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Search Results (1,150)

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15 pages, 615 KB  
Article
Association Between Dietary Patterns, Weight Loss, and Handgrip Strength Among Qatari Adults with a History of Bariatric Surgery: Results from the Qatar Biobank Study
by Shada Almaket, Gana Hissain, Salma Mehrez, Joyce Moawad and Zumin Shi
Nutrients 2026, 18(9), 1411; https://doi.org/10.3390/nu18091411 - 29 Apr 2026
Abstract
Background/Objectives: This study examines cross-sectional associations between dietary patterns, weight loss, and handgrip strength (HGS) among adults with a history of bariatric surgery. Methods: We analyzed data of 1888 adults (62.3% women; mean age 38.8 years) who attended the Qatar Biobank study. Dietary [...] Read more.
Background/Objectives: This study examines cross-sectional associations between dietary patterns, weight loss, and handgrip strength (HGS) among adults with a history of bariatric surgery. Methods: We analyzed data of 1888 adults (62.3% women; mean age 38.8 years) who attended the Qatar Biobank study. Dietary patterns were identified using factor analysis of data from a food frequency questionnaire. HGS was measured using dynamometry, and relative HGS (RHGS) was calculated as HGS/BMI. Results: The mean weight loss after bariatric surgery was 27.6 kg (23.4%), and the mean HGS was 30.1 (SD 11.2) kg. The mean duration after bariatric surgery was 3.6 years. Greater weight loss was associated with lower HGS (Q4 vs. Q1: −1.29 (95%CI −2.26 to −0.33)) but higher RHGS (Q4 vs. Q1: 0.10 (0.06 to 0.13)). Higher adherence to a “prudent diet” with high intake of fruits and vegetables was associated with stronger HGS (Q4 vs Q1: 1.07 (0.18 to 1.96)). In contrast, a “traditional diet” (high intake of mixed dishes, e.g., biryani, croissants, zaatar fatayer, lasagna, white rice, and Arabic bread) was inversely associated with HGS (Q4 vs. Q1: −1.27 (−2.19 to −0.35)). Conclusions: In conclusion, greater weight loss was associated with improved relative muscle strength, while adherence to a traditional diet was linked to weaker HGS. These findings highlight the importance of diet quality in maintaining muscle function after bariatric surgery. Full article
(This article belongs to the Special Issue Nutrition Modulation in Cardiometabolic Outcomes)
49 pages, 4662 KB  
Systematic Review
Explore the Optimal Treatment Regimen Across Combinations of Variate Protein Sources and Exercise Modalities and Its Associated Factors in Older Adults: A Network Meta-Analysis and Meta-Regression of Randomized Controlled Trials
by Che-Li Lin, Shih-Wei Huang, Hung-Chou Chen, Mao-Hua Huang, Tsan-Hon Liou and Chun-De Liao
Nutrients 2026, 18(9), 1409; https://doi.org/10.3390/nu18091409 - 29 Apr 2026
Abstract
Background/Objectives: Aging is closely associated with sarcopenia, which has a significant impact on muscle mass and its function. Protein supplementation (PS) brings benefits such as lean mass and strength gains during exercise training. This paper determined the optimal regimen among the composites of [...] Read more.
Background/Objectives: Aging is closely associated with sarcopenia, which has a significant impact on muscle mass and its function. Protein supplementation (PS) brings benefits such as lean mass and strength gains during exercise training. This paper determined the optimal regimen among the composites of variate protein sources and training modalities for older individuals. Methods: We comprehensively searched the electronic databases, namely MEDLINE Complete, PEDro, the Cochrane Library, Google Scholar, EMBASE, and the China National Knowledge Infrastructure, from its inception until December 2025. We included randomized controlled trials (RCTs) that examined the effectiveness of any type of PS combined with one of three exercise types—resistance, aerobic, or multicomponent training—in untrained older adults. The main outcomes used to identify sarcopenia were assessed, including lean mass, handgrip and leg strength, and physical mobility measures. Network meta-analysis (NMA) was performed by a frequentist method using random-effects models. The estimated treatment effect was expressed as the standard mean difference (SMD) with a 95% confidence interval (CI). Any potential factor moderating the treatment effect was determined by the meta-regression analyses, including participant characteristics and methodological factors. Certainty of evidence (CoE) was assessed by the GRADE framework. Results: In total, we included 235 RCTs (20,980 participants) for analyses. A total of 10 protein sources (whey, soy, casein, milk, and the others) were identified, corresponding to 24 monotherapy and combined regimens of PS and exercise. Among the treatment arms, whey plus resistance training was ranked as the most effective treatment for muscle mass (large SMD, 1.29; CoE, moderate) and leg strength (large SMD, 1.16; CoE, moderate); additionally, whey plus multicomponent exercise training achieved the most promising effects on such sarcopenia-related physical indicators such as chair rise (large effect, SMD = 1.09; CoE: high), timed up and go (medium SMD, 0.70; CoE, high), and global mobility score (large SMD, 1.02; CoE, high). Conclusions: The treatment efficacy appears to be moderated by the participant’s conditions, PS resource, and PS dose, particularly the outcome of muscle mass and strength. The present NMA results indicate that whey protein incorporated with resistance training is the optimal program to help combat sarcopenia in older adults. Full article
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22 pages, 628 KB  
Article
Exercise-Based Rehabilitation in Severe COVID-19 Survivors with Long COVID: A Randomized Controlled Pilot Study
by Edson Fonseca Pinto, Nailton José Brandão Albuquerque Filho, Jéssica Costa Leite, Tatianne Moura Estrela Gusmão, Larissa Nayara de Souza, Roque Ribeiro da Silva Júnior, Maria Irany Knackfuss and Grasiela Piuvezam
Med. Sci. 2026, 14(2), 222; https://doi.org/10.3390/medsci14020222 - 29 Apr 2026
Abstract
Introduction: Post-hospital rehabilitation is essential for survivors of severe COVID-19, as prolonged immobility and clinical severity often lead to muscle weakness, reduced cardiovascular capacity, and impaired respiratory function. Physical exercise during and after hospitalization may mitigate these effects and support functional recovery. This [...] Read more.
Introduction: Post-hospital rehabilitation is essential for survivors of severe COVID-19, as prolonged immobility and clinical severity often lead to muscle weakness, reduced cardiovascular capacity, and impaired respiratory function. Physical exercise during and after hospitalization may mitigate these effects and support functional recovery. This study aimed to evaluate the effectiveness of a physical exercise-based rehabilitation program in survivors of severe COVID-19. Methodology: A randomized clinical trial was conducted with 30 survivors allocated to two groups: multicomponent exercise (GEm) and multicomponent exercise combined with inspiratory muscle training (GEmTMI). The interventions were performed three times per week for 40–60 min. Quality of life, physical activity level, functional status, and physical capacity were assessed before and after six weeks. Results: Comparisons between GEm and GEmTMI showed significant differences in the 6 min walk test (6MWT) at baseline (p = 0.043) and in the Physical Activity Index (IPAQ) after the intervention (p = 0.002). When the total sample was analyzed, significant improvements were observed across all outcomes after rehabilitation, including quality of life (SF-36), functional capacity (PCFS), physical activity level (IPAQ), respiratory muscle strength, and additional functional tests. Notable improvements included SF-36 Physical Functioning (p = 0.006) and Social Functioning (p = 0.009), PCFS (p = 0.011), IPAQ (p = 0.012), and performance in the 6MWT, STS, STS-1min, TUG, handgrip strength, PEmax, and PImax (all p < 0.001). Discussion: Multicomponent physical rehabilitation, with or without inspiratory muscle training, produced significant gains in physical activity level, functional capacity, dynamic balance, neuromuscular fitness, respiratory muscle strength, and quality of life. These findings underscore the importance of structured post-ICU rehabilitation to support comprehensive physical and psychosocial recovery in survivors of severe COVID-19. Full article
(This article belongs to the Section Pneumology and Respiratory Diseases)
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26 pages, 1654 KB  
Article
Effectiveness of a Comprehensive Program Including a Novel Concentrated High-Protein, High-Calorie Oral Nutritional Supplement to Enhance Nutritional and Morphofunctional Recovery in Malnourished Patients with Cancer: The ONAVIDA Study
by José Manuel García-Almeida, Rocío Fernández-Jiménez, Ana Hernández-Moreno, Gabriel Olveira, Mercedes Vázquez-Gutiérrez, Carolina Dassen, Pedro Pablo García-Luna, Amalia González-Jiménez, Josefina Olivares, María García-Duque, Mª José Martínez-Ramírez, Juan Manuel Guardia-Baena, María I. Rebollo-Pérez, Miguel Civera, Visitación Álvarez-de Frutos, Vicente Faus, Lucía Díaz-Naya, José Joaquín Alfaro-Martínez and Alejandro Sanz-París
Nutrients 2026, 18(9), 1398; https://doi.org/10.3390/nu18091398 - 29 Apr 2026
Abstract
Background/Objectives: Malnutrition in cancer adversely affects treatment outcomes and survival. Early intervention through oral nutritional supplements (ONSs) and dietary counseling can improve outcomes. This study evaluated the evolution of nutritional and morphofunctional parameters over three months in malnourished patients with cancer undergoing a [...] Read more.
Background/Objectives: Malnutrition in cancer adversely affects treatment outcomes and survival. Early intervention through oral nutritional supplements (ONSs) and dietary counseling can improve outcomes. This study evaluated the evolution of nutritional and morphofunctional parameters over three months in malnourished patients with cancer undergoing a comprehensive nutritional support program comprising dietary counseling, physical activity, and a novel concentrated high-protein, high-calorie ONS (cHPHC-ONS) with a high intrinsic leucine content. Methods: A prospective, observational, multicenter cohort study was conducted across 18 public hospitals in Spain. Two hundred thirty malnourished patients with cancer were enrolled: 147 naïve (no ONS treatment in the last three months) and 83 non-naïve (who transitioned to cHPHC-ONS after inadequate response to initial ONSs). Nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria and morphofunctional parameters via bioelectrical impedance analysis, nutritional ultrasound, handgrip strength, the Timed Up and Go (TUG) test, and analysis of biochemical parameters. Results: After three months, 23.8% achieved normal GLIM nutritional status (p < 0.0001), with a greater improvement seen in non-naïve patients (28.4%, p < 0.0001). Weight loss ceased in 42.6% (p < 0.0001). and inflammation resolved for 10.3% (p = 0.0015). Non-naïve patients experienced a significant increase in fat-free mass index (p = 0.0159), appendicular skeletal muscle index (p = 0.0248), and rectus femoris cross-sectional area (p = 0.0016). Muscle strength increased significantly by +1.7 kg (p = 0.0025), and TUG test time decreased by 1.13 s (p = 0.0003) overall. Conclusions: The comprehensive nutritional support program—including a novel cHPHC-ONS, along with dietary and physical activity guidance—significantly improved the nutritional and morphofunctional status of malnourished patients with cancer, with benefits particularly evident in non-naïve individuals. Limitations: Observational design, no control group, short follow-up, and unadjusted non-multivariable comparisons, limiting causal inference. Full article
(This article belongs to the Section Clinical Nutrition)
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13 pages, 402 KB  
Article
Prospective Associations of Serum Vitamin B12, Homocysteine, and Ferritin Levels with Probable Sarcopenia
by Inkyung Baik
Nutrients 2026, 18(9), 1362; https://doi.org/10.3390/nu18091362 - 25 Apr 2026
Viewed by 200
Abstract
Background/Objectives: Previous cross-sectional studies investigated the associations of low handgrip strength (HS), a primary indicator of probable sarcopenia (PS), with biomarkers related to anemia. However, existing evidence is inconsistent, and data establishing causality remain limited. The present prospective study aimed to evaluate [...] Read more.
Background/Objectives: Previous cross-sectional studies investigated the associations of low handgrip strength (HS), a primary indicator of probable sarcopenia (PS), with biomarkers related to anemia. However, existing evidence is inconsistent, and data establishing causality remain limited. The present prospective study aimed to evaluate whether serum vitamin B12, folate, homocysteine (Hcy), and ferritin levels are associated with PS risk. Methods: This study analyzed data from 1930 adults aged 45–76 years who had normal muscle quantity at baseline. Serum biomarkers were assessed at baseline and PS defined by low HS was determined at 6-year follow-up. The modified Poisson regression method was employed to calculate multivariable risk ratios (RRs) and 95% confidence intervals (CIs). Results: Among all participants, PS risk was inversely related to serum vitamin B12 levels (p = 0.06), while it was lowest in the high-normal ranges of serum Hcy (12.1–15 μmol/L) and ferritin (101–200 ng/mL) levels. The RRs (95% CIs) for PS risk were 0.73 (0.60, 0.89) and 0.75 (0.64, 0.87) for high-normal Hcy and ferritin categories, respectively, compared with the lowest category. On examining the associations of elevated Hcy and ferritin levels with PS risk, age was identified as a significant modifier for elevated Hcy levels (>15 μmol/L) (p for interaction < 0.05); a reduced risk was observed in younger participants, whereas an increased risk was noted in older participants. Conclusions: These findings suggest that high-normal ferritin levels may be optimal for alleviating PS risk, irrespective of age, and that elevated Hcy levels could be detrimental for older adults in preventing PS risk. Full article
(This article belongs to the Special Issue Vitamins and Human Health: 3rd Edition)
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14 pages, 289 KB  
Article
Field-Based Fitness Tests Predict Completion of a Firefighter Recruit Academy
by Scott D. Brau, Benjamin J. Mendelson, Rudi A. Marciniak, David J. Cornell and Kyle T. Ebersole
Fire 2026, 9(5), 181; https://doi.org/10.3390/fire9050181 - 24 Apr 2026
Viewed by 712
Abstract
Recruitment of firefighters is, in part, hindered due to attrition from fire academies. This study explored initial fitness differences between those who graduated (GRAD) or were released (REL) from the academy. During the first week of the academy, recruits (N = 407; [...] Read more.
Recruitment of firefighters is, in part, hindered due to attrition from fire academies. This study explored initial fitness differences between those who graduated (GRAD) or were released (REL) from the academy. During the first week of the academy, recruits (N = 407; GRAD = 354, REL = 53; 26.6 ± 7.2 yrs; 177.6 ± 8.6 cm; 87.9 ± 17.2 kg) completed an assessment battery including: body composition using skinfold calipers to estimate percent body fat (BF) and fat-free mass (FFM); shoulder mobility via Apley’s scratch test (APLEY); aerobic fitness (VO2peak) and heart rate recovery (HRR1min) estimated from the five-minute Forestry step test; muscular strength via the sum of right and left handgrip (SHG); and muscular endurance via a paced two-minute push-up test (PU). A t-test identified age differences between GRAD and REL, followed by separate ANCOVAs for each fitness measure, and logistic regression to identify the ability of fitness measures to predict academy outcome. GRAD had a lower age and BF and a higher FFM, VO2peak, SHG, and PU, but did not differ in APLEY or HRR1min. The full model predicting release was significant; age, BF, and FFM were significant predictors. These results provide pre-fire academy preparation guidance for optimizing the potential for successful academy completion. Full article
23 pages, 1795 KB  
Article
Combined Measure of Hand Grip Strength and Body Mass Index for Predicting Excess Body Fat in a University Population in Kentucky, USA
by Jason W. Marion, Michael C. Shenkel, Laurie J. Larkin and Jim M. Larkin
Diagnostics 2026, 16(8), 1210; https://doi.org/10.3390/diagnostics16081210 - 17 Apr 2026
Viewed by 207
Abstract
Background/Objectives: Measures of excess body fat are often more informative for predicting health risk than body mass index (BMI) alone. With obesity prevalence increasing among young adults, this study evaluated whether adding dominant handgrip strength improves prediction of body fat percentage (BF%) and [...] Read more.
Background/Objectives: Measures of excess body fat are often more informative for predicting health risk than body mass index (BMI) alone. With obesity prevalence increasing among young adults, this study evaluated whether adding dominant handgrip strength improves prediction of body fat percentage (BF%) and BF%-defined obesity in a university population. Methods: Cross-sectional data from 895 students (401 women, 494 men; mean age 19.9 years; fall 2015–spring 2016) in Kentucky, USA were analyzed. BMI was calculated from self-reported height and weight. BF% was estimated using bioelectrical impedance analysis (BIA), and dominant handgrip strength was measured with a hydraulic hand grip dynamometer. Sex-specific linear and logistic regression models assessed associations among BMI, grip strength, relative grip strength, and BF%. Results: BMI was a strong predictor of BF% in linear models (R2 = 0.74 in women; 0.68 in men). Grip strength alone was not associated with BF% but showed an inverse association when combined with BMI. For BF%-defined obesity, BMI remained the most influential predictor, with grip strength contributing additional predictive value. Among men, age significantly modified these relationships, with marked differences between those aged 18–19 years versus older participants. Conclusions: BMI strongly predicted BF% and BF%-based obesity in this cross-sectional study of a predominantly white young adult population. Incorporating handgrip strength modestly improved classification, particularly among women, suggesting that a functional measure like hand grip strength may enhance obesity screening and health communication in young adults. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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17 pages, 1345 KB  
Article
Functional Symmetry of Upper Limbs in Young Adults: An Analysis of Muscle Strength and Mobility
by Piotr Osial, Michalina Błażkiewicz, Dagmara Iwańska and Jacek Wąsik
Appl. Sci. 2026, 16(8), 3874; https://doi.org/10.3390/app16083874 - 16 Apr 2026
Viewed by 347
Abstract
Background: Upper limb functional performance depends on the interaction of strength, mobility, and neuromuscular control, while inter-limb asymmetries may increase injury risk. However, comprehensive analyses integrating these factors remain limited. This study aimed to evaluate sex differences and identify functional phenotypes in young [...] Read more.
Background: Upper limb functional performance depends on the interaction of strength, mobility, and neuromuscular control, while inter-limb asymmetries may increase injury risk. However, comprehensive analyses integrating these factors remain limited. This study aimed to evaluate sex differences and identify functional phenotypes in young adults using a multidimensional assessment approach. Methods: Forty-six healthy young adults (23 women, 23 men) underwent a comprehensive battery of upper limb assessments, including anthropometric measurements, maximal handgrip strength, isometric elbow flexion and extension torque, postural stability via the Fall Risk Index (FRI), and functional reach using the Upper Quarter Y-Balance Test (YBT-UQ). Inter-limb symmetry was calculated using the Limb Symmetry Index (LSI). K-means clustering was applied to standardized variables to identify latent functional phenotypes. Results: Men demonstrated significantly greater body mass, height, limb length, and absolute strength (p < 0.01), while functional performance (YBT-UQ composite scores) and inter-limb symmetry were similar between sexes. Strength asymmetry was most prevalent for elbow flexion and handgrip strength (up to 89%), whereas stability asymmetry was less frequent (≈54%). Three functional clusters were identified: Cluster 1—high strength and moderate stability, Cluster 2—lower anthropometry and strength, Cluster 3—high strength but reduced stability and increased asymmetry. Despite phenotypic differences, composite functional performance was comparable across clusters. Conclusions: Upper limb function reflects the interaction of morphological and neuromuscular factors rather than strength alone. Observed asymmetries should be interpreted within a functional context, as moderate asymmetries may represent normal variation in motor control, while larger asymmetries may indicate potential functional imbalance; however, due to the cross-sectional design of this study, no causal inferences regarding injury risk can be made. Functional phenotyping provides a framework for individualized training, screening, and rehabilitation strategies. Full article
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14 pages, 636 KB  
Article
Association Between Chin-Tuck-Generated Force and Sarcopenia in Community-Dwelling Older Adults: A Cross-Sectional Study
by Naoto Kamide, Takeshi Murakami, Takuya Sawada, Masataka Ando and Miki Sakamoto
Healthcare 2026, 14(8), 1018; https://doi.org/10.3390/healthcare14081018 - 13 Apr 2026
Viewed by 322
Abstract
Background: Although swallowing-related muscle function has been implicated in sarcopenia, the association between swallowing-related cervical muscle function and sarcopenia has not been thoroughly examined. The aim of this study was to investigate this association in community-dwelling older adults. Methods: This cross-sectional [...] Read more.
Background: Although swallowing-related muscle function has been implicated in sarcopenia, the association between swallowing-related cervical muscle function and sarcopenia has not been thoroughly examined. The aim of this study was to investigate this association in community-dwelling older adults. Methods: This cross-sectional study included 390 community-dwelling adults aged ≥65 years. Sarcopenia was defined as the concurrent presence of low handgrip strength and low appendicular skeletal muscle mass. The force generated during the chin-tuck maneuver (chin-tuck force) was measured using a dynamometer to indicate swallowing-related cervical muscle function. Tongue pressure and oral diadochokinesis were measured as indicators of swallowing-related muscle function. Potential confounders included body mass index, comorbidities, number of medications, functional capacity, timed up-and-go test and trail-making test times. Results: In logistic regression analyses adjusted for age and sex, chin-tuck force was found to have a statistically significant association with sarcopenia; greater force correlated inversely with sarcopenia (odds ratio = 0.59, p < 0.001). Receiver operating characteristic curve analysis demonstrated acceptable discriminative ability of chin-tuck force for identifying sarcopenia (area under the curve (AUC) = 0.82, 95% confidence interval (CI): 0.72–0.90), which was significantly higher than that for tongue pressure (AUC = 0.62, 95% CI: 0.50–0.74; p < 0.01). Conclusions: Among swallowing-related muscle functions, reduced chin-tuck force may be associated with sarcopenia in older adults. Future studies should investigate targeted assessments and interventions focused on improving swallowing-related cervical muscle function as a potential strategy for sarcopenia prevention. Full article
(This article belongs to the Section Public Health and Preventive Medicine)
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19 pages, 1090 KB  
Article
A Cross-Sectional Pilot Study of Probable Sarcopenia in Hemodialysis Patients
by Juan Rodríguez-Mansilla, Jaime Becerra Fernández, María Victoria Martín Hidalgo-Barquero, María Jiménez-Palomares, Blanca González-Sánchez and Elisa María Garrido-Ardila
Life 2026, 16(4), 649; https://doi.org/10.3390/life16040649 - 12 Apr 2026
Viewed by 409
Abstract
Chronic kidney disease is defined as a progressive pathology that affects more than 10% of the world’s population, affecting waste filtration capacity. Sarcopenia, characterized by loss of muscle mass and strength, is a common complication in patients with chronic kidney disease undergoing hemodialysis. [...] Read more.
Chronic kidney disease is defined as a progressive pathology that affects more than 10% of the world’s population, affecting waste filtration capacity. Sarcopenia, characterized by loss of muscle mass and strength, is a common complication in patients with chronic kidney disease undergoing hemodialysis. It is associated with inflammation, malnutrition and reduced quality of life. Hemodialysis is the fundamental treatment for people with chronic kidney disease, as it is key to the elimination of toxins from the body. Objective: The objective of this study was to determine the prevalence of probable sarcopenia in patients with chronic kidney disease in the Dialysis Unit of Extremadura (Spain). Material and Methods: This is a descriptive study in which 33 patients with chronic kidney disease receiving hemodialysis were selected as participants in the assessment of functional capacity and physical fitness. The procedure was performed prior to the dialysis session. Socio-demographic, clinical and physical variables were assessed. The assessment of probable sarcopenia was carried out using manual grip strength test (dynamometry), physical performance (4-meter walk test) and phase angle (PhA) (single frequency 50 Hz bioimpedance). The Charlson Comorbidity Index (CCI) was used to determine the severity of chronic disease and its impact, and analytical variables such as albumin, C-reactive protein (CRP), Neutrophil/Lymphocyte Index (NLI), Lymphocyte–Platelet Index (LPI) and total protein (TP), among others, were also included. Results: The prevalence of probable sarcopenia was 93.9% according to the criteria for muscle strength and physical performance (EWGSOP2). PhA showed statistically significant differences between the groups with and without sarcopenia (p = 0.039), suggesting its usefulness as a nutritional marker. No statistically significant differences were found between sarcopenia and age, albumin, Neutrophil/Lymphocyte Index or C-reactive protein (p > 0.05). Conclusions: There is a high prevalence of probable sarcopenia, associated with decreased handgrip strength and gait speed in patients with chronic kidney disease in hemodialysis. In addition, PhA stands out as an influential factor in the development of sarcopenia. Full article
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13 pages, 1259 KB  
Article
Adiposity, Fat-Free Mass Index, and Muscular Strength in Children: Independent Effects on Functional Performance in a Tertiary Pediatric Endocrinology Cohort
by Bogdan Mihai Pascu, Ana Maria Cula, Anca Bălănescu, Paul Cristian Bălănescu and Ioan Gherghina
Medicina 2026, 62(4), 730; https://doi.org/10.3390/medicina62040730 - 11 Apr 2026
Viewed by 440
Abstract
Background and Objectives: Childhood obesity is associated with alterations in body composition that may impair muscular strength and functional capacity. While higher body mass is often accompanied by greater absolute strength, the independent effect of adiposity on muscle strength after accounting for [...] Read more.
Background and Objectives: Childhood obesity is associated with alterations in body composition that may impair muscular strength and functional capacity. While higher body mass is often accompanied by greater absolute strength, the independent effect of adiposity on muscle strength after accounting for lean mass remains insufficiently understood. This study aimed to evaluate the associations between adiposity and muscle strength in children and adolescents, while accounting for growth and maturation, and to examine differences according to weight status. Materials and Methods: This retrospective cross-sectional study included 84 children and adolescents aged 5–18 years. Anthropometric measurements were used to calculate body mass index (BMI), waist-to-hip ratio, and waist-to-height ratio, with weight status classified according to CDC BMI-for-age percentiles. Body composition was assessed using bioelectrical impedance analysis (Tanita). Pubertal stage was evaluated using Tanner classification. Muscle strength was assessed using dominant handgrip strength. Associations between adiposity-related parameters and muscle strength were analyzed using correlation and multivariable linear regression models adjusted for age, sex, pubertal stage, physical activity, and body composition. Results: Body mass index was positively correlated with absolute handgrip strength (r = 0.561, p < 0.001). Body fat percentage was negatively associated with relative handgrip strength (r = −0.381, p < 0.001). In multivariable regression analyses, body fat percentage remained an independent negative predictor of handgrip strength (β = −0.203, p = 0.0046), whereas fat-free mass and fat-free mass index were positive predictors in respective models (p < 0.001). Conclusions: Increased adiposity is associated with reduced muscle strength in children and adolescents when strength is evaluated relative to body size or adjusted for lean mass. These findings support the concept of impaired muscle performance in pediatric populations with excess adiposity and highlight the importance of integrating body composition and functional assessments in clinical evaluation. Full article
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12 pages, 228 KB  
Article
Handgrip and Pinch Grip Strength as Functional Indicators of Pediatric Malnutrition and Early Response to Nutritional Therapy: A Preliminary Single-Center Study
by Mehmet Emin Yıldız, Tuğba Gürsoy Koca and Halil Kocamaz
Children 2026, 13(4), 531; https://doi.org/10.3390/children13040531 - 11 Apr 2026
Viewed by 261
Abstract
Background/Objectives: Pediatric malnutrition is associated with loss of muscle mass and impaired physical function. While anthropometric measurements are widely used for diagnosis, functional indicators that reflect early changes in nutritional status are limited in children. Handgrip strength has been proposed as a simple [...] Read more.
Background/Objectives: Pediatric malnutrition is associated with loss of muscle mass and impaired physical function. While anthropometric measurements are widely used for diagnosis, functional indicators that reflect early changes in nutritional status are limited in children. Handgrip strength has been proposed as a simple and objective marker of muscle function; however, pediatric data remain scarce. Methods: In this prospective controlled study, 55 children aged 3–17 years diagnosed with malnutrition and 50 age- and sex-matched healthy controls were evaluated. Anthropometric measurements and muscle strength assessments, including handgrip and pinch grip strength, were performed in both groups. Muscle strength values were additionally converted to age- and sex-adjusted standard deviation scores (SDS). In the malnutrition group, measurements were repeated at 2 and 8 weeks following individualized nutritional therapy to assess treatment response. Results: Children with malnutrition had significantly lower body weight, body mass index, mid-upper arm circumference, triceps skinfold thickness, and lean body mass compared with controls (p < 0.05 for all). Both dominant and non-dominant handgrip strength values were also significantly reduced in the malnutrition group. When adjusted for age and sex, handgrip strength SDS values remained significantly lower in children with malnutrition, whereas pinch grip strength SDS values did not differ significantly between groups. During follow-up, nutritional therapy was associated with significant improvements in anthropometric parameters and absolute muscle strength measurements. However, SDS-based analyses demonstrated that these changes were not uniform across all parameters, suggesting that observed improvements may only partly exceed expected physiological growth. Conclusions: Handgrip strength appears to reflect nutritional status in children, and its association with malnutrition persists after adjustment for growth-related factors. These findings support its potential role as a complementary functional marker. However, longitudinal changes in standardized scores indicate that recovery is variable, and interpretation should consider the influence of normal growth and development. Further large-scale, age-standardized studies are needed to better define their role in clinical practice. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
14 pages, 943 KB  
Article
Predictive Value of Musculoskeletal Fitness for Cardiovascular Risk Factors in Adolescents with Congenital Heart Disease: A Cross-Sectional Study
by Kunyu Hao, Craig A. Williams, Alan R. Barker, Curtis A. Wadey, Jan Müller, Renate Oberhoffer and Laura Willinger
J. Clin. Med. 2026, 15(8), 2863; https://doi.org/10.3390/jcm15082863 - 9 Apr 2026
Viewed by 278
Abstract
Objectives: We aimed to investigate the association between musculoskeletal fitness (MF) and cardiovascular risk factors in adolescents with congenital heart disease (ConHD). Methods: This cross-sectional study included 355 adolescents with ConHD (median age 12.4 years [range: 5.7–21.7]; 43.4% female). Participants completed musculoskeletal fitness [...] Read more.
Objectives: We aimed to investigate the association between musculoskeletal fitness (MF) and cardiovascular risk factors in adolescents with congenital heart disease (ConHD). Methods: This cross-sectional study included 355 adolescents with ConHD (median age 12.4 years [range: 5.7–21.7]; 43.4% female). Participants completed musculoskeletal fitness (MF) tests, including handgrip strength (HGS), curl-ups, push-ups, and trunk lifts, and underwent an assessment of anthropometric indices, blood pressure, pulse wave velocity (PWV), and carotid intima–media thickness (cIMT). To account for body size, HGS was allometrically scaled to body mass with adjustment for age, sex, and ConHD severity. Clustered MF was derived by calculating z-scores for allometric HGS, curl-ups, push-ups, and trunk lifts. Results: Allometric HGS was inversely associated with anthropometric indices: waist circumference [WC] (β = −4.467, p = 0.014), waist-to-hip ratio [WHR] (β =−0.039, p = 0.005), waist-to-height ratio [WHtR] (β = −0.052, p = 0.001), and BMI (β = −3.115, p = 0.001). Push-ups were inversely related to all anthropometric indices (p < 0.05). Trunk lift showed positive associations with multiple anthropometric indices except WHR (all p < 0.05). Clustered MF was negatively associated with WHR (β = −0.004, p = 0.008) and WHtR (β = −0.006, p = 0.001). HGS (β = 0.18, p = 0.033), push-ups (β = 0.004, p = 0.041), and clustered fitness (β = 0.028, p = 0.006) were inversely associated with PWV. Conclusions: Systematically increasing MF in rehabilitation may provide a feasible strategy to mitigate CVD risk in adolescents with ConHD. Full article
(This article belongs to the Section Cardiology)
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16 pages, 1351 KB  
Article
The Relation Between Quality of Life, Functional Impairment and Nutritional Status in Older People
by Gabriela Cristina Chelu, Cătălina Raluca Nuță, Ovidiu Lucian Băjenaru, Lidia Băjenaru and Gabriel Ioan Prada
Healthcare 2026, 14(8), 978; https://doi.org/10.3390/healthcare14080978 - 8 Apr 2026
Viewed by 367
Abstract
Background/Objectives: Autonomy and the ability to live independently are priority goals for older adults and are closely linked to healthy aging and quality of life (QoL). However, nutrition, although a crucial and modifiable determinant, remains undervalued. Cardiovascular diseases are highly prevalent in [...] Read more.
Background/Objectives: Autonomy and the ability to live independently are priority goals for older adults and are closely linked to healthy aging and quality of life (QoL). However, nutrition, although a crucial and modifiable determinant, remains undervalued. Cardiovascular diseases are highly prevalent in middle-aged and older adults and increase the risk of functional impairment, burdening the economy and limiting the patient’s autonomy. This study aimed to analyse the quality of life in older adults and its relationship with functional impairment and nutritional status. Methods: This was a cross-sectional study that included 359 patients with a mean age of 71.52 years who were admitted to the National Institute of Gerontology and Geriatrics “Ana Aslan”, between January 2024 and April 2025. Data were collected through interviews, medical records, and standardized instruments, including the Up and Go Test, Tinetti Test, Downton Fall Risk Index, and handgrip strength assessment. Quality of life was assessed using the EQ-5D-5L and the visual analog scale (VAS). Results: Nutritional status assessed using MNA showed significant moderate-to-strong correlations with EQ-5D-5L mobility (r = −0.326, p = 0.007 in the ≥80 years’ group), anxiety/depression (r = −0.544, p < 0.001 in the ≥80 years’ group), self-care (r = −0.271 to −0.311, p < 0.05 in patients over 65), and usual activities (r = −0.294, p = 0.016 in the ≥80 years’ group). In contrast, BMI showed moderate positive correlations with EQ-5D-5L pain/discomfort across all age groups (r = 0.365 to 0.524, p < 0.002). Functional assessment revealed strong negative correlations between EQ-5D-5L mobility and the Tinetti Test (r = −0.583 to −0.728, p < 0.001), with weaker correlations for pain/discomfort and anxiety/depression dimensions. While BMI-EQ-5D-5L pain/discomfort correlations were consistent across age groups, a stronger correlation was observed in the ≥80 years’ group for MNA-EQ-5D-5L anxiety/depression. Conclusions: In this exploratory cross-sectional study, MNA and BMI were associated with different quality of life domains. Lower MNA scores were more frequently associated with anxiety/depression and certain functional domains, particularly in the ≥80 years’ group, whereas higher BMI was more consistently associated with pain/discomfort across age groups. Full article
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18 pages, 2735 KB  
Article
Short- and Long-Term Survival Prediction Using Different Prognostic Scores in Cardiovascular Surgeries
by Alexandros C. Liatsos, Styliani Ioakeimidou, Mairi Panagidi, Andreas S. Papazoglou, Dimitrios V. Moysidis, Athanasios Samaras, Fani Tsolaki and Georgios I. Tagarakis
J. Clin. Med. 2026, 15(7), 2760; https://doi.org/10.3390/jcm15072760 - 6 Apr 2026
Viewed by 413
Abstract
Background: Early identification of patients at risk for adverse outcomes after cardiac surgery remains a major clinical challenge. While preoperative risk scores are widely used, the prognostic value of early postoperative ICU severity scores and functional performance measures has not been fully [...] Read more.
Background: Early identification of patients at risk for adverse outcomes after cardiac surgery remains a major clinical challenge. While preoperative risk scores are widely used, the prognostic value of early postoperative ICU severity scores and functional performance measures has not been fully clarified. Methods: This prospective observational study included 195 patients undergoing cardiac surgery between 2018 and 2024. Predictive performance of EuroSCORE II, the SOFA score, the APACHE II score, Karnofsky performance status, handgrip strength, and phase angle was assessed for postoperative complications and mortality. Receiver operating characteristic (ROC) curves with 95% confidence intervals were calculated, and pairwise comparisons between ROC curves were performed. Major postoperative complications were analyzed using a composite endpoint including stroke, prolonged intubation, sepsis, and reoperation, excluding systemic inflammatory response syndrome (SIRS). Results: Major postoperative complications occurred in 46 patients (23.6%). For prediction of major postoperative complications, SOFA demonstrated the highest discrimination (AUC = 0.881, 95% CI 0.819–0.928), followed by APACHE II (AUC = 0.826, 95% CI 0.753–0.888) and EuroSCORE II (AUC = 0.695, 95% CI 0.602–0.785). In-hospital mortality occurred in 19 patients (9.7%). SOFA showed the strongest predictive performance (AUC = 0.915, 95% CI 0.851–0.968), followed by APACHE II (AUC = 0.869, 95% CI 0.781–0.939) and EuroSCORE II (AUC = 0.742, 95% CI 0.595–0.870). During follow-up, 54 patients (27.7%) died. Predictive performance was comparable between SOFA (AUC = 0.710, 95% CI 0.618–0.793), APACHE II (AUC = 0.695, 95% CI 0.606–0.782), and EuroSCORE II (AUC = 0.680, 95% CI 0.599–0.757). Conclusions: Early postoperative ICU severity scores, particularly SOFA and APACHE II, demonstrated strong predictive ability for major postoperative complications and in-hospital mortality following cardiac surgery and outperformed preoperative risk scores. Full article
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