Despite the abundance of research conducted into the effects of exercise on mucosal immunity the results remain controversial. Much of the inconsistencies arise from the exercise protocols, the participants studied and their nutritional status, as well as methodological and analytical differences. The purpose of this thesis was to examine the influence of some of these factors, and to investigate potential means of enhancing the mucosal immune response to exercise. In study 1 (Chapter 3) it was shown that a fed or fasted state 2 h prior to exercise had no effect on the s-IgA concentration or secretion rate during prolonged exercise. However, when participants were fed during exercise (Chapter 4), the secretion rate of salivary antimicrobial proteins lysozyme and a-amylase increased, but sIgA remained unchanged. These changes were likely due to the activation of mechanical and gustatory receptors leading to a reflex stimulation of protein secretion via the autonomic nerves, rather than changes in stress hOnliones, since cortisol did not change significantly during exercise. Study 3 (Chapter 5) extended these findings where it was demonstrated that chewing flavoured gum during exercise enhanced lysozyme and a-amylase secretion but resulted in a small reduction in s-IgA secretion rate. Salivary antimicrobial proteins are affected by the exercise intensity since both s-IgA and lysozyme secretion rate increased post -exercise following an incremental test to exhaustion, but not after exercise at 50% Y02max. Moreover, lysozyme secretion rate was also elevated following exercise at 75% Y02mru<, whereas s-IgA remained unchanged. These effects are thought to be mediated by increased sympathetic nervous system activity reflected by the concomitant increases in (lamylase and chromogranin A, rather than the hypothalamic-pituitary-adrenal axis. Resting mucosal immunity exhibits significant gender differences. In study 1 (Chapter 3) s-IgA concentration, secretion rate and osmolality were found to be lower in females than in males at rest. In addition, saliva flow rate was found to be lower in females compared with males in study 5 (Chapter 7). However, these differences did not appear to influence the salivary responses to acute exercise or exercise training. Chronic exercise training in elite male and female swimmers resulted in lower levels of s-IgA secretion rate following periods of intense training prior to competition compared with post-competition (Chapter 7), but these levels were not directly associated with reported episodes of respiratory illness.

OBJECTIVES: Despite declining tobacco consumption in the U.S., it remains a public health concern. The aim of this study was to assess the impact of tobacco consumption, different tobacco products and smoking duration on dental caries risk among different populations. METHODS: National Health and Nutrition Examination Survey data were used in an epidemiological cross-sectional study of a representative sample of U.S. civilian non-institutionalized population to investigate the influence of tobacco use and different tobacco products on caries prevalence among adolescents and adults. The outcomes were DMFT and DFT indices. Data from the Dental Longitudinal Study (DLS), a closed-panel prospective cohort study of oral health and aging, was used in longitudinal design to determine if changes in tobacco use status change the risk of developing new caries in adult men. Caries increment was used as an outcome. In addition, a cross-sectional study, using DLS, evaluated the association between smoking duration and caries prevalence, and to determine if it is mediated by unstimulated saliva flow rate. DMFS was used as an outcome. Descriptive and bivariate analyses were conducted on dental caries outcomes by tobacco use status and product consumption. Multiple regression, GEE, and mediation analyses were conducted controlling for confounders. RESULTS: Active tobacco use was significantly associated with dental caries, with the highest caries prevalence compared to passive or non-use among adolescents and adults (P-value <.0001). Among adolescents, passive tobacco users had higher caries prevalence than non-tobacco users. In the DLS, continuous use, quitting and starting/ restarting tobacco use between examinations were all associated with higher caries increments (p-value <0.01). Smoking duration was significantly associated with caries prevalence as long smoking duration (31- 70 years) had on average 14 more DMFS than nonsmokers (p-value= 0.0002) and USFR may partially mediate this relation by about 8.70%. CONCLUSION: Dental caries was significantly associated with active tobacco use among adolescents and adults. Caries prevalence is also high among adolescents passively exposed to tobacco. In adult men, continuous tobacco use was associated with higher caries increments. Long-term smoking was associated with high caries prevalence and this relation could be partially mediated by unstimulated saliva flow rate. / 2019-09-26T00:00:00Z

Prolonged strenuous exercise affects the circulating numbers and functions of immune cells. These effects are thought to be largely mediated by the actions of elevated circulating stress hormones and alterations in regulatory cytokines. Although the effects of a single acute bout of exercise on immune system function are quite well established, it is still not clear how time of day and repeated bouts of prolonged exercise on the same day influence immune function. It is of particular interest to understand the effects of nutritional supplementation on immunoendocrine responses. Therefore, the aims of the studies described in this thesis were to determine the effects of two bouts of prolonged cycling and carbohydrate supplementation on immunoendocrine responses. The saliva collection study showed that the use of a swab for collecting saliva is not an ideal method because it affects the results of saliva composition (Chapter 4). The comparison of the effects of exercise at different times of day on immunoendocrine responses showed that a single bout of prolonged exercise performed in the afternoon induces a larger perturbation in the redistribution of leukocytes into the circulation than an identical bout of morning exercise, which maybe due to higher hypothalamic-pituitaryadrenal (HP A) activation and. circadian rhythms. However, in terms of oral mucosal immunity, performing prolonged cycling at different times of day does not differently affect the salivary responses. The second compared with the first of two bouts of prolonged exercise on the same day induces a greater HP A activation, a larger leukocyte trafficking into the circulation, a decreased neutrophil degranulation response to lipopolysaccharide (LPS) on per cell basis and a lower saliva flow rate, but does not increase plasma interleukin-6 (IL-6), or change saliva immunoglobulin A (slgA) secretion rate (Chapter 5). Furthermore, carbohydrate (CHO) ingestion during any period of two bouts of prolonged exercise shows limited beneficial effect in blunting these higher responses in the second exercise bout compared with the first identical exercise bout on the same day (Chapter 6, 7 and 8). The determination of the effects of CHO ingestion on exercise-induced immunoendocrine responses showed that when two bouts of exercise are performed on the same day, the greater benefit in terms of circulating immunoendocrine responses is obtained by feeding CHO at the earliest opportunity (Chapter 6, 7 and 8). A 3-h interval is insufficient for recovery of leukocyte mobilisation and neutrophil function from the impact of previous exercise whether subjects consumed placebo or CHO during exercise or recovery (Chapter 5, 6, 7 and 8). However, an 18-h interval is sufficient for full recovery of all immunoendocrine variables that were measured in this thesis from the impact of two bouts of prolonged exercise (Chapter 8).

Post-exercise carbohydrate-protein consumption and tapering periods during training periodisation have been proposed as effective recovery strategies in several sports; however, limited attention has been given to judo. Apart from training and recovery, effective competition performance can also be influenced by several stimuli on the competition day, which may be manifested as distinct endocrine responses. The main objective of this thesis was to influence effective competition performance in judo, through examining strategies that can aid recovery from intense exercise/training and examining endocrine responses to competition. Three experimental studies on recovery were completed (chapters 3-5) followed by an observational study on a judo competition day (chapter 6) in elite, national level, male judo athletes. Studies 1 and 2 examined the effects 1000 ml of post-exercise chocolate milk (CM) consumption compared with water (W) following an intense judo training session (chapter 3) and five days of intense judo training with concomitant weight loss (chapter 4) on the recovery of salivary cortisol (sC), salivary testosterone (sT), salivary testosterone:cortisol (sT/C) ratio, salivary secretory IgA (SIgA) absolute concentrations and secretion rate, muscle soreness, mood state and judo-related performance. Study 1 (n=10) did not show any beneficial effects of acute CM consumption on aspects of recovery of any of the measured variables, except for a lower perception of soreness (p<0.05) and a tendency for better push-up performance (p=0.09). Study 2 (n=12) showed that post-exercise CM consumption resulted in significantly lower sC levels, a tendency for higher sT/C ratio (p=0.07), better judo-related performance, lower muscle soreness and reduced mood disturbance (p<0.05) with W. In addition, post-exercise consumption of CM resulted in a 1.1% decrease in body weight, indicating that CM is an effective recovery beverage during periods of intense judo training without affecting intentional weight loss. Study 3 (n=11) examined the effects of a 2-week exponential taper following 2 weeks of intense judo training on recovery of the aforementioned variables. Within 12 days of tapering there were evidence of enhanced performance, lower sC, higher sT and higher sT/C ratio, higher SIgA secretion rate, lower muscle soreness and reduced mood disturbance, indicating that a tapering period of ~10 days is an effective recovery strategy for optimising judo performance. Study 4 observed the responses of sC, sT, SIgA absolute concentrations and SIgA secretion rate and self-measured anxiety state in the winners (n=12) and losers (n=11) of a judo competition. Winners presented significantly higher morning sC levels and higher cognitive anxiety in anticipation of the competition, as well as a tendency for higher SIgA secretion rate (p=0.07) and significantly higher saliva flow rate mid-competition. These findings indicate that winners experienced higher arousal levels and that anticipatory sC might have some predictive value for winning performance in judo. This thesis concludes that nutrition and tapering are both important aspects of effective recovery; CM can be an effective nutritional recovery aid during periods of intense judo training and tapering for 7-12 days can optimise judo performance and can be implemented prior to competitions. In addition, elevated sC levels in anticipation of a judo competition and higher levels of arousal could have some predictive value for winning performance in judo. Further research could focus on strategies to increase levels of arousal in anticipation of competition.