Search Results (10,997)

Background/Objectives: Frailty is a common geriatric syndrome associated with adverse outcomes such as disability, hospitalization, and mortality. This study aimed to assess the association between body mass index (BMI) trajectories over ten years and frailty among community-dwelling older adults in Brazil. Methods: This population-based longitudinal study used data from the COMO VAI? cohort, conducted with individuals aged ≥60 years in Pelotas, southern Brazil. Frailty was defined in 2024 using Fried’s phenotype, which evaluates weight loss, exhaustion, low physical activity, slowness, and weakness. BMI categories were defined as underweight (BMI < 22.0 kg/m²), eutrophy (22.0–27.0 kg/m²) and overweight (>27.0 kg/m²). BMI trajectories were identified using group-based trajectory modeling for 789 participants with data from at least two of three assessments (2014, 2019, 2024). Only trajectory groups comprising at least 5% of the sample were retained. Associations of baseline BMI and BMI trajectories with frailty were analyzed using Poisson regression with robust variance, adjusted for confounders and calf circumference. Results: Baseline underweight and overweight prevalence were 9.2% and 56.2%, respectively. Trajectory modeling identified three BMI groups: eutrophic (31.6%), overweight (56.4%), and obesity (12.0%). Obesity emerged as a distinct longitudinal trajectory rather than a baseline BMI category. Underweight did not emerge as a distinct BMI trajectory due to its low prevalence over time. Frailty prevalence in 2024 was 36.5%. Overweight trajectory participants had lower frailty prevalence after ten years (PR = 0.73; 95% CI: 0.54–0.99), while baseline underweight was associated with higher frailty ten years later (PR = 1.73; 95% CI: 1.05–2.84), consistent with the known risk of underweight and the potential protective effect observed in overweight older adults. Conclusions: Baseline underweight increased frailty risk, whereas an overweight trajectory showed a potential protective effect, consistent with the “obesity paradox” in older populations. Full article

Global water environment monitoring urgently requires remote sensing data with high temporal resolution and wide spatial coverage. However, current space-borne ocean color spectrometers still face a significant trade-off among spatial resolution, swath width, and system compactness, which limits the large-scale deployment of satellite constellations. To address this challenge, this study developed a lightweight high-resolution spectral imager (LHRSI) with a total mass of less than 25 kg and power consumption below 80 W. The visible (VIS) camera adopts an interleaved dual-field-of-view and detectors splicing fusion design, while the shortwave infrared (SWIR) camera employs a transmission-type focal plane with staggered detector arrays. Through the field-of-view (FOV) optical design, the instrument achieves swath widths of 207.33 km for the VIS bands and 187.8 km for the SWIR bands at an orbital altitude of 500 km, while maintaining spatial resolutions of 12 m and 24 m, respectively. On-orbit imaging results demonstrate that the spectrometer achieves excellent performance in both spatial resolution and swath width. In addition, preliminary analysis using index-based indicators illustrates LHRSI’s potential for observing chlorophyll-related features in water bodies. This research not only provides a high-performance, miniaturized spectrometer solution but also lays an engineering foundation for developing low-cost, high-revisit global ocean and water environment monitoring constellations. Full article

Background: Obesity is characterized by chronic low-grade inflammation and metabolic disturbances, including an altered tryptophan (Trp) catabolism through the kynurenine pathway (KP). Since the KP is closely linked to immune activity, energy metabolism, and hepatic function, modulating its flux through lifestyle interventions has gained interest as a potential therapeutic strategy. Objective: This exploratory study aimed to investigate the impact of a structured 12-week weight loss program (WLP) on serum KP metabolites in a sample of Mexican women with obesity. Methods: This study involved a pre–post-intervention design conducted in twenty-four women with clinically diagnosed obesity from the Mexican Navy who underwent a structured 12-week weight loss program combining a hypocaloric diet with moderate-intensity aerobic exercise; no control group was included. Anthropometric parameters, serum biochemistry, and circulating levels of Trp, kynurenine (KYN), kynurenic acid (KYNA), and 3-hydroxykynurenine (3-HK) were assessed before and after intervention. Psychological assessments of anxiety and depression were also conducted in a subset of participants. Results: The WLP significantly reduced body weight, BMI, fat mass, fasting insulin, and C-reactive protein levels. Serum concentrations of Trp, KYN, and KYNA decreased, while 3-HK showed a non-significant upward trend. Enzymatic indexes revealed a significant increase in the 3-HK/KYN ratio and a decrease in the KYNA/3-HK ratio, suggesting a shift toward kynurenine monooxygenase (KMO) branch. Notably, higher KYNA-related ratios were inversely associated with depressive symptoms. Conclusions: These findings position the KP as a responsive metabolic interface potentially linking improvements in body composition, liver function, and psychological status during structured weight loss efforts. Full article

Background/objectives: Metabolic abnormalities, independent of excess weight, may contribute to cancer risk even among individuals of normal weight, though their role remains unclear. This study sought to ascertain if metabolically unhealthy normal-weight (MUNW) individuals, generally characterized by a normal body mass index alongside the presence of metabolic abnormalities, have higher cancer risk than metabolically healthy peers, to analyze variations in risk across obesity-related cancer types, and to examine which single specific metabolic components can predict cancer independently in normal-weight individuals. Methods: Two authors systematically searched the PubMed, EMBASE, and Web of Science databases for longitudinal studies, published from inception to July 2025, that included normal-weight adults, classified participants by metabolic health status, and reported incident cancer outcomes in metabolically unhealthy versus healthy normal-weight groups. Hazard ratio (HR) estimates were extracted from each study and were pooled using random-effects inverse-variance model with empirical Bayes variance estimator. Results: Thirty-five studies involving 18,210,858 participants (56.0% females, mean age = 53.8 years) were included. A total of 280,828 new cancer cases were diagnosed during follow-up (mean = 10.6 years). In comparison with metabolically healthy normal-weight individuals, MUNW individuals had a 20% higher risk of cancer (HR = 1.20, 95% confidence interval [CI]: 1.13–1.28). Increased risks were observed for gastric cancer (HR = 1.40, 95% CI: 1.04–1.87), pancreatic cancer (HR = 1.37, 95% CI: 1.21–1.54), and colorectal cancer (HR = 1.34, 95% CI: 1.14–1.57), which were the cancer types showing statistically significant associations in subgroup analyses. Normal-weight participants presenting specific metabolic factors like central adiposity or glucose metabolism abnormalities had a 20% (HR = 1.20, 95% CI: 1.13–1.37) and 23% (HR = 1.23, 95% CI: 1.06–1.41) increased cancer risk, respectively. Conclusions: MUNW individuals are at higher risk of cancer, with specific metabolic abnormalities, particularly central adiposity and impaired glucose regulation, emerging as the factors most strongly associated with increased risk in normal-weight individuals. Routine metabolic screening and detailed phenotyping are crucial to identify these risks. Full article

This study aimed to test the factorial structure of the Eating Motivation Survey (TEMS) using Confirmatory Factor Analysis (CFA) in a sample of 632 university students from the Western Brazilian Amazon. A cross-sectional study was conducted between December 2022 and April 2023 with participants of both sexes, aged 18 or older. In addition to CFA, psychometric analyses were performed, and a Structural Equation Model was developed to examine the relationships between individual characteristics (age, sex, and Body Mass Index (BMI)) and the TEMS constructs. The results showed that 58.3% of participants were female, with a mean age of 25.29 years. The CFA supported an eight-factor model (health, natural concerns, socialization, price, visual appeal, weight control, emotional control, and social image) with 24 items, presenting good validity and reliability indices. Older individuals and those with lower BMIs prioritized health, natural concerns, and weight control, while younger participants, women, and those with higher BMIs were more influenced by emotional control. The findings contribute to understanding eating motivations in culturally diverse contexts and may support strategies aimed at promoting healthier dietary behaviors and preventing diet-related chronic diseases. Full article

Background and Objectives: Lower-extremity injuries are common among female athletes; however, their multifactorial predictors remain insufficiently understood. Given the interplay between physiological and psychological readiness in athletic performance, identifying the factors that influence lower limb performance is crucial for effective injury prevention. This study aimed to evaluate the predictive effects of physiological (VO₂peak, anaerobic power, agility, and isokinetic strength) and psychological (resilience and self-efficacy) variables on functional performance related to risk of injury. Materials and Methods: This cross-sectional study included 60 athletes with a mean age of 24.5 ± 6.90 years and mean body mass index of 23.12 ± 3.6 kg/m² (range: 16–30 kg/m²). The testing protocol included anthropometric measurements, the Lower Extremity Functional Test (LEFT), Wingate anaerobic cycling test, assessments of aerobic capacity, isokinetic muscle strength, and jumping performance (Single-Leg Hop [SLH] and Standing Long Jump [SLJ] tests). Psychological assessments included the General Self-Efficacy Scale (GSES) and a resilience questionnaire. A hierarchical regression analysis was performed. Results: The participants trained 5 ± 2 days per week and had 42 ± 39 months of sports experience. The mean VO_2peak was 40.82 ± 5.8 mL·kg⁻¹·min⁻¹, relative anaerobic peak power was 7.53 ± 1.92 W/kg, and fatigue index was 60.63 ± 15.41%. The mean isokinetic knee extension and flexion torque were 184.55 ± 44.60 N·m and 95.08 ± 21.44 N·m, respectively, with a flexion-to-extension ratio of 53.5%. The mean LEFT completion time was 160 ± 22 s. The participants demonstrated moderate resilience (BRS = 21 ± 4) and good self-efficacy (GSES = 33 ± 7.5). Among the psychological variables, GSES exhibited a modest negative correlation with LEFT (r = −0.28, p = 0.02). No significant associations were found between LEFT and psychological resilience. Longer LEFT completion times were associated with lower VO_2peak, mean power, and jump distance (p < 0.01). In the final model (R² = 0.58, p = 0.02), SLH (β = −0.54), VO_2peak (β = −10.32), and GSES (β = −0.70) were the strongest independent predictors of LEFT performance. Conclusions: SLH distance, VO_2peak, and general self-efficacy are key predictors of functional performance on the LEFT among female athletes. These factors may serve as practical indicators for identifying athletes who could benefit from targeted injury prevention programs. Full article

Background: Eating disorders are increasingly diagnosed in young women, particularly during adolescence. The recently described Anorexic Readiness Syndrome (ARS) is more common than full-blown anorexia. It has been identified in female athletes engaging in disciplines focusing on the aesthetics of the body, in women involved in recreational exercise and in those who are not physically active but strive to achieve the “perfect” figure. The study aimed to assess the severity and prevalence of ARS in women regularly engaging in body-shaping physical activity. Methods: The study included 659 women aged ≥14 years who engaged in regular body-shaping physical activity, provided informed consent to participate in the study (in the case of minors, also the consent of a parent or legal guardian), and had no diagnosed chronic diseases. The level of ARS was assessed using a questionnaire measuring attitudes toward food, supplemented with a specially designed survey consisting of 32 questions and a personal data form. Based on the frequency of body-shaping physical activity, participants were divided into two groups: the study group comprised women exercising ≥3 times per week (n = 301), while women exercising <3 times per week constituted the control group (n = 358). The analyses examined the relationships between ARS, frequency of body-shaping physical activity, BMI, and menstrual irregularities. Results: Medium or high ARS level was identified in over 96% (n = 637) of the respondents. The level of ARS was significantly related to the allocation into the group (p = 0.034) and the weekly hours of physical activity (p = 0.011 in the control group; p = 0.020 in the study group). There was a correlation between ARS and menstrual irregularities (p = 0.001). Weak but significant correlations were identified for awareness of eating disorders (V = 0.20; p = 0.001), adherence to a special diet (V = 0.18; p < 0.001) and self-assessed health (V = 0.18; p < 0.001). Conclusions: Higher ARS levels were observed in women reporting greater weekly physical activity. No significant associations were found between ARS and body mass index or body weight. Medium and high ARS levels were significantly associated with self-reported menstrual disturbances, while most participants with elevated ARS were unaware of disordered eating risk. Full article

Background: Maternal overweight and obesity, which show a rising trend globally, are associated with adverse pregnancy outcomes and long-term health risks for both mother and child. Awareness and understanding of these risks among women of reproductive age are essential for effective prevention and early intervention. Methods: We conducted a cross-sectional survey among 958 women planning pregnancy, currently pregnant or breastfeeding to assess their knowledge and attitudes regarding overweight and obesity in the perinatal period. The questionnaire covered lifestyle behaviors, breastfeeding practices, and knowledge related to overweight and obesity in pregnancy. Results: Overall knowledge regarding the consequences of maternal overweight and obesity was low, with notable deficits in understanding the associated health risks and frequent misconceptions about dietary recommendations during pregnancy. Awareness gaps were particularly noticeable in domains related to fetal outcomes and recommended energy requirements across pregnancy. Excessive gestational weight gain was reported in over 75% of pregnancies, including among women with normal body mass index. Participation in antenatal classes, current breastfeeding and older age were significantly associated with higher knowledge; however, these factors together explained only 6.2% of variability. Still, several key aspects were not well recognized despite high educational attainment and frequent contact with maternity care services. Conclusions: Our study highlights a clear and urgent need for better, more targeted educational strategies to improve women’s understanding of metabolic health and nutrition before and during pregnancy. The low explained variance indicates that maternal knowledge is influenced by multifactorial and not easily captured determinants, emphasizing the need for comprehensive and individualized educational approaches. Enhancing maternal awareness could support better health outcomes for both mothers and their offspring. Full article

Background: Vegetarian diets are becoming increasingly popular among young adults. The aim of this study was to examine the association between adherence to a vegetarian diet and body composition parameters in young adult women. Methods: A sample of 647 young adult women, mainly university students from Slovakia, consisting of 66 vegetarians (22.02 ± 2.74 years old) and 581 omnivores (21.13 ± 2.20 years old) was analysed. Body composition was measured using a bioelectrical impedance analyser, the InBody 770. Information on participants’ diet was collected using a modified version of the WHO STEPS 2014 questionnaire. Results: Vegetarian women showed significantly lower phase angle (PhA) values compared with omnivores (5.06 ± 0.45 vs. 5.23 ± 0.48; p = 0.004). They also had a higher extracellular-to-total body water ratio (ECW/TBW; 0.382 ± 0.004 vs. 0.380 ± 0.005; p = 0.026). In multivariable linear regression adjusted for smoking status, physical activity, body mass index (BMI) and waist-to-hip ratio (WHR), vegetarian diet remained independently associated with lower PhA (β = −0.094; p = 0.011) and higher ECW/TBW (β = 0.085; p = 0.028). No significant indirect associations between a vegetarian diet and PhA or ECW/TBW through smoking status or physical activity were observed. Conclusions: In this study of young adult Slovak women, adherence to a vegetarian diet was independently associated with lower PhA and a higher ECW/TBW ratio. These findings indicate differences in BIA-derived indicators of cellular integrity and fluid distribution between vegetarian and omnivorous women, although causal relationships cannot be inferred. Full article

Background: ABO blood type was reported to have a profound influence on hemostasis. This study aimed to determine the association between ABO blood type and the hemoglobin drop after total hip arthroplasty (THA). Methods: We retrospectively reviewed the changes in hemoglobin after elective primary THA. Demographic characteristics were analyzed for 794 eligible THAs. Changes in hemoglobin at postoperative days 1, 7, and 14 relative to the preoperative level were analyzed for 777 THAs that did not require allogenic blood transfusion (ABT). The effects of blood type were examined using a multivariate regression model and a propensity score matching model. Results: The hemoglobin drop was largest at 7 days, and the values differed significantly between type O cases and non-type O cases (2.68 ± 1.08 g/dL vs. 2.41 ± 1.02 g/dL; p = 0.0013). In the multivariate model, blood type O was identified as an independent factor for larger hemoglobin drop at 7 days (p = 0.015). Lower body mass index, non-hybrid THA, higher preoperative hemoglobin level, direct lateral approach, and prophylactic use of factor Xa inhibitor were also identified as independent risk factors for larger hemoglobin drop. After successful matching of 232 THAs in type O patients with 232 THAs in non-type O patients, hemoglobin drop at 7 days was significantly larger in type O patients (−2.44 ± 1.05 g/dL vs. −2.70 ± 1.05 g/dL, p = 0.0092). Conclusions: Blood type O was independently associated with a slightly greater postoperative hemoglobin decline after primary THA; however, the absolute between-group difference was small and was not accompanied by a higher allogenic transfusion rate. Therefore, ABO blood type may represent a minor risk marker and should be interpreted in the context of clinically more relevant bleeding- and hemodilution-related factors (e.g., perioperative anticoagulant/antiplatelet therapy and underlying coagulopathies). Full article

Background. The aim of this study was to develop a predictive model of anticancer drug therapy toxicity in patients with gastric cancer. Methods. The retrospective study included 100 patients with stage II–IV gastric cancer who underwent 4 chemotherapy cycles. Initial significant toxicity factors included age, gender, height, body mass, body mass index, disease stage, skeletal muscle index (SMI), as well as plasma levels of trace elements (copper, zinc, selenium, manganese) and thyroid-stimulating hormone, cancer histology type and treatment regimen. The CTCAE v5.0 scale was employed to assess the severity of adverse events. Statistical analysis and building of mathematical neural network models were carried out in SPSS Statistics (v19.0). Results. Lower SMI values were associated with higher rates of toxicity-related complications of anticancer drug therapy (p < 0.05): leukopenia, hypoproteinemia, nausea, vomiting, cardiovascular events. Anemia, thrombocytopenia, hepatic cytolysis syndrome, nausea, diarrhea, constipation and stomatitis showed a weaker correlation with SMI. An increase in TSH was associated with higher rates of thrombocytopenia, nausea and vomiting. A decrease in Cu/Zn in plasma correlated with the severity of leukopenia and diarrhea, whereas Se/Mn showed an inverse correlation with the severity of anemia. Conclusions. Sarcopenia, abnormal thyroid status and imbalances in copper, zinc, selenium and manganese in blood plasma of patients with gastric cancer may be used as predictors of increased toxicity of anticancer drug therapy. Full article

Background: Children and adolescents with autism spectrum disorder (ASD) frequently receive antipsychotics and are considered at increased risk for weight gain. Few studies have compared longitudinal weight trajectories between youth with ASD and those with other psychiatric disorders. Methods: This naturalistic, registry-based study used data from the SENTIA cohort, which prospectively monitors antipsychotic safety in individuals under 18 years at a university hospital in Spain. Clinical characteristics were compared between participants with and without ASD. Longitudinal body mass index (BMI) z-score trajectories were analysed using linear mixed-effects models. Results: The sample included 266 participants, of whom 113 (42.5%) had ASD. Individuals with ASD were more often male and initiated antipsychotic treatment at a younger age. Of the 26 participants prescribed an antipsychotic before age 6, 88.5% had ASD. Comorbidity profiles were similar across groups. Risperidone and aripiprazole were the most frequently prescribed antipsychotics. BMI z-scores increased over time (β = 0.130, p = 0.017), and baseline BMI z-score was the strongest predictor. ASD diagnosis did not modify the average linear rate of BMI z-score change (time × ASD: p = 0.251); however, a significant quadratic time × ASD interaction (β = −0.016, p = 0.041) was consistent with a more pronounced early increase followed by earlier attenuation of BMI z-scores in the ASD group. Conclusions: Although antipsychotic treatment was initiated earlier in youth with ASD, no clear difference was observed in the rate of BMI z-score change. Differences in weight trajectories underscore the need for metabolic monitoring in antipsychotic-treated youth. Full article

Objectives: This study examined whether integrating an isometric exercise program into physical education (PE) lessons influences functional outcomes and cardiovascular risk markers in adolescents beyond the effects of standard PE alone. Methods: Boys aged 14–15 years were randomly assigned to an experimental group (EG, n = 19) or a control group (CG, n = 21). The EG completed a 6-week isometric exercise program integrated into PE lessons, while the CG followed the regular PE curriculum only. The intervention was based on hold isometric muscle actions (HIMA) with progressively increased volume. Anthropometric measures included body height, body mass, and body mass index (BMI). Body composition was assessed using bioelectrical impedance analysis. Functional capacity was evaluated using field-based measures of lower-limb strength and power (isometric mid-thigh pull, standing broad jump, squat jump, and countermovement jump). Systolic and diastolic blood pressure were measured as indicators of cardiovascular health. Results: A mixed model ANOVA showed that no significant group × time interactions were observed for body composition, functional outcomes, or blood pressure (all p > 0.05). Lean body mass increased over time in both groups (p < 0.01). Improvements in isometric mid-thigh pull (p < 0.01) and standing broad jump (p = 0.01) occurred irrespective of group allocation. Blood pressure remained unchanged. Linear regression revealed that biological maturation did not moderate intervention effects; however, more mature participants demonstrated higher absolute strength levels independent of the intervention (p < 0.05). Conclusions: The inclusion of an isometric exercise program within PE lessons did not provide additional benefits for health-related functional outcomes beyond standard PE alone. In its current format, isometric exercise does not appear to add sufficient value to justify its implementation as a stand-alone strategy in school-based PE. Full article

Background and Objectives: There is a lack of information on the dietary intake of long-term combined oral contraceptive users (COC-users) in relation to their body composition. The aim of the pilot study was to determine the food consumption of young women using COCs for >6 months and its relationship to body composition compared to non-users. Materials and Methods: A total of 45 healthy women (21.8 ± 1.7 years) were divided into COC non-users (n = 19) and users of a low (≤20 μg) ethinylestradiol (EE) dose (n = 18) and a medium (30–35 μg) EE dose (n = 8). Anthropometric data, body composition, physical activity levels, three-consecutive-days of dietary records, and serum concentrations of calcium, magnesium, and vitamin D were assessed. Statistical methods included chi-squared, Fisher’s exact test, t-test, Mann–Whitney U test, Spearman’s correlation, and multiple linear regression. Results: There were no differences between COC-users and non-users in terms of physical activity, intake of micronutrients, body mass index, body fat percentage (BF%), or bone mineral density (BMD). COC-users consumed a higher percentage of energy from fats (p = 0.02) and had higher serum vitamin D levels (p < 0.01). BF% was negatively associated with BMD (coefficient −0.008; p = 0.027). Conclusions: The use of COCs for ˃6 months is not associated with FM or BMD, regardless of dietary differences. Further attention should be paid to possible associations between COCs use, dietary habits, and body composition (including BMD). Full article

Background: Physical inactivity during adolescence remains a major public health concern, yet its multifactorial determinants are not fully understood in low- and middle-income settings. Objective: To identify and quantify the determinants of physical activity (PA) among Brazilian adolescents using a hierarchical logistic regression model that reflects the theoretical ordering of distal to proximal factors. Methods: A cross-sectional study was conducted with 856 adolescents (13–19 years). Data were obtained from the validated Brazilian Youth Risk Behavior Survey and the Brazilian Economic Classification Criteria (ABEP) socioeconomic questionnaire. PA was dichotomized according to World Health Organization recommendations. Hierarchical logistic regression examined five theoretical blocks: sociodemographic, anthropometric, substance use, weight/diet, and sedentary behavior. Results: Overall, 5 out of 17 predictors were significant in the full model. extended Body mass index (eBMI) was negatively associated with physical activity (OR = 0.331, 95% CI: 0.169–0.647, p = 0.001), while body mass was positively associated (OR = 2.078, 95% CI: 1.045–4.135, p = 0.037). Working status (OR = 1.235, 95% CI: 1.035–1.475, p = 0.019) and weight loss attempts (OR = 1.327, 95% CI: 1.042–1.690, p = 0.022) increased the odds of being active, whereas current smoking reduced it (OR = 0.715, 95% CI: 0.517–0.990, p = 0.043). Model discrimination improved progressively (AUC = 0.577 to 0.692). Conclusions: Physical activity among Brazilian adolescents was primarily influenced by behavioral and perceptual rather than demographic factors. These findings highlight the need for integrated interventions promoting muscle development, body positivity, and smoking prevention. Full article