Physical activity in metabolic syndrome.

Obesity has become one of the global epidemics, contributing to the burden of disease in society, increasing the risk of diabetes, cardiovascular and liver diseases. Inadequate energy balance resulting from excessive energy intake and insufficient physical activity (PA) is one of the main factors contributing to the incidence of obesity and the development of metabolic syndrome (MetS). Treatment options for obesity include lifestyle modifications, pharmacotherapy and bariatric surgery, with the latter being the most effective treatment. Lifestyle interventions involving increased PA and reduced caloric intake improve metabolic outcomes. Early implementation of exercise leads to improved physical fitness, better glycemic control and lipid profile. Undertaking systematic PA is associated with better quality of life, improves insulin sensitivity, causes additional weight loss, reduces its adverse effects on bone mass and results in better body composition. In this narrative review we summarized the current state of knowledge on the impact of PA on the components of MetS and the latest recommendations for PA in patients with MetS.

Below or all the way to the peak? Oxygen uptake efficiency slope as the index of cardiorespiratory response to exercise-the NOODLE study.

Background: The ratio of oxygen uptake (VO2) to minute ventilation (VE) is described as the oxygen uptake efficiency slope (OUES). OUES has been suggested as a valuable submaximal cardiorespiratory index; however, its characteristics in endurance athletes remain unknown. In this study, we a) investigated OUES between different time intervals, b) assessed their prediction power for VO2peak, and c) derived new prediction equations for OUES tailored for well-trained individuals. Materials and Methods: A total of 77 male (age = 21.4 ± 4.8 yrs; BMI = 22.1 ± 1.6 kg·m-2; peak oxygen uptake = 4.40 ± 0.64 L·min-1) and 63 female individuals (age = 23.4 ± 4.3 yrs; BMI = 23.1 ± 1.6 kg·m-2; peak oxygen uptake = 3.21 ± 0.48 L·min-1) underwent the cycling cardiopulmonary exercise test. OUES was measured at 75%, 90%, and 100% of exercise duration. Prediction power and new models were derived with the multiple linear regression method. Results: In male subjects, OUES [mL·min-1/L·min-1] from 75% = 4.53 ± 0.90, from 90% = 4.52 ± 0.91, and from 100% = 4.41 ± 0.87. In female subjects, OUES [mL·min-1/L·min-1] from 75% = 3.50 ± 0.65, from 90% = 3.49 ± 0.62, and from 100% = 3.41 ± 0.58. OUES did not differ between time intervals in male (p = 0.65) and female individuals (p = 0.69). OUES strongly predicts peak VO2 independently from the measuring interval (ß = 0.71-0.80; R 2 = 0.50-0.63). The prediction model designed for elite athletes was OUES [mL·min-1/L·min-1] = -1.54 + 2.99; BSA [m2]-0.0014; (age [in years]; sex [1 = male, 2 = female]) (R 2 = 0.36). Conclusion: OUES enables an accurate prediction of peak cardiorespiratory fitness in elite endurance athletes. OUES is a feasible alternative to maximal exercise testing. A new prediction equation should be used for highly trained individuals. Physicians should understand OUES physiology to properly assess the cardiorespiratory response to exercise in athletic cohorts.

Is the Ventilatory Efficiency in Endurance Athletes Different?-Findings from the NOODLE Study.

Background: Ventilatory efficiency (VE/VCO2) is a strong predictor of cardiovascular diseases and defines individuals' responses to exercise. Its characteristics among endurance athletes (EA) remain understudied. In a cohort of EA, we aimed to (1) investigate the relationship between different methods of calculation of VE/VCO2 and (2) externally validate prediction equations for VE/VCO2. Methods: In total, 140 EA (55% males; age = 22.7 ± 4.6 yrs; BMI = 22.6 ± 1.7 kg·m-2; peak oxygen uptake = 3.86 ± 0.82 L·min-1) underwent an effort-limited cycling cardiopulmonary exercise test. VE/VCO2 was first calculated to ventilatory threshold (VE/VCO2-slope), as the lowest 30-s average (VE/VCO2-Nadir) and from whole exercises (VE/VCO2-Total). Twelve prediction equations for VE/VCO2-slope were externally validated. Results: VE/VCO2-slope was higher in females than males (27.7 ± 2.6 vs. 26.1 ± 2.0, p < 0.001). Measuring methods for VE/VCO2 differed significantly in males and females. VE/VCO2 increased in EA with age independently from its type or sex (ß = 0.066-0.127). Eleven equations underestimated VE/VCO2-slope (from -0.5 to -3.6). One equation overestimated VE/VCO2-slope (+0.2). Predicted and observed measurements differed significantly in nine models. Models explained a low amount of variance in the VE/VCO2-slope (R2 = 0.003-0.031). Conclusions: VE/VCO2-slope, VE/VCO2-Nadir, and VE/VCO2-Total were significantly different in EA. Prediction equations for the VE/VCO2-slope were inaccurate in EA. Physicians should be acknowledged to properly assess cardiorespiratory fitness in EA.

Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines-Hospital Diet Medical Investigation) (HDMI) Study.

Cardiovascular diseases (CVDs) are the leading causes of death worldwide. CVDs have become the dominant cause of death and have been a significant health challenge since the second half of the 20th century in the Polish population. The aim of our HDMI (hospital diet medical investigation) study was to examine the quality of the hospital diets given to cardiac patients and assess how much they adhere to the European Society of Cardiology (ESC) 2021 guidelines. By comparing the diets received by patients with the recommended dietary patterns outlined in the ESC 2021 guidelines, we sought to identify discrepancies. The study was conducted in two steps: creating a 7-day model menu and comparing it with the received diets and then making comparisons with ESC 2021 guidelines. Additionally, we designed a survey to obtain the characteristics of the hospitals. The results show that the nutrition in hospitals remains substandard. None of the diets had an appropriate salt supply or predominance of plant-based food patterns. Only 1/7 diets avoided sweetened beverages, and 2/7 diets had an appropriate amount of fiber. This underscores a gap in the healthcare system to improve patients' health by implementing dietary interventions that foster the development of healthy eating habits.

Validity of the Maximal Heart Rate Prediction Models among Runners and Cyclists.

Maximal heart rate (HRmax) is a widely used measure of cardiorespiratory fitness. Prediction of HRmax is an alternative to cardiopulmonary exercise testing (CPET), but its accuracy among endurance athletes (EA) requires evaluation. This study aimed to externally validate HRmax prediction models in the EA independently for running and cycling CPET. A total of 4043 runners (age = 33.6 (8.1) years; 83.5% males; BMI = 23.7 (2.5) kg·m-2) and 1026 cyclists (age = 36.9 (9.0) years; 89.7% males; BMI = 24.0 (2.7) kg·m-2) underwent maximum CPET. Student t-test, mean absolute percentage error (MAPE), and root mean square error (RMSE) were applied to validate eight running and five cycling HRmax equations externally. HRmax was 184.6 (9.8) beats·min-1 and 182.7 (10.3) beats·min-1, respectively, for running and cycling, p = 0.001. Measured and predicted HRmax differed significantly (p = 0.001) for 9 of 13 (69.2%) models. HRmax was overestimated by eight (61.5%) and underestimated by five (38.5%) formulae. Overestimated HRmax amounted to 4.9 beats·min-1 and underestimated HRmax was in the range up to 4.9 beats·min-1. RMSE was 9.1-10.5. MAPE ranged to 4.7%. Prediction models allow for limited precision of HRmax estimation and present inaccuracies. HRmax was more often underestimated than overestimated. Predicted HRmax can be implemented for EA as a supplemental method, but CPET is the preferable method.

Impact of COVID-19 Infection on Cardiorespiratory Fitness, Sleep, and Psychology of Endurance Athletes-CAESAR Study.

COVID-19 has a deteriorating impact on health which is especially important for endurance athletes (EAs) who need to maintain continuity of training. The illness affects sleep and psychology, which influence sport performance. The aims of this study were: (1) to assess the consequences of mild COVID-19 on sleep and psychology and (2) to assess the consequences of mild COVID-19 on cardiopulmonary exercise test (CPET) results. A total of 49 EAs (males = 43, 87.76%; females = 6, 12.24%; age = 39.9 ± 7.8 years; height = 178.4 ± 6.8 cm; weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m-2) underwent a maximal cycling or running CPET pre- and post-COVID-19 and completed an original survey. Exercise performance deteriorated after COVID-19 (maximal oxygen uptake, VO2max = 47.81 ± 7.81 vs. 44.97 ± 7.00 mL·kg·min-1 pre- and post-infection, respectively; p < 0.001). Waking up at night affected the heart rate (HR) at the respiratory compensation point (RCP) (p = 0.028). Sleep time influenced pulmonary ventilation (p = 0.013), breathing frequency (p = 0.010), and blood lactate concentration (Lac) (p = 0.013) at the RCP. The maximal power/speed (p = 0.046) and HR (p = 0.070) were linked to the quality of sleep. Stress management and relaxation techniques were linked with VO2max (p = 0.046), maximal power/speed (p = 0.033), and maximal Lac (p = 0.045). Cardiorespiratory fitness deteriorated after mild COVID-19 and was correlated with sleep and psychological indices. Medical professionals should encourage EAs to maintain proper mental health and sleep after COVID-19 infection to facilitate recovery.

The Influence of Metabolic Factors and Diet on Fertility.

Infertility is a disease globally affecting 20-30% of the reproductive age female population. However, in up to 50% on recorded cases, problems with infertility are ascribed to men; therefore, it is important to popularize healthy eating also in this group. During the last decade, it has been observed that society's lifestyle changed drastically: reduced energy expenditure in physical activity per day, increased consumption of hypercaloric and high-glycemic-index foods with high content of trans fats, and reduced consumption of dietary fiber, which negatively affects fertility. Increasing evidence points to a link between diet and fertility. It is becoming clear that well-planned nutrition can also contribute to the effectiveness of ART. The low-GI plant-based diet appears to have a positive effect, especially when it is based on Mediterranean dietary patterns: rich in antioxidants, vegetable protein, fiber, MUFA fatty acids, omega-3, vitamins, and minerals. Importantly, this diet has been shown to protect against chronic diseases associated with oxidative stress, which also translates into pregnancy success. As lifestyle and nutrition seem to be important factors affecting fertility, it is worth expanding knowledge in this regard among couples trying to conceive a child.

External validation of VO2max prediction models based on recreational and elite endurance athletes.

In recent years, numerous prognostic models have been developed to predict VO2max. Nevertheless, their accuracy in endurance athletes (EA) stays mostly unvalidated. This study aimed to compare predicted VO2max (pVO2max) with directly measured VO2max by assessing the transferability of the currently available prediction models based on their R2, calibration-in-the-large, and calibration slope. 5,260 healthy adult EA underwent a maximal exertion cardiopulmonary exercise test (CPET) (84.76% male; age 34.6±9.5 yrs.; VO2max 52.97±7.39 mL·min-1·kg-1, BMI 23.59±2.73 kg·m-2). 13 models have been selected to establish pVO2max. Participants were classified into four endurance subgroups (high-, recreational-, low- trained, and "transition") and four age subgroups (18-30, 31-45, 46-60, and ≥61 yrs.). Validation was performed according to TRIPOD guidelines. pVO2max was low-to-moderately associated with direct CPET measurements (p>0.05). Models with the highest accuracy were for males on a cycle ergometer (CE) (Kokkinos R2 = 0.64), females on CE (Kokkinos R2 = 0.65), males on a treadmill (TE) (Wasserman R2 = 0.26), females on TE (Wasserman R2 = 0.30). However, selected models underestimated pVO2max for younger and higher trained EA and overestimated for older and lower trained EA. All equations demonstrated merely moderate accuracy and should only be used as a supplemental method for physicians to estimate CRF in EA. It is necessary to derive new models on EA populations to include routinely in clinical practice and sports diagnostic.

The Influence of Nutrition and Physical Activity on Exercise Performance after Mild COVID-19 Infection in Endurance Athletes-CESAR Study.

COVID-19 and imposed restrictions are linked with numerous health consequences, especially among endurance athletes (EA). Unfavorable changes in physical activity and nutrition may affect later sports and competition performance. The aims of this study were: (1) to assess the impact of COVID-19 infection and pandemic restrictions on the nutrition and physical activity of EAs and (2) to compare them with the results of cardiopulmonary exercise testing (CPET). In total, 49 EAs (nmale = 43, nfemale = 6, mean age = 39.9 ± 7.8 year., height = 178.4 ± 6.8 cm, weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m−2) underwent pre- and post-COVID-19 CPET and fulfilled the dietary and physical activity survey. COVID-19 infection significantly deteriorated CPET performance. There was a reduction in oxygen uptake and in heart rate post-COVID-19 (both p < 0.001). Consuming processed meat and replacing meat with plant-based protein affected blood lactate concentration (p = 0.035). Fat-free mass was linked with consuming unsaturated fatty acids (p = 0.031). Adding salt to meals influenced maximal speed/power (p = 0.024) and breathing frequency (p = 0.033). Dietary and Fitness Practitioners and Medical Professionals should be aware of possible COVID-19 infection and pandemic consequences among EA. The results of this study are a helpful guideline to properly adjust the treatment, nutrition, and training of EA.

Modeling Physiological Predictors of Running Velocity for Endurance Athletes.

Background: Properly performed training is a matter of importance for endurance athletes (EA). It allows for achieving better results and safer participation. Recently, the development of machine learning methods has been observed in sports diagnostics. Velocity at anaerobic threshold (VAT), respiratory compensation point (VRCP), and maximal velocity (Vmax) are the variables closely corresponding to endurance performance. The primary aims of this study were to find the strongest predictors of VAT, VRCP, Vmax, to derive and internally validate prediction models for males (1) and females (2) under TRIPOD guidelines, and to assess their machine learning accuracy. Materials and Methods: A total of 4001 EA (nmales = 3300, nfemales = 671; age = 35.56 ± 8.12 years; BMI = 23.66 ± 2.58 kg·m-2; VO2max = 53.20 ± 7.17 mL·min-1·kg-1) underwent treadmill cardiopulmonary exercise testing (CPET) and bioimpedance body composition analysis. XGBoost was used to select running performance predictors. Multivariable linear regression was applied to build prediction models. Ten-fold cross-validation was incorporated for accuracy evaluation during internal validation. Results: Oxygen uptake, blood lactate, pulmonary ventilation, and somatic parameters (BMI, age, and body fat percentage) showed the highest impact on velocity. For VAT R2 = 0.57 (1) and 0.62 (2), derivation RMSE = 0.909 (1); 0.828 (2), validation RMSE = 0.913 (1); 0.838 (2), derivation MAE = 0.708 (1); 0.657 (2), and validation MAE = 0.710 (1); 0.665 (2). For VRCP R2 = 0.62 (1) and 0.67 (2), derivation RMSE = 1.066 (1) and 0.964 (2), validation RMSE = 1.070 (1) and 0.978 (2), derivation MAE = 0.832 (1) and 0.752 (2), validation MAE = 0.060 (1) and 0.763 (2). For Vmax R2 = 0.57 (1) and 0.65 (2), derivation RMSE = 1.202 (1) and 1.095 (2), validation RMSE = 1.205 (1) and 1.111 (2), derivation MAE = 0.943 (1) and 0.861 (2), and validation MAE = 0.944 (1) and 0.881 (2). Conclusions: The use of machine-learning methods allows for the precise determination of predictors of both submaximal and maximal running performance. Prediction models based on selected variables are characterized by high precision and high repeatability. The results can be used to personalize training and adjust the optimal therapeutic protocol in clinical settings, with a target population of EA.

Factors Associated with Willingness to Receive a COVID-19 Vaccine in Adult Polish Population-A Cross-Sectional Survey.

Vaccinations are proven to be the most efficient in preventing COVID-19 disease. Nonetheless, some people are skeptical and hesitant. The study aimed to determine factors associated with willingness to receive a COVID-19 vaccine in the Polish adult population. An online survey consisting of questions regarding (1) demographic information and (2) health issues (the status of vaccination, comorbidities, receiving the flu vaccine and usage of health monitoring apps) was distributed between 13 January and 14 February 2022. Of the 7018 participants who met the study conditions, 76.89% (n = 5396) were females, 22.44% (n = 1575) were males and 0.67% (n = 47) did not specify gender. The median age was 31 years. Among them, 81.82% (n = 5742) were vaccinated and 18.18% (n = 1276) were not. 46.87% (n = 3289) had no chronic co-morbidities. Factors associated with lower odds to receive the vaccine were: being men (p = 0.02; OR = 0.83), having lower education status (p = 0.001, OR = 0.56−0.77), living in a smaller residence area (p < 0.001, OR = 0.47−0.73.), not receiving flu vaccination (p < 0.001, OR = 24.51) and not using health monitoring applications (p < 0.001, OR = 1.56). Health education and communication strategies are needed to achieve large-scale vaccine acceptability and finally herd immunity.

COVID-19 Pandemic Consequences among Individuals with Eating Disorders on a Clinical Sample in Poland-A Cross-Sectional Study.

The COVID-19 pandemic and imposed restrictions had negative consequences on overall health among many populations. This study aimed to investigate the influence of the pandemic on eating disorders (ED) and mental health (MH) of individuals with confirmed ED diagnoses. A survey consisting of questions related to (1) diagnosis of COVID-19, (2) changes in ED symptoms and onset of new symptoms, (3) psychological and MH aspects regarding to the pandemic, (4) lifestyle changes, and (5) social media (SM) usage was distributed between April-June 2021. One hundred and ninety-eight individuals met all of the inclusion criteria (nfemales = 195, 98.48%; nother gender = 3, 1.52%). Of the participants, 78.79% reported worsening of their ED symptoms, 42.93% of them noticed an onset of new ED symptoms, and 57.58% believed that the pandemic had a negative impact on their ED treatment. Negative changes due to the pandemic on MH were reported by 88.89%. Of the participants, 91.92% increased their time spent on SM and 54.04% of them declared that it had a negative impact on their MH. Medical professionals should consider results while providing comprehensive psychological care, which can be crucial information in the application of the appropriate treatment strategy.

Differences between Treadmill and Cycle Ergometer Cardiopulmonary Exercise Testing Results in Triathletes and Their Association with Body Composition and Body Mass Index.

Cardiopulmonary exercise testing (CPET) is the method of choice to assess aerobic fitness. Previous research was ambiguous as to whether treadmill (TE) and cycle ergometry (CE) results are transferrable or different between testing modalities in triathletes. The aim of this paper was to investigate the differences in HR and VO2 at maximum exertion between TE and CE, at anaerobic threshold (AT) and respiratory compensation point (RCP) and evaluate their association with body fat (BF), fat-free mass (FFM) and body mass index (BMI). In total, 143 adult (n = 18 female), Caucasian triathletes had both Tr and CE CPET performed. The male group was divided into <40 years (n = 80) and >40 years (n = 45). Females were aged between 18 and 46 years. Body composition was measured with bioelectrical impedance before tests. Differences were evaluated using paired t-tests, and associations were evaluated in males using multiple linear regression (MLR). Significant differences were found in VO2 and HR at maximum exertion, at AT and at RCP between CE and TE testing, in both males and females. VO2AT was 38.8 (±4.6) mL/kg/min in TE vs. 32.8 (±5.4) in CE in males and 36.0 (±3.6) vs. 32.1 (±3.8) in females (p < 0.001). HRAT was 149 (±10) bpm in TE vs. 136 (±11) in CE in males and 156 (±7) vs. 146 (±11) in females (p < 0.001). VO2max was 52 (±6) mL/kg/min vs. 49 (±7) in CE in males and 45.3 (±4.9) in Tr vs. 43.9 (±5.2) in females (p < 0.001). HRmax was 183 (±10) bpm in TE vs. 177 (±10) in CE in males and 183 (±9) vs. 179 (±10) in females (p < 0.001). MLR showed that BMI, BF and FFM are significantly associated with differences in HR and VO2 at maximum, AT and RCP in males aged >40. Both tests should be used independently to achieve optimal fitness assessments and further training planning.

Transferability of Cardiopulmonary Parameters between Treadmill and Cycle Ergometer Testing in Male Triathletes-Prediction Formulae.

Cardiopulmonary exercise testing (CPET) on a treadmill (TE) or cycle ergometry (CE) is a common method in sports diagnostics to assess athletes' aerobic fitness and prescribe training. In a triathlon, the gold standard is performing both CE and TE CPET. The purpose of this research was to create models using CPET results from one modality to predict results for the other modality. A total of 152 male triathletes (age = 38.20 ± 9.53 year; BMI = 23.97 ± 2.10 kg·m-2) underwent CPET on TE and CE, preceded by body composition (BC) analysis. Speed, power, heart rate (HR), oxygen uptake (VO2), respiratory exchange ratio (RER), ventilation (VE), respiratory frequency (fR), blood lactate concentration (LA) (at the anaerobic threshold (AT)), respiratory compensation point (RCP), and maximum exertion were measured. Random forests (RF) were used to find the variables with the highest importance, which were selected for multiple linear regression (MLR) models. Based on R2 and RF variable selection, MLR equations in full, simplified, and the most simplified forms were created for VO2AT, HRAT, VO2RCP, HRRCP, VO2max, and HRmax for CE (R2 = 0.46-0.78) and TE (R2 = 0.59-0.80). By inputting only HR and power/speed into the RF, MLR models for practical HR calculation on TE and CE (both R2 = 0.41-0.75) were created. BC had a significant impact on the majority of CPET parameters. CPET parameters can be accurately predicted between CE and TE testing. Maximal parameters are more predictable than submaximal. Only HR and speed/power from one testing modality could be used to predict HR for another. Created equations, combined with BC analysis, could be used as a method of choice in comprehensive sports diagnostics.

PaLS Study: Tobacco, Alcohol and Drugs Usage among Polish University Students in the Context of Stress Caused by the COVID-19 Pandemic.

The COVID-19 pandemic and imposed restrictions were strong stress factors for young people, especially students. Increased alcohol consumption, smoking cigarettes, usage of heated tobacco products, and other stimulants are common methods of coping with anxiety. However, they can have serious negative health effects. A survey consisting of 12 questions related to mental health and psychoactive substance taking habits was distributed among Polish students between 22 February 2021 and 3 April 2021. A total of 1323 participants met all inclusion criteria (nfemales = 1021, nmales = 297, nother gender = 5). The mean age was 22 years old (±4.17); 47.62% were medical university students. A total of 71.92% reported negative impact, 8.25% did not notice changes, and 12.58% declared a positive pandemic impact on their mental health. A total of 12.58% declared an increase, 70.22% did not see any differences, and 17.20% reported a decrease in their psychoactive substance usage tendency due to the pandemic. Worse perceived psychologic well-being was correlated with a higher tendency to use tobacco (p < 0.001) and alcohol (p < 0.001), and not with marijuana and products containing tetrahydrocannabinol (p = 0.136), and hard drugs (p = 0.799). The majority of participants declared a negative pandemic impact on mental health and did not report significant changes in psychoactive substance taking habits. Medical personnel should be aware of the current situation and apply for proper prevention and treatment programs.

COVID-19 and athletes: Endurance sport and activity resilience study-CAESAR study.

Background: The COVID-19 pandemic and imposed restrictions influenced athletic societies, although current knowledge about mild COVID-19 consequences on cardiopulmonary and physiologic parameters remains inconclusive. This study aimed to assess the impact of mild COVID-19 inflection on cardiopulmonary exercise test (CPET) performance among endurance athletes (EA) with varied fitness level. Materials and Methods: 49 EA (nmale = 43, nfemale = 6, mean age = 39.94 ± 7.80 yr, height = 178.45 cm, weight = 76.62 kg; BMI = 24.03 kgm-2) underwent double treadmill or cycle ergometer CPET and body analysis (BA) pre- and post-mild COVID-19 infection. Mild infection was defined as: (1) without hospitalization and (2) without prolonged health complications lasting for >14 days. Speed, power, heart rate (HR), oxygen uptake (VO2), pulmonary ventilation, blood lactate concentration (at the anaerobic threshold (AT)), respiratory compensation point (RCP), and maximum exertion were measured before and after COVID-19 infection. Pearson's and Spearman's r correlation coefficients and Student t-test were applied to assess relationship between physiologic or exercise variables and time. Results: The anthropometric measurements did not differ significantly before and after COVID-19. There was a significant reduction in VO2 at the AT and RCP (both p < 0.001). Pre-COVID-19 VO2 was 34.97 ± 6.43 ml kg·min-1, 43.88 ± 7.31 ml kg·min-1 and 47.81 ± 7.81 ml kg·min-1 respectively for AT, RCP and maximal and post-COVID-19 VO2 was 32.35 ± 5.93 ml kg·min-1, 40.49 ± 6.63 ml kg·min-1 and 44.97 ± 7.00 ml kg·min-1 respectively for AT, RCP and maximal. Differences of HR at AT (p < 0.001) and RCP (p < 0.001) was observed. The HR before infection was 145.08 ± 10.82 bpm for AT and 168.78 ± 9.01 bpm for RCP and HR after infection was 141.12 ± 9.99 bpm for AT and 165.14 ± 9.74 bpm for RCP. Time-adjusted measures showed significance for body fat (r = 0.46, p < 0.001), fat mass (r = 0.33, p = 0.020), cycling power at the AT (r = -0.29, p = 0.045), and HR at RCP (r = -0.30, p = 0.036). Conclusion: A mild COVID-19 infection resulted in a decrease in EA's CPET performance. The most significant changes were observed for VO2 and HR. Medical Professionals and Training Specialists should be aware of the consequences of a mild COVID-19 infection in order to recommend optimal therapeutic methods and properly adjust the intensity of training.

Sleeping Disorders in Healthy Individuals with Different Dietary Patterns and BMI, Questionnaire Assessment.

The COVID-19 pandemic and abiding restrictions have affected every life domain. Sleep disturbances are a major health issue that is linked with a higher prevalence of metabolic syndrome, obesity, and psychological burdens. Research of sleeping disorders among vegetarian and non-vegetarian subpopulations is limited. The aim of the study was to assess the prevalence of sleeping disorders during the COVID-19 pandemic among people with different dietary patterns. Using a web-based cross-sectional survey, data were collected from 1987 people. A total of 1956 respondents met all study conditions. The questionnaire consisted of sociodemographic information, assessment of dietary habits, and assessment of the prevalence of insomnia and sleepiness, based on the Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale (ESS). A total of 36.04% (n = 705) respondents declared that they noticed a change in the quality of their sleep during the last year. According to AIS and ESS, non-vegetarians suffered from insomnia or sleepiness more often than vegetarians. Insomnia and sleepiness were also more prevalent among those respondents who declared consumption of fruit and vegetables less often than once a day compared with those who consumed fruit and vegetables daily. Respondents with BMI within the recommended limit (18.5-24.99) suffered from insomnia less often when compared with underweight (BMI < 18.5) or obese (BMI ≥ 25) respondents. Those results may be useful for public health workers and medical professionals in terms of establishing new instruments that help treat sleeping disorders.

Social Prescribing and Lifestyle Medicine-A Remedy to Chronic Health Problems?

Social prescribing has been identified as a chance to take a holistic approach to people's health and wellbeing, especially for people with one or more long-term conditions. Its systemic implementation was a part of the recent United Kingdom National Health Service Long Term Plan. With a lifestyle medicine focus on equipping patients in tools necessary for self-care and self-management of their lifestyle-related health problems that coexists with the need for creating an environment supporting healthy choices, a social prescribing model seems to offer a promising strategy for advancing lifestyle medicine. This idea was discussed during a meeting hosted by the Polish Society of Lifestyle Medicine in collaboration with European Rural and Isolated Practitioners Association, Polish Society of Young Family Doctors ("Mlodzi Lekarze Rodzinni"), British Society of Lifestyle Medicine and European Lifestyle Medicine Council in June 2020. The aftermath-this position statement is an Authors' attempt at summarizing the common ground for social prescribing and lifestyle medicine. It collects experiences of practitioners and researchers from five European countries as well as making recommendations for applying this model in Poland. Despite referring to local conditions, it might provide universal takeaway messages for any healthcare providers interested in combining social prescribing with lifestyle medicine practice.