Search Results (535)

Background/Objective: This study investigated the associations between dietary patterns and subjective cognitive function among older Japanese adults and examined whether these associations differed according to sleep duration. Methods: This longitudinal cohort study was conducted using data from the Community Empowerment and Care study (2017–2020). Data were obtained from the Community Empowerment and Care Study of the T-Village, Aichi Prefecture, Japan. Latent class analysis was used to identify dietary patterns based on the intake frequencies of seven food groups. Logistic regression models assessed the associations between dietary patterns and subjective cognitive function stratified by sleep duration (optimal: 7–8 h; unfavorable: <7 or >8 h). Results: Three dietary patterns were identified (diverse, balanced, restricted). Compared with the restricted pattern, the diverse (odds ratio = 0.13, 95% confidence interval: 0.07–0.26; p < 0.0001) and balanced patterns (odds ratio = 0.33, 95% confidence interval: 0.18–0.62; p = 0.0006) were associated with lower odds of poor subjective cognitive function. Associations were broadly similar across sleep groups, and interaction testing was not significant. Conclusions: Dietary quality was associated with better subjective cognitive function, particularly among older adults with unfavorable sleep duration. The study findings underscore the need for integrated lifestyle interventions that target both nutrition and sleep in aging populations. Full article

This narrative review explores the impact of diet and physical exercise both as a risk factor of central nervous system inflammatory diseases, but more importantly as potential adjunctive disease modifiers in Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorders (NMOSD), and Myelin Oligodendrocyte Glycoprotein (MOG) antibody-associated disease (MOGAD). The majority of evidence relies on MS preclinical and clinical studies, but preclinical studies also support the benefit of lifestyle intervention in NMOSD and MOGAD. In MS, adherence to healthy diets (particularly Mediterranean and MIND diets) could lead to a milder disease course with reduced relapse rates, while structured exercise from early disease stages promotes neuroprotection by upregulating neurotrophic factors and preserving brain volume, possibly impacting disease progression. The ketogenic diet and intermittent caloric restriction also showed promising results. Physical activity, including both aerobic training and resistance training, emerges as a potential disease-modifying strategy by promoting neuroprotection, reducing inflammation, and supporting functional and cognitive outcomes, particularly when implemented early in the disease course. A synergistic approach alongside disease-modifying treatments (DMTs) would further positively modulate core pathological processes. Evidence for NMOSD and MOGAD warrants further investigation. We highlight that integrating personalized lifestyle strategies would be beneficial from the early stages. However, future large-scale, standardized trials are required to fully confirm the neuroprotective potential of diet and exercise across the entire spectrum of CNS disorders. Full article

Background: The (COVID-19) pandemic profoundly disrupted daily routines and physical activity (PA), especially among university students, due to restrictions and limited access to sports facilities. As this group is particularly vulnerable to sedentary lifestyles and mental health issues, understanding their PA patterns is crucial. This study explores overall and domain-specific PA levels and the influence of sociodemographic factors, offering insights for promoting sustainable PA strategies in higher education during and beyond health crises. Methods: A cross-sectional online survey was conducted among University of Foggia students during the pandemic. The participants completed the validated Italian IPAQ-Long to assess PA across various domains. Associations with demographics and perceived barriers were analyzed via t tests, ANOVA, and nonparametric tests. Results: A total of 301 students completed the survey. Despite barriers such as limited living space, low income, and sports facility closures, 66% of the participants reported high PA levels, mainly through work-related and leisure activities. This remains insufficient. PA varied significantly by gender, income, residence, and employment status: males reported higher leisure PA, whereas females engaged more in active transport and domestic activities. Rural residents and those with moderate incomes demonstrated higher overall PA, whereas employed students presented lower activity levels. These findings underscore the complex socioeconomic and environmental factors shaping PA behavior during an unprecedented global health crisis. Conclusions: The findings reveal that students’ resilience in maintaining PA is a coping mechanism despite socioeconomic and environmental barriers. Tailored, accessible PA initiatives integrated into university curricula can enhance student well-being, academic performance, and long-term health during and after public health emergencies. Universities should adopt accessible, equity-oriented PA initiatives to promote physical and mental health and enhance public-health preparedness during future emergencies. Full article

Adult hippocampal neurogenesis (AHN) is a dynamic process that sustains neural plasticity and contributes to cognition, emotion, and stress resilience. While its functional significance in humans remains debated, growing evidence suggests that AHN plays an important role in health and disease. In this review, we summarize intrinsic and extrinsic factors that modulate AHN, with particular emphasis on hormones, behavior, diet, and their impact along the hippocampal dorsoventral axis, where baseline neurogenesis is higher dorsally, but ventral neurogenesis exhibits greater plasticity and sensitivity to modulatory systems. We highlight how cognitive stimulation, physical activity, and rewarding experiences preferentially enhance dorsal hippocampal neurogenesis, whereas chronic stress and glucocorticoids mainly impair neurogenesis in the ventral hippocampus. Nutritional influences such as caloric restriction, high-fat diets, vitamins, and polyphenols are also considered, with evidence for region-specific effects. We further examine the relevance of AHN alterations in neuropsychiatric diseases, such as major depressive disorder, schizophrenia, Alzheimer’s disease, and addiction, highlighting both common mechanisms and disorder-specific vulnerabilities. Collectively, current findings suggest that AHN serves as a converging pathway connecting lifestyle, neuroendocrine regulation, and psychiatric or neurodegenerative disease. Recognizing the dorsoventral specialization of AHN could refine mechanistic models of brain function and inform the development of targeted and distinct therapeutic strategies for cognitive and affective diseases. Full article

Background/Objectives: Reducing the dietary intake of sugar and salt is considered a key strategy for preventing the onset and progression of lifestyle-related diseases. However, these dietary interventions often compromise the taste of foods, which can reduce patient satisfaction. To address this challenge, we focused on novel food-derived particles (NFPs; patent number P7383867) consisting of lipid, α-cyclodextrin, and xanthan gum formulated as an emulsion with excellent retention and diffusion properties. Methods: Here, we investigated the effects of NFPs on the taste responses of mice. Results: In two-bottle preference tests (n = 4–6), NFPs enhanced preferences for sweet and salty stimuli in behavioral tests (one-way ANOVA, p < 0.05) and increased the responses of the chorda tympani nerve (n = 6–8) to sweet and salty stimuli (two-way ANOVA, main treatment effect p < 0.05), but had no effect on the responses to sour, bitter, or umami stimuli. Conclusion: These findings suggest that NFPs may enhance peripheral taste responses to sweet and salty flavors, thereby helping maintain the palatability of foods with reduced sugar or salt content. Such modulation may have broad applications in improving the acceptability of therapeutic or restricted diets and supporting both disease management and prevention, including lifestyle-related diseases, kidney disease, and other conditions requiring dietary restriction and may offer translational relevance for human dietary interventions. Full article

Background/Objectives: Interventions promoting the Mediterranean Diet (MedDiet) and healthy lifestyle behaviours are effective and cost-efficient in preventing non-communicable diseases (NCDs), yet sustaining adherence remains challenging. This study explored perceived health impacts on, barriers to, and facilitators of adherence among older Spanish adults participating in a randomised clinical trial (RCT) based on the MedDiet and lifestyle interventions. Methods: A qualitative study was conducted with 17 Spanish participants (aged 60–81 years) with overweight/obesity and metabolic syndrome (MetS). In-depth, semi-structured interviews were audio-recorded, transcribed verbatim, and analysed through inductive thematic analysis with a gender-sensitive approach. Results: Participants identified several facilitators, including perceived improvements in vitality, psychological well-being, and physical performance, alongside enhanced nutritional literacy and confidence in orchestrating daily dietary practices. Women emphasised empowerment, autonomy, and the satisfaction of promoting family health. Main barriers included low motivation, disease burden, mobility restrictions, and limited partner support, with women particularly highlighting emotional and relational factors. A continuous, trust-based relationship with the research team acted as a strong external facilitator supporting long-term commitment. Conclusions: Perceived health gains, self-efficacy, social engagement, and research team support facilitated adherence, while low motivation, illness burden, and limited partner involvement hindered it. These findings highlight the importance of gender- and context-sensitive strategies to optimise adherence and the long-term effectiveness of Mediterranean lifestyle interventions. Full article

Background: Obesity is a multifactorial chronic disease associated with increased risk of metabolic disorders, reduced quality of life, and rising healthcare costs. Although weight reduction is achievable through various dietary approaches, maintaining the achieved results remains a major clinical challenge. This review aims to identify and discuss dietary, behavioral, and lifestyle strategies that support long-term weight loss and weight maintenance. Methods: A narrative literature review was conducted in two stages using PubMed, Scopus, and Google Scholar. The search included peer-reviewed studies published between 2015 and 2025 focusing on individuals with overweight and obesity. Randomized controlled trials, observational studies, systematic and narrative reviews, and meta-analyses discussing short-term and long-term weight loss outcomes and factors influencing the maintenance of reduced body weight were included. Results: Multiple nutritional strategies, including continuous and intermittent energy restriction, very low-calorie diets, and macronutrient modification, can be effective for weight reduction. However, long-term outcomes are primarily dependent on adherence and consistent implementation of recommendations. Behavioral and psychological factors, such as emotional eating, dietary fatigue, and unrealistic expectations, often contribute to weight regain. Social support, personalized dietary strategies, and sustainable lifestyle habits are key determinants of maintaining weight loss. The current evidence base is limited by the scarcity of long-term follow-up studies and high methodological variability across interventions. Conclusions: Long-term weight management requires a comprehensive, individualized approach that integrates dietary strategies with behavioral and lifestyle support. Strengthening adherence and addressing psychological and environmental factors may significantly improve the effectiveness and durability of obesity treatment. Full article

Cancer remains a leading global cause of morbidity and mortality. Modifiable lifestyle factors, including avoidance of tobacco use and excessive ultraviolet radiation, healthy dietary patterns, regular physical activity, and weight management, play key roles in prevention and care. This narrative review synthesizes evidence on lifestyle-based interventions influencing cancer risk, treatment tolerance, and survivorship. A literature search was conducted in PubMed and Scopus, supplemented by manual screening via Google Scholar. The time frame (2001–2025) was selected to reflect evidence produced within the modern era of molecular oncology and contemporary lifestyle medicine research. Eligible publications addressed carcinogen exposure (tobacco, alcohol, ultraviolet radiation), diet and nutritional strategies, physical activity, sedentary behavior, obesity, metabolic health, complementary therapies, and cancer outcomes. Evidence indicates that reducing exposure to tobacco and ultraviolet radiation remains central to cancer prevention. Adherence to predominantly plant-based diets, regular physical activity, and maintenance of healthy body weight are consistently associated with lower incidence of several cancers, including breast, colorectal, and liver cancer. Nutritional strategies such as caloric restriction, ketogenic diets, and fasting-mimicking diets show promise in improving treatment efficacy and quality of life. Complementary and mind–body therapies may alleviate treatment-related symptoms, although high-quality evidence on long-term safety and effectiveness is limited. Integrating lifestyle medicine into oncology offers a cost-effective, sustainable strategy to reduce cancer burden and enhance survivorship. Comprehensive programs combining carcinogen avoidance, dietary regulation, structured exercise, and effective radiation risk mitigation may extend healthspan, improve treatment tolerance, and help prevent recurrence. Full article

Obesity remains a major global health challenge, with glucagon-like peptide-1 receptor agonists (GLP-1RAs) providing substantial yet sensitive benefits in weight reduction, glycemic control, and cardiovascular protection. Despite robust trial data, real-world persistence is limited by cost, tolerability, and hedonic adaptation. Intermittent fasting and time-restricted eating offer physiologically complementary, low-cost strategies that enhance fat oxidation, insulin sensitivity, and metabolic flexibility while engaging behavioral mechanisms of self-control and dietary regularity. This narrative review synthesizes current evidence and proposes a pragmatic, phased framework integrating GLP-1RA therapy with structured intermittent fasting and protein-optimized nutrition. The model emphasizes sequential initiation, transition, and maintenance phases designed to align pharmacologic appetite suppression with lifestyle-driven metabolic remodeling. Mechanistically, GLP-1RAs target vascular and neuroendocrine pathways, whereas fasting activates nutrient-sensing networks (AMPK, mTOR, sirtuins) associated with autophagy and longevity. Combined application may preserve lean mass, improve psychological autonomy, and reduce healthcare costs. Future research should validate this hybrid strategy in randomized trials assessing long-term weight durability, functional outcomes, and cost-effectiveness. By uniting pharmacologic potency with behavioral sustainability, phased GLP-1–fasting integration may represent an effective, affordable, and longevity-oriented paradigm for metabolic health. Full article

Background: Ageing leads to physical, cognitive, and social changes that affect people’s functioning and social participation. Health literacy, sociodemographic, and environmental factors influence health outcomes and access to care. This study aimed to characterize the health and functioning of Portuguese adults aged 65 and over, focusing on sociodemographic factors, health status, lifestyle, fall risk, functional capacity, and social participation, and on comparing rural and urban populations. Materials and Methods: An exploratory, cross-sectional study was conducted using data from older adults who completed the FallSensing screening protocol. Participants were classified by residence type (rural vs. urban), and group comparisons were made. Results: The sample (n = 474) was predominantly female (66.5%) with a mean age of 74.62 (±6.49) years. Rural participants were older (76.87 ± 6.89 vs. 73.50 ± 5.87) and had higher body mass index (BMI) (28.32 ± 4.31 vs. 27.51 ± 4.12), lower educational attainment—for example, 22.9% had no formal education compared to 7.0% of urban participants—and a higher prevalence of hypertension (72.6% vs. 55.4%), whereas urban participants experienced higher rates of osteoporosis (24.4% vs. 14.3%), hearing loss (41.9% vs. 26.9%), and alcohol consumption (12.7% vs. 2.3%) (p ≤ 0.05). Rural residents also demonstrated significantly poorer results for grip strength (21.03 ± 7.36 vs. 23.73 ± 8.61), gait speed (1.17 ± 0.44 vs. 1.45 ± 0.39), and the Timed Up and Go (TUG) test (13.4 ± 10.40 vs. 9.62 ± 4.43), as well as lower exercise self-efficacy (12.83 ± 4.97 vs. 14.28 ± 4.40) (p < 0.001), and more pronounced moderate-to-severe restrictions in social participation (28.0% vs. 15.7%) (p = 0.013). They reported greater use of assistive devices and more severe limitations in social participation. Although falls were reported more often in urban areas, rural residents experienced greater fall frequency. Conclusions: These findings suggest that rural living is associated with lower functional capacity and poorer health, underscoring the need for targeted physiotherapy and primary care strategies in rural settings. Full article

Obesity and its related disorders, such as type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatotic liver disease (MASLD), represent a worldwide health challenge, which is driven primarily by the dysfunction of the adipose tissue–gut–liver axis. This article compiles mechanistic and translational data on curcumin and its analogs as multi-organ regulators targeting this axis. Curcumin plays a pleiotropic role by modulating adipogenesis, lipid metabolism, inflammation, fibrosis, and thermogenic remodeling in adipose tissue, tailoring gut microbial diversity, gut barrier integrity, and metabolic endotoxemia. Curcumin in the liver attenuates steatosis, oxidation, and fibrosis by inhibiting lipogenesis, increasing β-oxidation, and modulating the NF-κB and TGF-β signal pathways. These actions result in overall systemic insulin sensitivity and energy balance. On the contrary, the clinical application of curcumin is restricted due to its low solubility, instability, and poor bioavailability. New formulations (nanoparticles/liposomes/micelles) together with structurally enhanced analogs such as tetrahydrocurcumin and monocarbonyl analogs (C66, B2BrBC) exhibited superior pharmacokinetic and tissue-targeting properties in preclinical models. Pilot and randomized clinical trials suggest that curcumin supplementation enhances glucose and lipid metabolism, reduces liver fat content, and modulates inflammatory markers; however, results across studies remain heterogeneous. Large, high-quality multicenter trials using rigorously standardized, bioavailable curcumin formulations are still required to reliably establish the efficacy and safety of curcumin in metabolic diseases. Next steps involve comparing curcumin analogs, conducting multi-omics analyses to understand host–microbiota–organ crosstalk, and determining cooperative approaches with lifestyle and pharmacological interventions. Taken together, curcumin and its next-generation derivatives may offer a novel therapeutic approach to intervene in the adipose tissue–gut–liver axis for the treatment of obesity-related metabolic diseases. Full article

Obesity and overweight conditions, frequently accompanied by hypercholesterolemia, are major risk factors for cardiovascular disease. Lifestyle interventions remain the cornerstone of non-pharmacological treatment; however, their effectiveness in improving lipid profiles is limited. Intermittent hypoxic training (IHT) has recently emerged as a potential strategy to enhance metabolic outcomes. This study aimed to evaluate the effects of a 4-week intensive IHT program combined with a calorie-restricted diet on lipid profile and body composition in men with overweight or obesity and secondary hypercholesterolemia. Twenty physically inactive men (35.3 ± 5.4 years) were randomly assigned to either a hypoxic group (H, n = 10) or a normoxic control group (C, n = 10). Both groups followed the same training protocol and diet, differing only in environmental training conditions. Body composition, resting metabolic rate, and blood lipid parameters (total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C; non-high-density lipoprotein cholesterol, non-HDL-C; Triglycerides, TG) were assessed before and after the intervention. Compared with the C group, participants in the H group achieved significantly greater reductions in body mass (−5.4% vs. −2.6%, p < 0.05) and fat mass (−14.7% vs. −7%, p < 0.01). IHT also induced marked decreases in TC (−22.6%, p < 0.001), LDL-C (−25.8%, p < 0.001), non-HDL-C (−26.5%, p < 0.001), and TG (−31.4%, p < 0.01), along with a significant improvement in the atherogenic index of plasma (AIP, −24.4%, p < 0.05). In contrast, the C group showed only non-significant downward trends. No significant changes in HDL-C were observed in either group. These findings suggest that IHT combined with dietary restriction produces more favorable changes in lipid profile and body composition than normoxic training. IHT may therefore represent a promising adjunct to conventional lifestyle-based interventions in the management of obesity-related hypercholesterolemia. Full article

Patient-reported outcome measures (PROMs) are integral to assessing patient function, quality of life, and pain both before and after knee arthroplasty (KA). Given the frequently excellent outcomes associated with KA, meaningful comparisons between patient cohorts or interventions require validated, precise PROMs that reliably reflect patient priorities and satisfaction. However, patients undergoing KA today have different demographic characteristics, different expectations, and different outcomes from those for whom these metrics were originally designed. Given changing lifestyles, many items in legacy PROMs may no longer represent priorities for patients in their postoperative recovery, and current evidence suggests that many are not associated with patient satisfaction. The frequent ceiling effects observed in PROMs for some subgroups following KA limit their reliability and utility in assessing outcomes for high-functioning patients. Whilst combining multiple PROM tools can provide a better, more holistic overview of patient outcome, it carries with it a significant burden and feasibility restriction. Item response theory and computerised adaptive testing present opportunities to collect PROMs from patients in a convenient manner and minimise question burden. Contemporary PROM collection requires both these innovative collection tools and analytic techniques, and questions that reliably reflect the priorities of the modern-day patient undergoing KA. Full article

Background: Obesity is a multifactorial disease with significant physical, psychological, and economic impacts on individuals and society. Workers are particularly vulnerable, as obesity is associated with reduced productivity, absenteeism, and premature mortality. Lifestyle interventions combining dietary, physical activity, and behavioural strategies have been investigated as therapeutic approaches in this population. Objective: We aimed to conduct an integrative review assessing the effectiveness of workplace-based obesity treatment models involving dietary interventions, physical activity, and behavioural change. Methods: A search was conducted in PubMed for studies published between 2006 and 2024, with no language restrictions. Eligible studies included experimental or quasi-experimental longitudinal designs involving adult workers. After screening 95 articles, 18 were evaluated in full, and 8 met all inclusion criteria. Data extraction covered study design, intervention type, comparators, outcomes, and methodological quality, assessed using the Newcastle–Ottawa Scale. Results: Half of the included studies reported no significant reduction in body mass index after 6 or 12 months, while the others showed only modest decreases. Nevertheless, all interventions demonstrated improvements in dietary habits (reduced sugar-sweetened beverage intake, increased fruit, vegetable, and fibre consumption), physical activity (increased walking, reduced sedentary behaviour), and behavioural domains (adherence to healthy routines, self-monitoring, and family or employer support). Conclusions: Lifestyle-based workplace interventions for obesity show limited long-term effectiveness in weight reduction but promote healthier lifestyle habits, cardiometabolic health, and more supportive work environments. Future research should include diverse socioeconomic settings, particularly in developing countries, and apply robust designs, longer follow-ups, and innovative strategies to enhance adherence and outcomes. Full article

Objectives: Gestational diabetes mellitus (GDM), particularly when combined with overweight or obesity, is associated with adverse neonatal outcomes such as high birth weight and increased adiposity. We determined the effect of a preconception lifestyle intervention initiated before and continued throughout pregnancy on neonatal, birth-related, and body composition outcomes at birth and 6–8 weeks of age in children of participants in the BEFORE THE BEGINNING randomized controlled trial. Methods: People (N = 167) at increased risk of GDM and planning pregnancy were randomly allocated 1:1 to intervention or control. The intervention included time-restricted eating and exercise training. Time-restricted eating involved consuming all energy within ≤10 h/day, ≥5 days per week, and the amount of exercise was set using a heart rate-based physical activity metric (Personal Activity Intelligence, PAI), with the goal of ≥100 weekly PAI points. The main outcome of interest in this report was the proportion of infants with birth weight > 4.0 kg. Results: Among 106 live births, 21% (11/53) of infants in the intervention group and 28% (15/53) in the control group had birth weight > 4 kg (p = 0.367). Mean birth weight did not differ significantly between groups (mean difference −159.3 g, 95% confidence interval −375.7 to 57.2, p = 0.148). No significant between-group differences were found for additional neonatal, birth-related, or early postnatal body composition outcomes. Conclusions: In this secondary analysis, we found no evidence of effects of a preconception lifestyle intervention on the risk of macrosomia or neonatal body composition. Full article