Physical training affects carbohydrate metabolism and results in an increased insulin-stimulated glucose disposal. To investigate if carbohydrate and lipid metabolism would be affected by nutritional factors in optimally trained elite athletes, during a 1-year period we studies elite ice-hockey players on two Swedish top-performance teams. Players on one team were subjected to extensive dietary monitoring and intervention, whereas players on the second team continued their ordinary diet. Blood levels of insulin, C-peptide, glucose, hemoglobin A1C (HbA1c), lipids, and lipoproteins were measured repeatedly. Basal insulin levels and insulin resistance (IR) were significantly lower among athletes on both teams compared with a sedentary group, and muscle weight and body mass index were significantly higher. During the course of the study in the intervention group, insulin levels decreased (3.6 +/- 0.3 v 6.2 +/- 0.6 [mean +/- SEM], P <.05) in conjunction with a decreased relative fat energy content, but returned toward baseline levels when relative fat energy content increased. IR decreased in parallel (0.59 +/- 0.05 v l.12 +/- 0.12, P <.05) and followed a similar pattern, reverting toward baseline levels. Also, levels of HbA1c changed during dietary manipulation. No changes in these parameters were observed among the elite players from the team not participating in the diet regimen. In contrast to the parameters for glucose homeostasis, no significant changes were found in serum lipid or lipoprotein levels in either team during the course of the study. The results verify the presence of an improved carbohydrate metabolism in elite athletes. The observed changes in glycemic control and glucose homeostasis as a consequence of dietary modification demonstrate further that nutritional factors may affect carbohydrate metabolism also in well-trained athletes.

We analyzed blood samples from 407 healthy Swedish individuals, 244 men and 163 women, ages 17 to 86 years, for apolipoprotein (apo) E isoforms and serum triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol. Parallel genotyping by means of polymerase chain reaction (PCR)-amplified DNA was performed in 200 subjects. Identical results were obtained by genotyping and phenotyping in 95% of all subjects analyzed. The apo E allelic frequencies were 7.8% for epsilon2, 71.9% for epsilon3, and 20.3% for epsilon4. Compared with other Caucasian populations, the present population had a high relative allelic frequency of epsilon4. The epsilon4 frequency decreased with increasing age and was significantly lower in individuals >60 years of age (14.7%). When controlling for age and sex, there were strong correlations between total serum and LDL cholesterol and the various epsilon alleles. The epsilon4 and epsilon3 alleles correlated positively with serum cholesterol and the epsilon4 allele correlated positively with LDL cholesterol. In contrast, HDL cholesterol and serum triglycerides did not show any correlation to the allele types. Thus, the results demonstrate a considerable age variation of the epsilon allele frequency among healthy Swedes and an influence of apo E alleles on serum and LDL cholesterol concentrations.

Serum concentrations of androgens, cortisol, androgen binding proteins, pituitary hormones, together with anthropometric variables and sports performance were studied in two different elite male ice hockey teams. One of the teams (DIF, n = 22) participated in a special dietary program including reduction in fat from approximately 40 per cent of total energy intake (E%) to less than 30 E% and an increase in carbohydrate intake from 45 E% to about 55 E%, while the other (SSK, n = 21) served as a control group and had no special dietary program. The study covered a 7-month period. Basal values of serum testosterone, sex hormone binding globulin (SHBG), non-SHBG-bound testosterone (NST), cortisol, dehydroepiandrosterone sulfate (DHAS) and LH did not differ between the two teams. Serum concentrations of testosterone, SHBG, NST and cortisol increased significantly during the study period in the DIF group and were, with the exception of SHBG, significantly higher than in the SSK group at the end of the study (33.0 vs 26.8 nmol/l, p less than 0.05; 22.5 vs 18.3 nmol/l, p less than 0.05; and 548 vs 464 nmol/l, p less than 0.01). The ratio between NST and cortisol which was used as an index of anabolic/catabolic steroid balance did not change in either group during the study. A significant decrease in the serum concentrations of LH during the observation period was found in the SSK group. The endocrine differences between the teams may be explained by a relative negative energy balance in DIF, together with a reduced fat and increased carbohydrate intake.(ABSTRACT TRUNCATED AT 250 WORDS)

ABSTRACT. The general health and nutritional status of 105 refugee children from Chile and the Middle East were examined shortly after the arrival in Stockholm. A chronic medical condition was present in 10% and there were clinical signs of canes in 57% of the children. Iron deficiency was found in 15% of Chileans and 6% of Middle Easterners, but no other nutritional deficiencies were discovered. Stunting and wasting was rare and a significant catch‐up growth was observed in both groups in a follow‐up 18 months after resettlement. Obesity was common in the Chilean group on arrival in Sweden and increased further after resettlement. We conclude that chronic medical conditions, canes and obesity were the major somatic health problems in this sample of newly resettled refugee children.

Consumption and restoration of muscle glycogen and changes in anabolic and catabolic steroid hormones were analyzed in five male elite orienteers during and after an orienteering competition. The magnitude of glycogen consumption and pronounced increase in serum-cortisol during the orienteering race reflect the great muscular output demands during forest running. The free testosterone/cortisol ratio was normalized to the initial level within four hours post-exercise. Synchronously, only 25% of the muscle glycogen loss was restored. Within 24 hours post-exercise all runners showed normalized levels of testosterone, cortisol and free testosterone/cortisol ratio. The glycogen content was also restored except in one of the runners. We conclude that daily orienteering competitions per se do not seem to create risks for developing a state of hormonal imbalance or significant decrease in glycogen when the carbohydrate supply is appropriate.

Peripheral serum hormone levels during the off season were analysed in 10 male and 10 female athletes, all belonging to the Swedish national teams in skiing and orienteering and in age matched sedentary controls (15 males, 13 females). No clinical signs of overuse strain were observed in any of the athletes. No significant differences in hormone variables were found between male athletes and controls. The female athletes had significantly higher levels of cortisol and significantly lower ratios between total testosterone and cortisol, between non-SHBG-bound testosterone and cortisol and between 4-androstene-3, 17-dione and cortisol than the sedentary controls. The increased levels of cortisol found in the female athletes probably reflect an adaptation to several years of hard training. A decrease of the free T/cortisol ratio has earlier been shown to indicate an overuse distress. One may speculate that the low androgen/cortisol ratios found in the female athletes in contrast to the males could indicate that the female athletes might need longer time to recover from hard exercise than male athletes, or could suggest an insufficient dietary intake.

Summary Pituitary hormones, adrenal and testicular steroids and steroid-binding proteins were analysed in 4 active ice hockey players and in 3 spectators, matched for physical fitness, during the night after a 26-hour cup tournament. The examined period included the last match of three matches. Unconjugated adrenal steroids (Cortisol, 4-androstene-3, 17-dione [A-4] and dehydroepiandrosterone [DHA]) and prolactin were increased in players immediately following the match, but were normalized within 3–4 h. After that similar nocturnal patterns were observed in players and spectators. The time-courses for DHA sulphate, albumin and sex hormone binding globulin (SHBG) were identical in players and spectators. Serum testosterone (T), 17α-hydroxyprogesterone (17OHP) and LH levels had time-courses with a nadir between 20.00 and 24.00 h and maximum values in the morning; however, this pattern was less pronounced in players. The results illustrate the rapid normalization of adrenocortical activity after physical stress and further support the view that interference with pituitary LH secretion may be the main mechanism responsible for the observed changes in testicular steroids. Zusammenfassung Serumkonzentrationen von Hypophysenhormen, Hoden- und Nebennierenrindensteroiden und steroidbindenden Proteinen wurden in Blutproben während der Nacht nach einem 26stündigem Turnier bei 4 aktiven Eishockeyspielern und 3 vergleichbaren Zuschauern bestimmt. Die unkonjugierten Nebennierenrindensteroide Cortisol, Dehydroepiandrosteron und 4-Androsten-3, 17-dion sowie Prolaktin zeigten erhöhte Werte bei den Spielern unmittelbar nach dem letzten Spiel, normalisierten sich aber nach 3–4 Stunden. Dehydroepiandrosteronsulfat, Albumin und SHBG zeigten bei Spielern und Zuschauern einen identischen Zeitverlauf. Testosteron, 17α-Hydroxyprogesteron und LH zeigten Minimumwerte zwischen 20 und 24 Uhr und höchste Werte am Morgen. Dieser Verlauf war bei den Spielern weniger ausgeprägt. Die Ergebnisse unserer Untersuchung zeigen die schnelle Normalisierung der Nebennierenrindenaktivität nach körperlicher Anstrengung und bestätigen die Anschauung, daß der Einfluß von Hypophysenhormonen der Hauptgrund für die von uns beobachteten Veränderungen der Hodensteroide ist.

Pituitary, adrenal and testicular hormones and steroid-binding proteins were analysed in 15 active ice hockey players and in 16 spectators, matched for physical fitness, during a 26-h cup tournament including three matches. Diurnal variations were noted for all compounds except FSH and SHBG. The levels of cortisol, dehydroepiandrosterone (DHA), 4-androstene-3, 17-dione (A-4) and prolactin increased in players but not in spectators following the matches played in the afternoons, but not following the match played in the morning. Albumin and DHA sulphate (DHAS) levels increased in players following all three matches and SHBG levels increased slightly in players following the afternoon matches, all probably due to haemoconcentration. DHAS and albumin showed simultaneous diurnal variations with a nadir in the morning. 17 alpha-hydroxyprogesterone (17-OHP) and total and non-SHBG-bound testosterone showed similar diurnal patterns in spectators, with maximum levels in the morning. Levels of 17-OHP were largely unaffected by physical stress, while the morning maximum for total and non-SHBG-bound testosterone was completely abolished in players. Minor or insignificant changes were noted for LH and FSH. While the changes in unconjugated adrenal steroids (cortisol, DHA and A-4) reflect changes in acute ACTH stimulation, changes in albumin binding may be more important for the short-term variations in levels of DHAS. The influence of physical stress upon the pattern of testosterone may be mediated mainly by inhibition of testicular steroidogenesis by elevated cortisol and/or prolactin levels, rather than by decreased gonadotrophic stimulation or by alterations in binding to SHBG.

The effect of one week of controlled fasting (31 of fluid containing 50 g of carbohydrate/day) upon the serum levels of hormones, sex hormone binding globulin, and albumin was studied in healthy subjects. Fasting caused decreased levels of prolactin and T3, no changes in the levels of TSH, FSH, LH, dehydroepiandrosterone, 4-androstene-3, 17-dione, total oestrone, and total testosterone, and increased levels of cortisol, dehydroepiandrosterone sulphate and albumin. A significant positive correlation was found between albumin and dehydroepiandrosterone sulphate. Fasting rapidly increased the levels of sex hormone binding globulin and decreased the percentage of free testosterone and the calculated free testosterone level in both sexes. A decreased metabolic clearance of certain steroids (cortisol, dehydroepiandrosterone sulphate) owing to an increased protein binding may be one of the endocrine consequences of fasting. An increased protein binding of testosterone may be outweighed by a decreased gonadal production, thus resulting in an unchanged total testosterone level. The increased sex hormone binding globulin level could not be explained by changes in gonadal and thyroid hormones.