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Extreme athletes should especially be screened, however the recommendation is valid for any sport, any athlete, at any level.
Screening should include a thorough family history that covers any premature death whether it was directly cardiac related or not.
Other symptoms that may have been dismissed previously should also be investigated.
These include shortness of breath, dizziness, chest pain or discomfort, fainting or near fainting episodes.
Tests such as the electrocardiogram (EKG) or the echocardiogram (ECHO) should be included as well.
The concern with athletes, who should technically be in the best of health, is the increased risk for a phenomenon called Sudden Cardiac Death or SCD.
SCD is most often associated with: - Thickening of the heart muscle (hypertrophy cardiomyopathy) - Anomalous coronary artery leaving the muscle without enough oxygen - Congenital Long QT Syndrome, a faulty heart rhythm.
- Abnormal blood clotting - Arrhytmogenic right ventricular dysphasia or cardiomyopathy (ARVD) abnormal heart muscle tissue which can cause heart rhythm problems.
- Cocaine use Heart testing and other health screenings are important especially for those who are going to be involved in extreme or endurance related sports including triathlons, marathons and other high intensity sports.
Examples of why the screening is so important: - Four to eight out of every one million marathon runners will die during the marathon.
- Fifteen out of every one million triathlon athletes will die, typically it will happen during the swimming portion of the competition - 1/3 of runners after a marathon had an increased level of a biomarker that indicates heart muscle damage - Long distance runners have been found to find higher levels of the enzyme creatine kinase which is used to measure damage in the heart after a heart attack.
- On October 18, 2009, three otherwise healthy runners died during a half-marathon in Detroit, Michigan.
They were aged 26, 36 and 65.
Autopsies were not conclusive.
There have been other examples of seemingly healthy athletes dying during or after a game or a competition including a healthy skater who was later found to have a heart defect that had gone undetected well into his twenties and a high school basketball player who developed a fatal heart arrhythmia during a game.
Extreme Sports and Good Nutrition The amount of calories that the average person needs will be smaller than the athlete needs.
During training, an athlete burns up far more energy than they normally do and will need high quality nutrients and extra calories to keep up with their body's demands.
Because they are typically pushing their body past its normal endurance, the extreme or elite athlete is likely to miss the symptoms of impending danger- including pain and fatigue.
Everyone, whether they are a couch potato or in training for another marathon or other event, need the same basic nutrition: macronutrients that include protein, carbohydrates and fats and micronutrients that include the vitamins and minerals.
The American Heart Association recommends that the diet have 35% protein or less for safety.
Carbohydrates - The body uses carbohydrates to burn for fuel.
The amount of carbs that should be included in the diet is around 50-60% of the daily calories.
The carbohydrates that the athlete as well as the average person should choose are the healthy and complex ones, slow to break down and digest in the body.
These do not spike the level of the blood glucose which can lead to insulin surges and weight gain.
Fats - The diet should include around 20% of the daily calories, however the athlete may be shaving this amount.
It is not safe to cut the fat calories too far however- healthy fats are important.
Healthy fat options include fish like salmon, tuna, halibut and other cold water fish, avocado, olive oil.
Nut oils are also healthy but can sometimes be difficult to find and some will need special care.
Walnut oil for instance should be kept in the refrigerator.
Proteins - Protein comes in two sources: animal based and plant based.
All animal based proteins are complete because they contain all of the eight essential amino acids that the human body cannot create on its own.
Plant based proteins are not complete because they lack one or more of these amino acids.
Soy protein is the exception; it is a complete, plant based protein.
In addition to getting protein from natural food sources, you can get the protein that you need from protein supplements which can serve as a meal replacement or as a between meal snack.
Animal Proteins - All meats are good sources of protein, however red meats are high in saturated fats and calories and should be eaten only in small quantities and occasionally.
Better animal proteins include roasted, skinless turkey breast, low fat dairy foods and cheese.
Plant Proteins - Plant proteins include soy, grains, nuts and seeds.
Each of the plant proteins (except for soy) is incomplete but a healthy balance of protein can still be met if you are eating a varied diet.
Grains, nuts and seeds are low in isoleucine and lysine, while legumes are low in tryptophan and methionine.
Protein Supplements - Protein powders, like whey, soy, egg and rice can be made from a single protein or can be combined with one another.
If there is any risk of food allergies, it is better to stick with a single protein supplement.
Whey Protein Powder - Whey protein is derived from milk and is one of the most common protein supplements.
The whey protein isolate is the highest in protein at 90% and has a number of healthy benefits including those that are heart related.
Whey protein boosts immunity, enhances muscle recovery after a workout (especially important for the elite athlete) and prevents muscle breakdown.
Whey protein enhances blood vessel function including better blood flow and may work to keep the blood pressure stable.
Soy Protein Powder - Soy is derived from soy flour and is highly digestible.
It not only enhances the nutritional value of foods but also lowers the cholesterol, the blood pressure and the risk of heart disease.
Soy is suitable for vegans and vegetarians.
Egg Protein Powder - Derived from egg white, egg protein powder is fat free and high in protein.
It is the highest food source of the amino acids, alanine, argine, glycine and methione.
Rice Protein Powder - Rice protein powder is hypoallergenic and is a complete protein.
Like soy protein, rice protein is suitable for vegans and vegetarians.
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