Effectiveness of a lifestyle weight-loss intervention targeting inactive former elite athletes: the Champ4Life randomised controlled trial

ObjectivesMany athletes struggle in managing the end of their career, often gaining weight and adopting unhealthy lifestyles. Lifestyle programmes targeting former athletes who have gained substantial fat mass (FM) postsports career are lacking. We studied the effects of the Champ4Life programme on body composition and other health-related outcomes in former elite athletes with overweight or obesity.MethodsNinety-four former athletes(42.4±7.3 y, 34.0% female) were recruited and randomly assigned to either an intervention group (IG; n=49) or a control group (CG; n=45). The IG attended 12 educational sessions addressing physical activity, weight management and nutrition. They also had a nutrition appointment aimed to prescribe a moderate caloric deficit(~300–500 kcal/day). Dual-energy X-ray absorptiometry was used to assess body composition. The Short-Form Health Survey-36 questionnaire was used to measure general health-related quality of life. Blood samples were collected to assess cardiometabolic health parameters.ResultsAt 12 months, the IG lost more weight (estimated difference (ED)=−5.3 kg; −6.9 to −3.8), total FM (ED=−4.1 kg; −5.4 to −2.8) and abdominal FM (ED=−0.49 kg; −0.64 to −0.33) than did the CG (p’s<0.001). Cardiometabolic health markers also improved significantly (p<0.05) more in the IG at 12 months (insulin (ED=−4.9 μU/mL;−8.0 to −1.8); homoeostatic model assessment (ED=−1.2; −2.1 to −0.4); total cholesterol (ED=−21.8 mg/dL; -35.4 to −8.2); low-density lipoprotein (ED=18.2 mg/dL;−29.2 to −7.1)), as did quality-of-life dimensions (physical functioning (ED=11.7; 6.5 to 16.9); physical role (ED=17.6; 2.1 to 33.0); general health (ED=19.4; 11.4 to 27.4); vitality (ED=13.3; 5.3 to 21.3) and mental health (ED=12.3; 4.1 to 20.6)).ConclusionsThe Champ4Life programme was effective in substantially reducing total and abdominal FM while preserving fat-free mass and improving health-related markers. These findings will enable evidence-based decisions when implementing lifestyle interventions targeting retired elite athletes.Trial registeration numberNCT03031951.

Orienteering from Cradle to Grave—How a Sport Could Offer Lifelong Participation

Background: The aim of this present study is to explore what makes orienteering meaningful and rewarding to former elite athletes’ years or even decades after ending their elite careers. Methods: Applying a qualitative approach with a case study design, data was collected through semi-structured interviews with 11 former elite orienteers from Norway and Sweden, and the data was subsequently analyzed with thematic analysis, resulting in two main themes: individually matched challenges and a social community. Results: The character, structure, and culture of orienteering both enabled and encouraged former elite athletes to make the transition into recreational sport. Even so, the characteristics of the sport related to both its structure (range of ages, level, and ambition) and organization (well-organized) as well as the participants’ backgrounds (well-educated) and intrinsic motivation (satisfaction, enjoyment, mastery) seemed to match a lifelong sport participation. Conclusions: These factors could indicate that orienteering is a sport that can facilitate a lifelong sport participation for athletes with such a background.

Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes

Introduction Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be ‘J’ shaped; with elite athlete’s likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes. Methods 38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio’s (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis. Results Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61–0.78]; female SMR 0.51 [95% CI 0.40–0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91–1.12]). Although male athlete’s CVD (SMR 0.73 [95% CI 0.62–0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63–0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86–1.40]) or END athletes cancer mortality (SMR 0.73 [0.50–1.07]). There was insufficient data to calculate female sport-specific SMR’s. Discussion Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the ‘J’ shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).

Analysis of the Athletic Career and Retirement Depending on the Type of Sport: A Comparison between Individual and Team Sports

The type of sport practiced may shape the athletic career, considered as the period in which an athlete is dedicated to obtaining their maximum performance in one or more sports. The aim of this study was to compare athletic careers and retirement in individual and team sports. Four hundred and ten former elite athletes (38.5 ± 7.6 years) answered an ad hoc questionnaire; 61.5% were men and 38.5% women; 45.1% were from individual sports, while 54.9% were from team sports. It emerged that the age of maximum sports performance and the retirement age occurred significantly later in team sports than in individual sports (U = 15,042 and U = 12,624.5, respectively p < 0.001). Team sports athletes combined their athletic career with work to a greater extent than those from individual sports (χ2 (3, N = 408) = 14.2; p = 0.003; Cv = 0.187). Individual sports athletes trained more hours per week (30.0 ± 11.7 h) than those involved in team sports (19.2 ± 10.7 h; U = 9682; p < 0.001). These athletes (team sports) were in a better economic and working situation at retirement transition (χ2 (3, N = 406) = 23.9; p < 0.001; Cv = 0.242). Individual sports athletes perform physical activity more frequently than team sports athletes (U = 16,267.5; p = 0.045), while team sports athletes participate more actively in veteran competitions (χ2 (1, N = 390) = 3.9; p = 0.047; Cv = 0.104) and more frequently attend events as spectators (χ2 (1, N = 390) = 8.4; p = 0.004; Cv = 0.151). dual career support providers should be aware that team sports athletes enjoy a longer athletic career, and they are in a better position to face the retirement transition than individual sports athletes.

International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health

ObjectivesTo develop an assessment and recognition tool to identify elite athletes at risk for mental health symptoms and disorders.MethodsWe conducted narrative and systematic reviews about mental health symptoms and disorders in active and former elite athletes. The views of active and former elite athletes (N=360) on mental health symptoms in elite sports were retrieved through an electronic questionnaire. Our group identified the objective(s), target group(s) and approach of the mental health tools. For the assessment tool, we undertook a modified Delphi consensus process and used existing validated screening instruments. Both tools were compiled during two 2-day meeting. We also explored the appropriateness and preliminary reliability and validity of the assessment tool.Sport Mental Health Assessment Tool 1 and Sport Mental Health Recognition Tool 1The International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) was developed for sports medicine physicians and other licensed/registered health professionals to assess elite athletes (defined as professional, Olympic, Paralympic or collegiate level; aged 16 years and older) potentially at risk for or already experiencing mental health symptoms and disorders. The SMHAT-1 consists of: (i) triage with an athlete-specific screening tool, (ii) six subsequent disorder-specific screening tools and (iii) a clinical assessment (and related management) by a sports medicine physician or licensed/registered mental health professional (eg, psychiatrist and psychologist). The International Olympic Committee Sport Mental Health Recognition Tool 1 (SMHRT-1) was developed for athletes and their entourage (eg, friends, fellow athletes, family and coaches).ConclusionThe SMHAT-1 and SMHRT-1 enable that mental health symptoms and disorders in elite athletes are recognised earlier than they otherwise would. These tools should facilitate the timely referral of those athletes in need for appropriate support and treatment.

Van jonge topsporter naar chronische pijnpatiënt

From young elite athlete to chronic pain patient. A reflection on working with students as a researcher A qualitative study on the (psychological) characteristics of young, former elite athletes with chronic, non-specific pain complaints was initiated to answer the following questions: (1) Which factors could play a role in the development of chronic, non-specific pain in young, former elite athletes? And (2) How can we optimize treatment for young, former elite athletes with chronic, non-specific pain? A master student in Mental Health first interviewed six young former elite athletes with non-specific pain complaints who were receiving treatment in the rehabilitation clinic. The student analyzed the data. As data analysis based on six interviews is rather limited and the findings did not lead to unambiguous conclusions, several parts of the interview were re-coded by researcher 1, leading to different conclusions. We then decided to re-code all interviews in a new project by researcher 1, have researcher 2 double code several interviews and recruit at least six more participants to expand the qualitative sample. Reflecting on working with students in our qualitative study, we found another researcher coding the interview data to be important as it minimizes interpretation bias and allows for a check of the thoroughness of the interview content. Secondly, master students writing their thesis have limited time for these projects, which may lead to a small number of participants in the study. This holds especially when recruiting from a patient population, as availability depends on the number of suitable patients during this period of time.