Impact of menstrual cycle or combined oral contraception on elite female cyclists' training responses through a clustering analysis of training sessions

Objectives

(i) To classify training sessions of elite female cyclists according to an intensity index based on a longitudinal follow-up using multiparametric data collected in situ (ii) to measure the effect of estimated menstrual cycle (MC) phases and oral contraceptive pills (OC) phases on the athletes' training responses on each type of training identified.

Method

Thirteen elite French cyclists were followed up over 30 months and 5,190 training sessions were collected and 81 MC/OCs full cycles analyzed. Power sensors and position devices captured training data in situ, which was summarized into 14 external load variables. Principal Component Analysis and K-means clustering were used to identify cycling sessions according to an intensity load index. The clusters were then verified and categorized through the analysis of heart rate and rate of perceived effort. A calendar method was used to estimate 3 phases of the MC: menstruation, mid-cycle phase (MP) and late-cycle phase (LP). Two phases were defined among monophasic OC users: pills' taking/withdrawal.

Results

Four main types of training effort were identified: Intensive, Long, Medium and Light. In the MC group (n = 7; 52 cycles), the intensity index is 8% higher during the mid-cycle (vs. menstrual phase, p = 0.032) in the Intensive effort sessions. No differences were observed in Long, Medium or Light effort, nor between the phases of pills' taking/withdrawal among OC users.

Conclusion

The clustering analyses developed allows a training classification and a robust method to investigate the influence of the MC/OC in situ. A better training response during the mid-cycle when the sessions are the most intense suggest an impact of the MC when the athletes approach their maximal capacity.

Individual In-Situ GPS-Derived Acceleration-Speed Profiling: Toward Automatization and Refinement in Male Professional Rugby Union Players

BACKGROUND

Recently a proof-of-concept was proposed to derive the soccer players' individual in-situ acceleration-speed (AS) profile from global positioning system (GPS) data collected over several sessions and games. The present study aimed to propose an automatized method of individual GPS-derived in-situ AS profiling in a professional rugby union setting.

METHOD

AS profiles of forty-nine male professional rugby union players representing 61.5 million positions, from which acceleration was derived from speed during 51 training sessions and 11 official games, were analyzed. A density-based clustering algorithm was applied to identify outlier points. Multiple AS linear relationships were modeled for each player and session, generating numerous theoretical maximal acceleration (A0), theoretical maximal running speed (S0) and AS slope (ASslope, i.e., overall orientation of the AS profile). Each average provides information on the most relevant value while the standard deviation denotes the method accuracy. In order to assess the reliability of the AS profile within the data collection period, data were compared over two 2-week phases by the inter-class correlation coefficient. A0 and S0 between positions and type of sessions (trainings and games) were compared using ANOVA and post hoc tests when the significant threshold had been reached.

RESULTS

All AS individual profiles show linear trends with high coefficient of determination (r2 > 0.81). Good reliability (Inter-class Correlation Coefficient ranging from 0.92 to 0.72) was observed between AS profiles, when determined 2 weeks apart for each player. AS profiles depend on players' positions, types of training and games. Training and games data highlight that highest A0 are obtained during games, while greatest S0 are attained during speed sessions.

CONCLUSIONS

This study provides individual in-situ GPS-derived AS profiles with automatization capability. The method calculates an error of measurement for A0 and S0, of paramount importance in order to improve their daily use. The AS profile differences between training, games and playing positions open several perspectives for performance testing, training monitoring, injury prevention and return-to-sport sequences in professional rugby union, with possible transferability to other sprint-based sports.

KEY POINTS

AS profiles computed from rugby union GPS data provide positional benchmarks during training and competition. This study provides automatic detection of atypical data and the computation of error measurement of theoretical maximal acceleration and speed components. This refinement constitutes a step forward for a daily use of ecological data by considering data collection and method reliabilities. This easy-to-implement approach may facilitate its use to the performance management process (talent identification, training monitoring and individualization, return-to-sport).

On-Field Methodological Approach to Monitor the Menstrual Cycle and Hormonal Phases in Elite Female Athletes

OBJECTIVES

Currently, there are no guidelines for implementing the monitoring of menstrual status, including the natural menstrual cycle (NC) or oral contraception (OC), in a sport setting. We aimed to provide a feasible, on-field methodological approach for monitoring NC and OC in female athletes.

METHODS

We developed a smartphone app with daily questionnaires to monitor both NC and OC phases in 19 elite female soccer players (23.7 [4.4] y) over 7 months. Adherence and compliance were evaluated. The NC and OC phases were based on calendar data to establish an individual menstrual profile for each athlete.

RESULTS

The initial questionnaire revealed that the vast majority of female players (80%) were interested in monitoring their menstrual status. The online monitoring yielded high athlete adherence (87.0% [14.2%]) with a slight decrease over the winter break and at the end of the championship, which necessitated adaptations to promote compliance. Monitoring identified the specific menstrual pattern of each athlete and highlighted large interindividual variability.

CONCLUSION

This study assesses, for the first time, the interest of female players in monitoring their menstrual status. It provides a new methodological approach, as well as guidelines for optimizing on-field monitoring. It also anticipates some obstacles sport staff may encounter when trying to implement such follow-up. It is essential to better understand the menstrual profile of athletes and determine its potential impacts on well-being and performance.

Medical withdrawals in elite tennis in reference to playing standards, court surfaces and genders

OBJECTIVES

To examine the relationships between medical withdrawals, playing standards, court surfaces and genders in tennis players participating in all elite tours.

DESIGN

Descriptive epidemiology study.

METHODS

Medical withdrawals of men and women tennis players from Association of Tennis Professionals, Women Tennis Association, Challengers and International Tennis Federation Futures tours' matches have been identified considering the court surfaces (fast vs. slow). Proportion comparison and the binomial regression model were used to determine the influence of playing standards, court surfaces and genders on tennis players' likelihoods to withdraw.

RESULTS

A higher proportion of withdrawals was found for men in Challengers and Futures vs. Association of Tennis Professionals (4.8 %, 5.9 % vs 3.4 %; p < 0.001), but without difference between court surfaces (0.1 %, p > 0.05) whatever the playing standards. Women reported higher proportion of medical withdrawals sustained on slow surfaces (0.4 %, p < 0.001), but without different withdrawal rates between playing standards (3.9 %, p > 0.05). After adjustment, the odds of medical withdrawals were higher for Challengers (1.18, p < 0.001) and Futures (1.34, p < 0.001), with a higher likelihood to withdraw (1.04, p < 0.001) when playing on slow surfaces and with a gender-dependent effect indicating higher odds (1.29, p < 0.001) to withdraw for medical reasons in men in reference to women.

CONCLUSIONS

These findings demonstrated a gender-dependent effect on medical withdrawals from an elite tennis tournament with higher likelihood for men participating in Challengers/Futures tours and for women playing on slow surfaces.

Impact of COVID-19 Vaccination on Short-Term Perceived Change in Physical Performance among Elite Athletes: An International Survey

COVID-19 vaccination raised concerns about its potential effects on physical performance. To assess the impact of COVID-19 vaccination on the perceived change in physical performance, we conducted an online survey among elite athletes from Belgium, Canada, France and Luxembourg, with questions about socio-demographics, COVID-19 vaccination, perceived impact on physical performance and perceived pressure to get vaccinated. Full vaccination was defined as two doses of mRNA or vector vaccine or a heterologous vaccine scheme. Among 1106 eligible athletes contacted, 306 athletes answered the survey and were included in this study. Of these, 72% perceived no change in their physical performance, 4% an improvement and 24% a negative impact following full COVID-19 vaccination. For 82% of the included athletes, the duration of the negative vaccine reactions was ≤3 days. After adjustment for potential confounding variables, practicing an individual sport, a duration of vaccine reactions longer than 3 days, a high level of vaccine reaction and the perceived pressure to get vaccinated were independently associated with a perceived negative impact on physical performance of more than 3 days after the vaccination. The perceived pressure to get vaccinated appears to be a parameter associated with the negative perceived change in the physical performance and deserves further consideration.

Training load and intensity distribution for sprinting among world-class track cyclists

BACKGROUND

Only few studies analyzed real training programs of sprinters while that should be a valuable step in the understanding of sprint training. The present study aimed at characterizing track cycling sprinter training by training load and intensity distribution.

METHODS

Twenty-nine weeks of prechampionship training data were retrospectively analyzed for 6 world-class athletes. Training load was measured by the ratio of volume completed to maximal volume and categorized by five intensity zones (endurance: zones1-2; sprinting: zones3-5) and exercise type (on-bike or resistance). Intra-week (training monotony) and inter-week (acute-chronic workload ratio) variation was also studied.

RESULTS

On-bike training represented 77.4±15.3% of total training load; resistance training, 22.6±15.2% (note high standard deviation). Total weekly training load significantly varied (P=0.0002) with high acute-chronic workload ratio (12.0±3.2 weeks >1.5 or <0.8), but low intra-week variations (training monotony, 1.81±0.20). Zone4 and zone5 made up 74.4±16.9% of total training load; zone1, 15.8±11%. Training load was seldom in zone2 (6.4±5.3%) or zone3 (3.3±4.2%). From the first to the second half of the period, zone3-4 training load decreased (39.3±3.3 to 27.4±1.7%; P=0.01), while zone5 increased (34.9±2.4 to 50±3.7%; P=0.002).

CONCLUSIONS

In this reduced group of elite athletes, training appeared to mainly consist of on-bike exercises within the highest intensity zones. As demonstrated by monotony and acute-chronic workload ratio overloading and unloading are based on high variations over weeks, not days. Essentially, this study describes a polarized intensity distribution on the highest intensities which increased with world championships approach.

Relative age effects in track-and-field: Identification and performance rebalancing

Introduction: Relative Age Effect (RAE) consists of a biased distribution of the dates of birth in a same-age group. Objectives: This study aimed to investigate Relative Age Effect among French athletes in different track-and-field events, and propose a corrective adjustment method to highlight the true potential of an athlete with respect to his/her relative age. Methods: 358,610 performances from 2009 to 2019 of female and male athletes between 12 and 21 years old were collected. Relative age distributions of performances were analyzed by level of competitiveness ("All," "Top50%," "Top10%" where "all" represents all athletes, top50% and top10% represent the best 50% and 10% of athletes per age category respectively) and age category, with chi-square and odd-ratio statistics. A linear relationship between distribution of performances and age leads to a calibration coefficient allowing to rebalance the performance by considering the effect of Relative Age Effect. Validation is obtained by Wilcoxon statistical test on actual athlete data. Results: Relative Age Effect is present in all types of events. It is larger when the level of competitiveness increases. In male 100 m sprint, 1 year difference between two athletes birth date represents an average gain of 931.01 ms (6.5%) in the U13 (Under 13 years old) and 229.65 ms (1.9%) in the U17 (Under 17 years old) categories. Our validated rebalancing methods allows to compensate for the biases induced by the relative age effect. By comparing the rebalanced performance and the realised performance of each athlete, we cannot say that they are significantly different. On average, there is no significant difference between these two performances. Conclusion: This study showed that there is a relative age effect among young French athletes, with an even greater effect as the level of competition increases. Thanks to the rebalancing method that has been validated, performances can now be better appreciated according to category and event.

Menstrual cycle and hormonal contraceptive phases' effect on elite rowers' training, performance and wellness

Objectives: To investigate the effect of menstrual cycle (MC) and hormonal contraception (HC) phases in elite rowers training, performance and wellness monitoring. Methods: Twelve French elite rowers were follow-up for 4,2 cycles on average in their final preparation for the Olympics and Paralympics Games in Tokyo 2021 through an on-site longitudinal study based on repeated measures. Daily self-reported evaluation using Likert rating scales of wellness (sleep quality, fitness, mood, injuries' pain), menstrual symptoms and training parameters (perceived exertion and self-assessment of performance) were collected (n = 1,281) in parallel to a coach evaluation of rowers' performance (n = 136), blinded to theirs MC and HC phases. Salivary samples of estradiol and progesterone were collected in each cycle to help to classify the MC into 6 phases and HC into 2-3 phases depending on the pills' hormone concentration. A chi-square test normalized by each rower was used to compare the upper quintile scores of each studied variable across phases. A Bayesian ordinal logistic regression was applied to model the rowers' self-reported performance. Results: Rowers with a natural cycle, n = 6 ( + 1 amenorrhea) evaluate their performance and wellness with significant higher score indices at the middle of their cycle. Top assessments are rarer at the premenstrual and menses phases, when they more frequently experience menstrual symptoms which are negatively correlated with their performance. The HC rowers, n = 5, also better evaluate their performance when taking the pills and more frequently experience menstrual symptoms during the pill withdrawal. The athletes self-reported performance is correlated with their coach's evaluation. Conclusion: It seems important to integrate MC and HC data in the wellness and training monitoring of female athletes since these parameters vary across hormonal phases affecting training perception of both athlete and coach.

Corrective adjustment methods for relative age effects on French young swimmers' performances

BACKGROUND

This study aimed to identify a Relative Age Effect (RAE) among French young swimmers and apply corrective adjustment procedures to rebalance performances according to categories and events.

METHODS

5,339,351 performances of French swimmers aged 10 to 18 were collected between 2000 and 2019. Birth quarters distribution was examined according to competitiveness level ('All', 'Top50%', 'Top25%' and 'Top10%'), event and age category. A linear relationship between the distribution of performances and calendar days provides a calibration coefficient allowing to rebalance performances by considering the effect of RAE for each event. Then, adjusted performances are recalculated using this coefficient, the initial performance and the relative age.

RESULTS

Proportion of swimmers born in the first quarter was higher than the proportion of those born in the last quarter for all events and strokes (p < 0.01). RAE increases with the competitiveness level for all events. Indeed, among 'All' 12 years old 50m freestyle swimmers, the proportion born in the first quarter is 30.9% vs 19.2% in the fourth quarter, while among the "Top10%", 47.5% were born in the first quarter vs 10.3% in the last one. (p-value < 0.01). In average, each day represents a gap of 0.008 second, resulting in a difference of almost 3 seconds over a year. This tool is validated by comparing swimmers who have performed at least twice in a season. It provides a day by day rebalancing method for all swimming events and age categories.

CONCLUSIONS

Relative age effect is present among French young male and female swimmers, and is strengthened by competitiveness level. A new corrective adjustment procedure to rebalance performances considering categories and events is proposed and validated. By applying such a tool, we are able to reveal the full potential of swimmers and make it possible to compare them at the same relative age.

ChAd155-RSV vaccine is immunogenic and efficacious against bovine RSV infection-induced disease in young calves

Respiratory syncytial virus (RSV) infection causes a substantial lower-respiratory-tract disease burden in infants, constituting a global priority for vaccine development. We evaluated immunogenicity, safety and efficacy of a chimpanzee adenovirus (ChAd)-based vaccine candidate, ChAd155-RSV, in a bovine RSV (bRSV) challenge model. This model closely reproduces the pathogenesis/clinical manifestations of severe pediatric RSV disease. In seronegative calves, ChAd155-RSV elicits robust neutralizing antibody responses against human RSV. Two doses protect calves from clinical symptoms/lung pathological changes, and reduce nasal/lung virus loads after both a short (4-week) and a long (16-week) interval between last immunization and subsequent bRSV challenge. The one-dose regimen confers near-complete or significant protection after short-term or long-term intervals before challenge, respectively. The presence of pre-existing bRSV-antibodies does not affect short-term efficacy of the two-dose regimen. Immunized calves present no clinical signs of enhanced respiratory disease. Collectively, this supports the development of ChAd155-RSV as an RSV vaccine candidate for infants.

P01-11 Economic impact of health-enhancing-physical activity from different settings in France

Background

There is strong evidence of the multiple benefits of physical activity on health in primary, secondary and tertiary prevention (WHO, 2020). However, economic evaluations are still needed to estimate direct and indirect costs that could be saved from various Health-Enhancing Physical Activity (HEPA) promotion strategies (Ding et al., 2020). Moreover, these savings might be influenced by specificities of the national health system. The aim of this study is to explore the economic impact of HEPA from different settings in France.

Methods

A systematic scoping review of grey and scientific literature was conducted. Relevant articles were identified through searching from PubMed, ScienceDirect, SportDiscus databases and from google. Searches were conducted in English and French between January 2000 and December 2020. A data extraction template was used to collect, organize and summarize data regarding the following variables: aim of the study, study population, study settings, methods, and main results.

Results

A total of 17 studies were included from the grey literature (n = 10) and the scientific peer-reviewed literature (n = 7). Data from each variables of interest were heterogeneous, making comparisons difficult. Studies were categorized in 5 types: studies aiming to estimate the cost of physical inactivity or the cost that could be saved from HEPA promotion in general population (n = 8); studies aiming to evaluate the medico-economic impact of a physical activity adapted program (n = 5); studies aiming to assess the economic benefit of active travel in a city (n = 3); study aiming to estimate the economic impact of physical activity from a company and its employee's perspectives (n = 1). Whatever the methods, the study population or the study setting, several tens of millions of euros to several billions of euros could be saved each year by investing in HEPA promotion.

Conclusions

HEPA promotion can lead to substantial saving. Methods should be standardized to more precisely estimate its extent in different settings in France. This could help policy-makers in their decision to invest in HEPA promotion, especially in phases of epidemics, where sedentarity and physical inactivity account for major health risks.

Dealing with menstrual cycle in sport: stop finding excuses to exclude women from research

The current literature is mostly male-based, limiting evidence-based recommendations for training individualization for female athletes. Recently, studies have relied on recent findings showing a potential effect of the menstrual cycle to exclude female athletes from their samples. We highlight that the arguments usually put forward to this action are not acceptable. Our discussion aims to elucidate that female physiological parameter can be confounding variables in the same way than other parameters (temperature, nutrition, fatigue, etc.). Those are usually well handled in most studies. This is important to bridge the current sex data gap and promote research on female athletes. Specially, as we approach the next Olympic Games, were, for the first time, there will be full gender parity in terms of athlete numbers at the Olympic Games Paris 2024.

Does maternity during sports career jeopardize future athletic success in elite marathon runners?

The impact of maternity (Mat) on subsequent athletic performance is not well known. This study aims to investigate the impact of maternity among elite marathoners on their overall performance progression. For each runner listed in the top 150 female marathoners, who had experienced a mid-career maternity, performance development was reconstituted throughout the career. Maternity data and career break time span (T_total) were collected from publicly available informations. Performances were modelled according to the known age-performance relationship and the impact of maternity was added into the model. Linear mixed effect model was used to study the influence of maternity on the overall career. Among this sample, 37 runners had at least 1 child during her career. Among them, 14 had 2 children. Eleven runners (29.72%) made their personal best performance before Mat, which occurred at an average age of 28.40 ± 4.00 years. Twenty-six runners (70.28%) establish their best performances after Mat, at an average age of 32.20 ± 4.28. The age-performance relationship model explains 92% of the performance variability during the career's progression. When age is considered, maternity does not have significant impact on performance development. World's most competitive marathoners can still perform at their best level after pregnancy. The ability to return and surpass previous performance level is influenced by the age at which pregnancy occurs, relative to the age of peak performance during career development.Highlights Mid-career maternity does not have a significant impact on overall progression in high level runners, who return to official races.The ability to return and surpass previous performance level is influenced by the age at which pregnancy occurs, relative to the age of peak performance.Age is the variable that explains most of performance progression, independently of mid-career maternity occurrence(s).

Digital phenotyping in young breast cancer patients treated with neoadjuvant chemotherapy (the NeoFit Trial): protocol for a national, multicenter single-arm trial

Background

Breast cancer (BC) has particular characteristics in young women, with diagnosis at more advanced stages, a poorer prognosis and highly aggressive tumors. In NeoFit, we will use an activity tracker to identify and describe various digital profiles (heart rate, physical activity, and sleep patterns) in women below the age of 45 years on neoadjuvant chemotherapy for BC.

Methods

NeoFit is a prospective, national, multicenter, single-arm open-label study. It will include 300 women below the age of 45 years treated with neoadjuvant chemotherapy for BC. Participants will be asked to wear a Withing Steel HR activity tracker round the clock for 12 months. The principal assessments will be performed at baseline, at the end of neoadjuvant chemotherapy and at 12 months. We will evaluate clinical parameters, such as toxicity and the efficacy of chemotherapy, together with quality of life, fatigue, and parameters relating to lifestyle and physical activity. The women will complete REDCap form questionnaires via a secure internet link.

Discussion

In this study, the use of an activity tracker will enable us to visualize changes in the lifestyle of young women on neoadjuvant chemotherapy for BC, over the course of a one-year period. This exploratory study will provide crucial insight into the digital phenotypes of young BC patients on neoadjuvant chemotherapy and the relationship between these phenotypes and the toxicity and efficacy of treatment. This trial will pave the way for interventional studies involving sleep and physical activity interventions.

Trial registration

Clinicaltrials.gov identifier: NCT05011721. Registration date: 18/08/2021.

Exercise Dose Equalization in High-Intensity Interval Training: A Scoping Review

Based on comparisons to moderate continuous exercise (MICT), high-intensity interval training (HIIT) is becoming a worldwide trend in physical exercise. This raises methodological questions related to equalization of exercise dose when comparing protocols. The present scoping review aims to identify in the literature the evidence for protocol equalization and the soundness of methods used for it. PubMed and Scopus databases were searched for original investigations comparing the effects of HIIT to MICT. A total of 2041 articles were identified, and 169 were included. Of these, 98 articles equalized protocols by utilizing energy-based methods or exercise volume (58 and 31 articles, respectively). No clear consensus for protocol equalization appears to have evolved over recent years. Prominent equalization methods consider the exercise dose (i.e., energy expenditure/production or total volume) in absolute values without considering the nonlinear nature of its relationship with duration. Exercises resulting from these methods induced maximal exertion in HIIT but low exertion in MICT. A key question is, therefore, whether exercise doses are best considered in absolute terms or relative to individual exercise maximums. If protocol equalization is accepted as an essential methodological prerequisite, it is hypothesized that comparison of program effects would be more accurate if exercise was quantified relative to intensity-related maximums.

Relative age effect in French alpine skiing: Problem and solution

This study aims to identify the potential bias of the relative age effect (RAE) in French alpine skiers and to propose a mathematical correction adjustment for such a bias. All performances and birthdates of skiers on the national and international circuit were collected from the 2004 up to 2019. A goodness-of-fit chi-square test and the residuals were used to study the distribution of birth trimesters in youth competitors. A linear relationship between the distribution of performances and the months obtains a calibration coefficient allowing to rebalance the performance by considering the effect of RAE. Individuals born at the beginning of the year are over-represented in the elite young selections in all disciplines for both genders. A coefficient based on the relationship between month of birth and performance adjusts individual performance and cancels out the effect of RAE. The results show that RAE is present in French alpine skiing. We present a method allowing to consider the effect of the RAE in the performances realized in each gender and discipline. This method allows coaches to have a more objective opinion on performance and to reduce selection bias.

The COVID-19 pandemic impact on the best performers in Athletics and Swimming among Paralympic and non-disabled athletes

BACKGROUND

The COVID 19 pandemic has greatly disrupted high performance sport and international competition. The aim of this study was to quantify the impact of the COVID-19 pandemic on the world's top 10 performances in Athletics and Swimming among nondisabled and Paralympic athletes.

METHODS

The results of the 10-best world performers in 66 Olympic events since 1891 and 255 Paralympic events since 2010 were collected. To quantify the performance trend, the slopes of the 4 years moving average were calculated and analyzed by time period. The distribution of performances (in % of the world record) by year was analyzed to compare the 2020 values to the ten previous years. The stability rate (athletes joining and leaving each year) since 2010 and the number of annual competitions events were also measured.

RESULTS

Over the study period, such declines in performance have only been observed during the two World Wars. In 2020, the level of performances has decreased significantly, corresponding to a 6 to 10 years setback. In 2020, the number of new athletes in the 10-best was significantly higher with a lower number of organized competitions.

CONCLUSIONS

The impact on the performances of the best international non-disabled and Para athletes has been considerable.

Is the visual impairment origin a performance factor? Analysis of international-level para swimmers and para athletes

The aim of this study was to investigate the effect of congenital and acquired visual impairments on the international performance of Para swimmers and Para track and field athletes. We collected results from visually impaired Para athletes competing in Para swimming or Para athletic events at all IPC-labelled competitions between 2009 and 2019. The dataset contained 20,689 events results. Impairment origin was collected from the International Paralympic Committee (IPC) website. We separated impairment origin into two groups to distinguish those with a congenital impairment from those with an acquired impairment. In visual impairment sport classes (11-12-13), the performance level and the age performance relationship were investigated according to the impairment origin. In classes 11 and 12, peak performance was achieved earlier by male and female swimmers with a congenital impairment compared with those who had an acquired impairment (p < 0.05). No differences were present in class 13 or in any class in Para athletics (p > 0.05). A similar performance level was observed among the two sport disciplines for each class (p > 0.05). This study demonstrated that impairment origin can influence the performance pathway among visually impaired swimmers.

Heads-Up: Risk-Specific Neurodegenerative Mortality and Years-Saved Analysis on the US Olympian Cohort

Purpose: This study aimed to identify the risk of neurodegenerative death (ND) that former Olympians endure due to their participation in sports grouped based on presumed repeated shocks to the head, and to understand the impact of their participation in such elite sports on their total longevity.

Materials and Methods: The cohort included all former US Olympians, who participated in the Olympic Games (OG) between 1948 and 1972, and whose vital status and causes of death were verified (n = 2,193). Olympic sports were classified into three categories of exposure: Collision (the highest presumed risk of repeated shocks to the head), Contact, and No-Contact. The Fine-Gray competing risk regression model was used to compare the risk of ND where the No-Contact category was a reference group. The years-saved analysis was performed to quantify the number of years saved or lost to ND and total longevity compared with the US general population.

Results: A total of 65 NDs were identified. Collision sports Olympians had a 3.11 (95% CI: 1.31–7.40) higher risk of ND while the Contact group showed a risk of 0.56 (95% CI: 0.21–1.48) compared with the No-Contact sports Olympians. Compared with the general population, the Collision group lost 0.61 (95% CI: -1.16—0.06) years of life from ND, while the Contact group saved 0.4 (95% CI: 0.26–0.54) and the No-Contact group saved 0.09 (-0.09–0.28) years of life up to the age of 90. Regarding the total longevity, Collision, Contact, and No-Contact groups saved 4.67 (95% CI: 3.13–6.22), 5.8 (95% CI: 4.93–6.67), and 6.24 (95% CI: 5.57–6.92) years of life, respectively, from all causes of death.

Conclusion: There is an elevated risk of ND among US Olympians, who engaged in sports with the highest presumed risk of repeated shocks to the head compared with those exposed to no such hazard. Such risk does not jeopardize the total longevity among Olympians in Collision sports.

The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review

Background: In elite athletes, training individualization is widely recommended to optimize competitive performance. Previous studies have evidenced the impact of hormonal fluctuations on different performance parameters among female athletes. While consideration of menstrual cycle (MC) phases as a parameter in training individualization strategies is necessary, systematic evidence identifying such impacts in elite athletes should be evaluated. Objective: Systematically review publications that have investigated the link between MC phases and performance in elite female athletes. The overarching aim is to identify whether a consensus across studies exists enabling evidence-based recommendations for training individualization depending on menstrual cycle phases. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three major scientific publication databases were searched from inception until November 3, 2020. Studies included focused on the influence of physiological or psychological parameters throughout at least one phase of the menstrual cycle of elite athletes. Results: A total of 780 search results were yielded and 26 references from a past bibliography were added manually. About 662 papers were reviewed of which 218 studies were assessed for eligibility. Of these, only seven (1%) precisely investigated the influence of a performance or physical parameter during at least one menstrual cycle phase. These seven studies included a total of 314 elite female participants (20.58 ± 1.91 years). Three used interviews, questionnaires or prospective analyses of reports. Four conducted several performance tests or included physical measures although only two performed tests during training or before/during competition. Among the seven studies, five performed hormonal testing through sampling of blood, saliva, or urine. The remaining relied on athletes' menstruation diaries. The current evidence suggests a variable association between menstrual cycle and a few performance-related outcomes, such as endurance or power resistance, ligament stiffness, decision making skills, psychology, or competitiveness. Conclusion: Different sports performance-related parameters are affected during the menstrual cycle among elite athletes, but the parameters themselves and the magnitude and the direction of the effects are inconclusive. Additional longitudinal and prospective studies to systematically monitor on-field performance parameters are urgently required in order to enable recommendations and training individualization in female elite athletes.

Lack of Skeletal Muscle Serotonin Impairs Physical Performance

Low levels of the neurotransmitter serotonin have been associated with the onset of depression. While traditional treatments include antidepressants, physical exercise has emerged as an alternative for patients with depressive disorders. Yet there remains the fundamental question of how exercise is sensed by the brain. The existence of a muscle–brain endocrine loop has been proposed: according to this scenario, exercise modulates metabolization of tryptophan into kynurenine within skeletal muscle, which in turn affects the brain, enhancing resistance to depression. But the breakdown of tryptophan into kynurenine during exercise may also alter serotonin synthesis and help limit depression. In this study, we investigated whether peripheral serotonin might play a role in muscle–brain communication permitting adaptation for endurance training. We first quantified tryptophan metabolites in the blood of 4 trained athletes before and after a long-distance trail race and correlated changes in tryptophan metabolism with physical performance. In parallel, to assess exercise capacity and endurance in trained control and peripheral serotonin–deficient mice, we used a treadmill incremental test. Peripheral serotonin–deficient mice exhibited a significant drop in physical performance despite endurance training. Brain levels of tryptophan metabolites were similar in wild-type and peripheral serotonin–deficient animals, and no products of muscle-induced tryptophan metabolism were found in the plasma or brains of peripheral serotonin–deficient mice. But mass spectrometric analyses revealed a significant decrease in levels of 5-hydroxyindoleacetic acid (5-HIAA), the main serotonin metabolite, in both the soleus and plantaris muscles, demonstrating that metabolization of tryptophan into serotonin in muscles is essential for adaptation to endurance training. In light of these findings, the breakdown of tryptophan into peripheral but not brain serotonin appears to be the rate-limiting step for muscle adaptation to endurance training. The data suggest that there is a peripheral mechanism responsible for the positive effects of exercise, and that muscles are secretory organs with autocrine-paracrine roles in which serotonin has a local effect.

Is physical fitness associated with the type of attended school? A cross-sectional analysis among 20.000 adolescents

BACKGROUND

While academic achievement has been associated with physical activity, the present work questions the potential association between the physical fitness level of adolescents and the type of school they attend, ranging from academic to technical schools.

METHODS

20,228 young French students from 76 schools (9,196 females), mean age 15.8±1.8 years, performed the Diagnoform© test. This dataset includes two higher education institutions (n=870), 37 general high schools (n=13,125), 18 professional-oriented high schools (n=3,569), 5 agricultural high schools (n=132), 2 vocational training centers (n=202) and 12 rural vocational training centers (n=1,137).

RESULTS

In higher education institutions and general high schools, girls showed better performances for all physical tests. A decreasing Quotient of overall Physical fitness Condition (QPC) was observed for both genders from urban higher education schools to rural and technical institutions (p<0.001). The proportion of total variance accounting for within institution variation is strong (intra-class correlation coefficients (ICC) 0.20 [0.15; 0.27] for QPC).

CONCLUSIONS

The lower physical fitness level observed here among students from technical or training schools places them at higher risks for the development of future chronic diseases. These results suggest that specific interventions are needed depending on the educational setting.

Involvement in Multiple Race Events Among International Para and Non-disabled Swimmers

International elite Para swimmers form a large portion of the overall multi-medalist winning population. For the highest performing Para swimmers, world class performances were achieved across different strokes. The aim of this study was to quantify the level of involvement across different events and to examine this in relation to the level of performance. The performances in swimming speed of the top 100 females and males for both Para- and non-disabled swimmers were collected in 11 race events between 2009 and 2019 (4,400 performances for 307 Para females and 365 Para males, 605 non-disabled females, and 715 non-disabled males). We tallied the number of events in which each swimmer was involved. Swimmers were grouped according to the total number of race events in which they participated. Then the association between involvement and level of performance was investigated. Para swimmers with impairment from classes seven to 14 were involved in a range of race events across different strokes. The most common combination for both Para and non-disabled athletes was over similarly distanced races of the same stroke (50 and 100 m freestyle). The more race events in which Para swimmers involved, the higher the level of performance that was achieved. This trend can partially be explained by the less concentrated competition pool for Para swimmers compared to able-bodied swimmers. Para swimmers with minimal and no physical impairment perform in multiple race events more often than able-bodied swimmers. Fewer Para swimmers at the international level and a less concentrated competition pool could explain these differences.

Non-targeted metabolomics analyses by mass spectrometry to explore metabolic stress after six training weeks in high level swimmers

The objective was to compare the metabolic responses of high-level national swimmers to threshold or polarised training. 22 swimmers (n = 12 males and 10 females) participated in a 28-week cross-over intervention study consisting of 2 × 6 period weeks of training. Swimmers were assigned randomly to either training group for the first period: polarised (POL) (81% in energetic zone 1: blood lactate [La]b ≤ 2 mmol.L^-1; 4% in zone 2: 2 mmol.L^-1 <[La]b ≤ 4 mmol.L^-1; 15% in zone 3: [La]b > 4 mmol.L^-1) or threshold (THR) (65%/25%/10%). Before and after each training period, urine samples were collected for non-targeted metabolomics analysis. Mixed model analysis was performed on metabolomics data including fatigue class factors and/or training and/or interaction. Ion intensities of 6-keto-decanoylcarnitine (+31%), pregnanediol-3-glucuronide (+81%), P-cresol sulphate (+18%) were higher in the threshold group (P < 0.05) indicating higher glycogenic depletion and inflammation without alteration of the neuroendocrine stress axis. 4-phenylbutanic acid sulphate was 200% higher in less fatigued swimmers (P < 0.01) linking the anti-inflammatory activity at the cell membrane level to the subjective perception of fatigue. This research suggests the importance of replenishing glycogen stores and reducing inflammation during high thresholds training loads.

High hopes: lower risk of death due to mental disorders and self-harm in a century-long US Olympian cohort compared with the general population

OBJECTIVE

To determine the risk of death due to prominent mental disorders, substance abuse, and self-harm among US Olympians compared with the general population.

METHODS

All female (n=2301) and male (n=5823) US Olympians who participated in the summer or winter Games between 1912 and 2012 were followed until 2016. The National Death Index certified their vital statuses and causes of death. We performed a Standard Mortality Ratio (SMR) analysis for all causes studied and applied the years-saved (YS) method to quantify differences in the risk of death for (1) anxiety, depression and self-harm and (2) substance abuse and eating disorders. Additionally, we examined the YS across sports with greater than 100 total deaths and between medalists and non-medalists.

RESULTS

US Olympians had a 32% (SMR=0.68, 95% CI 0.49 to 0.91) lower risk of death compared with the general population, resulting in a longevity advantage of 0.21 YS (95% CI 0.14 to 0.29) for deaths by depression, anxiety and self-harm and 0.12 years (95% CI 0.08 to 0.15) for substance abuse and eating disorders. There were no significant differences between medalists and non-medalists, but findings varied by sports. Most sports (eg, athletics, swimming, rowing) had significantly lower risks of deaths than the general population with the exceptions of fencing and shooting. Shooting showed a trend towards a higher risk through suicide by firearm.

CONCLUSION

Olympians have a lower risk of death, favouring an increased longevity compared with the general population for mental disorders, substance abuse and suicides.

Covid-19 Mortality: A Matter of Vulnerability Among Nations Facing Limited Margins of Adaptation

Context: The human development territories have been severely constrained under the Covid-19 pandemic. A common dynamics has been observed, but its propagation has not been homogeneous over each continent. We aimed at characterizing the non-viral parameters that were most associated with death rate.

Methods: We tested major indices from five domains (demography, public health, economy, politics, environment) and their potential associations with Covid-19 mortality during the first 8 months of 2020, through a Principal Component Analysis and a correlation matrix with a Pearson correlation test. Data of all countries, or states in federal countries, showing at least 10 fatality cases, were retrieved from official public sites. For countries that have not yet finished the first epidemic phase, a prospective model has been computed to provide options of death rates evolution.

Results: Higher Covid death rates are observed in the [25/65°] latitude and in the [−35/−125°] longitude ranges. The national criteria most associated with death rate are life expectancy and its slowdown, public health context (metabolic and non-communicable diseases (NCD) burden vs. infectious diseases prevalence), economy (growth national product, financial support), and environment (temperature, ultra-violet index). Stringency of the measures settled to fight pandemia, including lockdown, did not appear to be linked with death rate.

Conclusion: Countries that already experienced a stagnation or regression of life expectancy, with high income and NCD rates, had the highest price to pay. This burden was not alleviated by more stringent public decisions. Inherent factors have predetermined the Covid-19 mortality: understanding them may improve prevention strategies by increasing population resilience through better physical fitness and immunity.

Female and male US Olympic athletes live 5 years longer than their general population counterparts: a study of 8124 former US Olympians

Objective

To quantify US female and male Olympic athletes’ longevity and the years of life lost or saved due to multiple causes of death as compared with the US general population.

Methods

Former US athletes who had participated in the summer or winter Olympic Games at least once between 1912 and 2012 were included. Olympians’ date of birth, death and the underlying causes of death were certified by the National Death Index. The Olympians’ overall and cause-specific mortality were compared with the US general population based on the US life tables, adjusted by sex, period and age. Mortality differences between the populations were quantified using the years lost/years saved (YS) method.

Results

8124 US Olympians (2301 women and 5823 men) lived 5.1 years longer (YS 95% CI 4.3 to 6.0) than the general population, based on 2309 deaths observed (225 women, 2084 men). Different causes of death contributed to longevity for Olympians as follows: 2.2 years were saved (1.9 to 2.5) from cardiovascular diseases (CVDs); cancer, 1.5 years (1.3 to 1.8); respiratory diseases (eg, influenza, pneumonia), 0.8 years (0.7 to 0.9); external causes (eg, accidents, homicides), 0.5 years (0.4 to 0.6); endocrine and metabolic diseases (eg, diabetes, hyperlipidaemia), 0.4 years (0.2 to 0.5) and digestive system diseases (eg, cirrhosis, hepatic failure), 0.3 years (0.2 to 0.4). Mortality rates due to nervous system disorders (eg, Alzheimer’s and Parkinsons’s diseases) and mental illness (eg, dementia, schizophrenia) were not different from the general population.

Conclusion

US Olympians lived longer than the general population, an advantage mainly conferred by lower risks of CVD and cancer. Nervous system disorders and mental illness did not differ between US Olympians and the general population.

The age-performance relationship in the general population and strategies to delay age related decline in performance

The age-performance relationship describes changes in the organism's structural and functional capabilities over the course of the lifespan. The typical, empirical pattern is an asymmetrical inverted-U shape association with peak capacity occurring early in life. This process is well described in the literature, with an increasing interest in features that characterize this pattern, such as the rate of growth, age of peak performance, and rate of decline with aging. This is usually examined in cohorts of individuals followed over time with repeat assessments of physical or cognitive abilities. This framework ought to be integrated into public health programs, embedding the beneficial (such as physical or cognitive training) or adverse effects (such as chronic diseases or injuries) that respectively sustain or limit capabilities. The maintenance of physical or cognitive performances at older ages would result in both optimal health and promote resistance to disabling conditions and chronic diseases, such as obesity and type 2 diabetes. The causes of accelerated degeneration of health optima are mainly: sedentary and unhealthy lifestyles -including poor nutrition-, exposure to environmental pollutants, and heterogeneity in aging. Better knowledge of optima, compatible with or required for good health, should also allow for establishing ideal conditions for longevity.

Bayesian approach to quantify morphological impact on performance in international elite freestyle swimming

Objectives

The purpose of this study was to quantify the impact of morphological characteristics on freestyle swimming performance by event and gender.

Design

Height, mass, body mass index (BMI) and speed data were collected for the top 100 international male and female swimmers from 50 to 1500 m freestyle events for the 2000–2014 seasons.

Methods

Several Bayesian hierarchical regressions were performed on race speed with height, mass and BMI as predictors. Posterior probability distributions were computed using Markov chain Monte Carlo algorithms.

Results

Regression results exhibited relationships between morphology and performance for both genders and all race distances. Height was always positively correlated with speed with a 95% probability. Conversely, mass plays a different role according to the context. Heavier profiles seem favourable on sprint distances, whereas mass becomes a handicap as distance increases. Male and female swimmers present several differences on the influence of morphology on speed, particularly about the mass. Best morphological profiles are associated with a gain of speed of 0.7%–3.0% for men and 1%–6% for women, depending on race distance. BMI has been investigated as a predictor of race speed but appears as weakly informative in this context.

Conclusion

Morphological indicators such as height and mass strongly contribute to swimming performance from sprint to distance events, and this contribution is quantified for each race distance. These profiles may help swimming federations to detect athletes and drive them to compete in specific distances according to their morphology.

Robust Exponential Decreasing Index (REDI): adaptive and robust method for computing cumulated workload

Objective

The purpose of this study was to define a new index the Robust Exponential Decreasing Index (REDI), which is capable of an improved analysis of the cumulative workload. This allows for precise control of the decreasing influence of load over time. Additionally, REDI is robust to missing data that are frequently present in sport.

Methods

200 cumulative workloads were simulated in two ways (Gaussian and uniform distributions) to test the robustness and flexibility of the REDI, as compared with classical methods (acute:chronic workload ratio and exponentially weighted moving average). Theoretical properties have been highlighted especially around the decreasing parameter.

Results

The REDI allows practitioners to consistently monitor load with missing data as it remains consistent even when a significant portion of the dataset is absent. Adjusting the decreasing parameter allows practitioners to choose the weight given to each daily workload.

Discussion

Computation of cumulative workload is not easy due to many factors (weekends, international training sessions, national selections and injuries). Several practical and theoretical drawbacks of the existing indices are discussed in the paper, especially in the context of missing data; the REDI aims to settle some of them. The decreasing parameter may be modified according to the studied sport. Further research should focus on methodology around setting this parameter.

Conclusion

The robust and adaptable nature of the REDI is a credible alternative for computing a cumulative workload with decreasing weight over time.

Quantifying Collective Performance in Rugby Union

Objectives: The aim of this study was to quantify collective experience based on cumulative shared selections of players and to assess its impact on team performance in international rugby union. We assume that the greater the experience, the better the group will perform. Methods: Scoresheets of all games involving at least one of all 10 nations participating at the Rugby Championship and the Six Nations Championship were collected from the end of the 1999 Rugby World Cup (RWC) up to the 2015 RWC. A single indicator quantifying the cumulative shared selections (CSS, the number of selections that each player has shared with the other ones) was computed for each match as a key collective experience indicator. The World Rugby Ranking points of each nation and the percentage of victories were used to estimate team performance. The study period was divided into sequences of 4 years corresponding to the period between two consecutive RWCs. For each sequence and nation, slopes and intercept of CSS trends were computed along with victory percentage and mean ranking points. Multiple linear regression analysis was used to establish the associations between team performance and experience. Results: In regards to the CSS trends, both intra- and inter-nation variability appears to exist. Positive and negative slopes can be observed for the same team from one 4-year cycle to the next. Still, CSS slope is found to be significantly associated with both ranking points (p value = 0.042, R ² = 0.13) and victory percentage (p value = 0.001, R ² = 0.42). Conclusion: The evolution of the CSS that quantifies the collective experience of a team is linked to its performance. Such an indicator could be helpful in the decision-making process of national coaching staff.

Training Organization, Physiological Profile and Heart Rate Variability Changes in an Open-water World Champion

This case study reports the training of an elite 25-km open-water swimmer and the daily heart rate variability (HRV) changes during the 19-week period leading to his world champion title. Training load was collected every day and resting HRV was recorded every morning. The swimmer's characteristics were V̇O_2max: 58.5 ml·min^-1·kg^-1, maximal heart rate: 178 beats per minute, and maximal ventilation: 170 L·min^-1. Weekly training volume was 85±21 km, 39±8% was at [La]_b<2 mmol · L^-1 (Z1), 53±8% was at [La]_b 2-4 mmol·L^-1 (Z2), and 8±4% was at [La]_b>4 mmol·L^-1 (Z3). In the supine position, the increase in training volume and Z2 training were related to increases in rMSSD and HF. In the standing position, an increase in parasympathetic activity and decrease in sympathetic activity were observed when Z1 training increased. Seasonal changes indicated higher values in the LF/HF ratio during taper, whereas higher values in parasympathetic indices were observed in heavy workload periods. This study reports extreme load of an elite ultra-endurance swimmer. Improvements in parasympathetic indices with increasing Z2 volume indicate that this training zone was useful to improve cardiac autonomic activity, whereas Z1 training reduced sympathetic activity.

Elite Swimmers' Training Patterns in the 25 Weeks Prior to Their Season's Best Performances: Insights Into Periodization From a 20-Years Cohort

Background

This study investigated the periodization of elite swimmers’ training over the 25 weeks preceding the major competition of the season.

Methods

We conducted a retrospective observational study of elite male (n = 60) and female (n = 67) swimmers (46 sprint, 81 middle-distance) over 20 competitive seasons (1992–2012). The following variables were monitored: training corresponding to blood lactate <2 mmol⋅L^-1, 2 to ≤4 mmol⋅L^-1, >4–6 mmol⋅L^-1, >6 mmol⋅L^-1, and maximal swimming speed; general conditioning and maximal strength training hours; total training load (TTL); and the mean normalized volumes for both in-water and dryland workouts. Latent class mixed modeling was used to identify various TTL pattern groups. The associations between pattern groups and sex, age, competition event, Olympic quadrennial year, training contents, and relative performance were quantified.

Results

For the entire cohort, ∼86–90% of the training was swum at an intensity of [La]_b ≤ 4 mmol⋅L^-1. This training volume was divided into 40–44% at <2 mmol⋅L^-1 and 44–46% at 2 to ≤4 mmol⋅L^-1, leaving 6–9.5% at >4–6 mmol⋅L^-1, and 3.5–4.5% at >6 mmol⋅L^-1. Three sprint TTL patterns were identified: a pattern with two long ∼14–15-week macrocycles, one with two ∼12–13 week macrocycles each composed of a balanced training load, and one with a single stable flat macrocycle. The long pattern elicited the fastest performances and was most prevalent in Olympic quadrennials (i.e., 4 seasons preceding the 2004, 2008, and 2012 Olympic Games). This pattern exhibited moderate week-to-week TTL variability (6 ± 3%), progressive training load increases between macrocycles, and more training at ≤4 mmol⋅L^-1 and >6 mmol⋅L^-1. This fastest sprint pattern showed a waveform in the second macrocycle consisting of two progressive load peaks 10–11 and 4–6 weeks before competition. The stable flat pattern was the slowest and showed low TTL variability (4 ± 3%), training load decreases between macrocycles (P < 0.01), and more training at 4–6 mmol⋅L^-1 (P < 0.01).

Conclusion

Progressive increases in training load, macrocycles lasting about 14–15 weeks, and substantial volume of training at intensities ≤4 mmol⋅L^-1 and >6 mmol⋅L^-1, were associated with peak performance in elite swimmers.

Age-Related Changes in Para and Wheelchair Racing Athlete's Performances

During the last decades, all para-athletes with disabilities have significantly increased their performance level due to technological progress and human investment, through better training or recovery protocols, medical care and nutritional monitoring. Among these elements, the athlete’s age is one of the determining factors in performance. The aim of this study was to investigate the effect of age on maximal performances for para-athletes and wheelchair racing athletes, scaled on able-bodied records. We collected 53,554 results including athlete’s best performance of the year, event, age and disability classification from the International Paralympic Committee competitions between 2009 and 2017 for both female and male para-athletics and wheelchair racing disciplines for a total of 472 sport events in Track and Field (considering each impairment type for each event) and gathered the all-time able-bodied records from the International Association of Athletics Federations (IAAF) at the end of 2017. Maximal performance by age was fitted with the Moore function for each para-athletics and wheelchair racing event. This study finds a similar age-related pattern in maximal performance among para-athletes and wheelchair racing athletes. The age at peak performance varies according to sex, impairment type and event and increases gradually from sprint to endurance events. The best Top 100 performances include a large age range suggesting that performance has probably not been optimized yet for most elite para-athletes and wheelchair racers. The next Paralympic Games of Tokyo 2020 and Paris 2024 will certainly offer exceptional performance.

An integrative modeling approach to the age-performance relationship in mammals at the cellular scale

Physical and cognitive performances change across lifespan. Studying cohorts of individuals in specific age ranges and athletic abilities remains essential in assessing the underlying physiological mechanisms that result in such a drop in performance. This decline is now viewed as a unique phenotypic biomarker and a hallmark of the aging process. The rates of decline are well documented for sets of traits such as running or swimming but only a limited number of studies have examined the developmental and senescent phases together. Moreover, the few attempts to do so are merely descriptive and do not include any meaningful biological features. Here we propose an averaged and deterministic model, based on cell population dynamics, replicative senescence and functionality loss. It describes the age-related change of performance in 17 time-series phenotypic traits, including human physical and cognitive skills, mouse lemur strength, greyhound and thoroughbred speed, and mouse activity. We demonstrate that the estimated age of peak performance occurs in the early part of life (20.5% ± 6.6% of the estimated lifespan) thus emphasizing the asymmetrical nature of the relationship. This model is an initial attempt to relate performance dynamics to cellular dynamics and will lead to more sophisticated models in the future.

A Medal in the Olympics Runs in the Family: A Cohort Study of Performance Heritability in the Games History

Introduction: Elite performance in sports is known to be influenced by heritable components, but the magnitude of such an influence has never been quantified.

Hypothesis/Objectives: We hypothesized that having a former world-class champion in the family increases the chances of an athlete to repeat the achievement of her or his kinship. We aimed to measure the heritability of a medal in the Olympic Games (OG) among Olympians and to estimate the percentage of the genetic contribution to such a heritance.

Study Design: Twin-family study of a retrospective cohort.

Methods: All the 125,051 worldwide athletes that have participated in the OG between 1896 and 2012 were included. The expected probability to win a medal in the OG was defined as the frequency of medallists among Olympians without any blood kinship in the OG. This expected probability was compared with the probability to win a medal for Olympians having a kinship (grandparent, aunt/uncle, parent, or siblings) with a former Olympian that was a (1) non-medallist or (2) medallist. The heritability of the genetically determined phenotype (h²) was assessed by probandwise concordance rates among dizygotic (DZ) and monozygotic (MZ) twins (n = 90).

Results: The expected probability to win a medal in the OG was 20.4%. No significant difference of medal probability was found in the subgroups of Olympians with a Non-medallist kinship, except among siblings for whom this probability was lower: 13.3% (95% CI 11.2–14.8). The medal probability was significantly greater among Olympians having a kinship with a former Olympic Medallist: 44.4% for niece/nephew (33.7–54.2); 43.4% for offspring (37.4–48.6); 64.8% for siblings (61.2–68.8); 75.5% for DZ twins (63.3–86.6); and 85.7% for MZ twins (63.6–96.9); with significantly greater concordance between MZ than DZ (p = 0.01) and h² estimated at 20.5%.

Conclusion: Having a kinship with a former Olympic medallist is associated with a greater probability for an Olympian to also become a medallist, the closer an athlete is genetically to such kinship the greater this probability. Once in the OG, the genetic contribution to win a medal is estimated to be 20.5%.

[Improving national health-enhancing physical activity promotion policies]

CONTEXT

In order to help states to develop policies and strategies impacting on all determinants of physical activity, the WHO has set up a policy analysis tool, the HEPA PAT (Health-Enhancing Physical Activity Policy Analysis Tool). This tool allows evaluation of national policies, while considering the complex network of determinants and influencing factors. This article has a double objective: firstly, to present this tool in order to define its specificity and utility in the development of HEPA national policies; secondly, to illustrate its application in the case of France.

METHODS

The national HEPA policies and projects in France were identified and analysed using the HEPA PAT methodology and quality criteria to highlight the opportunities and to propose recommendations for improvement.

RESULTS

HEPA promotion is a recent and fragmented process in France. Development is more intensive at the local level and needs stronger national support and coordination. The main problem seems to be the lack of long-term vision accompanied by a unified national strategy. Implementation is impaired by vaguely defined action plans, very often without any evaluation criteria or sustainable financing methods.

CONCLUSION

The use of HEPA PAT provides a clear and complete overview of the political structure in the field of physical activity promotion. Further analysis of regional policies and projects is recommended to complete this work.

Understanding how outcomes are measured in workplace physical activity interventions: a scoping review

Background

An inverse relationship exists between physical activity and many non-communicable diseases, such as obesity. Given the daily time spent, a logical domain to reach an adult population for intervention is within and around the workplace. Many government bodies, including the World Health Organization (WHO), include worksite health promotions (WHPs) targeted at increasing physical activity as a public health intervention. The aim of this scoping review was to determine what was measured (outcomes) and how they were measured (evaluation tools) during workplace physical activity interventions in order to identify gaps and implications for policies and practice.

Methods

A scoping review was executed in April 2017 via PubMed, SPORTDiscus, EBSCOhost and the Cochrane Library. This search included articles published between January 2008 to February 2017 in order to coincide with the WHO’s Global Plan of Action on Worker’s Health. Extracted information was arranged into data collection grids. Cross-analysis of measured outcomes with their corresponding evaluation tools was completed. A quality assessment based on study design was executed.

Results

Identification of 732 records was made and ultimately 20 studies and reviews that met criteria were selected. Researchers themed 9 primary measured outcomes. Studies utilized various forms of both objective and subjective evaluation methods. Three primary evaluation methods were categorized: biologic, electronic and declarative tools. The researchers discovered 92 unique tools: 27 objective and 65 subjective, within these parameters.

Conclusion

Study quality, measurement tools and data collection were heterogeneous making analysis of effect comparisons problematic and unreliable. Much of the published research does not employ robust statistical analysis making effects difficult to ascertain. Considering the variety of both measured outcomes and evaluation tools, only educated inferences can be made as to the effectiveness and efficiency of WHPs. More standardized measurement practices are therefore suggested for assessment efficiency.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5980-x) contains supplementary material, which is available to authorized users.

The heart of the matter: years-saved from cardiovascular and cancer deaths in an elite athlete cohort with over a century of follow-up

To quantify the years of life saved from cardiovascular (CVD), cancer and overall deaths among elite athletes according to their main type of physiological effort performed in the Olympic Games. All French athletes participating in the Games from 1912 to 2012, with vital status validated and cause of death (if concerned) identified by the national registries were included (n = 2814, 455 died) and classified according to 6 groups of effort: POWER (continuous effort < 45 s); INTERMEDIATE (45 s ≤ continuous effort < 600 s); ENDURANCE (continuous effort ≥ 600 s); POLYVALENT (participating in different events entering different classifications), INTERMITTENT (intermittent effort, i.e. team sports); PRECISION (targeting events). The theoretical years-lost method was adapted to calculate gains in longevity (years-saved) according to specific-risks under the competing risks model and was implemented in R software. Considering overall-deaths, all groups significantly saved, on average, 6.5 years of life (95% CI 5.8-7.2) compared to the general population. This longevity advantage is mainly driven by a lower risk of cancer which, isolated, contributed to significantly save 2.3 years of life (95% CI 1.2-1.9) on average in each group. The risk of CVD-related mortality in the ENDURANCE and PRECISION groups is not significantly different from the general population. The other groups significantly saved, on average, 1.6 years of life (95% CI 1.2-1.9) from CVD death. The longevity benefits in elite athletes are associated with the type of effort performed during their career, mainly due to differences on the CVD-risk of death.

Phase I Randomized Study of a Tetravalent Dengue Purified Inactivated Vaccine in Healthy Adults from Puerto Rico

The safety and immunogenicity of four adjuvanted formulations of an investigational tetravalent dengue purified inactivated vaccine (DPIV) were evaluated in a predominantly dengue-primed population in Puerto Rico. In this placebo-controlled, randomized, observer-blind, phase I trial, 100 healthy adults were randomized 1:1:1:1:1 to receive DPIV at Day (D)0 and D28 (1 μg per dengue virus [DENV] type 1–4 adjuvanted with either alum, AS01_E or AS03_B, or 4 μg per DENV type adjuvanted with alum) or saline placebo. Functional antibody responses were assessed using a microneutralization assay at D56, Month (M)7, and M13. All DPIV formulations were well tolerated and no safety signals were identified through M13. The M13 according-to-protocol (ATP) immunogenicity cohort included 83 participants. The ATP analysis of immunogenicity was performed only on the 78 subjects seropositive for ≥ 1 DENV type at baseline: 69 tetravalent, three trivalent, two bivalent, and four monovalent. In all DPIV groups, geometric mean antibody titers (GMTs) increased from D0 to D56 and waned modestly through M13, while remaining well above prevaccination levels. The 4 μg + alum and the AS01_E- and AS03_B-adjuvanted formulations were highly immunogenic, with M13-neutralizing antibody GMTs against all four DENV types above 1,000. M13/D0 GMT ratios were highest in the 1 μg + AS03_B group (ranging 3.2–3.7 depending on the DENV type). These results encourage continued clinical development of DPIV (ClinicalTrials.gov: NCT01702857).

Are We Reaching the Limits of Homo sapiens?

Echoing scientific and industrial progress, the Twentieth century was an unprecedented period of improvement for human capabilities and performances, with a significant increase in lifespan, adult height, and maximal physiological performance. Analyses of historical data show a major slow down occurring in the most recent years. This triggered large and passionate debates in the academic scene within multiple disciplines; as such an observation could be interpreted as our upper biological limits. Such a new phase of human history may be related to structural and functional limits determined by long term evolutionary constraints, and the interaction between complex systems and their environment. In this interdisciplinary approach, we call into question the validity of subsequent forecasts and projections through innovative and related biomarkers such as sport, lifespan, and height indicators. We set a theoretical framework based on biological and environmental relevance rather than using a typical single-variable forecasting approach. As demonstrated within the article, these new views will have major social, economical, and political implications.

Phase 1 Randomized Study of a Tetravalent Dengue Purified Inactivated Vaccine in Healthy Adults in the United States

The safety and immunogenicity of four formulations of an investigational tetravalent dengue purified inactivated vaccine (DPIV), formulated at 1 or 4 μg with aluminum hydroxide (alum) or at 1 μg with an adjuvant system (AS01_E or AS03_B), were evaluated in a first-time-in-human, placebo-controlled, randomized, observer-blind, phase 1 trial in the continental United States. Two doses of vaccine or placebo were administered intramuscularly 4 weeks apart to 100 healthy adults 18–39 years of age, randomized 1:1:1:1:1 to receive one of four DPIV formulations or saline placebo. The response to a third dose was evaluated in a subset of nine participants remote from primary vaccination. Humoral immunogenicity was assessed using a 50% microneutralization assay. All DPIV formulations were well tolerated. No vaccine-related serious adverse events were observed through 12 months after the second vaccine dose. In all DPIV groups, geometric mean antibody titers peaked at Day 56, waned through 6 months after the second vaccine dose, and then stabilized. In the nine subjects where boosting was evaluated, a strong anamnestic response was observed. These results support continuation of the clinical development of this dengue vaccine candidate (clinicaltrials.gov: NCT01666652).

Age-Related Changes in Locomotor Performance Reveal a Similar Pattern for Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens

Locomotion is one of the major physiological functions for most animals. Previous studies have described aging mechanisms linked to locomotor performance among different species. However, the precise dynamics of these age-related changes, and their interactions with development and senescence, are largely unknown. Here, we use the same conceptual framework to describe locomotor performances in Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens. We show that locomotion is a consistent biomarker of age-related changes, with an asymmetrical pattern throughout life, regardless of the type of effort or its duration. However, there is variation (i) among species for the same mode of locomotion, (ii) within species for different modes of locomotion, and (iii) among individuals of the same species for the same mode of locomotion. Age-related patterns are modulated by genetic (such as selective breeding) as well as environmental conditions (such as temperature). However, in all cases, the intersection of the rising developmental phase and the declining senescent phase reveals neither a sharp transition nor a plateau, but a smooth transition, emphasizing a crucial moment: the age at peak performance. This transition may define a specific target for future investigations on the dynamics of such biological interactions.