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To investigate the response to endurance training on (from 102.0 to 71.4 lmol L 1 (Po0.01)) at 9.9 km h 1
physiological characteristics, 10 Nandi town boys and 14 were observed in the town boys, while similar decreases in
Nandi village boys 16.5 and 16.6 years of age, respectively, heart rate (from 170.2 to 159.2 beats min 1 (Po0.001)),
from western Kenya performed 12 weeks of running blood lactate (from 2.4 to 1.4 mmol L 1 (Po0.001)) and
training. The study was performed at altitude ( 2000 ammonia concentration (from 102.5 to 72.7 lmol L 1
m.a.s.l. 595 mm Hg). Training heart rate and speed were (Po0.001)) at 10.9 km h 1 were observed in the village
registered during every training session throughout the boys. The oxygen cost of running was decreased from 221.5
entire training period. While town and village boys trained to 211.5 mL kg 1 km 1 (Po0.03) in the town boys and
at similar heart rates (172.1 vs. 172.5 beats min 1), the from 220.1 to 207.2 mL kg 1 km 1 (Po0.01) in the village
training speed of the town boys was 9% lower compared boys. The 5000 m performance time of the town boys was
with the village boys (12.4 vs. 13.6 km h 1, Po0.001). significantly greater than that of the village boys (20.25 vs.
Significant increases in VO2max were observed in the town 18.42 min (P 5 0.01)). It is concluded that no difference was
boys (from 50.3 to 55.6 mL kg 1 min 1, Po0.001) and in observed in trainability with respect to VO2max, running
village boys (from 56.0 to 59.1 mL kg 1 min 1, Po0.002). economy, submaximal heart rate, and submaximal blood
Significant decreases in submaximal heart rate (from 172.4 lactate and ammonia concentration between Kenyan Nandi
to 160.3 beats min 1 (Po0.005)), blood lactate (from 2.7 town and village boys. The higher performance level of the
to 1.4 mmol L 1 (Po0.005)) and ammonia concentration village boys was likely due to a higher VO2max of these boys.
Over the last few decades, Kenyan runners have is determined by a number of factors. These include
dominated middle- and long-distance running events both aerobic and anaerobic capacity for energy
(800 m marathon). The Kenyan record of success turnover, muscular strength, running economy,
has been particularly profound at the world cross- motivation and tactics.
country championships at which the Kenyan senior A previous study of Kenyan elite runners by Saltin
men have won the team title in the 12 km distance et al. (1995) revealed one of the highest VO2max so
for the past 18 years. At 10 of these championships, far observed in any elite runner. In addition, the
Kenyan dominance has been so marked that the study showed that Kenyan elite runners have a
aggregate performance of the Kenyan team sur- highly proficient running economy as judged from
passed a team chosen from the best finishers from the oxygen uptake at submaximal speeds. Furthermore,
rest of the world. Furthermore, the performances of Kenyan elite runners had lower plasma lactic acid
Kenyan men in middle- and long-distance events at and ammonia concentrations during running than
the Olympic Games and world championships in elite runners from Scandinavia (Saltin et al., 1995).
track events have shown Kenyan superiority. A It has been speculated that heredity may play a
remarkable observation is that the majority of these role in the success of Kenyan runners. This notion is
Kenyan achievements have been produced by a supported by the general observation that while the
group of 8 small tribes called Kalenjin, which today Kenyans and to some extent the Ethiopians have
number only 3.5 million people. Among the excelled in middle- and long-distance races, the West
Kalenjins, the Nandi has been most outstanding. Africans or runners of West African ancestry have
Even though the Nandi tribe constitutes only 2% shown remarkable superiority in the short distances
of the Kenyan population, it is the most successful (100 400 m). In fact, there exists considerable
single tribe in Kenya to date with respect to anecdotal evidence suggesting a greater response
performance in running. Success in running events to training in Kenyan runners compared with
48
Trainability of adolescent Kenyan boys
Caucasians. In line with this, the study by Saltin sexual maturation was assessed by checking the development
et al. (1995) revealed that adolescent boys who did of secondary sex characteristics. The method described by
not train, but who were physically active, had Marshall and Tanner (1970) was employed. The vast majority
of the boys were in stage 5 (PH5) while a few ones were
maximal oxygen uptakes which were 30% higher in stage 4 (PH4). The study was approved by the Ethics
than the oxygen uptakes of sedentary Kenyan boys. Committee of the Faculty of Health Sciences at Moi
This indicates a high response to training in these University, Eldoret, Kenya. All subjects and their parents
boys. In fact, several training studies have shown were fully informed of the experimental procedures and
marked variability between individuals in their possible risks connected with the study and gave written
consent. All subjects were informed that they were free to
physiological response (VO2max) to standardized train- withdraw from the study at any time. All subjects were studied
ing indicating different trainability (Prud’homme at altitude (2000 m.a.s.l., barometric pressure 595 mmHg).
et al., 1984; Bouchard et al., 1992; Bouchard et al.,
1999). In addition, two studies have suggested a
strong genetic determination of the sensitivity of Protocol and methods
submaximal endurance performance to training
All subjects performed 12 weeks of endurance running.
(Lortie et al., 1984; Hamel et al., 1986). Immediately prior to and after the training period the subjects
These findings indicate that different trainability went through submaximal and maximal tests on a treadmill.
in Kenyans and Caucasians may underlie Kenyan Prior to the initial tests, all boys performed 2–3 (totally more
superiority in middle- and long-distance running and than 50 min) practice sessions on different days at three
that village boys, who, as indicated in a previous different speeds each day to familiarize themselves with
running on a treadmill as well as to the equipment used to
investigation (Larsen et al., 2004) are more physi- determine the respiratory variables. The exercise protocol on
cally active than town boys, may have a further the treadmill consisted of a 10-min warm-up at speeds from
advantage. Therefore, the hypothesis to be tested 6.0 to 10.0 km h 1. After 7–10 min of rest, the subjects ran 7
was whether there was a difference in endurance and 6 min, respectively at 2 different individual speeds with
training response in village as compared with town 0.5–1.0 min of rest in between. The two velocities were chosen
to demand a heart rate of 150–155 (6.0–11.5 km h 1) and
boys from the Nandi tribe. 165–175 (8.0–14.0 km h 1) b.p.m., respectively. In order to
be able to calculate exact running economy, body weight
including test equipment was measured immediately before
Materials and methods and after the test. After 10 min of rest, the maximal test was
performed at speeds from 13.0 to 17.5 km h 1. The test
Subjects started without inclination and every second minute the
Sixty Kenyan boys from two secondary day schools volun- inclination was raised by 2% grade until exhaustion. During
teered for the present study. Before entering the investigation, the last 1.5 min at each submaximal speed the expired air was
all subjects completed questionnaires encompassing questions collected in Douglas bags while during the maximal test it was
related to (a) tribe, (b) transportation to and from school collected continuously. Heart rate was measured continuously
during childhood, (c) leisure time activities and (d) coach- during all tests, while a blood sample was taken from a
organized training. Based on the questionnaires, 12 town boys superficial arm vein at rest and during the last 15 s of each
and 22 village boys all belonging to the Nandi tribe (verified to submaximal run or immediately after this. Furthermore,
the level of grandparents) not previously engaged in any kind blood samples were taken at rest shortly before the maximal
of organized endurance training were selected. The remaining run and 1 and 3 min, after the test.
26 boys were excluded due to the fact that they were not The oxygen uptake was calculated after measuring the
Nandies. Three Nandi boys were excluded due to illness, while volume of expired air with a gasmeter (London Gasmeter Co.,
one was excluded due to insufficient sexual maturation. London, UK) calibrated with a Tissot spirometer and the
During the investigation one town boy left the study due to fractions of O2 and CO2 using a Servomex S-3 A/I and a
injury. In addition, 4 village boys left the study due to the fact Beckman LB-2, respectively. Heart rate was monitored with a
that they left school, while one village boy left the study due to telemetric system (Polar Accurex Plus, Polar Electro, Fin-
hospitalization for malaria. Ten Nandi town boys and 14 land). The blood samples were analyzed for lactate and
Nandi village boys completed the study. Mean (range) age, ammonia (Kun & Kearney, 1974). In addition to the tests of
height and weight were 16.5 (15.7 17.4) years, 168.1 running economy on the treadmill, similar tests were performed
(157 178) cm and 52.7 (41.3 63.4) kg for town boys and on a level road on a windless day using a portable metabolic
16.6 (15.2 17.9) years, 170.8 (162 187) cm and 53.2 system (Cosmed K4b2, Italy) for measuring oxygen uptake. In
(45.4 63.2) kg for village boys. order to test the validity of the system, comparisons were made
The town boys were recruited from Uasin Gishu High with the Douglas bag system in 21 subjects by performing
School in the town of Eldoret located in the western part of VO2max tests with the K4b2 a few days before the initial max-
Kenya on a plateau at an altitude of 2000 m.a.s.l. Except tests were performed with the Douglas bags. The two methods
for two subjects who were raised in a town/city they were all gave mean values of 2.79 and 2.81 L min 1 with the K4b2
born and raised in the rural area around Eldoret. At the age of values given first. The coefficient of variation (c.v.) was 4.9%.
14 years, 9 of the subjects had moved to Eldoret in order to Accurate marks were placed on the road for each 100 m by
begin their studies at secondary school, while one subject using a tape measure. The protocol on the road consisted
continued living in the countryside. The village boys were of a 10-min warm-up at speeds from 6.0 to 10.0 km h 1.
recruited from Kamobo Secondary School located in Nandi After 10 min of rest, the subjects ran for 7 min at
district about 50 km southwest of Eldoret at the same altitude 11.0 km h 1. A constant speed was kept by one of the
as this town. All subjects were living in the rural area within a investigators running alongside the subject checking the speed
radius of 4 km from the school. Before entering the study, by using a stopwatch. The oxygen uptake during the final
49
Larsen et al.
1.5 min was used as a measure of running economy. Body nificance of differences between conditions was tested using
weight including test equipment was measured immediately the paired t-test as well as one-way analysis of variance
before and after the test. (ANOVA). Differences between conditions were considered
significant at the 95% confidence level.
Training
During the first 5 weeks of the 12-week training period, Results
training intensity, frequency and distance increased continu- Training (Table 1, Fig. 1)
ously. The weekly training frequency increased from 2 to 4
times while the distance increased from 8 to 28 km. The The mean total training volume, mean number of
training intensity increased from 70% to 80% of training sessions and mean relative training intensity
VO2max. During the last 7 weeks, the weekly training consisted during the 12-week training period were similar in
of four sessions, a total of 28 km performed at an intensity the two groups of boys. The town boys reached
demanding 80% of VO2max. A total of 40 training sessions
were planned. Heart rate monitors were used during every
252.2 km in 38.2 training sessions at a mean heart
training session to control for training intensity. Individual rate of 172.1 beats min 1, while the village boys
target heart rates were calculated for all subjects by using the trained 260.1 km in 38.6 sessions at a mean heart rate
VO2/heart rate relationships from the initial treadmill tests. of 172.5 beats min 1. The training intensity during
Each heart rate monitor was adjusted to beep if the train the final week of the ‘‘ 80% VO2max’’ training
ing heart rate was more than 5 beats min 1 from the
calculated target heart rate. Of the performed number of
period measured in one training session by using the
training sessions training heart rates were collected in 97.1% portable system was 2.49 0.30 L min 1 (n 5 10)
and 96.1%, respectively in town and village boys. In addition, corresponding to 85.4 6.7% of post VO2max at
the target oxygen uptake was verified during training (one 13.3 1.4 km h 1 in the town boys and 2.66
session) using the portable metabolic system (K4b2). Average 0.38 L min 1 (n 5 13) corresponding to 83.5 6.6%
oxygen uptake was calculated from the 3rd to the 14th minute
of the training session. All training was performed on a 400-m
of post VO2max at 14.6 1.5 km h 1 in the village
track with gravel surface. All training was supervised by one boys. The corresponding heart rates were 173.6 7.8
of the investigators, and the time for each training session was and 175.7 6.1 beats min 1, respectively, in town
carefully registered in training logs. Following each training and village boys. The average training speed of the
session, average training speed and heart rate were calculated. entire training performed was significantly higher in
Average training heart rate was calculated from the 2nd
minute to the termination of the training session. Two days
the village boys compared with the town boys (13.8
after the final test round, all subjects performed a 5000 m vs. 12.4 km h 1, Po0.001). Furthermore, the speed
competition on a 400-m track. Racing time was registered. of the village boys was significantly higher every
During the race, heart rate was recorded each 5 s by using single week (Po0.002–Po0.05) except for the
heart rate monitors. One village boy dropped out of the 10th week (P 5 0.0503) during the 12-week training
competition due to a stitch and the results from one of the
village boys were excluded as he misjudged the opening speed
period. During the ‘‘ 80% VO2max’’ training
and finished with a slower average race speed than his average period (weeks 5–12), the average training speed
speed during 8 km of training. increased significantly in both groups of boys. For
the town boys, the training speed in weeks 6–12 were
faster than week 5. After this, this elevation in
Statistics training speed continued almost weekly. The same
Means SDs and significance between groups were obtained adjustments were made as for the village boys. The
using standard statistical methods (Siegel, 1956). The sig- significance level for all these differences is Po0.05.
Table 1. Target training intensity, mean heart rate and training speed, total training volume and number of training sessions during week 1–2, 3–4, 5–12
and 1–12 of the 12-week training period in Nandi town and village boys (mean values SD are given)
Week Target intensity Heart rate Training speed Cumulative distance Cumulative number of
1
(% of VO2max) (beats min ) (km h 1) (km) training sessions
Town boys 1–2 70 163.5 7.8 10.7 1.1 23.0 0.2 5.0 0.0
3–4 75 168.9 8.7 11.5 0.9 37.9 0.3 6.0 0.0
5–12 80 173.9 9.0 13.1 1.2 191.4 16.4 27.2 1.7
1–12 70–80 172.1 9.7 12.4 1.5 252.2 16.4 38.2 1.7
Village boys 1–2 70 165.5 6.7 12.1 1.3a 19.4 5.0c 4.1 1.1b
3–4 75 168.4 7.1 13.1 1.5a 36.8 3.2 5.8 0.6
5–12 80 174.2 6.5 14.4 1.3a 203.9 6.4c 28.6 0.8c
1–12 70–80 172.5 7.9 13.8 1.6a 260.1 9.5 38.6 1.7
50
Trainability of adolescent Kenyan boys
228.0 71.1 (n 5 7)
241.9 17.2 (n 5 7)
300
)
1
NH3max (mmol l
250
Table 2. VO2max, maximal heart rate and peak blood lactate and ammonia concentration before and after 12 weeks of training in Nandi town and village boys (mean values SD and range are given)
200
km
150
100
9.7 2.9 (n 5 7)
11.0 1.7 (n 5 7)
)
1
0
Hlamax (mmol l
SPEED
18
16
km . h-1
14
)
1
HRmax (beats min
12
10.0b
11.5
6.7a
6.3
10
197.4
189.7
197.6
190.1
0
HEART RATE
1
)
190
min
10.3b,g
11.6a
14.5
9.1f
0.75
beats . min-1
180
(mL kg
135.5
149.6
151.3
159.4
170
160
1
)
150
min
59.1 3.3b,g
0
55.6 4.0a
56.0 2.9f
50.3 4.4
1
0 1 2 3 4 5 6 7 8 9 10 11 12
(mL kg
Week
3.14 0.37c
2.66 0.51
2.98 0.35
The relatively high values of heart rate during the first week
VO2max
(l min
52.7 7.7
52.7 7.0
53.2 5.2
53.2 4.8
7.9e
6.5
7.7
Height (cm)
Post
Pre
Pre
Po 0.001;
Town boys
Po0.002;
Po0.003;
Po0.01.
Po0.05.
g
a
51
Larsen et al.
10% for town boys and 5% for village boys. (Po0.06) no difference in adaptability of VO2max
Although VO2max for the town boys tended to was observed between the two groups of boys.
increase more than it did for the village boys Maximal heart rate decreased significantly in both
groups of boys while peak concentration of blood
25
lactate and ammonia increased significantly in the
Town boys
Slope = -0.49 village boys.
Village boys
20
10
Fig. 2. Relationship between D VO2max caused by the 12 Submaximal blood lactate and ammonia (Table 3, Fig. 3)
weeks of training and initial VO2max in Nandi town and
village boys. Individual values are given. R 5 0.59 At 9.9 km h 1, the mean concentration of blood
(Po0.001). lactate and ammonia, respectively, decreased from
-1
ml kg km
220
. -1.
56
.
52
200
48
180
44
Before Before
0 0
0 44 48 52 56 60 64 68 0 180 200 220 240 260
. .
ml kg-1 . min-1 ml kg-1 . km-1
4 180
-1
mmoles l-1
beats min
170
3
.
160
2
150
1
Fig. 3. VO2max, running economy, blood lactate, and submaximal heart rate before vs. after 12 weeks of endurance running in
Kenyan town and village boys. Individual values are given. J: town boys }: village boys. The running economy is measured
at 10.4 and 10.9 km h 1, respectively, on average while blood lactate and submaximal heart rates are measured at 9.9 and
10.9 km h 1, respectively, on average in town and village boys.
52
Trainability of adolescent Kenyan boys
Table 3. Submaximal test speeds, heart rate, blood lactate and ammonia concentration before and after 12 weeks of training in Nandi town and village
boys (mean values SD and range are given)
1 1 1 1
n Test speed (km h ) Heart rate (beats min ) Blood lactate (mmol L ) NH3 (mmol L )
Table 4. Running economy before and after 12 weeks of endurance running in Nandi town and village boys (mean values SD are given)
1
n Test speed (km h ) VO2
1 1 1 1 0.75 1
(mL min kg ) (mL kg km ) (mL kg km )
Town boys 7 10.4 1.1 Pre 38.1 4.1 221.5 17.2 596.6 50.8
Post 36.5 5.0c 211.3 18.3c 570.5 59.7b
Village boys 13 10.9 1.2 Pre 39.6 3.6 220.1 18.3 593.5 39.3
Post 37.2 2.4a 207.2 20.3a 559.8 46.1b
53
Larsen et al.
PERFORMANCE (Table 2, Figs 2, 3). This is consistent with previous
24
investigations that have demonstrated a higher
Town boys trainability of subjects having the lowest initial
Village boys VO2max (e.g. Saltin et al., 1968; Wenger & Macnab,
21
* 1975). When plotting the D VO2max against the initial
VO2max (Fig. 2) it appears that Kenyan town and
18
village boys achieved similar improvement taken the
initial VO2max into account. Is this elevation more or
Min
54
Trainability of adolescent Kenyan boys
following training is in line with findings in other studies have shown that the running economy
numerous training studies of Caucasian adults is improved by training (Sjödin et al., 1982;
(Andrew et al., 1966; Ekblom, 1969) as well as a Svedenhag & Sjödin, 1985; Franch et al., 1998).
study of Caucasian adolescents (Fournier et al., Three previous studies have examined the long-
1982). In addition, a reduced submaximal heart rate itudinal effect of running training during several
at a given absolute exercise intensity has been shown years among young Caucasian runners 10–18 years
in black North Americans after training (Wilmore et of age (Daniels & Oldridge, 1971; Daniels et al.,
al., 2001). Similarly, a decrease in blood lactate 1978; Sjödin & Svedenhag, 1992). These investiga-
concentrations at the same submaximal oxygen tions showed an improved running economy over
uptake or at a given submaximal running velocity the years when expressing the oxygen cost in
has been demonstrated in several investigations of mL kg 1 min 1. However, in one of these studies
Caucasian adults (e.g. Ekblom et al., 1968; Hurley the lowered cost of running seemed to be solely due
et al., 1984). Furthermore, Sjödin and Svedenhag to an increased body mass of the subjects (Sjödin &
(1992) have shown that the running velocity corre- Svedenhag, 1992). That this is a possible explanation
sponding to a blood lactate concentration of has been demonstrated in a study comparing the
4 mmol L 1 increased in circumpubertal boys during running economy of non-run-trained boys at ages of
7 years of running training while no change was 10 and 17 years showing a considerable improvement
observed over the years in boys who were not in running economy expressed in mL kg 1 min 1
training. Therefore, the observed decrease in blood with age (Krahenbuhl et al., 1989). However, the
lactate concentrations at submaximal running velo- improved running economy in the study by Daniels
cities in the Kenyan boys following training is in et al. (1978) appeared to be due to a combination of
agreement with the findings on Caucasians. Finally, both increased body mass as well as training.
the observed decrease in blood ammonia concentra- The oxygen cost of running tested with the K4b2
tions at given submaximal running speeds in the on a road appeared to be higher in the town boys
Nandi boys as a result of training is consistent with compared with the village boys. This is due to the
findings on Caucasians. Thus, Lo and Dudley (1987) fact that the few town boys who were tested on the
have demonstrated that short-term, but intensive, road were among the less efficient town boys when
cycle and running training induced a reduction in the all the town boys were tested on the treadmill. In the
blood ammonia concentration during short constant village boys it was opposite.
submaximal exercise intensities after training.
Furthermore, Denis et al. (1989) and Green et al.
(1991) have demonstrated that short periods of
endurance cycle training resulted in a decline in the Performance
blood ammonia concentration during prolonged The significantly better 5000-m performance time of
work at submaximal exercise intensities following the village boys compared with the town boys is
training. probably due to the observed higher VO2max of the
Whether the magnitude of the observed decreases village boys. Thus, an inverse correlation between
in heart rate, blood lactate and ammonia in the VO2max and performance was found when taking all
Kenyan boys differ from observations from other subjects into consideration (R 5 0.82, Po0.001,
investigations on Caucasians cannot be established n 5 23) as well as when studying town boys
due to the fact that different training regimens have (R 5 0.76, Po0.01, n 5 10) and village boys
been employed, thus making a direct comparison (R 5 0.80, Po0.001, n 5 13) separately. In addi-
impossible. tion, the fact that no difference was observed in
running economy after 12 weeks of training between
the two groups of boys lends further support to the
assumption of VO2max being the critical physiologi-
Running economy cal factor for the observed difference in performance
While the oxygen cost of running decreased in both between the boys. The relationship between perfor-
town and village boys as a result of training, no mance and running economy when studying all boys
significant difference was observed between the two was actually rather moderate (R 5 0.53, Po0.02,
groups of boys with respect to the magnitude of the n 5 18), which according to the scientific literature is
adaptation to training. Conflicting results have been quite normal when studying groups of runners with
published in the scientific literature on Caucasians heterogeneous running ability (Sjödin & Svedenhag,
with respect to the trainability of running economy. 1985). A few scientific studies have shown a
While several studies have shown no improvement in moderate correlation between performance in run-
running economy with training (Daniels et al., 1978; ning and the percentage of VO2max sustained
Wilcox & Bulbulian, 1984; Lake & Cavanagh, 1996), throughout competition (Costill et al., 1971; Davies
55
Larsen et al.
& Thompson, 1979; Maughan & Leiper, 1983). Nandi town boys. This is probably due to a higher
However, when studying the relationship between VO2max of the village boys during and after the
the percentage of HRmax, which parallels the training period.
percentage of VO2max, exploited throughout the
competition and performance, no correlation be-
tween these variables was found in the present study Perspective
(R 5 0.07, n 5 9). This lends further support to the
assumption that VO2max is the key factor when While the principal features of the physiological
explaining the difference in performance between the responses to endurance running in the Nandi boys
Nandi town and village boys. are in line with previous findings in Caucasians, it
remains to be established whether the magnitude of
these responses is similar in Kenyans and Caucasians
Training speed as well as in people of other ethnic origins, and thus
whether the trainability of the Kenyans contributes to
In line with the physiological findings, no difference their dominance in running. Similarly, just as the
in the increase in the training speed was observed village boys had a higher initial level with respect to
between the town and the village boys during the 12- physical characteristics necessary to become an elite
week training period (Table 1, Fig. 1). The village runner and performed better following training than
boys ran significantly faster from the very first day of the town boys, it needs to be established whether these
training, and with the exception of a 1-week period, properties are superior in untrained Kenyans com-
they continued to do so during the 12-week training pared with untrained people of other ethnic origins.
period. This is probably primarily due to a higher
VO2max of the village boys during all 12 weeks of Key words: Kalenjin, trainability, energy cost, perfor-
training for the same reasons as described above for mance.
the difference in performance.
In conclusion, we found no difference in train-
ability with respect to VO2max, running economy,
submaximal heart rate, and submaximal blood Acknowledgements
lactate and ammonia concentration between Kenyan We are grateful to all participating boys and their parents. We
Nandi town and village boys. In addition, Nandi are also thankful to Gilbert Simiyu, who was a great help
village boys perform better in a 5000 m competition when the study was performed. We thank Johnny Nielsen and
Nike Danmark for supplying all subjects with running shoes
following 12 weeks of endurance running, just as and sports equipment. The study was supported by grants
they run gradually faster during 12 weeks of training from TEAM DANMARK Research Committee and the
at a given submaximal heart rate compared with Danish Ministry of Culture.
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