Obesity has become one of the global epidemics, contributing to the burden of disease in society, increasing the risk of diabetes, cardiovascular and liver diseases. Inadequate energy balance ...resulting from excessive energy intake and insufficient physical activity (PA) is one of the main factors contributing to the incidence of obesity and the development of metabolic syndrome (MetS). Treatment options for obesity include lifestyle modifications, pharmacotherapy and bariatric surgery, with the latter being the most effective treatment. Lifestyle interventions involving increased PA and reduced caloric intake improve metabolic outcomes. Early implementation of exercise leads to improved physical fitness, better glycemic control and lipid profile. Undertaking systematic PA is associated with better quality of life, improves insulin sensitivity, causes additional weight loss, reduces its adverse effects on bone mass and results in better body composition. In this narrative review we summarized the current state of knowledge on the impact of PA on the components of MetS and the latest recommendations for PA in patients with MetS.
In recent years, numerous prognostic models have been developed to predict VO2max. Nevertheless, their accuracy in endurance athletes (EA) stays mostly unvalidated. This study aimed to compare ...predicted VO2max (pVO2max) with directly measured VO2max by assessing the transferability of the currently available prediction models based on their R2, calibration-in-the-large, and calibration slope. 5,260 healthy adult EA underwent a maximal exertion cardiopulmonary exercise test (CPET) (84.76% male; age 34.6±9.5 yrs.; VO2max 52.97±7.39 mL·min-1·kg-1, BMI 23.59±2.73 kg·m-2). 13 models have been selected to establish pVO2max. Participants were classified into four endurance subgroups (high-, recreational-, low- trained, and "transition") and four age subgroups (18-30, 31-45, 46-60, and ≥61 yrs.). Validation was performed according to TRIPOD guidelines. pVO2max was low-to-moderately associated with direct CPET measurements (p>0.05). Models with the highest accuracy were for males on a cycle ergometer (CE) (Kokkinos R2 = 0.64), females on CE (Kokkinos R2 = 0.65), males on a treadmill (TE) (Wasserman R2 = 0.26), females on TE (Wasserman R2 = 0.30). However, selected models underestimated pVO2max for younger and higher trained EA and overestimated for older and lower trained EA. All equations demonstrated merely moderate accuracy and should only be used as a supplemental method for physicians to estimate CRF in EA. It is necessary to derive new models on EA populations to include routinely in clinical practice and sports diagnostic.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The COVID-19 pandemic has changed the way many people live. To assess its impact on sleep quality and quantity, blue light exposure, and the mental health of Polish university students, a ...cross-sectional survey was conducted. Almost half of the participants were medical students (47.62%; n = 630). The majority of students were suffering from insomnia (58.13%, n = 769). Almost every third student was sleeping less than 7 h a day (30.39%, n = 402). Our study showed that a short sleep duration correlates with poorer mental health outcomes. Respondents who declared sadness and depression were more likely to suffer from insomnia (OR = 5.6997, 95% CI: 4.3641–7.4441). Difficulty with tasks was also more likely to co-occur with insomnia (OR = 5.4723, 95% CI: 4.3007 to 6.9630). The results of this study showed that the COVID-19 pandemic contributed to the deterioration of sleep quality and quantity as well as the psychological well-being of Polish students. It is important to take steps to promote proper sleeping habits to alleviate the risk of mental health disorders in this group of people.
Maximal heart rate (HRmax) is associated mostly with age, but age alone explains the variance in HRmax to a limited degree and may not be adequate to predict HRmax in certain groups. The present ...study was carried out on 3374 healthy Caucasian, Polish men and women, clients of a sports clinic, mostly sportspeople, with a mean age of 36.57 years, body mass 74.54 kg, maximum oxygen uptake (VO
2
max, ml
∗
kg
–1
∗
min
–1
) 50.07. Cardiopulmonary exercise tests (CPET) were carried out on treadmills or cycle ergometers to evaluate HRmax and VO
2
max. Linear, multiple linear, stepwise, Ridge and LASSO regression modeling were applied to establish the relationship between HRmax, age, fitness level, VO
2
max, body mass, age, testing modality and body mass index (BMI). Mean HRmax predictions calculated with 5 previously published formulae were evaluated in subgroups created according to all variables. HRmax was univariately explained by a 202.5–0.53
∗
age formula (
R
2
= 19.18). The weak relationship may be explained by the similar age with small standard deviation (SD). Multiple linear regression, stepwise and LASSO yielded an
R
2
of 0.224, while Ridge yielded
R
2
0.20. Previously published formulae were less precise in the more outlying groups of the studied population, overestimating HRmax in older age groups and underestimating in younger. The 202.5–0.53
∗
age formula developed in the present study was the best in the studied population, yielding lowest mean errors in most groups, suggesting it could be used in more active individuals. Tanaka’s formula offers the second best overall prediction, while the 220-age formula yields remarkably high mean errors of up to 9 bpm. In conclusion, adding the studied variables in multiple regression models improves the accuracy of prediction only slightly over age alone and is unlikely to be useful in clinical practice.
The COVID-19 pandemic and imposed restrictions influenced athletic societies, although current knowledge about mild COVID-19 consequences on cardiopulmonary and physiologic parameters remains ...inconclusive. This study aimed to assess the impact of mild COVID-19 inflection on cardiopulmonary exercise test (CPET) performance among endurance athletes (EA) with varied fitness level.
49 EA (n
= 43, n
= 6, mean age = 39.94 ± 7.80 yr, height = 178.45 cm, weight = 76.62 kg; BMI = 24.03 kgm
) underwent double treadmill or cycle ergometer CPET and body analysis (BA) pre- and post-mild COVID-19 infection. Mild infection was defined as: (1) without hospitalization and (2) without prolonged health complications lasting for >14 days. Speed, power, heart rate (HR), oxygen uptake (VO
), pulmonary ventilation, blood lactate concentration (at the anaerobic threshold (AT)), respiratory compensation point (RCP), and maximum exertion were measured before and after COVID-19 infection. Pearson's and Spearman's r correlation coefficients and Student t-test were applied to assess relationship between physiologic or exercise variables and time.
The anthropometric measurements did not differ significantly before and after COVID-19. There was a significant reduction in VO
at the AT and RCP (both
< 0.001). Pre-COVID-19 VO
was 34.97 ± 6.43 ml kg·min
, 43.88 ± 7.31 ml kg·min
and 47.81 ± 7.81 ml kg·min
respectively for AT, RCP and maximal and post-COVID-19 VO
was 32.35 ± 5.93 ml kg·min
, 40.49 ± 6.63 ml kg·min
and 44.97 ± 7.00 ml kg·min
respectively for AT, RCP and maximal. Differences of HR at AT (
< 0.001) and RCP (
< 0.001) was observed. The HR before infection was 145.08 ± 10.82 bpm for AT and 168.78 ± 9.01 bpm for RCP and HR after infection was 141.12 ± 9.99 bpm for AT and 165.14 ± 9.74 bpm for RCP. Time-adjusted measures showed significance for body fat (r = 0.46,
< 0.001), fat mass (r = 0.33,
= 0.020), cycling power at the AT (r = -0.29,
= 0.045), and HR at RCP (r = -0.30,
= 0.036).
A mild COVID-19 infection resulted in a decrease in EA's CPET performance. The most significant changes were observed for VO
and HR. Medical Professionals and Training Specialists should be aware of the consequences of a mild COVID-19 infection in order to recommend optimal therapeutic methods and properly adjust the intensity of training.
The ratio of oxygen uptake (VO
) to minute ventilation (VE) is described as the oxygen uptake efficiency slope (OUES). OUES has been suggested as a valuable submaximal cardiorespiratory index; ...however, its characteristics in endurance athletes remain unknown. In this study, we a) investigated OUES between different time intervals, b) assessed their prediction power for VO
peak, and c) derived new prediction equations for OUES tailored for well-trained individuals.
A total of 77 male (age = 21.4 ± 4.8 yrs; BMI = 22.1 ± 1.6 kg·m
; peak oxygen uptake = 4.40 ± 0.64 L·min
) and 63 female individuals (age = 23.4 ± 4.3 yrs; BMI = 23.1 ± 1.6 kg·m
; peak oxygen uptake = 3.21 ± 0.48 L·min
) underwent the cycling cardiopulmonary exercise test. OUES was measured at 75%, 90%, and 100% of exercise duration. Prediction power and new models were derived with the multiple linear regression method.
In male subjects, OUES mL·min
/L·min
from 75% = 4.53 ± 0.90, from 90% = 4.52 ± 0.91, and from 100% = 4.41 ± 0.87. In female subjects, OUES mL·min
/L·min
from 75% = 3.50 ± 0.65, from 90% = 3.49 ± 0.62, and from 100% = 3.41 ± 0.58. OUES did not differ between time intervals in male (
= 0.65) and female individuals (
= 0.69). OUES strongly predicts peak VO
independently from the measuring interval (
= 0.71-0.80;
= 0.50-0.63). The prediction model designed for elite athletes was OUES mL·min
/L·min
= -1.54 + 2.99; BSA m
-0.0014; (age in years; sex 1 = male, 2 = female) (
= 0.36).
OUES enables an accurate prediction of peak cardiorespiratory fitness in elite endurance athletes. OUES is a feasible alternative to maximal exercise testing. A new prediction equation should be used for highly trained individuals. Physicians should understand OUES physiology to properly assess the cardiorespiratory response to exercise in athletic cohorts.
COVID-19 and imposed restrictions are linked with numerous health consequences, especially among endurance athletes (EA). Unfavorable changes in physical activity and nutrition may affect later ...sports and competition performance. The aims of this study were: (1) to assess the impact of COVID-19 infection and pandemic restrictions on the nutrition and physical activity of EAs and (2) to compare them with the results of cardiopulmonary exercise testing (CPET). In total, 49 EAs (nmale = 43, nfemale = 6, mean age = 39.9 ± 7.8 year., height = 178.4 ± 6.8 cm, weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m−2) underwent pre- and post-COVID-19 CPET and fulfilled the dietary and physical activity survey. COVID-19 infection significantly deteriorated CPET performance. There was a reduction in oxygen uptake and in heart rate post-COVID-19 (both p < 0.001). Consuming processed meat and replacing meat with plant-based protein affected blood lactate concentration (p = 0.035). Fat-free mass was linked with consuming unsaturated fatty acids (p = 0.031). Adding salt to meals influenced maximal speed/power (p = 0.024) and breathing frequency (p = 0.033). Dietary and Fitness Practitioners and Medical Professionals should be aware of possible COVID-19 infection and pandemic consequences among EA. The results of this study are a helpful guideline to properly adjust the treatment, nutrition, and training of EA.
Fracture of the proximal femur is common in elderly patients, in fact threatening their lives. Age-related sarcopenia may be involved in the imbalance resulting in the injury. Handy and readily ...accessible biochemical tests would be useful to assess the musculoskeletal system condition in daily practice. The aim of the study was to determine whether there is any relation between muscle decay and fracture of the proximal femur and to assess bone quality in elderly patients.
In the study 22 patients who represented the treatment group were hospitalized due to proximal femur fracture. Eighteen patients from the control group with no fracture in their history were admitted to the Internal Medicine Department. Anyone treated for osteoporosis, immune disease affecting protein balance, neoplasm, mental illness, heart failure, or myocardial infarction was excluded from the study. In every case a blood sample from an elbow vein was drawn, collected in EDTA-K2 tubes, and then centrifuged to separate plasma from the whole blood. Subsequently, the concentrations of C-terminal cross-linked telopeptide of type I collagen (CTX-I), sex hormone binding globulin (SHBG) and creatine kinase (CK) in plasma were determined using commercial enzyme-linked immunosorbent assays.
The CK plasma concentration differed between the patient groups (
= 0.011). The SHBG plasma concentration was significantly higher in the treatment group (
= 0.006), whereas a slight difference in CTX-I plasma concentration between the groups was found (
= 0.038). No significant correlations between plasma CK, SHBG or CTX-I were found (
> 0.05).
Creatine kinase is actually not an appropriate marker for the clinical assessment of muscle tissue quality in patients with or at risk of proximal femur fracture. Analyzing the quality of bone tissue, we can conclude it was poorer in patients with proximal femur fracture than in the control group.
Pancreas transplantation is a high-risk procedure in terms of cardiovascular complications. Therefore, identification of all cardiovascular risk factors is crucial to prevent cardiovascular ...complications after pancreas transplantation. Vitamin D deficiency (VDD) appears to be a potential risk factor for coronary artery disease.
To determine the prevalence of VDD in pancreas transplant candidates, and further to examine the relationship between vitamin D and the prevalence of coronary artery disease and lipid profile parameters.
This is a prospective cross-sectional study. We enrolled consecutive patients with type 1 diabetes eligible for simultaneous pancreas-kidney transplantation or pancreas transplant alone. The laboratory tests included HbA1c, lipid profile, creatinine, and total 25-hydroxyvitamin D (25(OH)D). The diagnosis of coronary artery disease was based on coronary angiography.
The study population included 48 patients. VDD was revealed in 48% of patients and coronary artery disease in 35% of patients. The mean concentration of vitamin D in the entire cohort was 21.3 ± 9.48 ng/ml. The median value of 25(OH)D in patients with coronary artery disease was significantly lower than in patients without coronary artery disease (18.5 (11.6-21.5)
. 24.8 (18.4-31.8) ng/ml, p = 0.018). There was a significant relationship between VDD and coronary artery disease (OR = 4.36; 95% confidence interval (CI): 1.22-15.64, p = 0.034). A patient's odds of having coronary artery disease while having a sufficient level of vitamin D was 4.36 times lower than if the patient had VDD. There was a significant relationship between VDD and hypertension (OR = 5.91; 95% CI: 1.12-31.20, p = 0.039) and hemodialysis (OR = 4.25; 95% CI: 1.25-14.5, p = 0.023). There was no significant correlation between 25(OH)D and lipid profile.
VDD is highly prevalent in pancreas transplant candidates with type 1 diabetes. There is a significant relationship between VDD and increased prevalence of coronary disease. The lack of any significant association between serum vitamin D and lipid profile suggests that the relationship between vitamin D and coronary artery disease results from other causes.
PDF
