Physical fitness has been identified as one of the most important predictors of all-cause mortality among adults. Specifically, low cardiorespiratory fitness has been shown to be responsible for a greater number of deaths than other risk factors such as hypertension, smoking or metabolic disease.1 2 The relevance of achieving an adequate physical fitness status is such that people with obesity or metabolic disease who present adequate cardiorespiratory fitness exhibit a diminished mortality risk when compared with people without obesity or metabolic disease but presenting low cardiorespiratory fitness.3 This has been described as the ‘fat but fit’ paradox.4
As the COVID-19 pandemic disrupts every element of daily life, professional athletes – who typically travel globally, train in close quarters, and rely on their physical health for their livelihoods – have been uniquely affected. To better understand the challenges professional athletes have faced, Strava partnered with Stanford University for a study of 131 professional athletes.
The results offer a lens into the disruptive nature of COVID-19 in the athletic community. While many of the professional athletes surveyed suffered new mental, financial and physical challenges, the study ultimately offers a picture of perseverance.
Onset of psychosis is believed to be associated with neuronal dysregulation and degeneration. Reductions in brain volumes have been related in part to neuronal loss but more substantially to loss of neuronal connectivity, loss of dendritic spines, and reductions in supporting glial cells. These changes have been associated with alterations in neurotrophic factors in the brain. Recent evidence suggests that aggressive synaptic pruning may underlie onset of psychosis for some individuals (1). While reductions in regional brain volumes have been demonstrated in individuals in their first episode of schizophrenia, further deterioration has been shown to occur even after initiation of treatment (2, 3). The disruption of myelination has been proposed as one mechanism underlying these effects (4, 5). Duration of untreated psychosis is associated with both symptom severity and poor functional outcomes (6). Therefore, the time around onset of psychosis is considered a critical period when neuronal systems in the brain are vulnerable to deterioration, fragile, unstable, and in need of protection and, possibly, regeneration.