Faculty of Medicine

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THE INFLUENCE OF THE REDUCTION DIETING ON RESTING METABOLIC RATE AND OXIDATIVE STRESS IN ATHLETES
(Macedonian Association of Anatomists and Morphologists, 2024-12-31)
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Vidoevski, Filip
Oxidative stress (OS) represents an imbalance between the production of reactive oxygen species (ROS) and the ability to detoxify the reactive intermediates, as well as the body's inability to provide adequate antioxidant defense. The aim of the study was to present the current data from the literature regarding influence of the reduction dieting on resting metabolic rate (RMR) and OS, in order to emphasize the need of dietary balance on sport performance and quality of life in athletes. By using the current literature of the Systematic Reviews databases such as Medline, the Cochrane Library, Scopus, Pubmed and Web of Science, the data were selected and analyzed. The effect that regular exercising has on OS is different, depending on age, sex, workout intensity and its duration. Moderate physical activity has a positive impact on OS, improving health, while intensive physical activity may lead to excessive production of ROS. Although the physical activity can lead to increased OS, it gives a positive stimulus for the endogenous antioxidative defense, according to the theory of hormesis. Athletes compared to the sedentary subjects have a higher percentage of muscle mass due to their active lifestyle. Higher percentage of muscle mass contributes to higher energy requirement. Although athletes strive to maintain the energy balance, reduction diets are considered to have a positive effect on OS. Experimental studies show that prolonged caloric deficit increases the average lifespan of rodents and other animal species. One of the hypotheses explaining the effect of slowing down the ageing process by a reduction diet is the decreased energetic expenditure, leading to decreased ROS production. Focused on OS decreasing and improving the sport performance, athletes need balanced nutrition, including reduction diets. Reduction diets that decrease RMR by a combination with moderate physical activity show a positive impact on OS, slowing down the ageing process, prolonging the lifespan.
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Diet-Related Improvement Of Non-Alcoholic Steatohepatitis
(2020)
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Nikolovska Trpchevska, Emilija
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Non-alcoholic fatty liver disease (NAFLD) refers to a wide pathological spectrum ranging from simple steatosis to steatohepatitis (NASH) with or without variable degrees of fibrosis. It represents an increasing health problem since it leads to the development of cirrhosis and liver cancer. In Western countries NAFLD/NASH-associated cirrhosis is becoming one of the most frequent indications for liver transplantation. Thus it is important to recognize and identify patients at risk of progression of NAFLD and implement therapeutic interventions. The goal is to prevent or reverse the liver inflammation and finally prevent detrimental consequences of advanced NASH. NAFLD is more commonly encountered in obese and patients with diabetes. The key pathogenic trigger is insulin resistance, which through simple steatosis leads to steatohepatitis. The later is the strongest predictor of fibrosis progression in NAFLD. The management of NAFLD/NASH is challenging as there is lack of an effective therapy and no approved pharmacological agent for the treatment of NASH. The results from clinical studies point to dietary intervention as the cornerstone of the therapy. We present a case where improvement of NASH was achieved solely by lifestyle modification. A 37 year old male patient with elevated transaminases was referred to our clinic for evaluation. After initial assessment with detalied history, compre - hensive laboratory analyses and abdominal ultrasound, a liver biopsy was performed and he was diagnosed with NASH. His initial body mass index (BMI) was 28.9 kg/m2, the homeostasis model assessment-insulin resistance (HOMA-IR) was 5.6. Presence of hypercholesterolemia and hyperferritinemia was also noted. He was advised to commence a low calorie diet accompanied with physical activity. Additionaly he was prescribed hepatoprotective (silymarin) therapy, vitamin D and C supplementation and lipid lowering agents. In the following year the transaminase activity and insulin resistance were maintened despite pharmacological treatment but the patient reported that he hasn’t been paying attention to his calorie in - take and has been practicing only mild physical activity. Upon re-evaluation, he was advised to initiate metformin therapy, but he refused, so a dedicated nutritional counseling was performed emphisizing the risks of ongoing liver inflammation and ensuing liver damage. The patient started with calorie restrictive diet, low impact aerobic exercise (pool swimming) and continiued only with vitamin D supplementation. After 3 months he achieved a reduction of 10% of his initial body weight. Control blood analyses showed normalisation of the transaminase activity, as well as a decrease in HOMA-IR value. The BMI was 25.7 kg/m2, his lipid profile improved and ferritin levels also decresed. He was advised to continue with his lifestyle modification and was scheduled for 3 months interval monitoring as to sustain his compliance. The results achieved with dieting and physical activity presented in this case strongly support the role of lifestyle modification as primary therapy for the management of NAFLD/NASH. But there is a reasonable possibility of relapses, so dietary intervention accompanied with strategies to avoid relapse and weight regain should be implemented.
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THE IMPACT OF PHYSICAL ACTIVITY ON CARDIOVASCULAR DISEASE
(MIT Univerzitet Skopje, 2022)
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Grueva E
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Petkovski Z
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Bojovski I
Background: Cardiovascular diseases are the leading cause of death in the adult population worldwide. Factors that affect heart health can be split into two groups: factors that can be controlled, influenced i.e. modified (obesity, diabetes, hyperlipemia, hypertension, physical activity, etc.), and factors that cannot be controlled, influenced i.e. non - modifying factors (genetics, aging, congenital valvular diseases, etc.). The advantage of physical activity is that it belongs to the modifying factors for preserving heart health, which means that it is never too late to start exercising. The aim of this paper is to introduce international experiences and recommendations for physical activity and its contribution to preserving heart health. The impact and connection of physical activity on the health of the human body have been observed and studied by many scientists from various medical fields over the years. Regular physical activity also helps in reducing the levels of glycemia in the blood, improving the mental state, as well as reducing body weight factors that directly affect the health of the heart. It has been proven on several occasions that physical activity or lack of it has an impact on almost all organs in the human body. The physical activity of the heart, as one of the most active organs in the human body, has both direct and indirect effects. In the continuation of this paper,we will refer to some of the global experiences and recommendations for physical activity that will lead to benefits not only for the heart but also for the entire organism. Conclusion: Physical activity is crucial for a healthy heart and a long life. More involvement from the scientific communityis needed for the promotion of the physical activity.
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PHYSICAL ACTIVITY FOR BETTER HEALTH – SUMMARY OF GUIDELINES AND RECOMMENDATIONS
(Ss. Cyril and Methodius University, Faculty of Physical Education, Sport, and Health, 2018)
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Physical activity is the fundamental human ability and basis for surviving at all. It can be described by performance parameters: frequency, duration and intensity. Physical activity is key determinant for maintaining of good conditions for vital physiological systems, such as cardiovascular, locomotors, respiratory, nervous etc. The main goal of developing the strategy for physical activity for better health is to control of noncomunicable diseases. The most important world health organizations (including World Health Organization, World Health Assembly etc) are united with the global targets to reduce the prevalence of insufficient physical activity and consecutively increase the level of physical activity. There are many different forms, kinds and levels of intensity of physical activity. The proper prescribing of the physical activity should lead to attaining the very important targets: reduction of premature mortality from cardiovascular diseases, cancer, diabetes, high blood pressure and obesity. To fulfill the proposed health benefits physical activity should be dosed according to individual features and needs. The World Health Organization and range of other international and national health organizations made a set of recommendations for different populations group which could help to practice physical activity safely and with optimal results.
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The association between BMI, vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema in children and adolescents: ISAAC Phase Three
(Wiley, 2013-01)
Mitchell, E A
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Beasley, R
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Björkstén, B
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Crane, J
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García-Marcos, L
Background: Several studies have observed an association between obesity and asthma, but whether or not there is an association with rhinoconjunctivitis or eczema is unclear. Aims To examine the relationship between body mass index categories (underweight, overweight and obesity), vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema. Methods: As part of International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, parents or guardians of children aged 6–7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several potential risk factors, such as vigorous physical activity and television viewing, and other information such as the child’s height and weight. Adolescents aged 13–14 years self-completed the questionnaires on these symptoms and potential risk factors and reported their own height and weight. For 28% of children and 24% of adolescents, the height and weight was objectively measured. Results: A total of 76 164 children aged 6–7 years (from 29 centres and 17 countries) and 201 370 adolescents aged 13–14 years (from 73 centres and 35 countries) provided data meeting the inclusion criteria. There were associations between overweight and obesity, but not underweight, and symptoms of asthma and eczema but not rhinoconjunctivitis. Vigorous physical activity was positively associated with symptoms of asthma, rhinoconjunctivitis and eczema in adolescents, but not children. Viewing television for five or more hours/day was associated with an increased risk of symptoms of asthma, rhinoconjunctivitis and eczema in adolescents and symptoms of asthma in children. Conclusions and Clinical Relevance: This study has confirmed the association between overweight and obesity and symptoms of asthma. It has extended these observations to include significant associations with symptoms of eczema, but not rhinoconjunctivitis. There are complex relationships between obesity, vigorous physical activity and sedentary behaviour and the symptoms of asthma, rhinoconjunctivitis and eczema in children.
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Influence of physical activity and television-watching time on asthma and allergic rhinitis among young adolescents: preventive or aggravating?
(Elsevier BV, 2008)
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Stavric, Katerina
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Seckova, Lidija
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Kimovska, Milica
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BACKGROUND: Related to exercise hypothesis, the aim of the present study was to explore the influence of physical activity on asthma and allergic rhinitis in a developing country where publicity campaigns about the benefits of exercise are scarce. METHODS: The analysed data were self-reported and obtained through the standardized International Study of Asthma and Allergies in Childhood Phase Three written questionnaires completed by 3026 adolescents 13/14 year old in Skopje (Republic of Macedonia). Vigorous physical activity and television-watching timeboth unadjusted and adjusted for confounding factorswere used as variables for analysis. Odds ratios (OR, 95 % CI) in binary logistic regression were employed for statistic analysis of the data. RESULTS: Vigorous physical activity both > or = 3 times and 1-2 times per week was associated with an increased risk of current wheeze (aOR: 1.66; 1.08-2.55; p = 0.020 and aOR: 1.70; 1.23-2.36; p = 0.001, respectively), speech-limiting wheeze (aOR: 3.15; 1.13-8.77; p = 0.028 and aOR: 4.62; 2.22-9.62; p = 0.000, respectively) and exercise-induced wheeze (aOR: 2.72; 1.93-3.83; p = 0.000 and aOR: 4.01; 3.12-5.14; p = 0.000, respectively). Frequent physical activity was positively associated only with current allergic rhinitis symptoms (aOR: 1.40; 1.04-1.90; p = 0.029). Television watching > or = 3 hours a day increased the risk of current wheeze (aOR: 1.34; 1.01-1.77; p = 0.042) and exercise-induced wheeze (aOR: 1.32; 1.05-1.65; p = 0.016). CONCLUSION: The findings support the aggravating role of sedentary regimen and poor physical fitness on asthma symptoms, but not on allergic rhinitis. Physical activity may trigger asthma symptoms when physical fitness is poor and asthma is not controlled.

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