Search Results (649)

Dementia prevention is a global public health priority, and lifestyle interventions, including nutrition, have gained interest for their potential to maintain cognitive health. Among nutritional interventions, omega-3 polyunsaturated fatty acids (n-3 FA), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been widely studied for their potential to support cognitive health. This systematic review evaluated whether n-3 FA supplementation improves global cognition in cognitively unimpaired older adults. Nineteen randomized controlled trials (RCTs) met inclusion criteria, of which five reported significant improvements in global cognition. A random-effects meta-analysis of 11 placebo-controlled RCTs showed no significant effect (SMD = −0.02, 95% CI: −0.07 to 0.04). Heterogeneity in supplement type, dosage, duration, and outcome measures may have contributed to inconsistent findings and limited comparability. Furthermore, methodological quality of the trials was generally low. While current evidence does not demonstrate a significant effect of n-3 FA supplementation on global cognition, future research should prioritize well-powered, longer-duration RCTs that incorporate biomarker monitoring and more appropriate doses. Clarifying the role of n-3 FA in cognitive aging remains essential for informing nutrition-based dementia prevention strategies. Full article

Osteoarthritis (OA) remains a major contributor to pain and disability; however, the current management is largely reactive, focusing on symptoms rather than preventing irreversible cartilage loss. This review first examines the mechanistic foundations for pharmacological chondroprotection—illustrating how conventional agents, such as glucosamine sulfate and chondroitin sulfate, can potentially restore extracellular matrix (ECM) components, may attenuate catabolic enzyme activity, and might enhance joint lubrication—and explores the delivery challenges posed by avascular cartilage and synovial diffusion barriers. Subsequently, a practical “What–How–When” framework is introduced to guide community pharmacists in risk screening, DMOAD selection, chronotherapeutic dosing, safety monitoring, and lifestyle integration, as exemplified by the CHONDROMOVING infographic brochure designed for diverse health literacy levels. Building on these strategies, the P4–4P Chondroprotection Framework is proposed, integrating predictive risk profiling (physicians), preventive pharmacokinetic and chronotherapy optimization (pharmacists), personalized biomechanical interventions (physiotherapists), and participatory self-management (patients) into a unified, feedback-driven OA care model. To translate this framework into routine practice, I recommend the development of DMOAD-specific clinical guidelines, incorporation of chondroprotective chronotherapy and interprofessional collaboration into health-professional curricula, and establishment of multidisciplinary OA management pathways—supported by appropriate reimbursement structures, to support preventive, team-based management, and prioritization of large-scale randomized trials and real-world evidence studies to validate the long-term structural, functional, and quality of life benefits of synchronized DMOAD and exercise-timed interventions. This comprehensive, precision-driven paradigm aims to shift OA care from reactive palliation to true disease modification, preserving cartilage integrity and improving the quality of life for millions worldwide. Full article

Cardiorespiratory fitness is a predictor of long-term health, traditionally assessed through structured exercise protocols that require maximal effort and controlled laboratory conditions. These protocols, while clinically validated, are often inaccessible, physically demanding, and unsuitable for unsupervised monitoring. This study proposes a non-invasive, unsupervised alternative—predicting the heart rate a person would reach after completing the step test, using wearable data collected during natural daily activities. Ground truth post-exercise heart rate was obtained through the Queens College Step Test, which is a submaximal protocol widely used in fitness settings. Separately, wearable sensors recorded heart rate (HR), blood oxygen saturation, and motion data during a protocol of lifestyle tasks spanning a range of intensities. Two machine learning models were developed—a Human Activity Recognition (HAR) model that classified daily activities from inertial data with 96.93% accuracy, and a regression model that estimated post step test HR using motion features, physiological trends, and demographic context. The regression model achieved an average root mean squared error (RMSE) of 5.13 beats per minute (bpm) and a mean absolute error (MAE) of 4.37 bpm. These findings demonstrate the potential of test-free methods to estimate standardized test outcomes from daily activity data, offering an accessible pathway to infer cardiorespiratory fitness. Full article

Insulin resistance (IR), a core component in the development of type 2 diabetes mellitus (T2DM), is increasingly recognized for its role in cardiovascular and pulmonary complications. This review explores the relationship between IR, right ventricular dysfunction (RVD), and decreased lung volume in patients with T2DM. Emerging evidence suggests that IR contributes to early structural and functional alterations in the right ventricle, independent of overt cardiovascular disease. The mechanisms involved include oxidative stress, inflammation, dyslipidemia, and obesity—factors commonly found in metabolic syndrome and T2DM. These pathophysiological changes compromise right ventricular contractility, leading to reduced pulmonary perfusion and respiratory capacity. RVD has been associated with chronic lung disease, pulmonary hypertension, and obstructive sleep apnea, all of which are prevalent in the diabetic population. As RVD progresses, it can result in impaired gas exchange, interstitial pulmonary edema, and exercise intolerance—highlighting the importance of early recognition and management. Therapeutic strategies should aim to improve insulin sensitivity and cardiac function through lifestyle interventions, pharmacological agents such as SGLT2 inhibitors and GLP-1/GIP analogs, and routine cardiac monitoring. These approaches may help slow the progression of RVD and its respiratory consequences. Considering the global burden of diabetes and obesity, and the growing incidence of related complications, further research is warranted to clarify the mechanisms linking IR, RVD, and respiratory dysfunction. Understanding this triad will be crucial for developing targeted interventions that improve outcomes and quality of life in affected patients. Full article

Per- or polyfluoroalkyl substances (PFASs) are man-made compounds involved in compositions of many industrial processes and consumer products. The largest-volume man-made PFAS are made up of refrigerants and fluoropolymers. Major concerns for our society related to these substances are their contribution to global warming as greenhouse gasses and the potential for adverse effects on living organisms, particularly by long-chain perfluoroalkyl acid derivatives. Restrictions on manufacturing and applications will increase in the near future. The full remediation of historical and current contaminations of air, soil and water remains problematic, especially for ultra-short PFASs, such as trifluoroacetic acid. Future monitoring of PFAS levels and their impact on ecosystems remains important. PFASs have become integrated in the lifestyle and infrastructures of our modern worldwide society and are likely to be part of that society for years to come in essential applications by closing the fluorine loop. Full article

Background/Objectives: Affecting close to one-third of the global population, metabolic dysfunction-associated steatotic liver disease (MASLD) is a highly prevalent chronic liver disorder linked to metabolic risk factors such as obesity and insulin resistance. Liver fibrosis is a key determinant of prognosis, and its progression increases the risk of liver-related and overall mortality. This exploratory research evaluated the potential impact of a 3-month intervention involving dietary counseling and liraglutide therapy on liver fibrosis and related metabolic markers in patients with MASLD and obesity without diabetes. Methods: In this prospective, single-arm exploratory intervention, 28 adult patients with MASLD and obesity received structured dietary counseling and daily subcutaneous liraglutide for 12 weeks. Liver fibrosis was assessed using non-invasive indices (FIB-4, APRI, BARD, ELF) and transient elastography performed with the FibroScan^® device (Echosens, Paris, France). Results: After 3 months, a significant reduction in liver stiffness (−7.14%, p < 0.05) and ELF score (from 6.71 to 6.63; −1.2%, p < 0.05) was observed. APRI (p = 0.06) and FIB-4 (p = 0.09) showed trends toward improvement, while the BARD score and AST/ALT ratio remained unchanged. Conclusions: Short-term liraglutide therapy combined with lifestyle modification may improve early-stage liver fibrosis in patients with MASLD and obesity, as indicated by reductions in liver stiffness and ELF score. These preliminary findings highlight the potential of advanced non-invasive fibrosis markers in monitoring treatment response. However, as an exploratory study, results should be interpreted with caution, and larger, long-term trials are needed to confirm these observations and evaluate efficacy in patients with more advanced fibrosis stages. Full article

Background/Objectives: Since breast cancer (BC) survival rates have increased to 91% at 5 years and 80% at 15 years postdiagnosis, there is a growing awareness of the importance of addressing the long-term well-being of patients. Consequently, integrative oncology, which combines standard therapies with complementary approaches (nutrition, mind–body practices, and lifestyle modifications), has emerged as a patient-centred model aimed at improving symptom management, treatment adherence, and overall quality of life (QoL). This study aims to demonstrate how integrative therapies can benefit body composition, phase angle, and fluid and electrolyte balance through bioelectrical impedance analysis (BIA). Methods: This study considers a patient who underwent BC surgery and was enrolled in the AMICO clinic for anamnesis, as well as their oncological pathology data, assessment of QoL, and BIA. The breast surgeon specialising in integrative oncology therapies prescribed the patient curcumin and polydatin, moderate physical activity, a balanced diet, and Qigong sessions. The patient underwent monitoring through haematochemical analysis, BIA, and a QoL questionnaire, with follow-up every four months. Results: Between 4 and 12 months, fat mass (FM) and body mass index (BMI) markedly decreased, whereas fat-free mass (FFM), total body water (TBW), and skeletal muscle mass (SMM) increased progressively. Moreover, the improvements in the Na/K ratio and phase angle (PhA) suggest a shift toward better electrolyte and fluid balance and enhanced cellular integrity and membrane function. Equally outstanding were her psychological benefits in terms of mood, sleep, anxiety, and melancholy. Conclusions: Patient progress in body composition, metabolic function, pain management, and psychological status measured during the 12-month follow-up demonstrates the potential benefits of an integrative approach to supportive cancer care. Full article

Obesity is a growing global health concern with widespread impacts on physical, psychological, and social well-being. Clinically, it is a major driver of type 2 diabetes (T2D), cardiovascular disease (CVD), non-alcoholic fatty liver disease (NAFLD), and cancer, reducing life expectancy by 5–20 years and imposing a staggering economic burden of USD 2 trillion annually (2.8% of global GDP). Despite its significant health and socioeconomic impact, earlier obesity medications, such as fenfluramine, sibutramine, and orlistat, fell short of expectations due to limited effectiveness, serious side effects including valvular heart disease and gastrointestinal issues, and high rates of treatment discontinuation. The advent of glucagon-like peptide-1 (GLP-1) receptor agonists (e.g., semaglutide, tirzepatide) has revolutionized obesity management. These agents demonstrate unprecedented efficacy, achieving 15–25% mean weight loss in clinical trials, alongside reducing major adverse cardiovascular events by 20% and T2D incidence by 72%. Emerging therapies, including oral GLP-1 agonists and triple-receptor agonists (e.g., retatrutide), promise enhanced tolerability and muscle preservation, potentially bridging the efficacy gap with bariatric surgery. However, challenges persist. High costs, supply shortages, and unequal access pose significant barriers to the widespread implementation of obesity treatment, particularly in low-resource settings. Gastrointestinal side effects and long-term safety concerns require close monitoring, while weight regain after medication discontinuation emphasizes the need for ongoing adherence and lifestyle support. This review highlights the transformative potential of incretin-based therapies while advocating for policy reforms to address cost barriers, equitable access, and preventive strategies. Future research must prioritize long-term cardiovascular outcome trials and mitigate emerging risks, such as sarcopenia and joint degeneration. A multidisciplinary approach combining pharmacotherapy, behavioral interventions, and systemic policy changes is critical to curbing the obesity epidemic and its downstream consequences. Full article

Aquatic plants, as sedentary lifestyle organisms that accumulate chemical substances from their surroundings, can serve as valuable indicators of long-term anthropogenic pressure. In Poland, water monitoring is limited both spatially and temporally, which hampers a comprehensive assessment of water quality. Since the implementation of the Water Framework Directive (WFD), biotic elements, including macrophytes, have played an increasingly important role in water monitoring. Moreover, running waters, due to their dynamic nature, are susceptible to episodic pollution inputs that may be difficult to detect during isolated, point-in-time sampling campaigns. The analysis of stable carbon (δ¹³C) and nitrogen (δ¹⁵N) isotope signatures in macrophytes enables the identification of elemental sources, including potential pollutants. Research conducted between 2008 and 2011 encompassed 38 sites along 15 rivers and 108 sites across 21 lakes in northern Poland. This study focused on the isotope signatures of three pondweed species: Stuckenia pectinata, Potamogeton perfoliatus, and Potamogeton crispus. The results revealed statistically significant differences in the δ¹³C and δ¹⁵N values of plant organic matter between river and lake environments. Higher δ¹⁵N values were observed in rivers, whereas higher δ¹³C values were recorded in lakes. Spearman correlation analysis showed a negative relationship between δ¹³C and δ¹⁵N, as well as correlations between δ¹⁵N and the concentrations of Ca²⁺ and HCO₃⁻. A positive correlation was also found between δ¹³C and dissolved oxygen levels. These findings confirm the utility of δ¹³C and, in particular, δ¹⁵N as indicators of anthropogenic eutrophication, including potentially domestic sewage input and its impact on aquatic ecosystems. Full article

Cardiovascular disease (CVD) remains the foremost global cause of mortality, driven significantly by modifiable lifestyle factors. This study employs a data-driven approach to identify and evaluate these risk factors using advanced machine learning techniques. Analysing a large publicly available dataset of over 300,000 adult health records containing lifestyle behaviours, clinical risk factors, and self-reported health indicators, this research implemented traditional classifiers, ensemble methods, and deep learning architectures to examine the impact of behaviours such as smoking, diet, physical activity, and alcohol consumption on CVD risk. The Random Forest model demonstrated superior performance, achieving high accuracy, recall, and ROC-AUC scores. To demonstrate real-world utility, the model was deployed as an interactive Streamlit web application. This tool allows individuals to input lifestyle and health data to receive real-time CVD risk predictions, offering a novel, user-friendly prototype that bridges machine learning insights with personalised digital health engagement. This tool can facilitate personalised health monitoring and supports early detection by providing actionable insights. The findings underscore the efficacy of predictive modelling in informing targeted interventions and public health strategies. By bridging advanced analytics with practical applications, this research offers a scalable framework for reducing CVD burden, paving the way for precision medicine and improved population health outcomes through data-driven decision-making. Full article

Precision nutrition is an emerging approach that tailors dietary recommendations based on an individual’s unique genetic, metabolic, microbiome, and lifestyle factors. β-hydroxybutyrate (β-HB) is a key ketone body produced during fat metabolism, especially in states of fasting, low-carbohydrate intake, or prolonged exercise. Therefore, monitoring β-HB levels provides valuable insights into an individual’s metabolic state, making it an essential biomarker for precision and personalized nutrition. A smartphone-connected electrochemical biosensor for single-use, rapid, low-cost, accurate, and selective detection of β-HB in whole blood and saliva at the Point-of-Care (POC) is reported. A graphite screen-printed carbon electrode modified with potassium ferricyanide (Fe(III)GSPE) was used as an electrode platform for the deposition of β-hydroxybutyrate dehydrogenase (HBDH), nicotinamide adenine dinucleotide oxidized form (NAD⁺), and chitosan nanoparticles (ChitNPs). An outer poly(vinyl) chloride (PVC) diffusion-limiting membrane was used to protect the modified electrode. The biosensor showed a linear range in the clinically relevant range, between 0.4 and 8 mM, with a detection limit (LOD) of 0.1 mM. The biosensor was tested on human blood and saliva samples, and the results were compared to those obtained with a commercial ketone meter, showing excellent agreement. Full article

Background/Objectives: Despite its well-established health benefits, adherence to the Mediterranean lifestyle (MedLife) has declined globally, including in its region of origin, alongside a significant shift toward ultra-processed food consumption. Understanding the factors associated with MedLife adherence is essential for developing targeted interventions and tailored policy recommendations. As part of the MEDIET4ALL PRIMA project, this cross-sectional study aimed to comprehensively examine geo-demographic, socio-economic, psychological, behavioral, and barrier-related factors associated with and potentially contributing to MedLife adherence. Methods: Data were collected from 4010 participants aged 18 years and above across ten Mediterranean and neighboring countries using the multinational MEDIET4ALL e-survey, which included the validated MedLife index, along with various other questionnaires. Results: Results indicate that only 22% of respondents demonstrated high adherence to the Mediterranean lifestyle (MedLife), with significant variability observed across countries, age groups, education levels, and health statuses. Spain had the highest proportion of participants with high adherence (38%). Factors associated with significantly higher adherence rates include older age, living in the Mediterranean region, higher education levels, a greater awareness of MedLife principles, lower perceived barriers, normal BMI, better health status, and stable economic and marital conditions (p-values ranging from 0.04 to <0.001). Additionally, individuals with high MedLife adherence exhibited more socially and physically active lifestyles and experienced less psychological strain (p < 0.001). Regression analyses identified MedLife awareness as the strongest positive predictor of adherence (β = 0.206), followed by social participation (β = 0.194) and physical activity (β = 0.096). Additional positive contributors include life satisfaction, sleep quality, living in the Mediterranean region, age, and education (β ranging from 0.049 to 0.093). Conversely, factors that are negatively associated with adherence include sedentary behavior, living environment, and barriers such as low motivation, taste dislike, price unaffordability, limited availability, and the time-consuming nature of preparing Mediterranean food (MedFood; β ranging from −0.036 to −0.067). Conclusions: These findings indicate that fewer than one in four adults across Mediterranean and neighboring countries demonstrate high adherence to MedLife, supporting prior evidence of suboptimal adherence even within Mediterranean regions. This study identified a range of behavioral, socio-demographic, and environmental factors—both positive and negative predictors—that can help guide the design of targeted, culturally adapted interventions to promote MedLife behavior. Future research should incorporate objective measurements and longitudinal monitoring to better understand underlying mechanisms, establish causality, and develop sustainable strategies for enhancing MedLife adherence in diverse populations. 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

Homocysteine (Hcy) is becoming a well-established risk factor for cardiovascular disease (CVD), mainly involving endothelial dysfunction and atherogenesis. Endothelial dysfunction is reflected primarily in the complex regulation of the main physiological and pathophysiological processes. There is increasing evidence regarding abnormally high concentrations of plasma total homocysteine, or plasma hyperhomocysteinemia, contributing to endothelial dysfunction, inflammation, and CVD. This clinical and experimental study examined the connection between Hcy and cardiovascular disease risk. Homocysteine is a marker of total vascular damage that must be monitored and controlled as early as possible. Dietary and lifestyle changes are recommended for most patients with hyperhomocysteinemia (Hhcy). The purpose of this paper is to review the data from the specialized literature that demonstrate that there is a direct link between endothelial injury and increased homocysteine levels, identifying existing evidence, describing new mechanisms, and exploring potential new therapeutic options. These aspects continue to be debated, and additional efforts are required to refine therapeutic strategies and to investigate the potential implications of Hcy in health and disease. Full article

The increasing prevalence of sedentary lifestyles poses significant global health challenges, including obesity, diabetes, musculoskeletal disorders, and cardiovascular issues. This paper presents the design and development of a universal smart chair system aimed at mitigating the adverse effects of prolonged sitting. The proposed solution integrates a pressure sensor, vibration motors, an LED strip, and Bluetooth Low-Energy (BLE) communication into a modular and adaptable design. Powered by an STM32WB55CGU6 microcontroller and a rechargeable lithium-ion battery system, the smart chair monitors sitting duration and the user’s posture, and provides alerts through tactile, visual, and auditory notifications. A complementary mobile application allows users to customize sitting time thresholds, monitor activity, and assess battery status. Designed for universal compatibility, the system can be adapted to various chair types. Technical and functional testing demonstrated reliable performance, with the chair operating for over eight workdays on a single charge. The smart chair offers an innovative, cost-effective approach to improving workplace ergonomics and health outcomes, with potential for further enhancements such as posture monitoring. A pilot study with 83 students at VILNIUS TECH showed that the smart chair detected correct posture with 94.78% accuracy, and 97.59% of users responded to alerts by adjusting their posture within an average of 3.27 s. Full article