A preliminary study: effects of football training on glucose control, body composition, and performance in men with type 2 diabetes

The Standard Error/Standard Deviation Mix-Up: Potential Impacts on Meta-Analyses in Sports Medicine

BACKGROUND

A recent review found that 45% of meta-analyses included statistical errors, of which, the most common was the calculation of effect sizes based on standard error (SE) rather than standard deviation (SD) [the SE/SD mix-up].

OBJECTIVES

The first aim of this study was to assess the impact of the SE/SD mix-up on the results of one highly cited meta-analysis. Our second aim was to identify one potential source of the SE/SD mix-up, by assessing how often SE is reported as a measure of sample variability in randomised controlled trials in sports medicine.

METHODS

We checked for potential SE/SD mix-ups in a 2015 meta-analysis of randomised controlled trials reporting the effects of recreational football interventions on aerobic fitness in adults. We corrected effect sizes affected by SE/SD mix-ups and re-analysed the data according to the original methodology. We compared pooled estimates of effect sizes from our re-analysis of corrected values with those of the original study. To assess how often SE was reported instead of SD as a measure of sample variance, we text mined results of randomised controlled trials from seven sports medicine journals and reported the proportion reporting of SE versus SD.

RESULTS

We identified potential SE/SD mix-ups in 9/16 effect sizes included in the meta-analysis describing the effects of football-based interventions versus non-exercise control. The published effect size was standardised mean difference (SMD) = 1.46 (95% confidence interval [CI] 0.91, 2.01). After correcting for SE/SD mix-ups, our re-analysis produced a smaller pooled estimate (SMD = 0.54 [95% CI 0.37, 0.71]). The original pooled estimate for trials comparing football versus running interventions was SMD = 0.68 (95% CI 0.06, 1.4). After correcting for SE/SD mix-ups and re-analysis, the effect was no longer statistically significant (SMD = 0.20 [95% CI - 0.10, 0.49)]). We found that 19.3% of randomised controlled trials reported SE rather than SD to describe sample variability. The relative frequency of the practice ranged from 0 to 25% across the seven journals sampled.

CONCLUSIONS

We found the SE/SD mix-up had inflated estimates for the effects of football on aerobic fitness. Meta-analysts should be vigilant to avoid miscalculating effect sizes. Authors, reviewers and editors should avoid and discourage (respectively) the practice of reporting SE as a measure of sample variability in sports medicine research.

Physical Exercise Methods and Their Effects on Glycemic Control and Body Composition in Adults with Type 2 Diabetes Mellitus (T2DM): A Systematic Review

The prevalence of T2DM represents a challenge for health agencies due to its high risk of morbidity and mortality. Physical Activity (PA) is one of the fundamental pillars for the treatment of T2DM, so Physical Exercise (PE) programs have been applied to research their effectiveness. The objective of the study was to analyze the effects of PE methods on glycemic control and body composition of adults with T2DM. A systematic review without meta-analysis was performed, using the PubMed database. Quasi-experimental and pure experimental clinical trials were included, which were available free of charge and were published during 2010-2020. In the results, 589 articles were found and 25 passed the inclusion criteria. These were classified and analyzed according to the methods identified (AE, IE, RE, COM, and others), duration and variable(s) studied. It is concluded that PE is effective for glycemic control and body composition in adults with T2DM using different methods (AE, IE, RE, COM, and others), both in the short and long term. Adequate organization of PE components such as frequency, duration, volume, and intensity, is essential.

The Role of Organokines in Obesity and Type 2 Diabetes and Their Functions as Molecular Transducers of Nutrition and Exercise

Maintaining systemic homeostasis requires the coordination of different organs and tissues in the body. Our bodies rely on complex inter-organ communications to adapt to perturbations or changes in metabolic homeostasis. Consequently, the liver, muscle, and adipose tissues produce and secrete specific organokines such as hepatokines, myokines, and adipokines in response to nutritional and environmental stimuli. Emerging evidence suggests that dysregulation of the interplay of organokines between organs is associated with the pathophysiology of obesity and type 2 diabetes (T2D). Strategies aimed at remodeling organokines may be effective therapeutic interventions. Diet modification and exercise have been established as the first-line therapeutic intervention to prevent or treat metabolic diseases. This review summarizes the current knowledge on organokines secreted by the liver, muscle, and adipose tissues in obesity and T2D. Additionally, we highlighted the effects of diet/nutrition and exercise on the remodeling of organokines in obesity and T2D. Specifically, we investigated the ameliorative effects of caloric restriction, selective nutrients including ω3 PUFAs, selenium, vitamins, and metabolites of vitamins, and acute/chronic exercise on the dysregulation of organokines in obesity and T2D. Finally, this study dissected the underlying molecular mechanisms by which nutrition and exercise regulate the expression and secretion of organokines in specific tissues.

The effects of a 1-year recreational football protocol on bone health parameters in a group of healthy inactive 50-year-old men

The main aim of the current study was to explore the effects of a 1-year recreational football protocol on bone health parameters (bone mineral content (BMC), bone mineral density (BMD), femoral neck geometry and composite indices of femoral neck strength) in a group of healthy inactive 50-year-old men. 51 middle-aged men voluntarily participated in this study, but only 41 of them completed it. Thus, the study population included 11 former football (FF) players and 30 inactive men. Inactive men were assigned to 3 different groups: controls (n=10), recreational football 30 (RF30; n=10) and recreational football 60 (RF60; n=10). The RF30 group performed two sessions of recreational football per week; the duration of each session was 30 minutes. The RF60 group performed two sessions of recreational football per week; the duration of each session was 60 minutes. The current study has demonstrated that whole body (WB) BMC, femoral neck BMD, cross-sectional moment of inertia, compression strength index, bending strength index and impact strength index increased in both experimental groups (RF30 and RF60) but not in the control group. The percentages of variations in bone health parameters were not significantly different between RF30 and RF60. In conclusion, this study suggests that recreational football is an effective method to improve bone health parameters in middle-aged men. In the studied population, most of the bone health benefits occurred after a low volume training protocol (2 * 30 minutes of recreational football per week).

Football training as a non-pharmacological treatment of the global aging population-A topical review

In the present topical mini-review, the beneficial impact of small-sided game football training for the increasing elderly global population is presented. As a multicomponent type of physical activity, football training executed on small pitched with 4-6 players in each team is targeting a myriad of physiological systems and causes positive adaptations of relevance for several non-communicable diseases, of which the incidence increases with advancing age. There is strong scientific evidence that this type of football training promotes cardiovascular, metabolic and musculo-skeletal health in elderly individuals. These positive adaptations can prevent cardiovascular disease, type 2 diabetes, sarcopenia and osteoporosis, and lower the risk of falls. Also, football training has been proven an efficient part of the treatment of several patient groups including men with prostate cancer and women after breast cancer. Finally, regular football training has an anti-inflammatory effect and may slow the biological aging. Overall, there is a growing body of evidence suggesting that recreational football training can promote health in the elderly.

The Effect of 12-Weeks Recreational Football (Soccer) for Health Intervention on Functional Movement in Older Adults

There is growing evidence that recreational football offers health benefits for older adults and an important pathway for physical activity for older adult groups. Despite anecdotal evidence that recreational football is beneficial for older adults, no empirical data are available to support this assertion. This study addressed this issue and examined the effects of a 12-week recreational football intervention on the functional fitness of older adults. Using a pre-post case-control design, thirteen males, aged 61-73 years (mean age ± SD = 66 ± 4 years) undertook a twice-weekly, 12-week recreational football for health intervention, and were matched with a control group, comprising thirteen males, aged 62-78 years (mean age ± SD = 66 ± 4 years) who maintained their typical exercise habits during the intervention period. Pre- and postintervention, participants underwent assessment of functional fitness, using the Rikli and Jones functional fitness battery as well as an assessment of body fatness, via bioelectrical impedance analysis and dominant handgrip strength using handgrip dynamometry. Results from a series of 2 (pre-post) X 2 (intervention vs. control) repeated-measures ANOVAs indicate significant pre-post X group interactions for the 30-second chair stand (p = 0.038, Pƞ² = 0.168), 8-foot timed up and go (p = 0.001, Pƞ² = 0.577) and 6 min walk test (p = 0.036, Pƞ² = 0.171). In all cases, performance improved significantly after the intervention for the football intervention group but not the control group. There were no significant differences in the 30 s arm curl test or dominant handgrip strength (p > 0.05). There was a non-significant trend (p = 0.07, Pƞ² = 0.127) towards a pre-post X group interaction for body fatness, showing a decreased percent body fat for the intervention group over the control group. The results of the present study demonstrate the utility of recreational football as a physical activity intervention in older adults to improve functional movement.

Effect of aquatic exercise on mental health, functional autonomy, and oxidative damages in diabetes elderly individuals

This study investigated the effect of aquatic exercise on mental health, functional autonomy, and oxidative dysfunction in elderly with DM2. A total of 104 elderly were included in the longitudinal clinical study and were attributed to the diabetes group (n = 30) and the non-diabetic group (n = 29). Both groups were involved in the aquatic exercise (nine exercises; 3 sets x 1-minute duration each; linear intensity and frequency measured twice a week) for 12 weeks. The assessments of mental health, functional autonomy, and oxidative dysfunction were done. All results were evaluated at baseline and 12 weeks later. The values of the following variable scores decreased in the DM2 group after participation in the aquatic exercise: depression (-56 ± 2 scores; 57%), anxiety (-8.2 ± 2 scores; 41%), stress (-3.1 ± 0.3 scores; 32%), and sleep (-3. 7 ± 1.3 points; 51%); an improvement in Berg scores was observed (+53.1 ± 2 points; 8%), Tug tests (-6.1 ± 0.7 points; 25%), carbonyl groups (-0.048 ± 0.01 nnmol/mg/protein; 49%), and total thiol (+0.33 ± 0.08 nnmol/mg/protein; 83%). We have concluded that a linear intensity aquatic exercise program improves mental health, functional autonomy, and oxidative dysfunction in elderly with DM2.

The effect of 5 years of team sport on elderly males' health and social capital—An interdisciplinary follow‐up study

Background and Aims

Floorball training induces positive effects on health among untrained older adults. However, the effect of long‐term participation (>2 years) in floorball training among elderly males has not been investigated. The aim of the present study was to examine the effect of 5 years of floorball training on risk factors for lifestyle diseases, fitness, physical function, and social capital of elderly males and compare to a control group that continued their usual lifestyle.

Methods

Twenty‐nine recreationally active elderly men aged 75.1 ± 3.3 (mean ± SD; range: 69–81) years with a height, body mass, and body mass index of 1.78 ± 0.06 m, 79.8 ± 10.9 kg, and 25.8 ± 4.1 kg/m², respectively, volunteered to take part in follow‐up investigations about 5 years after participating in a study on the effect of 12 weeks of floorball or petanque training. At the end of the parental study 15 subjects chose to participate in floorball training (floorball group [FG]) whereas 14 subjects (control group [CG]), resumed their usual lifestyle. FG participated in small‐sided floorball training 1 h ~1.75 times/week for 5 years in a local sports club.

Results

From baseline to 5 years, FG had reduced fat percentage, android, and visceral fat, increased total and leg bone mineral density, leg extension maximal voluntary contraction, maximal walk distance in 6 min and 30 s sit‐to‐stand repetitions, decreased time for 5 sit‐to‐stand repetitions and Timed Up and Go (p < 0.05). These changes were all different from less favorable changes in CG (p < 0.05). In FG there was a decline in maximum oxygen uptake which was smaller than the decline in CG (p < 0.05). In addition, FG had developed social capital through the 5 years strengthening their social connectedness and group cohesion.

Conclusion

In conclusion, both from a sociological and physiological perspective, small‐sided floorball training can be considered a health‐promoting activity for older men.

Metabolic Changes After a 24-Week Soccer-Based Adaptation of the Diabetes Prevention Program in Hispanic Males: A One-Arm Pilot Clinical Trial

Aims: One third of the U.S. adult population is estimated to have obesity-associated prediabetes. Hispanics have a 50% higher type 2 diabetes death rate compared to non-Hispanic whites, yet low participation in lifestyle change programs, making this subgroup an important target for prevention. Our objective was to determine the feasibility and the effects of an intervention implementing the Center for Disease Control and Prevention National Diabetes Prevention Program (NDPP) plus recreational soccer (RS) in Hispanic men.

Methods: Overweight and obese Hispanic men, aged 30–57 years with prediabetes at screening were recruited (n = 41). Trained soccer coaches led 30-min facilitated discussion of the NDPP modules after each RS session, with two sessions per week for 12 weeks and once per week for the following 12 weeks. The 1-h RS sessions followed the Football Fitness curriculum. Assessments included body mass index, waist circumference, bioelectrical impedance analysis (InBody 270), blood pressure, glycated hemoglobin (HbA1c), and validated physical fitness tests. Multilevel mixed models assessed the outcomes as a function of time and cohort and incorporated an unstructured covariance structure to examine the changes from baseline to 24 weeks. All analyses were conducted as intent-to-treat using SAS v 9.4.

Results: Hispanic males (n = 41; mean age 41.7 [0.1] years) were obese at baseline (mean BMI 32.7, standard error of mean [0.7], mean weight 93.9 [2.2] kg). Attendance rate was 65% overall at 12 weeks but differed between cohorts. Five mild injuries occurred over the trial. After 24 weeks of the NDPP+RS intervention, there were significant decreases in systolic and diastolic blood pressure (%change −4.7[SE 2.4]; 95% CI [−11.5, −1.7] and −6.1 [1.7] mmHg; [−9.6, −2.6], respectively), HbA1c (−0.2 [0.1]; [−0.3, −0.1]), Despite significant reductions in weight (−3.8 [0.7]; [−5.2, −2.5]), waist circumference (−6.6 [0.7] cm; [−8.0, −5.1]), body fat % (−1.9 [0.5]; [−2.8, −1.0]), lean body mass was preserved (−0.9 [0.3]; [−1.6, −0.2]).

Conclusion: A 24-week soccer-based adaptation of the Diabetes Prevention Program is safe and feasible among middle-aged Latino men.

Effects of recreational sports and combined training on blood pressure and glycated hemoglobin in middle-aged and older adults: A systematic review with meta-analysis

BACKGROUND

Combined resistance and aerobic training (CT) is the most suitable form of exercise training to simultaneously improve strength and cardiometabolic profile in middle-aged and older adults. Recreational sports (RS) emerge as an alternative to CT to improve these outcomes. We performed a meta-analysis on the effects of RS and CT on systolic blood pressure (SBP), diastolic blood pressure (DBP) and glycated hemoglobin (HbA1c) in middle-aged and older adults and to compare these exercise interventions to a non-exercising control group (CON).

METHODS

Search was conducted using the databases at PubMed, COCHRANE and SciELO between July and August 2020. Studies that included men and women aged ≥45 years, healthy or with values for SBP ≥130 mmHg or DBP ≥80 mmHg or with type 2 diabetes and performed RS or CT versus CON.

RESULTS

From 6017 records, 27 studies were included (9 RS and 18 CT). The analysis included 1411 participants with 55 ± 8 years. RS and CT were associated with reductions in SBP (RS: -7.2 mmHg, P = 0.03; CT: -3.6 mmHg, P < 0.001) and DBP (RS: -3.6 mmHg, P = 0.02; CT: -3.1 mmHg, P < 0.001) versus CON. Only CT was associated with a reduction in HbA1c versus CON (-0.47%; P < 0.001).

CONCLUSIONS

RS and CT are effective exercise interventions to improve BP in middle-aged and older adults. CT seems to be an excellent strategy to reduce HbA1c, and future studies are necessary to confirm the effectiveness of RS to improve HbA1c.

Effect of High-intensity Interval Training on Endothelial Function in Type 2 Diabetic Females

Background: Flow-mediated dilation (FMD) is a noninvasive approach to examine endothelial function. Objectives: The purpose of this study was to investigate the effect of 12 weeks of high-intensity interval training (HIIT) on FMD and circulating levels of adropin and nitric oxide (NO) in females with type 2 diabetes. Methods: Thirty females with type 2 diabetes were randomly assigned into two equal groups of HIIT and control. The exercise program consisted of three sessions a week for 12 weeks. Each training session included 4 × 4-minute running intervals at 85 - 95% of maximal heart rate (HRmax) with 3-minute active recoveries at 50 - 60% of HRmax. Circulating levels of adropin, NO, glucose, HbA1c, insulin, HOMA-IR, as well as lipid profile, and body composition parameters were measured before and after the intervention. Results: A significant increase of FMD% was observed after the intervention in the HIIT group (P = 0.001). In addition, the circulation levels of adropin and NO enhanced as a result of HIIT (P = 0.012 and P < 0.001, respectively). There were also significant positive effects on the levels of lipid profile (except for HDL), FBS, and HbA1c; as well as on the insulin resistance and the body composition variables. There were no significant changes in the control group except an increase in the total cholesterol levels (P < 0.01). Conclusions: The results showed that 12 weeks of the HIIT program could improve the endothelial function, glucose-related indices, lipid profile, and body composition variables in females with type 2 diabetes.

Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat-A systematic review and meta-analysis

This systematic review examined the impact of exercise intervention programs on selected cardiometabolic health indicators in adults with overweight or obesity. Three electronic databases were explored for randomized controlled trials (RCTs) that included adults with overweight or obesity and provided exercise-training interventions. Effects on blood pressure, insulin resistance (homeostasis model of insulin resistance, HOMA-IR), and magnetic resonance measures of intrahepatic fat in exercise versus control groups were analyzed using random effects meta-analyses. Fifty-four articles matched inclusion criteria. Exercise training reduced systolic and diastolic blood pressure (mean difference, MD = -2.95 mmHg [95% CI -4.22, -1.68], p < 0.00001, I²  = 63% and MD = -1.93 mmHg [95% CI -2.73, -1.13], p < 0.00001, I²  = 54%, 60 and 58 study arms, respectively). Systolic and diastolic blood pressure decreased also when considering only subjects with hypertension. Exercise training significantly decreased HOMA-IR (standardized mean difference, SMD = -0.34 [-0.49, -0.18], p < 0.0001, I²  = 48%, 37 study arms), with higher effect size in subgroup of patients with type 2 diabetes (SMD = -0.50 [95% CI: -0.83, -0.17], p = 0.003, I²  = 39%). Intrahepatic fat decreased significantly after exercise interventions (SMD = -0.59 [95% CI: -0.78, -0.41], p < 0.00001, I²  = 0%), with a larger effect size after high-intensity interval training. In conclusion, exercise training is effective in improving cardiometabolic health in adults with overweight or obesity also when living with comorbitidies.

Fußball – neue Wege in der Prävention und Behandlung des Typ-2-Diabetes

Über die Hälfte der Bevölkerung in westlichen Ländern ist übergewichtig, und nahezu jeder Vierte ist adipös. In den nächsten Jahren wird es deshalb zu einem enormen Anstieg der Zahl an nicht übertragbaren Erkrankungen wie Diabetes, kardiovaskuläre Erkrankungen und Krebs kommen. Eine ausgewogene Ernährung, begleitet von regelmäßiger Bewegung, ist entscheidend bei der Prävention der Entwicklung und des Fortschreitens nicht übertragbarer Erkrankungen. Gesundheitsfördernde Programme besitzen eine große Bedeutung bei der langfristigen Verbesserung des Gesundheitsstatus unserer Bevölkerung, jedoch nehmen insbesondere Männer selten an gesundheitsfördernden Programmen teil. Deshalb gilt es nach neuen Wegen zu suchen, um effizienter Menschen mit einem erhöhten Risiko zu erreichen. Fußball verfügt über ein großes Potenzial, Menschen und vor allem Männer mit einem erhöhten Risiko für nicht übertragbare Erkrankungen, die üblichen gesundheitsfördernden Maßnahmen ablehnend gegenüberstehen, für die Teilnahme an Gesundheitsprogrammen zu gewinnen. Für ältere Spieler ist Walking Football eine neue Fußball-Variante mit einem geringeren Risiko für Verletzungen und eine körperliche Überlastung. Die vorliegende Arbeit gibt einen Überblick über die metabolischen Auswirkungen von Freizeitfußball und insbesondere Walking Football sowie Maßnahmen zur Gesundheitsförderung, die von professionellen Fußballvereinen angeboten werden, bei Menschen mit einem erhöhten Risiko für oder mit bereits bestehenden nicht übertragbaren Erkrankungen, wie insbesondere Typ-2-Diabetes.

Time-course of V̇o2 kinetics responses during moderate-intensity exercise subsequent to HIIT versus moderate-intensity continuous training in type 2 diabetes

We assessed the time-course of changes in oxygen uptake (V̇o₂) and muscle deoxygenation (i.e., deoxygenated hemoglobin and myoglobin, [HHb + Mb]) kinetics during transitions to moderate-intensity cycling following 12 wk of low-volume high-intensity interval training (HIIT) vs. moderate-intensity continuous training (MICT) in adults with type 2 diabetes (T2D). Participants were randomly assigned to MICT (n = 10, 50 min of moderate-intensity cycling), HIIT (n = 9, 10 × 1 min at ∼90% maximal heart rate), or nonexercising control (n = 9) groups. Exercising groups trained three times per week, and measurements were taken every 3 wk. [HHb + Mb] kinetics were measured by near-infrared spectroscopy at the vastus lateralis muscle. The local matching of O₂ delivery to O₂ utilization was assessed by the Δ[HHb + Mb]/ΔV̇o₂ ratio. The pretraining time constant of the primary phase of V̇o₂ (τV̇o_2p) decreased (P < 0.05) at wk 3 of training in both MICT (from 44 ± 12 to 32 ± 5 s) and HIIT (from 42 ± 8 to 32 ± 4 s) with no further changes thereafter, whereas no changes were reported in controls. The pretraining overall dynamic response of muscle deoxygenation (τ'[HHb + Mb]) was faster than τV̇o_2p in all groups, resulting in Δ[HHb + Mb]/V̇o_2p showing a transient "overshoot" relative to the subsequent steady-state level. After 3 wk, the Δ[HHb + Mb]/V̇o_2p overshoot was eliminated only in the training groups, so that τ'[HHb + Mb] was not different to τV̇o_2p in MICT and HIIT. The enhanced V̇o₂ kinetics response consequent to both MICT and HIIT in T2D was likely attributed to a training-induced improvement in matching of O₂ delivery to utilization.NEW & NOTEWORTHY High-intensity interval training and moderate-intensity continuous training elicited faster pulmonary oxygen uptake (V̇o₂) kinetics during moderate-intensity cycling within 3 wk of training with no further changes thereafter in individuals with type 2 diabetes. These adaptations were accompanied by unaltered near-infrared spectroscopy-derived muscle deoxygenation (i.e. deoxygenated hemoglobin and myoglobin concentration, [HHb+Mb]) kinetics and transiently reduced Δ[HHb+Mb]-to-ΔV̇o₂ ratio, suggesting an enhanced blood flow distribution within the active muscles subsequent to both training interventions.

Skeletal Muscle and Bone - Emerging Targets of Fibroblast Growth Factor-21

Fibroblast growth factor 21 (FGF21) is an atypical member of the FGF family, which functions as a powerful endocrine and paracrine regulator of glucose and lipid metabolism. In addition to liver and adipose tissue, recent studies have shown that FGF21 can also be produced in skeletal muscle. As the most abundant tissue in the human body, skeletal muscle has become increasingly recognized as a major site of metabolic activity and an important modulator of systemic metabolic homeostasis. The function and mechanism of action of muscle-derived FGF21 have recently gained attention due to the findings of considerably increased expression and secretion of FGF21 from skeletal muscle under certain pathological conditions. Recent reports regarding the ectopic expression of FGF21 from skeletal muscle and its potential effects on the musculoskeletal system unfolds a new chapter in the story of FGF21. In this review, we summarize the current knowledge base of muscle-derived FGF21 and the possible functions of FGF21 on homeostasis of the musculoskeletal system with a focus on skeletal muscle and bone.

Prevalence of Prediabetes and Type 2 Diabetes Mellitus in Football Players: A Novel Multi Football Clubs Cross Sectional Study

Sports offer great benefits, improving health and reducing the risk of illnesses. This study’s aim was to investigate the prevalence of prediabetes and type 2 diabetes mellitus in football players compared to population based non-elite athlete control subjects. Initially 1100 male volunteers, (550) football players, and (550) population based non-elite athlete control subjects were interviewed. After socio-demographic and medical history analysis, 756 (378) nonsmoker male football players and (378) nonsmoker male control subjects were recruited. The control subjects were not involved in regular sports activities such as football, volleyball, badminton, cricket, hockey, and swimming. Participants with a known history of anemia, blood diseases, diabetes mellitus, and malignancy were excluded from the study. The mean age of football players was 31.80 ± 5.46 years, Body Mass Index (BMI) was 26.40 ± 2.08 (kg/m²), and the mean age of control subjects was 32.32 ± 4.37 years, and BMI was 26.66 ± 1.87 (kg/m²). The selected football players have been playing football for about 2 h a day, 3 days per week, and so the total mean duration of playing football was 1.08 years. American Diabetes Association (ADA) based criteria on Glycated Hemoglobin (HbA1c) was used to investigate prediabetes and type 2 diabetes mellitus. In football players the prevalence of prediabetes was 30 (7.93%) and type 2 diabetes mellitus (T2DM) was 6 (1.59%) compared to population based matched non-elite athlete control subjects where the prediabetes was 71 (18.78%) and T2DM was 89 (23.54%) (p = 0.001). Among football players there was a 7-fold decrease in T2DM compared to control subjects. Football recreational activities markedly reduce the prevalence of prediabetes and T2DM. The study findings demonstrate the benefits of football and other such sport activities and emphasize the urgent need for promoting football based physical activities as a physiological preventive strategy against the globally growing diabetes epidemic.

Moderate-Intensity Continuous Training Improves FGF21 and KLB Expression in Obese Mice

Fibroblast growth factor 21 (FGF21) and β-Klotho (KLB) play an important role in preventing and treating overweight and obesity. However, it is unclear what conditions promote FGF21 and KLB expression in different tissues. Therefore, we studied expression of FGF21 and KLB with respect to two exercise regimes: moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) (two popular strategies in weight loss). Mice were randomly divided into three groups (n = 8 per group): MICT, HIIT, and sedentary lifestyle (SED). All mice were fed a high-fat diet (HFD) for 12 weeks to induce obesity. The exercise was performed on a motorized treadmill for another eight weeks and the diet continued in each group. We found that both MICT and HIIT had positive effects on the loss of HFD-induced body weight increase and serum FGF21 levels. HIIT promoted decrease of the body weight and serum triglyceride (TG) levels, while MICT was more effective at enhancing FGF21 and KLB expression in the liver, brown adipose tissue (BAT), and muscle at the mRNA and protein levels.

Effects of a 4 week touch rugby and self-paced interval running intervention on health markers in active young men

Background

Modified team sport activity has been proposed as effective exercise modality for promoting markers of health that are comparable or greater than continuous forms of activity. However, research using modified team sports is currently limited to sedentary populations using 2–3 sessions across a minimum of 8 weeks.

Aim

To investigate the effects of a 4-week touch rugby and self-paced interval running intervention on a range of health markers in active men.

Methods

Sixteen participants (age 26.4 ± 6.4 years) were matched for age, demographic and physical activity before completing a single touch rugby (n = 8) or running (n = 8) session per week for 4 weeks. Measures of systolic and diastolic blood pressure, resting heart rate (RHR), body composition and biochemical status were recorded pre- and post-intervention.

Results

ANCOVA analysis revealed between-group differences for impedance (P = 0.027), fat mass (P = 0.008), percentage body fat (P = 0.008) and fat-free mass (P = 0.002), with greater changes after touch rugby. Systolic blood pressure decreased for both groups with greater reductions observed after touch rugby (P = 0.002). No between-group difference was observed for RHR, interleukin-6 or C-reactive protein (P > 0.05). Contrasting internal, external and perceptual loads were observed.

Conclusion

The results of this study suggest that a single session of touch rugby over a 4-week period elicited greater improvements in body composition and SBP than self-paced running, with both being equally beneficial for improving RHR, diastolic blood pressure and inflammatory status in active young men.

Football - Novel Approaches to Tackle Diabetes

Balanced diet and regular physical activity are of key importance to the prevention of the development and progression of non-communicable diseases. In 2050, 50% of the European population is expected to be obese. Cardiovascular diseases, diabetes mellitus, cancer, as well as joint impairments, will further increase. Therefore, programmes are critical to the improvement of the population's health status in the long run. New ways have to be found that allow addressing more people than with the current approaches. Football has a great potential to attract people at risk for or with already existing non-communicable diseases, such as type 2 diabetes, to participate in health-promoting programmes. The novel football version, walking football was developed for elderly players, aiming at avoiding injuries and physical overload. The present article gives a brief overview on the metabolic effects of recreational football, particularly walking football, as well as health-promoting programmes offered by professional football clubs in humans at risk for or with already existing non-communicable diseases.

Football can tackle type 2 diabetes: a systematic review of the health effects of recreational football practice in individuals with prediabetes and type 2 diabetes

This work aimed to summarize the health effects of recreational football practice in individuals with prediabetes and type 2 diabetes (T2D), through a systematic review. An electronic search was performed in PubMed, Scopus, Web of Science, LILACS and list of references of the available reviews, until July 2019. Studies were eligible if they included any form of football practice, in patients diagnosed with prediabetes or T2D. After recreational football practice, participants with prediabetes or T2D improved fasting glucose, total and LDL cholesterol, triglycerides, body mass, body fat percentage, waist circumference, blood pressure, and maximal oxygen uptake. Further benefits were found in fat-free mass and resting heart rate for participants with prediabetes, and in glycated haemoglobin, body mass index and fat mass in individuals with T2D. This systematic review showed promising benefits of recreational football practice on both the prevention and control of T2D and related cardiovascular risk.

Adapted recreational football small-sided games improve cardiac capacity, body composition and muscular fitness in patients with type 2 diabetes

BACKGROUND

The usefulness of adapted small-sided games (SSGs) in improving cardiac function in subjects with T2DM is still debated. Here we evaluated the effects of 18 weeks indoor muscular activation training (6 weeks; IMA) followed by adapted SSGs football training (12 weeks) on cardiac function, muscular fitness, body composition and adiponectin expression in sedentary T2DM volunteers.

METHODS

Six T2DM patients underwent IMA protocol of 6 weeks, twice a week followed by 12 weeks SSGs (5-a-side, once a week) training. Glucose, lipid profile and serum homocysteine concentration, body composition (BC), bone mineral density (DEXA), were determined at baseline and after 18 weeks (IMA+SSGs). VO<inf>2max</inf> and muscular fitness were recorded at baseline and after IMA (6 weeks) and SSGs (12 weeks), respectively.

RESULTS

No significant differences were found for VO<inf>2max</inf> and muscular fitness after 6weeks of IMA. After 18 weeks (6 weeks IMA + 12 weeks SSGs) of training, significant improvements were found in the following parameters: work capacity, VO<inf>2peak</inf>, Ventilation (VE<inf>peak</inf>), breathing reserve consumption and oxygen uptake efficiency slope (P<0.05); leg fitness (P<0.05), BC (P<0.05), vertebral column T-score (P<0.01) and adiponectin (total and high-molecular-weight; P<0.05). Compared to baseline, a reduction in serum homocysteine occurred after 18 weeks of training (P<0.05).

CONCLUSIONS

We evidenced that weekly adapted SSGs friendly football matches for 12 weeks improve cardiorespiratory capacity and the expression of independent markers associated with cardiovascular risk in T2DM patients, suggesting an overall reduced CVD-risk in these patients. These preliminary data encourage us to test the efficacy of this type of exercise in a larger population.

Long-Term Recreational Football Training and Health in Aging

This narrative review aims to critically analyze the effects of exercise on health in aging. Here we discuss the main clinical and biomolecular modifications induced by long-term recreational football training in older subjects. In particular, the effects induced by long-term recreational football training on cardiovascular, metabolic and musculo-skeletal fitness, together with the modifications in the muscle expression of hallmarks related to oxidative metabolism, DNA repair and senescence suppression pathways and protein quality control mechanisms will be provided. All these topics will be debated also in terms of preventing non-communicable metabolic diseases, in order to achieve successful aging over time.

Recreational football is medicine against non-communicable diseases: A systematic review

The purpose of this research was to conduct a systematic review of published articles related to the effect of recreational football on non-communicable diseases. A systematic review of Web of Science, SPORTDiscus, MEDLINE, and PubMed databases was performed according to PRISMA guidelines. Only empirical studies were included. There were no restrictions on the types of study design eligible for inclusion. The primary outcome measures result from the potential effects of recreational football on non-communicable diseases (eg, blood pressure, bone density, LDL cholesterol, and fat mass). A total of 44 articles met the inclusion criteria and were included. Recreational football is shown to: (a) decrease blood pressure and resting heart rate, improve cardiac structure and functioning, as well as increase maximal oxygen uptake in both sexes; (b) reduce cholesterol and triglycerides levels, increase insulin sensitivity, and have a positive impact on glycemic control; (c) improve bone mineralization, increase both bone mineral density and content, as well as acting as a stimulus for osteogenesis; and (d) be clearly beneficial for bone health, while slightly beneficial for body composition, muscle strength, and maximal oxygen uptake in adults with prostate cancer. The present systematic review demonstrated the benefits of recreational football practice on non-communicable diseases related to cardiovascular and bone health, body composition, type 2 diabetes, and prostate cancer. The effectiveness of recreational football on the aforementioned diseases may be related to age and gender; however, further research is required.

Gender-dependent evaluation of football as medicine for prediabetes

PURPOSE

Training intensity and health effects of football were investigated gender specifically in individuals with prediabetes.

METHODS

Participants with prediabetes (age 60 ± 6 years) were randomised into a football and dietary advice group (FD-men n = 13 and FD-women n = 14) or a dietary advice only group (D-men n = 12 and D-women n = 11). FD performed football training (twice/week for 16 weeks), while both groups received dietary advice. Body composition, bone variables, blood pressure, blood lipid profile and peak oxygen uptake (VO2peak) were determined pre- and post-intervention.

RESULTS

Mean heart rate during football training was 79 ± 2 and 80 ± 3% HRmax for FD-men and FD-women, respectively, with peak heart rate values of 96 ± 1 and 97 ± 2% HRmax, with no gender differences. VO2peak increased more (P < 0.05) in FD-men and FD-women than in D-men and D-women. However, relative delta change in VO2peak was 21 ± 14% in FD-women, which was greater (P < 0.05) than in FD-men (11 ± 12%). Reduction in SBP and DBP, respectively, was similar in FD-men (- 10.8 ± 13.0 and - 7.3 ± 11.8 mmHg) and FD-women (- 11.3 ± 11.0 and - 7.1 ± 6.2 mmHg), with within-gender differences for men. Total plasma cholesterol and LDL cholesterol decreased (P < 0.05) by - 0.7 ± 1.1 and - 0.5 ± 0.9 mmol L-1, respectively, in FD-women and - 0.2 ± 0.4 and - 0.2 ± 0.3 mmol L-1 in FD-men, with no significant gender differences (P = 0.08). Body fat content was lowered (P < 0.05) by 3 and 4%-points in FD-men and FD-women, respectively.

CONCLUSION

Gender-mixed football training combined with dietary advice causes broad-spectrum health effects for men and women with prediabetes, with minor gender-specific differences. Thus, the intensity and training-induced effects of football training are also high for elderly women with prediabetes.

Role of exercise-induced hepatokines in metabolic disorders

The health-promoting effects of physical activity to prevent and treat metabolic disorders are numerous. However, the underlying molecular mechanisms are not yet completely deciphered. In recent years, studies have referred to the liver as an endocrine organ, since it releases specific proteins called hepatokines. Some of these hepatokines are involved in whole body metabolic homeostasis and are theorized to participate in the development of metabolic disease. In this regard, the present review describes the role of Fibroblast Growth Factor 21, Fetuin-A, Angiopoietin-like protein 4, and Follistatin in metabolic disease and their production in response to acute exercise. Also, we discuss the potential role of hepatokines in mediating the beneficial effects of regular exercise and the future challenges to the discovery of new exercise-induced hepatokines.

Integrated method for quantitative morphometry and oxygen transport modeling in striated muscle

Identifying structural limitations in O2 transport is primarily restricted by current methods employed to characterize the nature of physiological remodeling. Inadequate resolution or breadth of available data has impaired development of routine diagnostic protocols and effective therapeutic strategies. Understanding O2 transport within striated muscle faces major challenges, most notably in quantifying how well individual fibers are supplied by the microcirculation, which has necessitated exploring tissue O2 supply using theoretical modeling of diffusive exchange. With capillary domains identified as a suitable model for the description of local O2 supply and requiring less computation than numerically calculating the trapping regions that are supplied by each capillary via biophysical transport models, we sought to design a high-throughput method for histological analysis. We present an integrated package that identifies optimal protocols for identification of important input elements, processing of digitized images with semiautomated routines, and incorporation of these data into a mathematical modeling framework with computed output visualized as the tissue partial pressure of O2 (Po2) distribution across a biopsy sample. Worked examples are provided using muscle samples from experiments involving rats and humans.

NEW & NOTEWORTHY Progress in quantitative morphometry and analytical modeling has tended to develop independently. Real diagnostic power lies in harnessing both disciplines within one user-friendly package. We present a semiautomated, high-throughput tool for determining muscle phenotype from biopsy material, which also provides anatomically relevant input to quantify tissue oxygenation, in a coherent package not previously available to nonspecialist investigators.

Lifelong Football Training: Effects on Autophagy and Healthy Longevity Promotion

Aging is a physiological process characterized by a progressive decline of biological functions and an increase in destructive processes in cells and organs. Physical activity and exercise positively affects the expression of skeletal muscle markers involved in longevity pathways. Recently, a new mechanism, autophagy, was introduced to the adaptations induced by acute and chronic exercise as responsible of positive metabolic modification and health-longevity promotion. However, the molecular mechanisms regulating autophagy in response to physical activity and exercise are sparsely described. We investigated the long-term adaptations resulting from lifelong recreational football training on the expression of skeletal muscle markers involved in autophagy signaling. We demonstrated that lifelong football training increased the expression of messengers: RAD23A, HSPB6, RAB1B, TRAP1, SIRT2, and HSBPB1, involved in the auto-lysosomal and proteasome-mediated protein degradation machinery; of RPL1, RPL4, RPL36, MRLP37, involved in cellular growth and differentiation processes; of the Bcl-2, HSP70, HSP90, PSMD13, and of the ATG5-ATG12 protein complex, involved in proteasome promotion and autophagy processes in muscle samples from lifelong trained subjects compared to age-matched untrained controls. In conclusion, our results indicated that lifelong football training positively influence exercise-induced autophagy processes and protein quality control in skeletal muscle, thus promoting healthy aging.

The effect of two exercise modalities on skeletal muscle capillary ultrastructure in individuals with type 2 diabetes

Type 2 diabetes is associated with microvascular dysfunction, but little is known about how capillary ultrastructure is affected by exercise training. To investigate the effect of two types of exercise training on skeletal muscle capillary ultrastructure and capillarization in individuals with type 2 diabetes, 21 individuals with type 2 diabetes were allocated (randomized controlled trial) to 11 weeks of aerobic exercise training consisting of either moderate-intensity endurance training (END; n = 10) or low-volume high-intensity interval training (HIIT; n = 11). Skeletal muscle biopsies (m vastus lateralis) were obtained before and after the training intervention. At baseline, there was no difference in capillarization, capillary structure, and exercise hyperemia between the two groups. After the training intervention, capillary-to-fiber ratio increased by 8% ± 3% in the END group (P < 0.05) and was unchanged in the HIIT group with no difference between groups. Endothelium thickness increased (P < 0.05), basement membrane thickness decreased (P < 0.05), and the capillary lumen tended (P = 0.07) to increase in the END group, whereas these structural indicators were unchanged after HIIT. In contrast, skeletal muscle endothelial nitric oxide synthase (eNOS) increased after HIIT (P < 0.05), but not END, whereas there was no change in vascular endothelial growth factor (VEGF), superoxide dismutase (SOD)-2, or NADPH oxidase after both training protocols. In contrast to END training, HIIT did not alter capillarization or capillary structure in individuals with type 2 diabetes. In conclusion, HIIT appears to be a less effective strategy to treat capillary rarefaction and reduce basement thickening in type 2 diabetes.

Cardiometabolic Risk Reduction Through Recreational Group Sport Interventions in Adults: A Systematic Review and Meta-analysis

OBJECTIVE

To estimate the pooled effects of community-based, recreational-level group sports on cardiometabolic risk factors and fitness parameters among adults.

PARTICIPANTS AND METHODS

We systematically searched PubMed, EMBASE, PsychINFO, CINAHL, and Web of Science electronic databases for English-language articles reporting the effectiveness of recreational-level group sports published between January 1, 1965, and January 17, 2017. We extracted baseline and end of intervention means for cardiometabolic and fitness parameters. Random- or fixed-effects meta-analyses were used to obtain pooled before and after change in outcome means within intervention participants and between groups.

RESULTS

From 2491 screened titles, 23 publications were included (902 participants; mean ± SD age, 46.6±11.7 years), comprising 21 soccer and 2 rugby interventions. Intervention participants achieved larger improvements (mean [95% CI]) compared with control subjects in weight (-1.44 kg [-1.79 to -1.08 kg]), body mass index (-0.88 kg/m² [-1.73 to -0.03 kg/m²]), waist circumference (-0.77 cm [-1.21 to -0.33 cm]), body fat (-1.8% [-3.12% to -0.49%]), total cholesterol level (-0.33 mmol/L [-0.53 to -0.13 mmol/L]), low-density lipoprotein cholesterol level (-0.35 mmol/L [-0.54 to -0.15 mmol/L]), systolic blood pressure (-5.71 mm Hg [-7.98 to -3.44 mm Hg]), diastolic blood pressure (-3.36 mm Hg [-4.93 to -1.78 mm Hg]), maximum oxygen consumption (3.93 mL/min per kg [2.96-4.91 mL/min]), and resting heart rate (-5.51 beats/min [-7.37 to -3.66 beats/min]). Most studies (16) were classified as high quality, and we found no evidence of publication bias.

CONCLUSION

We found significant cardiometabolic and fitness improvements following group sport participation, primarily recreational soccer. These findings suggest that group sport interventions are promising strategies for reducing cardiometabolic risk in adults.

Recreational soccer as sport medicine for middle-aged and older adults: a systematic review

Background

Strategies to prevent or attenuate the age-related decline in physical and physiological function and reduce chronic disease risk factors are of clinical importance.

Objective

To examine the health benefits of recreational soccer in middle-aged and older adults.

Design

Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

All available records up until 9 June 2017 in PubMed, Web of Science, SPORTDiscus, MEDLINE, Embase, CINAHL Plus, PsycINFO and Cochrane Library databases.

Eligibility criteria for selecting studies

All randomised trials with or without a control group (randomised controlled trials or randomised uncontrolled trials) and non-randomised controlled trials that used recreational soccer, which includes small-sided soccer games, as the sole or principal intervention, and reported relevant effects in untrained/sedentary, healthy or unhealthy adults aged 40 years and above were included.

Results

Five trials described in 13 articles were included, which scored 6–9 out of 12 points on the modified Delphi quality rating scale. The duration was from 12 to 52 weeks, with various frequencies, volumes and game formats performed both outdoors and indoors with men and women. The trials indicate that recreational soccer may result in improvement in cardiovascular function, body composition and functional ability, although no significant changes were observed in postural balance.

Conclusion

Recreational soccer should be considered an alternative exercise modality for untrained, healthy or unhealthy middle-aged and older adults of both sexes to maintain an active lifestyle and mitigate a wide array of physical and physiological age-related changes.

Effect of a 26-month floorball training on male elderly's cardiovascular fitness, glucose control, body composition, and functional capacity

BACKGROUND

Floorball training offers a motivating and socially stimulating team activity for older adults, and 12 weeks of floorball training twice a week among men aged 65-76 years have been shown to have positive effects on a number of physiological parameters important for health. However, the effect of long-term participation in floorball training among male elderly has not been investigated. The aim of the present study was to examine the effect of 26-month self-organized regular participation in floorball training on cardiovascular fitness, body composition, blood lipids, glucose control, and physical function among recreationally active men aged 66-78 years.

METHODS

After completing a 12-week randomized and controlled intervention with floorball and petanque training in the autumn 2014 or spring 2015, 15 subjects chose to participate in floorball training (floorball group, FG), whereas 16 subjects resumed their usual lifestyle (control group, CG). FG took part in self-organized floorball training 1.7 sessions of 40 min/week, and CG continued their normal recreationally active lifestyle during a 26-month follow-up period. At baseline and after the follow-up period subjects were tested for cardiovascular fitness, glucose control (resting blood samples), body composition dual-energy X-ray absorptiometry (DXA-scanning), and functional capacity.

RESULTS

In FG, the decline in maximal oxygen uptake (VO_2max) during the follow-up period was lower (242 ± 379 mL/min, p = 0.01), blood glycosylated hemoglobin (HbA1c) increased less (-1.6 ± 2.9 mmol/L, p = 0.02), and leg bone mineral density increased more (0.03 ± 0.05 g/cm², p = 0.02) than those in CG. The effects on body mass, total lean body mass, fat mass, blood lipids, and physical function were similar in FG and CG.

CONCLUSION

Approximately twice weekly floorball sessions with 40 min/session over 26-month appear to reduce age-related decline in cardiovascular fitness and glucose control and improve leg bone mineral density, suggesting that long-term participation in floorball training can be considered as a health-enhancing activity in recreationally active male elderly.

Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis

BACKGROUND

A previous meta-analysis showed that maximal oxygen uptake increased by 3.51 mL/kg/min (95% CI 3.07 to 4.15) during a recreational football programme of 3-6 months in comparison with continuous moderate-intensity running, strength training or a passive control group. In addition, narrative reviews have demonstrated beneficial effects of recreational football on physical fitness and health status.

OBJECTIVE

The purpose of this systematic review and meta-analysis was to evaluate the magnitude of effects of recreational football on blood pressure, body composition, lipid profile and muscular fitness with reference to age, gender and health status.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

MEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to 1 February 2017. In addition, Google Scholar alerts were set up in January 2012 to identify potential papers with the following key terms: recreational football, recreational soccer, street football and street soccer.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomised and matched controlled trials with participants allocated to a recreational football group or any other type of exercises or passive control group were included. Training programmes had to last at least 2 weeks to meet the inclusion criteria. The primary outcome measures were blood pressure, resting heart rate, body composition, muscular fitness, and blood lipids and glucose tolerance. A total of 31 papers met the inclusion criteria and were included.

RESULTS

The effect of recreational football on systolic blood pressure (SBP) versus no-exercise controls was most likely extremely largely beneficial (effect size (ES)=4.20 mm Hg; 95% CI 1.87 to 6.53). In addition, a most likely very large beneficial (ES=3.89 mm Hg; 95% CI 2.33 to 5.44) effect was observed for diastolic blood pressure (DBP), when compared with non-active groups. Furthermore, a most likely extremely large beneficial effect was shown for SBP and DBP in participants with mild hypertension (11 and 7 mm Hg decrease, respectively) and participants with prehypertension (10 and 7 mm Hg decrease, respectively). Meta-analysis of recreational football determined the impact on resting heart rate as most likely extremely largely beneficial (ES=6.03 beats/min; 95% CI 4.43 to 7.64) when compared with non-active groups. The observed recreational football effect on fat mass was most likely largely beneficial (ES=1.72 kg; 95% CI 0.86 to 2.58) and the effect on countermovement jump (CMJ) performance was most likely very largely beneficial (ES=2.27 cm; 95% CI 1.29 to 3.25) when compared with non-active groups. Possibly beneficial decreases were found in low-density lipoprotein levels (ES=0.21 mmol/L; 95% CI 0.06 to 0.36). Possibly largely beneficial effect was observed for DBP in comparison with continuous running training. Small harmful and unclear results were noted for SBP, fat and lean body mass, body mass index, as well as muscular fitness when compared with running and Zumba training.

CONCLUSION

The present meta-analysis demonstrated multiple broad-spectrum benefits of recreational football on health-related physical fitness compared with no-exercise controls, including improvements in blood pressure, resting heart rate, fat mass, low-density lipoprotein cholesterol and CMJ performance. Additionally, recreational football is efficient and effective as Zumba and continuous running exercise regimens with highlighted social, motivational and competitive components.

The effect of high-intensity aerobic interval training on markers of systemic inflammation in sedentary populations

PURPOSE

This study examined the effects of high-intensity interval training (HIIT; 30 s sprint, 4-5 min passive recovery) and prolonged intermittent sprint training (PIST; 10 s sprint, 2-3 min moderate exercise) on the systemic inflammatory markers C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α), aerobic capacity, and anthropometry in a middle-aged, sedentary population.

METHODS

Fifty-five sedentary adults (age 49.2 ± 6.1 years) were randomised into HIIT (n = 20), PIST (n = 21), or a sedentary control group (CTRL n = 14). HIIT and PIST performed three training sessions per week for 9 weeks on a cycle ergometer, matched for total high-intensity time, while CTRL continued normal sedentary behaviours. Pre- and post-intervention testing involved measures of anthropometry, peak oxygen consumption (VO_2peak), and venous blood collection for analyses of CRP and TNF-α.

RESULTS

HIIT and PIST increased VO_2peak compared to CTRL (+3.66 ± 2.23 and 3.74 ± 2.62 mL kg min^-1). A group × time interaction (p = 0.042) and main effect of time (p = 0.026) were evident for waist girth, with only HIIT showing a significant reduction compared to CTRL (-2.1 ± 2.8 cm). TNF-α and CRP showed no group × time interaction or time effect (p > 0.05).

CONCLUSIONS

In sedentary individuals, 9 weeks of HIIT or PIST were effective to improve aerobic capacity; however, only HIIT significantly reduced waist girth and WHR compared to CTRL. Markers of systemic inflammation remained unchanged across all groups. Accordingly, for inflammation and VO2_peak, the distribution of sprints and the active or passive recovery periods are inconsequential provided that total duration of high-intensity efforts is similar.

Barriers to and motivators for physical activity among people with Type 2 diabetes: patients' perspectives

AIM

To explore barriers to and motivators for physical activity in a group of overweight and obese individuals with dysregulated Type 2 diabetes.

METHODS

Data were collected from the Steno Diabetes Center's outpatient clinic in Denmark. Four focus groups were conducted including 28 individuals with Type 2 diabetes aged 39-71 years. The facilitators used open-ended questions and probes such as images, statements and quotations about physical activity to foster active participation and interaction among participants. Focus groups were recorded on video and the discussions were transcribed and analysed thematically.

RESULTS

We identified four main themes: 1) the body as a barrier to physical activity because of functional limitations; 2) logistical challenges, including lack of time and awareness of where to exercise in the local area; 3) being physically active with others, providing a sense of mutual commitment and enjoyment; and 4) goal-setting and self-tracking, which was seen as an opportunity to track physical improvement over time.

CONCLUSIONS

The findings suggest that, once people are active, a high level of social interaction may help maintain their activity levels. Further research is needed to investigate the effect of combining individually tailored exercise plans with the establishment of customized and locally based exercise communities that offer enjoyment and support. Additionally, it is relevant to explore experiences of using self-tracking technologies to review short- and long-term goals.

Effect of floorball training on blood lipids, body composition, muscle strength, and functional capacity of elderly men

Floorball training consists of intense repeated exercise and may offer a motivating and social stimulating team activity in elderly individuals. However, the effect of floorball training in elderly adults on physiological adaptations important for health is not known. Thus, this study examined the effect of floorball training on blood lipids, muscle strength, body composition, and functional capacity of men aged 65-76 years. Thirty-nine recreational active men were randomized into a floorball group (FG; n = 22) or petanque group (PG; n = 17), in which training was performed 1 h twice a week for 12 weeks. In FG and PG, average heart rate (HR) during training was 80% and 57%, respectively, of maximal HR. In FG, plasma low-density lipoprotein (LDL) cholesterol and triglycerides were 11% and 8% lower (P < 0.05), respectively. Insulin resistance determined by homeostatic model assessment (HOMA-IR) was reduced (P < 0.05) by 18%. HR during submaximal cycling was 5% lower (P < 0.05), and maximal voluntary contraction force was 8% higher (P < 0.05). Total and visceral fat content was lowered (P < 0.05) by 5% and 14%, respectively, HR at rest was 8% lower (P < 0.05) and performance in four different functional capacity tests were better (P < 0.05) after compared to before the training period. No changes were observed in PG. In conclusion, 12 weeks of floorball training resulted in a number of favorable effects important for health and functional capacity, suggesting that floorball training can be used as a health-promoting activity in elderly men.

Evaluating a Nationwide Recreational Football Intervention: Recruitment, Attendance, Adherence, Exercise Intensity, and Health Effects

The present study evaluated a nationwide exercise intervention with Football Fitness in a small-scale society. In all, 741 adult participants (20–72 yrs) were successfully recruited for Football Fitness training in local football clubs, corresponding to 2.1% of the adult population. A preintervention test battery including resting heart rate (RHR), blood pressure, and body mass measurements along with performance tests (Yo-Yo Intermittent Endurance level 1 (Yo-Yo IE1), the Arrowhead Agility Test, and the Flamingo Balance Test) were performed (n = 502). Training attendance (n = 310) was 1.6 ± 0.2 sessions per week (range: 0.6–2.9), corresponding to 28.8 ± 1.0 sessions during the 18 wk intervention period. After 18 wks mean arterial pressure (MAP) was −2.7 ± 0.7 mmHg lower (P < 0.05; n = 151) with even greater (P < 0.05) reductions for those with baseline MAP values >99 mmHg (−5.6 ± 1.5 mmHg; n = 50). RHR was lowered (P < 0.05) by 6 bpm after intervention (77 ± 1 to 71 ± 1 bpm). Yo-Yo IE1 performance increased by 41% (540 ± 27 to 752 ± 45 m), while agility and postural balance were improved (P < 0.05) by ~6 and ~45%, respectively. In conclusion, Football Fitness was shown to be a successful health-promoting nationwide training intervention for adult participants with an extraordinary recruitment, a high attendance rate, moderate adherence, high exercise intensity, and marked benefits in cardiovascular health profile and fitness.

Is Recreational Soccer Effective for Improving VO2max A Systematic Review and Meta-Analysis

Background

Soccer is the most popular sport worldwide, with a long history and currently more than 500 million active participants, of whom 300 million are registered football club members. On the basis of scientific findings showing positive fitness and health effects of recreational soccer, FIFA (Fédération Internationale de Football Association) introduced the slogan “Playing football for 45 min twice a week—best prevention of non-communicable diseases” in 2010.

Objective

The objective of this paper was to perform a systematic review and meta-analysis of the literature to determine the effects of recreational soccer on maximal oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max).

Methods

Six electronic databases (MEDLINE, PubMed, SPORTDiscus, Web of Science, CINAHL and Google Scholar) were searched for original research articles. A manual search was performed to cover the areas of recreational soccer, recreational physical activity, recreational small-sided games and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max using the following key terms, either singly or in combination: recreational small-sided games, recreational football, recreational soccer, street football, street soccer, effect, maximal oxygen uptake, peak oxygen uptake, cardiorespiratory fitness, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max. The inclusion criteria were divided into four sections: type of study, type of participants, type of interventions and type of outcome measures. Probabilistic magnitude-based inferences for meta-analysed effects were based on standardised thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations for baseline fitness.

Results

Seventeen studies met the inclusion criteria and were included in the systematic review and meta-analysis. Mean differences showed that \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max increased by 3.51 mL/kg/min (95 % CI 3.07–4.15) over a recreational soccer training programme in comparison with other training models. The meta-analysed effects of recreational soccer on \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max compared with the controls of no exercise, continuous running and strength training were most likely largely beneficial [effect size (ES) = 1.46; 95 % confidence interval (CI) 0.91, 2.01; I² = 88.35 %], most likely moderately beneficial (ES = 0.68; 95 % CI 0.06, 1.29; I² = 69.13 %) and most likely moderately beneficial (ES = 1.08; 95 % CI −0.25, 2.42; I² = 71.06 %), respectively. In men and women, the meta-analysed effect was most likely largely beneficial for men (ES = 1.22) and most likely moderately beneficial for women (ES = 0.96) compared with the controls. After 12 weeks of recreational soccer with an intensity of 78–84 % maximal heart rate (HR_max), healthy untrained men improved their \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max by 8–13 %, while untrained elderly participants improved their \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max by 15–18 %. Soccer training for 12–70 weeks in healthy women resulted in an improvement in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max of 5–16 %. Significant improvements in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max have been observed in patients with diabetes mellitus, hypertension and prostate cancer.

Conclusion

Recreational soccer produces large improvements in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ \dot{V}{\text{O}}_{2\;\hbox{max} } $$\end{document}V˙O2max compared to strength training and no exercise, regardless of the age, sex and health status of the participants. Furthermore, recreational soccer is better than continuous endurance running, albeit the additional effect is moderate. This kind of physical activity has great potential for enhancing aerobic fitness, and for preventing and treating non-communicable diseases, and is ideal for addressing lack of motivation, a key component in physical (in)activity.

The Effects of 52 Weeks of Soccer or Resistance Training on Body Composition and Muscle Function in +65-Year-Old Healthy Males--A Randomized Controlled Trial

The effects of 52 weeks of soccer or resistance training were investigated in untrained elderly men. The subjects aged 68.1±2.1 yrs were randomised into a soccer (SG; n = 9), a resistance (RG; n = 9) and a control group (CG; n = 8). The subjects in SG and RG, respectively, trained 1.7±0.3 and 1.8±0.3 times weekly on average during the intervention period. Muscle function and body composition were determined before and after 16 and 52 weeks of the intervention period. In SG, BMI was reduced by 1.5% and 3.0% (p<0.05) after 16 and 52 weeks, respectively, unchanged in RG and 2% higher (p<0.05) in CG after 52 weeks of the intervention period. In SG, the response to a glucose tolerance test was 16% lower (p<0.05) after 16 wks, but not after 52 wks, compared to before the intervention period, and unchanged in RG and CG. In SG, superoxide dismutase-2 expression was 59% higher (p<0.05) after 52 wks compared to before the intervention period, and unchanged in RG and CG. In RG, upper body lean mass was 3 and 2% higher (p<0.05) after 16 and 52 wks, respectively, compared to before the intervention period, and unchanged in SG and CG. In RG, Akt-2 expression increased by 28% (p<0.01) and follistatin expression decreased by 38% (p<0.05) during the 52-wk intervention period, and was unchanged in SG and CG. Thus, long-term soccer training reduces BMI and improves anti-oxidative capacity, while long-term resistance training impacts muscle protein enzyme expression and increases lean body mass in elderly men. Trial Registration: ClinicalTrials.gov: NCT01530035.

Recreational football for disease prevention and treatment in untrained men: a narrative review examining cardiovascular health, lipid profile, body composition, muscle strength and functional capacity

Over the past 10 years, researchers have studied the effects of recreational football training as a health-promoting activity for participants across the lifespan. This has important public health implications as over 400 million people play football annually. Results from the first randomised controlled trial, published in the BJSM in January 2009, showed that football increased maximal oxygen uptake and muscle and bone mass, and lowered fat percentage and blood pressure, in untrained men, and since then more than 70 articles about football for health have been published, including publications in two supplements of the Scandinavian Journal of Medicine and Science in Sports in 2010 and 2014, prior to the FIFA World Cup tournaments in South Africa and Brazil. While studies of football training effects have also been performed in women and children, this article reviews the current evidence linking recreational football training with favourable effects in the prevention and treatment of disease in adult men.

Rugby-specific small-sided games training is an effective alternative to stationary cycling at reducing clinical risk factors associated with the development of type 2 diabetes: a randomized, controlled trial

INTRODUCTION

The present study investigated whether rugby small-sided games (SSG) could be an effective alternative to continuous stationary cycling (CYC) training at reducing clinical risk factors associated with the development of type 2 diabetes mellitus (T2DM).

METHODS

Thirty-three middle-aged (48.6±6.6y), inactive men were randomized into a CYC (n=11), SSG (n=11), or control (CON, n=11) group. Participants trained 3d·wk(-1) for 8 weeks, while control participants maintained normal activity and dietary patterns. Exercise duration was matched between groups, which involved CYC or SSG (four quarters, interspersed with 2-min passive recovery). Both training programs were designed to induce similar internal loads of maximal heart rate (~80-85%HRmax) and rating of perceived exertion. Pre- and post-intervention testing included dual-energy x-ray absorptiometry scan, graded exercise test, fasting 2 h oral glucose tolerance test and resting muscle biopsy. Western blotting was used to assess the content of skeletal muscle proteins associated with mitochondrial biogenesis and glucose regulation.

RESULTS

Both CYC and SSG increased VO2 at 80%HRmax, and reduced glycated haemoglobin, glucose area under the curve (AUC; SSG, -2.3±2.4; CYC -2.2±1.6 mmol·L(1)(120 min)(1); p<0.05), and total body fat-mass (SSG -2.6±0.9%; CYC -2.9±1.1%), compared to no change in CON (p<0.05). SSG reduced insulin AUC (-30.4±40.7 µlU·mL(1)(120 min)(1); p<0.05) and increased total body fat-free mass (1.1±1.2 kg; p<0.05), with no change in CYC or CON (P>0.05). There were no differences within or between conditions for protein content of peroxisome proliferator-activated receptor gamma coactivator-1α, sirtuin-1, p53, glucose transporter-4, protein kinase AKT/PKB, myocyte enhancer factor 2A, mitochondrial transcription factor, nuclear respiratory factor (NRF)-1, NRF-2 or mitochondrial complexes I-V (p>0.05).

CONCLUSION

Rugby small-sided games is an effective alternative to continuous cycling for improving metabolic risk-factors associated with the prevention of T2DM. Despite such positive adaptations in clinical risk factors, there were no changes in the content of skeletal muscle proteins associated with glucose regulation and mitochondrial biogenesis.

TRIAL REGISTRATION

Australian New Zealand Clinical Trial Registry ACTRN12613000874718.

Effects of long-term football training on the expression profile of genes involved in muscle oxidative metabolism

We investigated whether long-term recreational football training affects the expression of health-related biochemical and molecular markers in healthy untrained subjects. Five untrained healthy men trained for 1 h 2.4 times/week for 12 weeks and 1.3 times/week for another 52 weeks. Blood samples and a muscle biopsy from the vastus lateralis were collected at T0 (pre intervention) and at T1 (post intervention). Gene expression was measured by RTqPCR on RNA extracted from muscle biopsies. The expression levels of the genes principally involved in energy metabolism (PPARγ, adiponectin, AMPKα1/α2, TFAM, NAMPT, PGC1α and SIRT1) were measured at T0 and T1. Up-regulation of PPARγ (p < 0.0005), AMPKα1 (p < 0.01), AMPKα2 (p < 0.0005) and adiponectin was observed at T1 vs T0. Increases were also found in the expression of TFAM (p < 0.001), NAMPT (p < 0.01), PGC1α (p < 0.01) and SIRT1 (p < 0.01), which are directly or indirectly involved in the glucose and lipid oxidative metabolism. Multiple linear regression analysis revealed that fat percentage was independently associated with NAMPT, PPARγ and adiponectin expression. In conclusion, long-term recreational football training could be a useful tool to improve the expression of muscle molecular biomarkers that are correlated to oxidative metabolism in healthy males.