Lack of exercise is a major cause of chronic diseases

Unveiling the role of physical exercise in promoting social interaction and adolescents' psychological prosperity

The existing research on physical exercise mainly focuses on the effect of exercise intervention, and pays less attention to the role of physical exercise in social interaction. From the perspective of social interaction, this study uses social network theory to explore explored how physical exercise affects adolescents' psychological prosperity through relationship network construction, and examines the moderating effect of proactive personality with the help of personality trait theory. The empirical analysis of 652 paired data from multiple sources and time points revealed that physical exercise can significantly promote adolescents' relationship network construction. Adolescents' relationship network construction has a significant positive effect on their psychological prosperity, and can play a mediating role between physical exercise and psychological prosperity. Proactive personality can not only moderate the direct relationship between physical exercise and adolescents' relationship network construction, but also moderate the indirect relationship between physical exercise and adolescents' psychological prosperity via relationship network construction. These findings reveal the role of physical exercise in promoting social interaction and adolescents' psychological prosperity, helping people to have a more comprehensive understanding of the impact of physical exercise and providing theoretical guidance for the realization of adolescents' psychological well-being.

Study on the comorbid mechanisms of sarcopenia and late-life depression

The increasing global aging population has brought greater focus to age-related diseases, particularly muscle-brain comorbidities such as sarcopenia and late-life depression. Sarcopenia, defined by the gradual loss of muscle mass and function, is notably prevalent among older individuals, while late-life depression profoundly affects their mental health and overall well-being. Epidemiological evidence suggests a high co-occurrence of these two conditions, although the precise biological mechanisms linking them remain inadequately understood. This review synthesizes the existing body of literature on sarcopenia and late-life depression, examining their definitions, prevalence, clinical presentations, and available treatments. The goal is to clarify the potential connections between these comorbidities and offer a theoretical framework for the development of future preventive and therapeutic strategies.

Osteoarthritis is a risk factor for renal function injury based on the National Health and Nutrition Examination Survey and Mendelian Randomized study

This study aims to investigate the association and causality between osteoarthritis (OA) and chronic kidney disease (CKD) using data from the National Health and Nutrition Examination Survey (NHANES) and Mendelian Randomization (MR) analysis. Participants with OA, urinary albumin, urinary creatinine, urinary albumin-to-creatinine ratio (UACR), blood creatinine, and estimated glomerular filtration rate (eGFR) were selected from NHANES. CKD was calculated using the CKD-EPI equation, and logistic regression assessed by the OA-CKD association. A two-sample MR analysis was conducted using Genome-wide association studies (GWAS) data for OA, hip OA (HOA), knee OA (KOA), acute renal failure (ARF), chronic renal failure (CRF), cystatin C, serum creatinine (eGFRcrea), and microalbuminuria. The inverse variance weighted (IVW) method was used, with heterogeneity, sensitivity, and pleiotropy assessments. The cross-sectional analysis showed a significant positive association between OA and CKD [unadjusted OR: 2.398 (95% CI: 2.176-2.643), p < 0.001], which persisted after adjustment for demographic factors, socioeconomic status, lifestyle factors, and medical history [adjusted OR: 1.161 (95% CI: 1.029-1.310), p = 0.015]. The MR analysis revealed no significant causal relationship between overall OA and renal function markers but found a significant genetic association between HOA and cystatin C [IVW p = 0.0014, OR = 1.02, 95% CI: 1.01-1.03], and between KOA and cystatin C [IVW p < 0.0001, OR = 1.06, 95% CI: 1.04-1.08]. Our study indicates that HOA and KOA are risk factors for renal function injury, providing new insights for clinical OA management.

Impact of resistance and high-intensity interval training on body composition, physical function, and temporal dynamics of adaptation in older women with impaired cardiometabolic health: a randomized clinical trial

PURPOSE

Physical inactivity is associated with reduced physical fitness (PF) in older women with impaired cardiometabolic health. Although exercise has been shown to improve PF, interindividual variability in response and adaptation changes over time remain unclear. This study evaluated the effects of eight weeks of resistance training (RT) and high-intensity interval training (HIIT) on body composition, isometric strength, and the 6-minute walk test (6MWT) in older women with impaired cardiometabolic health. Additionally, the study explored the reduction of non-responders (NRs) and adaptation changes over time.

METHODS

This randomized clinical trial involved 36 older women (64 ± 8.4 years; BMI: 31.8 ± 5.5) with impaired cardiometabolic health, divided into RT-G (n = 12; 62 ± 7 years; BMI: 32.2 ± 4.1), HIIT-G (n = 12; 66 ± 10 years; BMI: 31.2 ± 4.1), and CG (n = 12; 64 ± 9 years; BMI: 31.8 ± 6) groups. RT-G performed elastic band exercises, and HIIT-G performed cycle ergometer intervals. BMI, body fat, lean mass, isometric strength, and 6MWT were measured at baseline and at four and eight weeks. The Student's t-test was applied for normally distributed variables and the Mann-Whitney U test for non-normal variables. Intra- and inter-group differences were analyzed using a two-way repeated measures ANOVA, considering group, time, and their interaction. Post-hoc comparisons were conducted using the Bonferroni test. Individual responses (IR) were calculated using the equation proposed by Hopkins: SDIR = √(SDExp2 - SDCon2). The prevalence of responders (Rs) and non-responders (NRs) was expressed as a percentage, and percentage changes from baseline to weeks four and eight were used to evaluate adaptations dynamics.

RESULTS

By week eight, isometric strength in RT-G significantly improved from 21.3 ± 4.4 to 24.37 ± 3.99 kg (p = 0.027; 95% CI: 1.8, 4.3 kg; Cohen's d = 0.731) and 6MWT distance in HIIT-G increased from 441.0 ± 48.9 to 480.0 ± 53.0 m. (p = 0.002; 95% CI: 22, 55 m; Cohen's d = 0.757). Both protocols reduced NRs for body fat, lean mass, and 6MWT. Responders showed greater adaptations in the first four weeks, stabilizing by week eight.

CONCLUSION

RT and HIIT improved PF in older women with impaired cardiometabolic health, reducing NRs in terms of body composition and 6MWT over eight weeks, with similar adaptation changes over time among the responders. These findings highlight the importance of individualized exercise interventions to maximize health benefits.

TRIAL REGISTRATION

This study was part of a trial registered at ClinicalTrials.gov (ID: NCT06201273). Date: 22/12/2023.

Differential impacts of jogging and rope skipping in college students in China based on physical test score: a randomized controlled trial baseline indicator comparison in the intervention

Introduction

Studying the differential effects of jogging and rope skipping provides useful insights for teens, adolescents, and even adults to make choices and maintain healthy physical activities, which may also have positive significance for the promotion of public physical fitness and health.

Methods

A total of 92 college students were enrolled in the study and randomly divided into jogging group, rope skipping group and control group. Tests and questionnaires were conducted before and right after the intervention, and a questionnaire survey was conducted again half a year after the intervention.

Results

The results showed that the standing long jump performance and the cardiopulmonary function in the jogging group were significantly improved after the intervention, the average score of standing long jump increased from 72.00 to 76.45 and the mean systolic blood pressure decreased from 125.07 to 121.24 (t = 3.048, 2.139, p = 0.005, 0.041). The scores of 800 or 1,000 meters and the total scores of physical test in the rope skipping group and the control group were decreased significantly. The improvement of standing long jump performance in the jogging group was significantly higher than that in the control group.

Discussion

The main reason for the decline in the rope skipping group may be due to insufficient strength. Jogging differs from rope skipping in terms of muscle focus, arm-swinging style, nature of the exercise, and the associated exercise mood. As a result, after short-term training, jogging has a more positive significance than skipping rope in maintaining and improving physical fitness and cardiopulmonary function. If you want to improve your physical fitness in a shorter period of time, then jog.

Associations of physical activity, sedentary behavior, and sleep with risk of incident Parkinson's disease: A prospective cohort study of 401,697 participants

BACKGROUND

Physical activity, sedentary behavior (SB), and sleep duration are associated with brain health. Effects of those on developing Parkinson's disease (PD) are poorly investigated. This study aimed to examine the independent and joint associations of physical activity, SB, sleep with PD risk.

METHODS

We analyzed data on 401,697 participants from the UK Biobank cohort, which was enrolled in 2006-2010. Physical activities were measured based on a questionnaire. Sleep and SB time were defined through self-reported total number of hours. Models fitted with restricted cubic spline were conducted to test for linear and non-linear shapes of each association. Cox proportional hazards regression models were used to estimate the association of three modifiable behaviors.

RESULTS

Our analytic sample included 401,697 participants with 3030 identified cases of PD (mean age, 63 years; 62.9% male). PD risk was 18% lower in the high total physical activity group (95% CI, 0.75-0.90), 22% lower in the high leisure-time physical activity (LTPA) group (95% CI, 0.71-0.86) compared with the low level and 14% higher in the high sleep duration group (95% CI, 1.05-1.24) compared to moderate group. Total SB time was irrelevant with PD risk, while high TV viewing showed a 12% increase of PD risk compared to the low group (95% CI, 1.02-1.22). Low computer use (0 h/day) was associated with a 14% higher risk compared to 1 h/day use (95% CI, 1.04-1.26). Those associations were independent. A combination of 7 h/day sleep, moderate-to-high computer use, and moderate-to-vigorous intensity of LTPA showed lowest PD risk (HR, 0.70; 95% CI, 0.57-0.85).

CONCLUSIONS

Physical activity, SB, and sleep were associated with PD risks separately. Our findings emphasize the possibility for changing these three daily activities concurrently to lower the risk of PD. These findings may promote an active lifestyle for PD prevention.

Physical activity and DNA methylation-based markers of ageing in 6208 middle-aged and older Australians: cross-sectional and longitudinal analyses

Epigenetic age quantifies biological age using DNA methylation information and is a potential pathway by which physical activity benefits general health. We aimed to assess the cross-sectional and longitudinal associations between physical activity and epigenetic age in middle-aged and older Australians. Blood DNA methylation data for 6208 participants (40% female) in the Melbourne Collaborative Cohort Study (MCCS) were available at baseline (1990-1994, mean age, 59 years) and, of those, for 1009 at follow-up (2003-2007, mean age, 69 years). Physical activity measurements (weighted scores at baseline and follow-up and total MET hours per week at follow-up) were calculated from self-reported questionnaire data. Five blood methylation-based markers of ageing (PCGrimAge, PCPhenoAge, bAge, DNAmFitAge, and DunedinPACE) and four fitness-related markers (DNAmGaitspeed, DNAmGripmax, DNAmVO2max, and DNAmFEV1) were calculated and adjusted for age. Linear regression was used to examine the cross-sectional and longitudinal associations between physical activity and epigenetic age. Effect modification by age, sex, and BMI was assessed. At baseline, a standard deviation (SD) increment in physical activity was associated with 0.03-SD (DNAmFitAge, 95%CI = 0.01, 0.06, P = 0.02) to 0.07-SD (bAge, 95%CI = 0.04, 0.09, P = 2 × 10-8) lower epigenetic age. These associations were attenuated after adjustment for other lifestyle variables. Only weak evidence was found for the longitudinal association (N = 1009) of changes in physical activity and epigenetic age (e.g. DNAmFitAge: adjusted β =  - 0.04, 95%CI =  - 0.08, 0.01). The associations were not modified by age, sex, or BMI. In middle-aged and older Australians, higher levels of self-reported physical activity were associated with slightly lower epigenetic age.

The role of irisin in exercise-induced muscle and metabolic health: a narrative review

Irisin, a myokine released during physical exercise, has emerged as a key mediator of muscle health and metabolic regulation. This review synthesizes current evidence on how aerobic exercise stimulates irisin release and its subsequent effects, including enhanced muscle mass, strength, and recovery. Additionally, irisin promotes the browning of white adipose tissue, improving fat metabolism and glucose regulation. These adaptations position irisin as a promising therapeutic target for preventing metabolic disorders and optimizing exercise protocols. By exploring human studies and mechanistic insights, this review underscores irisin's potential to address global health challenges, such as obesity and type 2 diabetes, while advancing strategies for personalized exercise interventions.

Effects of 10 weeks of walking-based exercise training on resting substrate oxidation in postmenopausal women with obesity

BACKGROUND AND AIMS

Accumulating evidence supports the effectiveness of moderate-intensity aerobic training on metabolic health, with limited studies investigating change in resting substrate oxidation. The aim of this study was to explore whether 10 weeks of walking-based aerobic training would alter substrate oxidation in postmenopausal women with obesity.

METHODS AND RESULTS

Twenty-four postmenopausal women with obesity who were assigned into the control (n = 12) or exercise groups (n = 12) undertook a 10-week aerobic training program (3 d·week-1) that involved walking exercises at 50-70% of heart rate reserve on a treadmill, with exercise volume increased from 25 to 40 min·day-1. Resting metabolic rate (RMR) and body composition were measured pre- and post-training. Whole-body substrate oxidation was calculated using respiratory data collected during RMR measurement via indirect calorimetry. No significant change was noted (p > 0.05) in resting fat oxidation and carbohydrate oxidation in the exercise group. Resting respiratory exchange ratio and RMR did not alter in response to the training program (p > 0.05).

CONCLUSION

Our results show that a 10-week of moderate-intensity aerobic training does not modify substrate oxidation in postmenopausal women with obesity.

[Multimorbidity and the Kidney]

Multimorbidity, i.e. the simultaneous presence of 2 or more diseases, is common in patients with chronic kidney disease (CKD). Cardiovascular diseases such as coronary heart disease, heart failure, stroke or vascular dementia are of particular importance. CKD and comorbidities influence each other, which is why the current KDIGO guidelines emphasize the need for personalized treatment approaches. This applies in particular to older patients, who are especially frequently affected by CKD. The diagnosis of CKD patients should not only include typical comorbidities, but also a comprehensive risk assessment and an evaluation to avoid polypharmacy.Recognising CKD is of particular importance for patients with chronic diseases in old age, as kidney disease can have a profound effect on or worsen the course of other diseases and the limitation of kidney function has a significant influence on the treatment approach. Particular attention must be paid to the correct assessment of kidney function in older people in terms of determining the estimated glomerular filtration rate (eGFR). Here, a measurement of serum creatinine is not always sufficient due to lower muscle mass and may need to be supplemented by additional parameters to estimate the glomerular filtration rate, such as cystatin C.Depending on the eGFR, kidney disease is categorized into the stages CKD G1-G5. In addition, if kidney disease is suspected, a test for proteinuria should also be performed, preferably as a measurement of albumin excretion in spontaneous urine (albumin-to-creatinine ratio, ACR). Geriatric screening and assessment are also crucial to recognize the multimorbidity, frailty and psychosocial aspects of older patients.The treatment of multimorbidity in CKD patients focusses on progression reduction and secondary and tertiary prevention, whereby a healthy lifestyle, regular exercise and a balanced diet are also important. The prevention of cardiovascular disease, particularly in the case of high blood pressure and diabetes mellitus, requires individualized therapy, in which the choice and dosage of medication must also be taken into account, particularly in the case of advanced renal impairment. If heart failure and/or atrial fibrillation are also present, close interdisciplinary collaboration between nephrologists, cardiologists and GPs is helpful in order to optimize treatment. In addition, CKD patients with dementia face particular challenges in terms of medication and the avoidance of delirium and mental symptoms.

Physical exercise, systemic inflammation and adult-onset asthma: a 12-year follow-up study

Objective: Physical exercise in treatment of asthma is scarcely studied with no clear exercise guidelines for asthmatics. We aimed to investigate the associations between physical exercise frequency, systemic inflammation and asthma control. This has not been previously studied in adult-onset asthma.

Methods: This study is part of Seinäjoki Adult Asthma Study (SAAS), where 203 patients with adult-onset asthma were evaluated in 2012-2013. Exercise frequency was recorded with a structured lifestyle questionnaire. Study population was divided into two categories by exercise frequency: Low-frequency group exercised ≤2 times/week and high frequency group >2 times/week. Blood inflammatory markers were measured and IL-6 > 1.55 pg/ml and hs-CRP > 4.12 mg/l indicated systemic inflammation.

Results: High-exercise frequency group had lower levels of hs-CRP (p = 0.007), IL-6 (p = 0.015), suPAR (p = 0.008) and adipsin (p = 0.031) and higher levels of adiponectin (p = 0.010) than low-exercise frequency group. In logistic multivariate regression models, higher-exercise frequency lowered odds for elevated hs-CRP (OR = 0.37, 95% CI 0.15-0.94) and IL-6 levels (OR = 0.43, 95% CI 0.20-0.91), after adjusting for possible confounding factors. There was no difference in lung function tests, asthma control test or airways questionnaire 20 scores between the exercise frequency groups. However, differences were found in single symptom questions; high-exercise frequency group had less symptoms during light housework and laughing but experienced more limitation of activity in self-reports.

Conclusions: Higher-exercise frequency is associated with lower level of systemic inflammation in patients with adult-onset asthma but no clear association was found to asthma outcomes. Exercise frequency may be associated with lesser amount of some individual asthma symptoms.

Bridging the gap: Integrating exercise mimicry into chronic disease management through suppressing chronic inflammation

BACKGROUND

Chronic inflammation is a common hallmark of many chronic diseases. Although exercise holds paramount importance in preventing and managing chronic diseases, adherence to exercise programs can be challenging for some patients. Consequently, there is a pressing need to explore alternative strategies to emulate the anti-inflammatory effects of exercise for chronic diseases.

AIM OF REVIEW

This review explores the emerging role of green tea bioactive components as potential mitigators of chronic inflammation, offering insights into their capacity to mimic the beneficial effects of exercise. We propose that bioactive components in green tea are promising agents for suppressing chronic inflammation, suggesting their unique capability to replicate the health benefits of exercise.

KEY SCIENTIFIC CONCEPTS OF REVIEW

This review focuses on several key concepts, including chronic inflammation and its role in chronic diseases, the anti-inflammatory effects of regular exercise, and bioactive components in green tea responsible for its health benefits. It elaborates on scientific evidence supporting the anti-inflammatory properties of green tea bioactive components, such as epigallocatechin gallate (EGCG), and theorizes how these bioactive components might replicate the effects of exercise at a molecular level. Through a comprehensive analysis of current research, this review proposes a novel perspective on the application of green tea as a potential intervention strategy to suppress chronic inflammation, thereby extending the benefits akin to those achieved through exercise.

Identify the direct and indirect impacts of the community built environment on the health of older adults

Background

The global ageing population is increasing. As their physical functions deteriorate, older adults face not only physical health challenges but also mental health issues. Enhancing the health status of older adults is imperative to improve their quality of life. However, research on the health status of older adults living in the community is limited, and the association between the built environment and daily activities remains largely unexplored.

Objective

This study aimed to utilize structural equation modeling to (1) explore the interrelationships between the community built environment, daily activities of older adults, and their health, and (2) examine the interrelationships among their correlates.

Methods

For data collection, this study administered structured questionnaires to 494 community-dwelling older adults across ten representative urban communities in Fuzhou, China. The questionnaire comprised four validated sections: demographic characteristics, perceived community built environment features, daily activity and health outcomes. Data analysis employed structural equation modeling (SEM) using AMOS 27.0, with SPSS 27.0 for preliminary analyses, to examine both direct effects of built environment on health outcomes and indirect effects mediated through daily activities.

Results

Structural equation modeling revealed three pathways: Path 1 (community built environment →health of older adults), Path 2 (community built environment → daily exercise for older adults), and Path 3 (daily exercise for older adults →health of older adults). All three pathways were supported, indicating interaction among the factors.

Conclusion

The health status of older adults is influenced by their living environment and daily activities. An improved community built environment can enhance health status among older adults. Furthermore, daily activities serve as partial mediators between community built environments and health outcomes. Our methodology and findings offer valuable insights for optimizing community built environments to promote the health of older adults.

Exercise Testing for Metabolic Flexibility: Time for Protocol Standardization

Metabolic syndrome (MetS) is a combination of risk factors that contribute to the development of many of today's chronic diseases. Rates of MetS continue to increase and it is now considered a worldwide epidemic. As with many chronic diseases it may take years for symptoms and the effects of MetS to manifest into severe health problems. Therefore, early detection is paramount A recently proposed method for the early detection of MetS is the assessment of an individual's metabolic flexibility during exercise. Metabolic flexibility is defined as the ability of the body to switch between energy substrates, primarily fats and carbohydrates, to produce energy and meet metabolic demand. This provides an indication of mitochondrial health, the possible beginning point of early insulin resistance and the development of MetS.Although there is widespread use of exercise and expired gas analysis to determine metabolic flexibility, there is no consensus on the appropriate guidelines, protocol, or interpretation of the subsequent data. Studies have used a variety of different protocols involving maximal and submaximal tests with step protocols ranging from 2 to 10 min, differences in data averaging, analysis, and stoichiometric equations, as well as variations in nutritional status of participants, and mode of exercise. This has led to considerable variation in reported results. Although the use of exercise to determine metabolic flexibility and act as a possible marker of early mitochondrial dysfunction holds significant promise, more work is required to determine the optimal protocol for clinical and research purposes.

Exercise Training Alters the Hippocampal Expression of Blood-Brain Barrier Components and Behavior of Western Diet-Fed Female Rats

Overeating highly palatable foods typical of a Western diet (WD) has been linked to cognitive impairments in animal models and humans. Exercise training was proposed as an important behavioral intervention with beneficial effects, including improving peripheral insulin sensitivity, improving central functions such as learning and memory, and restoring a dysregulated blood-brain barrier (BBB). The purpose of the present study was to characterize the effect of exercise training in rats fed with the WD with special emphasis on BBB. Adult female Long Evans rats were subjected to 12 weeks of WD feeding (WD group), or simultaneous WD feeding and wheel-running training (WD/EX group), or were fed a WD for 6 weeks without training and then subjected to diet and training for an additional 6 weeks (WD_WD/EX group). A sedentary (untrained) group of lean rats was fed a standard rodent chow (CTR group). In all experimental groups, we measured behavioral and physiological parameters, and the hippocampal levels of proteins structurally and functionally related to BBB, including proinflammatory cytokines and products of elevated lipid peroxidation. Exercise training in combination with a WD decreased locomotor and exploratory activities and induced short-term memory impairments. The behavioral changes were accompanied by reduced levels of occludin, claudin-5, and ZO-1 proteins in the hippocampus, suggesting changes in the integrity and increased permeability of BBB. In the WD_WD/EX rats, we found increased hippocampal levels of malondialdehyde (MDA) and neurotrophins (Bdnf, Vegfa) suggesting that increased energy expenditure by obese rats stimulates endogenous protective processes. The training introduced after 6 weeks of WD feeding in rats showing an obese phenotype may suggest that the sequence and moment of presumably protective intervention (exercise training) could alleviate or, on the contrary, exacerbate the level of stress and its consequences.

Movement behaviors and cardiorespiratory fitness - a cross-sectional compositional data analysis among German adults

BACKGROUND

We investigated associations of movement behaviors (moderate-vigorous physical activity, light physical activity, and stationary time) with various parameters measured during cardiopulmonary exercise testing. We applied compositional data analysis to account for the relative contributions of different movement behaviors to the overall time budget of the waking day.

METHODS

We used data from 1,396 participants of the cross-sectional population-based Study of Health in Pomerania (SHIP-TREND-1), who provided valid accelerometer data worn on the hip for seven days during waking hours and participated in cardiopulmonary exercise testing on a cycle ergometer (n = 1,396 participants with a mean age of 57.1 (SD 13.2, 51% men). Linear regression models applying compositional data analysis were used to examine associations of proportions of movement behaviors (exposure) with parameters derived during cardiopulmonary exercise testing (outcome) normalized for body weight and stratified by sex. Models were adjusted for age, education, smoking, and partnership, except the %predicted VO2peak model, where age was omitted, as it is part of the calculation of the %predicted VO2peak. In models examining O2pulse or HRmax, individuals using beta blockers were excluded.

RESULTS

In males and females, more time spent in moderate-to-vigorous physical activity was associated with greater VO2VT1, VO2peak, and VO2 recovery after 60 s (all p < 0.01). Greater moderate-to-vigorous physical activity was also related to higher %predicted VO2peak and maximum heart rate in males and to higher VO2/work in females (all p < 0.01). In both sexes, more time in stationary time was associated with less %predicted VO2peak (p < 0.01). More light intensity physical activity was associated to higher %predicted VO2peak in both sexes and with lower VO2/work in women (all p < 0.01). Greater stationary time was related to less VO2/work, VO2VT1, and VO2peak in males and to less VO2 recovery after 60 s and O2pulse in females (p values < 0.05).

CONCLUSION

Moderate-to-vigorous physical activity (positive) and stationary time (inverse) influence parameters derived during cardiopulmonary exercise testing irrespective of age, smoking, and living in a relationship. The sex specific effects were rather small. Hence, promoting physical activity should be encouraged to increase cardiorespiratory fitness.

Move to improve - Prescribing physical activity and deprescribing paracetamol for people with low back pain: Findings from a hybrid type III feasibility study

OBJECTIVE

To evaluate the feasibility of implementing a culturally adapted multimedia intervention in the waiting room of a public hospital physiotherapy outpatient service to guide the implementation of a large multicentre trial investigating the effects of a multimedia intervention to promote physical activity and reduce paracetamol use in people reporting low back pain (LBP).

METHODS

A six-month (March to September 2024) hybrid type III feasibility study was conducted in an outpatient physiotherapy department of a public hospital in Sydney, Australia. The intervention included a brief video and booklet designed to engage patients and encourage informed management of LBP. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework guided the evaluation. The educational materials were available in English, Arabic and Mandarin.

RESULTS

The study revealed limited engagement, with only 11% of 688 potential people exposed to the intervention interacting with it. A total of 66 people completed the surveys (mostly English speakers), and six accepted to participate in a follow-up survey. Despite this low engagement, feedback from those who participated was positive. Satisfaction and usefulness ratings were high, with scores of 7.7-7.9 out of 10 for both video and booklet. Helpfulness was also rated positively, particularly for the video (8.6/10). Barriers to engagement included unfamiliarity with digital formats, video length, and the need for staff assistance in accessing the materials.

CONCLUSION

The findings suggest that the intervention, as currently designed, is not feasible for effective implementation in its present form. While engagement with the multimedia intervention was limited, findings allowed for a comprehensive understanding of the barriers and contextual factors impacting patient interaction. Notably, the majority of feedback was positive, with high satisfaction and usefulness ratings. The results underscore the need for alternative implementation strategies and further refinement of the approach to improve engagement with culturally diverse populations experiencing LBP and optimise outcomes in future implementations.

The association between chronic pain and metabolic syndrome: A scoping review

Metabolic syndrome (MetS) is a prevalent comorbidity in patients with chronic pain conditions. Emerging evidence suggests that the relationship between MetS and chronic pain is bidirectional. This interplay involves complex mechanisms, including proinflammatory mediators in nociceptive modulation and pain-induced lifestyle changes affecting metabolic function. This scoping review examines the association between MetS and chronic pain. We conducted a scoping review, including 28 studies. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We included observational studies (cross-sectional, case-control, and cohort studies) from the following databases: Ovid MEDLINE, EMBASE, Cochrane Central, Cochrane Database of Systematic Reviews, and Scopus. We identified studies on migraine (n = 9), spinal pain (n = 8), general chronic pain (n = 4), fibromyalgia syndrome (n = 3), carpal tunnel syndrome (n = 1), osteoarthritis (n = 1), shoulder pain (n = 1), and neuropathic pain (n = 1). Most studies used a cross-sectional design and standard criteria to define MetS, with some exceptions. Individuals with MetS and spinal pain, fibromyalgia, or general chronic pain showed higher pain scores and increased functional limitations. MetS was common in patients with migraine, but its effect on pain severity was inconclusive. The relationship between MetS and other pain conditions requires further investigation to clarify the association and potential mechanisms. MetS is prevalent in patients with chronic pain and is associated with worse pain and functional outcomes. Health care providers should acknowledge the wide spectrum of MetS beyond obesity. This understanding may help identify those at risk for more severe chronic pain.

Perceived Changes in Physical Activity, Sedentary Behavior, and Stress During the Pandemic Predict Current Levels of These Same Variables

The COVID-19 pandemic and its associated restrictions placed on daily life may have negatively impacted overall physical and psychological health as well as health behaviors such as decreased physical activity and increased sedentary behavior. It is important to understand if these potential changes during the pandemic may be predictive of current health behaviors where pandemic-related restrictions are no longer being implemented. This study aimed to assess the relationships between perceived changes in physical activity, sitting, and stress during the COVID-19 pandemic to current measures of these same variables. In April 2022, participants (N = 208) completed a survey in which they indicated perceived changes in physical activity, sitting, and stress during the pandemic. Participants then self-reported their current total physical activity, daily sitting, and anxiety. Multiple Pearson correlation analyses were performed to assess the relationships between perceived measures of physical activity, sitting, and stress during the pandemic to current measures of these same variables. Greater perceived inactivity (i.e., reduced physical activity) during the pandemic was associated with lower current total physical activity (r = -0.28, p < 0.001) and greater daily sitting (r = 0.19, p = 0.007). Greater perceived sitting during the pandemic was associated with lower current total physical activity (r = -0.26, p < 0.001). Lastly, greater perceived stress during the pandemic was associated with greater current anxiety (r = 0.35, p < 0.001). This suggests that individuals who perceived negative health-related changes during the pandemic may still be impacted by persisting effects.

Impact of the COVID-19 Pandemic on Children's Physical Activity As Perceived by Their Parents

Background Since the outbreak and global spread of COVID-19, countries rapidly introduced a range of preventative measures and isolation protocols to ensure safety, which ultimately led to the implementation of total lockdowns. As a result, children lost access to spaces where they typically engage in physical activity and were required to stay indoors. Objective The objective of this study is to assess the impact of the COVID-19 pandemic on children's physical activity levels and analyze the factors influencing their physical activity during this period. Methods Parents from various Emirates participated in an online survey to evaluate changes in their children's physical activity during the COVID-19 lockdown compared to the pre-lockdown period. The survey included questions about time spent on sedentary activities, general physical activity, and specific play behaviors before and during the lockdown. It also assessed the parents' own physical activity and their involvement in their children's activities. The relationships between these behaviors, as well as demographic and environmental factors, were analyzed. Results The study included 272 parents who completed an online survey about their child's physical activity during the COVID-19 lockdown. Many parents reported significant changes in their children's physical activity and screen time. Specifically, 89 (32.7%) observed a major decrease in physical activity, while 77 (28.3%) noted a minor decrease. Regarding screen time, 79 (29.0%) of parents reported a major increase, and 87 (32.0%) saw a minor increase. Key factors influencing children's physical activity were identified. Most notably, parents' own activity levels had a significant impact on their children's activity (p < 0.001). Additionally, children living in villas were more active than those living in apartments or traditional houses (p = 0.007), and UAE national children were slightly more active than non-nationals (p = 0.023). Conclusion This study demonstrated the significant impact of the COVID-19 lockdown on children's activity and emphasized the importance of parental involvement in supporting their children's activity levels. It highlights the need for increased attention during the recovery phase from this crisis and calls for the development of strategies and guidelines to prevent similar challenges in future pandemics or similar emergencies.

Exercise alters molecular profiles of inflammation and substrate metabolism in human white adipose tissue

White adipose tissue (WAT) plays a significant role in whole body energy homeostasis, and its excess typifies obesity. In addition to WAT quantity, perturbations in the basic cellular processes of WAT (i.e., quality) are also associated with obesity and metabolic disease. Exercise training alleviates metabolic perturbations associated with obesity; however, the underlying molecular mechanisms that drive these metabolic adaptations in WAT are not well described. Abdominal subcutaneous WAT biopsies were collected after an acute bout of exercise (1 day after) at baseline and following 3 wk of supervised aerobic training in sedentary overweight women (n = 6) without alterations in body weight and fat mass. RNA-seq, global proteomics, and phosphoproteomics in WAT revealed training-induced changes in 1,527 transcripts, 154 proteins, and 144 phosphosites, respectively. Training decreased abundance of transcripts and proteins involved in inflammation and components of the extracellular matrix and increased abundance of transcripts and proteins related to fatty acid esterification and lipolysis. In summary, short-term aerobic training significantly reduces local inflammation and increases lipid metabolism in WAT of sedentary overweight women-independent of alterations in body and fat mass. As such, some of the health benefits of aerobic training may occur through molecular alterations in WAT (i.e., enhanced quality) rather than a sheer reduction in WAT quantity.NEW & NOTEWORTHY This is the first study to utilize a multiomic (RNAseq, proteomics, and phosphoproteomics) approach to investigate molecular adaptations in WAT after a short-term intervention in sedentary overweight women. We show that supervised aerobic training reduces molecular markers of inflammation and proteins regulating ECM and increases abundance of transcripts and proteins involved in lipolysis and fatty acid re-esterification, indicating that molecular adaptations in WAT occur independent of alterations in body weight or fat mass.

Cardiorespiratory fitness in a population with different glucose metabolic statuses: low cardiorespiratory fitness increases the risk of early abnormal glucose metabolism

BACKGROUND

Low cardiorespiratory fitness (CRF) is a risk factor for many chronic diseases. This study aimed to evaluate the CRF of a sample of adults with different glucose tolerance statuses to explore its relationship with early abnormal glucose metabolism according to sex.

METHODS

A total of 93 participants were assigned to three groups, i.e. the normal glucose tolerance (NGT) group, impaired glucose regulation (IGR) group and new-onset type 2 diabetes mellitus (T2DM) group, through an oral glucose tolerance test. Cardiopulmonary exercise testing was performed to evaluate the participants' CRF. The physical measurements (including height, weight, systolic blood pressure [SBP] and diastolic blood pressure) and laboratory test results (including fasting plasma glucose and two-hour plasma glucose [2h-PG]) of all participants were collected. Partial correlation, multiple linear regression (stepwise method) and logistic regression were used to analyse the data.

RESULTS

Compared to the males with NGT, those with T2DM or IGR had a lower exercise time (P=0.044), anaerobic threshold (AT) oxygen uptake (VO2) (P=0.009), maximum VO2/kg (P=0.041) and oxygen uptake efficiency slope (P=0.002). The male participants with T2DM had lower AT power (P=0.001) than those with IGR or NGT. Compared to the females with NGT, the AT heart rate (HR) (P=0.003), AT SBP (P=0.002) and maximum VO2/kg (P=0.039) were lower in the female T2DM and IGR groups. The multiple linear regression (stepwise method) analyses showed that the maximum VO2/kg (β=-0.268, P=0.026) and one-minute HR recovery (β=-0.239, P=0.039) of the females improved the prediction of the 2h-PG when entered in the model. The logistic analysis results indicated that the VO2 max of the male participants was related to pre-diabetes (β=-0.003, P=0.024) and that their AT power was associated with new-onset diabetes (β=-0.053, P=0.010). Meanwhile, the AT SBP of the female participants was related to pre-diabetes (β=0.120, P=0.019), and their AT HR was related to new-onset diabetes (β=-0.102, P=0.014).

CONCLUSIONS

Low CRF is associated with abnormal glucose metabolism. The CRF is closely associated with the 2h-PG after glucose load and is an important risk factor for pre-diabetes and new-onset diabetes.

Charting the Molecular Terrain of Exercise: Energetics, Exerkines, and the Future of Multiomic Mapping

Physical activity plays a fundamental role in human health and disease. Exercise has been shown to improve a wide variety of disease states, and the scientific community is committed to understanding the precise molecular mechanisms that underlie the exquisite benefits. This review provides an overview of molecular responses to acute exercise and chronic training, particularly energy mobilization and generation, structural adaptation, inflammation, and immune regulation. Furthermore, it offers a detailed discussion of known molecular signals and systemic regulators activated during various forms of exercise and their role in orchestrating health benefits. Critically, the increasing use of multiomic technologies is explored with an emphasis on how multiomic and multitissue studies contribute to a more profound understanding of exercise biology. These data inform anticipated future advancement in the field and highlight the prospect of integrating exercise with pharmacology for personalized disease prevention and treatment.

Resveratrol and Physical Activity: A Successful Combination for the Maintenance of Health and Wellbeing?

Physical exercise is an essential component of human health. In recent years, scientific research has focused on identifying natural compounds and formulating new supplements aimed at enhancing athletic performance, accelerating muscle recovery, and minimizing the damage caused by physical exertion. The use of antioxidants to counteract the formation of reactive oxygen species (ROS) following physical activity (PA) is already a widely adopted practice. Resveratrol (RES), a polyphenol belonging to the stilbene class, is well known for its potent antioxidant activity and anti-inflammatory effects primarily attributed to the activation of sirtuins. RES possesses multiple nutraceutical properties used for the prevention and treatment of inflammatory, cardiovascular, neoplastic, and infectious diseases, thus attracting attention to study its use in combination with physical exercise to promote well-being. Animal trials combining RES and PA have mainly reported improvements in muscle, energy, and cardiovascular functions. The data presented and discussed in this narrative review are from Pubmed, Scopus, and the Human Gene Database (search limited to 2011 to 2025 with the keywords RES, sirtuins, and physical activity altogether or in combination with each other). This review gathers several studies on RES focusing on its nutraceutical properties, epigenetic activities via sirtuins, and the potential benefits of combining RES with PA in maintaining health and well-being based on trials performed first in animals and later in humans. Human studies have been conducted on various populations, including active adults, sedentary individuals, patients with diseases, and elderly individuals. Some studies have confirmed the benefits of RES observed in animal experiments. However, in some cases, no substantial differences were found between RES supplementation and the control group. In conclusion, the benefits of RES on PA reported in the literature are still not fully evident, given the contrasting studies and the still limited number of trials, but both RES and PA are successful tools for the maintenance of health and wellbeing.

Exploring the non-linear association and threshold effect of sedentary behavior on testosterone deficiency

BACKGROUND

Sedentary behavior has emerged as a potential risk factor for various health issues, including hormonal imbalances like testosterone deficiency (TD). However, the relationship between sedentary time and TD remains underexplored, especially with respect to the complex biological mechanisms underlying this association. This study aimed to examine the association between sedentary time and TD in adult males.

METHODS

This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey 2011-2016. A total of 6057 male participants aged 20 years and older were included. Sedentary time was categorized into quartiles, and TD was defined as serum testosterone levels below 300 ng/dL. Logistic regression models were employed to assess the association between sedentary time and TD, adjusting for demographic, lifestyle, and health-related covariates. Restricted cubic spline (RCS) analysis and segmented regression were also conducted to explore potential non-linear relationships and thresholds. Subgroup analyses were performed to examine the consistency of associations across various groups.

RESULTS

The analysis revealed a significant positive association between sedentary time and TD. Prolonged sedentary behaviour was consistently associated with higher odds of TD across all models (all p < 0.001). RCS analysis showed a significant non-linear relationship, particularly as sedentary time exceeded 4.5 h per day, with a marked increase in the likelihood of TD (p-non-linear = 0.027). Subgroup analysis indicated that this association was most pronounced in Non-Hispanic Whites, current smokers, and drinkers, and was weaker in individuals with diabetes, where the association lost statistical significance after full adjustment.

CONCLUSIONS

This study identifies a significant association between prolonged sedentary behaviour and a higher risk of TD, suggesting that sedentary behavior may play a key role in the development of TD, particularly in specific high-risk populations.

Using music as a mood regulator in everyday life is associated with unfavourable health and fitness outcomes in overweight adults

Individual traits and habits have shown to be associated with health and health behaviour. One such habit is how individuals use music. This study aimed to examine if using music as a mood regulator is related to risk factors of lifestyle diseases. Participants who joined the present Motivation Makes the Move! lifestyle intervention were overweight and sedentary adults (n = 76, ages 19-40). They answered questionnaires about physical activity and use of music. They also underwent a cardiopulmonary exercise test and their body composition was assessed. Additionally, the analyses' robustness was tested through controlling for physical, sociodemographic and psychological health related factors. We observed that despite the participants' self-reported commitment to regular physical activity, their fitness level was poor. Using music as a mood regulator was associated with lower cardiorespiratory fitness. Use of music was also positively linked to body fat percentage, although this finding did not remain significant after adjusting for age, educational level and experienced health. We urge future research to address the relationship between music use and risk factors of lifestyle diseases in a population sample.

The Function of Myostatin in Ameliorating Bone Metabolism Abnormalities in Individuals with Type 2 Diabetes Mellitus by Exercise

PURPOSE

The molecular mechanisms involved in bone metabolism abnormalities in individuals with type 2 diabetes mellitus (T2DM) are a prominent area of investigation within the life sciences field. Myostatin (MSTN), a member of the TGF-β superfamily, serves as a critical negative regulator of skeletal muscle growth and bone metabolism. Current research on the exercise-mediated regulation of MSTN expression predominantly focuses on its role in skeletal muscle. However, due to the intricate and multifaceted mechanical and biochemical interactions between muscle and bone, the precise mechanisms by which exercise modulates MSTN to enhance bone metabolic disorders in T2DM necessitate additional exploration. The objective of this review is to systematically synthesize and evaluate the role of MSTN in the development of bone metabolism disorders associated with T2DM and elucidate the underlying mechanisms influenced by exercise interventions, aiming to offer novel insights and theoretical recommendations for enhancing bone health through physical activity.

METHODS

Relevant articles in Chinese and English up to July 2024 were selected using specific search terms and databases (PubMed, CNKI, Web of Science); 147 studies were finally included after evaluation, and the reference lists were checked for other relevant research.

RESULTS

Myostatin's heightened expression in the bone and skeletal muscle of individuals with T2DM can impede various pathways, such as PI3K/AKT/mTOR and Wnt/β-catenin, hindering osteoblast differentiation and bone mineralization. Additionally, it can stimulate osteoclast differentiation and bone resorption capacity by facilitating Smad2-dependent NFATc1 nuclear translocation and PI3K/AKT/AP-1-mediated pro-inflammatory factor expression pathways, thereby contributing to bone metabolism disorders. Physical exercise plays a crucial role in ameliorating bone metabolism abnormalities in individuals with T2DM. Exercise can activate pathways like Wnt/GSK-3β/β-catenin, thereby suppressing myostatin and downstream Smads, CCL20/CCR6, and Nox4 target gene expression, fostering bone formation, inhibiting bone resorption, and enhancing bone metabolism in T2DM.

CONCLUSION

In the context of T2DM, MSTN has been shown to exacerbate bone metabolic disorders by inhibiting the differentiation of osteoblasts and the process of bone mineralization while simultaneously promoting the differentiation and activity of osteoclasts. Exercise interventions have demonstrated efficacy in downregulating MSTN expression, disrupting its downstream signaling pathways, and enhancing bone metabolism.

A structured, home-based exercise programme in kidney transplant recipients (ECSERT): A randomised controlled feasibility study

BACKGROUND

Cardiometabolic diseases are a major cause of morbidity and mortality in kidney transplant recipients (KTR) due to clustering of traditional and non-traditional risk factors including poor physical fitness and physical inactivity. Exercise may mitigate the risk of these diseases in this population but evidence is limited, and physical activity levels are low. The ECSERT randomised controlled trial assessed the feasibility of delivering a structured, home-based exercise intervention in KTR at increased cardiometabolic risk.

METHODS

Fifty KTR (>1-year post-transplant) were randomised 1:1 to: intervention (INT: a 12-week home-based combined aerobic and resistance exercise programme) or control (CTR: guideline-directed care). The a-priori thresholds for feasibility were: recruitment of 20% of eligible participants (≥2 participants per month); adherence (an average of ≥ 3 exercise sessions per week); and attrition (≤30%).

RESULTS

One hundred and seventy-one patients were screened and 94 (55%) were eligible and invited to take part in the study. Fifty of those invited (53%) were recruited across 22 months of recruitment. Consented participant characteristics were: age 50 ± 14 years (INT 49 ± 13; CTR 51 ± 15), 23 male (INT 10; CTR 13), eGFR 59 ± 19 ml/min/1.73m2 (INT 60 ± 20; CTR 61 ± 21), 35 White British (WB), 13 South Asian (SA), 1 Caribbean, and 1 Mixed ethnicity (INT 17 WB, 7 SA, 1 Mixed; CTR 18 WB, 6 SA, 1 Caribbean). Intervention participants (n = 22 completed) recorded an average of 4.4 ± 1.4 exercise sessions per week (aerobic 2.8 ± 1.1; strength 1.6 ± 0.5). Three participants withdrew from the intervention group (1 COVID-19 infection, 1 recurrent urine infections unrelated to the trial, 1 time/family circumstances) and one from the control group (lost to follow-up; 8% attrition). There were no serious adverse events reported.

CONCLUSION

Despite previous evidence showing physical fitness and activity levels are low in KTR, the present results support that a structured, home-based exercise programme is feasible in this population. Specifically, a-priory recruitment, adherence, and retention thresholds were all exceeded. The groups were well matched and there was encouraging representation of female participants and participants from a non-white background. Thus, this study supports further development and testing of home-based programmes of exercise and activity for KTR.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04123951.

Association of Sleep Traits, Physical Activity, and Sedentary Leisure Behavior With Female Reproductive Health: A Two-Sample Mendelian Randomization Analysis

Purpose

Living habits affect female endocrine function and fertility, along with aging and other life factors. Because of this, female reproductive health can be promoted through living habit adjustment.

Methods

We used two-sample Mendelian randomization analysis with summary datasets from a genome-wide association study to investigate the causal relationships between sleep traits, sedentary leisure behavior, physical activity, and reproductive health traits in women, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Exposure genetic instruments were used for variants that were significantly related to traits. The inverse-variance weighted (IVW) method was used for the main analysis, and we also performed MR-Egger and weighted median analyses to supplement the sensitivity test. Horizontal pleiotropy was detected using the MRE intercept and MR-PRESSO methods, and heterogeneity was assessed using Cochran's Q statistics, IVW, and MR-Egger.

Results

Insomnia showed a significant inverse causal association with endometriosis [OR (95% CI) IVW = 1.80 (1.16, 2.80), P = 0.009] and abnormal menstruation [OR (95% CI) IVW = 2.37 (1.34, 4.20), P = 0.003]. Sleep duration was negatively related to menopause age (beta IVW = -0.034, P = 0.001), and long sleep duration could be a protective factor of endometriosis [OR (95% CI) IVW = 0.07 (0.01, 0.72), P = 0.024]. Strenuous sports were also negatively correlated with female infertility [OR (95% CI) IVW = 0.10 (0.02, 0.68), P = 0.019]. Sensitivity analysis revealed no signs of horizontal pleiotropy or heterogeneity.

Conclusion

Our findings suggest that insomnia is an adverse factor correlated with endometriosis and abnormal menstruation and that longer sleep duration protects against endometriosis. Adequate sleep and regular schedules may decrease the risk of endometriosis and abnormal menstruation, helping improve the reproductive health of women.

The association between fatigue and cardiometabolic diseases: Insights from the UK biobank study

BACKGROUND

Cardiometabolic diseases (CMD) are major global health concerns with significant morbidity and mortality. Fatigue, a common but often overlooked symptom, has been postulated as both a potential risk factor for and a consequence of these conditions. However, the relationships between fatigue and CMD remain unclear. This study aimed to investigate the relationship between fatigue and CMD using observational and genetic approaches.

METHOD

Observational study was conducted in the UK biobank. Genetic method was employed a bidirectional MR approach to examine the causal relationship between fatigue and CMD. Genetic variants associated with fatigue were identified through a GWAS, and summary statistics from the largest available GWAS were used to obtain variants associated with stroke, CAD, T2D, and HF. Inverse variance weighting (IVW) was conducted, with weighted median, MR-Egger, and MR-PRESSO as sensitivity analyses. Multivariable MR and mediation analysis were also employed.

RESULTS

Observational analyses indicated that individuals with fatigue had a significantly increased risk of developing stroke (HR 1.44, 95 % CI 1.27-1.63), T2D (HR 1.46, 95 % CI 1.41-1.51), CAD (HR 1.45, 95 % CI 1.4-1.5), and HF (HR 1.60, 95 % CI 1.52-1.68). Mendelian randomization analyses further supported a causal relationship. Additionally, observational and genetic analyses showed T2D was found to be associated with increased levels of fatigue. Mediation analysis identified lipid metabolites as mediators in the relationship between fatigue and CMD.

CONCLUSION

This study highlights a bidirectional relationship between fatigue and CMD, underscoring the importance of considering fatigue in the context of cardiometabolic health.

CLINICAL TRIAL NUMBER

Not applicable.

G-Protein-Coupled Receptor (GPCR) Signaling and Pharmacology in Metabolism: Physiology, Mechanisms, and Therapeutic Potential

G-protein coupled receptors (GPCRs), the largest family of integral membrane proteins, enable cells to sense and appropriately respond to the environment through mediating extracellular signaling to intercellular messenger molecules. GPCRs' pairing with a diverse array of G protein subunits and related downstream secondary messengers, combined with their ligand versatility-from conventional peptide hormone to numerous bioactive metabolites, allow GPCRs to comprehensively regulate metabolism and physiology. Consequently, GPCRs have garnered significant attention for their therapeutic potential in metabolic diseases. This review focuses on six GPCRs, GPR40, GPR120, GLP-1R, and ß-adrenergic receptors (ADRB1, ADRB2, and ADRB3), with GLP-1R recognized as a prominent regulator of system-level metabolism, while the roles of GPR40, GPR120 and ß-adrenergic receptors in central carbon metabolism and energy homeostasis are increasingly appreciated. Here, we discuss their physiological functions in metabolism, the current pharmacological landscape, and the intricacies of their signaling pathways via G protein and ß-arrestin activation. Additionally, we discuss the limitations of existing GPCR-targeted strategies for treating metabolic diseases and offer insights into future perspectives for advancing GPCR pharmacology.

Forensic considerations in cases of fatal constipation

Constipation is characterized by persistent difficulty in defecating. It is a common disorder in the community particularly affecting the elderly and those with intellectual disabilities and neuropsychiatric disorders. It is also caused by numerous medications including analgesic, antidepressant, antihypertensive and anticholinergic agents. It may be asymptomatic or it may produce abdominal pain/cramps, bloating, nausea and anorexia progressing to urinary incontinence and fecal impaction, or paradoxical diarrhea due to overflow. A wide range of mechanisms associated with constipation may result in death including bowel obstruction, stercoral colitis with ulceration, perforation and peritonitis, respiratory compromise, abdominal compartment syndrome and venous thrombosis with pulmonary thromboembolism. Constipation may exacerbate pre-existing diseases and treatments such as laxative and enemas may be lethal. The autopsy examination of a case with constipation and megacolon should take into account all of the pre-existing conditions, as well as the possibility of underlying disorders such as Hirschprung disease. Review of the decedent's medical and drug history and level of supportive care will be important. Toxicological evaluations may be useful.

Pregnancy intention, preconception health, health behaviours, and information and health advice seeking among expectant male partners

BACKGROUND

Attempting pregnancy as a conscious decision (pregnancy intention) can impact the likelihood that a future parent receives or seeks preconception health information, initiates discussions with health professionals, and ultimately optimises their health and behaviours in preparation for healthy pregnancy and child. Knowledge about the relationship between men's preconception health behaviours and their pregnancy intention is only emerging.

METHODS

This study aimed to describe the preconception health status, behaviours, information- and advice-seeking of male expectant partners, and to explore differences in these preconception factors based on pregnancy intention. An online retrospective cross-sectional survey was completed by male reproductive partners of pregnant females. Their pregnancy intention was assessed using the London Measure of Unplanned Pregnancy (LMUP). Participants were recruited via social media and all variables were self-reported by expectant partners. Chi-square tests examined differences by LMUP categories (planned or ambivalent/unplanned).

RESULTS

Of 156 expectant partners who consented to survey participation, 138 completed all LMUP questions and were included in analysis. Most expectant partners reported their partner's current pregnancy as planned (n = 90;65.2%), less than half reported looking for and finding information about becoming pregnant (40.0%). Expectant partners with planned pregnancy more often reported physical exercise three months before pregnancy compared with partners with unplanned/ambivalent pregnancy (p = 0.001). Expectant partners with ambivalent/unplanned pregnancy more often experienced longstanding illness, disability, or infirmity (p = 0.002) or disregarded contraception (p < 0.001). Despite perceiving good or excellent health, and undertaking physical exercise, numerous expectant partners with planned pregnancy had overweight. Further research exploring the reproductive life plan process for males with longstanding chronic illness or disability may help promote pregnancy planning and preconception health amongst this sub-population.

CONCLUSIONS

Further large-scale studies are needed to enable clinicians to better understand pregnancy intentions and preconception health of males and for policy makers to formulate health policies aimed at supporting male preconception health and awareness.

Longitudinal relationship between baseline Weight-Adjusted Waist Index and stroke risk over 8 years in Chinese adults aged 45 and older: a prospective cohort study

Background

This study explores the longitudinal relationship between the Weight-Adjusted Waist Index (WWI), an innovative obesity metric, and stroke incidence in aged 45 and older Chinese adults.

Methods

Data from 9,725 individuals aged 45 years and older were analyzed from the China Health and Retirement Longitudinal Study (2011-2020). Baseline characteristics were analyzed across different quartiles of the WWI. Stroke incidents were determined through self-reported doctor diagnoses. Multivariate logistic regression analyses and curve fitting assessed the WWI-stroke risk relationship, adjusting for various demographic, lifestyle, and health-related factors.

Results

Higher WWI quartiles were associated with older age and higher prevalence of stroke and adverse health conditions. In the fully adjusted model, participants in the highest WWI quartile had an odds ratio of 1.52 (95% CI: 1.19, 1.92) for stroke compared to the lowest quartile. Curve fitting revealed a linear relationship between WWI and stroke risk, consistent across various demographic and clinical subgroups.

Conclusion

Higher WWI is linked to an increased risk of stroke in aged 45 and older Chinese adults over an eight-year period. WWI may serve as an effective tool for predicting long-term stroke risk within this population. However, the study is limited by the reliance on self-reported stroke diagnoses and the presence of potential residual confounding factors.

Aerobic Exercise Prescription for Pain Reduction in Fibromyalgia: A Systematic Review and Meta-Analysis

BACKGROUND AND OBJECTIVE

Fibromyalgia is a condition characterised by disabling levels of pain of varying intensity. Aerobic exercise may play a role in reducing pain in these patients. The aim of this review is to assess the dose of aerobic exercise needed, based on the frequency, intensity, type, time, volume and progression (FITT-VP) model, to obtain clinically relevant reductions in pain.

DATABASES AND DATA TREATMENT

A systematic review and meta-analysis of randomised clinical trials was conducted in the Web of Science (WoS), PEDro, PubMed and Scopus databases, the search having been conducted between July and October of 2023. Risk of bias was assessed with the Cochrane Risk of Bias assessment tool 2.

RESULTS

Seventeen studies were included. The risk of bias varied, with six studies showing low risk; five, some concerns; and six, high risk. Aerobic exercise interventions were analysed using the FITT-VP model. Frequency ranged from 1 to 10 times per week, intensity varied from light to vigorous, and the types of exercise included music-based exercise, interval training, pool-based exercise, stationary cycling, swimming and walking. The intervention durations ranged from 3 to 24 weeks, with session lengths ranging from 10 to 45 min. Most of the studies presented significant differences, favouring aerobic exercise (MD -0.49; CI [-0.90, -0.08; p = 0.02]), with moderate to low heterogeneity in subgroup analyses.

CONCLUSIONS

The study findings underscore the efficacy of aerobic exercise in alleviating pain among fibromyalgia patients, advocating for tailored exercise dosing to optimise adherence and outcomes.

SIGNIFICANCE STATEMENT

Individuals with fibromyalgia should engage in aerobic exercises two to three times weekly, for twenty-five to forty minutes in each session, aiming for more than a hundred minutes per week. They should start at low intensity, gradually increasing to higher intensities over six to twelve weeks, for optimal pain management. Exercise types should be selected in collaboration with the patient and based on personal preferences and accessibility, such as walking, and swimming, to ensure long-term adherence to the regimen.

The Interplay Between Obesity and Aging in Breast Cancer and Regulatory Function of MicroRNAs in This Pathway

Breast cancer (BC) is a significant contributor to cancer-related deaths in women, and it has complex connections with obesity and aging. This review explores the interaction between obesity and aging in relation to the development and progression of BC, focusing on the controlling role of microRNAs (miRNAs). Obesity, characterized by excess adipose tissue, contributes to a proinflammatory environment and metabolic dysregulation, which are important in tumor development. Aging, associated with cellular senescence and systemic changes, further exacerbates these conditions. miRNAs, small noncoding RNAs that regulate gene expression, play key roles in these processes, impacting pathways involved in cell proliferation, apoptosis, and cancer metastasis, either as tumor suppressors or oncogenes. Importantly, specific miRNAs are implicated in mediating the impact of obesity and aging on BC. Exploring the regulatory networks controlled by miRNAs provides valuable information on new targets for therapy and predictive markers, demonstrating the potential for using miRNA-based interventions to treat BC in obese and elderly individuals. This review emphasizes the importance of integrated research strategies to understand the complex connections between obesity, aging, and miRNA regulation in BC.

County-level Racial/Ethnic Residential Segregation and Physical Activity Behavior among US Adults

The relationship between racial/ethnic residential segregation and physical activity (PA) remains unclear with both positive and negative associations between segregation and PA recently reported. We aimed to examine the relationship between county-level residential segregation and total daily PA and domain-specific PA and whether these associations varied by gender. Participants (N = 2625, mean age [SD] = 45.2 [15.4]) were recruited from the AmeriSpeak panel who completed up to two Activities Completed over Time in 24 Hours (ACT24) previous day recalls in 2019. PA outcomes were created for the following: (1) light PA (LPA), (2) moderate-to-vigorous PA (MVPA), (3) total active time, and (4) domain-specific PA, including leisure, work, household, transport, personal, and other activities. County-level residential segregation based on isolation. Weighted generalized linear models were used to examine the relationship between county-level segregation and each PA outcome, controlling for age, gender, race/ethnicity, income, employment, body mass index, county-level poverty, and census region. Overall, results showed no association between county-level residential segregation and LPA, MVPA, total active time, and domain-specific PA among NH Black and Hispanic populations. Among NH Black females, greater residential segregation was associated with more total hours/day of activity (β = 3.54, 95% CI [0.23, 6.85]). Only NH Black females living in segregated neighborhoods had more total active time. Additionally, it is important to acknowledge that these relationships may vary among NH Black and Hispanic populations. Future studies should examine the interaction between segregation and a broader range of individual, contextual, and environmental factors in relation to PA and domain-specific PA.

Benefits of physical exercise through multivariate analysis in sedentary adults and elderly: An analysis of physical fitness, health and anthropometrics

This study employed multivariate analysis to investigate the effects of a 14-week multicomponent training program on sedentary adults and older populations, focusing on improvements in physical fitness, health markers, and anthropometric measures. The data included 376 participants aged 30 to 84 years who had been inactive for at least 3 months. Results showed that participants aged 71 and above had lower systolic blood pressure, height, body mass, elbow flexion and extension, sitting and standing up from a chair, agility, 6-Minute Walk Test (6MWT), and handgrip strength values compared to younger age groups (p < 0.05). Initially, the 6MWT was inversely correlated with anthropometric measures and positively correlated with strength tests, but after the intervention, it remained correlated only with handgrip strength and agility. Interestingly, the elbow flexion and extension strongly correlated with other fitness measures pre-intervention, but these relationships weakened afterward. Agility became a key intermediary variable in the analysis. Despite improvements, anthropometric variables like body mass and waist circumference continued to have a strong relationship with fitness outcomes. Significant gains were observed in the 6MWT and elbow flexion and extension (p < 0.05), indicating improvements in aerobic fitness and strength. Multivariate analysis showed that hip circumference, chair stand test, handgrip strength, and agility significantly influenced 6MWT performance. Using multivariate analysis, we were able to highlight the importance of incorporating regular exercise into daily life to promote active and healthy aging. Furthermore, agility emerged as the most significant intermediate variable after the intervention. This insight suggests that improvements in agility may be crucial for physical fitness and overall health.

Optimised Skeletal Muscle Mass as a Key Strategy for Obesity Management

The 'Body Mass Index' (BMI) is an anachronistic and outdated ratio that is used as an internationally accepted diagnostic criterion for obesity, and to prioritise, stratify, and outcome-assess its management options. On an individual level, the BMI has the potential to mislead, including inaccuracies in cardiovascular risk assessment. Furthermore, the BMI places excessive emphasis on a reduction in overall body weight (rather than optimised body composition) and contributes towards a misunderstanding of the quiddity of obesity and a dispassionate societal perspective and response to the global obesity problem. The overall objective of this review is to provide an overview of obesity that transitions away from the BMI and towards a novel vista: viewing obesity from the perspective of the skeletal muscle (SM). We resurrect the SM as a tissue hidden in plain sight and provide an overview of the key role that the SM plays in influencing metabolic health and efficiency. We discuss the complex interlinks between the SM and the adipose tissue (AT) through key myokines and adipokines, and argue that rather than two separate tissues, the SM and AT should be considered as a single entity: the 'Adipo-Muscle Axis'. We discuss the vicious circle of sarcopenic obesity, in which aging- and obesity-related decline in SM mass contributes to a worsened metabolic status and insulin resistance, which in turn further compounds SM mass and function. We provide an overview of the approaches that can mitigate against the decline in SM mass in the context of negative energy balance, including the optimisation of dietary protein intake and resistance physical exercises, and of novel molecules in development that target the SM, which will play an important role in the future management of obesity. Finally, we argue that the Adipo-Muscle Ratio (AMR) would provide a more clinically meaningful descriptor and definition of obesity than the BMI and would help to shift our focus regarding its effective management away from merely inducing weight loss and towards optimising the AMR with proper attention to the maintenance and augmentation of SM mass and function.

Health benefits of leisure-time physical activity by socioeconomic status, lifestyle risk, and mental health: a multicohort study

BACKGROUND

Regular physical activity is recommended for all aged 5 years and older, but the health benefits gained might differ across population subgroups. The aim of this study was to examine these benefits in terms of years lived free from major non-communicable diseases in subgroups with varying levels of risk factors.

METHODS

Our analysis was based on a multicohort study of initially healthy European adults from the IPD-Work Consortium and initially healthy participants from the UK Biobank study. Self-reported leisure-time physical activity levels at baseline (1986-2010) were categorised as low (no or very little), intermediate (between low and recommended levels), and WHO-recommended (≥2·5 h of moderate or ≥1·25 h of vigorous physical activity per week). We divided the study population into 36 overlapping subgroups based on socioeconomic factors, lifestyle, and mental health at baseline, and assessed disease-free years between ages 40 years and 75 years for both the overall population and subgroups, accounting for coronary heart disease, stroke, type 2 diabetes, cancer, asthma, and chronic obstructive pulmonary disease.

FINDINGS

14 IPD-Work studies were assessed and six studies were excluded due to missing outcome data and unavailable data for pooling, resulting in the inclusion of eight studies with 124 909 participants. After the exclusion of 7685 participants due to prevalent diseases and 9265 due to missing data, the sample consisted of 107 959 initially healthy European adults (63 567 [58·9%] females and 44 392 [41·1%] males) from the IPD-Work consortium. For the UK Biobank sample, 9 238 453 million individuals were invited, 8 736 094 (94·6%) were non-respondents, and 502 359 participated in the baseline examination. After the exclusion of 73 460 participants, 428 899 participants had data on at least one measure of physical activity. 236 258 (55·1%) were female and 192 641 (44·9%) were male. During 1·6 million person-years at risk, 21 231 IPD-Work participants developed a non-communicable disease, while 101 319 UK Biobank participants developed a non-communicable disease over 4·8 million person-years at risk. Compared with individuals with low physical activity, those meeting the recommended physical activity levels during leisure-time gained an additional 1·1 (95% CI 1·0-1·2) to 2·0 (1·7-2·3) disease-free years, depending on sex and study. In males from the IPD-Work and UK Biobank cohorts, greater gains in disease-free years were observed in current smokers (2·4 [95% CI 2·1-2·8]) versus never smokers (0·7 [0·5-0·9]); those with low education (1·4 [1·1-1·7]) versus high education (0·8 [0·7-1·0]); low socioeconomic status (1·7 [1·5-2·0]) versus high socioeconomic status (0·9 [0·7-1·1]); and those with (1·6 [1·3-1·9]) versus without depressive symptoms (1·0 [0·9-1·1]; p value range <0·0001-0·0008). Similar differences were seen in women for smoking (2·3 [95% CI 1·9-2·7] vs 0·9 [0·7-1·1]), socioeconomic status (1·7 [1·4-2·0] vs 0·8 [0·5-1·0]), depressive symptoms (1·4 [1·1-1·7] vs 1·0 [0·9-1·1]), and for heavy drinkers compared with moderate drinkers (1·4 [1·1-1·6] vs 0·9 [0·7-1·1]; p value range <0·0001-0·010). No differences in physical activity-related health gains were observed between risk groups and non-risk groups by BMI, history of depression, and, in men, alcohol use (p value range 0·11-0·86).

INTERPRETATION

In addition to confirming the association between leisure-time physical activity and increased disease-free years across population subgroups, our findings show that these health benefits are often more pronounced among individuals with pre-existing health risks or disadvantaged backgrounds than in those with more favourable risk factor profiles. This suggests that enhancing population-wide physical activity initiatives could help reduce health disparities, while incorporating physical activity into targeted strategies addressing social disadvantage, unhealthy lifestyles, and depression might enhance their effectiveness.

FUNDING

Wellcome Trust, UK Medical Research Council, US National Institute on Aging, and Research Council of Finland.

A Pre-Post Study Design Exploring the Potential Benefits of a Hiking Intervention for Active and Inactive Older Adults

INTRODUCTION

Physical activity (PA) is essential for healthy aging, yet PA levels are low in older adults. Group-based nature programming may be an ideal opportunity for engaging older adults in PA and improving health-related quality of life.

METHODS

Twenty-seven older adults, 55-75 years of age (n = 14 active and n = 13 previously inactive), enrolled in a biweekly 8-week hiking program. At baseline, participants completed online questionnaires on health-related quality of life, behavioral and psychological outcomes, and a one-mile walk test to assess cardiorespiratory fitness.

RESULTS

Average attendance was 81% in the previously inactive groups and 74% in the active group. There was a significant increase in the physical component of quality of life over time in the previously inactive group (p = .03, d = 0.71). Participants significantly improved their cardiorespiratory fitness (p = .003, d = 0.77) and competency (p = .005, d = 0.41) as assessed by the Basic Psychological Needs for Exercise Scale. The previously inactive group additionally increased their self-efficacy for exercise (p = .001, d = 1.43). Both active and previously inactive groups exercised at a similar relative intensity during the hikes based on heart rate; however, perceived exertion at the end of the hike on average was lower among active participants (p = .014).

CONCLUSION

Group-based hiking for previously inactive older adults significantly improved physical health-related quality of life over an 8-week biweekly intervention. Hiking at an individualized pace may allow for hiking to be an appropriate PA program in previously inactive older adults.

Geographic and Grade-Level Disparities in Student Access to School-Based Physical Education and Physical Activity Opportunities Across 25 US States

BACKGROUND

Most US children and adolescents do not meet recommended daily physical activity (PA) guidelines. Determinants of PA are complex; however, access to opportunities precedes actual PA engagement. Schools are well positioned to support student PA through the provision of physical education (PE) and before, during, and after school PA opportunities through comprehensive (ie, expanded) school PA programming. Monitoring access to school PE and PA opportunities is an essential function of public health. However, there are limited comprehensive data across K-12 settings. Therefore, the purpose of this study was to evaluate students' access to PE and expanded recreation time before, during, and after school PA opportunities in K-12 schools across 25 US states.

METHODS

The US Physical Education and Physical Activity Policy questionnaire was completed by 4845 K-12 PE teachers across 25 states, representing diverse geographical regions, with responses standardized across varying academic calendars. Descriptive statistics were used to illustrate access to PE and PA opportunities.

RESULTS

Access to PE and PA varied, with elementary schools generally providing more opportunities than middle and high schools. There was an overall misalignment with national PE and recess recommendations. Limited before and after school PA opportunities were also reported.

DISCUSSION

The relative dearth of access to PE and expanded PA opportunities currently available to students in relation to national guidelines shows a need for states to prioritize expanding access to PE and recreational PA to reduce disparities. To ensure more equitable student access, collaborative efforts among educators, policymakers, and stakeholders are essential.

Assessment of cardiovascular risk and physical activity: the role of cardiac-specific biomarkers in the general population and athletes

The first part of this Inter-Society Document describes the mechanisms involved in the development of cardiovascular diseases, particularly arterial hypertension, in adults and the elderly. It will also examine how consistent physical exercise during adolescence and adulthood can help maintain blood pressure levels and prevent progression to symptomatic heart failure. The discussion will include experimental and clinical evidence on the use of specific exercise programs for preventing and controlling cardiovascular diseases in adults and the elderly. In the second part, the clinical relevance of cardiac-specific biomarkers in assessing cardiovascular risk in the general adult population will be examined, with a focus on individuals engaged in sports activities. This section will review recent studies that suggest a significant role of biomarkers in assessing cardiovascular risk, particularly the presence of cardiac damage, in athletes who participate in high-intensity sports. Finally, the document will discuss the potential of using cardiac-specific biomarkers to monitor the effectiveness of personalized physical activity programs (Adapted Physical Activity, APA). These programs are prescribed for specific situations, such as chronic diseases or physical disabilities, including cardiovascular diseases. The purposes of this Inter-Society Document are the following: 1) to discuss the close pathophysiological relationship between physical activity levels (ranging from sedentary behavior to competitive sports), age categories (from adolescence to elderly age), and the development of cardiovascular diseases; 2) to review in detail the experimental and clinical evidences supporting the role of cardiac biomarkers in identifying athletes and individuals of general population at higher cardiovascular risk; 3) to stimulate scientific societies and organizations to develop specific multicenter studies that may take into account the role of cardiac biomarkers in subjects who follow specific exercise programs in order to monitor their cardiovascular risk.

Sedentary lifestyle induces oxidative stress and atrophy in rat skeletal muscle

Abundant evidence indicates that skeletal muscle plays a key role in regulating metabolic homeostasis. Therefore, maintaining healthy skeletal muscles is essential to good health. While prolonged muscle inactivity is known to cause oxidative stress and muscle loss, it remains unclear whether a shift from an active to a sedentary lifestyle induces similar effects. This study tested the hypothesis that transitioning to a sedentary lifestyle rapidly leads to oxidative stress and muscle loss in the load-bearing soleus muscle. Adult Wistar rats were randomly divided into control (CON; n = 8) and sedentary (SED; n = 8) groups. During a 7-day experimental period, CON rats were housed in standard cages allowing free movement, while SED rats were confined to smaller cages promoting sedentary behaviour. Soleus muscles were analysed for antioxidant enzyme activities (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX)), as well as two oxidative stress biomarkers (advanced protein oxidation products (AOPPs) and 4-hydroxynonenal (4-HNE)). Sedentary behaviour caused a 17.2% reduction in the soleus-to-body weight ratio (P < 0.001). Moreover, the activities of SOD, CAT and GPX were significantly lower in the soleus muscle of SED animals (P < 0.05), while AOPPs and 4-HNE levels were higher (P < 0.001 and P < 0.05) compared to CON animals. These findings provide the first evidence that transitioning from an active to a sedentary lifestyle leads to the rapid onset of oxidative stress and atrophy in the soleus muscle. Importantly, the results suggest that impaired antioxidant defences contribute to sedentary behaviour-induced oxidative stress in load-bearing muscles.

Metabolome Alterations Associated with Three-Month Sitting-Time Reduction Among Sedentary Postmenopausal Latinas with Cardiometabolic Disease Risk

Background: Incidence of cardiometabolic disease among U.S. Hispanics/Latinos is higher than in non-Hispanic Whites. Prolonged sitting duration is prevalent in older adults, and compounded with menopause, greatly increases cardiometabolic risk in postmenopausal women. Metabolomic analyses of interventions to reduce sitting are lacking and mechanistic understanding of health-promoting behavior change in postmenopausal Latinas is needed. Methods: To address this knowledge gap, an exploratory analysis investigated the plasma metabolome impact of a 12-week increased standing intervention among sedentary postmenopausal Latinas with overweight or obesity. From a parent-randomized controlled trial, a subset of Best Responders (n = 43) was selected using parameters of highest mean change in sitting bout duration and total sitting time; baseline variable-Matched Controls (n = 43) were selected using random forest modeling. Targeted LC-MS/MS analysis of archived baseline and 12-week plasma samples was conducted. Metabolite change was determined using a covariate-controlled general linear model and multivariate testing was performed. A false discovery rate correction was applied to all analyses. Results: Best Responders significantly changed time sitting (-110.0 ± 11.0 min; -21%), standing (104.6 ± 10.1 min; 40%), and sitting in bouts >30 min (-102.3 ± 13.9 min; -35%) compared to Matched Controls (7.1 ± 9.8 min, -7.8 ± 9.0 min, and -4.6 ± 12.7 min, respectively; all p < 0.001). Twelve-week metabolite change was significantly different between the two groups for 24 metabolites (FDR < 0.05). These were primarily related to amino acid metabolism, improved blood flow, and ATP production. Enzyme enrichment analysis predicted significant changes regulating glutamate, histidine, phenylalanine, and mitochondrial short-chain fatty acid catabolism. Pathway analysis showed significant intervention effects on glutamate metabolism and phenylalanine, tyrosine, and tryptophan biosynthesis, potentially indicating reduced cardiometabolic disease risk. Conclusions: Replacing nearly two hours of daily sitting time with standing and reduced prolonged sitting bouts significantly improved metabolomic profiles associated with cardiometabolic risk among postmenopausal Latinas.

Effects of Recreational Football on Bone Mineral Density and Isokinetic Muscle Strength in Elderly Men: A Study of Turkish Older Men

Background and Objectives: Recreational football (RF) as a community activity can provide a positive transformative effect on the musculoskeletal systems necessary for the self-care and independent life demands of older adults when designed with a geriatric approach, in addition to its psycho-social benefits. However, studies investigating the potential value of these practices in older adults living in different ecosystems are needed. The aim of this study was to investigate the effects of RF on bone mineral density (BMD) and knee isokinetic muscle strength (KIMS) at angular velocities of 60°/s-1 and 120°/s-1 in older adult men. Material and Methods: A total of 57 elderly men (65.5 ± 2.7 years) were randomly divided into a football group (FG; n = 28) and a control group (CG; n = 29). The FG participated in 28 sessions of training, twice a week. Participants were evaluated using the DEXA and IsoMed 2000. The groups, their pre-test-post-test time differences, and group*time interactions were analyzed by mixed design ANOVA. Results: The results were analyzed considering a p < 0.05 significance level. There was no observed statistically significant difference between the groups for bone mineral density values (p > 0.078), but there was an observed statistically significant difference in the FG group*time interaction (F = 7.009, p < 0.009, η2p = 0.060). There was a statistically significant difference between the groups in the peak torque flexion and peak torque extension values at 60°/s-1 angular velocity, respectively (p < 0.002, p < 0.011). At 120°/s-1 angular velocity, peak torque flexion and extension, total work flexion and extension, and peak power flexion and extension showed statistically significant differences between the groups, respectively (p < 0.001, p < 0.0027; p < 0.003, p < 0.025; p < 0.001, p < 0.009). Conclusions: These results suggest that RF interventions provide positive biochemical and morphological adaptations in bone mineral density and lower extremity muscle groups, making older adults both more resistant to potential risks and encouraging exercise as a way of life with its autotelic flow structure.

Cardiovascular Diseases, Vital Organ Fibrosis, and Chronic Inflammation Associated with High-Intensity and/or High-Volume Exercise Training: Double-Edged Sword Effects of Vigorous Physical Activity in Elderly People and/or in Middle-Age Cancer-Therapy-Treated Patients

Cardiotoxicity, cardiovascular diseases (CVDs), hypertension, hepatotoxicity, and respiratory problems occurring several months to several years post-chemotherapy and/or radiotherapy are increasingly documented by scientists and clinicians. Anthracyclines, for example, were discovered in the late 1960s to be dose-dependently linked to induced cardiotoxicity, which frequently resulted in cardiomyopathy and heart failure. Most of those changes have also been associated with aging. While it is well known that exercise can slow down cellular aging processes, lessen the effects of chemotherapy, improve the effectiveness of cancer treatments, and prevent health problems in the general population, it remains unclear how exercise volume or intensity may affect the overall benefits of physical activity on health. For instance, higher rates of sudden cardiac arrest or coronary artery calcification have been found in marathon and ultra-marathon runners. Several additional pathological consequences have also been reported recently on many organs of those athletes. This review reports the most recent evidence suggesting that excessive intensity and/or volume may have deleterious effects on health. These findings are in clear contrast with the popular belief that all forms of physical activity can generally reduce the pathological changes associated with aging or cancer therapies. In conclusion, high-intensity training (HIT) and/or high-volume training (HVT) should not be recommended for middle-age and elderly people who have had cancer therapies or not in order to avoid an exacerbation of the consequences of aging or long-term cancer treatment effects on vital organ structures and functions.

Global trends and hotspots of type 2 diabetes in children and adolescents: A bibliometric study and visualization analysis

BACKGROUND

Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus (T2DM) among children and adolescents worldwide. Due to rapid disease progression, severe long-term cardiorenal complications, a lack of effective treatment strategies, and substantial socioeconomic burdens, it has become an urgent public health issue that requires management and resolution. Adolescent T2DM differs from adult T2DM. Despite a significant increase in our understanding of youth-onset T2DM over the past two decades, the related review and evidence-based content remain limited.

AIM

To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.

METHODS

This study utilized the terms "children", "adolescents", and "type 2 diabetes", retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection (SCI, SSCI, ESCI). Utilizing CiteSpace and VoSviewer software, we analyze and visually represent the annual output of literature, countries involved, and participating institutions. This allows us to predict trends in this research field. Our analysis encompasses co-cited authors, journal overlays, citation overlays, time-zone views, keyword analysis, and reference analysis, etc.

RESULTS

A total of 9210 articles were included, and the annual publication volume in this field showed a steady growth trend. The United States had the highest number of publications and the highest H-index. The United States also had the most research institutions and the strongest research capacity. The global hot journals were primarily diabetes professional journals but also included journals related to nutrition, endocrinology, and metabolism. Keyword analysis showed that research related to endothelial dysfunction, exposure risk, cardiac metabolic risk, changes in gut microbiota, the impact on comorbidities and outcomes, etc., were emerging keywords. They have maintained their popularity in this field, suggesting that these areas have garnered significant research interest in recent years.

CONCLUSION

Pediatric and adolescent T2DM is increasingly drawing global attention, with genes, behaviors, environmental factors, and multisystemic interventions potentially emerging as future research hot spots.