NUMBER
192
JANUARY 2004
PEAK AGEING & PERFORMANCE PERFORMANCE Special Issue
In this issue thirties and, in the case of Ottey, beyond. But can veteran athletes still put in speedy sprinting 1 Speed: how performances in their forties, fifties, sixties \u2013 andcan train sprinters beyond? smart to maintain First, let\u2019s take a look at why we slow with their age. quicksilver One significant factor is a decline in muscle mass qualities and muscle fibre (sarcopenia). We will all 4 Nutrition: tried and experience a 10% decline in muscle mass tested strategies for between the ages of 25 and 50 and a further 45% protecting older joints shrinkage by our eighth decade \u2013 if we do nothing 8 Physiology and about it. To illustrate this decline by example, the endurance: could biceps muscle of a newborn baby has around detraining be the key 500,000 fibres while that of an 80-year-old hasfactor a in the ageing Of all the physiological variables, speed seemsmere to 300,000. As we age, we also produce lessprocess? get written off most quickly as we age. Football growth hormone, which leads to reduced levels of pundits make jokes about outfield players being protein synthesis and, again, muscle atrophy. 10 What the Papers Say: \u2018a few yards slower\u2019 and goalkeepers in kind of acceleration needed by the This diving is not the \ u 2 5 c f fitness and the \u2018instalments\u2019 as soon as the former hit 30athlete and thein search of speed, as decreased veteran brain latter become David Seaman. But England\u2019s muscle equates to reduced strength and power \ u 2 5 c f activity and memory Rugby World Cup winning pack averaged welland less \u2018oomph\u2019 for sprinting. \ u 2 5 c f power v endurance Unfortunately, the bad news keeps on coming! over 30 and, despite being called \u2018Dad\u2019s Army\u2019, Fast-twitch muscle fibre, that most precious of still fathered a victory; the likes of Neil Back and Martin Johnson were certainly very speedy commodities for speed and power, displays a around the field. In track, Carl Lewis, Frankie much more marked decline than slow-twitch fibre as we age. Speedsters, it appears, are not as Fredericks, Linford Christie and Merlene Ottey blessed endurance athletes in the ageing-andare \u2013 or were \u2013 still winning titles well intoas their
SPEED
The bad news is that speed declines with age; the good news is that you can arrest, even reverse, this degenerative process
on the ratio of fast-twitch to slow-twitch fibres within the muscles. Unfortunately, as Craig Sharp points out in his article on aging and distance running (see For many years the conventional wisdom of exercise page 8), aging muscle has been shown to contain pundits was that more was better; that long, slow workouts were much more beneficial \u2013 forhigher healthproportions of slow-twitch fibres, which be good news for marathon runners, but is less and fitness \u2013 than short bursts of intensemight exertion. for any athlete in search of speed and power. For some time now the tide has been turningso \u2013 The theme is taken up again in a US study based and Peak Performance has been in the vanguard of on world record statistics (page 11), which shows opinion-formers arguing that intensity is (often) more important than volume when training for that a aging diminishes muscle power considerably sooner and more dramatically than endurance in wide range of sports and events. both men and women. And it now seems that health too benefits most from high-intensity exertion. Walking used to be But overall this is a \u2018good news\u2019 issue, with more recommended as a prophylactic against heart solutions than problems. Regular resistance training can offset the age-related loss of muscle disease, but the latest research suggests that only power, careful attention to diet can protect aging vigorous activity is effective in reducing heart deaths. The high-intensity-is-best theme is given a joints (page 4), while, as a bonus, those who different slant in this special issue on aging andmaintain their fitness will also protect their memories and other intellectual capacities from the performance. In his lead article on how to maintain ravages of age (page 10). speed in the face of advancing age, John Shepherd PP is in an excellent position to make these points out that human growth hormone, which plays claims: our ever-youthful chairman Sylvester Stein a crucial role in maintaining many aspects of fitness, including speed, is released in the body in directwon the UK Veterans 80-85 age group sprint double last summer! proportion to exercise intensity. Isabel Walker, Editor Speed and power are close cousins, both relying
FROM THE EDITOR
BY SUBSCRIPTION ONLY
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performance stakes. The latter can expect to length and an increase in contact time, with stride rate remaining largely unaffected until the oldest maintain their slow twitch fibres and even groups in both genders. increase them \u2013 by as much as 20% withage the right training \u2013 as they ripen. They can also holdHamilton on to compared 35-39-year-old runners nearly all their aerobic capacity until late into with 90-year-olds and found that stride length their fifth decade at least. If only it were so for declined by as much as 40%, from 4.72 metres per stride (2.36m per step) to 2.84m per stride their sprinting counterparts, whose fast-twitch (just 1.42m per step). The implication is that the fibre can decline by as much as 30% between the oldest veteran sprinters may need to take almost ages of 20 and 80. The oldest To add another blow, creatine phosphate, that twice as many steps in the 100m as their younger veteran premium ingredient for short-term activity, also counterparts. More positively, though, this sprinters may declines with age. With less quick-release energy research group also found that stride frequency in our muscles, we\u2019re theoretically less ablenot to decline significantly with age (2). did need to take If you take a look at table 1, you\u2019ll find some tackle high intensity sprint-type workouts. almost twice Flexibility, another important physiologicalmuch better news. Take note of the phenomenal times recorded by master 100m sprinters; these as many steps variable for sprinting, also declines with age as soft tissue hardens and our joints stiffen.indicate that it is possible to maintain a in the 100m asourWhat are the known effects on performancesignificant of amount of speed with age. So now let\u2019 their younger these various reductions in capacity? It gets take a look at what we have to do to achieve that counterparts worse! Numerous studies have indicated that goal. stride length declines considerably with age. Korhonen analysed the performances of 70 Hill training for stride length As we\u2019ve seen, two crucial factors affecting spee finalists (males 40-88, females 35-87) in the 100m decline in the older sprinter are a reduction in event at the European Veterans Athletics stride length and an increase in ground contact Championships in Jyv\u00e4skyl\u00e4, Finland in 2000, time. Hill sprinting can reverse these negatives; using high-speed cameras with a panning video technique to measure velocity, stride length, the gradient will emphasis dorsiflexion (a greater (1) . foot position) on foot strike, which will, in stride rate, ground contact time and flight timetoe-up turn, generate more work for the calf muscles on Unsurprisingly, his research team discovered a push off, enhancing stride length and reducing general decline in sprint performance with age, time on the level. Lower limb and ankle which was particularly marked for those aged contact 65strength and power are crucial for sprinters of all 70. Velocity during the different phases of the run declined, on average, between 5 and 6% per ages, although they can be overlooked by coaches decade in men and 5-7% in women. Key to this and athletes in favour of conditioning the decline was an accelerating reduction in stridequadriceps and glutes. One of the key factors contributing to the agerelated decline in stride length is the action of the Table 1: Masters world age records free leg as it leaves the running surface and the Age Time Age when foot travels a curvilinear path beneath the body group (secs) Athlete record set Country to a forward position in preparation for the subsequent foot strike. An older runner\u2019s \u2018 40 10.84 Erik Oostweegel 40 NED phase\u2019 is much less dynamic than that of his or 45 10.96 Neville Hodge 45 US her younger counterparts. For optimising speed 50 10.95 William Collins 50 US transference into the next running stride, the lower leg needs to \u2018fold up\u2019 towards the bu 55 11.57 Ron Taylor 57 GB be pulled through quickly and powerfully as a 60 11.70 Ron Taylor 61 GB short lever. This action relies on hip, glute and 65 12.62 Malcom Pirie 65 AUS hamstring strength. Returning to Hamilton\u2019s work, she and her co 70 12.91 Patton Jordan 74 US workers discovered that range of motion at the 75 13.40 Patton Jordan 75 US knees during running decreased by 33% \u2013 from 123\u00b0 to just 95\u00b0 \u2013 between ages 35 a 80 14.35 Patton Jordan 80 US oldest runners in the study, this meant that the 85 16.16 Suda Giichi 85 JPN lower part of the leg attained a right angle with 90 18.08 Kozo Haraguchi 90 JPN the thigh at the point of maximum flexion, dramatically slowing free leg transition into the 95 24.01 Erwin Jaskulski 96 AUT next stride. 100 43.00 Everett Hosak 100 US Hill sprints can play a key role in combating this lower leg lethargy; by creating a greater leg Source: World Masters Athletics Association as at 24/09/02 drive, they can increase the speed of the free leg
\u2018
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References for muscle power through reaction to the ground and condition Creatine a much more effective and speedy biomechanical Intense speed and power training can also 1. Med Sci Sports sprinting action. combat the normal age-related decline in Exerc 2003; creatine phosphate. Research has shown that35(8):1419-28 Weights for fast-twitch maintenance anaerobic (and aerobic) training increases the2. Journal of Applied Biomechanics, vol 9, Weight training is crucial for mature sprintersproduction of creatine phosphate. Research by 1993 determined to hang on to as much zip as possible, Moller and co-workers showed that six weeksPP15-26, of 3. Sports Medicine particularly after 50 when muscle mass beginscycle to ergometer training increased the creatine decline more steeply. Training with weights set phosphate levels of 61-80 year olds to levels 2003;33(8): 599613 around 75% of one rep maximum will offset fastsimilar to those of younger adults (5). The regular twitch fibre shrinkage quite significantly. anaerobic workouts of sprint training will 4. Journal of Applied Physiology 92:60Unfortunately, though, it has no impact on maintain and increase the ability of our muscles 608 2002 muscle fibre reduction, which is governed by an to replenish high-energy phosphates, regardless 5. Clinical Psychology age-related decline in motor cells in the spinalof age. (4): 307-314, But since there\u2019s nothing wrong with2giving cord. Weight training, by strengthening soft tissue, Mother Nature a legal helping hand, the older1982 will also go some way towards protecting older sprinter should take supplementary creatine.6. J Physiology. speed merchants from injury. Numerous studies have shown that creatine 2000 Apr;50(2):273-6. supplementation can increase muscle power and Plyometrics for stretch/reflex power maintenance over a series of anaerobic Plyometric exercises condition the stretch/reflex repetitions and will contribute to the in our muscles and, as well as boosting speed and maintenance of lean muscle mass. power, can stimulate the fast-twitch fibres of One interesting piece of research that specifically addressed sprinting threw up some older sprinters into further action. As mentioned above, stride length declines significantly withencouraging \u2013 and other slightly less encouraging age, and plyometrics, like hill training, offers \u2013 information for veteran sprinters supplementing with creatine. Schedel et al looked at whether the another significant training option for offsetting improvement in maximal sprinting speed after this decline. Bounding and hopping are two very creatine supplementation could be attributed effective exercises for enhancing stride length. to an increase in stride frequency, stride length, Intense exercise for GH release or both(6). Exercise is known to stimulate growth hormone Seven sprinters completed four consecutive (GH) release, which is crucial for speed sprints after one week of placebo or creatine (3) maintenance in later life . Growth hormone supplementation. By comparison with the placebo helps us hold on to more lean muscle mass, retain condition, creatine-fed sprinters increased their more energy and offset some of the general running speed (+1.4%) and stride frequency effects of ageing. The positive release of GH (+1.5%), but not their stride length. This research also substantiated the use of begins almost immediately after we start to creatine for sustaining power output, as decline exercise, and it seem that the higher the intensity in performance of subsequent sprints was of the exercise, the more GH will be released. Stokes and co-workers compared the effectspartially of prevented after supplementation with maximal and less intense cycle ergometer creatine. The researchers concluded that their sprinting in a group of 10 male cyclists, who findings could be related to the recent discovery completed 2 x 30s sprints separated by one hour\u2019s that creatine supplementation can produce a (4) passive recovery on two occasions . The first shortening in muscular relaxation time, thus effort was completed against a resistance equalpromoting to increased sprint times. 7.5% of body mass and the second to 10% of body Train smart for all-round benefits mass. Blood samples were taken at rest, between Finally, the older sprinter needs to make use of the two sprints and one hour post exercise. Analysis of blood samples showed that the first the wiser head on his or her shoulders. Training needs to be intense to minimise the age-related effort elicited a much more significant serum GH response than the second. Note that, although decline in sprint speed, but it also needs to take account of the fact that older bodies may be less both sprints generated the same peak and mean power outputs, the first allowed the cyclists to able to sustain daily, flat-out power-oriented generate higher RPM scores \u2013 ie to pedalwork. faster.Rest, proper nutrition, supplementation Despite the apparent attenuation of GH and a commonsense approach that involves release in the second effort, since speed is \u2018listening to the body\u2019 need to be key features of maintained and enhanced by regular anaerobic the training routine of any veteran sprinter intent training, silver sprinters should benefit from on maintaining speed. John Shepherd regular and above-normal GH release. PAGE 3
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spinal structure as a whole. Another difference is that the main joints between the vertebral bodies are ‘cartilaginous’, containing an intervertebral disc. These discs are like soft pads, which allow relative movement between adjacent vertebrae and can accommodate the different curvature requirements of the spine at different points along its length. There are a large number of possible causes of joint pain and stiffness, and the diagnosis of a There’s good and bad news for veteran athletes. particular problem can be a very complex process The good news is that, if training intensity can–be just ask any physiotherapist! In general terms, performance however, there are a number of well-recognised maintained, age-related decrements are actually quite minimal; the bad causal factors. news is that recovery from hard training sessions takes longer, while the cumulative effects of 1. Acute injuries come on suddenly and are normal ‘wear and tear’ and previous injuries are usually associated with some kind of trauma. increasingly evident. As time goes by, joints tend Common examples include: to become less flexible, full-range movement ● ligaments torn or damaged by unusual or more difficult and pain and stiffness ever moreexcessive movement of the joint; apparent. It is these mechanical limitations, more ● impact injuries, where one of more of the joint structures is damaged by an external blow; than anything else, which can scupper the bestlaid plans of even the most determined veteran● protruding/prolapsed intervertebral disc, where unusual intervertebral forces lead to the athletes! However, there are a number of nutritional deformation of the disc, allowing it to come into strategies that can help to offset the inexorable close proximity with nerves. decline in mobility and even accelerate recovery 2. Chronic injuries usually come on quite from injury. Before we get down to nutritional nuts and gradually, which tends to make them trickier to bolts, it’s worth outlining some of the causes of diagnose and harder to overcome. Common joint degeneration and immobility. Basically, aexamples include: joint exists whenever two bones meet. Many ● overuse injuries, where the long-term training volume exceeds the capacity of the joints joints are freely moveable, allowing large ranges of movement; for example, the knees, ankles, involved to undergo adequate repair and recovery; hips, elbows and fingers. Others, such as those the spinal vertebrae, allow for only ● muscle imbalance injuries, where the joint fails As time goes between partial movement. There are even some fixed to operate through its correct range of movement by, joints tend joints, such as those in the skull, although because of unequal or unbalanced muscular forces acting on the joint, or (particularly in the to become lessmaintaining range of motion is obviously not an case of the spine) inadequate stabilisation of the issue here! flexible, fullThe freely moveable joints are generally joint(s) by the deep postural muscles. ‘synovial’-type joints, where the two ends of the range bones that meet are covered with ‘articular 3. Degenerative conditions are associated with movement longer-term, less easily reversible functioning of cartilage’ – a sort of ‘low friction’ coating. more difficult Although the two bones are in fairly close the joints and are much more common in mature and pain and proximity, they don’t actually touch, being athletes. While previous acute or chronic injuries separated by a joint cavity, which is like a fluid-are known to increase the risk of long-term stiffness ever filled sac. The walls of this cavity are lined withdegeneration, simple ageing factors also come into play. These conditions frequently include: synovial membrane, which secretes synovial fluid more into the cavity to lubricate the movement ● arthritic-type wear and tear, where the articular apparent cartilage becomes worn, leading to narrowed between the two cartilage surfaces. Meanwhile, joint spaces, sometimes referred to as the whole joint structure is stabilised by ligaments osteoarthritis; – tough fibrous tissues connecting and anchoring the two bones. ● rheumatoid arthritis, an inflammatory condition of the joints caused by an auto-immune The joints between the vertebrae of the spine are slightly different in that the movement reaction; between any two adjacent vertebrae is quite ● low synovial fluid secretions, leading to restricted. However, the cumulative effect of reduced lubrication in the joint capsule. several small intervertebral movements allows for a large degree of global movement of the Common to all these causal factors is the process
NUTRITION
The best foods and supplements to protect your joints from agerelated degeneration
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of inflammation which, although part of the (which contain ‘ready-made’ EPA) have been shown to have the same effect. normal healing process, can actually impede this process when it becomes chronic. Sulphur-containing amino acids The role of nutrition in combatting degenerative or inflammatory joint conditionsSulphur has long been recognised as an essential has traditionally been regarded with scepticism, nutrient for human health. In the diet, sulphur is but in recent years research has indicated that found in a number of forms, but mainly as the good nutritional practice can play a significant sulphur-containing amino acids methionine, role, both in promoting recovery from acute and cysteine and taurine. Dietary sulphur is also chronic injuries and in ameliorating some of the present as inorganic free sulphate and loosely effects of the degenerative conditions described bonded sulphates. Because these forms are above. present in much smaller amounts, they have been We’ll begin by taking a look at the latest considered relatively unimportant. However, As with all thinking on optimum dietary practice, then move recent research has shown that inorganic athletes, it is on to examine the claims of some of the more sulphates in the diet can be used not only to esoteric ‘joint health’ nutrients on offer! synthesise cysteine and taurine but also to important for As with all athletes, it is important for older synthesise the chondroitin matrix of joint older athletes athletes looking to maximise joint health to cartilage (1); (chondroitin helps to promote water looking to consume a whole, natural and unprocessed diet, retention and elasticity in joint cartilage and rich in fruit, vegetables, complex carbohydrates inhibit enzymes that break down cartilage.) maximise In the body, sulphur is present in a number of (such as whole grains, starchy vegetables, beans, compounds critical for joint function and health, joint health peas and lentils) and high-quality, low-fat sources in addition to the sulphur-containing amino acids to consume of protein, keeping processed, refined, fatty and (SAAs). Glutathione is a powerful antioxidant, sugary foods to a minimum. However, there are a a whole, which can be depleted during heavy training. If number of nutrients that are particularly important for older athletes, which should be intakes of the SAAs methionine and cysteine are natural and sub-optimal, cysteine can be preferentially well supplied in their diet. These and their effects unprocessed incorporated into body proteins, producing a are described below. diet pro-inflammatory response (2). Vitamin C Chondroitin sulphate is a sulphur-containing Among other roles in the body, vitamin C is vital polysaccharide essential for joint cartilage health, for the formation of collagen, which is a protein while glucosamine is an amino-acid-containing forming the basis for connective tissue, such as monosaccharide, concentrated in joint cartilage, tendons and intervertebral discs. Vitamin C which is used to synthesise cartilage activates the enzymes that convert proline and glycosaminoglycan (GAG for short) GAGs are lysine into hydroxyproline and hydroxylysine large molecules comprising long-branched chains respectively, both of which are needed to giveof sugars and smaller nitrogen-containing collagen its correct 3D structure. molecules known as amino-sugars. Methlysulphonylmethane (more commonly Omega-3 oils known as MSM) is another sulphur-containing Prostaglandins (PGs) are short-lived hormone-compound found in some foods, which is also like chemicals synthesised from dietary fatty acids present in the body. Although the biochemistry to regulate cellular activities. There are three of MSM is poorly understood, it appears to be families of prostaglandins – series 1, 2 and 3. able to donate some of its sulphur for the Series 1 PGs play a number of roles in the body,formation of connective tissue and may also have including exerting an anti-inflammatory effect.an By anti-inflammatory effect. Meanwhile contrast, series 2 PGs exert an inflammatory S-adenosylmethionine (SAMe) is another effect; (remember that inflammation can be a sulphur-containing compound in the body good thing when it is required!) (produced from the metabolism of methionine), While series 1 and 2 PGs are synthesised from which also appears to exert an anti-inflammatory the omega-6 essential fatty acid, ‘linoleic acid’, effect. We’ll revisit these last four compounds series 3 PGs are synthesised from the other later in this article. essential fatty acid, omega-3 alpha-linolenic acid. Bioflavanoids One of the intermediate steps during the These are naturally occurring compounds found conversion of alpha-linolenic acid to series 3 PGs mainly in fruit and vegetables, which appear to involves the formation of eicosapentaenoic acid possess anti-inflammatory properties in addition (EPA). EPA acts to inhibit the excessive to their antioxidant effects. Animal studies on formation of the inflammatory series 2 PGs, and this explains why omega-3 oils exert an anti- two such compounds, rutin and quercetin, have demonstrated significant anti-inflammatory inflammatory effect in the body, and why fish oils
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effects in both acute and chronic inflammationarachidonic . acid, which is a precursor to the The only Furthermore, there is also evidence that theseinflammatory series 2 PGs. Likewise, too much drawback compounds improve local circulation and omega-6 and insufficient omega-3 oils (a to using promote a strong collagen matrix in joints .common imbalance in Western diets) enhances the production of series 2 PGs (see PP190, glucosamine is December 2003). Antioxidants that the benefits When free radical damage occurs in joint linings,The importance of the sulphur amino acids is take a while to inflammation can be increased. There are a worth emphasising. The US committee on number of antioxidant nutrients that afford recommended daily amounts suggests a accrue, with protection from free radical damage in the body, combined SAA intake of around 1g per day for a but selenium and vitamin E appear to be typical adult. Other authorities believe this figure most users . is too low and should be closer to 2g per day finding it takes especially important. Vitamin E has been shown to help combat the effects of exercise-inducedGiven that the stress of heavy training can a good six oxidative stress (which increases free radical deplete blood glutathione, which is an important production), while selenium is an essential peptide and reservoir for the SAA cysteine, weeks-or-so component of the critically important antioxidant athletes need to take more care than most before the full enzyme called glutathione peroxidase, as wellpeople . This is especially true for those on low as being involved in the production of the protein or strict vegetarian diets, which tend to effects are felt (3)
(4)
(7,8)
(9,10)
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prostaglandins and substances known as supply lower levels of SAAs per calorie leukotrienes that are also involved in regulating consumed. Vegetarians may wish to note that (5) inflammatory processes . corn, sunflower seeds, oats, chocolate, cashew nuts, walnuts and almonds are all good very Zinc and copper sources of methionine, while oats and corn are Zinc is an important mineral, activating numerous high in cysteine too! Assuming that your diet is optimal, are there enzyme systems in the body. These include enzymes that process amino acids in the body any food supplements that can further improve joint health, both in terms of helping to overcome (including the SAAs) – a process known as acute and chronic injuries and in combating the transamination. Zinc also functions as an antioxidant and is able to protect sulphurlong-term degeneration that is an inevitable part of the ageing process? Those which might be containing bio-molecules from oxidation. Additionally, sub-optimum intakes of zinc are useful are described below. known to impede the formation of collagen (6). Glucosamine sulphate Like zinc, copper is needed for important Glucosamine is used in the manufacture of very antioxidant enzymes (eg superoxide dismutase) and is also required for collagen formation. large molecules found in cartilage, called proteoglycans. These are large linear chains of Key sources of these nutrients are listed in repeating polysaccharide units (GAGs), which table 1, below. In addition to ensuring a good supply of the radiate out from a protein core like the bristles of above nutrients, it is important to avoid excessive a bottlebrush and can attract and hold water like intakes of saturated fats from red meats, full fat a sponge. When compressed, this bound water dairy produce etc, as these tend to be rich in helps to absorb force and distribute it equally,
Table 1: Dietary sources of key nutrients Nutrient Vitamin C
Good sources in the diet
Grapefruit, lemons, oranges, kiwis, strawberries, raspberries, blackberries, blackcurrants, pineapple, papaya, peppers, tomatoes, cabbage, broccoli, Brussels sprouts, new potatoes Omega-3 oils Walnuts, pumpkin seeds, flax and flax-seed oil, herring, trout, mackerel, salmon, sardines, pilchards, wheat germ Bioflavanoids All fruit and vegetables, especially citrus fruit (particularly the pith), apricots, cherries, grapes green peppers, tomatoes, broccoli. Buckwheat (a cereal) is also a good source Broccoli, cabbage, onion, garlic, eggs, meat, poultry, fish, milk and cheese, oats, corn, SAAs sunflower seeds Almonds, sunflower seeds, spinach, wheat germ, whole grain breads and cereals, coldVitamin E pressed seed oils, egg yolk Brazil nuts (extremely good source), tuna, whole grain breads and cereals, swordfish, herring Selenium Oysters, lean beef, pumpkin seeds, lamb, peanuts, crab meat, pork, sunflower seeds, Zinc wholemeal flour and bread, turkey Beef liver, oysters, lobster, sunflower seeds, hazelnuts, crab, baked beans, chickpeas, Copper lentils, wholemeal bread and whole grain cereals
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which explains the ability of cartilage to protect outcomes of supplementing chondroitin were References the joints under load and during movement.also observed and it was found to be effective in 1. Prog. Food Nutr Sci 1986;10:133-178 In the body, these GAG chains are synthesised reducing pain and increasing mobility. Moreover, from glucose, the amino acid glutamine, and chondroitin also appears to offer long-term 2. Nutrition sulphate, but there’s plenty of evidence that benefits in arthritic conditions. In a one-year 1998;14:605-610 additional supplementation not only increases Swiss RCT of 42 patients with knee pain, those3. Farmaco 2001; GAG significantly but can also relieve the pain taking 800mg of chondroitin per day showed Sep;56(9):683-7 (11) . and inflammation associated with osteoarthritis significantly reduced pain and increased overall 4. J Orthop Sports Last year, researchers carried out an mobility compared with those on placebo (17). In Phys Ther 2002 exhaustive meta-analysis of all the randomised, addition, the metabolism of bone and joint, as Jul;32(7):357-63 placebo-controlled clinical trials (RCTs) on theassessed by various biochemical markers, 5. Nutrition 2001 efficacy of oral glucosamine that were published stabilised in the chondroitin group but remained Oct;17(10):809-14 or performed between January 1980 and March abnormal in the placebo group. 6. J Lab Clin Med 2002 (12). They concluded that the supplement was 1993;122:549-56 not just highly effective in reducing pain and Methylsulphonylmethane (MSM) 7. Am J Physiol increasing mobility but also reduced the joint This micronutrient is extremely rich in sulphur 1988;255:E322(containing 34% elemental sulphur by weight)E331 space narrowing that typically occurs in and is found in small amounts in fruit, alfalfa 8. Am J Clin Nutr degenerative conditions. The long-term benefits of oral glucosamine sprouts, tomatoes, tea and coffee. Despite its 1991;54:377-385 sulphate appear to be supported by a three-year rapidly growing popularity as a supplement, its 9. Sports Med study in which 200 patients with osteoarthritis of metabolism in the human body remains poorly1993;15:196-209 the knee were randomised to receive either oral understood. One study found that 97% of orally 10. J Appl Physiol glucosamine sulphate (1500mg daily) or placebo. ingested MSM is converted into other 1988;64:115-119 By the end of the study, average joint spaces had metabolites, while its very high sulphur content 11. J Orthop Res reduced by more than 5% in the placebo group, has led researchers to speculate that it could act 1990;8:565-571 while the glucosamine group showed no as a sulphur donor in the synthesis of sulphur 12. Arch Intern Med narrowing at all! Moreover, pain and stiffnessamino acids(18). However, studies on guinea pigs, 2003;163(13): was significantly reduced in the glucosamine using radio-labelled MSM, showed that only 1% 1514-22 group by comparison with the controls. (13) of the sulphur is actually incorporated, so this 13. Arch Intern Med The pain relief afforded by glucosamine is also seems unlikely (19). 2002;162: 2113significant. In a mini meta-analysis of two double-By comparison with glucosamine and 2123 chondroitin, scientific studies of MSM blind RCTs, oral glucosamine sulphate (1.5g/day) 14. Br J Community was compared with ibuprofen (1.2g/day) for thesupplementation for joint health are thin on the Nurs 2002; 7(3): ground. In a preliminary study carried out on 16 relief of joint pain in osteoarthritis and was shown 148-52 with degenerative arthritis, one group is to be equally effective (14). Even more persuasivepatients 15. J Rheumatol received 2,250mgs per day of MSM and the other the fact that many non-steroidal anti1982;9:3-5 a placebo (20). After six weeks, eight out of 10 inflammatory drugs (NSAIDS), including patients in the MSM group experienced 16. Semin Arthritis ibuprofen, have been shown to inhibit the repair Rheum 2001;31:58(15) significant pain relief compared with just one . and even accelerate the destruction of cartilage 68 In fact, the only drawback to using glucosaminewho is experienced minimal pain relief in the 17. Osteoarthritis placebo group. that the benefits take a while to accrue, with most Cartilage 1998;6 users finding it takes a good six or so weeks beforeAnother RCT was conducted on athletes with Suppl A:39-46 acute injuries, who were undergoing routine the full effects are felt. 18. Arch Biochem chiropractic manipulation, ultrasound and muscle Biophys Chondroitin sulphate stimulation (21). On average, those taking MSM 1966;113:251-252 This is another of the GAG polysaccharides were discharged from care after just 3.25 visits and 19. Life Sci found in cartilage. But whereas glucosamine experienced a 58.3% reduction in symptom 1986;39:263-268 appears to promote the formation and repair of severity, while those on placebo needed 5.25 visits 20. Lawrence RM cartilage, chondroitin seems to promote cartilage and experienced a reduction in symptom severity 2001;Lignisul MSM; A water retention and elasticity. Initially it was of just 33.3%. While these results are encouraging, double blind study of believed that, as a big molecule, chondroitin both of these studies were sponsored by suppliers its use in degenerative couldn’t be absorbed intact. But subsequent of MSM, and further independent peer-reviewed arthritis. Web: research has shown not only that up to 15% is trials are needed before firm conclusions abouthttp://www.msm.com/ absorbed whole but also that, once in the body,the efficacy of MSM can be drawn. PDF/DegenerativeArthri chondroitin makes beeline for GAG-rich tissues tisStudy.pdf S-adenosylmethionine (SAMe) such as the joints and lumbar discs (16). 21. Lawrence RM Although fewer studies have been carried out This is produced in the body by the metabolism2001 Lignisul MSM in on chondroitin than on glucosamine, the of the SAA methionine and, like methionine, the treatment of acute athletic injuries. Web: evidence points very strongly towards its efficacy. SAMe is used in a number of metabolic processes the require sulphur. Normally the body can http://www.msm.com/ In the large meta-analysis described above (12),that PAGE 7
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PDF/SportsInjuryStudy. synthesise all it needs, but low intakes of pdf methionine, or of other co-factors needed 22. Am J Med 1987;83:60-65
23. J Fam Pract 2002; 51(5): 425-30 24. J Rheumatol 1994; 21(5): 905-11 25. Toxicology of Drugs and Chemicals, 4th ed, NY Academic Press; 1969:656-657
manufacture to consumption. SAMe is also being studied as an alternative and more ‘natural’ anti(choline, folic acid), or an inherited defect in the depressant; it appears to exhibit significant antiability to carry out a biochemical process known depressive activity in some people by increasing as methylation, are all thought to reduce the the levels of two brain neurochemicals, serotonin body’s ability to make SAMe. and dopamine. However, if you are currently Orally supplemented SAMe has been showntaking to any anti-depressant medication or stimulate the synthesis of cartilage proteoglycans receiving any other psychiatric treatment, you and to be as effective as commonly prescribed should not experiment with SAMe without first NSAIDS (eg ibuprofen) for pain relief(22). A largeconsulting your doctor! Andrew Hamilton meta-analysis of RCTs on SAMe found it as effective as NSAIDs in relieving pain and improving functional limitation in patients with PHYSIOLOGY & ENDURANCE osteoarthritis, without the adverse effects often associated with NSAIDS (23). SAMe therapy for joint pain may also offer an advantage over glucosamine in that pain relief appears to occur relatively rapidly – within two weeks (24)! In summary, despite the fact that older athletes are more vulnerable to chronic joint pain A leading question to ask senior citizens, or those and stiffness, you are not powerless to act. While nearing seniority, is: ‘how old would you think you it is obviously vital to get your training right, and were if you didn’t know how old you are?’ I would to incorporate any other rehab/injury prevention predict that the disparity between theory and fact techniques deemed necessary by your coach/trainer/physiotherapist, there is also a in the answer would give an indication of that person’s exercise level. No one can escape their place for nutrition. genetic programme, but most people can do a Diet before supplements great deal, barring injury and illness, to minimise Your number one priority should be to follow the some of the physiological aspects of ageing by dietary recommendations outlined earlier, paying means of modest exercise programmes which special attention to the key joint health nutrients. embrace conditioning in strength and flexibility as Only then should you consider supplementation. well as aerobic exercise. It is worth noting that, from the 100m to the On the available evidence, glucosamine and marathon, men and women of 80 take only up to chondroitin, supplemented at around a gram per 55% and 110% respectively longer than they did day, both offer effective pain and stiffness reduction, and even appear to be able to slow at 40, with a virtual plateau in performance between 20 and 35-40 (see table 1 opposite). The down the process of cartilage degeneration itself. Their regenerative mode of action means they current gap between men and women will narrow with time, as women’s times need to be supplemented on a long-term basis (undoubtedly ie for six weeks or longer), but for those prone to are coming down faster than men’s. chronic joint stiffness and pain, there’s no reasonThis article will focus on the achievements of older distance runners, including veteran and not to take them indefinitely. One word of caution: virtually all the studiesmasters athletes, together with changes in some on glucosamine have been carried out using of the physiological parameters relating glucosamine sulphate, and this is the especially to distance running in older people. In 1900 people were considered old in their 40s; recommended form to use. The evidence in favour of MSM is much less convincing. True, just 40 years ago people seemed old in their 60s; there are promising signs, but there’s simply too but today many do not feel old in their 80s – a little peer-reviewed scientific evidence in the phenomenon described as ‘youth creep’. Yet there literature to recommend its use unreservedly. is no common experience in the ageing process, Nevertheless, it is also one of the least toxic for while an orchestra conductor might see himself as a mere stripling at 50, a 20-year-old rhythmic substances known in biology, so if you want to try it and see for yourself there’s little to worry gymnast can feel hopelessly middle-aged. about(25). Although probably less familiar to mostThe oldest Olympic medallist (silver) was Swedish rifleman Oscar Swahn, at 72 in 1920. He readers, and less extensively researched, SAMe (supplemented at 0.5-1g/day) looks promisingwas for also picked for the 1924 Paris Games, but had to drop out due to injury, and had previously helping to combat joint degeneration. However, won gold in 1912. The oldest British competitor drawbacks include its high cost and its chemically was dressage expert Hilda Johnstone, aged 70 at fragile nature, which means it needs to be stored in a cool, dry, dark environment from the pointthe of Munich Olympics. At least six Olympians
Is ageing inevitable – or simply the result of ‘detraining’?
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able 1 USA single-age marathon have spanned 40 years, three yachtsmen, Ttwo records fencers and one equestrian. Turning to running, in 1994 41-year-old Age Male Female Age Male Female Eamon Coughlan ran the mile in 3:58:15, while4 6:03 – 49 2:33 2:51 42-year-old Yekaterina Podkopayeva just beat 5 5:25 4:56:30 50 2:25:42 2:50 38-year-old Mary Decker in the 1997 world 6 4:07 4:00:30 51 2:29 2:52 indoor 1500m final, and later ran 3:59:10. In the 7 4:04 3:52 52 2:25 3:01 marathon, Carlos Lopez won the Los Angeles 8 3:37 3:13:30 53 2:31 3:00 event in an Olympic record of 2:09:21 at age 38, 3:07 3:11 54 2:32 2:52 having broken the world 10,000m record at 37,9 3:07 55 2:34 2:52 running 27:17:48. A 90-year-old man has run 10 3:02 3:04 56 2:39 3:07 4:25.27 and an 80-year-old woman 5:10:04. 11 2:47 12 2:46:30 2:58 57 2:38 3:13 At 80, men and women can run 100m in 14.35 and 18.0 respectively and 10k in under 45 and 59 13 2:43 2:53 58 2:38 3:21 minutes; and in all distances, from 100m to 14 2:41:30 2:51 59 2:48 3:24 10,000m, the general decline with age in trained 15 2:29 2:46:30 60 2:47 3:15 men and women is linear and very gradual until16 2:23 2:34 61 2:43 3:28 80, when times become less consistent (1,2). Until 17 2:24 2:47 62 2:49 3:31 then, the rate of slowing-up is about 1-2% per Older athletes 18 2:17 2:42 63 2:48 3:30 year, about the same as the loss of maximum (especially 19 2:15 2:34:42 64 2:43 3:39 heart rate over the same period. novices) 20 2:13 2:30:18 65 2:51 3:37 What are the key physiological changes 2:30:10 66 2:43 3:49 impacting on performance with age? Body fat 23 2:08 are more 25 2:09:18 2:26:00 67 2:55 4:02 composition, which at 20 stands at about 12-16% susceptible to in men and 23-28% in women, rises steadily to 26 2:11 2:29 68 2:52 4:03 sunburn than some 19-26% and 28-38% respectively by age 6027 2:08:40 2:28 69 3:01 4:01 70, while lean body mass declines. Height tends 28 2:10:40 2:21 70 3:01 4:09 the young but to decrease by about 1cm per decade after age 40. 29 2:10 2:31 71 3:01 4:25 do not show its The ‘rete pegs’, which anchor the outer layer 30 2:10 2:28 72 3:09 4:38 of skin – the epidermis – to the dermis beneath, acute effects 31 2:09:30 2:30 73 3:13 4:57 shorten with age, making older runners as promptly 32 2:11:30 2:30 74 3:37 4:48 increasingly susceptible to blister formation and 33 2:11:30 2:28 75 3:18 4:32 skin trauma. Melanocytes, the skin cells 76 3:35 4:31 producing melanin, diminish at a rate of some 34 2:13:12 2:30 2% annually in the 40s, and the cutaneous 35 2:12 2:32 77 3:33 5:13 inflammatory response diminishes. Hence older 36 2:15:30 2:36 78 3:37 5:01 athletes (especially novices) are more susceptible 37 2:12:42 2:28 79 3:49 5:04 to sunburn than the young but do not show its 38 2:17:18 2:27 80 4:28 5:10 acute effects as promptly. 39 2:14:18 2:31 81 4:50 5:51 40 2:17 2:40:30 82 4:38 6:14 The ageing heart and lungs 41 2:19:18 2:38 83 5:20 6:33 As far as the cardiorespiratory system is 2:42 84 4:18 6:02 concerned, forced vital capacity decreases by 42 2:20 2:40 85 5:22 6:54 about 250ml per decade. The elasticity of the 43 2:23 44 2:25 2:35 86 5:40 7:57 pulmonary support structures diminishes, and the size of the alveoli (air sacs) increases, which can45 2:26 2:45 87 6:49 7:09 boost the work of breathing from 10% of the 46 2:26 2:53 88 6:52 8:03 energy cost of exercise in the 20s to up to 20% in47 2:27 2:52 89 6:36 8:09 the 60s. The number of pulmonary capillaries 48 2:31 2:51 90 7:53 10:13 declines, as does perfusion quality, and the respiratory centre becomes increasingly sensitive chamber. These changes contribute to a decline to blood levels of carbon dioxide. Thus ventilation in VO2max of about 5ml.kg-1.min-1 per decade in increases disproportionately to oxygen intake in older subjects – ie they need to breathe in moreuntrained men and women(3). For those who remain in training, VO2max may remain air to get the same amount of oxygen. Maximum heart rate declines by some 40 beats consistently higher than in the untrained, eg by per minute between 20 and 60, while an age- 20ml.kg-1.min-1 at age 40 and 10ml.kg-1.min-1 at 70. Skeletal muscle capillarisation has been found related increase in the size of the myocardium (heart muscle) leads to a diminishing stroke to be as high in older runners as in younger ones volume by decreasing the size of the ventricularof equivalent performance (4). Ageing muscle has
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References
1. Sportspages of The Scotsman and The Times (London), 1990-1997 2. Veteran’s Athletics 1996, Autumn Issue, p17 3. J Sports Med, 1987 27: 146-149 4. J Appl Physiol, 1990, 68: 18961901 5. Jones, DA and Round, JM, Skeletal muscle in health and disease: a textbook of muscle physiology, 1990, Manchester University Press 6. Age and ageing,1994, 23, 371-377 7. Acta Physiol Scand, 1990 140: 41- 54 8. Eur J Appl Physiol, 1977 37: 173-180 9. JAMA, 1990. 263: 3029-3034 10. J Gerontol, 1975 30: 435-440
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incidence of illness – eg respiratory disease. been shown by some workers to contain higher percentages of type 1 fibres, which would appearIn very approximate terms, one might potentially beneficial to elderly marathon estimate that 20-40% (or more) of the runners (5). With age, muscle protein diminishes, physiological deterioration associated with as does the size and number of mitochondria ageing is not inevitable but is due to a detraining (the site of the cell’s energy production), effect of decreased exercise, often coupled with although this is less true if relative habitual an increase in body fat. The athletes’ motto ‘If activity is held constant. In part, such decreases you don’t use it – you lose it’ applies equally to may be due to disuse atrophy – or ‘detraining’.the ageing population. And the extraordinary marathon performances of elderly runners set Muscle power and strength out in the table on the previous page confirm it. Craig Sharp Between the ages of 65 and 90, muscle power is lost more rapidly than strength – 3.5% per year Adapted from ‘Ageing and the marathon’, a paper for the former compared with about 1.8% for the (6) in Marathon Medicine, RSM Press Ltd, RSM Press latter . Also, concentric force development is lost more rapidly than the eccentric variety. InLtd, £19.95, 2001, www.rsmpress.co.uk/bktunstall. htm. All statistics correct at time of publication. both sexes there is little fall-off in strength until about the mid-40s, after which it drops by approximately 25% by age 65. In women, there WHAT THE PAPERS SAY may be an accelerated post-menopausal fall-off in power and strength. With ageing in generalReports by Isabel Walker there is progressive muscle atrophy (wasting). Nevertheless, to some extent these force How fitness protects the parameter losses appear to be reversible (7); for ageing brain… example, eight weeks’ strength training in 56-70An important new US study has provided the first year-old-men has produced marked improvement (8) in local muscle endurance ; and strength empirical proof that aerobic fitness protects the brain as well as the body from the degenerative training, even of nonagenarians, may produce a (9) of ageing. . doubling of force development by quadriceps effects It is noteworthy that regular exercise appearsThe human brain gradually loses tissue from to be accompanied by a slowing in the rate of the third decade onwards, with concomitant declines in cognitive (intellectual) performance. decline of movement/reaction times in the And given the projected rapid growth in aged elderly, which could help minimise falls or populations and the staggering costs associated stumbling during the later stages of endurance runs or races. Studies have shown that ‘old with geriatric care, identifying mechanisms that may reduce or reverse brain deterioration is rapidly active’ subjects have faster response times than emerging as an important public health goal. both their inactive counterparts and ‘young non(10) Previous research has demonstrated that active’ people . Well-used tendon retains more of its elasticaerobic fitness training improves cognitive function in older adults and can enhance brain properties. And collagen turnover is increased with exercise, which would allow for greater health in ageing laboratory animals. But no previous study has demonstrated a direct elastic energy storage in tendon and ligament, protective effect of fitness on ageing brain tissue. thus improving running economy. The participants in the current study were 55 Regular weight-bearing exercise has been right-handed, high-functioning, communityshown to decrease the rate of bone dwelling over-50s, recruited locally by demineralisation leading to osteoporosis, researchers based at the University of Illinois. All although this effect is reasonably specific to the had their brains scanned by high-resolution body segments exercised. In sedentary people, thermal control in the magnetic resonance imaging (MRI), with the resultant images scanned for systematic cold is diminished with age on account of a variation in tissue density as a function of age, combination of factors, including reduced body aerobic fitness (as assessed by a one-mile walk mass, lowered basal metabolic rate and diminished shiver response by muscles. But protocol) and other health markers. exercise has also been shown to improve thermalConsistent with previous studies, the researchers observed substantial age-related control, helping older people to resist hypothermia in the cold and overheating whiledeterioration in tissue densities in the frontal, exercising in hot weather. There is increasing parietal and temporal cortices of the brain. More importantly, though, they found that losses in evidence that moderate exercise, perhaps particularly in the elderly, may enhance some these areas were substantially reduced as a function of cardiovascular fitness, quite immune responses and lead to a lowered
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independently of other ‘moderator variables’, by adding activities together. including alcohol and caffeine consumption, Both kinds of activity were significantly and HRT, education and hypertension. positively associated with memory performance The researchers state that: ‘the role of at age 43, independently of such other variables cardiovascular fitness as protector and enhancer as sex, education, occupational social class, IQ of cognitive function and [central nervous and physical and mental health. Furthermore, system] integrity in older adults appears to havephysical exercise at 36 (but not spare time a solid biological basis’. The results also ‘suggestactivity) was associated with a significantly a rather simple and inexpensive mechanism to slower rate of memory decline from 43 to 53 ward off the effects of senescence on human years. There was also evidence that continuing Physical brain tissue’. exercise after age 36 was important for exercise at age Most importantly, the regions and tissue that protection, since those who gave up exercise 36 was show the greatest sparing with aerobic fitness after 36 years did not show the same benefit as are the ones that play central roles in successfulthose who were still exercising at age 43 or had associated everyday functioning, while declines are taken it up for the first time. with a The researchers comment: ‘Not only does this associated with a variety of clinical syndromes, strengthen the suggestion of a causal link including schizophrenia and Alzheimer’s disease. significantly ‘Future research examining the benefits of between physical activity and protection of slower rate of aerobic fitness on the functional and structural memory in midlife, but it also implies that the cognitive benefit of physical exercise is enhanced integrity of the CNS in clinical populations seems memory by persistent or more recent activity. both promising and highly desirable,’ the decline from Conversely…these findings suggest that this researchers conclude. age 43 to 53 J Gerontol A Biol Sci Med Sci 2003 Feb; benefit is lost if activity is not maintained. ‘Our study suggests,’ they conclude, ‘that 58(2):176-180 uptake of physical exercise in young to middle adulthood benefits memory, an aspect of …and improves memory cognitive function likely to be important for in mid-life conduct of activities of daily living during ageing. New British research has linked physical activity Furthermore, sustained physical activity appears in the mid-30s with a significantly slower rate ofto reinforce this benefit, whereas abandonment memory decline in middle age. But it also of this activity appears to result in its loss. suggests that this protective effect is lost in ‘It is therefore important to investigate whether those who do not maintain their fitness. uptake of physical activity in later life can result in Participants in this study, carried out by cognitive benefit or whether this is more likely to researchers from University College, London, be observed following long-established patterns were the study population of the Medical of activity. Continuing follow-up of this cohort will Research Council National Survey of Health andhelp to resolve this question.’ Development, also known as the British 1946 Social Science & Medicine 56(2003):785-792 birth cohort. This initially consisted of 5,362 children born during one week in March 1946. The cohort has been studied on 21 occasions for Power v endurance: a variety of reasons between birth and age 53 what goes first in the and has been shown to be a representative ageing stakes? sample, in most respects, of the UK population A fascinating US study based on world record born in the immediate post-war era. For the current study, the researchers tested statistics has made it clear that ageing the association between two kinds of activity at diminishes muscle power considerably sooner 36 years – physical exercise and spare-time and more dramatically than endurance in both activity – with verbal memory at age 43 and 53 men and women. The researchers compared age-related years in a total of 1,919 of the surviving changes in athletic performance, as reflected in members of the cohort. world records for stationary rowing and powerPhysical activity was assessed by a lifting, to test the theory that ageing affects questionnaire asking about engagement in a choice of 25 sports and recreational activities inactivities requiring short bursts of muscle power the previous month, with those who engaged in more than those based on endurance. ‘any’ activity being compared with those who did World-record performance data were plotted for each event across the age groups, from ‘none’. Participants were also asked about under-12 to 80-89 for one-hour stationary current engagement in seven spare-time activities (eg chess, Church, the arts, voluntary rowing, and from 20-35 to 80-plus for Olympic work etc), with a total spare-time score obtainedpower-lifting. Heavyweight and lightweight-class
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This month’s contributors:
world records were plotted for men and women decreasing by 1.2% per year until age 52. ‘Our findings suggest,’ say the researchers, in each age group. ‘that a statistically significant difference exists in Key findings were as follows: John Shepherd MA is the effect of ageing on the ability to engage in ● In the heavyweight-class men’s rowing event, a specialist health, performance rises rapidly and peaks in the thirdactivities requiring explosive movements over sport and fitness decade. From age 25 to 85 performance short time intervals versus activities requiring writer and a former decreases by 29%, with a gradual decline of just greater endurance capacity. Moreover, rates of international long 4% from 25 to 55 and a more rapid decline men’s and women’s age-related changes in jumper thereafter of 0.83% per year. These values these activities are similar. Andrew Hamilton BSc, indicate a strong relation between performance The findings also indicate, they add, that there MRSC trained as a and age for the entire age range, with the curve is ‘an inherent loss of ability to produce powerful chemist and is now a for lightweight-class men’s records following a muscle contractions with increasing age, despite consultant to the similar trend but at 0-6% lower performance;persistent training and otherwise good health. In fitness industry and other words, the effectiveness of training for ● Data for women in the same age groups show an experienced similar trends but at a lower level. Notably, development and maintenance of muscle science writer however, whereas men’s performance peaks in strength decreases progressively with age’. NC Craig Sharp PhD, the third decade, women’s peaks in the fourth Although the biological mechanisms DSc, FIBiol, FBASES, decade. From age 35-55 there is a gradual (5%) underlying this effect remain to be clarified, the FPEAUK is Professor decline in rowing performance, after which it researchers speculate that preferential loss of of Sports Science at declines more rapidly by 0.80% per year; fast-twitch muscle fibre function with age – as Brunel University in previous studies – may play a role. ● For power-lifting, men’s records show reported a performance peak in the third decade, rapidly From their particular viewpoint as orthopaedic decreasing by 3% per year until age 37 and thensurgeons and rehabilitation specialists, they steadily declining by 0.9% per year from age suggest that some form of regular resistance 37.5 to age 85; training should be advocated for orthopaedic patients over 30 in an attempt to offset age● Women’s power-lifting performance also peaks in the third decade, rapidly decreasing by 3.4% associated strength loss. per year until age 37.5 and then steadily Am J Orthop 2002 Feb;31(2):93-98
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