Health, Hormones and Human Performance Part 1

How hormones determine health and athletic performance

Endocrine and Metabolic aspects of Sports and Exercise Medicine are crucial determinants of health and human performance, from reluctant exerciser through to elite athlete and professional dancer. This is what I set out to demonstrate as the chair of the recent British Association of Sport and Medicine conference, with insightful presentations from my colleagues whom I had invited to share their research and practical applications of their work. The audience comprised of doctors with interest in sport and exercise medicine, representatives from the dance world, research scientists, nutritionists, physiotherapists, coaches and trainers. In short, all were members of multi-disciplinary teams supporting aspiring athletes. The importance of the conference was reflected in CDP awards from FSEM, BASES, Royal College of Physicians (RCP), REP-S and endorsement for international education from BJSM and National Institute of Dance Medicine and Science (NIDMS).

Exercise is a crucial lifestyle factor in determining health and disease. Yet we see an increasing polarisation in the amount of exercise taken across the general population. At one end of the spectrum, the increasing training loads of elite athletes and professional dancers push the levels of human performance to greater heights. On the other side of the spectrum, rising levels of inactivity, in large swathes of the population, increase the risk of poor health and developing disease states. Which fundamental biological processes and systems link these groups with apparently dichotomous levels of exercise? What determines the outcome of the underlying Endocrine and metabolic network interactions? How can an understanding of these factors help prevent sports injuries and lead to more effective rehabilitation? How can we employ Endocrine markers to predict and provide guidance towards beneficial outcomes for health and human performance?

If you weren’t able to come and participate in the discussion, these are some topics presented. My opening presentation (see video below) set the scene, outlining why having an optimally functioning Endocrine system is fundamental to health and performance. Conversely, functional disruption of Endocrine networks occurs with non integrated periodisation of the three key lifestyle factors of exercise/training, nutrition and recovery/sleep, which can lead to adverse effects on health and athletic performance.

In the case of an imbalance in training load and nutrition, this can manifest as the female athlete triad, which has now evolved into relative energy deficiency in sports (RED-S) in recognition of the fact that Endocrine feedback loops are disrupted across many hormonal axes, not just the reproductive axis. And, significantly, acknowledging the fact that males athletes can also be impacted by insufficient energy availability to meet both training and “housekeeping” energy requirements. Why and how RED-S can affect male athletes, in particular male competitive road cyclists, was discussed, highlighting the need for further research to investigate practical and effective strategies to optimise health and therefore ultimately performance in competition.

A degree of overlap and interplay exists between RED-S (imbalance in nutrition and training load), non functional over-reaching and over-training syndrome (imbalances in training load and recovery). Indeed research evidence was presented suggesting that RED-S increases the risk of developing over-training syndrome. In these situations of functional disruption of the Endocrine networks, underlying Endocrine conditions per se should be excluded. Case studies demonstrated this principle in the diagnosis of RED-S. This is particularly important in the investigation of amenorrhoea. All women of reproductive age, whether athletes or not, should have regular menstruation (apart from when pregnant!), as a barometer of healthy hormones. Indeed, since hormones are essential to drive positive adaptations to exercise, healthy hormones are key in attaining full athletic potential in any athlete/dancer, whether male or female. Evidence was presented from research studies for the role of validated Endocrine markers and clinical menstrual status in females as objective and quantifiable measures of energy availability and hence injury risk in both male and female athletes.

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Triumvirate of external factors impacting Endocrine system and hence performance

Alongside training metrics, if female athletes recorded menstrual pattern (as Gwen Jorgensen recently showed on her Training Peaks) and all athletes kept a biological passport of selected Endocrine markers; this could potentially identify at an early stage any imbalances in the triumvirate of training load, nutrition and recovery. Pre-empting development of RED-S or over-training syndrome, supports the maintenance of healthy hormones and hence optimal human performance.

Look out for presentations from speakers which will be uploaded on BASEM website shortly.

References

Video of presentation on the Endocrine and Metabolic Aspects of Sports and Exercise Medicine BASEM conference “Health, Hormones and Human Performance”

Study of hormones, body composition, bone mineral density and performance in competitive male road cyclists Investigation of effective and practical nutrition and off bike exercise interventions

Sports Endocrinology – what does it have to do with performance? Keay BJSM 2017

 

 

 

Ballet for Injury Prevention

 

Ballet is an excellent way for people of all ages to improve mobility and build strength.

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Barnes Studio

Furthermore, if athletes take Ballet classes then this can aid in injury prevention. Ballet incorporates all the elements of a balanced training session improving core strength, muscle tone, muscle dynamics, flexibility, neuromuscular skills and proprioception. Taking Ballet class also provides an interesting challenge both mentally and physically as described in amina sana corpore sano. Ballet offers something different to the usual strength and conditioning training sessions taken by athletes.

Development of neuromuscular skills is vital for young people not only for physical fitness and enabling sports performance, but to enhance cognitive ability, both in short and long term.

The American Academy of Orthopaedic Surgeons recommend that if you are tempted to try Ballet, make sure you go to a class where the teacher can ensure you learn proper technique. I teach Ballet, backed up with my experience in sport medicine and Pilates, in small class setting for individual attention and correction. Whatever your previous dance experience or current level of fitness: are you ready for the challenge and some fun?

For further discussion on Endocrine and Metabolic aspects of SEM come to the BASEM annual conference 22/3/18: Health, Hormones and Human Performance

References

Ballet

Stories

Anima sana corpore sano

Young people: neuromuscular skills for sports performance

AAOS

Amina Sana in Corpore Sano

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Barnes Studio

Why not give both your body and brain a workout simultaneously? Recall sequences of steps and translate into movement with musicality and expression. Challenge mind and body by taking a Ballet class. Develop and maintain a healthy mind in a healthy body.

A healthy mind in a healthy body: the WHO (World Health Organisation) defines health as a positive state, incorporating the elements of physical, mental and social health, not simply the absence of disease.

Medical evidence demonstrates that exercise is beneficial for the cardio vascular, respiratory, metabolic, endocrine and musculoskeletal systems. It also enhances wellbeing, through the release of endorphins.

Longer term interaction of physical and mental health is now being reported more in scientific journals and the press. Exercise has a long term positive effect on mental health. Exercise is a modifiable lifestyle factor that can decrease the risk of cognitive decline by 18-30%. The mechanism is thought to be related to blood flow to areas of the brain associated with memory.

Ballet is recommended by American Academy of Orthopaedic Surgeons as an injury prevention strategy for athletes as improves neuromuscular skills, proprioception, muscle tone and muscle dynamics.

Ballet

For further discussion on Endocrine and Metabolic aspects of SEM come to the BASEM annual conference 22/3/18: Health, Hormones and Human Performance

References

http://gpcpd.walesdeanery.org/index.php/welcome-to-motivate-2-move

http://www.businessinsider.com/master-athletes-stopped-exer…

Ballet for Injury Prevention