Excessive exercise and IPED use among sport disciplines

Background: Physical distancing under the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on lifestyles, including exercise routines. In this study, we examined the difference of tendency of addictive behaviors, such as excessive exercise and the usage of the image and performance-enhancing drug (IPED) across 12 sport disciplines Method: A large cross-sectional sample of the adult population (N= 2,295) was surveyed. The use of IPED was assessed in conjunction with psychometric measures such as the Exercise Addiction Inventory (EAI) and the Appearance Anxiety Inventory (AAI). The participants were grouped into activity group (AG) and non-activity group (NAG) according to the presence or absence of their exercise habits. The results were compared between these groups, as well as across sport disciplines. Results: The frequency of IPEDs use was higher among AG (34.6%) than NAG (14.6%). The logistic regression analysis revealed that scores equal to or above cutoff points, in both the EAI and AAI, predicted the IPED use. Regarding the differences across the various sports disciplines, those who were involved in practicing Weight Lifting and Cross-Fit were found to be more at risk of excessive exercising and more inclined to use a wide range of IPED. Conversely, those who were engaged in walking is low EAI as well as a low rate of IPED use. Conclusions: These results may indicate that excessive exercise is associated with the risk of cross-addiction with substance intake, particularly in disciplines that demand high-intensity functional training.

IDEAL IMPLEMENTATION OF THE MINIMALLY INVASIVE CERVICAL ESOPHAGECTOMY (MICE), A JAPANESE-DUTCH COLLABORATION

Background and aim: MICE is an innovative Japanese surgical technique, combining a laparoscopic transhiatal and a single port cervical mediastinal dissection in patients operated for esophageal cancer. This complex surgical techniques aims to reduce pulmonary morbidity without compromising oncological radicality by avoiding thoracic access, prevailing pleural integrity and facilitating cervical or abdominal instead of pleural drainage of mediastinal infections in case of anastomotic leakage. Potential drawbacks are an increased risk of recurrent laryngeal nerve injury and learning associated morbidity during the implementation phase. Up to date this technique is not routinely performed in European esophageal cancer patients. Methods: In order to explore the feasibility and safe implementation of the MICE procedure in Dutch esophageal cancer patients, the evidence based IDEAL-framework will be followed. This framework describes 6 stages of evolution for new surgical therapeutic interventions: Pre-clinical, First in human, Development, Exploration, Assessment and Long-term Study. Outcomes of the first two phases will be described. Results: The Pre-clinical phase consisted of on-site visits to a Japanese expert center, protocol development, prospective risk assessment, instrument collection and extensive cadaveric training on six fresh frozen human bodies. A 'virtual supervision platform' has been developed to proceed with the implementation process despite the COVID pandemic. After thorough evaluation with Dutch upper GI surgical experts and esophageal cancer patients, we have proceeded to the 'First in Human' phase. Conclusion: The IDEAL framework was used as an evidence based tool for safe implementation of the MICE procedure. We will present the results of the 'pre-clinical' and 'first in human' stage as well as the surgical technique of the MICE procedure.

Exercise addiction, body dysmorphic disorder, and use of enhancement drugs during the COVID-19 pandemic confinement period: A transcultural study

IntroductionThe Coronavirus pandemic has originated unprecedented sanitary control measures that have conditioned people’s lifestyles and habits. Little is known about the impact of such measures, especially the most restrictive, on recent and growing phenomena such as exercise addiction, use of enhancement drugs, and Body Dysmorphic Disorder (BDD).ObjectivesThe objective was to investigate the above-mentioned phenomena during COVID-19 pandemic and how they relate.MethodsThe sample consisted of 3161 participants (65% women), from Portugal (11%), Italy (41%), Spain (16%), the UK (12%), Lithuania (12%), Japan (6%), and Hungary (4%). Mean age was 35.05 (SD = 12.10). Participants responded online to the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and questions about use of enhancement drugs.Results4.3% of the participants scored above the cut-off point of the EAI, with higher values registered in the UK and Spain. Exercise addiction was higher among men. Appearance anxiety and body satisfaction problems were found in participants of all participating countries, with 15.2% scoring over the cut-off point for BDD. Higher numbers of those at risk of BDD were found in Italy, Japan, and Portugal. About 29% reported the use of fitness supplements to make them look better, with 6.4% starting a new use during the lockdown. Change in supplements use and exercise are predicted by EAI scores. Change in mental health is predicted by AAI scores.ConclusionsThis study helps to shed light on how COVID-19 lookdown induced behavioral changes and how they affect physical and mental health-related aspects in different countries.