Morphological Characteristics of Elite International Soccer Referees: Somatotype and Bioelectrical Impedance Vector Analysis.

This study aimed to assess the physical characteristics of elite international soccer referees, compare them with other referee populations in the literature, and establish reference tolerance ellipses for the bioelectrical impedance vector analysis (BIVA) point graph. Forty-one elite international soccer referees (age 38.8 ± 3.6 years) participated in the study. The participants underwent body composition assessments, including dual-energy X-ray absorptiometry, BIVA, and somatotype. The Somatotype Attitudinal Distance (SAD), the two-sample Hotelling's T2 test and the Mahalanobis test were used to determine somatotype and bioelectrical vector differences with the literature. The average somatotype of the referees was a balanced mesomorph (2.8, 6.5, 2.8). Elite international referees significantly differed from other samples in the literature (SAD = 2.1, 2.6, 2.9 with respect to Zimbabwean, Brazilian, and South African referees, respectively). The bioelectrical vector was significantly different from the general population (T2 ≤ 76.6; F = 38.8; D = 1.44; p < 0.001) and athletes (T2 ≤ 25.3; F = 12.6; D = 0.8; p < 0.001). Somatotype values and tolerance ellipses from this study may be useful as a reference for developing training programs and improving the selection process of referees in soccer.

Normative values and a new predicted model of exercise blood pressure in young athletes.

OBJECTIVES: Assessing the systolic and diastolic blood pressure during acute physical exertion can allow the discovery of many cardiovascular diseases even at a young age. However, this response depends on the age, sex of the subject, and the modality of the graded exercise test. This study aims to provide sex-and age-related normative values of peak and recovery blood pressure performance and to develop a predicted model of systolic and diastolic blood pressure peak in young athletes. DESIGN: Retrospective-study. METHODS: We analyzed 8224 young athletes (5516 males and 2708 females) aged between 8 and 18. Anthropometric and blood pressure parameters related to the effort are reported. Then, according to sex, graded exercise test modality, and age were calculated 1) the fifth, tenth, fiftieth, ninetieth, and ninety-fifth percentiles for the systolic and diastolic blood pressure at peak and after 1 min of recovery and 2) predictive equations of systolic and diastolic blood pressure at the peak. RESULTS: Younger athletes show lower peak blood pressure values, gradually increasing as they age. Males showed higher peak systolic blood pressure values starting at 12-13 years on the cycle ergometer and 10-11 years on the treadmill, while there was no difference in peak diastolic blood pressure values. CONCLUSIONS: Sex, age, and the specificity of the movement performed must be considered in assessing the blood pressure response in the young population. In addition, providing reference values and predictive equations of blood pressure response to acute physical exertion may allow for a better functional assessment of young athletes.

Normative values for heart rate response to exercise in young athletes at 10-18 years old.

The assessment of the chronotropic response during acute physical exertion can allow the discovery of many cardiovascular diseases even at a young age. However, the increase in heart rate (HR) depends on the age and sex of the subject and the modality of the graded exercise test. This study aims to provide sex- and age-related normative values for heart rate performance in young athletes aged 10-18. A retrospective study was carried out on 7896 young athletes (5356 males and 2540 females) aged between 10 and 18 who underwent pre-participation screening to obtain eligibility for competitive sport. First, anthropometric parameters, performance data, and HR are reported. Thus, each age calculated third, tenth, twenty-fifth, fiftieth, seventy-fifth, ninetieth, and ninety-seventh percentiles for the stage-by-stage HR response, according to sex and graded exercise test modality category. Young female athletes of all ages showed lower performance with fewer stages performed on the cycle ergometer and the treadmill. Young male athletes on treadmill and cycle ergometers show lower HR values at submaximal intensities. The treadmill allows a longer duration than the cycle ergometer for males and females. Sex, age, and the specificity of the movement performed must be considered in assessing the chronotropic response in the young population, particularly for those who carry out a training program. In addition, providing reference values of HR response to acute physical exertion may allow for a better functional assessment of the young athletes.HighlightsGrowth and physical training induce continuous changes in the cardiovascular system. However, each young athlete shows individual features. The chronotropic response to incremental load is a common method for assessing health and fitness.Comparing the heart rate data obtained from the incremental effort with the reference percentiles can provide information in a short time in the evaluation of young athletes and the general youth population. Therefore, this methodology is regularly performed in the evaluation of anthropometric growth.In evaluating the chronotropic response to physical exertion, in addition to age and sex, should take the specificity of the movement performed during the test into account.

Observability of the Very-High-Energy Emission from GRB 221009A.

The LHAASO Collaboration detected the gamma ray burst GRB 221009A at energies above 500 GeV with a tail extending up to 18 TeV, whose spectral analysis has presently been performed up to 7 TeV for the lower energy instrument LHAASO-WCDA only, with no indication of a cutoff. Soon thereafter, Carpet-2 at Baksan Neutrino Observatory reported the observation of an air shower consistent with being caused by a photon of energy 251 TeV from the same GRB. Given the source redshift z=0.151, the expected attenuation due to the extragalactic background light is very severe so that these detections have proven very hard to explain. In this Letter, we show that the existence of axionlike particles with mass m_{a}≃(10^{-11}-10^{-7}) eV and two-photon coupling g_{aγγ}≃(3-5)×10^{-12} GeV^{-1} strongly reduce the optical depth of TeV photons, thus explaining the observations. Our ALPs meet all available constraints, are consistent with two previous hints at their existence, and are good candidates for cold dark matter. Moreover, we show that Lorentz invariance violation can explain the Carpet-2 result but not the LHAASO observations.

Difference in cardiac remodeling between female athletes and pregnant women: a case control study.

OBJECTIVES: The aim of this study was to detect possible differences in reversible cardiac remodeling occurring in sport training and twin pregnancy. BACKGROUND: cardiac remodeling occurs in athletes and pregnant women due to training and fetal requirements, respectively. These changes could be apparently similar. METHODS: 21 female elite athletes (23.2 ± 5.3 years), 25 women with twin pregnancies (35.4 ± 5.7 years) and 25 healthy competitive female athletes (controls), age-matched with pregnant women (34.9 ± 7.9 years), were enrolled. This latter group was included to minimize the effect of age on cardiac remodeling. All women evaluated through anamnestic collection, physical examination, 12 leads ECG, standard echocardiogram and strain analysis. Sphericity (SI) and apical conicity (ACI) indexes were also calculated. RESULTS: Pregnant women showed higher LA dimension (p < 0.001) compared to both groups of athletes. LV e RV GLS were significantly different in pregnant women compared to female athletes (p = 0.02 and 0.03, respectively). RV GLS was also different between pregnant women and controls (p = 0.02). Pregnant women showed significantly higher S' wave compared to female athletes (p = 0.02) but not controls. Parameters of diastolic function were significantly higher in athletes (p = 0.08 for IVRT and p < 0.001 for E/A,). SI was lower in athletes in both diastole (p = 0.01) and systole (p < 0.001), while ACIs was lower in pregnant women (p = 0.04). CONCLUSIONS: Cardiac remodeling of athletes and pregnant women could be similar at first sight but different in LV shape and in GLS, highlighting a profound difference in longitudinal deformation between athletes and pregnant women. This difference seems not to be related with age. These findings suggest that an initial maternal cardiovascular maladaptation could occur in the third trimester of twin pregnancies.

Gender differences in acculturation and cardiovascular disease risk-factor changes among Chinese immigrants in Italy: Evidence from a large population-based cohort.

BACKGROUND: In recent decades, the Chinese presence in Southern Europe has grown rapidly but no data is available on the influence that residing in Mediterranean countries has on Chinese immigrants. In this study, we aim to examine the association between acculturation and cardiovascular risk factors among first-generation Chinese immigrants in Italy. DESIGN: Population-based, cross-sectional study. METHODS: A sample of 2589 Chinese first-generation immigrants (1599 women and 990 men) living in Prato, Italy, underwent blood pressure measurement, blood tests (with measurement of glucose, cholesterol, and triglycerides), and anthropometric measurements. The influence of length of residence (dependent variable) on hypertension, type 2 diabetes, overweight/obesity, and hyperlipidemia (high cholesterol) (independent variables) was investigated with multivariable logistic regression adjusted for age, sex, education and urban/rural home area in China before migration. RESULTS: Mean age of Chinese participants was 47.2 ± 10.7 years and 61.7% were women. Immigrants residing in Italy for ≥20 years were more likely to be hypertensive [odd ratio (OR) 1.84; 95% confidence interval (CI) 1.33 to 2.59], or diabetic (1.91; 1.26 to 2.86) than those residing in Italy for <10 years. Differently, prevalence of hypercholesterolemia (total cholesterol≥240 mg/dl) was lower in immigrants residing in Italy for ≥20 years than in those with <10 years of residence (0.52; 0.32 to 0.83). The association between indicators of acculturation and cardiovascular risk factors appeared to differ by sex. CONCLUSION: Acculturation of Chinese immigrants in Italy was associated with hypertension and type 2 diabetes whereas a favorable effect on hypercholesterolemia was observed.

Lifestyle and resulting body composition in young athletes.

BACKGROUND: Key aspects in a lifestyle analysis are physical activity level and eating habits. An unhealthy lifestyle results in fat mass increase and in a predisposition to non-communicable chronic diseases even in young age. The purpose of this study was to investigate the lifestyle and body composition in young athletes. METHODS: The subjects underwent to an assessment of body composition and they completed two questionnaires, one concerning the level of physical activity and the other regarding eating habits. RESULTS: One hundred fifty-two young athletes (63 females and 89 males) aged 8 to 18 years (13.4±2.5 years, height 159±14 cm) were enrolled in this study. 80.3% of subjects were normal weight (13.4±2.6 years) and 19.7% subjects (13.5±2.5 years) were overweight or obese. Greater sedentary behaviors were found in the overweight or obese participants compared to normal weight (618±125 vs. 523±89 min; P<0.001) and a lower consumption of milk and yoghurt (5.0±3.2 vs. 6.9±4.1 times/week; P=0.031). CONCLUSIONS: Although competitive sports often increase physical activity levels in young people, this activity does not seem to reach the daily recommended amount of physical activity during youth. Therefore, it is necessary to have a comprehensive approach to create a primary prevention strategy from even a young age.

Eating Habits and Body Composition of International Elite Soccer Referees.

Soccer referees are a specific group of the athletes' population whose careers peak from 30 to 45 years old. An athlete's performance is not only determined by physical training but also by a lifestyle, e.g. eating habits. The purpose of this study was to verify current eating habits and resulting body composition of a group of elite international soccer referees. At an international FIFA seminar 60 elite international soccer referees (aged 39.2 ± 4.2 years) were enrolled. A body composition assessment was performed with skinfold thickness and bio impedance analysis, while eating habits were evaluated with a multi-pass 24-hour dietary recall. The body composition showed a normal weight condition with a fat content of 11.4 ± 2.5%. Macronutrients showed a low level of carbohydrates (43.6 ± 5.4%) and a high level of fat (40.0 ± 4.5%). Micronutrients showed a low level of calcium, potassium, zinc, magnesium, iodine, vitamin B12 and vitamin B9. Even though their body composition was within the normal range, the current eating habits of elite international soccer referees did not appear to follow the nutrition guidelines. Therefore, it would be advisable to provide knowledge on nutrition for this particular category of sports subjects, an individualized nutritional plan would be advisable, in order to achieve and maintain better performance and appropriate body composition for their role.

Streamlining Analysis of RR Interval Variability in Elite Soccer Players: Preliminary Experience with a Composite Indicator of Cardiac Autonomic Regulation.

It is well recognized that regular physical activity may improve cardiac autonomic regulation preventing chronic non-communicable diseases. Accordingly, the assessment of cardiac autonomic regulation (CAR) with non-invasive techniques, such as RR interval Variability (V) might be of practical interest. We studied 56 soccer players (21.2 ± 4.2 years.) and 56 controls (22.2 ± 1.5 years.) and used a ranked Autonomic Nervous System Index (ANSI), resulting from the combination of multivariate statistical methodologies applied to spectral analysis derived indices from RRV. We hypothesized that ANSI would be higher in soccer players as compared to controls (p < 0.001) and that values would be greatest in defenders and midfielders, who are known to run longer distances during competitions. Conversely in the intrinsically stationary goalkeepers ANSI would be similar to controls. Our data show that it is possible to assess the overall level of autonomic performance in soccer players as compared to the general population, using a ranked composite autonomic proxy (ANSI). This approach suggests as well that CAR is better in those players who during competitions run for a greater distance. We conclude that it is possible to highlight the differences in autonomic profile due to distinct exercise routines, using ANSI, a simple ranked, composite autonomic proxy.

Preliminary Results of an Exercise Program After Laparoscopic Resective Colorectal Cancer Surgery in Non-Metastatic Adenocarcinoma: A Pilot Study of a Randomized Control Trial.

Performing physical exercise after a colorectal cancer diagnosis is associated with lower mortality related to the tumor itself. In order to improve physical recovery after elective surgery, there are no specific exercise protocols after discharge from the hospital. The purpose of this study is to show the preliminary results of an exercise program after colorectal cancer surgery. Six patients with non-metastatic colorectal adenocarcinoma addressed to respective laparoscopic were randomly assigned to a mixed supervised/home-based exercise program for six months and compared to a control group without exercise. To assess the effectiveness of the program, functional and body composition parameters were evaluated. Three months after surgery, the exercise group increased flexibility (p < 0.01, ES = 0.33), strength of lower limbs (p < 0.01, ES = 0.42) and aerobic capacity (p < 0.01, ES = 0.28). After surgery, the six patients experienced a significant reduction in body mass index (BMI) and free fat mass. More specifically, fat mass reached the lowest values, with a concomitant increase in cell mass after six months (p < 0.01, ES = 0.33). This did not occur in the control group. Colorectal cancer treatment induces a reduction in physical function, particularly during the first six months after treatment. A mixed exercise approach appears promising in countering this process after colorectal cancer surgery.

Dysmenorrhea and Heavy Menstrual Bleeding in Elite Female Athletes: Quality of Life and Perceived Stress.

In female athletes, the incidence of menstrual disorders is variable, and their impact on perceived stress and quality of life (QoL) is poorly known.The aim of the present study was to investigate the menstrual cycle characteristics and disorders in athletes performing different sports, also evaluating perceived stress and QoL according to their menstrual cycle features. A cross-sectional survey was conducted in nulliparous elite athletes of reproductive age, and the study population included 112 cases. Three questionnaires were administered on (1) gynecological health, (2) perceived stress scale (PSS), and (3) short form QoL (SF-12). A group of women not practising regular sport activities (n = 103) was used as control. Data obtained in elite athletes were also analyzed according to the static and dynamic component percentage of practised sports in 3 sub-groups. Athletes had a significantly higher incidence of irregular periods and heavy menstrual bleeding (HMB) (p < 0.01) and a lower incidence of dysmenorrhea (p < 0.01) than controls. Furthermore, athletes had a better physical QoL (53.9 ± 5.9 vs 51.2 ± 6.0) (p < 0.05) but higher PPS level (17.3 ± 4.8 vs 13.8 ± 4.8) and a worse mental QoL (44.9 ± 9.9 vs 47.6 ± 9.0) (p < 0.05) than controls. HMB was associated with lower mental scores (39.7 ± .8.9 vs 45.6 ± 9.9) and higher PSS scores (19.8 ± .3.2 vs 17.0 ± .4.9) than those observed in athletes with normal bleeding. No difference was found in different sports regarding gynecological health, PSS level, and QoL. An increased incidence of HMB should be considered in elite athletes with increased PSS and impaired QoL.

Integrated total body composition versus Body Mass Index in young athletes.

BACKGROUND: The aim of this study was to assess if the evaluation of Body Mass Index is sufficient to define an overweight index in young athletes, or if a more effective evaluation is preferable in order to examine body fat mass, free-fat mass and hydration status in young athletes. METHODS: Two hundred ninety-nine young athletes between the ages of 8 to 18 have been analyzed in this study. Data from evaluation in body composition of young athletes were studied and subdivided by age, sex and method used. In order to measure body composition in young people, the participants who attend our Department for sport eligibility examination, were evaluated through anthropometric measurements as far as, fat mass, fat-free mass and hydration status are concerned. RESULTS: The statistical differences showed with Body Mass Index and body fat assessment reflect that more accurate evaluation is preferable: the normal-weight with Body Mass Index are 78.0%, overweight 18.7% and obese 3.3% respect to a 75.0%, 14.0% and 11.0% detected with a body fat evaluation (P<0.000); statistical differences have been found also subdividing the group per sex, higher in males (P=0.046) than to females (P<0.000). Bio-impedance data shown a statistical differences in young obese athletes. CONCLUSIONS: The results obtained show clearly that the analysis of the Body Mass Index is not sufficient in young athletes. Therefore, for young athletes a full assessment of body composition would be appropriate to reduce classific-tion errors.

Body Fat Assessment in International Elite Soccer Referees.

Soccer referees are a specific group in the sports population that are receiving increasing attention from sports scientists. A lower fat mass percentage (FM%) is a useful parameter to monitor fitness status and aerobic performance, while being able to evaluate it with a simple and quick field-based method can allow a regular assessment. The aim of this study was to provide a specific profile for referees based on morphological and body composition features while comparing the accuracy of different skinfold-based equations in estimating FM% in a cohort of soccer referees. Forty-three elite international soccer referees (age 38.8 ± 3.6 years), who participated in the 2018 Russian World Cup, underwent body composition assessments with skinfold thickness and dual-energy X-ray absorptiometry (DXA). Six equations used to derive FM% from skinfold thickness were compared with DXA measurements. The percentage of body fat estimated using DXA was 18.2 ± 4.1%, whereas skinfold-based FM% assessed from the six formulas ranged between 11.0% ± 1.7% to 15.6% ± 2.4%. Among the six equations considered, the Faulkner's formula showed the highest correlation with FM% estimated by DXA (r = 0.77; R2 = 0.59 p < 0.001). Additionally, a new skinfold-based equation was developed: FM% = 8.386 + (0.478 × iliac crest skinfold) + (0.395 × abdominal skinfold, r = 0.78; R2 = 0.61; standard error of the estimate (SEE) = 2.62 %; p < 0.001). Due to these findings, national and international federations will now be able to perform regular body composition assessments using skinfold measurements.

Adjuvant Therapy Reduces Fat Mass Loss during Exercise Prescription in Breast Cancer Survivors.

Improvements in cancer care over the years have increased the numbers of cancer survivors. Therefore, quality of life, fat mass management and physical activity are growing areas of interest in these people. After the surgical removal of a breast cancer, adjuvant therapy remains anyway a common strategy. The aim of this study was to assess how adjuvant therapy can affect the effectiveness of an unsupervised exercise program. Forty-two women were enrolled (52.0 ± 10.1 years). Assessments performed at baseline and after six months of exercise prescription were body composition, health-related quality of life, aerobic capacity by Six-Minute Walk Test, limbs strength by hand grip and chair test and flexibility by sit and reach. Statistical analyses were conducted by ANOVA tests and multiple regression. Improvements in body composition, physical fitness and quality of life (physical functioning, general health, social functioning and mental health items) were found. The percentage change in fat mass has been associated with adjuvant cancer therapy (intercept = -0.016; b = 8.629; p < 0.05). An unsupervised exercise prescription program improves body composition, physical fitness and health-related quality of life in breast cancer survivors. Adjuvant therapy in cancer slows down the effectiveness of an exercise program in the loss of fat mass.

Blood pressure and fasting glucose changes in male migrants waiting for an asylum decision in Italy. A pilot study.

BACKGROUND: The Central Mediterranean route from Libya to Italy has been for years the major port of entry from Africa to Europe. However, information on the early effects of permanence in Italy on cardiovascular risk factors is limited. Therefore, the association between length of stay in Italy and blood pressure or blood glucose was explored in young asylum seekers. METHODS: Cross-sectional study performed on male asylum seekers (aged 18-40 years), hosted for 0-30 months in Prato, Italy. Blood pressure and blood glucose, measured with validated instruments, were classified according to European Society of Hypertension and American Diabetes Association guidelines respectively. The relationship of quartiles of months of stay in Italy (independent variable) with blood pressure and fasting glucose was investigated with multivariate linear regression adjusted for years of age, world area of origin, education level, travel duration in months, smoking habit, alcohol use, body mass index, triglycerides. RESULTS: On average, the 217 asylum seekers lived in Italy for 8.4 months (95% CI 7.5-9.3; range 0-30 months). At multivariate adjusted linear regression analysis, quartiles of months in Italy were associated with a forward shift in the blood pressure categories of the European Society of Hypertension (B = 0.396; 95% CI 0.190 to 0.602) and in the categories fasting glucose levels of the American Diabetes Association (B = 0.450; 95% CI 0.023 to 0.876). CONCLUSIONS: When considering the importance of high blood pressure and type 2 diabetes for ethnic minorities living in Europe, changes of cardiovascular risk factors in the new environment probably need more attention.

Growth Charts for Height, Weight, and BMI (6-18 y) for the Tuscany Youth Sports Population.

Overweight during youth is a large-scale public health issue. Engaging in regular physical activity generally reduces weight status. The hypothesis of the study is that organized sport plays an active role in maintaining a correct body weight during youth. The purpose of this study is to trace growth charts by height, weight, and body mass index (BMI) to be applied to the youth sports population. A retrospective study was conducted on 14,700 young athletes (10,469 males and 4231 females) aged between 6 and 18 years from surveillance carried out during the pre-participation screening of sports eligibility. The calculation of the prevalence of overweight and obesity was also performed. The new percentiles for the youth sports population show BMI values at 18 years 21.9 kg/m2 for males and 20.7 kg/m2 for females at the 50th percentile. The male sample shows 12.3% of the subjects were overweight and 1.5% were obese, while the female sample shows 9.8% are overweight and 1.1% obese. The higher prevalence of excess weight is evident up to 12 years old in both sexes and then gradually decreases. The development of the new specific growth charts for the youth sports population could reduce the risk of error in identifying the correct weight status of young athletes.

Evaluation of left ventricular remodelling in young Afro-Caribbean athletes.

BACKGROUND: Cardiac adaptation to intense physical training is determined by many factors including age, gender, body size, load training and ethnicity. Despite the wide availability of ECG analysis, with a higher presence of abnormalities in different races, echocardiographic studies on young Afro-Caribean (AA) and Caucasian athletes (CA) are lacking in literature. We aimed to assess the effect in the secondary LV remodelling of load training in young AA players compared to matched CA players. METHOD: Seventy-seven AA and 53 CA matched soccer players (mean age 17.35 ± 0.50 and 18.25 ± 0.77 y) were enrolled. They were evaluated with echocardiography. A subgroup of 30 AA and 27 CA were followed up for a period of 4 years. The myocardial contractile function was evaluated by speckle-tracking echocardiographic global longitudinal strain (GLS). RESULTS: No significant differences were found in weight and height and in blood pressure response to maximal ergometer test in either group. In AA a higher level of LV remodelling, consisting in higher LV wall thickness, higher interventricular septum (IVS) and posterior wall (PW) thickness were found (IVS: 10.04 ± 0.14 and 9.35 ± 0.10 in AA and CA respectively, p < 0.001. PW: 9.70 ± 0.20 and 9.19 ± 0.10 mm in AA and CA respectively, p < 0.05). Strain data showed no significant differences between the two groups (22.35 ± 0.48 and 23.38 ± 0.69 in AA (n = 27) and CA (n = 25), respectively). At the beginning of the follow-up study AA showed a significantly higher left ventricular remodelling (IVS = 9.29 ± 0.3 and 8.53 ± 0.12 mm in AA and CA respectively, p < 0.002. PW = 9.01 ± 0.2 and 8.40 ± 0.20 in AA and CA respectively, p = 0.1). During the next four years of follow-up we observed a regular parallel increase in LV wall thickness and chamber diameters in both groups, proportionally to the increase in body size and LV mass. (IVS = 10.52 ± 0.17 and 9.03 ± 0.22 mm in AA and CA respectively, p < 0.001. PW: 10.06 ± 0.17 and 8.26 ± 0.19 mm in AA and CA respectively, p < 0.001). CONCLUSION: The study shows that the ventricular remodelling observed in AA appears to be a specific phenotype already present in pre-adolescence. These data also suggest that genetic/ethnic factors play a central role in left ventricular remodelling during the first years of life in elite athletes.

Breast cancer: effectiveness of a one-year unsupervised exercise program.

BACKGROUND: Improvements in prevention and therapeutic strategies over the years have considerably increased the number of breast cancer survivors. Sedentary behavior is now acknowledged to be a risk factor for cancer and cancer relapse. Currently, there are different approaches to increasing the effectiveness of long-term physical activity in these patients. The aim of this study was to verify the long-term effectiveness of a home-based program for active lifestyle change in overweight breast cancer survivors. METHODS: We enrolled 43 women (age 51.5±9.9 years), who underwent an evaluation of their spontaneous physical activity levels, their baseline aerobic capacity through a 6-Minute Walking Test (6MWT), their flexibility, grip and lower limb strength, and their body composition. We repeated the measurements of these physical and anthropometric parameters six times during one year of unsupervised exercise. RESULTS: At the beginning of the program the sample showed a moderate level of spontaneous physical activity (physical activity level=1.44±0.12, steps/day=7420.3±1622.3). After being prescribed an individual exercise program, a significant reduction in BMI (T0=27.9±4.3, T5=25.8±3.0 kg/m2; P<0.001) and skinfold sum was observed (T0=99.5±25.2, T5=86.2±22.7 mm; P=0.019), with a parallel maintenance of cell mass (T0= 21.4±3.3, T5= 22.5±3.0 kg; P=0.654). The functional parameters showed an increase in lower limb muscle fitness and a reduction in diastolic blood pressure after 6 MWT (T0= 78.4±10.1, T5= 72.5±14.9 mmhg; P=0.032). CONCLUSIONS: Physical activity is recommended for cancer patients; this model of prescribing unsupervised exercise seems to ensure optimal compliance, thus allowing long-term therapeutic efficacy.

Link between body cellular mass and left ventricular hypertrophy in female and male athletes.

BACKGROUND: Cardiac adaptation to intense physical training is determined by many factors. Differences between the sexes in the left ventricle parameters are well established, however, both sport activity and body composition seem to reduce them. In order to better explain some heart modifications, a first approach was to eliminate the FM from the indexing of the left ventricular parameters. Fat free mass also contains the extracellular mass which does not represent a metabolically active compartment. The aim of this study is to verify the differences between the sexes with a new left ventricular indexation with the metabolically active tissue of the body as body cell mass in elite athletes. METHODS: Twenty-five females were matched with 25 elite male soccer players (females=26.2±1.9 yrs, males=26.5±1.8 yrs; P=NS). An accurate body composition analysis (skinfold and bioimpedance) and an echocardiography were performed. RESULTS: Differences between the sexes in body composition were confirmed in fat mass (fat mass index females=3.5±0.5 kg/m2, males=2.4±0.5 kg/m2, P<0.001), while no differences were found in the extra cellular mass index (females=7.3±1.1 kg/m2, males=7.5±0.5 kg/m2; P=NS). There are no differences in systo-diastolic parameters between sexes. Greater relationships were found between left ventricular mass and body cells (r=0.829, r2=0.686, COV=401.5) compared to fat free mass (r=0.819, r2=0.675, COV=344.7). Left ventricular dimensions show higher values in males who also have the following body cell indexation (females=128.2±15.8 g/m2, males=143.4±14.7 g/m2; P<0.001). CONCLUSIONS: Analyzing body composition in three compartments appears a solution that physiologically can explain some aspects of the athlete's heart. These results could be considered as preliminary data which can be used to create a new indexation.

Effects of a home-based exercise rehabilitation program for cancer survivors.

BACKGROUND: Aerobic and resistance exercises have been promoted recently to improve quality of life in cancer patients. Most cancer survivorship rehabilitation programs consist of supervised exercise programs; however, less data is available on the effects of unsupervised or home-based exercise interventions. The study aimed to compare the physical and physiologic changes in a group of cancer survivors (CS) and a control group of non-cancer, health controls (HC) who participated in individualized home-based aerobic and resistance exercises for 12 months. METHODS: Thirty-three surviving cancer survivors (CS) aged 55.6±3 years were enrolled for 1 year of unsupervised exercise prescription programs. Anthropometric parameters hydration status, fitness, and echocardiographic examination were measured every six month and compared to10 HC (aged 52.6±7.7 years) individuals prior to starting the program (t0) and at 6 (t6) and 12 (t12) months. RESULTS: Among the CS subjects, a significant reductions in waist circumference (t0: 97.5±15.2 cm, t6: 86.6±13.5 cm, t12: 85.8±13.9 cm; P<0.05), body cell mass (t0: 50.9±4.7%, t6: 52.3±4.4%, t12: 53.7±3.7%; P<0.05), and extracellular mass (t0: 49.1±4.7%, t6: 47.6±4.4%, t12: 46.2±3.7%; P<0.05) were observed, as well significant improvements in lower body muscle strength (chair test t0: 13.3±4.1, t6: 14.2±3.5, t12: 15.1±3.2; P<0.05). Changes in functionality and heart function were similar between CS and HC. CONCLUSIONS: Individually-prescribed home-based exercise programs were cost effective, safe and resulted in modest improvements in body composition, strength, and total body water distribution with little to no adverse effect on cardiac function.