高原训练中运动员腹泻发生状况及肠道菌群的变化

目的:通过实地调研考察高原训练中运动员腹泻发生率,并采集运动员粪便样品,研究高原训练过程中运动员肠道菌群变化。方法:赴多巴国家高原训练基地调研在训运动员胃肠道反应,统计腹泻发生率及发生的时间特点。分别在运动员进驻高原前和高原训练过程中采集粪便样品,进行粪便常规检测、提取全基因组DNA,质检合格样品采用高通量测序的手段进行微生物多样性分析。结果:1)高原训练期间运动员腹泻发生率为46.7%,所有腹泻案例持续时间均10天,其中74.1%持续时间5天。2)腹泻案例发生主要集中在两个时间段,分别是进入高原后的第1-3天(占总腹泻案例数的35.7%)及进入高原后的第7-10天(占总腹泻案例数的46.4%),至进入高原后的第12天不再有新增腹泻案例出现。3)运动员进驻高原前后微生物多样性无显著差异。4)相较与平原时,运动员肠道菌群拟杆菌门先上升后恢复,厚壁菌门先下降后恢复。结论:1)高原训练中运动员多发腹泻,腹泻案例呈现出两个爆发高峰。2)运动员进驻高原后肠道菌群结构发生改变,表现为拟杆菌门占比上升、厚壁菌门占比下降。随着微生物多样性分析技术的普及,针对性补充有益菌保障运动员平稳度过高原习服期,有助于降低高原训练期间腹泻发生率。     

Primitive running: a survey analysis of runners' interest, participation, and implementation

Running is a sport that has continued to see growth in numbers over the years. Recently, there has been a movement promoting running barefoot and in light, "minimalist" shoes. Advocates of barefoot running believe that a more primitive style of running may result in fewer running-related injuries and even possibly improve performance. To identify the current interest level and participation in barefoot or minimalist shod running, an electronic survey was developed and dispersed to 6,082 runners. The survey instrument examined demographics, motivating factors, used resources, perceived barriers, and expectations in runners who add barefoot or in minimalist shod running to their training. Seven hundred eighty-five (13%) runners completed the survey. Six hundred and thirty (75.7%) indicated they were at least somewhat interested in running barefoot or in minimalist shoes. One hundred seventy-two (21.9%) runners had previously tried barefoot running, whereas 239 (30.4%) had previously tried minimalist shoes. The primary motivating factor for those running barefoot or in minimalist shoes (n = 283) was to prevent future injury (n = 97, 34.3%). Advice from friends (n = 68, 24.5%) or books (n = 68, 24.5%) was the most commonly used resource in transitioning to barefoot or minimalist shod running. Fear of possible injury (n = 424, 54%) was the most prevalent perceived barrier in transitioning to barefoot or minimalist shod running. An overwhelming 671 (85.5%) indicated that they were at least somewhat likely to continue with or to add barefoot or minimalist shod running if provided sufficient instruction. Runners who are men, of younger age, and who consider themselves elite runners are somewhat more likely to be interested in barefoot or minimalist shod running.     

Marathon running: physiological and chemical changes accompanying late-race functional deterioration

Twenty-one experienced runners were studied before, during and immediately after a marathon race to ascertain whether either depletion of energy substrate or rise in body temperature, or both, contribute to late-race slowing of running pace. Seven runners drank a glucose/electrolyte (GE) solution ad libitum (Na+ 21 mmol l-1, K+ 2.5 mmol l-1, Cl- 17 mmol l-1, PO4(2-) 6 mmol l-1, glucose 28 mmol l-1) throughout the race; 6 drank water and 8 drank the GE solution diluted 1:1 with water. Although average running speeds for the three groups were not significantly different during the first two-thirds (29 km) of the race, rectal temperature was significantly higher (P < 0.05) and reduction of plasma volume was greater (P < 0.05) in runners who replaced sweat losses with water. During the last one-third of the race, the average running pace of the water-replacement group slowed by 37.2%; the pace slowed by 27.9% in the 8 runners who replaced their sweat loss with GE diluted 1:1 with water (1/2 GE) and 18.2% in runners who replaced fluid loss with full-strength solution (GE). Eleven runners (5 in the water group, 4 in the 1/2 GE group and 2 in the GE group) lapsed into a walk/run/walk pace during the last 6 miles of the race. Ten of these had a rectal temperature of 39 degrees C or greater after 29 km of running, and plasma volume in these runners was reduced by more than 10%.(ABSTRACT TRUNCATED AT 250 WORDS)     

Role of brain IL-1beta on fatigue after exercise-induced muscle damage

Brain cytokines, induced by various inflammatory challenges, have been linked to sickness behaviors, including fatigue. However, the relationship between brain cytokines and fatigue after exercise is not well understood. Delayed recovery of running performance after muscle-damaging downhill running is associated with increased brain IL-1beta concentration compared with uphill running. However, there has been no systematic evaluation of the direct effect of brain IL-1beta on running performance after exercise-induced muscle damage. This study examined the specific role of brain IL-1beta on running performance (either treadmill or wheel running) after uphill and downhill running by manipulating brain IL-1beta activity via intracerebroventricular injection of either IL-1 receptor antagonist (ra; downhill runners) or IL-1beta (uphill runners). Male C57BL/6 mice were assigned to the following groups: uphill-saline, uphill-IL-1beta, downhill-saline, or downhill-IL-1ra. Mice initially ran on a motor-driven treadmill at 22 m/min and -14% or +14% grade for 150 min. After the run, at 8 h (wheel cage) or 22 h (treadmill), uphill mice received intracerebroventricular injections of IL-1beta (900 pg in 2 microl saline) or saline (2 microl), whereas downhill runners received IL-1ra (1.8 microg in 2 microl saline) or saline (2 microl). Later (2 h), running performance was measured (wheel running activity and treadmill run to fatigue). Injection of IL-1beta significantly decreased wheel running activity in uphill runners (P<0.01), whereas IL-1ra improved wheel running in downhill runners (P<0.05). Similarly, IL-1beta decreased and Il-1ra increased run time to fatigue in the uphill and downhill runners, respectively (P<0.01). These results support the hypothesis that increased brain IL-1beta plays an important role in fatigue after muscle-damaging exercise.     

Exercise Training in Transgenic Mice Is Associated with Attenuation of Early Breast Cancer Growth in a Dose-Dependent Manner

Epidemiological research suggests that regular physical activity confers beneficial effects that mediate an anti-tumor response and may reduce cancer recurrence. It is unclear what amount of physical activity is necessary to exert such a protective effect and what mechanisms are involved. We investigated the effects of voluntary wheel running on tumor progression and cytokine gene expression in the transgenic polyoma middle T oncoprotein (PyMT) mouse model of invasive breast cancer. Runners showed significantly reduced tumor sizes compared with non-runners after 3 weeks of running (p≤0.01), and the greater the running distance the smaller the tumor size (Pearson''s r = −0.61, p≤0.04, R² = 0.38). Mice running greater than 150 km per week had a significantly attenuated tumor size compared with non-runners (p≤0.05). Adipose tissue mass was inversely correlated with tumor size in runners (Pearson''s r = −0.77, p = 0.014) but not non-runners. Gene expression of CCL22, a cytokine associated with recruitment of immunosuppressive T regulatory cells, was decreased in tumors of runners compared to non-runners (p≤0.005). No differences in tumor burden or metastatic burden were observed between runners and non-runners after ten weeks of running when the study was completed. We conclude that voluntary wheel running in PyMT mice correlates with an attenuation in tumor progression early during the course of invasive breast cancer. This effect is absent in the later stages of overwhelming tumor burden even though cytokine signaling for immunosuppressive regulatory T cells was down regulated. These observations suggest that the initiation of moderate exercise training for adjunctive therapeutic benefit early in the course of invasive breast cancer should be considered for further investigation.     

Reduced Incidence of Cardiac Arrhythmias in Walkers and Runners

Purpose

Walking is purported to reduce the risk of atrial fibrillation by 48%, whereas jogging is purported to increase its risk by 53%, suggesting a strong anti-arrhythmic benefit of walking over running. The purpose of these analyses is to compare incident self-reported physician-diagnosed cardiac arrhythmia to baseline energy expenditure (metabolic equivalent hours per day, METhr/d) from walking, running and other exercise.

Methods

Proportional hazards analysis of 14,734 walkers and 32,073 runners.

Results

There were 1,060 incident cardiac arrhythmias (412 walkers, 648 runners) during 6.2 years of follow-up. The risk for incident cardiac arrhythmias declined 4.4% per baseline METhr/d walked by the walkers, or running in the runners (P = 0.0001). Specifically, the risk declined 14.2% (hazard ratio: 0.858) for 1.8 to 3.6 METhr/d, 26.5% for 3.6 to 5.4 METhr/d, and 31.7% for ≥5.4 METhr/d, relative to <1.8 METhr/d. The risk reduction per METhr/d was significantly greater for walking than running (P<0.01), but only because walkers were at 34% greater risk than runners who fell below contemporary physical activity guideline recommendations; otherwise the walkers and runners had similar risks for cardiac arrhythmias. Cardiac arrhythmias were unrelated to walking and running intensity, and unrelated to marathon participation and performance.

Conclusions

The risk for cardiac arrhythmias was similar in walkers and runners who expended comparable METhr/d during structured exercise. We found no significant risk increase for self-reported cardiac arrhythmias associated with running distance, exercise intensity, or marathon participation. Rhythm abnormalities were based on self-report, precluding definitive categorization of the nature of the rhythm disturbance. However, even if the runners’ arrhythmias include sinus bradycardia due to running itself, there was no increase in arrhythmias with greater running distance.     

Menstrual status and plasma vasopressin, renin activity, and aldosterone exercise responses

The effects of menstrual cycle phase (early follicular vs. midluteal) and menstrual status (eumenorrhea vs. amenorrhea) on plasma arginine vasopressin (AVP), renin activity (PRA), and aldosterone (ALDO) were studied before and after 40 min of submaximal running (80% maximal O2 uptake). Eumenorrheic runners were studied in the early follicular and midluteal phases determined by urinary luteinizing hormone and progesterone and plasma estradiol and progesterone assays; amenorrheic runners were studied once. Menstrual phase was associated with no significant differences in preexercise plasma AVP or PRA, but ALDO levels were significantly higher during the midluteal phase than the early follicular phase. Plasma AVP and PRA were significantly elevated at 4 min after the 40-min run in the eumenorrheic runners during both menstrual phases and returned to preexercise levels by 40 min after exercise. Plasma ALDO responses at 4 and 40 min after exercise were higher in the midluteal phase than the early follicular phase. Menstrual status was associated with no significant differences in preexercise AVP or PRA; however, ALDO levels were significantly higher in the amenorrheic runners. After exercise, responses in the amenorrheic runners were comparable with the eumenorrheic runners during the early follicular phase. Thus, submaximal exercise elicits significant increases in plasma AVP and PRA independent of menstrual phase and status. However, plasma ALDO is significantly elevated during the midluteal phase, exercise results in a greater response during this menstrual phase, and amenorrheic runners have elevated resting levels of ALDO.     

Foot strike patterns of runners at the 15-km point during an elite-level half marathon

There are various recommendations by many coaches regarding foot landing techniques in distance running that are meant to improve running performance and prevent injuries. Several studies have investigated the kinematic and kinetic differences between rearfoot strike (RFS), midfoot strike (MFS), and forefoot strike (FFS) patterns at foot landing and their effects on running efficiency on a treadmill and over ground conditions. However, little is known about the actual condition of the foot strike pattern during an actual road race at the elite level of competition. The purpose of the present study was to document actual foot strike patterns during a half marathon in which elite international level runners, including Olympians, compete. Four hundred fifteen runners were filmed by 2 120-Hz video cameras in the height of 0.15 m placed at the 15.0-km point and obtained sagittal foot landing and taking off images for 283 runners. Rearfoot strike was observed in 74.9% of all analyzed runners, MFS in 23.7%, and FFS in 1.4%. The percentage of MFS was higher in the faster runners group, when all runners were ranked and divided into 50 runner groups at the 15.0-km point of the competition. In the top 50, which included up to the 69th place runner in actual order who passed the 15-km point at 45 minutes, 53 second (this speed represents 5.45 m x s(-1), or 15 minutes, 17 seconds per 5 km), RFS, MFS, and FFS were 62.0, 36.0, and 2.0%, respectively. Contact time (CT) clearly increased for the slower runners, or the placement order increased (r = 0.71, p < or = 0.05). The CT for RFS + FFS for every 50 runners group significantly increased with increase of the placement order. The CT for RFS was significantly longer than MFS + FFS (200.0 +/- 21.3 vs. 183.0 +/- 16 millisecond). Apparent inversion (INV) of the foot at the foot strike was observed in 42% of all runners. The percentage of INV for MFS was higher than for RFS and FFS (62.5, 32.0, and 50%, respectively). The CT with INV for MFS + FFS was significantly shorter than the CT with and without INV for RFS. Furthermore, the CT with INV was significantly shorter than push-off time without INV for RFS. The findings of this study indicate that foot strike patterns are related to running speed. The percentage of RFS increases with the decreasing of the running speed; conversely, the percentage of MFS increases as the running speed increases. A shorter contact time and a higher frequency of inversion at the foot contact might contribute to higher running economy.     

Variations in running activity and enzymatic adaptations in voluntary running rats

The running behavior and biochemical markers of oxidative and glycolytic activities associated with voluntary running activity were studied in male Sprague-Dawley rats after 6 wk of training in exercise wheel cages. Twenty-four-hour recordings of running activity were used to quantify the number of individual running bouts, their duration and running speed, and the distance run per day. We then established three categories of voluntary running activity based on the mean distance run per day during the last 3 wk of training: low-activity runners averaged 2-5 km/day, medium runners 6-9 km/day, and high runners greater than 11 km/day. Each group demonstrated an intermittent, nocturnal running pattern, at relatively high intensities, with a similar mean running speed for all groups (avg approximately 45 m/min). Differences in total distance run per day were the result of variations in both the number and duration of individual running bouts. Specifically, high runners (n = 7) had 206 +/- 30 individual running bouts per 24 h, each lasting 87 +/- 7 s; medium runners (n = 7) 221 +/- 22 running bouts, lasting 47 +/- 5 s; and low runners (n = 7) 113 +/- 7 bouts, each lasting 40 +/- 7 s. Voluntary running depressed the rate of body weight gain compared with sedentary control rats, despite an increased food and water intake for all runners. Furthermore, drinking activity was temporally associated with running periods.(ABSTRACT TRUNCATED AT 250 WORDS)     

Superior performance of African runners in warm humid but not in cool environmental conditions.

The purpose of this study was to examine the running performances and associated thermoregulatory responses of African and Caucasian runners in cool and warm conditions. On two separate occasions, 12 (n = 6 African, n = 6 Caucasian) well-trained men ran on a motorized treadmill at 70% of peak treadmill running velocity for 30 min followed by an 8-km self-paced performance run (PR) in cool (15 degrees C) or warm (35 degrees C) humid (60% relative humidity) conditions. Time to complete the PR in the cool condition was not different between groups ( approximately 27 min) but was significantly longer in warm conditions for Caucasian (33.0 +/- 1.6 min) vs. African (29.7 +/- 2.3 min, P < 0.01) runners. Rectal temperatures were not different between groups but were higher during warm compared with cool conditions. During the 8-km PR, sweat rates for Africans (25.3 +/- 2.3 ml/min) were lower compared with Caucasians (32.2 +/- 4.1 ml/min; P < 0.01). Relative rates of heat production were less for Africans than Caucasians in the heat. The finding that African runners ran faster only in the heat despite similar thermoregulatory responses as Caucasian runners suggests that the larger Caucasians reduce their running speed to ensure an optimal rate of heat storage without developing dangerous hyperthermia. According to this model, the superior running performance in the heat of these African runners can be partly attributed to their smaller size and hence their capacity to run faster in the heat while storing heat at the same rate as heavier Caucasian runners.     

The effects of resistance training on endurance distance running performance among highly trained runners: a systematic review

The current perception among highly competitive endurance runners is that concurrent resistance and endurance training (CT) will improve running performance despite the limited research in this area. The purpose of this review was to search the body of scientific literature for original research addressing the effects of CT on distance running performance in highly competitive endurance runners. Specific key words (including running, strength training, performance, and endurance) were used to search relevant databases through April 2007 for literature related to CT. Original research was reviewed using the Physiotherapy Evidence Database (PEDro) scale. Five studies met inclusion criteria: highly trained runners (>or= 30 mile x wk(-1) or >or= 5 d x wk(-1)), CT intervention for a period >or= 6 weeks, performance distance between 3K and 42.2K, and a PEDro scale score >or= 5 (out of 10). Exclusion criteria were prepubertal children and elderly populations. Four of the five studies employed sport-specific, explosive resistance training, whereas one study used traditional heavy weight resistance training. Two of the five studies measured 2.9% improved performance (3K and 5K), and all five studies measured 4.6% improved running economy (RE; range = 3-8.1%). After critically reviewing the literature for the impact of CT on high-level runners, we conclude that resistance training likely has a positive effect on endurance running performance or RE. The short duration and wide range of exercises implemented are of concern, but coaches should not hesitate to implement a well-planned, periodized CT program for their endurance runners.     

Humans adjust the height of their center of mass within one step when running across camouflaged changes in ground level

In running, humans use different control strategies that are most likely influenced by environmental conditions. For example, when human runners face a change in ground level, they adapt the height of their center of mass (CoM) in preparation. In a situation in which a drop might occur but without visual cues regarding its actual height, such a preparation is not possible. We here used camouflaged drops (which occurred by chance) as mechanical disturbances and analyzed the adaptations in the vertical oscillation of the runners CoM. We found that humans lowered their CoM by about 25% of the possible drop height in preparation for the camouflaged contact, regardless of whether a drop occurred or not. In flight phase following the disturbance, the CoM was lowered by about 90% of the drop height in the case of the camouflaged drop and remained almost unaffected (+5%) in the case of level ground. Thus, runners resort to a CoM-control strategy with a fixed desired trajectory height in the flight phase following the camouflaged ground contact. In contrast to previously reported results which show that visible ground level changes were compensated within several steps, this strategy compensates ground level disturbances instantly within a single step.     

Cerebrospinal fluid immunoreactive beta-endorphin concentration is increased by voluntary exercise in the spontaneously hypertensive rat

The effect of voluntary exercise on cerebrospinal fluid (CSF) levels of immunoreactive beta-endorphin has been studied in the spontaneously hypertensive rat (SHR). The exercise consisted of 5-6 weeks of spontaneous running in wheels and the average running distance was 3.5 +/- 0.4 km/24 h. CSF samples were obtained under anaesthesia from the cisterna magna. Five experimental groups were examined, four groups of runners and one group of sedentary controls. The runners were sampled either (a) shortly (0-3 h) after termination of exercise, or after the wheel had been locked for (b) 24, (c) 48 or (d) 96 h. The runners in group a had significantly higher immunoreactive beta-endorphin levels than the controls. The levels remained increased as compared with controls after 24 and 48 h of enforced abstinence but had returned to control after 96 h. The data indicate that voluntary exercise induces adaptive changes in central beta-endorphin systems.     

Relationship between fat-to-fat-free mass ratio and decrements in leg strength after downhill running.

The purpose of this study was to determine whether greater body fat mass (FM) relative to lean mass would result in more severe muscle damage and greater decrements in leg strength after downhill running. The relationship between the FM-to-fat-free mass ratio (FM/FFM) and the strength decline resulting from downhill running (-11% grade) was investigated in 24 male runners [age 23.4 +/- 0.7 (SE) yr]. The runners were divided into two groups on the basis of FM/FFM: low fat (FM/FFM = 0.100 +/- 0.008, body mass = 68.4 +/- 1.3 kg) and normal fat (FM/FFM = 0.233 +/- 0.020, body mass = 76.5 +/- 3.3 kg, P < 0.05). Leg strength was reduced less in the low-fat (-0.7 +/- 1.3%) than in the normal-fat individuals (-10.3 +/- 1.5%) 48 h after, compared with before, downhill running (P < 0.01). Multiple linear regression analysis revealed that the decline in strength could be predicted best by FM/FFM (r2 = 0.44, P < 0.05) and FM-to-thigh lean tissue cross-sectional area ratio (r2 = 0.53, P < 0.05), with no additional variables enhancing the prediction equation. There were no differences in muscle glycogen, creatine phosphate, ATP, or total creatine 48 h after, compared with before, downhill running; however, the change in muscle glycogen after downhill running was associated with a higher FM/FFM (r = -0.56, P < 0.05). These data suggest that FM/FFM is a major determinant of losses in muscle strength after downhill running.     

Decreased intestinal polyp multiplicity is related to exercise mode and gender in ApcMin/+ mice.

Moderate-intensity treadmill running can alter male Apc(Min/+) mouse polyp formation. This purpose of this study was to examine whether exercise mode differentially affects Apc(Min/+) mouse intestinal polyp development in male and female mice. Male and female Apc(Min/+) mice were randomly assigned to control, treadmill (18 m/min; 60 min/day; 6 days/wk), or voluntary wheel running (24-h access) groups. Nine weeks of training decreased total intestinal polyps by 29% in male treadmill runners (66 +/- 9; P = 0.038) compared with male controls (93 +/- 7). The number of large polyps (>/=1-mm diameter) were also reduced by 38% in male treadmill runners (49 +/- 6; P = 0.005) compared with male controls (79 +/- 6). Treadmill running in female Apc(Min/+) mice and wheel running in both genders did not affect polyp number or size. Spleen weight decreased in male treadmill runners (91 +/- 9 mg; P = 0.011) and wheel runners (75 +/- 6 mg; P = 0.004) compared with controls (141 +/- 13 mg). Plasma IL-6 was reduced by 96% in male treadmill runners (1.2 +/- 0.6 pg/ml) and 78% in male wheel runners (6.6 +/- 3.3 pg/ml) compared with control mice (27.9 +/- 2.8 pg/ml; P < 0.05). Female mice responded similarly with an 86% decrease in plasma IL-6 with treadmill running (3.2 +/- 1.2 pg/ml) and 90% decrease with wheel running (2.9 +/- 2.0 pg/ml) compared with control mice (21.1 +/- 5.3 pg/ml; P < 0.05). The crypt depth-to-villus height ratio in the intestine, an indirect marker of intestinal inflammation, decreased by 21 (P = 0.024) and 24% (P = 0.029), respectively, in male and female treadmill runners but not wheel runners. Physical activity-induced attenuation of intestinal polyp number and size is dependent on exercise mode and differs between genders. The modulation of systemic and intestinal inflammation may also depend on exercise mode.     

复方嗜酸乳杆菌片对感染性腹泻患者胃肠道症状的影响

目的应用复方嗜酸乳杆菌片治疗感染性腹泻,观察微生态制剂对患者胃肠道症状的影响。方法选择100例感染性腹泻患者,均来自青岛大学附属中心医院,采用随机数字表法随机分为A、B组。其中A组患者(80例)单用复方嗜酸乳杆菌片(1.0g/次,3次/d,口服)治疗;B组患者(20例)单用利福昔明片(0.2g/次,4次/d,口服)治疗。两组患者均采用配对设计方法,治疗前进行胃肠道症状分级评分,包括单个症状(腹痛、腹胀、腹泻频率、大便性状)的评分和上述症状的总评分。治疗3d后门诊随访或电话随访,再次进行胃肠道症状分级评分,比较治疗前后患者的胃肠道症状评分改善情况并判断疗效以及治疗中的不良反应。结果两组患者的总有效率分别为78.75%和85.00%,差异无统计学意义(P0.05)。两组患者治疗过程中均未见不良反应。复方嗜酸乳杆菌片治疗后患者腹胀、腹泻频率、大便性状的症状评分和症状总评分较治疗前显著降低,差异有统计学意义(P0.01)。腹痛症状评分治疗前后差异无统计学意义(P0.05)。结论复方嗜酸乳杆菌片治疗感染性腹泻能达到满意的疗效,可改善患者腹胀、腹泻频率、大便性状等胃肠道症状。     

Metabolism of rats running up and down an incline

The purpose of these experiments was to determine oxygen consumption (VO2) in rats as a function of treadmill speed (10, 20, 30, 40, and 50 m . min-1) as they ran on the level and up and down a 16 degree (17.8%) incline. The slopes of the regression lines relating VO2 (ml O2 . kg-1 . min-1) to running speed (m . min-1) were linear for all three inclines. The regression slope for uphill runners (y = 1.25x + 47.7) was greater than the regression slopes for level (y = 0.88x + 41.2) (P less than 0.025) or downhill (y = 0.68x + 39.7) (P less than 0.005) runners, and the regression slope for level runners was greater than that for downhill runners (P less than 0.10). All VO2 measurements were submaximal. In conclusion, incline has a significant effect on the metabolism of rats running on a motor-driven treadmill.     

Distance Walked and Run as Improved Metrics over Time-Based Energy Estimation in Epidemiological Studies and Prevention; Evidence from Medication Use

Purpose

The guideline physical activity levels are prescribed in terms of time, frequency, and intensity (e.g., 30 minutes brisk walking, five days a week or its energy equivalence) and assume that different activities may be combined to meet targeted goals (exchangeability premise). Habitual runners and walkers may quantify exercise in terms of distance (km/day), and for them, the relationship between activity dose and health benefits may be better assessed in terms of distance rather than time. Analyses were therefore performed to test: 1) whether time-based or distance-based estimates of energy expenditure provide the best metric for relating running and walking to hypertensive, high cholesterol, and diabetes medication use (conditions known to be diminished by exercise), and 2) the exchangeability premise.

Methods

Logistic regression analyses of medication use (dependent variable) vs. metabolic equivalent hours per day (METhr/d) of running, walking and other exercise (independent variables) using cross-sectional data from the National Runners'' (17,201 male, 16,173 female) and Walkers'' Health Studies (3,434 male, 12,384 female).

Results

Estimated METhr/d of running and walking activity were 38% and 31% greater, respectively, when calculated from self-reported time than distance in men, and 43% and 37% greater in women, respectively. Percent reductions in the odds for hypertension and high cholesterol medication use per METhr/d run or per METhr/d walked were ≥2-fold greater when estimated from reported distance (km/wk) than from time (hr/wk). The per METhr/d odds reduction was significantly greater for the distance- than the time-based estimate for hypertension (runners: P<10⁻⁵ for males and P = 0.003 for females; walkers: P = 0.03 for males and P<10⁻⁴ for females), high cholesterol medication use in runners (P<10⁻⁴ for males and P = 0.02 for females) and male walkers (P = 0.01 for males and P = 0.08 for females) and for diabetes medication use in male runners (P<10⁻³).

Conclusions

Although causality between greater exercise and lower prevalence of hypertension, high cholesterol and diabetes cannot be inferred from these cross-sectional data, the results do suggest that distance-based estimates of METhr/d run or walked provide superior metrics for epidemiological analyses to their traditional time-based estimates.     

The use of ultrasound in vivo to determine acute change in the mechanical properties of bone following intense physical activity

The velocity of ultrasound was measured transcutaneously across the patella and tibia in 98 volunteers both before and after running the 26 mile Boston Marathon. Absolute sound velocities were 2.9% higher in those runners finishing before 3 h when compared to runners finishing after 3 h. Tibial velocities in males were 8.8% higher than in female runners. The mean velocity across the patella of three wheelchair racers was 28% lower than the mean combined patella velocity measured in all runners. These data suggest that 'faster' velocities are associated with bone that is better suited for high functional demands. Surprisingly, when pre- and post-race velocities were compared in each runner, there was a 1.6% increase in ultrasonic velocity across the tibia, and a 3.5% increase across the patella. An increase in ultrasonic velocity following extreme physical activity suggests that adaptive mechanisms exist in healthy bone to withstand, or possibly avoid, the microdamage which might be caused by repetitive cyclic loading.