Diabetes in sports

Benefits of A2 Milk for Sports Nutrition, Health and Performance

Bovine milk is one of the best pre-and pro-workout sources for athletes owing to its rich nutritional content. Even though bovine milk consumption significantly benefits athletes' health and performance, many athletes cannot consume bovine milk since they struggle with gastrointestinal problems caused after milk consumption. Especially, the consumption of regular milk, which contains A1 β-casein, is associated with a variety of diseases ranging from gastrointestinal discomfort to ischemic heart diseases. The main reason behind this is related to β-casomorphine 7 (BCM-7), which is derived from A1 β-casein during the digestion of A1 milk. A1 β-casein is formed as a result of a point mutation in the position of 67th in the amino acid sequence A2 β-casein by changing proline to histidine. Therefore, this mutated form of β-casein in regular milk cannot easily be digested by the human-associated digestion enzymes. A2 milk, which includes A2 β-casein instead of A1 β-casein, is the best substitute for regular milk with the same nutritional content. This natural form of milk positively affects the athlete's health as well as performance without causing any gastrointestinal discomfort or more serious problems which are seen in the consumption of regular milk. In this review, A2 milk and its potential health effects in comparison to diseases related to A1 milk consumption are discussed.

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Zusammenfassung. Wir berichten über einen 64-jährigen Marathonläufer mit bisher 990 erfolgreich gefinishten Marathons, der fälschlicherweise mit Diabetes mellitus Typ 2 diagnostiziert und therapiert wurde. Unter peroraler Therapie mit Metformin kam es zu keiner Reduktion der Blutzuckerwerte. Nach korrekter Diagnose und Therapie mit Insulin ist der Läufer wieder voll im Training, um bald seinen 1000. Marathon zu laufen. Für Sportler mit Diabetes mellitus Typ 1 ist es wichtig, den Blutzucker vor, während und nach Belastung zu messen und die Insulindosis individuell während eines Wettkampfs, wie etwa einem Marathon, zu reduzieren.

Effects of exercise training on systo-diastolic ventricular dysfunction in patients with hypertension: an echocardiographic study with tissue velocity and strain imaging evaluation

There is a lack of detailed data regarding the effect of exercise training in pharmacologically treated hypertensive patients. Therefore, the aim of this study was to evaluate the effects of exercise training on left and right ventricular morphologic and functional parameters by means of conventional echocardiography and sensitive new echocardiographic techniques including tissue Doppler velocity and strain imaging, that were performed in pharmacologically treated hypertensive patients at baseline and at the end of a specific exercise training protocol for primary prevention of cardiovascular disease. We selected 116 pharmacologically treated hypertensive patients who completed the exercise training protocol. All patients underwent a clinical history and examination; transthoracic echocardiography and exercise testing were performed at baseline and at the end of the exercise training protocol. Conventional echocardiography revealed a mild degree of diastolic dysfunction without significant differences or variations from baseline to the end of the exercise training protocol. In contrast, tissue Doppler velocity and strain imaging measurements demonstrated and highlighted the positive influence of exercise training: for both left and right ventricle myocardial early peak diastolic velocities (Em), the ratio of myocardial early-late peak diastolic velocity (Em/Am), myocardial peak systolic velocities (Sm) and peak strain and strain rate values significantly increased at the end of the exercise training protocol, suggesting a relationship between exercise capacity and both left and right ventricular systo-diastolic function. Our study, by means of newer more sensitive echocardiographic techniques, clearly demonstrated the positive impact of exercise training on both left and right ventricular systo-diastolic function, in terms of adjunctive subclinical improvement, in pharmacologically treated hypertensive patients.

Physical exercise with weight reduction lowers blood pressure and improves abnormal left ventricular relaxation in pharmacologically treated hypertensive patients

In spite of appropriate pharmacologic therapy, many hypertensive patients develop an abnormal left ventricular relaxation with preserved systolic function. This cardiac dysfunction increases the risk of cardiovascular complications. The authors assessed the therapeutic effects of an intervention with exercise training and weight reduction in patients with pharmacologically well-treated hypertension who had abnormal left ventricular relaxation with normal systolic function. Eighty-eight (44%) of 202 medically treated hypertensive patients had abnormal ventricular relaxation with normal ejection fraction. These patients were randomized to either a 6-month intervention program (cycle ergometer training twice a day for 5 days a week and a hypocaloric diet) or a control program (unchanged pharmacologic therapy without exercise and diet. Body weight, blood pressure, New York Heart Association class, glomerular filtration rate, and exercise capacity and workload were measured. Cardiac function was assessed by measuring N-terminal pro-B-type natriuretic peptide values, the electrocardiographic QT dispersion interval, and echocardiography (left atrial size, Doppler-derived E/A ratio, and mitral deceleration time). Physical exercise with weight reduction reduced blood pressure, decreased cardiovascular risks, and improved abnormal left ventricular relaxation. Measuring left atrial size is the best method for assessing changes in left ventricular relaxation with preserved systolic function.