Skip to main content
SpringerLink
Log in

Exercise and Diet in the Prevention and Control of the Metabolic Syndrome

  • Leading Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Reaven GM. Role of insulin resistance in human disease. Diabetes 1988; 37: 1595–607

    Article  PubMed  CAS  Google Scholar 

  2. Kaplan NM. The deadly quartet: upper-body obesity, glucose intolerance, hypertriglyceridema, and hypertension. Arch Intern Med 1989; 149: 1514–20

    Article  PubMed  CAS  Google Scholar 

  3. Foster DW. Insulin resistance — a secret killer? N Engl J Med 1989; 320: 733–4

    Article  PubMed  CAS  Google Scholar 

  4. Landin K, Tengborn L, Smith U. Elevated fibrinogen and plasminogen activator inhibitor (PAI-1) in hypertension are related to metabolic risk factors for cardiovascular disease. J Intern Med 1990; 227: 273–8

    Article  PubMed  CAS  Google Scholar 

  5. Barakat HA, Carpenter JW, McLendon VD, et al. Influence of obesity, impaired glucose tolerance, and NIDDM on LDL structure and composition. Diabetes 1990; 39: 1527–33

    Article  PubMed  CAS  Google Scholar 

  6. Reaven GM, Chen Y-DI, Jeppesen J, et al. Insulin resistance and hyperinsulinemia in individuals with small, dense, low density lipoprotein particles. J Clin Invest 1993; 92: 141–6

    Article  PubMed  CAS  Google Scholar 

  7. DeFronzo RA, Ferrannini E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14: 173–94

    Article  PubMed  CAS  Google Scholar 

  8. Rupp H. Insulin resistance, hyperinsulinemia, and cardiovascular disease: the need for novel dietary prevention strategies. Basic Res Cardiol 1992; 87: 99–105

    Article  PubMed  CAS  Google Scholar 

  9. Ferrannini E, Haffner SM, Mitchell BD, et al. Hyperinsulinemia: the key feature of a cardiovascular and metabolic syndrome. Diabetiologia 1991; 34: 416–22

    Article  CAS  Google Scholar 

  10. Srinivasan SR, Bao W, Berenson GS. Coexistance of increased levels of adiposity, insulin, and blood pressure in a young adult cohort with elevated very-low-density lipoprotein cholesterol: the Bogalusa Heart Study. Metabolism 1993; 42: 170–6

    Article  PubMed  CAS  Google Scholar 

  11. Haffner SM, Valdez RA, Hazuda HP, et al. Prospective analysis of the insulin-resistance syndrome (Syndrome X). Diabetes 1992; 41: 715–22

    Article  PubMed  CAS  Google Scholar 

  12. Vague J. La différenciation sexuelle, facteur déterminant des formes de l’obésité. Presse Med 1947; 30: 339–40

    Google Scholar 

  13. Després J-P, Moorjani S, Lupien PJ, et al. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis 1990; 10: 497–511

    Article  PubMed  Google Scholar 

  14. Björntorp P. ‘Portal’ adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis 1990; 10: 495–6

    Google Scholar 

  15. Kissebah AH, Peiris AN. Biology of regional body fat distribution: relationship to non-insulin-dependent diabetes mellitus. Diabetes Metab Rev 1989; 5: 83–109

    Article  PubMed  CAS  Google Scholar 

  16. Bouchard C, Bray GA, Hubbard VS. Basic and clinical aspects of regional fat distribution. Am J Clin Nutr 1990; 52: 946–50

    PubMed  CAS  Google Scholar 

  17. Grimditch GK, Barnard RJ, Sternlicht E, et al. Effect of diet on insulin binding and glucose transport in rat sarcolemmal vessicles. Am J Physiol 1987; 252: E420–E425

    PubMed  CAS  Google Scholar 

  18. Grimditch GK, Barnard RJ, Hendrick L, et al. Effects of diet and exercise training on peripheral insulin sensitivity. Am J Clin Nutr 1988; 48: 38–43

    PubMed  CAS  Google Scholar 

  19. Storlien LH, Pan DA, Kirketos AD, et al. High fat diet-induced insulin resistance. Lessons and implications from animal studies. Ann NY Acad Sci 1993; 683: 82–90

    Article  PubMed  CAS  Google Scholar 

  20. Vrána A, Kazdová L, Dobesová Z, et al. Triglyceridemia, glucoregulation, and blood pressure in various rat strains. Effects of dietary carbohydrates. Ann NY Acad Sci 1993; 683: 57–9

    Article  PubMed  Google Scholar 

  21. Davidson MB, Garvey D. Studies on mechanisms of hepatic insulin resistance in cafeteria-fed rats. Am J Physiol 1993; 264: E18–E23

    PubMed  CAS  Google Scholar 

  22. Barnard RJ, Ugianskis EJ, Martin DA, et al. Role of diet and exercise in the management of hyperinsulinemia and associated atherosclerotic risk factors. Am J Cardiol 1992; 69: 440–4

    Article  PubMed  CAS  Google Scholar 

  23. Barnard RJ, Faria DJ, Menges JE, et al. Effects of a high-fat, sucrose diet on serum insulin and related atherosclerotic risk factors in rats. Atherosclerosis 1993; 100: 229–36

    Article  PubMed  CAS  Google Scholar 

  24. O’Dea K. Diabetes in Australian Aborigines: impact of the western diet and life style. J Intern Med 1992; 232: 103–17

    Article  PubMed  Google Scholar 

  25. Brindley DN, Rolland Y. Possible connections between stress, diabetes, obesity, hypertension and altered lipoprotein metabolism that may result in atherosclerosis. Clin Sci 1989; 77: 453–61

    PubMed  CAS  Google Scholar 

  26. Mårin P, Björntorp P. Endocine-metabolic pattern and adipose tissue distribution. Hormone Res 1993; 39Suppl. 3: 81–5

    PubMed  Google Scholar 

  27. Salans LB, Reaven GM. Effect of insulin pretreatment on glucose and lipid metabolism of liver slices from normal rats. Proc Soc Exp Biol Med 1966; 122: 1208–13

    PubMed  CAS  Google Scholar 

  28. Olefsky JM, Farquhar JW, Reaven GM. Reappraisal of the role of insulin in hypertriglyceridemia. Am J Med 1974; 57: 551–60

    Article  PubMed  CAS  Google Scholar 

  29. Tobey TA, Greenfield M, Kraemer F, et al. Relationship between insulin resistance, insulin secretion, very low density lipoprotein kinetics, and plasma triglyceride levels in normotriglyceridemic man. Metabolism 1981; 30: 165–71

    Article  PubMed  CAS  Google Scholar 

  30. Reaven GM, Risser TR, Chen Y-DI, et al. Characterization of a model of dietary-induced hypertriglyceridemia in young, nonobese rats. J Lipid Res 1979; 20: 371–8

    PubMed  CAS  Google Scholar 

  31. McNamara JR, Jenner JL, Li Z, et al. Change in LDL particle size is associated with change in plasma triglyceride concentration. Arterioscler Thromb 1992; 12: 1284–90

    Article  PubMed  CAS  Google Scholar 

  32. Stacpoole PW, Von Bergmann K, Kilgore LL, et al. Nutritional regulation of cholesterol synthesis and apolipoprotein B kinetics: studies in patients with familial hypercholesterolema and normal subjects treated with a high carbohydrate, low fat diet. J Lipid Res 1991; 32: 1837–40

    PubMed  CAS  Google Scholar 

  33. Taskinen MR. Lipoprotein lipase in diabetes. Diabetes Metab Rev 1987; 3: 551–70

    Article  PubMed  CAS  Google Scholar 

  34. Brunzell JD, Porte Jr D, Bierman EL. Abnormal lipoprotein mediated plasma triglyceride removal in untreated diabetes mellitus associated with hypertriglyceridemia. Metabolism 1979; 28: 901–7

    Article  PubMed  CAS  Google Scholar 

  35. Ooi TC, Simo IE, Yakichuk JA. Delayed clearance of postprandial chylomicrons and their remnants in the hypoalphalipoproteinemia and mild hypertriglyceridemia syndrome. Arterioscler Thromb 1992; 12: 1184–90

    Article  PubMed  CAS  Google Scholar 

  36. DeFronzo RA. Insulin resistance, hyperinsulinemia, and coronary artery disease: a complex metabolic web. J Cardiovasc Pharmacol 1992; 20Suppl. II: S1–S16

    Article  PubMed  Google Scholar 

  37. Gans ROB, Donker AJM. Insulin and blood pressure regulation. J Intern Med 1991; 229Suppl. 2: 49–64

    Google Scholar 

  38. Juhan-Vague I, Thompson SG, Jespersen J. Involvement of the hemostatic system in the insulin resistance syndrome: a study of 1500 patients with angina pectoris. Arterioscler Thromb 1993; 13: 1865–73

    Article  PubMed  CAS  Google Scholar 

  39. Alessi MC, Juhan-Vague I, Kooistra T, et al. Insulin stimulates the synthesis of plasminogen activator inhibitor 1 by the human hepatocellular cell line Hep G2. Thromb Haemost 1988; 60: 491–4

    PubMed  CAS  Google Scholar 

  40. Stiko-Rahm A, Wiman B, Hamsten A, et al. Secretion of plasminogen activator inhibitor 1 from cultured human umbilical vein endothelial cells is induced by very low density lipoprotein. Arteriosclerosis 1990; 10: 1067–73

    Article  PubMed  CAS  Google Scholar 

  41. Latron Y, Chautan M, Anfosso F, et al. Stimulating effect of oxidized-low-density lipoproteins on plasminogen activator inhibitor 1 synthesis by endothelial cells. Arterioscler Thromb 1991; 11: 1821–9

    Article  PubMed  CAS  Google Scholar 

  42. Pollare T, Vessby B, Lithell H. Lipoprotein lipase activity in skeletal muscle is related to insulin sensitivity. Arterioscler Thromb 1991; 11: 1192–203

    Article  PubMed  CAS  Google Scholar 

  43. Kiens B, Lithell H, Mikines KJ, et al. Effects of insulin and exercise on muscle lipoprotein lipase activity in man and its relation to insulin action. J Clin Invest 1989; 84: 1124–9

    Article  PubMed  CAS  Google Scholar 

  44. Farese RV, Yost TJ, Eckel RH. Tissue-specific regulation of lipoprotein lipase activity by insulin/glucose in normal weight humans. Metabolism 1991; 40: 214–16

    Article  PubMed  CAS  Google Scholar 

  45. Ong JM, Kirchegessner TG, Schatz MC, et al. Insulin increases the synthetic rate and messenger RNA level of lipoprotein lipase in isolated rat adipocytes. J Biol Chem 1988; 263: 12933–8

    PubMed  CAS  Google Scholar 

  46. Barnard RJ, Youngren JF. Regulation of glucose transport in skeletal muscle. FASEB J 1992; 6: 3238–44

    PubMed  CAS  Google Scholar 

  47. Fryer LG, Kruszynska YT. Insulin resistance in high fat fed rats. Role of glucose transporters, membrane lipids, and triglyceride stores. Ann NY Acad Sci 1993; 683: 91–7

    Article  PubMed  CAS  Google Scholar 

  48. Boyd JJ, Contreras I, Kern M, et al. Effect of a high-fat-sucrose diet on in vivo insulin receptor kinase activation. Am J Physiol 1990; 259: E111–E116

    PubMed  CAS  Google Scholar 

  49. Iwanishi M, Kobayashi M. Effect of pioglitazone on insulin receptors of skeletal muscles from high-fat-fed rats. Metabolism 1993; 42: 1017–21

    Article  PubMed  CAS  Google Scholar 

  50. Scheck SH, Barnard RJ, Lawani LO, et al. Effects of NIDDM on the glucose transport system in human skeletal muscle. Diabetes Res 1991; 16: 111–9

    PubMed  CAS  Google Scholar 

  51. Anderson JW, Gustafson NJ, Bryant CA, et al. Dietary fiber and diabetes: a comprehensive review and practical application. J Am Diet Assoc 1987; 87: 1189–97

    PubMed  CAS  Google Scholar 

  52. Fukagawa NK, Anderson JW, Hogeman G, et al. High-carbohydrate, high-fiber diets increase peripheral insulin sensitivity in healthy young and old adults. Am J Clin Nutr 1990; 52: 524–8

    PubMed  CAS  Google Scholar 

  53. Ivy JL. The insulin-like effect of muscle contraction. Exercise Sport Sci Rev 1987; 15: 29–51

    Article  CAS  Google Scholar 

  54. Brozinick JT, Etgen GJ, Yaspelkis BB, et al. Contraction activated glucose uptake is normal in insulin-resistant muscle of the obese Zucker rat. J Appl Physiol 1992; 73: 382–8

    PubMed  CAS  Google Scholar 

  55. Devlin JT, Hirshman M, Horton ED, et al. Enhanced peripheral and splanchnic insulin sensitivity in NIDDM men after a single bout of exercise. Diabetes 1987; 36: 434–9

    Article  PubMed  CAS  Google Scholar 

  56. Burstein R, Epstein Y, Shapiro Y, et al. Effect of an acute bout of exercise on glucose disposal in human obesity. J Appl Physiol 1990; 69: 299–304

    PubMed  CAS  Google Scholar 

  57. Mikines KJ. The influence of physical activity and inactivity on insulin action and secretion in man. Acta Physiol Scand 1992; 146Suppl. 609: 1–43

    Google Scholar 

  58. Ivy JL, Brozinick JR, Torgan CE, et al. Skeletal muscle glucose transport in obese Zucker rats after exercise training. J Appl Physiol 1989; 66: 2635–41

    PubMed  CAS  Google Scholar 

  59. Willems MET, Brozinick JT, Torgan CE, et al. Muscle glucose uptake of obese Zucker rats trained at two different intensities. J Appl Physiol 1991; 70: 36–42

    Article  PubMed  CAS  Google Scholar 

  60. Kraegen EW, Storlien LH, Jenkins AB, et al. Chronic exercise compensates for insulin resistence induced by a high fat diet in rats. Am J Physiol 1989; 256: E242–E249

    PubMed  CAS  Google Scholar 

  61. Wallberg-Henricksson H. Exercise and diabetes mellitus. Exer Sport Sci Rev 1992; 20: 339–68

    Google Scholar 

  62. Rogers MA, Yamamoto C, King DS, et al. Improvement in glucose tolerance after 1 week of exercise in patients with NIDDM. Diabetes Care 1988; 11: 613–8

    Article  PubMed  CAS  Google Scholar 

  63. Després J-P, Prud’Homme D, Tremblay A, et al. Contribution of low intensity exercise training to treatment of abdominal obesity. In: Guy-Grand B, Ricquier D, Lafontan M, et al., editors. Importance of ‘metabolic fitness’ in obesity in Europe 91. London: John Libby, 1992: 177–81

    Google Scholar 

  64. Helmrich SP, Ragland DR, Leung RW, et al. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991; 325: 147–52

    Article  PubMed  CAS  Google Scholar 

  65. Manson JE, Rimm EB, Stampfer MJ, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991; 338: 774–8

    Article  PubMed  CAS  Google Scholar 

  66. Manson JE, Nathan DM, Krolewski AS, et al. A prospective study of exercise and incidence of diabetes among US male physicians. JAMA 1992; 268: 63–7

    Article  PubMed  CAS  Google Scholar 

  67. Després J-P, Moorjani S, Tremblay A, et al. Heredity and changes in plasma lipids and lipoproteins after short-term exercise training in men. Arteriosclerosis 1988; 8: 402–9

    Article  PubMed  Google Scholar 

  68. Després J-P, Trembley A, Nadaeu A, et al. Physical training and changes in regional adipose tissue distribution. Acta Med Scand 1988; Suppl. 723: 205–12

    Google Scholar 

  69. Després J-P, Pouliot MC, Moorjani S, et al. Loss of abdominal fat and metabolic response to training in obese women. Am J Physiol 1991; 261: E159–E167

    PubMed  Google Scholar 

  70. Lampman RM, Santinga JT, Bassett DR, et al. Effectiveness of unsupervised and supervised high intensity physical training in normalizing serum lipids in men with type IV hyperlipoproteinemia. Circulation 1978; 57: 172–80

    Article  PubMed  CAS  Google Scholar 

  71. Lampman RM, Santinga JT, Savage PJ, et al. Effect of exercise training on glucose tolerance, in vivo insulin sensitivity, lipid and lipoprotein concentrations in middle-aged men with mild hypertriglyceridema. Metabolism 1985; 34: 205–11

    Article  PubMed  CAS  Google Scholar 

  72. Lampman RM, Schteingart DE, Santinga JT, et al. The influence of physical training on glucose tolerance, insulin sensitivity, and lipid and lipoprotein concentrations in middle-aged hypertriglyceridemic, carbohydrate intolerant men. Diabetologia 1987; 30: 380–5

    Article  PubMed  CAS  Google Scholar 

  73. Bouchard C, Shephard RJ, Stephens T. Physical activity, fitness, and health. International proceedings and consensus statement. Champaign: Human Kinetics Publishers, 1994: 417–683

    Google Scholar 

  74. Baumstark MU, Frey I, Berg A. Acute and delayed effects of prolonged exercise on serum lipoproteins II. Concentration and composition of low-density lipoprotein subfractions and very low-density lipoproteins. Europ J Appl Physiol 1993; 66: 526–30

    Article  CAS  Google Scholar 

  75. Lamon-Fava S, McNamara JR, Farber HW, et al. Acute changes in lipid lipoprotein, apolipoprotein, and low-density lipoprotein particle size after an endurance triathlon. Metabolism 1989; 38: 921–5

    Article  PubMed  CAS  Google Scholar 

  76. Lamon-Fava S, Fischer EC, Nelson ME, et al. Effect of exercise and menstrual cycle status on plasma lipids, low density lipoprotein particle size, and apolipoproteins. J Clin Endocrinol Metab 1989; 68: 17–21

    Article  PubMed  CAS  Google Scholar 

  77. Williams PT, Krauss RM, Wood PD, et al. Lipoprotein sub-fractions of runners and sedentary men. Metabolism 1986; 35: 45–52

    Article  PubMed  CAS  Google Scholar 

  78. Williams PT, Krauss RM, Vranizan KM, et al. Changes in lipoprotein subfractions during diet-induced weight loss in moderately overweight men. Circulation 1990; 81: 1293–1304

    Article  PubMed  CAS  Google Scholar 

  79. Williams PT, Krauss RM, Vranizan KM, et al. Effects of exercise-induced weight loss on low density lipoprotein sub-fractions in healthy men. Arteriosclerosis 1989; 9: 623–32

    Article  PubMed  CAS  Google Scholar 

  80. Coulston AM, Hollenbeck CB, Swislock ALM. Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin dependent diabetes mellitus. Am J Med 1987; 82: 213–20

    Article  PubMed  CAS  Google Scholar 

  81. Coulston AM, Hollenbeck CB, Suislocki ALM, et al. Persistence of hypertriglyceridemic effect of low-fat, high-carbohydrate diets in NIDDM patients. Diabetes Care 1989; 12: 94–101

    Article  PubMed  CAS  Google Scholar 

  82. Rivellese AA, Giacco R, Genovese S, et al. Effects of changing amount of carbohydrate in diet on plasma lipoproteins and apoproteins in type II patients. Diabetes Care 1990; 13: 446–8

    Article  PubMed  CAS  Google Scholar 

  83. Fuh MMT, Lee MMS, Jeng CY, et al. Effect of low fat-high carbohydrate diet in hypertensive patients with non-insulin-dependent diabetes mellitus. Am J Hypertens 1990; 3: 527–32

    PubMed  CAS  Google Scholar 

  84. Ullman D, Connor WE, Hatcher LF, et al. Will a high-carbohydrate, low-fat diet lower plasma lipids and lipoproteins without producing hypertriglyceridemia? Arterioscler Thromb 1991; 11: 1059–67

    Article  Google Scholar 

  85. Brinton EA, Eisenberg S, Breslow JL. A low-fat diet decreases high density lipoprotein (HDL) cholesterol levels by decreasing HDL apoprotein transport rates. J Clin Invest 1990; 85: 144–51

    Article  PubMed  CAS  Google Scholar 

  86. Trowell H. Hypertension, obesity, diabetes mellitus and coronary heart disease. In: Trowell HC, Burkitt DP, editors. Western diseases: their emergence and prevention. London: Edward Arnold, 1981: 3–32

    Google Scholar 

  87. Wright A, Burstyn PF, Gibney MJ. Dietary fiber and blood pressure. BMJ 1979; 2: 1541–3

    Article  PubMed  CAS  Google Scholar 

  88. Anderson JW. Plant fiber and blood pressure. Ann Intern Med 1983; 98: 842–6

    PubMed  CAS  Google Scholar 

  89. Iacono JM, Binder RA, Marshall MW, et al. Decreased susceptibility to thrombin and collagen platelet aggregation in man fed a low fat diet. Haemostasis 1974; 3: 306–18

    PubMed  CAS  Google Scholar 

  90. Marckmann P, Sandström B, Jespersen J. Favorable long-term effect of a low-fat/high-fiber diet on human blood coagulation and fibrinolysis. Arterioscler Thromb 1993; 13: 505–11

    Article  PubMed  CAS  Google Scholar 

  91. Steele P, Rainwater J. Effect of dietary and pharmacologic alteration of serum lipids on platelet survival time. Circulation 1978; 58: 365–7

    Article  PubMed  CAS  Google Scholar 

  92. Goodnight SHJ, Harris WS, Connor WE. The effects of dietary W3 fatty acids on platelet composition and function in men: a prospective controlled study. Blood 1981; 58: 880–5

    PubMed  CAS  Google Scholar 

  93. Siess W, Roth P, Scherer B, et al. Platelet membrane fatty acids, platelet aggregation and thromboxane formation during a mackerel diet. Lancet 1980; I: 441–4

    Article  Google Scholar 

  94. Dyerberg J, Bang HO. Haemostatic function and polyunsaturated fatty acids in Eskimos. Lancet 1979; II: 433–5

    Article  Google Scholar 

  95. Barnard RJ. Effects of life-style modification on serum lipids. Arch Intern Med 1991; 151: 1389–94

    Article  PubMed  CAS  Google Scholar 

  96. Barnard RJ, Guzy PM, Rosenberg JM, et al. Effects of an intensive exercise and nutrition program on patients with coronary artery disease: five-year follow-up. J Cardiac Rehab 1983; 3: 183–90

    Google Scholar 

  97. Barnard RJ, Massey MR, Cherny S, et al. Long-term use of a high-complex-carbohydrate, high-fiber diet and exercise in the treatment of NIDDM patients. Diabetes Care 1983; 6: 268–73

    Article  PubMed  CAS  Google Scholar 

  98. Barnard RJ, Zifferblatt SM, Rosenberg JM, et al. Effects of a high-complex-carbohydrate diet and daily walking on blood pressure and medication status of hypertensive patients. J Cardiac Rehab 1983; 3: 839–46

    Google Scholar 

  99. Barnard RJ, Hall JA, Chaudhari A, et al. Effects of a low-fat, low-chloresterol diet on serum lipids, platelet aggregation and thromboxane formation. Prostaglandins Leukotrienes Med 1987; 26: 241–52

    Article  CAS  Google Scholar 

  100. Mehrabian M, Peter JB, Barnard RJ, et al. Dietary regulation of fibrinolytic factors. Atherosclerosis 1990; 84: 25–32

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physiological Science, UCLA, 2322 Life Sciences Bldg, 405 Hilgard Avenue, Los Angeles, California, 90024-1527, USA

    R. James Barnard & Stephen J. Wen

Authors
  1. R. James Barnard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen J. Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barnard, R.J., Wen, S.J. Exercise and Diet in the Prevention and Control of the Metabolic Syndrome. Sports Med 18, 218–228 (1994). https://doi.org/10.2165/00007256-199418040-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199418040-00002

Keywords

Search

Navigation