed publications in exercise immunology (currently >2, 200 publications using search terms "exercise" and "immune") have been published since the formation of the International Society of Exercise and Immunology (ISEI) in 1989 (ISI Web of Knowledge). We recognise the epidemiological distinction between the generic term "physical activity" and the specific category of "exercise", which implies activity for a specific purpose such as improvement of physical condition or competition.

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Aug
2011

Little is known about the influence of exercise on induction and elicitation phases of in vivo immunity in humans. We used experimental contact-hypersensitivity, a clinically relevant in vivo measure of T cell-mediated immunity, to investigate the effects of exercise on induction and elicitation phases of immune responses to a novel antigen. The effects of 2 h-moderate-intensity-exercise upon the induction (Study One) and elicitation of in vivo immune memory (Study Two) to diphenylcyclopropenone (DPCP) were examined.

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Aug
2011

It has been suggested that tear fluid is isotonic with plasma, and plasma osmolality (P(osm)) is an accepted, albeit invasive, hydration marker. Our aim was to determine whether tear fluid osmolarity (T(osm)) assessed using a new, portable, noninvasive, rapid collection and measurement device tracks hydration.
This study aimed to compare changes in T(osm) and another widely used noninvasive marker, urine specific gravity (USG), with changes in P(osm) during hypertonic-hypovolemia.

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Aug
2009

The aim of the study was to determine the influence of immediate and 1-hr-delayed carbohydrate (CHO) and protein (PRO) feeding after prolonged exercise on leukocyte trafficking, bacterially stimulated neutrophil degranulation, saliva secretory IgA (S-IgA) responses, and circulating stress hormones. In randomized order, separated by 1 wk, 9 male runners completed 3 feeding interventions after 2 hr of running at 75% VO2max. During control (CON), participants received water (12 ml/kg body mass [BM]) immediately and 1 hr postexercise.

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Sep
2009

The aim was to test the hypothesis that one night of sleep deprivation will impair pre-loaded 30 min endurance performance and alter the cardio-respiratory, thermoregulatory and perceptual responses to exercise. Eleven males completed two randomised trials separated by 7 days: once after normal sleep (496 (18) min: CON) and once following 30 h without sleep (SDEP). After 30 h participants performed a 30 min pre-load at 60% [VO(2 max) followed by a 30 min self-paced treadmill distance test.

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Oct
2008

The aim was to investigate the effects of 48 hr of fluid, energy, or combined fluid and energy restriction on circulating leukocyte and lymphocyte subset counts (CD3+, CD4+, and CD8+) and bacterially stimulated neutrophil degranulation at rest and after exercise. Thirteen healthy men (M +/- SEM age 21 +/- 1 yr) participated in 4 randomized 48-hr trials. During control (CON) participants received their estimated energy (2,903 +/- 17 kcal/day) and fluid (3,912 +/- 140 ml/day) requirements.

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Feb
2009

A one night period without sleep is not uncommon amongst athletes travelling across time zones and military personnel during training and operations. However, the effect of one night without sleep on immune indices in response to strenuous exercise remains unknown. The objective was to determine the effect of one night without sleep on immune indices in response to subsequent strenuous exercise.

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Oct
2008

To investigate whether unstimulated whole saliva flow rate (UFR) and osmolality (Sosm) track changes in hydration status during 48h of restricted fluid intake (RF) or combined fluid and energy restriction (RF+RE). Following the 48h periods, UFR and Sosm were assessed after acute exercise dehydration and rehydration.
Thirteen healthy males completed three trials in a randomised order: control (CON) where participants received their estimated energy (12,154+/-230kJ/d: mean+/-S.

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Jan
2008

The purpose of this study was to investigate the effects of prolonged exercise with and without a thermal clamp on neutrophil trafficking, bacterial-stimulated neutrophil degranulation, stress hormones, and cytokine responses. Thirteen healthy male volunteers (means +/- SE: age 21 +/- 1 yr; mass 74.9 +/- 2.

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Oct
2007

The contribution of heat and exercise related stress to the release of heat shock protein 72 (HSP72) is currently unknown. The purpose of the present study was to determine the combined and independent effects of heat and exercise on the extracellular (e)HSP72 response. Eleven moderately trained male volunteers [means +/- SD: age 21 +/- 4 yr; body mass 75.

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Jun
2007

The aim was to investigate the effects of a 48 h period of fluid, energy or combined fluid and energy restriction on salivary IgA (s-IgA) responses at rest and after exercise. Thirteen healthy males (age 21 (sem 1) years) participated in four randomised 48 h trials. In the control trial participants received their estimated energy (12,154 (sem 230) kJ/d) and water (3912 (sem 140) ml/d) requirements.

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Dec
1969

Athletes, military personnel, fire fighters, mountaineers and astronauts may be required to perform in environmental extremes (e.g. heat, cold, high altitude and microgravity).

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Aug
2006

The effects of the first 19 weeks of U.K. Parachute Regiment (PARA) training on upper respiratory tract infection (URTI) incidence and immune function (circulating leukocyte counts, lymphocyte subsets, lipopolysaccharide-stimulated neutrophil degranulation, and salivary immunoglobulin A concentrations) were investigated for 14 PARA recruits and 12 control subjects.

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Nov
2005

Evidence supports an interaction between neuro-endocrine responses to exercise and immune responses to exercise. We hypothesized that prolonged exercise in the heat would evoke a greater stress hormone response and a greater decrease in neutrophil degranulation [lipopolysaccharide (LPS)-stimulated elastase release] than when the same exercise was performed in thermoneutral conditions.
In counterbalanced order and separated by 7 d, 13 male cyclists cycled for 2 h at 62 +/- 3% VO2max (mean +/- SEM), with ad libitum water intake, on one occasion with heat (HOT: 30.

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Sep
2004

Firstly, to identify whether saliva flow rate, osmolality, and total protein are potential markers of hydration, we compared changes in these parameters with changes in plasma osmolality during progressive dehydration. Secondly, we compared the sensitivity of saliva parameters to track hydration changes with the sensitivity of urine osmolality. Thirdly, to test the hypothesis that dehydration, rather than neuroendocrine regulation, is responsible for the decrease in saliva flow rate during prolonged exercise, we compared flow rate and catecholamine responses to prolonged exercise with and without fluids.

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Feb
2004

To identify whether saliva flow rate, total protein concentration and osmolality are sensitive non-invasive markers of whole body hydration status, we compared changes in these parameters with changes in body mass during progressive acute dehydration.
Twelve euhydrated males reported to the laboratory following an overnight fast and cycled on a stationary ergometer at 60% maximal oxygen uptake in an environmental chamber (30 degrees C and 70% RH) until progressive body mass loss (BML) of 1.1+/-0.

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Aug
2003

The purpose of the present study was twofold: first, to assess the effect of prolonged intense exercise on total neutrophil elastase content in endurance-trained cyclists and to determine whether this is associated with postexercise falls in lipopolysaccharide (LPS)-stimulated neutrophil elastase release; and second, to determine the effect of carbohydrate (CHO) ingestion during exercise on these responses.
In a randomized design, nine trained male cyclists cycled for 2 h at 75% VO(2max) on two occasions with either CHO (6.4%, i.

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