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Sport-Exercise and Stress: A Winning Combination

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 43361

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Special Issue Editors

Prof. Dr. Daniela Lucini

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Guest Editor

Department of Medical Biotechnology and Translational Medicine, University of Milan, 20135 Milan, Italy
Interests: autonomic nervous system; lifestyle

Prof. Dr. Ferdinando Iellamo

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Co-Guest Editor

Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Interests: exercise physiology; cardiac rehabilitation; autonomic nervous system; hypertension; heart failure
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Massimo Pagani

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Co-Guest Editor

Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
Interests: sympathetic activity; autonomic nervous system; heart rate variability; sport; exercise; exercise Medicine; applied physiology; computational physiology

Special Issue Information

Dear Colleagues,

The link between physical activity and stress is complex and fascinating. Stress management techniques are now considered an important tool to improve physical performance, particularly in elite sports; on the other hand, regularly performing exercise represents a strategy to manage chronic stress, particularly when the exercise is correctly prescribed.

Physical exercise and stress share another important issue: Both act on the main control systems of the body—immunological, hormonal, and autonomic nervous systems—and may have an epigenetic role.

Many chronic noncommunicable diseases such as ischemic heart disease, arterial hypertension, diabetes, obesity, some forms of cancer, and functional syndromes (conditions characterized by the presence of somatic symptoms that cannot be explained in terms of conventionally defined medical disease entities) are characterized per se by an impairment of immunological, hormonal, and autonomic nervous system controls that may be worsened by sedentariness and stress and may be improved by physical training and stress management.

Stress management techniques, such as mindfulness, mental relaxation, and psychological strategies such as a cognitive behavioral approach or motivational interview, may play an important role in improving physical performance in athletes or helping healthy subjects or patients to improve their behavior, introducing physical exercise in daily life.

This Special Issue of the International Journal of Environmental Research and Public Health aims to collect papers which explore the fascinating relationship between sport or exercise and stress, considering all the possible links, for instance, etiopathogenetic mechanisms (genetic, molecular, immunological, hormonal, autonomic nervous systems, etc.), therapeutic strategies, epidemiological, educational and preventive aspects, considering patients, healthy subjects, and athletes of traditional sport disciplines and of new frontiers or sport such as e-Sport (electronic sport), which is an emerging and interesting phenomenon.

Prof. Dr. Daniela Lucini
Prof. Dr. Ferdinando Iellamo
Prof. Dr. Massimo Pagani
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Sport
Exercise
Exercise medicine
Stress management
Autonomic nervous system
Performance, lifestyle

Published Papers (9 papers)

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Research

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10 pages, 340 KiB

Open AccessArticle

The Effects of Physical Inactivity and Exercise at Home in Young Patients with Congenital Heart Disease during the COVID-19 Pandemic

by Federica Gentili, Giulia Cafiero, Marco Alfonso Perrone, Massimiliano Bianco, Annamaria Salvati, Ugo Giordano, Stefani Silva Kikina, Paolo Guccione, Andrea De Zorzi, Lorenzo Galletti, Fabrizio Drago, Benedetta Leonardi and Attilio Turchetta

Int. J. Environ. Res. Public Health 2021, 18(19), 10065; https://doi.org/10.3390/ijerph181910065 - 25 Sep 2021

Cited by 13 | Viewed by 2666

Abstract

Background: The COVID-19 pandemic had a significant impact on the population’s ability to be physically active. Purpose: Evaluate the effect of the COVID-19 mitigation measures on exercise tolerance in patients with congenital heart disease (CHD). Materials and methods: All subjects (880, 6–18 years old) who performed a stress test at our hospital from October 2020 to February 2021 and had a similar test one year earlier were enrolled. A questionnaire on the degree of physical activity carried out in 2020 concerning the period prior to the pandemic was compiled. Exercise tolerance and the main anthropometric parameters between the first and second tests were compared. Results: 110 subjects (11.9 ± 4.1 years) were included in the study. The percentage of patients engaged in regular physical activity (RPA) decreased significantly during the pandemic (p < 0.001), and BMI increased significantly (p < 0.001), except among the subjects who began RPA during the lockdown, whereas test duration did not decrease significantly overall but increased in this last subgroup (p < 0.05) Conclusions: The COVID-19 lockdown led to a less active lifestyle with a significant increase in BMI in our group of CHD. These data could have negative effects on the risk profile of this population. RPA practiced at home seems to be effective in counteracting such effects. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

12 pages, 667 KiB

Open AccessArticle

Evidence of Better Psychological Profile in Working Population Meeting Current Physical Activity Recommendations

by Daniela Lucini, Eleonora Pagani, Francesco Capria, Michele Galliano, Marcello Marchese and Stefano Cribellati

Int. J. Environ. Res. Public Health 2021, 18(17), 8991; https://doi.org/10.3390/ijerph18178991 - 26 Aug 2021

Cited by 3 | Viewed by 2074

Abstract

Workplace Health Promotion (WHP) may improve health, productivity and safety and reduce absenteeism. However, although desirable, it is difficult to design tailored (and thus effective) WHP programs, particularly in small–medium companies, which rarely have access to sufficient economic and organizational resources. In this study, 1305 employees filled out an online anonymous lifestyle questionnaire hosted on the website of a non-profit organization, which aims to promote a healthy lifestyle among workers. The data show gender differences regarding stress perception and, in the working population meeting current physical activity recommendations (threshold = 600 MET·min/week), they point out the evidence of a better psychological and nutrition profile, a perception of better job performance, and improved sleep and health quality. Moreover, a unitary index (ranging from 0–100 (with higher scores being healthier)), combining self-reported metrics for diet, exercise and stress, was significantly higher in active employees (67.51 ± 12.46 vs. 39.84 ± 18.34, p < 0.001). The possibility of assessing individual lifestyle in an easy, timely and cost-effective manner, offers the opportunity to collect grouped data useful to drive tailored WHP policies and to have metric to quantify results of interventions. This potentiality may help in creating effective programs and in improving employees’ and companies’ motivation and attitude towards a feasible WHP. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

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9 pages, 611 KiB

Open AccessArticle

The Effects of Reduced Physical Activity on the Lipid Profile in Patients with High Cardiovascular Risk during COVID-19 Lockdown

by Marco Alfonso Perrone, Alessandro Feola, Massimo Pieri, Bruno Donatucci, Chiara Salimei, Mauro Lombardo, Andrea Perrone and Attilio Parisi

Int. J. Environ. Res. Public Health 2021, 18(16), 8858; https://doi.org/10.3390/ijerph18168858 - 23 Aug 2021

Cited by 19 | Viewed by 3108

Abstract

Background: The COVID-19 pandemic is a serious global health problem. In Italy, to limit the infections, the government ordered lockdown from March 2020. This measure, designed to contain the virus, led to serious limitations on the daily life of the individuals it affected, and in particular in the limitation of physical exercise. The aim of this study was to evaluate the effects of reduced physical activity on the lipid profile in patients with high cardiovascular risk. Methods: We enrolled 38 dyslipidemic patients, 56% male, with an age range of 44–62 years, considered to be at high cardiovascular risk. All patients were prescribed statin drug therapy (atorvastatin 40 mg) and a vigorous physical activity program four times a week, 1 h per session. In addition, a personalized Mediterranean diet was prescribed to all the patients. Total cholesterol, LDL, HDL and triglycerides were measured in patients at T0 before lockdown and at T1 during lockdown. Results: Data showed a significant increase (p < 0.01) in total cholesterol (+6,8%) and LDL (+15,8%). Furthermore, the analysis of the data revealed a reduction in HDL (−3%) and an increase in triglycerides (+3,2%), although both were not significant (p > 0.05). Conclusions: Our study showed that the reduction in physical activity during lockdown led to an increase in LDL levels, and therefore, in the risk of ischemic heart disease in dyslipidemic patients with high cardiovascular risk. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

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11 pages, 850 KiB

Open AccessArticle

Prolonged Post-Exercise Hypotension: Effects of Different Exercise Modalities and Training Statuses in Elderly Patients with Hypertension

by Ferdinando Iellamo, Giuseppe Caminiti, Matteo Montano, Vincenzo Manzi, Alessio Franchini, Annalisa Mancuso and Maurizio Volterrani

Int. J. Environ. Res. Public Health 2021, 18(6), 3229; https://doi.org/10.3390/ijerph18063229 - 20 Mar 2021

Cited by 15 | Viewed by 4406

Abstract

Background: In this study, we aimed at comparing the effects of three different exercise modalities on post-exercise hypotension (PEH) in elderly hypertensive patients and at investigating whether PEH responses to the same exercises are affected by their training status. Methods: Thirty-six male sedentary hypertensive patients over 60 years old, were included. They were divided into three groups each one corresponding to a different exercise modality, i.e., aerobic continuous exercise (ACE), high-intensive interval exercise (HIIE), and combined (aerobic and resistance) exercise (CE). PEH was assessed in each group by ambulatory blood pressure monitoring (ABPM) in two different conditions as follows: (1) sedentary status and (2) trained status, at the end of a 12 week of ACE training program. A cardiopulmonary test was performed before and at the end of the training program. Results: In the sedentary status, 24-h and nocturnal systolic and diastolic blood pressure (BP) decreased in all groups as compared with top pre-exercise, with a greater but not significant reduction in the ACE and CE groups as compared with HIIE. ACE and HIIE groups presented a more sustained PEH than CE. In the trained status, 24-h and nighttime systolic and diastolic BP decreased significantly only after HIIE, but were unchanged as compared with pre-exercise in the ACE and CE groups. Conclusions: ACE and CE produced greater PEH than HIIE in sedentary elderly hypertensive patients. However, after training, HIIE produced the greater and more sustained PEH. The training status appears to exert significant effects on PEH produced by different exercise modalities. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

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Review

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10 pages, 338 KiB

Open AccessReview

Physical Exercise and Mental Health: The Routes of a Reciprocal Relation

by Chiara Fossati, Guglielmo Torre, Sebastiano Vasta, Arrigo Giombini, Federico Quaranta, Rocco Papalia and Fabio Pigozzi

Int. J. Environ. Res. Public Health 2021, 18(23), 12364; https://doi.org/10.3390/ijerph182312364 - 24 Nov 2021

Cited by 25 | Viewed by 12422

Abstract

Sport participation and exercise practice are considered to be beneficial for mental status, yielding an improved mood and better quality of life. On the other hand, good mental fitness is thought to lead to better physical status and sport performance. The key aim of this narrative review is to provide an unstructured overview on the topic with special considerations on the role of mental and physical health to summarize the evidence on their reciprocal influence. While very few papers describe the role of mental health measures in affecting physical performance, more evidence is available concerning the effect of exercise and sport in improving mental health outcomes. Furthermore, there is a consistent role of depressive and anxiety symptoms in influencing the risk of sport injury in either recreational or elite athletes. Moreover, the importance of investigating mental health issues in elite and retired athletes is highlighted. On the basis of the available literature, several biases were found to affect the provided evidence mainly because of the complexity of a proper study design in this field. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

14 pages, 895 KiB

Open AccessReview

Vascular Ageing and Aerobic Exercise

by Michaela Kozakova and Carlo Palombo

Int. J. Environ. Res. Public Health 2021, 18(20), 10666; https://doi.org/10.3390/ijerph182010666 - 12 Oct 2021

Cited by 16 | Viewed by 3120

Abstract

Impairment of vascular function, in particular endothelial dysfunction and large elastic artery stiffening, represents a major link between ageing and cardiovascular risk. Clinical and experimental studies identified numerous mechanisms responsible for age-related decline of endothelial function and arterial compliance. Since most of these mechanisms are related to oxidative stress or low-grade inflammation, strategies that suppress oxidative stress and inflammation could be effective for preventing age-related changes in arterial function. Indeed, aerobic physical activity, which has been shown to improve intracellular redox balance and mitochondrial health and reduce levels of systemic inflammatory markers, also improves endothelial function and arterial distensibility and reduces risk of cardiovascular diseases. The present paper provides a brief overview of processes underlying age-related changes in arterial function, as well as the mechanisms through which aerobic exercise might prevent or interrupt these processes, and thus attenuate vascular ageing. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

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17 pages, 2700 KiB

Open AccessReview

Chronic Stress, Exercise and Cardiovascular Disease: Placing the Benefits and Risks of Physical Activity into Perspective

by Barry A. Franklin, Akash Rusia, Cindy Haskin-Popp and Adam Tawney

Int. J. Environ. Res. Public Health 2021, 18(18), 9922; https://doi.org/10.3390/ijerph18189922 - 21 Sep 2021

Cited by 11 | Viewed by 7028

Abstract

Chronic stress, which has been exacerbated worldwide by the lingering COVID pandemic, has been strongly linked to cardiovascular disease (CVD). In addition, autonomic dysregulation via sustained sympathetic activity has been shown to increase the risk of arrhythmias, platelet aggregation, acute coronary syndromes and heart failure. Fortunately, effective coping strategies have been shown to attenuate the magnitude of hyperarousal associated with the stress response, including moderate-to-vigorous lifestyle activity and/or structured exercise. A good-to-excellent level of cardiorespiratory fitness also appears to be highly cardioprotective. These beneficial effects have been substantiated by numerous studies that have evaluated the levels of stress reactivity and stress recovery in physically active individuals versus matched sedentary controls, as well as before and after exercise interventions. On the other hand, unaccustomed strenuous exercise in habitually sedentary persons with underlying CVD is associated with a disproportionate incidence of acute cardiac events. Moreover, extreme exercise regimens appear to increase coronary calcification and the likelihood of developing atrial fibrillation. This review summarizes these relations and more, with specific reference to placing the benefits and risks of physical activity into perspective. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

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22 pages, 1201 KiB

Open AccessReview

Exercise Prescription to Foster Health and Well-Being: A Behavioral Approach to Transform Barriers into Opportunities

by Daniela Lucini and Massimo Pagani

Int. J. Environ. Res. Public Health 2021, 18(3), 968; https://doi.org/10.3390/ijerph18030968 - 22 Jan 2021

Cited by 21 | Viewed by 5118

Abstract

The current literature contains multiple examples of exercise interventions to foster health and to prevent/treat many chronic non-communicable diseases; stress and functional syndromes. On the other hand, sedentariness is increasing and to transform a sedentary subject into a regular exerciser is not only very difficult but considered by some unrealistic in current clinical practice. Ideally a physical activity intervention may be considered actually efficacious when it outgrows the research setting and becomes embedded in a system, ensuring maintenance and sustainability of its health benefits. Physicians need specific skills to improve patients’ exercise habits. These range from traditional clinical competencies, to technical competencies to correctly prescribe exercise, to competencies in behavioral medicine to motivate the subject. From a behavioral and medical point of view, an exercise prescription may be considered correct only if the subject actually performs the prescribed exercise and this results in an improvement of physiological mechanisms such as endocrine, immunological and autonomic controls. Here we describe a model of intervention intended to nurture exercise prescription in everyday clinical setting. It aims to a tailored prescription, starts from the subject’s assessment, continues defining clinical goals/possible limitations and ends when the subject is performing exercise obtaining results. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

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Other

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6 pages, 295 KiB

Open AccessCommentary

From Oncological Paradigms to Non-Communicable Disease Pandemic. The Need of Recovery Human Biology Evolution

by Elia Biganzoli and Romano Demicheli

Int. J. Environ. Res. Public Health 2021, 18(19), 10087; https://doi.org/10.3390/ijerph181910087 - 25 Sep 2021

Cited by 2 | Viewed by 1883

Abstract

The paradigm of the Somatic Mutation Theory (SMT) is failing, and a new paradigm is underway but not yet established. What is being challenged is a conceptual approach that involves the entire human biology and the development of chronic diseases. The behavior of breast and other solid cancers is compatible with the concept that the primary tumor is able to control its microscopic metastases, in the same way that an organ (e.g., the liver) is able to control its physiological size. This finding suggested that cancer and its metastases may behave as an organoid. The new paradigm under construction considers the origin of tumors as a disturbance in the communication network between tissue cell populations and between cells and extracellular matrix, and supports a systemic approach to the study of both healthy and pathologic tissues. The commentary provides a rationale for the role of physical exercise in the control of tumor dormancy according to a human evolutionary perspective. Full article

(This article belongs to the Special Issue Sport-Exercise and Stress: A Winning Combination)

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