Influence of the natural environment on health: evaluation of different environmental contexts (urban, green spaces) and intervention proposals

Urbanization has grown during the last decades, with an increase in population concentrated in cities. Cities are usually relatively nature-poor, and the loss of green urban space likely leads to less contact with the natural world for urban dwellers. It is known that the natural environment could provide important advantages, and the loss of contact with this type of environment has potential negative impacts on the quality of life. The use of green urban space demonstrated stronger benefits for mental health and stress reduction. In general, exposure to green urban space is linked to a reduction in mortality rates, due to the promotion of a healthy lifestyle. Green urban space could be an optimal environment in which to perform physical activity. Undertaking regular physical activity is one of the major determinants of health. The benefits of exercise have been widely demonstrated through a wide range of studies. Benefits are linked to the treatment and prevention of most chronic and non-communicable diseases, that are not contagious, but they are usually long-lasting. Regular physical activity could reduce mental health problems, such as anxiety. The World Health Organization proposed to improve physical activity programs through the implementation of interventions in green urban spaces. Green urban space provides a safe, accessible, and attractive place to perform physical activity. All the interventions aimed to promote the practice of physical activity and to reduce sedentary behavior are important. It is well known that physical activity has several positive effects, a great amount of the population remains inactive. A good strategy could be to show people how integrated physical activity into their all-day life, for example through the use of green urban space or active commuting. The results in the present thesis showed the effectiveness of performing physical activity in a natural environment and of active commuting

The Effect of Physical Activity Interventions Carried Out in Outdoor Natural Blue and Green Spaces on Health Outcomes: A Systematic Review

In the last few years, interest about the natural environment and its influences on health conditions has been growing. In particular, physical activity interventions carried out in blue and green environment are being investigated as a potential strategy to increase health outcomes in people with and without chronic conditions. Many recent studies reported positive results, but a high number of these studies were focused on people with mental or physical disorders. In this scenario, the present systematic review, conducted according to the PRISMA statement, was aimed at investigating the existing evidence regarding the effects of physical activity interventions carried out in green-blue space settings involving healthy people. A literature search was performed through PubMed, Cochrane, Cinahl, and Psychinfo, and the quality of each study was assessed. Out of 239 identified articles, 75 full texts were screened. Six eligible studies showed an improvement in health outcomes, such as well-being, mood, and physical performance, in the experimental group compared with the control group. No exhaustive conclusion can be drawn based on available evidence. However, this systematic review highlighted the need to extend this kind of intervention to reveal more robust evidence that green and blue exercises benefit health

The Determinants of Health-Related Quality of Life in a Sample of Primary School Children: A Cross-Sectional Analysis

Background: Health-related quality of life (HRQoL) in childhood is a multidimensional construct with many sub dimensions of subjective experience, including physical activity (PA), psychological well-being, social interaction, and school performance, that represents a fundamental health outcome to assess a child’s physical and psycho-social functioning. Our study aims to explore the potential predictors of children’s health-related quality of life, using a convenience sample from the Imola Active Break Study (I-MOVE), considering demographic, anthropometric measures, PA level measured by Actigraph accelerometers, parent-reported/self-reported HRQoL, and body image. Methods: A cross-sectional analysis was conducted among 151 primary school children in Italy. HRQoL was assessed using the Italian version 4.0 of the Paediatric Quality of Life (PedsQL) questionnaire. Results: Children who spent more time partaking in moderate PA were associated with a higher total PedsQL score (p < 0.03). Mother’s body mass index (BMI) was the only variable statistically significant associated with the physical health domain of PedsQL. Parent’s proxy-report perception concerning children’s psychosocial health was statistically relevant. The children’s gender, age, and BMI had no association with any of the HRQoL outcomes. Discussion: Parent proxy-report psychosocial health and mother’s BMI should be considered as predictors of HRQoL for the psychosocial and physical domain. PA should be implemented in order to improve the HRQoL of primary school children

New bioelectrical impedance vector references and phase angle centile curves in 4,367 adults: The need for an urgent update after 30 years

Background & aims: The bioelectrical impedance vector analysis (BIVA) represents a qualitative analysis of body composition. The vector, defined by resistance (R) and reactance (Xc) standardized by stature, can be evaluated compared to the 50%,75%, and 95% tolerance ellipses representative of the reference populations. The tolerance ellipses for healthy adults have been provided in 1995 and were developed by mixing underage, adult, and elderly subjects, possibly misrepresenting the actual adult population. The current multicentric, cross-sectional study aimed to provide new tolerance ellipses specific for the general adult population and as a secondary aim to present centile curves for the bioelectrical phase angle. Methods: R, Xc, and phase angle were measured in 2137 and 2230 males and females using phase-sensitive foot-to-hand analyzers at 50 kHz. A minimum of 35 subjects were included for each sex and age category from 18 to 65 years. Results: The new mean vectors showed a leftward shift on the R-Xc graph with respect to the former reference values (males: F = 75.3; p < 0.001; females: F = 36.6, p < 0.001). The results provided new 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentile curves for phase angle, identifying time point phases of decrement (males: -0.03° per year at 33.0-51.0 years and -0.05° per year after 51 years; females: -0.03° per year from 37.2 to 57.9 years). Conclusions: Compared to the original references, the new data are characterized by a different distribution within the R-Xc graph with a higher phase angle. Thirty years after the BIVA invention, the current study presents new tolerance ellipses and phase angle reference values for the adult population

Effects of Nordic Walking Training on Anthropometric, Body Composition and Functional Parameters in the Middle-Aged Population

Nordic walking (NW) is an easy physical exercise that is usually proposed for clinical populations and for the elderly. The aim of the present study was to examine the effects of a period of NW training in a non-clinical middle-aged population on anthropometric, body composition and functional parameters. A pre-test/post-test study design was conducted on 77 participants: 56 women (72.7%, age 55.53 ± 9.73 years) and 21 men (27.3%, age 60.51 ± 8.15 years). The measurements were carried out with physical tests at the baseline and at the follow up. Participants did two weekly NW training sessions of about 60 min each. A questionnaire was administered to evaluate their feelings after the training period. Paired Students’ test was carried out to evaluate the pre–post differences, and the analysis of variance was performed to evaluate the questionnaire. Participants had significantly less stress and anxiety after the NW training. Body fat parameters showed a significant decrease, especially for women. Phase angle and strength of lower body presented a significant increase in both sexes after the training period. In conclusion, NW shows many potential benefits also for the nonclinical population and could be an important exercise to remain active and to maintain a good health condition

Evaluation of the Effectiveness of a Nordic Walking and a Resistance Indoor Training Program: Anthropometric, Body Composition, and Functional Parameters in the Middle-Aged Population

Sedentary behaviors are increasing in the population, so strategies for the increment of physical activity levels are needed. The use of green space seems to be a valid support to be more active. The present study aimed to compare the effectiveness of a period of outdoor training (Nordic walking (NW)) with indoor resistance training (GYM) in a nonclinical population based on anthropometric characteristics, body composition, and functional parameters. This study was conducted on 102 participants (77 middle-aged people performed NW and 25 performed indoor training). Participants were measured twice: at baseline and after three months. Anthropometric measurements (weight, BMI, skinfolds, perimeters), body composition, bioelectrical impedance, vectorial analysis (BIA and BIVA), and physical tests were carried out. A two-way repeated measures analysis of variance (ANOVA) was performed to evaluate the effect of the treatments, groups, and sexes. There were several intervention effects linked to a decrease in fat parameters (such as skinfolds, fat mass, and percentage of fat mass). Considering the type of intervention, NW showed a higher increase in muscle mass and a higher decrease in fat parameters than the GYM group. In conclusion, the two types of training could represent a good way to remain active and prevent sedentary behaviors

Body Image Perception in Adolescents: The Role of Sports Practice and Sex

Concerns about weight and body image are common among adolescents, as adolescence represents a time of intense and rapid change. This cross-sectional study assessed the difference in body image perception by sex, weight status and sports practice in a sample of Italians aged 13-18 years. For this purpose, we considered a sample of 140 adolescents subdivided into two groups: a group of sports-playing teenagers practicing volleyball (39 males and 26 females), and a group of teenagers not actively involved in sports (24 males and 51 females). Body mass index (BMI), body image variables, and sports practice were examined. Due to COVID-19 limitations, height and weight were self-reported and BMI was calculated as weight (in kilograms) divided by the square of height (in meters). Body image perception was assessed by the short version of the Body Shape Questionnaire (BSQ-14) and by the Stunkard Body Silhouette Chart. Two-way ANCOVAs adjusted for age were performed to test the differences between sexes and sports groups. Adolescent volleyball players had a lower incidence of weight disorders. Weight status significantly differed between those who played sports and those who did not, but there was no significant difference in weight status between sexes. On the whole, sports players and males showed higher results than non-sports players and females. The highest level of body image dissatisfaction was found in non-sports-playing females, while sports-playing males showed the lowest. The present study confirms the positive link between sport and body image and can be of support to lead adolescents to adopt a healthier and more active lifestyle. Further research is needed to validate our findings through a longitudinal study during the entire period of adolescence. In addition, it would be interesting to validate the results on a larger sample, also taking into account socio-demographic variables and including athletes engaged in different types of sports

The association between body composition and quality of life among elderly Italians

Objective This study aimed to assess the body composition and quality of life in elderly Italian people and to value the association between these variables. Methods Height, weight, humerus breadth, circumferences, skinfolds, and hand grip strength were measured in 256 older adults (age: M: 81.1 +/- 7.3, F: 84.9 +/- 8.1 years). Body mass index, waist-hip ratio, waist-height ratio, upper-arm areas, and body composition parameters were calculated. Quality of life (QoL) was measured by WHO Quality of Life-BREF questionnaire (WHOQOL-BREF). Differences between sexes were valued. A multiple regression analysis was carried out to assess the influence of nutritional status and of socio-demographic characteristics on QoL. Results The participants were in average overweight. Even if the percentage of overweight/obese subjects was high in both sexes, males presented a more centripetal fat distribution. These characteristics, joined to data regarding lower values of arm-muscle area and hand grip strength, put males at greater risk of cardiometabolic diseases. Regarding quality of life assessments, psychological domain showed the worst scores, and, marital status resulted the main explanatory variable for this domain. Conclusions Social care facilities for the elderly people require planning strategies based on health promotion criteria in order to accentuate active ageing interventions to ameliorate the quality of life of residents

Safety and efficacy of sectorial resection with piezoelectric device in ONJ

Aim of the study was to evaluate the efficacy and safety of sectorial bone resection with piezoelectric device in patients with STAGE 1 and 2 (SIPMO/SICMF) ONJ. Materials and methods: A retrospective study was conducted in cancer and osteometabolic patients with ONJ of Stage 1 or Stage 2 according to SIPMO/SICMF 2.0 who underwent to sectorial bone resection with piezoelectric device and contextual first intention closure.All procedures were performed in local anesthesia and conscious sedation, in out-patients clinical setting.Treatment was considered efficient in case of complete epithelization of the site, complete resolution of symptoms and absence of exposure of bone. Piezoelectric device was used without other rotating handpieces.All patients were followed up at 2 weeks, 8 weeks and 6 months after the surgery.Results: 10 patients, from 45 to 83 (average 68.4) years old, 7 females and 3 males, were identified.Bisphosphonates were administrated in 7 cases (zoledronate) for oncological reasons, 2 patients for osteometabolic reasons (1 alendronate, 1 hybandronate) while in 1 case for algodystrophy (an off-label use of clodronate).8 mandibular sectorial osteotomies and 2 maxillary were performed, with a single recurrence.3 patients were heavy smokers: this surprising did not compromise the outcome.Conclusions: According to our case studies the use of piezoelectric device in sectorial bone resection in ONJ seem to be effective and easy to use

Effects of Nordic Walking Training on Anthropometric, Body Composition and Functional Parameters in the Middle-Aged Population

Nordic walking (NW) is an easy physical exercise that is usually proposed for clinical populations and for the elderly. The aim of the present study was to examine the effects of a period of NW training in a non-clinical middle-aged population on anthropometric, body composition and functional parameters. A pre-test/post-test study design was conducted on 77 participants: 56 women (72.7%, age 55.53 ± 9.73 years) and 21 men (27.3%, age 60.51 ± 8.15 years). The measurements were carried out with physical tests at the baseline and at the follow up. Participants did two weekly NW training sessions of about 60 min each. A questionnaire was administered to evaluate their feelings after the training period. Paired Students’ test was carried out to evaluate the pre–post differences, and the analysis of variance was performed to evaluate the questionnaire. Participants had significantly less stress and anxiety after the NW training. Body fat parameters showed a significant decrease, especially for women. Phase angle and strength of lower body presented a significant increase in both sexes after the training period. In conclusion, NW shows many potential benefits also for the nonclinical population and could be an important exercise to remain active and to maintain a good health condition