Physical activity levels and estimated energy expenditure in overweight and normal-weight 11-year-old children.

AIM: To objectively evaluate physical activity and energy expenditure in overweight and normal-weight 11-year-old children. METHODS: The final sample consisted of 91 children (32 overweight and 59 normal-weight children), mean age (SD) = 11.3 (0.2) years. Energy expenditure and physical activity were assessed during two weekdays and two weekend days using a multiple-sensor body monitor (SenseWear Armband; BodyMedia Inc., Pittsburgh, PA, USA). RESULTS: Time spent in physical activity was higher in normal-weight compared with overweight children (p = 0.002). The highest level of physical activity was noted in normal-weight boys [mean (SD) = 258 (114) min/day] and the lowest in overweight girls [mean (SD) = 136 (59) min/day] (p = 0.002). In contrast, energy expended during physical activity did not differ between normal-weight and overweight children (2.6 and 2.7 MJ/day, respectively, p = 0.89). The average decrease in physical activity at weekends was 39 min in overweight children (from 166 to 127 min/day) and 27 min in their normal-weight counterparts (from 230 to 203 min/day). CONCLUSION: Overweight children engaged in less physical activity of both moderate and vigorous intensity compared with their normal-weight peers. Both overweight and normal-weight children were less active at weekends than on weekdays. Initiatives aiming to increase physical activity of overweight children at weekends are warranted.

Sudden cardiac death due to physical exercise in male competitive athletes. A report of six cases.

In the period of 30 years, i.e. from 1973 to 2002, we noticed in Croatia 6 sudden and unexpected cardiac deaths in male athletes during or after training. Two were soccer players, 2 athletic runners, one was a rugby player and one was a basketball player. All of them were without cardiovascular symptoms. At the forensic autopsy, the first athlete, aged 29, had chronic myocarditis and thickened left ventricular wall of 15 mm. The second, aged 21, had an acute myocardial infarction of the posterior wall with normal coronaries and thickened left ventricular wall of 15 mm. The third aged 17, had hypoplastic right coronary artery and narrowed ascending aorta, suppurant tonsillitis and subacute myocarditis. Two athletes, aged 29 and 15, had hypertrophic cardiomyopathy and normal coronaries, and one dilated aorta. The sixth, aged 24, had arrhythmogenic cardiomyopathy of the right ventricle. All the 6 athletes died suddenly, obviously because of malignant ventricular arrhythmias. In Croatia the death rate among athletes reached 0.15/100 000, in others who practice exercise reached 0.74/100,000 and the difference is highly significant (c2=14.487, Poisson rates=3.81, P=0.00014) and in physicians-specialists reached 33.6/100,000. Preventive medical examinations are essential, especially in athletes before physical exercise, as are other investigations in every case suspicious of heart disease, including electrocardiogram (ECG), stress ECG, echocardiography and stress-echocardiography and other findings if indicated. Physical exercise is contraindicated in acute respiratory infection: in 2 of those cases had been a cause of death as a trigger.

Q-T and JT dispersion in the elderly with urban hypothermia.

Twenty elderly patients (12 females and 8 males, aged 65-88 years) were treated because of hypothermia: 11 suffered from moderate (35-32 degrees C) and nine from severe hypothermia (<32 degrees C). The control group consisted of 20 age and sex-matched healthy elderly persons. Twelve-channel electrocardiograms were recorded on admission and during hospitalization. In patients with moderate hypothermia Osborn wave was present in eight of 11, and minimal Osborn wave in three of 11; in severe hypothermia Osborn wave was seen in seven of nine, and minimal in two of nine. The corrected Q-T interval (Q-Tc) was analyzed according to the formula of Bazett: measured Q-T(s)/ radical R-R(s). The JT and the corrected JT interval (JTc) were measured according to the formula: JT=Q-T-QRS. The Q-T interval index (Q-TI) was measured according to the formula: (Q-TI:656)x(HR+100); and the JT interval index JTI: (JT:518)x(HR+100). The dispersion of the Q-Tc (JTc) was defined as the difference between maximum and minimum measured Q-Tc interval (JTc). The Q-Tc interval in the group with hypothermia was 651.41+/-130.06 ms, while in the control group it was 398.14+/-76.21 ms (P<0.001). The Q-Tc dispersion in the group with hypothermia was 91.39+/-51.98, and in the control group 33.21+/-10.25 ms (P<0.001). The Q-TcI in the group with hypothermia was 89.91+/-21.44, and in the control group 39.56+/-9.41 ms ((P<0.001). The JTc in the group with hypothermia was 542.66+/-132.74, in the control group: 328.06+/-76.92 (P<0.001). The JTc dispersion in the group with hypothermia was 79.35+/-46.22, and in the control group 28.53+/-7.99 (P<0.0001). The JTcI in the group with hypothermia was 93.06+/-17.38, in the control group it was 40.23+/-7.59 (P<0.001). The mean values of the Q-TcI were greater than Q-TI, and the mean values of the JTcI were greater than JTI, but the difference was not significant (P>0.10). The mean values of the JTcI were greater than Q-TcI, but the difference was not significant as well (P>0.05). There was no correlation between rectal temperature and dispersion of Q-T, Q-Tc, JT, JTc, and Osborn wave. The maximum Osborn wave and the maximum Q-T interval were registered in anteroseptal leads (V(2)-V(3)). The dispersion of the Q-Tc and of the JTc lasted more than Osborn wave. There was no correlation between rectal temperature and PR interval, RR interval and QRS duration. The prolonged dispersion of the Q-Tc (and JTc) last 24-48 h longer than Osborn wave.

Increased occupational physical activity does not improve physical fitness.

AIM: To determine the possible influence of high physical load in the workplace on the physical fitness of employees. METHODS: The subjects (494 men) were tested by means of Baecke's questionnaire for evaluation of the Work Index, measuring occupational physical load. The EUROFIT battery of tests was used for testing the functional and motor abilities of the subjects. RESULTS: Subjects with a higher Work Index (n = 274) performed worse than the subjects with a lower Work Index (n = 220), indicating that high physical load in the workplace does not necessarily mean improvement in functional and motor abilities. The "heavy" workers were only found to have a stronger handgrip. This could be attributed to the fact that physical activity performed at the workplace did not have adequate intensity, volume, and duration to effect positive changes in other motor and functional capacities.

Characteristics of the morphological and functional status of kayakers and canoeists.

A study of anthropometric and functional characteristics was conducted in a sample of 29 athletes, flatwater racers 18 kayakers and 11 canoeists. The results of morphological tests suggest an evident reduction of subcutaneous fat, above-average values of limb circumferences (especially upper limbs) and of body mass, attributable to a high proportion of lean body mass. Trunk extension strength was to be below the average, while the strength of the remaining analyzed static movements were on the level of trained persons. Aerobic capacity, i.e. the functioning of the cardiopulmonary system, in the sample under discussion has shown above-average values, comparable to those obtained in athletes in the aerobic sports group. The results of discriminant analysis applied separately to morphological, dynamogenic and aerobic characteristics with the aim to identify possible differences between the two sports suggest that our sample constituted a homogeneous group, regardless of which of the two sports were practiced.

Croatian rugby project-Part I. Anthropometric characteristics, body composition and constitution.

BACKGROUND: There are no data in important literature about the anthropometric characteristics of rugby players in countries where rugby is not a popular sport. The goals of this study were to analyze morphological anthropometric characteristics, body composition and constitution of players in the first Croatian-Slovenian rugby league (CSRL) with regard to player's position in the team, team position in the division, and to compare results with the results of rugby players from the more popular rugby leagues. METHODS: The study was carried out in a sample of voluntarily included 111 male rugby players from six clubs members of the CSRL, in the season 1996/97. Eleven anthropometric measures required for the calculations of body mass index (BMI), body fat percentage (BF%), and somatotype components were obtained in the clubs according to the recommendations by Jackson and Pollock and Heath and Carter. RESULTS: Forwards in the CSRL are on the average 93.5 kg heavy, 182.4 cm tall, with BMI 28.3 kg/m2, BF% 20.8% and somatotype 6.7-5.9-1.4. Backs are on average 82.2 kg heavy, 178.3 cm tall, with BMI 26.1 kg/m2, BF% 16.9% and somatotype 5.3-5.3-1.5. Backs from upper half of the division are on the average heavier than those from lower half, BF% in forwards from upper half of the division is higher than in forwards from lower half. Both differences were found to be statistically significant (p<0.05). CONCLUSIONS: Compared with the rugby players from more developed rugby leagues, forwards from the CSRL are lighter, backs are heavier and both have higher body fat percentage. Backs and forwards are more endomorphic and forwards are less mesomorphic compared with the rugby players from more developed rugby leagues.

Croatian rugby project. Part II: injuries.

BACKGROUND: Studies of rugby injuries in countries where rugby is not popular are rare. The aim of the study was to analyze the epidemiology and other characteristics of injuries in the first Croatian-Slovenian rugby league (CSRL) and the influence of anthropometric characteristics, body composition and constitution on the epidemiology of injuries. METHODS: Eleven anthropometric measures for the assessment of anthropometric characteristics, body composition and constitution were obtained in a sample of 111 voluntarily participating rugby players from the CSRL in the middle of the season 1996/97. After the season a questionnaire about injuries sustained in the past season was retrospectively filled up by 106 players who finished the first part of the study. Injuries were classified according to Garraway and Macleod and the 9th revision of the International Classification of Diseases. RESULTS: The incidence of injuries was 1.24 per 1000 hours of rugby training and 28.22 per 1000 hours of playing in matches. Low club position in rugby division (statistically significant, p<0.05), age from 25 to 34 years, forwards position in a team, being tackled, and beginning of autumn or spring season were identified as risk factors for injuries. The most frequent sites of injury were legs. The most frequent injuries were dislocations, strains and sprains of ankle and foot. CONCLUSIONS: The incidence of injuries in matches was more than two times higher than in more developed Scottish rugby, statistically positively correlating with the team position in division. There are no statistically significant differences in anthropometric characteristics, body composition and constitution of injured and uninjured players.

Occult gastrointestinal bleeding in rugby player.

BACKGROUND: Local ischemia and mechanical trauma to hollow abdominal organs are quoted as a cause of gastrointestinal (GI) bleeding during and after long distance running. There are no data on athletes from rugby and other contact sports where mechanical trauma of the abdomen is frequent. METHODS: Occult bleeding in the stool of Croatian national rugby team players has been investigated during and after qualification match with Italy for the World Cup 1999 on June 6th 1998 in Makarska, Croatia. One player with positive test was followed and examined in detail after the game. RESULTS: Among 11 Croatian players authors discovered one with a history of GI symptoms and one with conversion of negative to positive test for occult bleeding in stool after the match. The latter player had no GI symptoms or diseases, took no medications, played only 20 minutes in the match on forward position. Conversion has been found in the second stool sample after game (24 to 48 hours after game). The athlete was followed for 18 months. Persistent low values of hemoglobin, hematocrit and serum iron were revealed, as well as expressed hemorrhoids without signs of haemorrhage or inflammation. CONCLUSIONS: Lower incidence of GI bleeding among rugby players than among long distance runners minimize the importance of mechanical abdominal trauma in the etiology of GI bleeding during sports activity. Hemorrhoids are not quoted as a cause of GI bleeding after sport activity among athletes.

Sudden death due to recreational exercise in physicians.

In a period from 1982-2002 we noticed five dead among Croatian male physicians aged 34 to 67, during or after recreational physical exercise: swimming, soccer, tennis and jogging. Three of them who were autopsied, have been non-smokers and without previous symptoms. In all coronary heart disease was found. The left descending anterior artery was stenotic in one and occluded in two, with myocardial scars in one. An acute myocardial infarction was found in none of them, and in two-left ventricular hypertrophy 15 and 18 mm. We could not find a recent medical record in those physicians including a clinical finding and other findings. Two physicians who were not been autopsied, had possible an alcohol cardiomyopathy. Both of them were smokers. In Croatia about 7% of the whole population are engaged in recreational physical exercise. In a period of twenty years (1982-2002) we noticed 43 sudden and unexpected deaths during or immediately after physical exercise: it reached 43/6,300,000 sudden death in Croatia in twenty years or 2.15/315,000 yearly among persons engaged in physical exercise. In Croatia there are 4,957 male physicians-specialists, and a rate of sudden cardiac death during or immediately after physical exercise in this group reached 5/99,140 in 20 years or 1/19,828 every four years. A medical check up before recreational physical exercise is essential including a clinical examination, a serum concentration of risk factors and other risk factors, an electrocardiogram at rest, a stress test and echocardiography in clinical indication, as are medical controls over persons taking exercise. This study shows that medical evaluation is important because of the underlying problems such as sudden death during exercise. In non-trained persons and in the elderly a physical exercise should be recommended of a gradually intensity, which could not exceed 6 METs.

Sudden death due to physical exercise in the elderly.

Physical exercise has a beneficial effect to the humans. Sudden death in healthy persons engaged in physical exercise is extremely rare since healthy heart is protected from complications. The records of five elderly men who died during or immediately after exercise in the period between 1988-2001 in our region have been given, out of 23 men (and no one woman) aged 14-68 who died due to physical exercise in that time. They have been engaged in tennis, jogging and swimming recreatively. In all of them coronary heart disease has been found by the forensic autopsy. Only one has had arterial hypertension, symptoms of chest pain few years before accident and acute myocardial infarction has been found. The other four have been without symptoms. In three of them myocardial scars have been found of past myocardial infarctions. In all of them the thickness of the left ventricle wall was 15 mm or more (from 15 to 25 mm). It seems that the thickness of the wall of the left ventricle increases cardiovascular risk in persons without symptoms. In Croatia about 7% of the whole population are engaged in recreation. In this population 13% are elderly: 40,950. The reported five deaths due to recreational physical exercise in the elderly reached 1/114,660 persons every three years, or 1/573,300 persons during fourteen years.

Urban hypothermia and hyperglycemia in the elderly.

From December 1993 to March 1999 we treated 18 elderly patients aged 66-87 years, suffering from urban hypothermia: 11 women and 7 men. Ten patients suffered from moderate hypothermia (rectal temperature 32-35 degrees C), and eight from severe hypothermia (rectal temperature < 32 degrees C). Regarding consciousness, in the group suffering from moderate hypothermia, 3 were somnolent and 6 in various degrees of comatose states. In the group suffering from severe hypothermia, 3 patients were somnolent or soporous and 5 in comatose states of various degrees. Values of arterial blood pressure in the group with moderate hypothermia was normal in one, in 3 arterial hypotension was observed and 6 were in a state of shock. In the group with severe hypothermia, 3 presented arterial hypotension and 5 were in a state of shock. In the group with moderate hypothermia the blood glucose level was elevated in six: 9.3-10.2-10.7-17.9-21.3-99.0, and in one patient the blood glucose level was low: 2.3 mmol/L, in correlation with hypoglycemic coma. In the group with severe hypothermia in all eight patients the values were elevated: 6.7-7.4-7.6-8.7-9.1-11.2-12.4-17.9 mmol/L.

The corrected Q-T interval in the elderly with urban hypothermia.

During winter time in the period from 1993 to 1998, 18 elderly patients: 11 female and 7 male aged 65-88 years, were treated because of hypothermia. Rectal temperature on admission was 20-34.5 degrees C. Ten patients suffered from moderate hypothermia (35-32 degrees C), and eight suffered of severe hypothermia (< 32 degrees C). Arterial hypotension was recorded in 7, and shock in 11 patients. In all of them, and in 18 controls, an electrocardiogram was analyzed with the special reference to the corrected Q-T interval. Decompensated metabolic acidosis was observed in 7/8 patients with severe hypothermia and in 4/10 with moderate hypothermia. Among patients with moderate hypothermia, sinus tachycardia was present in 2, sinus bradycardia in 2, idioventricular rhythm in 2 and atrial fibrillation in 4/10 patients. In patients with severe hypothermia, sinus tachycardia was present in 2, sinus bradycardia in 3, idioventricular rhythm in one, and atrial fibrillation in 2/8 patients. In moderate hypothermia Osborn's or Tomaszewski's J wave was present in 7/10, and it only appeared in 3/10 patients; in severe hypothermia it was present in 6/8 and only appeared in 2/8 patients. The corrected Q-T interval in the group with hypothermia ranged 0.450-0.688 s, in the control group 0.343-0.444 s. The X minimum (s) in the group with hypothermia was 0.508 +/- 0.079, in the control group it was 0.371-0-139 s, and the difference was statistically significant (p < 0.001). The X maximum (s) in the group with hypothermia was 0.576 +/- 0.067 s, in the control group 0.390 +/- 0.019 s, and the difference was also statistically significant (p < 0.0001). In both groups the most significant prolongation of the corrected Q-T interval in the majority of patients was found in anteroseptal leads. The dispersion of the corrected Q-T interval in the group with hypothermia was 87.19 +/- 28.44 ms, in the control group it was 32.06 +/- 8.94 ms, and the difference was statistically significant (p < 0.001).

Hypothermia and acute renal failure in the elderly.

During 1993-1998, in winter time 14 elderly patients: 8 female and 6 male aged 65-88, were treated because of hypothermia. Rectal temperature on admission was 20-34.9 degrees C. Sopor was present in 2 and various grades of coma were present in 10 patients. Arterial hypotension was recorded in 5, and shock in 9 patients. Increased serum creatinine level was found in 8 patients. The mean rectal temperature in the whole group was 31.3 degrees C +/- 4.7, ranging from 20.0 to 34.9 degrees C, and the mean serum creatinine level was 172.2 +/- 93.5, in range of 66.0 to 360.0 mumol/L. Negative correlation between those two parameters was found: r = -0.572. In 2 of them parameters of renal failure were analyzed: urine sodium concentration, creatinine urine/plasma ratio, urine osmolality, urine/plasma osmolality ratio, renal failure index and fractional excretion of filtered sodium. In one of the patients all parameters were within the range of functional oliguria, in an other the urine sodium concentration serum showed acute renal failure, but all other findings showed borderline values between functional oliguria and acute renal failure. Twelve out of 14 patients died within 1-216 hours from admission.

Body composition and functional abilities in terms of the quality of professional ballerinas.

The objective of this research was to determine the variability of the sample of professional ballerinas in the space of characteristics of their body composition and some functional characteristics according to the requirements of their roles in ballet. The sample of examinees was comprised of 30 professional ballerinas, members of the Croatian National Theatre Ballet (15 soloists and 15 members of the corps de ballet). The data showed that the soloists were characterized by a significantly larger knee diameter, significantly lower thickness of skin folds on the trunk and the lower fat body mass percentage, as well as by greater grip strength. Aerobic capacity was only moderately more developed than in fit people who participated in physical exercising because of recreational reasons, and there were no differences between soloists and the members of the corps.

[The cardiovascular system and sports]. / Kardiovaskularni sustav i sport.

The article deals with the athlete's heart syndrome as well as the views on this phenomenon throughout this century. The basic diagnostic procedures for heart examination as a part of general medical examination are listed. The authors confront the position recommendations of American and European authors for determining eligibility for competition in athletes with cardiovascular abnormalities.

Estimation of physical activity by different questionnaires in overweight subjects and patients with Type 2 diabetes mellitus: relationship with anthropometric and metabolic variables.

AIM: This study assessed the level of physical activity in overweight and obese subjects, and overweight and obese patients with Type 2 diabetes mellitus (T2DM). It also compared their physical activity level with that of the general population and investigated benefits of physical activity on anthropometric and metabolic parameters and blood pressure in the studied groups of patients using Baecke's questionnaire and the Lipid Research Clinics Physical Activity (LRC PA) questionnaire. The two questionnaires were also compared in the evaluation of benefits. METHODS: Physical activity level and other parameters (body weight, body height, body mass index, waist-to-hip ratio, systolic and diastolic blood pressure, lipoprotein and creatinine concentrations in the blood, concentration of fasting glucose and HbA1c in the blood, albuminuria-to-creatinuria ratio) of 136 subjects and their relationships were investigated during their out-patient visits. RESULTS: No difference in physical activity level was found among the four groups of investigated patients. The comparison between the level of physical activity in the investigated patients and the general population obtained by Baecke's questionnaire revealed a lower sports index in all groups of investigated men and obese women with diabetes mellitus. Our results confirm the benefit of physical activity on a high number of investigated parameters in the studied patients. The Baecke's questionnaire was found to estimate the effects of physical activity on metabolic and anthropometric parameters, as well as blood pressure, better than the LRC PA questionnaire, especially the two-point scoring system. CONCLUSIONS: LRC PA and especially Baecke's questionnaires are valuable aids in the estimation of physical activity level and its benefits in overweight and obese patients and patients with T2DM.

Physical activity of urban adult population: questionnaire study.

AIM: To assess the level of physical activity of an urban population according to gender, age, smoking, and educational differences. METHODS: The sample comprised 594 men and women living and working in Zagreb, Croatia. Work, sport, and leisure-time activity indices were obtained by the Baecke's questionnaire. Significance of differences was tested by the Student's t-test. The relation between the indices and the education was determined by correlation analysis. RESULTS: Women had lower work and sport indices score, and higher leisure-time activity index. After the age of 50, women participated significantly more in sport activities than men. There was a negative correlation between the education and the work index, and a significantly positive correlation between the educational level and the sport activity index, regardless of gender and age. Women smokers participated to a significantly lesser extent in sport activities than women non-smokers. Such differences were not observed in men. CONCLUSION: People with lower educational level sustain more workload at their jobs than those with higher education. More educated people participate more in sport activities, although leisure time activity is not significantly related to education. In women, participation in sport activities negatively correlates with the smoking habit.