Among other things, this should be free of body shaming, idealised body types, and gendered norms, says the world’s first Consensus Statement on this topic

Creating a safe, gender-specific, supportive environment—one that is free of body shaming and idealised female forms, for example—is key to minimising female athletes’ future risks of injury and protecting their health, emphasises the Female/woman/girl Athlete Injury pRevention (FAIR) Consensus Statement—the first of its kind—published online in the British Journal of Sports Medicine.

Women and girls have increasingly been taking part in sports, which has led to a concomitant rise in their risk of injury. But how best to minimise this risk has been hampered by a lack of comprehensive and practical gender-specific evidence.

In a bid to tackle this knowledge gap and both promote and protect female athletes’ health, the International Olympic Committee convened a panel of sports and exercise specialists from around the globe to draw up a series of workable recommendations, with the aim of  informing current policy and practice and guiding future avenues of research.

The 56 recommendations in the Statement are based on syntheses of the best available evidence, combined with the lived experiences of athletes, as well as those involved in regulation, policy, practice, professional and personal support, to span the ‘whole sports system’.

The recommendations, which range from universal to sport specific, also include primary injury prevention strategies; policy, rules, and legislation; personal protective equipment; training; secondary injury prevention; modifiable risk factors; and approaches to diversity and inclusion.

“Injury prevention strategies cannot work if female/women/girl athletes do not have access to resources, knowledge or training/competition environments that support implementation of best practice injury prevention, health, and performance strategies that consider their needs,” says the Statement.

“The FAIR recommendations to facilitate a supportive environment include creating equitable funding and resource allocation (eg, injury prevention implementation, equipment, coach/support staff, gender/sex-preferred uniforms and surveillance systems with female/woman/girl-specific health codes) and access to expertise and knowledge through education, targeted research and hiring practices,” it continues.

Everyone who works in sport needs to be involved, urges the Statement.

“Recommendations such as ‘Create safe spaces free from body shaming or promoting ideal body types, or gendered norms’ might appear sensible, but they are NOT always part of female/woman/athletes’ reality. They should be front-of-mind and non-negotiable. At all levels of sport, responsibility must be taken for actions that can influence female/woman/girl athlete health,” it emphasises.

Other related recommendations include creating and enforcing gender based policies and procedures to tackle interpersonal violence and harassment, and fostering a non-judgmental culture in which issues, such as pregnancy, bone health, and breast care can be discussed and accommodated.

Policies to address unconscious and explicit social and cultural biases against women and girls’ sports participation and health are also essential, it says.

Lifelong injury prevention needs to start early to forge good preventive behaviours. And it needs to be a collaborative effort between athletes, coaches, and practitioners, and be evidence based, says the Statement.

Other key recommendations include:

●       Mandatory neuromuscular training warm-ups for all sports and all ages to ward off first and recurrent leg injuries, lasting a minimum of 10 minutes, twice a week

●       Implementation and enforcement of rules/policies that penalise unlawful head/body contact

●       Mandatory injury management across all sports to prevent concussion

●       All child and teen ice hockey players to wear mouthguards

●       All cyclists, skiers, snowboarders, skateboarders, horseriders to wear helmets

●       Neckguards/protectors to be worn for collision/contact ice sports

“We recognise that these recommendations must be responsive to diverse contexts, including uniqueness in experiences, expertise, geography, culture, healthcare access, sport structure, level of participation and sociocultural considerations,” says the Statement.

But it concludes: “To bolster female/women/girl athlete health and safety, every person (at all levels of sport participation and in their own specific context) can, and should, take responsibility to carefully consider and action these recommendations.”

03/12/2025

Notes for editors
*The Statement was informed by 5 systematic reviews, 1 scoping review, and 1 concept mapping study that synthesised more than 600 research articles involving more than 600,000 participants

Consensus statement: Female, woman and/or girl Athlete Injury pRevention (FAIR) practical recommendations: International Olympic Committee (IOC) consensus meeting held in Lausanne, Switzerland, 2025 Doi: 10.1136/bjsports-2025-110889
Journal: British Journal of Sports Medicine

External funding: International Olympic Committee

Link to Academy of Medical Science press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

About the journal
The British‌ ‌Journal‌ ‌of‌ ‌Sports‌ ‌Medicine‌‌ is one of 70 journals published by BMJ Group. ‌The title is co-owned with the British‌ ‌Association‌ ‌of‌ ‌Sports‌ ‌and‌ ‌Exercise‌ ‌Medicine‌ ‌(BASEM).‌
https://bjsm.bmj.com

Externally peer reviewed? Yes
Evidence type: Consensus statement
Subjects: Female athletes

The post Gender-specific supportive environment key to cutting female athletes’ injury risks first appeared on BMJ Group.

4000 steps once/twice weekly is associated with 26% lower risk of death rising to 40% if done on 3 days of the week
But it’s daily step count rather than number of days that matters, findings suggest 

Clocking up at least 4000 daily steps on just 1 or 2 days per week is linked to a lower risk of death and cardiovascular disease among older women, finds research published online in the British Journal of Sports Medicine.

This large prospective study examined not only how many steps older women take but how often they reach their step targets across the week, addressing a key gap in current physical activity guidelines.

Researchers found that achieving at least 4000 steps per day on 1-2 days per week was associated with a significantly lower risk of death and lower risk of cardiovascular disease (CVD), compared with not reaching this level on any day.

A large body of evidence shows that lifelong physical activity is important for improving the healthspan, say the researchers. But it’s not entirely clear how much physical activity people should do as they age to reap appreciable health benefits, particularly in respect of step counts which are yet to make it into physical activity guideline recommendations, they add.

To explore this further, they set out to look at the associations between daily step counts of between 4000 and 7000 and death from all causes and from cardiovascular disease in older women.

They also wanted to find out if the total number of daily steps might drive any observed associations, rather than the frequency of achieving step count thresholds, with a view to informing future guidelines–in particular the US Physical Activity Guidelines, the next edition of which is planned for 2028.

The study followed 13547 women (average age 71) from the U.S. Women’s Health Study who wore accelerometers (activity trackers) for 7 consecutive days between 2011–2015 and were tracked for nearly 11 years. The women were free of cardiovascular disease or cancer at the start of the study.

During the monitoring period of nearly 11 years up to the end of 2024, 1765 women (13%) died and 781 (5%) developed cardiovascular disease.

Clocking up at least 4000 steps/day on 1–2 days of the week was associated with a 26% lower risk of death from all causes and a 27% lower risk of a cardiovascular disease death compared with not reaching this threshold on any day of the week.

For those achieving this step count on at least 3 days of the week, the lower risk of death from any cause increased to 40%, but remained at 27% for the risk of cardiovascular death.

But while higher daily step counts of 5000 to 7000 on 3 or more days of the week were associated with a further fall in the risk of death from any cause—32%—they were associated with a levelling out in the risk of a cardiovascular disease death—16%.

When the findings were adjusted to take account of average daily steps, previously observed associations weakened, suggesting that [average] steps is the key driver of the protective effect, suggest the researchers.

This is an observational study, and as such, no firm conclusions can be drawn about cause and effect. The researchers also acknowledge that physical activity was assessed only for 1 week, and therefore couldn’t account for variations in behaviour over longer periods, nor did they have information on dietary patterns.

Nevertheless, they suggest: “The present study….suggests that frequency of meeting daily step thresholds is not critical (even 1–2 days/week of ≥4000 steps/day was related to lower mortality and CVD), and that step volume is more important than the frequency of meeting daily step thresholds in the older population.”

And they go on to explain: “An important translational implication of these findings is that since step volume is the important driver of the inverse associations, there is no ‘better’ or ‘best’ pattern to take steps; individuals can undertake [physical activity] in any preferred pattern (eg, ‘slow and steady’ vs ‘bunched patterns’) for lower mortality and CVD risk, at least among older women.”

They conclude: “These findings provide additional evidence for considering including step metrics in the next [physical activity] guidelines, and that ‘bunching’ steps is a viable option for health.”

21/10/2025

Notes for editors
Research:  Association between frequency of meeting daily step thresholds and all- cause mortality and cardiovascular disease in older women Doi: 10.1136/bjsports-2025-110311
Journal: British Journal of Sports Medicine

External funding:  National Institutes of Health; National Cancer Institute; National Heart, Lung, and Blood Institute

Link to Academy of Medical Science press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: Observational
Subjects: Women

The post Number of steps taken matters more for better health in older women than the frequency first appeared on BMJ Group.

Adherence is high and exercise snacks can counter perceived lack of time and motivation

Exercise snacks—intentional short bursts of physical activity—may be an effective way of boosting the cardiorespiratory fitness of physically inactive adults, finds a synthesis of the available research, published online in the British Journal of Sports Medicine.

Adherence to exercise snacking throughout the day was high, the findings indicate, and this approach could counter perceived lack of time and low motivation—frequently cited barriers to fulfilling the recommended weekly quota of physical activity for health—say the researchers.

Globally, around a third of adults, and 80% of teens, fail to meet the recommended physical activity levels of 300 minutes/week of moderate, or 75–150 minutes/week of vigorous, intensity physical activity, note the researchers.

A growing body of evidence indicates that exercise snacks, such as stair climbing or weights, have the potential to improve health and counter the deleterious effects of prolonged sitting. But most of these studies have relied on quasi-experimental designs or qualitative analyses, they add.

To fill this gap, the researchers set out to evaluate the effects of exercise snacks on cardiorespiratory fitness, muscular endurance, and cardiometabolic factors, such as blood fats and body fat distribution, to see if this might be a practical and scalable approach to curbing physical inactivity and its associated effects on health.

They scoured research databases for relevant clinical trials published up to April 2025, and found 11 from Australia, Canada, China and the UK that were suitable for pooled data analysis. These involved a total of 414 sedentary or physically inactive adults, over two thirds of whom (69%) were women.

Exercise snacks were defined as bursts of moderate to vigorous intensity physical activity lasting 5 minutes or less, excluding warm-up, cool-down, and intermediate recovery periods, and done at least twice a day for between 3 and 7 days a week for 4 to 12 weeks.

They mainly consisted of stair climbing, either as continuous bouts or at repeated intervals, for young and middle aged adults. Leg focused strength exercises and tai chi were the dominant forms among older adults.

Synthesis of the data showed that exercise snacking significantly improved cardiorespiratory fitness in adults (moderate certainty of evidence), although the evidence in support of its impact on muscular endurance in older adults (69-74 year olds) was limited.

Nor was exercise snacking associated with any significant effects on leg strength or cardiometabolic factors, including body composition, blood pressure, and blood fat profiles.

But compliance was high, at 91%, as was the ability to stick with the programme (83%), highlighting the potential feasibility and acceptability of this approach in real world unsupervised settings, suggest the researchers.

They acknowledge various limitations to their findings, chief among which was the limited number of studies with limited sample sizes included in their data synthesis. The study design and methodology of the included studies also varied considerably.

Nevertheless, they conclude: “The time efficient nature of exercise snacks may help overcome common barriers to physical activity, such as perceived lack of time and low motivation.

“Exercise snacks may enhance adherence to regular physical activity by providing short, flexible exercise bouts that are easier to integrate into daily routines.”

07/10/2025

Notes for editors
Research: Effect of exercise snacks on fitness and cardiometabolic health in physically inactive individuals: systematic review and meta- analysis Doi: 10.1136/bjsports-2025-110027
Journal: British Journal of Sports Medicine

External funding: None declared

Link to Academy of Medical Science press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: Systematic review + meta-analysis
Subjects: People

The post Exercise snacks may boost cardiorespiratory fitness of physically inactive adults first appeared on BMJ Group.

As well as improving general exercise capacity and mental health, finds pooled data analysis

Exercise-based cardiac rehabilitation lessens the severity, frequency, and recurrence of the most common form of irregular heart rhythm, atrial fibrillation, or AF for short, finds a pooled data analysis of the available research, published online in the British Journal of Sports Medicine.

It also improves general exercise capacity and mental health, without incurring any serious side effects, the findings show.

AF occurs when the heart’s upper chambers (atria) don’t contract properly and instead twitch, disrupting the electrical signals to the lower chambers (ventricles). Symptoms can include palpitations, chest pain, fatigue, dizziness, and shortness of breath.

AF is associated with a heightened risk of stroke and heart failure. An estimated 6–12 million people will develop it in the US by 2050 and nearly 18 million in Europe by 2060, note the researchers.

While current treatment is effective, the ability of patients to manage their condition themselves may help slow progression, maintain functional capacity, and minimise impact on their quality of life, they add.

Exercise based cardiac rehabilitation includes exercise training alongside personalised lifestyle risk factor management, psychosocial intervention, medical risk management and health behaviour education.

It’s used for patients who have had a heart attack, been diagnosed with heart failure, or who have had a stent fitted to improve blood flow to the heart, explain the researchers. But it’s not clear if this type of rehab is suitable for patients with AF, and it’s therefore not been included in international AF treatment guidelines.

Previous systematic reviews on the subject, published in 2017 and 2018, provided inconclusive evidence for its broader benefits. But since then, several other relevant clinical trials have been published, so the researchers set out to update the evidence.

They scoured research databases for randomised clinical trials on the effects of exercise based cardiac rehabilitation in patients with AF, published up to March 2024.

They found 20 relevant clinical trials carried out between 2006 and 2024 that involved 2039 patients, who were subsequently monitored for an average of 11 months. Ten trials were carried out in Europe, four in Asia, two in Australia, one each in Brazil, Canada, and Russia, and one in several countries.

Five trials assessed comprehensive exercise rehabilitation, which included educational and/or psychological components; the remainder assessed exercise only rehabilitation.

The exercise interventions ranged from 8 to 24 weeks, involving 1–7 weekly sessions of 15–90 minutes in length. Most trials included moderate intensity interventions, with only three  looking at the impact of vigorous intensity. Most trials included only aerobic based exercise training, although 6 included both aerobic and resistance based cardiac rehab.

Pooled data analysis of the results showed that this type of rehab didn’t affect the relative risks of death from any cause (8% vs 6% in the comparison group) or serious side effects (3% vs 4%).

But compared with those in the comparison groups, it reduced symptom severity by 39%, frequency and length of AF episodes by 43% and 42%, respectively, and risk of recurrence by 32%.

It also significantly improved exercise capacity, as measured by maximal oxygen intake. The scores for the mental component of a health related quality of life questionnaire also improved significantly, although this wasn’t the case for the physical component.

The effects were consistent, irrespective of type of AF, ‘dose’ of rehab, patient characteristics, or method of delivery.

The researchers acknowledge some limitations to their findings. Several trials lacked key methodological information, and those reporting the primary outcomes of interest were few. Most trials were relatively small and had a short monitoring period. The number of reported deaths and serious side effects was small, which substantially reduced the ability to reliably detect any true effect. And most participants were men.

Notwithstanding these caveats, the researchers suggest: “While improvements in traditional cardiovascular risk factors likely account for a substantial proportion of the benefit, additional mechanisms may directly impact AF burden and recurrence.

“Exercise training promotes favourable atrial remodelling, including reduced atrial stiffness and fibrosis, which may help limit [conditions favourable for AF], although further research is needed.”

They add: “Exercise training is known to have psychological benefits, including reductions in anxiety and depression, which are prevalent in individuals with AF and can exacerbate symptom perception.”

And they continue: “Collectively, these adaptations provide plausible mechanisms through which [exercise based rehab] not only supports general cardiovascular health and wellbeing but also gives AF specific benefits, including reductions in AF recurrence post-treatment and improvements in self-reported AF burden and severity.”

They conclude: “AF management guidelines should reflect this updated evidence base by recommending [exercise based cardiac rehabilitation] alongside drug and ablation therapies for patients with AF.”

In a linked editorial, expanding on the role of exercise in the treatment of AF, Drs Sarandeep Marwaha and Sanjay Sharma of the Institute of Cardiovascular and Cell Sciences, London, say the findings “provide further compelling evidence that [exercise based cardiac rehabilitation] significantly benefits patients with AF.”

They add: “Exercise is widely recognised as an important management tool, and it is crucial to highlight that it remains one of the most cost-effective, readily available, and manageable interventions for improving cardiovascular health.”

They continue: Patients may fear that exercise can trigger AF episodes, especially those with underlying heart conditions, and clinicians will often underemphasise exercise guidance and exercise prescriptions due to uncertainty. However, most studies evaluating moderate exercise in patients with AF have demonstrated safety with a very low risk of adverse events.”

But they caution: “It is essential to highlight that while exercise is a powerful tool in managing AF, it is most effective when precisely tailored to individual factors, such as comorbidities, AF characteristics, functional status, psychological factors and the requirement for supervision or monitoring.”

30/07/2025

Notes for editors
Research: Exercise based cardiac rehabilitation for atrial fibrillation: Cochrane systematic review, meta analysis, meta-regression and trial sequential analysis Doi: 10.1136/bjsports-2024-109149
Editorial: Role of exercise in atrial fibrillation management Doi: 10.1136/bjsports-2025-110191
Journal: British Journal of Sports Medicine

External funding: None declared

Link to Academy of Medical Science press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes (Research); No (Linked editorial)
Evidence type: Systematic review + meta analysis; Opinion
Subjects: People

The post Exercise rehab lessens severity, frequency + recurrence of irregular heart rhythm (AF) first appeared on BMJ Group.

But upping physical activity level still linked to 20–25% lower risk of death from any cause
Switching to a more active lifestyle at any point in adulthood may extend lifespan

Being consistently physically active in adulthood is linked to a 30–40% lower risk of death from any cause in later life, while upping levels from below those recommended for health is still associated with a 20–25% lower risk, finds a pooled data analysis of the available evidence, published online in the British Journal of Sports Medicine.

The findings prompt the researchers to conclude that switching to a more active lifestyle at any point in adult life may extend the lifespan, and that it’s never too late to start.

Currently, it’s recommended that adults should aim for 150-300 weekly minutes of moderate intensity physical activity, or 75-150 weekly minutes of vigorous intensity physical activity, or a combination of the two, note the researchers.

But while these recommendations were based on the best evidence available, most of it captured measurements of physical activity at only one point in time, which might hide the potential impact of changing patterns during adulthood, they add.

The researchers therefore wanted to find out if differing patterns of physical activity, as well as its cumulative impact during adulthood, might be associated with a lower risk of death from all causes, and specifically from cardiovascular disease and cancer.

They scoured research databases for relevant studies that assessed physical activity at two or more points in time, and included in their review 85 studies published in English up to April 2024, with sample sizes ranging from 357 to 6,572,984 participants.

Fifty nine of the studies looked at long term patterns of physical activity across adulthood; 16 looked at the average benefits of different physical activity levels; and 11 explored the potential impact of cumulative physical activity on risk of death.

To overcome the challenges posed by different analytical methods used, the researchers carried out separate analyses for each of them.

Pooled data analysis of the study results showed that, overall, a higher level of physical activity was associated with lower risks of all the included outcomes.

Consistently active people (32 studies) had around a 30–40% lower risk of dying from any cause, while those who increased their levels of physical activity (21 studies) from below those recommended had a 20-25% lower risk of death from any cause.

Specifically, participants who switched from being physically inactive to being active were 22% less likely to die from any cause than those who remained inactive, while those who increased their leisure time physical activity levels were 27% less likely to do so.

On the other hand, swapping an active lifestyle for an inactive one wasn’t associated with a lower risk of death from any cause.

Generally, the associations observed between a high level of physical activity and a lower risk of death were more evident for cardiovascular disease than for cancer.

Compared with participants who were consistently inactive over time, those who were consistently active, overall, or only in their leisure time, were around 40% and 25% less likely to die from cardiovascular disease and cancer, respectively.

But in general, the evidence for the associations between physical activity patterns and death from a specific cause remained inconclusive, especially for death from cancer.

The pooled data suggested that people who were consistently active or who became active had lower risks of death from any cause, and specifically from cardiovascular disease, when meeting the recommended weekly physical activity levels.

But being consistently physically active and clocking up more than the recommended maximum weekly amount of moderate to vigorous intensity exercise was associated with only a small additional reduction in risk.

Maintaining or increasing physical activity at levels below the recommended weekly amount, however, was associated with appreciable health benefits, indicating that some physical activity is always better than none, say the researchers.

And an average volume of physical activity that met the recommended weekly amount was also associated with a 30–40% lower risk of death from all causes. But more research is needed to confirm this, they add.

The researchers acknowledge some limitations to their findings, including that most of the studies included in the pooled data analyses relied on subjective assessments of physical activity, which may not always have been accurate.

And there were only a few studies that looked at cumulative amounts of physical activity, or cancer deaths.

Nevertheless, the findings have important public health implications, insist the researchers.

“First, our results emphasised the importance of [physical activity] across adulthood, indicating that initiating [it] at any point in adulthood may provide survival benefits.”

They add: “As being consistently active provides greater health benefits than being previously active (ie, no longer maintaining activity), this highlights the importance of sustained [physical activity] over time.

“Future [physical activity] interventions may not only target inactive people, but also support active people to maintain their activity.”

11/07/2025

Notes for editors
Research: Physical activity trajectories and accumulation over adulthood and their associations with all-cause and cause-specific mortality: a systematic review and meta-analysis Doi: 10.1136/bjsports-2024-109122
Journal: British Journal of Sports Medicine

External funding: National Health and Medical Research Council

Link to Academy of Medical Science press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: Systematic review + meta analysis
Subjects: People

The post Being consistently physically active in adulthood linked to 30–40% lower risk of death first appeared on BMJ Group.

But clear sex differences in protective effects, depending on condition, findings indicate

Physical activity in early childhood, especially taking part in organised sports,may ward off several mental health disorders in later childhood and adolescence, suggests research published online in the British Journal of Sports Medicine.

But there seem to be clear sex differences in the observed protective effects, depending on the condition, the findings indicate.

The prevalence of mental ill health among children and teens has risen sharply worldwide, with a heightened vulnerability to stress thought to partially explain the increase, note the researchers.

Physical activity has been suggested as crucial for helping build resilience to stress and lowering the risks of mental ill health in childhood. But it’s not clear if there are time points when it might be most beneficial.

To try and find out, the researchers drew on the ABIS Study (All Babies in Southeast Sweden), which includes nationally representative data collected from 17055 families with children born between 1 October 1997 and 1 October 1999 in Southeast Sweden.

In all, 16,365 children were included in the study from birth, 7880 (48%) of whom were girls and 8485 (52%) of whom were boys.

The parents reported on their children’s physical activity levels, the amount of time they spent outdoors, and any participation in organised sports at the ages of 5, 8, and 11.

One in four children experienced a traumatic event before the age of 5 and almost 30% had done so by the age of 10.

Their mental health was tracked up to the age of 18, with confirmed mental health diagnoses obtained from a national registry.  In all, 1353 participants (15%) were diagnosed with at least one mental health issue during childhood, while 4% had three or more such diagnoses.

Analysis of all the data showed that physical activity levels fell from a daily average of just over 4 hours to 2.5 hours between the ages of 5 and 11.

The daily amount of physical activity at the age of 11 was associated with a 12% lower risk of being diagnosed with any mental disorder before the age of 18 for each additional physically active hour.

But there were sex differences in the level of associated protection afforded. For example, physical activity was associated with a 30% lower risk of any mental ill health among boys at the age of 11, but not among girls after adjusting for mothers’ education and use of mental health medication, adverse life events, and sex.

When the incidence of specific mental health conditions was analysed in relation to daily physical activity levels, the risk of depression among girls was 18% lower, but 29% lower among boys at the age of 11.

The effects seemed to start early—at least in boys. The risk of depression was 19% lower at the age of 5 and 23% lower at the age of 8 among boys, but not among girls. And while the risk of anxiety fell sharply at both the ages of 5 (21% lower) and 11 (39% lower) among boys, no such effects were seen among girls.

Similarly, the risk of addiction was 34% lower at the age of 8 and 35% lower at the age of 11 among boys, but not among girls.

Time spent outdoors wasn’t influential, but taking part in organised sports at the age of 11 was strongly associated with lower risks of a first-time occurrence of any mental health disorder among both boys (23% lower) and girls (12% lower).

When stratified by specific condition, organised sports participation was associated with a 35% lower risk of depression among boys, but only an 11% lower risk among girls for every additional weekly hour engaged in it.

Organised sports participation was also associated with a 14% lower risk of anxiety among girls and a 21% lower risk among boys, as well as a 41% lower risk of addiction among girls and a 30% lower risk among boys. It didn’t influence the risks of eating and sleep disorders.

“Physical activity may influence boys and girls in different ways, including changes mediated by different levels of sex hormones. However, these effects might be direct—for example, by influencing brain health and development, or indirect—for example, by reducing subclinical hyperactivity, which is more common among boys,” explain the researchers.

“Furthermore, there may exist differences in physiological consequences (eg, variation in intensity of physical activity) and psychological experiences that are connected to gender and cultural norms.”

Although covering an extended period, this is an observational study, thereby precluding any firm conclusions to be drawn about cause and effect. The study also relied on parental recall.

“Our results support the hypothesis that the period just before, and during, the early stages of puberty might represent a sensitive period in which [physical activity] is key to the development of resilience and hardiness,” with the period between the ages of 10 and 12 representing a critical window of opportunity,” suggest the researchers.

“Given the dramatic increase in the global prevalence of psychiatric disorders among children and adolescents, this study highlights the importance of promoting [physical activity], particularly through organised sports,” they conclude.

14/05/2025

Research: Impact of physical activity on the incidence of psychiatric conditions during childhood: a longitudinal Swedish birth cohort study Doi 10.1136/bjsports-2024-108148
Journal: British Journal of Sports Medicine

External funding: Swedish Child Diabetes Foundation; Swedish Council for Working Life and Social Research; Swedish Research Council; Medical Research Council of Southeast Sweden (FORSS)

Externally peer reviewed? Yes
Evidence type: Observational
Subjects: People

The post Physical activity + organised sports participation may ward off childhood mental ill health first appeared on BMJ Group.

t also boosts wellbeing and quality of life, suggests umbrella review of pooled data analyses
Findings lend weight to its routine inclusion in cancer treatment protocols, say researchers

Exercise can counter the detrimental effects of cancer treatment, such as heart and nerve damage and brain fog, suggests an overarching review of the existing pooled data analyses of the most recent research, published online in the British Journal of Sports Medicine.

Exercise also seems to boost psychological wellbeing and overall quality of life, lending weight to its routine inclusion in treatment protocols for the disease, say the researchers.

Several pooled data analyses of the available research have evaluated the impact of exercise on health outcomes in people with cancer, but significant gaps remain in our understanding, explain the researchers.

And to date, no comprehensive evaluation of the results of existing pooled data analyses on exercise and health outcomes in people with a broad range of cancers has been published, they add.

To plug this gap, with the aim of strengthening the evidence base and informing clinical care, the researchers carried out an umbrella review of the existing pooled data analyses of randomised controlled trial results, published between 2012 and July 2024.

The review included 485 associations from 80 articles, all evaluated as being of moderate to high quality.

Among these associations, the types of exercise of any length, intensity, and duration included mind–body (138, 28.5%), such as Qigong, tai-chi, and yoga; aerobic and resistance  exercise (48,10%), high intensity interval training (HIIT) (18,4%); and other types (281,59%).

These associations were explored in people with cancers of the breast (244, 50%), digestive system (20,4%), blood (13, 3%), lung (47,10%), prostate (12, 2.5%) plus others (149, 31%).

In all, 260 (54%) associations were statistically significant, and 81 (17%) and 152 (31%), respectively, were supported by high and moderate certainty evidence, according to GRADE criteria—used to assess the certainty of scientific evidence and the strength of recommendations in health care.

Exercise significantly reduced various side effects associated with cancer and its treatment compared with usual care or no exercise. For example, it lessened heart and peripheral nerve damage associated with chemotherapy, brain fog (cognitive impairment), and shortness of breath (dyspnoea).

It also changed body composition and key physiological indicators of health, such as insulin, insulin-like growth factor, and C-reactive protein in people with cancer. And it improved sleep quality, psychological wellbeing, the normal workings of the body, and social interaction, while boosting overall quality of life.

And there was evidence of high to moderate certainty that preoperative exercise reduced the risk of postoperative complications, pain, length of hospital stay, and risk of death.

The researchers acknowledge various limitations to their findings. The pooled data analyses included in the review differed considerably, including the number of studies on which they variously drew.

Participants with cancer able to exercise might also have been healthier, the researchers suggest. And side effects of treatment vary, depending on cancer type and how advanced the disease is, they point out.

But they conclude: “Incorporating mind–body exercises into the exercise guidelines for people with cancer may be a valuable consideration. Future high quality research is needed to explore additional outcomes, clarify underlying mechanisms and refine exercise prescriptions tailored to cancer type, treatment timing, exercise modality and individual characteristics, ensuring more precise and clinically relevant interventions for diverse cancer populations.”

30 April 2025

Notes for editors
Research: Impact of exercise on health outcomes in people with cancer: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials  Doi: 10.1136/bjsports-2024-109392
Journal: British Journal of Sports Medicine

External funding: primarily Natural Science Foundation of China

Externally peer reviewed? Yes
Evidence type: Umbrella review of existing meta analyses
Subjects: People

The post Exercise can counter detrimental effects of cancer treatment first appeared on BMJ Group.

Daily pelvic floor muscle training also strongly recommended
Following this new guideline is likely to result in large improvements in maternal and infant health and well-being, say experts

New mums should be strongly encouraged to begin clocking up at least two hours of moderate to vigorous intensity physical activity such as brisk walking and muscle strengthening exercises each week in the first three months after birth, when physically able, to improve health and well-being, say experts in a new guideline published by the British Journal of Sports Medicine.

They also strongly recommend daily pelvic floor muscle training to reduce the risk of urinary incontinence, and taking steps to improve sleep quality and duration.

In the weeks and months following birth (postpartum period), risk of depression, weight retention, sleep disorders, diabetes, and cardiovascular disease increases, especially after pregnancy complications. But clear guidance on how to appropriately engage in postpartum physical activity is severely lacking.

To address this, a panel of expert researchers and clinicians set out to provide up to date, evidence-based guidance on physical activity, sedentary behaviour, and sleep throughout the first year after childbirth.

Their recommendations are based on in-depth analyses of evidence from 574 studies and are relevant to those who have recently given birth, irrespective of breastfeeding status, gender, cultural background, disability, or socio-economic status.

After consulting with new mums, the panel selected 21 ‘critical’ and ‘important’ outcomes for analysis. These included injury, reduced breast milk quality or quantity, depression and anxiety, urinary incontinence, fear of movement, fatigue, and poor infant growth and development.

The quality and certainty of evidence for each outcome was evaluated using the GRADE system.

Based on this evidence, the panel strongly recommends that in the first 12 weeks after giving birth, new mums with no conditions or symptoms preventing them from being physically active should aim for a mix of aerobic and resistance activities (eg, brisk walking, cycling and muscle strengthening exercises) for at least 120 minutes each week, spread over four or more days of the week.

Those with underlying conditions or symptoms should seek medical advice before beginning or returning to moderate physical activity, they add. However, they stress that everyone who has recently given birth should be doing light daily activities such as gentle walking, to prevent the known harms of inactivity.

Other strong recommendations include daily pelvic floor muscle training to reduce the risk of urinary incontinence and rehabilitate pelvic floor muscles, and developing a healthy sleep routine (eg, avoiding screen time and maintaining a dark, quiet environment before bed) to support mental health.

New mums who follow this guideline, produced by the Canadian Society for Exercise Physiology, are likely to reap many health benefits, including reduced depression, urinary incontinence, and low back pain, and improvements in weight, cholesterol levels, and fatigue, with no increased risk of injury or adverse effects on breastmilk quality or quantity, they explain.

They acknowledge that meeting these recommendations may not always be possible, but say “even small steps towards achieving them will still promote physical and mental health benefits.”

And while future research will need to address gaps in the literature, they argue that these clinically meaningful benefits “strongly support incorporating consultation and guidance on movement behaviours into clinical practice for the postpartum period.”

Feedback also indicates that following these recommendations would be feasible, acceptable and equitable, and likely to incur minimal costs to individuals and health systems, while yielding significant healthcare savings.

26/03/2025

Notes for editors
Consensus statement: 2025 Canadian guideline for physical activity, sedentary behaviour, and sleep throughout the first year postpartum doi: 10.1136/bjsports-2025-109785
Journal: British Journal of Sports Medicine

External funding: The Christenson Professor in Active Healthy Living Research Stipend

Link to Academy of Medical Sciences press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf 

Externally peer reviewed? Yes
Evidence type: Consensus statement based on systematic reviews and meta-analyses
Subjects: People

The post New mums advised to do two hours of moderate to vigorous exercise a week first appeared on BMJ Group.

Athletes with disabilities and those in team sports most at risk, survey reveals 

Nearly 1 in 5 college athletes reports some form of abusive supervision—defined as sustained hostile verbal and non-verbal behaviours—by their coaches, reveals an analysis of survey responses, involving National Collegiate Athletic Association (NCAA) athletes, and published online in the British Journal of Sports Medicine.

While there is no evidence of vulnerability according to race/ethnicity, sexual orientation, or gender, athletes with disabilities and those participating in team sports seem to be most at risk, the findings indicate.

Athletes view their coaches as role models, which makes their interactions susceptible to supervised abuse, say the researchers.

“While transformational leadership can inspire players and impart valuable life lessons that positively impact athletes’ play and contribute to their development, an unethical leader can severely negatively affect an athlete’s mental health, quality of life, and wellbeing in adulthood,” they point out.

Given that most coaches identify as White, male, cisgender, able-bodied and straight, the researchers wanted to find out if race/ethnicity, gender, sexual orientation and disability, were distinguishing features of abusive coach supervision.

They drew on data from the 2021–22 myPlaybook survey administered by the University of North Carolina Greensboro Institute to Promote Athlete Health & Wellness in collaboration with Stanford University’s Sports Equity Lab. The dataset included 4337 NCAA athletes from 123 universities across the USA.

The validated Tepper 2000 questionnaire was adapted to ask respondents whether they had experienced certain abusive coaching behaviours, with each answer ranging from 1 to 5, representing frequency.

Four additional questionnaires probed athlete autonomy, team culture, perceived coach leadership skills and care for their athlete’s wellbeing.

In all, 3317 respondents provided complete data on abusive supervision and 1926 (58%) provided complete data on this plus the areas covered by the other 4 questionnaires.

Most respondents (89%; 2959) were aged between 18 and 21, and male respondents made up 57% (1891) of the total.

Sexual orientation was reported as predominantly straight (3125). And as only 19 identifed themselves as non-binary, transgender, or ‘other’, their number was too small to be statistically meaningful, and they were excluded from the analysis.

Some 81% (2689) of respondents were involved in non-lean sports—where leanness is not considered a competitive advantage—and about 75% (2480) participated in team sports.

Around three quarters of participants shared the same gender as their coach: 1844 male–male pairs; 660 female–female pairs.

Of the total number of respondents, 2699 reported no abusive supervision, but 618 (nearly 19%) said they had experienced it.

There was no significant age difference between those who reported abuse and those who didn’t. And gender identity analysis revealed that while women were slightly more likely to report abuse, this wasn’t statistically significant.

Race/ethnicity data indicated that nearly two thirds (2162) of participants were White, but there was no significant difference between the different racial groups in terms of reporting abuse.

After accounting for potentially influential factors, significant differences were noted in the type of sport played as team sports participants were 10% more likely to report abusive supervision than their peers who participated in individual sports.

And non-lean sports participants reported more abusive supervision than those participating in lean sports, although this didn’t reach statistical significance.

The prevalence of disability was just under 3% (88), and after accounting for potentially influential factors, those reporting a disability were 17% more likely to say they had experienced abusive supervision than their able bodied peers.

Coach behaviours indicative of concern for the athlete’s wellbeing were associated with a lower risk of abusive supervision reports.

Coaches who reacted harshly and who focused predominantly on team success/outcomes were deemed more abusive, with a 24%-47% heightened risk of an abusive supervision report.

On the other hand, those who were attentive to, and respectful of, their athletes’ needs and efforts; who were demonstrably accountable; and who regularly communicated respectfully with their athletes were deemed more supportive. Their risk of being reported as abusive was around 35% lower.

The researchers acknowledge that the survey responses reflect just one point in time, and  would not have captured those who discontinued their sporting careers because of the abuse they endured.

And the findings might not be applicable to other age groups, sports organisations, or athletes worldwide, they add.

But they nevertheless comment: “Overall, these findings are concerning as we know from prior research the role abusive coaching plays in psychological, training, performance and academic outcomes in comparison with coaches who use a more athlete-centred and humanistic approach.”

They continue: “Promoting positive coaching strategies that prioritise athlete wellbeing, motivation and teamwork is essential to protecting collegiate athletes and facilitating their development.

“Therefore, NCAA member institutions should consider a nationwide policy that mandates the implementation of a standardised educational programme and training created by the NCAA e-learning team for coaches to recognise and address abusive supervision behaviours while recognising and amplifying supportive supervision behaviours.”

They conclude: “Ultimately, dealing with this problem is crucial for safeguarding NCAA athletes, particularly those from equity-deserving groups. Further solutions-focused research is necessary to advance the goal of fostering a safe sporting environment for collegiate athletes to thrive both on and off the field.”

04/03/2025

Notes for editors
Research: Associations of abusive supervision among collegiate athletes from equity-deserving groups Doi: 10.1136/bjsports-2024-108282
Journal: British Journal of Sports Medicine

External funding: None declared

Link to Academy of Medical Science press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: Observational; survey data
Subjects: People

The post Nearly 1 in 5 US college athletes reports abusive supervision by their coaches first appeared on BMJ Group.

Tailored exercise may prolong life in these patients, suggest researchers

Muscular strength and good physical fitness are linked to a significantly lower risk of death from any cause in people with cancer, finds a pooled data analysis of the available evidence, published online in the British Journal of Sports Medicine.

Tailored exercise to boost muscle strength and cardiorespiratory fitness in patients with cancer may help boost their chances of survival, suggest the researchers.

In 2022 alone, 20 million people were diagnosed with cancer worldwide, and nearly 10 million died from their disease—trends that are projected to increase in the coming decades, note the researchers.

And despite notable advances in cancer prevention, diagnosis, and treatment, the side effects of treatment, including those on the heart and muscles, can take their toll on survival, they add.

To inform potential options for extending survival in people diagnosed with cancer, the researchers set out to see if muscular strength and cardiorespiratory fitness might be associated with lower risks of death in these patients, and whether cancer type and stage might be influential.

They searched for relevant studies published in English up to August 2023 and included 42 in their pooled data analysis, involving nearly 47,000 patients (average age 64) with various  types and stages of cancer.

Low muscle strength, using handgrip strength, was classified as either less than 13 kg to less than 25 kg in women, and from less than around 20 kg to less than 40 kg in men.

Cardiorespiratory fitness was assessed using either cardiopulmonary exercise testing (CPET) or the 6 minute walk test (MWT).

The pooled data analysis of the study results showed that both muscular strength and cardiorespiratory fitness were significantly associated with the risk of death from any cause and specifically from cancer.

Compared with those with poor muscle strength and low levels of cardiorespiratory fitness, those at the other end of the spectrum were 31%-46% less likely to die from any cause.

And this risk fell by a further 11% with each unit increase in muscular strength.

What’s more, this combination of strength and fitness was associated with an 8%-46% lower risk of death from any cause in patients with advanced cancer (stages 3 and 4), and a 19%–41% lower risk of death from any cause among those with lung or digestive cancers.

And each unit increase in fitness level was associated with an 18% lower risk of death from cancer itself.

“Our findings highlight that muscle strength could potentially be used in clinical practice to determine mortality risk in cancer patients in advanced stages and, therefore, muscle strengthening activities could be employed to increase life expectancy,” suggest the researchers.

22/01/2025

Notes for editors
Systematic review: Association of muscle strength and cardiorespiratory fitness with all-cause and cancer-specific mortality in patients diagnosed with cancer: a systematic review with meta-analysis  Doi: 10.1136/bjsports-2024-108671
Journal: British Journal of Sports Medicine

External funding: None declared

Link to Academy of Medical Science press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: Systematic review
Subjects: People

The post Muscular strength and good physical fitness linked to lower risk of death in people with cancer first appeared on BMJ Group.