Int J Sports Med 2024; 45(04): 272-281
DOI: 10.1055/a-2195-3131
Physiology & Biochemistry

Does Age Influence Gastrointestinal Status Responses to Exertional-heat Stress?

Pascale Young
1   Department of Nutrition Dietetics & Food, Monash University, Notting Hill, Victoria, Australia
,
Kayla Henningsen
1   Department of Nutrition Dietetics & Food, Monash University, Notting Hill, Victoria, Australia
,
Rhiannon Snipe
2   Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
,
Stephanie Gaskell
1   Department of Nutrition Dietetics & Food, Monash University, Notting Hill, Victoria, Australia
,
Rebekah Alcock
3   La Trobe University, Bundoora, Victoria, Australia
,
Alice Mika
1   Department of Nutrition Dietetics & Food, Monash University, Notting Hill, Victoria, Australia
,
Christopher Rauch
1   Department of Nutrition Dietetics & Food, Monash University, Notting Hill, Victoria, Australia
,
Ricardo J. S. Costa
1   Department of Nutrition Dietetics & Food, Monash University, Notting Hill, Victoria, Australia
› Author Affiliations

Abstract

This meta-data exploration aimed to determine the impact of exertional-heat stress (EHS) on gastrointestinal status of masters age and young adult endurance athletes. Sixteen MASTERS (mean: 44y) and twenty-one YOUNG (26y) recreational endurance athletes completed 2 h of running at 60% ˙V O2max in 35˚C ambient conditions. Blood samples were collected pre-, immediately and 1 h post-EHS, and analyzed for markers of exercise-induced gastrointestinal syndrome (EIGS). Thermo-physiological measures and gastrointestinal symptoms (GIS) were recorded every 10–20 min during EHS. Peak Δ pre- to post-EHS did not substantially differ (p>0.05) between MASTERS and YOUNG for intestinal epithelial injury [I-FABP: 1652pg/ml vs. 1524pg/ml, respectively], bacterial endotoxic translocation [sCD14: -0.09µg/mL vs. 0.84µg/mL, respectively], lipopolysaccharide-binding protein [LBP: 0.26µg/mL vs. 1.76µg/mL, respectively], and systemic inflammatory response profile (SIR-Profile: 92.0arb.unit vs. 154arb.unit, respectively). A significantly higher peak Δ pre- to post-EHS in endogenous endotoxin anti-body IgM (p=0.042), and pro-inflammatory cytokine IL-1β (p=0.038), was observed in YOUNG compared to MASTERS. No difference was observed between incidence (81% and 80%, respectively) and severity (summative accumulation: 21 and 30, respectively) of reported GIS during EHS between MASTERS and YOUNG. Pathophysiology of EIGS in response to EHS does not substantially differ with age progression, since masters and younger adult endurance athletes responded comparably.



Publication History

Received: 19 July 2023

Accepted: 10 October 2023

Article published online:
10 January 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Costa RJS, Snipe RMJ, Kitic CM. et al. Systematic review: Exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Aliment Pharmacol Ther 2017; 46: 246-265
  • 2 Costa RJS, Gaskell SK, McCubbin AJ. et al. Exertional-heat stress-associated gastrointestinal perturbations during Olympic sports: Management strategies for athletes preparing and competing in the 2020 Tokyo Olympic Games. Temp 2019; 7: 58-88
  • 3 Gill SK, Hankey J, Wright A. et al. The Impact of a 24-h Ultra-Marathon on Circulatory Endotoxin and Cytokine Profile. Int J Sports Med 2015; 36: 688-695
  • 4 Gill SK, Teixeira A, Rama L. et al. Circulatory endotoxin concentration and cytokine profile in response to exertional-heat stress during a multi-stage ultra-marathon competition. Exerc Immunol Rev 2015; 21: 114-128
  • 5 Snipe RMJ, Costa RJS. Does the temperature of water ingested during exertional-heat stress influence gastrointestinal injury, symptoms, and systemic inflammatory profile?. J Sci Med Sport 2018; 21: 771-776
  • 6 Snipe R, Khoo A, Kitic C. et al. The impact of exertional-heat stress on gastrointestinal integrity, gastrointestinal symptoms, systemic endotoxin and cytokine profile. Euro J Appl Physiol 2018; 118: 389-400
  • 7 Gaskell SK, Taylor B, Muir J. et al. Impact of 24-hour low and high fermentable oligo- di- mono- saccharide polyol diets on markers of exercise-induced gastrointestinal syndrome in response to exertional-heat stress. Appl Physiol Nutri Metab 2020; 45: 569-580
  • 8 Costa RJS, Snipe R, Camões-Costa V. et al. The impact of gastrointestinal symptoms and dermatological injuries on nutritional intake and hydration status during ultramarathon events. Sports Med – Open 2016; 2: 1-14
  • 9 Gaskell SK, Snipe RMJ, Costa RJS. Test-Retest Reliability of a Modified Visual Analog Scale Assessment Tool for Determining Incidence and Severity of Gastrointestinal Symptoms in Response to Exercise Stress. Int J Sport Nutr Exerc Metab 2019; 29: 411-419
  • 10 Gaskell SK, Rauch CE, Costa RJS. Gastrointestinal assessment and therapeutic intervention for the management of exercise-associated gastrointestinal symptoms: A case series translational and professional practice approach. Front Physiol 2021; 12: 719142
  • 11 Grames C, Berry-Cabán CS. Ischemic colitis in an endurance runner. Case Rep Gastrointest Med 2012; 2012: 356895
  • 12 Benmassaoud A, Kanber Y, Nawar J. et al. Exercise-induced ischemic colitis in an amateur marathon runner. Endoscopy 2014; 46: E480
  • 13 Pietro A, Mervyn S. Pathophysiology of sepsis. Curr Opin Anaesthesiol 2021; 34: 77-84
  • 14 Costa RJS, Young P, Gill SK. et al. Assessment of exercise-associated gastrointestinal perturbations in research and practical settings: Methodological concerns and recommendations for best practice. Int J Sport Nutr Exerc Metab 2022; 32: 387-418
  • 15 Snipe RMJ, Khoo A, Kitic CM. et al. Mild heat stress during prolonged running results in exacerbated intestinal epithelial injury and gastrointestinal symptoms. Int J Sports Med 2018; 39: 255-263
  • 16 Young P, Russo I, Gill P. et al. Reliability of pathophysiological markers reflective of exercise-induced gastrointestinal syndrome (EIGS) in response to 2-h high-intensity interval exercise: A comprehensive methodological efficacy exploration. Front Physiol 2023; 14: 1063335
  • 17 Henningsen K, Mika A, Alcock R. et al The increase in core body temperature in response to exertional-heat stress can predict exercise-induced gastrointestinal syndrome. Temp 2023; In press DOI: 10.1080/23328940.2023.2213625.
  • 18 Snipe RMJ, Costa RJS. Does biological sex impact intestinal epithelial injury, small intestine permeability, gastrointestinal symptoms and systemic cytokine profile in response to exertional-heat stress?. J Sports Sci 2018; 36: 2827-2835
  • 19 Bennett CJ, Henry R, Snipe RMJ. et al. Is the gut microbiota bacterial abundance and composition associated with intestinal epithelial injury, systemic inflammatory profile, and gastrointestinal symptoms in response to exertional-heat stress?. J Sci Med Sport 2020; 23: 1141-1153
  • 20 Costa RJS, Camões-Costa V, Snipe RMJ. et al. The impact of exercise-induced hypohydration on intestinal integrity, function, symptoms, and systemic endotoxin and inflammatory responses. J Appl Physiol 2019; 126: 1281-1291
  • 21 Steele AK, Lee EJ, Vestal B. et al. Contribution of intestinal barrier damage, microbial translocation and HIV-1 infection status to an inflammaging signature. PLoS One 2014; 9: e97171
  • 22 Man AL, Bertelli E, Rentini S. et al. Age-associated modifications of intestinal permeability and innate immunity in human small intestine. Clin Sci (Lond) 2015; 129: 515-527
  • 23 Nicoletti C. Age-associated changes of the intestinal epithelial barrier: Local and systemic implications. Expert Rev Gastroenterol Hepatol 2015; 9: 1467-1469
  • 24 Branca JJV, Gulisano M, Nicoletti C. Intestinal epithelial barrier functions in ageing. Ageing Res Rev 2019; 54: 100938
  • 25 Franceschi C, Garagnani P, Vitale G. et al. Inflammaging and 'Garb-aging'. Trends Endocrinol Metab 2017; 28: 199-212
  • 26 van Beek AA, Sovran B, Hugenholtz F. et al. Supplementation with lactobacillus plantarum WCFS1 prevents decline of mucus barrier in colon of accelerated aging Ercc1-/Δ7 mice. Front Immunol 2016; 7: 408
  • 27 Sovran B, Hugenholtz F, Elderman M. et al. Age-associated impairment of the mucus barrier function is associated with profound changes in microbiota and immunity. Sci Rep 2019; 9: 1437
  • 28 Walrath T, Dyamenahalli KU, Hulsebus HJ. et al. Age-related changes in intestinal immunity and the microbiome. J Leukoc Biol 2021; 109: 1045-1061
  • 29 Lepers R, Stapley PJ. Master athletes are extending the limits of human endurance. Front Physiol 2016; 7: 613
  • 30 Thuany M, Gomes TN, Villiger E. et al. Trends in participation, sex differences and age of peak performance in time-limited ultramarathon events: A secular analysis. Medicina (Kaunas) 2022; 58: 366
  • 31 Rauch CE, McCubbin AJ, Gaskell SK. et al. Feeding tolerance, glucose availability, whole-body total carbohydrate and fat oxidation in male endurance and ultra-endurance runners in response to prolonged exercise consuming a habitual mixed macronutrient diet and carbohydrate feeding during exercise. Front Physiol 2022; 12: 773054
  • 32 Costa RJS, Henningsen K, Gaskell SK. et al. Amino acid-based beverage interventions ameliorate exercise-induced gastrointestinal syndrome in response to exertional-heat stress: The heat exertion amino acid technology (HEAAT) study. Int J Sport Nutr Exerc Metab 2023; 33: 230-242
  • 33 Lau E, Marques C, Pestana D. et al. The role of I-FABP as a biomarker of intestinal barrier dysfunction driven by gut microbiota changes in obesity. Nutr Metab (Lond) 2016; 13: 31
  • 34 van Wijck K, Lenaerts K, van Loon LJ. et al. Exercise-induced splanchnic hypoperfusion results in gut dysfunction in healthy men. PLoS One 2011; 6: e22366
  • 35 Gaskell SK, Parr A, Rauch C. et al. Diurnal versus Nocturnal Exercise—Impact on the Gastrointestinal Tract. Med Sci Sport Exerc 2021; 53: 1056-1067
  • 36 Young P, Rauch C, Russo I. et al. Plasma endogenous endotoxin core antibody response to exercise in endurance athletes. Int J Sports Med 2022; 43: 1023-1032
  • 37 Peake JM, Della Gatta P, Suzuki K. et al. Cytokine expression and secretion by skeletal muscle cells: Regulatory mechanisms and exercise effects. Exerc Immunol Rev 2015; 21: 8-25
  • 38 Walsh NP, Gleeson M, Shephard RJ. et al. Position statement. Part one: Immune function and exercise. Exerc Immunol Rev 2011; 17: 6-63
  • 39 Russo I, Della Gatta PA, Garnham A. et al. Assessing overall exercise recovery processes using carbohydrate and carbohydrate-protein containing recovery beverages. Front Physiol 2021; 12: 50
  • 40 Russo I, Della Gatta PA, Garnham A. et al. Does the nutritional composition of dairy milk based recovery beverages influence post-exercise gastrointestinal and immune status, and subsequent markers of recovery optimisation in response to high intensity interval exercise?. Front Nutr 2021; 7: 343
  • 41 Russo I, Della Gatta PA, Garnham A. et al. The effect of an acute “train-low” nutritional protocol on markers of recovery optimisation in endurance trained male athletes. Int J Sports Physiol Perf 2021; 16: 1764-1776
  • 42 Costa RJS, Miall A, Khoo A. et al. Gut-training: The impact of two weeks repetitive gut-challenge during exercise on gastrointestinal status, glucose availability, fuel kinetics, and running performance. Appl Physiol Nutr Metab 2017; 42: 547-557