74 research outputs found
ROLE OF EXERCISE IN STRESS MANAGEMENT
U modernom druÅ”tvu razvijenih ekonomija stres je postao jednako neizbježan kao i porez. Stres ima brojne negativne posljedice, ponajprije vezane uz mentalno zdravlje. K tome, povezan je i s mnogim k bolestima, kao i s poveÄanim mortalitetom. S druge strane, redovita tjelesna aktivnost smanjuje morbiditet i mortalitet od brojnih kroniÄnih bolesti. TakoÄer, redovita tjelesna aktivnost poveÄava kvalitetu života i osjeÄaj blagostanja. Tjelesna aktivnost i stres su obrnuto povezani, a ta je povezanost dvosmjerna. Dakle, redovita tjelesna aktivnost smanjuje osjeÄaj stresa, ali, isto tako, visoki stres poveÄava Å”ansu za neaktivan stil života. Nadalje, vježbanje je jedna od najuÄinkovitijih strategija za noÅ”enje sa stresom. I redovita tjelesna aktivnost i vježbanje uÄinkovito poveÄavaju otpornost na stres. Uz to, vježbanje smanjuje zamijeÄeni stres te ublažava njegove posljedice na mentalno zdravlje kao Å”to su depresija, anksioznost ili nesanica. PredstavljajuÄi dokaze za navedene tvrdnje, ovo predavanje Äe pokazati zbog Äega bi promicanje redovite tjelesne aktivnosti trebalo Äiniti glavni oslonac svake strategije za smanjenje stresa i prevenciju povezanih stanja i bolesti
EFFECT OF CAFFEINE ON EXERCISE
Kofein je gotovo neizbježan sastojak naÅ”e svakodnevne prehrane. Donedavno je pretjerana upotreba kofeina smatrana dopingom. Od 2004. godine kofein nije viÅ”e na listi zabranjenih sredstava MeÄunarodnog olimpijskog odbora. No, i prije te promjene interes za ergogena svojstva kofeina bio je velik. U ovom Äe se preglednom Älanku ukratko prezentirati ergogena svojstva kofeina, kao i mehanizmi koji bi im mogli biti u podlozi. Osvrnut Äemo se i na doze kofeina i tempiranje njegove primjene, ali i na moguÄe neželjene uÄinke kofeina. Na kraju, razmotrit Äe se neke etiÄke dvojbe oko uporabe kofeina u sportuCaffeine is an almost inevitable part of our daily diet. Until recently, caffeine was banned from sports. However, in 2004 caffeine was taken off the list of banned substances of the International Olympic Committee. Even before that, caffeine has been widely used as an ergogenic substance. Therefore, we will review its ergogenic benefits and underlying mechanisms. Dose and timing of ingestion will also be mentioned, as well as possible adverse affects of caffeine. Last but not least, we will address some ethical doubts about its ab(use) by athletes in order to improve performance
THE FEMALE ATHLETE TRIAD
PrepoznajuÄi pozitivne strane redovite tjelesne
aktivnosti, AmeriÄko druÅ”tvo za sportsku medicinu
(ACSM) potiÄe djevojke i žene da se ukljuÄe u razne
sportske aktivnosti radi oÄuvanja i unaprjeÄenja zdravlja.
No, 1992. godine u sportovima koje naglaŔavaju vitku
graÄu tijela prepoznat je skup meÄusobno povezanih
kliniÄkih entiteta ukljuÄujuÄi amenoreju, poremeÄaj
hranjenja i osteoporozu koji je kasnije definiran kao trijas
sportaŔica. Iako postoji puno radova na temu trijasa
sportaÅ”ica, relativno je malen broj Älanaka koji donose
rezultate u svjetlu novih stajaliŔta o pojedinim dijelovima
trijasa sportaŔica. Upravo je zato cilj ovog rada iznijeti
nove smjerniceAmeriÄkog druÅ”tva za sportsku medicinu i
MeÄunarodnog druÅ”tva za kliniÄku denzitometriju
(ISCD) kojima je revidiran pojam trijasa sportaŔica.
Trenutno poimanje trijasa sportaŔica predstavlja
meÄusobno povezane pojmove raspoložive energije,
menstruacijskog ciklusa i mineralne gustoÄe kostiju koji
se kliniÄki manifestiraju od blažih poremeÄaja do izrazito
teÅ”kih stanja kao Å”to su poremeÄaji hranjenja, amenoreja i
osteoporoza. Kao glavni pokretaÄ Trijasa smatra se
nepravilna prilagodba prehrambenih navika u ovisnosti o
trajanju i intenzitetu tjelesne aktivnosti ne samo kod
sportaŔica nego i kod osoba koje se rekreativno bave
sportom. U ovom Älanku donosimo pregled
epidemiologije, kliniÄke slike te metoda dijagnosticiranja
i moguÄnosti lijeÄenja trijasa sportaÅ”ica kao i njegovih
pojedinih komponenti. Posebno se razmatra i moguÄnost
postojanja sliÄnih poremeÄaja kod muÅ”karaca.Recognizing the positive sides of exercising on a
regular basis, the American College of Sports Medicine
(ACSM) encourages girls and women to engage in
various sport activities to preserve and improve their
health. However, in 1992 in sports that emphasize a slim
body figure, an association of symptoms including
amenorrhea, eating disorders and osteoporosis was
recognized. Later it was defined as the Female athlete
triad. Although there is a large amount of articles on this
subject, a relatively small number of articles bring results
on the new points of view of certain parts of the Female
athlete triad. That is why the goal of this article is to
introduce new guidelines from the American College of
Sports and the International Society for Clinical
Densitometry (ISCD) which changed the concept of the
Female athlete triad. The current comprehension of the
Female athlete triad is presented as related notions of
available energy, menstrual cycle and bone mineral
density which clinically manifest from mild disorders to
severe conditions such as eating disorder, amenorrhea and
osteoporosis. The main trigger of the Triad is considered
to be irregular adjustment of eating habits due to the length
and intensity of the physical activity, not only in
professional athletes but also in amateurs. In this article
we also discuss the epidemiology, clinical picture,
diagnostic methods and therapy options of the Female
athlete triad and all of its components. Finally, the
possibility that a similar association of disorders exists in
male athletes will also be discussed
Exercise-Related Cardiovascular Risks
Niska razina uobiÄajene tjelesne aktivnosti povezuje se s poviÅ”enim rizikom od mnogih kroniÄnih bolesti te poveÄanim kardiovaskularnim i opÄim mortalitetom. Stoga je redovita tjelesna aktivnost nezaobilazan dio strategija u primarnoj, ali i sekundarnoj prevenciji mnogih kroniÄnih nezaraznih bolesti. S druge strane, tjelesna aktivnost nosi i zdravstvene rizike, od kojih su najozbiljniji akutni kardiovaskularni incidenti, posebno nagla srÄana smrt. Odnos koristi i rizika tjelesne aktivnosti znaÄajno se razlikuje kod djece i mladih u odnosu na osobe starije od 35 godina. Kod osoba mlaÄih od 35 godina kardiovaskularni incidenti vezani uz vježbanje su rijetka pojava i bilježe se u 1 do 6 osoba na 100.000 ljudi godiÅ”nje. Uzrok tim alarmantnim dogaÄajima najÄeÅ”Äe je neka od kongenitalnih bolesti srca ukljuÄujuÄi razliÄite oblike kardiomiopatija, anomalije koronarnih arterija, valvularne greÅ”ke, nasljedne kanalopatije i rupturu aorte. Nakon 20. godine znaÄajno raste udio naglih smrti vezanih uz koronarnu arterijsku bolest. Ova je bolest daleko najÄeÅ”Äi uzrok naglih smrti vezanih uz vježbanje kod osoba starijih od 35 godina. U toj su dobi akutni kardiovaskularni incidenti Äesta pojava, ali je tek svaki 10. vezan uz vježbanje. Apsolutni rizik smrti
tijekom vježbanja je malen, s otprilike jednom smrti na 2.500.000 sati vježbanja. MeÄutim, rizik raste sa starenjem, a pogotovo kod osoba s prisutnim kardiovaskularnim rizicima. Relativni rizik za naglu srÄanu smrt nekoliko je puta veÄi za vrijeme žustre tjelesne aktivnosti u odnosu na mirovanje ili vrlo laganu aktivnost. Ipak, taj je rizik daleko najveÄi kod sedentarnih osoba nenaviklih na tjelesnu aktivnost, dok redovita tjelesna aktivnost ima zaÅ”titni uÄinak. TakoÄer, redovito aktivne osobe imaju mnogostruko manji
rizik za ukupnu pojavnost nagle srÄane smrti. Slijedom toga, oÄito je da dobrobiti tjelesne aktivnosti, barem kod starijih od 35 godina, daleko nadmaÅ”uju pridružene kardiovaskularne rizike te bi, stoga, tjelesnu aktivnost trebalo poticati u cjelokupnoj populaciji. DoduÅ”e, u svrhu smanjivanja kardiovaskularnih rizika vezanih uz vježbanje, prethodno sedentarne osobe koje se odluÄe na vježbanje trebaju zapoÄeti s laganim i umjerenim aktivnostima te postupno napredovati prema aktivnostima visokog intenziteta.Physical inactivity has been implicated in the development of various chronic illnesses. Furthermore, abundant evidence coming from observational studies links physical inactivity to increased cardiovascular and overall mortality. Then again, physical activity alone is accompanied by several health risks including acute cardiovascular events. Risk to benefit ratio of physical activity differs greatly in children and young adults compared to individuals over 35 years of age. The incidence of acute cardiovascular events during
exercise in children and young adults is estimated to be about 1/100,000 to 6/100,000 person-years. The majority of these events are attributable to an underlying congenital heart disease such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, coronary artery anomalies, ionchannelopathies,
valvular disease, and aortic rupture. With increasing age, coronary artery disease becomes one of the leading causes of exercise-related sudden cardiac deaths. In individuals >35 years, this disease is the principal cause of exercise-related sudden deaths. Yet, it is estimated that only about 10 % of acute coronary events occur during physical exertion. In addition, the absolute risk of sudden death during
physical activity is very small, with approximately 1 death occurring in 2,500,000 hours of exercise. The risk increases with increasing age and, to a larger extent, in individuals with cardiovascular risk factors and known cardiovascular disease. Vigorous physical activity is accompanied by substantially increased risk of sudden cardiac death compared to rest and low-activity conditions. Still, the risk is the greatest in previously sedentary individuals unaccustomed to vigorous activity and is attenuated by regular physical activity. In addition, regular physical activity is accompanied by a decreased risk of sudden death and overall mortality. Therefore, it is evident that the benefi ts of physical activity exceed the related risks, at
least in individuals >35 years, and that physical activity should be widely advocated. Finally, when starting an exercise programme, previously sedentary individuals should begin with low to moderate activities and gradually progress to more vigorous physical activity
Physical Activity in Prevention, Treatment, and Rehabilitation of Cardiovascular Diseases
SrÄanožilne bolesti vodeÄi su uzrok oboljevanja i umiranja danaÅ”njeg stanovniÅ”tva. U najznaÄajnije Äimbenike rizika na koje je moguÄe djelovati ubrajamo nepravilnu prehranu, tjelesnu neaktivnost i naviku
puÅ”enja cigareta. Tjelesna aktivnost smatra se znaÄajnim Äimbenikom, kako u primarnoj i sekundarnoj prevenciji niza kroniÄnih metaboliÄkih bolesti (debljine, hiperlipidemije, ateroskleroze, Å”eÄerne bolesti tipa 2) i s njima povezanih bolesti srca i krvnih žila (arterijska hipertenzija, koronarna bolest srca, moždani
udar), tako i u njihovom lijeÄenju i rehabilitaciji kardiovaskularnih bolesnika. Brojna istraživanja provedena tijekom zadnjih pedesetak godina govore u prilog znaÄajnog uÄinka redovite tjelesne aktivnosti na tradicionalne Äimbenike rizika za razvoj i progresiju koronarne bolesti srca, iako mehanizmi kojima tjelesna aktivnost smanjuje rizik kardiovaskularnog obolijevanja nisu u potpunosti razjaÅ”njeni. Novija istraživanja dokazuju da redovita tjelesna aktivnost smanjuje razine pokazatelja upale i Äimbenike rizika povezane s hemostazom te djeluje na endotelnu funkciju. Za zdrave odrasle osobe preporuÄuju se svakodnevni aerobni oblici aktivnosti umjerenog intenziteta u trajanju od najmanje 30 minuta ili tri puta tjedno intenzivnije aerobne aktivnosti u trajanju od najmanje 20 minuta. Aktivnost može biti i u kraÄim trajanjima od desetak minuta, ali ponavljana viÅ”e puta tijekom dana. Dodatno se preporuÄuju kratke serije vježbi miÅ”iÄne
izdržljivosti umjerenoga intenziteta koje valja provoditi dva puta tjedno. U sekundarnoj prevenciji i rehabilitaciji, tjelesna aktivnost propisuje se u skladu sa zdravstvenim statusom bolesnika, razinom
individualnog rizika i prilagoÄena je prethodno procijenjenoj funkcijskoj sposobnosti bolesnika. Od iznimne je važnosti postupno i nadzirano uvoÄenje u aerobnu aktivnost do umjerenog intenziteta prema individualnom funkcijskom kapacitetu te sigurno i redovito provoÄenje umjerene tjelesne aktivnosti.Cardiovascular diseases are the leading reasons for morbidity and mortality in todayās population. The most important modifying risk factors are bad diet habits, physical inactivity, and cigarette smoking.
Physical activity is an important risk factor in primary and secondary prevention of some chronic metabolic diseases such as obesity, hyperlipidaemias, atherosclerosis, diabetes type 2, and related cardiovascular diseases such as arterial hypertension, coronary heart disease, and stroke, and in their treatment and rehabilitation. Many studies conducted in the last half of the century show that physical activity and exercise significantly lower traditional risk factors for the development and progression of coronary heart disease,
although the mechanisms for this are not fully clear. Recent data show that regular physical activity reduces inflammatory factors and improves endothelial function. Recommendations for physical activity in healthy adults are as follows: everyday aerobic activity of moderate intensity for 30 minutes, or three times a week for at least 20 minutes. Physical activity could be done over a shorter interval lasting 10 minutes, but several times during the day. In addition, it is necessary to practice muscle strengthening exercise of moderate intensity, two times a week. In secondary prevention and rehabilitation, physical activity has to be in line with the patientās health conditions and level of individual risk, and must be adapted to individual functional ability. It is important to monitor and gradually introduce aerobic physical activity of moderate intensity, always observing individualās functional capacity. Physical activity must always be regular, safe, and moderate
Anthropometry in cardio-metabolic risk assessment
S visokom prevalencijom debljine i s njom povezanih kroniÄnih metaboliÄkih i srÄano-žilnih bolesti aktualizirana je potreba primjene jednostavnih antropometrijskih pokazatelja u procjeni prekomjerne tjelesne mase i debljine i u primarnom probiru riziÄnih skupina, najÄeÅ”Äe ITM-om odnosno indeksom tjelesne mase. On se primjenjuje u epidemioloÅ”kim istraživanjima, ali i u svakodnevnom radu u primarnoj zdravstvenoj zaÅ”titi, pri procjeni kardiovaskularnog rizika uz kliniÄku i laboratorijsku dijagnostiku, savjetovanju pravilne prehrane i praÄenju uÄinaka dijetetskih mjera u prehrani te savjetovanju tjelesne aktivnosti i vježbanja. MeÄutim, s obzirom na to da nije pokazatelj tjelesnoga sastava, u individualnoj procjeni prekomjerne mase u mnogim sluÄajevima ne zadovoljava. To se osobito odnosi na procjenu tjelesno aktivnih osoba i sportaÅ”a s dobro razvijenom nemasnom tjelesnom masom, u kojih nalazimo prekomjernu tjelesnu masu, ali bez viÅ”ka masti, kao i u osoba s normalnom tjelesnom masom i malom nemasnom masom i/ili gracilnim skeletom. Posljednjih desetljeÄa posebnu pozornost zaokuplja uloga razliÄite raspodjele tjelesne masti u razvoju kroniÄnih metaboliÄkih i srÄanožilnih bolesti. Najboljim antropometrijskim prediktorom kardiovaskularnog rizika smatra se opseg trbuha (OT). Neizravni je pokazatelj veliÄine nakupljanja visceralne masti. OT i omjer opsega struka i kukova dobri su pokazatelji distribucije tjelesne masti i kardio-metaboliÄkog rizika. Razmatra se varijabilnost i unutar skupine osoba s poveÄanim OT-om s obzirom na rizik od razvoja metaboliÄkog sindroma. Hipertrigliceridemija uz poveÄani OT smatra se prvim pokazateljem poveÄanog metaboliÄkog rizika. U radu su navedeni postupci analize tjelesnog sastava, posebno antropometrijski, koje se svrstava u skupinu jednostavnih i jeftinijih postupaka. Razvoj generaliziranih jednadžbi za procjenu gustoÄe tijela doveo je do uporabe antropometrije u analizi tjelesnog sastava u praktiÄnom radu.High prevalence of obesity, as a major public health problem, is connected with chronic cardiovascular and metabolic diseases. That is why some simple anthropometric parameters were developed to estimate overweight and obesity, and in the primary screening of risk groups. In this field, body mass index (BMI) is the most frequent parameter, both in epidemiological research and in everyday practice. It is a part of the algorithm used in the early detection of overweight and obese persons. However, BMI does not provide any data on body composition. This is why it is particularly insufficient in estimating body mass in physically active persons and in athletes who are often overweight, with a higher proportion of lean body mass but without any excess fat, as well as in those with normal weight but lower than normal lean body mass and/or gentle skeleton. Over the last few decades, attention has been especially directed to different body fat distribution in relation to chronic cardio-vascular and metabolic diseases. Waist circumference (WC) is the best anthropometric predictor of cardiovascular risk. It is considered an indirect parameter of visceral fat. WC and waist-to-hip ratio are good parameters showing body fat distribution and cardio-metabolic risk. Waist-to-height ratio is suggested by some authors to be an even better parameter of cardio-vascular risk and metabolic syndrome. Hypertriglyceridemia combined with increased WC is considered a marker of atherogenic metabolic risk. The paper also deals with procedures of body composition analysis. Anthropometric assessment of body composition analysis belongs to a group of simple and inexpensive procedures. Development of generalised equations for body density prediction introduced anthropometric methods in the analysis of body composition in everyday practice
DIETARY HABITS AND PREVALENCE OF SMOKING IN TEAM SPORTS ATHLETES
Ovo istraživanje je poduzeto s ciljem opisivanja kvalitete prehrane i zdravstvenih navika sportaÅ”a i sportaÅ”ica ekipnih sportova u Republici Hrvatskoj. Istraživanje je obuhvatilo ukupno 50 dvadesetogodiÅ”njih sportaÅ”a (27 muÅ”karaca i 23 žene) ekipnih sportova (koÅ”arka, rukomet, odbojka). Prehrambeni unosi su procijenjeni upitnikom za procjenu prehrambenih navika sastavljenim od opÄeg upitnika i upitnika frekvencija. ZnaÄajne razlike meÄu spolovima su utvrÄene kako za apsolutni unos energije (3209Ā±1075 kcal/dan kod muÅ”karaca i 2111Ā±765 kcal/dan kod žena, p<0,001), tako i za relativni unos energije (40,0Ā±12,8 vs. 32,2Ā±10,5 kcal/kg/dan, p=0,02). Kod muÅ”karaca su takoÄer utvrÄeni i veÄi relativni unosi ugljikohidrata, masti i proteina, kao i svih minerala, ali ne i vitamina. Odstupanje prehrane ispitanika od preporuka se oÄituje u preniskom unosu ugljikohidrata kod oba spola (5,0Ā±1,5 g/dan kod muÅ”karaca i 4,2Ā±1,3 g/dan kod žena) i u previsokom unosu kolesterola kod muÅ”karaca (449Ā±320 g/dan). Prevalencija puÅ”enja cigareta je izrazito visoka u oba spola. PuÅ”i 33% sportaÅ”a i Äak 39% sportaÅ”ica. S druge strane, alkohol se konzumira znatno viÅ”e meÄu sportaÅ”ima nego meÄu sportaÅ”icama (73% vs. 39%, p=0,01). Iako je prehrana ispitanih sportaÅ”a u najveÄem dijelu primjerena, potrebno je obratiti posebnu pozornost educiranju sportaÅ”a o nužnosti izbjegavanja duhanskih proizvoda i alkohola. U tome bi znaÄajnu ulogu trebali imati treneri.The purpose of this study was to assess the quality of nutrition and health related habits of team athletes in Croatia. Fifty athletes (27 males and 23 females) were recruited for the purpose of this study. Dietary intake was assessed by the food frequency questionnaire. Significant differences between genders were detected for both absolute (3209Ā±1075 kcal/day in men and 2111Ā±765 kcal/day in women, p<0,001), and relative energy intakes (40,0Ā±12,8 vs. 32,2Ā±10,5 kcal/kg/day, p=0,02). Men athletes also had higher relative intakes of carbohydrates, fat, proteins and all minerals, while vitamin intakes were not different between groups. The intake of carbohydrates was slightly lower than recommended, 5,0Ā±1,5 g/day in men and 4,2Ā±1,3 g/day in women. Also, the intake of cholesterol was high in males, 449Ā±320 g/day. The prevalence of smoking was very high, 33% in males and even 39% in females. On the other hand, there were more alcohol consumers in male than in female athletes (73% vs. 39%, p=0,01). In conclusion, although the overall nutrient intakes in our group of athletes appear to be adequate, special attention should be given to educating young athletes about the risks of alcohol and tobacco consumption. One of the leading roles in education should be given to team coaches
Exercise-Related Cardiovascular Risks
Niska razina uobiÄajene tjelesne aktivnosti povezuje se s poviÅ”enim rizikom od mnogih kroniÄnih bolesti te poveÄanim kardiovaskularnim i opÄim mortalitetom. Stoga je redovita tjelesna aktivnost nezaobilazan dio strategija u primarnoj, ali i sekundarnoj prevenciji mnogih kroniÄnih nezaraznih bolesti. S druge strane, tjelesna aktivnost nosi i zdravstvene rizike, od kojih su najozbiljniji akutni kardiovaskularni incidenti, posebno nagla srÄana smrt. Odnos koristi i rizika tjelesne aktivnosti znaÄajno se razlikuje kod djece i mladih u odnosu na osobe starije od 35 godina. Kod osoba mlaÄih od 35 godina kardiovaskularni incidenti vezani uz vježbanje su rijetka pojava i bilježe se u 1 do 6 osoba na 100.000 ljudi godiÅ”nje. Uzrok tim alarmantnim dogaÄajima najÄeÅ”Äe je neka od kongenitalnih bolesti srca ukljuÄujuÄi razliÄite oblike kardiomiopatija, anomalije koronarnih arterija, valvularne greÅ”ke, nasljedne kanalopatije i rupturu aorte. Nakon 20. godine znaÄajno raste udio naglih smrti vezanih uz koronarnu arterijsku bolest. Ova je bolest daleko najÄeÅ”Äi uzrok naglih smrti vezanih uz vježbanje kod osoba starijih od 35 godina. U toj su dobi akutni kardiovaskularni incidenti Äesta pojava, ali je tek svaki 10. vezan uz vježbanje. Apsolutni rizik smrti
tijekom vježbanja je malen, s otprilike jednom smrti na 2.500.000 sati vježbanja. MeÄutim, rizik raste sa starenjem, a pogotovo kod osoba s prisutnim kardiovaskularnim rizicima. Relativni rizik za naglu srÄanu smrt nekoliko je puta veÄi za vrijeme žustre tjelesne aktivnosti u odnosu na mirovanje ili vrlo laganu aktivnost. Ipak, taj je rizik daleko najveÄi kod sedentarnih osoba nenaviklih na tjelesnu aktivnost, dok redovita tjelesna aktivnost ima zaÅ”titni uÄinak. TakoÄer, redovito aktivne osobe imaju mnogostruko manji
rizik za ukupnu pojavnost nagle srÄane smrti. Slijedom toga, oÄito je da dobrobiti tjelesne aktivnosti, barem kod starijih od 35 godina, daleko nadmaÅ”uju pridružene kardiovaskularne rizike te bi, stoga, tjelesnu aktivnost trebalo poticati u cjelokupnoj populaciji. DoduÅ”e, u svrhu smanjivanja kardiovaskularnih rizika vezanih uz vježbanje, prethodno sedentarne osobe koje se odluÄe na vježbanje trebaju zapoÄeti s laganim i umjerenim aktivnostima te postupno napredovati prema aktivnostima visokog intenziteta.Physical inactivity has been implicated in the development of various chronic illnesses. Furthermore, abundant evidence coming from observational studies links physical inactivity to increased cardiovascular and overall mortality. Then again, physical activity alone is accompanied by several health risks including acute cardiovascular events. Risk to benefit ratio of physical activity differs greatly in children and young adults compared to individuals over 35 years of age. The incidence of acute cardiovascular events during
exercise in children and young adults is estimated to be about 1/100,000 to 6/100,000 person-years. The majority of these events are attributable to an underlying congenital heart disease such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, coronary artery anomalies, ionchannelopathies,
valvular disease, and aortic rupture. With increasing age, coronary artery disease becomes one of the leading causes of exercise-related sudden cardiac deaths. In individuals >35 years, this disease is the principal cause of exercise-related sudden deaths. Yet, it is estimated that only about 10 % of acute coronary events occur during physical exertion. In addition, the absolute risk of sudden death during
physical activity is very small, with approximately 1 death occurring in 2,500,000 hours of exercise. The risk increases with increasing age and, to a larger extent, in individuals with cardiovascular risk factors and known cardiovascular disease. Vigorous physical activity is accompanied by substantially increased risk of sudden cardiac death compared to rest and low-activity conditions. Still, the risk is the greatest in previously sedentary individuals unaccustomed to vigorous activity and is attenuated by regular physical activity. In addition, regular physical activity is accompanied by a decreased risk of sudden death and overall mortality. Therefore, it is evident that the benefi ts of physical activity exceed the related risks, at
least in individuals >35 years, and that physical activity should be widely advocated. Finally, when starting an exercise programme, previously sedentary individuals should begin with low to moderate activities and gradually progress to more vigorous physical activity
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