Muscle DamageNCT02374619
Iron Supplementation and Eccentric Exercise
A study testing Iron supplement Resoferon Ferrous Sulfate in people with Muscle Damage and Oxidative Stress, run by University of Thessaly.
Trial summary
Iron supplementation is very common in athletes, probably due to its catalytic role on the oxygen transport and optimal function of oxidative enzymes and proteins during exercise. Read more about this study
- Who is it for?
- Ages 10 to 45 years, men onlyHealthy volunteers can take part
- Conditions the study is for
- Muscle Damage, Oxidative Stress
- What is being tested?
- Iron supplement Resoferon Ferrous Sulfate
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 28 participants
- Where
- No sites listed yet
- Study dates
- Dec 2011to Dec 2013
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 10 to 45 years
- Men only
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Physiological body mass index (BMI).
- Physiological health profile.
- Subject provides written informed consent.
Who cannot join
- Professional athlete.
- Consumed any nutritional supplement the last 3 months.
- Performed pure eccentric exercise the last 6 months.
- Non Caucasian.
About this study
Official title: The Effect of Eccentric Exercise and Iron Supplementation on Blood Redox Status and Muscle Performance in Different Age Groups
Iron supplementation is very common in athletes, probably due to its catalytic role on the oxygen transport and optimal function of oxidative enzymes and proteins during exercise.
Iron is also characterized as a potent pro-oxidant, as it can lead to increased production of reactive oxygen and nitrogen species (RONS) that are involved in critical biological processes, such as gene expression, signal transduction and enzyme activity. In exercise, low levels of RONS are essential for optimal force production, whereas excessive production of RONS can cause contractile dysfunction, resulting in muscle weakness and fatigue. On the other hand, RONS are involved in signaling pathways and up-regulation of the expression of several genes, and therefore, RONS can provoke favorable effects such as training adaptations.
The purpose of the present study is to investigate the effect of iron supplementation on redox status, muscle damage and muscle performance after an acute bout of a valid muscle damaging eccentric exercise model in adults and children.
Read the detailed description
Eccentric muscle work is an essential part of human daily activities, such as walking, and in particular, when walking downhill or descending stairs. It is also a component of almost all of the athletic actions. The most notable and well-described effect of eccentric exercise is the muscle damage that peaks one to three days after exercise and is accompanied by several hematological, biochemical and physiological responses. Excessive production of reactive oxygen and nitrogen species (RONS) has been reported as a result of eccentric exercise. The typical approach so far, was to provide antioxidants to minimize oxidative stress, yet the effectiveness of such an approach is still under debate. Earlier studies reported positive effects of antioxidant supplementation on muscle performance, muscle damage and redox status, whereas more recently, well-received studies pointed towards the negative impact of antioxidant supplementation.
Iron is an essential element for the completion of numerous important biological functions, and also for optimal exercise performance. It is a vital component for the formation of oxygen-transport and iron-storage proteins hemoglobin and myoglobin, and for the most favorable function of many oxidative enzymes that affect the intracellular metabolism. Therefore, iron supplementation is commonly used to avoid exercise-induced perturbations of iron homeostasis and maintain the required iron stores that are necessary to address exercise needs or enhance physical performance. Iron is also characterized as a potent pro-oxidant, as it can lead to increased production of reactive oxygen and nitrogen species (RONS) that are involved in critical biological processes, such as gene expression, signal transduction and enzyme activity. Nevertheless, the role of iron on modifying redox responses after eccentric exercise has not yet been examined.
In a double blind, randomized cross over study that will be conducted in two cycles, healthy men and boys will receive either the iron supplement (37mg of elemental iron per day for three weeks before and one week after the eccentric exercise) or the placebo.
Blood samples will be collected: a) in adults prior to, at the end of first supplementation period, 24, 48,72 and 96 hours following an acute bout of eccentric exercise (5 sets x 15 max reps), and b) in children prior to, at the end of first supplementation period and 72 hours following the same exercise protocol. Blood drawings will be repeated at the same time points during the second supplementation cycle.
The aims of the present research are to investigate:
- The effect of an acute bout of eccentric exercise on muscle performance, redox status, and iron status.
- The effect of three weeks of iron supplementation on muscle performance, redox status, and iron status.
- The effect of four weeks of iron supplementation on muscle damage, muscle performance, and redox status after an acute eccentric exercise bout.
- The effect of age on muscle damage, muscle performance and redox status after an acute eccentric exercise bout and iron supplementation.
- Conditions
- Muscle Damage, Oxidative Stress
- Being tested
- Iron supplement Resoferon Ferrous Sulfate, Placebo
- Keywords
- eccentric exercise, pro-oxidants, free radicals, adults, children
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Iron supplement Resoferon Ferrous SulfateDietary supplement
Oral supplementation with one tablet of iron supplement [Resoferon Ferrous Sulfate 125 (37) mg]
PlaceboDietary supplement
| Study group | Role | What they receive |
|---|---|---|
| Iron supplement | Experimental | Oral supplementation Receives: Dietary Supplement: Iron supplement Resoferon Ferrous Sulfate |
| Control | Placebo comparator | Oral supplementation Receives: Dietary Supplement: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Changes in Maximum isometric torque (N.m)
An isokinetic dynamometer (Cybex, Ronkonkoma, NY) will be used for the estimation of changes in isometric knee extensor's peak torque at 90o knee flexion between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. The average of the three best maximal voluntary contractions with the subjects' one lower extremity will be recorded. To ensure that the subjects provide their maximal effort, the measurements will be repeated if the difference between the lower and the higher torque value exceed 10%. There will be two minutes rest between isometric efforts.
Measured: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
Changes in Maximum concentric torque (N.m)
An isokinetic dynamometer (Cybex, Ronkonkoma, NY) will be used for the estimation of changes in isokinetic knee extensor's peak torque at 60o/sec angular velocity between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. The higher absolute value of five maximal voluntary contractions with the subjects' one lower extremity will be recorded.
Measured: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
Changes in Maximum eccentric torque (N.m)
An isokinetic dynamometer (Cybex, Ronkonkoma, NY) will be used for the estimation of changes in isokinetic knee extensor's peak torque at 60o/sec angular velocity between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. The higher absolute value of five maximal voluntary contractions with the subjects' one lower extremity will be recorded.
Measured: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
Changes in Range of motion, ROM (degrees)
The assessment of changes in pain-free ROM between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise, will be performed manually using the isokinetic dynamometer. The investigator will move the calf at a very low angular velocity from 0 knee extension to the position where the subject will feel any discomfort.
Measured: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
Changes in Delayed onset muscle soreness, DOMS (scale 1-10)
Each participant will assess changes in delayed onset of muscle soreness (DOMS) during walking and squat movement (90o knee flexion) and perceived soreness between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. DOMS and perceived soreness will be rated on a scale ranging from 1 (normal) to 10 (very sore).
Measured: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
Changes in Creatine kinase, CK (activity IU)
CK activity will be measured as a general indicator of muscle damage. Changes in CK activity between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be estimated in a Clinical Chemistry Analyzer Z1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece).
Measured: Before the beginning of iron supplementation (baseline), at the end of the first supplementation period (3 weeks: pre exercise), and 72h after the eccentric exercise
Secondary outcomes (12)
Changes in Reduced glutathione, GSH (μmol/g Hb)
GSH will be measured as a general index of oxidative stress. Changes in GSH between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be assessed. For GSH, 20 μL of erythrocyte lysate will be treated with 5% TCA mixed with 660 μL of 67 mM sodium potassium phosphate (pH 8.0) and 330 ΜL of 1 mM 5,5-dithiobis-2 nitrobenzoate. The samples will be incubated in the dark at room temperature for 45 min, and the absorbance will be read at 412 nm.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Oxidized glutathione, GSSG (μmol/g Hb)
GSSG will be measured as a general index of oxidative stress. Changes in GSSG between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. GSSG will be assayed by treating 50 μL of erythrocyte lysate with 5% TCA and neutralized up to pH 7.0-7.5. One microliter of 2-vinylpyridine will be added, and the samples will be incubated for 2 h. Sample will be treated with TCA and will be mixed with 600 μL of 143 mM sodium phosphate 100 ΜL of 3 mM NADPH, 100 ΜL of 10 mM 5,5-dithiobis-2-nitrobenzoate, and 194 μL of distilled water. After the addition of 1 μL of glutathione reductase, the change in absorbance at 412 nm will be read for 3 min.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Thiobarbituric acid-reactive substances, TBARS (μM)
TBARS will be measured as an index of lipid peroxidation. Changes in TBARS between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. For TBARS determination, 100 μL of plasma will be mixed with 500 ΜL of 35% TCA and 500 μL of Tris-HCl (200 mM, pH 7.4) and will be incubated for 10 min at room temperature. One milliliter of 2 M Na2SO4 and 55 mM thiobarbituric acid solution will be added, and the samples will be incubated at 95O C for 45 min. The samples will be cooled on ice for 5 min and then will be vortexed after adding 1 mL of 70% TCA. The samples will be centrifuged at 15,000g for 3 min, and the absorbance of the supernatant will be read at 530 nm.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Protein carbonyls, PC (nmol/mg pr)
Carbonyls will be measured as an index of protein oxidation. Changes in PC between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. Protein carbonyls will be determined adding 50 μL of 20% TCA to 50 μL of plasma. Samples will be incubated in the dark at room temperature for 1 hour. The supernatant will be discarded, and 1 mL of 10% TCA will be added. The supernatant will be discarded, and 1 mL of ethanol-ethyl acetate will be added and centrifuged. The supernatant will be discarded, and 1 mL of 5 M urea will be added, vortexed, and incubated at 37C for 15 min. The samples will be centrifuged at 15,000g for 3 min at 4C, and the absorbance will be read at 375 nm.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Catalase (μmol/min/mg Hb)
Catalase will be measured as one of the main antioxidant enzyme of erythrocytes. Changes in catalase between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. Catalase activity will be determined adding 4 μL of erythrocyte lysate, 2955 μL of 67 mM sodium potassium phosphate (pH 7.4), and the samples will be incubated at 37C for 10 min. Five microliters of 30% hydrogen peroxide was added to the samples, and the change in absorbance will immediately read at 240 nm for 1.5 min.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Total antioxidant capacity, TAC (mm DPPH)
Changes in TAC between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. TAC will be determined adding 20 μL of plasma to 480 ΜL of 10 mM sodium potassium phosphate (pH 7.4) and 500 μL of 0.1 mM 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical, and the samples will be incubated in the dark for 30 min at room temperature. The samples will be centrifuged for 3 min at 20,000g, and the absorbance will be read at 520 nm.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Uric acid (μm)
Uric acid will be measured as the main antioxidant component of blood plasma. Changes in Uric acid between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. It will be measured in a Clinical Chemistry Analyzer Z1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece).
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Bilirubin (μM)
Changes in Bilirubin between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. Bilirubin will be measured in a Clinical Chemistry Analyzer Z1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece).
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Iron concentration (mg/dL)
Changes in Iron concentration between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. Iron concentration will be measured in a Clinical Chemistry Analyzer Z1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece).
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Total Iron Binding Capacity (TIBC) (μmol/L)
Changes in TIBC between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. TIBC will be measured in a Clinical Chemistry Analyzer Z1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece).
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Transferin saturation (TS) (%)
Changes in TS between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. Transferrin saturation will be calculated from iron and TIBC values.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Ferritin (ng/mL)
Changes in Ferritin concentration between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be investigated. For the determination of serum Ferritin an immunoenzymometric assay (EIA) kit based on sandwich ELISA will be used (Accubind, Monobind Inc., USA®) which contains all the necessary reagents. The absorbance in each well will be read at 450nm using a microplate reader (Biochrom Asys Expert 96, UK). For the calculation of the concentration of ferritin, a dose response curve was used according to the assay directions.
Measured: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Mar 2015 (estimated)
- Study startDec 2011
- Primary completionOct 2013
- Study completionDec 2013
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Muscle DamageStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 28 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Thessaly
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Athanasios Z. Jamurtas, University of Thessaly
- Investigators
- Athanasios Z Jamurtas, Dr, Study chair, University of Thessaly
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02374619
- Sponsor's protocol ID
- UTH2010
- Status last verified
- Apr 2015
- First submitted
- 16 Feb 2015
- Last updated
- 14 Apr 2015
- Results posted
- No
- Data monitoring committee
- No
Publications
Theodorou AA, Nikolaidis MG, Paschalis V, Koutsias S, Panayiotou G, Fatouros IG, Koutedakis Y, Jamurtas AZ. No effect of antioxidant supplementation on muscle performance and blood redox status adaptations to eccentric training. Am J Clin Nutr. 2011 Jun;93(6):1373-83. doi: 10.3945/ajcn.110.009266. Epub 2011 Apr 20.
PubMed 21508092Gomez-Cabrera MC, Martinez A, Santangelo G, Pallardo FV, Sastre J, Vina J. Oxidative stress in marathon runners: interest of antioxidant supplementation. Br J Nutr. 2006 Aug;96 Suppl 1:S31-3. doi: 10.1079/bjn20061696.
PubMed 16923247Deli CK, Fatouros IG, Paschalis V, Tsiokanos A, Georgakouli K, Zalavras A, Avloniti A, Koutedakis Y, Jamurtas AZ. Iron Supplementation Effects on Redox Status following Aseptic Skeletal Muscle Trauma in Adults and Children. Oxid Med Cell Longev. 2017;2017:4120421. doi: 10.1155/2017/4120421. Epub 2017 Jan 22.
PubMed 28203319
Study at a glance
From the registry record, last updated by the sponsor on 14 Apr 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Eccentric Exercise and Iron Supplementation on Blood Redox Status and Muscle Performance in Different Age Groups
- ClinicalTrials.gov ID
- NCT02374619
- Acronym / sponsor ID
- UTH2010
- Conditions
- Muscle Damage, Oxidative Stress
- Keywords
- eccentric exercise, pro-oxidants, free radicals, adults, children
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 28 participants (actual)
- Lead sponsor
- University of ThessalyUniversity, hospital or other
- Study start
- Dec 2011
- Primary completion
- Oct 2013 (actual)
- Study completion
- Dec 2013 (actual)
- First posted
- 2 Mar 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Iron supplementation is very common in athletes, probably due to its catalytic role on the oxygen transport and optimal function of oxidative enzymes and proteins during exercise.
Iron is also characterized as a potent pro-oxidant, as it can lead to increased production of reactive oxygen and nitrogen species (RONS) that are involved in critical biological processes, such as gene expression, signal transduction and enzyme activity. In exercise, low levels of RONS are essential for optimal force production, whereas excessive production of RONS can cause contractile dysfunction, resulting in muscle weakness and fatigue. On the other hand, RONS are involved in signaling pathways and up-regulation of the expression of several genes, and therefore, RONS can provoke favorable effects such as training adaptations.
The purpose of the present study is to investigate the effect of iron supplementation on redox status, muscle damage and muscle performance after an acute bout of a valid muscle damaging eccentric exercise model in adults and children.
Detailed description
Eccentric muscle work is an essential part of human daily activities, such as walking, and in particular, when walking downhill or descending stairs. It is also a component of almost all of the athletic actions. The most notable and well-described effect of eccentric exercise is the muscle damage that peaks one to three days after exercise and is accompanied by several hematological, biochemical and physiological responses. Excessive production of reactive oxygen and nitrogen species (RONS) has been reported as a result of eccentric exercise. The typical approach so far, was to provide antioxidants to minimize oxidative stress, yet the effectiveness of such an approach is still under debate. Earlier studies reported positive effects of antioxidant supplementation on muscle performance, muscle damage and redox status, whereas more recently, well-received studies pointed towards the negative impact of antioxidant supplementation.
Iron is an essential element for the completion of numerous important biological functions, and also for optimal exercise performance. It is a vital component for the formation of oxygen-transport and iron-storage proteins hemoglobin and myoglobin, and for the most favorable function of many oxidative enzymes that affect the intracellular metabolism. Therefore, iron supplementation is commonly used to avoid exercise-induced perturbations of iron homeostasis and maintain the required iron stores that are necessary to address exercise needs or enhance physical performance. Iron is also characterized as a potent pro-oxidant, as it can lead to increased production of reactive oxygen and nitrogen species (RONS) that are involved in critical biological processes, such as gene expression, signal transduction and enzyme activity. Nevertheless, the role of iron on modifying redox responses after eccentric exercise has not yet been examined.
In a double blind, randomized cross over study that will be conducted in two cycles, healthy men and boys will receive either the iron supplement (37mg of elemental iron per day for three weeks before and one week after the eccentric exercise) or the placebo.
Blood samples will be collected: a) in adults prior to, at the end of first supplementation period, 24, 48,72 and 96 hours following an acute bout of eccentric exercise (5 sets x 15 max reps), and b) in children prior to, at the end of first supplementation period and 72 hours following the same exercise protocol. Blood drawings will be repeated at the same time points during the second supplementation cycle.
The aims of the present research are to investigate:
- The effect of an acute bout of eccentric exercise on muscle performance, redox status, and iron status.
- The effect of three weeks of iron supplementation on muscle performance, redox status, and iron status.
- The effect of four weeks of iron supplementation on muscle damage, muscle performance, and redox status after an acute eccentric exercise bout.
- The effect of age on muscle damage, muscle performance and redox status after an acute eccentric exercise bout and iron supplementation.
Study design
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Iron supplement | Experimental | Dietary Supplement: Iron supplement Resoferon Ferrous SulfateOral supplementation |
| Control | Placebo comparator | Dietary Supplement: PlaceboOral supplementation |
Who may qualify
- Ages
- 10 to 45 years
- Sex
- Male only
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (3 listed)
- Physiological body mass index (BMI).
- Physiological health profile.
- Subject provides written informed consent.
Key exclusion criteria (4 listed)
- Professional athlete.
- Consumed any nutritional supplement the last 3 months.
- Performed pure eccentric exercise the last 6 months.
- Non Caucasian.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Iron supplement Resoferon Ferrous SulfateOral supplementation with one tablet of iron supplement [Resoferon Ferrous Sulfate 125 (37) mg] | Dietary supplement | Iron supplement |
| Placebo | Dietary supplement | Control |
Primary outcome
Changes in Maximum isometric torque (N.m)
Time frame: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
An isokinetic dynamometer (Cybex, Ronkonkoma, NY) will be used for the estimation of changes in isometric knee extensor's peak torque at 90o knee flexion between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. The average of the three best maximal voluntary contractions with the subjects' one lower extremity will be recorded. To ensure that the subjects provide their maximal effort, the measurements will be repeated if the difference between the lower and the higher torque value exceed 10%. There will be two minutes rest between isometric efforts.
Changes in Maximum concentric torque (N.m)
Time frame: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
An isokinetic dynamometer (Cybex, Ronkonkoma, NY) will be used for the estimation of changes in isokinetic knee extensor's peak torque at 60o/sec angular velocity between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. The higher absolute value of five maximal voluntary contractions with the subjects' one lower extremity will be recorded.
Changes in Maximum eccentric torque (N.m)
Time frame: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
An isokinetic dynamometer (Cybex, Ronkonkoma, NY) will be used for the estimation of changes in isokinetic knee extensor's peak torque at 60o/sec angular velocity between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. The higher absolute value of five maximal voluntary contractions with the subjects' one lower extremity will be recorded.
Changes in Range of motion, ROM (degrees)
Time frame: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
The assessment of changes in pain-free ROM between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise, will be performed manually using the isokinetic dynamometer. The investigator will move the calf at a very low angular velocity from 0 knee extension to the position where the subject will feel any discomfort.
Changes in Delayed onset muscle soreness, DOMS (scale 1-10)
Time frame: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise
Each participant will assess changes in delayed onset of muscle soreness (DOMS) during walking and squat movement (90o knee flexion) and perceived soreness between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise. DOMS and perceived soreness will be rated on a scale ranging from 1 (normal) to 10 (very sore).
Changes in Creatine kinase, CK (activity IU)
Time frame: Before the beginning of iron supplementation (baseline), at the end of the first supplementation period (3 weeks: pre exercise), and 72h after the eccentric exercise
CK activity will be measured as a general indicator of muscle damage. Changes in CK activity between baseline and after 3 weeks of supplementation (pre-eccentric exercise), and also between pre-eccentric exercise and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise will be estimated in a Clinical Chemistry Analyzer Z1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece).
12 secondary outcomes
Changes in Reduced glutathione, GSH (μmol/g Hb)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Oxidized glutathione, GSSG (μmol/g Hb)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Thiobarbituric acid-reactive substances, TBARS (μM)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Protein carbonyls, PC (nmol/mg pr)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Catalase (μmol/min/mg Hb)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Total antioxidant capacity, TAC (mm DPPH)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Uric acid (μm)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Bilirubin (μM)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Iron concentration (mg/dL)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Total Iron Binding Capacity (TIBC) (μmol/L)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Transferin saturation (TS) (%)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Changes in Ferritin (ng/mL)
Time frame: Adults: at baseline, pre-eccentric exercise, 24,48,72 & 96 hours after the eccentric exercise. Children: at baseline, pre-eccentric exercise and 72 hours after the eccentric exercise
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Apr 2015.
- Background: PubMed 21508092Theodorou AA, Nikolaidis MG, Paschalis V, Koutsias S, Panayiotou G, Fatouros IG, Koutedakis Y, Jamurtas AZ. No effect of antioxidant supplementation on muscle performance and blood redox status adaptations to eccentric training. Am J Clin Nutr. 2011 Jun;93(6):1373-83. doi: 10.3945/ajcn.110.009266. Epub 2011 Apr 20.
- Background: PubMed 16923247Gomez-Cabrera MC, Martinez A, Santangelo G, Pallardo FV, Sastre J, Vina J. Oxidative stress in marathon runners: interest of antioxidant supplementation. Br J Nutr. 2006 Aug;96 Suppl 1:S31-3. doi: 10.1079/bjn20061696.
- Derived from this study: PubMed 28203319Deli CK, Fatouros IG, Paschalis V, Tsiokanos A, Georgakouli K, Zalavras A, Avloniti A, Koutedakis Y, Jamurtas AZ. Iron Supplementation Effects on Redox Status following Aseptic Skeletal Muscle Trauma in Adults and Children. Oxid Med Cell Longev. 2017;2017:4120421. doi: 10.1155/2017/4120421. Epub 2017 Jan 22.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Athanasios Z Jamurtas, Dr study chair
University of Thessaly
Questions about this trial
What is this clinical trial studying?
A study testing Iron supplement Resoferon Ferrous Sulfate in people with Muscle Damage and Oxidative Stress, run by University of Thessaly.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Apr 2015. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Changes in Maximum isometric torque (N.m) (time frame: Before the beginning of iron supplementation (baseline) at the end of the first supplementation period (3 weeks: pre-eccentric exercise), immediately after the eccentric exercise, and 24 hours, 48 hours, 72 hours, 96 hours after the eccentric exercise). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02374619, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Apr 2015.