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In this short inquiry we asked two questions: how
robust is the research and evidence base for improving the performance
of elite and non-elite athletes; and how can this knowledge be
translated into treatments and preventative interventions to improve
the nation's health? We focused on biomedical research that could
enhance the performance of the individual. The context for our
inquiry was the London 2012 Summer Olympic Games and the Government's
commitments to the following legacies: to support the performance
of elite athletes (measured by medals won at the Games); and to
encourage the nation to be "healthier, happier and more active".
Science applied to the fields of sport and exercise
is referred to as "sport and exercise science" (SES),
and medical treatment and prevention of illness related to exercise
and sport are referred to as "sport and exercise medicine"
(SEM). Although this inquiry focused on sport as a form of physical
activity, other forms of activity such as recreational walking
and cycling, gardening and housework are also potentially important
in improving people's health.
Quality of science
The evidence we received indicated that it is difficult
to carry out high quality research on elite athletes. This is
because sample sizes are small and there are no control groups
for experimentally testing the effects of interventions to improve
performance. Therefore, research on elite athletes is generally
observational and anecdotal; at best it describes what, but does
not explain why. We were presented with little evidence to suggest
that the enhancement of the performance of elite athletes is generally
based on strong biomedical science, nor that the latest advances
in relevant areas of biomedical research are consistently applied
to this work.
Given the difficulties associated with conducting
research with elite athletes, the importance of a two-way flow
between observations from elite athletes and rigorous research
conducted on non-elite athletes and the wider public is all the
greater. Neither UK Sport, the agency charged with ensuring the
highest possible performance of the UK's elite athletes, nor their
sponsoring Department, the Department for Culture, Media and Sport,
were able to demonstrate that they have rigorous, independent
methods for ensuring that the science they rely on is of high
quality.
Health benefits for the wider population
There is good international evidence that physical
activity improves health in relation to a wide range of chronic
diseases, although the underpinning mechanisms by which these
benefits are brought about are not well understood. The majority
of witnesses, although not all, agreed that, in principle, research
on athletes by sports scientists could help provide health benefits
for the wider public, as this could aid the development of preventative
measures, treatments for members of the public who exercise infrequently
(for example, weekly rather than daily), and inform the development
of new interventions based on knowledge of physiological responses.
However, there is relatively little "trickle-down" at
the moment.
Barriers
The evidence we received suggested that barriers
preventing the treatment of ill health by exercise include lack
of awareness by health professionals, inadequate training and
guidance for these professionals, and lack of confidence in exercise
referral schemes. In a survey of 48 London GP practices, no GP
was aware of the latest physical activity guidelines.
We were also surprised, and disappointed, by the
apparent lack of joined-up thinking in Government about the Olympic
health legacy. The Sports Minister, Hugh Robertson MP, told
us that his interest was in increasing participation in sport
rather than improving the nation's health, the latter being the
responsibility of the Department of Health. The Government need
to take a consistent approach to health, physical activity and
sport, and we recommend that they look to international models
to learn from best practice.
Leadership
As part of the Olympic legacy, the Department of
Health has set up a National Centre for Sport and Exercise Medicine
(NCSEM). We welcome this development. We are concerned that the
funding for this is a one off £30 million capital investment,
and there is no strategy for the long term sustainability of the
NCSEM, nor is the role of the Centre clearly defined. We conclude
that there is a need for greater leadership, particularly to improve
the quality of research, if sport science research is to be more
effective in both improving the performance of elite athletes,
and if that knowledge is to be translated into public health benefits.
Without this leadership, the opportunity provided by the Olympic
legacy could be lost.
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