By Dr. Laura Basterfield

Whilst physical activity has long been promoted as cure for different ailments, our understanding of, and interest in, just how far-reaching those effects are has grown in the last few decades.  One of the benefits of a physically active lifestyle is that at higher intensities it leads to higher physical fitness. Having a fitter heart and lungs means that they can supply your muscles with energy and oxygen more efficiently, so you can keep an activity going for longer. Building stronger muscles also helps strengthen bones, preventing fractures (and making carrying shopping or children easier!). Physical fitness also helps maintain a healthy body composition and reduces the risk of cardiovascular disease and Type 2 diabetes. In addition to the physical benefits, and there is also good evidence suggesting that being physically fit benefits children and young people’s mental wellbeing, too.

What I’m trying to get across is the need not just to increase the amount of physical activity everyone does, but also to make sure that it is enough to increase their fitness.

Sadly we know that globally, children and young people’s physical fitness is in decline, so we need to find innovative ways of encouraging children and young people to get active. Key to this is accessibility – we need to remove any barriers, whether financial, physical, social or geographical  – and offer fun, challenging, varied activities, that children and young people want to join in with.

There are multiple ways to address the problem, including safe active transport, free sports, convenient locations, access to appropriate kit, and exercise sessions at school. High intensity exercise can increase fitness in adolescents, but so far has been led by researchers or teachers. We wanted to increase the sustainability of the programme by using older peers to lead the exercises for younger pupils, which had not previously been tested.

In 2023 I ran a small pilot study to test whether we could train sixth form students (aged 17-18 years) to lead Year 7 pupils (aged 11-12 years) in high intensity exercise sessions, twice a week. We had designed the study with pupils and teachers, to try and offer them what they wanted, and get as many pupils as possible taking part. This wasn’t just for the ‘sporty’ kids – we wanted everyone to join in and feel the benefits. Most children and young people are in school, so this is an easy place for them to take part. The sessions were only 10 minutes long, and took place during morning tutor time. All the exercises could be done in school uniform, and exercises were chosen based on what the pupils said they wanted to do.

Over an afternoon of training with my collaborator Dr Katy Weston (University of Strathclyde) and me, the Young Leaders were taught safe and effective exercises, and how to demonstrate them. They were given a training manual and access to an online site with all the information. For 8 weeks, the five Young Leaders got to know the Year 7 pupils in the group, and led their sessions. The exercises changed from full-body exercises like squat jumps to boxing with sprints, an activity the Year 7s really enjoyed doing.

I was at each of the sessions to support the Young Leaders, and was able to observe the changes in both them and the younger pupils. The confidence and organisational skills of the Young Leaders grew as time went on, and it was great to see the bonds forming between the Year 7s and the Young Leaders. The Year 7s were enthusiastic about joining in each time, and gave it their all. The Young Leaders were dedicated to their role, and tried to involve all the pupils in each session. In addition, we had positive comments from teachers and both sets of pupils, and lots of helpful suggestions on improvements we could make to the training. The benefits to the pupils that were entirely separate from any improvements to their fitness were really encouraging, so we are working on the next version of the programme to test with another group of young people.

We are currently writing up the study for publication (watch this space!), but this is something we will be championing for years to come!

With thanks to my collaborators Dr Katy Weston (University of Strathclyde), Dr Brook Galna (Murdoch University) and Dr Naomi Burn (University of South Australia), and the pupils and teachers at Dukes Secondary School.  

References:

Demchenko, I. et al., (2025).  British Journal of Sports Medicine: bjsports-2024-109184.

Lubans, D. et al., (2021). British Journal of Sports Medicine 55:751-758.

Weston K et al., (2016). PLOS ONE 11(8): e0159116.

By Dr. Anthony Watson

Like any good story, this one starts a long time ago in a land far away. It was in 2011 when I embarked on an industry focussed PhD with Northumbria University and the New Zealand Institute for Plant and Food Research. My memories of my time in New Zealand are very fond but this bog is about science. Since I had the freedom, I thought would write about research many, at least at Newcastle Uni, wont know me for. But it’s a research focus which has been trundling on in the background for a while (my current main projects can be found here).

This research broadly focussed around conducting research to evidence the health benefits of berry fruit, with a specific focus on blackcurrants and their surprising impact on the brain.

It has long been established that blackcurrants contain phytochemicals such as anthocyanins, the compounds which are responsible for their deep purple colour. These compounds have been linked to numerous health benefits, ranging from cardiovascular support to anti-inflammatory effects. But a report by Borman in 1999 outlined that in test tubes, anthocyanins from blackcurrants could inhibit a class of enzymes called monoamine oxidase (MAO). A potential mechanism with potential to be explored (there’s a twist later on).

What is Monoamine Oxidase?

MAO is an enzyme responsible for breaking down key neurotransmitters in the brain, like dopamine, serotonin, and noradrenaline. These chemicals help regulate mood, motivation, and emotional balance. There are two types of MAO A and B.

MAO inhibitors (MAOIs) are a class of drugs historically used to treat depression, anxiety and neurological disorders, because they block this enzyme’s activity, leading to higher levels of these neurotransmitters in the brain. But nonselective and non-reversable inhibition can come with serious side effects and dietary restrictions.

Blackcurrants and MAO Inhibition

As mentioned earlier, there was previous test tube data which showed that anthocyanins from blackcurrants could inhibit MAO. So, we set out to test this in people. A randomised, double-blind, placebo-controlled, crossover study was conducted using 36 healthy young participants. Participants consumed two different blackcurrant extracts (a fresh blackcurrant juice or a commercially available blackcurrant powder fortified with anthocyanins) and a placebo across three separate sessions. The study also aimed to assess the effects on cognitive performance, mood, and circulating neurotransmitters. Participants improved in tasks requiring attention and mental flexibility after consuming blackcurrant extracts when compared to the placebo. Interestingly only the freshly juiced blackcurrant juice and not the anthocyanin fortified powder inhibited MAO. This was a little odd since the original hypothesis was based around anthocyanins, illustrating that compounds other than anthocyanins may be responsible for the observed in vivo MAO inhibition. But, this showed for the first time that the Blackadder variety of blackcurrants (now marketed under the name of Neuroberry) could inhibit both MAO-A and MAO-B in healthy people. The serving size of the juice was about 140ml. You can find the paper here.

I mentioned earlier that there are potentially negative effects of MAO-Is, especially if they are irreversible. For example, hypotensive crisis can occur If someone eats foods high in tyramine (like aged cheeses, cured meats, soy products, red wine, etc.), it can cause a dangerous spike in blood pressure.

Next we set out to assess the pharmacodynamics (time course) of the inhibition to understand if this inhibition is reversible. Just like the first study, we used a double-blind, placebo-controlled, randomised crossover design. Eight healthy male participants consumed a single serving of blackcurrant juice or a placebo. Blood samples were collected at multiple intervals up to 24 hours post-consumption to assess changes in monoamine oxidase activity. The outcome was a fast and absolute inhibition MAO. This was seen from the first measurement at 15 minutes post dose, through to the final day 1 measurement at 4 hours. The inhibition had disappeared by 24 hours. This showed that the inhibition was nonselective, absolute and reversable. Great news! The paper is here and contains some cool effects of blackcurrant on prolactin which may indicate dopamine modulations.

Blackcurrants and Brain activity

I then wanted to understand if blackcurrants were affecting brain activity; the idea was to combine cognitive tests and physiological measurements. Now at Newcastle, I ran a pilot study with nine healthy young adults. The goal was to see if drinking a single serving of blackcurrant juice would acutely brain wave activity in the prefrontal cortex, as measured by electroencephalography (EEG). This time the blackcurrant juice used was made from the UK ‘Ben Hope’ cultivar. Participants visited the lab twice, at least a week apart. On the study days, they arrived fasted, did some baseline tests, drank either the blackcurrant juice or a placebo drink, rested for 45 minutes, and then completed a set of cognitive tasks while their brain waves were recorded. Outcomes of this study were also pretty interesting, an increase delta and theta brain waves was seen after consuming the blackcurrant drink. Changes in these brain waves are an indication of relaxation, suggesting an anxiolytic (anxiety-reducing) effect of the blackcurrant juice. The paper can be found here. My most recent paper which is under review in nutritional neuroscience also showed increases in blood flow in the pre frontal cortex during cognitive demand after consuming blackcurrants. This is potentially mediated by increased neurovascular coupling.

All of this evidence is quite compelling with measurable and repeatable inhibition of MAO, improvements in cognitive performance and effects on brain activity after consumption of New Zealand and UK blackcurrant cultivars. But, there was still the issue of which compound was actually driving the MAO inhibition. The papers which we based the whole research idea on described anthocyanins as the molecule responsible, but our research showed that anthocyanin enriched powders did not have the same effect as a standard juice. Scientists at Plant and Food Research carried on this work and recently found the molecule responsible. It was not anthocyanins but sarmentosin, a glycoside and that is found in several plant species. The paper can be found here.

Back to the original question, “can blackcurrants boost your brain”? Definitely! And there is plenty more great research emerging showing similar results to mine. How much do you need to eat? The studies all focussed on 140ml of Juice, which is about 200g of berries.

What is exiting is the potential application of MAO inhibition in clinical populations, and that will probably be where this line of research goes next.

By Ollie Page (Graduate Teaching Assistant)

Most of us have no immediate health problems consuming a chocolate bar or a pint of beer – sure you might feel guilty, but it’s likely many of us have consumed more than one at a time without worrying. Your average chocolate bar contains ~25g of carbohydrate, with ~15g in a typical pint of beer. To respond, your liver, muscles and adipose (fat) tissue all subdue this influx of glucose all under the watchful protection of a happy pancreas.

However, consider you have type 1 diabetes, and you have no endogenous insulin (that is, the insulin produced by your body) to aid glucose uptake. Or maybe you have type 2 diabetes, and your body resists the insulin being delivered in favour of producing and releasing more fatty acids. The instant and long-term physical, mental, social and occupational health impacts of excess glucose are why it is fundamental to keep an accurate track of your blood glucose using continuous glucose monitors (CGMs).  

But is this technology suitable for the changing environments its users are being exposed to?

People of the UK love a warm summer holiday; however, the sunburn and face fans are becoming increasingly common at home. Climate change has increased average summer temperatures in the UK by 1.3°C in the past 60 years, with maximum temperatures similarly increasing over time and reaching highs of 40.3°C in July 2022. Crucially these temperatures are of high risk to clinical and vulnerable populations, including the elderly and those with diabetes mellitus, as highlighted by a 6.2% rise in excess deaths compared to a 5-year average during the 2022 heat wave (Office for National Statistics, 2022). Due to several physiological factors including impaired hydration and hemodynamics, the rate of core temperature increase and risk of heat-related illness can be higher among people with diabetes and age-associated chronic health conditions than other populations (Meade et al., 2020).

Previous research has calculated an odds ratio of 1.097 per 1°C increase in temperature above 22°C that medical attention will be required (Hajat et al., 2017). In other words, for every 1°C increase in temperature above 22°C, there is an almost 10% increased odds of requiring medical attention. There is a clear heat-related health risk in people with diabetes and hospitals have observed greater inpatients with hypo- or hyperglycaemic events alongside heat stroke or other heat-related illnesses during heat waves (Xu et al., 2019), partly due to increased insulin-independent glucose uptake along with enhanced insulin sensitivity. With this increased risk to health clearly apparent, it is vital CGMs are accurate during hot temperatures.

Leading CGM manufacturers Dexcom and Abbott report maximum operating temperatures of their newest products of 40°C and 45°C, respectively, seemingly within sensible boundaries for heat waves. However, a recent survey by our team has shown 68.4% of recipients have experienced issues with their CGM accuracy and functionality in the heat, with 35.7% unable to take a reading at all (Page et al., 2025. Unpublished). This clearly highlights a key health risk in diabetes populations and the need to adhere for technological failures.

Ultimately, our current work aims to bridge the gaps in understanding of factors affecting CGM accuracy and functionality during different thermal challenges, along with identifying ways to reduce CGM inaccuracy and raise awareness of heat-related risk within people with diabetes.

I’m worried about getting too hot this summer, what can I do??

Cooling strategies are applied in performance and health settings worldwide to avoid heat-related illnesses and reduce core temperature back to safe levels (individual but often below 38°C), however, can be difficult to implement in certain environments or for those with lower socioeconomic status. Strategies can be split into internal and external application depending on their mechanism of action (inside vs outside the body).

Strategies are commonly advertised by health organisations with large variation used, along with adaptation to different settings. According to our recent survey, the most common cooling strategies applied by people with type 1 and type 2 diabetes in the UK are: having a cold drink, using a fan/air conditioning, or having a cold shower/bath (Page et al., 2025. Unpublished). This may be different to your own personal strategies however no strategy that lowers core temperature and reduces cardiovascular stress is wrong and is recommended before, during, and/or after heat exposure.

An extensive list of strategies by world leading experts can be found here published in The Lancet alongside any pros and cons for use (Jay et al., 2021).

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01209-5/fulltext

References:

Hajat, S., Haines, A., Sarran, C., Sharma, A., Bates, C., & Fleming, L. E. (2017). The effect of ambient temperature on type-2-diabetes: case-crossover analysis of 4+ million GP consultations across England. Environmental health : a global access science source, 16(1), 73. https://doi.org/10.1186/s12940-017-0284-7

Heat Mortality Monitoring Report: 2022. (2024). Office for National Statistics. https://www.gov.uk/government/publications/heat-mortality-monitoring-reports/heat-mortality-monitoring-report-2022

Jay, O., Capon, A., Berry, P., Broderick, C., de Dear, R., Havenith, G., Honda, Y., Kovats, R. S., Ma, W., Malik, A., Morris, N. B., Nybo, L., Seneviratne, S. I., Vanos, J., & Ebi, K. L. (2021). Reducing the health effects of hot weather and heat extremes: from personal cooling strategies to green cities. Lancet (London, England), 398(10301), 709–724. https://doi.org/10.1016/S0140-6736(21)01209-5

Meade, R. D., Akerman, A. P., Notley, S. R., McGinn, R., Poirier, P., Gosselin, P., & Kenny, G. P. (2020). Physiological factors characterizing heat-vulnerable older adults: A narrative review. Environment international, 144, 105909. https://doi.org/10.1016/j.envint.2020.105909

Page, O., Orange, ST., Coussens, A., Dulson, D.K., Jeffries, O. & West D.J. (2025) Perceived Impact of Heat Waves on Daily Health and Management of Type 1 and Type 2 Diabetes Unpublished.

Xu, R., Zhao, Q., Coelho, M. S. Z. S., Saldiva, P. H. N., Zoungas, S., Huxley, R. R., Abramson, M. J., Guo, Y., & Li, S. (2019). Association between Heat Exposure and Hospitalization for Diabetes in Brazil during 2000-2015: A Nationwide Case-Crossover Study. Environmental health perspectives, 127(11), 117005. https://doi.org/10.1289/EHP5688

By Dr. Adrian Holliday

The “obesity epidemic” is a term with which we are all very familiar. However, the prevalence and health consequences of low weight and undernutrition are less well documented and communicated. This is of particular relevance for older adults.

Somewhat paradoxically, we are at an increased risk of both excess weight and low weight as we enter later life. Perhaps surprising to many of us, is that the latter carries the greater risk to health for older adults. In fact, what many would consider as excess weight is protective as we age. A study in the USA followed a cohort of over 4000 over 65s for an average period of 10 years¹. Using World Health Organisation definitions of healthy weight (18.5 – 24.9 km/m²), overweight (25 – 29.9 km/m², and obesity (30 km/m² and above), those in the “overweight” category had a 20% lower risk of all-cause mortality than those in the “healthy weight” category. In fact, those classified as living with obesity were 22% more likely to pass away than those deemed healthy weight. At the other end of the BMI spectrum, those with a BMI of less than 18.5 km/m² were over three-times more likely to pass away than those not classified as underweight. Given that unintentional weight-loss is experienced by 15-20% of older adults, awareness of the health detriments of low weight should be raised.

One reason for older adults having an increased risk of losing weight is a decline in appetite. We may have observed this in loved ones: parents or grandparents who have a small appetite and struggle to eat what we would consider to be a “normal” portion. This age-related reduction in appetite and food intake – termed “anorexia of ageing” – effects approximately 30% of free-living older adults and over half of those in residential care.

Low appetite can be the result of numerous changes experienced in later life. These include the loss of a loved one and loneliness, reductions in physical activity, reductions in smell and taste, and the onset of disease. Recently, our research group has shown that another possible contributing factor is a change in the way our gut senses and responds to the nutrients that we eat. We recruited younger adults and older adults, who we identified as exhibiting either a healthy appetite or low appetite². All participants ate the same porridge breakfast. Before, and for 4 hours after breakfast, we took blood samples to measure the concentration of some appetite-related hormones that are released from the gut in response to feeding. We measured the hunger hormone, ghrelin, and two satiety hormones that signal fullness: PYY and GLP-1. Compared with younger adults, older adults with low appetite had a greater suppression of the hunger hormone ghrelin, while PYY and GLP-1 concentrations increased to a greater extent and stayed elevated for longer. This was not seen in the older adults with healthy appetite, who showed a very similar hormone response to food that was seen in younger people. Consequently, the older adults with low appetite ate less at lunch.

These data suggest that some, but not all, older adults exhibit a degree of hypersensitivity to nutrients, causing an amplified hormone response to cause greater feelings of fullness and suppression of hunger.

Why this occurs in some older adults but not others is not currently known. But, continuing our research in this field, we hope to find out. We suspect that it could be a result of changes in the way the gut digests and absorbs nutrients; changes in the gut environments, such as altered gut microbiome; or changes in the behaviour of the cells which secrete hormones³.

Identifying the cause of this heightened hormone response to feeding may help us design nutritional and pharmaceutical interventions to help appetite-suppressed older adults eat well for health, wellbeing, and longevity in later life.

1. Cheng et al., 2016. Body mass index and all-cause mortality among older adults. Obesity, 24(10), 2232-2239. doi.org/10.1002/oby.21612
2. Dagbasi et al., 2024. Augmented gut hormone response to feeding in older adults exhibiting low appetite. Appetite, 201(3), 107415. doi.org/10.1016/j.appet.2024.107415
3. Dagbasi et al., 2024. The role of nutrient sensing dysregulation in anorexia of ageing: The little we know and the much we don’t. Appetite, 203(6), 107718. doi.org/10.1016/j.appet.2024.107718

Dr. Rachel Stocker

I’m Dr Rachel Stocker and I joined Newcastle University in early 2016, moving to my current lectureship in 2022. As a lecturer in exercise and health psychology, I’m particularly interested in how our thoughts, emotions, and behaviours influence our physical health. My research focuses on helping people engage in various aspects of healthy lifestyles, especially those living with chronic conditions like diabetes.

Breaking down the barriers

For people with chronic illnesses, there are often extra psychological barriers that make it hard to stay active. An example is those living with insulin-treated diabetes. Whilst we know that exercising is good for us, many people with diabetes worry about managing their blood glucose levels during exercise. Resistance training, however, carries less risk of low blood sugar (hypoglycaemia) than aerobic forms of exercise. Resistance training involves working against a force to build strength—think weightlifting, or resistance band exercises. Research shows that resistance exercise is not only safe but also beneficial for managing insulin-treated diabetes.

In fact, resistance training can help stave off sarcopenia—the age-related loss of muscle mass and strength—and frailty, a syndrome that involves decreased physical reserve and increased vulnerability to stressors, which can lead to poor health outcomes. Both conditions are common in older adults, especially in those with insulin-treated diabetes, and contribute significantly to loss of independence. The evidence suggests that regular resistance exercise can slow down the progression of sarcopenia, improving muscle strength and overall physical function. This, in turn, reduces the risk of frailty and helps maintain quality of life.

In my current research, I’m investigating the experiences of older adults with insulin-treated diabetes who are mildly frail, and exploring the psychological and practical challenges they face when engaging in resistance exercise. Using qualitative methods, I’m identifying their fears and barriers to exercising, and also, the strategies they’ve developed to stay active. This work will be important in designing tailored interventions that encourage more people to take up resistance training, ultimately improving health and reducing frailty in this population.

Other research projects

As a chartered psychologist specialising in health psychology, I really enjoy applying health psychology and behaviour science principles in different settings and disease/illnesses. Alongside my work in diabetes, I’m involved in some exciting projects that look at other health issues. One of these explores the experiences of patients using the NHS specialist Chimeric Antigen Receptor (CAR) T-cell therapy service, focusing on their psychosocial and supportive care needs and how to address them. Another project is about increasing physical activity to reduce dementia risk in ethnically minoritised communities in the North East of England, by working together to create interventions that really fit their needs.

Supporting future health researchers

Another part of my work that I’m passionate about is supervising PhD students. For example, Ayat Bashir is working on improving the diagnosis and management of diabetes secondary to chronic pancreatitis. Keaton Irvine is researching how to improve health for individuals with type 2 diabetes from historically underrepresented groups. Blossom Bell is exploring the long-term care experiences of haematopoietic stem cell recipients, and Evridiki Iliaki is studying how museum experiences can promote mindfulness and social unity in the Middle East.

Looking ahead

Ultimately, my aim is to make healthy lifestyles more accessible for everyone, particularly for those living with chronic health conditions. By understanding the psychological factors that affect exercise and dietary behaviour, we can design strategies that don’t just improve physical health but also have a positive impact on mental wellbeing and quality of life.

By Dr. Changhyun Lim

As many of you know, lifting heavier weights is the most effective method for muscle hypertrophy. I completely agree with this. However, if you’re asking whether lifting heavy weights is the only way to induce muscle growth, my answer is clearly NO.

The practice of lifting heavier weights (70-80% of your 1 rep max or maximal effort) for muscle growth originally came from the bodybuilding community. Interestingly, this approach wasn’t based on scientific research at first, but rather on the undeniable visual proof — the massive muscle mass of bodybuilders. This was so persuasive that most exercise prescription textbooks have long recommended heavy weight lifting for hypertrophy. However, this can sometimes become a barrier to initiating exercise for the first or increase the risk of injury, especially for individuals who may be physically frail, ill, ageing, or simply uncomfortable lifting heavy weights.

Thankfully, research, including my own study, has shown that lifting lighter weights (30% 1RM) can result in similar muscle growth to higher weights, as long as the sets are performed to near failure [1-3]. In other words, whether you’re lifting heavy or light weights, muscle hypertrophy can be achieved as long as you push your muscles close to fatigue (you don’t need to reach complete failure but close to it).  

So, how does this work? When you lift weights, your body recruits motor units — bundles of muscle fibres controlled by a nerve — to contract the muscle. As you continue lifting closer to fatigue, some motor units get tired, and your body has to recruit additional motor units to maintain the effort. Eventually, all available motor units (i.e., muscle fibres) are recruited [4], triggering the cellular and molecular mechanisms responsible for protein synthesis [5].

In line with this, my previous study demonstrated that lighter-weight resistance training effectively recruits type II fibres (those typically activated during higher-force contractions, such as with heavier weight lifting) [1]. This was evidenced by the increase in the cross-sectional area of both type I and II muscle fibres. Additionally, and surprisingly, lighter-weight training with higher repetitions (to reach near fatigue) showed significantly improved mitochondrial function ¾ an effect usually associated with aerobic exercise, not heavy-weight training.

This doesn’t mean there’s anything wrong with lifting heavy for muscle growth. However, it’s important to know that there are more choices available for muscle hypertrophy, such as lighter-weight training. The lighter-weight training can be safer, reduce barriers to participation, and offer similar results. Lastly, while more research is needed, lighter weight training may even provide the added bonus of improving aerobic adaptations while building muscle mass— essentially, “kill two birds with one stone.”

References

1. Lim C, Kim HJ, Morton RW, Harris R, Phillips SM, Jeong TS, et al. Resistance Exercise-induced Changes in Muscle Phenotype Are Load Dependent. Med Sci Sports Exerc. 2019;51:2578-85. doi:10.1249/MSS.0000000000002088

2. Carvalho L, Junior RM, Barreira J, Schoenfeld BJ, Orazem J, Barroso R. Muscle hypertrophy and strength gains after resistance training with different volume-matched loads: a systematic review and meta-analysis. Appl Physiol Nutr Metab. 2022;47:357-68. doi:10.1139/apnm-2021-0515

3. Schoenfeld BJ, Grgic J, Ogborn D, Krieger JW. Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training: A Systematic Review and Meta-analysis. J Strength Cond Res. 2017;31:3508-23. doi:10.1519/JSC.0000000000002200

4. Morton RW, Sonne MW, Farias Zuniga A, Mohammad IYZ, Jones A, McGlory C, et al. Muscle fibre activation is unaffected by load and repetition duration when resistance exercise is performed to task failure. J Physiol. 2019;597:4601-13. doi:10.1113/JP278056

5. Lim C, Nunes EA, Currier BS, McLeod JC, Thomas ACQ, Phillips SM. An Evidence-Based Narrative Review of Mechanisms of Resistance Exercise-Induced Human Skeletal Muscle Hypertrophy. Med Sci Sports Exerc. 2022;54:1546-59. doi:10.1249/MSS.0000000000002929

By Dr. Wouter Peeters

Whether you are a weekend-warrior going out for a ride with your friends or are an elite cyclist, there is usually an element of competition in road cycling. For the weekend-warrior, this could be winning the sprint for the coffee stop or the town sign, for an elite cyclist it means putting in a final effort after having already cycled for several hours. To understand what makes you be able to beat the competition, you first need to understand the physiology behind it. Historically, determinants of endurance performance have been based on three pillars: your maximal oxygen uptake capacity (VO2max), the ability to sustain high exercise intensities without rapidly fatiguing (lactate thresholds) and how much oxygen you use for at a particular exercise intensity (exercise economy)(1). However, in the last few years sports scientists have revealed the possibility of a fourth pillar. This pillar is defined as “physiological resilience” (2). There are plenty of people that can produce extraordinarily exercise values in a fresh, non-fatigued state. However, ask the same group of people to do the same test after several hours of exercise and there will be great variability in the ability to produce the same exercise values. Those who are more physiologically resilient will see a smaller decline in their exercise values. As road cycling races are usually decided after several hours of racing, having greater resilience will help you outperform the competition (3). So, understanding this fourth pillar and how to improve on it will become an active area of research over the next few years.

In science, testing methods have to be robust, reliable and ideally ecologically valid. In exercise physiology, this means: the test in the laboratory should reflect the real-world scenario (ecological validity), where, without any experimental intervention, the outcome of the test should produce very similar results on two different occasions (test-retest reliability). In that way, when an intervention in a subsequent experiment shows a significant difference in the outcome, you can be more confident that this is due to the actual intervention and not because of variability originating from the test itself.

Most cycling experiments in the laboratory use exercise protocols where participants cycle for a fixed time at a fixed exercise intensity before completing the final effort. Although the test-retest reliability of such protocols are found to be good (4), it has limited ecological validity, since in the real world, road races constantly vary in intensity in response to tactics and changes in gradients of the road whilst the race is distance-based rather than time-based. Moreover, performance is differentially affected following a protocol of variable intensity compared to a fixed intensity (5, 6).

Combining the points raised above, we are currently testing the reliability of an exercise protocol that is accessible in a commercially-available application. In this exercise protocol, participants have to cover a distance of 128 km on three separate occasions to assess the reliability of the protocol. The virtual course contains several climbs where participants have to dig deep just as in the real world and the final 12 km is all uphill, which in the real world is often where competition of the Tour de France and the likes are decided. The overall outcomes on reliability can inform researchers whether this protocol can be used or not in subsequent investigations. If the results shows that this protocol is a reliable test, it can have an impact in the way future research in this area is conducted. For example, since the application is available from a device with Bluetooth anywhere with an internet connection, people could complete the protocol at home instead of having to come to the laboratory. Travelling to laboratories can sometimes be a barrier for people to participate in scientific experiments whilst often laboratories can only host one participant at a time. By simplifying the logistics for both the researcher and participant, these experiments could be completed at a much higher rate and thereby advancing knowledge in the area of cycling performance under fatigued conditions more rapidly.

References:

1.           Joyner MJ, Coyle EF. Endurance exercise performance: the physiology of champions. J Physiol. 2008;586(1):35-44.

2.           Jones AM. The fourth dimension: physiological resilience as an independent determinant of endurance exercise performance. J Physiol. 2023.

3.           T VANE, Sanders D, Lamberts RP. Maintaining Power Output with Accumulating Levels of Work Done Is a Key Determinant for Success in Professional Cycling. Med Sci Sports Exerc. 2021;53(9):1903-10.

4.           Sewell DA, McGregor RA. Evaluation of a cycling pre-load time trial protocol in recreationally active humans. Eur J Appl Physiol. 2008;102(5):615-21.

5.           Mateo-March M, Leo P, Muriel X, Javaloyes A, Mujika I, Barranco-Gil D, Pallarés JG, Lucia A, Valenzuela PL. Is all work the same? Performance after accumulated work of differing intensities in male professional cyclists. J Sci Med Sport. 2024.

6.           Palmer GS, Noakes TD, Hawley JA. Effects of steady-state versus stochastic exercise on subsequent cycling performance. Med Sci Sports Exerc. 1997;29(5):684-7.

Dr. Jen Bradley

The state of a nation’s dietary habits often makes the news headlines. But how do we know what people are eating and drinking? Dietary assessment is the collection of information on food and drink consumption from an individual or a group of people and the evaluation of this information to assess nutrient intake and dietary patterns. In nutritional epidemiology, dietary assessment methods are needed to obtain food intake data from a large population of individuals to investigate dietary exposure – these findings sometimes make the news.

My research is based on self-reported dietary assessment, which means the data we collect is based on people recalling or recording what they consume. Dietary assessment has changed a lot in recent years and I have observed this change. When I started working as a research assistant at HNRC (before it gained the ‘E’) in 2008, dietary assessment was an arduous task and quite cumbersome at times! Conducting dietary interviews with secondary school pupils required a car boot full of equipment; paper food diaries, food portion photos and food models. In addition, finding a suitable space for us to work in, in a busy school environment was not always easy. After weeks working in schools we would have a pile of completed paper food diaries and would spend months of project time linking the foods and drinks in the diaries to a nutrient food code (to allow us to look at nutrient intakes) and then more time entering these onto a database. Eventually we would have some dietary intake data to analyse!

Fast forward 16 years, and dietary assessment is a much more streamlined process. Intake24 is an online dietary recall system. I worked on the initial development and testing of the tool, which was led by Dr Emma Foster and Prof Patrick Olivier at Newcastle University. Research participants can log on to the website and enter all the foods and drinks they consumed the previous day. There are 1000s of foods in the system which users can select from and choose the portion size eaten by clicking on the relevant photo. The system has been created to be as close to an in-person interviewer-led recall as possible, for example the system prompts for any additions to foods which are commonly forgotten, such as ketchup on chips, milk on cereal, sugar in tea. If there are long gaps between meals, the user will be prompted to think if they had anything to eat within that time.   

One of the many advantages of Intake24 compared to the traditional paper-based methods, is the ability to collect dietary data from 1000s of study participants remotely. Arranging suitable times to meet with participants to conduct dietary interviews is no longer a requirement and saves hours of researcher time. Intake24 automatically codes the food and drink intakes, therefore dietary data can be downloaded from the system immediately, removing the laborious task of food diary coding and data entry onto a database. This also improves consistency of nutrient coding and removes human error. The development of Intake24 has changed the way dietary intakes are collected globally. The system is being used in the UK National Diet and Nutrition Survey and national surveys in Australia and New Zealand. Versions have been created for Portugal, Denmark, Malaysia, Indonesia and Japan.

However, I have a small confession. I miss meeting study participants. I always had a great deal of fun talking about what they had eaten and the little conversations they led to. In a pilot study for the Diet and Nutrition Survey of Infants and Young Children I met many parents of young babies and infants and it was an absolute joy to talk about foods their infants were eating and funny anecdotes about food flying onto ceilings and how on earth they were meant to measure the amount eaten when half of it was soaked into the bib! Dietary interviews with school children were always enlightening and again often led to interesting conversations about favourite foods and drinks. There is an argument, however, that removing the researcher from the dietary collection process, reduces the risk of social desirability; participants who may not have recorded that extra biscuit, might feel they can be more honest without a researcher present.

I remember the first time I downloaded dietary data from Intake24 during the testing of the tool in 180 participants in Scotland. At the end of a very busy few weeks collecting data from participants, I clicked the download button, and everyone’s food and nutrient intakes were there on the screen right in front of me. I didn’t need to cart a pile of food diaries and food models around with me, spend hours coding them and entering them into a database. I realised that Intake24 was going to vastly improve the process of dietary assessment, and importantly help make dietary assessment possible in large population-based studies where the cost of traditional methods would have previously been prohibitive. It was a moment I won’t forget, and I am so proud to have played a small part in its very successful journey so far.

The Power of Connection: Exploring Support in Performance and Health

Supporting others, or getting support, can be beneficial in lots of ways. It helps build and maintain relationships and allows us to feel connected to the people around us. This support can help every one of us, including people trying to become physically active, or to improve self-confidence and performance.

But are we comfortable opening up and asking for help? Do we really know the intricacies of support and how it should be provided or perceived? What are the effects of support for different populations?

Beyond SMART Goals: Tailoring Motivation Interventions

Goal setting has been shown to be beneficial for helping develop and maintain motivation in a variety of settings. Although recent research suggests a one-size fits all approach to goal setting might not lead to sustained change, particularly for an inactive population.

What innovative alternatives might be available to us? How might we design goals for clinical populations looking to improve physical activity?

Behind the Scenes: Unveiling the Science of Support in Health and Performance

Dr Adam Coussens, of Newcastle University, has been addressing these types of questions from his PhD focussing on social support of athletes, through to his recent research applying support and goal setting principles in different populations, including emergency services. Adam also co-hosts the internationally attended conference, Psychological Insights into Coaching Practice. This blog will focus on one current project Adam is working on, an intervention to improve physical activity levels in heart failure patients.

Adam has collaborated with fellow researchers from Teesside University, Newcastle University, and healthcare professionals from NHS Trusts across the north-east, as part of the BeActive Heart Failure group. Adam is working on this Heart Failure UK funded feasibility project to provide resources and support to people to understand the barriers within cardiac rehabilitation, and subsequently promote physical activity and cardiac rehabilitation uptake.

Adam has been working with healthcare professionals leading tailored workshops, equipping them with the tools to guide their patients towards utilising social support and setting effective goals. These workshops emphasise the crucial role of perceived and received support, identify potential gaps, and offer strategies for effectively utilising existing networks. Furthermore, practical guidance is provided on how to set more ‘open’ and ‘do your best’ goals, to help maintain motivation and physical activity.

What is Next for the Project?

Physical activity levels of heart failure patients involved in the project are being monitored using Actigraph measures. Interviews will also take place with healthcare professionals who delivered the intervention, and heart failure patients, to evaluate the effectiveness and practicality of this project.

As this is currently a feasibility study, the aim is to develop the multidisciplinary intervention further to include more NHS Trusts and identify whether a BeActive-HF intervention could be used as part of routine clinical care for patients with heart failure.

Reposted with permission from the Newcastle University Extreme Environments Group blog (https://blogs.ncl.ac.uk/extremeenvironments/blog-why-is-the-kona-ironman-world-champs-so-hard-for-the-pros/)

Hawaii is the birth place of the IronMan triathlon where in 1978 Judy and John Collins challenged individuals to swim bike and run 140.6 miles and joked they would call the winner an “Iron man”. The event now sees 1000s of athletes test themselves in IronMan races all over the globe, including myself. But Kona, home to the Ironman World Championships which begins today (6^th October 2022), holds something special for all triathletes. The history of the race is full of epic tails of survival (see the story of Julie Moss or Sian Welsh & Wendy Ingraham) and infamous battles such as the Iron War (between Dave Scott and Mark Allen). The weather is generally consistent and therefore predictable in Kona in October: sunny, windy and humid. However, while the air temperatures are generally around 30 ^oC which are not necessarily remarkable, it is the humidity “swamp-like” conditions that really challenge athlete’s thermoregulatory capacity when competing in the Ironman World Championships.

So why is Kona so hard?

It is well established that heat will reduce exercise performance incrementally, mediated by increasing heat gain and a rise in core body temperature. When athletes are faced with hot environments, preparation strategies such as heat acclimation facilitate heat tolerance which drive a range of physiological adaptations to help them tolerate heat. However, it is an adaptive increase in sweat rate that facilitates the greatest heat loss. Heat transfer is mediated by evaporation of sweat from the skin which transfers heat away from the body. In fact, when all sweat is able to evaporate from the skin (we will call this ideal conditions – typically dry-hot) heat is removed at a rate of 2.34 kJ/g. The human body can produce sweat at rates approximating ~ 30 g/min (losses in body mass equivalent to ~ 1.5-2 L/hr). Although, if you have been keeping up to date with Lionel Sanders vlog he mentions much higher changes in body mass after training that indicate sweat losses of ~2.5 L/hr. However, if using our sweat rate value of ~ 30 g/min this equates to removing heat at 73 kJ/min (~1219 W). The human body has only ~ 20% efficiency therefore this reported heat loss would support normothermic total energy use of 1520 W. As a result external work rate would be equivalent to ~ 305 W (20% of total energy use). Athletes across a number of social media platforms discuss numbers in the range of 300-350 W for average sustainable power during the cycling portion of an IronMan, meaning that in ideal conditions these numbers are perfectly reasonable and heat gain can be controlled (being mindful of dehydration of course).

Post race edit: Sam Laidlow beat the bike course record with a time of 4 hr 4 min and reported average power ~315 W. source: https://www.youtube.com/watch?v=njUjiu_AOeA].

However, the big problem in Kona, like we have said, is the humidity. Kona may see humidity in the range of 80-90% (30 ^oC air temp at 90% RH = WBGT ~ 28.6 ^oC) meaning the air contains a greater amount of water vapor thus reducing the gradient for evaporative heat transfer. This means our ideal scenario no longer holds true and the ability to dissipate heat decreases. It is the efficiency of sweating, defined as the ratio between secreted and evaporated sweat that is reduced as humidity increases, with some studies indicating that efficiency can decrease by ~35 % when humidity increases from 50 to 70% (Alber-Wallerstron & Homer, 1985; Frye & Kamon 1983). Clearly if humidity tops 90% the athlete’s sweat efficiency will be further reduced. As a result, athletes gain heat more quickly, core temperature increases more rapidly reaching critical limits facilitating a drop in exercise intensity and potentially leading to hyperthermia or more serious consequences. Indeed, Jan Frodeno, arguably the best IronMan athlete of all time, famously said that his rule of thumb is to take 15-20% off his normal wattage on the bike to account for the extreme heat stress in Kona.

So, what are the anticipated conditions in Kona?

Over the past 3 days humidity has ranged from 65 to 94% relative humidity, with temperatures ranging from 25-30 ^oC during the approximate times the professional athletes will race (6am-3pm) (https://w1.weather.gov/data/obhistory/PHKO.html – accessed 5/10/22 23:00). Whilst athletes and coaches are much more aware of the impact of heat stress and humidity in Kona, we will probably still see the breakdowns and collapses in the professional field that we are so accustomed to seeing at Kona. Science and technology, with respect to maximising heat tolerance, has pervaded the sport in recent years with the Norwegians taking the game to another level and other professionals following suit. It will be fascinating to see who has prepared the best, what strategies they adopt and who’s body can tolerate the conditions best. It will be a great race to watch! My money is on Daniela Ryf or Lucy Charles-Barclay in todays race and in the men’s race on saturday its the Big Blu although really hope Sanders has the race he capable of.

Updated 06/10/22 18:00 – Women’s environmental conditions at start of swim – as predicted 24 ^oC and 88% humidity.

Updated 08/10/22 – Men’s environmental conditions at start of swim (~6:00am left) and at the start of the run (~10:44am right) – as predicted temps increased from 24 to 28 ^oC and humidity remained stable around 85%.

Written by Owen Jeffries