Search Results (536)

The incretin hormones glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) play central roles in metabolic and cardiovascular regulation. GLP-1 receptor agonists (GLP-1RAs) are established therapies for type 2 diabetes mellitus (T2DM) and obesity because of their insulinotropic effects, weight reduction, and proven cardiovascular benefit in trial level. In contrast, GIP was historically overlooked due to reduced β-cell responsiveness in T2DM. The development of dual GIP/GLP-1 receptor agonists has reshaped this view. Tirzepatide, the first-in-class co-agonist, an antidiabetic medication to treat type 2 diabetes and for weight loss, provides superior glycemic control and weight loss compared with selective GLP-1RAs in clinical trials, demonstrating synergistic actions between the two incretin pathways. This review summarizes key physiology, pathophysiology, and therapeutic evidence in incretin biology. We describe secretion patterns, receptor distributions, and distinct actions of GIP and GLP-1, as well as alterations in incretin signaling in T2DM and obesity. Cardiovascular protective mechanisms are outlined, including improvements in lipid metabolism, reductions in blood pressure, enhanced endothelial nitric oxide activity, suppression of macrophage inflammation, decreased foam-cell formation, and stabilization of atherosclerotic plaques. At the therapeutic level, emerging directions—such as dual and triple agonists—and unresolved questions regarding long-term vascular effects of GIP and the potential for genotype-guided incretin therapy are also discussed. Collectively, these findings highlight an emerging shift toward integrated incretin-axis modulation as a therapeutic strategy for metabolic and cardiovascular disease. Full article

Background: Type 2 diabetes mellitus (T2DM) is a growing global health challenge requiring effective dietary management strategies. While the Mediterranean diet shows promise for cardiovascular and metabolic health, the last comprehensive meta-analysis of randomized controlled trials (RCTs) examining its effects on glycemic control and body mass index (BMI) in T2DM was published in 2015. Multiple RCTs, including culturally adapted interventions with extended follow-up, have since been completed, but remain unsynthesized. Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines (PROSPERO: CRD420251147035), searching PubMed, Web of Science, and Embase from inception through 17 August 2025. Unlike previous syntheses that combined observational cohorts or mixed dietary approaches, our analysis focused strictly on RCTs in adults with established T2DM and incorporated trials published after 2015. We included RCTs comparing Mediterranean diet interventions against non-Mediterranean control diets in adults with T2DM. Primary outcomes included glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body mass index (BMI). Secondary outcomes comprised low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Pooled effects were estimated using random-effects models. Results: Eleven RCTs (10 publications) involving diverse populations met inclusion criteria. Compared with control diets, Mediterranean diet interventions showed reductions in HbA1c (mean difference [MD] −0.307%, 95% CI: −0.451 to −0.163), FPG (MD −0.845 mmol/L, 95% CI: −1.307 to −0.384), and BMI (MD −0.828 kg/m², 95% CI: −1.4 to −0.256). Secondary analyses revealed reductions in LDL-C (MD −8.060 mg/dL, 95% CI: −14.213 to −1.907), SBP (MD −5.130 mmHg, 95% CI: −10.877 to 0.617), and DBP (MD −2.008 mmHg, 95% CI: −3.027 to −0.989). Sensitivity analyses supported stability of findings, with no substantial publication bias detected. Subgroup analyses revealed geographic variation in blood pressure responses, with greater benefits observed in non-Mediterranean populations. Conclusions: Mediterranean dietary patterns were associated with modest improvements in glycemic control, body composition, and cardiometabolic risk factors among adults with T2DM. The cultural adaptability of this approach may support implementation in clinical practice, though larger multicenter trials with standardized protocols and extended follow-up remain necessary. Full article

Neonatal pulmonary hypertension (PH) is a major cause of illness and death in newborns. Neonatologist-performed echocardiography (NPE) is increasingly used as a bedside tool to assess heart function, shunt patterns, and pulmonary blood flow in real time, helping clinicians better understand the severity and type of PH. This narrative review summarizes current evidence on the use of NPE in diagnosing, monitoring, and treating neonatal PH, drawing on clinical studies, guidelines, and expert recommendations. NPE provides key diagnostic and therapeutic information, including evaluation of ventricular function, estimation of pulmonary pressures, and assessment of shunt direction. Advanced measures—such as tricuspid annular plane systolic excursion (TAPSE), myocardial performance index, pulmonary artery acceleration time (PAAT), and deformation imaging—improve accuracy and help guide therapies like inhaled nitric oxide, milrinone, and sildenafil. NPE is also useful in chronic conditions such as bronchopulmonary dysplasia (BPD)- and congenital diaphragmatic hernia (CDH)-associated PH. Despite its clear clinical value, NPE use remains limited by variations in training, protocols, and resource availability. Standardized curricula, accreditation, and unified reporting practices are needed to ensure safe, consistent integration of NPE into neonatal care pathways. Full article

Background/Objectives: This systematic review aimed to evaluate the effectiveness and feasibility of “exercise snacks,” brief, intermittent bouts of physical activity designed to interrupt prolonged sedentary behavior. The review synthesized findings across metabolic, cardiovascular, cognitive, and functional health domains to identify consistent patterns of benefit and determine their practical applicability across populations. Methods: A total of 26 studies met inclusion criteria, encompassing diverse populations such as healthy adults, older adults, and individuals with obesity, type 2 diabetes, or PCOS. Following the PRISMA 2020 guidelines, comprehensive searches were conducted across PubMed, Scopus, Web of Science, and CINAHL databases for studies published between 2012 and 2025. Eligible studies included randomized controlled trials, crossover trials, and feasibility studies assessing health outcomes following exercise snack interventions in adults. Data were extracted using standardized protocols, and methodological quality was evaluated using the Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale. Narrative synthesis was prioritized due to intervention heterogeneity. Results: Exercise snacks consistently improved postprandial glucose, insulin, and triglyceride responses, reduced blood pressure, preserved endothelial and cerebral blood flow, and enhanced cardiorespiratory fitness. Older adults demonstrated significant gains in lower-limb strength and mobility. Emerging evidence also indicated improvements in mood, fatigue, and cognitive performance. Feasibility trials confirmed high acceptability and adherence across settings and age groups. Conclusions: Exercise snacking represents a time-efficient, feasible, and evidence-based strategy to mitigate the health risks of sedentary behavior. By incorporating brief, frequent activity bouts into daily routines, individuals can achieve meaningful benefits in metabolic regulation, cardiovascular health, physical function, and cognitive well-being. Future research should refine optimal protocols and explore long-term sustainability across varied populations. Full article

Metabolic syndrome (MetS) is a multifactorial condition characterized by central obesity, hypertension, dyslipidaemia, and hyperglycaemia, predisposing individuals to cardiovascular disease and type 2 diabetes. This cross-sectional study investigated the relationship between dietary intake, sociodemographic factors, and components of MetS among Saudi adults aged 30 years and older attending King Abdulaziz University Hospital. Fifty-three participants meeting MetS diagnostic criteria were assessed through anthropometric measurements, biochemical markers, and two-day dietary recalls analyzed using MyFood24 software. Descriptive and correlation analyses were conducted using SPSS 26.0. The majority of participants (73.6%) were aged over 50 years, were obese (75.5%), and exhibited a high waist circumference (94.3%). Low fibre (6.6 g/day) and high fat (41.8 g/day) intake patterns were evident. Salt intake showed a significant inverse correlation with systolic blood pressure (ρ = −0.36, p < 0.01), potentially reflecting under-reporting or dietary adjustments following diagnosis. Higher BMI correlated positively with waist circumference and diastolic pressure, while frequent physical activity correlated negatively with these parameters. These findings emphasize the influence of diet and lifestyle on metabolic risk and underscore the need for culturally tailored interventions promoting balanced macronutrient intake, increased fibre consumption, and enhanced physical activity to mitigate MetS prevalence among Saudi adults. Full article

Objectives: To characterise multidomain physiological responses to a maximal cycling effort and identify consistent physiological responder profiles. A secondary objective was to compare professionals and amateurs and assess the practical value of these profiles for personalised monitoring and performance management. Methods: This observational study included 22 trained male cyclists (10 professionals, 12 competitive amateurs; age 27.6 ± 6.4 years; height 177.3 ± 5.5 cm; weight 65.5 ± 4.1 kg). Participants performed a maximal 20-min functional threshold power (FTP) test and complementary assessments (Bosco jump tests, blood pressure, heart rate, lactate, glycaemia, creatine kinase, albuminuria) across three time points (baseline, immediately post-FTP, and 24 h post-FTP). Statistical analyses included t-tests, ANOVA, and Spearman correlations, for recovery dynamics, with significance set at p < 0.05. Results: Professionals exhibited significantly higher FTP (5.5 ± 0.3 vs. 4.3 ± 0.4 W/kg, p < 0.001), greater post-exercise lactate (13.8 ± 1.6 vs. 11.2 ± 1.4 mmol/L, p < 0.01) and higher CK 24-h responses (412 ± 86 vs. 291 ± 74 U/L, p < 0.05). Cardiovascular and metabolic recovery slopes were faster in professionals (p < 0.05). Despite lower baseline jump values, professionals showed reduced neuromuscular fatigue (SJ post/pre = 0.94 ± 0.04 vs. 0.88 ± 0.05, p < 0.05). FTP correlated strongly with 5-min all-out power (r = 0.76, p < 0.01) and Wingate mean power (r = 0.75, p < 0.01). Eight responder profiles emerged across four physiological domains, with professionals predominantly showing multi-domain adaptation patterns. Although additional variables, such as elevated albuminuria and altered Elasticity Index (EI), provide insight into renal and neuromechanical stress responses, they were excluded from the final profiling due to limited practical interpretability. Conclusions: Fatigue and recovery in prolonged cycling show substantial interindividual variability across neuromuscular, metabolic, cardiovascular, and biochemical domains. Professional cyclists display faster recovery and more frequent multidomain responder profiles. The four-variable model (FTP, lactate, CK, SJ post/pre) enables clear identification of physiological responder types and offers a practical, integrative framework for personalised monitoring and performance management. Full article

Background/Objectives: Metabolic and bariatric surgery (MBS) promotes improved redox response and weight loss and reduced cardiovascular risk. However, there is still no consensus on whether some of these results may be affected years after the surgery. This study evaluated the association between redox response and cardiovascular risk markers following MBS. Methods: Patients (n = 91) of both sexes who underwent MBS 2–7 years ago were evaluated. Antioxidant enzymatic activity (catalase, superoxide dismutase, glutathione-S-transferase, and glutathione peroxidase) and oxidative damage (malondialdehyde and carbonylated protein) were quantified. Blood pressure, glucose, insulin, triglyceride/glucose (TyG) index, LDL-C, HDL-C, non-HDL-C, triglyceride (TG), and cholesterol were analyzed. Principal component analysis (PCA) and generalized linear models were used. Results: The participants had a mean age of 39.82 ± 7.87 years, and a current body mass index of 29.53 ± 5.01 kg/m². The PCA identified two patterns: enzymatic antioxidant activity (PC1) and oxidative damage (PC2). No association was found between PC1 and cardiovascular risk markers. A positive association was observed between PC2 and diastolic blood pressure (β: 6.79, 95% confidence intervals [CI]: 1.97; 11.61), TyG index (β: 0.13, 95% CI: 0.05; 0.21), total cholesterol (β: 15.17, 95% CI: 3.61; 26.72), TG (β: 25.88, 95% CI: 8.58; 43.18; p = 0.003), and non-HDL-C (β: 10.91, 95% CI: 0.02; 21.88). Conclusions: Oxidative damage markers were positively associated with diastolic blood pressure, TyG index, TG, total cholesterol, and non-HDL-C levels after MBS. However, further studies are required to confirm and elucidate these findings. Full article

Background: Left atrial strain (LAS) derived from speckle-tracking echocardiography (STE) provides a sensitive, load-dependent measure of atrial function and ventricular filling pressures. Data on LAS in paediatric cardiomyopathies are still scarce; therefore, this study aimed to assess LA phasic function in dilated (DCM) and hypertrophic (HCM) cardiomyopathy and to determine its relationship with clinical and echocardiographic indices of disease severity. Methods: We conducted a cross-sectional case–control study that included 84 children (DCM n = 29, HCM n = 29, control n = 26) who underwent comprehensive clinical and echocardiography evaluation, including LAS parameters (reservoir—LASr; conduit—LAScd; and contractile—LASct). Group comparisons were performed using ANOVA or Kruskal–Wallis tests with post hoc adjustments, and correlations were analysed using Pearson’s or Spearman’s coefficients. Multivariable linear and logistic regression models were adjusted for age, body surface area (BSA), heart rate (HR), and blood pressure (BP) percentiles. Results: LASr and LAScd were significantly reduced in both cardiomyopathy groups compared with controls (p < 0.001), following a graded pattern (DCM < HCM < control). In DCM, lower LASr was independently associated with higher left atrial volume index (LAVi) and elevated E/E′ ratio, whereas in HCM, septal hypertrophy (IVSd Z-score) and log NT-proBNP were dominant determinants of impaired LASr. In logistic regression, LASr (OR = 0.93, p = 0.016) and LAScd (OR = 1.21, p = 0.001) independently predicted severe NYHA/Ross functional class after covariate adjustment, while LASct showed no significant association. Conclusions: These findings demonstrate that LA reservoir and conduit strain are markedly impaired in paediatric cardiomyopathy and are strongly linked to structural remodelling and functional limitation, underscoring their value as sensitive non-invasive markers of disease severity. Full article

Background: Obesity represents a multisystemic disorder that extends beyond metabolic dysfunction, involving hepatic, renal, and cardiovascular axes. This study introduces the Cardio–Reno–Metabolic–Liver–Obesity (CaRaMeL-O) framework as an integrated tool to assess multi-organ metabolic stress in adults with obesity. Methods: In this cross-sectional study, 287 adults with obesity (mean BMI 35.1 ± 4.6 kg/m²) were evaluated. The CaRaMeL-O score (0–13 points) incorporated metabolic (TyG index), hepatic (FIB-4, transaminases), and renal (eGFR, UACR) parameters, as well as classical and lifestyle risk factors. Participants were stratified into low, moderate, and high risk categories. Group comparisons were conducted using ANOVA and Kruskal–Wallis tests, while multivariate regressions identified independent predictors of FIB-4 and eGFR. Distributional characteristics were further analyzed using Weibull modeling. Results: Higher CaRaMeL-O scores were associated with a progressive increase in TyG (p < 0.001) and FIB-4 (p < 0.001), while eGFR showed a mild, nonsignificant downward trend. In multivariate models, age was the strongest predictor of FIB-4 (β_std = 0.33), whereas age, FIB-4, BMI, blood pressure, and UACR independently predicted eGFR. TyG did not remain significant after full adjustment. Weibull analysis revealed distinct distributional profiles, with TyG showing a narrow, homogeneous curve and FIB-4 and eGFR broader, right-skewed patterns. Conclusions: The CaRaMeL-O framework effectively captures inter-organ metabolic stress, demonstrating that hepatic and metabolic alterations precede overt renal decline. This integrated score may support early stratification and targeted prevention in obesity-related cardio-metabolic risk. Full article

Background: Metabolic syndrome (MetS) comprises a cluster of metabolic abnormalities that increase the risk of type 2 diabetes mellitus (T2DM) and cardiometabolic morbidity. Although widely recognized, evidence on its documentation and follow-up in primary care is limited. This study aimed to evaluate the extent of MetS documentation in electronic medical records (EMRs), examine follow-up patterns and metabolic changes over time, and assess the incidence and predictors of new-onset T2DM according to baseline MetS severity. Methods: A retrospective cohort study was conducted on 8170 adults aged 30–50 years, insured by Clalit Health Services in Southern Israel, who met ATP III criteria for MetS in 2008 and were followed through 2015. MetS severity was classified as mild (three components), moderate (four), or severe (five). Changes in metabolic indices were assessed longitudinally, and predictors of T2DM were analyzed using Kaplan–Meier survival and multivariable Cox regression models. Results: Although all participants met the diagnostic criteria, only 1.6% had a recorded MetS diagnosis. Over the eight years of follow-up, 26% developed T2DM, with incidence increasing from 21% among those with mild MetS to 49% among those with severe MetS (p < 0.0001). Fasting plasma glucose rose significantly (median +13 mg/dL, p < 0.001), BMI remained stable, and modest improvements were observed in blood pressure and lipid levels. Elevated fasting glucose (HR 2.13, p < 0.001), higher BMI (HR 1.33, p = 0.010), and lower HDL (HR 1.26, p = 0.045) independently predicted diabetes onset. Conclusions: MetS remains markedly under-documented and insufficiently integrated into primary care follow-up. Despite regular clinical follow-up, improvements in metabolic indices were limited. These findings highlight the need for structured strategies to enhance MetS recognition and long-term management within routine practice. Full article

Microchannels can create disturbed flow patterns by altering pressure gradients, shear forces, and flow symmetry, which are essential in the design of microfluidic devices and, hence, blood-contacting devices. The effect of asymmetric stenosis on pressure, wall shear stress, and velocity in rectangular and circular microchannels with same operating conditions was analyzed in this study using three-dimensional (3D) steady laminar computational fluid dynamics (CFD) simulations. Asymmetric flow patterns induced by asymmetric stenosis are of particular importance and remain underexplored, especially in the context of multiple constrictions. This is, to our knowledge, is the first systematic CFD comparison of multiple asymmetric stenoses in circular microchannels directly contrasted with rectangular and single-stenosis cases under identical settings. Several parameters, such as wall shear stress (WSS), pressure, and velocity distributions, were analyzed in various stenotic and non-stenotic geometries. These microchannel models, while not reflecting real blood vessels themselves nor exhibiting wall compliance, pulsatility, or non-Newtonian rheology, replicate important mechanical characteristics of stenosis-mediated flow disturbance. Single and multiple asymmetric stenoses create flow patterns that are similar to those of vascular pathologies. For this reason, these channels should be considered as simplified device-scale models of vascular phenomena as opposed to realistic, in vitro vascular models. The results showed that asymmetric stenosis creates asymmetric velocity peaks and elevated WSS, which are more evident in the case of circular configurations with double asymmetric stenosis. The findings will help design microfluidic devices that mimic unstable flow characteristics that occur in stenotic conditions, and assist in testing clinical devices. In this study, two fabrication-ready microchannel designs under fixed operating conditions (identical inlet velocity and fluid properties) that reflect common microfluidic use were compared. Consequently, all pressure, velocity, and WSS outcomes are interpreted as device-scale responses under fixed velocity, rather than a fundamental isolation of cross-section shape, which would require matched hydraulic diameters or flow rates. This study is explicitly device-oriented, representing a fixed operating point rather than a strict geometric isolation. Accordingly, the results are also expressed with dimensionless loss coefficients (Ktot and Klocal) to enable scale-independent, device-level comparison. Full article

Introduction: The PROMOTE cohort study is a prospective pregnancy cohort study that seeks to improve the understanding of cardiometabolic risk and determinants, such as diet, during pregnancy in a multi-ethnic population. Increasing age and obesity has resulted in an increased risk of cardiometabolic complications during pregnancy, including gestational diabetes. Trials of lifestyle interventions have so far produced mixed results, partly due to a wide variation in the methods, duration, adherence and type of dietary intervention. There is a need for high quality data about dietary habits in pregnancy, particularly in multi-ethnic populations. Objectives: In this study, we report the dietary habits of women in early pregnancy in the population of interest. We report early data seeking to assess the relationship between dietary patterns and risks of gestational diabetes. Methods and analysis: The PROMOTE cohort study is a prospective pregnancy cohort study recruiting pregnant participants with <16 weeks gestation in an area of high social and cultural diversity in western Sydney, Australia. The participants are surveyed about their physical activity levels, diet quality, emotional wellbeing and sociodemographic status using validated tools. Participants have consented to the use of routinely collected clinical and social data, including medical conditions, body mass index (BMI), blood pressure (BP) and glycaemia. The follow-up is from routinely collected data. This paper presents dietary data. Results: A total of 459 participants were recruited (n = 459), including 416 with GDM data available, at the conclusion of the first 2 years of recruitment. No participants met national dietary guideline recommendations. Fifty-six participants (n = 56, 13%) met a pragmatic composite standard of favourable diet, defined as two servings of vegetables and two servings of fruit per day, with a maximum of one discretionary serving per day. Over half the participants (n = 215, 51%) reported an adequate daily fruit intake. In total, 7 participants ate at least five servings of vegetables per day (n = 7, 1.7%), 61 participants (14.7%) ate three or more servings of vegetables per day and 212 (51.2%) participants reported one discretionary item per day. The data suggest that few women meet dietary recommendations in pregnancy. The association between dietary habits and GDM was unable to be assessed. The study was underpowered to detect an association due to the highly skewed distribution of dietary patterns in our population. Conclusions: The uptake of dietary recommendations was very low in our sample. This represents a major population health concern. Multi-level approaches are urgently needed to address poor dietary habits in pregnancy. Full article

Background/Objectives: Premature ejaculation (PE) is one of the most common sexual problems in men. Autonomic nervous system (ANS), which is an important determinant of circadian changes in blood pressure (BP), also has a mechanism that controls ejaculation. We aimed to investigate the relationship between PE and BP variability. Methods: This cross-sectional study included 80 normotensive patients with PE and 80 healthy volunteers. All the participants underwent 24-h ambulatory BP measurement. Participants were categorized into two groups based on the percentage of nocturnal BP dipping: the dipper BP (DBP), and non-dipper BP (NDBP) groups. Results: The frequency of the NDBP pattern was significantly higher in the PE group compared to the control group (48% vs. 28%, p = 0.009). In the multivariate logistic regression analysis, the NDBP pattern remained significantly associated with PE [odds ratio: 0.399, 95% confidence interval: (0.207–0.770), p = 0.006]. Within the PE group premature ejaculation diagnostic tool (PEDT) scores were significantly higher in individuals with NDBP than individuals with DBP (15.62 ± 2.85 vs. 14.32 ± 2.65, p = 0.038). Conclusions: The frequency of the NDBP pattern was significantly higher in the PE group among normotensive individuals. Additionally, within the PE group, PEDT scores were significantly higher in individuals with the NDBP pattern. A multidisciplinary approach and large-scale prospective studies are necessary to fully elucidate the relationship between PE and the cardiovascular system. Full article

Hypertension is a major public health problem worldwide, and high-salt diets are one of the main causes of hypertension. The intestinal mucosal immune system is the largest immune organ in vertebrates. Hypertension was associated with increased intestinal permeability and an inflammatory state. The bacterial communities attached to the intestinal mucosa played a significant role in the development and maturation of the autoimmune system, as well as inflammation and immunity to disease. In this review, we focused on the relationship between the impaired intestinal barrier and the development and progression of hypertension under the high-salt dietary pattern. We systematically reviewed how a high-salt diet caused hypertension by disrupting the intestinal mechanical, chemical, and microbial barriers, interacting with immunogenic isolevuglandin (IsoLG)-protein adducts and microbiota, and activating the mitogen-activated protein kinase (MAPK)/nuclear factor-kappa B (NF-κB) signaling pathway. Meanwhile, this review also summarizes the dietary therapy for hypertension, which involves supplementing natural antihypertensive substances and adjusting dietary patterns to repair the intestinal barrier and assist in lowering blood pressure. Such measures included supplementing plant-based foods, polyunsaturated fatty acids (PFAs), probiotics, prebiotics, food–medicine homologous substances (FMHS), vitamins, and minerals, as well as transforming high-salt dietary patterns into the dietary approaches to stop hypertension (DASH), the Mediterranean diet (MD), and the ketogenic diet (KD), with the aim of providing a reference for the occurrence, development, and dietary prevention and control of high-salt hypertension. Full article

Background/Objectives: High-altitude hypoxia may affect ECG readings, but it is unclear whether the “live-low–train-high” approach prevents these changes in winter sports athletes. Methods: This cross-sectional study assessed cardiovascular parameters in 102 winter-sport athletes (mean age 20 ± 4 y; 57% women), divided by training altitude into a high-altitude (HA) group (2500–3300 m, n = 70; skiers/snowboarders) and a low-altitude (LA) group (738 m, n = 32; ice hockey/figure skaters). Mid-season assessments included resting ECG, blood pressure, blood biochemistry, and three 24 h dietary recalls. Results: All ECG parameters were physiological, and no significant differences (p < 0.05) were observed in heart rate, PR interval, or QTc between groups. However, HA group exhibited higher systolic blood pressure and a short QT interval. Lactate was significantly higher in HA (p = 0.028). The HA diet contained more saturated fat (p < 0.001), cholesterol (p = 0.013), magnesium (p = 0.003) and potassium (p = 0.001), whereas LA athletes consumed more glucose (p = 0.024). In HA, total energy expenditure correlated positively (p ≥ 0.05) with QRS (ρ = 0.52) and QT (ρ = 0.56), while heart rate correlated inversely with vitamin D (ρ = −0.59). In LA, QTc showed strong inverse correlations with zinc (ρ = −0.62) and selenium (ρ = −0.85). Conclusions: This finding suggests that intermittent high-altitude training did not alter ECG patterns when nutrient intake was adequate. High lactate level and specific nutrient correlations point to a residual physiological load and a modulatory role of electrolytes, B-vitamins, and vitamin D on cardiac repolarisation. Full article