benefits | MY SPECIAL DOCTOR

Goals of physical training in cardiac rehabilitation

19 February 20246 January 2024 by Redazione My Special Doctor

Cardiac rehabilitation according to a currently accepted definition in Europe, the United States and Canada is “the sum total of interventions carried out on the patient to ensure the best physical and psycho-social condition.” Such improvement enables patients with chronic heart disease to resume their role in society. The main goal is to normalize the elements of disability, established subsequent to acute cardiac events. Usually, ideal candidates for physical training are patients in the low or intermediate risk range. Those who undergo the training can achieve the following benefits:

Reduced mortality.
Improved exercise tolerance.
Better overall feeling of well-being.
A more frequent return to work.

For these reasons, rehabilitation through physical training is an essential component of the coronary artery disease patient’s care program. In the United States, only 11% of those affected by a coronary event underwent rehabilitation, but in recent years the percentage has risen to nearly 40%. As for Italy, the exact figures are not known. The benefits brought by cardiac rehabilitation on cardiovascular mortality rates may be less significant than documented by major trials, performed a few years ago. Therefore, the importance of exercise can be traced back to its effect on mortality, but also to its role as a catalytic event, promoting other aspects of rehabilitation.

A physical rehabilitative training program includes the following stages:

Medical evaluation
Risk stratification
Exercise prescription
Patient education
Information aimed at patients about their disease

Physical training also sets short-term and long-term goals.

Source: Mediserve Cardiovascular Rehabilitation

Probiotics beneficial, but beware of some possible side effects

22 February 20246 January 2024 by Renato Torlaschi

Probiotics are healthy strains of live bacteria and yeast; taking them can provide a number of benefits, but they can also cause side effects. An article in Medscape clarifies how probiotics promote health and how they can be safely taken.

As is well known, there are billions of bacteria and other microorganisms living in the gut-this community makes up the gut microbiota, and more and more research is showing its importance for digestion, gut health, and the whole body, for example, through supporting the immune system. Many bacteria provide benefits to their human hosts, but others cause harm: altering the natural balance of bacteria in the gut can lead to some problems. Products such as certain yogurts, supplements, and fermented foods, including kefir, sauerkraut, and tempeh, contain probiotics, and numerous research suggests that their consumption can lead to an increase in healthier bacteria, which help restore the balance of the gut microbiota.

There is evidence on the positive effects produced by probiotics for various conditions: eczema, obesity, insulin resistance, type 2 diabetes, nonalcoholic liver steatosis, and immune system function.

However, some side effects may occur. Among these, experts list: digestive symptoms, skin problems, allergy risks, increased risks of infections, and bacterial overproliferation syndrome (Sibo).

Finally, albeit rarely, beneficial probiotics may contain antibiotic-resistant genes and could transmit these genes to other strains of bacteria, including dangerous and infection-causing ones. Manufacturers routinely test for antibiotic resistance in the probiotic strains placed on the market; therefore, the advice is to always obtain probiotics from reputable manufacturers.

More generally, it is recommended to read the labeling carefully and not to exceed the indicated dosage, although very little evidence suggests the possibility of probiotic overdose. However, if a probiotic is suspected of causing symptoms or side effects, its dosage should be reduced or its intake discontinued.

The fruit of health: the Cranberry

20 February 20246 January 2024 by Redazione My Special Doctor

NUTRITIONAL CHARACTERISTICS OF FRESH CRANBERRY

Cranberries have a high water content as well as a high sugar content. Berries contain fiber, minerals, and vitamins A, B, and C. The non-digestible fibrous compounds are able to regulate some metabolic functions. Due to their low sodium content and fair amount of potassium, cranberries have a fair diuretic effect. Within the American cranberry are several active ingredients: digestive tonic organic acids, myrtillin, flavonoids, proanthocyanidins and anthocyaninins, tannites, catechins, omega 3 and omega 6, phytosterols, tocopherols and tocotrienols. The organic acids that give the berries a sour taste represent a large blood spillover of alkaline bicarbonates, which counteract blood acidification. Another nutritional characteristic of cranberry is definitely the antioxidant capacity due to the presence of pigments, which accumulate in the outer layers of the berries. A number of dietary supplements, sold in supermarkets, pharmacies and herbalist shops, are also made from cranberries.

THE JUICE OF MULTIPLE VIRTUES

Almost all cranberry drinks contain about 25 percent pure juice. Undiluted natural juice has a pH of at least 2.5, and without the addition of sugar the taste tends to be unpleasant to the palate. Cranberry juice blended with agave extract has an excellent reputation as a nutraceutical because of its nutritional components. A dose of 70 ml of juice is recommended to enjoy the beneficial effects of cranberry. Regular intake turns out to be an easy and tasty aid to counteract arterial degeneration and osteoporosis.

HEALTH PROPERTIES OF CRANBERRY EXTRACT

Indians used the cranberry both as a food and as a medicine. Sailors, on the other hand, consumed blueberries to fight scurvy. There are so many recognized healing properties of cranberry that it has interested so many medical and scientific studies. Blueberry berries protect and strengthen vessel walls due to the presence of anthocyanosides. In addition, these small fruits are rich in an antioxidant first discovered in grapes that plays an important role in reducing “bad” cholesterol. The tannites in cranberry act on bacteria. This mechanism helps prevent infection. It is bound to the proanthocyanidin subfraction that contains oligomers in which epicatechin units are bound together.

THE ANTIOXIDANT CAPACITY OF ANTHOCYANINS

Anthocyani or anthocyanins are water-soluble plant pigments of the flavonoid family, found in plants in the form of glycosides. The production and quantity of flavonoid pigments, which are easily recognized in flowers, fruits, shrubs and leaves, depend on the type of plant and outdoor conditions. Anthocyanins are present in large amounts in fruits and inflorescences, but can also be found on leaves and roots. The color can vary from red to blue to violet, depending on the pH in the medium in which they are found and the formation of salts with heavy metals. Regarding antioxidant properties, anthocyanins are known for this characteristic and prevent cardiovascular disorders, obesity, inflammatory responses, and cancerous proliferations.

ROLE IN THE PREVENTION OF CHRONIC URINARY INFECTIONS

Cranberry is used as a natural antiseptic to prevent and treat urinary infections. Its benefits were initially attributed to urine acidification. Then, some researchers have shown that blueberry can inhibit bacterial adhesion to urinary epithelial cells. In 1998, Howell identified proanthocyandins as the active components of cranberry that can prevent the adhesion of fimbriae of uropathogenic Escherichia coli strains to the urinary epithelium, protecting it from infection.

THE MECHANICAL PREVENTIVE ACTION OF PROANTHOCYANIDINS

In urinary tract infections, the bacteria colonize the colon, pass through the periurethral/vaginal zonus, and ascend the urinary tract, bringing an infection to the bladder and then to the kidneys. Cranberry proanthocyanidins help prevent infection and bacterial colonization.

Source: The Cranberry – A fruit that never ceases to amaze by Mediserve

Vinegar of a thousand virtues: true or alleged?

20 February 20246 January 2024 by Redazione My Special Doctor

Wine, red or white, balsamic, apple, pear, rice, coconut, honey or beer. These are just a few variants of vinegar much-loved food in all parts of the world and used for many different purposes. Seasoning, flavoring, cooking, preserving, disinfecting, and even achieving specific health benefits, from weight control to blood sugar control. But what is true among the many touted virtues?
Here is what is known
about this valuable fermentation product and what, on the other hand, remains to be proven.

Alternative therapies: do they work or not?

18 February 20246 January 2024 by Redazione My Special Doctor

In most cases, those who rely on alternative therapies exercise an act of faith. Scientific evidence supporting its objective, or at least probable, efficacy is in fact often lacking, and the touted benefits find confirmation in personal opinions, widespread suggestions and fanciful interpretations, more philosophical than biological. What is true about it? Which practices can really help and which cannot? And to what extent?
A few clarifications on the subject,
to really care and not take risks.

Nordic Walking

17 February 20246 January 2024 by Redazione My Special Doctor

By Roberto Vallabio, instructor Italian Nordic Walking School (SINW)

Translated into Italian it means Nordic Walking and consists of walking with the help of special sticks. An aid that turns into a push forward, facilitating advancement. You should not think that you will go faster or exert less effort, because the basic principle of this discipline is to involve as many muscles as possible and, as a result, increase energy expenditure for the same speed and distance traveled. All of this results in improved fitness.

Walking with poles appears as early as the 1930s and was practiced as summer-autumn training by Scandinavian cross-country and Nordic combined athletes. Born in Scandinavian countries many years ago it was initially practiced by cross-country ski athletes during summer-autumn dry training. Later, it was refined and developed into a full-fledged fitness exercise.

In Italy, the modern concept of Nordic Walking arrived in late 2003 when the activity began to develop in South Tyrol and then continued to expand to all other Italian regions. In 2008 the Italian Nordic Walking School was founded, an association that has become the Italian reference point for Nordic walking, with thousands of instructors distributed throughout the country and many followers. In October 2013, the Italian Nordic Walking School joined Fidal as the sole contact and training association for Nordic Walking instructors in Italy.

The technique

Nordic walking is nothing more than natural walking done by “good stepping,” to which is added the functional use of two poles to bring a whole range of benefits to our bodies. The sticks are used in such a way as to exert forward momentum, involving a large number of muscles and thus increasing energy expenditure that improves cardiorespiratory function. However, to get the maximum benefits and have the maximum efficiency from the movements, technique becomes crucial.

To learn the basic technique, or alternating step, (i.e., alternating opposite arm and leg movements) you need to develop:

alternating arm-leg coordination
range of motion of the legs and arms
opening and closing the hands around the handle of the sticks
foot roll
push phase and stick recovery

Advanced techniques

In addition to the classic alternating walk, there are other variations (advanced techniques) that are used to improve technical movements, coordination and training status.

Equipment

Basic equipment consists of a pair of Nordic Walking poles and associated mittens. Everything else is of secondary importance, although the choice of shoes plays a very important role as they must have a sole suitable for walking on slippery and slippery ground. As we said, poles are made precisely for this type of sporting activity and are composed of ahandle (where the glove is inserted by means of the string), a central part called the shaft and finally the tip. The material from which they are made can be aluminum, fiberglass or carbon. They can consist of one piece, or two or three pieces that make them easy to carry. The handle is made of soft plastic, rubber or cork (better choice because it absorbs sweat and does not make the palm of the hand slip). The tip is usually made of widia and can be covered with special non-slip rubbers to adhere better on asphalt. Finally, a mention should be made of the choice of shoes whose soles should ensure excellent grip on the ground, which can vary from concrete to earth, sand, cobblestones, and mudo…..in short, offer completely different adherences. In addition, they should also ensure that they are sturdy and waterproof in case of rain.

The benefits

Only by adopting proper technique can you achieve all the benefits that Nordic Walking can offer.

High muscle involvement improves cardiovascular and lymphatic circulation and increases respiratory capacity. In particular:

It allows 20 to 30% higher energy consumption than walking without poles.
It results in the involvement of about 90% of our muscles (over 600 muscles)
Due to the active involvement of the auxiliary muscles of the respiratory system, oxygenation of the whole body is increased.
It keeps four of the five main forms of motor stress in exercise: endurance, strength, mobility, coordination.
Stimulates the elimination of hormones originating from stress
It increases heart rate by 10 to 15 beats per minute compared to traditional walking at the same gait. It therefore generates good cardiovascular exercise
Strengthens the immune system
Improves posture and promotes spinal mobilization
Lightens the load on joints and the motor system in general
Blood pressure, triglyceride and cholesterol levels over time tend to normalize
Glycemic values in diabetic disease are lowered
There is greater protection from osteoporosis and osteoarthritis: moderate and constant exertion stimulates bone remodeling and the production of substances such as elastin and collagen that form cartilage.

Stress-reducing benefits of Nordic walking

It improves mood because our bodies release substances, endorphins and serotonins, which can counter anxiety and depression;
With physical improvements in the body, the mind tends to push away problems making them less nagging and, at the same time, tends to see everyday worries more calmly so that it can deal with them peacefully
It regularizes breathing, which, on the other hand, in moments of anxiety and fear tends to become short and shallow
Accumulated muscle tension is discharged without the risk of tears or strains;
Practiced in groups, it constitutes a time of aggregation and lightheartedness

Where it is practiced

The strength of Nordic Walking is that it can be practiced anywhere, on the Mountain trails, in the city, on the beach, in parks. Of course, the more homogeneous the terrain, regardless of how it is made, the better one can express the technical-athletic gesture and consequently achieve maximum results. Be careful, however, not to confuse the terrains of Nordic walking with those of hiking. Trekking is mainly practiced on high-altitude trails that have little uniformity and steep inclines, while for Nordic walking, the optimal terrain is trails with varying and yet not steep inclines, so that the range of motion and continuity of stride can be maximized.

The optimal terrain

Suitable terrain for Nordic walking is flat or slightly uphill trails. For the technical gesture and the performance of all muscles to be maximum, the ideal incline is between 4 and 8 percent. It is precisely here that the push of the arms becomes powerful, the foot is able to complete the right roll, and each step becomes satisfaction.

With steeper slopes the push of the arms turns into support and the roll of the foot loses its completeness; as the terrain becomes steeper you will gradually go to rest first the flat foot on the metatarsal and finally the toe only.

Conclusions

Nordic walking is considered one of the most complete sports disciplines ever. The physical and mental benefits to be gained are many and obvious. It is suitable for any age. It can also be practiced in the city. It can also be used as a form of training for other sports.

Italian Nordic Walking School (SINW) instructor