Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients.

(1) Background: Cardiovascular disease is one of the leading causes of mortality after liver transplantation. Body composition and cardiovascular performance assessment represent a potential approach for modulating lifestyle correction and proper follow-up in chronic disease patients. This study aimed to verify the additional role of an unsupervised physical activity program in a sample of male liver transplant recipients who follow the Mediterranean diet. (2) Methods: Thirty-three male liver transplant recipients were enrolled. Sixteen subjects followed a moderate-intensity home exercise program in addition to nutritional support, and seventeen received advice on the Mediterranean diet. After six months, bioelectrical vector impedance analysis (BIVA) and cardiopulmonary exercise testing (CPET) were performed. (3) Results: No differences in CPET (VO2 peak: exercise 21.4 ± 4.1 vs. diet 23.5 ± 6.5 mL/kg/min; p = 0.283) and BIVA (Z/H: exercise 288.3 ± 33.9 vs. diet 310.5 ± 34.2 Ω/m; p = 0.071) were found. Furthermore, the BIVA values of resistance correlate with the submaximal performance of the Ve/VCO2 slope (R = 0.509; p < 0.05) and phase angle with the maximal effort of the VO2 peak (R = 0.557; p < 0.05). (4) Conclusions: Unsupervised physical exercise alone for six months does not substantially modify liver transplant recipients' cardiovascular performance and hydration status, despite their adherence to a Mediterranean diet. The body composition analysis is useful to stratify the risk profile, and it is potentially associated with better outcomes in transplanted subjects.

New Multilevel Partnerships and Policy Perspectives on Active Ageing in Italy: A National Plan of Action.

Active ageing (AA) policies aim to improve quality of life of older people by enabling better social participation and inclusion. Despite many international initiatives to promote AA undertaken in recent years, Italy did not systematically address this policy challenge until very recently. This paper presents the first national Plan-of-Action (PoA) (2019-2022) adopted by this country for supporting policy design and recommendation in this field. The PoA aims to create a multilevel, co-managed coordination of AA policies, by involving a network of national and regional policy makers, experts, researchers and stakeholders in civil society. The ad-hoc consultation process established for this purpose helps the recognition of different interests and expectations on AA, fostering new solutions by involvement, consultation and joint discussion of policy options. The PoA is designed to cover the traditional policy cycle, including the stages of agenda setting, policy formulation, decision-making, implementation and monitoring. At the end of the period covered by the PoA, an Italian AA Strategy will be launched to achieve systematic impact in this field, thus ensuring a long-term, sustainable impact on national and regional policy makers, civil society and research community.