What makes an endurance athlete world-class? Not simply a physiological conundrum

Inter-individual variation in endurance performance capacity is a characteristic, not only of the general population, but also in trained athletes. The ability of sport scientists to predict which athletes amongst an elite group will become world-class is limited. We do not fully understand the interactions between biological factors, training, recovery and competitive performance. Assessment methods and interpretation of results do not take into account the facts that most research is not done on elite athletes and performances of world-class endurance athletes cannot be attributed to aerobic capacity alone. Many lines of evidence suggest that there is a limit to adaptation in aerobic capacity. Recent advances in molecular biology and genetics should be harnessed by exercise biologists in conjunction with previously used physiological, histological and biochemical techniques to study elite athletes and their responses to different training and recovery regimens. Technological advances should be harnessed to study world-class athletes to determine optimal training and competition strategies. In summary, it is likely that multiple factors are essential contributors to world-class endurance performance and that it is only by using a multidisciplinary approach that we will come closer to solving the conundrum: 'What makes an endurance athlete world class?'     

No Evidence of a Common DNA Variant Profile Specific to World Class Endurance Athletes

There are strong genetic components to cardiorespiratory fitness and its response to exercise training. It would be useful to understand the differences in the genomic profile of highly trained endurance athletes of world class caliber and sedentary controls. An international consortium (GAMES) was established in order to compare elite endurance athletes and ethnicity-matched controls in a case-control study design. Genome-wide association studies were undertaken on two cohorts of elite endurance athletes and controls (GENATHLETE and Japanese endurance runners), from which a panel of 45 promising markers was identified. These markers were tested for replication in seven additional cohorts of endurance athletes and controls: from Australia, Ethiopia, Japan, Kenya, Poland, Russia and Spain. The study is based on a total of 1520 endurance athletes (835 who took part in endurance events in World Championships and/or Olympic Games) and 2760 controls. We hypothesized that world-class athletes are likely to be characterized by an even higher concentration of endurance performance alleles and we performed separate analyses on this subsample. The meta-analysis of all available studies revealed one statistically significant marker (rs558129 at GALNTL6 locus, p = 0.0002), even after correcting for multiple testing. As shown by the low heterogeneity index (I² = 0), all eight cohorts showed the same direction of association with rs558129, even though p-values varied across the individual studies. In summary, this study did not identify a panel of genomic variants common to these elite endurance athlete groups. Since GAMES was underpowered to identify alleles with small effect sizes, some of the suggestive leads identified should be explored in expanded comparisons of world-class endurance athletes and sedentary controls and in tightly controlled exercise training studies. Such studies have the potential to illuminate the biology not only of world class endurance performance but also of compromised cardiac functions and cardiometabolic diseases.     

Neuromuscular training techniques to target deficits before return to sport after anterior cruciate ligament reconstruction

Surgical intervention and early-phase rehabilitation after anterior cruciate ligament (ACL) reconstruction have undergone a relatively rapid and global evolution over the past 25 years. Despite the advances that have significantly improved outcomes, decreases in healthcare coverage (limited visits allowed for physical therapy) have increased the role of the strength and conditioning specialist in the rehabilitation of athletes returning to sport after ACL reconstruction. In addition, there is an absence of standardized, objective criteria to accurately assess an athlete's ability to progress through the end stages of rehabilitation and safely return to sport. The purpose of this Scientific Commentary is to present an example of a progressive, end-stage return to sport protocol that is targeted to measured deficits of neuromuscular control, strength, power, and functional symmetry that are rehabilitative landmarks after ACL reconstruction. The proposed return to sport training protocol incorporates quantitative measurement tools that will provide the athlete with objective feedback and targeted goal setting. Objective feedback and targeted goal setting may aid the strength and conditioning specialist with exercise selection and progression. In addition, a rationale for exercise selection is outlined to provide the strength and conditioning specialist with a flexible decision-making approach that will aid in the modification of return to sport training to meet the individual athlete's abilities and to target objectively measured deficits. This algorithmic approach may improve the potential for athletes to return to sport after ACL reconstruction at the optimal performance level and with minimized risk of reinjury.     

Adrenal medulla and exercise training

The adrenaline release from the adrenal medulla increases during exercise, but at a given absolute work intensity the magnitude of this response is less pronounced in endurance trained vs sedentary individuals most likely due to a lower sympathetic stimulation of the adrenal medulla. However, when trained and untrained subjects are compared at identical relative work loads as well as in response to numerous non-exercise stimuli, endurance trained athletes have a higher epinephrine secretion capacity compared to sedentary individuals. This indicates a development of a so-called “sports adrenal medulla” as a result of a long term adaption of an endocrine gland to physical training. Such an adaptation is parallel to adaptations taking place in other tissues like skeletal muscle and the heart, and can be advantageous in relation to both exercise performance in the competing athlete and cause a biological rejuvenation in relation to aging. Accepted: 4 September 1997     

Status and metabolism of iron in elite sportsmen during a period of professional competition

The aim of this study was to determine the effect of both acute exercise and maintained training during a period of competition (3 mo, at the start of the season) on iron metabolism in sportsmen on a professional volleyball team. Twelve sportsmen volunteered for this study. The exercise test was performed on a mechanically braked Monark cycle ergometer and consisted of a triangular progressive test. Three blood samples were obtained in each test: at rest, just after exercise, and after recovery. The following hematological parameters were determined: red blood count (RBC), hemoglobin (Hb) and hematocrit (Hto), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), total proteins (TP), serum iron (Fe) and total iron-binding capacity (TIBC), ferritin (FER), transferrin (TRF), haptoglobin (HPT), and serum cortisol (COR) concentrations. We have found changes in hematological and biochemical variables related to Fe metabolism during the study. The changes observed could be the result of hemoconcentration processes after exercise and, at least in part, to physical stress and muscular damage. We conclude that athletes, after a period of adaptation, with a good plan of work/recovery series, undergo a biological redistribution on hematological and biochemical parameters concerning Fe metabolism during the training and competition period. Also, daily Fe supplementation could restore and mask the true repercussions of maintained training observed in other sports.     

The Functional State of Athletes Addicted to Exercises during Exercise Deprivation

The objective of this study is to identify markers of the addictive condition developing in athletes during exercise deprivation by analyzing electroencephalograms (EEGs), electromyograms (EMGs), skin temperature measurements, sympathetic nervous system activity, levels of anxiety and depression (by psychological tests). A cohort of professional football players (N = 50) voluntarily participated in the study. The athletes were tested under two test conditions: during active training sessions and during exercise deprivation (for seven days). The analyzed results have shown that the functional state of athletes with exercise addiction (due to exercise deprivation), compared with athletes showing no addictive behavior, was characterized by lower brain bioelectric activity (a decrease in the α-rhythm amplitude and power), growth in the muscular tension, increased sympathetic activity, and elevated levels of anxiety and depression. We have concluded that an athlete’s functional state during exercise deprivation is an important predictor for exercise dependence. A prolonged exercise deprivation causes intense psychophysiological changes in the body of athletes inclined to exercise addiction. The obtained results may be useful for experts in the field of sports medicine, as well as for further studies in different types of addictions.     

Hypertrophic cardiomyopathy and sudden cardiac death due to physical exercise in Croatia in a 27-year period

The paper deals with the sudden cardiac death during physical exercise in males in Croatia. The data are a part of a retrospective study dealing with 69 sudden death due to physical activity in men in Croatia during 27 years: from January 1, 1984 to December 31, 2010. Three of them suddenly died during training and two of them died during recreational physical exercise, probably because of malignant ventricular arrhythmia due to hyperthrophic cardiomyopathy. One had an obstructive form of hypertrophic cardiomyopathy with i.v. septum of 40 mm and four had a non-obstructive forms of hyperthrophic cardiomyopathy with left ventricular wall of 18-20-22-25 mm. First athlete was a short trails runner, aged 24, with no any previous physical discomforts, who suddenly collapsed and died during training. The second athlete was a soccer player aged 18, with no any previous physical discomfort, who suddenly collapsed and died during training. The third aged 15, was a school boy, basketball player, with no any previous physical discomfort, who collapsed and died during training. Two aged 25 and 34, were with no physical discomfort during exercise and died suddenly during recreational soccer games. A sudden cardiac death due to physical exercise in young athletes in Croatia suffered of hyperthropic cardiomyopathy reached 0.06/100 000 yearly (p = 0.00000) in 27 years, in teenagers 0.26/100 000 (p = 0.00226), in teenagers suffered of hypertrophic cardiomyopathy reached 0.10/100 000 (p = 0.00000), in all young athletes suffered of other heart diseases reached 0.19/100 000 (p = 0.00005), and in the total male population aged 15 or more, engaged in sports and recreational physical exercise: 0.71/100.0000 (p = 0.00001).     

Patellofemoral knee pain treatment using neuromuscular retraining of the hip musculature in an adolescent female: a case report

The purpose of this case study is to demonstrate the treatment of patella-femoral knee pain in an adolescent female athlete with emphasis on neuromuscular training of the knee and hip in synergy movement strategies. A 1.67-m, 61.5-kg, 15-year-old woman athlete reported to rehabilitation with the complaint of a 1-year history of bilateral knee pain. The patient noted that the symptoms were exacerbated with any sports-specific training. The patient played softball as an infielder. The athlete was referred by her family practice physician. After the patient was assessed, a clinical hypothesis was generated. It was thought that neuromuscular dysfunction of the hips and knees was causing faulty knee mechanics. These abnormal mechanics were presenting as patella-femoral knee pain. Initially, the athlete was assigned a home exercise program of side-lying hip abduction and lateral step-downs. At her first follow-up appointment, she noted increased symptoms that were aggravated with her home program. Upon inspecting her exercise technique, faulty step-down mechanics were contributing to her symptoms. Step-downs were discontinued, and the patient was instructed in and performed a chair squatting exercise, which was added to her home program. At her next follow-up, the patient noted being asymptomatic for 2 days. Her exercises were increased in intensity to include a Stairmaster and hip abduction and adduction on a 4-way hip machine. Eventually, over her treatment course, perturbation and proprioceptive training were initiated. By the sixth visit, the patient reported no symptoms and felt comfortable with self-management. A phone interview 3 months later indicated that the patient had no recurrent symptoms and was participating in sports without difficulty. This case demonstrates effectiveness of using hip and knee joint synergy to treat patella-femoral pain (PFP). The use of this synergy promotes proper patella–femoral alignment and improved knee mechanics. This case also is unique in the lack of physical agents and taping used to improve the patient's condition. It reinforces how exercise technique can carry over to functional athletic activities. This study provides a case for the use of hip and knee mechanical retraining in the treatment of PFP in adolescent female athletes who do not exhibit abnormal foot mechanics in weight bearing. It is important that sports medicine professionals be aware of these treatment options and are able to use them to correct these deficits in order to facilitate return to training and competition as quickly and safely as possible.     

Acute effects of verbal feedback on upper-body performance in elite athletes

Argus, CK, Gill, ND, Keogh, JWL, and Hopkins, WG. Acute effects of verbal feedback on upper-body performance in elite athletes. J Strength Cond Res 25(12): 3282-3287, 2011-Improved training quality has the potential to enhance training adaptations. Previous research suggests that receiving feedback improves single-effort maximal strength and power tasks, but whether quality of a training session with repeated efforts can be improved remains unclear. The purpose of this investigation was to determine the effects of verbal feedback on upper-body performance in a resistance training session consisting of multiple sets and repetitions in well-trained athletes. Nine elite rugby union athletes were assessed using the bench throw exercise on 4 separate occasions each separated by 7 days. Each athlete completed 2 sessions consisting of 3 sets of 4 repetitions of the bench throw with feedback provided after each repetition and 2 identical sessions where no feedback was provided after each repetition. When feedback was received, there was a small increase of 1.8% (90% confidence limits, ±2.7%) and 1.3% (±0.7%) in mean peak power and velocity when averaged over the 3 sets. When individual sets were compared, there was a tendency toward the improvements in mean peak power being greater in the second and third sets. These results indicate that providing verbal feedback produced acute improvements in upper-body power output of well-trained athletes. The benefits of feedback may be greatest in the latter sets of training and could improve training quality and result in greater long-term adaptation.     

The altered human serum metabolome induced by a marathon

Introduction

Endurance races have been associated with a substantial amount of adverse effects which could lead to chronic disease and long-term performance impairment. However, little is known about the holistic metabolic changes occurring within the serum metabolome of athletes after the completion of a marathon.

Objectives

Considering this, the aim of this study was to better characterize the acute metabolic changes induced by a marathon.

Methods

Using an untargeted two dimensional gas chromatography time-of-flight mass spectrometry metabolomics approach, pre- and post-marathon serum samples of 31 athletes were analyzed and compared to identify those metabolites varying the most after the marathon perturbation.

Results

Principle component analysis of the comparative groups indicated natural differentiation due to variation in the total metabolite profiles. Elevated concentrations of carbohydrates, fatty acids, tricarboxylic acid cycle intermediates, ketones and reduced concentrations of amino acids indicated a metabolic shift between various fuel substrate systems. Additionally, elevated odd-chain fatty acids and α-hydroxy acids indicated the utilization of α-oxidation and autophagy as alternative energy-producing mechanisms. Adaptations in gut microbe-associated markers were also observed and correlated with the metabolic flexibility of the athlete.

Conclusion

From these results it is evident that a marathon places immense strain on the energy-producing pathways of the athlete, leading to extensive protein degradation, oxidative stress, mammalian target of rapamycin complex 1 inhibition and autophagy. A better understanding of this metabolic shift could provide new insights for optimizing athletic performance, developing more efficient nutrition regimens and identify strategies to improve recovery.

     

Assessment of association of estrogen receptor-α gene polymorphism with physical activity and bone metabolism

Genetic and environmental factors have long been suspected to influence on athletic performance and bone metabolism. We have therefore investigated a population-based association study of Korean elite athletes relative to the general population with PvuII polymorphism of the ER-α gene. In addition, interactions between the ER-a genotype distribution and variation of biochemical parameters for bone metabolism during short-duration aerobic performance development were analyzed in a Korean middle-aged women population. The ER-a gene locus was found to be deviation from Hardy-Weinberg equilibrium (p<0.05), but not in the female athlete group. The most common ER-α genotype wasPp in elite athletes (44/72) and controls (74/109), with higher than expected number of heterozygotes (p<0.05). No statistically significant difference in the distribution of ER-a genotype frequency was observed between the elite athletes and control groups. In contrast, almost all biochemical markers studied here appeared to be significantly higher levels after 12-week exercise training compared with baseline in both groups of Korean women, although there was no genotype effect on the change of levels of the bone metabolic parameters. Thus, our data imply that regularly exercise training may affect bone metabolism, but the genetic marker of ER-a gene polymorphism may not be valuable indicator for the development of elite athletes and physical therapy educational program.     

Skeletal muscle adaptation to exercise: a century of progress.

Skeletal muscle physiology and biochemistry is an established field with Nobel Prize-winning scientists, dating back to the 1920s. Not until the mid to late 1960s did there appear a major focus on physiological and biochemical training adaptations in skeletal muscle. The study of adaptations to exercise training reveals a wide range of integrative approaches, from the systemic to the molecular level. Advances in our understanding of training adaptations have come in waves caused by the introduction of new experimental approaches. Research has revealed that exercise can be effective at preventing and/or treating some of the most common chronic diseases of the latter half of the 20th century. Endurance-trained muscle is more effective at clearing plasma triglyceride, glucose, and free fatty acids. However, at the present time, most of the mechanisms underlying the adaptation of human skeletal muscle to exercise still remain to be discovered. Little is known about the regulatory factors (e.g., trans-acting proteins or signaling pathways) directly modulating the expression of exercise-responsive genes. Because so many potential physiological and biochemical signals change during exercise, it will be an important challenge in the next century to move beyond "correlational studies" and to identify responsible mechanisms. Skeletal muscle metabolic adaptations may prove to be a critical component to preventing diseases such as coronary heart disease, type 2 diabetes, and obesity. Therefore, training studies have had an impact on setting the stage for a potential "preventive medicine reformation" in a society needing a return to a naturally active lifestyle of our ancestors.     

Adaptations in skeletal muscle exercise metabolism to a sustained session of heavy intermittent exercise

The purpose of this study was to investigate the hypothesis that a single, extended session of heavy exercise would be effective in inducing adaptations in energy metabolism during exercise in the absence of increases in oxidative potential. Ten healthy males [maximal aerobic power (VO(2 peak)) = 43.4 +/- 2.2 (SE) ml x kg(-1) x min(-1)] participated in a 16-h training session involving cycling for 6 min each hour at approximately 90% of maximal oxygen consumption. Measurements of metabolic changes were made on tissue extracted from the vastus lateralis during a two-stage standardized submaximal cycle protocol before (Pre) and 36-48 h after (Post) the training session. At Pre, creatine phosphate (PCr) declined (P < 0.05) by 32% from 0 to 3 min and then remained stable until 20 min of exercise at 60% VO(2 peak) before declining (P < 0.05) by a further 35% during 20 min of exercise at 75% VO(2 peak). Muscle lactate (mmol/kg dry wt) progressively increased (P < 0.05) from 4.59 +/- 0.64 at 0 min to 17.8 +/- 2.7 and 30.9 +/- 5.3 at 3 and 40 min, respectively, whereas muscle glycogen (mmol glucosyl units/kg dry wt) declined (P < 0.05) from a rest value of 360 +/- 24 to 276 +/- 31 and 178 +/- 36 at similar time points. During exercise after the training session, PCr and glycogen were not as depressed (P < 0.05), and increases in muscle lactate were blunted (P < 0.05). All of these changes occurred in the absence of increases in oxidative potential as measured by the maximal activities of citrate synthase and malate dehydrogenase. These findings are consistent with other studies, namely, that muscle metabolic adaptations to regular exercise are an early adaptive event that occurs before increases in oxidative potential.     

Dietary implications on mechanisms of sarcopenia: roles of protein,amino acids and antioxidants

Sarcopenia, the age-related loss of muscle mass and strength, is a fundamental cause of frailty, functional decline and disability. In the year 2000, $18.5 billion in health care costs were directly attributable to sarcopenia. This economic burden will increase dramatically as the elderly population grows over the next decade. The primary causes of sarcopenia include a sedentary lifestyle and malnutrition. While resistance training appears to be a promising intervention, older individuals exhibit a blunted hypertrophic response to exercise stimuli. It has been posited that this decrement in regenerative capacity may be due to the loss of postprandial anabolism as well as an increase in reactive oxygen species. As such, a combination of resistance training and nutritional interventions may be a promising candidate in combating sarcopenia. Nevertheless, the mechanisms by which the manipulation of dietary variables may improve the sarcopenic condition are not well understood. To address this gap in extant knowledge, this review will examine the effects of protein, amino acid and/or antioxidant intake on sarcopenia both at rest and following resistance training exercise.     

Effects of training on the exercise-induced changes in serum amino acids and hormones

The purpose of this study was to examine power-type athletes to determine changes in amino acid and hormone concentrations in circulating blood following 2 different high-intensity exercise sessions before and after the 5-week training period. Eleven competitive male sprinters and jumpers performed 2 different running exercise sessions: a short run session (SRS) of 3 x 4 x 60 m (intensity of 91-95%) with recoveries of 120 and 360 seconds, and a long run session (LRS) with 20-second intervals (intensity of 56-100%) with recoveries of 100 seconds to exhaustion. The concentrations of serum amino acids, hormones, and lactate were determined from the blood samples drawn after an overnight fast and 10 minutes before and after both SRS and LRS. The average blood lactate concentrations were 12.7 +/- 1.6 mmol;pdL(-1) and 16.6 +/- 1.4 mmol;pdL(-1) (p < 0.01) following SRS and LRS, respectively. The average total running time was longer (p < 0.001) following LRS (164 +/- 20 seconds) than following SRS (91 +/- 8 seconds). The fasting levels of all amino acids decreased (p = 0.024; 19.4%) after the 5-week period, whereas an increase (p = 0.007; 24.5%) was observed in the fasting concentration of testosterone (TE). The exercise sessions induced no changes in the total sum of all amino acids, but significant increases or decreases were observed in single amino acids. When the range of the relative concentration changes before and after the training period was compared, significant decreases were found in valine (p = 0.048), asparagine (p = 0.029), and taurine (p = 0.030) following SRS. There were significant increases in the absolute hormonal concentration changes following LRS with TE (p = 0.002; 30.4%), cortisol (COR; p = 0.006; 12.0%), and in the TE/COR ratio (p = 0.047; 21.0%) but not in the concentration of growth hormone (GH). The results of the study indicate that the speed and strength training period strongly decreases the fasting concentrations of amino acids in the power-trained athletes in a good anabolic state with the daily protein intake of 1.26 g;pdkg(-1) body weight. At the same time the intensive lactic exercise session induces strong decreases, especially in valine, asparagine, and taurine.     

Building a beverage for recovery from endurance activity: a review

Recovery beverages are commonly used by endurance and team-sport athletes during the time between exercise sessions. Practical recommendations on the optimal nutrient composition of these drinks and timing of their consumption are therefore needed. This article summarizes research to date on the use of recovery beverages after aerobic activities and provides the following recommendations for practitioners on the optimal formula and timing of use for endurance and team-sport athletes. Current evidence suggests that, to maximize glycogen resynthesis, athletes should consume about 1.2 g carbohydrate per kilogram body weight as glucose and sucrose immediately after exercise and each hour thereafter for 4-6 hours postexercise. Alternatively, they may consume 0.8 g·kg(-1)·h(-1) in combination with 0.4 g·kg(-1)·h(-1) amino acids or protein. Liquids provide valuable fluids for rehydration, and an ideal recovery beverage should not only contain carbohydrate and protein but also contain electrolytes, including about 0.3-0.7 g sodium·per liter fluid to help restore sodium lost through sweat. Commercial beverages with this type of nutrient composition are effective, and recent work indicates that chocolate milk may be as effective as or superior to these in promoting recovery. Research regarding the effects of specific types of amino acids and antioxidants on recovery is mixed; thus, further investigation is needed before specific recommendations about these nutrients can be made. Future studies that include women and athletes representing a variety of sports, ages, and training levels and that use consistent methodology will lead to a better understanding of the effects of postexercise intake on recovery.     

Analysis of biomechanical quantities during a squat jump: evaluation of a performance index

In this study, a procedure for evaluating the performance of an athlete in a squat jump has been developed. The athletes were divided into 2 categories according to their level of merit: elite athletes and non-elite athletes. In some of the subjects, the vertical component of acceleration during the squat jump was acquired with a uniaxial accelerometer. The acceleration-time curves obtained for each category of athletes were analyzed. Some analysis parameters suitable for establishing an athletic training level index were determined. A threshold value for this index that can be used to check gesture learning was also established, allowing the index to be used as a parameter for defining sport performance in a squat jump; thus it can also be used, during the training of an athlete, as the performance index to which reference should be made.