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Background. Exercise performance and recovery are impaired by excessive levels of oxidative stress and inflammation. However, both reactive oxygen species (ROS) and inflammation improve exercise performance including mitochondrial ATP production and force of muscle contraction. They also are essential mediators in providing the benefits and training adaptations that occur from exercise. Nitric oxide (NO•) is a gaseous radical that increases blood flow via dilation of the blood vessels and also improves mitochondrial function. Therefore, NO• improves exercise performance and capacity, but only when produced at the right times and in the right locations. Excessive levels of NO• contribute to nitrosative stress due to the spontaneous reaction with superoxide to form toxic peroxynitrite. This decreases the ½ life of nitric oxide resulting in less NO• benefits and in cellular damage leading to impaired exercise performance. In contrast to conventional antioxidants and anti-inflammatories, molecular hydrogen (H2) has been demonstrated to exert selective antioxidant and anti-inflammatory effects by decreasing only excessive inflammation and reducing toxic oxidants without disturbing important signaling ROS, like NO•. Moreover, H2 can regulate NO• production, increase its circulating ½ life and beneficial NO• cycling, potentiate the bioactivity of NO•, and act as a NO• mimetic by increasing cGMP levels. At the same time H2 can prevent peroxynitrite formation and reduce the harm from NO• metabolism, such as lower nitrotyrosine levels. Methods. The effects of an H2-infused, nitric oxide-producing beverage (Hydro Shot) on nitric oxide production, blood flow, aerobic and anaerobic exercise, and cognitive function were assessed. Results. Ingestion of the functional beverage significantly increased production of NO• and a concomitant increase in blood flow. It also improved aerobic performance as measured by VO2, and anaerobic performance as indicated by delayed muscle fatigue, and increased peak torque during maximal isokinetic leg extensions. Additionally, the H2/NO• combination significantly improved indices of cognitive function including, focus, speed, plasticity, etc. Conclusion. The molecular crosstalk between H2 and NO•coupled with these preliminary results indicate that Hydro Shot is uniquely qualified for sports performance and exercise medicine and warrants additional clinical and mechanistic research.
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H2 has been clinically demonstrated to provide antioxidant and anti-inflammatory effects, which makes it an attractive agent in exercise medicine. Although exercise provides a multiplicity of benefits including decreased risk of disease, it can also have detrimental effects. For example, chronic high-intensity exercise in elite athletes, or sporadic bouts of exercise (i.e., noxious exercise) in untrained individuals, result in similar pathological factors such as inflammation, oxidation, and cellular damage that arise from and result in disease. Paradoxically, exercise-induced pro-inflammatory cytokines and reactive oxygen species largely mediate the benefits of exercise. Ingestion of conventional antioxidants and anti-inflammatories often impairs exercise-induced training adaptations. Disease and noxious forms of exercise promote redox dysregulation and chronic inflammation, changes that are mitigated by H2 administration. Beneficial exercise and H2 administration promote cytoprotective hormesis, mitochondrial biogenesis, ATP production, increased NAD+/NADH ratio, cytoprotective phase II enzymes, heat-shock proteins, sirtuins, etc. We review the biomedical effects of exercise and those of H2, and we propose that hydrogen may act as an exercise mimetic and redox adaptogen, potentiate the benefits from beneficial exercise, and reduce the harm from noxious exercise. However, more research is warranted to elucidate the potential ergogenic and therapeutic effects of H2 in exercise medicine.
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