Burns, Stephen Francis

Background The implementation of blood flow restriction (BFR) during exercise is becoming an increasingly useful adjunct method in both athletic and rehabilitative settings. Advantages in pairing BFR with training can be observed in two scenarios: (1) training at lower absolute intensities (e.g. walking) elicits adaptations akin to high-intensity sessions (e.g. running intervals); (2) when performing exercise at moderate to high intensities, higher physiological stimulus may be attained, leading to larger improvements in aerobic, anaerobic, and muscular parameters. The former has been well documented in recent systematic reviews, but consensus on BFR (concomitant or post-exercise) combined with high-intensity interval training (HIIT) protocols is not well established. Therefore, this systematic review evaluates the acute and chronic effects of BFR + HIIT.

Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify relevant studies. A systematic search on 1 February 2022, was conducted on four key databases: ScienceDirect, PubMed, Scopus and SPORTDiscus. Quality of each individual study was assessed using the Physiotherapy Evidence Database (PEDro) scale. Extraction of data from included studies was conducted using an adapted version of the 'Population, Intervention, Comparison, Outcome' (PICO) framework.

Results
A total of 208 articles were identified, 18 of which met inclusion criteria. Of the 18 BFR + HIIT studies (244 subjects), 1 reported both acute and chronic effects, 5 examined acute responses and 12 investigated chronic effects. Acutely, BFR challenges the metabolic processes (vascular and oxygenation responses) during high-intensity repeated sprint exercise—which accelerates central and peripheral neuromuscular fatigue mechanisms resulting in performance impairments. Analysis of the literature exploring the chronic effects of BFR + HIIT suggests that BFR does provide an additive physiological training stimulus to HIIT protocols, especially for measured aerobic, muscular, and, to some extent, anaerobic parameters.

Conclusion
Presently, it appears that the addition of BFR into HIIT enhances physiological improvements in aerobic, muscular, and, to some extent, anaerobic performance. However due to large variability in permutations of BFR + HIIT methodologies, it is necessary for future research to explore and recommend standardised BFR guidelines for each HIIT exercise type.

Good nutrition is a cornerstone of health essential to physical growth and immunity and for reducing susceptibility to disease. Moreover, good nutrition contributes to the development of brain structure and function across the entire spectrum of childhood by providing nutrient building blocks for creating and maintaining neural connections. This contribution of nutrition to brain development is also associated with cognition and academic performance and this chapter reviews evidence examining these associations from the prenatal through to adolescent years. It examines the role of the overall quality of nutrition supplied in the diet and individual nutrients in contributing to cognition and academic outcomes in childhood and explores the potential mechanisms via which these contributions are made. Differences in the acute versus long-term influence of nutrition on influencing cognitive performance in children are highlighted where appropriate. The evidence for the special role of breakfast as a meal contributing to cognitive and academic performance is explored. Nutrients of special interest which may influence cognition in childhood are discussed, followed by a section on the current pandemic of children with overweight and obesity and the link of this disease with diet/energy intake and cognition in children. Throughout the chapter, where available, studies examining nutrition and cognitive outcomes in children in Singapore are included. Finally, recommendations for future research are made.

Purpose: Nutrition education programmes are often created to improve dietary intake in athletes. Unfortunately, the inconsistent link between nutrition knowledge and dietary behavior suggests that nutrition knowledge may not be a key influencer of dietary behavior. The Knowledge–Attitude–Behavior (KAB) model has been used in nutrition education although studies that evaluated this model were largely compromised by poorly constructed instruments and methodological discrepancies.

Method: To improve understanding of the model, a Nutrition Knowledge Questionnaire (NKQ) and Athlete’s Perspective on Nutrition (APN) instrument was developed using the theory of planned behavior as its theoretical framework. Validity and reliability were examined for 193 Sports Science students and 11 elite netballers. Content and face validity of the 48-item NKQ was confirmed by expert sport dietitians. Discriminant validity of the NKQ and factorial validity of the APN was established. Both instruments demonstrated acceptable internal consistency and good test-retest reliability. The final instruments were administered to elite athletes in a pilot study to understand the KAB model.

Results: Correlation between nutrition knowledge and dietary behavior was significant (r = .811, p = .01). Nutrition knowledge was a positive predictor of netballers’ dietary behavior (β = .8, t(2) = 3.899, p = .005) but attitude was not (β = −.097, t(2) = −.471, p = .65).

Conclusion: Two psychometrically sound instruments developed in this study can be used to measure nutrition knowledge and attitude in an Asian group of athletes. The pilot study with athletes showed that nutrition knowledge predicted dietary behavior.