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PubMed2000

Influence of sympatho-vagal balance on airway responsiveness in athletes.

The increased prevalence of airway hyperresponsiveness (AHR) observed among athletes suggests that high-level training may contribute to the development of AHR. We investigated the possible influence of the sympatho-vagal balance on this phenomenon in 40 athletes and 10 sedentary controls. Each subject filled out a respiratory questionnaire, had a methacholine challenge, and measurements were made of their baseline plasma catecholamines [epinephrine (E), norepinephrine (NE) and dopamine (DA)] as a reflection of sympathetic tone, and their heart rate variability (SDNN: standard deviation of all normal-to-normal intervals) as an indicator of parasympathetic tone. The athletes had a 45% prevalence of AHR (defined as PC20 < 16 mg/ml, where PC20 is the concentration of methacholine inducing a 20% fall in the forced expiratory volume in 1 s, FEV1) with a mean PC20 of 21.2 mg/ml compared with 10% prevalence (mean PC20: 74.4 mg/ml) in sedentary subjects (P < 0.01). Plasma catecholamine values were not significantly different between the two groups (all P > 0.05), but the estimated parasympathetic tone was higher in athletes (P = 0.01). When data from all subjects were analyzed together, plasma E and NE correlated with PC20 (r = 0.39, P = 0.005 and r = 0.29, P < 0.005) but DA and SDNN did not (both P > 0.05). However, the ratios E/SDNN, NE/SDNN and DA/SDNN showed significant correlations with PC20 (r = 0.42, P < 0.01; r = 0.33, P < 0.005 and r = 0.31, P < 0.05, respectively) This study suggests that the sympatho-vagal balance may contribute to the increased AHR in the population studied but this influence alone cannot explain the higher prevalence of AHR in athletes.

Adult↗

PubMed2000

Genetic variation in the renin-angiotensin system and athletic performance.

The D allele at the angiotensin-I-converting enzyme (ACE)-insertion/deletion polymorphism has been associated with an increased risk of developing several pathological processes, such as coronary heart disease and ventricular hypertrophy. Individuals with the DD genotype show a significantly increased left-ventricular mass in response to physical training, compared to the II genotype (which would be associated with the lowest plasma ACE levels) and the ID genotype. The II genotype has been linked to a greater anabolic response. In accordance with a role for ACE in the response to rigorous physical training, a higher frequency of the I allele has been reported to exist among elite rowers and high-altitude mountaineers. Sixty elite (professional) athletes (25 cyclists, 20 long-distance runners, and 15 handball players), and 400 healthy controls were genotyped for the DNA polymorphisms of the ACE, angiotensinogen (Ang) and angiotensin receptor type 1 (AT1) genes. Plasma ACE levels showed a strong correlation with the I/D genotype in our population. The I-allele occurred at a significantly higher frequency in athletes compared to controls (P = 0.0009). Gene and genotype frequencies for the Ang and AT1 polymorphisms did not differ between athletes and controls. Since the frequency of the ACE I allele was significantly increased among our elite athletes, we conclude that the ACE polymorphism represents a genetic factor that contributes to the development of an elite athlete.

Adult↗

PubMed2003

Effect of different sports on body cell mass in highly trained athletes.

The objective of this study was to verify the impact of various sports on body cell mass (BCM). Ninety-eight male subjects, 17-33 years of age, participated in the study. The sample included athletes from three professional Italian football (soccer) teams, representing three different divisions (A, n=16; B, n=14; and C, n=18), judo athletes (J, n=10), and water polo athletes (W, n=14) who all competed at the national level. Twenty-six age-matched individuals served as the control group (CG). Fat-free mass (FFM), fat mass (FM), percent body fat (%BF), and BCM were assessed using bioimpedance spectroscopy (BIS). There were no significant differences in body weight and FFM among the groups. A and B were significantly taller than J and CG. B had a significantly lower body mass index (BMI; kg/m(2)) than CG, while C had a significantly lower BMI than J and CG. CG had a significantly greater FM and %BF than A, B, and C. C had a significantly lower BCM than Aand B. CG had a significantly lower BCM than A, B, J, and W. In conclusion, differences in BCM exist among athletes of different sports, and among athletes within the same sport who compete at different levels.

Adipose Tissue↗

PubMed2003

Body composition differences in adolescent female athletes and anorexic patients.

Osteopenia is a frequent complication affecting adolescent girls with anorexia nervosa (AN). Moreover, female athletes suffering from eating disorders can be affected by premature osteoporotic fractures. The aim of this study was to examine bone mineral content (BMC) and bone mineral density (BMD) in three groups of adolescent females. Anthropometric and body composition measurements were performed on 22 adolescent females (age+/-SD=15.6+/-1.4 years) divided into groups: athletes ( n=8), patients with AN ( n=8) and age-height matched control subjects ( n=6). Body weight and body mass index were significantly lower ( p<0.01) in athletes and AN patients compared with healthy controls. BMC and BMD were lower ( p<0.01) for AN patients and athletes compared with healthy controls; AN patients had the lowest BMC value. Athletes had higher lean body mass values compared with AN patients and healthy controls. These results suggest that the effects of eating disorders, specifically BMC loss, could be attenuated by physical activity.

Adipose Tissue↗

PubMed2026

Self-Report Health Screening Tools in Female Athletes: A Systematic Review of Domain Coverage, Validation, and Use Across Participation Levels.

BACKGROUND: Female athlete health encompasses multiple interconnected domains; however, the self-report screening tools used to assess these domains have not been comprehensively synthesised. OBJECTIVE: To systematically identify self-report health screening tools used to assess female athlete health, map domain coverage, determine validation reporting, and describe application across participation levels. METHODS: This systematic review was pre-registered with PROSPERO ( CRD420251056910 ) and conducted in accordance with PRISMA guidelines. Four databases (PubMed, MEDLINE, SPORTDiscus and Web of Science) were searched from inception to January 2026 using female health and screening-related terms. Methodological quality was appraised using Joanna Briggs Institute and National Institutes of Health tools, and findings were synthesised descriptively. Eligible, peer-reviewed studies reported the use, development or validation of self-report health screening tools assessing one or more domains relevant to female health applied in female athlete populations, spanning recreational through elite participation levels. All sports and activities were included. The search was restricted to English language with no date limits. RESULTS: In total, 360 studies (1990-2026) representing 134,506 female participants spanning recreational to elite sport and 273 screening tools were included. Mental health (n = 77, 34.1%), disordered eating (n = 33, 14.6%) and body image (n = 30, 13.3%) predominated. Domains related to female health, including menstrual health, pelvic floor health, pregnancy/postpartum and breast health were comparatively underrepresented. Most studies reported tools were used for risk identification (n = 323, 80.3%). Validation reporting was inconsistent, with half (n = 180, 50%) reporting use of at least one validated tool. Tool use was concentrated in professional and elite sport, with limited inclusion of recreational, masters and disability athlete cohorts. Health literacy constructs were explicitly assessed in 12.5% of studies (n = 45). CONCLUSIONS: Health screening in female athlete populations remains fragmented and uneven in domain coverage, with inconsistent validation reporting. Development of integrated, multi-domain and contextually inclusive screening frameworks is warranted.

Journal Article↗

PubMed1989

Prevalence of multivalvular regurgitation in athletes.

To assess the effects of exercise training on the prevalence of valvular regurgitation, 2-dimensional echocardiography and Doppler flow mapping were performed in 45 athletes and 26 sedentary control subjects of similar age and sex. Mitral, tricuspid, aortic and pulmonic regurgitations were sought in all possible views and mitral and tricuspid flow velocities were recorded. Mitral and tricuspid anulus diameters and the maximal areas of regurgitant flow were planimetered. Regurgitation of at least one of the cardiac valves was found in 91% of athletes but in only 38% of control subjects (p less than 0.001). Mitral and tricuspid regurgitation occurred more commonly in athletes than in control subjects (mitral 69 vs 27%; tricuspid 76 vs 15%). The prevalence of aortic and pulmonic regurgitation was similar. Although athletes and sedentary normal subjects differed with respect to heart rate, right and left ventricular filling patterns and tricuspid and mitral anulus diameters, none of these variables was related to the presence or severity of regurgitation. Thus, exercise training is associated with an increased prevalence of mitral and tricuspid regurgitation and altered ventricular inflow patterns. The mechanism of these findings is unclear. Multivalvular regurgitation is common in athletes and does not imply structural valvular abnormalities.

Adult↗

PubMed1992

Left ventricular dimensions and mass using magnetic resonance imaging in female endurance athletes.

Few published studies of left ventricular (LV) mass in female endurance athletes have been performed with M-mode echocardiography, which involves assumptions of LV geometry. Therefore, magnetic resonance imaging, a 3-dimensional technique, was used to examine LV mass, LV end-diastolic volume and mean wall thickness in female long distance runners (n = 13; mean age 29 years), cyclists (n = 12; mean age 26 years) and cross-country skiers (n = 11; mean age 24 years), and the findings were compared with sedentary control subjects (n = 10; mean age 27 years) matched for height and body weight. The physical characteristics for all subjects included height (mean 166 cm, and body weight (mean 56 kg). The percent body fat (mean 11.7) and maximal oxygen uptake (VO2max, mean 63 ml.kg-1.min-1) were similar (p greater than 0.05) among all athletic groups, but significantly different from the control group (body fat, mean 22.5%; VO2max, mean 35 ml.kg-1.min-1). LV mass (mean 159 kg), LV end-diastolic volume (mean 122 ml), and mean wall thickness (mean 11.5 mm) were also similar among the athletic groups and significantly larger than the following control values: LV mass (mean 115 g), LV end-diastolic volume (mean 93 ml) and mean wall thickness (mean 9.8 mm). Ratios of LV mass to lean body weight were similar among all athletic groups, although athletic groups had larger ratios (p less than 0.05) than the sedentary control subjects. LV mass/LV end-diastolic volume ratio was similar (p greater than 0.05) among all groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1993

Left ventricular wall tension and stress during exercise in athletes and sedentary men.

This investigation examines the hypothesis that hypertrophy attenuates wall stress during exercise, when left ventricular wall tension is highest and most likely to contribute to hypertrophy. Upright bicycle exercise was performed by 17 endurance-trained male athletes and 15 sedentary men. M-mode echocardiograms were obtained during submaximal exercise at predetermined heart rates. At all levels of exercise, at a matched heart rate, wall tension was higher in athletes than in sedentary subjects. In both groups, wall tension increased with exercise, then plateaued. Wall stress did not differ significantly in athletes and sedentary subjects at rest and at heart rates of 110 and 150 beats/min, although a difference was observed at a heart rate of 130 beats/min. Wall stress decreased in both athletes and sedentary subjects with exercise. In conclusion, left ventricular hypertrophy caused wall stress in athletes to be maintained at values similar to sedentary subjects during exercise as well as at rest.

Adult↗

PubMed1986

Health maintenance: paraplegic athletes and nonathletes.

The relationship between participation in competitive wheelchair sports and health maintenance in individuals having paraplegia was examined. Twenty-one wheelchair athletes and 21 nonathletes completed two self-report questionnaires. The t-test for Independent Groups, the Mann-Whitney U-Test, and the Test for Significance of Difference Between Two Proportions were used to test for group differences. A p value of 0.05 significance level was used. The subjects were similar in age, sex, race, education, age at onset of injury, duration of injury, and preinjury level of sports involvement. A large percentage of both groups had been hospitalized since rehabilitation discharge; however, the mean number of hospitalizations per year since discharge was almost three times greater for nonathletes. Fewer athletes had been hospitalized for pressure sores. Within the athlete group the more serious medical complications occurred before beginning wheelchair sports. Frequency counts of specific complications occurring during the past year showed that nonathletes had more serious conditions such as kidney infections and skin breakdowns due to pressure as opposed to those due to external trauma. The findings indicate that paraplegic athletes are more successful than nonathletes in avoiding the major medical complications for which they are at risk. It follows, then, that this athletically active subgroup of the paraplegic population is costing the individual, medical insurance companies, and the state less money for ongoing medical care and extensive repeat hospitalizations.

Adult↗

PubMed1988

Elevated high-density lipoprotein cholesterol in endurance athletes is related to enhanced plasma triglyceride clearance.

We compared the clearance rate (K2) of plasma triglycerides (TG) following the intravenous (IV) infusion of a fat emulsion in 13 male endurance athletes (age 33 +/- 5.6 years, mean +/- SD) and 12 sedentary men (33 +/- 5.6 years). The athletes had lower fasting triglycerides (TG) (75 +/- 30.4 mg/dL v 125 +/- 52.5 mg/dL) and higher high-density lipoprotein (HDL) cholesterol concentrations (64 +/- 16.2 mg/dL v 42 +/- 9.4 mg/dL) than the sedentary subjects (P less than .01 for all). The higher HDL concentrations were due to increases in both the HDL2 and HDL3 subfractions. K2 in the athletes was 92% higher than that in the sedentary men (4.8 +/- 2.3%/min v 2.5 +/- 0.7%/min, P less than .01), but there was no difference in postheparin lipoprotein lipase activity (LPLA) between the groups (P greater than .05). K2 was positively correlated with LPLA (r = .51) and inversely related to fasting TG concentrations (r = -.73, P less than .01 for both). Furthermore, K2 was directly related to HDL (r = .75), HDL2 (r = .72), and HDL3 (r = .60) cholesterol concentrations (P less than .01 for all). These data suggest that the low TG levels in endurance athletes result at least in part from increased TG removal and that the elevated HDL concentrations of endurance athletes are related to enhanced fat clearance.

Adult↗

PubMed2006

Performance-enhancing drug use in young athletes.

This article explores the issue of performance-enhancing drug use in adolescent athletes. The article describes current substances that are being used by adolescent athletes, explains their positive and negative effects, examines factors contributing to their increased use in adolescent athletes, and discusses approaches to educating adolescents about alternate means of enhancing their athletic performance. It is hoped that this information will be useful toward encouraging young athletes to pursue, safe, healthy, and natural means of performance enhancement, such as practice and strength training, to improve sports performance in a safe, effective manner.

Adolescent↗

PubMed2005

Independent elevations of N-terminal pro-brain natriuretic peptide and cardiac troponins in endurance athletes after prolonged strenuous exercise.

BACKGROUND: Although elevated resting brain natriuretic peptide (BNP) concentrations reflect heart disease, the meaning of exercise-induced increases is poorly understood and has been examined in small groups only. Therefore, the present study aimed to examine the increase in N-terminal pro-brain natriuretic peptide (NT-proBNP) and relations to cardiac troponin I and T (cTnI, cTnT) elevations after prolonged strenuous exercise in a large cohort of athletes. METHODS: We examined exercise-induced changes in NT-proBNP, cTnI, and cTnT in 105 obviously healthy endurance athletes (40 +/- 8 years) before and after prolonged strenuous exercise. Blood samples were taken before, 15 minutes, and 3 hours after a marathon (n = 46), a 100-km run (n = 14), and a mountain bike marathon (n = 45). RESULTS: Eighty-one of 105 athletes exceeded the upper reference limit of NT-proBNP (males/females 88:153 ng/L) after exercise. NT-proBNP increased in all 3 events (P < .001) with the highest increase in the 100-km runners (median increase 200 ng/L; 25th/75th percentile 115/770 ng/L), which differed from the increase in the marathon (97 ng/L; 36/254 ng/L) or the mountain bike marathon (78 ng/L; 37/196 ng/L) (P < .01). Cardiac troponin I exceeded 0.04 microg/L in 74%; cTnT exceeded 0.01 microg/L in 47% of athletes after exercise. NT-proBNP was not related to exercise-induced increases in cTnI or cTnT, but correlated with exercise time (r = 0.55, P < .001). CONCLUSIONS: Increases in NT-proBNP can be found in a major part of obviously healthy athletes after prolonged strenuous exercise. The release of BNP during and after exercise may not result from myocardial damage but may have cytoprotective and growth-regulating effects. The different nature of exercise-induced increases in BNP and cardiac troponins has to be elucidated in the future.

Adult↗

PubMed2005

Positron emission tomographic evaluation of regulation of myocardial perfusion in physiological (elite athletes) and pathological (systemic hypertension) left ventricular hypertrophy.

Myocardial perfusion (MP) may differ in physiologic and pathologic left ventricular hypertrophy (LVH). We compared MP in LVH in elite athletes and patients with hypertension with healthy, age-matched subjects. We included 12 rowers with LVH, 19 patients with hypertension with LVH, and 2 age-matched groups of healthy subjects (n = 11 and n = 12). The left ventricular mass index was determined echocardiographically. MP was measured by N-13 ammonia positron emission tomography. The maximal perfusion and perfusion reserve were studied using dipyridamole, and endothelial function was assessed by a cold pressor test. The degree of LVH was similar in athletes and those with hypertension. Compared with controls, athletes had 20% lower baseline MP (p <0.05), a similar response to the cold pressor test, and a higher perfusion reserve (31%, p <0.05). The patients with hypertension had a 25% higher baseline MP (p <0.05), a reduced increase during the cold pressor test (12% vs 25% in controls, p <0.05), and a reduced perfusion reserve (27% lower, p <0.001). The peak global perfusion (MP x left ventricular mass index) was 62% higher in athletes (p <0.05) than in controls, but the peak global perfusion in patients with hypertension did not differ from that of controls. In conclusion, physiologic LVH in athletes is suited for a high peak workload at the cost of only a small increase in basal myocardial oxygen consumption. In contrast, LVH in the presence of hypertension is a good adaptation to the increased baseline workload with maintained maximal cardiac performance. Endothelial dysfunction may contribute to the reduced perfusion reserve seen in hypertensive LVH.

Adult↗

PubMed2003

High-sensitive C-reactive protein level and oxidative stress-related status in former athletes in relation to traditional cardiovascular risk factors.

OBJECTIVE: To analyze systemic and cellular oxidative stress-related indices as well as C-reactive protein level in former top-level athletes in relation to traditional cardiovascular risk factors. METHODS: A cross-sectional study was performed in 53 former male athletes and 25 sedentary controls (age range: 39-59 years). We measured anthropometric factors (BMI, fat percentage, WHR), resting blood pressure (SBP, DBP), serum cholesterol (CHOL), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), total antioxidant status (TAS), oxidized LDL-C (oxLDL), diene conjugates (DC), glutathione redox status, high-sensitive C-reactive protein (hsCRP), and leisure-time physical activity. RESULTS: Physically active former athletes had significantly lower mean overweight (BMI, fat percentage, WHR), better spectrum of atherogenesis indicators (CHOL, HDL-C, TG, TG:HDL-C ratio) and lower oxidative stress (oxLDL, oxLDL:LDL-C ratio, DC) values than sedentary ex-athletes. No significant differences in these variables were found between the sedentary ex-athletes and control group. Significant associations were found between physical activity (METs), SBP, DBP, hypertension, CHOL, HDL-C, TG, TG:HDL-C ratio, oxLDL, oxLDL:LDL-C ratio, DC and hsCRP. CONCLUSIONS: A physically active lifestyle is related to a lower cardiovascular disease (CVD) risk profile including a substantially lower systemic and cellular oxidative stress status as well as C-reactive protein level in middle-aged men.

Adult↗

PubMed2004

Age at first oral contraceptive use as a major determinant of vertebral bone mass in female endurance athletes.

It was the aim of this retrospective analysis to examine the influence of low-dose monophasic oral contraceptives (OCs) on bone mineral density (BMD) of the femoral neck and of the spine in young female endurance athletes. Data on training intensity, dietary intake, menarche, menstrual cycle disorders, years of OC use, and age at first OC use were determined by a self-report questionnaire. Only athletes performing regular endurance exercise for more than 3 years with more than 3 h of exercise per week were included in this study and underwent a clinical assessment including measurement of weight, height, spine, and hip BMD by dual-energy X-ray absorptiometry, and collection of a blood sample. The data from 75 regularly exercising endurance athletes aged 18-35 years (26.5 +/- 4.8 years) were initially included in this analysis. Six athletes were later excluded due to oligo-/amenorrhea. Subjects were allocated into the OC group when they reported OC use for more than 3 years in women younger than 22 years of age, or when they reported OC use for more than 50% of the time after menarche in women aged 22-35 years. There were no differences in age, weight, height, body mass index (BMI), body fat, menarche, training intensity, age at start of training, or any serum parameters between OC users (n = 31) and control subjects (n = 38). However, OC users had 7.9% lower spine BMD and 8.8% lower proximal femur BMD (P < 0.01 for both sites). When the relationship between BMD of the spine and OC use was further analyzed by a stepwise model of multiple regression analysis using OC years, age at OC initiation, BMI, and menarche as independent variables, age at first OC use was found to be the best predictor of vertebral BMD, while the only significant predictor of femoral neck BMD was BMI. We conclude that OC use is associated with decreased BMD of the spine and the femoral neck in female endurance athletes, and that early age at initiation of OC use may be an important risk factor for low peak bone mass in young women.

Adolescent↗

PubMed2005

Mitochondrial DNA lineages of elite Ethiopian athletes.

Previous studies have hypothesised that mitochondrial DNA (mtDNA) polymorphisms may influence aerobic performance. The matrilineal inheritance and accumulation of polymorphisms in mtDNA means that mtDNA haplogroups, characterised by key polymorphisms, are often represented at different frequencies in different populations. The present study aimed to compare the mtDNA haplogroup distribution of elite Ethiopian athletes relative to the general Ethiopian population. The haplogroup distribution of 76 endurance athletes (E), members of the Ethiopian national athletics team, was compared to 108 members of the general Ethiopian population (C). DNA was extracted from buccal swabs and haplogroups assigned by sequencing part of the hypervariable sequence (HVS-I), followed by analysis of key coding-region polymorphisms. A high proportion of African 'L' haplogroups was found in athletes and controls (C=53%; E=55%). Haplogroup distribution of endurance runners did not differ from that of C (P=0.63). Elite Ethiopian athletes are not a mitochondrially distinct group relative to the Ethiopian population. It appears that environment and, perhaps, polymorphisms in the nuclear genome are more important determinants of Ethiopian running success than mtDNA polymorphisms.

Black People↗

PubMed2004

Cardiovascular disease in athletes.

Cardiovascular disease (CVD) is the leading cause of death in the United States, resulting in increased awareness of the preventive importance of regular physical activity. Because athletes are considered physically fit, occurrence of sudden athlete death from CVD is perplexing. Regular intense physical activity can cause changes to the cardiovascular system that mimic known CVD processes. Therefore, screening of athletes for conditions that may increase risk for sudden cardiac death (SCD) is challenging. This article focuses on this problem, discussing the athlete's heart, SCD and associated CV conditions, and preparticipation screening. We also review recommendations of the 26th Bethesda Conference on determining eligibility for competition in athletes with known CV abnormalities, and how the recommendations relate to individual disease processes.

Cardiovascular Diseases↗

PubMed2006

Labral tears, extra-articular injuries, and hip arthroscopy in the athlete.

Labral tears in athletes can lead to disabling hip pain and affect their athletic performance. Other intra-articular lesions, including chondral injuries, capsular abnormalities, and ligamentum teres tears, commonly coexist with acetabular labral tears. Isolated athletic injury or repetitive traumatic activity can lead to labral tears; however, underlying structural (femoroacetabular impingement) and developmental abnormalities predisposing athletes to labral pathology must be addressed. Recent studies have demonstrated lesions associated with acetabular labral tears, and that labral tears rarely occur as isolated injuries. Return to sport is favorable in athletes who have labral tears if they are properly treated with arthroscopic intervention.

Adult↗