Search Results (578)

Background/Objectives: We evaluated the efficacy of a good lifestyle intervention on the severity of metabolic dysfunction-associated steatotic liver disease (MASLD) in children with Down syndrome (DS). Methods: This retrospective longitudinal study included 31 children with Down syndrome (DS) who were affected by MASLD and attended nutritional counseling based on a nutritional approach (e.g., Mediterranean diet and antioxidant supplements), as well as physical exercise. Clinical parameters, markers of low-grade systemic inflammation, and hepatic steatosis, as assessed by ultrasound, were evaluated at baseline (T0) and after 6 months (T1). Results: Several anthropometric and biochemical parameters, including body mass index, waist circumference, diastolic and systolic blood pressure, aspartate aminotransferase, basal insulin, insulin resistance, pro-inflammatory interleukin-1β, and anti-inflammatory interleukin-10, showed significant improvement after 6 months of a nutritional approach. This study also found a regression of at least one grade of hepatic steatosis in a significant portion of patients, especially in those who received antioxidant supplements. Conclusions: Our study further supports the hypothesis that a healthy lifestyle intervention, based on adherence to the Mediterranean diet, natural supplements with antioxidant properties, and regular physical activity, can be considered a safe therapeutic approach for reducing the risk and severity of MASLD in children with DS. Full article

The gut microbiota, dominated by bacteria from the Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria phyla, plays an essential role in fermenting indigestible carbohydrates, regulating metabolism, synthesizing vitamins, and maintaining immune functions and intestinal barrier integrity. Dysbiosis is associated with obesity development. Shifts in the ratio of Firmicutes to Bacteroidetes, particularly an increase in Firmicutes, may promote enhanced energy storage, appetite dysregulation, and increased inflammatory processes linked to insulin resistance and other metabolic disorders. The purpose of this literature review is to summarize the current state of knowledge on the relationship between the development and treatment of obesity and overweight and the gut microbiota. Current evidence suggests that probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) can influence gut microbiota composition and metabolic parameters, including body weight and BMI. The most promising effects are observed with probiotic supplementation, particularly when combined with prebiotics, although efficacy depends on strain type, dose, and duration. Despite encouraging preclinical findings, FMT has shown limited and inconsistent results in human studies. Diet and physical activity are key modulators of the gut microbiota. Fiber, plant proteins, and omega-3 fatty acids support beneficial bacteria, while diets low in fiber and high in saturated fats promote dysbiosis. Aerobic exercise increases microbial diversity and supports growth of favorable bacterial strains. While microbiota changes do not always lead to immediate weight loss, modulating gut microbiota represents an important aspect of obesity prevention and treatment strategies. Further research is necessary to better understand the mechanisms and therapeutic potential of these interventions. Full article

Background: This study aimed to evaluate the changes in fat utilization associated with transitioning from a traditional to a vegan Mediterranean diet in healthy, physically active men during a ramp exercise test. Methods: In a controlled crossover design, fourteen healthy, physically active men followed a traditional Mediterranean diet for three weeks (baseline). Then, participants transitioned to a four-week isocaloric vegan version of the Mediterranean diet, matched for macronutrient distribution but excluding all animal foods. Immediately after each dietary intervention, participants completed an incremental exercise test (from 30% to 70% of VO_2peak) on a cycle ergometer in a fasted state to determine peak fat oxidation (PFO) and its associated exercise intensity (Fatmax). Exercise heart rate and the rating of perceived exertion were also recorded at each exercise intensity. Results: The traditional and vegan Mediterranean diets provided comparable amounts of energy (2599.6 ± 180.8 and 2634.9 ± 148.3 kcal/day, p = 0.140) and total fat (97.0 ± 17.8 and 99.0 ± 13.2 g/day; p = 0.620). However, the vegan Mediterranean diet contained a lower proportion of saturated fat (25.2 ± 6.8 vs. 13.6 ± 4.4% of total fat, p < 0.010). Still, the dietary transition was not associated with modifications in PFO (0.323 ± 0.153 and 0.347 ± 0.147 g/min; p = 0.678) or Fatmax (40.51 ± 7.30 and 40.51 ± 10.71%VO_2peak; p = 1.000) during exercise. Moreover, the dietary transition did not significantly change the response curves across exercise intensities for fat oxidation (p = 0.553), heart rate (p = 0.280), or the rating of perceived exertion (p = 0.433). Conclusions: Switching from a traditional to a vegan Mediterranean diet did not affect fat oxidation, exercise intensity at peak fat oxidation, or perceptual responses during exercise in healthy, active men. These findings suggest that physically active individuals can adopt a vegan version of the Mediterranean diet without compromising fat utilization during submaximal aerobic exercise. Clinical Trial Registry: NCT06008886. Date of registration: 28 July 2023. Full article

Background: Diabetic lung disease, characterized by inflammation and fibrosis, is an emerging chronic complication of type 2 diabetes mellitus (T2DM). However, systematic studies on the effects of exercise interventions remain limited. This study aimed to investigate the impact of different exercise types (swimming, resistance training, and high-intensity interval training [HIIT]) on pulmonary inflammation and fibrosis in T2DM mice, and to explore underlying molecular mechanisms. Methods: A T2DM mouse model was established by a high-fat diet (HFD) combined with streptozotocin (STZ) induction. Mice were randomly divided into sedentary control, swimming, resistance training, and HIIT groups, and underwent 8 weeks of exercise intervention. After the intervention, body composition was assessed. Lung histopathological changes were evaluated by hematoxylin&eosin (HE) and Masson staining. Inflammatory cytokines, fibrosis markers, and the expression of the TGF-β1/Smad signaling pathway were detected. Macrophage infiltration and polarization were also analyzed. Results: Exercise intervention improved body composition and reduced oxidative stress in T2DM mice. All three exercise modalities downregulated inflammatory cytokine expression, inhibited macrophage activation and M1 polarization, and promoted M2 polarization. Additionally, exercise improved lung tissue structure, reduced collagen deposition, and decreased the expression of fibrosis-related markers. Furthermore, anti-fibrotic effects were mediated by suppression of the TGF-β1/Smad signaling pathway and inhibition of epithelial-mesenchymal transition (EMT). Among the interventions, HIIT demonstrated the strongest inhibitory effect on the TGF-β1/Smad pathway, while swimming showed the most significant anti-inflammatory benefits. Conclusions: Different types of exercise effectively alleviate pulmonary inflammation and fibrosis in T2DM mice. These effects are closely related to the inhibition of oxidative stress, regulation of macrophage polarization, and suppression of TGF-β1/Smad signaling activation, with swimming and HIIT demonstrating superior protective benefits. Full article

Background: Obesity in adults is a growing health concern. The principal interventions used in obesity management are lifestyle-change interventions such as diet, exercise, and behavioral therapy. Although they are effective, current treatment options have not succeeded in halting the global rise in the prevalence of obesity or achieving sustained long-term weight maintenance at the population level. E-health and m-health are both integral components of digital health that focus on the use of technology to improve healthcare delivery and outcomes. The use of eHealth/mHealth might improve the management of some of these treatments. Several digital health interventions to manage obesity are currently in clinical trials. Objective: The aim of our systematic review is to evaluate whether digital health interventions (e-Health and m-Health) have effects on changes in anthropometric measures, such as weight, BMI, and waist circumference and behaviors such as energy intake, eating behaviors, and physical activity. Methods: A search was conducted for randomized controlled trials (RCTs) conducted through 4 October 2024 through three databases (Medline, Web of Science, and Scopus). Studies were included if they evaluated digital health interventions (e-Health and m-Health) compared to control groups in overweight or obese adults (BMI ≥ 25 kg/m²) and reported anthropometric or lifestyle behavioral outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool (RoB 2). Meta-analyses were performed using random-effects or fixed-effects models as appropriate, with statistical significance set at p < 0.05. Results: Twenty-two RCTs involving diverse populations (obese adults, overweight individuals, postpartum women, patients with eating disorders) were included. Digital interventions included biofeedback devices, smartphone apps, e-coaching systems, web-based interventions, and mixed approaches. Only waist circumference showed a statistically significant reduction (WMD = −1.77 cm; 95% CI: −3.10 to −0.44; p = 0.009). No significant effects were observed for BMI (WMD = −0.43 kg/m²; p = 0.247), body weight (WMD = 0.42 kg; p = 0.341), or lifestyle behaviors, including physical activity (SMD = −0.01; p = 0.939) and eating behavior (SMD = −0.13; p = 0.341). Body-fat percentage showed a borderline-significant trend toward reduction (WMD = −0.79%; p = 0.068). High heterogeneity was observed across most outcomes (I² > 80%), indicating substantial variability between studies. Quality assessment revealed predominant judgments of “Some Concerns” and “High Risk” across the evaluated domains. Conclusions: Digital health interventions produce modest but significant benefits on waist circumference in overweight and obese adults, without significant effects on other anthropometric or behavioral parameters. The high heterogeneity observed underscores the need for more personalized approaches and future research focused on identifying the most effective components of digital interventions. Digital health interventions should be positioned as valuable adjuncts to, rather than replacements for, established obesity treatments. Their integration within comprehensive care models may enhance traditional interventions through continuous monitoring, real-time feedback, and improved accessibility, but interventions with proven efficacy such as behavioral counseling and clinical oversight should be maintained. Full article

Background/Objectives: The urine sodium/potassium (Na/K) ratio can potentially be used to detect dietary habits that contribute to hypertension. In this prospective cohort interventional trial, we aimed to verify whether private insurance sales staff can help clients change their lifestyle habits based on their urinalysis results. Methods: Clients of the life insurance company (20–65 years old) who were considered to have “high risk” lifestyle factors, which was defined as having high values for two or more of the following indicators: body mass index, blood pressure, triglycerides, liver enzymes, and glucose metabolism, were included. The clients were randomly assigned to three groups: a face-to-face (FF) intervention by sales staff (n = 83), non-FF (Non-FF) intervention via a social networking service (n = 87), and no intervention (Control) (n = 58). Urinalysis and surveys about diet and exercise habits were conducted before and after a 3-month interventional period in all groups. Three interventions were performed for the FF and Non-FF groups, including dietary advice based on urinalysis results, education encouraging reduced salt intake and increased locomotor activity, and viewing an educational video. The Control group only received their urinalysis results by mail. Results: The participants’ mean age was 44.0 years old. Significant improvements in estimated potassium intake were observed in the Non-FF group, and significant reductions in urine Na/K ratios were noted in both the FF and Non-FF groups. Multiple logistic regression analysis indicated that watching the video was the most effective factor for decreasing the urine Na/K ratio (odds ratio = 1.869). The total points for dietary behavior, based on the questionnaire, significantly improved among the individuals who watched the video. Conclusions: This study demonstrates the potential for private health insurance companies to contribute to health promotion and introduces a novel strategy for improving lifestyle habits among individuals at high risk of lifestyle-related diseases. Full article

Background/Objectives: Access to nutritious and well-balanced food is essential for well-being. We investigated the relationship between food insecurity (FI) and cardiovascular health (CVH). Methods: This cross-sectional analysis included a nationwide sample consisting of 12,369 Korean adults. The 18-item Household Food Security Survey Module was employed to evaluate FI, with categories ranging from none, to mild, to moderate-to-severe. CVH was assessed through the “Life’s Essential 8” (LE8) framework established by the American Heart Association. This framework includes four health behaviors (diet quality, exercise, tobacco use, and sleep) and four biometric factors (body mass index, blood lipids, blood glucose, and blood pressure). Overall, CVH was scored on a scale from 0 to 100 and categorized into ideal (LE8 score: 80–100), intermediate (LE8 score: 50–79), and poor CVH (LE8 score: 0–49). Multivariate linear and logistic regression models were used to determine the association of FI with CVH status. Results: Within the sample, 3.7% and 0.8% experienced mild and moderate-to-severe FI, respectively. Compared with those without FI, individuals with mild (β: −2.92; 95% CI [confidence interval]: −4.37, −1.48) or moderate-to-severe (β: −7.71; 95% CI: −11.22, −4.20) FI had lower LE8 scores. Additionally, those with mild or moderate-to-severe FI were more likely to have poor CVH status (OR [odds ratio]: 2.14; 95% CI: 1.33, 3.66 for mild FI and OR: 4.83; 95% CI: 1.64, 14.17 for moderate-to-severe FI). Conclusions: FI is negatively associated with CVH in Korean adults. These findings underscore the need for comprehensive policy interventions to enhance food access and promote CVH in this at-risk population. Full article

Background/Objectives: Demyelination occurs to a variable extent in various neurological diseases, such as multiple sclerosis. Physical exercise benefits central neural functions that depend on the brain’s electrophysiological and glial activity. It is unclear whether both factors—i.e., demyelination and exercise—interact in the brain. We aimed to investigate if this interaction occurs during brain development. Methods: Developing rats were subjected to a cuprizone-induced demyelination. Part of these rats were treadmill-exercised for five weeks. After this period, some demyelinated animals were allowed to remyelinate by receiving a similar diet, without cuprizone, for six weeks. The exercised groups were compared with the corresponding sedentary groups. All groups were evaluated electrophysiologically (cortical spreading depression features), and their brains were processed for immunohistochemical labeling with four specific glial antibodies (anti-APC, MBP, GFAP, and Iba1). Results: Compared with the corresponding controls, cuprizone demyelination and treadmill exercise accelerated and decelerated CSD propagation. Cuprizone reduced APC, MBP, and GFAP immunolabeling and increased Iba1 immunostaining. Remyelination reverted the cuprizone effects. Exercise counteracted the cuprizone-induced changes in GFAP- and Iba1-containing cells but not in MBP- and APC-containing ones. Conclusions: Our data confirmed the effectiveness of the cuprizone demyelination paradigm. They evidenced the potential neuroprotective effect of regular physical exercise, suggesting that this non-pharmacological intervention could benefit patients with central demyelination-dependent diseases. Full article

Bacground/Objectives: Obesity in adolescents is escalating, accompanied by comorbidities such as insulin resistance and cardiovascular disease, which favor the early onset of metabolic syndrome (MetS). There is an urgent need for effective interventions to prevent and treat MetS. We aimed to analyze intervention studies targeting lifestyle improvements in adolescents with obesity. We also determined the effect of combining dietary and/or physical activity interventions with educational, psychological, and emotional support-based interventions compared to traditional interventions in preventing MetS in adolescents with obesity. Methods: The PubMed, Cochrane, Web of Science, CINAHL, and Scopus databases were consulted. Ten clinical trials were included in the systematic review, of which six were eligible for the meta-analysis. Results: Combined interventions significantly decreased body weight (−1.10 [−1.64, −0.55], p < 0.001). Although not statistically significant improvements were observed in the meta-analysis for zBMI and waist circumference. The results indicate that diet- and exercise-based interventions are associated with a further decrease in body composition and non-anthropometric variables associated with MetS when combined with educational, psychological, and behavioral interventions. Conclusions: Some studies suggest potential long-term benefits, but further research is necessary to define effective interventions for improving body composition and preventing MetS in obese adolescents, addressing the inconsistencies in current clinical trials. Systematic Review Registration (PROSPERO CRD42023463428). Full article

Background: Exercise and nutritional interventions are often recommended to help manage risk related to metabolic syndrome (MetSyn). The co-ingestion of Phyllanthus emblica (PE) with trivalent chromium (Cr) has been purported to improve the bioavailability of chromium and enhance endothelial function, reduce platelet aggregation, and help manage blood glucose as well as lipid levels. Shilajit (SJ) has been reported to have anti-inflammatory, adaptogenic, immunomodulatory, and lipid-lowering properties. This study evaluated whether dietary supplementation with Cr, PE, and SJ, or PE alone, during an exercise and diet intervention may help individuals with risk factors to MetSyn experience greater benefits. Methods: In total, 166 sedentary men and women with at least two markers of metabolic syndrome participated in a randomized, placebo-controlled, parallel-arm, and repeated-measure intervention study, of which 109 completed the study (48.6 ± 10 yrs., 34.2 ± 6 kg/m², 41.3 ± 7% fat). All volunteers participated in a 12-week exercise program (supervised resistance and endurance exercise 3 days/week with walking 10,000 steps/day on non-training days) and were instructed to reduce energy intake by −5 kcals/kg/d. Participants were matched by age, sex, BMI, and body mass for the double-blind and randomized supplementation of a placebo (PLA), 500 mg of PE (PE-500), 1000 mg/d of PE (PE-1000), 400 µg of trivalent chromium (Cr) with 6 mg of PE and 6 mg of SJ (Cr-400), or 800 µg of trivalent chromium with 12 mg of PE and 12 mg of SJ (Cr-800) once a day for 12 weeks. Data were obtained at 0, 6, and 12 weeks of supplementation, and analyzed using general linear model multivariate and univariate analyses with repeated measures, pairwise comparisons, and mean changes from the baseline with 95% confidence intervals (CIs). Results: Compared to PLA responses, there was some evidence (p < 0.05 or approaching significance, p > 0.05 to p < 0.10) that PE and/or Cr with PE and SJ supplementation improved pulse wave velocity, flow-mediated dilation, platelet aggregation, insulin sensitivity, and blood lipid profiles while promoting more optimal changes in body composition, strength, and aerobic capacity. Differences among groups were more consistently seen at 6 weeks rather than 12 weeks. While some benefits were seen at both dosages, greater benefits were more consistently observed with PE-1000 and Cr-800 ingestion. Conclusions: The results suggest that PE and Cr with PE and SJ supplementation may enhance some exercise- and diet-induced changes in markers of health in overweight individuals with at least two risk factors to MetSyn. Registered clinical trial #NCT06641596. Full article

Ketone bodies (KBs), particularly β-hydroxybutyrate, are crucial metabolites that provide clean and efficient energy, especially during periods of low glucose availability. Ketogenesis is a promising therapeutic avenue for conditions such as obesity, metabolic syndrome, and diabetes. This review aims to summarize the current evidence on ketogenesis across different health conditions and therapeutic modalities, highlighting the potential to mitigate metabolic disorders and diabetes-related complications. By reducing inflammation and oxidative stress, increased KB production provides cardiovascular and neuroprotective benefits. Ketogenesis is enhanced under physiological conditions like pregnancy and fasting, as well as in pathophysiological states such as diabetes and heart failure. Various interventions, including the promotion of endogenous ketogenesis through diet and exercise, drug-induced ketogenesis via sodium-glucose cotransporter 2 inhibitors, and exogenous ketone supplementation, have demonstrated favorable effects on metabolic health. However, challenges remain, including risks such as pathological ketoacidosis and dyslipidemia. In specific populations, such as lean mass hyper-responders, laboratory lipid profiles might reflect the metabolic privilege. This review will assist in the future clarification of individual differences and optimized therapeutic approaches leveraging ketogenesis for the personalized management of metabolic disorders. Full article

Objective: This study aimed to examine the impact of high-fat-diet(HFD)-induced obesity on pain sensitivity and tetrahydrobiopterin (BH4) levels. The effect of moderate-intensity physical exercise, an anti-inflammatory non-pharmacological intervention, on pain scores was also investigated. Methods: Adult male C57BL/J6 mice were fed standard or an HFD for eight weeks. Their total body weight, food intake, locomotor and motivational behavior, and pain reflexes were measured. A subgroup of animals underwent physical exercise for five days per week over six weeks. Blood was collected for glucose tolerance testing and levels of lactate. Urine samples were collected to measure BH4 levels. Results: We showed that the HFD increased weight gain, epididymal white adipose tissue, and the percentage of body weight as epididymal fat. These anthropometric alterations were characterized by impaired glucose tolerance at four and eight weeks of the dietary intervention. It was also observed that reduced locomotor activity and higher pain scores in the HFD-fed mice were prevented by a physical exercise intervention. The HFD also induced an increase in urinary BH4 levels at four and eight weeks of intervention. Conclusions: The HFD increased scores of chemical and mechanical hyperalgesias, as well as urinary BH4 levels. Urinary BH4 can be proposed as a potential easy-to-access, sensitive, and reliable biomarker of pain development, and a promising target for the control of pain hypersensitivity in obesity. Full article

Background/Objectives: Infertility in both men and women can be significantly influenced by oxidative stress (OS), which occurs due to an imbalance between reactive oxygen species (ROS) and the body’s antioxidant defenses. In women, OS disrupts oocyte maturation, implantation, and the viability of the embryo; in men, it impairs sperm quality, reduces motility, and damages DNA integrity. This review explores existing research on how dietary and lifestyle interventions can reduce OS and enhance reproductive health outcomes. Methods: We conducted a comprehensive review of clinical, translational, and molecular studies exploring the mechanisms by which OS affects fertility, as well as the efficacy of nutritional and behavioral strategies. The interventions evaluated include weight management, regular exercise, micronutrient supplementation, antioxidant-rich diets, smoking and alcohol cessation, and stress-reduction techniques. Results: Specific dietary components such as zinc, selenium, vitamins C and E, and polyphenols have been found to neutralize reactive oxygen species (ROS) and enhance gamete function. OS is additionally reduced through lifestyle modifications, including minimizing harmful exposures, managing stress, and participating in moderate physical activity. Biomarkers such as ROS levels, total antioxidant capacity, 8-OHdG, and DNA fragmentation index are essential for assessing the effectiveness of interventions. Conclusions: Fertility in both sexes can be improved, and oxidative stress significantly reduced, through a multimodal approach incorporating dietary and lifestyle changes. There are encouraging opportunities to improve reproductive health through customized approaches that are informed by biomarker profiles. To incorporate these treatments into regular fertility care, future studies should concentrate on standardized procedures and long-term results. Full article

Anthracyclines remain a cornerstone of cancer therapy but are associated with a significant risk of cardiotoxicity, which can lead to overt heart failure. The risk is modulated by cumulative dose, pre-existing cardiovascular disease, and patient-specific factors. As cancer survival improves, the long-term cardiovascular consequences of anthracycline exposure have become a growing concern, underscoring the need for effective preventive strategies. This narrative review examines lifestyle and pharmacological interventions aimed at mitigating anthracycline-induced cardiotoxicity. Evidence suggests that structured exercise programs and antioxidant-rich diets may enhance cardiovascular resilience, while beta-blockers, renin-angiotensin system inhibitors, and dexrazoxane remain central pharmacological options. Emerging therapies, including sodium-glucose co-transporter 2 inhibitors and sacubitril/valsartan, show promise but require further investigation. A comprehensive approach that integrates lifestyle modifications with pharmacological strategies within a multidisciplinary cardio-oncology framework may provide optimal protection, improving long-term cardiovascular outcomes in cancer patients receiving anthracyclines. Full article

mHealth apps can promote behavior change to prevent heart disease. This study examined the efficacy of an 8-week theory-based mHealth intervention to promote heart disease preventive behaviors. The BaseMetrics app was designed using the Health Belief Model to improve users’ understanding of heart disease and its risk factors to promote behavior change. In this proof-of-concept intervention with no control group, twenty-two participants (14F/8M; age 51 ± 8 years) received access to the BaseMetrics app for 8 weeks. Biological, behavioral, and self-assessed heart disease risk and knowledge were measured pre- and post-intervention. At post-intervention, significant improvements were seen in self-reported fruit and vegetable intake (+1.1 servings/day) and skin carotenoids (+28 a.u.). Self-tracked activity decreased (−665 steps/day). No other outcomes were significantly different. Non-significant improvements with small-to-moderate effect sizes were observed in triglycerides, energy expenditure, knowledge, perceived risk, and perceived benefits of diet and exercise. Conversely, non-significant deteriorations with small-to-moderate effect sizes were observed for total cholesterol, LDL, and AST. This study yielded preliminary findings suggesting the benefits of the BaseMetrics mobile app for heart disease prevention. The results must be validated in a larger randomized controlled trial. Full article