N. 14 - July 2014

Quarterly Journal

July 2014 - year IV

L’ACCADEMIA DEL FITNESS WELLNESS-ANTIAGING

N. 14

magazine

number 14 / 2014

ACCADEMIA DEL FITNESS Galleria Crocetta 10/A 43126 PARMA Tel. 0521.941319 Fax 0521.294971 www.accademiadelfitness.com accademia-magazine@libero.it

EDITORIAL

Editor in Chief: Valerio Merola Scientific director: Massimo Spattini Art director: Cinzia Ruggeri Executive editors: Silvia Iorio Editorial staff: Claudia Bonini Cristiana Pedrazzini Andrea Angelozzi Scientific committee: Dott. Damiano Galimberti Prof. Fulvio Marzatico Dott. Filippo Ongaro Prof. Mario Passeri Writers: Davide Antoniella Fabrizia Bamonti Marco Tullio Cau Daniele Cozzini Ciro di Cristino Giuseppe Notarnicola Giovanni Occhionero Filippo Ongaro Sonja Ongaro Antonio Polito Massimo Spattini Luca Speciani Cover: Giuseppe Notarnicola Photographer cover: Nicola De Luigi Managing Editor: Profitness S.a.s.

Galleria Crocetta 10/A 43126 Parma Tel. 0521.941319 Printed and delivered by: Mattioli 1885 S.r.l.

Str. della Lodesana, 649 sx Loc. Vaio 43036 Fidenza (PR) Tel. 0524.530383 www.mattioli1885.com Registration n. 12/2004 Court of Parma

Summer is the time when people are probably willing to do more physical activity, both because of better weather conditions and because they aim at reaching perfect fitness to show at the beach. Actually, summer is also the period for holidays, a time when – due to some excess and to probable idleness – people may lose their fitness in a short time, after all the time it took them to reach it. Yet, do not worry too much: leisure and relaxation are fundamental and they will allow you to resume your training with more enthusiasm. After the holidays there will be no excuses. Everybody will have re-invigorated and will be ready to continue our route dedicated to Fitness, Wellness and Antiaging. Every time you feel tired, every time you feel hungry, every time you feel depressed, you have to think: “no excuses”. Do your training, follow your diet, do your meditation exercises and you will feel better because energy, increased by emotion, reveals itself in the awareness that it must be aimed at a goal. In our case, our goal is wellness for the body and mind. George Eiferman, 1948 Mister America and 1962 Mister Universe, at a time when there was no such thing as bodybuilding but there was Physical Culture, said: “The greatest discovery we can make is probably to understand that we can change our life to the better by changing our immature behaviour into mature and constructive behaviour. We must live towards our models of thought and we must make our attitude work at our advantage and not against us”. A long time before him, Socrates said: “No man has the right to be superficial in the field of the care for one’s own body. It is a shame for man to grow old without seeing the beauty and fitness that the body is able to achieve”. The International Congress of Functional & Antiaging Medicine “Nutrition, Exercises & Mind” has already given some guidelines which go this way. We only have to follow them in order to become complete people, loving

oneself in order to love the others. In order to be fit we have to be informed. Knowledge is power and power makes action be accomplished. This summer doctor Ongaro and I are going on holiday to Los Angeles, the Mecca of Body Building, the home of Fitness, the origin of Antiaging. Filippo and I are the only ones in Italy to have A4M certification (American Academy Antiaging and Regenerative Medicine) and IFM certification (Institute of Functional Medicine). We are also the only ones to have been professional bodybuilders.

Perhaps not many people know that Filippo took part in an under 22 FIACF (Italian Federation of Physical Culture Amateurs) championship which I myself organised in Piacenza in 1988. This mix is apparently contradictory for the Italian way of thinking, but not for the American one. Therefore, this allows us to be the perfect “traits d’union” between the world of practised Fitness and the world of prescriptive medicine, to reach preventive medicine, represented by what is functional to keep one’s health, full efficiency and fitness.

Our aim, through our magazine L’Accademia del Fitness, Wellness & Antiaging Magazine, as well as through AFFWA (Accademia Funzionale, Fitness, Wellness and Antiaging) is to put in contact professional people with different backgrounds, yet all involved in the health sector. This will allow us to create a common language and to exchange knowledge which is fundamental for everyone. Excessive specialization has proved its limits and now we must not go back but rather go further on towards a global vision, besides having the necessary specializations and specific skills. We hope we will bring good news from the Golden State, and we hope to put at your disposal pieces of knowledge that not everybody – people less fortunate than us - can achieve.

Massimo Spattini AFFWA President

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INDEX EDITORIAL

3

BIOFEEDBACK AND STRESS MANAGEMENT IN ANTI-AGING MEDICINE

6

by Massimo Spattini

by Sonja Ongaro

HYPOTHALAMIC REGULATION OF BODY COMPOSITION

10

by Luca Speciani

GASTROINTESTINAL RECOVERY FOLLOWING THE 4R PROGRAMME

14

by Filippo Ongaro

ANTI-AGING CHRONOMORPHOLOGIC DIET

18

by Massimo Spattini

SEXERCISES

22

by Marco Tullio Cau

THE IMPORTANCE OF ORGANIC AND MUSCLE TESTS IN ANTI-AGING CHECK-UP 28

by Davide Antoniella

SARCOPENIA AND THE DISABLING CONDITION IN THE ELDERLY

32

by Antonio Polito

TRAINING WITH KETTLEBELLS

36

by Giuseppe Notarnicola

LIVING IN BALANCE

38

by Ciro Di Cristino

QI GONG THE ART OF RESPIRATION

42

by Daniele Cozzini

PHYTOEXTRACTS AS HORMONAL MODULATORS

44

by Giovanni Occhionero

OXIDATIVE STRESS AND BONE METABOLISM: EFFECTS OF CELLFOOD® SILICA PLUS

48

by Fabrizia Bamonti

LATEST RESEARCH IN FITNESS, WELLNESS AND ANTIAGING MEDICINE

by Filippo Ongaro 4

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L’Accademia del Fitness

BIOFEEDBACK AND STRESS MANAGEMENT

IN ANTI-AGING MEDICINE In antiaging medicine it is very important to examine every mechanism leading to some form of body stress and degeneration in order to be able to counterbalance these processes with adequate and regenerative means. The more stress and deteriorating factors we manage to identify, the better we can plan personalized programmes which can slow down aging and the loss of functional reserves. In anti-aging medicine the evaluation of organic and molecular mechanisms has gradually become more and more refined, whereas it is still quite difficult, and therefore often neglected, to analyze psychological factors such as thoughts, imagination, emotions and their impact on body functions. Besides the real difficulty in identifying and evaluating these aspects, we must add that many doctors do not believe there is a close link between the mental and the physical sphere. They believe it is not sufficiently grounded on scientific data and so, despite understanding its importance, they ignore it. Instead, we know that perhaps the deepest aspects of a person’s health and happiness depend on their psycho-emotional wellbeing and we cannot keep claiming that there is no scientific evidence of the deep interconnections between the mind and the body because, on the contrary, there are many studies also published on very prestigious medical magazines.

Computerized and multi-sensory biofeedback is a method which allows us to study the psycho-emotional sphere concretely and objectively. Therefore, it allows to better control mental stimuli and their impact on body functionality. This method includes both diagnostic and therapeutic techniques which, thanks to the use of sensors, allow us to record information on some physiological parameters and on their variation in different emotional states. Among the recorded parameters there are heart rate, respiration, skin electrical activity, muscular tension, skin temperature, electromyography and brain waves.

The data are then elaborated through a special software and evaluated according to the different phases of the test, generally subdivided into stressful moments followed by recovery phases. Besides simple data, it is possible to evaluate also more complex parameters, such as heart rate variability (HRV), that is, the examination of the regularity between one heart beat and another, recognized as a value which is strictly connected to stress degree, to functional reserves and even to the subject’s biological age. HRV is also used to understand the relation between the sympathetic and parasympathetic nervous system, but it is presumable that the behaviour of this variable is connected to many other factors. The parameters examined by biofeedback can in fact be considered as representations of

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L’Accademia del Fitness

The biofeedback is especially useful to increase one’s awareness on how the body adjusts to different emotional conditions

deep and complex regulating phenomena.

The stroop test is used for instance as a stressful agent which can create an interference between the automatic impulse to read a word that describes a colour and the task to say as quickly as possible only the colour in which the words are written (for example, the word orange can instead be written in blue, the word red can be written in purple, and so on). All this is seen by the subject on a screen where he/she will subsequently be able to observe the reaction of the various recorded parameters. The biofeedback instrument can also be used to do some exercise which can help bring the various parameters in the best functionality range. For example, the subject can quickly learn to use his/her abdominal respiration by means of an abdominal sensor which expands when the subject inspires and narrows when he/she expires and with each act, there will be a balloon on the screen - synchronized with the sensor - which will inflate or deflate. Or it will be possible to learn to synchronize heart rate and respiration or to increase skin temperature through a long series of funny and effective exercises.

The biofeedback is especially useful to increase one’s awareness on how the body adjusts to different emotional conditions.

It allows the subject to increase his/her capacity to interpret the

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symptoms connected to stress and to find his/her best way to activate relaxation response. Learning techniques for psychophysical self-relaxation can be enhanced by visual feedback. The operator can quantify the stress and its reduction, and can interpret the functionality and accumulation of fatigue and tension in a more accurate and complete way. However, it is important to remember that as for stress management, the operator must have an accurate outline of the subject’s personality and preferences. Also, the operator must find – together with the subject – some relaxation techniques and techniques for internal dialogue management in order to allow him/her to learn with pleasure. In order to reach real and lasting stress reduction, the emotional pleasure through which the subject faces the approach is more important than the method used.

Dr.ssa Sonja Ongaro Stress management and performance coaching In charge of the Psychophysiology Area Institute of Regenerative and Antiaging Medicine s.r.l.

(ISMERIAN), Treviso

L’Accademia del Fitness

HYPOTHALAMIC REGULATION

OF BODY COMPOSITION The adipose cell as an endocrine organ Friedman’s discovery of “leptin” in 1994, gave the first important shake-up to the granitic positions of dieticians convinced that everything depends on calories. Friedman was looking for a signal molecule which could send a stimulus of weight loss in laboratory animals.

Mice genetically lacking that molecule showed disproportionate fattening and had insatiable appetite. When Friedman succeeded in codifying this molecule (to which he gave the name of leptin, from the Greek “leptos” which means “thin”) and gave it to the mice lacking leptin, he obtained an extraordinary effect of immediate weight loss in them. Such molecule was naturally secreted by our adipose tissue, but those animals which genetically did not possess it, could not produce it. Therefore, it was evident that the correction of this deficit led the organism of those animals to greater energy consumption. Were we then in the presence of a molecule which would solve all our problems of overweight from here to eternity?

Unfortunately, the use of leptin on mice which had become obese due to hyper nutrition did not have any effect, and this was more difficult to explain. Actually, those mice did not lack leptin. They were leptin resistant. In other words, they produced so much of it that they were no longer sensible to its signal.

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But why is leptin so important in our energy balance? The reason is that leptin (someone defined it as “the most important hormone in our body”), which is secreted by the adipose cells after an abundant meal, represents the most important hypothalamic signal to orient the body towards activity and consumption rather than (if leptin is absent or there is not enough or it is not “read”) towards energy saving and the accumulation of reserves. This is why leptin has fundamental importance in our system and it is important to decode its signals clearly.

Metabolic signals Once the leptin signal informs the hypothalamus correctly (more precisely, it reaches a group of neurons called “arcuate nucleus”), the message is sent towards other areas having specific functions. First, leptin suppresses the need for sweet sugary food, by inhibiting the secretion of a neurotransmitter called NPY (neuropeptide Y). Nothing strange so far: if we eat enough food we are no longer hungry. However, it is interesting to underline that the secretion of NPY is permanently activated, except when the hypothalamus receives the leptin signal which can turn it off (in other words: we are always hungry thanks to evolution, and it is only by means of a clear signal of complete nutrition that our hunger is attenuated). The second action of

L’Accademia del Fitness

First, leptin suppresses the need for sweet sugary food, by inhibiting the secretion of a neurotransmitter called NPY (neuropeptide Y)

leptin is even more important than the one of hunger. In fact, our nervous projections concern, directly or indirectly, areas of the brain which have the function of regulating the hormonal activity of the thyroid, the adrenal gland, ovaries and testicles and the modulation of muscle and bone development. In short: all the most important metabolic axes of our body are under the control of leptin. If there is leptin (that is, if we eat) all these axes are activated. If there is no leptin (that is, we do not eat or are on a low calorie diet) these axes are inhibited. Our bones will be fragile, our muscles insignificant, our thyroid slow, we will respond to stress with difficulty (depression) and there will be an overall fall in fertility and sexual desire. And from the point of view of our metabolic rhythm, our consumption capacity will slow down because the body will defend itself from the lack of food and will tend to a leptinmediated accumulation.

This technique of “energy saving” is the answer of our body in the course of 800,000 years of our recent evolution: the adaptation to food shortenings by means of precious deposits of fat (which our body kept scrupulously) were a powerful weapon of survival. So, in conclusion, the reduced introduction of food for a long period determines a reduction in leptin and our body, in order to preserve its own fat, consumes less and deactivates muscle construction, the reproductive function etc.

It is interesting to understand that also an obese person is in the same situation for opposite reasons (excess of leptin which has led to the resistance and adaptation of the arcuate nucleus of the hypothalamus). Despite eating (sometimes) great amounts of food, obese people do not receive the leptin signal. Therefore, they are permanently hungry (NPY is not inhibited) and all their metabolic axes slow down (weak muscles, low fertility, slow thyroid). Obese, anorexic, overweight and low-calorie fanatics all share the same metabolic destiny for the simple reason that they all receive the same altered signal. The situation

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gets more complicated if we add other signals from other organs to the signal of leptin: from the pancreas (insulin, glucagon, somatostatin), from the stomach (ghrelin, GLP1), from the intestine (CCK, secretin) and also from the adipocytes (adiponectin, resistin). Each of these signals follows its own logic and interacts with the others synergically or in opposition.

It is only by working on these signals, understanding that they represent the language through which our central regulation centres act, that the pathology of obesity and the risk factor of overweight (as well as food disorders) can be understood and, hopefully, treated. Someone has invented the verbal expression “thrifty genotype” . We are the descendants of those individuals who scrupulously kept their reserves. Those who did not did not survive long enough to tell us this story.

Not calories but hypothalamic choices Therefore, the body composition is not determined by calorie intake, by the association of nutrients or by some magic food, but it is the result of a refined hypothalamic regulation which, in its turn, is activated by signal molecules coming mostly from the adipose tissue, and which have a strong evolutionary base.

Learning to dialogue with the inborn answers of the ancient brain within us, sending the correct signals to it concerning weight loss, hydration, muscles, represents the key towards stable, long lasting, permanent weight loss. Gradual, but surely effective, through the application of the correct diet habits and lifestyles which will make us orient the choices of our hypothalamus towards the direction we want.

Luca Speciani physician and dietician info@lucaspeciani.it - www.lucaspeciani.it

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GASTROINTESTINAL RECOVERY FOLLOWING

THE 4R PROGRAMME

A very high number of people complain about disorders of the gastrointestinal tract. Some typical symptoms are abdominal swelling, diarrhea, constipation, stomach burning and gastroesophageal reflux, only to mention some.

In the course of a lifetime, something like 20-40 tons of food pass through our gastrointestinal tract and from it we must extract the nutrients which keep us alive and healthy, whereas any possible harmful substances must be removed. This involves a very complex process which can be subdivided into 4 phases, in each of which some problems can arise with the risk of nullifying the whole process.

1. Digestion and absorption—> the lack of enzymes can compromise digestive capacity, hence the absorption of nutrients.

2. Intestinal barrier function—> the intestinal wall acts as a barrier and as a filter which separates the external part from the internal part of the body, in a similar way as the skin. The intestinal filter allows only certain substances to penetrate inside the body tissues. When this mechanism is altered, also the capacity to distinguish among the substances to absorb and those to keep out of the body and to eliminate through faeces is lost. This leads to the presence of substances inside the body which activate our immune system, which can become unstable and give rise to a series

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of abnormal reactions even against healthy tissues, as is the case of self-immune diseases.

3. Immune protection function—> besides being very rich in nervous tissue, our intestine contains GALT (gut associated lymphoid tissue), a fundamental component of the immune system which represents about 60% of our defences.

The main task of this apparatus is to create a first defence against external agents such as bacteria and toxins. When this function is not carried out or is altered, the immune system is chronically activated, creating in its turn chronic inflammation response.

4. Symbiotic function with probiotics—> the colon also contains a great amount of bacteria which form a symbiotic relation with the body hosting them and which support the digestive and immune functions. When protective bacteria are inadequate, there is an increase in the number of harmful bacteria, which instead alter the intestinal function, leading to swelling and weakening the immune system.

Owing to the complexity of the intestinal functions and to the frequent occurrence of the symptoms connected with it, the gastrointestinal tract is an important starting point for a preventive and healthy approach to the patient.

Besides, the “leaky gut” phenomenon can lead to a series of

IL TEST DIAGNOSTICO PIU’ COMPLETO PER VALUTARE LA SALUTE DEL TUO INTESTINO INFLORA SCAN L’intestino è un organo caratterizzato da complesse funzionalità: digestione ed assorbimento di nutrienti, produzione di anticorpi per difendere l’organismo, produzione di ormoni e neurotrasmettitori che regolano il senso di fame e sazietà e il ritmo della peristalsi. Il benessere dell’intestino si traduce in benessere generale della persona.

La buona funzionalità intestinale dipende da numerosi fattori tra cui l’equilibrio della flora batterica, il sistema immunitario nella mucosa, l’assenza di stati infiammatori, la presenza di batteri patogeni, virus o miceti.

INFLORA SCAN è un test innovativo, completo e non invasivo che valuta la presenza di microorganismi patogeni, specifici marker di infiammazione intestinale, capacità digestiva, permeabilità intestinale, funzione immunitaria intestinale e disbiosi.

NATRIX È IL LABORATORIO DI ANALISI DI RIFERIMENTO PER VALUTARE LA SALUTE DELL’INTESTINO.

INFLORA SCAN è consigliato a tutti, per valutare il benessere dell’intestino e particolarmente utile a chi soffre di diarrea o stipsi, gonfiori addominali, tensioni e crampi addominali, flatulenza, infezioni genitali ricorrenti (candida), malassorbimento, difficoltà digestive, a chi conduce ritmi frenetici e stressanti a chi ha una alimentazione scorretta, ricca di cibi raffinati e povera di fibre.

INFLORA SCAN è indicato anche a chi soffre di patologie croniche non intestinali, in quanto un disturbo o un’infiammazione intestinale si può ripercuotere a livello di vari distretti dell’organismo: mal di testa ed emicrania, stanchezza cronica, stati di ansia e sbalzi di umore, problemi dermatologici.

Natrix Lab: il laboratorio certificato (UNI-ENI-ISO 9001 : 2000) di riferimento per le tue analisi personalizzate: • FOOD INTOLERANCE TEST: valutazione delle intolleranze alimentari IgGmediate, metodo ELISA. • CELIAC TEST: Valutazione immunitaria della positività al morbo celiaco.

• ANTIAGING PROFILE: (Free Radical Test + Antioxidant Capacity Test) valutazione globale dello stress ossidativo.

• CELLULAR AGING FACTORS: valutazione dell’invecchiamento cellulare (ossidazione, metilazione, glicazione, infiammazione).

• LIPIDOMIC PROFILE: valutazione del profilo lipidomico plas-matico e di membrana (acidi grassi).

• CARDIO WELLNESS TEST: analisi globale del benessere cardiovascolare, integrato con l’indice di rischio di contrarre patologie a carico del sistema cardiovascolare.

• ZONA PLUS TEST: valutazione del rapporto (AA/EPA), Glicemia, Insulina, indice HOMA. • HORMONAL PROFILES: dimagrimento, stress, sport, buona notte, donna fertile, donna menopausa, uomo.

• MINERAL EVO: valutazione approfondita di minerali nutrizionali e metalli pesanti su capello.

Tutte queste analisi sono eseguibili anche tramite un semplicissimo prelievo capillare o salivare.

L’Accademia del Fitness negative consequences on various levels. Some conditions associated with the presence of leaky gut are psoriasis, steatohepatitis, arthritis, the metabolic syndrome and many forms of allergy.

The elimination diet is part of a wider 4R programme, a real protocol of gastrointestinal recovery divided into 4 phases: 1. Remove: it consists in eliminating the most frequent food allergens and in following an elimination diet for at least 4-8 weeks. The diet generally includes the following food: vegetables, fruit, legumes, wholemeal rice, fish, poultry. All the rest is completely eliminated. At the end of this period, gradual introduction of one food at a time every 24-48 hours takes place to observe if any possible symptoms appear. It is sometimes also necessary to eliminate parasite or fungi infections but in general, during the elimination phase, many symptoms disappear in a high number of cases. In case of suspected candida infection, it is useful to use the fungus saccharomyces boulardii.

2. Replace: it can sometimes be necessary to replace the lack of digestive enzymes which make digestion and the absorption of nutrients ineffective. The lack of digestive enzymes often results in constant abdominal swelling associated to cramps, a feeling of heaviness and of being full up after meals. The enzymes which can be used are pepsin, responsible for protein digestion, amylase, useful for carbohydrate degradation, trypsin and chymotrypsin and other proteolytic enzymes, lactase, necessary to metabolize lactase and lipase, responsible for fat degradation.

3. Re-inoculate this phase consists in the introduction of probiotics into the intestine to re-establish the proper bacterial flora. At present it is possible to establish the presence of dysbiosis by means of some urine tests of organic acids.

Once the problem is identified it will be necessary to use the

most useful bacteria branches and start a sufficiently long therapy to allow real restoration of the bacterial flora.

4. Repair: the 4R programme also considers the repair of the barrier functionality which, if compromised, leads to the already mentioned “leaky gut” phenomenon. Also in this case there are specific laboratory tests which can evaluate if we are in the presence of colander intestine. The test consists in swallowing a mixture of sugars (lactulose and mannitol) and analyse urine to detect the presence of these sugars. If lactulose, which has higher molecular weight, is found in urine, we are in the presence of “leaky gut”. At this point it is necessary to intervene with nutrients which can repair the barrier, optimizing the function of enterocytes. For this reason, some probiotics are employed such as inulin, ramified amino acids, glutamine, proteins of milk serum containing lactoferrin, omega 3 fatty acids and substances such as aloe and curcumin.

In the course of a lifetime, something like 20-40 tons of food pass through our gastrointestinal tract

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The 4 R programme represents a valid and complete intervention protocol to restore gastrointestinal functionality.

Considering the high number of people who suffer from intestinal symptoms and the amount of prescribed drugs in the attempt to arrest the phenomenon, it would seem logical to propose a more structured intervention which can attack the problem at its root. We also know that many aspects of our health in general depend on the health of our intestine. The 4R programme can therefore be considered as a fundamental prevention path.

Dr. Filippo Ongaro Board Certified Anti-Aging & Regenerative Medicine (ABAARM) Diplomate Functional Medicine (AFMCP) Certified Practioner International School of Gynecological Endocrinology (ISGE)

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L’Accademia del Fitness

ANTI-AGING

CHRONOMORPHOLOGIC DIET In the last decades the metabolic syndrome (MS) has become one of the most important pathologies and cause of death in industrialized countries. According to the WHO, the MS is characterized by abdominal obesity, dyslipidemia, hypercholesterolemia, artery hypertension and insulin resistance. Perspective studies carried out in Italy show that about 19% of people over 45, not suffering from diabetes, could be suffering from the MS. From a deep analysis of this pathology it appears that obesity is the main predisposing factor of the MS. The excessive increase of body fat and in particular of visceral fat is correlated to the appearance of many pathologies, among which insulin resistance.

The adipose tissue can in general be considered as an endocrine organ which secretes chemical mediators by which it is in turn influenced and, among these, there are certain hormones which influence its accumulation or decrease.

Cortisol, for instance, determines the increase of fat, not only visceral, in the central area of the body and it also interferes with other hormones such as GH and testosterone, besides fostering insulin release by the pancreas, thus creating insulin resistance.

In the randomized study “VARIATION IN BODY COMPOSITION AND FAT LOCALIZATION IN RELATION TO TESTOSTERONE CORTISOL AND ESTRADIOL LEVELS,” by A. Angelozzi; M. Spattini, carried out on 50 male subjects, it emerged that testosterone is the hormone which is mostly correlated to visceral fat (p<0.03). Therefore, low levels of this hormone are associated with a greater amount of visceral fat. Instead, as far as cortisol is concerned, no significant correlation was found, although there are many studies which associate high cortisol levels with the increase of visceral fat.

In the specific case of this study we must keep in mind that the subjects with high cortisol levels and normal levels of visceral fat also presented very high testosterone levels, therefore it seems that testosterone is the most determining hormone in men as far as visceral fat is concerned. With aging there are hormonal modifications such as testosterone and GH decrease, and insulin and cortisol increase.

These hormonal modifications contribute to the increase of visceral fat, thus starting a cycle which fosters the metabolic syndrome.

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PARMA 29-30 novembre 2014

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DietaCOM ADVISOR RELATORI Giovanni Montagna - Massimo Spattini CERTIFICAZIONE Alla fine del Workshop verrà rilasciata la Certificazione di “DietaCOM ADVISOR” previo superamento del test scritto finale ECM Sono stati richiesti al Ministero della Salute i crediti ECM per le figure professionali di: Medico Chirurgo, Biologo, Dietista, Farmacista RESPONSABILE SCIENTIFICO Massimo Spattini PROVIDER ECM AKESIOS GROUP S.r.l. - www.akesios.it SEGRETERIA Scientifica e Organizzativa AFFWA - Galleria Crocetta 9/A - 43126 PARMA Tel. 0521 1682083 - Fax 0521 294971 accademia-affwa@libero.it www.accademiadelfitness.com

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Endocrinologia generale Valutazione della composizione corporea Ritmi circadiani Dismetabolismi implicati nel sovrappeso Basi fisiologiche del dimagrimento Influenze ormonali sul deposito localizzato di grasso Attività fisica e dimagrimento localizzato Impostazioni pratiche di valutazione della composizione corporea Prove pratiche di formulazione Diete Integratori alimentari e dimagrimento Prove pratiche di integrazione alimentare

L’Accademia del Fitness The only way to invert this process is to lose weight and above all visceral fat, which is not easy, since hormonal modifications, which are the cause of fat increase, are also factors that slow down the physiological response to weight loss stimuli. Therefore, it is more than ever necessary to adopt a lifestyle that can balance the correct metabolic functionality altered by unhealthy and dissonant evolutionary signals.

The chronomorphodiet or DietCOM has the aim of reducing body and also visceral fat. To achieve this end, it has been suggested to move the calorie intake deriving from carbohydrates to the evening meal, since carbohydrates increase serotonin levels and therefore melatonin levels, and favour an improved physiological sleep and also a reduction of hypercortisolemia in the morning and of hyperglycaemia, which is common in hyperlypogenetic subjects who present an accumulation of android fat, that is “apple-shaped”.

A 2011 study (Greater weight loss and hormonal changes after 6 months diet with carbohydrates eaten mostly at dinner. Solfer S., Eliraz A.) was carried out on 78 Israeli policemen with a body mass index over 30. They were divided into 2 groups and were submitted to two different diets: the first group was given a Mediterranean diet with carbohydrates subdivided in the daily meals, while the second group followed a diet in which over 70% of the total carbohydrates were included in the evening meal.

The results showed that in the experimental group the improvements both at anthropometric level (BMI, abdominal circumference) and at hematochemical levels (IL-6, leptin, adiponectin, LDL, HDL) were significantly higher compared with the control group.

The authors of this study believe that these results, in the group who received carbohydrates at dinner, were due to a greater production of adiponectin which is an anti-inflammatory hormone, which explains the decrease of inflammatory markers and the improvement in insulin sensibility. Moreover, the stimulus of leptin, which is an anorexiant hormone, due to the insulin peak provoked by the evening dinner rich in carbohydrates, should favour a higher leptin level during the day, which would result in eating a minor amount of food.

The problem is that these subjects, above all if obese, present also leptin resistance and therefore the possible leptin increase does not have the desired anorexic results.

At this point a consideration comes spontaneous: even if the key to this study were leptin stimulation, as the authors suggest, and considering that its effect is mainly on appetite modulation - which has a fundamental role when following a diet protocol - this does not justify the fact that the subjects who had carbohydrates for dinner and who received the same amount of daily calories (1300- 1500) lost more weight compared with the ones who had carbohydrates in the meals throughout the day. Cortisol sets in here: these obese subjects probably belonged to the

With aging there are hormonal modifications such as testosterone and GH decrease, and insulin and cortisol increase

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hyperlypogenetic morphotype characterized by android obesity type with prevalent activation of the hypothalamus-hypophysissuprarenal axis and therefore greater production of cortisol.

Moreover, carbohydrates foster serotonin production and, as a consequence, of melatonin production, which has an inhibiting effect on cortisol production. This is not irrelevant although someone might say “I don’t mind being hungry on a diet if I get a result in the end”, but the problem is that chronic “appetite” generates chronic stress, and cortisol secretion induced by chronic stress favours an even greater increase of abdominal visceral fat rather than subcutaneous fat. Without doubt in hyperlypogenetic subjects who tend to be cortisol –responderstress correlated, this mechanism is particularly effective.

Doctor Massimo Spattini Specialized in Sports Medicine Specialized in Food Science Board Certificate in Anti-Aging & Regenerative Medicine (ABAARM-USA) Certificate AFMCP (Applying Functional Medicine in Clinical Practice) - (IFM-USA)

number 14 / 2014

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21

L’Accademia del Fitness

SEXERCISES

A normal sexual response depends on the perfect orchestration of many factors… In fact, it is a very complex phenomenon above all in males and, until a few decades ago, it was not fully understood.

Today we are aware that there can be problems in each of its phases… but this would take a long time!

However, leaving aside for a moment psychological, iatrogenic, neurologic, endocrine or post-surgical causes, erectile dysfunctions can be linked to the blood flux in the pelvic zone, in both sexes.

In the last years scholars have stated that a man of 40 with erectile defiictneeds to be immediately examined for possible concomitant cardiovascular problems. They even indicate specific «timing»: a recent study by Jackson from London BH has underlined that E.D. can occur from 2 to 5 years before a significant cardiovascular event.

The link between the two conditions can be explained by the size of the arteries, whose diameter in humans differs significantly, from the penile ones (1-2 mm) to the wider ones such as

22

the femur ones (6-8 mm). So, it is possible that in the smaller ones vessel obstructions caused by atherosclerosis due to unhealthy life styles can have more important effects and in less time. This hypothesis was spread by our Montorsi and supported by many other researchers: one of the most well known studies is by the Canadian Meldrum, and its title is very meaningful: “The canary in the coal mine”! However, not everybody agrees with this theory which, actually, has recently been disproved by Ponholzer and colleagues, who carried out a very interesting screening based on a rather high number of autopsies which took place in a Vienna hospital: it was discovered that actually the penile arteries were less atherosclerotic than other ones.

Yet, the authors conclude by saying that the vasculogenic erectile deficit was probably due not to an obstruction on penile level, but «but on a level up», on the level of the iliac arteries.

Anyway, the penis received an insufficient amount of blood all the same! The diminished blood flux with consequent low level of oxygen and accumulation of sclerotic plaques slowly damage (also) the corpora cavernosa, causing stiffening (sclerosis) and

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L’Accademia del Fitness reducing their elasticity. In some cases the changes can be so massive that the cavernous structures become completely inflexible and can receive but minimum amounts of blood...

We must keep in mind that in the penis at rest there is little oxygen, while during erection its pressure rises by 3-4 times together with blood… the constant presence of oxygen is important for the smooth muscular system and the corpora cavernosa, as it prevents tissue hardening, a problem which is also common in diabetes. Night erections, for instance (3-5 per night) seem to be a mechanism of Nature to maintain the sexual organs fully efficient and avoid this type of stiffening.

Moreover, other problematic complications can occur: for instance, the outflow can be excessive, due to malformations or, much more often, due to factors acquired after the formation of atherosclerosis.

The less elastic corpora cavernosa can even reach the point of not pressing the veins properly, which contributes to create a serious impediment to the outflow of blood, especially in association with the loss in tone of the pelvic muscles.

Furthermore, oxygen is very important for the correct release of nitric oxide [it is possible that men with significant obstruction of the penile arteries may not be able to increase arterial flow (and, therefore, intracavernous oxygen tension) to sufficient levels to fully activate NO synthesis in the corpora. The inability to relax the trabecular smooth muscle would lead to impotence.

Oxygen tension regulates the nitricoxide pathway. Physiological role in penile erection, Kim et al]. Therefore, in case of its reduced presence the smooth musculature cannot fully relax and the hollow spaces of the erectile tissues cannot fill properly, and… not even the famous blue pills (the inhibitors of phosphodiesterase) can perform miracles in this situation.

In these cases, a differentiated flux (with phases of maximum congestion alternated with normal flux) can be useful to “train” the pelvic and penile blood vessels to congestion and to maximal erection pressure and it can also lead to moderate angiogenesis (even if not on the level of that which can be obtained with angiogenic growth factors).

As far as the outflow is concerned, the activity of all the pelvic floor (particularly of the ischiocavernosus and of the bulbospongiosus) contributes to increase up to 100 times the resistance of the veins to blood outflow. In the most severe cases of deficit due to excessive outflow, patients are operated and some veins receive a resection… In less serious cases a ring is applied at the base of the penis and it is tightened so hard as to reduce an excessive blood outflow, but it cannot be “worn” for too long.

As already pointed out, it is not possible to deal with this subject thoroughly here. However, as for prevention, apart from a healthy diet and correct physical exercise (both “cardio” training and using loads) there is no other more specific training. Some studies by the German urologist Dr. Sommer, carried out on pa-

tients with venous deficit, have shown that training involving the ischiocavernosus and the bulbospongiosus can have very good effects on penile stiffness: over 25% increase, with an increase in the electric activity which increased together with the stiffness of the penis. Besides, also the outflow decreased significantly. Training varied between «erection stableness» and «blood flow»: in case one prefers to effect both in the same session, it is always advisable to do the exercise in the above order, since the increased flux (which lasts also after the sessions) could be nullified by the muscular contractions which are necessary in sessions with loads.

In fact, one of the goals of sexercise is the search of this varied inflow which takes place during a targeted training session.

For many years protocols that included only Kegel exercises were followed, sometimes with the help of small intervaginal or interrectal weights: by doing so we run the risk that pelvic musculature becomes too strong and contracted compared with other muscles. It would be better to plan training sessions of contiguous muscle groups, of antagonists, and also a phase of stretching, since too much tension can be problematic (this also applies to psychological tension…)

A training programme which takes into account the various studies so far carried out should include a series of exercises with

In the last years scholars have stated that a man of 40 with erectile defiictneeds to be immediately examined for possible concomitant cardiovascular problems.

24

CONOSCERE CIO’ CHE MANGI

TI RENDE LIBERO FOOD INTOLERANCE TEST Le intolleranze alle proteine alimentari, dette allergie ritardate, sono reazioni conseguenti l’introduzione di alimenti di consumo comune. Queste reazioni sono causate da un’iperproduzione di immunoglobuline di classe G (IgG).

Emicrania, disturbi gastro-intestinali e respiratori, stanchezza cronica, dermatiti, irritabilità, sovrappeso, sono solo alcuni dei sintomi ricorrenti nei soggetti affetti da allergia ritardata.

Il FOOD INTOLERANCE TEST (F.I.T.) di Natrix permette di verificare la reazione dell’organismo nei confronti di 46, 92 o 184 alimenti. Ciò che ha reso il F.I.T. affidabile è la metodica analitica ELISA,

affidabile e ripetibile e la lunghissima esperienza di Natrix nel campo della diagnostica delle intolleranze.

celiaci, per il monitoraggio della malattia celiaca in soggetti che seguono una dieta priva di glutine.

CELIAC TEST

Natrix Lab: il laboratorio certificato (UNI-ENI-ISO 9001: 2000) di riferimento per le analisi:

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Il CELIAC TEST è una prova allergometrica che consente di effettuare un saggio di I° livello completo per la celiachia.

Il CELIAC TEST è consigliato in caso di sospetto di malattia celiaca, in familiari di primo grado (genitori, fratelli) di soggetti

• • • • • • • •

FOOD INTOLERANCE TEST CELIAC TEST ANTIAGING PROFILE CELLULAR AGING FACTORS LIPIDOMIC PROFILE ZONA PLUS TEST CARDIO WELLNESS PROFILE PROFILI ORMONALI

Tutte le analisi sono eseguibili anche tramite un semplicissimo prelievo capillare e salivare.

L’Accademia del Fitness weights (also floor exercises in the case of untrained subjects) which involve both the pelvic floor muscles, the abdominal floor and the synergic muscles, in particular all the gluteal and thigh muscles, which must be performed within specific recovery time and also some cardio exercises such as interval training ones, but always with well defined exercise/rest periods.

What makes the difference is the correct application of specific parameters between the two phases: the prolonged presence of big amounts of blood “in the area” allows us to obtain the best results. Pauses must not be too short in order not to lose the benefits of the increased blood inflow.

Better results also depend on the right choice of the equipment and of the exercise: for instance, narrow saddles or rowing machines for “cardio” phases should be avoided, while

Better results also depend on the right choice of the equipment and of the exercise

in the weight- room squat, lunge, Romanian deadlift exercises are advisable, as well as floor exercises (various types of leg and pelvic lifting exercises above all for the less trained subjects), while as for abdominal muscles, particular attention should be given to respiration in order to involve in the proper way the abdominal transverse.

The training session obviously includes specific contractions involving ischiocavernosus and bulbospongiosus, the control of which is not really… automatic, so it must be trained. However, in only a few sessions, thanks to some simple strategies, it can be easily achieved.

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26

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30/12/11 09.24

L’Accademia del Fitness

THE IMPORTANCE OF ORGANIC AND MUSCLE TESTS

IN ANTI-AGING CHECK-UP

An overall check-up and the creation of a document giving information on the subject during all his/her activities, with constant monitoring of each phase of growth, of coordinated and targeted planning of the training sessions, of the diet and needs are of fundamental importance in order to achieve harmonious development and to contrast many of today’s pathologies, coping with all the stages of one’s life with greater psycho-physical well-being.

This information is necessary for the creation of a personalized report containing all the obtained results and all the areas requiring any therapeutic intervention.

Every intervention is multi-modal and integrated, and it is composed of medical, motor and psychological elements.

Anti-aging medicine claims that real health does not simply consist in the absence of a disease, but rather in the presence of physical, mental and psychological wellbeing. Therefore, the aim of this new branch of medicine is to supply scientifically validated strategies to slow down aging, prevent chronic diseases and improve health conditions in general. It is important to become aware of one’s biological clock, of the correspondence between real age and biological age, to consider early diagnosis and to be informed on the alteration degree of the biological markers of aging in order to elaborate a personalized therapeutic and motor programme with the aim of improving the functionality of the body systems and to slow down, within

28

certain limits, some degenerative processes due to aging.

The check up has the aim of passing from disease medicine to prevention and predictive medicine by using physical exercise as a real cardio-active, preventive therapeutic drug. It is possible to determine its posology only by dosing correctly the dose-response curve and by measuring its effects.

Strength tests allow us to consider the maximum values, the lack of balance between homologous limbs, between agonist and antagonist limbs, to rebuild the natural patterns of muscle activation, and to identify the Power (dynamometer) of the various zones. They are a useful guide in order to plan personalized sessions. Strength and power are associated to the identification of silent metabolic pathologies, of osteo-muscular-articular algia, of static and dynamic functional incapacity and senile pathologies. We know there is a strict relation between muscle mass, muscle strength, appendicular muscle mass and metabolic syndrome.

Training strength means measuring properly the dose-response relation according to the aim. It is essential and can only be achieved through the application of accurate monitoring.

Strength training is the only means by which we can efficiently contrast muscle mass loss producing anabolic responses, inducing hypertrophy, increasing strength and contractile power, stimulating the specific neuro motor capacity of muscular fibre recruitment, thus allowing both an improvement in muscular

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L’Accademia del Fitness strength output and a positive action in slowing down denervation phenomena. Through proper-intensity stimuli it is possible to achieve an increase in strength, mass, muscular power at any age and in any condition, fighting the appearance of pathologies and aging.

Also in the application of organic training sessions it is fundamental to effect incremental tests which allow to identify the ZERO point (starting level) looking for vo2max, the aerobic and anaerobic thresholds, the heart rate (at rest, maximum and recovery), arterial pressure and its variations.

Maximum oxygen consumption is the global and integrated measurement of the maximum exercise intensity which can be tolerated by a subject for periods of about 10 minutes. However, the seventh minute is generally considered as the “barrier”.

Basically, it corresponds to the amount of O2 that can be received, carried and used by the body.

Vo2max = FC X GS X ( Δa-v) .

The important component is the capacity to use a certain percentage of oxygen. It is not by chance that subjects with high vo2max values can achieve performances with a lower amount compared with subjects with lower vo2max values. This underlines the importance of taking this parameter into consideration before applying any methods (HIT high intensity training or CON continuous) depending on the target and with proper dosage.

Other fundamental parameters to detect in organic tests : exercise capacity: the most powerful predictive factor of death.

Exercise length: exercise length suitable to age indicates a favourable prognosis. In asymptomatic patients, for example: the presence of a sub-levelling of the ST tract within the first six minutes of treadmill test according to Bruce protocol is associated to a 6.7 relative risk in males and a 3.6 relative risk in females; if such sub-levelling occurs within the first 5 minutes of the protocol, the relative risk increases to 14.7 in males and 5.6 in females.

Heart rate: HR modifications during exercise and during the post exercise recovery period are due to the balance between the activities of the sympathetic and the vagal systems. During the post exercise recovery phase, in normal subjects, HR decreases with a kinetics similar to that of its increase.

Chronotropic incompetence: Chronotropic incompetence is given by a lower response of HR to exercise. As an index of chronotropic incompetence it is possible to use the incapacity

to reach 85% of theoretical HRmax or the chronotropic index <0.8 Arterial pressure: Normally arterial systolic pressure (ASP) tends to increase by 5-10 mmHg for each MET sustained; in a middle-aged patient with a medium tolerance to efforts we can expect a 40-60 mmHg increase, with a peak of 160-200 mmHg. Diastolic arterial pressure (DAP) is generally unchanged or can present a slight increase or decrease.

During recovery phase ASP should normalize within 6 minutes and can also decrease to lower values than basal ones for some hours.

The importance of these physical tests, together with all the other anti-aging check up tests, lies in the fact that they give information concerning the structural-organic-muscular-genetic weaknesses which “affect” us throughout our life.

Therefore, they give us information on Healthy-Aging specifically and on the risk of contracting some cardio-vascular, neurodegenerative, metabolic and aesthetic diseases.

Strength and organic tests, by indentifying the zero point, allow us to perform physical exercise in the best of ways considering it as a real therapy with specific pleiotropic properties, that is, which can have both therapeutic and preventive effects.

The importance of these physical tests, together with all the other antiaging check up tests, lies in the fact that they give information concerning the structuralorganic-muscular-genetic weaknesses which “affect” us throughout our life

30

Prof. Davide Antoniella ISEF Diploma and Athletic Trainer

L’Accademia del Fitness

SARCOPENIA AND

THE DISABLING CONDITION IN THE ELDERLY We know that we are inevitably bound to a gradual process of aging in which our body composition changes, making us weaker and exposing us to diseases.

Aging is a physiological process which we can accelerate but also modify or slow down, which is one of the tasks of antiaging medicine.

In the course of my anti aging studies, I have often come across terms such as sarcopenia, dynapenia, osteopenia, which are all events directly correlated to the process of aging and they are all somehow connected in their origin and evolution.

In particular my intention is to investigate the term “Sarcopenia”, above all because it is one of the most evident phenomena which conditions the mobility and the autonomy of elderly people.

The term sarcopenia derives from the ancient Greek words sarx (flesh) and penia (loss). The term was used for the first time by Irwin Rosenberg in 1989, even if already in 1700 the term was used to refer to the process of the loss of muscular mass and strength.

32

Until recently, by “sarcopenia” we meant the loss of muscular mass and strength, but today we tend to distinguish the two processes and sarcopenia is referred to as only the loss of mass, while to define the loss of muscular strength, the term “dynapenia” is used.

The definition “sarcopenia” today refers to the clinical loss of muscular mass and it is the result of a metabolic condition in which muscular catabolism is activated for the survival of the individual. This catabolism is not counterbalanced by a sufficient protein synthesis which can maintain the integrity of the muscular mass.

Baumgartner, together with Rosenberg, was one of the greatest researchers of sarcopenia. He claimed that this physiological phenomenon involves cellular modifications leading to the weakening of factors which promote muscular anabolism and increase the expression of inflammatory factors and of other agents which contribute to muscular and skeleton catabolism.

From the cellular point to view, these molecular processes present a loss of cross sectional muscular fibres, innervation loss

number 14 / 2014 and adaptive changes in the proportions between slow and fast motor units of the muscular tissue.

In short, these alterations become collective modifications of muscular mass, strength and function, even including a reduction in physical abilities, disability, increase in risks of lesions caused by falls and by a state of chronic fragility.

We know that elderly people often risk falling due to their condition of chronic fragility. One of the facts which unfortunately accelerates the aging process is that old people often fall and break their femur bone, the etiopathology of which is correlated to bone density, but sarcopenia often contributes to its evolution.

There is an interesting study which summarizes the various phases of sarcopenia in a graph represented by a circle where the various stages follow and repeat in a degenerative process Increase in the risk of falls

Further reduction of muscular mass

Reduction of muscular mass

Feeling of higher exertion

Less physical activity Pic.1 Evolutionary process of Sarcopenia triggered by sarcopenia: When and why does the process of sarcopenia start?

We know that sarcopenia starts to appear around the fourth decade of life, leading to a 3-5% loss of muscular mass within 50 years of age and then to a 1-2% loss every year. A trend that in about 40% of subjects leads to a 50% muscle reduction before they are 75 years old, with a slightly higher percentage in men. All this, in the light of the improved life expectations made possible by the enormous advance in intervention medicine and drugs, often leads elderly people to live longer than in the past but often in conditions of disability.

The etiology of sarcopenia is not fully understood but many mechanisms have been suggested.

A 2009 study by T. Lang deals with the etiologic aspects and the mechanisms of appearance of sarcopenia. It seems to be due to cellular alterations such as for instance the decrease in the number of muscular cells, the reduction in the volume of the sarcoplasmatic reticulum and a decrease in the amount of calcium.

This study shows that the plasmatic membrane of the muscle

becomes less excitable and there is a significant increase in the accumulation of fat inside and around the muscle cells, while there is a decrease in the number of motor neurons and in the regenerative capacity of the nervous tissue.

In the same study T.B Harris points out that in the mitochondrial DNA, deletion mutations appear as a consequence of oxidative damage, reduced synthesis of mitochondrial proteins probably connected to a reduction of the enzymes involved in the glycolysis processes, a reduction in the availability of creatine phosphate and of the ATP reserves inside the muscular cells.

We have known for a long time that a variety of hormonal changes occur with aging and these changes can contribute to muscle loss.

We recognize for example that in men testosterone levels are already in the decreasing phase at the age of 30; in about 60% of men over 65 the levels are below normal values.

Since testosterone increases muscular protein synthesis, muscular mass and strength, it has been suggested that the decrease in the plasmatic levels of testosterone contribute to the loss of muscular mass.

Also the GH growth hormone and the IGF1 hormone present a decline in the normal course of aging.

The concentrations of dehydroepiandrosterone (DHEA) in the blood gradually diminish with normal aging. The levels can decrease to five times the values we can find in youth.

The capacity of the muscular tissue to respond to insulin is another important aspect involved in the phenomenon of sarcopenia. In fact, the incidence of insulin resistance and type 2 diabetes increases with aging and sarcopenia can play an important role.

The concentrations of dehydroepiandrosterone (DHEA) in the blood gradually diminish with normal aging.

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Lâ&#x20AC;&#x2122;Accademia del Fitness

Pic.2 Scheme of the evolution of the muscular-hormonal changes Sarcopenia can appear alone, contributing to make any other concomitant diseases more serious, but also as a consequence of chronic diseases. Obesity, for instance, is a condition which contributes significantly to induce disability by presumably accelerating the appearance of sarcopenia.

Sarcopenia is not a physiological process limited only to old people and it is not just a consequence of old age. For example, we can observe processes of muscular decline also in younger people obliged to a phase of convalescence after an operation or due to some illness which makes it impossible for the patient to perform any physical activity.

Moreover, aging is associated to a progressive decrease in the amount of food which is consumed and this leads to protein malnutrition; we often observe that elderly people voluntarily reduce their amount of food, eliminating above all proteins from their diet.

Therefore, nutritional interventions can represent, at least potentially, a means of prevention and treatment of sarcopenia in elderly people.

Many studies suggest that the essential amino acids are mainly responsible for the stimulation of protein synthesis, in particular leucine. Therefore, long term integration with essential amino acids can be a valid instrument to prevent and treat sarcopenia.

Several studies have shown that resistance exercises in old age can lead to substantial improvements in muscular strength and in their global functional condition. For subjects who do not tolerate or are not willing to do any physical exercise, drugs like

34

Testosterone, GH o IGF - 1 can become potential instruments against sarcopenia. The inhibition of myostatin and selective modulators of androgen receptors, even if still in an experimental phase, can represent promising instruments for sarcopenia regression.

Rosenbergâ&#x20AC;&#x2122;s reasons for the creation of a medical term for the loss of muscular mass in old age was to bring greater awareness and attention to this problem, which has been very undervalued and not sufficiently investigated.

Also thanks to the evolution of Antiaging medicine, today the problem is studied under a different profile, not generically geriatric. Attempts are made to put into practice prevention strategies which can slow down the process, preventing conditions of irreversible structural modifications which inevitably lead the elderly to live long years in a condition of disability without any autonomy.

The creation of those conditions in which the elderly can live in a state of wellbeing most of their last years of life, hence the reduction of that interval between the appearance of a disease and the inevitable end of life, might go through the study of the event to which Rosenberg gave a name in the far 1989.

Antonio Polito Dott. Antonio Polito Biologist and Nutritionist

L’Accademia del Fitness

TRAINING

WITH KETTLEBELLS The kettlebell is a tool of Slavic origin. Its original name is “girya” (pron. “ghiri”). It looks like a cannon ball, with a handle and a flat bottom. This word first appeared in a 1704 Russian dictionary, and it is an evolution of the spheres that the strongmen of the time used in their training.

Its weight varies and is measured in “pood”, Russian unit of measurement corresponding to 16 kg. It has now become an integrating part of the training of young people and adults in the former Eastern Europe, thus increasing the fitness and resistance of these populations.

The versatility of the kettlebell lies in the fact that it is possible to train almost everywhere. Also, it is not bulky and it allows the performance of a very wide range of exercises to train strength, resistance, balance, flexibility and to increase muscle mass.

Moreover, above all in women, it is useful to tone and protect the bones against osteoporosis.

The kettlebell became part of national competitions in the first half of the twentieth century, when many weightlifters used it for their training sessions. This discipline counts many champions, some of whom in modern times. Among them we must remember Pavel Tsasouline and Oleh Ilika, to whom we owe the spread of kettlebells in Italy.

Kettlebells are at the basis of athletic training for both Soviet and American special forces, thanks to the abovementioned features and also because this training is great to enhance the strength of the hip extensor chain – main position of strength of the abdominal muscles and of the finger-hand-forearm block.

36

The kettlebell can easily replace dumbbells and barbells, since the possible exercises activate long articular chains which are generally trained in all performance sports.

The fundamental aspect in this kind of training is core control, that is, the control of the abdominal muscles, whose main function is stabilization, rotation, torsion, side inclination and spine protection.

Also, they allow shoulder relaxation and flexibility, since the strength goes from the lower limbs to the upper limbs through the clavicle-glenohumeral joint.

In order to understand what this tool can do it is necessary to underline the fact that simply by handling it, trying to move it around, considerable results can be achieved. However, people must rely on experts in order not to get injured.

Training with kettlebells is based on strength and exercise duration. Also, the tool is constantly working against gravitational

number 14 / 2014

force. However, the progression of load, weight and intensity must be gradual.

Let’s see the main beneficial effects of this discipline, besides the already mentioned ones: • Since it is intensity that leads to results, it is possible to achieve big changes in little time • increase in lipolysis • increase in resistance • training affects all the energy systems • Enhancement of sport performance • improvement of the cardiovascular and respiratory systems • increase in the functionality of the whole body

When approaching kettlebell training, it is important to learn the proper way to perform the exercises. Technique is fundamental to achieve safe results without unpleasant injuries

When approaching kettlebell training, it is important to learn the proper way to perform the exercises. Technique is fundamental to achieve safe results without unpleasant injuries. The basic exercises must be repeated assiduously before introducing variations of any kind. Only by doing this it is possible to learn how to master the tool in the best way. Respiration has an important role, too. It gives rhythm to the movements and it can be of two types: diaphragmatic and anatomic.

The first one is based on inspiration in the eccentric phase of the movement.

The pressure within the chest will protect the spine (ex. in the squat you must breathe in while going down and breathe out when going up). Instead, the second one is used in the concentric phase of movement and breathing out takes place in the eccentric phase (ex. in the snatch you must breath out when going down and breathe in when going up).

It is important to do some stretching at the beginning and at the end of every training session.

EXERCISES Let’s see the main types of exercises to perform with kettlebells: • Ballistic: they aim at developing inertia and explosiveness because they work on the elastic component of the muscles, above all of the lower limbs and of the hip extensor chain. For example the swig, the clean and the snatch.

• Press: these exercises are based on stretching out the weight above one’s head. They allow the synergic work between lower and upper limbs. Examples: Jerk, bent press, push press, side press.

• Overhead: they must be carried out by keeping the kettlebell above one’s head, always looking towards the tool, like in the overhead squat, in the Turkish get up and in the windmill.

In conclusion, it is important to stress a small precaution to be taken before starting this type of training: use shoes with very thin soles, control that they do not have pads to cushion the ground or rather do your training barefoot. Shoes with a little heel or pad may unbalance you, thus causing back damage. Always take care of your hands, eliminate the corns which will inevitably form.

Giuseppe Notarnicola Fitness Consultant, Personal Trainer, Nutrition Educator

37

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LIVING IN BALANCE “ The aim of life is to live in harmony with nature” ZENO OF CITIUM Greek philosopher c. 336 B.C.- 264 B.C. A living being is an organism that is born, develops, competes, eats, reproduces itself... and eventually dies.

In ecology dynamic equilibrium is based on the principle of continuous transformation and adjustment to an ecosystem in constant evolution. Therefore, dynamic equilibrium is the ability to use energies and/or information in the best way with the fewest possible changes in the parameters taken into consideration. The balance of the natural environment is influenced by various factors which are generally differentiated into abiotic (“lifeless”), biotic (“vital”) and limiting (essential for the life of an organism). The complex interaction between these environmental factors and the other living beings is called ecosystem.

Hence, it is fundamental for the system to be in constant balance to preserve the ecosystems and life.

Balance can be distinguished into static and dynamic, but they are both integrated.

Someone who owns good balance is not someone who never loses it, but someone who can re-establish it quickly.

According to physics, a system is in mechanical equilibrium when the sum of all its external forces and that of all the external mechanical moments is null. The barycentre (or gravity centre) is the point where the weight of a body can be thought to concentrate on.

A) The barycentre of a cone is in its point of minimum height; a small blow would make it oscillate and then fall back in its equilibrium point (stable equilibrium).

B) The barycentre is it its highest point and any alteration of its precarious equilibrium condition would make the cone fall (unstable equilibrium).

C) The barycentre, with any little solicitation, would always remain at the same distance from the ground (indifferent equilibrium).

The term “POSTURE” derives from the Latin word: “positura” which meant “position - attitude”; “the price man pays for standing straight”.

The interacting factors are of the following nature: biomechanical, kinesiological, neurophysiological, psychomotor.

Posture represents a process of adaptation: “the personal adjustment of the subject to the physical, psychological and emotional environment”.

Orthostatic posture is maintained thanks to the wonderful organization of sensors which allow us to contrast the gravity force.

The balance sensors are: 1. The ear. Inside the ear we find some receptors placed in

38

a structure called “labyrinth” and they are stimulated by the movements and changes in the position of the head.

2. Muscles, tendons and articulations. Muscles contain receptors which pick up information on the length of the muscle according to its condition of stretching or contraction. In the same way tendons and articulations have receptors which detect the tension, pressure and the stretching of these structures.

3. The eye. The stimulations coming from our sight, through the optic nerve, are integrated by special nerve centres which have the function of adjusting balance.

However, going back to the question: What is a living organism?

We could define it as a being that is born, develops, reproduces itself and dies. But this is only a list of functions. Among the functions of a living being there is a very important one: movement. Therefore, we can give this definition: “an organism is alive when it moves”.

Thirty years ago my dream to open a gym came true and I gave it the name of “Life”.

Through this name I tried to express the idea of giving or regiving life to the body by means of movement.

Walter Bradford Cannon’s quote explains what he meant by homeostasis: The constant conditions which are maintained in the body might

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be termed equilibria. That word, however, has come to have fairly exact meaning as applied to relatively simple physicochemical states, in closed systems, where known forces are balanced. The coordinated physiological processes which maintain most of the steady states in the organism are so complex and so peculiar to living beings - involving, as they may, the brain and nerves, the heart, lungs, kidneys and spleen, all working cooperatively - that I have suggested a special designation for these states, homeostasis. The word does not imply something set and immobile, a stagnation. It means the capacity to go back to a condition of dynamic balance every time this balance is somehow compromised.

The control system of balance and posture are substantially the same and correspond to the control of muscular tone, thus forming the tonic postural system which has the task of allowing us postural stability both when we are still and while moving, adapting to the continuous environmental modifications.

In order to achieve this aim, the system makes use of a complex network of resources, subdivided into 3 levels: 1) sensorial receptors (cutaneous esteroceptors and proprioceptors, visual, vestibular and auditory) which position the various body parts in relation to the whole and to the environment; 2) superior centres (vestibular nuclei, cerebellum, reticular formation or substance, cerebral cortex) which integrate and re- elaborate the data coming from the above mentioned sources, combining cognitive and strategic processes (engrams); 3) effectors (oculomotor cranial nuclei from which the

oculomotor muscles receive commands for visual stability and the spinal marrow which sends direct signals to the motor plates of the skeletal muscles for antigravity stability).

However, balance can sometimes have surprises in store for us.

The term “ATAXIA” indicates a disorder in muscular coordination. The absence of motor control is a symptom of many complex pathologies. The origin of ataxia lies in an alteration of the genetic code; this gives rise to a series of events which inexorably, gradually but irreversibly alter the functions of the Central Nervous System (CNS), thus affecting the cerebellum and the areas connected to it, such as the cerebral trunk, the spinal marrow and possibly also the cerebral hemispheres. Ataxia could be due to more or less severe pathologies. Also lesions at the level of the dorsal vertebrae could cause it.

“DIZZINESS” is less serious, but it is another potential cause for balance loss. Dizziness is usually due to the detachment of “little pebbles” called otoliths in the ear, which can be removed through careful manoeuvres, thus making the symptoms disappear.

The law of Haeckell or law of recapitulation claims that: “an organism in the course of its development goes through the same successive stages (in abbreviated form) as did the species in its evolutionary development”.

During his evolution, man found himself facing an involution from the motor point of view, reaching a form of pathology: “HYPOKINESIA”. A sedentary life, the lack of physical activity, an unhealthy lifestyle, the accumulation of psycho-physical stress reveal an asthenic, hypotonic subject and, in most cases, overweight. In such situation, all our body parts become weaker and the risk of being affected by some typical pathologies of old age increases (heart diseases, respiratory deficit, metabolic and hormonal alterations, skeletal and neuro-psychological diseases). Our psychological structure must be seen as a development process which goes on throughout the cycle of life, where growth and old age are inexorable phases. In old age people tend to express the characteristics of their lifestyle.

Therefore, following a healthy lifestyle will allow us to have a healthy old age in the future. Also in this case it is nature which decides… but we can try to cope with the situation, above all through prevention and respect for “LIFE”.

The term “ATAXIA” indicates a disorder in muscular coordination.

The absence of motor control is a symptom of many complex pathologies.

40

Prof. Ciro di Cristino Qualified at ISEF; Teacher at the AFFWA National Courses; Teacher at the Training Course “Wellbeing and Lifestyles”: at Sapienza University in Rome; Teacher-Educator-Trainer of various Sport Disciplines.

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PROGRAMMA

■ ANTROPOMETRIA: misurazioni - plicometria ed impedenziometria ■ Biochimica ed endocrinologia dell’alimentazione ■ Alimentazione nell’attività fisica ■ Diete del Fitness: Gruppi sanguigni - Mediterranea Metabolica - Paleodieta - Warrior Diet - Dieta Zona ■ DietaCOM ® e dimagrimento localizzato ■ Integrazione alimentare ■ Intolleranze ed allergie alimentari - I Prebiotici ■ Alimentazione Antiaging ■ Programmazione neurolinguistica : l’aspetto motivazionale

Accademia Funzionale del Fitness - Wellness - Antiaging Tel. 0521.1682083 - Fax 0521.294971 accademia-affwa@libero.it

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QI GONG

THE ART OF RESPIRATION The term qigong means the technique of respiration or technique of the spirit. It is the art of making air circulate in the most suitable way to reach and maintain psycho-physical wellbeing.

In fact, it indicates everything that can be done to act on Qi: from physical exercise for the body, muscles, joints, internal organs, to the regulation of respiration, of the heart and mind; from the efforts made on oneself, on one’s inner self, to the efforts made in relation to the external world and to the human beings around us.

All the techniques of interior practice of the “body-respiration– mind” system correspond to Qigong, which is composed of the two ideograms: “Qi” and “Gong”.

Qi stands for ENERGY and contains all the energy sources such as food and air. It is also called vital breath. Gong stands for “practice” or “worthy work”, and it indicates all that can be done to act on Qi, from the physical effort on the body, muscles, joints, organs up to the regulation of respiration and of the mind.

The styles of qigong are numerous and differ first of all according to the philosophy of life they refer to. Therefore, we can find Taoist, Buddhist, Confucian schools. They also differ according to their aims: martial, medical and so on.

In this case we will concentrate our attention on medical qigong, which concerns the maintenance of health, the prevention of diseases and the process of slowing down aging.

The practice of qigong is based on three fundamental pillars: the position and the use of the body, respiration and intention.

Posture contemplates dynamic or static techniques, or the position of the body in space, therefore in the position of lying,

42

sitting or standing.

Each of these variables will have an effect on the toning up or dispersing action of the exercise. Yang is movement and Yin is stillness. Lying positions will have greater influence on the lungs and on all their “energy activities”. Sitting positions will mostly have an effect on the spleen/pancreas organs and on the stomach. Standing up positions will mainly act on the kidneys, which are the depositaries of the so-called ancestral energy and acquired energy.

Therefore, the standing techniques are important for our lifestyle, owing to the need to “tone up” the kidneys which so often show deficit due to the psycho-physical stress of our industrial world.

What is important about the posture is how it is maintained, using some of the basic positions which we find in martial arts.

In particular, the knees must be kept flexed so that it is impos-

number 14 / 2014 sible to see the tip of the big toe. We should keep a vertical line which would guarantee greater stability. In the positions of movement the distance between the feet corresponds to the width of the shoulders.

Respiration is another fundamental pillar of qigong.

Using the nose or the mouth while breathing can modify the type of energy effect. If we breathe through the nose we give greater impact to tonification, while if we breathe through the mouth greater impact is given to the draining of excesses.

We know little about respiration, we breathe unconsciously and this does not allow us to focus on its meaning.

INSPIRATION

INSPIRATION

INSPIRATION

PAUSE

EXPIRATION

PAUSE

EXPIRATION

EXPIRATION

PAUSE

This table shows that there can be various types of respiration.

If we examine the first type, inspiration and expiration are repeated quickly and last the same time, producing an increase in adrenalin production. This type of respiration is called nerve respiration and prepares us to an escape, as we activate it in moments of fear and danger. By varying respiration mode and length, pauses included, different effects will be achieved.

Respiration can be thoracic or abdominal. By varying time intervals and modes of the way we breathe we can obtain many modulations of the exercises we perform.

Inspiration is generally intended as tonification, whereas expiration is intended as a way to drain excesses.

Another way of considering respiration is proposed by Roger Clerc, who analyses it according to a cycle of 4 seconds where each cycle is associated to an organ. The prevalence of a cycle

in the respiratory rotation allows us to underline deficit or excess in one of the organs. The cycle includes a first abdominal inspiration followed by thoracic inspiration then by an inspiration suspension, thoracic expiration, abdominal expiration and finally an expiratory pause.

By inserting these variables in the qigong sequences, we can obtain different effects even if performing the same exercise, so we can direct the exercise towards tonification or dispersion, towards one organ or another or rather towards a movement (given by organ pairs) or another.

Last but not least, an important pillar concerns awareness. This practice is about becoming conscious and visualising what effect our energy is having while performing the exercises. We refer to visualisation of the energy and visualisation of the path followed by our respiration. There is a substantial difference between qi gong and ordinary physical exercises, since visualisation has a therapeutic effect. THE MIND DIRECTS QI. If this is true we must obviously consider the greater or minor effect of medical exercise or qi gong. In the phases of visualisation we will provoke a real â&#x20AC;&#x153;heatingâ&#x20AC;? effect of the various areas of the body, in particular of the lower part of the abdomen - in which the techniques of concentration start -, the palms of the hands and of the feet. Many thermographic studies have underlined this aspect.

Clinical and experimental evidence shows that the practice of qigong influences some organs and body functions. Among these, the brain, the blood flux, heart functions, kidney functions, visual capacity etc. If we consider, in the light of the most recent scientific discoveries, the possibility to modify and regularize the hormonal flux, we can understand that qigong has the effect of slowing down aging and can maintain our organ functionality and the respiratory capacity of our body at their best.

Ph. Daniele Cozzini Graduated in Medicine and Surgery, Degree in Sports Medicine, Graduated at Chinese Medicine School, Health and Society Study Group

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PHYTOEXTRACTS

AS HORMONAL MODULATORS It is misleading, both from the pharmacological and pharmacodynamic points of view, to consider vegetable extracts for hormonal rebalance in the same way as synthetic hormones.

A vegetable extract, unlike a synthetic compound, contains a series of substances which act synergically and form what is defined as a phyto-complex. Every phytocomplex has a molecule or a group of molecules which determine its pharmacological action. For example, in the field of medicinal plants used for hormonal rebalance, those rich in steroidal saponins are chosen. Such molecules are important since they mime the action of steroid hormones and can be useful to contrast the symptoms determined by their lack: chronic tiredness, sexual disorders, memory disorders, depression, menstrual disorders, menopause, articulation disorders.

Stress and an unbalanced diet can give rise to a state of hormonal deficit starting with pregnenolone, a natural cholesterol metabolite and a precursor of sexual hormones, of stress hormones and DHEA. Since the amount of pregnenolone diminishes with aging, also the metabolic functions depending on steroid hormones diminish. Moreover, alterations of pregnenolone production can occur also after the prolonged use of some drugs such as statins.

44

Statins act by inhibiting cholesterol synthesis which, rightly or wrongly, was believed to be responsible for the increased risk of cardiovascular diseases. A decrease of cholesterol synthesis can also determine a reduction of pregnenolone synthesis, leading to memory disorders. (Statin-Associated Memory Loss: Analysis of 60 Case Reports and Review of the Literature Leslie R. Wagstaff, Pharm.D., Melinda W. Mitton, Pharm.D., Beth McLendon Arvik, Pharm.D., P. Murali Doraiswamy, M.D.Disclosures Pharmacotherapy. 2003;23(7) The regular integration of vegetable substances rich in molecules which imitate the action of pregnenolone or that contrast its symptoms, can slow down aging and make the body more resistant to stress. Among these plants, the most indicated are: eleutherococcus, schisandra, withania.

The steroid substances contained in the plant Withania have similar activities to pregnenoloneâ&#x20AC;&#x2122;s. The plant can enhance learning and memory and it also has a powerful anti-oxidant action. It has been demonstrated that Withania can improve the activity of cortical receptors for acetylcholine, a neurotransmitter lacking in dementia syndromes, so one of the main indications for the use of this plant is to treat these pathologies or others correlated to it.

number 14 / 2014

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Many studies have demonstrated that Schisandra is efficient to contrast stress, above all if it is linked to the cortico-surrenal system. In particular, Schisandra has a toning action on mental processes, improving concentration and memory, without the typical side effects of other stimulating and nerve tonic remedies. In Russia it is very appreciated and popular for its action on the endogenous antioxidant system of glutathione.

Moreover, interesting studies correlate the use of this plant with mental acuity and it also acts against visual strain.

There are also preliminary results on the influence on the increase in the levels of nitric oxide.

Eleutherococcus can rightfully be considered as a real drug with “adaptogenic” activity, that is, a phytocomplex which can act on the homeostatic mechanisms which allow the body to “adapt” to situations of psychological or physical stress and to adverse environmental conditions. This causes an increase in physical and psychological energy which help the body cope better with situations of stress, often associated to anxiety, weakening of immune defences and metabolic deficits, typical of conditions lacking pregnenolone.

Eleutherococcus seems to act on the hypothalamus-hypophysis-

adrenal axis. Clinical studies have demonstrated that some components of Eleutherococcus extracts bind with the receptors of many steroid hormones: the authors of these studies presume that, by interfering with the feedback mechanism, Eleutherococcus can determine a stimulation of the cortico-surrenal function in conditions of moderate hypocorticosurrenalism.

Experimentally, Eleutherococcus extract improves physical activity and reduces fatigue sensation.

It is important to remember that a vegetal extract cannot be considered as a substitute of a hormone, but it can imitate its activity binding itself to the same receptors, it can contrast the symptoms which arise when there is lack of hormones and it can stimulate their production without creating negative feedback. Therefore, the use, even cyclic, of vegetal extracts rich in steroid molecules can represent an energy reserve to help us cope with the numerous solicitations to which we are submitted.

Many studies have demonstrated that Schisandra is efficient to contrast stress, above all if it is linked to the cortico-surrenal system

46

Dr. Giovanni Occhionero Pharmaceutical Chemist expert in natural integration in sport and antiaging phytotherapy Simeb teacher (Italian Society of Biointegrated Medicine)

number 14 / 2014

CORSI

PERSONAL TRAINER

Istruttore di BODY BUILDING e FITNESS PARMA 27-28 SETTEMBRE 11-12 OTTOBRE 18-19 OTTOBRE Esame: 25 ottobre

PERSONAL TRAINER PARMA 8-9 NOVEMBRE 22-23 NOVEMBRE 29 NOVEMBRE - 13 DICEMBRE Esame: 14 DICEMBRE AFFWA - Accademia Funzionale del Fitness - Wellness - Antiaging Tel. 0521.1682083 - Fax 0521.294971 accademia-affwa@libero.it www.affwa.it

INFORMAZIONI

47

L’Accademia del Fitness

OXIDATIVE STRESS AND BONE METABOLISM:

EFFECTS OF CELLFOOD® SILICA PLUS

Introduction: Osteopenia, a condition which precedes osteoporosis, is characterized by a reduction of mineral bone density.

Many existing studies claim that there is an association between osteoporosis and vascular pathologies such as atherosclerosis, probably due to the presence of oxidative stress.

Thirty-one women suffering from osteopenia (mean age 59 ± 6.4 years) were studied to assess the effect of supplementation with CELLFOOD® SILICA (Nu Science Corporation, CA, USA), a nutraceutical product with antioxidant properties rich in silicon dioxide, on bone density and oxidation condition (length of treatment: 12 weeks). The diagnosis of Osteopenia was performed by means of an ultrasonography test applied to the phalanx (DMB Sonic Bone Profiler, IGEA, Italy; values of reference for osteopenia: -3.2<t-score≤-1; t-score=-1.99 ± 0.97).

Materials and e Methods: As markers of bone resorption, we assessed the urinary levels of the pyridine cross-link normalized for the values of urinary creatinine (Pyridinoline, PYD; interval of reference 25-83 PYD/ creatinine pmol/µmol; Deoxypyridinoline, DPD; interval of reference 6-23 DPD/ creatinine pmol/µmol; HPLC, Chromsystem Instrument chemicals, Munich, Germany) together with seric concentrations of oxidized LDL 5 (LDLox; ELISA, Mercodia, Sweden; cut-off<70 U/L), marker of lipidic

Titolo del volume cognome / nome indirizzo cap pagherò euro

48

peroxidation involved in the development and progress of the atherosclerotic disease.

Results: Before supplementation, 16% of the subjects presented levels of pyridine cross-link over the top limits of the reference interval and, at the end of treatment, in 60% of the cases the levels of these markers returned within normal values.

Concentrations of LDLox, altered in 61% of the women suffering from osteopenia, resulted to be under cut-off after supplementation (80 ± 30 vs 65 ± 23 U/L; p=0.01).

Conclusions: These preliminary data, on a population of women suffering from osteopenia, suggest a double effect of the supplementation with CELLFOOD® SILICA: a reduction in bone mineral resorption mediated by silicon dioxide and antioxidant properties for the prevention and treatment of oxidative stress.

Fabrizia Bamonti Department of Biomedical, Surgical and Dental Sciences, University of Milan, IRCCS Ca’ Granda Foundation, Ospedale Maggiore General Hospital, Milan

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I SINTOMI DA NON TRASCURARE I PRINCIPALI DISTURBI DEL BAMBINO COSA FARE E COSA NON FARE A CHI RIVOLGERSI / LA FARMACIA DI CASA

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DEL BAMBINO | DAL DISTURBO ALLA MALATTIA: COSA FARE E COSA NON FARE

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Lâ&#x20AC;&#x2122;Accademia del Fitness LATEST RESEARCH IN FITNESS, WELLNESS AND ANTIAGING MEDICINE

By Dr. Filippo Ongaro AFFWA Vice President www.filippo-ongaro.it We are still debating if taking multi-vitamin pills makes sense today. A great number of studies confirm that the regular use of a balanced vitamin complex can prevent many diseases.

A recent study by Harvard University has confirmed that the use of multivitamins reduces the risk of developing colon rectum tumours. 43,641 women were studied in the Nurseâ&#x20AC;&#x2122;s Health Study II and it was observed that the women who had taken multivitamins for a longer period (over 20 years) had a 20% lower risk of developing a colon tumour compared to those who had not (Br J Cancer 2014 Jan 7;110(1):249-55).

Considering that high homocysteine can be associated to a greater incidence of colon rectum tumours, we can presume that a decrease in that parameter through the intake of vitamin B6 and folic acid is one of the reasons why vitamins contribute to the reduction of tumour risks (Clin Nutr 2013 Nov 13).

Instead, a new study in the cardiovascular field confirms that higher intake of polyunsaturated omega 3 fatty acids reduces the risk of death from cardiovascular diseases Cardio 2013 Dec 16). Omega 3 also contribute to the maintenance of muscular mass in elderly people.

A study carried out by the University of Trieste confirms that these fatty acids are important anabolic signals which contribute to stimulate protein synthesis. It seems that omega 3 act in synergy with other nutrients such as leucine and hormones such as testosterone and GH in modulating muscular responses (Curr Opin Clin Nutr Met Care 17:145-150, 2014). At the same time omega 3 also have an anti- hypertension effect (Am J Hypert March 1, 2014).

It has recently been seen that omega 3 associated to alpha lipoic acid can slow down the cognitive decline in people suffering from Alzheimerâ&#x20AC;&#x2122;s disease (J Alzheimers Dis 2014, Jan 1; 38(19:111-20).

Also the intake of vitamin E, in particular in the form of gamma tocopherol, (Exp Gerontol 2013 Dec; 48(12):1428-35), seems to be useful to slow down cognitive decline. But we must be careful, since in most integrators it is not contained in this form but in that of alpha tocopherol.

Some time ago an article appeared which expressed doubts on the fact that slight overweight or even obesity without particular metabolic dysfunctions was a problem.

Some were rightly sceptical. In fact, a current study shows

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that metabolically healthy people who are overweight have a 24% higher risk of dying within 10 years (Ann Int Med 2013, Dec 2).

Actually, obesity entails scanty tissue oxygenation and an inflammation increase, thus contributing to the development of many pathological processes. Moreover, excessive fat becomes a perfect container for toxins and polluters of every kind (Obesity Rev 15:19-28, 2014).

Moreover, obesity in males contributes to the decrease in testosterone secretion which goes together with excessive estrogen production. Adipose tissue is rich in aromatase, the enzyme which turns androgens into estrogens. All this alters the metabolism and increases the risk of metabolic and oncological diseases (Asian J Andrology Feb 14, 2014).

As for vitamin D, which is increasingly studied, a recent study shows that its levels during pregnancy can determine the health of the child even after years.

The children of mothers with higher levels of vitamin D are stronger and have more muscular mass than the others (J Clin Endocrinol Metab 2014 Jan 99(1):330-7). Low vitamin D and magnesium levels are instead linked to an increase in insulin resistance, as demonstrated by a study published by a group of Indian researchers (J Clin Diagn Res 2013 Nov;7(11):2438-41).

The lack of vitamin D seems to produce negative effects also on the brain, with an increase of damage due to free radicals (Free Radic Biol Med 2013 Dec; 65;324-34) More and more data show that a scientific approach to food integration can have important results in terms of prevention.

Antiaging medicine gives voice to this new approach which without denying the importance of drugs, considers diet, food integration, physical exercise and stress control as the pillars of any complete and sensible preventive or therapeutic intervention.

Dr. Filippo Ongaro Surgeon Health Director Institute of Regenerative and Anti-Aging Medicine s.r.l. (Ismerian) Vice-President of AMIA (Italian Association of Anti-Aging Medical Doctors) Vice-President of AFFWA Functional Fitness-Wellness-Antiaging Academy