Race Participation Research Articles

Effect of Years of Endurance Exercise on Risk of Atrial Fibrillation and Atrial Flutter

Emerging evidence suggests that endurance exercise increases the risk for atrial fibrillation (AF) in men, but few studies have investigated the dose-response relation between exercise and risk for atrial arrhythmias. Both exposure to exercise and reference points vary among studies, and previous studies have not differentiated between AF and atrial flutter. The aim of this study was to assess the risk for atrial arrhythmias by cumulative years of regular endurance exercise in men. To cover the range from physical inactivity to long-term endurance exercise, the study sample in this retrospective cohort study was based on 2 distinct cohorts: male participants in a long-distance cross-country ski race and men from the general population, in total 3,545 men aged ≥ 53 years. Arrhythmia diagnoses were validated by electrocardiograms during review of medical records. Regular endurance exercise was self-reported by questionnaire. A broad range of confounding factors was available for adjustment. The adjusted odds ratios per 10 years of regular endurance exercise were 1.16 (95% confidence interval 1.06 to 1.29) for AF and 1.42 (95% confidence interval 1.20 to 1.69) for atrial flutter. In stratified analyses, the associations were significant in cross-country skiers and in men from the general population. In conclusion, cumulative years of regular endurance exercise were associated with a gradually increased risk for AF and atrial flutter.

Early Repolarization in Middle-Age Runners

This study aimed to assess the prevalence and patterns of early repolarization (ER) in middle-age long-distance runners, its relation to cardiac structure and function, and its response to strenuous physical activity. Male first-time cross-country race participants >45 yr were assessed pre- and postrace by medical history and physical examination, 12-lead ECG, vectorcardiography, blood tests, and echocardiography. ER was defined either as ST elevation or J wave and categorized according to localization and morphology. One hundred and fifty-one subjects (50 ± 5 yr) were evaluated before the race, and 47 subjects were evaluated after the race. Altogether, 67 subjects (44%) had ER. Subjects with versus without ER had a lower resting HR (56 ± 8 vs 69 ± 9 bpm, P = 0.02), lower body mass index (24 ± 2 vs 25 ± 3 kg·m(-2), P < 0.001), higher training volume (3.0 ± 2.6 vs 2.1 ± 2.7 h·wk(-1), P = 0.03), and faster 30-km running times (194 ± 28 vs 208 ± 31 min, P = 0.01). Vectorcardiography parameters in subjects with ER showed more repolarization heterogeneity: vector gradient (QRS-T(area)) (120 ± 25 vs 92 ± 29 μVs, P < 0.001), T(area) (105 ± 18 vs 73 ± 23 μVs, P < 0.001), and T(amplitude) (0.63 ± 0.13 vs 0.53 ± 0.16 mm, P < 0.001); these parameters were inversely related to HR (r = -0.37 to -0.48, P < 0.001). ER disappeared in 15 (75%) of 20 subjects after the race. ER is a common finding in middle-age male runners. This ECG pattern, regardless of morphology and localization, is associated with normal cardiac examinations including noninvasive electrophysiology, features of better physical conditioning, and disappears after strenuous exercise in most cases. These findings support that ER should be regarded as a common and training-related finding also in middle-age physically active men.

Analysis of Weight Change and Borg Rating of Perceived Exertion as Measurements of Runner Health and Safety During a 6-Day, Multistage, Remote Ultramarathon

To determine the feasibility of using weight change and Borg score as tools for monitoring runner health and safety during a multistage, remote ultramarathon. Observational cohort study of feasibility on nonblinded event participants. Six-day, multistage, remote ultramarathon in Utah. Twenty-seven athletes in the 2012 Desert R.A.T.S. (Race Across the Sand) ultramarathon. Participant weight, health conditions that limited race participation, such as fatigue or exhaustion, and Borg score were reviewed. Inability to complete a stage of the race (Did Not Finish status) or development of a clinically significant health condition during the race. Potential prognostic risk factors, such as a high Borg score and weight loss, were analyzed. An overall decrease in weight was observed over the course of the event. Median percent weight changes were losses of 2.96% (day 1), 7.42% (day 2), 2.21% (day 4), and 3.35% (day 6). There was no statistically significant difference in percent weight change between the 14 runners who finished the race and the 13 runners who did not finish the race (U = 73; z = 0.189; P = 0.85). Runners' ability to complete the race was related to the development of adverse health conditions (P = 0.004). Median Borg scores reported were 15 (day 1), 17 (day 2), 13 (day 3), 16 (day 4), and 15 (day 6). Only 2 racers who finished the entire event without adverse events ever gave a Borg score of ≥ 18. The feasibility of weight change as a tool for monitoring runner health and safety in this setting is limited, but the Borg rating of perceived exertion warrants further study as a potential field expedient tool for monitoring runner health and safety during a multiday, remote ultramarathon.

Medical services at ultra-endurance foot races in remote environments: medical issues and consensus guidelines.

An increasing participation in ultra-endurance foot races is cause for greater need to ensure the presence of appropriate medical care at these events. Unique medical challenges result from the extreme physical demands these events place on participants, the often remote settings spanning broad geographical areas, and the potential for extremes in weather conditions and various environmental hazards. Medical issues in these events can adversely affect race performance, and there is the potential for the presentation of life-threatening issues such as exercise-associated hyponatremia, severe altitude illnesses, and major trauma from falls or animal attacks. Organization of a medical support system for ultra-endurance foot races starts with a determination of the level of medical support that is appropriate and feasible for the event. Once that is defined, various legal considerations and organizational issues must be addressed, and medical guidelines and protocols should be developed. While there is no specific or universal standard of medical care for ultra-endurance foot races since a variety of factors determine the level and type of medical services that are appropriate and feasible, the minimum level of services that each event should have in place is a plan for emergency transport of injured or ill participants, pacers, spectators and event personnel to local medical facilities.

Resveratrol exerts no effect on inflammatory response and delayed onset muscle soreness after a marathon in male athletes.: A randomised, double-blind, placebo-controlled pilot feasibility study.

We investigated whether the inflammatory response and delayed onset of muscle soreness after a marathon are altered by resveratrol, a natural polyphenolic flavonoid antioxidant. Double blind placebo-controlled randomised pilot study. London Marathon. Marathon race participants. 7 healthy male athletes were randomised to receive Resveratrol (600 mg Resveratrol daily for 7 days immediately before the marathon) or a placebo. Blood samples taken 48 hours before and 18-32 hours after the marathon were analysed for white blood cell count (WBC) and C-reactive protein (CRP). A VAS score was taken at the same times as the blood samples to assess delayed onset muscle soreness. There were no significant differences between the two groups in terms of changes occurring between pre- and post- tests for WBC, CRP or VAS. There were no differences in immune response or delayed onset muscle soreness between resveratrol and placebo after a marathon. Further investigations are needed with longer treatment time and higher doses, analysing additional parameters such interleukins for a possible effect of resveratrol on the inflammatory response due to extensive exercise. To avoid a type II error, 17 subjects in each group would be required.

The Ironman Triathlon shifts innate/adaptive immune cell populations and increases systemic inflammation (705.3)

The Ironman Triathlon shifts innate/adaptive immune cell populations and increases systemic inflammation Colleen X. Munoz1, Jenna M. Apicella1, Shlomit Radom‐Aizik2, Carl M. Maresh1, Fadia Haddad2, Dan M Cooper2, Cherryl Nugas2, Frank P Zaldivar2, Douglas J. Casa1, Elaine C. Lee1 1University of Connecticut, Storrs, CT2University of California Irvine, Irvine, CA Exercise and environmental stressors threaten cellular function and integrity. We recently showed that whole body acute stress determines the extent of measurable cellular stress. In this study, we tested the hypothesis that the profile of circulating immune cells, level of systemic inflammation, and chaperone response would reflect the whole body stress of an Ironman. To test this hypothesis, we recruited 40 race participants (29 males, 11 females) and 17 control subjects (9 males, 8 females). Blood was drawn between 2‐3 days before the triathlon (baseline), and during recovery at 1‐, 24‐, and 48‐h after completion. CBC (with differential), multiplex cytometric bead array, and ELISA were used to determine cell counts, inflammatory cytokines, and chaperone HSP70, respectively. Statistical significance was defined by repeated measure ANOVA with Bonferroni‐corrected post hoc tests (p&lt;0.05). Total white blood cell counts increased post‐exercise and returned to normal by 48h post‐race. Neutrophil and monocyte subsets increased post‐exercise and remained elevated even 2 days post‐race, while lymphocyte, eosinophil, and basophil subsets transiently decreased post‐exercise before increasing above normal 24h and 48h later. Inflammatory cytokines IL‐10, IL‐6, and IL‐8 increased &gt;10 fold post‐race and returned to normal by 24h post‐race. HSP70 similarly increased ~2‐fold post‐ race and returned to normal levels by 24h later. The stress of the Ironman event likely shifted the balance of innate/adaptive immune cells, and induced a systemic inflammatory response and chaperone response.Grant Funding Source: Timex, Inc.

CARDIO-METABOLIC ADAPTATIONS TO MARATHON TRAINING

Marathon (42 km foot race) participation has risen steadily among middle-aged people seeking the reported health benefits of regular physical exercise. To date, data defining the cardio-metabolic responses to marathon preparation are sparse. Recreational male runners [n = 45; age = 48 ± 7 years;

Association of procedure length on outcomes and adverse events of endoscopic retrograde cholangiopancreatography.

Objective: The aims of this study were to determine the effects of length of procedure on endoscopic retrograde cholangiopancreatography (ERCP) outcomes and adverse events.Methods: All ERCP procedures, performed by experienced advanced endoscopists, in patients without prior papillary intervention from 2006 to 2008 were reviewed. Procedures were arbitrarily divided into two groups: shorter procedures (SP), with a duration shorter than the overall mean procedure length, and longer procedures (LP), with a duration longer than overall mean procedure length. Length of procedure was defined as the time from endoscope insertion to endoscope removal.Results: Two hundred and ninety-five procedures were included in the analysis. Mean procedure length was 45.6 ± 30.1 min. One hundred and seventy-seven procedures (60%) were SP and 118 (40%) were LP. There were no differences between the groups with regard to patients’ ages, genders, race, or trainee participation. SP cases were more likely to be biliary vs pancreatic or bi-ductal evaluations (P = 0.03). LP had significantly higher complexity scores (34% with >3 vs 13%; P = 0.046) and were more likely to require pre-cut papillotomy (39% vs 15%; P < 0.001). There was no significant difference between the groups in overall completion rates (91.5% LP vs 96% SP; P = 0.10) or adverse events (10.2% LP vs 6.2% SP; P = 0.21). However, LP cases were associated with higher rates of post-ERCP bleeding (4.2% vs 0.6%; P = 0.029).Conclusion: There was no significant difference in outcomes or overall adverse events between shorter and longer ERCP procedures. However, longer procedures were associated with higher procedure complexity, higher utilization of pre-cut technique, and increased risk of bleeding.

Characterisation of baroreflex sensitivity of recreational ultra-endurance athletes

Altered autonomic function has been identified following ultra-endurance event participation among elite world-class athletes. Despite dramatic increases in recreational athlete participation in these ultra-endurance events, the physiological effects on these athletes are less known. This investigation sought to characterise changes in surrogate measures of autonomic function: heart rate variability (HRV), blood pressure variability (BPV) and baroreceptor sensitivity (BRS) following ultra-endurance race participation. Further, we sought to compare baseline measures among ultra-endurance athletes and recreationally active controls not participating in the ultra-endurance race. Recreational ultra-endurance athletes (n = 25, 44.6 ± 8.2 years, 8 females) and recreationally active age, sex and body mass index matched controls (n = 25) were evaluated. Measurements of HRV, BPV and BRS were collected pre- and post-race for recreational ultra-endurance athletes and at baseline, for recreationally active controls. Post-race, ultra-endurance athletes demonstrated significantly greater sympathetic modulation [low frequency (LF) power HRV: 50.3 ± 21.6 normalised units (n.u.) to 65.9 ± 20.4 n.u., p = 0.01] and significantly lower parasympathetic modulation [high frequency (HF) power HRV: 45.0 ± 22.4 n.u. to 23.9 ± 13.1 n.u., p < 0.001] and BRS. Baseline measurements BRS (spectral: 13.96 ± 10.82 ms·mmHg−1 vs. 11.39 ± 5.33 ms·mmHg−1) were similar among recreational ultra-endurance athletes and recreationally active controls, though recreational ultra-endurance athletes demonstrated greater parasympathetic modulation of some HRV and BPV measures. Recreational ultra-endurance athletes experienced increased sympathetic tone and declines in BRS post-race, similar to previously reported elite world-class ultra-endurance athletes, though still within normal population ranges.

Exploring Experiences of Running an Ultramarathon

The overall purpose of this study was to examine individuals’ experiences of running an ultramarathon. Following pilot work data were collected with six people who entered the 2012 Canadian Death Race. Participants were interviewed before the race, took photographs and made video recordings during the race, wrote a summary of their experience, and attended a focus group after the race. The research team also interviewed participants during the race. Before the race participants had mixed emotions. During the race they experienced numerous stressors (i.e., cramping and injuries, gastrointestinal problems, and thoughts about quitting). They used coping strategies such as making small goals, engaging in a mental/physical battle, monitoring pace, nutrition, and hydration, and social support. After the race, nonfinishers experienced dejection or acceptance whereas finishers commented on the race as a major life experience. These findings provide some insights into factors involved in attempting to complete ultramarathons and offer some implications for applied sport psychology.

A Statewide Medicaid Enhanced Prenatal Care Program

Policy makers and practitioners need rigorous evaluations of state-based Medicaid enhanced prenatal care programs that provide home visiting to guide improvements and inform future investments. Effects on adverse birth outcomes are of particular interest. To test if participation in the Michigan statewide enhanced prenatal care program, the Maternal Infant Health Program (MIHP), accounting for program timing and dosage, reduced risk for low birth weight (LBW) and preterm birth, particularly among black women who are at greater risk for adverse outcomes. Quasi-experimental cohort study. Data, including birth records, Medicaid claims, and monthly program participation, were extracted from the Michigan Department of Community Health warehouse. Participants included all 60 653 pregnant women who had a Medicaid-insured singleton birth between January 1 and December 31, 2010, in Michigan. The MIHP participants were propensity score-matched with nonparticipants based on demographics, previous pregnancies, socioeconomic status, and chronic disease. An enhanced prenatal care program. Low birth weight, very low birth weight (VLBW), preterm birth, and very preterm birth. In the propensity score-matched models, black women who enrolled and were screened in the MIHP by the end of the second trimester had lower odds of VLBW (odds ratio [OR], 0.76; 95% CI, 0.59-0.97) and very preterm births (OR, 0.68; 95% CI, 0.54-0.85) than matched nonparticipants. Black MIHP participants who enrolled and were screened in the program by the second trimester and had at least 3 additional prenatal MIHP contacts had lower odds of LBW (OR, 0.76; 95% CI, 0.65-0.89), VLBW (0.42; 0.30-0.61), preterm birth (0.71; 0.61-0.83), and very preterm birth (0.41; 0.30-0.57) compared with matched nonparticipants. The MIHP participants of other races and ethnicities who enrolled and were screened in the program by the second trimester and had at least 3 additional prenatal MIHP contacts had lower odds of LBW (OR, 0.78; 95% CI, 0.66-0.93), VLBW (0.38; 0.22-0.66), preterm birth (0.77; 0.66-0.89), and very preterm birth (0.63; 0.43-0.91) compared with matched nonparticipants. Participation in MIHP reduced the risk for adverse birth outcomes in a diverse, disadvantaged population. The study adds to the evidence base for enhanced prenatal care home visiting programs and informs state and federal investments.

The nature of holistic processing in face and object recognition: current opinions

The nature of holistic processing in face and object recognition: current opinions

A Qualitative Study to Understand Cultural Factors Affecting a Mother’s Decision to Breast or Formula Feed

The presence of barriers is not sufficient to explain breastfeeding rate disparities. A relatively unexplored area in coping with breastfeeding barriers is culture. This research aims to better understand the role of culture in a woman's infant feeding decision by using race and socioeconomic status as indicators of culture. Focus groups and individual interviews were conducted with 42 pregnant women or mothers of infants younger than 12 months. Focus group composition was determined by self-identified African American or white race and self-reported eligibility for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or ineligibility (non-WIC). Most participants acknowledged that breastfeeding was best, yet differences arose between groups in the perception of, and reaction to, breastfeeding barriers. WIC and non-WIC participants of both races indicated that some circumstances necessitated formula use. WIC participants felt that this was personally and socially acceptable due to need, whereas non-WIC participants felt that this was personally and socially unacceptable. When a barrier arose, WIC participants of both races felt that the infant feeding choice was not theirs and formula use might be inevitable. In contrast, non-WIC participants of both races expressed that they persevered to continue breastfeeding and did so by establishing small, achievable goals and seeking mentors. Educational and public health efforts to reduce breastfeeding disparities may be enhanced if support is tailored to acknowledge cultural differences among women and address factors that make either breastfeeding or formula feeding acceptable, or even preferable, within their communities.

Health Literacy and Complementary and Alternative Medicine Use Among Underserved Inpatients in a Safety Net Hospital

Little is known about the relationship between health literacy and complementary and alternative medicine (CAM) use in low-income racially diverse patients. The authors conducted a secondary analysis of baseline data from 581 participants enrolled in the Re-Engineered Discharge clinical trial. The authors assessed sociodemographic characteristics, CAM use, and health literacy. They used bivariate and multivariate logistic regression to test the association of health literacy with four patterns of CAM use. Of the 581 participants, 50% reported using any CAM, 28% used provider-delivered CAM therapies, 27% used relaxation techniques, and 21% used herbal medicine. Of those with higher health literacy, 55% used CAM. Although there was no association between health literacy and CAM use for non-Hispanic Black participants, non-Hispanic White (OR = 3.68, 95% CI [1.27, 9.99]) and Hispanic/other race (OR = 3.40, 95% CI [1.46, 7.91]) participants were significantly more likely to use CAM if they had higher health literacy. For each racial/ethnic group, there were higher odds of using relaxation techniques among those with higher health literacy. Underserved hospitalized patients use CAM. Regardless of race, patients with high health literacy make greater use of relaxation techniques.

Marathon-Related Cardiac Arrest

To investigate the incidence and assess the outcomes of cardiac arrest occurring in the context of participation in marathon or half-marathon races. Incidence study. Data came from long-distance race records in the United States from January 1, 2001, to May 31, 2010. All participants were registered entrants in the long-distance races. Participation statistics (sex, participant identity numbers, and race distance) were publicly accessible from Running USA. Data on possible risk factors for cases were obtained retrospectively through computer searches (age, sex, location of cardiac arrest, publicly released cause of death). Three attempts were made to obtain information from survivors or from the next-of-kin of deceased cases. This information included demographic characteristics, exercise and running history, and personal and family medical history. The main outcome measures were the incidence and characteristics of cases of cardiac arrest that occurred during the race, at the finish-line, or ≤ 1 hour after completion of a marathon or half marathon. Cardiac arrests were defined by a medical professional as an unconscious state and an absence of spontaneous respirations and pulse. Successful resuscitation and discharge from hospital defined a survivor, whereas a nonsurvivor was a person who was not successfully resuscitated in the field or who died before hospital discharge. Cases of cardiac arrest had to be independently identified in 3 separate sources of data or confirmed with official race medical staff. Further information, including details of the cardiac arrest, was obtained from medical records and autopsies and the survivors or next of kin. Among 10.9 million registered race participants there were 40 cardiac arrests in marathons and 19 in half marathons (overall incidence, 0.54 per 100,000; 95% confidence interval [CI], 0.41-0.70). The mean age of runners with cardiac arrest was 42 (SD 13) years and 86% were men. The incidence per 100,000 was higher in marathons (1.01; 95% CI, 0.72-1.38) than in half marathons (0.27; 95% CI, 0.17-0.43; and among men (0.90; 95% CI, 0.67-1.18) than among women (0.16; 95% CI, 0.07-0.31). More runners died than survived the cardiac arrest (42 [71%] vs 17[29%]); the incidence of sudden death was 0.39 per 100,000 participants (95% CI, 0.28-0.52). The mean age of the nonsurvivors was younger than that of the survivors (39 vs 49 years; P = 0.002). Complete clinical information on cause of death was available for 23 runners. The most common confirmed or possible cause of death was hypertrophic cardiomyopathy (15 cases, of whom 9 had an additional clinical factor). Among the 8 survivors with complete information, ischemic heart disease was the cause of cardiac arrest in 5. The survivors were older than nonsurvivors (53 vs 40 years), had completed more long-distance races, and were more likely to have known cardiac risk factors. The strongest predictors of survival were initiation of cardiopulmonary resuscitation by bystanders (P = 0.01) and an underlying diagnosis other than hypertrophic cardiomyopathy (P = 0.01) CONCLUSIONS:: The incidence of cardiac arrest and sudden death per 100,000 runner hours was 0.2 and 0.14. Risk factors for cardiac arrest were full marathon and male sex. Younger age and no previous knowledge of cardiovascular risk were associated with sudden death.

7-217 電動モビリティの製作とレース参戦(オーガナイズドセッション:学生の学習活動事例-V)

7-217 電動モビリティの製作とレース参戦(オーガナイズドセッション:学生の学習活動事例-V)

Power, Not Fear: A Collusion-Based Account of Betting Market Inefficiency

We examine racetrack betting market inefficiency. We argue that the overround – an established measure of inefficiency – may be seen as a reflection of bookmakers’ collusive returns maximising behaviour, rather than simply as their response to an adverse selection problem. We test, and find empirical support for, several proposed market effects of bookmaker (market maker) collusion. Besides number of race participants, overround varies significantly according to (1) whether or not the race is the last at the race meeting, (2) racetrack location, (3) day of the week (weekday vs. weekend), (4) type of race (handicap vs. non-handicap), and (5) type of race event (Flat/National Hunt). The study provides fresh insight into the origins of betting market inefficiency, where the link between market structure and context and bookmaker behaviour is a key feature. Regarding the broader implications, the study alerts us to the potential for financial market inefficiencies such as the bid-ask spread to be explained, in part, as a consequence of market makers’ opportunistic behaviour wherever and whenever it is possible for intermediaries to exploit their understanding of investor behaviour.

Age group athletes in inline skating: decrease in overall and increase in master athlete participation in the longest inline skating race in Europe &amp;ndash; the Inline One-Eleven

BackgroundParticipation and performance trends in age group athletes have been investigated in endurance and ultraendurance races in swimming, cycling, running, and triathlon, but not in long-distance inline skating. The aim of this study was to investigate trends in participation, age, and performance in the longest inline race in Europe, the Inline One-Eleven over 111 km, held between 1998 and 2009.MethodsThe total number, age distribution, age at the time of the competition, and race times of male and female finishers at the Inline One-Eleven were analyzed.ResultsOverall participation increased until 2003 but decreased thereafter. During the 12-year period, the relative participation in skaters younger than 40 years old decreased while relative participation increased for skaters older than 40 years. The mean top ten skating time was 199 ± 9 minutes (range: 189–220 minutes) for men and 234 ± 17 minutes (range: 211–271 minutes) for women, respectively. The gender difference in performance remained stable at 17% ± 5% across years.ConclusionTo summarize, although the participation of master long-distance inline skaters increased, the overall participation decreased across years in the Inline One-Eleven. The race times of the best female and male skaters stabilized across years with a gender difference in performance of 17% ± 5%. Further studies should focus on the participation in the international World Inline Cup races.

Participation and performance trends in ultra-endurance running races under extreme conditions - ‘Spartathlon’ versus ‘Badwater’

BackgroundThe aim of the present study was to compare the trends in participation, performance and age of finishers in ‘Badwater’ and ‘Spartathlon’ as two of the toughest ultramarathons in the world of more than 200 km of distance.MethodsRunning speed and age of male and female finishers in Badwater and Spartathlon were analyzed from 2000 to 2012. Age of peak performance and sex difference in running speed were investigated during the studied period.ResultsThe number of female and male finishes increased in Badwater and Spartathlon. Women accounted on average for 21.5% ± 6.9% in Badwater and 10.8% ± 2.3% in Spartathlon. There was a significant increase in female participation in Badwater from 18.4% to 19.1% (p < 0.01) and in Spartathlon from 11.9% to 12.5% (p = 0.02). In men, the age of finishers was higher in Badwater (46.5 ± 9.3 years) compared to Spartathlon (44.8 ± 8.2 years) (p < 0.01). The age of female finishers of both races was similar with 43.0 ± 7.5 years in Badwater and 44.5 ± 7.8 years in Spartathlon (p > 0.05). Over the years, the age of the annual five fastest men decreased in Badwater from 42.4 ± 4.2 to 39.8 ± 5.7 years (p < 0.05). For women, the age remained unchanged at 42.3 ± 3.8 years in Badwater (p > 0.05). In Spartathlon, the age was unchanged at 39.7 ± 2.4 years for men and 44.6 ± 3.2 years for women (p > 0.05). In Badwater, women and men became faster over the years. The running speed increased from 7.9 ± 0.7 to 8.7 ± 0.6 km/h (p < 0.01) in men and from 5.4 ± 1.1 to 6.6 ± 0.5 km/h (p < 0.01) in women. The sex difference in running speed remained unchanged at 19.8% ± 4.8% (p > 0.05). In Spartathlon, the running speed was stable over time at 10.8 ± 0.7 km/h for men and 8.7 ± 0.5 km/h for women (p > 0.05). The sex difference remained unchanged at 19.6% ± 2.5% (p > 0.05).ConclusionsThese results suggest that for both Badwater and Spartathlon, (a) female participation increased, (b) the fastest finishers were approximately 40 to 45 years, and (c) the sex difference was at approximately 20%. Women will not outrun men in both Badwater and Spartathlon races. Master ultramarathoners can achieve a high level of performance in ultramarathons greater than 200 km under extreme conditions.

Muscle-enhancing behaviors among adolescent girls and boys.

Media images of men and women have become increasingly muscular, and muscle-enhancing techniques are available to youth. Identifying populations at risk for unhealthy muscle-enhancingbehaviors is of considerable public health importance. The current study uses a large and diverse population-based sample of adolescents to examine the prevalence of muscle-enhancing behaviors and differences across demographic characteristics, weight status, and sports team involvement. Survey data from 2793 diverse adolescents (mean age = 14.4) were collected at 20 urban middle and high schools. Use of 5 muscle-enhancing behaviors was assessed (changing eating, exercising, protein powders, steroids and other muscle-enhancing substances), and a summary score reflecting use of 3 or more behaviors was created. Logistic regression was used to test for differences in each behavior across age group, race/ethnicity, socioeconomic status, BMI category, and sports team participation. Muscle-enhancing behaviors were common in this sample for both boys and girls. For example, 34.7% used protein powders or shakes and 5.9% reported steroid use. Most behaviors were significantly more common among boys. In models mutually adjusted for all covariates, grade level, Asian race, BMI category, and sports team participation were significantly associated with the use of muscle-enhancing behaviors. For example, overweight (odds ratio = 1.45) and obese (odds ratio = 1.90) girls had significantly greater odds of using protein powders or shakes than girls of average BMI. The use of muscle-enhancing behaviors is substantially higher than has been previously reported and is cause for concern. Pediatricians and other health care providers should ask their adolescent patients about muscle-enhancing behaviors.