Gianni Mazzoni

Increased frequency of the homozygous II ACE genotype in Italian Olympic endurance athletes

Increased frequency of the homozygous II ACE genotype in Italian Olympic endurance athletes

Body image and weight perceptions in relation to actual measurements by means of a new index and level of physical activity in Italian university students.

BackgroundBody image perception depends on anthropometric and psychological factors. Body dissatisfaction is influenced by the socio-cultural environment and is associated with eating disorders and low self-esteem. This study examined the body image perception, the degree of dissatisfaction and the weight status perception inconsistency in relation to sex, weight status and amount of physical activity in a sample of university students.MethodsThe participants were 734 university students (354 females aged 21.5 ± 2.9 yrs and 380 males aged 22.1 ± 3.6 yrs) recruited from the second year of the Sport Sciences degree program. A self-administered questionnaire was used to acquire socio-demographic and sport participation information. Height, weight, BMI and weight status were considered for each subject. Body image perception was assessed by a silhouette matching technique. A new index, FAI (Feel status minus Actual status Inconsistency), was used to assess weight status perception inconsistency.ResultsA large proportion of the sample had normal weight status. On average, females chose as feel status a significantly higher figure than the males (4.7 versus 3.8) and they would have liked to have a significantly thinner figure than the males (3.4 versus 3.6). Therefore, the mean FID (Feel minus Ideal Discrepancy) values (positive in both sexes) were significantly higher in females than in males, meaning higher dissatisfaction. The mean FAI values were positive in females and negative in males, indicating a tendency of the women to overestimate their weight status and of the men to underestimate it. Men were more physically active than women. Less active women showed significantly lower body weight and BMI than more active women. Men less engaged in physical activity showed significantly higher FID than more active men.ConclusionsThese results show greater dissatisfaction and higher weight status perception consistency in females than in males among Italian university students examined. Our findings suggest that the FAI index can be very useful to evaluate the perceived weight status by body image in comparison to actual weight status assessed anthropometrically.

Identification of a Oo2 Deflection Point Coinciding With the Heart Rate Deflection Point and Ventilatory Threshold in Cycling

Grazzi, G, Mazzoni, G, Casoni, I, Uliari, S, Collini, G, van der Heide, L, and Conconi, F. Identification of a &OV0312;o2 deflection point coinciding with the heart rate deflection point and ventilatory threshold in cycling. J Strength Cond Res 22: 1116-1123, 2008-The purposes of this study were to compare the patterns of the work rate (WR)-&OV0312;o2 and WR-heart rate (HR) relationships in incremental cycling, to ascertain the occurrence of a &OV0312;o2 deflection (&OV0312;o2def) coinciding with the HR deflection point (HRdef ), and to determine whether the &OV0312;o2def, if present, coincides with the ventilatory anaerobic threshold (VT). Twenty-four professional cyclists performed a maximal incremental test on a wind-load cycle ergometer. Work rate, HR, &OV0312;o2, and &OV0312;co2 were recorded. The WR-&OV0312;o2 relationships obtained were linear up to submaximal WR and curvilinear thereafter and thus described a &OV0312;o2def. The WR and &OV0312;o2 at &OV0312;o2def were mathematically determined for all subjects. The ratio of ΔWR·Δ&OV0312;o2−1 up to &OV0312;o2def was significantly lower than that above &OV0312;o2def (90 ± 11 W·L−1·min−1 versus 133 ± 35 W·L−1·min−1, p < 0.0001). The WR-HR relationships obtained were linear up to submaximal WR and curvilinear thereafter. The WR and HR at HRdef were mathematically determined for all subjects. The WR values at &OV0312;o2def and at HRdef (329 ± 32 W and 326 ± 34 W) were significantly correlated (R2 = 0.96, p < 0.0001) and in good concordance (limits of agreement from -4.7% to 3.2%, Bland-Altman analysis). The &OV0312;o2 at VT was then determined for all subjects. The &OV0312;o2 values at &OV0312;o2def and at VT were significantly correlated (R2 = 0.99, p < 0.0001) and in strong concordance (limits of agreement from -1.9% to 1.0%, Bland-Altman analysis). In conclusion, a &OV0312;o2def coinciding with HRdef and VT was shown. This confirms that the determination of the WR-HR relationship and of HRdef is a practical and noninvasive means of identifying anaerobic threshold.

Treadmill walking speed and survival prediction in men with cardiovascular disease: a 10-year follow-up study

Objective To determine whether the walking speed maintained during a 1 km treadmill test at moderate intensity predicts survival in patients with cardiovascular disease. Design Population-based prospective study. Setting Outpatient secondary prevention programme in Ferrara, Italy. Participants 1255 male stable cardiac patients, aged 25–85 years at baseline. Main outcome measures Walking speed maintained during a 1 km treadmill test, measured at baseline and mortality over a median follow-up of 8.2 years. Results Among 1255 patients, 141 died, for an average annual mortality of 1.4%. Of the variables considered, the strongest predictor of all-cause mortality was walking speed (95% CI 0.45 to 0.75, p<0.0001). Based on the average speed maintained during the test, participants were subdivided into quartiles and mortality risk adjusted for confounders was calculated. Compared to the slowest quartile (average walking speed 3.4 km/h), the relative mortality risk decreased for the second, third and fourth quartiles (average walking speed 5.5 km/h), with HRs of 0.73 (95% CI 0.46 to 1.18); 0.54 (95% CI 0.31 to 0.95) and 0.20 (95% CI 0.07 to 0.56), respectively (p for trend <0.0001). Receiver operating curve analysis showed an area under the curve of 0.71 (p<0.0001) and the highest Youden index (0.35) for a walking speed of 4.0 km/h. Conclusions The average speed maintained during a 1 km treadmill walking test is inversely related to survival in patients with cardiovascular disease and is a simple and useful tool for stratifying risk in patients undergoing secondary prevention and cardiac rehabilitation programmes.

Peak oxygen uptake prediction from a moderate, perceptually regulated, 1-km treadmill walk in male cardiac patients.

PURPOSE: To determine whether a moderate 1-km treadmill walking test (1KTWT) could be used to predict peak oxygen uptake ( O2peak) in patients with cardiovascular disease. METHODS: One hundred seventy-eight male patients, aged 38 to 83 years, completed a O2peak treadmill test and a 1KTWT using a self-regulated intensity of 11 to 13 of 20 on the Borg scale. Multivariable regression analysis was used to develop equations for predicting O2peak in a development group (n = 110), both for subjects prescribed and not prescribed a &bgr;-blocking agent (BB/NBB, 66/44). These equations were then applied to a cross-validation and reproducibility group (n = 68, BB/NBB, 37/31), who completed the protocol twice within 2 weeks. RESULTS: Analysis from 1KTWT in the development group showed that age, body mass index, walking speed, and heart rate were the most potent predictors of O2peak. Measured and predicted O2peak were not significantly different, and were strongly associated among both the NBB (r = 0.81, P < .0001) and BB (r = 0.69, P < .0001) groups, with a mean residual of approximately 1.0 mL·kg−1·min−1. When applied to the cross-validation and reproducibility group, the equations similarly yielded strong associations (r = 0.64, P < 0.001 and r = 0.71, P < 0.001 for the NBB and BB groups, respectively), with no significantly differences between measured and predicted O2peak. Mean test-retest differences for measured and predicted O2peak were between 0.1 and −0.5 mL·kg−1·min−1. CONCLUSIONS: Equations developed from the 1KTWT accurately predicted O2peak in patients with cardiovascular disease. The model may represent a valid, low cost, and simple tool for indirect estimations of cardiorespiratory fitness in an outpatient setting.

Home-centred physical fitness programme in morbidly obese individuals: a randomized controlled trial

Objective: To assess the effectiveness of domiciliary physical fitness programmes in obese individuals. Design: Nine-month randomized controlled trial. Setting: Home-based intervention with outpatient visits. Subjects: Morbidly obese subjects (body mass index (BMI) ≥30) aged 25—65 years suitable for physical activities at home. Intervention: At the end of a preliminary one-month in-hospital rehabilitation programme (baseline), 52 patients were randomly assigned either to a structured educational programme (intervention group) of daily incremental physical activity at home (walking and skeletal muscle resistance training, with booklets and written instructions) or to a programme of general advice (control group) regarding exercise and long-term fitness. Main measures: Both groups were evaluated at baseline and every three months for: (1) time, metabolic equivalents (METs), and heart rate reserve (HRR) during a standardized 2-km walking test (2kmWT); (2) anthropometric measures (body weight, BMI, abdominal and neck circumference); (3) the Polar Fitness Test index (PFTI), and (4) time to exhaustion while sustaining consecutive isoload extensions in the dominant leg (isoload LE). Time during 2kmWT was the study primary outcome. Results: Body weight, BMI and abdominal circumference improved significantly (P<0.05) over time in the intervention group. The cardiopulmonary fitness variables changed significantly (P<0.05) over time in both study groups. However, all variables improved in the intervention patients, while some worsened or remained stable in the controls. Thus, the mean group difference in changes was significant (P<0.05) for 2kmWT time (—77.4 seconds), HRR (11.7%), and PFTI (5.4 points). Conclusion: This structured domiciliary fitness programme is feasible and provides sustained anthropometric and physiological benefits in some morbidly obese individuals.

Association between VO2 peak estimated by a 1-km treadmill walk and mortality. A 10-year follow-up study in patients with cardiovascular disease

PURPOSE The aim of this study is to assess the association between peak oxygen uptake (VO2 peak), determined using a perceptually regulated 1-km walking test (1k-TWT), and all-cause mortality in cardiac patients. METHODS 1255 male patients, aged 25-85 years, completed a moderate 1k-TWT to estimate VO2 peak. Subjects were followed for all-cause mortality for up to 10 years. Cox proportional hazard models were employed to determine variables associated with mortality. Based on the estimated VO2 peak, the sample was subdivided into quartiles and mortality risks were calculated. To assess the discriminatory accuracy of the estimated VO2 peak for estimating survival, receiver-operating-characteristics curves were constructed. RESULTS During a median 8.2 year follow-up, a total of 141 deaths from any cause occurred, yielding an average annual mortality of 1.4%. The strongest predictor of all-cause mortality was the estimated VO2 peak (c-statistic 0.71, 95% confidence intervals: 0.69-0.74, P<0.0001). Survival decreased in a graded fashion from the highest estimated VO2 peak quartile to the lowest quartile. Compared to the lowest quartile, the hazard ratios (95% confidence intervals) for the second, third, and fourth quartiles were 0.77 (0.35-1.33), 0.43 (0.20-0.91), and 0.16 (0.05-0.54) respectively (P for trend <0.0001). An 89% reduction in mortality risk was observed among a subset of subjects in the fittest quartile who improved their estimated VO2 peak over the follow-up period relative to subjects in the least fit quartile who did not improve. CONCLUSION VO2 peak estimated by a novel 1k-TWT predicts survival in subjects with stable cardiovascular disease.

Improved walking speed is associated with lower hospitalisation rates in patients in an exercise-based secondary prevention programme

Objective To determine the relationship between walking speed (WS) maintained during a 1 km test and its improvement on hospitalisation in cardiac outpatients who were referred to an exercise-based secondary prevention programme. Methods Hospitalisation was assessed in 1791 patients 3 years after enrolment and related to the WS achieved during a 1 km walk at moderate intensity on a treadmill. Hospitalisation was also assessed during the fourth-to-sixth years as function of improvement in WS in 1111 participants who were re-evaluated 3 years after baseline. Results Three-year hospitalisation rate across tertiles of baseline WS was 50% for the slow walkers (2.7±0.6 km/hour), 41% for the moderate (4.1±0.3 km/hour) and 25% for the fast walkers (5.2±0.5 km/hour) (p for trend <0.0001), with adjusted HRs (95% CI) of 0.93 (0.74 to 1.17, p=0.53) for intermediate and 0.58 (0.43 to 0.78, p=0.0003) for fast. Every 1 km/hour increase in WS was associated with a 21% reduction in hospitalisation (p<0.0001). Hospitalisation from the fourth-to-sixth years was lower across tertiles of improved WS, with 44% for the low (0.2±0.4 km/hour), 34% for the intermediate (0.8±0.2 km/hour) and 30% for the high tertile (1.6±0.4 km/hour) (p for trend <0.0001). Adjusted HRs were 0.68 (p=0.002) for the intermediate and 0.58 (p<0.0001) for the high tertile. Every 1 km/hour increase in WS was associated with a 35% reduction in hospitalisation (p<0.0001). Conclusion Improvement in WS is associated with a significant, dose-dependent lower rate of all-cause hospitalisation in cardiac outpatients. WS is a simple, easily applied and clinically useful tool for cardiac patients undergoing secondary prevention.

A moderate 1-km treadmill walk predicts mortality in men with mid-range left ventricular dysfunction

The prevalence of heart failure considerably increased over the last three decades because of the aging population and the improved survival rate after acute cardiac events. Clinical and research programs more frequently are directed to patients with severely impaired functional capacity. Nevertheless, heart failure with mid-range left ventricular dysfunction (HFmrEF) has been recently defined as a distinct clinical entity. Cardiorespiratory fitness (CRF), usually best reflected by peak oxygen consumption (VO2peak), has been shown to be a powerful and independent prognostic marker in patients with heart failure. CRF has been linked to both cardiovascular and non-cardiovascular outcomes in ambulatory patients with heart failure. VO2peak is strongly related to walking capacity in older adults, and among heart failure patients. The walking speed maintained during a submaximal 1-km treadmill walk (1 k-TWT) has been demonstrated to be a valid and simple tool for VO2peak estimation, 12–14 and is inversely related to survival, and hospitalization, in outpatients with cardiovascular disease and preserved left ventricular ejection fraction (LVEF). We examine the association between VO2peak estimated by the 1 k-TWT and all-cause mortality in men with HFmrEF. We studied 209 medically stable male outpatients aged 65 10 years, with LVEF 40% 5%, referred to our exercise-based secondary prevention program. Each patient performed the moderate perceptually-regulated (11–13 on the 6–20 Borg scale) 1 k-TWT. Time to walk 1-km, mean and maximal heart rates during the walk, age, height, and weight were entered into the equations for VO2 peak estimation. Based on the VO2peak, the sample was subdivided into tertiles and mortality risks were calculated during a median follow up of 9.4 years. The local Ethics Committee approved the study protocol, and all patients gave written informed consent. Survival decreased in a graded fashion from the highest VO2peak tertile to the lowest tertile (p< 0.0001, Figure 1). During the follow-up period, 23, 11, and 3 all-cause deaths occurred among the lowest, intermediate, and highest VO2peak tertile respectively. Mortality rate was independent from traditional cardiovascular risk factors, including LVEF and clinical history. Compared with the lowest tertile (mean walking speed 2.8 km/h), the full-adjusted mortality risk decreased for the second (mean walking speed 3.8 km/h), and third tertile (mean walking speed 4.6 km/h), with hazard ratios of 0.64 (95% confidence interval (CI): 0.33–1.20, p1⁄4 0.18), and 0.26 (95% CI: 0.08–0.80, p1⁄4 0.02), respectively (p for trend< 0.0001). These results are similar to those obtained by other studies in which VO2peak was determined by maximal cardiopulmonary exercise testing. Consistent with previous studies, we observed a 24.5% reduction in all cause mortality associated with each 1-Metabolic equivalent (MET) increment in VO2peak (p1⁄4 0.04). In conclusion, our findings show that VO2peak estimated from a simple moderate 1 k-TWT predicts

Influence of low-density lipoprotein (LDL) receptor-related protein and ABO blood group genotypes on factor XI levels

Influence of low-density lipoprotein (LDL) receptor-related protein and ABO blood group genotypes on factor XI levels -