Search Results (298)

Introduction: Primary dysmenorrhea is one of the most prevalent gynecological disorders. It has been shown to negatively impact quality of life and overall wellbeing, as recent studies have associated stress and physical inactivity with both the onset and severity of menstrual pain. Objective: To analyze the effectiveness of a moderate-to-high-intensity interval aerobic exercise on menstrual pain intensity, menstrual-related quality of life, general health-related quality of life, sleep quality, stress and anxiety, and drug intake in young women with primary dysmenorrhea. Methodology: A total of 20 women were randomly allocated to either the exercise (N = 10) or control group (N = 10). Primary outcomes were menstrual pain intensity and menstrual-related quality of life. Secondary outcomes included general health-related quality of life, sleep quality, stress and anxiety, and drug intake. A supervised moderate-to-high-intensity interval aerobic exercise program on a stationary bicycle was carried out twice a week, for eight weeks, in young women with regular cycles and no diagnosed medical conditions. Patients were assessed at baseline, and at 1- and 2-month follow-ups. Results: At 8 weeks, 17 women completed the follow-up. Analyses showed statistically significant differences in favor of moderate-to-high-intensity interval aerobic exercise at 2-month follow-up for menstrual pain intensity, with a large size effect. Significant changes were also found in menstrual-related quality of life at both follow-ups in the exercise group, but they were not superior to the control group. No significant changes were observed for the rest of the variables in either group. Conclusions: The results from this pilot study suggest that the moderate-to-high-intensity interval aerobic exercise program is effective in reducing menstrual pain intensity at 2-month follow-ups. Future randomized controlled trials with larger samples are required to confirm the results. Full article

Background and Objectives: Saudi Arabia’s aging population faces significant challenges from physical inactivity and prolonged sedentary behavior. This study quantified the prevalence of physical inactivity and sedentary behavior among older adults (aged 65 years and above) compared with those aged 55–64 years. Materials and Methods: We conducted a secondary analysis of data from the 2013 Saudi Health Interview Survey. The analysis focused on adults aged 55–64 years and those aged 65 years and older, stratified by sex. Physical inactivity was defined as <150 min of moderate-to-vigorous activity per week, and sedentary behavior as ≥6 h per day sitting or screen time. Results: Among adults ≥65 years (n = 875; 517 men, 358 women), 70.6% of women (95% CI 63.4–77.8) and 37.9% of men (95% CI 32.3–43.5) were inactive (difference: 32.7 percentage points). 42.7% of women (95% CI, 34.7–50.7%) and 32.0% of men (95% CI, 26.3–37.7%) reported ≥6 h of daily sitting. From ages 55–64 to ≥65, inactivity increased by 16.4 percentage points in women and 10.7 percentage points in men, while sitting increased by 9.5 percentage points and 8.5 pp, respectively. Conclusions: Older Saudi adults, especially women, face significant challenges related to physical inactivity and sedentary lifestyles, particularly after age 65. Addressing these issues through gender-responsive policies and interventions is vital for promoting health as part of Saudi Vision 2030. Full article

Background/Objectives: Postmenopausal women face an elevated risk of sarcopenia and functional decline, yet the distinct roles of type 2 diabetes mellitus (T2DM) and physical inactivity in these outcomes remain unclear. This study aimed to investigate the independent and combined associations of T2DM and physical activity on sarcopenia and functional performance in postmenopausal women. Methods: This was a cross-sectional study of 175 postmenopausal women stratified by T2DM status and physical activity level (active ≥150 min/week vs. insufficiently active). Body composition was assessed via dual-energy X-ray absorptiometry, muscle strength by handgrip dynamometry, and functional performance by gait speed. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia 2019 criteria. Binary logistic regression calculated odds ratios (ORs) for adverse outcomes. Results: Physical inactivity was the strongest predictor of functional decline, with insufficiently active women showing nearly four-fold increased odds of slow gait speed (<1.0 m/s) compared to active counterparts (OR: 3.93; 95% CI: 1.24–12.45). While T2DM appeared protective against sarcopenia in unadjusted analysis, multivariate adjustment revealed obesity (OR: 4.97; 95% CI: 1.62–15.20) and T2DM (OR: 3.80; 95% CI: 1.59–9.08) as independent sarcopenia predictors. Conclusions: Distinct associational profiles emerged for sarcopenia and functional decline in postmenopausal women. While T2DM and obesity are independently associated with sarcopenia through metabolic mechanisms, physical inactivity emerged as the strongest predictor of functional impairment. These findings support targeted interventions: metabolic optimization for muscle mass preservation and structured physical activity, particularly resistance training, for maintaining functional independence in this high-risk population. Full article

Background and Objectives: COVID-19 has been associated with prolonged inactivity and reduced physical performance, even in mild and moderate cases. This study aimed to evaluate changes in functional mobility and gait speed, assessed with the Timed Up and Go (TUG) and 10-Meter Walk Test (10MWT), in patients with mild to moderate post-COVID-19 conditions undergoing a structured rehabilitation program. Materials and Methods: A controlled observational study was conducted on 193 patients (115 women, 78 men) who had recovered from mild to moderate COVID-19. Participants were divided into a rehabilitation group (n = 160) and a control group (n = 33) who did not undergo structured physical therapy. Functional performance was assessed with TUG and 10MWT at admission and at one-year follow-up. Results: Both tests showed significant improvements following rehabilitation. In the rehabilitation group, the proportion of patients classified as functionally independent increased significantly for both the TUG (Cramér’s V = 0.468, p < 0.001) and 10MWT (Cramér’s V = 0.500, p < 0.001). The McNemar test confirmed a moderate within-group improvement for 10MWT (p = 0.001). Older adults (≥60 years) exhibited functional gains comparable to younger participants. A strong association between final TUG and 10MWT categories (Cramér’s V = 0.40, p < 0.001) confirmed the consistency of outcomes. Conclusions: Structured rehabilitation significantly improves balance, gait speed, and functional independence in mild-to-moderate post-COVID-19 patients. These findings highlight that rehabilitation should be integrated into the continuum of post-COVID care, as meaningful recovery is achievable even outside severe cases. Full article

Introduction: The demographic shift amongst pregnant women, including older age and increasing obesity, has resulted in an increased risk of cardiometabolic complications during pregnancy, particularly gestational diabetes. This paper presents physical activity and gestational diabetes data in a multi-ethnic urban Australian population. Methods and analysis: The PROMOTE cohort study is an ongoing prospective pregnancy cohort study recruiting pregnant participants < 16 weeks gestation at a large urban public teaching hospital with high social and cultural diversity in Sydney, Australia. Participants are surveyed about their physical activity levels, dietary quality, emotional wellbeing and socio-demographic status using validated tools. Participants are consented for use of routinely collected clinical and social data, including medical conditions, body mass index (BMI), blood pressure (BP) and glycaemia. Follow-up is from routinely collected data. Results: A total of 459 participants were recruited between February 2022 and February 2024. Physical activity levels at recruitment were sufficiently active, low active and inactive in 39%, 45% and 16% of participants. Participation in moderate or vigorous physical activity was reported in 19% and 16% of participants, respectively. Participation in vigorous physical activity occurred in 10% of those with GDM vs. 17% of those without GDM (p = 0.11). Participation in any moderate/vigorous physical activity was reported in 20% of those with GDM vs. 30% of those without GDM (p = 0.058). Compared to inactive behaviour, the unadjusted odds ratio of developing GDM amongst those participating in any moderate/vigorous physical activity was 0.58 (95% CI 0.33–0.97), p = 0.045. Participation in any moderate/vigorous physical activity showed an association with lower oral glucose tolerance test levels at 1 h (7.49 vs. 8.17 mmol/L, p = 0.002). Participation in any vigorous activity was associated with lower oral glucose tolerance test levels at 1 h (7.25 vs. 8.11, p = <0.001). Conclusions: Uptake of existing physical activity recommendations is low. Gestational diabetes risk showed a trend toward variation by intensity of physical activity, with a trend toward greater intensity being associated with a possible lower rate of gestational diabetes. Full article

Background: Insulin resistance (IR) is a key pathophysiological mechanism linking obesity, type 2 diabetes, and cardiovascular disease. Office workers, due to prolonged sedentary behavior and suboptimal lifestyle patterns, may be particularly susceptible to IR. However, large-scale studies in this occupational group remain scarce. Objective: To evaluate the prevalence of elevated IR risk using non–insulin-based indices—TyG, METS-IR, and SPISE—and their associations with sociodemographic and lifestyle factors in a large sample of Spanish office workers. Methods: This cross-sectional study included 82,020 office workers from Spain (2021–2022). IR risk was assessed using the TyG index, METS-IR, and SPISE, all derived from fasting biochemical and anthropometric data. Sociodemographic and lifestyle variables were self-reported using validated questionnaires. Sex-stratified analyses and multivariate logistic regression models were performed. Results: Men showed significantly higher odds of elevated IR risk compared to women across all indices: TyG (OR = 2.48, 95% CI: 2.37–2.60), METS-IR (OR = 1.47, 95% CI: 1.38–1.57), and SPISE (OR = 1.88, 95% CI: 1.78–1.99). Smoking, physical inactivity, and low adherence to the Mediterranean diet were independently associated with elevated IR scores, regardless of sex or age. Conclusions: A substantial proportion of office workers exhibit elevated insulin resistance risk, particularly among men and those with unhealthy lifestyles. TyG, METS-IR, and SPISE are valuable, low-cost tools for early IR detection in occupational health settings. These findings support the implementation of preventive strategies targeting modifiable behaviors in sedentary working populations. Full article

Objectives: To describe the outcomes of patients with refractory noninfectious ocular inflammatory diseases who underwent treatment with repository corticotropin injection (RCI). Methods: A retrospective cohort study was conducted. Patients who failed treatment with corticosteroids and were subsequently treated with RCI were included. Primary outcome measures were intraocular inflammatory activity, intraocular pressure (IOP), and the development of complications. Results: A total of 19 eyes from 10 patients were included. Most of the patients were women (70.0%) and the median age at presentation was 49.0 years (30.0–84.0 years). The ocular diagnoses were anterior/intermediate uveitis, intermediate/posterior uveitis, panuveitis, ocular cicatricial pemphigoid, and anterior scleritis. Seventeen (89.5%) eyes had active disease. The median duration of RCI treatment was 16.0 months (6.0–28.0 months). Nine (90.0%) patients, representing 17 (89.5%) eyes, achieved disease inactivity and remained quiescent at the last visit. No patient was on systemic corticosteroids at the last evaluation. The mean IOP was lower under RCI than corticosteroid at one month (16.0 mmHg ± 6.1 vs. 20.8 mmHg ± 9.5, p = 0.033) and four months (15.6 mmHg ± 2.9 vs. 17.8 mmHg ± 3.7, p = 0.046); however, the overall difference was not significant (16.2 mmHg ± 1.1 vs. 17.3 mmHg ± 1.8, p = 0.057). Incidence rates were the highest for posterior subcapsular cataracts (44.4% per eye-year). Relative risk analysis (RR) showed a 40.0% risk reduction for cystoid macular edema (RR = 0.60, p = 0.054). Conclusions: RCI may be an alternative treatment for refractory noninfectious ocular inflammatory diseases in patients who have failed treatment with corticosteroids. Full article

Objective: This systematic review evaluated the effects of body weight strength training (BWST) on cognitive function and health-related quality of life (HRQoL) in apparently healthy older people compared with active/inactive control groups. Methods: A literature search was conducted in six databases: PubMed, Web of Science, Scopus, ScienceDirect, EBSCOhost, and PsycINFO. The PRISMA, TESTEX, RoB 2, and GRADEpro tools were used to assess the methodological quality and certainty of evidence. The protocol was registered in PROSPERO (code: CRD42024623038). Results: Among the 27,241 records, 9 randomized controlled trials involving 682 (85% women) apparently healthy older people were included. Compared with the active/inactive control groups, the BWST resulted in significant improvements in orientation to place, language, visuospatial ability, processing speed, attention, and short-term memory. Within-group improvements were observed in general cognitive function and health-related anxiety scores in both the BWST and active control groups. The calculation and set shifting improved only within the BWST group. Conclusions: The individual results of the RCTs suggest that BWST may have potential effects on cognitive function and HRQoL in apparently healthy older people. Nevertheless, the certainty of evidence was insufficient to support definitive recommendations. Therefore, further high-quality studies are needed to establish solid conclusions. Full article

Background/Objectives: Dynapenia, characterized by an age-related decline in muscle strength, has recently gained attention as a major public health concern. While prior studies identified individual risk factors, little is known about how these factors cluster differently by sex. This study investigated sex-specific risk factors and their combinations associated with dynapenia among Korean middle-aged and older adults. Methods: We analyzed 22,850 participants aged ≥ 40 years from the 2014–2019 Korea National Health and Nutrition Examination Survey. Dynapenia was defined as handgrip strength < 28 kg in men and <18 kg in women. Sex-stratified multivariable logistic regression identified independent predictors, and association rule mining (ARM) detected synergistic risk factor combinations. Results: Dynapenia was more prevalent in women (13.9%) than in men (8.5%). Advancing age, physical inactivity, lack of resistance exercise, and a high incidence of diabetes and stroke were consistent risk factors in both sexes. However, ARM revealed distinct clustering patterns: behavioral factors predominated in men, whereas socioeconomic disadvantage and metabolic comorbidities were more relevant in women with dynapenia. Conclusions: These findings emphasize the need for sex-specific prevention strategies for dynapenia, promoting resistance exercise among men and addressing both inactivity and socioeconomic barriers in women. Full article

Background and Objectives: Physical inactivity contributes to high rates of cardiovascular disease, diabetes, and obesity in Kazakhstan, yet national data remain scarce. The primary objective of this study was to assess the level of physical activity among the adult population of Kazakhstan. The secondary objectives were to identify demographic, socioeconomic, and regional factors associated with physical activity, to determine risk groups, and to develop recommendations aimed at increasing physical activity and improving public health. Materials and Methods: We conducted a cross-sectional nationwide survey (December 2021–May 2022) including 6720 adults aged 18–69 years from all 17 regions. Data were collected using the WHO STEPS questionnaire and the Global Physical Activity Questionnaire. Results: Overall, 19.7% of adults did not meet WHO recommendations. Average weekly activity was 7108 min, mainly from transport (42.1%) and work (28.9%). Men and young adults were more likely to be sufficiently active. Lower levels were observed among women, individuals over 35, married respondents, civil servants, students, and the unemployed. Significant regional and ethnic disparities were identified. Conclusions: One in five adults in Kazakhstan has insufficient physical activity. Targeted, multisectoral interventions are needed, with special focus on women, older adults, and urban populations. Full article

This study seeks to provide insight into the comprehensive efforts aimed at advancing gender justice, eliminating period poverty, and exposing stigmatizing views toward women’s bodies, specifically in relation to menstrual health. Menstruation is a normal bodily process for all women and girls, but the availability of menstrual products, dignity, and justice during menstruation remains a worrying concern. Menstruators still suffer from adverse circumstances when they menstruate, adding to their sufferings of experiencing pain and distress on a monthly basis. Menstrual hygiene requires the use of standardized menstrual products to maintain cleanliness during menses. However, women experiencing economic hardship and women who are marginalized bear the burden of inadequate hygiene amenities, basic hygiene services, and affordable menstrual products; they are victims of period poverty. The failure to recognize and effectively address menstrual issues perpetuates the idea that menstruation is a burden unique to women. In other words, government inaction on menstrual issues strengthens the perception that menstruation is an individual problem that women must manage independently. This study argues that when menstruation is identified as a bodily problem or a neglected subject, it perpetuates gender inequities and restricts access to well-suited hygiene material, which is known to cause urogenital infections. Given these challenges, the study recommends recognizing menstrual health as a serious health challenge. The absence of robust legal and international norms that specifically address menstrual health perpetuates neglect and the ongoing failure to meet the needs of menstruating women. Full article

Background: Pregnancy is a time when women are uniquely engaged with the healthcare system and are often motivated to participate in activities directed toward improvement of their own health and ensuring the health of their unborn child, which also provides an opportunity for healthcare interventions such as treatment for hepatitis C virus (HCV) infection. Methods: This was a multi-site, prospective, open-label, pharmacokinetic (PK) study conducted at two large maternity hospitals in Melbourne, Australia, to evaluate the safety and pharmacokinetics of antenatal sofosbuvir (SOF) and velpatasvir (VEL) treatment administered for 12 weeks during the second and third trimester. Five women were recruited and underwent detailed PK assessments across three visits. Results: Compared to historical data in non-pregnant women, SOF area under the concentration curve (AUC) and maximum concentrations (Cmax) were 60% and 49% higher in pregnancy, respectively. In contrast, exposure to the inactive metabolite of SOF, GS-331007, was 43% lower in pregnancy. Both Cmax and AUC for VEL in pregnancy were similar to values reported in historic non-pregnant women (~21% lower in pregnant women). SOF/VEL was safe and well tolerated. Conclusions: These results add to the limited published experience prescribing antivirals in pregnancy and provide further support for a larger ongoing prospective study and other efforts to support HCV treatment in pregnancy. Full article

Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95% CI 3.70–4.75) and AD (OR 2.95, 95% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings. Full article

Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p < 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p < 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions. Full article

In Poland—especially in the less developed eastern regions—the level of health-enhancing physical activity (HEPA) remains below the WHO recommendations, and its determinants are not yet fully understood. The study was conducted as part of the international EUPASMOS PLUS project on a sample of 173 adult individuals living in eastern Poland. Physical activity was measured using accelerometers worn continuously for seven days (24/7). The duration of moderate and vigorous physical activity as well as episodes of physical activity lasting at least 10 min were analyzed. The median daily MVPA time was 50 min, and the median VPA time only 10 s, both below WHO recommendations of 150 min/week of MVPA or 75 min/week of VPA. Overall, more than 70% of participants did not meet the recommended levels. The level of HEPA was found to be below WHO recommendations, especially among men, individuals over 50 years old, and those who were professionally inactive. Higher physical activity levels were recorded among women and younger participants. Significant correlations were found between HEPA level and self-rated health status (ρ = 0.28–0.38, p < 0.001), as well as body mass index and waist circumference (ρ ≈ −0.20 to −0.30, p < 0.01). Although statistically significant, the effect sizes were small to moderate, indicating limited explanatory power. Unemployment negatively affected MVPA and VPA levels, while household size positively correlated with physical activity. Interventions promoting HEPA should consider demographic and regional diversity, with particular focus on less active groups such as older adults and the unemployed. It is also necessary to develop new screening tools aimed at easy and quick diagnosis of social groups that should be targeted by HEPA promotion strategies. Full article