Bone Mineral Density and Osteoporotic Vertebral Fractures in Traditional, Unassisted, Free-Diving Women (Haenyeos)

BACKGROUND

Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture.

METHODS

Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured.

RESULTS

Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was 72.1 ± 4.7 years and that of the controls was 72.7 ± 4.0 years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers.

CONCLUSION

BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.

Whole-body cold tolerance in older Korean female divers "haenyeo" during cold air exposure: effects of repetitive cold exposure and aging

This study was conducted to investigate the effects of chronic and repetitive diving in cold sea water on physiological responses to cold in older Korean female divers, Haenyeo, who have been exposed to cold water through breath-hold diving since their teens. Young and older females, who have no experience of swimming in cold sea water, were recruited as control groups: older haenyeos (N = 10, 70 ± 3 years of age), young non-diving females (N = 10, 23 ± 2 years), and older non-diving females (N = 6, 73 ± 4 years). For the test of cold exposure, all subjects were exposed to cold in an air temperature of 12 °C with 45% RH in a sitting position for 60 min. The changes in core temperature showed no significant differences between older haenyeos and the other two groups. The decreases in mean skin temperature were greater for older haenyeos than the other two groups (P < 0.01). Older haenyeos had significantly lower energy expenditure during cold exposure when compared to older non-diving females (P < 0.05). Heart rate was significantly lower in older haenyeos than that of young non-diving females (P < 0.05). Older haenyeos felt cooler at the face with lower face temperature when compared with older non-diving females. The results indicate that older haenyeos respond to cold through reducing heat loss from the skin rather than increasing metabolic rate. These responses are distinctive features from the cold defensive system of young or older non-diving females.

Cold adaptation, aging, and Korean women divers haenyeo

BACKGROUND

We have been studying the thermoregulatory responses of Korean breath-hold women divers, called haenyeo, in terms of aging and cold adaptation. During the 1960s to the 1980s, haenyeos received attention from environmental physiologists due to their unique ability to endure cold water while wearing only a thin cotton bathing suit. However, their overall cold-adaptive traits have disappeared since they began to wear wetsuits and research has waned since the 1980s. For social and economic reasons, the number of haenyeos rapidly decreased to 4005 in 2015 from 14,143 in 1970 and the average age of haenyeos is about 75 years old at present.

METHODS

For the past several years, we revisited and explored older haenyeos in terms of environmental physiology, beginning with questionnaire and field studies and later advancing to thermal tolerance tests in conjunction with cutaneous thermal threshold tests in a climate chamber. As control group counterparts, older non-diving females and young non-diving females were compared with older haenyeos in the controlled experiments.

RESULTS

Our findings were that older haenyeos still retain local cold tolerance on the extremities despite their aging. Finger cold tests supported more superior local cold tolerance for older haenyeos than for older non-diving females. However, thermal perception in cold reflected aging effects rather than local cold acclimatization. An interesting finding was the possibility of positive cross-adaptation which might be supported by greater heat tolerance and cutaneous warm perception thresholds of older haenyeos who adapted to cold water.

CONCLUSIONS

It was known that cold-adaptive traits of haenyeos disappeared, but we confirmed that cold-adaptive traits are still retained on the face and hands which could be interpreted by a mode switch to local adaptation from the overall adaptation to cold. Further studies on cross-adaptation between chronic cold stress and heat tolerance are needed.

Finger cold-induced vasodilation of older Korean female divers, haenyeo: effects of chronic cold exposure and aging

The aim of the present study was to evaluate the local cold tolerance of older Korean female divers, haenyeo (N = 22) in terms of cold acclimatization and ageing. As control groups, older non-diving females (N = 25) and young females from a rural area (N = 15) and an urban area (N = 51) participated in this study. To evaluate local cold tolerance, finger cold-induced vasodilation (CIVD) during finger immersion of 4 °C water was examined. As a result, older haenyeos showed greater minimum finger temperature and recovery finger temperature than older non-diving females (P < 0.05), but similar responses in onset time, peak time, maximum finger temperature, frequency of CIVD, heart rate, blood pressure, and thermal and pain sensations as those of older non-diving females. Another novel finding was that young urban females showed more vulnerable responses to local cold in CIVD variables and subjective sensations when compared to older females, whereas young rural females had the most excellent cold tolerance in terms of maximum temperature and frequency of CIVD among the four groups (P < 0.05). The present results imply that older haenyeos still retain cold acclimatized features on the periphery even though they changed their cotton diving suits to wet suits in the early 1980s. However, cardiovascular responses and subjective sensations to cold reflect aging effects. In addition, we suggest that young people who have been adapted to highly insulated clothing and indoor heating systems in winter should be distinguished from young people who were exposed to less modern conveniences when compared to the aged in terms of cold tolerance.