Football is medicine: it is time for patients to play!

Effects of Small-Sided Soccer Games on Physical Fitness and Cardiometabolic Health Biomarkers in Untrained Children and Adolescents: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis aimed to determine the benefits of an exercise intervention based on small-sided soccer games (SSSGs) on health-related physical fitness and cardiometabolic health in previously untrained children and adolescents. Methods: A systematic search on PubMed/MEDLINE, Web of Science, Scopus, Cochrane, and EBSCO databases was performed. Randomized or non-randomized controlled trials conducted in previously untrained children or adolescents (age < 18 years) that assessed the effect of SSSG-based intervention on health-related physical fitness and cardiometabolic risk biomarkers were included. Primary outcomes were cardiorespiratory fitness and waist circumference. Evidence was synthesized as the mean difference or standardized mean difference using a random-effects meta-analysis. The quality of evidence was assessed using ROB2 and ROBINS-I tools. Results: Sixteen studies (n = 2872 participants) were included in this meta-analysis. SSSGs significantly improved cardiorespiratory fitness (SMD, 0.12 [0.01; 0.23]) and showed a non-significant trend in decreased waist circumference (-7.49 cm [-15.03; 0.06]). Additionally, SSSGs significantly decreased systolic (MD, -3.85 mmHg [-5.75; -1.94]) and diastolic blood pressure (MD, -1.26 mmHg [-2.44; -0.08]) and triglycerides (-30.34 mg·dL-1 [-45.99; -14.69]). No effects on body composition or other cardiometabolic risk biomarkers were observed. After a sensitivity analysis, waist circumference and muscle strength were also shown to improve significantly following SSSGs. Comparisons between SSSG and other types of exercise interventions showed no differences in improved physical fitness or cardiometabolic risk. Conclusions: SSSG-based interventions effectively improve cardiorespiratory fitness, blood pressure, triglycerides, muscle strength, and waist circumference. There is less evidence of the effects of SSSGs on other health markers. Particular attention should be given to improving SSSG protocol reporting in future studies.

Evaluation of a football fitness implementation initiative for an older adult population in a small-scale island society

Background

The proportion of older people increases globally, which calls for sustainable interventions promoting healthy aging. Therefore, we aimed to evaluate the potential of Football Fitness as a sustainable model to promote quality of life, mental health, and physical function for older adult.

Methods

The study was conducted in collaboration with a municipality, a football club, and a university, and was designed as a randomized controlled trial. A total of 66 people (34 women, 32 men) older than 60 years were randomly assigned (60/40) to a Football Fitness (FOT) (n = 38, 20 women, 18 men) and a control group (CON) (n = 28, 14 women, 14 men). FOT participated in Football Fitness for 12 weeks. Quality of life (QoL) and mental wellbeing were determined pre-and post-intervention. Physical loading and Flow experience were measured in one representative training session. Blood pressure (BP), Yo-Yo Intermittent endurance test level 1 (Yo-Yo IE1), sprint performance, postural balance, and body composition were also performed pre-and post-intervention.

Results

An improvement in mental wellbeing was observed for both groups from pre- to post-intervention (p values <0.001) with no between-group differences. Regarding QoL, the environment domain improved in FOT compared to CON (p = 0.02). Mean Flow (M = 5.69; SD = 1.07) and perceived importance (M = 4.20; SD = 1.42) and average experienced difficulty was M = 5.23 (SD = 2.67), perceived skill (M = 5.23; SD = 2.56), and perceived balance (M = 5.64; SD = 1.56). These levels of flow can be characterized as being high. A between-group effect (p = 0.02) existed for systolic BP, which decreased (p < 0.01) by -5% [-8; -1%] in CON and remained unchanged in FOT. Both groups improved the Yo-Yo IE1 to a similar extent, with 28% [11; 44%] (p = 0.001) in FOT and 27% [9; 46%] in CON (p = 0.005). Postural balance improved (p = 0.004) by 38% [13; 63%] in FOT only, resulting in a superior (p = 0.01) balance score in FOT compared to CON post-intervention (p = 0.004).

Conclusion

Football Fitness improved the environmental quality of life domain and postural balance in older adults. Additionally, it appears to be a feasible group activity for older adults that promotes high flow and physical loading during training.

Long-term continuous exercise training counteracts the negative impact of the menopause transition on cardiometabolic health in hypertensive women - a 9-year RCT follow-up

PURPOSE

The study examined effects of 9-yrs of multicomponent exercise training during the menopause interval on cardiometabolic health in hypertensive women.

METHODS

Sedentary, middle-aged women (n = 25) with mild-to-moderate arterial hypertension were randomized into a soccer training (multicomponent exercise; EX; n = 12) or control group (CON; n = 13). EX took part in 1-h football training sessions, 1-3 times weekly, for a consecutive 9-years, totaling ∼800 training sessions, while CON did not take part in regular exercise training. 22 participants entered menopause during the intervention.

RESULTS

A time×group interaction effect (P = 0.04) of 8.5 mmHg in favour of EX was observed for changes in mean arterial pressure (MAP) (EX: -4.8 [-10.7;1.1] mmHg, CON +3.7 [-2.0;9.3] mmHg). Time×group interaction effects in favour of EX were also observed for total body weight (4.6 kg, P = 0.008, EX: +0.7 [-1.7;3.0] kg, CON: +5.3 [3.0;7.6] kg, total fat percentage (5.7%-points, P = 0.02; EX (-1.9 [-4.4;0.6] %-points; P = 0.13), CON +3.8 [1.4;6.2] %-points and for total cholesterol (1.2 mmol/l, P = 0.03, EX: -0.5 [-1.0;-0.1] mmol/l, CON: +0.7 [0.2;1.1] mmol/l. EX reduced (P = 0.02) plasma low-density lipoprotein cholesterol by -0.4 [-0.8;-0.1] mmol/l, whereas an increase (P = 0.01) of 0.4 [0.1;0.8] mmol/l occurred in CON (interaction. P < 0.001). A time×group interaction (P = 0.004) existed for changes in exercise capacity in favour of EX. Fasting glucose remained unchanged in EX and increased (P < 0.001) by 0.7 [0.4;1.0] mmol/l in CON (time×group interaction P = 0.02).

CONCLUSION

In conclusion, long-term multicomponent exercise training fully counteracts the detrimental effects of the menopause transition on cardiometabolic health in hypertensive women.

Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants

BACKGROUND

Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated.

OBJECTIVES

To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports.

METHODS

Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability.

RESULTS

A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010).

CONCLUSIONS

A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839.

Health and performance effects of 12 weeks of small-sided street football training compared to grass football training in habitually active young men

PURPOSE

The purpose of the present study was to investigate the health and exercise performance effects of street football training on very small pitches surrounded by boards in young habitually active men in comparison to small-sided football training on grass.

METHODS

Thirty-nine habitually active men (30.7 ± 6.7 years, 90.9 ± 16.6 kg, 183.8 ± 4.5 cm, 39.6 ± 6.0 mL/min/kg) were randomly assigned to a street football training group (ST) or grass football group (GR) playing small-sided games for 70 min, 1.5 and 1.7 times per week for 12 weeks, respectively, or an inactive control group (CO). Intensity during training was measured using heart rate (HR) and GPS units. Pre- and post-intervention, a test battery was completed.

RESULTS

Mean HR (87.1 ± 5.0 vs. 84.0 ± 5.3%HRmax; P > 0.05) and percentage of training time above 90%HRmax (44 ± 28 vs. 34 ± 24%; P > 0.05) were not different between ST and GR. VO2max increased (P < 0.001) by 3.6[95% CI 1.8;5.4]mL/min/kg in GR with no significant change in ST or CO. HR during running at 8 km/h decreased (P < 0.001) by 14[10;17]bpm in ST and by 12[6;19]bpm in GR, with no change in CO. No changes were observed in blood pressure, resting HR, total body mass, lean body mass, whole-body bone mineral density, fasting blood glucose, HbA1c, plasma insulin, total cholesterol(C), LDL-C or HDL-C. Moreover, no changes were observed in Yo-Yo IE2 performance, 30-m sprint time, jump length or postural balance.

CONCLUSION

Small-sided street football training for 12 weeks with 1-2 weekly sessions led to improvements in submaximal exercise capacity only, whereas recreational grass football training confirmed previous positive effects on submaximal exercise capacity as well as cardiorespiratory fitness.

Evaluation of the lower extremity functional test to predict lower limb injuries in professional male footballers

The Lower Extremity Functional Test (LEFT) is a reliable and valid test for the measurement of athletic fitness, fatigue resistance, and speed performance. Contradictory results exist regarding the screening value of the LEFT in predicting lower limb injuries. The purpose of this study was to investigate the screening value of the LEFT in predicting lower limb injuries in professional male footballers. One hundred and twenty-one professional male football players participated in the study. LEFT was recorded pre-season and the lower-limb injuries were recorded during a 9-month season. Logistic regression analysis was used to determine the accuracy of the prognosis of LEFT. A total of twenty-five lower limb injuries were recorded. The model explained 53% of the variance in lower limb injury, showing that predictions by LEFT score is reliable, and correctly predicted 89.3% of cases, which is a large improvement. ROC analysis showed significant accuracy of the LEFT score (AUC 0.908, 95% CI 1.126-1.336, p = 0.001, OR = 1.227) in discriminating between injured and uninjured players. The optimum cut-off level of the LEFT score was 90.21 s; Our findings showed that the LEFT score was able to predict lower limb injuries in professional male footballers. The slower an athlete's LEFT scores, the more susceptible they are to future injury risk. Sports medicine specialists, football coaches and managers are suggested to use LEFT as a pre-season screening test to identify and prevent the weakness and functional imbalance of the athletes before the injury occurs by conducting this test.

Effect of virtual reality-based exercise and physical exercise on adolescents with overweight and obesity: study protocol for a randomised controlled trial

INTRODUCTION

Obesity is a complex and multifactorial disease that has affected many adolescents in recent decades. Clinical practice guidelines recommend exercise as the key treatment option for adolescents with overweight and obesity. However, the effects of virtual reality (VR) exercise on the physical and brain health of adolescents with overweight and obese remain unclear. This study aims to evaluate the effects of physical and VR exercises on physical and brain outcomes and explore the differences in benefits between them. Moreover, we will apply a multiomics analysis to investigate the mechanism underlying the effects of physical and VR exercises on adolescents with overweight and obesity.

METHODS AND ANALYSIS

This randomised controlled clinical trial will include 220 adolescents with overweight and obesity aged between 11 and 17 years. The participants will be randomised into five groups after screening. Participants in the exercise groups will perform an exercise programme by adding physical or VR table tennis or soccer classes to routine physical education classes in schools three times a week for 8 weeks. Participants in the control group will maintain their usual physical activity. The primary outcome will be the change in body fat mass measured using bioelectrical impedance analysis. The secondary outcomes will include changes in other physical health-related parameters, brain health-related parameters and multiomics variables.

ETHICS AND DISSEMINATION

This study was approved by the Ethics Committee of Shanghai Sixth People's Hospital and registered in the Chinese Clinical Trial Registry. Dissemination of the findings will include peer-reviewed publications, conference presentations and media releases.

TRIAL REGISTRATION NUMBER

ChiCTR2300068786.

The Women's Soccer Health Study: From Head to Toe

OBJECTIVES

Women are under-represented in the sports literature despite increasing rates of sports participation. Our objective was to investigate the risks and benefits of an elite women's soccer career in five health domains: general, musculoskeletal, reproductive endocrinology, post-concussion, and mental.

METHODS

An online survey was distributed to retired US college, semi-professional, professional, and national team soccer players using personal networks, email, and social media. Short validated questionnaires were used to evaluate the health domains, including the Patient-Reported Outcomes Measurement Information System (PROMIS), Single Assessment Numerical Evaluation (SANE), Post-Concussion Symptom Scale (PCSS), and Patient Health Questionnaire (PHQ).

RESULTS

A total of 560 eligible players responded to the survey over a 1-year period. The highest competitive levels were 73% college, 16% semi-professional, 8% professional, and 4% national team. The mean number of years since retirement was 12 (SD = 9), and 17.0% retired for involuntary reasons. The mean SANE scores (0-100 scale as percentage of normal) were knee = 75% (SD = 23), hip = 83% (SD = 23), and shoulder = 87% (SD = 21). The majority (63%) reported that their current activity level included participation in impact sports. A substantial proportion of players reported menstrual irregularities during their careers: 40% had fewer periods with increasing exercise and 22% had no periods for ≥ 3 months. The players (n = 44) who felt that post-concussion symptoms were due to soccer reported more time-loss concussions (F[2] = 6.80, p = 0.002) and symptom severity (F[2] = 30.26, p < 0.0001). Players who recently retired (0-5 years) reported the highest anxiety/depression scores and lowest satisfaction rates compared with those who retired 19+ years ago.

CONCLUSION

Health concerns include musculoskeletal injuries, post-concussion symptoms, and lower mental health in the early years following retirement. This comprehensive survey provides initial results that will lay the foundation for further analyses and prioritize research studies that can help all female athletes.

Recreational Football Training Increases Leg-Extensor Velocity Production in 55- To 70-Year Old Adults: A Randomized Controlled Trial

This study investigated the effects of 10 weeks of recreational football training on the leg-extensor force-velocity (F-V) profile in 55- to 70-year-old adults. Simultaneous effects on functional capacity, body composition and endurance exercise capacity were examined. Forty participants (age 63.5 ± 3.9 years; 36♂ 4♀) were randomized in a football training (FOOT, n = 20) and a control (CON, n = 20) group. FOOT performed 45-min to 1-h of football training sessions with small-sided games twice a week. Pre- and post-intervention assessments were performed. The results revealed a greater increase in maximal velocity (d = 0.62, pint = 0.043) in FOOT compared to CON. No interaction effects were found for maximal power and force (pint > 0.05). 10-m fast walk improved more (d = 1.39, pint < 0.001), 3-step stair ascent power (d = 0.73, pint = 0.053) and body fat percentage (d = 0.61, pint = 0.083) tended to improve more in FOOT than in CON. RPE and HR values at the highest speed level during a submaximal graded treadmill test decreased more in FOOT compared to CON (RPE: d = 0.96, pint = 0.005; HR: d = 1.07, pint = 0.004). Both the number of accelerations and decelerations as well as the distance spent in moderate- and high-speed zones increased markedly throughout the 10-week period (p < 0.05). Participants perceived the sessions as very enjoyable and feasible. In conclusion, recreational football training resulted in improved leg-extensor velocity production, which translated to a better performance on functional capacity tests that rely on a high execution velocity. Simultaneously, exercise tolerance was improved and body fat percentage tended to reduce. It appears that short-term recreational football training can induce broad-spectrum health benefits in 55- to 70-year-old adults with only 2 hours of training per week.

Effects of walking football on adherence, safety, quality of life and physical fitness in patients with prostate cancer: Findings from the PROSTATA_MOVE randomized controlled trial

Aims

To analyze the feasibility and impact of a walking football (WF) program on quality of life (QoL), cardiorespiratory fitness (CRF), muscle strength, and balance program in men with prostate cancer under androgen deprivation therapy (ADT).

Methods

Fifty patients with prostate cancer (stages IIb-IVb) under ADT were randomized to a 16-week WF program plus usual care (n=25) or usual care control group (n=25). The WF program consisted of three 90-minute sessions per week. Recruitment, withdrawal, adherence, enjoyment rate, and safety of the intervention were recorded throughout the study. Cardiorespiratory fitness was assessed before and after the interventions, while handgrip strength, lower limb muscle strength, static balance, and QoL were assessed before, during (week 8), and after (week 16) the interventions. Adverse events during sessions were also recorded.

Results

The WF group showed high levels of adherence (81.6 ± 15.9%) and enjoyment rate (4.5 ± 0.5 out of 5 points). In the intention-to-treat analysis, the WF group showed an improvement in chair sit-to-stand (p=0.035) compared to the control group. Within-group comparisons showed that handgrip strength in the dominant upper limb (p=0.024), maximal isometric muscle strength in the non-dominant lower limb (p=0.006), and balance in the dominant limb (p=0.009) improved over time in the WF group but not in the usual care group. The results obtained from the per-protocol analysis indicate that CRF improved significantly in the WF group as compared to the control group (p=0.035). Within-group analysis revealed that CRF (p=0.036), muscle strength in dominant (p=0.006) and non-dominant (p=0.001) lower limbs, and balance in the non-dominant lower limb (p=0.023) improved after 16 weeks of WF, but not in the control group. One major traumatic injury (muscle tear) was reported with a complete recovery before the end of the intervention.

Conclusion

This study suggests that WF is feasible, safe, and enjoyable in patients with prostate cancer under hormonal therapy. Furthermore, patients who adhere to the WF program can expect cardiorespiratory fitness, muscle strength, and balance improvements.

Clinical trials registration

clinicaltrials.gov, identifier NCT04062162.

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).

Validity and sensitivity of field tests' heart-rate recovery assessment in recreational football players

We aimed at examining the criterion validity and sensitivity of heart-rate recovery (HRRec) in profiling cardiorespiratory fitness in male recreational football players in the untrained and trained status, using endurance field-tests. Thirty-two male untrained subjects (age 40 ± 6 years, VO2max 41.7 ± 5.7 ml·kg-1·min-1, body mass 82.7 ± 9.8 kg, stature 173.3 ± 7.4 cm) participated in a 12-week (2‒3 sessions per week) recreational football intervention and were tested pre- and post-intervention (i.e. untrained and trained status). The participants performed three intermittent field tests for aerobic performance assessment, namely Yo-Yo intermittent endurance level 1 (YYIE1) and level 2 (YYIE2) tests, and Yo-Yo intermittent recovery level 1 (YYIR1) test. VO2max was assessed by performing a progressive maximal treadmill test (TT) and maximal HR (HRmax) determined as the maximal value across the testing conditions (i.e., Yo-Yo intermittent tests or TT). HRRec was calculated as the difference between Yo-Yo tests' HRpeak or HRmax and HR at 30 s (HR30), 60 s (HR60) and 120 s (HR120) and considered as beats·min-1 (absolute) and as % of tests' HRpeak or HRmax values. Significant post-intervention improvements (p<0.0001) were shown in VO2max (8.6%) and Yo-Yo tests performance (23-35%). Trivial to small (p>0.05) associations were found between VO2max and HRRec (r = -0.05-0.27, p>0.05) across the Yo-Yo tests, and training status either expressed as percentage of HRpeak or HRmax. The results of this study do not support the use of field-test derived HRRec to track cardiorespiratory fitness and training status in adult male recreational football players.

The Assessment of Ankle Range-of-Motion and Its Relationship with Overall Muscle Strength in a Cross-Section of Soccer Players

Soccer (football) practice can induce a limitation of ankle range of motion (ROM) that is a possible risk factor for injury and other negative consequences over time. The main objective of this research was to investigate the effects of soccer practice on ankle ROM throughout the entire period of a sports career of soccer players (SP). Furthermore, the relationship between ankle ROM and muscle strength in SP of different ages was studied. A total of 204 SP (range 6.7−45.1 years) and 87 controls (range: 7.5−45.2 years) matched for age, body mass index (BMI), and gender, were assessed. Ankle ROM in both plantar flexion (APF) and dorsiflexion (ADF) in addition to handgrip strength (HGS) were evaluated using an inclinometer and the Jamar hydraulic hand dynamometer, respectively. The comparison between SP and control groups showed a significant reduction in ankle ROM of both APF (26.3 ± 7.2° vs. 32.6 ± 7.4°; d = −0.90; p < 0.001) and ADF (95.5 ± 15.6° vs. 105.5 ± 15.8°; d = −0.66; p < 0.001). In SP, the results of the ANOVAs test indicate that age had a significant effect on ADF (F = 4.352, p = 0.038, partial eta-squared (ηp2) = 0.015) but not on APF (F = 0.430, p = 0.746, ηp2 = 0.001). Moreover, considering only the SP, a weak inverse correlation between ADF and HGS group ADF was found (rs = −0.27; p < 0.001). Factors such as the non-linear trend of growth in young SP could hinder the definition of the relationship between ankle ROM, age, and muscle strength. However, the appropriate consideration of age and muscle strength could facilitate the management of ankle ROM in PF of different ages.

Motivational predictors of children's involvement in out-of-school activities: An application of a football program

The "11 for Health in Denmark" in-school educational football program has shown to have numerous positive physiological and psychological effects in 10- to 12-year-old schoolchildren. A key part of the successful application of the program, however, has not yet been examined, namely the motivational processes underlying participation and behavioral changes. This study examined such motivational processes (i.e., autonomous motivation, beliefs, and intentions) using the trans-contextual model (TCM) and investigated if the 11 for Health in Denmark program increased intentions to participate in physical activity (PA) outside of school in 10- to 12-year-old schoolchildren. Using a web-based questionnaire, Danish-speaking schoolchildren (N = 276 [boys, 50.4%]; M_age  = 10.44, SD = 0.35) from three schools and seven classes completed TCM-based questionnaires at three time-points (weeks 0, 1, and 5) while participating in the 11 for Health in Denmark program. Single-indicator structural equation modeling was performed to examine goodness-of-fit and parameter estimates. A path analysis using maximum likelihood estimation was used to test the direct and indirect effects of the TCM model. The results partly supported a mediation sequence, as we found significant direct effects in eight of 13 motivational variables (β = -0.25-0.83, p < 0.05), indirect effects in one of nine variables (β = 0.15, p < 0.01), but no effects with regard to PA behavior. Findings provide evidence for a motivational link between Danish-speaking schoolchildren's autonomous and controlled motivation from in school to out of school, and may inform future interventions promoting motivation and participation in out of school PA.

Insight into the Molecular Signature of Skeletal Muscle Characterizing Lifelong Football Players

BACKGROUND

Aging and sedentary behavior are independent risk factors for non-communicable diseases. An active lifestyle and structured physical activity are positively associated with a healthier quality of life in the elderly. Here, we explored the proteomic/metabolomic muscular signature induced by lifelong football training associated with successful aging.

METHODS

The study was performed on nine lifelong football players (67.3 ± 2.8 yrs) and nine aged-matched untrained subjects. We performed a proteomic/metabolomic approach on V. lateralis muscle biopsies; the obtained data were analyzed by means of different bioinformatic tools.

RESULTS

Our results indicated that lifelong football training is able to enhance the muscles' oxidative capacity in the elderly by promoting fatty acids as preferential energetic substrates and hence determining a healthier body composition and metabolic profile; furthermore, we showed that the total polyamine content is higher in lifelong football players' muscle, enforcing the involvement of polyamines in muscle growth and hypertrophy.

CONCLUSIONS

Lifelong football training, as a structured physical activity, significantly influences the expression of the proteins and metabolites involved in oxidative metabolism and muscle hypertrophy associated with successful aging.

Acute arm and leg muscle glycogen and metabolite responses to small-sided football games in healthy young men

PURPOSE

Studies have indicated upper body involvement during football, provoking long-term muscular adaptations. This study aimed at examining the acute metabolic response in upper and lower body skeletal muscle to football training organized as small-sided games (SSG).

METHODS

Ten healthy male recreational football players [age 24 ± 1 (± SD) yrs; height 183 ± 4 cm; body mass 83.1 ± 9.7 kg; body fat 15.5 ± 5.4%] completed 1-h 5v5 SSG (4 × 12 min interspersed with 4-min recovery periods). Muscle biopsies were obtained from m. vastus lateralis (VL) and m. deltoideus (DE) pre- and post-SSG for muscle glycogen and metabolite analyses. Blood lactate samples were obtained at rest, middle and end of the SSG.

RESULTS

Muscle glycogen in VL decreased (P < 0.01) by 21% and tended (P = 0.08) to decrease in DE by 13%. Muscle lactate increased in VL (117%; P < 0.001) and DE (81%; P < 0.001) during the game, while blood lactate rose threefold. Muscle ATP and PCr were unaltered, but intermuscular differences were detected for ATP at both time points (P < 0.001) and for PCr at pre-SSG (P < 0.05) with VL demonstrating higher values than DE, while muscle creatine rose in VL (P < 0.001) by 41% and by 22% in DE (P = 0.02). Baseline citrate synthase maximal activity was higher (P < 0.05) in VL compared to DE, whereas baseline muscle lactate concentration was higher (P < 0.05) in DE than VL.

CONCLUSION

The upper body may be extensively involved during football play, but besides a rise in muscle lactate in the deltoideus muscle similar to the leg muscles, the present study did not demonstrate acute metabolic changes of an order that may explain the previously reported training effect of football play in the upper extremities.

A retrospective analysis of all-cause and cause-specific mortality rates in French male professional footballers

This study retrospectively compared all-cause and cause-specific mortality in French male professional football players with data from France's national population. Altogether, 6114 individuals born in Metropolitan France or in one of its overseas territories who played at least one competitive match in France's professional football championships between January 1, 1968 and December 31, 2015, were identified and followed up for vital status obtained from a national reference database until December 31, 2015. Data on all-cause and cause-specific mortality were subsequently compared to the expected number of deaths for the national population after standardization for the year, age, and sex. Ratios between observed and expected deaths provided standardized mortality ratios (SMR) along with 95% confidence intervals (95% CI). Linear trends were investigated using the Poisson trend test. Altogether, 662 player deaths were observed. All-cause mortality overall was lower than that of the national population (SMR: 0.69, 95% CI 0.64-0.75). An excess of deaths from dementia was observed in the players (SMR: 3.38, 95% CI: 2.49-4.50) whereas mortality from diseases of the nervous (SMR: 0.64, 95% CI: 0.35-1.08) and cardiovascular systems (SMR: 0.82, 95% CI: 0.70-0.96), and cancer (SMR: 0.67, 95% CI: 0.58-0.76) was lower. Lower overall mortality and that owing to common cardiovascular and cancer-related diseases were reported in French professional football players compared to France's national population. In line with previous studies, however, excess mortality from dementia was observed in the players. Career length was not associated with all-cause or cause-specific mortality. Prospective matched-cohort studies are necessary to identify the neurologic impact of participation in professional football.

The Faroe Islands COVID-19 Recreational Football Study: Player-to-Player Distance, Body-to-Body Contact, Body-to-Ball Contact and Exercise Intensity during Various Types of Football Training for Both Genders and Various Age Groups

We determined player-to-player distance, body-to-ball contact, and exercise intensity during three training modalities in various football populations. 213 participants were recruited, ranging from 9-year-old boys to young men and 11-year-old girls to middle-aged women. All groups were analysed with video-filming and GPS-based Polar Pro monitors during three types of football training for 20 min, i.e., COVID-19-modified training (CMT) with >2-metre player-to-player distance, small-sided games (SSG), and simulated match-play with normal rules (SMP), in randomised order. Time spent in a danger zone (1.5 m) per-percent-infected-player (DZ PPIP) ranged from 0.015 to 0.279% of playing time. DZ PPIP for SSG was higher (P < 0.05) than CMT and SMP. The average number of contacts (within 1.5 m) with a potentially infected player ranged from 12 to 73 contacts/hour. SSG had more (P < 0.05) contacts than CMT and SMP, with SMP having a higher (P < 0.05) number of contacts than CMT. Time/contact ranged from 0.87 to 3.00 seconds for the groups. No player-to-player and body-to-ball touches were registered for CMT. Total player-to-player contacts were 264% higher (P < 0.05) in SSG than SMP, ranging from 80 to 170 and 25 to 56 touches, respectively. In all groups, a greater total distance was covered during SMP compared to CMT (38-114%; P < 0.05). All groups performed more high-intensity running (33-54%; P < 0.05) and had higher heart rates during SMP compared to CMT. Different types of football training all appear to exert a minor COVID-19 infection risk; however, COVID-19-modified training may be safer than small-sided game training, but also match-play. In contrast, exercise intensity is lower during COVID-19-modified training than match-play.

Epidemiology of Football-Related Sudden Cardiac Death in Turkey

Background and Objectives: Sudden cardiac death (SCD), particular among elite footballers, has attracted much attention in recent times. However, limited information exists on football-related SCD in Turkey. Autopsy-based studies of sports-related sudden deaths in Turkey are rare and often have small sample sizes. To address this, this study aimed to determine the population-based incidence and profile of football-related SCD nationally in Turkey. Materials and Methods: Due to a lack of national data on this issue, football-related SCD (non-elite competitive or recreational football) between 1 January 2011, and 31 December 2019 were identified by dual, independent identification and screening of online media reports. Deaths were explored by sex, age group, season, and phase of exercise. Descriptive statistics were utilised. Age-specific mortality rates and proportional mortality rates were calculated. Results: In total, 118 football-related SCD were identified, a crude mortality rate of 0.41 per 100,000 population. All fatalities were males and the mean age was 35.5 years ± 10.4. Those aged 40–49 years recorded the highest mortality rate (0.67/100,000), three times the risk of those aged 50–59 years (RR = 3.1; 95%CI:1.5–6.4). Those aged 30–39 recorded the highest age-specific proportional mortality rate (0.86/1000 deaths). The highest risk occurred while playing football (n = 97; 82.2%), with another 15% of deaths (n = 18) occurring within 1 h of play. Almost all fatalities (n = 113; 95.8%) occurred during participation in recreational football. Conclusions: This study has identified football-related SCD most commonly occurs during recreational football among males aged 30–49 years. It is recommended males of this age participating in recreational football be encouraged to seek pre-participation heart health checks. Given the value of automated external defibrillators (AEDs) in responding to out-of-hospital cardiac arrest, future research should explore the feasibility and effectiveness of AEDs in preventing football-related SCD in Turkey including training of first responders in cardiopulmonary resuscitation and AED use.

Scoring Lifestyle Medicine Goals With FIFA 2022—An Opportunity to Strike Big!

Qatar is one of the few countries in the world with a dedicated national sports day. Qatar believes that sport is one of the best tools to promote a healthy lifestyle to help curb the growing burden of non-communicable diseases (NCDs). With the well-established positive health effects of soccer on cardiovascular, metabolic, and musculoskeletal conditions, the vision of the FIFA World Cup 2022™ hosted by Qatar to use the power of soccer to “open the door of an amazing world experience” is praiseworthy. With NCDs accounting for 70% of deaths in Qatar, there exists a perfect opportunity to promote healthy lifestyles to prevent, treat, and reverse NCDs. We believe that the FIFA World Cup 2022™ presents an opportunity that could contribute to generating valuable evidence on the lifestyle benefits of such large-scale events. This event comes at an opportune moment for countries in the region to make their health systems lifestyle-sensitive. FIFA World Cup 2022™ could just be the tipping point in the region that establishes the role of sports in mitigating the burden of NCDs. With the impact of COVID-19 on persons with pre-existing NCDs, the urgency for addressing the “syndemic” cannot be overemphasized and sport can be the lifestyle medicine.

Regular football training down-regulates miR-1303 muscle expression in veterans

PURPOSE

Regular exercise affects the expression of several genes, proteins and microRNAs (miRNAs) in time- and intensity-dependent manner promoting longevity. We previously identified from GeneChip Array analysis several differentially expressed genes and miRNAs in muscle from veteran football players (VPG) compared to active untrained elderly subjects (CG); here we focussed on miRNA-1303 (miR-1303). The aims of the present research were: to analyse the effects of football training on the expression of miR-1303 and to identify its putative target involved in the longevity pathways in skeletal muscle from VPG compared to CG.

METHODS

RNA samples from 12 VPG and 12 CG muscle biopsies were used to validate miR-1303 expression. Crossing four different bioinformatic algorithms, we identified 16 putative targets of miR-1303; from these, BAG-2, KLHL7 and KBTBD6 were chosen for further validation by Western blot analysis in LHCN-M2 human myoblasts transiently transfected with miR-1303.

RESULTS

Football training down-regulates miR-1303 expression in muscle from VPG compared to CG and the expression of BAG-2, a chaperon protein involved in the autophagy pathway, inversely correlated to overexpression of miR-1303 in a time-dependent manner, indicating that it is a miR-1303 potential target.

CONCLUSIONS

This is the first report, to our knowledge, describing miR-1303 regulation in skeletal muscle by football training and the identification of a target protein, BAG-2, involved in the autophagy pathway. This result contributes to the enlargement of knowledge on the molecular mechanisms linking football training, autophagy and longevity.

Intensity-Modified Recreational Volleyball Training Improves Health Markers and Physical Fitness in 25-55-Year-Old Men

The present study is aimed at determining the effects of intensity-modified recreational volleyball training on health markers and physical fitness in healthy middle-aged men. Thirty-four healthy untrained men aged 25–55 years were randomized to either a modified recreational volleyball group (MRV, n = 17) or a recreational volleyball group (RV, n = 17). Both groups performed volleyball training twice a week over 12 weeks, with participants in MRV playing a modified game with higher intensity due to shorter breaks between rallies. The small to moderate improvements of both groups were observed in SBP (MRV g_av = −0.50 [-0.67, -0.33] vs. RV g_av = −0.37 [-0.55, -0.20]) to a similar extent (p = 0.12). However, only the MRV significantly improved (p < 0.001) the mean body weight (g_av = −0.35 [-0.52, -0.18]) and BMI (g_av = −0.39 [-0.56, -0.22]) to a moderate extent and the YYIR1 performance (g_av = 2.45 [2.22, 2.69]) to a large extent. Even though both groups significantly improved the rest HR, the mean change of rest HR was significantly greater in MRV as compared to the RV (p < 0.001,  ŋ_p² = 0.47). The study revealed that an intensity-modified type of recreational volleyball, involving shorter breaks between rallies, improves cardiorespiratory fitness and health markers for men aged 25–55 years.

Football and team handball training postpone cellular aging in women

Several hallmarks of aging have been identified and examined separately in previous exercise studies. For the first time, this study investigates the effect of lifelong regular exercise in humans on two of the central aging hallmarks combined. This cross-sectional study involved 129 healthy, non-smoking women, including young elite football players (YF, n = 29), young untrained controls (YC, n = 30), elderly team handball players (EH, n = 35) and elderly untrained controls (EC, n = 35). From a resting blood sample, mononuclear cells (MNCs) were isolated and sorted into monocytes and lymphocytes. Telomere length, mitochondrial (mtDNA) copy number and key regulators of mitochondrial biogenesis and function (PGC-1α and PGC-1β expression) were measured using quantitative polymerase chain reaction (qPCR). Overall, young women showed significantly longer telomeres and higher PGC-1α and PGC-1β expression, but lower mtDNA copy number compared to elderly subjects. A multivariate analysis showed that YF had 22–24% longer telomeres in lymphocytes and MNCs compared to YC. In addition, YF showed 19–20% higher mtDNA copy number in lymphocytes and MNCs compared to YC. The two young groups did not differ in PGC-1α and PGC-1β expression. EH showed 14% lower mtDNA copy number in lymphocytes compared to EC, but 3.4-fold higher lymphocyte PGC-1α expression compared to EC. In MNCs, EH also showed 1.4–1.6-fold higher PGC-1α and PGC-1β expression. The two elderly groups did not differ in telomere length. Elite football training and lifelong team handball training are associated with anti-aging mechanisms in leukocytes in women, including maintenance of telomere length and superior mitochondrial characteristics.

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.

Improved metabolic fitness, but no cardiovascular health effects, of a low-frequency short-term combined exercise programme in 50-70-year-olds with low fitness: A randomized controlled trial

We evaluated the cardiometabolic effects of a 15-week combined exercise programme, implemented in sports clubs, for 50-70-year-olds with low aerobic fitness. In a randomized controlled trial, 45 participants (26 women) with low fitness were randomly assigned (2:1-ratio) to a training group (TG, n = 30) or inactive control group (CG, n = 15). TG had 15 weeks with one weekly 90-min supervised group-based session in a recreational sports club with combined aerobic exercise and strength training and were encouraged to perform home-based training 30 min/wk. Evaluations of relative VO_2max (mLO₂/min/kg), blood pressure, resting heart rate (HR), echocardiography, peripheral arterial tonometry, body composition, lipid profile and HbA1c were performed at 0 and 15 wks. Average HR during supervised training was 113 ± 13 bpm (68.6 ± 7.0%HR_max), with 4.3 ± 6.6% spent >90%HR_max. At 15-wk follow-up, intention-to-treat analyses revealed no between-group difference for VO_2max/kg (0.4 mLO₂/min/kg, 95%CI -0.8-1.5, P = 0.519; -3 mL/min, 95%CI -123-118, P = 0.966) or other cardiovascular outcomes (all P > 0.05). Compared to CG, total fat mass (-1.9 kg; 95%CI -3.2 to -0.5, P = 0.005), total fat percentage (-1.3%, 95%CI -2.2 to -0.3, P = 0.01) and total/HDL cholesterol ratio (P = 0.032) decreased in TG. Regular adherence to supervised training was high (81%), but 0% for home-based exercise. In conclusion, the group-based supervised training was associated with high adherence and moderate exercise intensity, whereas insufficiently supported home-based training was not feasible. Together, 15 wks of combined exercise training did not improve aerobic fitness or affected cardiovascular function in 50-70-yr-olds with low aerobic fitness, whereas some positive effects were observed in metabolic parameters.HighlightsCombined exercise training implemented in a sports club elicited moderate aerobic intensity in 50-70-year-old untrained individuals.Supervised group-based training had high adherence whereas unsupported home-based training had very low adherence.15 weeks of low-frequency combined moderate intensity exercise training improved lipid profile and fat mass, but had no effect on cardiovascular fitness.

Injury Profile in Women's Football: A Systematic Review and Meta-Analysis

BACKGROUND

Football is the most popular sport among women; however, little is known about the injury profile in this population. This information would help design tailored injury risk mitigation strategies that may make football safer for women.

OBJECTIVE

The aim of this study was to perform a systematic review and meta-analysis of epidemiological data of injuries in women´s football.

METHODS

A systematic review following PRISMA guidelines was performed up to January 2020 in PubMed, Web of Science, Sportdiscus and the Cochrane Library databases. Twenty-two studies reporting the incidence of injuries in women football were analysed. Two reviewers independently extracted data (intraclass correlation coefficient [ICC] for inter-reviewer reliability = 0.87) and assessed study quality using the STROBE statement, GRADE approach, Newcastle Ottawa Scale and Downs and Black assessment tools. Studies were combined in pooled analyses (injury incidence and injury proportion) using a Poisson random effects regression model.

RESULTS

The overall incidence of injuries in female football players was 6.1 injuries/1000 h of exposure. Match injury incidence (19.2 injuries/1000 h of exposure) was almost six times higher than training injury incidence rate (3.5 injuries/1000 h of exposure). Lower extremity injuries had the highest incidence rates (4.8 injuries/1000 h of exposure). The most common types of injuries were muscle/tendon (1.8 injuries/1000 h of exposure) and joint (non-bone) and ligament (1.5 injuries/1000 h of exposure), which were frequently associated with traumatic incidents. Slight/minimal injuries (1-3 days of time loss) were the most common. The incidence rate of injuries during matches in the top five world ranking leagues was higher than the rest of the leagues (19.3 vs 10.7 injuries/1000 h of exposure, respectively). The weighted injury proportion was 1.1 (95% confidence interval = 0.6-1.7) whereby on average players sustained more than one injury per season.

CONCLUSIONS

Female football players are exposed to a substantial risk of sustaining injuries, especially during matches that require the highest level of performance. To markedly reduce overall injury burden, efforts should focus on introducing and evaluating preventative measures that target match specific dynamics to make football players more capable of responding to the challenges that they have to deal with during match play.

REGISTRATION

This systematic review was registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42019118152).

Danger zone assessment in small-sided recreational football: providing data for consideration in relation to COVID-19 transmission

During the COVID-19 pandemic, physical inactivity has increased, and a wide range of sporting activities locked down, with possible long-term implications for public health. Football is the most popular sport worldwide, and recreational football training leads to broad-spectrum health effects. Football is, however, deemed a contact sport with frequent close contact important to consider during COVID-19 pandemic.

OBJECTIVES

This study investigated time spent with close contact (danger zone (DZ) within 1.5 m), number of contacts and time per contact, and compared game formats in recreational small-sided football games for young and adult male football players.

METHODS

Movement analyses were performed on 10 Hz Global Positioning System (GPS) data collected during various small-sided football games prior to the COVID-19 outbreak.

RESULTS

Time spent in the DZ was 4.3-7.9 s/h per per cent infected players, corresponding to 34.3-114.8 s/h if one player was infected. Number of contacts with one infected player was 23.5-87.7 per hour, with an average contact time of 1.1-1.4 s, and a total number of contacts of 311-691 per hour with all players. 53%-65% of all contacts were shorter than 1 s and 77%-85% shorter than 2 s. Trivial to small effects were found for number of participants and area per player, whereas standard of play and playing with/without boards had no effect.

CONCLUSION

This study demonstrated that during small-sided football limited time is spent within DZ and that player contacts are brief. Recreational football may therefore more appropriately be deemed as sporting activity with brief, sporadic contact.

Cardiovascular fitness and health effects of various types of team sports for adult and elderly inactive individuals - a brief narrative review

Recreational team sports offer an alternative form of exercise to inactive individuals across the lifespan and sexes. Soccer is the most investigated recreational team sport reporting a wide range of health benefits, including cardiovascular (CV) health. The quest for novel paradigms to promote exercise in the general population, recently extended its interest to other team sports besides soccer. The available research supports the importance of recreational team handball, floorball, basketball, touch rugby, futsal and volleyball as training paradigms to improve CV fitness and other health-related variables in inactive individuals across ages and sexes. In most cases, recreational team sports programs assume the form of small-sided games, eliciting mean heart rates of 72-85% of the individual maximal. The majority of the training interventions were carried out for 12weeks with a reported mean attendance of 2 times 40-60min per week. Maximal oxygen uptake improvements were different in magnitude across the recreational team sports, with recreational team handball providing significant and clinically relevant increases (>3.5ml·kg^-1·min^-1). Game format, training exposure and pre-intervention health and fitness status are issues that need further investigation with the aim to optimize recreational team sports exercise programs implementation. Furthermore, the nature and effects of grassroots team sports should be further studied in order to provide as many as possible effective training tools for former practitioners and for the general population that has none or little experience of sport. Given the potential positive impact of recreational team sports practice on world population's health, large-scale randomized controlled trials are warranted.

Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis

BACKGROUND

Research indicates that social isolation and loneliness increase the risk of mental disorders, but less is known about the distinct contributions of different aspects of isolation. We aimed to distinguish the pathways through which social disconnectedness (eg, small social network, infrequent social interaction) and perceptions of social isolation (eg, loneliness, perceived lack of support) contribute to anxiety and depression symptom severity in community-residing older adults aged 57-85 years at baseline.

METHODS

We did a longitudinal mediation analysis with data from the National Social Life, Health, and Aging Project (NSHAP). The study included individuals from the USA born between 1920 and 1947. Validated measures on social disconnectedness, perceived isolation, and depression and anxiety symptoms were used. Structural equation modelling was used to construct complete longitudinal path models.

FINDINGS

Using data from 3005 adults aged 57-85 years, we identified two significant longitudinal mediation patterns with symptoms of depression, and two with anxiety symptoms. Overall, social disconnectedness predicted higher subsequent perceived isolation (β=0·09; p<0·0001), which in turn predicted higher depression symptoms (β=0·12; p<0·0001) and anxiety symptoms (β=0·12; p<0·0001). The reverse pathways were statistically supported as well, suggesting bi-directional influences.

INTERPRETATION

Social network structure and function are strongly intertwined with anxiety and depression symptoms in the general population of older adults. Public health initiatives could reduce perceived isolation by facilitating social network integration and participation in community activities, thereby protecting against the development of affective disorders.

FUNDING

Nordea-fonden.

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.

Sport and Exercise in Improving Outcomes After Solid Organ Transplantation: Overview From a UK Meeting

Outcomes after solid organ transplantation continue to improve, but premature loss of life remains a major concern, with death from cerebrovascular disease and cardiovascular disease accounting for around 20% late deaths. There are multiple contributory factors including preexisting, and the posttransplant development of, cardiometabolic conditions (such as hypertension, diabetes mellitus, hyperlipidemia, and obesity). There is accumulating evidence that the regular engagement in exercise is an important factor affecting outcomes before, during, and after transplantation; yet most waitlist candidates and recipients have reduced levels of physical activity. The mechanisms whereby physical activity is associated with better outcomes and a reduction in risk factors for cardiovascular disease are incompletely understood. Attempts to increase physical activity in the transplant population, as in the general population, have had limited success. Use of concepts from Nudge theory provides an evidence-based approach that may help increase physical activity and so reduce premature mortality. Both National and International Transplant Games provide a vehicle for increasing physical activity in this population and may also help to reduce premature death by providing a forum for mutual support for recipients and their families as well as an excellent forum for highlighting the success and impact of organ donation.

Estimation of maximal heart rate in recreational football: a field study

PURPOSE

To examine the accuracy of practical indirect methods (i.e., recreational football match and estimation equations) in assessing individual maximal heart rate (HRmax) in recreational football players. Sixty-two untrained male participants engaged in a recreational football intervention (age 39.3 ± 5.8 years, VO2max 41.2 ± 6.2 ml·kg-1·min-1, body mass 81.9 ± 10.8 kg, height 173.2 ± 6.4 cm) were tested for HRmax using a multiple approach, at baseline and post-intervention (i.e., in the untrained and trained status, respectively). Observed HRmax was plotted against peak match HR (Match-HRpeak) and HRmax estimated from prediction equations (EstHRmax) at both time-points.

RESULTS

In the untrained status, only the 211 - 0.64 × Age and 226 - Age equations showed non-significant (medium-to-small) differences with observed HRmax. The differences between observed HRmax and Match-HRpeak were large (P < 0.0001). At post-intervention, the observed HRmax (Post-HRmax) was significantly and largely lower than at baseline. The prediction equations under consideration provided EstHRmax values that were lower than Post-HRmax, with small-to-large differences (P > 0.05). The exception was for the 226 - Age and 211 - 0.64 × Age equations, with values largely higher than Post-HRmax.

CONCLUSIONS

This study suggests caution when considering EstHRmax and Match-HRpeak in recreational football interventions to track HRmax. The accuracy of EstHRmax may vary according to training status, suggesting the need for different approaches and equations across training interventions.

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.

Yo-Yo intermittent tests are a valid tool for aerobic fitness assessment in recreational football

PURPOSE

To examine the suitability of three versions and two levels of the Yo-Yo intermittent tests for assessing and tracking aerobic fitness status development in male recreational football players. Sixty-six untrained participants (age 39 ± 6 years, VO2max 41.2 ± 6.2 ml kg-1 min-1, body mass 81.9 ± 10.8 kg, height 173.2 ± 6.4 cm) partook in a 12-week recreational football training program. They were evaluated during the Yo-Yo intermittent endurance level 1 (YYIE1) and 2 (YYIE2) tests and the Yo-Yo intermittent recovery level 1 test (YYIR1), and during a treadmill test for VO2max assessment, at baseline. Thirty-two out of these 66 participants replicated all these tests at post-intervention. An additional group of 30 male age-matched recreational football players that afterwards started the 12-week recreational football program (age 39 ± 6 years, VO2max 45.3 ± 5.8 ml kg-1 min-1, body mass 82.5 ± 7.8 kg, height 172.8 ± 5.4 cm) was evaluated at baseline to test cross-validation.

RESULTS

The Yo-Yo tests showed very large associations with VO2max at baseline (r = 0.75-0.77; P < 0.0001) and at post-intervention (r = 0.76-0.82; P < 0.0005). Post-training, very large associations were found between YYIE2 performance and VO2max (r = 0.65, P < 0.0001). Cross-validation revealed small to large differences between the observed and estimated VO2max values (1.5-2.96 ml kg-1 min-1) with moderate typical error of estimation (7.9-8.7%) across the tests. Performance in the YYIE1, YYIE2 and YYIR1 tests of ≥ 1760, 480 and 600 m, respectively, indicated good to excellent VO2max values.

CONCLUSIONS

The Yo-Yo tests considered here showed robust and consistent criterion validity. The YYIE2 could be a more accurate option to track aerobic fitness development in recreational football players.

Submaximal field testing validity for aerobic fitness assessment in recreational football

Submaximal field tests are especially recommended when repeated testing is warranted. This study aimed at assessing the validity of the submaximal versions of the Yo-Yo intermittent tests in male recreational football players in untrained and trained status. The participants' (n = 66; age 39.3 ± 5.8 years, VO_2max 41.2 ± 6.2 mL·kg^-1 ·min^-1 , body mass 81.9 ± 10.8 kg, height 173.2 ± 6.4 cm) heart rate after 2 minutes (HR_2min ) during the level 1 (YYIE1_HR2min ) and 2 (YYIE2_HR2min ) versions of the Yo-Yo intermittent endurance test and the level 1 version of the Yo-Yo intermittent recovery test (YYIR1_HR2min ) was plotted against individual VO_2max values. Thirty-two participants performed all the tests after a 12-week recreational football intervention for test responsiveness. Associations between VO_2max and YYIE1_HR2min were large to small (P = .0001). Large to trivial associations were found between YYIE2_HR2min , YYIR1_HR2min , and VO_2max (P < .01). Maximal Yo-Yo performances were large, significant, and inversely related to HR_2min (-0.68 to -0.49, P < .0001). Pre- to post-intervention ICC values were good for YYIE1_HR2min and YYIE2_HR2min , and excellent for YYIR1_HR2min . Post-intervention associations between HR_2min and Yo-Yo maximal performances were large to very large (-0.55 to -0.72; P < .002, n = 32). Training-induced changes in VO_2max moderately correlated with YYIR1_HR2min (-0.48; P = .007; n = 32). HR_2min lower than 89%, 98%, and 91% HR_max for YYIE1_HR2min , YYIE2_HR2min , and YYIR1_HR2min , respectively, may be considered as signs of good to excellent VO_2max levels. Since in the YYIE1_HR2min , the participants attained 84% HR_max and test specificity increased for HR_2min values <89%, this test may be the preferred choice when repeated assessment of aerobic fitness, using submaximal intermittent Yo-Yo tests, is considered in recreational football.

Cardiovascular and metabolic health effects of team handball training in overweight women: Impact of prior experience

PURPOSE

We tested the hypothesis that participation in small-sided team handball training could provide beneficial effects on cardiovascular and metabolic parameters in overweight premenopausal women with special focus on the importance of prior team handball experience.

METHODS

A 16-week RCT training intervention was conducted in overweight premenopausal women randomized into three groups: a team handball training group without prior experience (UN; n = 13), a team handball group with prior experience (EXP; n = 10), and an inactive control group (CON; n = 9). Both UN and EXP completed 1.6 ± 0.3 training sessions per week with average heart rates of 84 ± 5 and 85 ± 9% of maximal heart rate, respectively. Cardiovascular and metabolic parameters were assessed before and after the intervention.

RESULTS

Compared to CON, UN had significant increases in VO_2max  (7 ± 4%) and intermittent endurance performance (26 ± 14%) as well as reduced total fat mass (4 ± 6%), total fat percentage (4 ± 5%), and android fat mass (7 ± 12%), respectively (all P < .05). Compared to UN and CON, EXP displayed increased left ventricular mass and left ventricular mass index (both P < .05) after the training period. There were no significant changes between any of the groups in muscle mass, blood lipids, resting heart rate, and blood pressure (all P > .05).

CONCLUSION

Small-sided team handball training in overweight premenopausal women resulted in improvement of VO_2max and body composition for participants with minimal team handball experience, indicating that prior team handball experience is not a prerequisite for improving physiological parameters of importance for health. Furthermore, EXP displayed cardiac adaptations, including increased left ventricular mass and left ventricular mass index.

Is running associated with a lower risk of all-cause, cardiovascular and cancer mortality, and is the more the better? A systematic review and meta-analysis

OBJECTIVE

To investigate the association of running participation and the dose of running with the risk of all-cause, cardiovascular and cancer mortality.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Journal articles, conference papers and doctoral theses indexed in Academic Search Ultimate, CINAHL, Health Source: Nursing/Academic Edition, MasterFILE Complete, Networked Digital Library of Theses and Dissertations, Open Access Theses and Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus and Web of Science.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Prospective cohort studies on the association between running or jogging participation and the risk of all-cause, cardiovascular and/or cancer mortality in a non-clinical population of adults were included.

RESULTS

Fourteen studies from six prospective cohorts with a pooled sample of 232 149 participants were included. In total, 25 951 deaths were recorded during 5.5-35 year follow-ups. Our meta-analysis showed that running participation is associated with 27%, 30% and 23% lower risk of all-cause (pooled adjusted hazard ratio (HR)=0.73; 95% confidence interval (CI) 0.68 to 0.79), cardiovascular (HR=0.70; 95% CI 0.49 to 0.98) and cancer (HR=0.77; 95% CI 0.68 to 0.87) mortality, respectively, compared with no running. A meta-regression analysis showed no significant dose-response trends for weekly frequency, weekly duration, pace and the total volume of running.

CONCLUSION

Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity. Any amount of running, even just once a week, is better than no running, but higher doses of running may not necessarily be associated with greater mortality benefits.

Biomarkers of insulin action during single soccer sessions before and after a 12-week training period in type 2 diabetes patients on a caloric-restricted diet

BACKGROUND

We investigated the biomarkers of insulin action as well as changes in free fatty acids and lactate concentration after an acute soccer session pre and post training with caloric-restricted diet versus diet alone in type 2 diabetes (T2D) patients.

METHODS

Fifty-one middle-aged (61.1 ± 6.4 years) T2D patients were randomly allocated to the soccer+diet group (SDG) or the diet group (DG). The control group comprised T2D patients observing a caloric-restricted diet who did not receive soccer training. Over 12 weeks, SDG performed 3 × 40 min per week of soccer training.

RESULTS

The first soccer session for SDG induced acute increases in blood lactate (1.4 ± 0.1-6.0 ± 0.7 mmol/l, P < 0.05) and glucagon levels (112.1 ± 6.2-142.9 ± 8.0 pg/ml, P < 0.05), whereas glucose and insulin levels remained unchanged. Moreover, this session showed suppressed insulin levels as well as higher free fatty acids, lactate levels and glucagon/insulin ratio compared to DG (p < 0.05). After 12 weeks, a baseline decrease was observed in glucagon, leptin and lactate levels in SDG and DG (p < 0.05), whereas HOMA-IR, Adipo-IR and glucose levels were lower only in SDG (p < 0.05). At the last soccer training session, the blood lactate response was significantly lower than for the first session (4.0 ± 0.4 vs 6.0 ± 0.7 mmol/l). At 48 h pre intervention, a decrease was observed in leptin levels (p < 0.05), which remained lower post intervention. The positive correlation between leptin and insulin, and the lower levels after training, could be attributed to the improved insulin sensitivity along with the weight loss observed in both groups (~3.4 kg for DG and 3.7 kg for SDG).

CONCLUSION

Acute soccer sessions markedly improved insulin action markers in T2D patients, while the cumulative effects enhanced insulin sensitivity and decreased risk factors associated with cardiovascular disease after 12 weeks of intervention better than caloric-restricted diet.

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.

Cardiovascular, muscular, and skeletal adaptations to recreational team handball training: a randomized controlled trial with young adult untrained men

PURPOSE

The prevalence of lifestyle diseases has escalated, and effective exercise training programmes are warranted. This study tested the hypothesis that regular participation in small-sided team handball training could provide beneficial health effects on cardiovascular, skeletal, and muscular parameters in young adult untrained men.

METHOD

Twenty-six untrained 20-30-year-old men were randomly allocated to either a team handball training group (HG; n = 14), which completed 1.9 ± 0.3 training sessions per week over 12 weeks, or an inactive control group (CG; n = 12). Physiological training adaptations were assessed pre- and post interventions by DXA scans, blood samples, muscle biopsies, and physical tests.

RESULTS

The average heart rate during training was equivalent to 84 ± 4% of maximal heart rate. Compared to CG, HG displayed significant increases in VO_2max (11 ± 6%), proximal femur bone mineral density (2 ± 1%), whole-body bone mineral content (2 ± 1%), intermittent endurance performance (32 ± 16%), incremental treadmill test performance (16 ± 7%) and muscle citrate synthase activity (22 ± 28%) as well as decreases in total fat mass (7 ± 7%) and total fat percentage (6 ± 7%) (all p < 0.05). There were no significant changes in muscle mass, blood pressure, resting heart rate, muscle hydroxyl-acyl-dehydrogenase activity, or blood lipids (all p > 0.05).

CONCLUSION

Participation in regular recreational team handball training was associated with positive cardiovascular, skeletal, and muscular adaptations, including increased maximal oxygen uptake, increased muscle enzymatic activity, and improved bone mineralization as well as lower fat percentage. These findings suggest that recreational team handball training may be an effective health-promoting activity for young adult men.