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Exercise performance and cardiovascular health variables in 70-year-old male soccer players compared to endurance-trained, strength-trained and untrained age-matched men
Journal of Sports Sciences
Abstract
Abstract The aim was to investigate performance variables and indicators of cardiovascular health profile in elderly soccer players (SP, n = 11) compared to endurance-trained (ET, n = 8), strength-trained (ST, n = 7) and untrained (UT, n = 7) age-matched men. The 33 men aged 65-85 years underwent a testing protocol including measurements of cycle performance, maximal oxygen uptake (VO2max) and body composition, and muscle fibre types and capillarisation were determined from m. vastus lateralis biopsy. In SP, time to exhaustion was longer (16.3 ± 2.0 min; P < 0.01) than in UT (+48%) and ST (+41%), but similar to ET (+1%). Fat percentage was lower (P < 0.05) in SP (-6.5% points) than UT but not ET and ST. Heart rate reserve was higher (P < 0.05) in SP (104 ± 16 bpm) than UT (+21 bpm) and ST (+24 bpm), but similar to ET (+2 bpm), whereas VO2max was not significantly different in SP (30.2 ± 4.9 ml O2 · min(-1) · kg(-1)) compared to UT (+14%) and ST (+9%), but lower (P < 0.05) than ET (-22%). The number of capillaries per fibre was higher (P < 0.05) in SP than UT (53%) and ST (42%) but similar to ET. SP had less type IIx fibres than UT (-12% points). In conclusion, the exercise performance and cardiovascular health profile are markedly better for lifelong trained SP than for age-matched UT controls. Incremental exercise capacity and muscle aerobic capacity of SP are also superior to lifelong ST athletes and comparable to endurance athletes.
... Masters athletes have a later onset of decline in sprint performance, as measured by velocity, decreases in stride length, and increased ground contact time, compared to controls; male and female Masters 100-m race runners experienced this decline around 65 to 70 years old (41). This is congruent with a recent meta-analysis citing Masters athletes having more similar body composition, physical function, and strength to younger, healthy individuals, which may be an example of more healthy or graceful aging (7,42). ...
... Similarly, a recent comparison of 70-year-old soccer players with strength-and endurance-trained controls aged between 65 and 85 years showed that soccer players had many of the same benefits of endurance-trained individuals (42). Using cycle performance as a barometer for performance, athletes had 48% and 41% greater time to exhaustion than untrained controls and strength-trained individuals, respectively, and 1% greater time to exhaustion than endurance-trained individuals (42). ...
... Similarly, a recent comparison of 70-year-old soccer players with strength-and endurance-trained controls aged between 65 and 85 years showed that soccer players had many of the same benefits of endurance-trained individuals (42). Using cycle performance as a barometer for performance, athletes had 48% and 41% greater time to exhaustion than untrained controls and strength-trained individuals, respectively, and 1% greater time to exhaustion than endurance-trained individuals (42). They also had similar improvements in VȮ 2max and heart rate reserve compared to endurance-and strength-trained individuals (42). ...
Exercise leads to robust cardiovascular, musculoskeletal, and psychological benefits that improve quality of life and longevity for older adults, but accompanying improvements in athletic parameters are less well explored. The aim of this review is to summarize some of the most common exercise modalities, namely, Pilates, martial arts (tai chi, Japanese-style karate, hard martial arts), locomotion (brisk walking/jogging and running), Masters sports, resistance training, and high-intensity interval training, in improving athletic performance for older adults. Regular participation in these activities can have robust yet unique impacts on physical performance that prolong exercise participation. In particular, this review will explore benefits in cardiorespiratory fitness, power, strength, flexibility, and balance, thereby hopefully improving endurance, exercise adherence, and overall fall risk. A narrative literature review was performed to explore benefits, pitfalls, and recommendations for some of the most popular exercise modalities for older adults.
... Despite the vast amount of work done in this field, including several reviews and meta-analysis, no reviews have been published on the effect of SSG football training on elderly populations and healthy aging. In this review, the term SSG and recreational football were used, which covers 4v4-6v6 games on small pitches played for 1 h 2-3 times weekly (Elbe et al., 2010;Randers et al., 2014;Bangsbo et al., 2015;Milanović et al., 2015;Krustrup et al., 2018a). ...
... Hybrid-type multicomponent exercise modalities such as SSG football (Elbe et al., 2010;Randers et al., 2014;Bangsbo et al., 2015;Milanović et al., 2015;Krustrup et al., 2018a) are causing broadspectrum adaptation (Batrakoulis et al., 2022) in a safe environment (Barbosa et al., 2020). SSG training induces substantial improvements of both endurance and muscular strength at the same or even greater extent than aerobic or resistance exercise alone (Krustrup et al., 2010a;Randers et al., 2010;Krustrup et al., 2018a), adaptations that may exert an anti-inflammatory effect (Bouassida et al., 2010). ...
... Finally, postural balance and rapid muscle force which are considered to be important factors related to the risk of falls, are both affected positively by football participation (Krustrup et al., 2010b). Several cross-sectional studies comparing lifelong recreational and elite football players with untrained age matched 60-80-year-olds have shown that elderly footballs have an extraordinary good rapid muscle force and postural balance, to a level comparable to 30-year-old untrained men Helge et al., 2014;Randers et al., 2014). Moreover, several RCT intervention studies have shown that the postural balance is markedly improved with 2 times 60 min of football training for 3-12 months for 55-70-year-old women and for 60-80-year-old men (Andersen et al., 2016;Krustrup et al., Frontiers in Aging frontiersin.org ...
In the present topical mini-review, the beneficial impact of small-sided game football training for the increasing elderly global population is presented. As a multicomponent type of physical activity, football training executed on small pitched with 4-6 players in each team is targeting a myriad of physiological systems and causes positive adaptations of relevance for several non-communicable diseases, of which the incidence increases with advancing age. There is strong scientific evidence that this type of football training promotes cardiovascular, metabolic and musculo-skeletal health in elderly individuals. These positive adaptations can prevent cardiovascular disease, type 2 diabetes, sarcopenia and osteoporosis, and lower the risk of falls. Also, football training has been proven an efficient part of the treatment of several patient groups including men with prostate cancer and women after breast cancer. Finally, regular football training has an anti-inflammatory effect and may slow the biological aging. Overall, there is a growing body of evidence suggesting that recreational football training can promote health in the elderly.
... Soccer is an intermittent activity involving various intensities of locomotive movements, ranging from walking to high-speed sprints, imposing considerable demands on the cardiovascular system. 39 Studies suggest that cardiovascular fitness is superior in older soccer players with lifelong soccer participation than for age-matched sedentary individuals [40][41][42] and lifelong strength-trained athletes, 42 and comparable with elderly endurance runners. 42 It is well established that RS has similar high aerobic demands to elite soccer training. ...
... Soccer is an intermittent activity involving various intensities of locomotive movements, ranging from walking to high-speed sprints, imposing considerable demands on the cardiovascular system. 39 Studies suggest that cardiovascular fitness is superior in older soccer players with lifelong soccer participation than for age-matched sedentary individuals [40][41][42] and lifelong strength-trained athletes, 42 and comparable with elderly endurance runners. 42 It is well established that RS has similar high aerobic demands to elite soccer training. ...
... 39 Studies suggest that cardiovascular fitness is superior in older soccer players with lifelong soccer participation than for age-matched sedentary individuals [40][41][42] and lifelong strength-trained athletes, 42 and comparable with elderly endurance runners. 42 It is well established that RS has similar high aerobic demands to elite soccer training. 21 43 Moreover, several reviews and a meta-analysis indicate that short-term to long-term RS training is similar to interval training and superior to continuous running and strength training in improving VO 2max 16 20 21 44 and BP 16 21 44 in untrained, healthy or unhealthy persons. ...
Background
Strategies to prevent or attenuate the age-related decline in physical and physiological function and reduce chronic disease risk factors are of clinical importance.
Objective
To examine the health benefits of recreational soccer in middle-aged and older adults.
Design
Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Data sources
All available records up until 9 June 2017 in PubMed, Web of Science, SPORTDiscus, MEDLINE, Embase, CINAHL Plus, PsycINFO and Cochrane Library databases.
Eligibility criteria for selecting studies
All randomised trials with or without a control group (randomised controlled trials or randomised uncontrolled trials) and non-randomised controlled trials that used recreational soccer, which includes small-sided soccer games, as the sole or principal intervention, and reported relevant effects in untrained/sedentary, healthy or unhealthy adults aged 40 years and above were included.
Results
Five trials described in 13 articles were included, which scored 6–9 out of 12 points on the modified Delphi quality rating scale. The duration was from 12 to 52 weeks, with various frequencies, volumes and game formats performed both outdoors and indoors with men and women. The trials indicate that recreational soccer may result in improvement in cardiovascular function, body composition and functional ability, although no significant changes were observed in postural balance.
Conclusion
Recreational soccer should be considered an alternative exercise modality for untrained, healthy or unhealthy middle-aged and older adults of both sexes to maintain an active lifestyle and mitigate a wide array of physical and physiological age-related changes.
... Similar findings are observed in a group of lifelong football-trained veterans (>40 years of regular football training, 2.3 ± 1.1 h a week plus one match a week) compared to untrained age-matched subjects [73], suggesting a dose-response effect of the exercise. These results are confirmed by Randers et al. [81]: they demonstrated that lifelong football training induces the most positive improvements in terms of exercise capacity (VO2max) and muscle aerobic capacity (type I fibers enrichment and capillarization) compared to lifelong ST group. ...
... Recruited subjects were: lifelong football veterans, VPG: >40 years of regular football training with a total of 2.3 ± 1.1 football training session per week and a match once/week Body composition; heart rate; blood pressure; cardiac and microvascular function, VO2max; fasting blood samplings for metabolic parameterslipid profile and glycemia Lifelong football training induces an improvement in body composition and in CV fitness in VPG compared to untrained CG subjects: VPG shows a better cardiovascular function compared with CG [81] Lifelong trained older subjects (65-85y; n = 33, males) and agematched untrained subjects Controlled crosssectional study Recruited subjects included: lifelong Soccer Players (SP, n = 11); Endurance-Trained (ET, n = 8), Strength-Trained (ST, n = 7) and Untrained (UT, n = 7) age-matched older subjects. All trained subjects were physically active 2-3 times per week during the past 40-50y ...
This narrative review aims to critically analyze the effects of exercise on health in aging. Here we discuss the main clinical and biomolecular modifications induced by long-term recreational football training in older subjects. In particular, the effects induced by long-term recreational football training on cardiovascular, metabolic and musculo-skeletal fitness, together with the modifications in the muscle expression of hallmarks related to oxidative metabolism, DNA repair and senescence suppression pathways and protein quality control mechanisms will be provided. All these topics will be debated also in terms of preventing non-communicable metabolic diseases, in order to achieve successful aging over time.
... Football Fitness may qualify as a sport concept that satisfies the criteria above (7). The concept of using small-sided football games (8), as well as other team sports [see for example (9,10)], has been shown to be highly efficient in promoting healthy aging (11) and quality of life in older adult populations (12). Moreover, several long-term trials have been conducted in populations such as hypertensive women (13), older adult women (14), older adult men with prostate cancer (15)(16)(17), as well as other older adult populations (10), with positive results that demonstrate the strength of the model in relation to sustainability. ...
Background
The proportion of older people increases globally, which calls for sustainable interventions promoting healthy aging. Therefore, we aimed to evaluate the potential of Football Fitness as a sustainable model to promote quality of life, mental health, and physical function for older adult.
Methods
The study was conducted in collaboration with a municipality, a football club, and a university, and was designed as a randomized controlled trial. A total of 66 people (34 women, 32 men) older than 60 years were randomly assigned (60/40) to a Football Fitness (FOT) (n = 38, 20 women, 18 men) and a control group (CON) (n = 28, 14 women, 14 men). FOT participated in Football Fitness for 12 weeks. Quality of life (QoL) and mental wellbeing were determined pre-and post-intervention. Physical loading and Flow experience were measured in one representative training session. Blood pressure (BP), Yo–Yo Intermittent endurance test level 1 (Yo–Yo IE1), sprint performance, postural balance, and body composition were also performed pre-and post-intervention.
Results
An improvement in mental wellbeing was observed for both groups from pre- to post-intervention (p values <0.001) with no between-group differences. Regarding QoL, the environment domain improved in FOT compared to CON (p = 0.02). Mean Flow (M = 5.69; SD = 1.07) and perceived importance (M = 4.20; SD = 1.42) and average experienced difficulty was M = 5.23 (SD = 2.67), perceived skill (M = 5.23; SD = 2.56), and perceived balance (M = 5.64; SD = 1.56). These levels of flow can be characterized as being high. A between-group effect (p = 0.02) existed for systolic BP, which decreased (p < 0.01) by −5% [−8; −1%] in CON and remained unchanged in FOT. Both groups improved the Yo–Yo IE1 to a similar extent, with 28% [11; 44%] (p = 0.001) in FOT and 27% [9; 46%] in CON (p = 0.005). Postural balance improved (p = 0.004) by 38% [13; 63%] in FOT only, resulting in a superior (p = 0.01) balance score in FOT compared to CON post-intervention (p = 0.004).
Conclusion
Football Fitness improved the environmental quality of life domain and postural balance in older adults. Additionally, it appears to be a feasible group activity for older adults that promotes high flow and physical loading during training.
... Randers et al. compared the cardiovascular health and exercise performance among elderly soccer players, endurance athletes, strength-trained athletes and sedentary subjects. The authors concluded that exercise capacity and cardiovascular health were the best in the group of soccer players and endurance athletes [3]. ...
Marathons continue to grow in popularity among amateurs. However, the impact of intensive exercise on the amateur’s cardiovascular system has not yet been studied. Analysis of the influence of the marathon on kinetics of biomarkers reflecting cardiac injury and overload may bring new insights into this issue. We investigated the effect of running a marathon on the concentrations of high sensitivity cardiac troponin I (hs-cTnI), heart-type fatty acid binding protein (H-FABP), N-terminal proatrial natriuretic peptide (NT-proANP), B-type natriuretic peptide (BNP), growth differentiation factor 15 (GDF-15) and galectin 3 (Gal-3) in the population of male amateur runners. The study included 35 amateur marathoners and followed 3 stages: S1—two weeks prior to the marathon, S2—at the finish line and S3—two weeks after. Blood samples were collected at each stage and analyzed for biomarkers and laboratory parameters. Concentrations of all studied biomarkers were significantly higher at S2, whereas at S3 did not differ significantly compared to S1. Running a marathon by an amateur causes an acute rise in biomarkers of cardiac injury and stress. Whether repetitive bouts of intensive exercise elicit long-term adverse cardiovascular effects in amateur marathoners needs further research.
... In support of this, waist circumference was reduced by 4-5 cm in FD-men and FD-women, respectively, with no change in the D groups. The effect of football training on reducing body fat content is well documented in a new metaanalysis ( Milanovic et al. 2018), and cross-sectional studies in elderly football players also show markedly lower body fat content than age-matched sedentary controls ( Randers et al. 2014). Overall, football training appears to be a potent manipulator of body fat content in both men and women. ...
Purpose
Training intensity and health effects of football were investigated gender specifically in individuals with prediabetes.
Methods
Participants with prediabetes (age 60 ± 6 years) were randomised into a football and dietary advice group (FD-men n = 13 and FD-women n = 14) or a dietary advice only group (D-men n = 12 and D-women n = 11). FD performed football training (twice/week for 16 weeks), while both groups received dietary advice. Body composition, bone variables, blood pressure, blood lipid profile and peak oxygen uptake (VO2peak) were determined pre- and post-intervention.
Results
Mean heart rate during football training was 79 ± 2 and 80 ± 3% HRmax for FD-men and FD-women, respectively, with peak heart rate values of 96 ± 1 and 97 ± 2% HRmax, with no gender differences. VO2peak increased more (P < 0.05) in FD-men and FD-women than in D-men and D-women. However, relative delta change in VO2peak was 21 ± 14% in FD-women, which was greater (P < 0.05) than in FD-men (11 ± 12%). Reduction in SBP and DBP, respectively, was similar in FD-men (− 10.8 ± 13.0 and − 7.3 ± 11.8 mmHg) and FD-women (− 11.3 ± 11.0 and − 7.1 ± 6.2 mmHg), with within-gender differences for men. Total plasma cholesterol and LDL cholesterol decreased (P < 0.05) by − 0.7 ± 1.1 and − 0.5 ± 0.9 mmol L⁻¹, respectively, in FD-women and − 0.2 ± 0.4 and − 0.2 ± 0.3 mmol L⁻¹ in FD-men, with no significant gender differences (P = 0.08). Body fat content was lowered (P < 0.05) by 3 and 4%-points in FD-men and FD-women, respectively.
Conclusion
Gender-mixed football training combined with dietary advice causes broad-spectrum health effects for men and women with prediabetes, with minor gender-specific differences. Thus, the intensity and training-induced effects of football training are also high for elderly women with prediabetes.
... 9 In addition, cross-sectional studies in elderly football players show markedly lower body fat content than age-matched sedentary controls. 34 Recently, we demonstrated that 15 weeks of football training in middleaged sedentary hypertensive women upregulated skeletal muscle mitochondrial function and β-oxidative capacity, 9 which is also supported by increased whole-body fat oxidation during exercise after a football training intervention. 8 Thus, it is plausible to suggest that increased muscle fat oxidative capacity contributed to the decrease in body fat content in the football group. ...
We examined the effects of 16 weeks of football training and dietary advice on blood glucose control and health status in 55‐ to 70‐year‐old women and men with prediabetes. Fifty participants with prediabetes (age; 61 ± 6 years, BMI; 29.6 ± 4.7; VO2max 22.3 ± 5.7 mL·min⁻¹·kg⁻¹) were randomized into a football and dietary advice group (F+D; n = 27) and a dietary advice group (D; n = 23). F+D performed football training (twice weekly 30‐ to 60‐minutes sessions) and received dietary advice, while D only received dietary advice. An oral glucose tolerance test (OGTT) was completed pre and post the 16‐week period. Body composition, blood pressure, and maximal oxygen uptake (VO2max) were additionally measured. Both groups demonstrated a decrement (P < .05) in fasting blood glucose (−0.4 ± 0.5 mmol·L⁻¹) and lowered blood glucose throughout OGTT. F+D displayed lower values than D (P < .05) after 60 minutes (9.0 ± 2.7 vs 10.6 ± 2.9 mmol·L⁻¹) and 120 minutes (5.7 ± 1.6 vs 7.5 ± 2.4 mmol·L⁻¹). VO2max increased by 14% in F+D, with a higher (P < .05) change score than in D (2%). Mean arterial pressure declined more (P < .05) in F+D than in D (−8 ± 9 vs −4 ± 11 mm Hg). Fat loss was greater (P < .05) in F+D than in D (−3.4 ± 2.8 vs −1.2 ± 2.0 kg), and the increase in lean body mass was also greater (P < .05) in F+D than in D (0.7 ± 1.5 vs −0.3 ± 1.6 kg). In conclusion, football training combined with dietary advice has broad‐spectrum effects on metabolic and cardiovascular health profile with greater overall effects than professional dietary advice per se for 55‐ to 70‐year‐old women and men with prediabetes.
... Despite its worldwide popularity, it has only been more recently that the health benefits of football have been recognized. Some of these benefits include improved lipid profile, glucose control, body composition and bone health in men, women and children (Faude et al. 2010;Krustrup et al. 2010;Randers et al. 2013Randers et al. , 2011Schmidt et al. 2014;Randers 2014;Helge et al. 2010). In fact, such is its effectiveness that several nationwide initiatives have successfully demonstrated football as a way of reducing obesity levels in men (Hunt et al. 2014;Fløtum et al. 2016). ...
Cite this article as:
Paul, D.J., Bangsbo, J. & Nassis, G.P. Eur J Appl Physiol (2017). https://doi.org/10.1007/s00421-017-3766-y
Introduction
The aim of the present study was to examine the effects of playing football on postprandial lipaemia in normal and overweight individuals.
Methods
Fifteen (7 normal weight, age = 32.3 ± 6.0 years, BMI = 22.8 ± 3.4 kg/m2 and 8 overweight, age = 33.3 ± 5.5 years, BMI = 29.2 ± 3.2 kg/m2, mean ± SD) recreational football players were recruited. On the evening of day 1, participants played a 60-min 9-a-side football match (FOOT) or rested (control; CON) in a randomised counterbalanced cross-over design. Activity profile, heart rate and rate of perceived exertion were recorded. The next morning (> 10 h after the match), blood samples were collected before (0), 0.75, 2, 4, and 6 h after a high-fat meal.
Results
Total area under the curve for triglycerides were 22% and 28% lower for the normal weight (p < 0.01; 95% CI − 2.45 to − 0.68; ES = 0.87) and overweight (p < 0.01; 95% CI − 8.14 to − 0.88; ES = 0.68) groups in the FOOT compared to the CON. The postprandial incremental area under the curve for triglycerides was 31% lower in the normal weight group (ES = 0.79) for the FOOT compared to CON trial and a discernible trend was shown for the overweight group (22%; ES = 0.51). Two-hour Insulin Sensitivity Index was lower (ES = − 0.95) for FOOT compared to CON trial in the overweight group only.
Conclusion
Playing a 60-min football match can attenuate the triglyceride response to a high-fat meal in normal and overweight individuals.
... 9 In addition, cross-sectional studies in elderly football players show markedly lower body fat content than age-matched sedentary controls. 34 Recently, we demonstrated that 15 weeks of football training in middleaged sedentary hypertensive women upregulated skeletal muscle mitochondrial function and β-oxidative capacity, 9 which is also supported by increased whole-body fat oxidation during exercise after a football training intervention. 8 Thus, it is plausible to suggest that increased muscle fat oxidative capacity contributed to the decrease in body fat content in the football group. ...
... Thirty video-film recordings (22 outfield players and 8 goalkeepers) were analyzed to establish match activity profile according to the methods previously described by Póvoas et al. [26]. Outfield players' displacements were coded into eight locomotor categories defined according to Randers et al. [27] and considering handball's specific movements. Locomotor categories and the mean velocity of each category were determined by detailed analysis of match images using court-lines as reference during video replay analysis, as follows: (1) standing still (0 km⋅h −1 ), (2) walking (5 km⋅h −1 ), (3) jogging (10 km⋅h −1 ), (4) fast running (15 km⋅h −1 ), (5) sprinting (21 km⋅h −1 ), (6) backwards movement (5 km⋅h −1 ), (7) sideways medium-intensity movement (5 km⋅h −1 ), and (8) sideways high-intensity movement (14 km⋅h −1 ). ...
Lack of motivation to exercise was reported as a major cause of sedentary behavior in adulthood. This descriptive study examines the acute physical and physiological demands of recreational team handball and evaluates whether it could be suggested as an exercise mode for fitness and health enhancement in 33–55-year-old untrained men. Time-motion, heart rate (HR), and blood lactate analyses were obtained from 4 recreational matches. Mean distance covered during the 60 min matches was m. The players changed match activity times, of which high-intensity runs and unorthodox movements amounted to and per match, respectively. The most frequent highly demanding playing actions were jumps and throws. Match average and peak HR were % and %, respectively. Players exercised at intensities between 81 and 90% for 47% ( min) and >90% for 24% ( min) of total match time. Match average and peak blood lactate values were and mM, respectively. Recreational team handball is an intermittent high-intensity exercise mode with physical and physiological demands in the range of those found to have a positive effect on aerobic, anaerobic, and musculoskeletal fitness in adult individuals. Training studies considering recreational team handball as a health enhancing intervention are warranted.
The sport of hockey has various diversities (e.g. hockey, field hockey; grass hockey). It is a
kind of collective game that has its origins in the Commonwealth and is most well known as a
field hockey. In Bulgaria the game has been developing more intensively since 1991 with the
establishment of a national governing body – the Bulgarian Field Hockey Federation (BFHF).
After 2000 it is one of the most extensively developing sports in the country if gauged in
terms of club network growth, number of youth players, and the establishment of a
sustainable competition structure with national, regional and community championships and
tournaments. The national system of competitions is run by an annual Hockey Competitions
Regulations.
Our study comprises a course of 23 years (1991-2013) that witnessed the conduct of 22
consecutive championships. Models used for the realization of the national hockey
competitions calendar is based on two of the most popular three-cycle system of annual
sporting preparation – ‘autumn-winter-spring’ and ‘winter-spring-autumn’. The former model
is implemented within two calendar years while the latter within one calendar year.
The study traces the impact of different models on the dynamics of a series of independent
indicators: number of competitors across gender and age group, number of participating clubs
and number of planned and conducted championships – rankings, age group and gender.
The analysis of the results shows that the models used by the BFHF, based on two
fundamentally different systems have had a mixed impact on the dynamics of examined
indicators.
In conclusion, it can be said that the dynamics of indicators, although diverse for separate
competition years, reveals a positive trend. The largest growth in studied indicators is
witnessed between 2000 and 2007. After that, with a few exceptions, a period of stagnation
has occurred. This, however, is not due to the newly imposed by the BFHF model of national
competition structure after 2011 when a transition from "fall-winter-spring" to "winter-springfall"
model has been occurring. The peculiar ‘plateau’ that reflects the line of competition
indicators’ dynamics serve to conclude that quantity development has probably been
The purpose of this research was to conduct a systematic review of published articles related to the effect of recreational football on non‐communicable diseases.
A systematic review of Web of Science, SPORTDiscus, MEDLINE, and PubMed databases was performed according to PRISMA guidelines. Only empirical studies were included. There were no restrictions on the types of study design eligible for inclusion. The primary outcome measures result from the potential effects of recreational football on non‐communicable diseases (eg, blood pressure, bone density, LDL cholesterol, and fat mass).
A total of 44 articles met the inclusion criteria and were included. Recreational football is shown to: (a) decrease blood pressure and resting heart rate, improve cardiac structure and functioning, as well as increase maximal oxygen uptake in both sexes; (b) reduce cholesterol and triglycerides levels, increase insulin sensitivity, and have a positive impact on glycemic control; (c) improve bone mineralization, increase both bone mineral density and content, as well as acting as a stimulus for osteogenesis; and (d) be clearly beneficial for bone health, while slightly beneficial for body composition, muscle strength, and maximal oxygen uptake in adults with prostate cancer.
The present systematic review demonstrated the benefits of recreational football practice on non‐communicable diseases related to cardiovascular and bone health, body composition, type 2 diabetes, and prostate cancer. The effectiveness of recreational football on the aforementioned diseases may be related to age and gender; however, further research is required.
This report provides a systematic review of empirical studies examining economic inputs and outputs/outcomes of participation in physical education, physical activity, and sport (summarised under ‘physical activity’). The reviewed studies have been evaluated based on different levels of evidence-based research.
Only a few studies have related economic inputs directly to economic outputs. Those who did identified a positive benefit/cost ratio indicating that economic investments in physical activity generated a positive return on investment. The majority of studies have either looked at the effect of different types of public investments on participation in physical activity or on (non)monetary outputs/outcomes of physical activity.
Starting with economic inputs and public investments, respectively, countries with higher government spending on sport, health, and education are more likely to have higher participation rates. The evidence is mixed when looking at the regional level, probably because regions within one country are more homogeneous. Public investments in an activity friendly neighbourhood are positively related with participation in physical activity. Also, the supply of sport infrastructure and facilities, specifically swimming pools, in close proximity to the residents’ home significantly increases the population’s likelihood of being physically active.
Moreover, both community and school campaigns can also be considered an effective policy tool for increasing participation rates; however, it has not yet been examined whether such participation is sustainable. Elite sport which is financially supported by the federal government in many countries can have an inspirational function for the population, i.e., sporting success, athletes as role models, and hosting major sport events can inspire people to participate themselves. Yet, the empirical evidence is not consistent; some studies documented a significant positive effect of elite sport, while others were not able to identify a measurable inspirational effect.
Previous research has examined non-monetary outputs and outcomes of physical activity with the majority of studies looking at physical health outcomes. Most studies document a positive effect of physical activity on subjective health (i.e., how individuals perceive their health status) and various health parameters. Specifically, physical activity is associated with a reduced incidence of cancer, diabetes, cardiovascular diseases, and osteoporosis. Moreover, physical activity contributes positively to subjective well-being e.g., self-reported life satisfaction or happiness) and reduces mental health problems (e.g., depression, anxiety disorders) significantly. It can also assist in reducing post-traumatic disorders resulting from military services, natural disasters, and severe diseases.
Participation in physical activity programmes was also found to be beneficial for the integration and social inclusion of ethnic minorities and immigrants as well as for the development of social capital (e.g., social networks, friends, trust). Additionally, research shows that physical activity has a positive impact on educational outcomes (e.g., grades) of pupils and students. Similarly, physical activity is beneficial for labour market outcomes: physically active people utilise health care at work to a lesser extent, are more likely to exit from unemployment, and are less absent from work.
Some studies estimated the monetary return of participation in physical activity to the individual or to the community. On the individual level, research showed that physcially active people tend to earn higher incomes and have lower medical costs. On the community level, previous research focused on the estimation of the economic costs of inactivity and documented that the economic costs of inactivity are substantial, with indirect costs (i.e., productivity losses) typically exceeding the direct costs (i.e., health care costs). Sport-related injuries have largely been excluded from such analyses.
To provide a large reference material on aerobic fitness and exercise physiology data in a healthy population of Norwegian men and women aged 20-90 years.
Maximal and sub maximal levels of VO2, heart rate, oxygen pulse, and rating of perceived exertion (Borg scale: 6-20) were measured in 1929 men and 1881 women during treadmill running.
The highest VO2max and maximal heart rate among men and women were observed in the youngest age group (20-29 years) and was 54.4±8.4 mL·kg(-1)·min(-1) and 43.0±7.7 mL·kg(-1)·min(-1) (sex differences, p<0.001) and 196±10 beats·min(-1) and 194±9 beats·min(-1) (sex differences, p<0.05), respectively, with a subsequent reduction of approximately 3.5 mL·kg(-1)·min(-1) and 6 beats·min(-1) per decade. The highest oxygen pulses were observed in the 3 youngest age groups (20-29 years, 30-39 years, 40-49 years) among men and women; 22.3 mL·beat(-1)±3.6 and 14.7 mL·beat(-1)±2.7 (sex differences, p<0.001), respectively, with no significant difference between these age groups. After the age of 50 we observed an 8% reduction per decade among both sexes. Borg scores appear to give a good estimate of the relative exercise intensity, although observing a slightly different relationship than reported in previous reference material from small populations.
This is the largest European reference material of objectively measured parameters of aerobic fitness and exercise-physiology in healthy men and women aged 20-90 years, forming the basis for an easily accessible, valid and understandable tool for improved training prescription in healthy men and women.
We examined whole body aerobic capacity and myocellular markers of oxidative metabolism in lifelong endurance athletes (n=9, 81±1 y, 68±3 kg, BMI=23±1 kg/m(2)) and age-matched, healthy, untrained men (n=6; 82±1 y, 77±5 kg, BMI=26±1 kg/m(2)). The endurance athletes were cross-country skiers, including a former Olympic champion and several national/regional champions, with a history of aerobic exercise and participation in endurance events throughout their lives. Each subject performed a maximal cycle test to assess aerobic capacity (VO(2)max). Subjects had a resting vastus lateralis muscle biopsy to assess oxidative enzymes (citrate synthase and βHAD) and molecular (mRNA) targets associated with mitochondrial biogenesis (PGC-1α and Tfam). The octogenarian athletes had a higher (P<0.05) absolute (2.6±0.1 vs. 1.6±0.1 L•min(-1)) and relative (38±1 vs. 21±1 ml•kg(-1)•min(-1)) VO(2)max, ventilation (79±3 vs. 64±7 L•min(-1)), heart rate (160±5 vs. 146±8 b•min(-1)), and final workload (182±4 vs. 131±14 watts). Skeletal muscle oxidative enzymes were 54% (citrate synthase) and 42% (βHAD) higher (P<0.05) in the octogenarian athletes. Likewise, basal PGC-1α and Tfam mRNA were 135% and 80% greater (P<0.05) in the octogenarian athletes. To our knowledge, the VO(2)max of the lifelong endurance athletes is the highest recorded in humans >80 y of age and comparable to non-endurance trained men 40 years younger. The superior cardiovascular and skeletal muscle health profile of the octogenarian athletes provides a large functional reserve above the aerobic frailty threshold and is associated with lower risk for disability and mortality.
The aims of this study were to (1) determine the reproducibility of sub-maximal and maximal versions of the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2 test), (2) assess the relationship between the Yo-Yo IE2 test and match performance and (3) quantify the sensitivity of the Yo-Yo IE2 test to detect test-retest changes and discriminate between performance for different playing standards and positions in elite soccer. Elite (n = 148) and sub-elite male (n = 14) soccer players carried out the Yo-Yo IE2 test on several occasions over consecutive seasons. Test-retest coefficient of variation (CV) in Yo-Yo IE2 test performance and heart rate after 6 min were 3.9% (n = 37) and 1.4% (n = 32), respectively. Elite male senior and youth U19 players Yo-Yo IE2 performances were better (P < 0.01) than elite youth U16s and sub-elite players (2,603 ± 451 and 2,534 ± 549 vs. 1,855 ± 535 vs. 1,749 ± 382 m). The intra- and inter-season CV for Yo-Yo IE2 test performance were 4.2 and 5.6%, respectively. A correlation was observed (P < 0.05) between Yo-Yo IE2 test performance and the total (r = 0.74) and high-intensity (r = 0.58) running distance covered in a match. A correlation was also evident (P < 0.01) between Yo-Yo IE2 test heart rate after 6 min expressed in percentage of maximal heart rate and the peak values for high-intensity running performed by midfielders in 5-min (r = -0.71), 15-min (r = -0.75) and 45-min periods (r = -0.77). The present data demonstrate that the Yo-Yo IE2 test is reproducible and can be used to determine the capacity of elite soccer players to perform intense intermittent exercise. Furthermore, the Yo-Yo IE2 test was shown to be a sensitive tool that not only relates to match performance but can also differentiate between intermittent exercise performance of players in various standards, stages of the season and playing positions.
The purpose was to conduct systematic reviews of the relationship between physical activity of healthy community-dwelling older (>65 years) adults and outcomes of functional limitations, disability, or loss of independence.
Prospective cohort studies with an outcome related to functional independence or to cognitive function were searched, as well as exercise training interventions that reported a functional outcome. Electronic database search strategies were used to identify citations which were screened (title and abstract) for inclusion. Included articles were reviewed to complete standardized data extraction tables, and assess study quality. An established system of assessing the level and grade of evidence for recommendations was employed.
Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence, and 34 were included with a cognitive function outcome. Greater physical activity of an aerobic nature (categorized by a variety of methods) was associated with higher functional status (expressed by a host of outcome measures) in older age. For functional independence, moderate (and high) levels of physical activity appeared effective in conferring a reduced risk (odds ratio ~0.5) of functional limitations or disability. Limitation in higher level performance outcomes was reduced (odds ratio ~0.5) with vigorous (or high) activity with an apparent dose-response of moderate through to high activity. Exercise training interventions (including aerobic and resistance) of older adults showed improvement in physiological and functional measures, and suggestion of longer-term reduction in incidence of mobility disability. A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia; however, there were mixed results of the effects of exercise interventions on cognitive function indices.
There is a consistency of findings across studies and a range of outcome measures related to functional independence; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age. Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult, it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes.
The present study investigated whether football has favorable effects in the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men. Twenty-five untrained males aged 31-54 year with mild-to-moderate hypertension were randomized to a football training group (FTG, two 1-h sessions per week) and a control group receiving physician-guided traditional recommendations on cardiovascular risk factor modification (doctoral advice group, DAG). After 3 months, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lowered (P<0.05) by 12 +/- 3 and 7 +/- 1 mmHg in FTG, respectively, whereas no significant changes were observed for DAG, with the 3 months values being lower (P<0.05) in FTG than DAG (SBP: 138 +/- 2 vs 148 +/- 2 mmHg; DBP: 84 +/- 2 vs 92 +/- 2 mmHg). The resting heart rate was lowered (P<0.05) by 12 +/- 2 b.p.m. in FTG after 3 months (67 +/- 3 vs 79 +/- 3 b.p.m.), whereas no change was observed for DAG. After 3 months, FTG had higher (P<0.05) VO(2max) (8 +/- 2%; 35.0 +/- 1.6 vs 32.5 +/- 1.3 mL/min/kg) and lower (P<0.05) fat mass (1.7 +/- 0.6 kg), whereas no change was observed for DAG. In conclusion, football training is an attractive non-pharmacological supplement to the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men.
The purpose of this study was to determine the effectiveness of brief intense interval training as exercise intervention for promoting health and to evaluate potential benefits about common interventions, that is, prolonged exercise and strength training.
Thirty-six untrained men were divided into groups that completed 12 wk of intense interval running (INT; total training time 40 min wk(-1)), prolonged running (approximately 150 min wk(-1)), and strength training (approximately 150 min wk(-1)) or continued their habitual lifestyle without participation in physical training.
The improvement in cardiorespiratory fitness was superior in the INT (14% +/- 2% increase in V˙O2max) compared with the other two exercise interventions (7% +/- 2% and 3% +/- 2% increases). The blood glucose concentration 2 h after oral ingestion of 75 g of glucose was lowered to a similar extent after training in the INT (from 6.1 +/- 0.6 to 5.1 +/- 0.4 mM, P < 0.05) and the prolonged running group (from 5.6 +/- 1.5 to 4.9 +/- 1.1 mM, P < 0.05). In contrast, INT was less efficient than prolonged running for lowering the subjects' resting HR, fat percentage, and reducing the ratio between total and HDL plasma cholesterol. Furthermore, total bone mass and lean body mass remained unchanged in the INT group, whereas both these parameters were increased by the strength-training intervention.
INT for 12 wk is an effective training stimulus for improvement of cardiorespiratory fitness and glucose tolerance, but in relation to the treatment of hyperlipidemia and obesity, it is less effective than prolonged training. Furthermore and in contrast to strength training, 12 wk of INT had no impact on muscle mass or indices of skeletal health.
A study of a sample provides only an estimate of the true (population) value of an outcome statistic. A report of the study therefore usually includes an inference about the true value. Traditionally, a researcher makes an inference by declaring the value of the statistic statistically significant or nonsignificant on the basis of a P value derived from a null-hypothesis test. This approach is confusing and can be misleading, depending on the magnitude of the statistic, error of measurement, and sample size. The authors use a more intuitive and practical approach based directly on uncertainty in the true value of the statistic. First they express the uncertainty as confidence limits, which define the likely range of the true value. They then deal with the real-world relevance of this uncertainty by taking into account values of the statistic that are substantial in some positive and negative sense, such as beneficial or harmful. If the likely range overlaps substantially positive and negative values, they infer that the outcome is unclear; otherwise, they infer that the true value has the magnitude of the observed value: substantially positive, trivial, or substantially negative. They refine this crude inference by stating qualitatively the likelihood that the true value will have the observed magnitude (eg, very likely beneficial). Quantitative or qualitative probabilities that the true value has the other 2 magnitudes or more finely graded magnitudes (such as trivial, small, moderate, and large) can also be estimated to guide a decision about the utility of the outcome.
Abdominal obesity is an established risk factor for cardiovascular disease (CVD). However, the correlation of dual-energy x-ray absorptiometry (DEXA) measurements of regional fat mass with CVD risk factors has not been completely investigated.
The aim of this study was to investigate the association of estimated regional fat mass, measured with DEXA and CVD risk factors.
This was a cross-sectional study of 175 men and 417 women. DEXA measurements of regional fat mass were performed on all subjects, who subsequently participated in a community intervention program.
Outcome measures included impaired glucose tolerance, hypercholesterolemia, hypertriglyceridemia, and hypertension.
We began by assessing the associations of the adipose measures with the cardiovascular outcomes. After adjustment for confounders, a sd unit increase in abdominal fat mass was the strongest predictor of most cardiovascular variables in men [odds ratio (OR)=2.63-3.37; P<0.05], whereas the ratio of abdominal to gynoid fat mass was the strongest predictor in women (OR=1.48-2.19; P<0.05). Gynoid fat mass was positively associated with impaired glucose tolerance, hypertriglyceridemia, and hypertension in men (OR=2.07-2.15; P<0.05), whereas the ratio of gynoid to total fat mass showed a negative association with hypertriglyceridemia and hypertension (OR=0.42-0.62; P<0.005).
Abdominal fat mass is strongly independently associated with CVD risk factors in the present study. In contrast, gynoid fat mass was positively associated, whereas the ratio of gynoid to total fat mass was negatively associated with risk factors for CVD.
Sixteen highly trained masters endurance athletes, 59 +/- 6 yr, were compared with 16 young athletes, with whom they were matched on the basis of their training regimens, and with 18 untrained middle-aged men. On echocardiographic evaluation, both groups of athletes had a significantly greater left ventricular volume and mass than the untrained men; their were no significant differences in percent fiber shortening or velocity of fiber shortening among the three groups. Maximum O2 uptake (VO2max) averaged 15% less in the masters than in the young athletes (58.7 vs. 69 ml.kg-1.min-1). When expressed in terms of lean body mass to correct for differences in body fat content, VO2max of the masters athletes was about 60% higher than that of the middle-aged untrained men. Maximum heart rate was 14% lower in the masters athletes than in the young athletes (169 vs. 197 beats/min). The O2 pulse during maximum exercise (i.e., VO2max/heart rate at VO2max) was identical in the masters and young athletes. This finding suggests that the major factor responsible for the lower VO2max of the masters athletes, compared with the young athletes, is their slower heart rate.
The purpose was to determine the aerobic power (maximal oxygen uptake) and body composition of older track athletes after a 20-yr follow-up (T3). At 20 yr, 21 subjects [mean ages: 50.5 +/- 8.5 yr at initial evaluation (T1), 60.2 +/- 8.8 yr at 10-yr follow-up (T2), and 70.4 +/- 8.8 yr at 20-yr follow-up (T3)] were divided into three intensity groups: high (H; remained elite; n = 9); moderate (M; continued frequent moderate-to-rigorous endurance training; n = 10); and low (L; greatly reduced training; n = 2). All groups decreased in maximal oxygen uptake at each testing point (H, 8 and 15%; M, 13 and 14%; and L, 18 and 34% from T1 to T2 and T2 to T3, respectively). Maximal heart rate showed a linear decrease of approximately 5-7 beats.min-1.decade-1 and was independent of training status. Body weight remained stable for the H and M groups and percent fat increased approximately 2-2.5%/decade. Although fat-free weight decreased at each testing point, there was a trend for those who began weight-training exercise to better maintain it. Cross-sectional analysis at T3 showed that leg strength and bone mineral density were generally maintained from age 60 to 89 yr. Those who performed weight training had a greater arm region bone mineral density than those who did not. These longitudinal data show that the physiological capacities of older athletes are reduced despite continued vigorous endurance exercise over a 20-yr period (approximately 8-15%/decade). Changes in body composition appeared to be less than those shown for the healthy sedentary population and were related to changes in training habits.
This study determined the relationship between aerobic power (VO2max), physical activity (PA), and cardiovascular disease (CVD) risk factors. The study also determined how increased VO2max and increased PA levels influence CVD risk factors of 576 low-fit adults (VO2max < 30 mL.kg-1.min-1).
PA (Baeke questionnaire) and VO2max (submaximal cycle test) of 1664 law enforcement trainees were evaluated with respect to the CVD risk factors of total cholesterol, blood pressure (BP) [BP], smoking, and obesity using separate logistic regression, adjusting for age, gender, and the other major CVD risk factors.
Compared with the lowest tertile of VO2max, the highest tertile had a reduced relative risk (RR) for elevated cholesterol (RR, 0.56; CI, 0.36-0.43), BP (RR, 0.32; CI, 0.15-0.62) and obesity (RR, 0.09; CI, 0.06-0.12). The middle tertile of VO2max compared with the lowest had reduced RR for elevated diastolic BP (RR, 0.44; CI, 0.23-0.66) and obesity (RR: 0.38; CI 0.28-0.50). High PA tertile, compared with low PA tertile, only had lower RR for high systolic BP (RR, 0.48; CI, 0.23-0.95). Compared with the low PA tertile, moderate or high PA had no reduction in any of the RR (P > 0.05). Participation in a 9-wk exercise program by low-fit individuals resulted in a 9% increase in PA levels (P < 0.02); however, only those subjects who increased VO2max (> 3 mL.kg-1.min-1; N = 345) had a reduction in RR for high cholesterol (RR: 0.62; CI 0.42-0.92) and systolic BP (RR: 0.57; CI 0.40-0.80). No reduction in RR were noted for diastolic BP or obesity.
Aerobic power appears to have more of an influence on CVD risk factors than PA levels. Further, in low-fit persons, it appears that PA resulting in an increased aerobic power is associated with a reduction in CVD risk factors of cholesterol and BP in as little as 9 wk.
Background: Changes in body composition in men and women occur with age, but these changes are affected by numerous covariate factors.
Objective: The study examined patterns of change in body composition and determined the effects of long-term patterns of change in physical activity in older men and women and in menopausal status and estrogen use in women.
Design: Serial measures of height, weight, body mass index (BMI), total body fat (BF), percentage BF, and fat-free mass (FFM) from underwater weighing of 102 men and 108 women enrolled in the Fels Longitudinal Study were analyzed. Physical activity levels and menopausal status were included as covariates.
Results: There were significant age-related decreases in FFM and height and increases in total BF, percentage BF, weight, and BMI. Physical activity was associated with decreases in total BF, percentage BF, weight, and BMI in men and were associated with increases in FFM and decreases in total BF and percentage BF in women. Postmenopausal women had significantly higher total BF and percentage BF than did pre- and perimenopausal women. The longer the time since menopause the greater were the increases in weight, BMI, total BF, and percentage BF; however, estrogen use attenuated these increases.
Conclusions: Low FFM can be improved by increased physical activity. The effects of an intervention program on body composition can be masked if only body weight or BMI is measured. The effects of physical activity were more profound in postmenopausal than in premenopausal women, and estrogen use had beneficial effects on body composition.
The age-specific relevance of blood pressure to cause-specific mortality is best assessed by collaborative meta-analysis of individual participant data from the separate prospective studies. Methods Information was obtained on each of one million adults with no previous vascular disease recorded at baseline in 61 prospective observational studies of blood pressure and mortality. During 12.7 million person-years at risk, there were about 56 000 vascular deaths (12 000 stroke, 34000 ischaemic heart disease [IHD], 10000 other vascular) and 66 000 other deaths at ages 40-89 years. Meta-analyses, involving "time-dependent" correction for regression dilution, related mortality during each decade of age at death to the estimated usual blood pressure at the start of that decade. Findings Within each decade of age at death, the proportional difference in the risk of vascular death associated with a given absolute difference in usual blood pressure is about the same down to at least 115 mm Hg usual systolic blood pressure (SBP) and 75 mm Hg usual diastolic blood pressure (DBP), below which there is little evidence. At ages 40-69 years, each difference of 20 mm Hg usual SBP (or, approximately equivalently, 10 mm Hg usual DBP) is associated with more than a twofold difference in the stroke death rate, and with twofold differences in the death rates from IHD and from other vascular causes. All of these proportional differences in vascular mortality are about half as extreme at ages 80-89 years as at,ages 40-49 years, but the annual absolute differences in risk are greater in old age. The age-specific associations are similar for men and women, and for cerebral haemorrhage and cerebral ischaemia. For predicting vascular mortality from a single blood pressure measurement, the average of SBP and DBP is slightly more informative than either alone, and pulse pressure is much less informative. Interpretation Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.
Methods are described whereby very small amounts of alkali and other
metals may be accurately assayed in minute tissue samples by submitting them to a
neutron flux and, after suitable decay periods, measuring certain isotopes so
formed. (BBB)
Objective.
—To quantify the relation of cardiorespiratory fitness to cardiovascular disease (CVD) mortality and to all-cause mortality within strata of other personal characteristics that predispose to early mortality.
The aim of this study was to evaluate the application of the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2) to elite female soccer populations. Elite senior (n = 92), youth (n = 42), domestic (n = 46) and sub-elite female soccer players (n = 19) carried out the Yo-Yo IE2 test on numerous occasions across the season. Test-retest coefficient of variation (CV) in Yo-Yo IE2 test performance in domestic female players was 4.5%. Elite senior female players' Yo-Yo IE2 test performances were better (P < 0.01) than elite youth, domestic and sub-elite players (mean ± standard deviation; 1774 ± 532 vs 1490 ± 447, 1261 ± 449, and 994 ± 373 m). For elite senior female players, wide midfielders (2057 ± 550 m) had a higher Yo-Yo IE2 test performance (P < 0.05) than central defenders (1588 ± 534 m) and attackers (1516 ± 401 m), but not central midfielders (1764 ± 473 m) or full-backs (1964 ± 522 m). Large correlations were observed between Yo-Yo IE2 test performance and the total and high-intensity distance covered (r = 0.55; P < 0.05) during elite senior soccer matches (r = 0.70; P < 0.01). A large correlation was also obtained between Yo-Yo IE2 test performance and (r = 0.68; P < 0.01). Performances in the Yo-Yo IE2 test were greater (P < 0.05) in the middle and the end of the season compared with the preparation period for elite youth female players (1767 ± 539 and 1742 ± 503 vs 1564 ± 504 m) and in elite senior female players, Yo-Yo IE2 test performance increased by 14% (P < 0.01) after completing 4 weeks of intense training prior to the FIFA Women's World Cup Finals (2049 ± 283 vs 1803 ± 342 m). The data demonstrate that the Yo-Yo IE2 test is reproducible and is an indicator of the match-specific physical capacity of female soccer players. Furthermore, the Yo-Yo IE2 test illustrates sensitivity by differentiating intermittent exercise performance of female players in various competitive levels, stages of the season and playing positions.
This manuscript presents a brief summary of the substantial data supporting an inverse relationship between the amount of habitual physical activity performed and a variety of negative health outcomes throughout the lifespan. It points out that despite these data a large segment of the US population remain insufficiently active resulting in a high population attributable risk for chronic disease due to inactivity. The accumulated data support the need for more comprehensive health promoting physical activity policies and programs, especially for the economically and socially disadvantaged and medically underserved.
This study examined the effect of 12 weeks of small-sided street soccer (2.2 ± 0.7 sessions/week) and fitness center training (0.5 ± 0.2 sessions/week) on physical fitness and cardiovascular health profile for homeless men. Exercise capacity, maximal oxygen uptake (VO(2max)), body composition (DXA scans), blood pressure (BP), and blood lipid profile were determined before and after the intervention period for 22 soccer-group subjects (SG) and 10 waiting list controls (CO). In addition, time-motion analyses, HR measurements, and pedometer recordings were performed during street soccer training and daily-life activities. During a 60 min 4 versus 4 street soccer session 182 ± 62 intense running bouts were performed; mean HR was 82 ± 4% HR(max) and HR was >90% HR(max) for 21 ± 12% (±SD) of total time. On a day without training the participants performed 10,733 ± 4,341 steps and HR was >80% HR(max) for 2.4 ± 4.3 min. In SG, VO(2max) was elevated (p < 0.05) from 36.7 ± 7.6 to 40.6 ± 8.6 ml/min/kg after 12 weeks and incremental cycle test performance was improved (p < 0.05) by 81 s (95% CI: 47-128 s). After 12 weeks, fat percentage (19.4 ± 8.5 to 17.5 ± 8.6%) and LDL cholesterol (3.2 ± 1.1 to 2.8 ± 0.8 mmol L(-1)) were lowered (p < 0.05) in SG. The observed changes in SG were different (p < 0.05) from CO and no intra-group changes occurred for CO (p > 0.05). BP was unaltered after 12 weeks (p > 0.05), but diastolic BP was lowered for all SG subjects with pre-values >75 mmHg (83 ± 6 to 76 ± 6 mmHg, n = 8, p < 0.05). In conclusion, the exercise intensity is high during street soccer and regular street soccer training can be used as an effective activity to promote physical fitness and cardiovascular health status for homeless men.
Top-level training is associated with morphological and functional changes in the heart. Left atrial (LA) enlargement can be regarded as a physiologic adaptation to exercise conditioning. Athletes show an improvement in myocardial diastolic properties and supernormal left ventricular (LV) diastolic function. The aims of the study were to assess diastolic function by pulsed Doppler tissue imaging (DTI) and to analyze the role of LA in athletes by speckle tracking echocardiography (STE).
Twenty-three male elite soccer players underwent a complete echocardiographic analysis. Twenty-six age-matched healthy sedentary men were used as controls. Measured variables included LA indexed volumes, DTI of the LV, peak atrial longitudinal strain, and peak atrial contraction strain (PACS).
LA areas and indexed volumes were significantly higher in athletes (P < 0.001). Athletes had a higher peak E velocity (P < 0.001), a lower A peak (P < 0.01), and a higher peak E/A ratio (P < 0.0001); a higher Em peak (P < 0.001), a lower Am peak (P < 0.01), and a higher Em/Am ratio (P < 0.0001). Global PACS was lower in athletes compared with controls (P < 0.0001) and strongly correlated with mitral Am (r = 0.55; P < 0.0001), mitral Em (r =-0.41; P < 0.001), heart rate (r =-0.38; P < 0.01), and LA area (r = 0.18; P < 0.05).
Athletes showed a shift in the pattern of ventricular filling period toward early diastole as seen through DTI analysis of the diastolic properties of LV and STE analysis of LA function. DTI is a useful tool to analyze the improved myocardial diastolic properties of athletes and STE may elucidate the role of LA in the context of athlete's heart remodeling.
Many studies suggest that cardiorespiratory fitness, measured as peak oxygen uptake (VO2peak), may be the single best predictor of cardiovascular morbidity and premature cardiovascular mortality. However, current reference values are either estimates of oxygen uptake or come from small studies, mainly of men. Therefore, the aims of this study were to directly measure VO2peak in healthy adult men and women and to assess the association with cardiovascular risk factor levels.
A cross-sectional study of 4631 volunteering, free-living Norwegian men (n = 2368) and women (n = 2263) age 20-90 yr. The data collection was from June 2007 to June 2008. Participants were free from known pulmonary or cardiovascular disease. VO2peak was measured by ergospirometry during treadmill running. Associations (odds ratios, OR) with unfavorable levels of cardiovascular risk factors and a cluster of cardiovascular risk factors were assessed by logistic regression analysis.
Overall, mean VO2peak was 40.0 ± 9.5 mL·kg(-1)·min(-1). Women below the median VO2peak (<35.1 mL·kg(-1)·min(-1)) were five times (OR = 5.4, 95% confidence interval = 2.3-12.9) and men below the median (<44.2 mL·kg(-1)·min(-1)) were eight times (OR = 7.9, 95% confidence interval = 3.5-18.0) more likely to have a cluster of cardiovascular risk factors compared to those in the highest quartile of VO2peak (≥40.8 and ≥50.5 mL·kg(-1)·min(-1) in women and men, respectively). Each 5-mL·kg(-1)·min(-1) lower VO2peak corresponded to ∼56% higher odds of cardiovascular risk factor clustering.
These data represent the largest reference material of objectively measured VO2peak in healthy men and women age 20-90 yr. Even in people considered to be fit, VO2peak was clearly associated with levels of conventional cardiovascular risk factors.
This review summarizes the current literature and the open questions regarding the physiology and pathophysiology of the mechanical effects of heart rate on the vessel wall and the associated molecular signaling that may have implications for patient care. Epidemiological evidence shows that resting heart rate is associated with cardiovascular morbidity and mortality in the general population and in patients with cardiovascular disease. As a consequence, increased resting heart rate has emerged as an independent risk factor both in primary prevention and in patients with hypertension, coronary artery disease, and myocardial infarction. Experimental and clinical data suggest that sustained elevation of heart rate-independent of the underlying trigger-contributes to the pathogenesis of vascular disease. In animal studies, accelerated heart rate is associated with cellular signaling events leading to vascular oxidative stress, endothelial dysfunction, and acceleration of atherogenesis. The underlying mechanisms are only partially understood and appear to involve alterations of mechanic properties such as reduction of vascular compliance. Clinical studies reported a positive correlation between increased resting heart rate and circulating markers of inflammation. In patients with coronary heart disease, increased resting heart rate may influence the clinical course of atherosclerotic disease by facilitation of plaque disruption and progression of coronary atherosclerosis. While a benefit of pharmacological or interventional heart rate reduction on different vascular outcomes was observed in experimental studies, prospective clinical data are limited, and prospective evidence determining whether modulation of heart rate can reduce cardiovascular events in different patient populations is needed.
We examined long-term musculoskeletal and cardiac adaptations elicited by recreational football (FG, n=9) and running (RG, n=10) in untrained premenopausal women in comparison with a control group (CG, n=9). Training was performed for 16 months ( approximately 2 weekly 1-h sessions). For FG, right and left ventricular end-diastolic diameters were increased by 24% and 5% (P<0.05), respectively, after 16 months. Right ventricular systolic function measured by tricuspid annular plane systolic excursion (TAPSE) increased (P<0.05) in FG after 4 months and further (P<0.05) after 16 months (15% and 32%, respectively). In RG and CG, cardiac structure, E/A and TAPSE remained unchanged. For FG, whole-body bone mineral density (BMD) was 2.3% and 1.3% higher (P<0.05) after 16 months, than after 4 and 0 months, respectively, with no changes for RG and CG. FG demonstrated substantial improvements (P<0.05) in fast (27% and 16%) and slow (16% and 17%) eccentric muscle strength and rapid force capacity (Imp30ms: 66% and 65%) after 16 months compared with 4 and 0 months, with RG improving Imp30ms by 64% and 46%. In conclusion, long-term recreational football improved muscle function, postural balance and BMD in adult women with a potential favorable influence on the risk of falls and fractures. Moreover, football training induced consistent cardiac adaptations, which may have implications for long-term cardiovascular health.
To examine the combined associations and relative contributions of leisure-time physical activity (PA) and cardiorespiratory fitness (CRF) with all-cause mortality.
Prospective cohort study. Setting Aerobics centre longitudinal study.
31,818 men and 10 555 women who received a medical examination during 1978-2002. Assessment of risk factors Leisure-time PA assessed by self-reported questionnaire; CRF assessed by maximal treadmill test. Main outcome measures All-cause mortality until 31 December 2003.
There were 1492 (469 per 10,000) and 230 (218 per 10,000) deaths in men and women, respectively. PA and CRF were positively correlated in men (r = 0.49) and women (r = 0.47) controlling for age (p < 0.001 for both). PA was inversely associated with mortality in multivariable Cox regression analysis among men, but the association was eliminated after further adjustment for CRF. No significant association of PA with mortality was observed in women. CRF was inversely associated with mortality in men and women, and the associations remained significant after further adjustment for PA. In the PA and CRF combined analysis, compared with the reference group "not meeting the recommended PA (< 500 metabolic equivalent-minute/week) and unfit", the relative risks (95% CIs) of mortality were 0.62 (0.54 to 0.72) and 0.61 (0.44 to 0.86) in men and women "not meeting the recommended PA and fit", 0.96 (0.61 to 1.53) and 0.93 (0.33 to 2.58) in men and women "meeting the recommended PA and unfit" and 0.60 (0.51 to 0.70) and 0.56 (0.37 to 0.85) in men and women "meeting the recommended PA and fit", respectively.
CRF was more strongly associated with all-cause mortality than PA; therefore, improving CRF should be encouraged in unfit individuals to reduce risk of mortality and considered in the development of future PA guidelines.
The purpose of this study was to compare movement pattern, fatigue development, and heart rate (HR) for top-class elite female players when playing international (INT) vs. domestic league games (DOM). Video-based time-motion analyses and HR recordings were performed on 17 players during INT and DOM. The distances covered in high-intensity running (HIR) and sprinting were longer (p < 0.05) in INT compared with DOM. More (p < 0.05) HIR was covered in INT than DOM during first and second half. Additionally, more (p < 0.05) sprinting occurred in INT compared with DOM in the first half. In both game types, the amount of HIR was reduced by 24-27% (p < 0.05) in the last 15-minute period compared with the first four 15-minute periods of the game. The midfielders covered longer (p < 0.05) distances with HIR in INT than in DOM over the entire game and in the most intense 5-minute period of the games, whereas no differences were observed between the game types for defenders. No difference in the HR response was found between INT and DOM. In conclusion, more HIR and sprinting occur in international compared with domestic games, which may affect the fatigue development for players in physically demanding roles. Thus, our results are important to coaches to prepare players to meet the challenges of international soccer games and show that the ability to perform intense intermittent exercise should be trained regularly in elite female players.
The present intervention was designed to investigate whether a 14-week period of regular recreational association football (F) or endurance running (R) has an effect on the risk of falls and bone fractures due to gains in muscle function and volumetric bone mineral density (vBMD). Fifty healthy untrained Danish premenopausal women were randomized into two training groups (F and R) that trained 1.8+/-0.3 (+/-SD) and 1.9+/-0.3 h/week, respectively, and these groups were compared with an inactive control group (C). Jumping and dynamic muscle strength were tested and tibial vBMD was measured using peripheral quantitative computed tomography. Total vBMD in left and right tibia increased by 2.6+/-2.3% and 2.1+/-1.8% (P<0.005), respectively, in F and by 0.7+/-1.3% (P=0.05) and 1.1+/-1.5% (P<0.01), respectively, in R without any significant changes in C. Similar results were found for trabecular vBMD. In F, peak jump power increased by 3+/-6% (P<0.05), and hamstring strength during fast (240 degrees /s) and slow (30 degrees /s) contractions increased by 11+/-25% and 9+/-21%, respectively, (P<0.05) without any significant changes in R or C. In conclusion, 14 weeks of regular recreational football improved peak jump power, maximal hamstring strength and vBMD in the distal tibia, suggesting a decreased fracture risk due to stronger bones and a reduced risk of falling.
The present study examined the cardiovascular health effects of 16 weeks of recreational football training in untrained premenopausal women in comparison with continuous running training. Fifty healthy women were matched and randomized to a football (FG, n=25) or a running (RG, n=25) group and compared with a control group with no physical training (CO, n=15). Training was performed for 1 h twice a week. After 16 weeks, systolic and diastolic blood pressure was reduced (P<0.05) in FG (7+/-2 and 4+/-1 mmHg) and systolic blood pressure was lowered (P<0.05) in RG (6+/-2 mmHg). After 16 weeks, resting heart rate was lowered (P<0.05) by 5+/-1 bpm both in FG and RG, and maximal oxygen uptake was elevated (P<0.05) by 15% in FG and by 10% in RG (5.0+/-0.7 and 3.6+/-0.6 mL/min/kg, respectively). Total fat mass decreased (P<0.05) by 1.4+/-0.3 kg in FG and by 1.1+/-0.3 kg in RG. After 16 weeks, pulse pressure wave augmentation index (-0.9+/-2.5 vs 4.2+/-2.4%), skeletal muscle capillarization (2.44+/-0.15 vs 2.07+/-0.05 cap/fib) and low-density lipoprotein/high-density lipoprotein cholesterol ratio were improved (P<0.05) in FG, but not altered in RG. No changes were observed in CO. In conclusion, regular recreational football training has significant favorable effects on the cardiovascular risk profile in untrained premenopausal women and is at the least as efficient as continuous running.
The present study examined the activity profile, heart rate and metabolic response of small-sided football games for untrained males (UM, n=26) and females (UF, n=21) and investigated the influence of the number of players (UM: 1v1, 3v3, 7v7; UF: 2v2, 4v4 and 7v7). Moreover, heart rate response to small-sided games was studied for children aged 9 and 12 years (C9+C12, n=75), as well as homeless (HM, n=15), middle-aged (MM, n=9) and elderly (EM, n=11) men. During 7v7, muscle glycogen decreased more for UM than UF (28 +/- 6 vs 11 +/- 5%; P<0.05) and lactate increased more (18.4 +/- 3.6 vs 10.8 +/- 2.1 mmol kg(-1) d.w.; P<0.05). For UM, glycogen decreased in all fiber types and blood lactate, glucose and plasma FFA was elevated (P<0.05). The mean heart rate (HR(mean)) and time >90% of HR(max) ranged from 147 +/- 4 (EM) to 162 +/- 2 (UM) b.p.m. and 10.8 +/- 1.5 (UF) to 47.8 +/- 5.8% (EM). Time >90% of HR(max) (UM: 16-17%; UF: 8-13%) and time spent with high speed running (4.1-5.1%) was similar for training with 2-14 players, but more high-intensity runs were performed with few players (UM 1v1: 140 +/- 17; UM 7v7: 97 +/- 5; P<0.05): Small-sided games were shown to elucidate high heart rates for all player groups, independently of age, sex, social background and number of players, and a high number of intense actions both for men and women. Thus, small-sided football games appear to have the potential to create physiological adaptations and improve performance with regular training for a variety of study groups.
The present study examined the cardiac effects of football training and running for inactive pre-menopausal women by standard echocardiography and tissue Doppler imaging. Thirty-seven subjects were randomized to two training groups (football: FG; n=19; running; RG; n=18) training 1 h with equal average heart rates twice a week for 16 weeks and compared with a matched inactive control group (CG; n=10). During the training period, left ventricular end-diastolic volume increased by 13% in FG and 11% in RG (P<0.05). Left ventricular posterior wall thickness increased in FG from 8.5+/-1.4 to 9.0+/-1.3 mm (P<0.05). Right ventricle diameter increased by 12% in FG and 10% in RG (P<0.05). Tissue Doppler imaging demonstrated increased left ventricular systolic and diastolic performances in both training groups. Peak systolic velocity increased by 26% in FG and 17% in RG (P<0.05) and left ventricular longitudinal displacement increased in both groups by 13% (P<0.05). Isovolumetric relaxation time decreased significantly more in FG than in RG (26% vs 14%, respectively P<0.05). In conclusion, 16 weeks of football and running exercise training induced significant changes of cardiac dimensions and had favorable effects on both left ventricular systolic and diastolic function. These training-induced cardiac adaptations appeared to be more consistent after football training compared with running.
We examined the physical demands of small-sided soccer games in untrained middle-age males and muscle adaptations and performance effects over 12 weeks of recreational soccer training in comparison with continuous running. Thirty-eight healthy subjects (20-43 years) were randomized into a soccer (SO), running (RU) and control (CO) group. Two-three weekly 1-h training sessions were performed. Muscle lactate (30.1 +/- 4.1 vs. 15.6 +/- 3.3 mmol/kg d.w.), blood lactate, blood glucose and time above 90% HR(max) (20 +/- 4% vs. 1 +/- 1%) were higher (p < 0.05) during training in SO than in RU. After 12 weeks of training, quadriceps muscle mass and mean muscle fibre area were 9 and 15% larger (p < 0.05) in SO, but unaltered in RU, and in SO, the fraction of FTx fibres was lowered (10.7 +/- 1.8 vs. 17.9 +/- 3.2%). In SO, citrate synthase activity was 10 and 14% higher (p < 0.05) after 4 and 12 weeks, but unaltered in RU. After 4 weeks VO(2max) and Yo-Yo IE2 performance were elevated (p < 0.05) to a similar extent in SO (7 and 37%) and RU (6 and 36%) but increased further (p < 0.05) from 4 to 12 weeks in SO (6 and 23%). In SO, 30-m sprint performance was improved (p < 0.05) by 0.11 +/- 0.02 s. Blood lactate during running at 11 km/h was lowered (p < 0.05) from 0 to 4 and 4 to 12 weeks (2.6 +/- 0.3 vs. 3.8 +/- 0.6 vs. 6.1 +/- 0.9 mM) and from 0 to 12 weeks in RU. No changes occurred for CO. In conclusion, recreational soccer organized as small-sided games stimulates both aerobic and anaerobic energy turnover and is an effective type of training leading to significant cardiovascular and muscular adaptations as well as performance enhancements throughout a 12-week training period.
The present study investigated the performance effects and physiological adaptations over 16 weeks of recreational football training and continuous running for healthy untrained premenopausal women in comparison with an inactive control group [Football group (FG): n=21; running group (RG): n=18; CO: n=14]. Two weekly 1-h training sessions were performed in FG and RG. After 4 and 16 weeks of training VO(2max) was elevated (P<0.05) by 7% and 15%, respectively, in FG, and by 6% and 10%, respectively, in RG. After 16 weeks, Yo-Yo intermittent endurance level 2 performance was 33% and 19% better (P<0.05) for FG and 29% and 21% better (P<0.05) for RG than after 4 and 0 weeks, respectively. Peak sprinting speed was 12% higher (21.0 +/- 0.6 vs 18.8 +/- 0.7 km/h; P<0.05) for FG after the training period, whereas no difference was observed for RG. After 4 weeks citrate synthase (CS) and 3-hydroxyacyl-CoA dehydrogenase (HAD) activity was 9% and 8%, respectively, higher (P<0.05) than before training in FG with no further changes during the last 12 weeks. In RG, CS increased (P<0.05) by 12% after 4 weeks and no significant increase was observed for HAD. In FG, the number of capillaries per fiber was 18% higher (P<0.05) after 16 weeks (2.44 +/- 0.15 vs 2.07 +/- 0.05 cap/fiber), with no significant difference for RG. No differences were observed between 0 and 16 weeks for CO. In conclusion, recreational women's football leads to significant increases in VO(2max), performance and muscular adaptations throughout a 16-week training period. Thus, football can be used as an activity to elevate the physical capacity of untrained women.
The aims of this study were as follows: To evaluate total hemoglobin mass (tHbmass) in international field hockey players; to examine the correlation between tHbmass and maximum oxygen uptake (VO2max); and to assess influences of iron status on tHbmass and on VO2max. The players of the German women's (N = 17, aged 24.8 +/- 3.0 [21-31] years) and men's (N = 17, aged 24.2 +/- 2.9 [19-32] years) national field hockey team were investigated. tHbmass was measured by an optimized carbon monoxide rebreathing method. The following parameters were measured in venous blood: Hemoglobin concentration (Hbconc), hematocrit (Hct), number and percentage of reticulocytes, reticulocyte hemoglobin content, serum iron, serum ferritin, serum transferrin, unsaturated iron-binding capacity, and serum soluble transferrin receptor concentration. VO2max was determined in a treadmill test. tHbmass (women: 10.6 +/- 1.1 g/kg; men: 12.5 +/- 0.9 g/kg) correlated to VO2max (women: 46.6 +/- 2.9 mL/min/kg; men: 55.8 +/- 4.0 mL/min/kg) in women (r = 0.56, p < 0.05) and in men (r = 0.57, p < 0.05), whereas Hbconc and Hct did not. The investigated parameters of iron status showed no association to tHbmass or to VO2max. In conclusion, tHbmass can be used as an indicator for endurance capacity in elite field hockey players, whereas Hbconc may not. tHbmass or VO2max were not influenced by the actual iron status of the investigated athletes.
To examine the effects of regular participation in recreational soccer on health profile, 36 healthy untrained Danish men aged 20-43 years were randomised into a soccer group (SO; n = 13), a running group (RU; n = 12) and a control group (CO; n = 11). Training was performed for 1 h two or three times per week for 12 weeks; at an average heart rate of 82% (SEM 2%) and 82% (1%) of HR(max) for SO and RU, respectively. During the 12 week period, maximal oxygen uptake increased (p<0.05) by 13% (3%) and 8% (3%) in SO and RU, respectively. In SO, systolic and diastolic blood pressure were reduced (p<0.05) from 130 (2) to 122 (2) mm Hg and from 77 (2) to 72 (2) mm Hg, respectively, after 12 weeks, with similar decreases observed for RU. After the 12 weeks of training, fat mass was 3.0% (2.7 (0.6) kg) and 1.8% (1.8 (0.4) kg) lower (p<0.05) for SO and RU, respectively. Only SO had an increase in lean body mass (1.7 (0.4) kg, p<0.05), an increase in lower extremity bone mass (41 (8) g, p<0.05), a decrease in LDL-cholesterol (2.7 (0.2) to 2.3 (0.2) mmol/l; p<0.05) and an increase (p<0.05) in fat oxidation during running at 9.5 km/h. The number of capillaries per muscle fibre was 23% (4%) and 16% (7%) higher (p<0.05) in SO and RU, respectively, after 12 weeks. No changes in any of the measured variables were observed for CO. In conclusion, participation in regular recreational soccer training, organised as small-sided drills, has significant beneficial effects on health profile and physical capacity for untrained men, and in some aspects it is superior to frequent moderate-intensity running.
Ten female field hockey players were studied to determine if prolonged dynamic conditioning results in an increased left ventricular internal dimension at end diastole (LVIDD) and if this increase correlates with maximal oxygen consumption (VO2max). At peak season, echocardiograms were obtained and VO2max determined during maximal treadmill exercise. VO2max, LVIDD index (LVIDD/body surface area (BSA)), and ventricular septal and posterior wall thickness were compared to agematched nonathletic women. Mean LVIDD index was significantly greater in athletes than in controls: 29.3 +/- 0.9 mm/m2 vs. 26.3 +/- 0.6, P less than 0.005. Echocardiographic wall measurements did not differ significantly in the two groups. Mean VO2max for the athletes was significantly greater than controls: 51.7 +/- 4.0 ml O2.kg-1.min-1 vs. 41.2 +/- 2.1, P less than 0.001. VO2max correlated significantly with LVIDD index; r = 0.92, P less than 0.001. Female athletes show an increased LVIDD in response to dynamic conditioning similar to that seen in male athletes. The proficiency of athletic performance as measured by VO2max may be related to the heart's ability to increase LVIDD since there is a high correlation between VO2max and LVIDD index.
Several epidemiological studies have reported that the regional distribution of body fat is a significant and independent risk factor for cardiovascular disease (CVD) and related mortality. Although these associations are well established, the causal mechanisms are not fully understood. Numerous studies have, however, shown that specific topographic features of adipose tissue are associated with metabolic complications that are considered as risk factors for CVD such as insulin resistance, hyperinsulinemia, glucose intolerance and type II diabetes mellitus, hypertension, and changes in the concentration of plasma lipids and lipoproteins. The present article summarizes the evidence on the metabolic correlates of body fat distribution. Potential mechanisms for the association between body fat distribution, metabolic complications, and CVD are reviewed, with an emphasis on plasma lipoprotein levels and plasma lipid transport. From the evidence available, it seems likely that subjects with visceral obesity represent the subgroup of obese individuals with the highest risk for CVD. Although body fat distribution is now considered as a more significant risk factor for CVD and related death rate than obesity per se, further research is clearly needed to identify the determinants of body fat distribution and the causal mechanisms involved in the metabolic alterations. It appears certain, however, that an altered plasma lipid transport is a significant component of the relation between body fat distribution and CVD.
Fifteen well-trained master endurance athletes [62.0 +/- 2.3 (SE) yr] and 14 sedentary control subjects (61.4 +/- 1.4 yr) were reevaluated after an average follow-up period of approximately 8 yr to obtain information regarding the effects of physical activity on the age-related decline in maximal O2 uptake capacity (VO2max). The master athletes had been training for 10.2 +/- 2.9 yr before initial testing and continued to train during the follow-up period. The sedentary subjects' VO2max declined by an average of 3.3 ml.kg-1.min-1 (33.9 +/- 1.7 vs. 30.6 +/- 1.6, P less than 0.001) over the course of the study, a decline of 12% per decade. In these subjects maximal heart rate declined 8 beats/min (171 vs. 163) and maximal O2 pulse decreased from 0.20 to 0.18 ml.kg-1.beat (P less than 0.05). The master athletes' VO2 max decreased by an average of 2.2 ml.kg-1.min-1 (54.0 +/- 1.7 vs. 51.8 +/- 1.8, P less than 0.05), a 5.5% decline per decade. The master athletes' maximal heart rate was unchanged (171 +/- 3 beats/min) and their maximal O2 pulse decreased from 0.32 to 0.30 ml.kg-1.beat (P less than 0.05). These findings provide evidence that the age-related decrease in VO2max of master athletes who continue to engage in regular vigorous endurance exercise training is approximately one-half the rate of decline seen in age-matched sedentary subjects. Furthermore our results suggest that endurance exercise training may reduce the rate of decline in maximal heart rate that typically occurs as an individual ages.
The morphologic concepts of the "athlete heart" have been enhanced and clarified over the last 10 years by virtue of M-mode echocardiographic studies performed on more than 1,000 competitive athletes. Long-term athletic training produces relatively mild but predictable alterations in cardiac structure that result in an increase in calculated left ventricular mass. This increase in mass observed in highly trained athletes is due to a mild increase in either transverse end-diastolic dimension of the left ventricle or left ventricular wall thickness, or both. Cardiac dimensions in athletes compared with matched control subjects show increases of about 10% for left ventricular end-diastolic dimension, about 15 to 20% for wall thickness and about 45% for calculated left ventricular mass. Furthermore, there is evidence that the modest degree of "physiologic" left ventricular hypertrophy (both the cavity dilation and wall thickening) observed in athletes is dynamic in nature, that is, it may develop rapidly within weeks or months after the initiation of vigorous conditioning and may be reversed in a similar time period after the cessation of training. Several echocardiographic studies also suggest that the precise alterations in cardiac structure associated with training may differ depending on the type of athletic activity undertaken (that is, whether training is primarily dynamic [isotonic] or static [isometric]). Although the ventricular septal to free wall thickness ratio (on M-mode echocardiogram) is almost always within normal limits (less than 1.3), occasionally an athlete will show mild asymmetric thickening of the anterior basal septum (usually 13 to 15 mm). This circumstance may mimic certain pathologic conditions characterized by primary left ventricular hypertrophy such as nonobstructive hypertrophic cardiomyopathy. The long-term significance of increased left ventricular mass in trained athletes has not been conclusively defined. However, there is no evidence at this time suggesting that this form of hypertrophy is itself deleterious to the athlete or predisposes to (or prevents) the natural occurrence of cardiovascular disease later in life.
The cardiac profile of nine AIAW softball champions (SC) was compared with the cardiac profile of 10 sedentary women who were matched according to age and body size (SW). Standard M-mode echocardiography and a maximum graded stress test were performed on each subject. The mean (+/- SE) resting heart rate (50.6 +/- 2.6 bpm) and VO2max (55.3 +/- 2.0 ml O2 x kg-1 x min-1) of the SC were significantly different (P less than 0.001) than the heart rate (71.2 +/- 3.1 bpm) and VO2max (40.3 +/- 1.4 ml x kg-1 x min-1) of the SW. Significantly greater (P less than 0.05) interventricular septal thickness (IST), and left ventricular end-diastolic dimension (LVIDd) and volume (LVIDd3) were noted in the SC. The means (+/- SE) for IST, LVIDd, and LVIDd3 for the athletes were 8.9 +/- 0.4 mm, 4.8 +/- 0.1 cm, and 110 +/- 5.9 cm3, respectively; and for the SW were 7.5 +/- 0.5 mm. 4.4 +/- 0.2 cm, and 87.8 +/- 8.0 cm3, respectively. Although there was no difference in the left ventricular cavity/muscle volume ratio, the athletes had an increased (P less than 0.02) left ventricular mass (168 +/- 15 g) when compared with SW (123 +/- 9 g). Therefore, the cardiac adaptations noted during rest in moderate-endurance trained AIAW softball champions included a relative bradycardia and eccentric hypertrophy.
We investigated the relationships between the amount and distribution of body fat and fasting serum lipids and lipoproteins to explore whether coronary artery disease (CAD) risk may be mediated through effects on the serum lipid profile.
We determined serum total cholesterol and triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, and HDL subfractions 2 and 3 in 103 healthy men, aged 21 to 77 years (mean 48.7). The amount and distribution of fat were determined directly by dual energy X-ray absorptiometry. Adiposity was determined as the ratio between total body fat tissue and total body lean tissue, while fat distribution was taken as the ratio between the mass of fat tissue in the android (central) and gynoid (hip and thigh) regions.
Univariate analysis showed both adiposity and fat distribution to be correlated with total serum cholesterol and triglyceride concentrations (adiposity r = .20, .21; both P < 0.05: fat distribution r = .25, .38; P < 0.05, P < 0.001, respectively). Fat distribution was also negatively correlated with HDL2 cholesterol (r = -.20, P < 0.05). In multiple linear regression analysis, neither age nor adiposity was significantly correlated with any serum lipid or lipoprotein concentration, while increasing android-to-gynoid ratio was independently associated with elevated total serum triglyceride (r = .40, P < 0.01) and decreased HDL2 (r = -.25, P < 0.05) concentrations.
The association of both age and overall adiposity with the fasting serum lipid profile are mediated via their correlations with body fat distribution. In men, the distribution, rather than the amount, of body fat is related to adverse changes in serum lipids and lipoproteins, and hence potentially to increased CAD risk.
To quantify the relation of cardiorespiratory fitness to cardiovascular disease (CVD) mortality and to all-cause mortality within strata of other personal characteristics that predispose to early mortality. DESIGN--Observational cohort study. We calculated CVD and all-cause death rates for low (least fit 20%), moderate (next 40%), and high (most fit 40%) fitness categories by strata of smoking habit, cholesterol level, blood pressure, and health status.
Preventive medicine clinic.
Participants were 25341 men and 7080 women who completed preventive medical examinations, including a maximal exercise test.
Cardiovascular disease and all-cause mortality.
There were 601 deaths during 211996 man-years of follow-up, and 89 deaths during 52982 woman-years of follow-up. Independent predictors of mortality among men, with adjusted relative risks (RRs) and 95% confidence intervals (CIs), were low fitness (RR, 1.52;95% CI, 1.28-1.82), smoking (RR, 1.65; 95% CI, 1.39-1.97), abnormal electrocardiogram (RR, 1.64;95% CI, 1.34-2.01), chronic illness (RR, 1.63;95% CI, 1.37-1.95), increased cholesterol level (RR, 1.34; 95% CI, 1.13-1.59), and elevated systolic blood pressure (RR, 1.34; 95% CI, 1.13-1.59). The only statistically significant independent predictors of mortality in women were low fitness (RR, 2.10; 95% Cl, 1.36-3.21) and smoking (RR, 1.99; 95% Cl, 1.25-3.17). Inverse gradients were seen for mortality across fitness categories within strata of other mortality predictors for both sexes. Fit persons with any combination of smoking, elevated blood pressure, or elevated cholesterol level had lower adjusted death rates than low-fit persons with none of these characteristics.
Low fitness is an important precursor of mortality. The protective effect of fitness held for smokers and nonsmokers, those with and without elevated cholesterol levels or elevated blood pressure, and unhealthy and healthy persons. Moderate fitness seems to protect against the influence of these other predictors on mortality. Physicians should encourage sedentary patients to become physically active and thereby reduce the risk of premature mortality.
A double staining method combining Ulex europaeus agglutinin I lectin (UEA-I) and collagen type IV staining was used to determine the capillary density and the number of capillaries relative to different fibre types in human skeletal muscles. The result of this combined staining was compared with that of other staining methods including amylase-periodic acid Schiff (PAS), UEA-I, anti-collagen type IV and anti-von Willebrand factor. Muscle biopsy specimens, 12 from M. vastus lateralis and 6 from M. soleus, were obtained from 18 healthy young men. Compared with amylase-PAS staining, double staining showed a larger number of capillaries surrounding type I (+9.6%), type IIA (+8.6%) and type IIB (+11.6%) fibres in the M. vastus lateralis specimens (P < 0.001 for all differences). The capillary to fibre ratio (cap fibre-1) and the capillary density (cap.mm-2) were 8.3% (P < 0.002) and 7.9% (P < 0.001) larger, respectively. In the M. soleus specimens, cap.fibre-1 and cap.mm-2 were 7.4 and 9.9% larger, respectively, by double staining compared with PAS staining. Further comparisons showed that the cap.fibre-1 and cap.mm-2 obtained with double staining were similar to the values determined by the UEA-I staining, but greater than that measured by the collagen type IV method. The double staining gave a more marked stain of capillaries and revealed muscle fibre borders clearly, which is an advantage in studies that require comparisons between serial sections using computerised image analyses. It is concluded that the double staining method is superior to either the UEA-I, collagen type IV or the traditional amylase-PAS staining methods in analysing capillary density of normal human skeletal muscle.
Obesity-related metabolic disorders have not been adequately addressed due to a failure to distinguish the importance of general obesity or body fat distribution in relation to atherosclerotic risk factors, especially in the less obese populations. To assess the relationship between general obesity (reflected by BMI, total body fat percentage and total adiposity), body fat distribution (reflected by WHR, default regions and ROIs of DEXA) and atherosclerotic risk factors in the Chinese population, a total of 872 healthy subjects (477 male and 395 female) were enrolled in the study. The results indicated that the android pattern of fat distribution, independent of general obesity, was positively correlated with blood pressure, atherogenic indices, fasting and OGTT 2-h plasma glucose, glycosylated hemoglobin (HbA1c), serum concentration of cholesterol, triglyceride, LDL cholesterol and negatively correlated with HDL cholesterol in both genders. The gender differences in patterns of body fat distribution and atherosclerotic risk factors remained significant after adjustments were made for age, BMI and total adiposity, although diminished after further adjustments for body fat distribution. In conclusion, body fat distribution, rather than general obesity, is more correlated with obesity-related atherosclerotic risk factors and sex-associated differences. ROIs measured by DEXA may be a useful method to evaluate sex-associated changes in body fat distribution and atherosclerotic risk factors in the healthy Chinese population.
Point estimates of physical fitness give important information on the risk of death in healthy people, but there is little information available on effects of sequential changes in physical fitness on mortality. We studied this latter aspect in healthy middle-aged men over a total follow-up period of 22 years.
2014 healthy men aged 40-60 years had a bicycle exercise test and clinical examination, and completed a questionnaire in 1972-75 (survey 1). This was repeated for 1756 (91%) of 1932 men still alive by Dec 31, 1982 (survey 2). The exercise scores were adjusted for age. The change in exercise scores between surveys was divided into quartiles (Q1=least fit, Q4=fittest). An adjusted Cox's proportional hazards model was used to study the association between changes in physical fitness and mortality, with the Q1 men used as controls.
By Dec 31, 1994, 238 (17%) of the 1428 men had died, 120 from cardiovascular causes. There were 37 deaths in the Q4 group (19 cardiovascular); their relative risks of death were 0.45 (95% CI 0.29-0.69) for any cause and 0.47 (0.26-0.86) for cardiovascular causes. There was a graded, inverse relation between changes in physical fitness and mortality irrespective of physical fitness status at survey 1.
Change in physical fitness in healthy middle-aged men is a strong predictor of mortality. Even small improvements in physical fitness are associated with a significantly lowered risk of death. If confirmed, these findings should be used to influence public health policy.
The aim of this study was to establish whether extremely low serum ferritin values in female athletes were associated with indications of iron deficiency anemia and whether serum ferritin values were influenced by the type of training or participants' body size. Hematological data collected during 6 years at the Australian Institute of Sport were reviewed to quantify changes in serum ferritin concentration associated with training and to establish whether decrements in serum ferritin were associated with any change in hemoglobin concentration, mean corpuscular volume, or mean corpuscular hemoglobin concentration. Mean serum ferritin concentrations of 7.5 microg x L(-1) were not associated with any indication of iron-deficiency anemia. Serum ferritin declined by approximately 25% with the onset of rigorous daily training (p < .01) whether training was predominantly weight-bearing or non-weight-bearing. Rowers had significantly higher ferritin concentrations than basketball players of similar stature (p=.02). We conclude that considerable background information such as the stage of training, specific sport, and previous blood results should be sought when interpreting serum ferritin concentrations in female athletes.