Epithelial barrier theory in the context of nutrition and environmental exposure in athletes.

Exposure to toxic substances, introduced into our daily lives during industrialization and modernization, can disrupt the epithelial barriers in the skin, respiratory, and gastrointestinal systems, leading to microbial dysbiosis and inflammation. Athletes and physically active individuals are at increased risk of exposure to agents that damage the epithelial barriers and microbiome, and their extreme physical exercise exerts stress on many organs, resulting in tissue damage and inflammation. Epithelial barrier-damaging substances include surfactants and enzymes in cleaning products, laundry and dishwasher detergents, chlorine in swimming pools, microplastics, air pollutants such as ozone, particulate matter, and diesel exhaust. Athletes' high-calorie diet often relies on processed foods that may contain food emulsifiers and other additives that may cause epithelial barrier dysfunction and microbial dysbiosis. The type of the material used in the sport equipment and clothing and their extensive exposure may increase the inflammatory effects. Excessive travel-related stress, sleep disturbances and different food and microbe exposure may represent additional factors. Here, we review the detrimental impact of toxic agents on epithelial barriers and microbiome; bring a new perspective on the factors affecting the health and performance of athletes and physically active individuals.

Environmental factors associated with non-infective acute respiratory illness in athletes: A systematic review by a subgroup of the IOC consensus group on "acute respiratory illness in the athlete".

OBJECTIVES: The aim of this study is to review the evidence available suggesting that environmental conditions represent a risk factor associated with non-infective acute respiratory illness in athletes. DESIGN: Systematic review. METHODS: PubMed, EBSCOhost and Web of Science (1st January 1990-31 July 2020) were searched systematically using keywords related to male and female athletes (i.e. from physically active individuals to elite athletes), aged 15-65 years and a combination of the terms (non-infective acute respiratory illness AND [pollution OR allergies OR climate] AND athletes AND prevalence/incidence/risk factors). RESULTS: A total of seven papers (n = 1567 athletes) addressed our question. Among these, one focused on indoor air pollution, four on chlorinated swimming pool exposure and two on cold air conditions. None was selected for allergies, outdoor air pollution or other climatic conditions. Except rhinitis induced by swimming in chlorinated pools (n = 1), no respiratory disease due to the environment was identified specifically in athletes. The levels of chloramines in swimming pools (n = 2) and air pollutant in arenas (n = 1) were identified as risk factors for rhinitis and respiratory symptoms when exercising. DISCUSSIONS: There is a paucity of data on the prevalence, incidence and risk factors of being acutely exposed to chlorine by-products, air pollution, cold air or altitude on the development of respiratory disease specifically in athletes. Noting the lack of a clear definition of environmentally induced lung disease in athletes, distinct from that of the general population, we addressed the few published management plans to protect athletes' airways for each specific environment.

"On-site" prevention and education to improve cardiac pre-competition screening in competitive amateur athletes.

STUDY/PRINCIPLES: To assess the effects of an "on-site" prevention and education programme to improve the cardiac screening in competitive amateur athletes. METHODS: We integrated an "on-site prevention and education programme" at the 2012 edition of the Swiss Alpine Marathon in Davos, Switzerland. After a specific lecture, the athletes could visit a "Sports-Cardiology-Section" at the official "medical-park". On an anonymised questionnaire, they could state their intention for a screening programme in general and after our "on-site" intervention. RESULTS: Among the 150 athletes who attended the medical day (3.3% of 4,500 finishers) the response rate was 82%. While 39 (31.7%) athletes were aware of "exercise related SCD", more than twice as many (64.2%) were not. 72.4% of the participants (n = 89) reported that they never had taken part in cardiac screening examinations. 70.7% (n = 87) runners were convinced that they would benefit from such a screening. 65.9% (n = 81) of the runners stated that our "on-site" prevention concept influenced their decision to consider a cardiac screening in the future. CONCLUSION: An "on-site prevention and education" concept for the prevention of SCD in competitive amateur athletes is feasible and successfully increased the athletes' awareness of the issue. The vast majority of athletes felt to have benefited from such a programme. The current study confirms that there is an alarming lack of preventive measures in the very large group of ambitious, competitive, amateur athletes that are frequently underprepared for challenging sports events.

Developing Swiss paraplegic research: building a research institution from the comprehensive perspective.

PURPOSE: To illustrate the conceptualization and development of a research institution from the comprehensive perspective based on the integrative model of functioning provided by the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF). The newly founded research institution Swiss Paraplegic Research which focuses on the comprehensive study of spinal cord injury (SCI) serves as an example. METHOD: Description of organizational development and structure. RESULTS: The creation of specialized research institutions which develop their core competence from the comprehensive perspective poses unique challenges. It is depicted how these challenges can be met through several approaches. These encompass the identification and specification of a common mission and research goals, the organization of research along distinct scientific fields, the set-up of a respective core competence, and the design of research structures suited to conduct studies of high methodological and organizational complexity. Finally, they comprise the development of a transdisciplinary workforce and the integration into a research landscape which is organized along scientific disciplines and not along interdisciplinary themes. CONCLUSION: The ideas and approaches described in this paper may serve as an example for creating integrative research institutions dedicated to human functioning and rehabilitation research from the comprehensive perspective.