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Title:
Response to: We need to talk about manels: the problem of implicit gender bias in sport and exercise medicine
A recent editorial in the British Journal of Sports Medicine asserted that the presence of implicit bias in Sport and Exercise Medicine (SEM) is negatively affecting women in the field.1 We are concerned with the editorial’s lack of scientific approach, poor standard of evidence, and exclusion of important facts.
The editorial argued implicit bias results in pronounced real-world effects in the form of gendered differences in SEM and society as a whole. However, no substantial scientific evidence of the magnitude of implicit bias’s real-world consequences on gender differences was presented. Instead, circular reasoning was utilized as implicit bias was assumed to manifest the gendered differences present in the SEM field and society.
Implicit bias has been criticised within its field of psychology. A recent meta-analysis found little evidence that measurements of implicit bias are associated with any real-world manifestations of explicit bias or behaviour.2 Indeed, Patrick Forscher, one of the study’s authors implied in an interview that implicit bias’ use in policy making could be wasteful and even harmful.3
Research suggests gender has an influence on personality, career preferences, and priorities.4 Indeed, where more freedom is allowed, the greater the disparity in traditionally gendered sectors.5 Extrapolation of thes...
Title:
Response to: We need to talk about manels: the problem of implicit gender bias in sport and exercise medicine
A recent editorial in the British Journal of Sports Medicine asserted that the presence of implicit bias in Sport and Exercise Medicine (SEM) is negatively affecting women in the field.1 We are concerned with the editorial’s lack of scientific approach, poor standard of evidence, and exclusion of important facts.
The editorial argued implicit bias results in pronounced real-world effects in the form of gendered differences in SEM and society as a whole. However, no substantial scientific evidence of the magnitude of implicit bias’s real-world consequences on gender differences was presented. Instead, circular reasoning was utilized as implicit bias was assumed to manifest the gendered differences present in the SEM field and society.
Implicit bias has been criticised within its field of psychology. A recent meta-analysis found little evidence that measurements of implicit bias are associated with any real-world manifestations of explicit bias or behaviour.2 Indeed, Patrick Forscher, one of the study’s authors implied in an interview that implicit bias’ use in policy making could be wasteful and even harmful.3
Research suggests gender has an influence on personality, career preferences, and priorities.4 Indeed, where more freedom is allowed, the greater the disparity in traditionally gendered sectors.5 Extrapolation of these basic biological and social facts indicate the potential for gendered differences in roles (e.g. serving on a panel) to be a result of situations arising from free choice. These are very important points to consider when discussing discrepancies between genders, yet were not mentioned in the editorial.
The argument above is of course not for absolute biological determinism, nor that sexism does not exist. Recognizing the fact that there are differences between women and men does not mean equity between genders cannot exist. However, valid evidence should take precedence over ideological narratives. Any statements on this topic should be made with caution as to avoid promoting unnecessary interventions.
The authors of the editorial are free to critically examine the evidence presented opposing their conclusions. However, the editorial demonstrated a low standard of evidence. For this conversation to move forward a higher standard of evidence should be sought and adhered to.
In conclusion, the authors of the editorial failed to meet the necessary burden of proof to claim that implicit bias is a primary cause for the complex phenomenon of gender discrepancies in SEM or society. As such, the likelihood is high that the interventions cited within the editorial are unwarranted and unhelpful.
REFERENCES
1. Bekker, S. et al. We need to talk about manels: the problem of implicit gender bias in sport and exercise medicine. British Journal of Sports Medicine bjsports–2018–099084–4 (2018). doi:10.1136/bjsports-2018-099084
2. Forscher, P. S. et al. A meta-analysis of change in implicit bias. PsyArXiv 1–68 (2017). doi:10.17605/OSF.IO/DV8TU
3. Goldhill, O. The world is relying on a flawed psychological test to fight racism. Quartz (2017). Available at: https://qz.com/1144504/the-world-is-relying-on-a-flawed-psychological-te.... (Accessed: 9 April 2018)
4. Su, R., Rounds, J. & Armstrong, P. I. Men and things, women and people: A meta-analysis of sex differences in interests. Psychological Bulletin 135, 859–884 (2009).
5. Stoet, G. & Geary, D. C. The gender-equality paradox in science, technology, engineering, and mathematics education. Psychol Sci 095679761774171–20 (2018). doi:10.1177/0956797617741719
Hi!
First, I'd like to thank you for your precious work, as I'm doing a research about kitesurfing injuries statistics.
As kitesurfing instructor, I'd like to tell that in picture n°2, I think the guy is intentionally doing a trick. The kite is flying high, pulling him up. As far as the kite pulls the rider above the center of gravity, put the upper body below that point (as in the picture) requires strength, control and intentionality.
In really dangerous situation (those that need the rider to use quick release safety system), you usually can see the kite low in the air in front of the rider (power zone) pulling hard and the rider's legs behind.
I don't want to say that the situation described in the picture couldn't be dangerous at all, but in this case it depends on factors you can't see in the picture (obstacles, beach, other people, maximum height of the jump...).
Again, thanks for your research work and thanks to people working on safety on the beaches and in kitesurfing.
Whilst plantar heel pain be a more appropriate term than plantar fasciitis the later is more diagnostic than plantar heel pain which is more symptomatic. It is suggested that the attachments to the os calcis ought to be termed plantar enthesopathy for instance plantar enthesitis
I thank Dr. Batacan et al. for their excellent meta-analysis “Effects of high-intensity interval training on cardiometabolic health” in the March 2017 issue of the British Journal of Sports Medicine [1]. Even if the effects of high-intensity interval training (HIIT) on inflammation are still unclear, research in the coming years will hopefully prove more positive benefits. For example, two recent studies showed effects through a long-term HIIT (12 weeks or more) in the inflammatory profile of overweight/obese adults, such as decreased interleukin (IL) 6, and increased IL-10 concentrations [2, 3].
But regardless of the various health effects of HIIT, I think the following fact is also worth mentioning for consumers. Health is a motivation to start with regular exercise, but mostly no motive to stay in the long term. On a permanent and regular basis, sport is only practiced when factors such as pleasure and enjoyment are added to the movement. Therefore, I am especially pleased that even overweight/obese teenagers and adults feel HIIT for an enjoyable and time-efficient form of exercise, as several recent studies demonstrate [4-8].
To Dr. Batacan and colleagues: Very well written, correct results, and appropriate references. Congratulations!
References
1. Batacan RB Jr, Duncan MJ, Dalbo VJ, Tucker PS, Fenning AS. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of inte...
I thank Dr. Batacan et al. for their excellent meta-analysis “Effects of high-intensity interval training on cardiometabolic health” in the March 2017 issue of the British Journal of Sports Medicine [1]. Even if the effects of high-intensity interval training (HIIT) on inflammation are still unclear, research in the coming years will hopefully prove more positive benefits. For example, two recent studies showed effects through a long-term HIIT (12 weeks or more) in the inflammatory profile of overweight/obese adults, such as decreased interleukin (IL) 6, and increased IL-10 concentrations [2, 3].
But regardless of the various health effects of HIIT, I think the following fact is also worth mentioning for consumers. Health is a motivation to start with regular exercise, but mostly no motive to stay in the long term. On a permanent and regular basis, sport is only practiced when factors such as pleasure and enjoyment are added to the movement. Therefore, I am especially pleased that even overweight/obese teenagers and adults feel HIIT for an enjoyable and time-efficient form of exercise, as several recent studies demonstrate [4-8].
To Dr. Batacan and colleagues: Very well written, correct results, and appropriate references. Congratulations!
References
1. Batacan RB Jr, Duncan MJ, Dalbo VJ, Tucker PS, Fenning AS. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. Br J Sports Med 2017;51(6):494-503.
2. Steckling FM, Farinha JB, Santos DL, Bresciani G, Mortari JA, Stefanello ST, et al. High intensity interval training reduces the levels of serum inflammatory cytokine on women with metabolic syndrome. Exp Clin Endocrinol Diabetes 2016;124(10):597-601.
3. Gerosa-Neto J, Antunes BM, Campos EZ, Rodrigues J, Ferrari GD, Rosa Neto JC, et al. Impact of long-term high-intensity interval and moderate-intensity continuous training on subclinical inflammation in overweight/obese adults. J Exerc Rehabil 2016;12(6):575-580.
4. Lee S, Spector J, Reilly S. High-intensity interval training programme for obese youth (HIP4YOUTH): a pilot feasibility study. J Sports Sci 2017;35(18):1794-98.
5. Smith-Ryan AE. Enjoyment of high-intensity interval training in an overweight/obese cohort: a short report. Clin Physiol Funct Imaging 2017;37(1):89-93.
6. Kong Z, Fan X, Sun S, Song L, Shi Q, Nie J. Comparison of high-intensity interval training and moderate-to-vigorous continuous training for cardiometabolic health and exercise enjoyment in obese young women: a randomized controlled trial. PLoS One 2016;11(7):e0158589.
7. Martinez N, Kilpatrick MW, Salomon K, Jung ME, Little JP. Affective and enjoyment responses to high-intensity interval training in overweight-to-obese and insufficiently active adults. J Sport Exerc Psychol 2015;37(2):138-49.
8. Heinrich KM, Patel PM, O'Neal JL, Heinrich BS. High-intensity compared to moderate-intensity training for exercise initiation, enjoyment, adherence, and intentions: an intervention study. BMC Public Health 2014;14:789.
Saturated fat is an essential element in our diet. Our body uses saturated far for energy, hormone production, facilitating vitamin absorption and most importantly, for coating and padding to protect our cellular membranes and organs. In the last two decades, saturated fat has been demonised as the main culprit leading to fatty deposits in the coronary artery and causing heart attacks (myocardio-infarction) when the deposits block up the artery. The truth is that myocardio-infarction is not directly caused by deposition of saturated fat called ‘plaque’ in our coronary arteries. The main cause of myocardio-infarction is the rupture of the plaque [1]. The main cause of rupture is inflammation [2-4]. There are many factors which will trigger an inflammation response in our body. These include: infection, stress, allergy, and injury…etc. Other genetic factors and social and environment factors also play an important role. I salute the authors of this paper for their strong spirit of science, identifying new evidence which challenges previous views. “The important thing is not to stop questioning. Curiosity has its own reason for existing”. - Albert Einstein As an epidemiologist, public health practitioner and an educator, I concur with the author’s suggestion of the non-pharmaceutical approach to maintain good health. This simple approach involves an easy short daily walking exercise and eating a good balanced diet with...
Saturated fat is an essential element in our diet. Our body uses saturated far for energy, hormone production, facilitating vitamin absorption and most importantly, for coating and padding to protect our cellular membranes and organs. In the last two decades, saturated fat has been demonised as the main culprit leading to fatty deposits in the coronary artery and causing heart attacks (myocardio-infarction) when the deposits block up the artery. The truth is that myocardio-infarction is not directly caused by deposition of saturated fat called ‘plaque’ in our coronary arteries. The main cause of myocardio-infarction is the rupture of the plaque [1]. The main cause of rupture is inflammation [2-4]. There are many factors which will trigger an inflammation response in our body. These include: infection, stress, allergy, and injury…etc. Other genetic factors and social and environment factors also play an important role. I salute the authors of this paper for their strong spirit of science, identifying new evidence which challenges previous views. “The important thing is not to stop questioning. Curiosity has its own reason for existing”. - Albert Einstein As an epidemiologist, public health practitioner and an educator, I concur with the author’s suggestion of the non-pharmaceutical approach to maintain good health. This simple approach involves an easy short daily walking exercise and eating a good balanced diet with everything consumed in moderation.
References
1. Hansson , G.K. Inflammation, Atherosclerosis, and Coronary Artery Disease. New England Journal of Medicine, 2005;352(16):1685-1695.
2. Kovanen, P.T., M. Kaartinen, and T. Paavonen. Infiltrates of Activated Mast Cells at the Site of Coronary Atheromatous Erosion or Rupture in Myocardial Infarction. Circulation, 1995:92(5):1084-1088.
3. van der Wal, A.C., et al. Site of intimal rupture or erosion of thrombosed coronary atherosclerotic plaques is characterized by an inflammatory process irrespective of the dominant plaque morphology. Circulation, 1994;89(1):36-44.
4. Moreno, P.R., et al. Macrophage infiltration in acute coronary syndromes. Implications for plaque rupture. Circulation, 1994; 90(2): 775-8.
I read with interest the narrative review by Timothy David Noakes and
Johann Windt
However, the very name of this diet, 'low-carb, high-fat' can be
misleading, because it does not tell us which type(s) of fat such a diet
is high in. To the extent that low-carb, high-fat (LCHF) diets are low in
carbohydrates and high in monounsaturated and polyunsaturated fats (MUFAs
and PUFAs, respectively), p...
I read with interest the narrative review by Timothy David Noakes and
Johann Windt
However, the very name of this diet, 'low-carb, high-fat' can be
misleading, because it does not tell us which type(s) of fat such a diet
is high in. To the extent that low-carb, high-fat (LCHF) diets are low in
carbohydrates and high in monounsaturated and polyunsaturated fats (MUFAs
and PUFAs, respectively), particularly Omega-3 PUFAs, I would broadly
agree with the statements made in the review.
However, the authors also note that such diets are usually high in
animal proteins, such as steak and other unprocessed animal meats, as well
as coconut oil, all of which tend to be high in saturated fats (SFAs), and
concerns should be raised about this.
For example, a 2016 meta-analysis of randomized control trials found
that low-carb diets resulted in an increase in LDL-cholesterol, which is,
as the authors of the meta-analysis indicate, an "important"
cardiovascular risk factor.(1)
The authors of this narrative review do have some responses to this.
Firstly, they argue that this ignores a shift from small, dense LDL
particles to large and buoyant ones. Yet, according to Berneis and Krauss,
"large LDL particles also can be associated with increased coronary
disease risk, particularly in the setting of normal or low triglyceride
levels."(2)That said, I accept that large LDL particles may be less
damaging than small, dense LDL particles.
The authors of this review also note other positive changes in risk
factors on LCHF diets, particularly when compared to low-fat, high-carb
(LFHC) diets.
This, however, ignores the fact that we could potentially achieve
improvement in all of the main cardiovascular risk factors, from HDL to
triglycerides to ApoB to LDL-C (and its subfractions). We can do this with
a diet that is relatively low in carbohydrates and saturated fat, but is
relatively high in MUFAs and PUFAs, particularly Omega-3 PUFAs.
Indeed, replacing saturated fats with MUFAs and PUFAs has, in
general, been shown to improve the total:HDL cholesterol ratio, considered
by many to be the best marker of heart disease. This replacement has also
been shown to lower ApoB concentrations.(3)
Furthermore, replacing saturated fats with two key PUFAs, alpha-
linolenic acid (ALA) and linoleic acid (LA) has been shown to produce a
statistically significant improvement in the triglyceride to HDL ratio,
while replacement of saturated fat with MUFAs produced a non-significant
improvement.(4) EPA and DHA, two other polyunsaturated fats, are also
known to produce a substantial decrease in triglycerides and an increase
in HDL, relative to carbohydrates.(5)
Confirming this are RCTs which demonstrate that low-carb diets which
are high in MUFAs and PUFAs and relatively low in saturated fat result in
favourable changes in cardiovascular risk factors, including weight loss.
In addition to many of the improvements that LCHF diets produce mentioned
in this narrative review, a 2008 intervention study looking at a ketogenic
Mediterranean Diet found decreases in LDL-C resulting from the diet.(6)
The EcoAtkins trial also found that, relative to a high-carbohydrate
vegetarian diet, a low-carbohydrate vegan diet produced improvements in
LDL-C, the total: HDL ratio and ApoB concentrations.(7)
Similarly, a high-GI diet high in MUFAs reduces the total:HDL-C ratio
relative to a high-GI diet high in saturated fat.(8)
Studies have also found that diets higher in PUFAs and/or MUFAs and
correspondingly lower in saturated fats favourably affect LDL particle
size.(9, 10)
While the authors of this narrative review cite one trial suggesting
that a low-carb diet may even do better than a Mediterranean Diet, it is
important to note that people on the low-carb diet "were counseled to
choose vegetarian sources of fat and protein". Indeed, their total fat
intake increased to a greater extent than their saturated fat intake, as a
percentage of energy, and the numbers indicate that unsaturated fat intake
was increased to a greater extent than their saturated fat intake.
Furthermore, total fat as a percentage of energy was only 33% on the Med
Diet in that trial, significantly lower than the ~40% common in a
Mediterranean Diet.(11)
The authors of this narrative review claim that the benefits of
replacing saturated fats with PUFAs are "unproven", yet at least two meta-
analyses of RCTs have found that replacing them with PUFAs is beneficial
(12,13), and a meta-analysis of prospective cohort studies has found that
higher intake of the Omega-6 PUFA, linoleic acid, is beneficial.(14)
While concerns have been raised about Omega-6 PUFAs, due to possible
confounding by Omega-3 PUFAs in RCTs and prospective cohort studies (alpha
-linolenic acid in particular in the latter)(15), all this would show is
that replacing saturated fats with sources of PUFAs, as long as plant
and/or marine sources of Omega-3 PUFAs are specifically increased too, is
beneficial.
When plant sources of MUFAs were predominantly consumed, as in the
PREDIMED trial, prospective analysis found that replacing saturated fats
with MUFAs reduced the risk of cardiovascular disease.(16) Similarly, two
recent cohort studies have found that replacing saturated fats with MUFAs
is beneficial.(17,18)
In line with the mechanistic, observational and clinical evidence
cited above, an analysis of two cohorts in 2010 concluded that vegetable-
based low-carbohydrate diets were associated with lower CVD and all-cause
mortality risk, whereas animal-based low-carb diets were associated with
higher all-cause mortality risk.(19)
All in all, the evidence suggests that a Mediterranean-style diet
naturally low in saturated fat, sugar and refined carbohydrate, and
perhaps lower in whole-grains and unrefined carbohydrates than a
traditional Mediterranean diet, can not only produce the "unique" benefits
of a LCHF diet cited in this narrative review, but can produce even
greater benefits.
This would be a diet rich in fruits, vegetables, healthy plant
proteins such as legumes and beans, and MUFAs and Omega-3 PUFAs, one or
both of which can be found in some plant oils (olive, canola, flaxseed),
nuts, seeds and oily fish. We now have two well-conducted RCTs examining
events (not just risk factors) demonstrating the substantial benefits of
this dietary pattern.(20, 21)
References
(1) Mansoor N, et al. Effects of low-carbohydrate diets v. low-fat
diets on body weight and cardiovascular risk factors: a meta-analysis of
randomised controlled trials. Br J Nutr. 2016;115(3): 466-79.
(2) Berneis KK, Krauss RM. Metabolic origins and clinical
significance of LDL heterogeneity. The Journal of Lipid Research.
2002;43:1363-1379
(3) Mensink RP, et al. Effects of dietary fatty acids and
carbohydrates on the ratio of serum total to HDL cholesterol and on serum
lipids and apolipoproteins: a meta-analysis of 60 controlled trials. Am J
Clin Nutr. 2003;77(5):1146-1155.
(4) Mensink RP. Effects of saturated fatty acids on serum lipids and
lipoproteins: a systematic review and regression analysis. World Health
Organization, 2016.
(5) Harris WS. n-3 fatty acids and serum lipoproteins: human studies.
Am J Cln Nutr. 1997;65(5 Suppl):1645S-1654S.
(6) Perez-Guisado J, et al. Spanish Ketogenic Mediterranean Diet: a
healthy cardiovascular diet for weight loss. Nutr J. 2008;7:30.
(7) Jenkins DJ, et al. The effect of a plant-based low-carbohydrate
("Eco-Atkins") diet on body weight and blood lipid concentrations in
hyperlipidemic subjects. Arch Intern Med. 2009;169(11):1046-54.
(8) Jebb SA, Lovegrove JA, Griffin BA, et al. Effect of changing the
amount and type of fat and carbohydrate on insulin sensitivity and
cardiovascular risk: the RISCK (Reading, Imperial, Surrey, Cambridge, and
Kings) trial. Am J Cln Nutr. 2010;92(4):748-58.
(9) Kratz M, Gulbahce E, von Eckardstein A, Cullen P, Cignarella A,
Assmann G, Wahrburg U. Dietary mono- and polyunsaturated fatty acids
similarly affect LDL size in healthy men and women. J Nutr.
2002;132(4):715-8.
(10) Egert S, Kratz M, Kannenberg F, et al. Effects of high-fat and
low-fat diets rich in monounsaturated fatty acids on serum lipids, LDL
size and indices of lipid peroxidation in healthy non-obese men and women
when consumed under controlled conditions. Eur J Nutr. 2011;50(1):71-79.
(11) Shai I, et al. Weight-loss with a Low-Carbohydrate,
Mediterranean or Low-Fat Diet. New England Journal of Medicine.
2008;359(3):229-41.
(12) Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in
saturated fat intake for cardiovascular disease. Cochrane Database Syst
Rev. 2015;6:CD011737.
(13) Mozaffarian D, Micha R, Wallace S. Effects on coronary heart
disease of increasing polyunsaturated fat in place of saturated fat: a
systematic review and meta-analysis of randomized controlled trials. PLoS
medicine 2010;7(3):e1000252.
(14) Farvid MS, Ding M, Pan A, et al. Dietary linoleic acid and risk
of coronary heart disease:a systematic review and meta-analysis of
prospective cohort studies. Circulation 2014;130:1568-78.
(15) Ramsden CE, et al. All PUFAs Are Not Created Equal: Absence of
CHD Benefit Specific to Linoleic Acid in Randomized Control Trials and
Prospective Observational Cohorts. World Rev Nutr Diet. 2011;102:30-43.
(16) Guasch-Ferre M, et al. Dietary fat intake and risk of
cardiovascular disease and all-cause mortality in a population at high
risk of cardiovascular disease. Am J Cln Nutr. 2015;102(6):1563-73.
(17) Li Y, et al. Saturated Fats Compared with Unsaturated Fats and
Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease: A
Prospective Cohort Study. J Am Coll Cardiol, 2015;66(14):1538-48.
(18) Wang DD, et al. Association of Specific Dietary Fats with Total
and Cause-Specific Mortality. JAMA Intern Med. 2016;176(8):1134-45.
(19) Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu
FB. Low-carbohydrate diets and all-cause and cause-specific mortality: two
cohort studies. Ann Intern Med. 2010;153(5):289-98.
(20) de Lorgeril M, et al. Mediterranean Diet, Traditional Risk
Factors, and the Rate of Cardiovascular Complications After Myocardial
Infarction. Circulation. 1999;99:779-785.
(21) Estruch R, et al. Primary Prevention of Cardiovascular Disease
with a Mediterranean Diet. New England Journal of Medicine. 2013;368:1279-
1290.
The article identifies "associations" between various sports and
longevity. Associations do not deal with the issue of causality. Yet
articles like this seem to imply that there is a causal relationship. I'm
sure the authors would acknowledge that "correlation does not imply
causation". Yet articles like this seem to imply that "yes, we know we
haven't proved causality, but (nudge nudge, wink wink) we...
The article identifies "associations" between various sports and
longevity. Associations do not deal with the issue of causality. Yet
articles like this seem to imply that there is a causal relationship. I'm
sure the authors would acknowledge that "correlation does not imply
causation". Yet articles like this seem to imply that "yes, we know we
haven't proved causality, but (nudge nudge, wink wink) we all know that
really it is a causal relationship".
There is far too much of this pseudo science about these days aided
by the availability of large data stores and the tools to extract
associations.
Title:
Response to: We need to talk about manels: the problem of implicit gender bias in sport and exercise medicine
A recent editorial in the British Journal of Sports Medicine asserted that the presence of implicit bias in Sport and Exercise Medicine (SEM) is negatively affecting women in the field.1 We are concerned with the editorial’s lack of scientific approach, poor standard of evidence, and exclusion of important facts.
The editorial argued implicit bias results in pronounced real-world effects in the form of gendered differences in SEM and society as a whole. However, no substantial scientific evidence of the magnitude of implicit bias’s real-world consequences on gender differences was presented. Instead, circular reasoning was utilized as implicit bias was assumed to manifest the gendered differences present in the SEM field and society.
Implicit bias has been criticised within its field of psychology. A recent meta-analysis found little evidence that measurements of implicit bias are associated with any real-world manifestations of explicit bias or behaviour.2 Indeed, Patrick Forscher, one of the study’s authors implied in an interview that implicit bias’ use in policy making could be wasteful and even harmful.3
Research suggests gender has an influence on personality, career preferences, and priorities.4 Indeed, where more freedom is allowed, the greater the disparity in traditionally gendered sectors.5 Extrapolation of thes...
Show MoreTable 3: First supplement "Beta Alanine". This should read "Caffeine" as described in the text.
Hi!
First, I'd like to thank you for your precious work, as I'm doing a research about kitesurfing injuries statistics.
As kitesurfing instructor, I'd like to tell that in picture n°2, I think the guy is intentionally doing a trick. The kite is flying high, pulling him up. As far as the kite pulls the rider above the center of gravity, put the upper body below that point (as in the picture) requires strength, control and intentionality.
In really dangerous situation (those that need the rider to use quick release safety system), you usually can see the kite low in the air in front of the rider (power zone) pulling hard and the rider's legs behind.
I don't want to say that the situation described in the picture couldn't be dangerous at all, but in this case it depends on factors you can't see in the picture (obstacles, beach, other people, maximum height of the jump...).
Again, thanks for your research work and thanks to people working on safety on the beaches and in kitesurfing.
Gabriele
Whilst plantar heel pain be a more appropriate term than plantar fasciitis the later is more diagnostic than plantar heel pain which is more symptomatic. It is suggested that the attachments to the os calcis ought to be termed plantar enthesopathy for instance plantar enthesitis
Dear Editor,
I thank Dr. Batacan et al. for their excellent meta-analysis “Effects of high-intensity interval training on cardiometabolic health” in the March 2017 issue of the British Journal of Sports Medicine [1]. Even if the effects of high-intensity interval training (HIIT) on inflammation are still unclear, research in the coming years will hopefully prove more positive benefits. For example, two recent studies showed effects through a long-term HIIT (12 weeks or more) in the inflammatory profile of overweight/obese adults, such as decreased interleukin (IL) 6, and increased IL-10 concentrations [2, 3].
But regardless of the various health effects of HIIT, I think the following fact is also worth mentioning for consumers. Health is a motivation to start with regular exercise, but mostly no motive to stay in the long term. On a permanent and regular basis, sport is only practiced when factors such as pleasure and enjoyment are added to the movement. Therefore, I am especially pleased that even overweight/obese teenagers and adults feel HIIT for an enjoyable and time-efficient form of exercise, as several recent studies demonstrate [4-8].
To Dr. Batacan and colleagues: Very well written, correct results, and appropriate references. Congratulations!
References
1. Batacan RB Jr, Duncan MJ, Dalbo VJ, Tucker PS, Fenning AS. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of inte...
Show MoreHow soon after completion of the exercise regime were the cognitive measures taken, and what was the average length of the followup?
Dear Editor,
Saturated fat is an essential element in our diet. Our body uses saturated far for energy, hormone production, facilitating vitamin absorption and most importantly, for coating and padding to protect our cellular membranes and organs. In the last two decades, saturated fat has been demonised as the main culprit leading to fatty deposits in the coronary artery and causing heart attacks (myocardio-infarction) when the deposits block up the artery. The truth is that myocardio-infarction is not directly caused by deposition of saturated fat called ‘plaque’ in our coronary arteries. The main cause of myocardio-infarction is the rupture of the plaque [1]. The main cause of rupture is inflammation [2-4]. There are many factors which will trigger an inflammation response in our body. These include: infection, stress, allergy, and injury…etc. Other genetic factors and social and environment factors also play an important role. I salute the authors of this paper for their strong spirit of science, identifying new evidence which challenges previous views. “The important thing is not to stop questioning. Curiosity has its own reason for existing”. - Albert Einstein As an epidemiologist, public health practitioner and an educator, I concur with the author’s suggestion of the non-pharmaceutical approach to maintain good health. This simple approach involves an easy short daily walking exercise and eating a good balanced diet with...
Show MoreDear Editor,
I read with interest the narrative review by Timothy David Noakes and Johann Windt
However, the very name of this diet, 'low-carb, high-fat' can be misleading, because it does not tell us which type(s) of fat such a diet is high in. To the extent that low-carb, high-fat (LCHF) diets are low in carbohydrates and high in monounsaturated and polyunsaturated fats (MUFAs and PUFAs, respectively), p...
Dear Editor,
The article identifies "associations" between various sports and longevity. Associations do not deal with the issue of causality. Yet articles like this seem to imply that there is a causal relationship. I'm sure the authors would acknowledge that "correlation does not imply causation". Yet articles like this seem to imply that "yes, we know we haven't proved causality, but (nudge nudge, wink wink) we...
Dear Editor,
As for Fifa standards this is very lovely explained as well. The benefit of activity is in common interest of health professionals and the state.
Conflict of Interest:
Physiotherapy
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