For reasons of feasibility, proportionate sampling of all countries worldwide, or of regions within countries, was not undertaken. In brief, participating countries were selected to represent significant socioeconomic heterogeneity. The design of the PURE study has been described previously. The PURE study is an ongoing prospective cohort study of more than 154,000 community-based individuals from 21 low-, middle- and high-income countries and states. We examined this hypothesis using data from the Prospective Urban Rural Epidemiology (PURE) study. The values at the extremes reflect the mean values in a population, and so this led us to explore whether there are differences in mean levels of physical characteristics in the population among countries and whether these mean levels could predict their ranking in terms of Olympic medals. One may consider Olympic athletes to lie on an extreme of a Gaussian curve for any relevant physical characteristic, be it strength, speed, or endurance. India, despite being the most populous country in the world, has done relatively poorly in terms of winning Olympic medals, the “Asian dragons” underperform relative to their populations and economies while the USA and China do better than expected, and some quite small countries (e.g. There are many contemporary exceptions to these factors that are associated with Olympic medal success. Politics also matters, with research covering the games since 1952 finding that single party and communist regimes did particularly well the authors of that paper noted that those countries may have a “different approach to participation, training and incentives for success”. More controversially, it has been suggested that culture and religion may play a role. Sending more athletes helps, as does spending more on health and social development. Thus, more populous and wealthy countries do well, although the effects vary between summer and winter games, with national income more important for the latter along with, unsurprisingly, climate and geography (with countries that have Alpine conditions doing well at skiing and related sports). A nation’s medal success is likely to reflect its pool of athletic talent and ability to identify and nurture gifted athletes with sophisticated training techniques. Medal tallies are almost invariably the final statistic presented in any Olympic Games news report, and medallists are transformed overnight into fêted celebrities.Ĭonsiderable research and resources are devoted to identifying the factors that give athletes the advantage needed to become an Olympic medallist. The Olympic Creed reads, “The most important thing in the Olympic Games is not to win but to take part….The essential thing is not to have conquered but to have fought well.” Notwithstanding this noble sentiment, Olympic medals are, to a large extent, the standard by which the success of athletes and of their countries has been judged. The Olympic Games are the pinnacle of sporting contests for many athletes, and capture the attention of the world every four years. Among countries that won at least one medal over the four most recent Summer Olympic Games, there was a close linear relationship between adjusted GS and the natural logarithm of the per capita medal tally (adjusted r = 0.74, p = 0.002). For every 1kg increase in population GS, the medal tally increased by 36% (95% CI 13–65%, p = 0.001) after adjustment. There was a significant positive association between national population grip strength (GS) and medal tally that persisted after adjustment for sex, age, height, average daily caloric intake and GDP (total and per capita). Olympic medal tallies were made over the five most recent Summer Games. Handgrip strength was measured using a Jamar dynanometer. A total of 152,610 participants from these households, located in 21 countries, were included in this analysis. Households were eligible if at least one member was aged 35–70 years and if they intended living at the same address for a further four years. Within participating countries, households from both urban and rural communities were invited to participate using a sampling strategy intended to yield a sample that was representative of the community. This study of handgrip strength represents a cross-sectional analysis of the Prospective Urban Rural Epidemiology (PURE) study, which is an ongoing population cohort study of individuals from high-, middle-, and low-income countries.
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