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Aim: Given the time spent at work, the workplace represents an ideal setting to implement preventive programs for non-communicable diseases, the major cause of mortality and morbidity in Western and developing countries. We sought to verify if an ecological approach based on corporate culture, employees' education and concrete modifications of workplace environment, offering easy opportunity to assume healthy lifestyle, could be associated with reduced cardiometabolic risk. Methods: The study involved 1089 workers in two multinational companies following different workplace health promotion policies. Company A offered to all employees the opportunity to access a web platform dedicated to general information on health and diseases. Company B implemented an ecological model encompassing company culture, employees' education and concrete modifications of workplace environment, giving to all employees the opportunity to adopt healthy solutions throughout daily living at workplace. Participants volunteered self-reported clinical information using an IT tool. Numbers of Metabolic Syndrome components (MetS) were taken as proxy of cardiometabolic risk. Results: MetS probability obtained via statistical modeling was lower in company B as compared to company A, and absenteeism was also lower in company B. Our study shows that a work environment favoring assumption of healthy lifestyle, as in company B, is associated with a lower percentage of employees with MetS components and lower absenteeism. Moreover, statistical modeling shows that individual probabilities of being without MetS elements, controlling for age and gender, is remarkably higher in company B. Conclusions: Our data suggest that ecological approaches might be useful in worksite prevention policies. [ABSTRACT FROM AUTHOR]

The evidence supporting the importance of a healthy lifestyle (active life, healthy diet, not smoking, and low stress) as a part of programs for primary and secondary prevention of cardiometabolic diseases is strong, compelling, and continuously growing. In this study, we test whether a simple web-based healthy lifestyle index, using self-reports, is related to indices of cardiovascular health and metabolic syndrome and could be employed in large wellness programs intended to promote healthy lifestyle. We studied 411 workers in an Italian multinational factory who were enrolled in a voluntary program consisting of a health checkup and an online questionnaire on lifestyle. These domains were combined into a single simple index. Participants were subdivided into three healthy lifestyle index (HI) groups (red, yellow, and green) ranging from poor to good HI quality (HI from red to green: 41.8 ± 14.6; 75.7 ± 8.5; 93.8 ± 2.2; p < 0.05). The groups differed in indicators of cardiovascular and metabolic health (waist circumference females: 82.1 ± 9.56, 78.9 ± 9.3, 72.7 ± 6.6; males: 95.2 ± 11.7, 90.0 ± 9.5, 85.7 ± 6.1 cm; group difference p < 0.05). Moreover, they differed significantly in the likelihood of having more components of the metabolic syndrome and, conversely, fewer components of the ideal cardiovascular health profile (with red having the worst profile). The red group was also characterized by the highest absenteeism. We report for the first time that a web-based self-reported poor health behavior was significantly associated with clinical and laboratory (partial correlation between HI and high-density cholesterol 0.192; body mass index −0.288; systolic blood pressure −0.130; all p < 0.05) results indicating a negative cardiometabolic profile. [ABSTRACT FROM AUTHOR]

Purpose: The dynamics of vagal withdrawal and reactivation during pulses of exercise are described by indices computed from heart period (RR) variations, which may be sensitive to duration and load. We sought to assess the consistency over time of these indices, which is not well established. Methods: We recorded continuous electrocardiogram during series of five successive bouts (2 min) of submaximal exercise (at 40 and 70 % of VO, different days). Autonomic responsiveness was inferred from quantification of onset and offset of RR dynamics of each individual bout. Consistency of results was assessed with intraclass correlation (ICC). Results: During exercise bouts, indices from tachycardic and bradycardic transients reach lower levels in response to higher exercise loads and progression of exercise. There is a significant effect of load and time (i.e., bout repetition) for all examined variables, with a clear interaction. However, no interaction is observed with the 60 s change in heart rate. ICC analysis demonstrates that various indices are characterized by large differences in stability, which is generally greater within the same day (e.g., tachyspeed ICC at 40 % = 0.751, at 70 % = 0.704, both days = 0.633; bradyspeed, respectively, = 0.545, 0.666, 0.516). Conclusions: Intensity and duration of exercise modulate vagal withdrawal and reactivation. Analysis of RR variations, during successive brief exercise bouts at lower and higher intensity, ensures a consistency similar to that reported for autonomic cardiac regulation at rest and might guide the choice among multiple indices that are obtained from the tachogram. [ABSTRACT FROM AUTHOR]

Considering that changes in exercise routines might have relevance in treatment of adolescents with type 1 diabetes mellitus, we sought to assess whether spontaneous modifications to weekly exercise habits might occur in these patients and whether such variations would be accompanied by alterations in autonomic profile. In this observational study, we examined 77 patients (age 15.0 ± 0.6 years.) who in addition to a tailored optimal insulin treatment were invited to perform at least 1 h a day of moderate, aerobic exercise, as suggested by recent guidelines. Patients were studied at baseline (T0) and after 15.8 ± 0.7 months (T1). They were divided into three subgroups according to increased, unchanged and diminished total estimated weekly METs between T0 and T1. Autonomic profile was evaluated by assessing spontaneous baroreflex gain and low-frequency oscillation in arterial pressure, using spectral analysis of RR and systolic arterial pressure time series. Insulin therapy and biochemical data were similar among the 3 groups at T0 and T1, while body mass index standard deviation score was slightly reduced ( p < 0.04) and markers of autonomic performance were improved (alpha index, from 17 ± 1 to 20 ± 2 ms/mmHg, p < 0.002) in the group who increased the amount of exercise (from 1627 ± 250 to 3582 ± 448 METs min wt, p < 0.001). Furthermore, the change in total weekly METs significantly correlates with changes of key indices of autonomic regulation. The favourable autonomic effects of moderate increase in spontaneous exercise load suggest testing more formally this intervention in adolescents with type 1 diabetes. [ABSTRACT FROM AUTHOR]

Aims: To assess body composition by means of BOD POD in the large cohort of Italian Olympic athletes of many sport disciplines (studied at the same time), and to provide possible reference values for body composition in elite athletes. Methods: 1556 elite athletes, who took part in the selection procedure for the 2016 Rio Olympic Games for the National Italian Olympic Committee (CONI), were retrospectively studied. Body composition was determined using air plethysmography-based BOD POD. Results: We observed that Fat Mass (FM) and Fat-free Mass (FFM) should be considered as two mutually independent domains in elite athletes. By performing Principal Component Analysis, we defined two independent main domains (respectively, representing FM and FFM), which presented different trends according to gender and static or dynamic exercise load. Lastly, we reported possible reference values for FM index and FFM index, respectively, representing the largest contributors to FM domain and FFM domain, and calculated as FM or FFM (kg)/height (m2). Conclusions: Our findings might provide a basis to optimize the practical approach to body composition in athletes, highlighting the importance of considering indicators of fat mass and lean mass "simultaneously" and not specularly, according to different sport disciplines as well. Moreover, these data might contribute to standardize reference values for body composition in elite athletes, with a view to potentially helping to monitor and guide training regimens, prevent related detrimental practices and plan cardiometabolic prevention and rehabilitation programs. [ABSTRACT FROM AUTHOR]

Purpose: Optimal autonomic regulation and stress resilience might be considered critical elements of athletic performance. We hypothesize that a novel unitary autonomic index for sports (ANSIs), together with a somatic stress related symptom score (4SQ) might help characterize athletes who were eventually selected for the Rio 2016 Olympic Games Italian team (Rio +).Methods: In this retrospective study we examined 778 athletes (age 24.4 ± 6.7 yrs) who underwent a planned yearly pre-participation screening. All athletes underwent clinical, autonomic and exercise ECG evaluation. The combination of vagal and sympathetic indices from RR variability into ANSIs was performed by radar plot and percent ranking of index variables. We assessed (Rio +) versus (Rio -) athletes also after subdivision into three sport intensity groups (low, mid and high intensity).Results: Overall there were no significant differences between (Rio +) and (Rio -) athletes when considering individual spectral derived variables. Conversely, the unitary Index ANSIs was significantly higher in (Rio +) compared to (Rio -) athletes (respectively 54.5 ± 29.5 and 47.9 ± 28.4 p = 0.014). This difference was particularly evident (p = 0.017) in the group of athletes characterized by both high static and dynamic components. 4SQ was smaller in the (Rio +) group, particularly in the groups of athletes characterized by both low-medium static and dynamic components.Conclusions: ANSIs, a proxy of integrated cardiac autonomic regulation and simple assessment of resilience to stress, may differentiate Italian athletes who were eventually selected for participation in the 2016 Rio Olympic Games from those who were not, suggesting the possibility of a "winning functional phenotype". [ABSTRACT FROM AUTHOR]

Purpose: Autonomic assessment might be useful in training management. We planned to assess whether oscillatory metrics of RR variability (such as LFnu) would be more efficient than static indices from low order statistics (RR variance) at discriminating laying rest from stand posture, as an analog of a shift to sympathetic dominance.Methods: We studied a large population of elite Olympic athletes: a total of 406 athletes (162 females and 244 males, of similar age 21.7 and 24.4 years) participating to the selection for the upcoming 2016 Olympic games. We employed various methods to extract autonomic indices from RR variability and employed a stepwise statistical approach combining factor and discriminant analysis.Results: We observed that that relative power of oscillatory components from spectral analysis of RR variability (such as LF or HF in nu) and indices from symbolic analysis (particularly 0V) clearly outperform RR variance in discriminating between two physiological conditions (laying rest and stand) related to posture and autonomic activation.Conclusions: In world class Olympic athletes we have shown that a small subset of RR variability indices, related to sympathovagal balance, may be more appropriate than RR variance to assess excitatory sympathetic autonomic responsiveness of the SA node. These findings may have practical implications for the use of RR variability in guiding training and predicting success in competitions. [ABSTRACT FROM AUTHOR]

Introduction: Aerobic fitness seems to provide extra protection to the cardiovascular system beyond changing the traditional risk factors, a phenomenon referred to as the risk factor gap model. Aerobic fitness may possibly lead to improved autonomic regulation. The Task Force of the American Heart Association supports a national campaign to reach specific cardiovascular health goals considering various metrics, including recommended physical activity (PA) volumes. It may be clinically relevant to assess whether autonomic remodeling occurs in those who adhere to the PA recommendations. Methods: We studied 39 healthy subjects (22 males and 17 females), subdivided into two groups, according to whether they were meeting or not meeting PA recommendations (150 min/week of moderate aerobic activity, or 75 min/week of vigorous aerobic activity, or a combination of both). For each group, we evaluated aerobic capacity (VO Peak), body composition (Fat Mass) and autonomic nervous system profile, by way of mono and bivariate spectral analysis of cardiovascular beat by beat variability. Results: Subjects following PA recommendations show higher RR period, higher RR variance, greater absolute power of the respiratory component of RR variability (HF) and higher index alpha (a measure of spontaneous baroreflex). Moreover, as expected, the group that was meeting or exceeding current PA recommendations had higher VO peak, less fat mass and greater weekly energy expenditure. Conclusion: Data show that subjects meeting current PA recommendations present a phenotype suggestive of enhanced parasympathetic drive to the SA node. This finding is compatible with the hypothesis that a more favorable autonomic profile is part of the mechanisms of the risk factor gap. [ABSTRACT FROM AUTHOR]