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PubMed1987

The athletic heart.

The clinical features of athletic hearts are confusing to physicians who are unfamiliar with them. In particular, the diagnosis of hypertrophic cardiomyopathy may be suggested. The clinical signs of athletes' hearts are discussed with special reference to this difficult diagnosis. Emphasis is placed on the results of special investigations including the electrocardiogram and echocardiogram. The changes seen in athletic hearts are physiologic adaptations that do not appear to cause significant problems. Long-term follow up of the more extreme examples, however, is very limited, and this is an area where further information is needed. Resting bradycardia is a common feature in athletes, but abnormal tachyarrhythmias on exertion signify cardiac disease and are not a part of the athlete heart syndrome.

Arrhythmias, Cardiac↗
PubMed1987

Substance-abuse policies and guidelines in amateur and professional athletics.

Substance-abuse policies and guidelines in amateur and professional athletic organizations are described. Amateur athletic organizations, which are governed by the U.S. Olympic Committee or the National Collegiate Athletic Association (NCAA), have developed programs that include mandatory drug testing. Drugs banned by the two organizations include psychomotor stimulants, sympathomimetic amines, narcotic analgesics, anabolic steroids, miscellaneous central nervous system stimulants, and, in the case of the NCAA, certain street drugs. Professional organizations have been somewhat slower to follow and, with the exception of tennis, do not allow mandatory drug testing. Each formal drug-screening program includes penalties for violators. The enforcement practices of the organizations representing tennis, baseball, basketball, and football are described. One aspect unique to professional sports is the employee-assistance program, which allows the impaired athlete to receive treatment while continuing to play and receive a salary. As drug-control programs become more common in athletics, opportunities may arise for pharmacists to participate in the areas of drug information and educational services.

Doping in Sports↗
PubMed1987

Body composition in paraplegic male athletes.

The body composition and anthropometric characteristics of male paraplegic athletes (PARA, N = 22) were contrasted to an able-bodied ectomorphic (N = 22) and mesomorphic (N = 31) comparison group of moderately and highly trained male subjects. The validity of 12 body composition [density (Db)] prediction equations reported in the literature, 4 generalized, were determined (tested) on this special group of athletes (PARA). On the whole, the prediction equations over-predicted Db in PARA by 0.0039 to 0.0166 g X cm-3 (under-predicted relative fat by 1.8 to 7.4%). Five diameter, 11 circumference, and 7 skinfold measures were used in a SAS-STEPWISE multiple regression procedure with hydrostatically determined Db to develop several suitable Db prediction equations for the paraplegic athlete. Diameters were poor predictors (r = 0.60, SEE = 0.0164), while skinfolds, circumferences, or a combination of measures were acceptable, with the combined equation being best (r = 0.95, SEE = 0.0064). The findings of this study suggest that even generalized equations do not adequately predict Db in PARA and that paraplegic specific equations are presently best suited for predicting Db in paraplegic athletes. The results further indicate that although these equations meet many of the criteria of Lohman, the SEE and total error values are unusually high and make prediction of body composition using anthropometry in a heterogeneous group of PARA athletes slightly unreliable.

Adolescent↗
PubMed1987

Bone fractures among former college athletes compared with nonathletes in the menopausal and postmenopausal years.

Data are presented on the prevalence (lifetime occurrence) of bone fractures among 5398 college alumnae, 2622 former college athletes, and 2776 nonathletes, ranging in age from 21 to 80 years. As expected from increased physical activity, the former college athletes in each age decade from 20 to 70 years and over reported a higher lifetime occurrence (i.e., at any age up to the time of reporting) of bone fractures of all types, than that of nonathletes (40.5 versus 31.9%, P less than .001). However, when athletic activity was accounted for, the former college athletes were at no greater risk of fractures in the menopausal years than were nonathletes. Among women 60 years and over who were fracture-free up to age 40, the rate for any fracture at age 40 or over was 29% for former college athletes compared with 32% for nonathletes, a nonsignificant difference.

Adult↗
PubMed1985

Circadian rhythms and athletic performance.

Daily or circadian rhythmical oscillations occur in several physiological and behavioral functions that contribute to athletic performance. These functions include resting levels of sensory motor, perceptual, and cognitive performance and several neuromuscular, behavioral, cardiovascular, and metabolic variables. In addition, circadian rhythms have been reported in many indices of aerobic capacity, in certain physiological variables at different exercise levels, and, in a few studies, in actual athletic performance proficiency. Circadian rhythmicity in components of athletic performance can be modulated by workload, psychological stressors, motivation, "morningness/eveningness" differences, social interaction, lighting, sleep disturbances, the "postlunch dip" phenomenon, altitude, dietary constituents, gender, and age. These rhythms can significantly influence performance depending upon the time of day at which the athletic endeavor takes place. Disturbance of circadian rhythmicity resulting from transmeridian flight across several time zones can result in fatigue, malaise, sleep disturbance, gastrointestinal problems, and performance deterioration in susceptible individuals (circadian dysrhythmia or "jet-lag"). Factors influencing the degree of impairment and duration of readaptation include direction of flight, rhythm synchronizer intensity, dietary constituents and timing of meals, and individual factors such as morningness/eveningness, personality traits, and motivation. It is the intent of the authors to increase awareness of circadian rhythmic influences upon physiology and performance and to provide a scientific data base for the human circadian system so that coaches and athletes can make reasonable decisions to reduce the negative impact of jet-lag and facilitate readaptation following transmeridian travel.

Altitude↗
PubMed1985

Anabolic steroids in the training and treatment of athletes.

The use of anabolic steroids has become widespread in the athletic population in the hope of developing a competitive edge. The theoretical advantages of increases in lean body mass, body weight, and muscle strength have been difficult to document in the athletic population because of an inability to define a satisfactory placebo or safely test the extremely high doses of steroid purportedly used by the athletic population. Those studies that are available suggest that while some mild weight gain and lean body mass increase may be noted, athletic performance itself is not significantly altered by steroid use. The significant negative side effects that can occur, particularly those that alter liver function and endocrine balance, suggest that there is little to support the use and abuse of these drugs in the treatment and training of athletes.

Body Composition↗
PubMed1981

Calf blood flow and vascular resistance during reactive hyperaemia in young athletes and trained middle-aged subjects.

The effect of training on dilatation capacity in the lower limbs was evaluated by studying the blood flow and vascular resistance in the calf in 10 young athletes aged 19-29 years and 15 trained middle-aged subjects aged 52-58 years during post-ischaemic reactive hyperaemia. The control groups comprised untrained subjects of approximately the same ages, i.e. 16 men aged 18-29 and 37 aged 40-60. The calf blood flow as determined plethysmographically and the blood pressure was measured on the arm by auscultation. Vascular resistance was calculated from the mean blood pressure and from the maximal calf blood flow measured during hyperaemia. A significantly higher maximal blood flow and significantly lower resistance in the calf were found in young athletes than in untrained subjects. In athletes, the flow debt was significantly overpaid. In middle-aged subjects, the effect of training was manifested only in significant overpayment of the flow debt, while vascular resistance and the maximal blood flow were the same as in the controls. It can be concluded from these findings that significant improvement of vasodilatation ability in association with training occurs primarily in young subjects. The findings also correspond to the known ability of young athletes to give a higher maximal performance than veteran athletes.

Adult↗
PubMed1984

Nutrition knowledge and food practices of high school athletes.

The purpose of this study was to analyze the food practices and nutrition knowledge of high school athletes currently participating in interscholastic sports and to evaluate differences in terms of selected sports variables. The data for the study were obtained by a questionnaire administered to a sample of 943 athletes from randomly selected high schools in Connecticut. The stated hypotheses were tested statistically using analysis of variance, t-tests, and Pearson correlation coefficients where appropriate. The results of the study indicated that the female athletes had better knowledge of nutrition but poorer food practices than the male athletes. There were also significant relationships between sport forms, seasons, and nutrition knowledge and food practices. High school athletes perceived their best source of nutrition knowledge to be their parents. Results on the nutrition knowledge component of the instrument showed that out of 48 possible answers, the mean correct was 26.4, while out of a possible score of 5, the mean score for food practices was 2.2. Because a positive relationship existed between the number of sport seasons and nutrition knowledge and food practice scores, sport participation may be a catalyst for learning about nutrition.

Adolescent↗
PubMed1984

Coaching preferences of athletes.

The study examined the coaching preferences of 80 male and 80 female athletes, as measured by the Leadership Scale for Sports (Chelladurai and Saleh, 1978, 1980). In addition, it attempted to assess the applicability to sport of the Life-cycle and Path-goal theories of leadership. Comparisons between groups were made on the basis of sex, age, and type of sport. A MANOVA indicated that athletes in independent sports preferred more democratic behaviour (p less than .001) and less autocratic behaviour (p = .028) than athletes in interdependent sports. No differences in coaching preferences were found which could be attributed to the age or sex of the athlete, or the variability of the sports task. These results partially supported the Path-goal theory, but did not support the Life-cycle theory. Athletes of all groups tended to favour coaches who displayed training behaviour and rewarding behaviour "often", democratic behaviour and social support behaviour "occasionally", and autocratic behaviour "seldom". This consistency may be a useful finding for those organizations and institutions interested in preparing coaches.

Adolescent↗
PubMedDate not supplied

[Androgenic function of the adrenal cortex in girl athletes with retarded sexual development].

Diurnal excretion of 17-ketosteroids and their fractions was studied in 43 girl athletes with retarded sexual development (RSD) and 22 patients who did not go in for sports. Twenty-five healthy girls with a normal menstrual cycle constituted the control group. Athletes with RSD showed relative hyperandrogeny marked by a higher proportion of more active androgenic fractions (dehydroepiandrosterone and androsterone) in total 17-ketosteroids. Excretion of neutral 17-ketosteroids in athletes examined, as compared with non-athletes with RSD, was within age-associated norms or surpassed them. It is suggested that androgens of the adrenal cortex are involved into the pathogenesis of RSD in female athletes.

Adolescent↗
PubMed1980

[Echocardiograhy in athletes].

The electrocardiogrammes and echocardiogrammes of 10 weight lifters and 20 endurance trained top class athletes (runners, basket ball players and cyclists) were analysed. The electrocardiogrammes confirmed the notion of a specific profile in endurance trained athletes with left ventricular diastolic overload pattern. The echocardiogrammes did not show increased left ventricular wall thickness in the resistance trained athletes. It did show however a clear increase in left ventricular internal diastolic dimension and posteror wall thickness--the anatomical substratum of the large heart in athletes--in some categories of endurance trained athletes (cyclists and basket ball players). No change in the indices of left ventricular performance was found in either group.

Adult↗
PubMed1983

The athlete's diet: a current view.

As a result of new interest in prescribing individual athletic programs and healthy life styles, the average participant and the health care provider are faced with confusing information on what constitutes optimal nutrition. Not only has the efficacy of dietary supplements (high-protein, "megadose" vitamins and minerals) for improved athletic performance not been demonstrated, but these supplements can also have undesirable effects. A diet of adequate calories and composition remains the optimal source of good nutrition and must be balanced with energy output. While most mineral supplements are unnecessary, iron supplements for female athletes and for male long-distance runners may be advisable. Carbohydrate loading is the only dietary manipulation shown to affect athletic performance and then only in the endurance athlete. Conscious water replacement is needed during and after competition.

Diet↗
PubMed1981

Delayed menarche and amenorrhea of college athletes in relation to age of onset of training.

Age at menarche and menstrual periodicity of 21 college swimmers and 17 runners were studied in relation to the age of initiating training. The 18 premenarche-trained athletes had a mean menarcheal age of 15.1 +/- 0.5 years, whereas the 20 postmenarche-trained athletes had a mean menarcheal age of 12.8 +/- 0.2 years, similar to that of the college control subjects, 12.7 +/- 0.4 years. Each year of training before menarche delayed menarche by five months (0.4 years). Of the premenarche-trained athletes, 61% had irregular menstrual cycles and 22% were amenorrheic, whereas 60% of the postmenarche-trained athletes had regular menstrual cycles and none were amenorrheic. Training increased the incidence of oligomenorrhea and amenorrhea among both premenarche- and postmenarche-trained athletes. Metabolic and hormonal changes consequent to an increased lean/fat ratio may explain these findings.

Adipose Tissue↗
PubMed1995

Micronutrients (magnesium, zinc, and copper): are mineral supplements needed for athletes?

Mineral elements, including magnesium, zinc, and copper, are required by the body in modest amounts for the maintenance of health and for the development of optimal physiological function. For athletes, adequate amounts of these minerals are required for physical training and performance. Studies of athletes during training, as compared to nontraining control subjects, indicate the potential for increased losses of minerals in sweat and urine. Some studies report suboptimal intakes of minerals, particularly among athletes who are actively attempting to lose weight to meet standards for competition. However, most athletes consume diets that provide adequate amounts of minerals to meet population standards. Athletes should be counseled to consume foods with high nutrient density rather than to rely on mineral supplements. General use of mineral supplements can alter physiological function and impair health.

Copper↗
PubMed1995

[Signal-averaged electrocardiograms in young athletes--sudden death during exercise].

Our objective was to evaluate the incidence of abnormal SAECG in young athletes, and to evaluate the relationship between abnormal SAECG and electrocardiographic and echocardiographic parameters. The presence of an abnormal SAECG was evaluated in 796 athletes (mean age 19 years), and its relation to findings on 12-lead electro-cardiograms, echocardiograms, and arrhythmias was studied, as recorded by the Holter monitor. An abnormal SAECG was defined as two of the three following criteria: filtered QRS duration > or = 114 msec, root mean squared voltage in the terminal 40 msec < or = 20 microV, or duration < 40 microV > or = 38 msec. Abnormal SAECGs were present in 68 (8.5%) of the athletes and were associated with a smaller left ventricular mass. Athletes who performed anaerobic exercise tended to exhibit a high incidence of abnormal SAECG, which was associated with smaller left ventricular mass. No serious ventricular arrhythmias were observed on Holter monitoring for 24h and during a follow-up period of 20 +/- 10 months in 796 subjects. Continuous anaerobic exercise may induce abnormal SAECG due to the development of delayed myocardial conduction or to electrical inhomogeneity in the cardiac tissue. The presence of an abnormal SAECG was unrelated to the development of arrhythmias in young athletes.

Adult↗
PubMed1994

[ECG of the athlete's heart].

The athlete's heart is characterized by eccentric hypertrophy of all cardiac cavities and there is a close connection to increased tone of the vagal system. As a consequence, not only arrhythmias are observed in the ECG of healthy athletes, but also changes in the QRS complex and in the ST-T-segment. Left ventricular hypertrophy is diagnosed in ECG by a positive Sokolow-Lyon index. The frequent finding of a right ventricular conduction delay is possibly due to hypertrophy of the myocardium in the apex of the right ventricle. The causes of various T wave changes are generally unclear and await further diagnostic clarification. In cases when normalization of the T-wave deviation is observed under stress, such changes are of functional nature. Echocardiography is indicated in any case to establish the heart's size and function; hypertrophic cardiomyopathy has to be excluded. Frequent cardiac dysrhythmias found in athletes are sinus bradycardia and sinus arrhythmia, less often escape rhythms are seen. A arrhythmia more often found in athletes is the respiration-dependent simple atrioventricular dissociation. Also, escape rhythms are observed in some cases with ventricular origin. Finally, a pronounced vagotonia can lead to a prolonged conduction time; AV-blocks of all degrees of severity are observed in athletes. The functional character of these arrhythmias can be easily demonstrated by their disappearance under stress.

Arrhythmias, Cardiac↗
PubMed1995

Altered adrenal steroid metabolism underlying hypercortisolism in female endurance athletes.

OBJECTIVE: To explore possible changes in adrenal steroid metabolism and androgenic-anabolic status in female endurance athletes as a mechanism for their hypercortisolism. DESIGN: Adrenal steroids and androgenic-anabolic factors were studied during basal conditions and in response to ACTH stimulation related to menstrual status. SETTING: Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden. PARTICIPANTS: Thirteen female elite middle to long distance runners (six eumenorrheic, seven oligoamenorrheic) and seven regularly menstruating controls. INTERVENTIONS: Blood samples were collected before and after an injection of 250 micrograms IV synthetic ACTH 1-24. Body weight, height, and body fat were measured. MAIN OUTCOME MEASURES: Basal serum concentrations of cortisol, androstenedione (A), DHEA, DHEAS, 17 alpha-hydroxyprogesterone (17-OHP), T, steroid-binding proteins, and insulin-like growth factor I and ACTH-induced response (area under the curve) of cortisol, DHEA, and 17-OHP. RESULTS: Oligoamenorrheic athletes had higher basal cortisol and A concentrations compared with healthy controls, whereas basal levels of DHEA and DHEAS were normal. Important findings in the oligoamenorrheic athletes were a significantly lower ratio between the ACTH-induced increments of DHEA and 17-OHP and an increased ratio between basal A and DHEAS. Insulin-like growth factor I was correlated negatively to sex hormone-binding globulin and to the amount of body fat in the combined material. CONCLUSIONS: The results indicate a redistribution of adrenal steroid metabolism in favor of glucocorticoid production in female endurance athletes. We suggest that hypercortisolism in female endurance athletes is a physiological adaptation to maintain adequate blood glucose levels during a condition of energy deficiency.

17-alpha-Hydroxyprogesterone↗
PubMed1995

Daily energy expenditure in male endurance athletes with differing energy intakes.

The 24-h energy expenditure (24-h EE), resting EE (REE), sleeping EE (SEE), and spontaneous physical activity (SPA) were compared between six male endurance athletes whose reported energy intake was low (LOW) and did not match that theoretically required for weight maintenance and four whose reported energy intake appeared adequate (ADQ) and matched their estimated EE. Groups did not differ in age, body weight, fat-free mass, and daily EE estimated from activity records. The LOW athletes reported an energy intake 6338 +/- 2164 kJ.d-1 less than estimated EE. The 24-h EE, REE, SEE, and SPA of the LOW athletes were significantly lower than the ADQ athletes (862, 523, 770 kJ.d-1, and 43 min.d-1, respectively). Using all subjects, there was a significant positive correlation between REE and free thyroxine (FT4) (r = 0.82) and SEE and FT4 (r = 0.66). Thus, part of the LOW athlete's ability to maintain body weight on a seemingly low energy intake appears due to a lower daily sedentary EE.

Activities of Daily Living↗