Assessment of physical activity of members of the Helicopter Emergency Medical Service (HEMS)

The aim: Assessment of physical activity of members of the Helicopter Emergency Medical Service. Material and methods: The study was conducted in a group of 131 people (65 paramedics, 66 pilots), members of HEMS teams from all bases in Poland, aged 27-59. The characteristics of physical activity was obtained using the author’s questionnaire. Results: The mean age of the study population was 42.73 ± 9.58 years. Pilots were significantly older than paramedics and had significantly higher BMI values (p < 0.05). No significant relationship between the age and BMI in the analyzed groups was found (p > 0.05), while the relationship between the frequency of physical activity and BMI was demonstrated. 70% of subjects undertook physical activity less than three times a week. The most frequently chosen forms were cycling, walking and swimming. Paramedics statistically significant more often than pilots chose wall climbing (p = 0.001). Downhill skiing (61%) was the most common declared winter sport played by pilots, while hiking in the mountains – by paramedics (49%). The most important reason for pilots to take up physical activity was concern for their health (47%), while for paramedics – the pleasure (63%). Paramedics statistically significant more often than pilots indicated a large number of other activities (90.6 vs. 74.2%) and financial issues (18.8 vs. 6.1%) as barriers that prevented more involvement in physical activities. Conclusions: The frequency of physical activity undertaken by HEMS members is insufficient. Low physical activity of HEMS team members has an adverse effect on their nutritional status. It is necessary to take initiatives to promote physical activity in this professional group

Excess body weight as a risk factor to well-being and performance of flight personnel : potential strategies of prevention

Flight personnel is at risk of excessive weight and obesity. This is due to, for instance, irregular work schedules, irregular nutritional habits, excessive workload, and an inability to plan regular physical exercise or recreation. These factors lead to excessive body weight gains, and hence to obesity. Obesity directly infl uences quality of life as well as readiness to fulfi ll duties by the aircraft maintenance personnel. Obesity is an independent risk factor for various diseases such as hypertension, type 2 diabetes, coronary artery disease, atherosclerosis, each of which can lead to a loss of medical licence. Obesity is associated with extensive caloric consumption that cannot be controlled by the aff ected person. State of the art research has demonstrated not only hormonal and neuronal changes associated with obesity, but also points to deterioration of cognitive functions; these changes are likely induced by suboptimal diets. Furthermore, we will review prevention strategies, as well as treatments aimed at losing weight in fl ight personnel already aff ected by obesity. Implementation of these programs may prolong the time a pilot is fi t to fl y and improve his/her performance

Real life changes in physical activity due to intragastric balloon therapy and their relationship to improving cognitive functions : preliminary findings

Background. We evaluated if the intragastric balloon (IGB) treatment leads to the increase in physical activity (PA) and whether they are related to cognitive improvements. Methods. Fourteen morbidly obese patients (151 ± 24 kg, BMI = 51.8 ± 6.5, 107 ± 26% excess weight, 43.3 ± 10.6 years) underwent 6-day-long, uninterrupted evaluations of PA 1 month before IGB insertion and 1 month after its removal. Results Active energy expenditure and physical activity duration increased by more than 80% (p < 0.001) whereas the number of steps per day by 20% (p = 0.016). There was a pattern of relationships between cognitive improvements and increases in PA (p < 0.05). In particular, working memory improvements correlated with the increase in time spent on light physical activities (r = 0.673, p = 0.004). Conclusion. The relationships suggest that an increase in physical activity mediates cognitive improvements in bariatric patients

Cognitive improvements following body mass reduction induced by intragastric balloon placement in morbidly obese patients : a preliminary study

Introduction: Obesity and type 2 diabetes mellitus (T2DM) are associated with poorer cognitive performance. Reports suggest that bariatric surgery may lead to improvements in cognitive processes. However, the potential effects of mood improvements have not yet been evaluated. The aim of the study was to assess the effects of intragastric balloon (IGB) induced weight loss on cognitive performance in morbidly obese patients and relate them to changes in mood. Methods: Twenty four morbidly obese patients (43.9±12.0 years of age, 145.6±22.3kg, body mass index (BMI): 49.8±6.9, 11 females, 14 with T2DM), underwent tests of visual short-term memory (Benton Visual Retention Test), sustained and divided attention (Color Trail Test), and verbal short-term memory: (Digit Span from WAIS-R) 1) a month before IGB insertion, 2) three months after, 3) one month after IGB removal. Depressive symptoms were evaluated with the Beck Depression Inventory (BDI). Results: Significant cognitive improvement was observed over the first three months of IGB treatment in verbal short-term memory, visual short-term memory, and sustained and divided attention among all patients, regardless of their T2DM status. However, these changes correlated with weight loss only in patients without comorbid T2DM. The cognitive changes were not associated with changes in depressive symptoms. The improved cognitive performance was sustained over the last three months of the treatment. Conclusions: Morbid obesity treatment with an intragastric balloon leads to cognitive improvements. These improvements are not associated with mood changes

Does long-term high fat diet always lead to smaller hippocampi volumes, metabolite concentrations, and worse learning and memory? : a magnetic resonance and behavioral study in wistar rats

Background. Obesity is a worldwide epidemic with more than 600 million affected individuals. Human studies have demonstrated some alterations in brains of otherwise healthy obese individuals and elevated risk of neurodegenerative disease of old age; these studies have also pointed to slightly diminished memory and executive functions among healthy obese individuals. Similar findings were obtained in animal models of obesity induced by high fat diet. On the other hand, low carbohydrate high fat diets are currently promoted for losing weight (e.g., Atkin’s style diets). However, the long-term effects of such diets are not known. Additionally, high fat diets leading to (mild) ketonemia were shown to improve brain function in elderly humans and in some animal models. Aim. To evaluate the hypothesis that long-term use of a high fat diet was associated with decreases in spatial memory, smaller hippocampi and hippocampi metabolite concentrations in Wistar rats. Methods. Twenty five male Wistar rats were put on high fat diet (HFD; 60% calories from fat, 30% from carbohydrates) on their 55th day of life, while 25 control male rats (CONs) remained on chow. Adequate levels of essential nutrients were provided. Both groups underwent memory tests in 8-arm radial maze at 3rd, 6th, 9th, and 12th month. 1H magnetic resonance spectroscopy was employed to measure concentrations of tNAA (marker of neuronal integrity) at one month and one year, whereas MRI was used to evaluate hippocampal volumes. Results. Obese rats (OBRs) consumed similar amount of calories as CONs, but less proteins. However, their protein intake was within recommended amounts. Throughout the experiment OBRs had statistically higher concentrations of blood ketone bodies than CONs, but still within normal values. At post-mortem assessment, OBRs had 38% larger fat deposits than CONs (p<0.05), as evaluated by volume of epididymis fat, an acknowledged marker of fat deposits in rats. Contrary to our expectations, OBRs had better scores of memory behavioral tasks than CONs throughout the experiment. At one year, their hippocampi were by 2.6% larger than in CONs (p = 0.05), whereas concentration of tNAA was 9.8% higher (p = 0.014). Conclusion. Long-term HFD in our study resulted in better memory, larger hippocampal volumes, as well as higher hippocampal metabolite concentrations, possibly due to increased levels of blood ketone bodies. The results should be interpreted with caution, as results from animal models do not necessarily directly translate in human condition