Spirometry Measurements During an Episode of Exercise-Related Transient Abdominal Pain

Purpose: To determine whether changes in lung function are associated with exercise-related transient abdominal pain (ETAP). Methods: Twenty-eight subjects susceptible to ETAP performed a flow-volume loop before (pre) and after (post) treadmill exercise. Fourteen of the subjects developed symptoms of ETAP during the exercise and completed the flow-volume loop while the pain was present. The remaining 14 subjects reported no symptoms of ETAP. Results: Forced inspiratory vital capacity was essentially unchanged from pre to post in both groups (ETAP group –0.8% ± 5.1%, comparison group –0.9% ± 6.5%). Peak inspiratory-flow rate increased in both the ETAP group (12.4% ± 16.2%) and the comparison group (17.9% ± 16.6%), but the difference between groups (–4.6%, standardized effect size [EF] = –0.17) was trivial. Forced expiratory vital capacity decreased by approximately 4% in both groups (ETAP group –3.9% ± 3.3%, comparison group –4.0% ± 5.1%). Small differences in the mean change from pre to post between groups were recorded for peak expiratory-flow rate (–7.4%, EF = –0.28) and the forced expiratory volume in the first second of the test (–4.4%, EF = –0.44). Conclusions: ETAP does not appear to be associated with reduced inspiratory performance, suggesting that the diaphragm is not implicated directly in the etiology of ETAP. Expiratory power might be slightly reduced during an episode of ETAP, but the magnitude of this effect is unlikely to compromise exercise performance

Heart Rate Responses and Fluid Balance of Competitive Cross-Country Hang Gliding Pilots

Purpose: To evaluate the physiological challenges of competitive cross-country hang gliding. Methods: Seventeen experienced male pilots (age = 41 ± 9 y; mean ± SD) were fitted with a monitor that recorded heart rate and altitude at 0.5 Hz throughout a competitive flight. Fluid losses were evaluated by comparing pilot pre- and postflight mass. Results: The pilots’ displacement was 88.4 ± 43.7 km in 145.5 ± 49.4 min. Mean flight altitude was 1902 ± 427 m (range = 1363–2601 m) with a maximum altitude of 2925 ± 682 m (1870–3831 m). The mean in-flight heart rate of the pilots was 112 ± 11 bpm (64 ± 6% predicted HRmax). For all except one subject, heart rate was highest while launching (165 ± 12 bpm, 93 ± 7% predicted HRmax), followed by landing (154 ± 13 bpm, 87 ± 7% predicted HRmax). No statistically significant relationship was observed between heart rate during the launch and reported measures of state anxiety. Heart rate was inversely related (P \u3c .01) to altitude for all pilots except one. Fluid loss during the flight was 1.32 ± 0.70 L, which approximated 0.55 L/h, while mean in-flight fluid consumption was 0.39 ± 0.44 L. Six pilots consumed no fluid during the flight. Conclusions: Even among experienced pilots, high heart rates are more a function of state anxiety than physical work demand. Fluid losses during flight are surprisingly moderate but pilots may still benefit from attending to fluid balance

The Complete Health Improvement Program (CHIP)

Over 2,000 years ago Hippocrates asserted: Food and exercise... work together to produce health . Evidence for the wisdom of this Hippocratic council emerged throughout the 20th Century as large epidemiological studies, including the Framingham Heart Study, Nurses Health Study, EPIC (European Prospective Investigation into Cancer and Nutrition) and the Adventist Health Study, highlighted the relationship between lifestyle and disease

Combining Lifestyle Medicine and Positive Psychology to Improve Mental Health and Emotional Well-being

This article presents the evidence for a variety of lifestyle-based and non-pharmacological approaches for improving mental health and emotional well-being. The strategies presented arise from the lifestyle medicine literature as well as the complementary discipline of positive psychology, which is a branch of psychology that adopts a strengths-based approach to helping individuals to flourish

Wellbeing Education for Educators

This study examined the impact of a 10-week multimodal wellbeing intervention (The Lift Project) on pre-service teachers’ personal wellbeing and their perceptions of the value of the intervention when embedded into their course of study. Ninety-two percent of the 103 students (20.1±3.0 yrs, 29 males/74 females) indicated that the intervention positively influenced their wellbeing. Significant improvements were observed in all domains of wellbeing measured, including: perceived physical health (5.1%, p\u3c0.001), physical health behaviours (7.4%, p\u3c0.001), mental health (16.3%, p\u3c0.001), vitality (18.9%, p\u3c0.001), spirituality (4.4%, p\u3c0.01), and life satisfaction (7.1%, p\u3c0.001). Further, significant reductions were recorded in symptoms of depression (-30.6%, p\u3c0.001), anxiety (-34.9%, p\u3c0.001) and stress (-23.3%, p\u3c0.001). The pre-service teachers indicated that the intervention would equip them to support the wellbeing of their future students. The findings of the study suggest that meaningful improvements can be achieved in the wellbeing of pre-service teachers by embedding experiential studies of wellbeing into pre-service teacher education

Runner\u27s Stitch and the Thoracic Spine

The cause of the abdominal pain commonly referred to as stitch , but more accurately known as exercise related transient abdominal pain (ETAP), had until recently attracted more speculation than research. Explanations for the pain have included diaphragmatic ischaemia, (1) stress on peritoneal ligaments, (2) and irritation of the parietal peritoneum. (3) Although the exact cause of the pain remains to be elucidated, a neurogenic explanation has not appeared in the literature. We present the case of an elite runner who, after a thoracic spine trauma, developed severe and recurrent episodes of ETAP which were relieved by localised treatment. As a follow up study, we made observations on 17 other runners who often experience episodes of ETAP and found that palpation of specific facet joints could reproduce symptoms of ETAP shortly after an episode of the pain had been relieved

Exercise-Related Transient Abdominal Pain

Exercise-related transient abdominal pain (ETAP), commonly referred to as “stitch”, is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70% of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a well-localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well-trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain including: ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP, however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given its etiology remains to be fully elucidated. Commonly purported prevention strategies include: avoiding large volumes of food and beverages for at least two hours prior to exercise, especially hypertonic compounds; improving posture, especially in the thoracic region; and supporting the abdominal organs by improving core strength or wearing a supportive broad belt. Techniques for gaining relief from the pain during an episode are equivocal. This article presents a contemporary understanding of ETAP, which historically has received little research attention but over the past 15 years has been more carefully studied

The Influence of Human Support on the Effectiveness of Digital Mental Health Promotion Interventions for the General Population

Mental wellbeing amongst the general population is languishing—exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. Digital mental health promotion interventions, that improve mental health literacy and encourage adoption of evidence-informed practical strategies are essential. However, attrition and non-adherence are problematic in digital interventions. Human support is often applied as an antidote; yet, there is a paucity of randomized trials that compare different human support conditions amongst general population cohorts. Limited trials generally indicate that human support has little influence on adherence or outcomes in DMHPIs. However, providing participants autonomy to self-select automated support options may enhance motivation and adherence

Don\u27t Forget the Brain: Lifestyle Medicine in the Century of Neurodegeneration

Neurology is often not discussed in lifestyle medicine circles, but it might be an area that will propel the cause of lifestyle medicine in the future. This is especially relevant in increasingly common neurodegenerative conditions such as Alzheimer’s disease, which have no known disease modifying therapy but lifestyle factors are implicated in causation

Acceptability of a School-Based Incentivised Physical Activity Intervention: The B-Active Program

The purpose of this study was to examine the acceptability to students, parents and teachers of a school-based intervention that incentivised students using prizes to be more physically active (the B-Active program). Three hundred and eighty-five children (54% boys, 46% girls) in Years 3 – 6 from five schools participated in the study. Six parents and three teachers were also interviewed about their perception of the B-Active program. Overall, the students enjoyed the B-Active program but the level of acceptability was lower for the parents and teachers. This study indicates that to increase acceptability, parents need to be well informed and engaged and teachers need to be well supported so as to not add to their administrative responsibilities