The application of trimetazidine in healthy individuals: a systematic review.

OBJECTIVE: Currently, there is no evidence to support trimetazidine (TMZ) administration aimed at enhancing physical performance or post-exercise recovery in healthy individuals or athletes from the general and athletic populations, respectively. Considering the lack of empirical data, from a scientific and practical perspective, it would be interesting to review research with high methodological quality that examines the effects of TMZ on healthy individuals and athletes from various age groups. MATERIALS AND METHODS: Data sources included English articles that were initially searched by keywords utilizing PubMed, Scopus databases, and the Cochrane Library and published prior to November 2022. Thus, a systematic review of the scientific literature was performed with a traditional PRISMA methodology. An initial keyword search found 2,673 publications, and further screening selected 66 articles, of which only two articles met the inclusion criteria. RESULTS: Two trials examining the effect of TMZ on healthy members of the general population that were published in 2017 and 2019 were analyzed. Publications examining athletes were not recruited for this analysis. CONCLUSIONS: Currently, there are no data reporting a positive effect of TMZ on physical performance, post-exercise recovery, or other health parameters in members of the general population, while its administration is associated with the development of relatively common adverse effects.

[Nutritional factors of bone health in athletes].

The importance of proper nutrition when playing sports is difficult to overestimate. Athletes of any age need to consume a sufficient amount of macro- and micronutrients for bone health. High-quality and balanced nutrition in terms of quantity and composition is important for optimal recovery after training, adaptation to intense physical activity and prevention of sports injuries. The aim of the study was to summarize the current data of domestic and foreign literature on the factors affecting bone mineral density (BMD) in athletes, as well as to consider the key points of nutritional support necessary for the prevention and treatment of osteoporosis. Material and methods. The search was conducted using the Google Academy search engine and electronic databases PubMed, MEDLINE, EMBASE, Scopus, Web of Science, eLIBRARY for the period from 2008 to 2022. For the search, we used keywords and their combinations: "athletes", "osteoporosis", "stress fractures", "calcium" and "vitamin D". Results and discussion. Bone health is influenced by many factors, the most significant of which are lifestyle and the nature of a person's physical activity. Despite strong evidence for the benefits of exercise for bone health, there are sports that predispose to low BMD and increase the risk of osteoporosis. First of all, athletes involved in aerobic and aesthetic disciplines (long-distance running, cycling, swimming, rhythmic gymnastics, dancing, etc.) are at risk. In addition, factors that predispose to a decrease in BMD include female gender, low intake of energy substrates, protein, vitamin D and calcium, and certain medications. Of great importance for the regulation of bone metabolism and maintaining optimal BMD are the genetic characteristics of the athlete. The main adverse consequences for athletes with reduced BMD are fractures of various localization. At the same time, the problem of a high risk of developing stress injuries of bones is especially relevant. Calcium and vitamin D are key nutritional factors needed to maintain bone health. Optimal intake of carbohydrates, proteins, and polyunsaturated fatty acids is also important. There is evidence of a positive effect on the skeletal system of such nutritional factors as potassium, magnesium, sodium, vitamins K, C, B12 and folic acid. The specific mechanisms of the influence of these micronutrients on bone metabolism and the relationship of their consumption level with BMD need further research. Conclusion. Thus, athletes of all ages and specializations need to pay great attention to the state of the skeletal system. Given the association between the risk of osteoporosis and malnutrition, it is essential for athletes to maintain an optimal nutritional status and consume adequate amounts of vitamins and minerals.

[Relative energy deficiency in sport: modern approaches to diagnostics, treatment and prevention].

In recent years, close attention has been paid to energy deficiency in professional athletes. More and more studies confirm the widespread prevalence of relative energy deficiency syndrome in sports and its relationship with various pathological conditions that lead to a decrease in the level of athletic performance. Nowadays the possibilities of early diagnosis and treatment of this syndrome are being carefully studied, and clinical protocols are being actively developed to facilitate the early detection of energy deficiency. The aim of the study was to summarize the modern data on the influence of the syndrome of relative energy deficiency in sports on the health and performance of athletes, as well as to consider effective methods for the diagnosis, treatment and prevention of this syndrome. Material and methods. The search was carried out using the Google Academy engine and electronic databases PubMed, MEDLINE, EMBASE, Scopus, Web of Science, eLIBRARY for the period from 2017 to 2021. For the search, we used keywords and their combinations: "relative energy deficit in sports", "female athlete triad", "menstrual dysfunction", "osteoporosis". Results. Based on our analysis, we can conclude that the syndrome of relative energy deficit in sports has a multicomponent negative effect on the athlete's organism and negatively affects his performance, well-being and sports results. Diagnosis of this condition is challenging due to the nonspecificity and variety of symptoms. Key diagnostic methods include physical examination, anamnesis gaining, dual energy X-ray absorptiometry, bioimpedance body composition analysis, and hormonal profile studies. Additional methods include: electrocardiography, study of the basal metabolic rate, hematological examination (hemoglobin, ferritin, etc.), determining the level of energy consumption using diaries of food and physical activity, determining blood vitamin level, etc. To facilitate the screening, diagnosis and follow-up of athletes, it is possible to use specially developed clinical protocols. Non-drug nutritional correction and optimal training plan are the main methods of treatment and prevention of energy deficiency. If this type of treatment is ineffective, hormone therapy should be considered. It is recommended to use transdermal estrogen therapy in combination with shortterm progestin therapy. In some cases, when very low bone mineral density or delayed fracture consolidation is detected, it is possible to use recombinant parathyroid hormone. Conclusion. Due to the relatively high prevalence of relative energy deficiency syndrome in athletes of both sexes and its long-term negative impact on athlete health and performance, further research is needed to improve the effectiveness of early diagnosis, prevention and treatment of pathological conditions associated with malnutrition.

Federal medical biological agency of Russia's efforts to support Russian athletes during COVID-19 outbreak.

This paper dwells upon COVID-19-related efforts of the Center for Sports Medicine, Federal Medical and Biological Agency of Russia. The Agency has the following precautions in place: regular polymerase chain reaction (PCR) testing of athletes and staff; double PCR testing before going to training camps or medical examinations; isolating athletes and their traceable contacts when COVID is suspected; observation and isolation wards set up at training camp venues. Athlete vaccination has begun. Athletes are provided online advice on health, diet, and exercising plus special care for chronically ill athletes and remote psychological counseling. Athletes recovering from COVID-19 are offered rehabilitation programs and doctor-supervised return to training. Specialists of the Research Department at FMBA's Center for Sports Medicine carried out a research dedicated to the prevalence of COVID-19 and different variants of its course in Russian athletes. The study period lasted from March to December 2020. A total of 27,438 records were analyzed. In May, June, July and August 2020, the percentage of positive PCR tests for athletes was significantly lower than the nationwide percentage at p < 0.05, Pearson's chi-squared test. However, the differences were nullified by September-October. The disease was mild or asymptomatic in most patients. Athletes of summer sports were found to be most likely to contract COVID-19.