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PubMed2005

Aortic elastic properties in athletes using anabolic-androgenic steroids.

The use of anabolic-androgenic steroids (AAS) has been linked to acute cardiovascular events in athletes. The purpose of the present study was to investigate the aortic elastic properties in athletes who had been self-administering AAS compared with a group of athletes not using these drugs. Fourteen male bodybuilders using AAS and 27 male wrestlers (non-users) volunteered to the study. All subjects were placed in a mild recumbent position and the ascending aorta was recorded in the two-dimensional guided M-mode tracings. Although the aortic distensibility was found to be reduced in user athletes (2.1+/-1.1 vs. 3.8+/-1.4 cm(2) dyn(-1) 10(-6), p=0.01; 9.3+/-3.7 vs. 5.9+/-2.5, p=0.003, respectively). The results of this study indicate that aortic stiffness is increasing in athletes using AAS.

Adult↗
PubMed1996

Predicted and measured resting metabolic rate of male and female endurance athletes.

OBJECTIVE: To measure the resting metabolic rate (RMR) of a group of endurance-trained male and female athletes and to compare it with values predicted using published equations. DESIGN: RMR was measured twice: 1 week apart for the men and approximately 1 month apart for the women. RMR was predicted using equations of Harris and Benedict, Owen et al, Mifflin et al, and Cunningham. SUBJECTS/SETTING: Subjects were 37 trained endurance athletes (24 men, 13 women) who had participated in studies previously completed in our laboratory. MAIN OUTCOME MEASURES: The primary outcome measure was the comparison of predicted RMR with measured RMR. An exploratory procedure for the determination of predictive variables in these athletes was also performed. STATISTICAL ANALYSES PERFORMED: The Root Mean Squared Prediction Error method was used to compare predicted RMR with measured RMR. The maximum R2 procedure method was used to determine the best possible combination of four variables that explained the largest amount of variance in RMR. RESULTS: The Cunningham equation was found to predict measured RMR most accurately (within 158 kcal/d for men and 103 kcal/d for women). Fat-free mass was the best predictor of RMR in men, whereas energy intake was the best predictor in women. APPLICATIONS/CONCLUSIONS: The Cunningham equation provides an accurate estimate of RMR when determining energy needs of highly active people. Equations specific to athletes need to be developed. Factors in addition to body weight, height, and age should be investigated as possible predictor variables in athletes.

Adult↗
PubMed1998

Nutritional status of female athletes with subclinical eating disorders.

OBJECTIVE: To assess the energy and nutritional status of female athletes with subclinical eating disorders and compare them with that of control subjects and standard norms. DESIGN: Group classification (subclinical eating disorder or control) was based on responses to a health and diet history questionnaire, a battery of self-report eating disorder questionnaires, and an in-depth interview. Energy and nutrient intakes and energy expenditure were determined by means of 7-day weighed food records and 7-day activity logs. Micronutrient status was assessed for iron, zinc, magnesium, vitamin B-12, and folate. SUBJECTS: Twenty-four female athletes with subclinical eating disorders and 24 female control athletes. STATISTICAL ANALYSES: Descriptive statistics were used to analyze demographic data. One-way analysis of variance was used to determine group differences in energy and nutrient intakes, energy balance, and blood values. RESULTS: Groups were similar in age, height, weight, fat-free mass, and body mass index. Mean energy intake was lower in the group with subclinical eating disorders (1,989 kcal/day) than in the control group (2,300 kcal/day; P=.004), whereas mean energy expenditures were similar (2,405 and 2,293 kcal/day, respectively). The group with subclinical eating disorders had significantly (P<.05) lower mean protein and fat intakes compared with the control group; mean micronutrient intakes were not significantly different. Mean status measures for iron, zinc, magnesium, vitamin B-12, and folate were within the normal ranges for both groups and no differences were noted between the groups. A similar number of athletes within each group used vitamin/mineral supplements < or = 4 times per week. CONCLUSION: Although female athletes with subclinical eating disorders had dietary intakes of energy, protein, carbohydrate, and certain micronutrients that were below recommended levels, micronutrient status appeared relatively unaffected, probably due to their use of supplements.

Adult↗
PubMed1981

Menstrual dysfunction and hormonal status in athletic women: a review.

Since women have become more involved in physical fitness and competitive endurance sports, the incidence of menstrual dysfunction has increased. Long-distance running and other sports may lead to alterations in gonadotropins, androgens, estrogens, progesterone, or prolactin, which in some women may directly or indirectly result in amenorrhea or infertility. The effects of running and strenuous exercise on the menstrual cycle and reproductive hormones remain controversial. Reported incidences of menstrual dysfunction vary widely, and many factors have been implicated in the onset of this problem. Exercise associated menstrual dysfunction seems to occur more frequently in nulliparous athletes, in athletes with delayed menarche, and in athletes with low body fat. It is important to realize that disruption of the menstrual cycle, ranging from mild changes in flow to amenorrhea, is a relatively common problem for the female athlete engaged in strenuous endurance sports. Yet no evidence exists at present to indicate conclusively that this menstrual dysfunction is harmful to the female athlete's reproductive system.

Adipose Tissue↗
PubMed1991

Response of plasma endorphins, corticotropin, cortisol, and luteinizing hormone in the corticotropin-releasing hormone stimulation test in eumenorrheic and amenorrheic athletes.

We compared pituitary response in the corticotropin-releasing hormone (CRH) test between 9 eumenorrheic and 10 amenorrheic endurance athletes. The maximal oxygen capacity (VO2max), determined using an exercise test on a bicycle ergometer, was larger in amenorrheic (62.7 +/- 1.0 SE mL/min per kg) than in eumenorrheic (54.7 +/- 2.3 mL/min per kg) athletes. A 100 micrograms bolus of human CRH was administered intravenously, and blood samples were collected at -15, 0, 30, 60, 90, and 120 minutes. The mean basal concentrations of endorphins, adrenocorticotropic hormone (ACTH), and cortisol did not show significant differences between the groups. The cumulative response of ACTH in the CRH test was larger in eumenorrheic (7.7 +/- 1.3 pmol/L) than in amenorrheic (3.6 +/- 0.6 pmol/L) athletes, but the response of endorphins and cortisol did not differ between the groups. A negative correlation was found between the VO2max and the ACTH response during the CRH test in the total group of athletes. These findings indicated changes in the function of hypothalamic-pituitary-adrenal axis in amenorrheic athletes that can be attributed to intensive training.

Adolescent↗
PubMed1988

Caloric intake, stress, and menstrual function in athletes.

The cause of menstrual disturbance in athletes is still debated. Apart from the acute and chronic effects of exertion, other associated behavioral variables are suspected to play a key role. A longitudinal study with frequent blood sampling was undertaken to link information about nutrition and stress with a quantitative assessment of endocrine menstrual function in 18 endurance-trained athletes and 25 age-matched, nonathletic women. Four athletes did not show hormonal signs of follicular development. The 14 athletes with cyclic gonadal function did not differ from controls with regard to estradiol concentrations during the follicular phase and at midcycle. During the luteal phase, however, they showed significantly reduced areas under the estradiol and progesterone curves. Caloric intake, as assessed by nutritional diaries, correlated positively with the area under the progesterone curve during the luteal phase (rs = 0.70, P less than 0.01). Ratings of subjective stress in the area "partner, family, friends" correlated negatively with the luteal progesterone area (rs = 0.80; P less than 0.01). Data support the hypothesis that nutrition and stress may play a critical role in the genesis of menstrual disturbance in athletes.

Adult↗
PubMed2001

Gender differences in athlete's heart: association with 24-h blood pressure. A study of pairs in sport dancing.

BACKGROUND: Long term athletic training is associated with an increase in left ventricular diastolic cavity dimensions, wall thickness, and mass. These changes are described as the "athlete's heart". In comparison to men, athletic training in women athletes is not a stimulus for substantial increase in left ventricular wall thickness. Although many variables are related to these gender differences in cardiac morphology, some factors such as 24-h blood pressure and the level of training have not been studied yet. Therefore pairs in sport dancing, in which the level of training of both partners is the same, were chosen as models in order to evaluate whether 24-h blood pressure contributes to sex-related differences in an athlete's heart. METHODS: Fifteen pairs in the national sport dancing team and 30 control subjects (15 males, 15 females) were studied. In all subjects casual and 24-h ambulatory blood pressures, echocardiography, and maximal stress testing were performed. RESULTS: Female in comparison to male dancers had significantly lower M-mode (P<0.004) and 2-D left ventricular mass index (P<0.001), 24-h systolic blood pressure (P<0.003), day systolic blood pressure (P<0.002), casual systolic blood pressure (P<0.025), and achieved significantly lower peak systolic blood pressure at stress testing (P<0.004). Multiple stepwise regression analysis showed that the best predictors of 2-D left ventricular mass index are maximal work load and peak exercise systolic blood pressure, 24-h systolic blood pressure, day, and casual systolic blood pressure. CONCLUSIONS: Lower left ventricular mass index in female dancers can be partly explained by lower systolic blood pressures during 24-h and at exercise.

Adult↗
PubMed1998

Cardiovascular adaptations to endurance training and detraining in young and older athletes.

In order to evaluate the influence of aging on cardiovascular adaptations to endurance training and detraining, 12 young (range 19-25 years) and 12 older (range 50-65 years) male cyclists were examined during the training and after 2 months of detraining. Twelve young and 12 older healthy sedentary males matched for age and body surface area were used as control groups. Each subject underwent a maximal exercise test using a cycle-ergometer in order to measure maximum oxygen consumption, an M-mode and 2D echocardiography in order to assess left ventricle morphology and systolic function, and a Doppler echocardiography for evaluating the diastolic filling pattern. During the training period both groups of athletes showed higher values of maximum oxygen consumption, left ventricular wall thicknesses, end-diastolic diameter and volume, as well as left ventricular mass, than their control subjects; in the older subjects the adaptation of the heart to aerobic training seems to be obtained mainly through a higher increase in left ventricular diastolic filling. In both groups no significant modifications in the ejection fraction and diastolic function parameters were recorded. After the detraining period the wall thicknesses decreased only in young athletes, while left ventricular mass and end-diastolic diameter and volume reduced only in older athletes. In conclusion, training and detraining induced nearly similar left ventricular morphological modifications in the two age groups, even though greater in the older athletes with respect to the ventricular mass and volume. No relevant differences were observed in the Doppler filling pattern between athletes and sedentary controls.

Adaptation, Physiological↗
PubMed2002

Reaction times and anticipatory skills of karate athletes.

Two experiments were conducted to investigate the reaction times (RTs) and anticipation of karate athletes. In Experiment 1, choice RTs and simple RTs were measured with two types of stimuli. One was videotaped scenes of opponent's offensive actions, which simulated the athletes' view in real situations, and the other was static filled circles, or dots. In the choice RT task, participants were required to indicate as soon as possible whether the offensive actions would be aimed at the upper or middle level of their body, or the dot was presented either at a higher or a lower position. In the simple RT task, they were required to respond as soon as possible when the offensive action started from a static display of the opponent's ready stance, or a dot appeared on the display. The results showed significant differences between the karate athletes and the novices in the choice RT task, the difference being more marked for the video stimuli than for the dot stimuli. There was no significant difference in simple RT between the two groups of participants, for either type of stimuli. In Experiment 2, the proportions of correct responses (PCRs) were measured for video stimuli which were cut off at the seventh frame from the onset of the opponent's offensive action. The athletes yielded significantly higher PCRs than the novices. Collectively the results of the two experiments demonstrate the superior anticipatory skills of karate athletes regarding the target area of an opponent's attack (Scott, Williams, & Davids, Studies in perception and action II: Posters presented at the VIIth International conference on Event Perception and Action, Erlbaum, Hillsdale, NJ, 1993, p. 217; Wiiliams & Elliot, Journal of Sport & Exercise Psychology 21 (1999) 362), together with their advantage over novices in non-specific sensory functions (e.g., vertical discrimination).

Adult↗
PubMed1997

Outer limits of the athlete's heart, the effect of gender, and relevance to the differential diagnosis with primary cardiac diseases.

Two concepts from pathologic descriptions of myocardial hypertrophy in trained individuals merit consideration: (1) The heart of the trained athlete can be twice the normal size, but histologic structure remains intact, and (2) the weight of the trained heart does not usually surpass the limit of 500 g, defined as the critical heart weight. Even though this threshold cannot be accepted dogmatically, the concept of an upper limit for physiologic cardiac remodeling is nevertheless relevant to the clinical question of distinguishing extreme expressions of athlete's heart from primary pathologic conditions. This morphologic distinction depends on whether the magnitude of cardiac remodeling in athletes exceeds that expected as a result of athletic conditioning alone. There has also been a great interest in understanding the impact that types of athletic conditioning and gender have on defining the upper limits to which such physiologic hypertrophy may extend.

Adult↗
PubMed1997

The athlete's heart. Historical perspectives--solved and unsolved problems.

Clinicians are coming back to Henschen's assessment of the athlete's heart as a physiologic and positive phenomenon. An athlete's heart may be affected by clinical conditions. Regarding the extreme performance of the athlete's heart in training and competition, conditions that may be harmless in sedentary people can be fatal for the athlete. The athlete's heart therefore deserves the particular interest and care of the sports cardiologist.

Adaptation, Physiological↗
PubMed2003

Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy.

OBJECTIVES: The goal of this study was to determine the impact of race on identification of hypertrophic cardiomyopathy (HCM). BACKGROUND: Sudden death in young competitive athletes is due to a variety of cardiovascular diseases (CVDs) and, most commonly, HCM. These catastrophes have become an important issue for African Americans, although HCM has been previously regarded as rare in this segment of the U.S. population. METHODS: We studied the relationship of race to the prevalence of CVDs causing sudden death in our national athlete registry, and compared these findings with a representative multicenter hospital-based cohort of patients with HCM. RESULTS: Of 584 athlete deaths, 286 were documented to be due to CVD at ages 17 +/- 3 years; 156 (55%) were white, and 120 (42%) were African American. Most were male (90%), and 67% participated in basketball and football. Among the 286 cardiovascular deaths, most were due to HCM (n = 102; 36%) or anomalous coronary artery of wrong sinus origin (n = 37; 13%). Of the athletes who died of HCM, 42 (41%) were white, but 56 (55%) were African American. In contrast, of 1,986 clinically identified HCM patients, only 158 (8%) were African American (p < 0.001). CONCLUSIONS: In this autopsy series, HCM represented a common cause of sudden death in young and previously undiagnosed African American male athletes, in sharp contrast with the infrequent clinical identification of HCM in a hospital-based population (i.e., by seven-fold). This discrepancy suggests that many HCM cases go unrecognized in the African American community, underscoring the need for enhanced clinical recognition of HCM to create the opportunity for preventive measures to be employed in high-risk patients with this complex disease.

Adolescent↗
PubMed1986

Sudden death and the competitive athlete: perspectives on preparticipation screening studies.

Sudden death in healthy athletes is uncommon but, when it occurs, the primary mechanism is cardiovascular. The major cause of sudden death in the young athlete is hypertrophic cardiomyopathy or related conditions characterized by left ventricular hypertrophy, aortic rupture due to cystic medial necrosis and congenital coronary artery abnormalities. In the middle-aged or older athlete, coronary artery disease is the most significant cause of sudden death. Noninvasive screening procedures are currently available that can detect most subjects at risk of sudden death. However, although some potentially lethal diseases can be excluded by a relatively simple screening program, other diseases require expensive procedures, such as echocardiography and exercise electrocardiographic stress testing. This means that the sensitivity of detecting diseases leading to sudden death increases in proportion to the financial resources that can be applied to the screening program. Thus, when a screening program designed to identify all cardiac diseases that have the potential to cause sudden death is planned by a community, school or nonprofessional athletic team, the costs will almost undoubtedly be considered prohibitive. The practicality of applying a community- or school-initiated screening program can be questioned because of the very low incidence of sudden unexpected death in young healthy individuals. It is therefore likely that comprehensive screening programs will be confined to individuals or organizations with adequate financial resources. Less expensive, limited screening can be undertaken by individuals or groups to identify some subjects at risk of sudden death during athletic competition.

Adult↗
PubMed1999

Angiotensinogen gene M235T polymorphism predicts left ventricular hypertrophy in endurance athletes.

OBJECTIVES: We studied whether left ventricular mass in athletes associates with polymorphisms in genes encoding components of the renin-angiotensin system. BACKGROUND: Adaptive left ventricular hypertrophy is a feature of the athlete's heart. However, similarly training athletes develop left ventricular mass to a different extent, suggesting that genetic factors may modulate heart size. METHODS: We measured left ventricular mass by echocardiography in 50 male and 30 female elite endurance athletes aged 25 +/- 4 (mean +/- SD) years. Deoxyribonucleic acid samples were prepared for genotyping of angiotensinogen (AGT) gene M235T polymorphism, angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and angiotensin II type 1 receptor (AT1) gene A1166C polymorphism. RESULTS: The AGT gene M235T genotypes were significantly associated with left ventricular mass independently of blood pressure in both genders (p = 0.0036 for pooled data). TT homozygotes had greater mass compared with MM homozygotes in both men (147 +/- 12 g/m vs. 132 +/- 15 g/m, p = 0.032) and women (121 +/- 12 g/m vs. 101 +/- 13 g/m, p = 0.019). There was a gender difference in the relation between myocardial mass and AGT genotype, MT heterozygotes resembling MM homozygotes among women and TT homozygotes among men. The other studied gene polymorphisms were not associated with left ventricular mass. CONCLUSIONS: Angiotensinogen gene M235T polymorphism is associated with the variability in left ventricular hypertrophy induced by endurance training, with athletes homozygous for the T allele having the largest hearts. We found no association between ACE gene I/D or AT1 gene A1166C polymorphisms and left ventricular mass.

Adaptation, Physiological↗
PubMed2001

Eating disorders in athletes: a review of the literature.

Over the last two decades an increasing amount of research has begun to examine the issue of eating disorders in athletes. While a number of studies in this area have been published, the results have not been able to clarify the nature of the relationship between athletic involvement and eating problems. This review critically evaluates existing studies of eating disorders in athletes, highlighting various methodological limitations. Studies are grouped under three main headings: uncontrolled studies; controlled studies; and studies comparing athletes with different body type requirements. A fourth section of the paper evaluates studies which have addressed the issue of gender differences in eating disorders among athletes. Suggestions are made for guidelines that will improve future research in this area.

Adolescent↗
PubMed2003

The effects of anabolic-androgenic steroids upon resting and peak exercise left ventricular heart wall motion kinetics in male strength and power athletes.

Previous investigations reported alterations in myocardial fibres and systolic function associated with anabolic-androgenic steroid consumption by athletes. Advances in bio-medical technology have allowed further investigation in assessing the possible effects of anabolic-androgenic steroids on gross left ventricular kinetics. Twenty-three male strength and power athletes with a past and current history of anabolic-androgenic steroid consumption (x 46 days, range 28 days to 70 days), were compared to 23 controls. Testing consisted of resting and immediate post-exercise transthoracic left ventricular wall cardiokymograms. Statistical results identified no difference over time between groups or condition. Cardiokymographic waveform analysis found 32.61% of all (n =184) waveforms to be abnormal (Type II, n = 56 or Type III, n = 4). There were 14 treatment subjects (60.87%) who demonstrated an abnormal waveform as compared to 9 controls (39.13%). A significant difference (p < or = 0.01) in the overall proportions of waveform types was identified where the treatment group exhibited 41.30% abnormal waveforms, compared to 23.91% by controls. Additionally, two athletes (1 treatment, 1 control) demonstrated abnormal left ventricular wall motions (Type III) analogous to impaired left ventricular performance. The results indicated: (a) highly strength trained athletes with no history of anabolic-androgenic steroid usage exhibited an unexpected high incidence of Type II waveforms (28.26% pre/23.91% post); (b) a comparable group of strength trained athletes using anabolic-androgenic steroids exhibited a significantly higher percentage of abnormal waveforms as compared to controls (34.78% pre/37.21% post). Based on these results, high intensity strength training with and without anabolic-androgenic steroid supplementation induced alterations in the left ventricular wall motion.

Adult↗
PubMed2003

Predictors of disordered eating in a sample of elite Division I college athletes.

OBJECTIVE: The present study sought to investigate the relationship between a number of areas of elite student-athletes' lives and disordered eating. METHOD: We surveyed 1445 elite Division I athletes at 11 different institutions and in 11 different sports. Hierarchical regression was used to indicate specific areas of the participants' collegiate experience that may be associated with disordered eating attitudes and symptomatology. RESULTS: Results demonstrate that the variables entered into each model predicted between 40.5% and 46.4% of the variance for the restriction of food, body dissatisfaction, and drive for thinness. Categories of variables that generally predicted the most variance for each dependent measure were demographics, athletic involvement, and personality. Of the 11 sports included in the analysis, wrestling and gymnastics demonstrated elevated levels of drive for thinness, food restriction, and purging behavior compared to other athletes. DISCUSSION: Findings suggest that in elite athletes gender, ethnicity, sport, and self-esteem are associated with several behaviors and attitudes indicative of disordered eating.

Journal Article↗
PubMed2003

The College Health Related Information Survey (C.h.R.I.s.-73): a screen for college student athletes.

OBJECTIVE: To assess the reliability and discriminate validity of a new screening instrument for college student athletes. METHOD: 518 Stanford University students completed the proposed instrument (College Health Related Information Survey-CHRIS-73), which was based on the Juvenile Wellness and Health Survey (JWHS-76) but re-designed to assess mental health domains relevant to college athletes. RESULTS: Factor analysis yielded four factors: mental health problems, eating problems, risk behaviors, and performance pressure. Factors were internally consistent, reasonably independent, and clearly discriminated between athletes and non-athletes, and males and females. CONCLUSIONS: This study supports the CHRIS-73 as a useful screen for assessing mental health problems among college student athletes.

Adult↗