Kehakultuuriteaduskonna lõpetanute suremus Eestis 1983–2010

Eesmärk. Hinnata kehakultuuriteaduskonna lõpetanute suhtelist surmariski võrreldes Eesti kogurahvastikuga 1983–2010. Metoodika. Kohorti kuulus 2418 meest ja 2370 naist, kes lõpetasid ajavahemikul 1960–2007 Tallinna Ülikooli terviseteaduste ja spordi instituudi või 1948–2007 Tartu Ülikooli kehakultuuriteaduskonna. Iga isiku jälgimine algas ülikooli lõpetamise hetkest või 01.01.1983, kui ülikool lõpetati enne 1983. aastat. Isikuid jälgiti kas surmani, emigreerumiseni või 31.12.2010, sõltuvalt sellest, mis esines kõige varem. Emigreerumise fakt ja kuupäev tehti kindlaks linkimisel rahvastikuregistriga, surmapõhjused ja -kuupäev saadi surmapõhjuste registrist. Surmariski kohordis mõõdeti standarditud suremusmääraga (SMR). Tulemused. Kehakultuuriteaduskonna lõpetanud meestel registreeriti 305 ja naistel 132 surmajuhtu. Nii meeste kui ka naiste üldsuremus oli madalam vastavalt kogu mees- või naisrahvastiku suremusest (SMR = 0,42; 95% uv 0,37–0,46 meestel ja SMR = 0,55; 95% uv 0,45–0,64 naistel). Meestel ja naistel ilmnes madalam surmarisk vereringeelundite haiguste ja välispõhjuste korral. Lisaks täheldati meestel madalamat surmariski hingamiselundite haiguste ja pahaloomuliste kasvajate puhul ning madalamat valitud alkoholisõltuvatest põhjustest tingitud surmariski. Ühegi vaadeldud surmapõhjuse osas ei esinenud uuritutel kõrgemat suremust võrreldes kogurahvastikuga. Järeldused. Kehakultuuriteaduskonna lõpetanud mehi ja naisi iseloomustab madalam suremus võrreldes kogurahvastikuga. Eesti Arst 2013; 92(8):444–45

Relationships between Physical Activity and Musculoskeletal Disorders in Former Athletes

The purpose of the study was to determine the prevalence and risks for musculoskeletal disorders (MSD) in relation to previous athletic status and current physical activity level in former athletes. Main anthropometric data, sports history, current physical activity and MSD were estimated using a questionnaire in 219 (148 males, 71 females) former athletes (35–75 years old) and 79 controls (33 males, 46 females). According to the previous participation in top-level sports, former athletes were divided into three groups: a) endurance, n=120 (76 males, 44 females); b) speed-power, n=57 (43 males, 14 females); c) team sports, n=42 (29 males, 13 females). The most prevalent MSD among the male and female ex-athletes were back and knee pain. The endurance ex-athletes group (both males and females) had significantly higher risk for the knee problems than the control group (Odds ratio – OR 5.9, 95% CI 1.7–20.00, p<0.05). Team sports athletes (males and females) showed significantly higher risk for Achilles’ tendon injuries (OR 3.19 95% CI 1.19–8.5, p<0.05) as compared to controls. Back pain did not show any significant associations with previous physical activity and current physical activity level. Current physical activity was significantly associated with a lower risk for the knee and hip pain. Body mass index was positively associated with knee problems. In conclusion, our study results revealed that previous participation in enduranve sports events is associated with a significantly higher risk for knee problems. At the same time current regular physical exercise 6–11 times per month is associated with a lower prevalence of knee and hip problems as compared to those who exercised less than 6 times per month

Профилактическое обследование состояния здоровья молодых спортсменов в Эстонии

Aim of the present paper is to give an overview of periodic health evaluation (PHE) and of health conditions and diseases found in PHE of young athletes. The electronic medical record of Tartu University Hospital was searched to retrieve primary diagnoses of medical conditions and diseases as an outcome of PHE performed in Sports Medicine and Rehabilitation Clinic during 01.01 – 31.12.2014. The data of young (9-19 years) athletes (n=3479) were included. The primary diagnoses of health conditions and diseases were established in 24.9% (n=856) of evaluated young athletes as an outcome of PHE. The most frequent were diagnoses of the musculoskeletal system (44%) followed by the cardiovascular system (22%). Injuries were most frequently detected among diagnoses concerning the musculoskeletal system – in 53 % of all musculoskeletal system diagnoses, of which overuse injuries were the most frequent. PHE is a valuable tool in the management of athletes’ health, which permits the detection of health conditions that could be predisposing factors for the development of injuries or diseases in the future. The discovery of underlying silent diseases enhances the promotion of athletes’ health, timely treatment and risk assessment. The high incidence of overuse njuries among young athletes raises many concerns and prompts further study.Целью данного исследования было дать обзор используемой методики профилактического обследования здоровья (ПОЗ) молодых спортсменов и выявленных при проведении ПОЗ отклонений от состояния здоровья и заболеваний. Первичные диагнозы cocmoяний здоровья и заболеваний, выявленных при проведении ПОЗ в клинике спортивной медицины и восстановительной терапии в период 01.01 – 31.12.2014, были изъяты из электронной истории болезни Клиникума Тартуского Университета. В анализ включили данные молодых спортсменов в возрасте 9–19 лет (n=3479). У 24.9% (n=856) молодых спортсменов были диагностированы различные отклонения здоровья и заболевания. Самыми частыми были диагнозы, связанные с опорно-двигательным аппаратом (44%). Затем следуют заболевания и отклонения кардиоваскулярной системы (22%). Среди заболеваний опорно-двигательного аппарата больше всего было выявлено диагнозов, связанных с повреждениями – 53% всех диагнозов опорно-двигательной системы. Причём самыми частыми являлись повреждения, вызванные перегрузкой или перенапряжением.ПОЗ молодых спортсменов является неоценимым средством в определении состояния здоровья в разные периоды тренировочного процесса и помогает выявлять пограничные состояния, являющиеся факторами риска разных повреждений и заболеваний. Регулярное обследование спортсменов позволяет обнаруживать заболевания и повреждения, планировать их своевременное лечение. Выявленная высокая частота повреждений, связанных с перегрузкой или перенапряжением опорно-двигательного аппарата у молодых спортсменов, вызывает озабоченность и требует направления на последующие исследования с целью выяснения их причин

Impact of sodium citrate ingestion during recovery after strenuous exercise in the heat on heart rate variability: A randomized, crossover study

Changes in hydration status influence plasma volume (PV) which is associated with post-exercise parasympathetic reactivation. The present study hypothesized that, after dehydrating cycling exercise in the heat (DE), stimulation of PV expansion with sodium citrate (CIT) supplementation would promote heart rate variability (HRV) recovery in endurance-trained men. Twelve participants lost 4% of body mass during DE. During subsequent 16-h recovery, participants consumed water ad libitum (CIT =5.5-L, PLC =5.1-L) and ate prescribed food supplemented with CIT or placebo in a randomized, double-blind, crossover manner. Relative changes in PV were assessed across DE and 16-h recovery. HRV was analyzed before and 16 h after DE in three conditions for altogether four 5-min periods: supine in a thermoneutral environment, supine in the heat (32°C, 46% relative humidity; 2 periods), and standing in the heat. A larger expansion of PV across 16-h recovery occurred in CIT compared to placebo trial (p 0.05). Increases in HR (p < 0.001) and lnLF/HF (p = 0.005) and decreases in lnRMSSD (p < 0.001) and lnSDNN (p < 0.001) occurred following DE in both trials. Larger PV expansion induced by CIT supplementation after DE does not improve recovery of HRV at rest and has no influence on HRV responsiveness in endurance-trained men

Effects of vitamin D supplementation in vitamin D deficient men involved in resistance training

Introduction. The prevalence of vitamin D (Vit-D) deficiency is high worldwide, especially in countries located at north and south latitudes above approximately 35 degrees. Vit-D supplementation has been shown to increase muscle strength in young adults. However, it remains unclear if Vit-D supplementation enhances the efficacy of resistance training (RT). The data regarding the impact of Vit-D supplementation on cardiorespiratory fitness in subjects with varying Vit-D status are controversial and there is lack of knowledge on the potential additive effect of Vit-D supplementation on anti-inflammatory responses to RT in Vit-D deficient young men. Aim. The aim of the study was to test two hypotheses. First, we hypothesised that Vit-D supplementation would enhance the RT-induced increases in muscle strength and lean body mass (LBM) in Vit-D deficient young men. Our second hypothesis was that Vit-D supplementation would have a positive effect on cardiorespiratory fitness (measured as maximal rate of oxygen consumption; VO2max) and potentiate anti-inflammatory effect of RT. Our hypotheses assume that these effects of Vit-D supplementation, if present, are more likely to occur in subjects with Vit-D deficiency than in individuals with normal Vit-D status. Material and methods. Thirty-nine young healthy men (baseline serum 25(OH)D<50 nmol/L) were quasi-randomly assigned to one of two groups that performed a 12-week supervised RT program concomitant with either Vit-D (8000 IU daily; VD) or placebo (PLC) supplementation. The RT program consisted of 7 exercises which were carried out on RT equipment. Energy and nutrient intake of the participants were monitored during the 2 nd, 6th and 11th week of RT. A graded maximal exercise test on a motorized treadmill was used to determine VO2max before and after the 12-week RT program. Results. During the 12-week RT, energy and nutrient (except Vit-D) intake and training loads did not differ in the two groups. Serum 25(OH)D levels increased from 36.3±9.2 to 142.4±21.9 nmol/L (P0.05) in PLC group. Muscle strength (1-repetition maximum) increased (P<0.05) to an equal extent in the two groups in 5 exercises performed on RT equipment whereas strength gains in chest press and seated row were greater (P<0.05) in PLC compared to VD group. Total and regional LBM (measured by DXA scan) increased (P<0.05) equally in the two groups. Android fat mass decreased (P<0.05) in VD group only. Baseline VO2max did not differ in the two groups (50.2±4.8 and 49.7±5.5 mL/kg/min in VD and PLC, respectively; p>0.05) and remained unchanged during the intervention. Serum interleukin-10/tumor necrosis factor alpha ratio, an indicator of chronic low-grade inflammation, increased significantly (30%, p=0.007; effect size 0.399) in VD but not in PLC group. Conclusions. In young healthy Vit-D deficient men participating in 12-week supervised RT, daily Vit-D supplementation of 8000 IU rapidly (within 4 weeks) eliminates Vit-D deficiency and improves inflammatory status. However, it does not enhance RT-induced muscle strength or LBM gains, does not increase total or regional fat mass reductions, and has no impact on cardiorespiratory fitness

Raamatu tutvustus. Professor Jaak Maaroos – elupäästja

Eesti Arst 2022; 101(8):45

RED BLOOD CELL AND WHOLE BLOOD GLUTATHIONE REDOX STATUS IN ENDURANCE-TRAINED MEN FOLLOWING A SKI MARATHON

The aim of the present study was to evaluate the changes in glutathione redox ratio (GSSG·GSH-1) in red blood cells (RBCs) and whole blood in well-trained men following a ski marathon. 16 male subjects (27.0 ± 4.7 yrs, 1.81 ± 0.06 m, 77.6 ± 9.6 kg, VO2max 66.2 ± 5.7 ml·kg-1·min-1) were examined before the competition (pre- COMP), after the competition (post-COMP) and during an 18-hour recovery period (RECOV). There was a slight decrease in reduced glutathione (GSH) in blood and in RBCs in post-COMP. During RECOV, the GSH level in blood was reduced, the GSH level in RBCs was significantly elevated (a statistically significant difference as compared to the pre-COMP level). The post-COMP GSSG·GSH-1 in full blood did not increase significantly, but its increase was statistically significant during the 18-hour recovery period. During the post-COMP and RECOV, the GSSG·GSH-1 in RBCs slightly decreased in comparison with the pre-COMP. Vitamin C concentration in serum increased in post-COMP (49% vs. pre- COMP) and decreased to the baseline level during RECOV. In conclusion, our data show that acute exercise slightly increases the GSSG·GSH-1 in whole blood, while GSSG·GSH-1 in RBCs significantly decreases. Thus, exercise-related changes in the non-enzymatic components of the glutathione system (GSSG and GSH) in whole blood and RBCs are not identica

Influence of Sodium Citrate Supplementation after Dehydrating Exercise on Responses of Stress Hormones to Subsequent Endurance Cycling Time-Trial in the Heat

Background and objectives: In temperate environments, acute orally induced metabolic alkalosis alleviates exercise stress, as reflected in attenuated stress hormone responses to relatively short-duration exercise bouts. However, it is unknown whether the same phenomenon occurs during prolonged exercise in the heat. This study was undertaken with aim to test the hypothesis that ingestion of an alkalizing substance (sodium citrate; CIT) after dehydrating exercise would decrease blood levels of stress hormones during subsequent 40 km cycling time-trial (TT) in the heat. Materials and Methods: Male non-heat-acclimated athletes (n = 20) lost 4% of body mass by exercising in the heat. Then, during a 16 h recovery period prior to TT in a warm environment (32 &#176;C), participants ate the prescribed food and ingested CIT (600 mg&#183;kg&#8722;1) or placebo (PLC) in a double-blind, randomized, crossover manner with 7 days between the two trials. Blood aldosterone, cortisol, prolactin and growth hormone concentrations were measured before and after TT. Results: Total work performed during TT was similar in the two trials (p = 0.716). In CIT compared to PLC trial, lower levels of aldosterone occurred before (72%) and after (39%) TT (p ˂ 0.001), and acute response of aldosterone to TT was blunted (29%, p ˂ 0.001). Lower cortisol levels in CIT than in PLC trial occurred before (13%, p = 0.039) and after TT (14%, p = 0.001), but there were no between-trial differences in the acute responses of cortisol, prolactin or growth hormone to TT, or in concentrations of prolactin and growth hormone before or after TT (in all cases p &gt; 0.05). Conclusions: Reduced aldosterone and cortisol levels after TT and blunted acute response of aldosterone to TT indicate that CIT ingestion during recovery after dehydrating exercise may alleviate stress during the next hard endurance cycling bout in the heat

Pre-Practice Hydration Status in Soccer (Football) Players in a Cool Environment

Background and Objectives: Only a few studies have reported the pre-practice hydration status in soccer players (SPs) who train in a cool climate. The primary purpose of this study was to examine the hydration status of male semiprofessional SPs immediately before their regular training session in winter. The secondary purpose was to compare the urinary indices of the hydration status of Estonian and Latvian SPs. Materials and Methods: Pre-training urine samples were collected from 40 Estonian (age 22.1 &#177; 3.4 years, soccer training experience 13.7 &#177; 3.9 years) and 41 Latvian (age 20.8 &#177; 3.4 years, soccer training experience 13.3 &#177; 3.0 years) SPs and analyzed for urine specific gravity (USG). The average outdoor temperature during the sample collection period (January&#8315;March) was between &#8722;5.1 &#176;C and 0.2 &#176;C (Estonia) and &#8722;1.9 &#176;C and &#8722;5.0 &#176;C (Latvia). Results: The average pre-training USG of Estonian and Latvian SPs did not differ (P = 0.464). Pooling the data of Estonian and Latvian SPs yielded a mean USG value of 1.021 &#177; 0.007. Hypohydration (defined as a USG &#8805; 1.020) was evident altogether in fifty SPs (61.7%) and one of them had a USG value greater than 1.030. Conclusions: Estonian and Latvian SPs do not differ in respect of USG and the prevalence of pre-training hypohydration is high in this athletic cohort. These findings suggest that SPs as well as their coaches, athletic trainers, and sports physicians should be better educated to recognize the importance of maintaining euhydration during the daily training routine in wintertime and to apply appropriate measures to avoid hypohydration