Search

Background: Despite prominent public attention, data on life span health and exercise outcomes among elite, competitive athletes are sparse and do not reflect the diversity of modern athletes., Hypothesis: Life span exercise behavior differs between National Collegiate Athletic Association (NCAA) student athletes and a nonathlete control group. Sustained exercise is associated with improved cardiopulmonary health outcomes., Study Design: Cross-sectional, descriptive epidemiology study., Level of Evidence: Level 3., Methods: A total of 496 students and alumni (age range, 17-84 year) at a large, NCAA Division I university, including student athletes and an age- and sex-matched nonathlete control group, completed anonymous, self-report health and exercise questionnaires. Age-stratified, cross-sectional analysis evaluated previous week's total exercise volume (ExVol), self-rated exercise importance (ExImp), and compliance with American College of Sports Medicine (ACSM) exercise guidelines for healthy adults. The association of ACSM guideline compliance with lifetime cardiopulmonary health outcomes was also assessed., Results: Current student athletes reported significantly greater ExVol (P < 0.001. Cohen d = 0.99, probability of clinically important difference [pCID] >99.5%), ExImp (P < 0.001, d = 1.96, pCID = 96%), and likelihood of compliance with ACSM guidelines (odds ratio [OR], 95% confidence interval [CI] = 30.6, 11.0-84.6) compared with nonathletes. No significant differences were found between alumni student athletes and nonathletes. Alumni student athletes demonstrated substantially lower ExVol (P < 0.001, d = -0.94, pCID >99.5%) and guideline compliance (OR = 0.09, 95% CI = 0.05-0.19) compared with current student athletes, whereas nonathletes had similar exercise behavior across the life span. Among alumni, ACSM guideline compliance was associated with significant attenuation of cardiopulmonary health concerns (P = 0.02, d = -0.50, pCID = 14%) independent of intercollegiate athletic participation., Conclusion: Although current NCAA Division I student athletes demonstrated significant, clinically important differences in exercise behavior compared with nonathletes, no group differences were evident later in life. Irrespective of collegiate athletic status, healthy exercise behavior among alumni was associated with cardiopulmonary health benefits., Clinical Relevance: To realize life span health benefits, it is imperative that student athletes maintain consistent patterns of healthy exercise beyond retirement from competitive sports.

Background: Older persons often lose muscle mass, strength, and physical function. This report describes the challenges of conducting a complex clinical investigation assessing the effects of anabolic hormones on body composition, physical function, and metabolism during aging., Methods: HORMA is a multicenter, randomized double masked study of 65-90-year-old community dwelling men with testosterone levels of 150-550 ng/dL and IGF-1 < 167 ng/dL. Subjects were randomized to transdermal testosterone (5 or 10 g/day) and rhGH (0, 3, or 5 microg/kg/day) for 16 weeks. Outcome measures included body composition by DEXA, MRI, and (2)H(2)O dilution; muscle performance (strength, power, and fatigability), VO2peak, measures of physical function, synthesis/breakdown of myofibrillar proteins, other measures of metabolism, and quality of life., Results: Major challenges included delay in startup caused by need for 7 institutional contracts, creating a 142-page manual of operations, orientation and training, creating a 121-page CRF; enrollment inefficiencies; scheduling 16 evaluations/ subject; overnight admissions for invasive procedures and isotope infusions; large data and image management and transfer; quality control at multiples sites; staff turnover; and replacement of a clinical testing site. Impediments were largely solved by implementation of a web-based data entry and eligibility verification; electronic scheduling for multiple study visits; availability of research team members to educate and reassure subjects; more frequent site visits to validate all source documents and reliability of data entry; and intensifying quality control in testing and imaging. The study exceeded the target goal of 108 (n = 112) completely evaluable cases. Two interim DSMB meetings confirmed the lack of excessive adverse events, lack of center effects, comparability of subjects, and that distribution of subjects and enrollment will not jeopardize outcomes or generalizability of results., Conclusions: Flexibility and rapidly solving evolving problems is critical when conducting highly complex multicenter metabolic studies.