The North Sea Race Endurance Exercise Study
NEEDED Research Program
Developing new systems to detect heart disease early on and to find optimal levels of physical activity for best health outcome.
Physical activity is important for general health. Exercisers live an average of 7 years longer than those who are physically inactive, and reduced fitness is one of the strongest indicators for development of cardiovascular disease and death. A challenge is that under the physical strain, there is a small increased risk of incidents in some vulnerable people who have heart disease.
The aim of NEEDED's research program is to develop new systems that can detect heart disease earlier and optimize physical strain. This is done using exercise management parameters, which should help increase gains and reduce the risk of heart disease from physical strain.
- Investigate the relationship between physical strain and changes in biomarkers (blood tests) and sensor data (heart rate monitors and wattage meters) before and after a physical load in people with and without cardiovascular disease.
- Assess the ability of these markers to detect known and unknown disease.
- Consider whether these markers can help increase the gain from physical strain in both healthy and sick individuals.
Effect of exercise on cardiovascular disease
Physical inactivity is a growing health problem. The European time use survey (HETUS) shows that Norway is second to last in Europe when it comes to total daily physical activity related to transport, trips, exercise and sports. At the same time, there has been an increase in physical activity during leisure time during the period 1985-2011. Recreational exercise has therefore become increasingly important for public health. For many, exercise competitions such as the North Sea Race are an important motivating factor for training.
The risk of sudden death during competitions are small. One death per million marathon hours has been calculated. In Vasaloppet (90 km cross-country skiing) there were a total of 13 deaths among a total of 698 102 participants in the period 1970-2005. In a large material from France, the risk of sudden cardiac death in elite athletes during training and competition is estimated at 4.6 deaths per million/year. In relation to the health benefits of exercising regularly, the risk of incidents during competition appears to be very small.
Current research is inadequate in several areas of exercise training: There is a lack of data on the benefits and risks of intensive physical activity in likely healthy exercisers and elite athletes.
Systematic collection of information with samples from blood, heart (ECG and ultrasound), heart rate monitors (heart rate and wattage values), information on training status and load intensity can help clarify the boundary between benefits and risks associated with physical activity.
Milestones
NEEDED Pilot Study 2013
The pilot study was related to the North Sea Race of 2013. It was conducted on a scale of 1:10 in relation to the main study and provided valuable information about participants, study design and follow-up. Out of a total of 160 who expressed interest, 97 people who completed the cycling race were included in the study.
NEEDED Main Study 2014
The main study was carried out related to the North Sea Race of 2014. Here, all 1600 registered cyclists were invited to participate in the study. Of these, 1071 participants were included, of which 1013 carried out the project with all necessary measurements. Participants were surveyed 24 hours before the race, as well as 3 and 24 hours after completing the race.
NEEDED Mechanism Study 2018
This study consisted of 59 participants from the North Sea Race of 2018 who had also participated in the North Sea Race affiliated with one of the NEEDED studies from 2013 and 2014, and were found to have normal coronary arteries without narrowing with CT coronary angiography. Extensive measurements were carried out before and after both races, which included blood tests, measurement of lactate, fitness tests (V02-max), ECG, blood pressure, sensor measurements and ultrasound of the heart. The purpose was to investigate the relationship between these measurements and physical strain.
NEEDED Reproducibility
This study consisted of healthy subjects between the ages of 18-35 who performed fitness tests (VO2 max) before and after exercise, performed in the same manner, once a week, three weeks in a row. This was to investigate whether the same load gives the same values of different markers in the blood.
NEEDED Diagnostic
The first part of this study was conducted in 2022, where participants were exercisers with and without established heart disease. The group with established heart disease consisted of people who had undergone coronary angioplasty, but who had resumed prolonged high-intensity exercise. The physical load consisted of a short intensive training session until reaching the maximum performance level (VO2 max) and three longer training sessions, with the same intensity as with the short, but with increasing duration from 20 to 60 minutes. The purpose was to investigate whether there were different reactions to physical strain in the two groups.
NEEDED TopAthletic
This study started in 2024 and will include healthy elite athletes between the ages of 18-35 over a period of two years. The purpose is to determine normal blood troponin levels of athletes. This is an important study to further investigate whether troponins can be used as biomarkers in predicting heart risk and performance in competition.
Results
Organisation and responsibilities
The project group is responsible for the medical-professional development of the project, obtaining statutory and internal approvals, organisation and progress within established budgets, and all publication. The rights to the study and publication of the results are owned by the project group.
The steering group is responsible for contracts, media plan and media strategy, and supervise that projects are carried out within the formal approvals and agreements that is in place, at any given time.
Helse Stavanger HF, represented by the Research Director, is responsible for project compliance to the Health Research Act. The NEEDED projects follows Helse Stavanger's internal research routines, are registered in Helse Stavanger's internal project registry and stores sensitive data on the Western Norway Regional Health Authority secure research server.
The business aspects and agreements involved in NEEDED projects are handled according to internal routines in Helse Stavanger HF and Stavanger Helseforskning AS, on behalf of the project organization.
Project group
- Aina Andreassen, general manager of the North Sea Race
- Anders Galaasen Bakken MChiro, PhD
- Magnus Bjørkavoll-Bergseth MD
- Rolf Bergseth MD
- Stein Ørn (project leader) MD, PhD, Professor II
- Tor Harald Melberg MD, PhD, associate professor
- Øyunn Kleiven MD, PhD
- Øyvind Skadberg MD
Steering group
- Aina Andreassen, general manager of the North Sea Race
- Anders Galaasen Bakken MChiro, PhD
- Magnus Bjørkavoll-Bergseth MD
- Rolf Bergseth MD
- Stein Ørn (project leader) MD, PhD, Professor II
- Tor Harald Melberg MD, PhD, associate professor
- Øyunn Kleiven MD, PhD
- Øyvind Skadberg MD
Other members and student contributions
Post doc
- Anders Galaasen Bakken (SUH)
PhD students
- Christine Bjørkvik Erevik MD (UiB), ongoing
- Ida Høiland Hove MD (UiB), ongoing
- Jakob Svane Siv.ing (UiS), ongoing
- Magnus Bjørkavoll-Bergseth MD (UiB), ongoing
- Øyunn Kleiven (UiB), completed
Master's students
- Kay Raymond Jenssen Oskal (UiS), completed
- Martin Anders Nygård (UiS), completed
- Martin Tronstad Schau (UiS), completed
- Vegard Nessa (UiS), completed
From the North Sea Race
- Aina Andreassen
From Helse Stavanger HF
- Anne Hjelle
- Stein Ørn
Contact information
E-mail: Neededtopathletic@gmail.com
Address: NEEDED-senteret, Jærveien 107, 4318 Sandnes
Media contributions: