Veteran team sport players have great heart health

Introduction

We all know that physical activity is beneficial for several risk factors of cardiovascular disease and all-cause mortality. We also know that if we improve our aerobic fitness we increase our chances of living longer. However, despite this knowledge, the number of people meeting the recommendations for physical activity is lowest in older people. Why? Because with normal ageing, body fat increases and muscle mass decreases and these changes are more evident in the physically inactive than active people. Obesity is related to several metabolic and cardiovascular diseases and obese men have been shown to have 2.6 times higher mortality from cardiovascular disease than normal weight men.

Research has shown a strong relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. Research has also shown that lean unfit men had higher risk ratios for cardiovascular and all-cause mortality than obese but fit men. These findings highlight the importance of endurance fitness in older people to prevent heart disease and live longer. Moreover, no differences in risk ratios were found between lean and obese but fit men.

Research has also shown that higher levels of endurance fitness are related to more vigorous training rather then low to moderate intensity endurance training.  In team sports, a recent study has shown that the exercise intensity is high during recreational soccer independent of age, gender, the level of training and social background and that recreational soccer is an effective health-promoting activity for untrained men and women aged 20–45 years.

But is recreational soccer a health-promoting activity for the very old? This study aimed to investigate whether lifelong participation in recreational soccer results in superior exercise capacity and cardiovascular health status for elderly (65-85 years old) in comparison to age-matched active men with no regular exercise training as well as strength-trained and endurance-trained elderly men.

Methods

A number of performance measures and indicators of cardiovascular health were measured in elderly soccer players (n = 11) compared to endurance-trained (n = 8), strength-trained (n = 7) and untrained (n = 7) age-matched men. The 33 men aged 65–85 years underwent a testing protocol including measurements of cycling performance, maximal oxygen uptake (VO2max) and body composition, with muscle fibre type and capillarisation determined from a muscle biopsy from the thigh.

Results

In the veteran soccer players, peak aerobic power on the bike was significantly greater (203 ± 20 watts) than in the untrained older men (150 ± 16 watts) and strength-trained men (156 ± 22 watts), but similar to the performance of the endurance-trained older men (201 ± 38 watts). Fat percentage was significantly lower in the veteran soccer players (21.8 ± 4.9%) than the untrained men (28.3 ± 2.1%) but not the endurance-trained (20.7 ± 4.4%) or strength-trained older men (21.7 ± 6.4%). VO2max was not significantly different in the soccer players (30.2 ± 4.9 ml O2 · min−1 · kg−1) compared to untrained (only 14% higher) and ST (only 9% higher), but 22% lower than the endurance-trained older men. The number of capillaries per fibre (a measuer of blood carrying capacity in muscles) was significantly higher  (almost double) in the soccer players compared to both the untrained and strength-trained men but similar to that of the endurance-trained men.

So what?

The scandinavian and UK researchers concluded that both the exercise performance and cardiovascular health profile of lifelong veteran soccer players are markedly better than for age-matched untrained males. Moreover, the exercise capacity and muscle aerobic capacity of veteran soccer players are also superior to lifelong strength-trained athletes and comparable to veteran endurance athletes. Given how important endurance capacity is for reducing cardiovascular disease and all-cause mortality, the study strongly supports older individuals engaging in team sports to enhance the quality and quantity of life into older age.

Source: Randers and others (2014). . Journal of Sports Sciences, 32(13): 1300-1308.

 

Masters endurance athletes more at risk of heart arrythmias

Introduction

Over the last 5-10 years I have become aware of a number of former elite endurance athletes having heart issues. This is counter intuitive given endurance athletes are considered to have strong hearts. However, over the last 10 years research is increasingly showing that the incidence of arrhythmias is higher in athletes, especially in elderly athletes with a lifelong training history in marathons, ultra-marathons, ironman distance triathlons and long distance bicycle races. An arrhythmia is any change from the normal sequence of electrical impulses in the heart. The electrical impulses may happen too fast, too slowly (bradycardia), or erratically so that the heart can’t pump blood effectively.

Bradycardia, defined by a resting heart rate <60 beats min−1, is the most frequent rhythm disturbance in response to endurance training where the resting heart rate can be ~30 beats min−1 and even lower at night. Cyclists Sir Chris Hoy and Tour de France winner Miguel Indurain reportedly had resting heart rates of 30 and 28 beats per minute. Although the bradycardia is usually a harmless adaptation to endurance training, it can become a pathological condition. It was previously thought to affect the electrical activity of the heart that starts in what is called the sinus node (see photo) which is an area of specialized cells in the upper right chamber of the heart that controls the rhythm of your heart.

The most compelling evidence of a link between endurance training and sick sinus syndrome comes from a study of former professional cyclists. Their average heart rate was lower, sick sinus syndrome was more frequent, and pacemaker implantation for bradyarrythmias was more frequent relative to a control group with matched cardiac risk factors. Similarly, a high incidence of pacemaker implantation has been reported in elderly marathon runners.

Historically, this slowing of the heart rate was thought to be the result of a change in the nervous system stimulation of the heart muscle through the sinus node, the pacemaker structure in the heart muscle itself. However, a recent animal study is the first to show that the heart rate adaption to exercise training is not the result of changes in this nervous system control of the heart, and instead is primarily the result of a training-induced remodelling of the sinus node within the heart itself.

Methods

Rats were trained for 12 weeks (1 hour per day, 5 days per week) by aerobic interval training (uphill running) alternating between 4 min at 85–90% of the maximum oxygen uptake and 2 min active recovery at 50% of maximum oxygen uptake. Experiments were also carried out in mice that were trained for 4 weeks (1 hour per day, twice a day, 7 days per week) by swimming. Resting heart rates, electrical activity of the heart, as well as actual tissue samples from the sinus node of sedentary and trained animals were analyzed.

Results

The resting heart rate of the trained rats and mice was ~26% and ~20%, respectively, lower than the heart rate of untrained animals. The resting heart rate of exercise-trained human subjects in various studies varies between ~17–26% lower than the heart rate of inactive people, a reduction similar to that observed in the animal models in the present study. This decrease is less than in elite human athletes. However, severe bradycardia or heart rate slowing in human athletes is uncommon. A protein found in the sinus node (the heart’s pacemaker) changed in response to training with a decrease in an important pacemaker protein, known as HCN4, a protein that is responsible for the low heart rate seen in fit animals.

So What?

With lifelong endurance training, research has consistently shown that veteran endurance athletes have a higher incidence of sinus node disease and artificial pacemaker implantation than normal individuals. Historically, we always believed this was due to changes in the nervous system stimulation of the heart. The present study, although done on rats and mice, suggests the slowing of the heart rate may be due to actual remodeling of the sinus node in the heart wall that actually stimulates the heart muscle to beat. The researchers believe that this finding may also help explain syncope (fainting) in the young athlete as well as other heart rhythm disturbances in older athletes including atrial fibrillation, heart block, bundle branch blockand even sudden cardiac death.. They suggest that it is likely that these disturbances may be the consequence of an actual remodeling of other parts of the heart that are responsible for electrical activity in the heart and perhaps in combination with a pre-existing heart condition in the case of sudden cardiac death.

Critically, the researchers suggest endurance exercise is undoubtedly beneficial for the cardiovascular system, but at the same time intense endurance training over many year can have harmful effects, especially in elderly athletes with a lifelong history of training and competing in endurance events like marathons, triathlons and ironman. They conclude that although endurance exercise training can have harmful effects on the heart, it is more than outweighed by the beneficial effects. Importantly, the researchers also know that this animal study’s findings need to be reproduced in humans and that more research is needed before we could draw conclude that too much endurance training is bad for the heart health of veteran athletes who have undertaken years of endurance training.

Source: D’Souza, A. and others (2014). Exercise training reduces resting heart rate via downregulation of the funny channel HCN4. Nature Communications, 5, Article 3775.

Sleep, Recovery and Sports Performance

Introduction

Recovery is equally as important as training to achieve our best performances in sport. Sleep is a critical recovery strategy that many family- and career-focused masters athletes tend to negate. Here are some tips from a recently published review of the available research on how to improve your sleeping habits.

Sleep and Sports Performance

Research on young athletes has shown that when they sleep more they perform better and feel healthier. Not surprsing really given that research has shown that sleep is the ranked as the most important problem among athletes of any age when asked to identify their main causes of fatigue and tiredness.

In young athletes, it is suggested 7-9 hours of sleep is needed to ensure adequate physical and psychological recovery from training. Even more sleep is suggested during periods of injury, when travelling or during heavy training or in competition.

Napping of around 30 minutes has been suggested to help 20m sprint performance and alertness in sleep-deprived athletes, especially if taken just after lunch. So when in competition, think about a nap after lunch if you’ve had trouble sleeping the night before a major event.

As previously presented in this website, encouraging young athletes to get more sleep improved sprint performance, shooting accuracy and and feelings of wellbeing in young basketballers. Strategies to improve both the quality and quantity of sleep include:

  1. Maintain a regular sleep scedule of when you wake up and when you go to bed.
  2. If you can’t sleep within 15 minutes of going to bed, get up and do something that doesn’t require high level thinking – read, watch TV, meditate.
  3. Get rid of the bedroom clock.
  4. Avoid coffee, tobacco and alcohol in the hours before bed.
  5. Nap just after lunch not in the late afternoon.
  6. Maintain a cool (approx 18 degree C) room temperature.
  7. Don’t eat/drink large quantities of food or drink before bed.

When on a flight and wanting to sleep try:

  1. Ajusting your watch to the time zone you are travelling to.
  2. Use pillows to create a comfortable sleeping space.
  3. Use eyeshades and ear plugs.
  4. Avoid coffee, tobacco and alcohol.
  5. Eat meals to the destination schedule.
  6. Drink water regularly.

Sleep Recommendations for Athletes

1. Amount of Sleep: Suggested to be 7-9 hours in young athletes with young athleets in heavy training 4-6 hours a day suggested to get between 10-12 hours a night. It’s been a myth for years that the older we get the less sleep we need so it appears reasonable that we should be ensuring we get as much sleep as possible when in training. Not easy with family and careers!

2. Regular Routine and Sleep Habits: Having a regular sleep routine is key. Avoiding watching TV or using a computer in bed.

3. Napping: Naps of less than 30 minutes in duration taken just after lunch appear to improve performance and thinking. Avoid late afternoon or early evening naps.

4. Use recovery strategies after training or competition: Chapter 15 in my book examines in great detail the exact methods athletes need to recover after training or competition. These include nutrition, cold water immersion, ice baths and compression garments.

5. Lower Anxiety Before Sleeping: Life has it’s own stressors, especially with family, relationships and careers being juggled with training for a goal. Research has consistently shown, as life experience has, that stress lowers sleep quality and quantity. Relaxing before bed with a book, meditation, imagery, and/or self-talk can all help lower anxiety levels. Letting go of muscular tension by closing the eyes, focusing on breathing slowly and deeply, then progressively relaxing the muscles at top of the head, the forehead, face, neck, back, abdomen, arms, stomach, hips, legs, feet can help.

So What?

Both the quality and quantity of sleep are important in maximising both training and playing performance in athletes. As highlighted in Chapter 15 (Recovery Strategies for the Masters Athlete) of my book The Masters Athlete, sleep is crucial for recovery, performance, and maximising the immune system in older athletes. The same chapter in my book lists the above key strategies and others for getting a good night’s sleep and highlights which recovery strategies science says work and how to use them. Indeed, from a health perspective, research has shown that getting between 7-9 hours sleep a night is crucial for longevity and prevention of some chronic diseases, yet another reason we aging athletes need to get a good night’s sleep. Click here to read more.

Sources:

1. Bird, S. (2013). Sleep, recovery, and athletic performance: a brief review and recommendations. Strength and Conditioning Journal, 35(5): 43-47.

2. Mah, C. and others (2011). The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep, 34(7): 943-950.

Watermelon Juice Reduces Muscle Soreness

Introduction

I always knew watermelons were great recovery food after long or hard training or racing. Why? They’re loaded with water and have a high glycemic index meaning they help replace muscle and liver carbohydrate stores well, even if you need to eat a lot of it to get the energy stores back. Here is some new research suggesting the humble watermelon may also be good for relieving muscle soreness.

The Research

Seven healthy and active sport science students (22.7 ± 0.8 yr, 68.9 ± 3.8 kg, 170.8 ± 3.6 cm) completed a repeat sprint cycling test once every five days. One hour prior to each test, they drank one of three drinks: 500 ml of natural watermelon juice (contains 1.17 grams of the amino acid citrulline), 500 ml of enriched watermelon juice (containing 6 grams of citrulline – 1.17 grams natural plus added 4.83 grams), and a placebo created to look and taste like watermelon juice. One hour after drinking the 500 ml, each subject warmed up on a cycle ergometer for 5 minutes at 75 watts then completed 8 x 30 second sprints separated by one minute of rest then a 3 minute cool down. The researchers measured heart rates during each test, blood lactate during and after the tests, and both ratings of perceived exertion (6-20 scale) and muscle soreness levels immediately after the test then 24 and 48 hours after the tests on a 1-5 scale.

The Results

There were no differences in cycling performance, ratings of perceived exertion, lactate values or heart rates during the tests. Muscle soreness was no different between the three drinks immediately after or even 48 hours after testing. However, 24 hours after testing, both the watermelon juice and enriched watermelon juice drinks resulted in lower levels of muscle soreness than the placebo drink with no difference between the two watermelon drinks.

The So What?

This Spanish study strongly suggests that (yet again) natural products such as watermelon juice can help athlete performance, in this case recovery. The theory is that the amino acids found in watermelon (citrulline and argenine) aid blood flow and decrease inflammation.  While the study used healthy active sport science students and not trained cyclists, it does suggest that as little as two cups of natural watermelon juice may help us recover from hard training or races.

Source: Tarazona-Diaz, M. and others (2013) Watermelon juice: potential functional drink for sore muscle relief in athletes.  Journal of Agricultural and Food Chemistry, 61: 7522-7528

Supplementing with Probiotics Reduces Risk of Sore Throats in Physically Active Adults

Introduction

How often do we hear stories of people getting sore throats or ‘the cold’ leading into or following a major sporting goal or event. Research has shown that most adults get 2-3 of these a year and the older we get, the more of them we get. There is no doubt that the physical and emotional stress lowers the functioning of the immune system leading into the event. It also doesn’t help to be exposed to 100’s or 1000’s of people during and after racing – another time our immune system is compromised! Here is some new Aussie research suggesting that taking probiotics can help reduce upper respiratory tract infection (URTI) in physically active adults.

The Research

The World Health Organisation (WHO) defines probiotics as live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host. Probiotic foods include dairy foods including yoghurt, cheese, and acidophilus milk (eg Yakult) as well as non-dairy foods such as olives, gherkins, sauerkraut and probiotic drinks and supplements that are increasing in popularity. The researchers from a number of research institutions including Griffith University in Queensland and the Australian Institute of Sport conducted a randomised double-blind placebo-controlled trial (this means well-controlled study!). 465 male and female adults aged between 18 and 60 years who exercise a minimum of three times a week for 30 minutes for 3 months took part. They were assigned to one of three groups:

  1. Bifidobacterium animalis subsp. lactis group
  2. Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis group
  3. Placebo group

Patterns of illness were determined via a web-based questionnaire. Signs and symptoms of URTI included a scratchy or sore throat, sneezing, and a stuffy or runny nose. URTI was diagnosed when two or more of these symptoms were recorded for three or more consecutive days.  The researchers also monitored gut upsets such as diarrhoea, constipation, tummy rumbles, nausea and abdominal pain but did not get enough people experiencing these to do an analysis on gut upsets.

The Results

The risk of an URTI episode was significantly reduced by 27% in the Bifidobacterium animalis subsp. lactis group. While it wasn’t statistically significant, the combined probiotic of Lactobacillus acidophilus NCFM and Bifidobacterium animalis subsp. lactis did reduce the risk of URTI too. Importantly in this study, those taking both probiotics also delayed getting URTIs compared to the placebo group by about 3 weeks.

The So What?

While I don’t advocate or push products through my website, I do like to ‘bridge the gap’ between science and masters sport. In Australia the two probiotics listed above are available as a product called Inner Health Plus. The study reported here showed that risk of an URTI episode was significantly reduced by about 25% by taking probiotics.  Interestingly, taking vitamin C, something most of us are aware of to fight colds, only reduces the risk of getting a common cold by about 3%. Those taking the probiotics in this study also delayed getting URTIs compared to the placebo group. Be aware that probiotics take about 10-14 days to colonise the gut so if you plan to use them leading into an event, travel, or the winter months, plan ahead. For plenty of great ideas on how to stay healthy and well as an athlete over 30 years of age, chapter 14 (Staying healthy and illness-free) of my book The Masters Athlete has heaps of great scientifically-proven tips to stay healthy while training hard and often.

Source: West, N. and others (2013) Probiotic supplementation for respiratory and gastrointestinal illness symptoms in healthy physically active individuals.  Clinical Nutrition (published ahead of print).