Giorgio GalantiGiorgio Galanti

Cuore di Atleta:Cuore di Atleta:work and restwork and rest

Elite AthleteElite AthleteAn elite athlete is defined as An elite athlete is defined as one who partecipates in an one who partecipates in an organized team or individual organized team or individual sport that sport that requires regular competition requires regular competition against others as a central against others as a central componentcomponentplaces a high premium on places a high premium on excellence and achievementexcellence and achievement requires vigorous and intense requires vigorous and intense training in a systematic fashiontraining in a systematic fashion

B.J.Maron 2000B.J.Maron 2000

Elite AthleteElite Athlete must be in Good Health

American Journal of Health Promotion: September/October 2009, Vol. 24, No. 1, pp. iv-iv.

Good Health is….Physical : Fitness.

Nutrition. Medical self-care. Control of substance abuse.

Emotional : Care for emotional crisis. 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.

PhysicaPhysicall

FitnessFitness

HeredityHeredity

Other LifestylesOther Lifestyles

EnvironmentEnvironment

Personal Personal AttributesAttributes

Health Health and and

wellneswellnesss

PhysicaPhysical l

ActivityActivity

Fle

xib

ilit

yFle

xib

ilit

yM

usc.

Mu

sc.

Stre

ng

thS

tren

gth

Body Body CompositionComposition

CardiovascularCardiovascularFitnessFitness

AthleticAthleticFitnessFitness

TacticalTactical TechnicalTechnical

Psyco/socialPsyco/social

PhysiologicalPhysiological

Anaerobic Performance*Anaerobic Power*Anaerobic capacity

Aerobic Performance*Aerobic Power*Aerobic capacity

Muscle strenght*Low speed force*High speed force

External factorsExternal factors*temperature*temperature*attitude*attitude*field condition*field condition*nutritrion diet/fluids*nutritrion diet/fluids

Intrinsic factorsIntrinsic factors*age/maturation*age/maturation*sex*sex*anthropometry*anthropometry

CoordinationFlexibilitySensorimotor

Cardiovascular FitnessCardiovascular Fitness Muscle characteristicMuscle characteristic

Endurance performance

High intensityexercise

performance

Sprint performance

ForceDevelopment

PerformancePerformance

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.

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.

The Athlete's Heart The Athlete's Heart

The only way to continue to improve The only way to continue to improve exercise hypertrophy with training is exercise hypertrophy with training is to progressively increase the to progressively increase the training stress. However, when this training stress. However, when this concept is carried too far, pushing concept is carried too far, pushing the body beyond its ability to adapt, the body beyond its ability to adapt, the training may became excessive.the training may became excessive.

An excessive training produces no An excessive training produces no additional improvement in additional improvement in conditioning or performance and can conditioning or performance and can lead to a chronic state of fatigue. lead to a chronic state of fatigue.

…….result of too much .result of too much training is not only fatigue…training is not only fatigue…

The dangers of excessive The dangers of excessive exercise exercise

and inadequate restand inadequate rest• Although regular PA is, Although regular PA is,

without question, highly without question, highly protective, emerging data protective, emerging data indicate that extreme indicate that extreme exercise exercise may be detrimental may be detrimental to general and CV health. to general and CV health.

• Protracted and excessive CV Protracted and excessive CV exercise, such as marathons, exercise, such as marathons, ultramarathons, full-distance ultramarathons, full-distance triathlons, and very long triathlons, and very long distance high intensity distance high intensity bicycle rides, is incongruent bicycle rides, is incongruent with our genetic with our genetic legacy.legacy.

The American Journal of Medicine (2010) 123, 1082-1086The American Journal of Medicine (2010) 123, 1082-1086

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.A STUDY 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, 1082-1086The American Journal of Medicine (2010) 123, 1082-1086

Percentage of runners with troponin increases byPercentage of runners with troponin increases byage and previous marathon experienceage and previous marathon experience

Ann Emerg Med. 2007;49:137-Ann Emerg Med. 2007;49:137-143143

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 exercise effort is associated with 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, 1082-1086The American Journal of Medicine (2010) 123, 1082-1086

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.

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.

Genoma e Gene Genoma e Gene

Genoma e Gene Genoma e Gene

(Athletic Fitness)

Our ancestors,

homo,about

2.4 million years ago,for approximately

84,000 generations, survived as

hunter-gatherers

Dramatic advances in technology

such as those

that ushered in the

agricultural revolution

(350 generations

ago)….

The industrial revolution (7 generations

ago), and the

digital age (2 generations

ago have resulted in

large reductions of

PA

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.

““I have only spent a long time hunting with two groups, the I have only spent a long time hunting with two groups, the Ache and the Hiwi. They were very different. The Ache Ache and the Hiwi. They were very different. The Ache hunted every day of the year if it didn't rain. Recent GPS hunted every day of the year if it didn't rain. Recent GPS data I collected with them suggests that about 10 km per data I collected with them suggests that about 10 km per day is probably closer to their average distance covered day is probably closer to their average distance covered during search. during search.

They might cover another 1-2 km per day in very rapid They might cover another 1-2 km per day in very rapid pursuit. Sometimes pursuits can be extremely strenuous pursuit. Sometimes pursuits can be extremely strenuous and last more than an hour.Ache hunters often take an and last more than an hour.Ache hunters often take an easy day after any particularly difficult day, and rainfall easy day after any particularly difficult day, and rainfall forces them to take a day or two a week with only an hour 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 or two of exercise. Basically they do moderate days most of the time, and sometimes really hard days usually followed the time, and sometimes really hard days usually followed by a very easy day. The difficulty of the terrain is really by a very easy day. The difficulty of the terrain is really what killed me (ducking under low branches and vines what killed me (ducking under low branches and vines about once every 20 seconds all day long, and climbing about once every 20 seconds all day long, and climbing over fallen trees, moving over fallen trees, moving through tangled thorns etc.through tangled thorns etc.

Kim Hill, Kim Hill, PhDPhD

Hunter Gathered As Hunter Gathered As AthleteAthlete

65

8085

80

60

0102030405060708090

Inuit NewGiunea

Tanzanians Athletes Modern

ml/kg

/min

VO2MAX IN NATIVES ,IN VO2MAX IN NATIVES ,IN ATHLETES AND IN CITIZENSATHLETES AND IN CITIZENS

L.Cortain et al Int J Sport Med 1998L.Cortain et al Int J Sport Med 1998

CHARACTERISTICS OF A HUNTER-GATHERERCHARACTERISTICS OF A HUNTER-GATHERERFITNESS PROGRAMFITNESS PROGRAM

A large amount of background daily light-to-moderate A large amount of background daily light-to-moderate activity such as walking was required. Although the activity such as walking was required. Although the distances covered would have varied widely(in the distances covered would have varied widely(in the range of 6 to 16 km). 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 sedentary adults.

Hard days were typically followed by an easier day. Hard days were typically followed by an easier day. Ample time for rest, relaxation,sexual activity and sleep Ample time for rest, relaxation,sexual activity and sleep was generally available to ensure complete recovery was generally available to ensure complete recovery after strenuous after strenuous exertion.exertion.

Walking and running were done on natural surfaces Walking and running were done on natural surfaces such as grass and dirt, often over uneven ground. such as grass and dirt, often over uneven ground. Concrete and asphalt surfaces are largely foreign to our Concrete and asphalt surfaces are largely foreign to our genetic genetic identity.identity.

Interval training sessions, involving intermittent bursts Interval training sessions, involving intermittent bursts of moderate- to high-level intensity exercise with of moderate- to high-level intensity exercise with intervening periods of rest and recovery, should be intervening periods of rest and recovery, should be performed once or twice per week.performed once or twice per week.

CHARACTERISTICS OF A HUNTER-GATHERERCHARACTERISTICS OF A HUNTER-GATHERERFITNESS PROGRAMFITNESS PROGRAM

Regular sessions of weight training and other Regular sessions of weight training and other strength and flexibility building exercises are strength and flexibility building exercises are essential for optimizing musculoskeletal and essential for optimizing musculoskeletal and general health and fitness. These need to be general health and fitness. These need to be performed at least 2 or 3 times per week, for at performed at least 2 or 3 times per week, for at least 20 to 30 minutes per session.least 20 to 30 minutes per session.

Virtually all of the exercise was done outdoors in Virtually all of the exercise was done outdoors in the the natural world.natural world.

Much of the physical activity was done in context Much of the physical activity was done in context of a social setting (small bands of individuals out of a social setting (small bands of individuals out hunting or foraging). Exercising with one or hunting or foraging). Exercising with one or more partners improves more partners improves adherence and moodadherence and mood

Except for the very young and the very old, all Except for the very young and the very old, all individuals were, by necessity, physical active individuals were, by necessity, physical active almost their almost their entire lives.entire lives.

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)

ConclusionsConclusions Humans remain genetically adapted for a very Humans remain genetically adapted for a very

physically active hunter-gatherer lifestyle. Many of the physically active hunter-gatherer lifestyle. Many of the health problems endemic today result from lifestyle health problems endemic today result from lifestyle that is at odds with this evolutionary milieu.that is at odds with this evolutionary milieu.

The daily physical activity pattern of the hunter-The daily physical activity pattern of the hunter-gatherer is an ideal template from which to design a gatherer is an ideal template from which to design a modern exercise Athlete’s modern exercise Athlete’s regimen.regimen.

Characteristics include: incorporation of Characteristics include: incorporation of physical physical activity into daily life wherever activity into daily life wherever possible, interval and possible, interval and strength/flexibility training, outdoor exercise on strength/flexibility training, outdoor exercise on natural natural surfaces, group exercise, ample time for surfaces, group exercise, ample time for rest/recovery, and lifelong fitness.rest/recovery, and lifelong fitness.

An obligatory and natural An obligatory and natural linkagelinkage

……ma quando si lavora……