The time spent sitting does not always mean a low level of physical activity.

BACKGROUND: The problem of spending most of the day in a sitting position concerns all people, regardless of their age. Unfortunately, this trend is more and more often observed among young people. The aim of the study was to assess self-reported physical activity and time spent sitting among students of different fields of health related faculty. METHODS: The study group included 216 students (22.3 ± 1.8 years of age) of the Medical University of Lodz: physiotherapy students (n = 101), pharmacy students (n = 73), and dietetics students (n = 42). The time spent sitting and physical activity level were assessed based on the International Physical Activity Questionnaire-long version. RESULTS: The time spent sitting among health related faculty students was on average more than 46 h a week (2781.8 ± 1238.5 MET-minutes/week). Regarding all the students the pharmacy students spent most time sitting (3086.0 ± 1032.1 MET-minutes/week), while the dietetics students spent the least (2215.7 ± 1230.1 MET-minutes/week). Taking into account the physical activity level almost 65% of all the students were in a high category (mainly physiotherapy students). Only 1.4% of all the surveyed students were classified as the low physical activity category. Statistical analysis showed no significant differences (P = 0.6880) between the time spent sitting and level of physical activity among all students. CONCLUSIONS: Students of medical universities spend too much hours on sitting, mostly 5-8 h a day. Despite this, they undertake various activities due to which their level of physical activity is moderate or even high. Therefore, it cannot be unequivocally stated that there is a relationship between the time spent sitting and physical activity level.

Type of training has a significant influence on the GH/IGF-1 axis but not on regulating miRNAs.

The growth hormone (GH)/insulin-like growth factor-1 axis is responsible for glucose homeostasis. In the present study we assessed the expression levels of miRNA-124, miRNA-210 and miRNA-375 and immunoexpression of IGFBP-3 in relation to the concentrations of IGF-1 and glucose in athletes performing different types of effort. Sixty-six young male athletes (age 25.4±4.1 years) were divided into: group EN (33 male athletes; age 25.6±4.4 years) with endurance-type efforts (disciplines: triathlon, long distance running, cycling) and group ST (33 male athletes; age 25.2±3.9 years) with strength-type efforts (disciplines: weightlifting, body building, CrossFit). The control group consisted of 28 non-training men (age 29.1±4.7 years). Statistically significantly higher IGF-1 concentration and lower glucose concentration (P<0.05) in serum were observed in the group of athletes (vs. controls). Immunoexpression of IGFBP-3 was higher in athletes (vs. controls), and a higher value of immunoexpression was obtained in athlete group ST vs. group EN (P>0.05). Levels of expression of miRNA-210 and miRNA-375 were higher in athletes vs. controls (P>0.05). The obtained data confirmed the importance of the somatotropic axis in the regulation of metabolic adaptation to physical exercise. The detected variation in the concentrations and expression levels of the studied molecules involved in the somatotropic axis in athletes confirmed the role of the somatotropic axis in adaptation to physical effort. Statistically significant reduction of glucose concentration and the highest expression of IGF-1in serum in athletes suggest the anabolic effect of IGF-1 through insulin receptors on many tissues under the influence of moderate physical exercises (mainly during resistance training).

Changes in lipid and apolipoprotein levels in response to 8-week cardiac rehabilitation in men with coronary artery disease.

Concentrations of selected lipoproteins are currently useful cardiovascular risk assessment indicators, especially in monitoring lipid-lowering therapy. AIM: The aim was to evaluate the influence of 8-week mid-term CR on apolipoproteins: A-I, B, E and VLDL in CAD patients in relation to conventional lipid profile and prior coronary intervention: PCI or CABG. MATERIALS AND METHODS: 93 male patients admitted to CR after PCI or CABG. At baseline and after CR, conventional lipid profile parameters and VLDL concentrations were evaluated. Apolipoproteins: A-I, B, E were also determined. Basic anthropometric indicators and measurements of hemodynamic and exercise tolerance at rest and peak workload in exercise testing (HR, sBP, dBP, DP, W) were measured. RESULTS: After CR, depending on revasculazation intervention, no changes in HDL-C, LDL-C, TG and VLDL values were observed (p>0.05). Reduction in apoA-I was noted in PCI group (p=0.0254). No statistically significant changes in apoB and apoE were found in groups. Significant increase in apo B/apo A-I index was observed only in PCI group (p=0.0329). PCI and CABG patients did not differ in hemodynamic and exercise tolerance parameters, except sBP in rest and dBP at peak workload in exercise testing (p=0.014 and p=0.031). Regardless on type of intervention, there was observed statistically significant increase in Wpeak (p=0,0000 in both groups) and DPpeak (p=0.0000 in PCI-patients and p=0.0003 in CABGpatients) after CR. CONCLUSIONS: CR has various effects on lipid concentrations. Indicators of conventional lipid profile and selected apolipoproteins are not optimal parameters allowing assessment of effectiveness of CR program in such a short time, this role is well fullfilled by the hemodynamic and physical exercise indices. Apo B/apo A-I ratio value suggests an increasing risk of IHD complications, especially in post- PCI group. CR program requires intensification of lipid-reducing therapy and education on lifestyle modification.

MicroRNA Profile and Adaptive Response to Exercise Training: A Review.

MicroRNAs are small non-coding regulatory RNAs which may be released into the systemic circulation as a consequence of the body's adaptation to exercise. The expression profile of circulating miRNAs (ci-miRNAs) has been proposed as a potential diagnostic biomarker for adaptive responses of particular systems to physical exertion. Several miRNAs are recognized as regulators of signalling pathways such as the IGF1/PI3K/AKT/mTOR axis, relevant to exercise adaptation. MicroRNA levels may fluctuate depending on training type/exercise regimen in correlation with phenotypic features such as VO2 max. Muscle-specific miRNAs have been proposed as regulators of skeletal muscle/myocardial interactions during physical exertion, thereby facilitating adaptation. Differential expression of miRNAs may relate to molecular patterns of communication triggered during/after exercise as response, recovery and adaptation mechanisms to training load. This review highlights recent findings and the potential significance of specific miRNAs in the process of exercise adaptation. Altered ci-miRNA profiles following exercise suggest that they may be useful biomarkers of health and adaptation to intervention strategies. Identification of the concert of miRNA expression signatures together with their targets is critical towards understanding gene regulation in this context. Understanding how the external environment influences gene expression via miRNAs will provide insight into potential therapeutic target strategies for disease.

The Influence of an Eight-Week Cycloergometer-Based Cardiac Rehabilitation on Serum Antioxidant Status in Men with Coronary Heart Disease: A Prospective Study.

Background and objectives: A body of evidence confirms the benefits of cardiac rehabilitation (CR) in coronary heart disease (CHD) patients, but it remains unclear whether it enhances the antioxidant potential. The aim of the study was to assess the influence of an eight-week aerobic cycloergometer-based CR program on serum total antioxidant capacity (TAC) and other CHD risk factors. Materials and Methods: The study involved 36 men with CHD (55.2 ± 9.0 years). TAC was assessed with two methods: ferric reducing ability of serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH). Aerobic capacity was evaluated during a submaximal exercise test. TAC and other anthropometric, biochemical and physical activity/fitness measures were performed twice: before the beginning and after termination of CR. Results: Aerobic capacity was higher (7.0 ± 2.6 vs. 8.0 ± 2.5 MET-metabolic equivalents; p < 0.01), but values of resting diastolic blood pressure were lower (81.9 ± 7.6 vs. 77.4 ± 8.9 mmHg; p < 0.01) after termination of CR. Other classic cardiometabolic, anthropometric, and biochemical measures did not change with CR. No difference in TAC-FRAS was found after CR, whereas TAC-DPPH was significantly lower (16.4 ± 4.0 vs. 13.2 ± 3.7% reduction; p < 0.01). Conclusions: Antioxidant potential measured as TAC-DPPH, but not as TAC-FRAS, decreased with the CR program. The recognized health benefits of CR are not related to augmented serum antioxidant status.

Investigation of oxidative stress parameters in different lifespan erythrocyte fractions in young untrained men after acute exercise.

NEW FINDINGS: What is the central question of this study? What is the influence of a single bout of exercise on the properties of erythrocyte fractions at different ages? What is the main finding and its importance? A single bout of exercise in untrained men induced oxidative stress in erythrocytes and had an influence on antioxidant defense in these cells. Old erythrocytes were more sensitive to oxidative damage than young and middle-aged cells. Higher levels of glutathione in old erythrocyte fractions did not protect them against oxidative stress. It seems that exercise may promote the removal of old erythrocytes from the circulation. The objective of this study was to establish the role of exercise-induced oxidative stress in the erythrocyte fractions [young (YF), middle-aged (MAF) and old (OF)] of young untrained men after acute exercise. Blood samples were collected before exercise, immediately after and 1 h after exercise. The maximal power generated was 292 ± 27 W, and exercise duration was 8.73 ± 0.9 min. Different optical properties and oxidative stress parameters were found in each erythrocyte fraction. Total thiols in YF and MAF after exercise and after 1 h rest were similar to values before exercise; however, in OF {32.7 ± 9.8 nmol [mg haemoglobin (Hb)]-1 } the concentration was lower in comparison to YF [55.5 ± 3.2 nmol (mg Hb)-1 ] and MAF [56.8 ± 7.7 nmol (mg Hb)-1 ] and increased 1 h later (P < 0.0002). The glutathione concentration was higher in OF [8.4 ± 0.4 nmol (mg Hb)-1 ] than in YF [4.5 ± 0.6 nmol (mg Hb)-1 ] and MAF [4.8 ± 0.5 nmol (mg Hb)-1 ; P < 0.0002] and did not change after exercise or 1 h later. In OF, the peroxide level was higher after exercise [1.2 ± 0.2 nmol (mg Hb)-1 ] and 1 h later [1.1 ± 0.2 nmol (mg Hb)-1 ], when compared with samples before exercise [0.9 ± 0.1 nmol (mg Hb)-1 ; P < 0.05]. Similar results were observed in YF and MAF. The level of thiobarbituric acid reactive substances (TBARS) was ∼2.5-fold higher in OF [0.19 ± 0.04 nmol (mg Hb)-1 ] when compared with YF [0.07 ± 0.01 nmol (mg Hb)-1 ] and MAF [0.08 ± 0.02 nmol (mg Hb)-1 ; P < 0.0002] and was increased after exercise, remaining unchanged 1 h later. In YF and MAF, no difference in the level of TBARS was detected after exercise or 1 h later. No difference in membrane fluidity was observed in all fractions. The erythrocyte OF appeared to be more sensitive to cellular oxidative damage.

Comparison of Different Physical Activity Measurement Methods in Adults Aged 45 to 64 Years Under Free-Living Conditions.

OBJECTIVE: To compare physical activity (PA) measured by 4 methods in adults under free-living conditions in relation to selected demographic and anthropometric variables. DESIGN: Cohort study. SETTING: Department of Sports Medicine. PARTICIPANTS: Clinically healthy men (81) and women (69) aged 45 to 64 years. INTERVENTIONS: Physical activity monitoring for 7 consecutive days under free-living conditions by pedometer (P) and accelerometer (A) simultaneously and PA questionnaires: International Physical Activity Questionnaire (IPAQ) and Seven-Day Physical Activity Questionnaire Recall (SDPAR) completed after the 7-day PA. MAIN OUTCOME MEASURES: Comparison of PA measured by pedometer, IPAQ, and SDPAR with accelerometer with regard to age, body mass, gender, and obesity type. RESULTS: Total energy expenditure (EE) by IPAQ was higher than A (P < 0.001) in both groups regardless of age, body mass, or obesity type. Mean EE value by P was greater than A (P < 0.001) in central-obesity males and lower than A (P < 0.001) in central-obesity females. There were differences in step counts in women, unnoticed in men. SDPAR overestimated total EE in gynoid-obesity males and in central-obesity females compared with A. Ninety-five percent CI was the largest around IPAQ compared with P and SDPAR, with SDPAR showing the best agreement with A. CONCLUSIONS: Body mass and obesity type influenced PA measurements. To monitor PA, it is recommended to use pedometer in normal bodyweight and overweight groups while accelerometer is advisable in obese subjects. A combined approach of objective and subjective PA monitoring tools is preferable.

Expression analysis of selected classes of circulating exosomal miRNAs in soccer players as an indicator of adaptation to physical activity.

Recently studies have shown that, depending on the type of training and its duration, the expression levels of selected circulating myomiRNAs (c-miR-27a,b, c-miR-29a,b,c, c-miR-133a) differ and correlate with the physiological indicators of adaptation to physical activity. To analyse the expression of selected classes of miRNAs in soccer players during different periods of their training cycle. The study involved 22 soccer players aged 17-18 years. The multi-stage 20-m shuttle run test was used to estimate VO2 max among the soccer players. Samples serum were collected at baseline (time point I), after one week (time point II), and after 2 months of training (time point III). The analysis of the relative quantification (RQ) level of three exosomal myomiRNAs, c-miRNA-27b, c-miR-29a, and c-miR-133, was performed by quantitative polymerase chain reaction (qPCR) at three time points - before the training, after 1 week of training and after the completion of two months of competition season training. The expression analysis showed low expression levels (according to references) of all evaluated myomiRNAs before the training cycle. Analysis performed after a week of the training cycle and after completion of the entire training cycle showed elevated expression of all tested myomiRNAs. Statistical analysis revealed significant differences between the first and the second time point in soccer players for c-miR-27b and c-miR-29a; between the first and the third time point for c-miR-27b and c-miR-29a; and between the second and the third time point for c-miR-27b. Statistical analysis showed a positive correlation between the levels of c-miR-29a and VO2 max. Two months of training affected the expression of c-miR-27b and miR-29a in soccer players. The increased expression of c-miR-27b and c-miR-29 with training could indicate their probable role in the adaptation process that takes place in the muscular system. Possibly, the expression of c-miR-29a will be found to be involved in cardiorespiratory fitness in future research.

Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study.

BACKGROUND: The purpose of the study was to examine the association between leisure-time physical activity (LTPA), cardiovascular biomarkers and atherosclerosis among asymptomatic men with stable LTPA level throughout the 25-year prospective observation. METHODS: Out of 101 asymptomatic men prospectively observed for their lifestyle and cardiovascular risk factors, the cohort of 62 individuals (mean age 59.9 years) maintained a stable LTPA level during the 25-year observation. Regular check-ups with the assessment of traditional risk factors, detailed measurements of LTPA level and aerobic capacity were performed since baseline. At the latest follow-up (2011/12) a set of cardiovascular biomarkers was measured using enzyme-linked immunosorbent assay. Subclinical atherosclerosis was assessed by means of coronary artery calcification score and intima-media thickness (IMT). Endothelial function was evaluated by means of the reactive hyperemia index. The studied biomarkers and indices were analyzed in the three cohorts representing stable low-tomoderate (<2050 kcal/week), high (2050-3840 kcal/week) and very high LTPA (>3840 kcal/week). RESULTS: At baseline the three cohorts were comparable in terms of age and clinical characteristics. At follow-up, the cohort with stable high LTPA (2050-3840 kcal/week) had significantly lower concentrations of hs-CRP (2.20 ± 1.0 mg/L), oxidized-LDL (68.35 ± 67.7 ng/mL), leptin (4.71 ± 3.07 ng/mL) and irisin (0.47 ± 0.13 µmol/L), and the most favorable indices of atherosclerosis and endothelial function as compared with other groups (p < 0.05). Regular marathon runners had increased concentrations of hsCRP (3.12 ± 1.4 mg/L), oxidized-LDL (249.8 ± 129 ng/ml), Interleukine-6 (3.74 ± 2.4 pg/ml). A positive correlation was observed between hsCRP and IMT (r = 0.301; p < 0.01), and irisin and IMT (r = 0.223; p < 0.05). CONCLUSIONS: The data suggest that stable high LTPA (2050-3840 kcal/week) is associated with the most favorable profile of key cardiovascular biomarkers and indices of atherosclerosis. Lifetime very high LTPA is associated with increased lowgrade inflammation and may, therefore, exert an atherogenic effect.

Body composition, nutritional status, and endothelial function in physically active men without metabolic syndrome--a 25 year cohort study.

BACKGROUND: The purpose of this analysis was to investigate the relationship between body composition, metabolic parameters and endothelial function among physically active healthy middle-aged and older men. METHODS: Out of 101 asymptomatic men prospectively tracked for traditional cardiovascular risk factors (mean observation period 25.1 years), 55 metabolically healthy individuals who maintained stable leisure time physical activity (LTPA) level throughout the observation and agreed to participate in the body composition assessment were recruited (mean age 60.3 ± 9.9 years). Body composition and raw bioelectrical parameters were measured with bioelectrical impedance analysis (BIA). Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system. RESULTS: Strong correlations were observed between lifetime physical activity (PA), aerobic fitness and most of analyzed body composition parameters. The strongest inverse correlation was found for fat mass (p < 0.01) while positive relationship for fat-free mass (p < 0.01), total body water (p < 0.05 for current aerobic capacity and p < 0.01 for historical PA), body cell mass (p < 0.001), muscle mass (p < 0.001), calcium and potassium (p < 0.01 and p < 0.001 for current aerobic capacity and p < 0.001 and p < 0.01 for historical PA, respectively) and glycogen mass (p < 0.001). Among metabolic parameters, HDL cholesterol (HDL-C) and uric acid were significantly associated with most body composition indicators. Regarding endothelial function, a negative correlation was found for RHI and body mass (p < 0.05) while positive relationship for RHI and body cell mass (p < 0.05), calcium (p < 0.05) and potassium mass (p < 0.05). Impaired endothelial function was observed among 8 subjects. Among bioelectrical parameters, impedance (Z) and resistance (R) normalized for subjects' height were negatively related with body mass, body mass index (BMI) and waist circumference (p < 0.001); while reactance (Xc) normalized for patients' height was negatively related with body mass (p < 0.05). The mean phase angle value was relatively high (8.83 ± 1.22) what reflects a good level of cellularity and cell function. Phase angle was positively related with body mass and BMI (p < 0.05). CONCLUSIONS: Both fat mass and muscle mass components are important predictors of metabolic profile. Maintaining regular high PA level and metabolically healthy status through young and middle adulthood may have beneficial influence on body composition parameters and may prevent age-related decrease of fat-free mass and endothelial dysfunction.

Alterations in red blood cells and plasma properties after acute single bout of exercise.

The aim of this study was to investigate alterations in haemoglobin conformation and parameters related to oxidative stress in whole erythrocytes, membranes, and plasma after a single bout of exercise in a group of young untrained men. Venous blood samples from eleven healthy young untrained males (age = 22 ± 2 years, BMI = 23 ± 2.5 kg/m(2)) were taken from the antecubital vein before an incremental cycling exercise test, immediately after exercise, and 1 hour after exercise. Individual heart rate response to this exercise was 195 ± 12 beats/min and the maximum wattage was 292 ± 27 W. Immediately after exercise, significant increase in standard parameters (haemoglobin, haematocrit, lactate levels, and plasma volume) of blood was observed as well as plasma antioxidant capacity one hour after exercise. Reversible conformational changes in haemoglobin, measured using a maleimide spin label, were found immediately following exercise. The concentration of ascorbic acid inside erythrocytes significantly decreased after exercise. A significant decline in membrane thiols was observed one hour after exercise, but simultaneously an increase in plasma thiols immediately after and 1 h after exercise was also observed. This study shows that a single bout of exercise can lead to mobilization of defensive antioxidant systems in blood against oxidative stress in young untrained men.

[Long term regular physical activity as a factor modifying the incidence of subclinical atherosclerosis in occupationally active men]. / Wieloletni systematyczny wysilek fizyczny jako czynnik modyfikujacy wystepowanie miazdzycy subklinicznej u mezczyzn aktywnych zawodowo.

BACKGROUND: Optimal dose of physical activity in the prevention of atherosclerosis remains unclear. The purpose of the study was to investigate the influence of leisure-time physical activity (LTPA) on selected indices of atherosclerosis in the working-age population of men. MATERIALS AND METHODS: The study was carried out in a cohort of asymptomatic men participating in follow-up examinations in the Healthy Men Clinic, Medical University of Lodz. Of the 132 men who responded to the invitation to participate in this study, 101 men were eligible for the non-invasive assessment of subclinical atherosclerosis indices. Self-reported PA was assessed by interviewer-administered validated questionnaires. During the latest follow-up subclinical atherosclerosis was measured by assessing the coronary artery calcification (CAC), the carotid inti ma-media thickness (IMT) and the reactive hyperemia index (RHI) using peripheral arterial tonometry (EndoPAT2000). RESULTS: Preliminary results have been elaborated in the group of 60 men (mean age: 61.3 +/- 8.85 years). The participants were predominantly white collar workers with low occupational LTPA. The cohort was divided into 3 groups according to the LTPA level. Both dose and energy expenditure of recreational PA significantly correlated with CA, IMT and RHI in the whole cohort. The majority of men maintained their baseline PA throughout the observation period. Men with the highest LTPA level had significantly lower mean CAC, IMT (p < 0.01), and significantly higher mean RHI (p < 0.05) compared to the least active group. On final examination men with high PA had also the most favorable cardiovascular profile. CONCLUSIONS: The preliminary results indicate the protective effect of high LTPA level in the context of subclinical atherosclerosis in men.

Dietary Zinc Is Associated with Cardiac Function in the Older Adult Population.

The elderly is a group at particularly high cardiovascular risk. The coexistence of chronic diseases and use of multiple medications creates the need to look for non-pharmacological agents to improve cardiovascular health in that population. In view of reports on the potential role of zinc in enhancing pathways of myocardial tissue repair, the aim of this study was to evaluate the association between dietary zinc intake and cardiac structure and function in individuals of advanced age. The study group included 251 community-dwelling patients, with a median age of 80 years. Dieta 6.0 software was used for calculation of zinc consumption. Percentage of Recommended Dietary Allowance (RDA) for zinc correlated with left ventricular ejection fraction (LVEF) (r = 0.196, p < 0.05), left ventricular mass index (r = -0.137, p < 0.05) and tricuspid annular plane systolic excursion (TAPSE) (r = 0.153, p < 0.05), while zinc density did so with E/E' ratio (r = -0.127, p < 0.05). In a multiple stepwise regression analysis, the best determinants of LVEF were %RDA for zinc (p = 0.014; ß = 0.143), presence of coronary artery disease (p < 0.001; ß = -0.39) and age (p = 0.036; ß = -0.12). Furthermore, %RDA for zinc (p = 0.009; ß = 0.16), female sex (p = 0.005; ß = -0.171), beta-blocker use (p = 0.024; ß = -0.136), body mass index (p = 0.008; ß = 0.16) and heart rate (p = 0.0006; ß = -0.209) had an independent effect on TAPSE. In conclusion, in individuals of very advanced age, lower zinc intake is associated with poorer cardiac function. Therefore, increasing the recommended zinc intake in this group deserves consideration.

Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Is a Biomarker Associated with Left Ventricular Hypertrophy in the Elderly, Specifically in Women.

Left ventricular hypertrophy (LVH) may result in the development of heart failure, which is widespread among people of advanced age. The pathophysiology of LVH is complex and its biochemical pathways are not fully understood in this group. Elevated soluble urokinase-type plasminogen activator receptor (suPAR), a biomarker of immune activation, including fibrosis, reflects subclinical organ damage in systematic diseases. The present study assesses the clinical role of suPAR measurement in determination of LVH-associated cardiac disorders in the elderly. The studied population consisted of 238 individuals aged 76-91 years; of these, 139 (58%) were diagnosed with LVH. Serum biomarkers measurement (suPAR, troponin T, NT-proBNP and CRP) and echocardiography were performed in all subjects. The suPAR level was significantly higher in the LVH group (4.01 vs. 3.82 ng/mL, p = 0.033) and correlated with the parameters of cardiac diastolic function. Stepwise logistic regression found suPAR level (OR = 1.55, p = 0.016), BMI (OR = 1.17, p = 0.0003) and hypertension (OR = 2.42, p = 0.046) to be independently associated with LVH in women. In men, the strongest predictors of LVH were hypertension (OR = 7.52, p = 0.014) and BMI (OR = 1.42, p = 0.032). The observations indicate suPAR as a promising marker reflecting LVH, especially in women at advanced age, independent of age-associated cardiac remodeling.

Global Alliance for the Promotion of Physical Activity: the Hamburg Declaration.

Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the 'Hamburg Declaration'. This represented an international commitment to take all necessary actions to increase PA and improve the health of individuals to entire communities. Individuals and organisations are working together as the 'Global Alliance for the Promotion of Physical Activity' to drive long-term individual and population-wide behaviour change by collaborating with all stakeholders in the community: active hospitals, physical activity specialists, community services and healthcare providers, all achieving sustainable health goals for their patients/clients. The 'Hamburg Declaration' calls on national and international policymakers to take concrete action to promote daily PA and exercise at a population level and in healthcare settings.

Clinical Outcomes of Cardiac Rehabilitation in Women with Coronary Artery Disease-Differences in Comparison with Men.

This study evaluated the clinical outcomes of cardiac rehabilitation (CR) in women with coronary artery disease (CAD) in comparison to men. Methods: Patients after acute coronary syndrome or after revascularization procedures (106 women, 180 men) were consecutively admitted to a comprehensive outpatient CR program, comprising of 45-min ergometer interval training three times a week for eight weeks. The training intensity was determined on the basis of training heart rate, calculated following an exercise test. Patients were divided into subgroups according to age (≤55, >55 years), BMI (<25, ≥25 kg/m2), left ventricular ejection fraction (LVEF; ≤40%, 41−49%, ≥50%), and number of affected coronary vessels. Results: After eight weeks, exercise capacity increased significantly by 0.6 ± 0.77 MET (women) and by 1.0 ± 0.74 MET (men). The greatest benefit was observed in men, women under 55 years, women with LVEF 41−49%, and women with single-vessel CAD. An outpatient CR program appears less beneficial for women, especially those over 55 years, with two or three coronary vessels affected with atherosclerosis or with LVEF > 50%. In women with CAD, eight weeks of 45-min interval training, with sessions three times a week, is insufficient to improve exercise capacity to an extent that is considered a predictor of mortality risk reduction.

Serum testosterone level correlates with left ventricular hypertrophy in older women.

Introduction: Sex hormones may play an important role in age-related cardiac remodeling. However, their impact on cardiac structure and function in females of advanced age still remains unclear. The aim of this study is to evaluate the relationship between sex hormones level and echocardiographic parameters in older women with concomitant cardiovascular diseases. Materials and Methods: The study group included 52 community-dwelling women with mean age 79.5 ± 2.8 years, consecutive patients of an outpatient geriatric clinic. In all the subjects, a transthoracic echocardiogram was performed and serum testosterone, estradiol, follicle-stimulating hormone, luteinising hormone, dehydroepiandrosterone sulphate, and cortisol levels were determined. Results: Testosterone level correlated positively with interventricular septum diastolic dimension (IVSd) (rS=0.293, p<0.05), left ventricular mass index (rS=0.285, p<0.05), E/E' ratio (rS=0.301, p<0.05), and negatively with E' (rS=-0.301, p<0.05). Estradiol level showed a positive correlation with the posterior wall dimension (rS=0.28, p<0.05). Besides, no significant correlations between clinical or echocardiographic parameters and other hormones were observed. Female subjects with diagnosed left ventricular hypertrophy (LVH) (n=34) were characterized by a significantly higher rate of hypertension (p=0.011), higher waist-to-height ratio (p=0.009), higher testosterone level (0.82 vs. 0.48 nmol/L, p=0.024), higher testosterone/estradiol ratio (16.4 vs. 9.9, p=0.021), and received more anti-hypertensive drugs (p=0.030). In a multiple stepwise logistic regression, the best determinants of LVH were the presence of hypertension (OR=6.51; 95% CI 1.62-26.1), and testosterone level (OR= 6.6; 95% CI 1.19-36.6). Conclusions: Higher serum testosterone levels may contribute to pathological cardiac remodeling, especially in hypertensive women. Estradiol, gonadotropins, DHEAS, and cortisol were not related to echocardiographic parameters.

[Physical activity and subclinical coronary atherosclerosis in asymptomatic middle-aged men]. / Aktywnosc fizyczna a subkliniczna miazdzyca tetnic wiencowych u bezobjawowych mezczyzn w wieku srednim.

INTRODUCTION: Few studies have examined the effect of physical activity (PA) on subclinical atherosclerosis. Those that have been conducted were not based on longitudinal observation of lifestyle and objective measures of cardiorespiratory fitness. AIM: The aim of the study was to assess the influence of PA level on subclinical atherosclerosis in a long-term prospective observation (mean 17.9 +/- 4.21 years) of asymptomatic middle aged-men. METHODS: We studied 27 men with stable high PA level (mean age 57.1 +/- 6.6 years) and 27 pair matched controls with sedentary lifestyle (mean age 56.1 +/- 6.6 years). PA level was assessed by detailed questionnaire based on the CINDI Health Monitor Questionnaire. Objective measurements of aerobic capacity was evaluated by exercise tests. Subclinical atherosclerosis was measured by assessing coronary calcification score (CCS) according to Agatston's method by means of the multi-slice computed tomography. RESULTS: Mean CCS was significantly lower among highly active men than among sedentary controls (28.3 +/- 70.6 vs 211.4 +/- 344.9; respectively, p<0.02). Active men had also more often CCS=0 (15 vs 7 persons). Not even one case of advanced calcification (CCS > 400) was noted among active men. Additional analysis of the active men group revealed that persons with CCS=0 had significantly higher energy expenditure, PA volume and better aerobic capacity as compared to other active men, but with CCS>0. CONCLUSIONS: Long-term high PA may be associated with a lower risk of developing subclinical atherosclerosis in asymptomatic middle-aged men.

The influence of cardiac rehabilitation on heart rate variability indices in men with type 2 diabetes and coronary artery disease.

METHOD: The study population included 141 male CAD patients prospectively and consecutively admitted to an outpatient comprehensive CR program. Twenty-seven patients with type-2 diabetes were compared with 114 males without diabetes. The participants performed a 45-min cycle ergometer interval training alternating 4-min workload and a 2-min active restitution three times a week for 8 weeks. The training intensity was adjusted so that the patient's heart rate achieved the training heart rate calculated according to the Karvonen formula. At the baseline and after 8 weeks, all the patients underwent the HRV assessment. RESULTS: HRV indices in the patients with diabetes were significantly lower as compared to the patients without diabetes in SDNN, TP, LF parameters, both at the baseline and after 8 weeks of CR. After 8 weeks of CR, a significant improvement of TP, SDNN, pNN50% and HF occurred in the patients without diabetes, whereas in the patients with diabetes only HF component improved significantly. CONCLUSIONS: As regards HRV indices, CR seems to be less effective in patients with CAD and type-2 diabetes.