Master athletes usually continue their training across decades, adhering to training regimens of three to six sessions (about 10 or more hours) per week (7). The incidence and risk of chronic diseases of affluence, for example, diabetes, metabolic syndrome, or coronary heart disease, reportedly are lower, and self-rated health is better in competitive master athletes (13) and former elite athletes (16) than in apparently healthy controls. Moreover, master athletes reach upper limits of human physical capacity (18) and are, thus, an adequate model to determine “successful aging.”
So far, studies on age-related changes in aerobic capacity and other health characteristics have concentrated on endurance sports (26,30). There only are few studies contrasting sprint- and endurance-trained master athletes (4,6,23). Unfortunately, specific goals and design of these studies do not allow a deeper insight into age-related changes. First of all, small numbers of subjects within narrow age ranges were analyzed, and untrained groups were not included for comparison. Moreover, aging sprint-trained athletes have never been the subject of any study on age-related changes in characteristics such as aerobic capacity, “anaerobic threshold,” or insulin sensitivity probably because they have no predictive value for sprint performance.
By “sprint-trained athletes” we mean those who perform short-time (conventionally ≤30 s) maximum-intensity exercise resulting in the highest possible movement velocity, speed, or frequency at a low external resistance. Typical examples are track sprinters and high and long jumpers who have to accelerate the body rapidly in an extremely short time. The exercise training pattern of sprint-oriented athletes clearly differs from that of endurance athletes. On the other hand, taking into consideration a standard training schedule, sprint also may be classified as a mixed sport, where different training modalities are undertaken to reach the main goal, that is, sprint performance. Master sprinters use varied exercise: apart from developing speed (0.8–2.0 training sessions per week), they improve specific speed-endurance abilities (0.6–2.1 training sessions per week), jumping ability (0.3–1.1 training sessions per week), strength (0.6–1.5 training sessions per week), and aerobic endurance (0.6–2.0 training sessions per week) (7). In effect, master sprinters and jumpers devote 10% to 50% of their training time to endurance development (7) because low-intensity exercise is necessary to warm up properly or to focus on improving movement technique. Moreover, aerobic mechanisms enable faster recovery after high-intensity exercise. Importantly, not only the incorporated endurance exercise determines health effects of sprint-oriented training. It was revealed in randomized control (3,28) and intervention (32) studies that sprint interval training itself induced beneficial metabolic and cardiovascular adaptations that normally are associated with aerobic training: increase in maximal oxygen uptake, insulin sensitivity, resting fat and carbohydrate oxidation, reduced systolic blood pressure, waist and hip circumferences. This suggests that chronic high-intensity (sprint) exercise might be an effective strategy to maintain health.
As sprint-trained athletes undertake different training modalities and given that sprint training itself causes some adaptations as advantageous as those resulting from endurance training, they represent a model of long-term physical activity with specific consequences for aging, which is interesting in the context of health and fitness preservation in a long-term perspective. Based on the previous premises, one may expect that sprint-trained athletes who practice competitive sport on a regular basis will maintain an optimal level of health characteristics across the lifespan.
Our recent studies among competitive athletes of different ages (20–94 yr) have thrown some light on the effects of sprint-oriented and endurance training models on characteristics that are not only related to sport performance but also are crucial to maintaining general health in a lifetime perspective: aerobic capacity, heart function, insulin sensitivity, glucose metabolism, lipid profile, body composition, bone density, neuromuscular function, and tendinopathy (11,15,17,19–22,25). In Figure 1, we present a brief comparison between the aging-related health effects of sprint and endurance training, which we subsequently discuss in more detail. We take into account health benefits as well as some risks connected with sport training. In general, both athletic groups benefit from their training models, and health benefits definitely outweigh a certain risk associated with competitive sport. Certainly, athletes specializing in different disciplines differ in health profile.
In this short review, we make an attempt to compare health- and aging-related benefits and risks of the sprint and endurance training model. We hypothesize that the sprint model of lifelong physical training based on short high-intensity exercise is in general as beneficial for successful aging and health as is the endurance model based on prolonged submaximal exercise.
Maximal Aerobic Capacity
In one of our studies, we analyzed relationships between age and maximal oxygen uptake (V˙O2max) and contributors to the age-related decline in master athletes and controls based on cross-sectional data (19). The sprint group showed a lower average level of V˙O2max than the endurance group (∼47 vs ∼58 mL·kg−1·min−1, respectively). This was in accordance with earlier cross-sectional studies based on smaller groups of middle-aged master athletes (4,6). However, at the same time, sprinters had significantly higher levels of aerobic capacity than untrained recreationally active individuals (∼41 mL·kg−1·min−1). Admittedly, in one study, a lower V˙O2max was reported in young nonendurance athletes (bobsledders) than in untrained controls; however, athletes were approximately 8 yr older and the difference in aerobic capacity changed to the advantage of bobsledders after a 15-yr follow-up (23). According to our data, the cross-sectional rate of decline in V˙O2max, expressed both as milliliters per kilogram per minute and as percent per decade, was smaller in the sprint group (0.31 mL·kg−1·min−1 per year) than in endurance runners (0.46 mL·kg−1·min−1 per year) and untrained controls (0.35 mL·kg−1·min−1 per year) (Fig. 2). In line with this finding, other researchers revealed that the longitudinal (15-yr follow-up) rate of decline in V˙O2max was slower in sprint athletes than in endurance runners (23). Interestingly, whereas, in the untrained participants and endurance groups, the rate of cross-sectional decline in V˙O2max “accelerated” over the age of 50 (0.50 and 0.63 mL·kg−1·min−1 per year, respectively), this was not the case in sprinters (0.19 mL·kg−1·min−1 per year for young and older groups) (19). As a result, the average levels of V˙O2max of the sprint and endurance groups become similar about the age of 80 yr. Our cross-sectional data suggest that sprint-trained athletes may be a distinct group characterized by the slowest decline in absolute and percentage V˙O2max whereas, in endurance-trained individuals, the decline in V˙O2max is reported to be faster (26,30) or similar at best (35) compared with untrained individuals.
It seems that it is the smaller rate of decline in maximal heart rate that accounts for the smaller rate of deterioration in V˙O2max in sprint-trained athletes compared with endurance athletes. Simultaneously, maximal oxygen pulse, a variable related to stroke volume, and hemoglobin concentration showed a similar rate of decrease in both groups (19).
In general, aging endurance-trained athletes are characterized by considerably higher maximal aerobic capacity than sprint-trained peers. The latter, in turn, exceed untrained subjects and surpass the values recommended in fitness norms. The rate of decline in V˙O2max seems to be significantly smaller in sprinters than in endurance runners and untrained individuals.
Submaximal Aerobic Capacity
In another cross-sectional study, we analyzed relationships between oxygen uptake at gas exchange threshold (V˙O2GET) and contributors to the age-related decline (17). It was revealed that endurance runners had, as expected, higher levels of V˙O2GET than sprint-trained athletes, expressed in absolute, body mass–adjusted, and relative (percentage of V˙O2max) values. The V˙O2GET of the sprint group exceeded that of the untrained group. The cross-sectional rate of absolute decline in V˙O2GET was significantly smaller in the sprint group (0.38 mL·kg−1·min−1 per year) than in the endurance group (0.56 mL·kg−1·min−1 per year) and least pronounced in the untrained group (0.22 mL·kg−1·min−1 per year). The percentage decline was comparable in all groups investigated (Fig. 3). However, the absolute rates of decline were virtually the same in sprint-trained athletes before and after the age of 50 yr whereas, in endurance runners and untrained participants, a considerably greater loss was observed in older subgroups. Older sprinters also showed a smaller percent decline in V˙O2GET (7.2% per decade) than older endurance athletes (13.4%) and older untrained participants (10.2%). Consequently, the regression lines for V˙O2GET converged to a similar value in the sprint and endurance groups at the age of 85 yr.
Cardiorespiratory factors, but not age, were predominant predictors of V˙O2GET in all groups. Oxygen pulse at gas exchange threshold explained 89.9% to 95.6% of variance in V˙O2GET. At the same time, nonsignificant between-group differences in threshold heart rate, hemoglobin, and hematocrit were shown. This suggests either a greater stroke volume or oxygen extraction at gas exchange threshold in athletic groups. In summary, submaximal aerobic capacity in master endurance runners is at a higher level than in sprinters who, in turn, have V˙O2GET above the population average and show a slower decrease with age than endurance runners.
Glucose Metabolism and Lipid Profile
In the third study, we showed the cross-sectional relation between parameters of glucose metabolism and age depending on training modality using Homeostatic Model Assessment (20). The major finding was that insulin sensitivity and pancreatic β-cell function were not associated with age in both sprint-oriented and endurance athletes. In other words, their glucose metabolism was stable and efficient across the whole age range of 20 to 90 yr (Fig. 4). However, the average fasting glucose and the proportion of individuals with impaired fasting glucose were higher in the sprint than endurance and untrained groups. The untrained group was characterized by a much greater age-related increase in fasting insulin and β-cell function and a considerable decrease in insulin sensitivity compared with both athletic groups. With age, untrained subjects seemed to compensate for their lowering insulin sensitivity with an increasing β-cell activity, whereas athletes maintained the balance between insulin sensitivity and insulin secretion. In support of our research, former top-level athletes representing endurance and mixed sports (including sprint and jumping events) were shown to have a considerably lower relative risk of diabetes than controls in the long-term (16). The risk (odds ratio) was lower in endurance athletes (0.24) than in the mixed group (0.52), whereas power sports did not differ from the general population (1.21).
The cross-sectional increase in fasting glucose with age was not significant in the sprint group (0.07 mmol·L−1 per decade) and did not differ substantially from that of endurance and untrained groups (0.12 and 0.08 mmol·L−1, respectively). The relation between fasting insulin and age was not significant in sprint and endurance groups whereas, in the untrained group, the correlation was strong (r = 0.78, 7.6 pmol·L−1 per decade). In addition, a higher level of V˙O2max was associated with significantly lower fasting glucose and insulin as well as with better insulin sensitivity for the combined group of participants, whereas β-cell function was not related to the levels of aerobic capacity.
The picture of the lipid profile seems to be more advantageous in master endurance athletes than in sprint-trained athletes, but older sprinters still look significantly better than untrained controls in this respect, according to a follow-up study (23).
To sum up, our data suggest that both aging sprinters and endurance runners effectively preserve a high level of insulin sensitivity and an optimal level of lipid profile.
Fat Mass and Lean Body Mass
In general, master athletes show more optimal body composition compared with untrained controls. According to our and other cross-sectional research, older sprint-trained and endurance athletes have similarly low body fat percentage (4,25). Aging sprinters, however, have a higher lean body mass, suggesting a greater proportion of muscle mass (11,25), which is important in the context of preventing age-related sarcopenia/dynapenia and accompanying disadvantageous changes in functional fitness.
In principle, in all track and field athletes, bone mineral density is higher than the expected age-adjusted population mean; however, this effect is greater in sprinters and middle-distance runners than in long-distance runners (11). Available cross-sectional studies on aging athletes suggest that sprint training affects bone characteristics more advantageously than endurance training or daily habitual physical activity. Master sprinters have a higher bone mineral density and bone mineral content at the legs, hip, lumbar spine, and trunk compared with master endurance athletes and controls (11,25,33). The difference may be seen even at nonloaded sites like the arms (25). Results for endurance athletes often are ambiguous, indicating somewhat greater but sometimes similar bone mineral density compared with untrained individuals depending on the measured site (5,12,25,31). It seems that higher-impact loading protocols in disciplines like sprint, jumping, or basketball are more effective in promoting bone mineral density in older athletes (9,11). As revealed in middle-aged and older sprinters versus active referents, mechanical power in the eccentric phase of hopping was one of the strongest independent predictors of bone characteristics, suggesting that regular high-impact training has positive effects on bone strength and structure (14). These effects are related to increased body and muscle mass because exercise training (especially strength and resistance) concurrently induces muscle adaptation. Nevertheless, the differences in bone mineral density and content between sprinters, long-distance runners, and nonathletes usually persist after adjustment for body mass (25,31), suggesting that the mechanical loading is crucial. However, it should be noted that the differences may be biased because of self-selection (voluntary participation), sport participation in young years, and genetic predispositions. Consequently, two explanations are possible: (i) greater skeletal size allows exertion of larger muscle forces, supporting engagement in sprint disciplines, or (ii) forces exerted during sprinting induce skeletal adaptation and augment bone density. Probably, both these factors cooperate and intensify each other.
Although bone mineral density and content clearly are greater in athletes than in untrained individuals, the decline with age seems to occur mainly in athletes. In a cross-sectional study, in both sprint- and endurance-trained subjects aged 33 to 94 yr, negative correlations of age and tibial bone strength indicators were found, whereas no significant effect of age was observed in sedentary controls (33). High values of bone strength indicators were not preserved beyond the age of 80 yr, and the characteristics of trained and untrained groups became similar with advancing age. This suggests that even training based on maximal mechanical loading does not prevent the age-related decline in bone strength in old age.
The sprint model of training better promotes neuromuscular function. Master sprinters performed better than endurance runners on tests of countermovement jump, multiple one-leg hopping, and grip force. Interestingly, the results of age-matched endurance athletes were below or equal at best to the average of the reference population for the countermovement jump (11,24). It can be explained by a different muscle fiber-type proportions in differently specialized athletes. Maximum force and power generated during jumping declined linearly with age (cross-sectional data) in master athletes, with no significant differences in the amount of decline between endurance runners and sprinters (0.29–0.58 W · kg-1 · yr-1); however, the latter kept a considerably higher level of power across the age span of 35 to 90 yr (24).
Both sprint and endurance training models offer many opportunities for long-term adherence to physical activity, but some differences are worth emphasizing. It was demonstrated experimentally that a purely endurance exertion is perceived as being more strenuous than sprint exercise (8). This suggests that the permanent continuation of endurance training may be more difficult and onerous. On the other hand, nonadapted, less-fit, or diseased individuals may perceive the single bouts of a high-intensity exercise as extremely stressful, sometimes accompanied by nausea and lightheadedness (1). In the context of lifelong sport adherence, sprint-trained competitive master athletes seem to be more persistent than long-distance runners. Among elite German track-and-field master athletes (n = 620), sprinters (n = 67) and jumpers (n = 54) participated on average 25.2 ± 15.8 yr and 27.6 ± 15.4 yr, respectively, in sport activity and competition, whereas long-distance runners specializing in track (n = 100) and road races (n = 97) participated 18.2 ± 12.8 yr and 15.7 ± 11.3 yr, respectively (7). However, the individual sport careers ranged widely from 4 to 73 yr because of age differences (45–80 yr).
Interestingly, master sprint-trained athletes are “early starters,” entering their first sport competition usually at the age between 20 and 30 yr, whereas master endurance runners most often start competition at age 40 yr or later. The overwhelming majority of sprinters/jumpers (∼87%) and throwers (∼98%) reported their first participation in any sport competition before the age of 30 yr compared with approximately 38% of endurance runners with early sport experiences (7). This suggests, in turn, that endurance disciplines may be more open to people in later phases of life because of better training availability and simplicity. The continual and still growing popularity of mass-participation marathons and similar events across the world testifies to this. Sprint-oriented disciplines seem to be more demanding, requiring, for example, technical skills, specific equipment or facilities, assistance during training session (coach), and so on.
The assumption seems to be justified that sprint- or endurance-oriented sports are preferred by certain groups of people because of their personal inclinations. Psychological studies show that there is a link between a sport or physical activity form preferred by a person and his/her personality traits (27). In addition, despite a great health potential of regular exercise, many adults do not participate in physical activity, citing the lack of time as the main barrier (29,32). As it was demonstrated in randomized controlled trials, various forms of sprint training may be a less time-consuming and more adherence-supporting solution that would be as effective as endurance training (28,32) and less energy consuming (3). However, time saving may be deceptive. Some authors rightly indicate that net time spent exercising at high intensity is relatively short, but actual training session times are longer, including warm-up, rest periods, and cooldown (1).
Tendinopathy and Rupture
One may be concerned about tendon and ligament overload because of sprint exercise. Two cross-sectional studies we coauthored have not revealed any significant relation between tendinopathy of Achilles and patellar tendons and sport specialization in master track-and-field athletes (21,22). However, injury rates during athletic competition seem to be significantly higher in sprinters, middle-distance runners, and jumpers than in long-distance runners, throwers, and combined events, even if overall injury rate is low and does not increase with age and performance level (10). Follow-up data indicate that the rupture risk for shoulder region and Achilles tendon in master track-and-field athletes after the age of 45 yr may be higher than in controls (13). Moreover, a significantly increased (∼2.5-fold compared with controls) risk of osteoarthritis of the hip, knee, or ankle in old age is a common adverse effect of competitive sport participation at a young age (16), but it seems that the health benefits still outweigh the risk (13).
According to a common and well-documented view, many years of endurance training is associated with undeniably beneficial physiological adaptation of the heart in competitive master athletes. Cross-sectional comparisons show that master endurance athletes have greater heart dimensions (cavities, walls) than aging sprinters and control individuals, but the hypertrophy is benign and the normal function of the heart is preserved (6,15). Recently, however, some undesired effects of endurance training have been revealed. In a comprehensive review, Wilson et al. (34) provide consistent evidence from different scientific sources that a lifelong career in intensive endurance exercise may be associated with deleterious changes in cardiac, peripheral, and cerebral vascular structure and function, and a “veteran athlete may not be as healthy as believed.” In an original study by Swedish researchers, more than 50,000 participants of cross-country 90-km skiing races were followed in a 16-yr period (2). Faster finishing time and high number of races (representing higher training load and longer training history, respectively) were significantly associated with a higher risk of arrhythmias, mainly of atrial fibrillation/flutter and bradyarrhythmias. Whether the long-term sprint-oriented training is less hazardous with regard to heart function is not clear as yet, and this issue requires investigation. Despite these hazards, available follow-up studies clearly show that endurance athletes are at much lower risk of chronic diseases of affluence, morbidity, and mortality than the general population (2,13,16). Most importantly, both training modalities seem to reduce the risk of coronary heart disease and cardiac insufficiency, with endurance athletes being best protected on later stages of life, as it was revealed in a long-term follow-up in former elite athletes (16).
When interpreting the above considerations, one should take into account some assumptions and limitations. There virtually are no longitudinal studies on lifelong age-related changes in health characteristics of sprint-trained athletes. An overwhelming number of data we presented were cross sectional in nature. It means that evidence on associations only, although strongly suggestive, but not clear causal proof could be demonstrated. Moreover, only main trends were shown, sometimes accompanied by a quite large variability among subjects of the same age. However, the obtained picture may be valuable still because obtaining longitudinal data in such a wide age range does not seem possible for the present.
It is worth considering to what extent physical training itself contributes to beneficial health characteristics in aging competitive athletes. In our opinion, training is the crucial factor; however, the selection bias must be taken into account. This is, first, genetic selection, as it is emphasized by authors investigating chronic diseases in former elite athletes (16). One should remember that physical fitness, activity, and training responsiveness have a genetic component, and genes modify the risk for many diseases. Thus, lifelong adherence to endurance or sprint training (or any physical activity) and related effects may not exclusively be a matter of personal choice because genetic selection may make it easier (or more difficult) to participate in and benefit from any training modality or just favor individuals with lower morbidity or mortality. One cannot be sure that the health profile would change to the same extent if, for example, sprinters had trained for endurance and vice versa. Second, selection type is related to health habits (smoking, diet, alcohol consumption, sleep, etc.) and socioeconomic status that are distributed differently between physically active and inactive peers (16,18) and even between master athletes specializing in different disciplines (7). Consequently, it must be supposed that the physical fitness and health of master athletes are far above average not only because of exercise training but also because of genetic and environmental (social and psychological) factors. They probably represent a model of a “genetically supported” aging, undisturbed by factors related to unhealthy lifestyle and based on a continuous lifelong physical activity in the form of a competitive sport. They start their training in youth and continue for many years. Moreover, athletes we recruited were “the best of the best,” an elite group highly ranked (places 1–10) in European or world championships (third selection).
One must be cautious when transferring conclusions from athletes to the general population. How is the competitive model of physical activity useful for the general healthy population currently cannot be decided clearly. On the other hand, as other authors suggest and we confirm, individuals who have a good training background and feel healthy can reap health benefits from master competitive sports without considerable risk (13). It seems that that the sprint-oriented model of physical training, similarly to the endurance one, if started early in life and then continued, may be an effective activity pattern resulting in the maintenance and improvement of important health outcomes.
It must be stressed here that recommendations and interventions for people who are chronically inactive to start exercising in advanced age or suffer from certain severe disorders are a separate issue that was not raised here. In particular, high-intensity exercise should be recommended, if at all, with extreme caution to people with cardiovascular and other disorders or to nonadapted ones. The use of “supramaximal” (all-out) sprint exercise in clinical populations is limited. Admittedly, sprint interval training was demonstrated to be effective and relatively well tolerated in patients with type 1 and 2 diabetes; however, some doubts arise about its acceptability, feasibility, safety, and costs of exercising. It seems that the less strenuous high-intensity training (≈90% of V˙O2max) could be a compromise between the optimal exercise strategy and potential risk (1).
Despite the above limitations, our research undoubtedly has some strengths. We analyzed a wide age range of sprint-trained athletes compared with earlier studies. Also, we examined elite competitive master athletes in which factors related to unhealthy and inactive lifestyle affect the aging process only to a small extent. Thus, we could separate and compare two strongly pronounced lifelong training models. In addition, we avoided the effect of seasonal changes because we tested athletes in competition periods. We recruited a large number of sprint-trained athletes despite some discipline-inadequate exercise tests (e.g., endurance) during important championships. Finally, we included control groups that allowed reliable comparisons.
The question arises, which model of physical training successfully supports maintaining basic health characteristics? Today, the endurance model is preferred, and its advantages have been demonstrated repeatedly. Until now, however, this “classic model” has not been compared with any other one in the context of lifelong physical activity and health. Consequently, the concepts of exercise and training in health and aging research are often used as equivalents for endurance exercise and endurance training. We provide evidence that the sprint-oriented training model also results in optimal health outcomes in a long-run perspective. It should be emphasized that both sprint and endurance athletic groups benefit from their lifelong competitive sport participation much more than recreationally active or inactive individuals and that health benefits definitely outweigh the risks associated with intensive training (Fig. 1). There are, however, differences in the profile of benefits: long-term sprint-oriented training more effectively promotes bone mineral density, muscle mass, neuromuscular function, and probably training adherence, whereas endurance training is more effective in maintaining high aerobic capacity and cardiovascular function as well as optimal glucose metabolism and lipid profile across the lifespan. Both training models seem to facilitate keeping low fat mass effectively. The risk of tendinopathy is similar in both groups and higher than in the general population, but the injury rate during competition is higher in sprinters. Competitive master athletes participating in long-term intensive endurance training regimens may have a somewhat higher risk of deleterious cardiovascular structural and functional changes than the general population. An analogous risk in aging sprint-trained athletes is not known.
The presented studies support the view that the age-related deterioration in health status is not an inherent feature of older age. The sprint model of lifelong physical activity is associated with higher levels of maximal and submaximal aerobic capacity than in inactive or recreationally active populations and is accompanied by a relatively slow rate of age-related decrease in aerobic capacity as well as by optimal insulin sensitivity and lipid profile, which has been considered the exclusive domain of endurance training.
Improvement in or maintenance of important health characteristics is advantageous to sport performance as well as to functioning in everyday life, where various activities can be carried out with less fatigue, without restraint and limitations. It is particularly important for older people and their independence. Long-lasting training that includes high-intensity exercise also seems to be effective in preventing the development of diseases of affluence. Moreover, sprint training may be perceived as less fatiguing, thus adequate for certain personality types, which may be of great significance for many years’ training adherence.
In conclusion, taking into account the presented research and the current state of knowledge, one can hardly regard endurance sports as the only appropriate model of lifelong physical activity for health. The paradigm of physical activity based solely on endurance exercise, although unusually valuable and commonplace, needs revision. We should consider the sprint model of lifelong physical activity as an alternative and equivalent proposal for maintaining recommended levels of crucial health characteristics with aging in healthy active people.
We would like to express our special thanks to all athletes, coaches, and colleagues who contributed to the research.
Disclosure of funding received for this work: Our studies presented in this article were supported by the Polish Ministry of Science and Higher Education (application grant no. N N404 191536) and by internal funding from universities involved in the research.
None of the authors have any conflicts of interest to declare.
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