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.

 

Multivitamin-Multimineral Supplements and Longevity

Introduction

I’ve long advocated taking multivitamins and multiminerals as an older athlete. Why? Because despite eating a healthy balanced diet full of fruit and vegetables, a hard training athlete of any age needs to ‘cover their bases’. Thus, a typical multivitamin and multimineral supplement that has moderate levels of B-group vitamins and sprinkling of other vitamins and minerals just gives me the piece of mind that I am getting the nutrients I need to keep training and performing.

Some research published in 2011 from The Iowa Woman’s Health Study showed an increased risk of death in 38,772 older women with an initial average age of 61.6 years  were regular supplementers and tracked since 1986. This study showed that regular use of multivitamins increased the risk of death by 2.4% compared to non-users. Increased risk of death in other vitamins and minerals included vitamin B(6) (4.1%), folic acid (5.9%), iron (3.9%), magnesium (3.6%), zinc (3.0%), and copper (18.0%) were associated with increased risk of total mortality when compared with corresponding nonusers. in contrast, use of calcium reduced mortality by 3.8%. However, this study was clouded by the fact that supplement use was higher in those with a history of disease and therefore more likely to pass away. So what does research say about regular use of multivitamins and multiminerals and how long we live for?

The Research

A group of Australian scientsist from Melbourne’s Swinburne University of Technology performed a large (meta-) analysis of all the vious research studies examining longevity and multivitamin and multimineral use. 21 eligible studies (91,074 people and 8794 deaths) investigated daily multivitamin-multimineral supplementation for ≥1 y. Studies using people described as institutionalized or as having terminal illness were excluded.  The scientsists used sophisticated statistical analysis to determine what we call the relative risk (a ratio of the probability of the event occurring in the exposed group versus a non-exposed group) of death.

The Results

The average age of the sample was 62 years and the average duration of supplementation was 43 months. Across all 21 studies, no effect of multivitamin-multimineral treatment on all causes of death was found. Furthermore, use of multivitamin-multimineral supplements had no effect on mortality due to vascular causes (eg. stroke, heart disease) or cancers.

The So What

This very rigorous study highlights that use of multivitamin-multimineral supplements won’t help us live longer. However, in older athletes who train regularly, use of a multivitamin-multimineral supplement that has a range of vitamins and minerals included in them should be considered. Importantly for older endurance athletes or those who train hard and often, multivitamin-multimineral supplements should be considered. For the most definitive discussion related to sports nutrition for older athletes that you will ever read (biased as I am!) check out Chapter 16 (Nutrition for the Masters Athlete) of my book The Masters Athlete, now available online in pdf format as a whole book or chapter by chapter. Also strongly consider a visit to a sports dieticiano have your own dietary needs and food intake analysed by a professional. In Australia you can find one by clicking here. In the USA, click here, and the UK here.

Source: Macpherson, H. and others (2012). Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition, Dec 19. [Epub ahead of print]

Heart damage from too much training??

Introduction

There’s been some recent media speculation that older endurance athletes are more prone to heart problems than healthy age-matched people. Just after one of our readers advised me of this negative press, a mate in his mid-60’s and pioneer of Ironman triathlon in Australia and now a lecturer in sport coaching at an Ozzie university told me he has had a pacemaker inserted. This goes against the common belief that aerobic exercise is good for you in that it keeps many of the heart disease risk factors in check. So what does the research really say when it comes to this supposed increased risk of heart problems in older endurance athletes?

The Facts

Exercise is increasingly been seen as medicine. In fact, internationally, there has been a movement started called Exercise is Medicine. The movement is being driven by the enormous amount of scientific evidence supporting the value of doctors prescribing exercise as medicine rather than pills!! Consistently and unequivocally recent research has found that regular exercise prevents and treats many of our common and deadly chronic diseases including:

  • coronary artery disease
  • diabetes
  • obesity
  • high blood pressure
  • heart failure
  • depression

Moreover, people who do regular physical activity have lowere rates of disability and an average life expectancy about 7 years longer than non-exercisers.

However, as with any drug there appears to be a safe upper range dose of activity above which there may be adverse effects that may outweigh the benefits above. For example, a long-term study published in 2011 in the highly prestigous medical journal the Lancet tracked 416,000 Taiwanese people over about 8 years and found that there was a protective health effect up to about 60 minutes of daily vigorous (huff and puff!) exercise. Another recent longitudinal study 0f 52,000 adults found that running distances of up to 19.9 miles/week, speeds of 6-7 miles/hour, or frequencies of 2-5 days/week were associated with a lower risk of all-cause mortality, whereas higher mileage, faster paces, and more frequent running were not associated with better survival.

Very recently, there has been some suggestion that long-term endurance vigorous training such as that greater then the doses above may increases the risk of atrial fibrillation (irregular heart beat). This review article presented many studies conducted over the last 15 years that have suggested training too hard for too long can increase the risk of atrial fibrillation in healthy middle-age men. They suggested that although such training may prevent coronary artery disease, it might also cause of atrial fibrillation.

An increasing amount of research evidence also suggests that training and competing long term in ‘extreme’ endurance events such as marathons, ultramarathons, ironman triathlons and very long cycling or swimming events can cause transient problems and damage to the heart walls and chambers as evidenced through blood markers. However, these problems return to normal within 7-10 days after stopping training.

In veteran extreme endurance athletes such as my mate, this consistent heart muscle damage and repair process may lead to heart fibrosis (thickening and stiffening of the heart valves and muscle). Over years, this may lead to heart arrythmias (irregular heart beats).

However, recently another group of cardiology researchers critically analysed these studies that suggested increased risk of heart issues in older endurance athletes (like me and my mates) who train long and hard and often. These researchers concluded that the

  1. the incidence of atrial fibrillation in middle-aged endurance athletes is rare
  2. if a risk exists, it is limited to vigorous endurance exercise only and in those middle-aged men with other risk factors such as smoking or high blood pressure
  3. there is no increased risk in healthy middle-aged men with a normal heart who have no blood pressure issues and no other risk factors
  4. Critically, the researchers concluded that the beneficial effects of exercise will offset this low risk which, even if increased, remains very low.

The So What?

As with any issue in science, research typically is inconclusive. There are always studies and papers that contradict each other. While a number of studies over the years have shown a potential increased risk of heart issues in older athletes who train long and hard and often, other studies suggest the risk is very low in these athletes if they are healthy and have no other risk factors. Moreover, the current concensus appears to be that while the the risk is very low, the benefits of such training outweigh the low risk of heart issues. For me, I intend to keep training regularly unless my body tells me otherwise!

Chapter 4 (Principles of Training the Masters Athlete), Chapter 6 (Endurance Development in the Masters Athlete), Chapter 10 (Periodisation and Peaking for the Masters Athlete), Chapter 13 (Preventing Overtraining in the Masters Athlete) and Chapter 14 (Staying Healthy and Illness-Free) are excellent guides and how-to chapters when it comes to optimising your training and preventing health issues as an older athlete. Each chapter is now available online as a pdf. Check it out by clicking here.

Sources:

  1. Delise, P. and others (2012) Does long-lasting sports practice increase the risk of atrial fibrillation in healthy middle-aged men? Weak suggestions, no objective evidence. Journal of Cardiovascular Medicine, 13: 381-385.
  2. Patil, H and others (2012) Cardiovascular damage resulting from chronic excessive endurance exercise. Missouri Medicine, 109(4): 312-321.

50 Ways to Live to 100

Popular Supplements May Increase Death Risk

Introduction

A recent study of almost 40,000 older women examined the association between vitamin and mineral supplement use and death rates.  The study showed that some common supplements appear to actually increase the risk of dying. Finnish and American scientists found that multivitamins, vitamin B6, folic acid, iron, magnesium, zinc, and copper, were all associated with increased risk of death in older women. Conversely, they found that the use of calcium reduced the risk of death.

The Research

38,772 older women from the Iowa Women’s Health Study were surveyed on their vitamin and mineral supplementation practices in 1984 (average age 61.6 years), 1997, and 2004. Through to the end of 2008, deaths were identified through the State and National authorities with 40.2% of the original women having died. The statistical analyses adjusted for levels of education, health risk factors such as high blood pressure and diabetes, smoking status and levels of physical activity.

The Results

The use of multivitamins increased the risk of death by 2.4%, vitamin B6 by 4.1%, folic acid by 5.9%, iron by 3.9%, magnesium by 3.6%, zinc by 3.0% and copper by 18.0% when compared to non-use. In contrast, use of calcium decreased risk of death by 3.8%.

So What?

Given that more than 30% of adults from high-income countries like ours take vitamin and mineral supplements, these results strongly suggest that eating a well-balanced and more natural diet emphasising a range of coloured natural foods is the way to go. The researchers in this study concluded that they see little justification for the general and widespread use of dietary supplements. However, they do suggest that they be used with a medically-based cause such as symptomatic nutrient deficiencies. Bottom line is ensure that you eat a well-balanced diet that takes into account your age, health status, training intensity and volume. If in doubt, visit an accreditted sports dietitian.

Source: Mursu, J. and others. (2011). Dietary supplements and mortality rate in older women: The Iowa Women’s Health Study. Archives of Internal Medicine. 171: 1625-1633.