Overtraining syndrome

Combined Turmeric, Vitamin C, and Vitamin D Ready-to-Drink Supplements Reduce Upper Respiratory Illness Symptoms and Gastrointestinal Discomfort in Elite Male Football Players

Elite football is associated with the increased risk of illness, although targeted supplementation can reduce illness risk. This study assessed the effects of a supplement containing turmeric root within a black pepper and fat-soluble blend, vitamin C and vitamin D, on upper respiratory symptoms (URS), gastrointestinal symptoms (GIS), muscle soreness, and markers of inflammation and gut permeability in elite male footballers. Twenty-three footballers completed 3 weeks of no intervention (CON), followed by 16 weeks of daily consuming 60 mL of a commercially available supplement containing raw turmeric root (17.5 g, estimated to contain 700 mg of curcumin), vitamin C (1000 mg), and vitamin D3 (3000 IU/75 mcg) (SUP). URS and GIS were measured daily. Immediately (0 h), 40, and 64 h after six competitive matches (two in CON, four in SUP), the subjective soreness and plasma concentrations of creatine kinase [CK], c-reactive protein [CRP], and intestinal fatty-acid binding protein [I-FABP] were assessed. URS incidence (p < 0.001), GIS (p < 0.05), and plasma [I-FABP] at 0 h (p < 0.05) were greater during CON versus SUP. At 40 h, [CRP] was greater than 0 h during CON (p < 0.01) but not SUP (p = 0.204). There were no differences in soreness or [CK]. This study indicates that turmeric root, vitamin C, and vitamin D supplementation over 16 weeks can reduce URS, GIS, and post-match [I-FABP] in elite footballers.

Cross-Cultural Validation of the Malaysian Mood Scale and Tests of Between-Group Mood Differences

Mood measures have been shown to have utility for monitoring risks to mental health and to predict performance among athletes. To facilitate use in a Malaysian context, we tested a Malay-language version of the 24-item Brunel Mood Scale (BRUMS), referred to as the Malaysian Mood Scale (MASMS). Following a thorough translation-back-translation process, the 24-item MASMS was administered to 4923 Malay-speaking respondents (2706 males, 2217 females; 2559 athletes, 2364 non-athletes), ranging in age from 17 to 75 years (M = 28.2 years, SD = 9.4 years). Confirmatory factor analysis supported the six-factor MASMS measurement model (CFI = 0.950, TLI = 0.940, RMSEA = 0.056 [CI 0.055, 0.058]). Convergent and divergent validity of the MASMS were supported via relationships with depression, anxiety, and stress measures. Significant differences in mood scores were found between athletes and non-athletes, males and females, and younger and older participants. Tables of normative data and profile sheets for specific groups were generated. We propose that the MASMS is a valid measure that can be used to monitor mental health status among athletes and non-athletes and that facilitates future mood-related research in Malaysia.

Neuromuscular Performance Changes in Elite Futsal Players Over a Competitive Season

ABSTRACT

Spyrou, K, Alcaraz, PE, Marín-Cascales, E, Herrero-Carrasco, R, Cohen, DD, and Freitas, TT. Neuromuscular performance changes in elite futsal players over a competitive season. J Strength Cond Res XX(X): 000-000, 2022-A professional futsal season imposes a great amount of physiological and mechanical stress on players. The main aim of this study was to examine the changes in neuromuscular performance qualities across the season. Ten professional male players performed a 10-m sprint, standing long jumps (SLJs), and countermovement jumps (CMJs) during the competitive season (i.e., every ∼5 weeks from September to January). A one-way repeated measures ANOVA with post hoc pairwise comparisons and effect sizes (ESs) were used to analyze potential differences among these assessments. A significant and large decline was found in concentric peak power (p = 0.040; ES = 1.24). A nonsignificant and moderate decrease was observed in sprint ability (p = 0.155; ES = 1.03), CMJ height (p = 0.175; ES = 1.00), and SLJ distance (p = 0.164; ES = 1.03). Regarding other CMJ kinetic variables, nonsignificant and moderate changes were found. In summary, considering the neuromuscular performance tests and variables assessed, only concentric peak power in CMJ decreased significantly across the season; however, nonsignificant decrements were observed in sprinting time, SLJ, CMJ height, and other kinetic metrics. CMJ variables during the jump-land cycle should be incorporated alongside more traditional measures (e.g., jump height) to monitor performance during the season.

Impact of autonomic regulation on burnout and performance in thoracic surgery residents

Objective

This study sought to determine the feasibility of collecting physiologic data in thoracic surgery residents and whether it would correlate with burnout and burnout with performance.

Methods

This was a prospective study of thoracic surgery residents over a 5-month period. Participants were evaluated with a wearable biometric device (heart rate variability and sleep) and the Maslach Burnout Inventory. Resident performance was quantified using Accreditation Council for Graduate Medical Education Milestones (scale, 1-5) normalized to program-designated targets (3 for postgraduate year 6 or lower residents and 4 for postgraduate year 7 residents).

Results

The cohort consisted of 71% female participants (5/7) with 86% of residents having 1 or more children. High levels of emotional exhaustion (median, 30 [interquartile range, 20-36], where >26 is high) and high levels of depersonalization (median, 16 [interquartile range, 14-22], where >12 is high) were common, but personal accomplishment was also uniformly high (median, 43 [interquartile range, 41-46], where >38 is high). There was a significant correlation between heart rate variability and emotional exhaustion (r(12) = 0.65, P = .01) but not depersonalization (P = .28) or personal accomplishment (P = .24). Depersonalization and personal accomplishment did not correlate with resident performance (P = .12 and P = .75, respectively); however, increased emotional exhaustion showed a significant correlation with higher resident performance during periods when burnout was reported (r(6) = 0.76, P = .047).

Conclusions

Dynamic measurement of resting heart rate variability may offer an objective measure of burnout in thoracic surgery residents. Thoracic surgery residents who report high levels of burnout in this cohort maintained the ability to meet program-designated milestones at or above the level expected of their postgraduate year.

The effects of endogenously- and exogenously-induced hyperketonemia on exercise performance and adaptation

Elevating blood ketones may enhance exercise capacity and modulate adaptations to exercise training; however, these effects may depend on whether hyperketonemia is induced endogenously through dietary carbohydrate restriction, or exogenously through ketone supplementation. To determine this, we compared the effects of endogenously- and exogenously-induced hyperketonemia on exercise capacity and adaptation. Trained endurance athletes undertook 6 days of laboratory based cycling ("race") whilst following either: a carbohydrate-rich control diet (n = 7; CHO); a carbohydrate-rich diet + ketone drink four-times daily (n = 7; Ex Ket); or a ketogenic diet (n = 7; End Ket). Exercise capacity was measured daily, and adaptations in exercise metabolism, exercise physiology and postprandial insulin sensitivity (via an oral glucose tolerance test) were measured before and after dietary interventions. Urinary β-hydroxybutyrate increased by ⁓150-fold and ⁓650-fold versus CHO with Ex Ket and End Ket, respectively. Exercise capacity was increased versus pre-intervention by ~5% on race day 1 with CHO (p < 0.05), by 6%-8% on days 1, 4, and 6 (all p < 0.05) with Ex Ket and decreased by 48%-57% on all race days (all p > 0.05) with End Ket. There was an ⁓3-fold increase in fat oxidation from pre- to post-intervention (p < 0.05) with End Ket and increased perceived exercise exertion (p < 0.05). No changes in exercise substrate metabolism occurred with Ex Ket, but participants had blunted postprandial insulin sensitivity (p < 0.05). Dietary carbohydrate restriction and ketone supplementation both induce hyperketonemia; however, these are distinct physiological conditions with contrasting effects on exercise capacity and adaptation to exercise training.

Heart Rate Variability-Based Subjective Physical Fatigue Assessment

Accurate assessment of physical fatigue is crucial to preventing physical injury caused by excessive exercise, overtraining during daily exercise and professional sports training. However, as a subjective feeling of an individual, physical fatigue is difficult for others to objectively evaluate. Heart rate variability (HRV), which is derived from electrocardiograms (ECG) and controlled by the autonomic nervous system, has been demonstrated to be a promising indicator for physical fatigue estimation. In this paper, we propose a novel method for the automatic and objective classification of physical fatigue based on HRV. First, a total of 24 HRV features were calculated. Then, a feature selection method was proposed to remove useless features that have a low correlation with physical fatigue and redundant features that have a high correlation with the selected features. After feature selection, the best 11 features were selected and were finally used for physical fatigue classifying. Four machine learning algorithms were trained to classify fatigue using the selected features. The experimental results indicate that the model trained using the selected 11 features could classify physical fatigue with high accuracy. More importantly, these selected features could provide important information regarding the identification of physical fatigue.

Mood Profiling for Sustainable Mental Health among Athletes

Mood responses are a well-established mental health indicator. Gauging mental health status over time often involves periodic mood assessment using a standardized measure, a process referred to as mood profiling. Comparison of observed mood scores against relevant normative data is central to effective mood profiling. The primary purpose of our study was to improve existing norms for the Brunel Mood Scale (BRUMS) using a large internet sample. The secondary purpose was to discuss how mood profiling can be used to promote sustainable mental health primarily among athletes but also with relevance to non-athletes. The BRUMS was completed via the In The Mood website by 15,692 participants. Significant differences between observed mean scores and existing normative data were evident for all six mood dimensions, prompting norm refinement. Specific group norms were generated to address sex differences in mood responses and differences by athlete/nonathlete status. The revised tables of normative data for the BRUMS should be used by researchers in future investigations of mood responses and by applied practitioners seeking to monitor mood responses as an indicator of mental health status. Applications of mood profiling with elite athletes are exemplified, along with recommendations for using mood profiling in the pursuit of sustainable mental health.

Motivations to exercise in young men following a residential weight loss programme conducted in National Service - a mixed methods study

Background

Physical activity is a critical component of lifestyle interventions to reduce body weight and maintain weight loss. The goal of this study was to examine the motivations to exercise in young men following a 5-month residential weight loss programme conducted in the Singapore military as part of National Service.

Methods

We conducted a sequential mixed methods study starting with three focus groups comprising 21 programme instructors. Fifteen former programme participants aged 20.8 years (±1.4) with an average body mass index (BMI) of 29.3 kg/m² (±4.6) were interviewed in-depth over a total duration of 9 h. Another 487 current programme participants aged 20.8 years (±1.1), BMI 27.1 kg/m² (±2.6), completed a survey on weight loss, physical fitness, and motivations to exercise using the Behaviours Regulating Exercise Questionnaire (BREQ-3). Qualitative data was coded thematically using the six constructs of exercise motivation described by self-determination theory: amotivation, external, introjected, identified and integrated regulation and intrinsic motivation. Quotes from interviewees were cross-tabulated according to their weight maintenance trajectories. BREQ-3 responses were analysed according to initial body mass index (BMI), percentage weight loss and fitness.

Results

Over the course of the residential programme interview and survey participants experienced an average weight loss of 15.6 kg (±6.5) and 13.0 kg (±5.4) respectively. Among the fifteen interviewees seven had gained no more than 34% of initial weight loss 6 months after completing the programme while another eight had gained more than 51%. We elicited three key themes from the data: (1) Barriers to exercise; (2) diminishing extrinsic motivation; and (3) unidentified exercise benefits. The integration of findings uncovered reinforcing motivational patterns in the areas of health, fitness, camaraderie and identified regulation. Narratives of self-acceptance and shift-work environments gave rise to potentially deleterious motivational patterns. Our findings suggest that successful transition from a residential programme to independent weight management requires a more deliberate pivot from predominantly extrinsic to intrinsic motivational approaches.

Conclusion

Residential programmes such as the one investigated here, should develop a deliberate transition strategy, replace weight loss targets with physical performance goals and promote sports that are appropriate for young men affected by overweight and obesity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10373-z.

Blood Biomarkers in Sports Medicine and Performance and the Future of Metabolomics

The field of sports medicine and performance has undergone an important transformation in the past years where the scientific approach is becoming increasingly more important for teams and athletes. Physical and physiological fitness, nutrition, fatigue and recovery, as well as injury prevention are key elements of the scientific monitoring of athletes nowadays. Many different methods are used nowadays as part of the scientific monitoring and testing of the competitive athlete. Among them, physiological and metabolic testing, biomechanical and movement assessments, GPS-based tracking systems, heart rate monitors, power meters, and training software are an integrative part of the scientific monitor program of many teams and athletes.Blood biomarkers through traditional blood analysis have been used for over three decades (mainly in Europe) to monitor athletic performance. In the same manner that different cells in the body respond to the stress of an infection or a disease, cells in athletes respond to the stress of competition and training. Nowadays, the area of blood biomarkers is an emerging field in the US offering important level of possibilities to monitor athletes. The field of metabolomics can offer a significantly higher level of blood biomarkers for sports medicine and performance monitoring.

Identifying the predisposing factors, signs and symptoms of overreaching and overtraining in physical education professionals

Background

It is possible that physical education professionals, especially those who participate in aerobic activities, have predisposing factors, signs and symptoms of overreaching (OVR) and overtraining (OVT) due to a high load and volume of exercise followed by suboptimal recovery time. The present study aimed to identify the predisposing factors, signs and symptoms of OVR and OVT in physical education professionals.

Methods

A questionnaire consisting of 42 questions (10 questions group) about predisposing factors and signs/symptoms was answered by 132 physical education professionals from both sexes (83 men and 49 women) who were allocated into a resistance training group (RG, n = 74), aerobic training group (AG, n = 20) and resistance and aerobic training group (RAG, n = 38). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence of predisposing factors and signs and symptoms of OVR and OVT was considered to be a question group score 4 or lower. Profile of Mood State Questionnaire (POMS) was also applied.

Results

A mean score of 2.5 ± 0.7, 2.7 ± 0.7 and 2.7 ± 0.8 was found for all question groups for RG, AG and RAG, respectively. Of the total sample, 40.6% trained at least five times/week. The POMS revealed that 67.5% of the RG (n = 50), 80% of the AG (n = 16) and 60.5% of the RAG (n = 23) were classified as having no mood disorders and a standard graphic iceberg was presented. There were no statistical differences (p > 0.05) in the total mood disorders among RG (13.9 ± 24.5), AG (10.3 ± 25.1) and RAG (14.6 ± 27.9) groups.

Conclusion

Despite the volume of training/body working performed by the physical education professionals surveyed being greater than the recommended to achieve improvements on physical fitness, they did not show predisposing factors, signs or symptoms of OVR and OVT.

Changes in Stress and Appetite Responses in Male Power-Trained Athletes during Intensive Training Camp

An intensive consecutive high-volume training camp may induce appetite loss in athletes. Therefore, this study aimed to investigate the changes in stress and appetite responses in male power-trained athletes during an intensive training camp. The measurements at Day 2 and at the end of a 9-day intensive training camp (Camp1 and Camp2, respectively) were compared with those of the resting period (Rest) and the regular training period (Regular; n = 13). The stress state was assessed based on plasma cortisol level, salivary immunoglobulin A level, and a profile of mood states score. The sensation of appetite was assessed using visual analog scale scores, and fasting plasma acylated ghrelin, insulin, and glucose were measured. The cortisol concentrations were significantly higher at Camp2 (466.7 ± 60.7 nmol∙L⁻¹) than at Rest (356.3 ± 100.9 nmol∙L⁻¹; p = 0.002) or Regular (361.7 ± 111.4 nmol∙L⁻¹; p = 0.003). Both prospective and actual food consumption significantly decreased at Camp2, and acylated ghrelin concentration was significantly lower at Camp1 (34.2 ± 8.0 pg∙mL⁻¹) and Camp2 (32.0 ± 8.7 pg∙mL⁻¹) than at Rest (47.2 ± 11.2 pg∙mL⁻¹) or Regular (53.4 ± 12.6 pg∙mL⁻¹). Furthermore, the change in acylated ghrelin level was negatively correlated with the change in cortisol concentration. This study’s findings suggest that an early-phase physiological stress response may decrease the acylated ghrelin level in male power-trained athletes during an intensive training camp.

Biological, Hormonal, and Psychological Parameters in Professional Soccer Players Throughout a Competitive Season

We examined changes in the haematological, metabolic, immunological, hormonal, and psychological fields using selected variables in 20 professional soccer players, over the course of a competitive season. The team performance was assessed by computing the winning percentage. A symptom checklist was used to assess the severity of upper respiratory tract infections. A high-intensity training programme induced a significant increase in cortisol and uric acid concentrations. Despite lower glutamine concentrations than the normal range throughout the study, infection occurred only in two of the soccer players. Moreover, the levels of immunological factors IgA, IgG, and IgM, and the haematological parameters were unaltered. Subsequent decreased performance coincided with changes in specific mood states of the team. Our results show some alterations on the metabolic, hormonal, and psychological variables over the five fields studied, suggesting that combined psychological and physiological changes during training are of primary interest to monitor the training stress in relation to performance in team sport.

How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury

Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities.

The aetiopathogenesis of fatigue: unpredictable, complex and persistent

BACKGROUND

Chronic fatigue syndrome is a common condition characterized by severe fatigue with post-exertional malaise, impaired cognitive ability, poor sleep quality, muscle pain, multi-joint pain, tender lymph nodes, sore throat or headache. Its defining symptom, fatigue is common to several diseases.

AREAS OF AGREEMENT

Research has established a broad picture of impairment across autonomic, endocrine and inflammatory systems though progress seems to have reached an impasse.

AREAS OF CONTROVERSY

The absence of a clear consensus view of the pathophysiology of fatigue suggests the need to switch from a focus on abnormalities in one system to an experimental and clinical approach which integrates findings across multiple systems and their constituent parts and to consider multiple environmental factors.

GROWING POINTS

We discuss this with reference to three key factors, non-determinism, non-reductionism and self-organization and suggest that an approach based on these principles may afford a coherent explanatory framework for much of the observed phenomena in fatigue and offers promising avenues for future research.

AREAS TIMELY FOR DEVELOPING RESEARCH

By adopting this approach, the field can examine issues regarding aetiopathogenesis and treatment, with relevance for future research and clinical practice.

Plasma vitamin D metabolites and C-reactive protein in stage-stop racing endurance sled dogs

Background

Dogs are a unique model for examining the effects of exercise on vitamin D status because of their lack of vitamin D synthesis by UV exposure. In addition, the inflammatory response may be associated with hypovitaminosis D.

Objectives

To investigate the effects of several days of endurance exercise on plasma vitamin D (25‐(OH)D₃, 24,25‐(OH)D₃ and 1,25(OH)D₃) and serum C‐reactive protein (CRP) concentrations in stage‐stop racing sled dogs.

Animals

12 racing sled dogs and 8 control dogs.

Methods

Blood was collected before the race and immediately after racing on days 2 and 8. Plasma vitamin D metabolites and serum CRP concentrations were measured.

Results

Racing dogs showed a significant increase in 25(OH)D₃ on day 2 (P = .027) and day 8 of the race (P < .001), whereas no increases were observed in control dogs. The plasma concentration of 24,25(OH)D₃ showed a significant increase by day 8 (P < .001). There were no significant changes in 1,25(OH) D₃ concentrations across all time points and groups. Racing dogs had significantly increased CRP concentrations by day 2 (39.3 ± 30.1 μg/mL; P < .001).

Conclusions and Clinical Importance

Increases in vitamin D metabolites as well as increases in CRP concentrations were observed in racing sled dogs. This finding was contrary to the hypothesis that decreases in vitamin D status in athletes may be related to the acute phase inflammatory response during exercise. In addition, the increased 24,25(OH)D₃ concentrations compared to what is observed in other species suggests metabolic variations in dogs that lead to enhanced disposal of vitamin D.

Prevalence of Depressive Symptoms and Correlating Variables Among German Elite Athletes

Depression among elite athletes is a topic of increasing interest, but empirical data are rare. The present study aimed to provide insight into the prevalence of depressive symptoms among German elite athletes and possible associated factors. In an online survey of 162 athletes, we explored depressive symptoms, chronic stress, coping strategies and stress-recovery states. Results indicated an overall prevalence of 15% for depression among elite athletes (n = 99), and revealed higher levels of depressive symptoms among the individual athletes than the team athletes. Furthermore, correlation analyses showed a significant connection between high levels of depressive symptoms and high levels of chronic stress, negative coping strategies and negative stress-recovery states. Results indicate that the prevalence for depressive symptoms in elite athletes is comparable to that in the general German population. Moreover, exploratory analyses provide first indications of factors associated with depressive symptoms.

Effect of 2 days of intensive resistance training on appetite-related hormone and anabolic hormone responses

This study was designed to determine endocrine responses during 2 days of strenuous resistance training. Ten healthy men performed resistance training twice a day for two successive days to induce acute fatigue (excessive physical stress). The resistance training consisted of four exercises for the lower body in the morning and seven exercises for the upper body in the afternoon. Maximal isometric and isokinetic strengths were measured from day 1 (before the training period) to day 3 (after the training period). Fasting blood samples were taken on days 1-3. Maximal isometric and isokinetic strengths significantly decreased with two successive days of training (P<0·05), with significant increases in serum creatine phosphokinase and myoglobin concentrations (P<0·05). Significant reductions in the fasting concentrations of serum insulin-like growth factor-1, free testosterone, insulin and high-molecular-weight adiponectin were observed on day 3 (P<0·05), whereas there were no changes in the serum cortisol concentration or the free testosterone/cortisol ratio. Plasma active ghrelin and serum leptin concentrations decreased by -20·7 ± 2·8% and -29·6 ± 4·1%, respectively (P<0·05). Two days strenuous resistance training significantly affects the profiles of anabolic hormone and endocrine regulators of appetite and energy balance, such as ghrelin and leptin. The present findings suggest that decreased ghrelin and leptin concentrations might reflect excessive physical stress and may be early signs of accumulated fatigue.

Overtraining During Preseason: Stress and Negative Affective States Among Professional Rugby Union Players

The aim of this study was to explore the perceived factors that contribute to stress and negative affective states during preseason among a sample of professional rugby union players. The participants were 12 male professional rugby union players between 18 and 21 years of age (M age = 19 years, SD = 0.85). Data were collected via semistructured interviews and analyzed using an inductive content analysis procedure. Players identified training (structure and volume), the number of matches played and the recovery period, diet, sleep, and travel as factors that they believed contributed to their experience of stress and negative affective states. The present findings suggest that players may require more time to recover between matches, alongside interventions to help players manage the symptoms of stress and negative affect during times in which players are overtraining.

[Changes in neutrophil immune functions under different exercise stresses]

The aim of this review is to provide a summary of the known effects of exercise on neutrophil immune functions of athletes. We measured three neutrophil immune functions (i.e., phagocytic activity (PA), reactive oxygen species (ROS) production, and serum opsonic activity (SOA)) in various types of exercise. The following is our recent findings. (1) A regular exercise increases ROS production and decreases PA. We call this change a normal pattern, and an abnormal pattern except this change. (2) A prolonged, strenuous activity (e.g., rugby match and marathon) decreases both ROS production and PA. This is one of the abnormal pattern. (3) The exercise loading performed after a camp training decreases ROS production whereas PA does not change. This is another abnormal pattern. (4) When judoists who had stopped judo training for 6 months restarted their training, the exercise loading at the beginning of their training decreases PA whereas ROS production does not change. This is another abnormal pattern. (5) A regular exercise 2 months after the beginning of their training increases ROS production and decreases PA. This change is a normal pattern. SOA showed a similar pattern of changes to ROS under all conditions. The changes in neutrophil immune functions after performing various exercises might result from the balance between external factors (intensity and style of exercise) and internal factors (e.g., fatigue and physical pain). Therefore, the changes in three neutrophil immune functions after exercise might be an index of athletes' condition.

The association of 5-HTTLPR genotype and depressive symptoms is moderated by physical activity

The s allele serotonin transporter polymorphic region (5-HTTLPR) is associated with a number of physiological mechanisms that may increase the risk of elevated depressive symptoms. However, reports of a relationship between serotonin transporter polymorphic region (5-HTTLPR) genotype and depressive symptoms have thus far been inconclusive. This heterogeneity of results suggests that other factors may be moderating the relationship between 5-HTTLPR and depressive symptoms. Higher levels of physical activity are associated with lower levels of depressive symptoms. Mechanisms responsible for this association include alterations of the serotonergic system and the hypothalamic-pituitary axis. The aim of the current study was to measure the moderating effect of physical activity on the relationship between 5-HTTLPR genotype and depressive symptoms. Participants, ages 18-23, provided a saliva sample for DNA analysis and completed questionnaires to assess depressive symptoms and physical activity. A hierarchical multiple regression analysis was conducted to examine the moderating effect of physical activity on the relationship between 5-HTTLPR genotype and depressive symptoms. Analysis revealed a significant interaction between 5-HTTLPR and physical activity (p = .010). At low levels of physical activity, individuals with at least one s allele had significantly higher levels of depressive symptoms compared to ll individuals (p = .011). This finding provides preliminary support for a moderating effect of physical activity on the relationship between 5-HTTLPR and depressive symptoms.

The effect of rest days on injury rates

Despite the importance of recuperation, few have studied the impact of rest periods on injury prevention. We determined the effect of rest days (breaks) on injury rates and treatments using electronic injury records from an acrobatic circus company that employs former world-class athletes as acrobats. To account for accumulated fatigue, we considered breaks across SD3 (third consecutive week of 1-day rest) to SD6 as a single exposure level (SD3-6), and vacation and DD (2-day rest) as a single exposure level. Medical attention injury rates were increased post- vs pre-break {rate ratio 1.45 [95% confidence intervals (95% CI): 1.22-1.73]} with less of an effect for 1-day time loss [1.25 (95% CI: 0.58-2.67)] and 15-day time loss [1.10 (95% CI: 0.26-4.56)]. However, the increase in injury rate post break for SD3-6 was similar to that of DD-Vacation (P=0.48, 0.53, and 0.65) for medical attention, and both ≥1 day and ≥15 days time loss, respectively. The increase in the number of treatments post-break was less for SD3-6 vs DD-vacation. Our findings suggest that 2-day breaks every four to 6 weeks may be sufficient to avoid an increasing injury rate due to cumulative fatigue in professional acrobatic circus artists.

[The psychological factors affecting athletic performance]

The physical and mental health complex is claimed as achievement of the XXI. century, whereby also among the sportsmen and sportswomen, beside the somatic medicine, growing attention is devoted to the psyche as well. The sports psychiatry was dragged in and put into service to enhance performance after all biological weapons run out of ammunition, and the long-awaited results still failed to come about. Moreover, despite the energy increasingly invested it was going from bad to worse. Among athletes many psychiatric disorders call attention, either by the high prevalence or by the development of a specific syndrome. Symptoms of depression (depression after the competition, depression following the failure at the competition), chronic stress, anxiety, fatigue syndrome of overtraining, enervation, sleep disturbances, eating problems, burnout, eating disorders (anorexia athletics, athlete triad), personality factors and the chemical addiction are all extremely important. The present study is the first to summarize the most crucial psychiatric disorders that may have great significance in the athlete population, in varying degrees according to the individual sports.

Effects of training on resting peripheral blood and BAL-derived leucocyte function in horses

In this study, the effects of prolonged, high intensity training on aspects of peripheral blood and bronchoalveolar lavage (BAL)-derived leucocyte function were evaluated in 8 horses. All horses undertook a 7 week endurance training programme, followed by 5 weeks of high intensity training (HIT). Thereafter, horses were divided into control (C) and overtraining (OT) groups. The frequency and intensity of training were increased more substantially for horses in the OT group. Training was terminated in week 32 when horses in the OT group demonstrated a significant performance reduction. Peripheral blood and BAL samples were collected from 4 horses in C and OT groups in training weeks 7, 11, 14, 18, 22, 28 and 32. Flow cytometric techniques were used to assess phagocytosis by peripheral blood neutrophils and pulmonary alveolar macrophages (PAM), and oxidative burst activity of neutrophils, PAM, peripheral blood and BAL-derived lymphocytes. Peripheral blood neutrophil phagocytosis (internalisation) increased during the initial HIT period and decreased from week 16 when the training workload was increased for both groups. The oxidative burst activity of peripheral blood neutrophils and lymphocytes similarly increased and then decreased in response to training. The oxidative burst activity of PAM was reduced towards the end of the overtraining phase of the programme. Pulmonary alveolar macrophage phagocytosis and oxidative burst activity of BAL-derived lymphocytes demonstrated no change throughout the course of the study. There was no difference in results obtained from C or OT group horses, suggesting that protracted HIT, rather than overtraining, was associated with impaired cell function. The detrimental effects observed in peripheral blood neitrophil and PAM function may indicate impaired nonspecific immunity which may adversely affect the health and performance of horses undergoing protracted periods of intense training.

Absence of the predisposing factors and signs and symptoms usually associated with overreaching and overtraining in physical fitness centers

OBJECTIVE

The aim of this study was to evaluate the occurrence of the well-known predisposing factors and signs and symptoms usually associated with either overreaching or overtraining syndrome in physical fitness centers in São Paulo City, Brazil.

METHOD

A questionnaire consisting of 13 question groups pertaining to either predisposing factors (1-7) or signs and symptoms (8-13) was given to 413 subjects. The general training schedule of the volunteers was characterized by workout sessions of 2.18 ± 0.04 h for a total of 11.0 ± 0.3 h/week for 33 ± 2 months independent of the type of exercise performed (walking, running, spinning, bodybuilding and stretching). A mean score was calculated ranging from 1 (completely absent) to 5 (severe) for each question group. A low occurrence was considered to be a question group score lower than 4, which was observed in all 13 question groups.

RESULTS

The psychological evaluation by POMS Mood State Questionnaire indicated a normal non-inverted iceberg. The hematological parameters, creatine kinase activity, cortisol, total testosterone and free testosterone concentrations were within the normal ranges for the majority of the volunteers selected for this analysis (n = 60).

CONCLUSION

According to the questionnaire score analysis, no predisposing factors or signs and symptoms usually associated with either overreaching or overtraining were detected among the members of physical fitness centers in São Paulo City, Brazil. This observation was corroborated by the absence of any significant hematological or stress hormone level alterations in blood analyses of the majority of the selected volunteers (n = 60).

Comparison of two lower-body modes of endurance training on lower-body strength development while concurrently training

The most recent American College of Sports Medicine (1998) recommendations for quantity and quality of exercise includes both resistance and endurance exercise components. Skeletal muscle adaptations to resistance-only and endurance-only programs may be different and possibly antagonistic when both types of training are imposed concurrently. The present study examined the effect of two different modes of lower-body endurance exercise (i.e., cycle ergometry and incline treadmill walking) on lower-body strength development with concurrent resistance training designed to improve lower-body strength (i.e., bilateral leg press 1 repetition maximum [RM]). Thirty untrained participants (22 men and 8 women, ages 18-23) were randomly assigned to one of 3 training groups (resistance only [R], N = 10; resistance + cycle ergometry [RC], N = 10; and resistance + incline treadmill [RT], N = 10). The 3 training groups exercised twice per week for 9 weeks. The reduced frequency of exercise treatments were selected specifically to avoid overtraining for in-season athletes attempting to maintain offseason conditioning. Body mass and body composition measurements were taken pre- and post-training. Before training began, 3 weeks of training, 6 weeks of training, and after training, the participants also performed a 1RM test for lower-body strength. Analysis of variance comparisons with repeated measures revealed the following statistically significant changes (alpha = 0.05) in the 3 training groups over time: (a) when men and women were combined, body mass of R was significantly greater than RC and RT post-training; (b) body mass of men only was significantly greater than RC and RT post-training; (c) body composition of men only was significantly smaller for RC and RT compared with R; (d) when men and women were combined, percent change in strength revealed significantly greater gains in R compared with RT at 6 weeks; (e) when men and women were combined, percent change in strength revealed significantly greater gains in R compared with RC and RT post-training; (f) percent change in strength for men only was significantly greater for R compared with RT at 3 weeks; (g) percent change in strength for men only was significantly greater for R compared with RC and RT at 6 weeks, and RC was significantly greater than RT at 6 weeks; (h) percent change in strength in men only was significantly greater for R compared with RC and RT post-training, and RC was significantly greater than RT post-training; and (i) percent change in strength in women was significantly greater in R compared with RT post-training. The findings confirm previous studies that reported attenuated strength development with concurrent resistance and endurance training compared with resistance-only training. More importantly, this study indicates that the mode of endurance exercise in concurrent training regimens may play a role in the development of strength. Specifically, it seems that cycling is superior to treadmill endurance training for an individual with the goal of developing strength in a multijoint movement (i.e., leg press or squat) in the lower-body because it more closely mimics the biomechanical movement of these exercises.

Monitoring for overreaching in rugby league players

The aim of this study was to identify indicators of non-functional overreaching (NFOR) in team sport athletes undertaking intensive training loads. Eighteen semi-professional rugby league players were randomly assigned into two pair matched groups. One group completed 6 weeks of normal training (NT) whilst the other group was deliberately overreached through intensified training (IT). Both groups then completed the same 7-day stepwise training load reduction taper. Multistage fitness test (MSFT) performance, VO2 (max), peak aerobic running velocity (V (max)), maximal heart rate, vertical jump, 10-s cycle sprint performance and body mass were measured pre- and post-training period and following the taper. Hormonal, haematological and immunological parameters were also measured pre-training and following weeks 2, 4 and 6 of training and post-taper. MANOVA for repeated measures with contrast analysis indicated that MSFT performance and VO2 (max) were significantly reduced in the IT group over time and condition, indicating that a state of overreaching was attained. However, the only biochemical measure that was significantly different between the IT and NT group was the glutamine to glutamate (Gln/Glu) ratio even though testosterone, testosterone to cortisol (T/C) ratio, plasma glutamate, and CK activity were significantly changed after training in both groups. Positive endurance and power performance changes were observed post-taper in the IT group confirming NFOR. These changes were associated with increases in the T/C ratio and the Gln/Glu ratio and decreases in plasma glutamate and CK activity. These results indicate that although there was no single reliable biochemical marker of NFOR in these athletes, the Gln/Glu ratio and MSFT test may be useful measures for monitoring responses to IT in team sport athletes.

Physical activity and mental health: the association between exercise and mood

Physical activity is an important public health tool used in the treatment and prevention of various physical diseases, as well as in the treatment of some psychiatric diseases such as depressive and anxiety disorders. However, studies have shown that in addition to its beneficial effects, physical activity can also be associated with impaired mental health, being related to disturbances like "excessive exercise" and "overtraining syndrome". Although the number of reports of the effects of physical activity on mental health is steadily increasing, these studies have not yet identified the mechanisms involved in the benefits and dangers to mental health associated with exercise. This article reviews the information available regarding the relationship between physical activity and mental health, specifically addressing the association between exercise and mood.

Elucidating the unexplained underperformance syndrome in endurance athletes : the interleukin-6 hypothesis

The unexplained underperformance syndrome (UPS), previously known as the overtraining syndrome (OTS), has been defined as a persistent decrement in athletic performance capacity despite 2 weeks of relative rest. It has been proposed that UPS may be caused by excessive cytokine release during and following exercise causing a chronic inflammatory state and 'cytokine sickness'. This article extends that hypothesis by proposing that time-dependent sensitisation could provide a model through which the aetiology of UPS may be explained. In this model, the principal abnormal factors in UPS are an increased production of and/or intolerance to interleukin (IL)-6 during exercise. Strategies to attenuate the IL-6 response to exercise that may also reduce an athlete's susceptibility to UPS are proposed.

A Framework for Understanding the Training Process Leading to Elite Performance

The development of performance in competition is achieved through a training process that is designed to induce automation of motor skills and enhance structural and metabolic functions. Training also promotes self-confidence and a tolerance for higher training levels and competition. In general, there are two broad categories of athletes that perform at the highest level: (i) the genetically talented (the thoroughbred); and (ii) those with a highly developed work ethic (the workhorse) with a system of training guiding their effort. The dynamics of training involve the manipulation of the training load through the variables: intensity, duration and frequency. In addition, sport activities are a combination of strength, speed and endurance executed in a coordinated and efficient manner with the development of sport-specific characteristics. Short- and long-term planning (periodisation) requires alternating periods of training load with recovery for avoiding excessive fatigue that may lead to overtraining. Overtraining is long-lasting performance incompetence due to an imbalance of training load, competition, non-training stressors and recovery. Furthermore, annual plans are normally constructed in macro-, meso- and microcycles around the competitive phases with the objective of improving performance for a peak at a predetermined time. Finally, at competition time, optimal performance requires a healthy body, and integration of not only the physiological elements but also the psychological, technical and tactical components.

Biochemical and immunological markers of over-training

Athletes fail to perform to the best of their ability if they become infected, stale, sore or malnourished. Excessive training with insufficient recovery can lead to a debilitating syndrome in which performance and well being can be affected for months. Eliminating or minimizing these problems by providing advice and guidelines on training loads, recovery times, nutrition or pharmacological intervention and regular monitoring of athletes using an appropriate battery of markers can help prevent the development of an overtraining syndrome in athletes. The potential usefulness of objective physiological, biochemical and immunological markers of overtraining has received much attention in recent years. Practical markers would be ones that could be measured routinely in the laboratory and offered to athletes as part of their sports science and medical support. The identification of common factors among overtrained athletes in comparison with well-trained athletes not suffering from underperformance could permit appropriate intervention to prevent athletes from progressing to a more serious stage of the overtraining syndrome. To date, no single reliable objective marker of impending overtraining has been identified. Some lines of research do, however, show promise and are based on findings that overtrained athletes appear to exhibit an altered hormonal response to stress. For example, in response to a standardized bout (or repeated bouts) of high intensity exercise, overtrained athletes show a lower heart rate, blood lactate and plasma cortisol response. Several immune measures that can be obtained from a resting blood sample (e.g. the expression of specific cell surface proteins such as CD45RO+ on T-lymphocytes) also seem to offer some hope of identifying impending overtraining. If an athlete is suspected of suffering from overtraining syndrome, other measures will also required, if only to exclude other possible causes of underperformance including post-viral fatigue, glandular fever, clinical depression, poor diet, anaemia, asthma, allergies, thyroid disorders, myocarditis and other medical problems interfering with recovery.

Chronic fatigue syndrome: an update

The chronic fatigue syndrome is characterised by a fatigue that is disproportionate to the intensity of effort that is undertaken, has persisted for 6 months or longer, and has no obvious cause. Unless there has been a long period of patient- or physician-imposed inactivity, objective data may show little reduction in muscle strength or peak aerobic power, but the affected individual avoids heavy activity. The study of aetiology and treatment has been hampered by the low disease prevalence (probably <0.1% of the general population), and (until recently) by a lack of clear and standardised diagnostic criteria. It is unclear how far the aetiology is similar for athletes and nonathletes. It appears that in top competitors, overtraining and/or a negative energy balance can be precipitating factors. A wide variety of other possible causes and/or precipitating factors have been cited in the general population, including psychological stress, disorders of personality and affect, dysfunction of the hypothalamic-pituitary-adrenal axis, hormonal imbalance, nutritional deficits, immune suppression or activation and chronic infection. However, none of these factors have been observed consistently. The prognosis is poor; often disability and impairment of athletic performance are prolonged. Prevention of overtraining by careful monitoring seems the most effective approach in athletes. In those where the condition is established, treatment should aim at breaking the vicious cycle of effort avoidance, deterioration in physical condition and an increase in fatigue through a combination of encouragement and a progressive exercise programme.

Coughing in thoroughbred racehorses: risk factors and tracheal endoscopic and cytological findings

A matched case-control study was made of 100 thoroughbred horses which were coughing and 148 control horses which were free of clinical signs of respiratory tract disease. The variables identified by multivariable conditional logistic regression as being significantly associated with coughing included age (the risk decreased with age), the stage of training (horses in early training were at greatest risk), the time since the last race (horses that had never raced were at greatest risk) and the time since they were last transported (horses transported more than 14 days previously were more likely to cough than those transported within the last week). The coughing horses were significantly more likely to have high scores for upper and lower tracheal mucus and pharyngeal lymphoid hyperplasia. In addition, the tracheal aspirates of the coughing horses had increased odds of neutrophilia and were more likely to have intracellular bacteria than the control horses. However, a considerable proportion of the control horses had cytological and/or endoscopic evidence of airway inflammation.

Exercise and sleep

This paper reviews the literature on the association between exercise and sleep. The epidemiological and experimental evidence for whether or not acute and chronic exercise promote sleep is discussed, as well as moderating factors and agendas for future directions of study. The expectation that exercise will benefit sleep can partly be attributed to traditional hypotheses that sleep serves energy conservation, body restoration or thermoregulatory functions, all of which have guided much of the research in this field. Exercise is a complex activity that can be beneficial to general well-being but may also stress the body. Differences in the exercise protocols studied (e.g. aerobic or anaerobic, intensity, duration) and interactions between individual characteristics (e.g. fitness, age and gender) cloud the current experimental evidence supporting a sleep-enhancing effect of exercise. In addition, the tendency to study changes in small groups of good sleepers may also underestimate the efficacy of exercise for promoting sleep. Athough only moderate effect sizes have been noted, meta-analytical techniques have shown that exercise increased total sleep time and delayed REM sleep onset (10 min), increased slow-wave sleep (SWS) and reduced REM sleep (2-5 min). The sleep-promoting efficacy of exercise in normal and clinical populations has yet to be established empirically.

Conseqüências do exercício para o metabolismo da glutamina e função imune

Para o atleta, o objetivo do treinamento é aperfeiçoar sua capacidade física para obtenção do melhor desempenho em competições. Isso o leva a procurar os mais novos e eficientes métodos de treinamento. Um aspecto importante do programa de treinamento é o período de recuperação entre as sessões de exercícios, imprescindível para que ocorram as adaptações fisiológicas, como as alterações morfológicas e a supercompensação das reservas energéticas. A liberação de glutamina pelos músculos esqueléticos é aumentada durante o exercício. Como conseqüência, o conteúdo muscular de glutamina diminui após um exercício extenuante. Este aminoácido, entretanto, é muito importante para a funcionalidade dos leucócitos (linfócitos, macrófagos e neutrófilos). Portanto, após um exercício intenso, a concentração plasmática de glutamina diminui, suprimindo a função imune e tornando o indivíduo mais suscetível a infecções respiratórias. Nesta revisão são discutidas as implicações do exercício sobre o metabolismo dos músculos esqueléticos e leucócitos.

Effect of single bouts of moderate and high intensity exercise and training on equine peripheral blood neutrophil function

The effects of single bouts of moderate (30 to 40 per cent VO(2)max) and high (115 per cent VO(2)max) intensity exercise on equine peripheral blood leucocyte function were evaluated by determining neutrophil phagocytosis and oxidative burst activity before and after treadmill exercise and training. Prior to all exercise tests, the possible effect of diurnal variation was evaluated in samples obtained from four resting horses. Subsequently eight horses underwent moderate and high intensity exercise protocols and then commenced a 17-week training period. High intensity exercise tests were repeated in week 10, after 7 weeks of endurance training, and in week 17, after a further 6 weeks of high intensity training. Time of sampling had a significant effect on neutrophil function for resting, untrained horses. Prior to training, moderate intensity exercise was associated with improved neutrophil phagocytosis and oxidative burst activity. High intensity exercise was associated with transient impairment of these responses. A similar reduction was not demonstrable following high intensity exercise in weeks 10 or 17 of training. Neutrophil function in week 17 was suppressed at all sampling times relative to results obtained in week 10, suggesting that high intensity training may have been associated with a general reduction in neutrophil function.

Eating attitudes, body shape perceptions and mood of elite rowers

The study assessed the influence of age, gender and weight category upon eating attitudes, body shape perceptions, and mood. Elite rowers (N = 103) participating in the 1996 World Championships or Great Britain National Championships completed the Eating Attitude Test (EAT), the Body Shape Questionnaire (BSQ), and a short form of the Profile of Mood States (POMS-C). Participants were grouped as lightweight (Female: < 59 kg, n = 19; Male: < 72.5 kg, n = 31) or heavyweight (Female: n = 25; Male: n = 28) competitors. Results showed higher EAT scores among the lightweight group, 12.0% of whom reported scores above the threshold associated with eating disorders. Body shape concerns were higher for heavyweights than lightweights and for females than males. The interaction effect was not significant. BSQ scores were negatively correlated with age. Depression, Confusion and Tension scores collectively predicted 37% of the variance in BSQ scores while Depression scores predicted 9% of the variance in EAT scores. The results provide further evidence that the risk of eating disorders among elite rowers is moderated by age, gender and weight category. Further, they suggest that measures of mood may help identify athletes at risk from eating disorders.