Browsing by Author "Rockwell, John A."
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- Dietary and Biological Assessment of the Omega-3 Status of Collegiate Athletes: A Cross-Sectional AnalysisRitz, Peter P.; Rogers, Mark B.; Zabinsky, Jennifer S.; Hedric, Valisa E.; Rockwell, John A.; Rimef, Ernest G.; Kostelnik, Samantha B.; Hulver, Matthew W.; Rockwell, Michelle S. (PLOS, 2020-04-29)Omega-3 fatty acids (ω-3 FA) are associated with cardiovascular health, brain function, reduction of inflammation, and several other physiological roles of importance to competitive athletes. The ω-3 FA status of National Collegiate Athletic Association (NCAA) Division I athletes has not been well-described. The purpose of this study was to evaluate the ω-3 FA status of NCAA Division I athletes using dietary and biological assessment methodology. Athletes from nine NCAA Division I institutions from throughout the U.S. (n = 1,528, 51% male, 34 sports represented, 19.9 ± 1.4 years of age) completed a food frequency questionnaire (FFQ) to assess ω-3 FA from diet and supplements. Omega-3 Index (O3i) was evaluated in a sub-set of these participants (n = 298, 55% male, 21 sports represented, 20.0 ± 1.3 years of age) using dried blood spot sampling. Only 6% (n = 93) of athletes achieved the Academy of Nutrition & Dietetics’ recommendation to consume 500 mg DHA+EPA per day. Use of ω-3 FA supplements was reported by 15% (n = 229) of participants. O3i was 4.33 ± 0.81%, with no participants meeting the O3i benchmark of 8% associated with the lowest risk of cardiovascular disease. Every additional weekly serving of fish or seafood was associated with an absolute O3i increase of 0.27%. Overall, sub-optimal ω-3 FA status was observed among a large, geographically diverse group of male and female NCAA Division I athletes. These findings may inform interventions aimed at improving ω-3 FA status of collegiate athletes. Further research on athlete-specific ω-3 FA requirements is needed. Introduction
- The Effect of Creatine Supplementation on Muscle Fuel Stores, Body Composition, and Exercise Performance During Energy RestrictionRockwell, John A. (Virginia Tech, 1998-11-09)The purpose of this investigation was to determine the effects of a four day creatine load and simultaneous energy restriction on muscle creatine content, exercise performance, and body composition in 24 male recreational resistance trainers, age 18-26. Sixteen subjects were randomly divided into placebo (Pl, n=8) and creatine supplement (CrS, n=8) groups. Control (C, n=8) subjects of the same age were recruited separately g à d-1 to complete the performance and body composition tests while consuming their normal diet. The CrS group was administered 20 g à d-1 of creatine monohydrate (Cr) mixed with 5 g à d-1 of sucrose, while the Pl group was administered 25 of sucrose. Both CrS and Pl consumed a formula diet of 75.3 kJ (18 kcal) à kg-1 à d-1 for 4 d. Testing before and after energy restriction consisted of a repeated sprint cycle performance test (10 sprints of 6s, with 30s rest), hydrostatic weighing, and resting needle muscle biopsy. Testing revealed that subjects in CrS and Pl demonstrated significant decreases in body weight and % body fat (%BF) with no difference between groups. However, Pl demonstrated a significantly greater % loss in FFM (2.4 ± 0.25%) compared to CrS (1.4 ± 0.4%) (p<0.05). The muscle fuel stores of CrS and Pl responded significantly to the diet. Significant increases in muscle total Cr (p<0.01), free Cr (p<0.01), and CrP (p<0.05) of 16.5%, 16.8%, and 16% respectively were demonstrated by CrS over the energy restriction period, while Pl demonstrated significant decreases of 7.2% and 8.2% respectively in muscle total Cr (p<0.01) and free Cr (p<0.05). There were no significant differences between groups for performance during the cycle test, however, there were trends toward group by time interactions for performance enhancement in CrS relative to Pl, as total work (p=0.078) and work capacity (p=0.058) increased 3.8 ± 2.2% in CrS and decreased 0.5 ± 0.4% in Pl. It was concluded that short-term energy restriction resulted in decreased muscle Cr storage, and that Cr supplementation during energy restriction increased muscle Cr and CrP stores. Consumption of Cr allowed CrS to lose a significantly lower % FFM compared to Pl. Cr supplementation resulted in trends toward improved performance in CrS relative to Pl after energy restriction, but did not influence losses in body weight or %BF.
- Reallocating Cervical Cancer Preventive Service Spending from Low- to High-Value Clinical ScenariosRockwell, Michelle S.; Armbruster, Shannon D.; Capucao, Jillian C.; Russell, Kyle B.; Rockwell, John A.; Perkins, Karen E.; Huffstetler, Alison N.; Mafi, John N.; Fendrick, A. Mark (American Association for Cancer Research, 2023-07-05)Timely follow-up care after an abnormal cervical cancer screening test result is critical to the prevention and early diagnosis of cervical cancer. The current inadequate and inequitable delivery of these potentially life-saving services is attributed to several factors, including patient out-of-pocket costs. Waiving of consumer cost-sharing for follow-up testing (e.g., colposcopy and related cervical services) is likely to improve access and uptake, especially among underserved populations. One approach to defray the incremental costs of providing more generous coverage for follow-up testing is reducing expenditures on "low-value" cervical cancer screening services. To explore the potential fiscal implications of a policy that redirects cervical cancer screening resources from potentially low- to high-value clinical scenarios, we analyzed 2019 claims from the Virginia All-Payer Claims Database to quantify (i) total spending on low-value cervical cancer screening and (ii) out-of-pocket costs associated with colposcopy and related cervical services among commercially insured Virginians. In a cohort of 1,806,921 female patients (ages 48.1 ± 24.8 years), 295,193 claims for cervical cancer screening were reported, 100,567 (34.0%) of which were determined to be low-value ($4,394,361 total; $4,172,777 for payers and $221,584 out-of-pocket [$2/patient]). Claims for 52,369 colposcopy and related cervical services were reported ($40,994,016 total; $33,457,518 for payers and $7,536,498 out-of-pocket [$144/patient]). These findings suggest that reallocating savings incurred from unnecessary spending to fund more generous coverage of necessary follow-up care is a feasible approach to enhancing cervical cancer prevention equity and outcomes. PREVENTION RELEVANCE: Out-of-pocket fees are a barrier to follow-up care after an abnormal cervical cancer screening test. Among commercially insured Virginians, out-of-pocket costs for follow-up services averaged $144/patient; 34% of cervical cancer screenings were classified as low value. Reallocating low-value cervical cancer screening expenditures to enhance coverage for follow-up care can improve screening outcomes. See related Spotlight, p. 363.