Performance and blood monitoring in sports: the artificial intelligence evoking target testing in antidoping (AR.I.E.T.T.A.) project.

AIM: Substances and methods used to increase oxygen blood transport and physical performance can be detected in the blood, but the screening of the athletes to be tested remains a critical issue for the International Federations. This project, AR.I.E.T.T.A., aimed to develop a software capable of analysing athletes' hematological and performance profiles to detect abnormal patterns. METHODS: One-hundred eighty athletes belonging to the International Biathlon Union gave written informed consent to have their hematological data, previously collected according to anti-doping rules, used to develop the AR.I.E.T.T.A. software. RESULTS: Software was developed with the included sections: 1) log-in; 2) data-entry: where data are loaded, stored and grouped; 3) analysis: where data are analysed, validated scores are calculated, and parameters are simultaneously displayed as statistics, tables and graphs, and individual or subpopulation profiles; 4) screening: where an immediate evaluation of the risk score of the present sample and/or the athlete under study is obtained. The sample risk score or AR.I.E.T.T.A. score is calculated by a simple computational system combining different parameters (absolute values and intra-individual variations) considered concurrently. The AR.I.E.T.T.A. score is obtained by the sum of the deviation units derived from each parameter, considering the shift of the present value from the reference values, based on the number of standard deviations. CONCLUSION: AR.I.E.T.T.A. enables a quick evaluation of blood results assisting surveillance programs and perform timely target testing controls on athletes by the International Federations. Future studies aiming to validate the AR.I.E.T.T.A. score and improve the diagnostic accuracy will improve the system.

Cardiorespiratory fitness in aging men and women: the DR's EXTRA study.

The aim of the study was to describe the levels and to create reference values of cardiorespiratory fitness, expressed as maximal oxygen consumption (VO(2max) ), maximal metabolic equivalents (METs) and maximal workload in aging men and women. We measured VO(2max) directly by a breath-by-breath method during a maximal exercise stress test on a bicycle ergometer with a linear workload increase of 20 W/min in a representative population sample of 672 men and 677 women aged 57-78 years. We presented the age and sex-specific categories of cardiorespiratory fitness (very low, low, medium, high and very high) based on variable distribution and non-linear regression models of VO(2max) , maximal METs and maximal workload. The linear age-related decrement of VO(2max) was -0.047 L/min/year (-2.3%) and -0.404 mL/kg/min/year (-1.6%) in men and -0.027 L/min/year (-1.9%) and -0.328 mL/kg/min/year (-1.6%) in women. After exclusion of diseased individuals, the rate of VO(2max) decrement remained similar. The number of chronic diseases (0, 1, 2 or ≥3) was inversely associated with VO(2max) in men (P<0.001) and women (P<0.001). The present study provides clinically useful reference values of cardiorespiratory fitness for primary and secondary prevention purposes in aging people.

Blood parameters and biathlon performance.

AIM: Biathlon is a sport that combines cross-country skiing with rifle shooting. There is no well-described model of performance in this multi-sport event. This study aimed to identify the parameters influencing biathlon performance. In addition, the study aimed to search for a relationship between performance and measured blood parameters and to determine whether higher hemoglobin concentration [Hb] was associated with improved performance. METHODS: Eighty-three male biathletes underwent pre-competition blood sampling in selected World Cup competitions. For all athletes (N=83) and for a subgroup of top-athletes (N=37), performance parameters identified were related to final standings by univariate and multiple regression analyses and, subsequently, to blood parameters measured on the same day. In athletes tested twice with different [Hb], performance corresponding to competitions with lower and higher [Hb] was compared. RESULTS: Among the parameters considered, the percent variation for both groups in best skiing time and percent of missed targets were independent determinants of performance (R2=0.853, 0.834, respectively) and were not correlated to blood parameters. In athletes with two samples, despite significantly different (Hb), no corresponding changes in performance were observed. CONCLUSIONS: In this study, the determinants of biathlon performance were identified. A relationship between measured blood parameters was not found, and the individual (Hb) variations observed were not associated with improved performance.

Blood tests and fair competition: the biathlon experience.

In recent years, some international sports federations have introduced blood testing procedures that can lead to suspension from competition for athletes whose haematologic values exceed certain established limits. In 1994 the International Biathlon Union initiated a three-phase blood testing program to safeguard athletes' health and ensure fair competition. The first phase, lasting three years, was aimed at measuring the haematocrit values of biathletes in order to determine statistically acceptable limits for participation in competition. The second phase, lasting four years, consisted of pre-race testing for an increasing number of athletes and suspension from competition for those whose haematocrit values exceeded 52 % for males and 48 % for females. The results of this second phase (third phase now in progress) are reported. Progressive increases have been made in the numbers of countries examined, athletes tested, and tests performed. This retrospective study reveals a reassuring trend in average values for haematocrit and haemoglobin in the entire study population, a minimal number of athletes with excessive values and a consequent low risk of false positive results, an acceptable incidence of relatively high values (50 % for males and 45 % for females), and constant non-elevated haematological profiles for elite athletes. The variability in individual haematocrit levels among all biathletes with a minimum of four observations during the four-year period is also evaluated and discussed.

Competition load and stress in sports: a preliminary study in biathlon.

International sports calendars are being increasingly filled with competitive events and fatiguing travel, at the risk of overloading the athletes involved. The Medical Committee of the International Biathlon Union, in order to check for any significant changes, analysed seven recent competitive seasons, calculating the number of races and total and daily numbers of racing kilometers for each season. A theoretical model for stress was subsequently developed, based on identification and quantification of favourable and unfavourable factors, with establishment of average and maximal stress scores for each season. A questionnaire was distributed to athletes to collect data about daily stress levels, and the correspondence between the theoretical model and the athletes' responses was determined. This analysis demonstrates that the biathlon has become more demanding for those athletes in the racing circuit, with significant increases in number of races, total and daily numbers of kilometers raced, and average stress scores for athletes of both sexes. The self-reported daily stress levels for some athletes show an interesting correspondence with the theoretical stress model. If such correspondence is confirmed, this model might constitute an instrument with which international sports federations, considering the concentration of races, related travel and recovery times, could plan sustainable competitive calendars.

Adherence to the salt restriction diet among people with mildly elevated blood pressure.

OBJECTIVE: The aim of the study was to examine the adherence to a salt restriction diet and the effect of salt restriction on blood pressure in free living subjects with mildly elevated blood pressure. DESIGN: Subjects with mildly elevated blood pressure participated in a controlled study on the effect of salt restriction on blood pressure. Subjects received oral and written instructions by a clinical nutritionist to reduce sodium chloride intake to five grams per day. A low sodium bread (0.5%) was supplied free of charge for the subjects during the whole low-sodium period (between weeks 4-24). SUBJECTS AND METHODS: Subjects were recruited from previous studies at the Kuopio Research Institute of Exercise Medicine and from local occupational health care services. Twenty-four men and 15 women aged 28-65 y with the mean daytime ambulatory diastolic blood pressure between 90-105 mmHg and office diastolic blood pressure between 95-115 mmHg were included in the study. Salt intake was monitored by 4-d food diaries and 24-h urinary sodium excretion. RESULTS: Twenty percent of the subjects achieved a urinary sodium excretion level of less than 74 mmol/24 h corresponding to a salt intake of five grams per day. There was a significant decline (7.1+/-12.7/4.2+/-7.5) in systolic and diastolic blood pressure levels during the salt restriction diet. CONCLUSIONS: Even moderate salt restriction seems to be effective in the treatment of mildly elevated blood pressure. However, the recommended salt intake level of less than five grams per day is difficult to achieve even after intensive counselling and regular use of low salt bread.

Does plasma L-arginine level play a role in regulation of blood pressure during exercise and autonomic nervous function?

Little is known of L-arginine's role in autonomic nervous regulation and physiological responses to dynamic exercise. We assessed heart rate and blood pressure during a maximal bicycle ergometer test and heart rate variability at rest in 15 healthy male volunteers, age 22-38 years. Venous blood samples for plasma L-arginine measurements were taken when subjects were sitting at rest before and at the end of exercise. The autonomic nervous function was assessed with time and frequency domain analysis of heart rate variability. Plasma L-arginine level decreased during maximal exercise from 71.4 mumol l-1 to 51.0 mumol l-1 (P < 0.0001) for all subjects studied. The systolic blood pressure during the maximal exercise test was inversely correlated with plasma L-arginine level at rest (r = -0.70, P < 0.01). Normalized low frequency band of power spectral analysis of heart rate variability correlated with L-arginine level at rest (r = 0.66, P < 0.01). In conclusion, plasma L-arginine level decreased in physical exercise, and plasma L-arginine level at rest was positively associated with the sympathetic component of power spectral analysis of heart rate variability at rest, and inversely with systolic blood pressure during physical exercise.

Effects of moderate salt restriction alone and in combination with cilazapril on office and ambulatory blood pressure.

The purpose of the present study was to examine the effects of salt-restriction alone and in combination with an angiotensin-converting enzyme (ACE) inhibitor (cilazapril) on both office and ambulatory blood pressure (BP) levels in free living subjects with elevated BP. The study was carried out in an out-patient setting with subjects recruited from occupational health care system mainly. After exclusions, 39 subjects (24 men, 15 women, aged 28-65 years) with mildly to moderately elevated BP completed the study. After 3 months run-in period with placebo (first month on normal-salt and the next 2 months on sodium-restricted diet) the subjects were randomised into either salt-restriction placebo or salt-restriction cilazapril (2.5 mg daily) groups for 3 months. In the whole group, 24-h urinary sodium excretion decreased (mean +/- s.d.) from 198 +/- 60 to 112 +/- 59 mmol (4 weeks vs 24 weeks, P < 0.001). Systolic and diastolic office BP decreased during the placebo-sodium-restriction phase (-7.1 [95% Cl -11.2; -3.0] and -4.2 [95% Cl -6.6; -1.8] mm Hg for systolic and diastolic BP), and similarly the daytime ambulatory BP (ABP) was reduced during this period (-2.8 [95% Cl -5.2; -0.5] and -2.8 [95% Cl -4.5; -1.2] mm Hg, systolic (SBP) and diastolic blood pressure (DBP) respectively). No changes were observed in the night time ABP. Addition of cilazapril to sodium-restriction enhanced significantly the office BP (-13.2, [95% Cl -20.2; -6.2], and -9.1 [95% Cl -13.5; -4.7]) and daytime ABP (-5.9, [95% Cl -10.1; -1.8] and -5.3, [95% Cl -8.8; -1.9]) reduction. Blood glucose, plasma insulin or serum lipids did not change during the study. Moderate sodium restriction seems to lower the office and daytime ABP levels in subjects with mild-to-moderate hypertension. The antihypertensive effect of cilazapril could be enhanced by sodium restriction.

Athletic heart: a metabolic, anatomical, and functional study.

Previous studies have suggested a reduced glucose uptake by the athlete's heart at rest. To examine whether there is a compensatory increase in the myocardial fatty acid utilization, we studied nine male endurance-trained athletes (age 26 +/- 2 yr, VO2max 60 +/- 1 ml.kg-1.min-1, mean +/- SEM) and eight sedentary subjects (age 26 +/- 1 yr, VO2max 38 +/- 2 ml.kg-1.min-1) by single photon emission tomography using 123I-heptadecanoic acid (HDA) and mathematical modeling. Magnetic resonance imaging (MRI) and echocardiography were performed for the measurements of cardiac dimensions and left ventricular (LV) mass. No significant differences were found in the myocardial HDA beta-oxidation index (5.2 +/- 2.0 vs 7.4 +/- 1.6 mumol.min-1.100 g-1, P = NS) between endurance-trained and sedentary subjects. Fractional amounts of HDA beta-oxidation, backdiffusion, and esterification were also similar. In MRI study, LV mass was greater in the trained subjects (213 +/- 9 vs 179 +/- 10 g, P < 0.01) and in particular, LV long-axis diameter measured from the mitral valve level to the apex was increased (102 +/- 2 vs 88 +/- 2 mm, P < 0.001, trained vs sedentary subjects). VO2max correlated with LV long-axis diameter (r = 0.77, P < 0.001). In contrast to our hypothesis, myocardial HDA utilization was not enhanced in endurance-trained athletes at rest. Increases in LV mass and especially in LV long-axis diameter were observed in the athletes, indicating LV longitudinal remodeling.

Fish diet and physical fitness in relation to membrane and serum lipids, prostanoid metabolism and platelet aggregation in female students.

The effects of a 14-week fish diet and exercise programme on lipid metabolism and platelet aggregation in healthy female students (n = 99) were studied. The subjects were divided into four groups: a control group, a fish diet group (3.5 meals containing fish per week, 0.9 g n-3 fatty acids per day), an exercise group (at least three training sessions per week) and a combined fish diet and exercise group. The proportion of n-3 fatty acids increased at the expense of n-6 fatty acids in platelets and erythrocyte ghosts in the fish diet groups. Serum triglyceride concentrations tended to decrease in the fish diet and exercise groups and a significant decrease was found in the combined fish diet and exercise group (13%, P less than 0.05). No significant changes took place in the other serum lipid and apolipoprotein concentrations. Platelet production of thromboxane B2, plasma 6-keto-PGF1 alpha concentrations and adenosine 5'-diphosphate (ADP)-induced platelet aggregation also remained unchanged in all groups during the study. However, an inverse correlation was found between physical fitness (maximal oxygen uptake and maximal exercise intensity) and serum triglycerides, total cholesterol, low density lipoprotein cholesterol and platelet aggregation. This suggests that improved physical fitness is related to beneficial changes in serum lipid concentrations and to a decreased aggregation tendency of platelets. The responses of the female subjects to a fish diet were smaller when compared to earlier studies on male subjects. This suggests that there are sex differences in the efficiency of n-3 fatty acids in modifying lipid metabolism.

Physiological profiles of young boys training in ballet.

In order to evaluate physiological characteristics in young male ballet dancers, 27 boys (aged 9 to 16 years) who participated in a boys' dance course during the Kuopio Dance and Music Festival in June 1988 were studied. In general, the boys had started dancing at the age of 8.6 years and had been training for 4.1 years. They had, on average, three dancing sessions per week and the mean time spent on dancing was four hours per week. In the study, some anthropometric measurements were taken, the maximal oxygen uptake (VO2 max) was measured by a cycle ergometer test and the explosive strength and the mechanical power of lower extremities were evaluated by a jumping test. The results indicate that boys who train in ballet are in general moderately lean, have relatively small body size and a high degree of flexibility. The younger boys especially have only moderate aerobic power, but both explosive strength and mechanical power in leg muscles are good in ballet trained boys.

Effect of submaximal exercise at low temperatures on pulmonary function in healthy young men.

In order to understand more fully the effect on pulmonary function of whole body exposure to cold during submaximal exercise, we measured pulmonary function indices in ten healthy male students and ten healthy male forestry workers of similar age following submaximal treadmill walking at different temperatures in a climatic chamber. After measuring the maximal aerobic capacity with a cycle ergometer test, the subjects had to walk on four separate occasions in the climatic chamber at an intensity of 70%-75% of their individual maximal heart rate; the first at normal room temperature and then randomly, either at 0 degrees C or at -20 degrees C, and vice versa. The duration of each walk was 8 min. Finally, each subject had to walk in the chamber at -20 degrees C for 17 min. Flow volume spirometry was performed at room temperature 1, 5, 10, and 20 min after exercise and the values were compared to baseline values taken prior to the last walking test. There were only minor changes in pulmonary function indices following exercise at different temperatures. Only one student showed a reduction of over 15% in peak expiratory flow rate after an 8-min walk at -20 degrees C. It seems that submaximal exercise of short duration, even at a temperature as low as -20 degrees C, does not impair pulmonary function in healthy young men.