Nationally up to 60 % of persons living with HIV are neither taking antiretroviral therapy (ART) nor well engaged in HIV care, mainly racial/ethnic minorities. This study examined a new culturally targeted multi-component intervention to address emotional, attitudinal, and social/structural barriers to ART initiation and HIV care. Participants (N = 95) were African American/Black and Latino adults with CD4<500 cells/mm3 not taking ART, randomized 1:1 to intervention or control arms, the latter receiving treatment as usual. Primary endpoints were adherence, evaluated via ART concentrations in hair samples, and HIV viral load suppression. The intervention was feasible and acceptable. Eight months post-baseline, intervention participants tended to be more likely to evidence “good” (that is, 7 days/week) adherence (60 vs. 26.7 %; p = 0.087; OR = 3.95), and had lower viral load levels than controls (t(22) = 2.29, p = 0.032; OR = 5.20), both large effect sizes. This highly promising intervention merits further study.

Numerous studies have shown that ingesting carbohydrate in the form of a drink can improve exercise performance by maintaining blood glucose levels and sparing endogenous glycogen stores. The effectiveness of carbohydrate gels or jellybeans in improving endurance performance has not been examined. On 4 separate days and 1-2 hr after a standardized meal, 16 male (8; 35.8 +/- 2.5 yr) and female (8; 32.4 +/- 2.4 yr) athletes cycled at 75% VO(2peak) for 80 min followed by a 10-km time trial. Participants consumed isocaloric (0.6 g of carbohydrate per kg per hour) amounts of randomly assigned sports beans, sports drink, gel, or water only, before, during, and after exercise. Blood glucose concentrations were similar at rest between treatments and decreased significantly during exercise with the water trial only. Blood glucose concentrations for all carbohydrate supplements were significantly, p < .05, higher than water during the 80-min exercise bout and during the time trial (5.7 +/- 0.2 mmol/L for sports beans, 5.6 +/- 0.2 mmol/L for sports drink, 5.7 +/- 0.3 mmol/L for gel, and 4.6 +/- 0.3 mmol/L for water). There were no significant differences in blood glucose between carbohydrate treatments. The 10-km time trials using all 3 carbohydrate treatments were significantly faster (17.2 +/- 0.6 min for sports beans, 17.3 +/- 0.6 min for sports drink, and 17.3 +/- 0.6 min for gel) than water (17.8 +/- 0.7 min). All carbohydrate-supplement types were equally effective in maintaining blood glucose levels during exercise and improving exercise performance compared with water only.

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The premise and promise of ergogenic aid use is rooted in antiquity and is based upon superstition and ritualistic behavior of athletes who perceive that past performances were predicated upon unique dietary constituents or dietary manipulation. Accounts from ancient times recommended that athletes and soldiers preparing for battle consume specific animal parts to confer agility, speed or strength associated with that animal. Scientific understanding of the chemical and physiological nature of muscular work in the early 20th century was followed by ergogenic aid use by athletes and rationalized as "scientific" justification. Ergogenic aids such as alkaline salts, caffeine, carbohydrate and protein have been used by athletes with variable success. As nutritionists and exercise physiologists discovered and perfected the scientific understanding of metabolic reactions, athletes in turn experimented with the amount, form and timing of administration in the search for optimal performance. Anabolic steroids and blood doping enhance athletic performance, but health risks, ethics and sportsmanship contravene their use. Popularity and use of ergogenic aids often have preceded scientific substantiation of claims. Current products such as protein isolates and antioxidant nutrients commonly are used by athletes, and many ergogenic aids available today differ little from those used long ago.

Five-week-old male, Osborne-Mendel rats were fed a control (CON) or high fat diet (HF) (18 and 68% calories as fat, respectively). At 15 weeks of age HF rats weighed more and had a greater percent body fat than CON rats. Half the rats in each diet group were then exercised for 6 weeks on a treadmill. During exercise, food intake was unaffected in both diet groups, while body weight gain was reduced only in HF rats compared to sedentary rats. Exercise lowered fat gain and decreased lipoprotein lipase (LPL) activity in all rats, reduced in vivo lipogenesis in CON rats, and attenuated the development of obesity in HF rats. Following exercise, rats were kept inactive (i.e., detrained) for 2 weeks. Detraining increased food intake, weight gain, fat deposition and LPL activity in comparison to sedentary rats. In CON detrained rats lipogenesis returned to sedentary levels; in all detrained rats retroperitoneal fat cell number increased over that found in exercised rats. Thus, HF feeding induced obesity while exercise attenuated its development. Exercise-induced effects were not long lasting as they were reversed within 2 weeks of exercise termination as evidenced by a rapid increase in food intake, weight gain and lipogenesis.