Cuore di Atleta : work and rest

1. Cuore di Atleta:work and rest Giorgio Galanti

2. EliteAthlete An eliteathleteisdefinedasonewhopartecipates in an organized team or individual sport that requires regular competitionagainstothersas a central component places a high premium on excellence and achievement requiresvigorous and intense training in a systematicfashion B.J.Maron 2000

3. EliteAthletemust be in GoodHealth American Journal of Health Promotion: September/October 2009, Vol. 24, No. 1, pp. iv-iv.

4. Good Health is…. Physical : Fitness. Nutrition. Medical self-care. Control of substanceabuse. Emotional : Care for emotionalcrisis. Stress Management Social : Communities. Families. Friends Intellectual : Educational. Achievement. Career development Spiritual: Love. Hope. Charity. American Journal of Health Promotion: September/October 2009, Vol. 24, No. 1, pp. iv-iv.

5. Heredity OtherLifestyles Environment Personal Attributes Physical Fitness PhysicalActivity Health and wellness

6. Cardiovascular Fitness Athletic Fitness Musc. Strength Flexibility Body Composition

7. Psyco/social Performance Technical Tactical Physiological Coordination Flexibility Sensorimotor Endurance performance High intensity exercise performance Sprint performance External factors *temperature *attitude *field condition *nutritrion diet/fluids Force Development Anaerobic Performance *Anaerobic Power *Anaerobic capacity Aerobic Performance *Aerobic Power *Aerobic capacity Muscle strenght *Low speed force *High speed force Intrinsic factors *age/maturation *sex *anthropometry Musclecharacteristic Cardiovascular Fitness

8. The Athlete's Heart • In untrained persons who assume regular jogging, the left ventricle (LV) undergoes mild hypertrophy without any dilation, thus showing that the prime response is to a pressure load. • In endurance-trained athletes (triathletes, cyclists, runners) there also is a pressure load as the cardiac output undergoes sustained increases,so that true physiologic hypertrophy occurs with both LV hypertrophy and dilation so that there is a balanced heart in which by inference wall stress remains normal. • Physiologic LV hypertrophy differs from pathologic LV hypertrophy by the setting in which it occurs, by the signals systems involved, by the accompanying bradycardia typical of the cardiac vagal phenotype,and by improved rather than impaired early diastolic filling on the Doppler echocardiogram. Thus, it is a “balanced enlarged heart,”beating slowly when at rest, with both LV hypertrophy and an increased end-diastolic volume.

9. The Athlete's Heart • The repetitively and intermittently increased stroke volume and increased blood pressure during endurance training stimulates both volume and pressure signals, resulting in an eccentrically enlarged heart that is both hypertrophied and dilated. In athletes who undertake a predominately pressure-inducing exercise such as weight-lifting or rowing, it is concentric hypertrophy that dominates. Experimentally, the beneficial hypertrophic paths involve Akt as the key signal, essential for physiologic cardiac growth . In trained athletes with eccentric hypertrophy, the growth paths also include stimulation of Akt as shown by increased cardiac formation of insulinlike growth factor • In those with repeated pressure induced hypertrophy, such as rowers, both LV hypertrophy and dilation may be excessive. However, the hypertrophy completely regresses when the training stops, whereas some dilation persists.

10. The Athlete's Heart

11. The only way to continue to improveexercisehypertrophy with training is to progressivelyincrease the training stress. However, whenthisconceptiscarriedtoo far, pushing the body beyonditsability to adapt, the training maybecameexcessive. • An excessive training produces no additionalimprovement in conditioning or performance and can lead to a chronic state of fatigue.

12. ….result of toomuch training isnotonlyfatigue…

13. The dangers of excessive exercise and inadequate rest • Although regular PA is, without question, highly protective, emerging data indicate that extreme exercise may be detrimental to general and CV health. • Protracted and excessive CV exercise, such as marathons, ultramarathons, full-distance triathlons, and very long distance high intensity bicycle rides, is incongruent with our genetic legacy. The American Journal of Medicine (2010) 123, 1082-1086

14. The dangers of excessive exercise and inadequate rest • A large number of studies have indicated that repetitive, prolonged, and intense aerobic activity may increase CV risk, possibly resulting from excessive physiological demands and protracted elevations of free radical–induced oxidative stress. Elevated biomarkers such a troponins suggesting myocardial damage have been documented immediately after marathon running.Astudy of more than 100 middle-aged marathon runners reported higher levels of coronary calcium compared with risk-factor matched nonrunners, and their risk of CV events during follow-up was similar to that noted for a coronary disease population. The American Journal of Medicine (2010) 123, 1082-1086

16. Percentage of runners with troponin increases byage and previous marathon experience AnnEmergMed. 2007;49:137-143

17. The dangers of excessive exercise and inadequate rest • The pattern of exercise for which we are genetically adapted involves a diversity of activities performed intermittently, at moderate intensities and moderate durations. Even in highly trained individuals, high intensity, multi-hour endurance exerciseeffortisassociatedwith damage to the myocardial cells and connective tissue. • Prolonged and excessive aerobic exercise efforts such as marathons, ultra-marathons, full-distance triathlons, and very-long-distance bicycle rides are inconsistent with our genetic heritage. The American Journal of Medicine (2010) 123, 1082-1086

19. Physical Activity, Energy Expenditure and Fitness:An Evolutionary Perspective • The model for human physical activity patterns was established not in gymnasia,athletic fields, or exercise physiology laboratories, but by natural selection acting over eons of evolutionary experience. • From the emergence of the genus Homo, over 2 million years ago , until the agricultural revolution of roughly 10000 years ago our ancestor were hunter-gatherers, so the adaptive pressures inherent in that environmental niche have exerted defining influence on human genetic makeup. • The portion of our genome that determines basic anatomy and physiology has remained relatively unchanged over the past 40000 years.

20. Genoma e Gene • Genoma Intera informazione genetica che caratterizza ogni organismo vivente, codificata dal DNA, e suddivisa in unità ereditarie distinte dette geni,per genoma si intende il gruppo completo di differenti molecole di DNA di un organulo, di una cellula o di un organismo. • Cromosoma è una struttura organizzata di DNA e proteine ​​che si trova nelle cellule. Si tratta di un unico pezzo di spirale del DNA che contiene molti geni • Gene Unità ereditaria localizzata nei cromosomi, che attraverso l’interazione con ambiente interno ed esterno controlla lo sviluppo di un carattere o fenotipo.

21. Genoma e Gene (Athletic Fitness) …40,000 years ago……

22. Our ancestors, homo,about 2.4 million years ago,for approximately 84,000 generations, survived as hunter-gatherers The industrial revolution (7 generations ago), and the digital age (2 generations ago have resulted in large reductions of PA Dramatic advances in technology such as those that ushered in the agricultural revolution (350 generations ago)….

23. Thus, the complex interrelationship between energy intake, energy expenditure and specific physical activity requirements for current humans remains very similar to that originally selected for Stone Age men and women who lived by gathering and hunting. • Research investigating optimal physical activity for human health and performance can be guided by understanding the evolution physical activity patterns in our species.

25. Kim Hill, PhD • “I have only spent a long time hunting with two groups, the Ache and the Hiwi. They were very different. The Ache hunted every day of the year if it didn't rain. Recent GPS data I collected with them suggests that about 10 km per day is probably closer to their average distance covered during search. • They might cover another 1-2 km per day in very rapid pursuit. Sometimes pursuits can be extremely strenuous and last more than an hour.Ache hunters often take an easy day after any particularly difficult day, and rainfall forces them to take a day or two a week with only an hour or two of exercise. Basically they do moderate days most of the time, and sometimes really hard days usually followed by a very easy day. The difficulty of the terrain is really what killed me (ducking under low branches and vines about once every 20 seconds all day long, and climbing over fallen trees, moving throughtangledthorns etc.

26. Hunter Gathered As Athlete

27. VO2max in Natives,in Athletes and in citizens ml/kg/min L.Cortainet al Int J Sport Med 1998

28. CHARACTERISTICS OF A HUNTER-GATHERERFITNESS PROGRAM • A large amount of background daily light-to-moderate activity such as walking was required. Although the distances covered would have varied widely(in the range of 6 to 16 km). The daily energy expenditures for PA were typically 3349 to 5024 kJ or about 5-fold that of modern sedentaryadults. • Hard days were typically followed by an easier day. Ample time for rest, relaxation,sexual activity and sleep was generally available to ensure complete recovery after strenuous exertion. • Walking and running were done on natural surfaces such as grass and dirt, often over uneven ground. Concrete and asphalt surfaces are largely foreign to our genetic identity. • Interval training sessions, involving intermittent bursts of moderate- to high-level intensity exercise with intervening periods of rest and recovery, should be performed once or twice per week.

29. CHARACTERISTICS OF A HUNTER-GATHERERFITNESS PROGRAM • Regular sessions of weight training and other strength and flexibility building exercises are essential for optimizing musculoskeletal and general health and fitness. These need to be performed at least 2 or 3 times per week, for at least 20 to 30 minutes per session. • Virtually all of the exercise was done outdoors in the naturalworld. • Much of the physical activity was done in context of a social setting (small bands of individuals out hunting or foraging). Exercising with one or more partners improves adherenceand mood • Except for the very young and the very old, all individuals were, by necessity, physical active almost their entirelives.

30. Conclusions • The logical answer is to replicate the native human activity pattern to the extent that this is achievable and practical. Recommendations for exercise mode, duration, intensity, and frequency are outlined with a focus on simulating the routine physical activities of our ancient hunter-gatherer ancestors whose genome we still largely share today. In a typical inactive person, this type of daily physical activity will optimize gene expression and help to confer the robust health that was enjoyed by hunter-gatherers in the wild. (Prog Cardiovasc Dis 2011;53:471-479)

31. Conclusions • Humans remain genetically adapted for a very physically active hunter-gatherer lifestyle. Many of the health problems endemic today result from lifestyle that is at odds with this evolutionary milieu. • The daily physical activity pattern of the hunter-gatherer is an ideal template from which to design a modern exercise Athlete’s regimen. • Characteristicsinclude: incorporationof physical activity into daily life wherever possible, interval and strength/flexibilitytraining, outdoor exercise on naturalsurfaces, group exercise, ample time for rest/recovery, and lifelong fitness.

32. An obligatory and natural linkage

34. ……ma quando si lavora……