Anthropometric evaluation in older individuals in relation to their physical activity level

Individuals older than 55 years tend to adopt sedentary lifestyles (European Commission, 2014) and unhealthy eating attitudes (Ahmed and Haboubi, 2010), which lead to an increase of body fat and risks of non-communicable diseases (Rosembloom and Bahnes, 2006; Sallinen et al., 2008). To investigate the association between the level of involvement in physical activity (PA) on anthropometric features with advancing age, height, body mass, waist (WC) and hip (HC) circumference, and triceps skinfold were measured in 20 athletes (training: >5 hr.week-1), 37 physically active (structured PA: 2 hr.week-1), and 42 sedentary (<1 hr.week-1), older individuals (55-84 yrs). Moreover body mass index (BMI), waist-hip (WHi) and waist-height (WHe) ratio, and fat arm index were calculated. A 2 (gender) x 3 (activity level) verified differences (p<0.05) between groups. No difference for gender emerged for BMI, HC, and WHi. Athletes showed lower (p<0.05) BMI, WC, HC, WHi, triceps skinfold, and arm fat index, and higher height values than physically active and sedentary counterparts. For body mass, a difference (p<0.05) emerged only between athletes with respect to sedentary counterpart. No differences emerged between physically active and sedentary groups. Findings indicate that in older ages only a high physical activity level allows controlling the anthropometric features, thus posing senior athletes at a lower risk of related non-communicable diseases

It is no longer the time to disregard thyroid metastases from breast cancer: A case report and review of the literature

Background: Metastases to the thyroid gland are more frequent than previously thought, although most of them are occult or not clinically relevant. Overall, only 42 cases of metastases to thyroid from breast cancer have been reported thus far. Here we report the case of a patient with breast cancer metastatic to the thyroid. We also review the 42 previously reported cases (published between 1962 and 2012). This is the first review about metastases to thyroid gland from breast cancer. Case presentation: A 64-year-old woman of Caucasian origin was diagnosed with a lobular invasive carcinoma of the breast (luminal A, stage II). She received adjuvant chemotherapy, followed by endocrine therapy. During follow- up, fine-needle cytology of a thyroid nodule revealed malignant cells that were estrogen-positive, which suggested a diagnosis of metastases to the thyroid. Imaging did not reveal any other metastatic site and showed only enlargement of the left thyroid lobe and an inhomogeneous pattern of colloid and cystic degeneration and calcifications. The patient underwent left hemithyroidectomy. Histology of thyroid tissue showed a colloid goitre containing dispersed small atypical neoplastic cells with eccentric nuclei. Immunohistochemistry showed cytokeratin-19 and oestrogen receptor, but not tireoglobulin, e-cadherin or cytokeratin-7, thereby confirming metastases from a lobular breast carcinoma. Hormonal treatment is ongoing. Conclusion: This case report and first review of the literature on metastases to thyroid from breast cancer highlight the importance of a correct early diagnostic work-up in such cases. Indeed, a primary lesion should be distinguished from metastases given the different treatment protocol related to primary cancer and the clinical impact on prognosis

Behavioural determinants of physical activity across the life course: a "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella literature review

Background Low levels of physical activity (PA) are a global concern and increasing PA engagement is becoming a priority in current public health policies. Despite the large number of studies and reviews available, the evidence regarding the behavioral determinants of PA is still inconclusive. Thus, the aim of this umbrella systematic literature review (SLR) was to summarize the evidence on the behavioral determinants of PA across the life course. Methods A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus, and SPORTDiscus databases. The search was limited to studies published in English from January, 2004 to April, 2016. SLRs and meta-analyses (MAs) of observational studies that investigated the behavioral determinants of PA were considered eligible. The extracted data were assessed based on the importance of the determinants, the strength of evidence, and the methodological quality. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42015010616). Results Seventeen reviews on 35 behavioral determinants of PA were eligible for this umbrella SLR. Regardless of age, the most investigated determinants were those related with ‘screen use’ and ‘smoking’. For youth, probable positive evidence emerged for ‘previous PA’ and ‘independent mobility and active transport’ among children and adolescents. For the adult population, ‘transition to university’ and ‘pregnancy/having a child’ showed probable negative associations. Conclusions Although the majority of the evidence was limited and most of the determinants were not associated with PA, this umbrella SLR provided a comprehensive overview of the associations between behavioral determinants and PA. Youth should be physically active in the early years and increase active transportation to/from school, independent mobility, and ‘free-range activities’ without adult supervision, whilst adult PA behaviors are mostly influenced by the life events. Finally, more research is needed that incorporates prospective study designs, standardized definitions of PA, objective measurement methods of PA assessment, and the use of interactionist and mediational approaches for the evaluation of different behavioral determinants influencing PA behaviors

The role of the LISTANet Consortium in the European DEDIPAC-KH project

Aim:To improve understanding of the determinants of dietary, physical activity (PA), and sedentary behaviours, the European multi-disciplinary consortium on “Determinants of Diet and Physical Activity Knowledge Hub” (DEDIPAC-KH) includes 46 consortia and organisations supported by joint programming grants from 12 countries across Europe (Lakerveld et al., 2014). Six Italian Universities (e.g., Cassino, Chieti-Pescara, Palermo, Roma Foro Italico, Roma Sapienza, and UCSC) participating in the LISTANet consortium supported by MIUR (B84G14000040008) contributed to the Thematic Area2 “Determinants of dietary, PA, and sedentary behaviours across the life course and in vulnerable groups”. In particular, the coordinator of LISTANet Prof Capranica and Prof. MacDonncha from the Irish Physical Activity and Health Consortium act as Work Package (WP) Leaders of PA determinants (WP2.2). Methods: A mix of methods has been used in identifying PA determinants by developing PA taxonomy and a European framework (EU-PAD), seven umbrella systematic literature reviews (e.g., behavioural, biological, economic, physical, policy, psychological, and socio-cultural), and identifying ongoing/recently completed European-funded projects and data sets for secondary data analyses. Results: LISTANet participated in DEDIPAC-KH meetings/seminars/courses/conferences, and organized two workshops dedicated to the EU-PAD framework and umbrella SLRs. Outcomes included internal reports, presentations to international conferences, and scientific papers submitted for publications. Conclusions: The DEDIPAC-KH project represents an excellent start in setting up a complex, cross-country, organisational structure to: 1) guide a European strategic plan for novel and multi-disciplinary research addressing the complexity of determinants of PA behaviours across the life course; and 2) identify key aspects for potential strategies and intervention programmes to implement multi-sectoral European policies in PA. Finally, the cumulated experience of LISTANet could be valuable to fully exploit effective research and actions to increase PA levels of Italian citizens

Informativa sui Tumori Ereditari e Familiari

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Two novel sequence variants in MSH2 gene in a patient who underwent cancer genetic counseling for a very early-onset epithelial ovarian cancer

Early-onset or hereditary ovarian cancer is mostly associated with BRCA1 or BRCA2 mutations. Mismatch repair genes sequence alteration frequently cause colorectal cancer, and, in less extent, other tumors, such as ovarian cancer. Subjects with personal and/or family history suggestive for hereditary cancer should be addressed to cancer genetic counseling. The multistep Cancer Genetic Counseling model, adopted at our unit, is aimed to identification, definition and management of hereditary cancer syndrome, by a multidisciplinary approach. A woman with a very early onset epithelial ovarian cancer underwent to cancer genetic counseling and genetic testing. Two germ-line mutations have been identified in exon 11 of MSH2 gene: c.1706A>T (p.Glu569Val) and c.1711G>T (p.Glu571*). Both DNA alterations were novel mutations not yet described in literature. The first is a missense mutation that is to be considered an unclassified variant; the second is nonsense mutation that created a premature stop codon resulting in a truncated not functioning protein. In conclusion, the present report finds out two unpublished sequence alterations in exon 11 of the MSH2 gene, one on which can be considered causative of Lynch phenotype, and stresses the importance of the onco-genetic counselling in order to offer the most appropriate management of the cancer risk for the patients and her family members

Energy Balance and Active Lifestyle: Potential Mediators of Health and Quality of Life Perception in Aging

The relationship between aging and perception of health and quality of life is complex and its mediation mechanisms need to be further explored. The purpose of this study was to investigate the mediating effects of total energy expenditure and intake, body mass, and body image dissatisfaction on the relationship between age and perception of health and quality of life. Forty-two senior athletes, 55 physically active, and 61 sedentary individuals (aged 55–84 years) were evaluated for total energy expenditure (EE), energy intake (EI), body mass index (BMI), absolute Body Dissatisfaction Index (BDIabx), and physical (PCS) and mental (MCS) health and quality of life perception. Multiple mediation analyses were applied to assess the relationship between age and PCS and MCS indices, through the mediators EE, EI, BMI, and BDIabx. For MCS, but not for PSC, the mediation analysis showed: (a) a direct effect of age; (b) a mediation path through EE, EI, BMI, and BDIabx; and (c) a positive total effect. The combination of positive and negative mediating effects influencing the mental health perception underlined that with advancing age, the maintenance of high levels of energy expenditure through physical activity could positively impact body image satisfaction and, in turn, mental health

How Older Adults Cope with Cognitive Complexity and Environmental Constraints during Dual-Task Walking: The Role of Executive Function Involvement

This cross-sectional study investigated the interactive dual-task (DT) effects of executive function demands and environmental constraints on older adults’ walking and the moderating role of habitual physical activity (PA). Locomotor performance under different environmental constraints (flat versus obstructed walking) and cognitive performance with different executive function involvement (backward counting versus random number generation) were assessed under single-task (ST) and DT conditions in 135 participants (mean age 68.1 ± 8.4). The weekly number of daily steps was measured. Reciprocal DT effects of walking on cognitive performance and of the cognitive task on gait performance were computed and submitted to analyses of covariance with age, PA level, and cognitive functioning as covariates, followed by linear regressions with PA level as predictor. Cognitive task demands and environmental constraints individually and jointly affected gait variability (p = 0.033, ηp2 = 0.08) and executive function performance (p = 0.009, ηp2 = 0.09). Physical activity level predicted a low but significant percentage of variance of DT effects on gait only in flat walking (R2 = 0.04, p = 0.027). Results suggest that older individuals may adopt variable task prioritization in dual tasking depending on the type of executive function involvement and the environmental constraints on walking. Their DT ability was slightly affected by habitual PA

The Interlink among Age, Functional Fitness, and Perception of Health and Quality of Life: A Mediation Analysis

In aging societies, physical activity may benefit functional fitness influencing the health of older people. The aim of this study was to explore the interrelation between age and perception of health and quality of life, and the mediating effects of functional fitness in older individuals. One hundred and sixty-six late middle-aged (55-64 years, young-old (65-74 years), and old (75-84 years) adults, divided into senior athletes (n = 44), physically active (n = 59), and sedentary individuals (n = 63) were evaluated for functional fitness (flexibility, strength, interlimb coordination, endurance) and physical (Physical Component Summary-PCS) and mental (Mental Component Summary-MCS) health and quality of life perception. Multiple mediation analyses were applied to assess the relationship between age and PCS and MCS indices and the role of functional fitness-related mediators. For MCS only, the mediation analysis showed a positive total and direct effect of age and a negative total indirect effect through mediators. No effects emerged for PCS. Despite a decline in their functional fitness, older individuals were able to maintain a mental health perception, also demonstrating how beneficial effects of physically active lifestyle on functional fitness can positively impact the cognitive-emotional dimension of mental health with advancing age