Issuu on Google+

men s

october 2012 | year II

na

corpore in sa

n

o

sa

L’Accademia del Fitness Wellness & Anti-aging Magazine

n.07


La dieta COM (acronimo di CronOrMorfo dieta) è un approccio integrato che tiene conto della Cronobiologia degli Ormoni e della Morfologia dell’essere umano. Non siamo tutti uguali e trovare la giusta alimentazione e tipologia di esercizio fisico per ognuno di noi è la strada per raggiungere la salute. Determinate morfologie, ovvero determinate forme del corpo, sono legate a specifiche espressioni caratteriali. Tutto questo, si sa, è legato alla genetica che indirizza il nostro sviluppo secondo le nostre predisposizioni. Oggi, tuttavia, si ha la certezza c he anche l’epigenetica (cioè l’influenza dell’ambiente esterno) gioca un ruolo fondamentale nel permettere o impedire il manifestarsi di determinate predisposizioni: “Nasciamo come siamo, diventiamo come mangiamo, come ci muoviamo, come pensiamo!”. La dieta COM tiene conto della Morfologia dell’individuo (a mela, a pera o a peperone) che corrisponde a specifiche prevalenze Ormonali, la cui influenza sulla distribuzione del grasso può essere controllata e modificata, in parte, dalla scelta qualitativa, quantitativa e Cronologica degli alimenti, favorendo, di conseguenza un dimagrimento localizzato.

DESIDERO RIEVERE UNA COPIA DEL LIBRO:

PAGHERO’ L’IMPORTO DI € 19,90 A MEZZO:

LA DIETA COM E IL DIMAGRIMENTO LOCALIZZATO

BONIFICO BANCARIO (allego fotocopia) intestato a: PROFITNESS S.a.s. - Galleria Crocetta 10/A 43126 Parma - presso: Banca Monte Parma IBAN: IT 64 Q 06930 12725 000000000221

INDIRIZZO DI SPEDIZIONE Cognome Nome Via Città E-mail Tel. Codice Fiscale /Partita IVA

Prov.

CAP

VAGLIA POSTALE (allego fotocopia) intestato a: PROFITNESS S.a.s. Galleria Crocetta 10/A - 43126 Parma Inviare il modulo compilato e la ricevuta del pagamento via fax al n. 0521.294971 oppure via mail a: profitness@libero.it, oppure via posta a : PROFITNESS S.a.s. - Galleria Crocetta 10/A - 43126 Parma (tel. 0521 941319)


number 07 / 2012

EDITORIAL ACCADEMIA DEL FITNESS Galleria Crocetta 10/A 43126 PARMA Ph. 0521.941319 Fax 0521.294971 www.accademiadelfitness.com magazine@accademiadelfitness.com Editor in Chief: Massimo Spattini Editorial staff: Claudia Bonini Cristiana Pedrazzini Cinzia Ruggeri Scientific committee: Prof. Marianno Franzini Prof. Fulvio Marzatico Dott. Filippo Ongaro Prof. Adolfo Panfili Prof. Mario Passeri Writers: Gianfranco Beltrami Krista Burns Marco Tullio Cau Alessandro Gelli Serena Missori Giovanni Montagna Giovanni Occhionero Adolfo Panfili Massimo Spattini Photographers: Alex Ardenti SHUTTERSTOCK FOTO

At a time when the economy is in general contraction, the sector of wellness activities is against the current trend. The increase in stress caused by the problems at work and in the economy probably leads to a higher awareness of how important it is to take care of one’s body as a unity of body and mind. Therefore, people prefer giving up a new car or the umpteenth garment in order to invest in their physical fitness and health which, in the end, are the most precious things we have and which we must protect. A proper diet, physical exercise, stress management, the use of integrators all become the heart of a functional approach aimed at improving our sensation of wellbeing as well as at the prevention of chronic degenerative diseases which by now affect relatively young people, too (obesity, diabetes, cardiovascular diseases, psycho-physical exhaustion, osteoarticular diseas-

es). Conventional medicine has managed to eradicate or control almost all the acute diseases, yet it has failed and perhaps it has even contributed to the increase in iatrogenic diseases (see the devastating effects of the abuse of anti-inflammatory medicines). New concepts are strongly emerging, for example functional training and functional medicine, which consider the body in its entirety rather than as an assemblage of independent single muscles and organs. They see the body as a whole interconnected system. We are only at the beginning of an epoch-making change which will bring about innovation and new possibilities. Those who do not understand this will have to deal with the disadvantages of being less competitive Massimo Spattini Accademia del Fitness President

Publisher: Profitness S.a.s. Galleria Crocetta 10/A 43126 Parma Ph. 0521.941319 Printed and delivered by: Mattioli 1885 S.r.l. Str. della Lodesana, 649 sx Loc. Vaio 43036 Fidenza (PR) Ph. 0524.530383 www.mattioli1885.com Registration n. 12/2004 Court of Parma

3


L’Accademia del Fitness

INDEx EDITORIAL

3

Massimo Spattini

COSMETIC TREATMENTS AND LOCALISED WEIGHT LOSS Massimo Spattini

6

SUPPLEMENTS FOR THE MIND

10

FIGHT INFLAMMATION the role of integrators

14

VITAMINS IN SPORTS ACTIVITY and the improvement of stress management

18

MEDICINAL HERBS AND PHYSICAL ACTIVITY the action on the emunctories, the organs of youth

24

THE NEW REVOLUTION FOR HEALTH IN ITALY: CHIROPRACTIC

28

THE PREMENSTRUAL SYNDROME the syndrome that transforms you

30

INFLUENCE OF PH VARIATION AT METABOLIC LEVEL

36

DIAGNOSIS OF HERNIATED DISC

42

Marco Tulio Cau

Gianfranco Beltrami

Alessandro Gelli

Giovanni Occhionero

Krista Burns

Serena Missori

Giovanni Montagna

Adolfo Panfili 4


L’Accademia del Fitness

COSMETIC TREATMENTS AND LOCALISED WEIGHT LOSS We have seen that there is a deep relation between our blood circulation and the deposit of localised fat. Therefore, every treatment aiming at the improvement of the former has a direct effect on localised weight loss. Although some scepticism still persists on the actual efficacy of creams, we must not forget that our skin is an “organ” and it can absorb a great number of substances which obviously have an effect both on a systemic level and, above all in case of vasoactive substances, on local blood circulation.

roids [July 2005 Decio Armanini et al.: Glycyrrhetic Acid, the active principle of licorice, can reduce the thickness of subcutaneus thigh fat through topical application”] describes the possibility of achieving localised slimming by applying locally some cream containing glycyrrhetic acid, which is an active principle obtained from the liquorice plant. Glycyrrhetic acid has the property of inhibiting the 11 Beta hydroxysteroid dehydrogenase type 1 enzyme which can regenerate cortisol from the less active cortisone. This enzyme is particularly present in fat tissues so, by inhibiting it, the amount of cortisol in fat tissues is reduced; it is well known that cortisol is involved in fat distribution and its depos-

Our skin absorbs

better the ingredients

Some publications have appeared in scientific literature concerning the possibility of achieving localised fat loss by means of topical products. A study published in Ste-

of pharmacological

substances, as well as active cosmetic

principles, in the evening.

6


Relatore: Massimo Spattini www.massimospattini.it

It is real … now we know it! I grandi del body building l’hanno sempre saputo : Arnold Schwarzenegger lo afferma nella sua enciclopedia del body building. Massimo Spattini lo sostiene da 20 anni. Chi lo nega si avvale di studi obsoleti e probabilmente non si è mai allenato. Ma ora lo sappiamo:

SPOT REDUCTION … it works!

La Spot Reduction o "dimagrimento localizzato" è un argomento controverso, ma recenti acquisizioni scientifiche ne hanno dimostrato l'esistenza. Nel seminario verranno analizzate le basi fisiologiche, i metodi di misurazione, le tecniche di all enamento, gli approcci dietologici, gli integratori, in riferimento ai vari biotipi costituzionali morfologici (ginoide, misto, androide) secondo i concetti della Dieta COM (CronOrMorfodieta) e della DADAM (Dieta e Allenamento Differenziati per Aree Muscolari) per ottenere un dimagrimento localizzato anche nelle zone più resistenti. QUOTA : € 120,00 (comprensiva della quota associativa)

www.accademiadelfitness.com

ACCADEMIA DEL FITNESS

Galleria Crocetta 10/A - 43126 PARMA Tel. +39 0521.941319 Fax +39 0521.294971 info@accademiadelfitness.com


L’Accademia del Fitness

it. 18 women (mean age 20-33 years) with a normal BMI (weight - height ratio) were studied and randomly submitted either to a treatment with some cream containing 2.5% glycyrrhetic acid applied to their dominant leg or to a placebo merely containing the excipient. Before and after one month of treatment, both the circumference and the thickness of their subcutaneous thigh fat were examined (by means of ultrasonic analysis) and were found to be significantly reduced compared with their untreated other leg and with the subjects submitted to the placebo cream treatment. No modifications in blood pressure, aldosterone or cortisol levels were observed. Glycyrrhetic acid can thus be effectively used to reduce undesired localised fat. Another study (M.K. Caruso, “Topical fat reduction from the waist”), carried out at the Louisiana State University Division of Human Ecology (USA), involved a group of 50 subjects - both men and women, mean age between 21 and 65 years, BMI > 27 - who took part in a walking programme. The control and the experimental groups both followed a low-calorie diet (1200 kcal.). The experimental group applied 15 cc of a cream containing 0.5% aminophylline twice a day around their waistline. No significant side effects were noticed. At the end of a 12-week period, the experimental group showed an average decrease of their waistline of 6 cm higher than the control group. The BMI of the group that used aminophylline turned out to be lower than

8

the one in the control group, in the same way as the waist/hip ratio was lower in the group which had made use of the cream. The women presented a greater reduction than the men. According to the study, this was due to the fat mass redistribution. The results of the study showed that the application of aminophylline was responsible for fat reduction. In conclusion we quote a study carried out by the Department of Dermatology of the Rabin Medical Center of Petah Tiqva, in Israel, where it was studied that the protective and skin barrier power varies according to the circadian rhythm of both men and women. The research found that skin permeability is higher in the evening and at night, while it radically decreases in the morning. It is certain that our skin absorbs better the ingredients of pharmacological substances, as well as active cosmetic principles, in the evening. Dr. Ph. Massimo Spattini Specialist in Sports Medicine Specialist in Food Science Board Certificate in Anti-Aging & Regenerative Medicine (ABAARM-USA)


L’Accademia del Fitness

SUPPLEMENTS FOR THE MIND Italy is one of the “oldest” countries in the world and it has been predicted that in the next 20 years the elderly will represent 25% of its population and soon after over 30%...... The mean age has shifted from 28 years in 1951 to the present 42: which means that in 1951 half of the population was younger than 28 years old and today the mean age is 42… The rise in the population’s mean age expectancy (over 84 years for women) has triggered a huge amount of studies concerning the quality of life: it is at last clear to us all that living to a very old age is certainly a target, but what matters more are the life conditions in which this target is reached! A healthy diet is one of the fundamental factors of a valid antiageing approach: it is fundamental to reach a correct psychophysical balance and to keep one’s body as efficient as possible both from the aesthetic and functional points of view. It is obvious that reaching a pleasant external aspect is possible only with a special diet, but unless all our organs function

10

correctly it will be difficult to reach this final goal: this applies above all to our brain… if that kilo of substance of which it is made starts losing control, all the rest will fatally suffer! There are many foods and micro-nutrients which can contribute to the correct functioning, but we will here deal with only the most famous ones which have been tested for a longer time. We will start from lipids since the ones commonly called “good” can be obtained through food without resorting to supplements which, besides having a cost, are (still…) considered with some distrust. It is by now universally well known that excessive consumption of saturated fats is unhealthy especially as far as concerns the appearance of atherosclerosis and its correlated health problems and also cerebral consequences which is our present theme. The use of mono and polyunsaturated fats are instead advisable also because they are useful against neurological disorders and


WWW.METOOCONSULTING.IT

M

E

T

O

O

C

O

N

S

U

L

T

I

N

G

TUTTA LA FORZA

di un servizio vincente

MUOVETEVI IN TUTTA SICUREZZA, LONTANO DAI PERICOLI DI UN MERCATO IN FORTE EVOLUZIONE. OGGI C’È METOO CONSULTING, UN POOL DI PROFESSIONISTI IN GRADO DI INDIRIZZARE OGNI VOSTRA AZIONE PER GARANTIRE ALLA VOSTRA AZIENDA FITNESS UN SUCCESSO DURATURO. IL PRIMO EVENTO FORMATIVO È GRATUITO! A pagamento pranzo, 2 coffee break e materiale didattico a 39 €.

I nostri partner:

HDemy

Chiama o scrivi per informazioni a:

MeToo Consulting Via XXIII Aprile, 37 Suzzara (MN) Via Variante Aurelia 173, 19038 Sarzana (SP) Mob: +393468584330 - Skype: igormanzini E-mail: info@metooconsulting.it


L’Accademia del Fitness because of their power to normalize oxidative stress, but our modern diets are so rich of Ω 6 (and Ω 9), that their ratio with Ω 3 reaches and goes beyond a 10/1 ratio and can even reach, in certain cases, a 20-30/1 ratio! We must also point out that our forefathers took high amounts of Ω 3 (presumably up to a 1/1 ratio) as they ate a great deal of fish and oily nuts as well as game (including the brain) which was particularly rich in it thanks to the necessarily “natural” diets of prehistoric animals. Owing to their high external supply of Ω 6 (some of which are pro inflammatory) a greater introduction of Ω 3 is recommendable and, since mammals are not very efficient in their production, they must be externally introduced through food or supplements. DHA (docosahexaenoic acid) is one of the most important among Ω 3 (it is present in high amounts in the human brain, 60% of which is composed of fats) and it is such an important component of the neuronal transmission at the synaptic level as to be considered vital for the brain structure and function. The amount of Ω 3 to be taken varies between 500mg and 2 gr according to different cases, with a prevalence of DHA over EPA. Carnitine is one of the most utilized supplements. It has the task of carrying the acid fats into the mitochondrions and is produced in the liver and the kidneys not always in sufficient amounts: it is available under different forms but it is greatly advisable to utilize it under L form (levorotatory), alone or with acetic/propionic acid, while the D form (dextrorotatory) must never be used. Carnitine is widely used during weight loss diets given its “fat burning” effects, but it also has many other capabilities: its effects on the central nervous system can even stimulate the gonads and so contribute in optimizing the testosterone levels. However, carnitine is above all having new success in the prevention and treatment of brain disorders and in these cases the acetylated form is the best one owing to its greater facility to penetrate the blood-brain barrier. A medium dose ranges between 1 and 2 gr. Alpha lipoic acid is another very promising supplement, a compound which has the peculiarity of being soluble both in aqueous and lipid mediums. This “universality” makes it particularly effective in many fields, among which the treatment of many neurological disorders. Moreover, besides being an ideal antioxidant, lipoic acid has an insulin-mimetic effect which prepares the body to burn fats and for this reason it is used in the treatment of diabetes II in hospitals. The suggested doses are between 100 up to 600-800 mg. Also Coenzyme Q10 (ubiquinone) is having a primary role in

anti-age diets (and not only); it is present in most human cells and actually its name recalls its ubiquity. CoQ10 acts in synergy with other antioxidants to improve the functionality of mitochondrions and it is also useful in pathologies such as Alzheimer’s and Parkinson’s diseases in which it compensates for the faulty electron transmission when it is used in high dosages (2-3 grams compared with the 30-200mg “normally” used). A healthy brain certainly needs the intake of many vitamins: among the most important are the ones belonging to group B (folic acid, vitamin B6 and vitamin B12 for instance), which are able to slow down brain atrophy which appears with ageing, thus preserving the cognitive functions which are also necessary for the synthesis of important neurotransmitters and for the creation and preservation of the myelin covering the nerve fibres. Many other studies point out the importance of other vitamins such as C, E and also D which are well known for their antioxidant properties (the famous InChianti study concerns the last two). Resveratrol is an antioxidant polyphenolic compound well known for its beneficial cardiovascular properties. Moreover, its contribution to correct brain functioning has recently been more and more appreciated for its blood flow improvement. Its poor bioavailability represents a limit to its potentialities…however, an intake of 200-500 mg is advisable. There would be other substances to mention but our space is limited. Yet, we cannot leave out a “supplement” which is the most useful for our mind: physical exercise! We have known for years that aerobics improves brain vascularization and boosts the production of neurotrophic factors which are necessary for its correct functioning. Moreover, its combination with the above mentioned nutrients creates a synergy which magnifies obtainable results. Finally, many other studies have given the right importance to exercise with weights! Many studies are in fact demonstrating that also vituperated bodybuilding increases the level of Brain Derived Neurotropic Factors and improves many cognitive parameters in elderly subjects and also in patients suffering from neurological diseases. This represents an important validation for the lifestyle the Accademia del Fitness has been supporting for years: all you need is some weights, some aerobics and a healthy diet… perform with care and repeat at will!

Reaching a pleasant

external aspect is only

possible if all our organs function correctly: this

applies above all to our brain… if that kilo of

substance of which it is made starts losing

control, all the rest will fatally suffer!

12

Dr Marco Tullio Cau Degree in Clinical Psichology and Science Communication


SEDE: PARMA DURATA: 6 giornate + esame finale DATE 2012: 29-30 settembre / 13-14 ottobre / 20-21 ottobre

SEDE: PARMA DURATA: 6 giornate + esame finale DATE 2012: 10-11 novembre / 24-25 novembre / 8-9 dicembre

QUOTA: € 890,00 PAGAMENTO: entro il 15-09-2012 L'importo può essere pagato, con una maggiorazione, in due rate: 1a rata entro il 15-09-2012 : € 480,00 2a rata entro il 15-10-2012. : € 480,00 Alle quote va aggiunta la quota di affiliazione all’Accademia del Fitness di € 40,00 QUOTA (per ogni singolo corso) : € 560,00 PAGAMENTI: - Corso ISTRUTTORE :: entro il 15-09-2012 - Corso PERSONAL TRAINER : entro il 15-10-2012 L'importo può essere pagato, con una maggiorazione, in due rate: - Corso ISTRUTTORE : 1a rata entro il 15-09-2012 : € 295,00 2a rata entro il 15-10-2012. : € 295,00 Corso PERSONAL TRAINER : 1a rata entro il 15-10-2012 : € 295,00 2a rata entro il 30-11-2012. : € 295,00

Alle quote va aggiunta la quota di affiliazione all’Accademia del Fitness di € 40,00 ACCADEMIA DEL FITNESS Galleria Crocetta 10/A - 43126 PARMA Tel. 0521.1682083 - Fax 0521.294971 info@accademiadelfitness.com

www.accademiadelfitness.com


L’Accademia del Fitness

FIGHT INFLAMMATION THE ROLE OF INTEGRATORS Acute inflammation represents a positive response of our body and our immune system to irritation or cellular damage, and it favours healing through the destruction or the arrest of injurious agents or diseased tissues. The clinical signs characterising acute inflammation are heat, pain, reddening and the loss of functionality, while the events that take place in the tissues are vasodilatation with oedema, histaminic response and migration of white blood cells and macrophages which favour tissue healing. Like acute inflammation, also chronic inflammation represents the body response to an injurious stimulus which may be represented by toxic substances, drugs, allergens, but also by chronic infections and stress. This type of reaction which should lead to tissue repair and

healing may become harmful and negative if the inflammatory stimulus is chronic. It is known that there is a close correlation between inflammation and all the chronic diseases among which the pathologies of the cardiovascular apparatus, diabetes, hypertension, various forms of neoplasia, rheumatic diseases. An inflammatory state is also present together with all the risk factors for the diseases of the cardiovascular apparatus (depression, stress, obesity, dyslipidemias, smoke, diabetes, etc.) but also with the risk factors fore neoplastic diseases (pollution, deficit of vitamin D, insulin-resistance etc.) as well as other chronic diseases among which Parkinson, Alzheimer’s, Crohn’s disease, macular degeneration.

Chronic inflammation may be closely linked to the reduction of life expectancy which (due to the increase of chronic diseases) may decrease of over five years.

foto Alex Ardenti

14


OLYMPIANSTORE.IT .IT E R O T S N A I P M OLY

INTEGRATORI ABBIGLIAMENTO ATTREZZATURE ACCESSORI POWERTEC ®

EDITORIA

Kettlebell

tutto cio che serve

i io r e s l u s a n a chi si alle Numero verde

Olympian’s S.r.l. Via Brodolini, 35B Figline Valdarno (Firenze)

800-776999

(solo customer customer care care ee ordini) ordini) (solo


L’Accademia del Fitness According to a recent report of the American department of public health, chronic inflammation may be closely linked to the reduction of life expectancy which (due to the increase of chronic diseases) may decrease of over five years, unless huge efforts are made in terms of prevention and proper adjustment of life styles.

mal proteins, and meat should come from organic farming, hen’s eggs should not come from batteries, fish should be fished and it should not come from breeding, and cereal should be made with wholemeal flour. In short, it is necessary to eat coloured fruit and vegetables, eliminating simple sugars and possibly chemical polluting

Life styles, in particular smoke and unhealthy diets, are the main responsible elements for chronic inflammation, together with the planet’s pollution. Think of a recent study published on the International Journal of Environment and Health: apparently, about one quarter of the total diseases on the planet is caused by environmental factors. So, what are the main causes of chronic inflammation? First of all smoke and environmental toxic substances, unhealthy diets with excess of simple sugars, food with additives and colouring agents, calorie excess, stress, sedentariness and the lack of physical exercise, scarce consumption of water and liquids, tendency to acidosis and the lack of sun light. There are several warning symptoms for chronic inflammation, which may appear with physical exhaustion, insomnia, uneasiness, muscular pain, mood disorders, memory decrease, psychophysical stress, headache, meteorism, insomnia, water retention, itch, increase in the pressure values. In all these cases we may find, through ematochemical exams, an increase in the values of inflammation markers, among which the most relevant one is C-reactive protein. How is it possible to prevent and fight chronic inflammation? First of all through a healthy diet with daily introduction of antiinflammatory food such as salmon, anchovies, sardines and mackerel (rich in omega 3), onions, apples, broccoli, red grapes and tea (rich in quercitrin), walnuts, pumpkins and linseed (which contain omega 3), blueberries (rich in anti-oxidants), spinach, thistles, turnips and other vegetables (rich in carotenoids), pineapples (which contain bromelain), red hot pepper, which contains curcuma, a powerful anti-inflammatory substance. This kind of diet is also characterised by a scarce amount of ani-

agents and environmental toxic substances. The healthy rules of life include proper physical activity, a sufficient number of sleeping hours and the periodical control of health conditions through proper and targeted clinical and laboratory controls carried out by experts. It is important and even essential to use some integrators which are often necessary since the food generally consumed has very often scarce nutrient contents. Among these it is important to take omega three fatty acids which, according to many studies, are able to reduce inflammation and insulin-resistance; calcium, which is good for hypertension, reducing the risk of colon cancer; the B complex, which can reduce the levels of homocysteine; vitamin D, which has documented activity against several neoplasias, it improves cardiac functionality and it is active in the prevention of several pathologies like diabetes and cutaneous inflammatory diseases. Also some minerals, among which chrome and magnesium, have the property of reducing insulin-resistance, while there are several substances provided with anti-oxidant and antiinflammatory activity, among which green tea (rich in polyphenols), lycopene, garlic, curcuma, resveratrol, ginkgo biloba and quercitrin.

16

Doctor. Gianfranco Beltrami Specialised in Sports Medicine President of IBAF and FIBS medical committees Lecturer of Anti-aging Medicine Degree Course in Motor Sciences University of Parma


L’IMPORTANZA DELL’ALIMENTAZIONE.

L’INVECCHIAMENTO PUO’ ESSERELIBERO BLOCCATO, SAPERE CIò CHENON MANGI TI RENDE MA SI PUO’ FARE MOLTO PERdell’alimentazione. RALLENTARLO! Ippocrate fu il primo a definire il ruolo fondamentale Egli sintetizzava

la propria filosofia in un semplicissimo concetto: “Fa che il cibo sia la tua medicina e la Il test CELLULAR medicina il tuo cibo”.AGING FACTORS (C.A.F.) di NatrixLab nasce con l’obiettivo di rispondere ad alcune preoccupazioni sentite dalla popolazione riguardo all’aspettativa Le attuali statistiche dimostrano che belli una persona su più dieci soffre consadi più invecchiare al meglio enutrizionali rimanere più giovani, più e più sani a lungo. pevolmente di allergie alimentari mentre almeno una sunella due categoria soffre di intolleranze pur Il C.A.F. è un test innovativo, il più completo e unico dei profili AntiAging,saperlo. poiché riunisce in un'unica analisi la valutazione deicausa principali processi disturbi, che por-i senza Questo accade perché queste ultime sono di tantissimi tano si all’invecchiamento: l’ossidazione, l’infiammazione, glicazione e la metilazione. quali manifestano in tempi e modi il più delle volte nonlaassociabili. Questo test può essere utilizzato come valutazione complessiva dello stato di benesseL’intolleranza alimentare è unadireazione avversa dell’organismo l’introdure dell’individuo: l’alterazione un parametro può rappresentareconseguente un importante fattore zione di alimenti di consumo comune che, per un dato periodo, sembrano non creare di rischio di invecchiamento cutaneo e tissutale. alcun disturbo all’organismo. E’ una reazione causata da un’iperproduzione di immunoMa quali sono le condizioni da modificare nello stile di vita per prevenire questo temuto globuline di classe G (IgG). invecchiamento precoce? Il sovrappeso e l’obesità, per tutte le complicazioni che ne Emicrania, respiratori, stanchezza derivano; lodisturbi stressgastro-intestinali psico-fisico, unaevita sregolata, freneticacronica, oppuredolore troppoarticolare, sedentaria e none da ultimo, undepressivi, eccessivo irritabilità, consumo didifficoltà alcol, droghe e fumo. Anche i fattori dermatiti ancora stati di concentrazione, cellulite, soambientalisono esterni protagonisti dell’invecchiamento, non dimentichiamo vrappeso, solosono alcunipurtroppo dei sintomi ricorrenti nei soggetti affetti da intolleranza alimenlo smog e i raggisapere UV. Quindi attenzione, da questa descrizione si evince che siatare. E’ importante che tutti questi problemi possono essere risolti definitivamente! mo tutti a rischio invecchiamento precoce! Ecco perché, qualunque sia il vostro disturbo, la prima cosa da fare è il FOOD INTOLEOggi loTEST specialista disporre di uno strumento di facile comprensione, affidabile e RANCE (F.I.T.), può un test di valutazione delle intolleranze alimentari eseguibile attracertificato, comodamente nel suo studio. E’ sufficiente un rapido prelievo di sangue verso un semplicissimo prelievo di sangue capillare. Ciò che ha reso il F.I.T. affidabile agli capillare da polpastrello per eseguire l’analisi C.A.F. e ricevere un referto di facile interocchi della comunità scientifica è la metodica analitica E.L.I.S.A, affidabile e ripetibile pretazione. eGrazie la lunghissima esperienza passo di Natrix nel campo delle intolleranze alimentari.loUna volta a questo importante avanti nella biologia dell’invecchiamento, specialiindividuati elementi causa di intolleranza è possibile richiedere una consulenza alista sarà ingli grado di personalizzare al massimo l’alimentazione, i trattamenti e l’attività fisica delpersonalizzata, paziente, a seconda delle e dei bisogni individuali. mentare garanzia di necessità recupero della tolleranza. È dimostrato che la terapia farmacologica in questo campo è un rimedio parziale e mai Altri test diagnostici effettuati da NatrixLab definitivo (si interviene sul sintomo ma non sulla causa del disturbo). È quindi importante ricordareFOOD che unINTOLERANCE test diagnostico affidabile e un regime alimentare corretto e personaTEST (F.I.T.): lizzato predispongono al mantenimento e/o al recupero delloinstato di salute. analisi quantitativa delle intolleranze alimentari E.L.I.S.A. ANTIAGING PROFILE (A.A.P.):

Altri test diagnostici effettuati da marker Natrix di Lab valutazione dello stress ossidativo: ossidazione ANTIAGING PROFILE (A.A.P.): valutazione dello stress ossidativo (marker di ossiLIPIDOMIC PROFILE (L.P.): dazione) profilo lipidomico e di membrana eritrocitaria CELLULAR AGING FACTORS (C.A.F.): valutazione completa dell’invecchiamento ZONA TEST cellulare (marker(AA/EPA): di ossidazione, metilazione, glicazione, infiammazione) rapporto acido arachidonico/acido eicosapentaenoico, indicazione LIPIDOMIC PROFILE (L.P.):grassi profiloOmega lipidomico dell’equilibrio tra acidi 6 eplasmatico Omega 3 e di membrana eritrocitaria CARDIO TEST (C.W.T.): ZONA PLUSWELLNESS TEST (Z.P.T.): valutazione del rapporto AA/EPA e indicazione dell’equivalutazione del rischio di incorrere in patologie cardiovascolari. librio ormonale CARDIO WELLNESS PROFILE (C.W.P.): valutazione del rischio di incorrere in patologie cardiovascolari PER ULTERIORI INFORMAZIONI:

NATRIX Per ulteriori informazioni o per conoscereS.r.l. il centro di prelievo più vicino a te: ViaNatrix Cavallotti, S.r.l. 16 Reggio Emilia Emilia – loc. –Mancasale Via F.42122 Cavallotti, 16 – Reggio loc. Mancasale Tel. +39Tel. 0522 +39506136 0522 506136 0522232606 232606 Fax. Fax. 0522 e-mail. info@natrixlab.it e-mail. info@natrixlab.it - www.natrixlab.it

www.natrixlab.it


L’Accademia del Fitness

VITAMINS IN SPORTS ACTIVITY

AND THE IMPROVEMENT OF STRESS MANAGEMENT A short outline on the XV Symposium International Centre of Vitaminology “Vitaminic Integration in the diet” The XV International Symposium of Vitaminology was held at the prestigious Accademia di S.A Sanitaria-Ospedale Santo Spirito in Rome, with very large attendance on part of doctors and chemists. During the Symposium Prof. Alberto Fidanza, President of the International Centre of Vitaminology, publicly appointed Prof. Alessandro Gelli Vicepresident of the International Centre of Vitaminology. This was met with great enthusiasm by the large audience while Prof. Alberto Fidanza wished him all the best. Until a few decades ago, sport was an activity mainly performed by athletes with competitive purpose. At present, science has demonstrated that sports – performed sparingly, with measure and personalized – associated to an

18

optimal diet and life-style, must be considered a therapeutic means and a way to keep healthy. Modern anti-aging strategies, also called age management, in the global system need to use specific methodologies of physical and psychophysical training. Therefore, sports has become – also for very different purposes – a habit of the population in general, and this can be both good and bad. The proliferation of more or less improvised trainers of many kinds of sports, as well as the widespread “DIY”, may lead to a series of risks for one’s health, many of which will not be discussed in this paper (Overtraining syndrome, sprain, excessive exertion without training – which is typical of amateurs -, wrong advice on food which may be risky for one’s health, etc...). Moreover, the body perceives a total level of stress, so stress


PROGRAMMA: ANTROPOMETRIA: misurazioni- plicometria ed impedenziometria BIOCHIMICA ED ENDOCRINOLOGIA DELL’ALIMENTAZIONE ALIMENTAZIONE NELL’ATTIVITA’ FISICA DIETE DEL FITNESS: Gruppi sanguigni - Mediterranea - Metabolica - Zona - Paleodieta - Warrior Diet DIETA ‘COM’ e DIMAGRIMENTO LOCALIZZATO INTEGRAZIONE ALIMENTARE INTOLLERANZE ED ALLERGIE ALIMENTARI - I PREBIOTICI ALIMENTAZIONE ANTI-AGING PROGRAMMAZIONE NEUROLINGUISTICA: l’aspetto motivazionale Il corso di Educatore Alimentare serve a dare una credibilità ed una competenza maggiore all’operatore di fitness che si trova a relazionare nell’ambito del suo lavoro con persone che cercano di migliorare il loro stato fisico come estetica, benessere, salute, tramite un percorso che prevede un adeguamento dello stile di vita. Se la pratica dell’esercizio fisico corretta è fondamentale in questo percorso altrettanto lo è un corretto approccio alimentare. Questo traguardo è raggiungibile tramite un’adeguata educazione alimentare che può essere impostata appunto da una figura come l’“Educatore Alimentare”, che non deve essere confuso con il “dietista” o il medico specialista in Scienza dell’Alimentazione, il primo preposto alla costruzione di una dieta calcolata e impostata per specifici obiettivi, il secondo unica autorità preposta a prescrivere diete finalizzate alla cura di patologie. Il compito dell’Educatore Alimentare sarà appunto quello di insegnare a scegliere i cibi più indicati nelle corrette proporzioni e modalità di assunzione senza impostare diete specifiche con grammature e percentuali.

SEDE: Parma DATE: 2012 : 24 novembre -15 dicembre 2013 : 19 gennaio - 16 febbraio - 23 marzo - 20 aprile DATA ESAME : da definire QUOTA: € 460,00

(alla quota va aggiunta la quota associativa di € 40,00)

Il pagamento deve pervenire entro il 31-10-2012 L'importo può essere pagato, con una maggiorazione in due rate : - 1a rata entro il 31-10-2012 : € 250,00 - 2a rata entro il 28-02-2013 : € 250,00

ACCADEMIA DEL FITNESS Galleria Crocetta 10/A 43126 PARMA Tel. 0521.1682083 Tel. 0521.941319 Fax 0521.294971


L’Accademia del Fitness caused by sport – with no measure in intensity and duration can be added to the inevitable stress of daily life. As a result, people will feel unwell and will experience overstrain symptoms, especially if they apply diets which are basically without carbohydrates, in favour of mainly proteinous food, insufficient consumption of vegetables and seasonal fruit. In many cases an athlete may consume non-optimum daily amounts of vitamins – and it is important to remember that an athlete under stress needs more vitamins. Vitamins, as well as a fundamental proper diet, represent a concrete help both in the optimization of sports performance and in dealing better with any kind of stress. According to the vitaminic class it is possible to reach targeted effects to favour the performance and/or fight some physiologic problems. As mentioned before, the body perceives global stress, which is the sum of physical and psychic stress. Basically, every stressful event sums up with the previous ones, producing in the subject a global biochemical and physiologic response. As it is well-known, sports activity at moderate intensity increases the production of free radicals (reactive kinds of oxygen which cause damage to the DNA, to proteins, tissues, etc..). To contrast this production we need proper amounts of anti-oxidant vitamins such as ascorbic acid (500 mg/die in divided doses to optimise absorption), vitamin E (alpha tocopherol 30 mg/die). Ascorbic acid and alpha tocopherol in these dosages and in non-pathologic situations, may be enough to contrast the increase of free radicals induced by sports activity (which is seen as a stress by the body from the point of view of radicals). Therefore, sports activity must be measured, exactly like food or medicines, and the concept of personalization is extremely important, due to the considerable subjective variability. The Italian Ministry for Health has recently raised the usable dosages of vitamins to doses which were already considered effective by vitaminologists. If anti-oxidant vitamins are particularly useful in endurance sports, which last several hours, other vitamins can favour and optimise the sports performance, in the so-called explosive gestures typical of athletics, martial arts and other sports characterised by high-intensity spring for a short time. Some vitamins of the B group are certainly useful in the aforementioned cases, to which we must also add the so-called gym

activity (fitness, bodybuilding), that is, the use of weights, performing exercises of counter-resistance, which is a very popular activity nowadays and must be measured subjectively. For all the sports which stimulate the muscles quite traumatically, pyridoxine or vitamin B6 is fundamental, since it intervenes in protein synthesis, thus favouring the formation of new muscle in case of balanced diet and with proper protein intake, in balance with all the other kinds of nutrients. Yet, pyridoxine does not exclusively show its effectiveness in the optimization of protein synthesis, but it makes athletes more brilliant as for reflexes, strength, concentration and the determination which are necessary to face athletic gestures. It can be said that pyridoxine acts both at body level and at psychic level, it helps fighting the feeling of excessive exertion and it improves one’s mood in general. Actually, pyridoxine is involved in the formation of 5HT (5- hydroxytryptamine) or serotonin, because the body uses it in the process of conversion of tryptophan into serotonin, which in turn is the precursor of melatonin. Thiamine, or vitamin B1, intervenes in the metabolism of carbohydrates. Therefore, it is fundamental to optimise energy production. Together with pyridoxine, it contributes to increase the feeling of liveliness and vital strength in athletes and it helps optimizing the recovery from exertion induced by physical stress due to training or by other kinds of stress. Pantothenic acid or vitamin B5 is a constituent part of Coenzyme A. In sport it helps increasing power and resistance, therefore it works in a synergic way with pyridoxine and thiamine. Cyanocobalamin and its various forms, or vitamin B12, intervenes in the synthesis of proteins and haemoglobin. Vegetarian athletes may lack it since this vitamin is mainly present in meat. Nicotinic acid, vitamin B3 in its carboxylic form, because of its vasodilatory capacity, improves the vascularisation of the muscle, optimising its use and development. It may also help improving muscle definition due to the phenomenon of capillarization (more evident muscle veins, which is a particularly sought-after effect by fitness and bodybuilding lovers). This function is not carried out by the amidic form, nicotinamide, which acts as a vitaminic principle but does not cause vasodilatation and “flushing”. A sufficient integration of nicotinic acid and/or nicotinamide allows higher availability of tryptophan, therefore of serotonin. Among the various positive effects, it will cause higher sense of

Some vitamins of the B group are certainly useful. We must also add the so-called gym activity (fitness, bodybuilding), that is, the use of weights, a very popular activity nowadays which must be measured subjectively.

20


L’Accademia del Fitness psycho-physical wellbeing, reduction of nervous hunger, higher concentration and much more. Vitamin D3 is fundamental for the metabolism of the bone and its turnover. It is also important, as demonstrated by recent research, to keep the immune system efficient. So, with different mechanisms it is associated to ascorbic acid, retinol and tocopherol. It is important to point out that after relatively prolonged period of intake of some group B vitamins, it is better to take the whole group B, to avoid metabolic imbalance. The intake of only some of the vitamins of group B is therefore advisable only for short periods and upon medical control or the control of expert chemists in the science of Vitaminology. Vitamins are not DOPING, since they physiologically optimise one’s performance, resistance to exertion, recovery from exertion itself, muscular development and vital strength. Yet, they cannot push the body beyond its limits, which is a typical characteristic of the well-known anabolic steroids. Unfortunately, doping substances are widespread, not only in competitive sport but also in amateur sport. They push protein synthesis, performance and recovery from exertion much be-

22

yond the physiologic and genetic limits of athletes, altering sometimes severely - their hormonal balance. The use of scientific and rational amounts of vitamins in sports activity optimises the normal physiology of the subject without altering the hormonal balance. Actually, even taking moderate amounts of vitamins, anti-doping tests will always be negative. In fact, many trainers, coaches and sports doctors probably still do not know the potential of these wonderful natural substances which can help achieve the best performance both in sport and in everyday life, and they can also certainly improve health both in the short and in the long period (anti-aging action), which doping substances, used in an iniquitous way, cannot certainly do (“swollen muscles due to doping”). Hopefully, doctors, chemists, trainers and the mass media will study and analyse, therefore help putting into practice a science which can bring great benefits on the body and mind: Vitaminology. Doctor Alessandro Gelli European Health Managers Forum (EHMF) Vitaminologist – Int. Centre


number 07 / 2012

23


L’Accademia del Fitness

MEDICINAL HERBS AND PHYSICAL ACTIVITY:

THE ACTION ON THE EMUNCTORIES, THE ORGANS OF YOUTH When we talk about integration for sport we very often neglect useful substances which favour the physiological functioning of emunctory organs, that is, organs such as the liver, the kidneys, the intestine and the lungs which are responsible for the elimination of toxic metabolites (including the metabolites due to physical activity), and are therefore fundamental to guarantee physical efficiency and longevity. Actually, it has been demonstrated that if we are not able to metabolize properly the substances we take, due to the bad functioning of our natural “filters”, then integration is useless. The depuration from bad substances is an incessant process in our body and the degree of detoxification and elimination of toxins is to a great extent responsible for the state of health of each one of us, in particular when slimming or when doing physical activity. Since we know that many toxins – whose concentration in the environment is bound to increase – may cause

24

severe disorders, it is essential to promote the optimal functioning of the emunctory organs. When the emunctories work at their best, the toxins produced are properly eliminated and the body keeps in balance and is healthy. When, due to excessive accumulation of toxins which slows down the activity of the emunctories or due to the insufficiency of the drainage systems, there is an overload of toxins which causes imbalance. As a result, the outbreak or recrudescence of the most varied disorders both on the psychic level – exhaustion, memory difficulty, insomnia and sometimes anxiety and depression - and on the physical level – digestive difficulty, proneness to fever, constipation, cold, recrudescence of immune-allergic diseases. Also the skin is affected, looking asphyxial and opaque. Moreover, by osmosis these toxins retain water, causing the classical phenomenon of water retention. Clearly, in case of this general disorder of the body it is neces-


Drenaggio d’organo e Di Riequilibrio ENergetico

BIODREN Fitosoluzioni ad azione elettiva, integrata e sinergica secondo i princìpi della moderna fitoterapia coniugati con quelli dell’antica medicina tradizionale cinese

BIODREN F: fegato BIODREN VB: vescica biliare BIODREN C: cuore BIODREN IT: intestino tenue BIODREN MC Circ: circolazione periferica BIODREN MC Genit: apparato genitale BIODREN TR: apparato digerente

BIODREN MP: milza, pancreas BIODREN S: stomaco BIODREN P: polmoni BIODREN GI: grosso intestino BIODREN R: reni BIODREN V: vescica


L’Accademia del Fitness sary to go back to the harmony of all the altered functions. In particular, it will be necessary to act on the hepatobiliary functions, the kidney functions and the intestinal functions. In these cases a detoxifying intervention is advisable, operating on several levels, from following a proper diet to the rational use of medicinal herbs. We can therefore talk of phytotherapy or, to be even more specific, of phytogenomics. Phytogenomics is the science which studies the action of the vegetable active principles at genomic level. Thanks to the most recent data found in literature, it is possible to explain many activities of medicinal herbs, above all as for their action on the emunctories, the so-called “drainers”. The emunctories are organs which need a physiological transcription of enzymes at genomic level in order to function properly. Many hepatic or kidney problems are related to an alteration in the synthesis of enzymes responsible for depuration. Vegetable extracts, acting at genomic level, can induce the transcription of the enzymes which are necessary for the reactions of conjunction and elimination of toxins. Some studies point out that polyphenols carry out an hepatoprotective action, acting at DNA level and inducing the transcription of anti-oxidant enzymes responsible for the reactions of phase 2 of hepatic conjugation. Experimental data prove that polyphenols determine a reinforcement of the reactions of endogenous hepatic conjugation and that this reinforcement is obtained through the activation of anti-oxidant responsive elements (ARE), involved in the induction of detoxifying enzymes. Therefore, polyphenols induce the expression of codifying genes for the enzymes of phase II through the intracellular ways of activation of the ARE/EpRE. Polyphenols can modify the capacity of Keap1 to confine the Nrf2, or activate the MAP kinases (ERK, JNK and p38) probably involved in the stabilization of the Nrf2. The Nrf2 may therefore move into the nucleus and activate the

genes containing the ARE/EpRE sequences in the promoter. Modified by: Masella R et al. J Nutr Biochem 2005;16:577. Therefore, it is fundamental to introduce in physiological integration substances which are able to carry out a “draining action on the emunctories”. For this reason medicinal herbs have been used for thousands of years. Medicinal herbs such as Artichoke, Taraxacum, Milk thistle, Crisantellum, Curcuma xanthorrhiza, Fumitory, Rosemary buds, Rye, Hazel buds are able to help the physiological hepatic functionality, while herbs like Equisetum, Silver birch, Wild fennel, Pilosella, Juniper berries, Ononis, Java tea leaves, common nettle, Zea mays L. are able to help the functionality of the kidneys. This just to mention two of the main emunctories, but in order to carry out a correct draining action it is necessary to know all the organs responsible for depuration very well. For example, what would be the point of following a proper diet if intestinal problems impeded the correct absorption of nutrients? On this point it is very interesting to see the philosophy of Biointegrated Medicine (www.medicinabiointegrata. it ) and of the MTD therapeutic system, which draws attention also on the organ to be drained (ex. Intestine, biliary bladder, lungs, etc.) and on the characteristics of the constitution of the individual, as well as on the targeted remedy. We can say that the correct use of medicinal herbs on the emunctory organs improves the athletic performances and above all the health of the individual. Yet, it is fundamental to research preparations which act in a safe, specific and effective way.

Phytogenomics is the science which studies the action of the vegetable active principles at genomic level. Thanks to it, it is possible to explain many activities of medicinal herbs.

26

Dr. Giovanni Occhionero


torna in forma

con il metodo su misura per te

www.dimabiodiet.com

Seguici su


L’Accademia del Fitness

THE NEW REVOLUTION FOR HEALTH IN ITALY:

CHIROPRACTIC

Chiropractic focuses on the relationship between your spine and nervous system (the brain, spinal cord, and nerves exiting the spine) and how that relationship affects the restoration and preservation of health and wellness. Chiropractic is based on the scientific principle that the body is a self-regulating, selfhealing organism and problems with the structure of the body, particularly the nervous system, can affect the body’s recuperative capabilities. Research showing the safety and effectiveness of chiropractic has been published throughout the world, and continues to show the benefits of using chiropractic care.

presence of pain and disease in adults who spend many hours standing or sitting during the day, increases proprioception for the elderly to prevent falls and traumas, helps pregnant mothers maintain the proper position of their hips during pregnancy to reduce complications during birth, and helps increase athletic performance and prevent injuries.

Chiropractic heals: back pain, neck pain, headache, migraine, sleeping problems, sciatica, disc herniation and, in children, colic, ear ache...

The bones of the spine protect the communication pathways of the brain, spinal cord, and nerve roots. If these nervous system pathways are impaired due to improper alignment of the vertebral column, malfunction of the tissue and organ function throughout the body can result. Chiropractors identify and correct these misalignments through manually adjusting the position of the vertebrae of the spine, thus allowing the body to properly self-regulate, adapt, and heal.

Chiropractic care is the key to transforming your health! Chiropractors work with the system that controls all functions of the body, the nervous system. If the nervous system is not functioning properly, therefore, the body is not operating at its optimal level. A healthy spine and nervous system, working at its very best, can help anyone at any time in their life; regardless of age, condition, presence or absence of disease, or obvious symptoms. Chiropractic has been proven to be safe and effective for people of all ages. For example, chiropractic helps children stay healthy and maintain proper development, helps reduce the

28

Chiropractic is a method of helping to ensure optimal joint function and nerve communication. Chiropractic has effectively assisted many others in healing a wide array of symptoms and conditions such as: back pain, neck pain, headaches, migraines, sciatica, disc herniation, fibromyalgia, fatigue, sleeping problems, and in children colic, ear aches, scoliosis, and more. There are many indications of spinal misalignments. Posture is a good example for evaluating this. When the bones of the vertebral column are misaligned, the body naturally compensates to balance the body with a change of posture. Examples of postural abnormalities include uneven shoulders, the head tilted or rotated to one side, the head anteriorly placed in relation to the shoulders, uneven hips or leg lengths, and abnormal curvatures of the spine. Chiropractic is effective for postural correction, pain management, improved bodily functions and immune system, increased proprioception and biomechanical function, and an overall increased quality of life! Dott.ssa Krista Burns B.S, D.C. P.h.D. Bella La Vita Chiropratica S.R.L. www.BLVChiropratica.it Parma/Sassari/Olbia BLV@BLVChiropratica.it


number 07 / 2012

La Chiropratica Può Aiutarvi! La  chiropratica  si   focalizza  sui   disturbi  del  sistema   nervoso,  e  sugli   effetti  di  questi   disturbi  per  la   salute  in  generale.     Le  interferenze  del   sistema  nervoso   indeboliscono  le   normali  funzioni   del  corpo  e  abbassa   la  sua  resistenza   alle  malattie.  I   disallineamenti   vertebrali  della   colonna  alterano   molte  importanti   funzioni  del  corpo.

Bella La Vita Chiropratica S.R.L. Via Mazzini, 1 43100, Parma, PR Tel. 0521 180 1234 BLVChiropratica.it BLV@BLVChiropratica.it

29


L’Accademia del Fitness

THE PREMENSTRUAL SYNDROME

THE SYNDROME THAT TRANSFORMS YOU One afternoon of routine outpatient activity, a distinguished gentleman in his forties came into my office. He seemed a bit embarrassed and when asked the typical question on the reason of his visit, he answered with many circumlocutions that his problem was the transformation of his wife on some days of the month. Smiling, I invited him to be more specific so he timidly told me that his wife, for about 15 days a month has a sweet and affable temper, but on the 15 days before menstruation she becomes more and more intractable, irritable, quick-tempered, at times depressed or anxious, and it seemed to him he had married two completely different women. He also told me his wife does not realise her change in mood at all, and when he tried to make her realise it he was told it was him who had health problems, and he was advised to see a specialised doctor. This is why he decided to make an appointment. I know it may seem paradoxical, but it is a real story. Before this episode, I had never stopped to consider with a man’s eyes what happens to women in the ill-famed Premenstrual Syndrome. The premenstrual syndrome (PMS) is a psychosomatic disorder even if it represents a nosological entity which has not been defined under many aspects yet. The symptoms, which are cyclic and are in close relation with the post-ovulatory period of the menstrual cycle, are very heterogeneous and variable from person to person, and often from one cycle to the other in the same person, according to their nature, number, intensity and duration. It is characterised by physical symptoms as well as symptoms affecting the emotive sphere and behaviour. According to a review by Milewicz e Jedrzejuk, the majority of women in their fertile age – 85-95% - experiences physical symptoms and psychic disorders of various entity before menstruation. Yet, in some cases PMS can have important clinical characteristics, to such an extent that it can be included in what the DSM IV defines as “Premenstrual dysphoric disorder”, which can be quite severe and disabling. In its severe form, the syndrome affects between 3 and 5% of the female population, while the minor or moderate premenstrual syndrome affects 40% of women, which is the majority. The syndrome often manifests itself a few years after the appearance of the menarche (the first menstruation) and women hardly ever see a specialist. The symptoms tend to worsen with age until menopause, which finally relieves them. Probably with the passing of time, due to neurobiological vulnerability, the symptoms add up and get worse, causing physical

30


number 07 / 2012

31


L’Accademia del Fitness and emotive troubles which partially reduce the quality of life and the efficiency of performance. Yet, it must be said that once they are menopausal, women who in their fertile age suffered from moderate-severe forms of PMS, have a higher risk of suffering from burst of heat, depressed mood, sleep disorders and reduced sexual desire. This leads to think that there is actually neuronal vulnerability both in the increase in hormonal fluctuations associated to the syndrome, and in the subsequent post-menopausal lack of estrogens. Many scientific studies show high familiarity of the syndrome, which may be caused by genetic factors that are not clear yet. The most widely documented observation is the decrease in the concentration of serotonin in the pre-menstrual phase. Other data, instead, refer to a lower production of melatonin (which probably depends on the reduction of serotonin, its precursor), a reduction in beta-endorphins in the premenstrual phase, an increase in the aldosterone hormone which causes higher retention of sodium and water, a modest increase in prolactin (mammary tension), lack of magnesium and pyridoxine in the diet, overweight and obesity, Metabolic Syndrome, alcohol, environmental factors and stress. So, clinical observation suggests there is a sort of biological vulnerability which is more evident in the pre-menstrual phase. It also suggests that a properly balanced diet, the management of stress and a higher knowledge of the mechanisms of the PMS may help reduce its symptoms in quantity and quality. Clinically, the symptomatology shows a disorder in the anxiousdepressive scope, with many pathologic aspects on the behavioural scope, such as easy irritability, an increase in smoking cigarettes, unusual impulsiveness or an alteration in the dietary habits (overindulgence in eating chocolate or sweets due to the lack of magnesium and tryptophan). Other frequent corollary symptoms are low self-esteem, an increase in interpersonal conflicts, a decrease in the interest towards daily and routine activities, lower concentration, the ongoing feeling of “being under pressure and about to explode”, a feeling of exhaustion, of not being able to make it, of losing control of situations. The symptoms can be associated in a variable way, also in the same woman and in a different way in time. They may cause different clinical pictures also in relation to stressful events in life. Within certain limits, fluctuations of mood and of the levels of anxiety are however physiological and they express the different phases of the hormonal production. Yet, when the symptoms become marked, they clearly limit all the activities. The DSM IV (diagnostic and statistical manual of mental disorders) established some criteria for the diagnosis of the premen-

strual dysphoric disorder, even if the classification aroused some criticism. This is probably due to the fact that, apart from feminism, it points out the emotive and behavioural instability of women linked to the physiological hormonal fluctuations. In a certain sense, the insertion of PMS in the DSM IV seems to penalise women for a physiological condition. On the other hand, it points out a problem which is becoming more and more widespread but which has always existed (yet, in the past women probably lived in a condition of more controllable stress, just taking care of their children and home). Today women are totally absorbed by life, therefore they undergo the same stress as men and, moreover, they have to deal with the stress of taking care of their family, children and home. This surplus of stress may have enhanced the threshold of irritation of the premenstrual Syndrome, with a consequent increase in the occurrence and frequency of symptoms. The scientific world objected that the criteria of the premenstrual dysphoric disorder are too restrictive and lead to an underestimation of the real dimension of the problem. In the social scene feminist movements are against it, since they interpret it as a medicalization or even a psychiatrization of the condition of women, even if other feminist environments considered the possibility of acquitting women who have committed an offence and who suffer from this disorder. In short, the criteria to identify premenstrual dysphoric disorder are as follows: A. In the majority of the cycles of the previous year, five or more of the following symptoms are almost always present in the last week of the luteal phase. They improve in the first days of the follicular phase and they are completely absent in the first week after menstruation (one of the symptoms must be among the first four mentioned): 1. Marked depressive mood, sense of desperation or self-depreciation (ideas of depreciation); 2. Tensions, marked anxiety, impression of being blocked, tense, irritable; 3. Marked emotional lability (for instance, marked sense of sadness, wish to cry, hypersensitivity to refusal); 4. Marked and persistent anger or irritability or increase in interpersonal conflicts; 5. Decrease in the interest for usual activities (for instance work, hobbies, school, friends); 6. Subjective difficulties in focusing; 7. Lethargy, quick exhaustion or lack of energy; 8. Mark changes in the appetite, hyperphagia, perentory craving for some food; 9. Hypersomnia or insomnia; 10. Impression of being overwhelmed or of losing control; other physical symptoms such as mammary swelling or tension, headache, articular or muscular pain, sensation of “swell-

According to a review by Milewicz e Jedrzejuk, the majority of women in their fertile age – 85-97% - experiences physical symptoms and psychic disorders of various entity before menstruation.

32


L’Accademia del Fitness ing”, weight gain. B. The Dysphoric premenstrual syndrome considerably interferes with one’s job or school activity, usual social activities and interpersonal relations (for example social activities are avoided, decrease in the productivity or effectiveness at work or at school). C. The Dysphoric premenstrual syndrome does not only correspond to the worsening of the symptoms of another disorder, such as severe depression, panic disorder, self-depreciation disorder or personality disorder (even if it can add up to each of these disorders). D. The A, B and C criteria must be confirmed by the daily comparative recordings of at least two consecutive symptomatic cycles (the diagnosis may be put temporarily on hold waiting for this confirmation). A further classification for the diagnosis of the premenstrual syndrome was elaborated by the American College of Obstetricians and Gynecologists. According to them, in order to make a correct diagnosis the woman must report one or more affective and physical symptoms during the five days or more which come before the cycle, in each of the three months before the visit.

• The patient reports a damage, caused by PMS, from the point of view of her social/professional interactions and/or her economic performance. Therefore, once it is clear that the Premenstrual Syndrome is a complex phenomenon involving both the psychic and physical sphere, its therapy must necessarily take both aspects into consideration. Among the non-pharmacological treatments, the introduction of proper dietary measures, according to the type of person and the entity of the symptomatology, will surely lead to benefits. Then regular physical activity is advisable (as an anti-stress activity, to keep proper body weight and to mitigate tension), as well as the reduction of salt to favour the elimination of liquids, reduction of caffeine, alcohol, sweets and fats. It seems to be useful to take magnesium, hydroxyl-tryptophan (as a precursor of serotonin and melatonin) and vitamins of the group B, especially vitamin B1 and vitamin B6. The pharmacological treatment is above all aimed at eliminating the different symptoms, particularly the most severe and disabling ones. Therefore, in case of somatic disorders, it is possible to use NSAIDs, diuretics and anything necessary to

• Affective symptoms: • Depression • Burst of anger • Anxiety • Irritability • Confusion • Withdraw from social life • Somatic symptoms • Mastodynia • Meteorism • Headache • Water retention in hands and feet • Moreover, by definition, the symptoms: • Disappear within the 4th day of the flux and do not reappear until at least the 13th; • They are present without any pharmacological therapy, hormonal therapy or overconsumption of alcohol or drugs; • They appear again – in a cyclic way – in two cycles which have been compared;

the specific clinical picture. In the forms characterised by important forms of psychic and behavioural nature, it is possible to take medicines which act on the central nervous system, such as anxyolitics or selective serotonin reuptake inhibitors (SSRI). The latter, in particular, have been met with great approval both in literature and in clinical practice. However, traditional pharmacological treatment aims at containing the symptoms, medicalizing women instead of allowing them to face with awareness a disorder which, as well as being cyclic and recurrent, is sometimes disabling. Instead, it is possible to make use of natural therapies, for example through a phytotherapeutic, integrative and dietetic treatment which accompanies the woman in all the hormonal phases, allowing her to manage with awareness and effectiveness a physiological component of her nature.

34

Doctor Serena Missori

Specialised in Endocrinology and Metabolism Diseases Teacher at the University La Sapienza in Rome Teacher at Accademia delle Scienze U.R.A.N.U.S Italy


Foto Mauro Mamone

Aperti al mondo che cambia

MOH parla la tua lingua

www.myonehotel.it

INFO LINE: +39 0521 1830000

7


L’Accademia del Fitness

INFLUENCE OF PH VARIATION AT METABOLIC LEVEL Bony Tissue (the most controversial) Calcium in the form of carbonate and phosphate is an alkaline reserve and it is put into circulation in order to tampon acid pH, for example due to the modern diet. [European Journal of Nutrition, vol. 40, no. 5, pp. 200–213, 2001]. It is estimated that due to the modern diet 480 g of calcium are released in 20 years [American Journal of Clinical Nutrition, vol. 88, no. 4, pp. 1159–1166, 2008]. However, the assessment of the loss of urinary calcium per se does not indicate osteoporosis. Moreover, the mere supplementation of potassium bicarbonate can tampon acidity preserving the loss of calcium [New England Journal of Medicine, vol. 331, no. 4, p. 279, 1994], while potassium alone does not lead to this effect [Journal of Clinical En-

36

docrinology and Metabolism, vol. 94, no. 1, pp. 96–102, 2009]. Instead, the plasmatic levels of Vitamin D are more important, since levels of Vitamin D like 25(OH)D >80 nmol/L are necessary for a proper absorption of calcium, magnesium and phosphate [Journal of the American College of Nutrition, vol. 22, no. 2, pp. 142–146, 2003]. Unfortunately, nowadays people often lack Vitamin D [Public Health, vol. 124, no. 6, pp. 350–359, 2010]. In case of chronic kidney failure, the correction of acidosis by means of bicarbonates leads to an improvement in the levels of parathormone (PTH) and of active vitamin D 1.25(OH)2D3 [Mineral and Electrolyte Metabolism, vol.21, no. 6, pp. 398–402, 1995]. Instead, as for phosphates, it seems they have a negative effect on the loss of urinary calcium [Nutrition Journal, vol. 8, article


Naturalmente innovativa La For Farma è una realtà italiana consolidata presente sul mercato dell’integrazione alimentare dal 2004, specializzata in fitoterapia clinica, particolarmente attenta alla qualità di materie prime, processi produttivi e prodotto finito. Attenzione alla qualità significa poter fornire alla Classe Medica e ai Farmacisti prodotti sicuri, ben tollerati ed efficaci. I nostri nutraceutici sono tutti formulati da esperti fitoterapeuti e specialisti clinici. Vengono prodotti presso stabilimenti certificati che ci garantiscono:

• I migliori principi attivi presenti sul mercato • Estratti titolati e standardizzati con le corrette metodologie • Tecniche e sinergie di fitocomplessi e nutrienti che ottimizzano la biodisponibilità per una migliore efficacia • Analisi sicure • Produzione, confezionamento, etichettatura in linea con la regolamentazione CEE Tutti i nostri prodotti sono formulati con dosaggi, titolazioni, posologie e forme farmaceutiche (compresse, capsule, perle) in linea con la letteratura scientifica e secondo le indicazioni del Ministero della Salute. I nostri prodotti sono tutti senza glutine e senza lattosio, tutte le creme sono di origine e ad azione naturale, nickel e gluten free, senza parabeni nè derivati animali nè olii minerali e dermatologicamente testate. Tutti i nostri integratori alimentari sono notificati al Ministero e presenti nel Registro degli integratori.

FOR FARMA s.r.l. Via delle Ombrine, 17 - 00054 Fiumicino (RM) tel.: 065916517 - fax: 0697626018 - info@forfarma.it - www.forfarma.it E00473_D1V_12_01.indd 1

30/12/11 09.24


L’Accademia del Fitness 41, 2009]. This is still controversial, though, even because an old study evaluating supplementation with phosphates in bedridden people showed a reduction in the loss of urinary calcium but not in the loss of bone mass [Journal of Clinical Investigation, vol. 50, no. 12, pp. 2506–2518, 1971]. The most recent review and meta-analysis has shown that the balance of calcium is kept and improved through the input of phosphate (in conflict with the hypothesis of acid load in the diet) [Journal of Bone and Mineral Research, vol. 24, no. 11, pp. 1835–1840, 2009]. This hypothesis has been recently confirmed where there was no relation between intake of fizzy drinks rich in phosphates and osteoporosis in menopausal women [Public Health Nutrition, pp. 1–7, 2011]. The only exception was represented by consumers of diet cola, normal cola and in a less marked way in decaf cola (Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: The Framingham Osteoporosis Study-Am J Clin Nutr 2006;84:936– 42), probably due to the acidogenic effect of caffeine. A recent systematic revision of literature aiming at finding proves to support the alkaline diet for the health of bones has found no protective role in the reduction of dietary acid load and osteoporosis [Nutrition Journal, vol. 10, no. 1, article 41, 2011]. A diet rich in sodium chloride, instead, will worsen protein loss and bone resorption [Journal of Applied Physiology, vol. 111, no. 2, pp. 537–542, 2011]. Proteins in excess cause renal acid load. If they are not compensated by alkaline food such as fruit and vegetables, they may lead to bone loss [Journal of Nutrition, vol. 128, no. 6, pp. 1051–1053, 1998]. However, proteins are necessary both for bone formation and to avoid sarcopenia. Instead of diminishing proteins, the consumption of fruit and vegetables should be increased [American Journal of Clinical Nutrition, vol. 87, no. 5, pp. 156S–157S, 2008] as it has been widely demonstrated in many studies. (Eur J Nutr. 2001;40(5):231-237., Am J Clin Nutr. 1999;69(4):727-736., Am J Clin Nutr. 2001;73(1):118-122). However, a diet which neutralizes the endogenous production of acid increases calcium and phosphate retention, reduces the markers of bone resorption and increases those of bone formation in menopausal women (N Engl J Med. 1994;330(25):17761781). Actually, it was demonstrated that the neutralization of acidosis with potassium carbonate led to better calcium retention and to a lower excretion of nitrogen, in post-menopausal women [N Engl J Med 1994;330:1776–81, 43; J clin Endocrinol Metab 1997;82:254–9]. Maurer et al. have found that the intake of bicarbonate in twen-

ty-year-old girls improves calcium balance and lowers the markers of bone degradation (pyridinolines and n-telopeptide) [Schw Med Wschr 2000;130]. After following an alkaline diet for 3 years, the urinary loss of calcium, equivalent to 5% of bone calcium, was reduced [Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 2, pp. 831–834, 2005].

Proteins are necessary both for bone formation and to avoid sarcopenia. Instead of diminishing proteins, the consumption of fruit and vegetables should be increased.

38

Muscular Tissue Due to the ageing process, the muscular mass is reduced, thus predisposing to falls and bone fractures (Frassetto, Morris, and Sebastian, 1997). In the elderly, a diet rich in potassium, which is present in fruit and vegetables, protects the muscular mass (American Journal of Clinical Nutrition, vol. 87, no. 3, pp. 662–665, 2008). In case of chronic kidney failure, metabolic acidosis is produced, with consequent loss of muscular mass (Mineral and Electrolyte Metabolism, vol. 22, no. 1–3, pp. 58–61, 1996). This confirms the hypothesis associated to acidosis and muscular catabolism. The positive thing is that by correcting acidosis, the muscular mass is protected in conditions of diabetic ketosis, trauma, sepsis, kidney failure and chronic obstructive pulmonary diseases (COPD) (Current Opinion in Clinical Nutrition and Metabolic Care, vol. 8, no. 1, pp. 73–76, 2005). As shown by the chart, the addition of potassium bicarbonate to the diet, with alkalizing effect, reduces the loss of muscular tissue.

Another relation between acidity and loss of muscular mass is present in children with tubular acidosis who experience late growth (with an increase of urinary elimination of nitrogen) which is reversible after treatment with alkalizers.


L’Accademia del Fitness Metabolic acidosis increases protein catabolism in humans and stimulates the oxidation of branched-chain amino acids. Moreover, protein synthesis (Albumin) is inhibited in man. Metabolic acidosis experimentally induced in healthy individuals causes a loss of 360 mmol of nitrogen or about 30 grams of proteins a day (Metabolic and endocrine effects of metabolic acidosis in humans; SWISS MED WKLY 2 0 0 1 ; 1 3 1 : 1 2 7 – 1 3 2). Sicuro et al. have demonstrated that metabolic acidosis, in healthy individuals, causes an increase in the activity of glucocorticoids, which in turn can have a catabolic-protein effect. Other hormonal alterations, linked to protein metabolism, are: variation in the GH/IGF-1 hormonal axis and in the metabolism of the thyroid hormone.

The improvement of GH secretion means an improvement in the quality of life, cardiovascular risk, body composition and memory [Journal of Endocrinology, vol. 207, no. 2, pp. 125–126, 2010], which is just what is aimed at from an anti-ageing perspective. In men with metabolic acidosis, the secretion of IGF-I seems to diminish, too. Some researchers show that metabolic acidosis leads to the insensitivity of GH receptors, but with a high secretion of hormone (Gh-realising hormone in high amount) [Kidney Int 1997;51:216–21]. Therefore, it is still not totally clear if the deficit is linked to the decrease in the secretion of GH or to a lower use at receptor level.

Growth hormone Children with tubular acidosis have a lower secretion of the growth hormone. If treated with bicarbonates [European Journal of Nutrition, vol. 40, no. 5, pp. 200–213, 2001; [J Clin Invest 1978;61:509–27] or potassium citrate [Journal of Clinical Investigation, vol. 61, no. 2, pp. 509–527, 1978] there is a significant increase in the secretion of GH and their growth. The use of bicarbonate potassium in menopausal women neutralizes the daily acid load with an increase in GH and osteocalcin [Journal of Clinical Endocrinology and Metabolism, vol. 82, no. 1, pp. 254–259, 1997].

Backache and alkaline diet There are some proves on the improvement of backache and the intake of alkalizer minerals [Journal of Trace Elements in Medicine and Biology, vol. 15, no. 2-3, pp. 179–183, 2001; Journal of the American Board of Family Medicine, vol. 22, no. 1, pp. 69–74, 2009]. This seems to be due to a small yet significant increase in blood pH and intracellular magnesium. A good level of intracellular magnesium allows the functioning of the enzymic systems, including the activation of vitamin D [Magnesium Research, vol. 8, no. 1, pp. 77–84, 1995].

Corso di formazione in Anti-aging

L’ Accademia del Fitness, in convenzione con l’Università Sapienza di Roma Facoltà di Farmacia e Medicina - organizza il Corso in Anti-aging

“BENESSERE E STILI DI VITA”

Direttore : Prof. Francesco Tomei Responsabile parte pratica: Prof. Massimo Spattini presso: Accademia del Fitness (Parma) Prof. Adolfo Panfili presso Area Sporting Club (Roma)

Si ringrazia:

40


number 07 / 2012

Medical Hypotheses, Volume 73, Issue 3, September 2009, Pages 347–356 Thyroid hormones Chronic metabolic acidosis in man slightly diminishes the free T3 and T4, increasing TSH (hormone which stimulates the thyroid) without lowering the reverse T3 [Am J Physiol 1997;272:F648– 53.], thus causing slight hypothyroidism. Glucocorticoids Evaluating the excretion of urinary tetrahydrocortisone and cortisol, it was found that metabolic acidosis in man significantly increases the activity of glucocorticoids [Am J Physiol 1998 Renal Physiol 43:F650–7]. The increase in glucocorticoids induced by acidosis is also responsible for protein degradation [J Clin Invest 1994;93:2127– 213]. It is also possible that the increase in glucocorticoids may determine the systemic and kidney response to the acid load, considering the enhancing effects of glucocorticoids on kidney acidification [Am J Physiol 1980;239:F30–43] and on the mechanism of acid-base transfer in the kidney tubule [Am J Physiol 1993;264:F1027–31., Proc Natl Acad Sci USA 1984;81:630–4]. The effects on the neutralization of an acid-load diet (equimolar amounts of NaHCO3 and KHCO3 replaced NaCl and KCl) have been studied in 9 healthy individuals (6 men, 3 women) without alterations in the balance of calcium, bone markers and hormones linked to the bony tissue [glucocorticoid secretion, IGF1, parathyroid hormone (PTH)/1,25(OH)2 vitamin D and thyroid hormones] . After 7 days there is a better retention of calcium (10.7 +/-0.4 mmol) and a significant reduction in the urinary excretion of deoxypyridinoline, pyridinoline, and n-telopeptide. The plasmatic cortisol decreased from 264 +/-45 to 232 +/-43 nmol/l (P 0.032), and the urinary excretion of tetrahydrocortisol (THF) diminished from 2.410 +/-210 to 2.098 +/-190 g/24 h (P 0.027).

No significant variation for IGF-1, PTH/1,25(OH)2 vitamin D, or thyroid hormones. The improvement of the acidogenic effects of the diet reduces the levels of cortisol and its possible effects also on bony tissue (Am J Physiol Renal Physiol 284: F32–F40, 2003) but also on insulinemic sensitivity, since it is by now ascertained that the chronic hyperproduction of cortisol leads to glycemic intolerance, with consequent weight gain. Latent metabolic acidosis may also cause weight gain up to obesity, and it may compromise the loss of body fat and muscular growth. It may be corrected through the introduction of bicarbonates and/or alkalinizing food (fruit and vegetables). The role of a hyper-protein diet seems to be controversial, but if it is well balanced by alkalinizing food, it does not cause problems of pH reduction. This diagram shows the contribution of latent acidosis to obesity: inability to synthesize muscular mass and/or to lose weight. Doctor Giovanni Montagna Dietician - Bio Age Advisor 393 9967076 - giannidiet@tiscali.it

41


L’Accademia del Fitness

DIAGNOSIS OF HERNIATED DISC With the passing of time the human body progressively dehydrates and intervertebral discs, mainly composed of water, are the first ones to pay the consequences for this. When degenerative phenomena go together with wrong posture - for example when sitting at a desk, or in the car – and no proper physical exercise is performed, then the spine may suffer from instability, which may lead to a herniated disc. If the disc slides behind towards the medullary canal (formed at the front by the vertebral bodies, at the side by peduncles and at the back by the laminae), it may impress the dural sac, from which the nervous roots which compose the sciatic nerve come out.

42

This big nerve, the biggest in our body, innervates the lower limb. This is the reason why an insult originated at the level of the vertebrae affects the leg (sciatica): if the pain starts from the back and radiates to the groin, it is much more likely to be caused by a syndrome of the articular facets. Types of Herniated Disc There are different degrees of escape of the disc from its place: they go from protrusion (see drawing), contained by the posterior longitudinal ligament, which runs along the posterior part of the vertebral bodies, to the real herniated disc, that is, when the intervertebral disc is completely out of place.


OBESITY WEEK Per informazioni e iscrizioni: www.obesityweek.info V Settimana per la prevenzione dell'obesità e per un corretto stile di vita. Parma, 2-14 Ottobre 2012

FOCUS CORSI ECM Venerdì 5 Ottobre “Da qui… all’obesità: qualità della vita e comorbidità” Sede: Sala Congressi della Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Parma. Orari: 8.45-18.30.

Giovedì 11 Ottobre “Dieta, proteine e attività fisica” Sede: Sala Congressi della Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Parma. Orari: 15.00-18.30.

Leone Arsenio SEGRETARIO Federico Cioni SSD Malattie del Ricambio e Diabetologia Az. Ospedaliera Universitaria di Parma, in collaborazione con Azienda Sanitaria Locale di Parma COLLABORAZIONE ORGANIZZATIVA E GESTIONE EDITORIALE Mattioli 1885 srl PRESIDENTE

SEGRETERIA SCIENTIFICA

Strada della Lodesana 649/sx, 43036 Fidenza (PR) Tel 0524530383 – Fax 052482537

In collaborazione con Fondazione

Sisterion


L’Accademia del Fitness Hernias can be classified into:

CONTAINED HERNIA It is the most frequent type of herniated disc: wide tears in the fibrous ring, both in the radius and in the circumference, reach the surface of the disc. The hernial tissue wedges in the tears but does not perforate the anulus and is therefore contained within it. EXPELLED HERNIA In this type the hernial tissue partially or completely comes out

of the disc, but does not migrate moving at a distance. According to its movement, it may be further distinguished into: Subligamentous, when it does not perforate the posterior longitudinal ligament; Transligamentous, when a part of it perforates the ligament without crossing it and the remaining part is under-ligamentous; Retroligamentous, when the hernia perforates the ligament and goes into the canal without migrating. MIGRATED HERNIA In this condition (shown by the image above) the expelled fragment migrates at a distance from the original disc, more frequently in caudal (down) or intraforaminal direction (in the foramen of conjunction where the nerve comes out and where a conflict with it may arise). It is important to remember that the symptomatology of the herniated disc is not always proportional to the real entity of the herniated material: there may hernias of considerable size which are basically asymptomatic, despite the important signs of imprint on the dural sac and on the nervous roots; on the contrary, small protrusions may cause intense pain, often resistant to common analgesic/anti-inflammatory medicines. CAT and NMR images are a very useful contribution to the formulation of a diagnosis, but it is necessary to remember that they are not always unequivocally reliable, since they are only photograms of the real situation of disc suffering which may hugely vary from a certain position to the other (usually lying and at rest). A minute later, under stress, the situation may change.

Different projections of NMR showing the presence of lumbar herniated disc to be treated with ED (Endoscopic Discectomy)

44


L’Accademia del Fitness Symptomatology § Pain when sitting for a prolonged time, exasperated by bending/extension/torsion, which is mitigated when walking; § The pain is often disabling; § Weakness, numbness and/or tingling of the lower limbs; § Decrease and/or loss of the sphincter tone (bladder-intestine). In the majority of cases painful symptoms of the herniated disc regress with mere rest in bed, physical therapy, postural rehabilitation and medicines. However, many patients are not so lucky. When a disc is herniated, it may cause compression against one or more spinal nerves, thus provoking pain, paraesthesia, numbness and asthenia from the lumbar trait, along the sciatic nerve, from the legs to the feet. Arthroscopic miniprobe inside the herniated disc during a normal ED (Endoscopic Discectomy)

This is what a surgeon can see with the microendoscope during the operation. The white matter at the back is the herniated disc.

46

Dr. Ph. Adolfo Panfili Specialised in Orthopaedics and Traumatology of the Locomotor Apparatus Centre of Minimally-invasive Surgery, Spine, Shoulder, Knee, Hand and Foot Member of the EFSA (European Food Safety Authority)



N. 07 - October 2012