Correspondence
In Reply
While Professor Scherer categorized the study cohort of over 500 000 long distance runners as a “tiny subgroup of the total population”, the group of the world’s top 10 marathon runners is enough to evaluate the age associated development of physical performance for Professor Kindermann.
As explicitly explained in our study (1)—cited by Kindermann—a generalization/transfer of the performance criteria of the top 10 athletes is problematic and does not make sense, for various reasons. Studies have shown, for example, that the most extreme high performance training of world class athletes can rarely be tolerated for any more than 10 years, independently of an athlete’s age (1). Restricting the data pool to the top 10 also entails enormous selection biases, genetic particularities, potential problems with doping and more. Comparing performance between younger professional athletes and elderly amateur athletes may be quick and easy to do, but this will certainly not reflect the age-
related physiological changes in endurance fitness that are relevant for the broad population.
A general problem in tracing age related performance changes is the fact that it is difficult to differentiate between physiological aging processes and effects that are caused by changed everyday habits (for example, a less active lifestyle). This matter of fact has widely been ignored in medical studies, which are often based only on small sample sizes, and has ultimately prompted the assumption that loss of performance begins around the age of 30 and is “fateful”. This hypothesis can no longer be maintained on the basis of the available data.
Scherer’s comments make it necessary to reiterate the objectives of the PACE study. By analyzing a subpopulation of the general population, which practices successfully and self-motivatedly health relevant exercise and behavioral measures, the objective was to clarify the potential of regular physical exercise for an inactive and aging society. However, our study did not intend to provide a representative snapshot of the status quo in society. For this reason the proportion of marathon runners within the general population is not relevant in this context, and neither is the question whether this is a sociological phenomenon. We share Scherer’s view that the statistics he cites paint a dismal picture of said status quo and that promoting sports in the population has “enormous potential for improvement.”
With regard to the correspondence by Professor Ulmer: It is undisputed that knowledge of “contraindications to sports” and “sports related adverse effects” is highly relevant for the clinical practice of sports physicians and general practitioners. This has repeatedly been a topic in the recommendations from the Deutsche Gesellschaft für Sportmedizin und Prävention (DGSP, the German Society for Sports Medicine and Prevention), in several monographs, and in our own publications (2, 3). Furthermore, attentive readers will find relevant information in the discussion section of our article.
It is, however, equally undisputable that regular exercise is of huge importance in prevention and therapy (4). It seems that Ulmer did not gain clarity about our actual research question, methodological approach, and objectives of the statistically—although they are being emphasized in the article with their own subheading (“Marathon running as a study model for physical performance”) and paragraph. The PACE study showed that performance losses in middle age were not so much the result of physiological aging processes but, rather, unfavorable lifestyles and lack of training.
DOI: 10.3238/arztebl.2011.0207
Prof. Dr. med. Dr. Sportwiss. Dieter Leyk
Institut für Physiologie und Anatomie
Am Sportpark Müngersdorf 6
50933 Köln, Germany
Leyk@dshs-koeln.de
Conflict of interest statement
The authors of all contributions declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.
| 1. | Leyk D, Erley O, Ridder D, Leurs M, Rüther T, Wunderlich M, Sievert A, Baum K, Essfeld D: Age related changes in marathon and half-marathon performances. Int J Sports Med 2007; 28: 513–7. MEDLINE |
| 2. | Löllgen H, Leyk D, Hansel J: The pre-participation examination for leisure physical activity – General medical and cardiological issues. Dtsch Arztbl Int 2010; 107: 742–9. VOLLTEXT |
| 3. | Leyk D, Rüther T, Wunderlich M, Heiss A, Ridder D, Küchmeister G, Löllgen H: Sporting activity, prevalence of overweight, and risk factors – cross-sectional study of more than 12500 participants aged 16 to 25 years. Dtsch Arztbl Int 2008; 105: 793–800. VOLLTEXT |
| 4. | Leyk D: The preventive and therapeutic roles or regular physical activity. Dtsch Arztebl Int 2009; 106: 713–4. VOLLTEXT |
| 5. | Leyk D, Rüther Th, Wunderlich M, et al.: Physical performance in middle age and old age: Good news for our sedentary and aging society. Dtsch Arztebl Int 2010; 107(46): 809–16. VOLLTEXT |
