Search Results (497)

Background: Physical activity is widely recommended for preserving musculoskeletal health and managing osteoarthritis-related pain, although its benefits are commonly framed in terms of muscle strengthening, weight control, and physical performance. This narrative review aimed to examine movement more broadly as a physiological regulator of synovial joint homeostasis, sensory calibration, and functional adaptation. Methods: A structured literature search was performed in PubMed/MEDLINE, Scopus, and Web of Science from database inception to 1 February 2026. Experimental studies, observational studies, clinical trials, systematic reviews, meta-analyses, and selected narrative reviews addressing movement-responsive joint biology or pain regulation were considered. Evidence was synthesized across four interrelated domains: mechanical, fluidic, immune-metabolic, and sensory regulation. Results: The narrative synthesis indicates that the concept of the synovial joint as a dynamic mechano-fluidic organ in which cartilage, synovium, synovial fluid, capsule, subchondral bone, periarticular tissues, and sensory pathways interact continuously. Repeated physiological movement may promote synovial fluid exchange, lubrication, cartilage nutrition, hyaluronic acid and lubricin function, matrix turnover, anti-inflammatory signaling, proprioceptive control, and exercise-induced hypoalgesia. In contrast, inactivity and unloading may impair fluid dynamics, promote muscle inhibition, stiffness, inflammatory persistence, sensory deconditioning, and loss of function. Excessive or poorly distributed loading may also disrupt homeostasis through matrix injury, inflammation, fatigue, and nociceptive sensitization. These findings informed the proposed adaptive loading window, a hypothesis-generating conceptual framework rather than a clinically validated threshold, describing the dynamic range of movement within which joint function and pain regulation may be supported without sustained tissue or symptom aggravation. Conclusions: Movement should be viewed not only as a therapeutic intervention, but also as a continuous regulator of joint biology and perception. Its clinical value may depend on identifying an individualized loading range that supports adaptation, function, and confidence in movement while avoiding both underloading and overload. Full article

Background: Endurance exercise is known to induce the excessive production of reactive oxygen metabolites due to enhanced metabolic activity and inflammation, leading to oxidative stress and related injuries. Sulforaphane (SFN), an isothiocyanate, is broadly acknowledged for its potential antioxidant and anti-inflammatory properties, along with other protective functions. Objective: The purpose of this study was to investigate the effects of short-term SFN precursor supplementation on maximal exercise-induced muscle damage, oxidative stress and endurance capacity in healthy adults. Methods: In a double-blind placebo-controlled crossover design, 14 healthy participants (7 males, 7 females; age, 25.07 ± 1.04 years; weight, 65.28 ± 4.13 kg; height, 170.07 ± 3.46 cm; BMI, 22.48 ± 0.91) received SFN glucosinolate capsules (200 µmol/day) or placebo for 2 weeks during the first trial. Following a three-week washout period, the participants crossed over to the alternate treatment. Maximal exercise tests were performed following each supplementation (SFN or placebo) period. Blood samples were collected at baseline (before treatment), pre-exercise, post-exercise and 2 h after each exercise session. Results: SFN supplementation did not alter endurance capacity or blood cell counts; however, it significantly attenuated serum creatine kinase (CK) activity (p = 0.034; SFN, 121.52 ± 16.89; placebo, 291.84 ± 133.07) and the myoglobin (Mb) concentration (p = 0.011; SFN, 15.82 ± 1.95; placebo; 27.31 ± 5.71) following exercise. Analysis of oxidative stress markers showed no significant changes in the absolute values; however, in the d-ROMs (p = 0.038; SFN, 107.42 ± 2.39; placebo; 112.32 ± 2.11) and OXY-adsorbent tests (p = 0.032; SFN, 115.97 ± 4.15; placebo; 107.73 ± 3.88), the percent changes from the baseline showed a significant interaction with the supplement. These findings suggest that short-term SFN supplementation may mitigate exercise-induced muscle damage and oxidative stress, suggesting a modest influence on the circulating biomarkers associated with muscle damage without altering the endurance capacity of healthy people. Conclusion: SFN intake may be a beneficial, non-invasive strategy to modulate acute biochemical responses to exercise via the antioxidant defense system in physically active individuals. Full article

Intensive training induces redox and inflammatory signaling that may facilitate adaptation but can also reflect excessive physiological strain. In this exploratory pilot longitudinal study, we assessed whether 8-iso-prostaglandin F2α (8-iso-PGF2α), a lipid peroxidation marker, and transcripts related to arachidonic acid lipoxygenase pathways change during a 10-week preparatory training period in elite female volleyball players. Twelve professional athletes were sampled at baseline after a training break and after training completion. 8-iso-PGF2α was quantified by gas chromatography–mass spectrometry (GC-MS), and the relative expression of arachidonate 5-lipoxygenase (ALOX5), arachidonate 12-lipoxygenase (ALOX12), and arachidonate 15-lipoxygenase (ALOX15) genes was measured by reverse transcription quantitative polymerase chain reaction (RT-qPCR) in leukocytes and plasma-derived RNA. Training increased 8-iso-PGF2α from 0.06 [0.05–0.09] to 0.16 [0.08–0.22] ng/mL (p = 0.03). ALOX5 expression increased in leukocytes (0.80 ± 0.29 vs. 1.00 ± 0.29; p = 0.02) and plasma-derived RNA (0.03 [0.02–0.06] vs. 0.06 [0.05–0.11]; p = 0.04), whereas no statistically detectable pre-to-post changes were observed for ALOX12 and ALOX15 expression. Given the exploratory design and small sample size, these results should be interpreted as hypothesis-generating. The observed changes suggest that 8-iso-PGF2α and ALOX5 are associated with physiological responses to preparatory training and exercise-induced lipid oxidative remodeling; however, their potential utility for monitoring training adaptation requires validation in larger, prospectively designed controlled cohorts. Full article

Hip fractures are among the most devastating fragility fractures, associated with excess mortality, disability, loss of independence, and substantial healthcare costs. Although age-standardized incidence has declined in several high-income countries, absolute case numbers continue to rise because of population aging. This review summarizes contemporary PubMed-indexed evidence on the epidemiology, risk stratification, and prevention of proximal femoral fractures, with emphasis on hip-fracture outcomes rather than vertebral or composite endpoints alone. We discuss secular trends, FRAX-based case findings and screening, non-pharmacologic strategies, pharmacologic therapy, and health-system interventions relevant to both primary and secondary prevention. Among non-pharmacologic measures, long-term balance-challenging and resistance-based exercise has the most consistent evidence for reducing falls and likely contributes to fracture prevention, whereas multifactorial interventions, home hazard modification, calcium/vitamin D supplementation, and hip protectors are best targeted to selected high-risk populations and care settings. Among medications, bisphosphonates, denosumab, and romosozumab-based sequential strategies show the strongest evidence for reducing hip-fracture risk, while teriparatide and abaloparatide have important roles in very-high-risk patients despite less direct hip-fracture evidence. Menopausal hormone therapy reduces hip fractures in younger postmenopausal women but is limited by extra-skeletal risk, and selective estrogen receptor modulators are primarily vertebral-fracture agents. A major message of this review is that effective prevention depends not only on drug efficacy but also on implementation. Fracture liaison services, orthogeriatric co-management, prompt treatment after fragility fracture, and sustained adherence support are essential to close persistent care gaps. Preventing hip fractures therefore requires an integrated, risk-stratified approach that combines skeletal protection, falls prevention, and reliable health-system delivery. Full article

The regular practice of physical exercise is often associated with promoting benefits for practitioners. In recent decades, street running has become popular worldwide, with most participants being recreational runners who engage in the activity primarily to promote health, well-being, leisure, and quality of life, although some also participate with competitive goals. Among the psychological aspects related to exercise, studies have shown that some individuals may become susceptible to “exercise dependence,” a condition in which exercise takes a central role in a person’s life. As a result, individuals may exhibit characteristics such as excessive training, injuries; weight control issues, withdrawal symptoms when unable to exercise and even problems in social relationships when exercise is exclusively prioritized. Background/Objectives: The aim of this study was to investigate and analyze levels of susceptibility to running dependence and its relationship with exercise volume and mood states (tension, depression, anger, vigor, fatigue, and mental confusion). Methods: This was a quantitative cross-sectional study involving 761 regular Brazilian runners (59.8% male and 40.2% female) who consented to participate and answered the Sociodemographic Questionnaire, the Escala de Dependência de Corrida (EDC), a Brazilian Portuguese adaptation of the Negative Addiction Scale (NAS), and the Brunel Mood Scale (BRUMS). The analysis plan was conducted through descriptive statistics (mean, standard deviation, median, 1st and 3rd quartiles, interquartile range, and 95% confidence intervals) and inferential statistics (Spearman’s Correlation and Kruskal–Wallis Test). In all tests, the significance level adopted was p < 0.05. Results: The sample was divided into three groups of susceptibility to exercise dependence: low (37.6%), moderate (36.4%), and high (26%). Scores indicative of greater susceptibility to exercise dependence showed positive correlations with running practice volume (years of experience, weekly training frequency, weekly training duration, and weekly mileage), as well as with vigor. Although a statistically significant correlation was also observed for tension, its magnitude was trivial (rs = 0.080). Comparisons using the Kruskal–Wallis test showed that higher susceptibility levels were associated with greater running volumes and higher raw vigor scores, whereas no significant group differences were observed for the remaining mood states. Conclusions: Higher susceptibility to exercise dependence was associated with greater running volume and higher raw vigor scores. No consistent associations were observed with negative mood states, except for a trivial correlation with tension. These findings suggest that greater susceptibility to exercise dependence among runners was primarily associated with higher raw vigor scores rather than with broader alterations in mood states. Full article

Background: Visceral obesity is increasingly recognised not as a simple excess of adipose tissue, but as a systemic pathological condition characterised by profound metabolic, endocrine, and immune dysregulation. Visceral adipose tissue (VAT) operates as an autonomous neuro-immune-endocrine organ whose dysfunctional expansion drives insulin resistance, atherogenesis, and accelerated cellular ageing through mechanisms converging on chronic low-grade sterile inflammation, referred to as inflammaging. Objectives: This narrative review integrates evidence across four domains: (1) the multi-system clinical complications of visceral obesity and the methodological controversies surrounding its measurement; (2) the cellular heterogeneity, immunometabolic reprogramming, and molecular mechanisms through which excess VAT accelerates biological ageing, with a focus on genomic instability, mitochondrial dysfunction, the NAD⁺/sirtuin regulatory axis, cellular senescence, and inter-organ communication; (3) the role of bioelectrical impedance analysis (BIA)—particularly phase angle—as a non-invasive functional biomarker of biological age and longevity, positioned critically against alternative assessment methods; and (4) current knowledge gaps and priorities for future research. Methods: A narrative review of PubMed/MEDLINE, Google Scholar, and the Cochrane Library was conducted using MeSH terms and free-text keywords including visceral obesity, bioelectrical impedance analysis, phase angle, sarcopenia, inflammaging, mitochondrial dysfunction, cellular senescence, epigenetic clocks, NAD⁺, sirtuin, and longevity, supplemented by citation-tracking of retrieved reviews. English-language articles published up to April 2025 were considered, prioritising systematic reviews, meta-analyses, and prospective cohort studies; formal risk-of-bias tools and quantitative synthesis were not applied, consistent with a narrative review design. Results and Discussion: BIA-derived phase angle constitutes a macroscopic electrobiological correlate of inflammaging: low phase angle values in visceral obese subjects overlap with those of frail elderly individuals, reflecting impaired membrane integrity, loss of active cell mass, and altered ICW/ECW balance. However, this evidence base remains largely cross-sectional and correlative; the directionality and population-specific calibration of BIA-derived indices constitute the principal unresolved methodological questions. Integration with epigenetic clocks, circulating NAD⁺ levels, and gut microbiome indices offers a framework for dynamic biological age assessment, though prospective interventional validation is still lacking. Sarcopenic obesity, evaluated through EWGSOP2 combined with BIA-derived skeletal muscle mass index and handgrip dynamometry, represents a critical comorbidity demanding integrated therapeutic targeting. Conclusions: BIA provides a quantitative, accessible correlate for translating cellular metabolic health into clinically actionable parameters, complementary to rather than a replacement for anthropometric and imaging-based methods. Optimising phase angle and reducing VAT through anti-inflammatory nutrition, exercise, and nutraceutical strategies targeting the NAD⁺/sirtuin and mTOR/AMPK axes constitutes a measurable objective for the promotion of healthy longevity, contingent on the longitudinal, mechanistic studies identified as priorities in this review. Full article

Excessive exercise without adequate recovery can induce prolonged fatigue, accompanied by skeletal muscle inflammation, oxidative stress, and impaired repair. Bergamot essential oil (BEO), a citrus-derived volatile essential oil, has been reported to have anti-inflammatory and antioxidant activities, but its effects on exercise-induced prolonged fatigue remain unclear. This study investigated the fatigue-relieving effects of long-term inhalation of BEO and its major constituents in a rat model of prolonged exercise-induced fatigue, with emphasis on skeletal muscle regulation. Rats were subjected to progressive exercise loading and exposed daily to BEO or its main components, followed by behavioral, biochemical, histological, transcriptional, and protein analyses. BEO inhalation significantly improved swimming endurance and alleviated fatigue-related physiological disturbances. In skeletal muscle, BEO reduced IL-1β and IL-6 levels, attenuated transcriptional changes in NF-κB/NLRP3-related inflammatory markers, decreased MDA accumulation, and enhanced GSH-Px activity. BEO also modulated muscle repair-related markers by reversing the abnormal elevation of Myod1 and restoring Myog mRNA expression. These effects were accompanied by increased Igf1 expression, restored PI3K protein expression, enhanced PI3K phosphorylation, and increased inhibitory phosphorylation of GSK3β. Overall, BEO alleviated prolonged exercise-induced fatigue by attenuating skeletal muscle inflammation, oxidative stress, and repair-related dysregulation, supporting its potential as a non-oral aromatic intervention for fatigue recovery. Full article

Despite the success of modern antiretroviral therapy in achieving virological suppression, people living with HIV face an elevated risk of cardiovascular diseases, particularly heart failure with preserved ejection fraction. This study evaluates the cardiometabolic phenotype and functional capacity in a Romanian HIV cohort to delineate the metabolic footprint of chronic infection. In this cross-sectional study based on prospectively collected, protocol-driven phenotyping, we evaluated 50 consecutive outpatients from a university-affiliated infectious diseases clinic in Timisoara. Eligibility strictly required clinical stability and sustained virological suppression (plasma HIV-RNA < 50 copies/mL for ≥12 months). The analysis revealed widespread metabolic dysregulation, with 52% exhibiting excess weight and 64% showing atherogenic dyslipidemia. Integrase strand transfer inhibitor-based regimens were significantly correlated with an increased body mass index (p = 0.034) and elevated LDL cholesterol (aOR = 2.4, 95% CI [1.18–4.95], p = 0.022). Furthermore, we observed a pronounced metabolic age gap (+4.5 ± 2.8 years), defined as the deviation of bioimpedance-estimated metabolic age from the patients’ chronological age. This gap (p = 0.028), alongside historical immunodeficiency indicated by a low nadir CD4+ count (aOR = 0.998, 95% CI [0.991–0.999], p = 0.021), strongly predicted exercise intolerance, independent of current immune reconstruction. Sarcopenic obesity (present in 18% of the cohort) and an elevated triglycerides-to-HDL ratio (aOR = 2.14, 95% CI [1.15–3.98], p = 0.016) emerged as robust independent negative predictors of functional capacity. Additionally, subclinical myocardial remodeling, evidenced by impaired Global Longitudinal Strain, significantly predicted reduced aerobic capacity (aOR = 0.72, 95% CI [0.58–0.89], p = 0.003). Consequently, contemporary HIV management must transition beyond virological control to integrated cardiometabolic screening. Utilizing cardiopulmonary exercise testing, echocardiography, and metabolic biomarkers is critical for the early identification of subclinical “functional HIV-associated frailty” and mitigating the trajectory toward overt cardiovascular diseases. Full article

Ferroptosis is an iron-dependent form of regulated cell death characterized by iron dyshomeostasis, glutathione depletion, glutathione peroxidase 4 dysfunction, and excessive lipid peroxidation. Exercise is a safe and accessible non-pharmacological intervention with broad neuroprotective potential, but the evidentiary basis linking exercise specifically to ferroptosis is uneven. Only a limited subset of studies directly combines an exercise intervention with ferroptosis-related outcomes in neurodegenerative models; much of the proposed pathway architecture is inferred from pharmacological, cellular, observational, or acute neurological injury studies. This review therefore separates direct exercise evidence from exercise-related supporting evidence and non-exercise mechanistic evidence. The most directly relevant findings, concentrated largely in aerobic exercise models, show exercise-associated changes in brain iron handling, the cystine/glutamate antiporter–glutathione peroxidase 4 antioxidant system, and lipoxygenase-dependent lipid peroxidation. Supporting studies suggest additional peripheral-to-central mechanisms involving muscle-derived exosomes, exercise-associated changes in systemic and cerebral iron handling, and inflammatory regulation. Bone marrow hematopoiesis, adult neurogenesis, synaptic plasticity, and astrocyte-controlled iron traffic are incorporated as biologically plausible but incompletely tested links. Evidence for resistance training, high-intensity interval training, mind–body exercise, and human disease remains insufficient. The central limitation is therefore not pathway plausibility but the scarcity of exercise-specific causal experiments demonstrating that ferroptosis suppression is required for neuroprotection. Full article

Background/Objectives: This study evaluated the impact of short-duration physical exercise sessions and daily exercise recordings on the physical health and psychological health of junior high school students in Japan. Methods: A 3-month longitudinal school-based intervention initially enrolled 235 students, and the final analysis included 127 students who completed the program. The study was conducted using a single-arm pre–post design without a control group. The intervention included biweekly group exercise sessions and daily activity recordings. Students were separated into two groups based on their screen time (≥4 h per day or <4 h per day). Results: After the intervention, a significant decrease in screen time was observed in the group with baseline screen time of 4 h or more, whereas the group with baseline screen time of less than 4 h showed an increase in daily screen time. The results indicated a significant increase in body mass index and trunk muscle mass in both groups. For psychological measures, including the General Self-Efficacy Scale and Communicative and Critical Health Literacy scale, no significant changes over time or group × time interactions were observed, although post-intervention scores were significantly higher in the lower screen time group compared to the higher screen time group. However, significant changes in skeletal muscle index, eHealth literacy, and sleep duration were not observed. Conclusions: Due to the lack of a control group, these findings remain preliminary, and observed changes cannot be definitively attributed solely to the intervention. However, the program showed potential in reducing excessive screen time and increasing trunk muscle mass. Future randomized controlled trials are required to confirm the true efficacy of the intervention. Full article

Obesity is a chronic relapsing disease associated with excess adiposity, metabolic dysfunction, low-grade inflammation, and persistent epigenetic alterations. Changes in DNA methylation, histone modifications, chromatin remodeling, and non-coding RNAs may contribute to adipose tissue dysfunction, insulin resistance, impaired metabolic flexibility, and weight regain. This narrative review aimed to critically examine current evidence on the epigenetic effects of physical activity and epigenetically active supplements in obesity, with particular attention to their potential shared and complementary mechanisms. A focused literature search covering publications from January 2000 to May 2026 was conducted using scientific databases. The search strategy was constructed around four main thematic areas: obesity and metabolic dysfunction, physical activity and exercise interventions, bioactive supplementation, and epigenetic regulation. Current evidence indicates that physical activity is a strong epigenetic stimulus, particularly in adipose tissue and skeletal muscle. Exercise-induced epigenetic modifications may regulate biological pathways involved in mitochondrial function, inflammation, insulin sensitivity, and metabolic adaptation. In contrast, evidence for omega-3 fatty acids, vitamin D, polyphenols, and multi-ingredient anti-inflammatory supplementation is more heterogeneous and relies largely on blood-derived or systemic biomarkers. Integrated exercise–supplementation strategies are biologically plausible, but their obesity-specific epigenetic effects require confirmation in long-term, well-controlled human studies. Full article

Background: Obesity is a chronic condition that compromises health and quality of life, with physical exercise representing a relevant therapeutic strategy in its management. Functional training (FT) has been adopted as a modality that integrates neuromuscular and cardiorespiratory stimuli, promoting both physical and psychosocial benefits. However, gaps remain in the literature regarding the effects of FT on body composition in individuals with excess weight. In this context, a systematic review was conducted to analyze the current state of scientific knowledge on this approach. Methods: Randomized controlled clinical trials investigating FT were selected, including interventions classified as high-intensity functional training (HIIT-F), multicomponent programs, and CrossFit-like interventions when they fulfilled the predefined FT eligibility criteria. Participants were required to be between 18 and 65 years of age, physically independent, and in generally good health. The systematic search was conducted in the PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, PEDro, and LILACS databases. The risk of bias (RoB 2.0) and the certainty of the evidence (GRADE) were assessed. Results: A total of 2,972 records were identified. Seven studies met the eligibility criteria, comprising 296 participants. Two randomized controlled trials (61 participants) were eligible for meta-analysis. The pooled analysis demonstrated a significant reduction in body fat percentage (%BF) in favor of FT/HIIT-F compared with non-exercising controls (mean difference = −4.44 percentage points; 95% confidence interval −7.08 to −1.80; p = 0.001). Risk of bias assessment showed moderate methodological limitations across studies. None were classified as low risk. Three had high risk due to missing outcome data and deviations from intended interventions, whereas four showed some concerns related to allocation concealment and analysis reporting. Bias in outcome measurement was consistently low. Conclusions: Current evidence suggests that FT/HIIT-F may be associated with reductions in %BF among adults with overweight or obesity. However, these findings should be interpreted with caution because the certainty of the evidence was rated as very low according to the GRADE approach, the quantitative synthesis included only two studies, and important methodological limitations were identified. As the available data are predominantly derived from female participants, the applicability of these findings to men remains uncertain. Full article

Background: Idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) are defined and monitored without definite exercise-based criterion, despite exertional desaturation being among the earliest functional signs of disease and an established independent predictor of mortality in IPF. The 6 min walk test (6MWT) provides robust prognostic information in IPF, yet whether it can kinetically distinguish IPF from PPF under sustained submaximal loading has not been systematically examined. We hypothesised that second-by-second oximetry during the 6MWT and the 1 min (min) sit-to-stand test (1STST) would expose phenotype-specific kinetic signatures invisible to static endpoints, and that test modality would matter. Methods: Fifty-one patients with IPF, 12 with PPF, and 100 with non-IPF/non-PPF ILD (reference cohort) from the European ILD Registry (eurILDreg) participated in this pilot study and completed both tests with continuous 1 Hz SpO₂ and pulse-rate recording. Phenotype-specific desaturation and recovery slopes were derived from random-effects panel regression models. Multivariable linear regression tested whether IPF and PPF phenotypes carried kinetic and static-endpoint signatures independent of DLCO, age, sex, and BMI. Results: Despite substantially lower DLCO in fibrosing phenotypes (IPF 45 ± 17%, PPF 38 ± 11%, reference 55 ± 19%; p < 0.001), conventional exercise performance metrics did not differ significantly between groups (6MWD p = 0.099; 1STST repetitions p = 0.351). The 6MWT produced statistically indistinguishable per-second desaturation slopes in IPF and PPF (both ≈ −0.016%/s versus −0.011%/s in the reference), whereas the 1STST exposed a clear phenotype gradient (PPF −0.044%/s, IPF −0.027%/s, reference −0.016%/s; a 2.75-fold spread). PPF additionally showed a blunted chronotropic response during the 6MWT (PR slope +0.014 vs. +0.032 and +0.033 bpm/s in IPF and reference). Likelihood-ratio tests confirmed significant phenotype effects on seven of eight time-resolved trajectories (all p < 0.001). IPF was independently associated with greater cumulative oxygenation deficit during the 1STST (SpO₂ AUC β = +669, p = 0.022), indicating excess dynamic burden beyond what diffusion capacity predicts. Conclusions: In this pilot analysis, continuous high-resolution oximetry identified two phenotype-related signals that were robust to the principal confounders. IPF was independently associated with a greater cumulative oxygenation impairment during the 1STST after DLCO adjustment, and PPF showed a blunted chronotropic response during sustained walking that, being pulse-rate based, was unaffected by supplemental oxygen and was not attributable to pulmonary hypertension. A phenotype gradient in per-second desaturation measurements during the 1STST was also observed but should be interpreted as hypothesis-generating, as the small PPF subgroup (n = 12), its greater disease severity, and supplemental oxygen use in half of its patients preclude firm attribution to phenotype. Taken as exploratory, these observations support the prospective evaluation of kinetic exercise parameters as candidate monitoring components for PPF. Full article

Excess adiposity increases cardiovascular and cardiometabolic risks, while aquatic exercise may reduce mechanical barriers to participation. This systematic review and meta-analysis examined aquatic exercise training in individuals with overweight or obesity. PubMed, Web of Science, and the Cochrane Library were searched through to June 2026. Eight randomized controlled trials involving 295 participants were included. Random-effects meta-analyses showed increased VO₂ max (MD 3.70 mL·kg⁻¹·min⁻¹, 95% CI 2.49–4.90; p < 0.001) and lower resting heart rate (MD −1.47 beats/min, 95% CI −2.73 to −0.21), systolic blood pressure (MD −4.50 mmHg, 95% CI −7.05 to −1.94), diastolic blood pressure (MD −2.17 mmHg, 95% CI −4.11 to −0.22), triglycerides (MD −15.75 mg/dL, 95% CI −23.12 to −8.39), and fasting glucose (MD −7.82 mg/dL, 95% CI −12.48 to −3.16). No significant pooled effects were observed for total cholesterol, HDL cholesterol, LDL cholesterol, BMI, or body fat percentage. Evidence certainty ranged from low to very low. Aquatic exercise may improve selected cardiovascular and metabolic outcomes, although small samples and heterogeneity limit confidence. Future research must focus on high-quality RCTs to further confirm these findings. PROSPERO: CRD420261340445. Full article

(1) Background: The double burden of malnutrition (DBM) occurs at the population level when undernutrition and overweight or obesity coexist. In this study, DBM was operationalized as BMI-defined underweight and excess body weight (EBW) within the sampled student population. (2) Objective: To identify dietary patterns and examine their associations with sociodemographic and health behavior factors among underweight and EBW nursing students in Southern Thailand. (3) Methods: This secondary analysis used cross-sectional data collected from 372 undergraduate nursing students in 2023. Dietary intake was assessed using a food frequency questionnaire; principal component analysis identified dietary patterns, and separate multivariable linear regression models examined associations with pattern scores in the underweight and EBW subgroups. (4) Results: Underweight and EBW were present in 22.0% and 26.3% of students, respectively. The snack pattern comprised milk and milk products, sweetened beverages, bakery items, desserts, pickled fruits, and snacks; the Thai dish pattern comprised rice, spicy curry, meat, entree-over-rice dishes, and vegetables; and the high-energy pattern comprised sticky rice and fried meat. Among underweight students, Thai dish scores were positively associated with year of study (p < 0.001), breakfast intake (p < 0.001), and supper intake (p = 0.008), and negatively associated with alcohol drinking (p = 0.014) and sedentary behavior (p = 0.018). Among students with EBW, snack pattern scores were higher among female students (p = 0.032) and students reporting exercise (p = 0.001) or sedentary behavior (p < 0.001), whereas Thai dish scores were associated with income (p = 0.006), dinner intake (p = 0.005), sex (p = 0.001), and supper intake (p = 0.034). Higher GPA (grade point average) was associated with lower high-energy-pattern scores in both subgroups (underweight, p = 0.018; EBW, p = 0.007). (5) Conclusion: BMI-defined underweight and EBW coexisted in this population. Dietary pattern correlates differed by nutritional status subgroup, underscoring the need for tailored nutrition and lifestyle interventions, as well as healthier university food environments. Full article