Cardiorespiratory fitness, energy intake and cardiovascular risk in a sample of Paralympic athletes with locomotor impairment

Purpose: To evaluate the possible relationship between oxygen uptake peak (VO2peak), energy and macronutrient intakes (E&MI) and cardiovascular and inflammatory risks (CVR and InR) in a population of Paralympic athletes (PA) with a locomotor impairment (PA-LI). Methods: A retrospective chart review of the health and fitness evaluations preceding London 2012 Paralympic Games1 was performed in 46 male PA-LI. They were divided in 2 groups depending on their health conditions: 29 PA with spinal cord injury (PA-SCI, mean age: 37±8.9 years old), and 17 PA with other health conditions, e.g., lower limb amputation and poliomyelitis (PA-OHC, mean age: 35±9.1 years old). They underwent anthropometry assessment (standard and skinfold measurements); laboratory blood tests, including C reactive protein (CRP) and uric acid to estimate InR; nutritional 24-hour recall to assess energy and macronutrient intakes (E&MI); arm cranking ergometer incremental maximal exercise tests to measure VO2peak. CVR was estimated through 3 indices: fatty liver index2 (FLI), lipid accumulation product3 (LAP) and visceral adiposity index4 (VAI). FLI was calculated from body mass index (BMI), waist circumference (WC), gamma-GT and triglycerides (TG); LAP from WC and TG; VAI from BMI, WC, TG and high-density lipoprotein cholesterol. Mann-Whitney test and Spearman correlations were performed to compare the groups and to evaluate the relationship between variables, respectively. Results: In spite of no differences in E&MI, body composition and CVR indices, PA-SCI vs PA-OHC showed lower VO2peak (30±10.6 vs 37±7.9 ml/kg/min, p<0.01) and higher CRP (1.37, IQR: 0.53-1.79 vs 0.33, IQR: 0.26-0.96 mg/l, p <0.01). VO2peak/kg correlated negatively with uric acid levels (r: -0.563, p<0.0001), CRP levels (r: -0.425, p<0.01), FLI (r: -0.564, p<0.0001), LAP (r: -0.513, p=0.0001) and VAI (r: -0.558, p<0.001). Conclusion: In PA-LI VO2peak is inversely related to markers and indices of InR and CVR, suggesting a protective role of the cardiorespiratory fitness on health. Physical exercise5 and sport6 are highly recommended to improve VO2peak.