The focus of this paper is on the glycemic index (GI) that provides effectual information on planning nutritional strategies for carbohydrate (CHO) supplementation in exercise. Related research has suggested that the GI can be used as a reference guide for the selection of an ideal CHO supplement in sports nutrition. Recently, the manipulation of GI of CHO supplementation in optimizing athletic performance has provided an exciting new research area in sports nutrition. There is a growing evidence to support the use of the GI in planning the nutritional strategies for CHO supplementation in sports. The optimum CHO availability for exercise has been demonstrated by manipulating the GI of CHO. Research has shown that a low GI CHO-rich meal is a suitable CHO source before prolonged exercise in order to promote the availability of the sustained CHO. In contrast, a high GI CHO-rich meal appears to be beneficial for glycogen storage after the exercise by promoting greater glucose and insulin responses. The prescribed feeding patterns of CHO intake during recovery and prior to exercise on glycogen re-synthesis and exercise metabolism have been studied in the literature. However, the studies on the subject are still limited, leaving some open questions waiting for further empirical evidences. The most significant question is whether CHO supplementation before and after exercise is beneficial when consumed as large feedings or as a series of snacks. Further research is needed on the effect of feeding patterns on exercise performance.

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This study was carried out to determine whether hemodynamics in inactive forearm muscle during ramp leg cycling is affected from the ventilatory threshold (VT) and respiratory compensation point (RCP), at which the rate of increase in ventilation (VE) against power output begins to increase abruptly. Change in hemodynamics was evaluated by change in oxygenation index (difference between concentrations of oxygenated hemoglobin and deoxygenated hemoglobin, HbD) measured using near-infrared spectrometry (NIRS). Each subject (n=9) performed 4-min constant-work-rate leg cycling and subsequent ramp leg cycling at an increasing rate of 10 watts·min⁻¹ in power output. The work rates at VT, RCP and peak oxygen uptake (VO_{2 peak}) were 107±11, 172±21 and 206±20 watts, respectively. The rates of increase in VE between 10-watt leg cycling, VT, RCP and VO_{2 peak} were 0.19±0.03, 0.44±0.07 and 1.32±0.47 l·min⁻¹·watts⁻¹, respectively. In one subject, HbD started to decrease during ramp exercise from the VT, and the rate of decrease increased at a high intensity of exercise. In eight subjects, although no decrease in HbD from the VT was observed, HbD showed a sudden drop at a high intensity of exercise. The work rate at which HbD began to decrease at a high intensity of exercise was 174±23 watts. This work rate was not significantly different from that at the RCP and was significantly correlated with that at the RCP (r=0.72, P<0.05). The results suggest that the abrupt increase in VE from the RCP affects hemodynamics, resulting in a decrease in HbD in inactive forearm muscle.

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Low-energy diets and fasting have suppressive effects on rheumatoid arthritis. It was reported recently that urine levels of pentosidine (i.e., an advanced glycation end product formed by glycosylation) is associated with the activity of rheumatoid arthritis. We conducted a regimen of caloric restriction combined with fasting in patients with rheumatoid arthritis, and then evaluated urinary pentosidine levels. Ten patients with rheumatoid arthritis underwent a 54-day caloric restriction program. Urinary pentosidine levels were measured and the Lansbury Index were determined by examining the clinical features, blood biochemistry and the inflammation activity of rheumatoid arthritis on days 0, 25 and 54. On day 0, the mean urinary pentosidine level of patients with rheumatoid arthritis was significantly higher than that of the control subjects. On day 54, the mean body weight had reduced due to caloric restriction. The mean values of the erythrocyte sedimentation rate and the Lansbury Index of patients both significantly decreased during the study. In addition, although the urinary pentosidine levels showed no significant difference between day 0 and 25, it was significantly decreased at the end of the study (day 54). The study showed that under a low energy diet a reduction of disease activity in rheumatoid arthritis was accompanied with a reduction of the urinary pentosidine.

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The validity of the BMI and fat mass index (FMI) as indicators of obesity was evaluated in a group of 3–5 yr old (n=486) children. Bioelectrical impedance analysis (BIA) was measured (using 50 kHz and tetrapolar electrodes) in order to calculate percent fat mass (%FM) and FMI (fat mass/stature squared). For boys, obesity was defined as ≧20%FM. For girls, the cutoff for obesity was ≧25%FM. However, obesity was defined as a BMI at or above the 90th percentile of age- and sex-specific data in this study. The percentile cutoffs for FMI were the same as for BMI using the same sample. There were correlations between BMI or FMI and %FM, but there was no significant correlation between BMI or FMI and stature. Therefore, it appears that both the BMI and FMI in this study are far more useful indices with which to assess obesity, and are reasonable indicators of fatness. However, with the use of %FM by BIA as the criterion for obesity, BMI and FMI had high specificities (95.5–96.4% for BMI and 99.5–100% for FMI) and lower but variable sensitivities (30.4–37.5% for BMI and 42.9–68.8% for FMI). Thus, almost all children who were not obese were classified correctly. In contrast, many obese children were not correctly identified by BMI and FMI. Therefore, we conclude that BMI should be used with caution as an indicator of childhood obesity. The new recommendations based on the FMI approach for defining childhood obesity are associated with a level of sensitivity that is somewhat higher than that of the BMI approach. Caution should, however, be used in generalizing from the findings in this study, and a further investigation of the issue is required.

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Wrong:Yoshihiro Shiomura
Right:Yoshihiro Shimomura

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