Daily urinary sodium and potassium excretion in Chinese first-generation migrants in Italy

BACKGROUND

China has one of the highest salt intake levels in the world, and Chinese people form one of the largest foreign-born communities now living in Europe. The present study was performed to assess 24-hour urinary sodium and potassium excretion in Chinese migrants in Italy and to explore possible associations with hypertension, hypertension awareness, and length of residence in Italy.

METHODS

A cross-sectional evaluation was conducted on 319 first-generation Chinese migrants (154 women and 165 men) aged 18-70 years. Subjects were asked to do a 24-hour urine collection and the relationships of urinary sodium and potassium and arterial blood pressure, hypertension (BP ≥ 140/90 mmHg or anti-hypertensive drug use), hypertension awareness, and years of residence in Italy were investigated with linear or logistic regression analysis.

RESULTS

Sodium excretion was 145.2 mmol/day (95%CI 138.0-152.3) in men, and 134.7 (95%CI 127.6-141.8) in women corresponding to a dietary salt intake of 9.4 g/day (95%CI 9.0-9.9) and 8.8 (95%CI 8.3-9.2) respectively. Potassium excretion was 35.1 mmol/day (95%CI 33.6-36.5), with no significant difference by gender. At multivariable adjusted linear regression analysis body mass index, low education level, and hypertension were positive predictors of sodium urinary excretion; gender (women), and body mass index were positive predictors of potassium excretion. Sodium and potassium excretion were unaffected by hypertension awareness or years of residence in Italy.

CONCLUSIONS

Sodium excretion in Chinese workers is higher than recommended and in line with high salt intake in Italy. Potassium consumption remains low.

Metabolic Profile and Myocardial Performance of Renal Transplant Recipients Participating in Unsupervised Physical Exercise as a Prescription Program

INTRODUCTION

Renal transplant recipients (RTRs) are at high cardiovascular risk (CV) compared to the general population, especially after surgical treatment. The literature supports the role of supervised exercise intervention; however no data are available regarding the effects of unsupervised exercise programs. We investigated whether a home exercise program could reduce CV risk in RTR based on possible changes in renal and cardiometabolic parameters and myocardial performance measured by echocardiography.

METHODS

From a large cohort of 60 RTRs, 30 RTRs (12 females and 18 males 48.3 ± 12.3 years) participated in individualized and unsupervised training programs for 6 months, at moderate intensity. Cardiometabolic risk factors, anthropometric parameters, lipid and glycemic blood sample profiles were studied as was myocardial performance from the 2D echo examination at T0, and T6 months.

RESULTS

The lipid profile remained in the range of a low level of risk, although there was no significant improvement, whereas myocardial performance, in particular the EF, was significantly improved.

CONCLUSIONS

A home exercise program for at least 6 months produces positive effects on myocardial function and helps maintain a low cardiovascular risk profile. The trend supports the importance of highlighting the role of a correct reconditioning of lifestyle in RTR, from the exercise program without supervision to moderate intensity, where well tolerated.

Exercise and Cancer Survivors: Lessons Learned from a Multi-Faceted Model for Exercise Prescription

Cancer is the second leading cause of death, and the most common diagnosis among the general population is breast and colon cancer. Recently, an increasing number of new cases of invasive breast and colon cancer have been estimated, and more people die from these diseases. In addition to the genetic pattern, diet and lifestyle including smoking, alcohol consumption, and sedentary behaviour have also been identified as potential risks factors. Recent studies of cancer survivors have shown the beneficial effects of regular physical activity to reduce the prevalence of comorbidity, muscle atrophy, weight changes, reduced aerobic capacity, fatigue, depression, and reduced quality of life. Dedicated and individual programs are crucial for achieving the goals of improving quality of life and reducing comorbidities. A multidisciplinary approach is fundamental: lifestyle assessment, including estimating the level of physical activity, as well as nutritional habits, may be the first step. A periodic cardiovascular examination is crucial for detecting asymptomatic early myocardial failure. According to current ACSM guidelines, different levels of exercise (low-moderate 40% and moderate up to 60% of the maximal HR) may be prescribed, and patients enrolled may follow the exercise program if in the absence of contraindications. The current paper reports observations from our clinical practice and provides practical strategies that bridge contemporary, published guidelines into practice within a multi-disciplinary team working with cancer survivors in Italy.

Differences between the sexes in athletes' body composition and lower limb bioimpedance values

Introduction

The differences between the sexes in body composition are well established, although sports activity at an elite level seems to reduce them. The aim of this study is a comparison of the sexes in terms of athletes' body composition with a three-compartment model and a localized bioimpedance analysis in elite soccer players.

Methods

18 female and 18 male elite soccer players of the same age were matched (female=26.2±2.4, male 26.9±2.5; p=0.87). An assessment of body composition was performed through the integration of anthropometrics parameters, skinfold thickness and bioimpedance data. The evaluations were carried out in the morning on a group of athletes who were in a rested condition, having not exercised in the previous 12 hours and having fasted for breakfast.

Results

A body composition assessment shows higher values in females for hip circumference/ height (female: 0.55±0.03, male: 0.52±0.02; p<0.01) and fat mass index (female: 3.7±0.7 kg/m², male: 2.4±0.4 kg/m²; p<0.001), while there is no difference between the genders in the extra cellular mass index (female: 7.1±1.2 kg/m², male: 7.6±0.4 kg/m²; p=0.11). A localized bioimpedance analysis describes well-defined differences in the thighs, while in the calves these differences are reversed for the reactance values.

Conclusion

Sports activity seems to slightly reduce differences in the whole body. The different adaption at the same physical effort appears to be mainly related to cellular mass. This study shows for the first time localized bioimpedance values in female athletes.

Level of evidence

II b.

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.

Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients

AIM

To evaluate the effect of a 12-mo supervised aerobic and resistance training, on renal function and exercise capacity compared to usual care recommendations.

METHODS

Ninety-nine kidney transplant recipients (KTRs) were assigned to interventional exercise (Group A; n = 52) and a usual care cohort (Group B; n = 47). Blood and urine chemistry, exercise capacity, muscular strength, anthropometric measures and health-related quality of life (HRQoL) were assessed at baseline, and after 6 and 12 mo. Group A underwent a supervised training three times per week for 12 mo. Group B received only general recommendations about home-based physical activities.

RESULTS

Eighty-five KTRs completed the study (Group A, n = 44; Group B, n = 41). After 12 mo, renal function remained stable in both groups. Group A significantly increased maximum workload (+13 W, P = 0.0003), V’O₂ peak (+3.1 mL/kg per minute, P = 0.0099), muscular strength in plantar flexor (+12 kg, P = 0.0368), height in the countermovement jump (+1.9 cm, P = 0.0293) and decreased in Body Mass Index (-0.5 kg/m², P = 0.0013). HRQoL significantly improved in physical function (P = 0.0019), physical-role limitations (P = 0.0321) and social functioning scales (P = 0.0346). No improvements were found in Group B.

CONCLUSION

Twelve-month of supervised aerobic and resistance training improves the physiological variables related to physical fitness and cardiovascular risks without consequences on renal function. Recommendations alone are not sufficient to induce changes in exercise capacity of KTRs. Our study is an example of collaborative working between transplant centres, sports medicine and exercise facilities.

[Phisycal activity and primary prevention: lifestyle analysis in young people]

OBJECTIVES

to assess physical activity and overweight in a young population as factors associated with well-being.

DESIGN

cross-sectional study.

SETTING AND PARTICIPANTS

data collection was performed in primary and secondary schools of a district located in Florence (Tuscany Region, Central Italy) by a validated questionnaire; 1,776 subjects were enrolled.

MAIN OUTCOME MEASURES

physical activity levels and overweight.

RESULTS

an overweight or obese condition in 14,4% of the study population was observed. Vigorous physical activity prevailed in normal weight children, while the time spent in a sitting position was higher in overweight subjects.

CONCLUSIONS

physical activity levels do not follow the guidelines for youth people. Educational programmes, also at schools, are recommended in order to prevent the risk of developing chronic diseases in adulthood.

2D longitudinal LV speckle tracking strain pattern in breast cancer survivors: sports activity vs exercise as prescription model

Prevention strategies are important to optimize and to manage heart care in breast cancer survivors. Regular physical activity at moderate intensity is normally proposed to maintain myocardial performance; however, no data is available about the different impact of different levels of physical exercise. 2D speckle tracking echocardiography (2DSTE) is an accepted method for early detection of myocardial dysfunction. The study aims to monitor the cardiac performances in breast cancer survivors by 2DSTE analysis to manage sports activity vs physical activity. Two groups of previous breast cancer survivors (33 BCS) trained at moderate intensity and 55 athletes practicing dragon boat (DBA) sport were enrolled. They were matched with two healthy subjects groups: 23 competitive female athletes practicing different sports and 20 healthy women trained with exercise as prescription model. All women were studied by a complete echo examination including LV global longitudinal strain (GLS) assessment (XStrain-Esaote). EF and GS are only significantly higher in healthy subjects (-25.4 ± 2.1). Nevertheless, GLS values are within the normal range for all groups. Particularly, GS does not show any significant differences among subjects (-19.93 ± 4) practicing exercise as prescription when compared to the DBA competitive trained group. 2DSTE method is an appropriate method to supervise the intensity of exercise in breast cancer patients. Particularly, GLS can optimize and improve cancer therapy supporting and creating efficiencies within the health system confirming the role of the exercise prescription therapy in maintaining normal heart function.

Redox status alterations during the competitive season in élite soccer players: focus on peripheral leukocyte-derived ROS

It is well known that exercise training can deeply affect redox homeostasis by enhancing antioxidant defenses. However, exhaustive exercise can induce excessive reactive oxygen species (ROS) production, leading to oxidative stress-related tissue injury and impaired muscle contractility. Hence, ROS represent important signaling molecules whose level has to be maintained to preserve normal cellular function, but which can also accumulate in response to repetitive muscle contraction. In fact, low levels of oxidants have been suggested to be essential for muscle contraction. Both aerobic and anaerobic exercise induce ROS production from several sources (mitochondria, NADPH oxidases and xanthine oxidases); however, the exact mechanisms underlying exercise-induced oxidative stress remain undefined. Professional athletes show a high risk for oxidative stress, and consequently muscle injury or decreased performance. Based on this background, we investigated leukocyte redox homeostasis alterations during the soccer season in élite soccer players. Overall blood redox status was investigated in twenty-seven male soccer players from primary division (Italian "Serie A" team) at four critical time points during the soccer season: T0: just before the first team training session; T1: at the beginning of the season; T2: in the middle of the season and T3: at the end of the season. The main markers of muscular damage (CK, myoglobin, LDH), assessed by standard routine methods, are significantly altered at the considered time points (T0 vs T1 P < 0.01). In peripheral leukocyte subpopulations, ROS production shows significant alterations at the considered time points during the soccer season, and strictly and significantly correlates with CK values at every considered time point. Our experimental data indicate that deep redox homeostasis alterations are evident during the soccer season in élite soccer players, and that oxidative stress can be easily monitored, besides using the standard plasma biochemical parameters, by leukocyte ROS production analysis.