Search Results (1,553)

Physical inactivity contributes to type 2 diabetes (T2D), but the molecular links between exercise and metabolic improvement remain incompletely understood. We meta-analyzed genome-wide association studies of vigorous physical activity and T2D (combined n ≈ 1.95 million) and integrated eQTL/sQTL maps with single-cell and spatial transcriptomic datasets to connect genetic risk with tissues, cell types, and regulatory programs. Tissue and cell-type enrichment, colocalization, and network analyses were performed. Computational findings were further examined in male 10-week-old C57BL/6J mice with high-fat diet-induced diabetes. After 1 week of acclimatization, mice were randomly assigned to normal chow, high-fat diet, or high-fat diet plus exercise groups (n = 6 per group; high-fat diet with 60% of total energy from fat). The exercise intervention consisted of treadmill running (10 m/min for 50 min per day, 5 days per week, total 16 weeks), followed by metabolic phenotyping, skeletal muscle histology, bulk RNA sequencing, alternative splicing analysis, and RT-qPCR of Mau2 isoforms. Exercise- and T2D-associated variants showed joint enrichment in skeletal muscle and adipose eQTL/sQTL signals. Integrated single-cell analyses prioritized fibro-adipogenic progenitors and endothelial cells, and identified an extracellular matrix- and collagen-related module in fibro-adipogenic progenitors associated with both exercise and T2D. Mau2 emerged as a shared candidate gene with tissue-specific splicing signals. In diabetic mice, exercise improved glucose homeostasis and muscle fiber structure, and reduced Mau2 intron retention in skeletal muscle without changing total Mau2 expression. These findings support a multiscale framework linking exercise-responsive regulation to T2D-related tissue remodeling and splicing plasticity. Full article

Background: Diabetes is a growing public health crisis across the Arab region, where rapid urbanization, dietary transitions, and physical inactivity have contributed to some of the highest diabetes rates globally. Despite a growing recognition of the problem, most diabetes prevention efforts in the region remain small-scale or insufficiently adapted to the sociocultural realities of adults living in the UAE. Evidence-based diabetes prevention strategies, such as the United States’ Centers for Disease Control Diabetes Prevention Program (DPP), reduce the risk of developing diabetes but remain underutilized. Methods: The objectives of this study were to (1) describe the systematic cultural adaptation of the Evidence-based Intervention for Diabetes Prevention (EID) using the Framework for Reporting Adaptations and Modifications–Expanded (FRAME), and (2) assess the preliminary acceptability of the adapted materials through formative focus groups. Results: Materials were culturally tailored to address both deep and surface structures. Deep structure adaptations incorporated Arab cultural values, social norms, and religious practices, including Ramadan-specific content. The original 26-session curriculum was condensed to 12 weekly sessions based on prior research and stakeholder input. Surface-level adaptations included translation into Arabic and development of culturally relevant educational videos. Three formative focus groups (n = 7 total participants) provided preliminary findings of strong acceptability of simplified, culturally relevant, and digitally supported materials. Conclusions: This work will inform the adaptation of an evidence-based lifestyle change program aimed at preventing type 2 diabetes in high-risk individuals to better meet the needs of adults living in the UAE. While some countries have created their own national diabetes prevention efforts, like the United Kingdom, there is notably no similar program in the Arab world. Full article

Survival rates in pediatric cancer have increased substantially over recent decades. However, children and survivors frequently experience treatment-related alterations in physical function, body composition, bone health, and metabolic regulation. Chemotherapy, glucocorticoid exposure, physical inactivity, nutritional imbalance, and inflammatory and neuroendocrine disturbances may contribute to reduced lean mass, decreased bone mineral density, sarcopenic obesity, and long-term cardiometabolic risk. This narrative review critically summarizes current evidence on multimodal exercise and nutritional interventions in pediatric oncology, with particular attention to their effects on physical function, body composition, nutritional status, and metabolic health. Literature searches were conducted in PubMed, Scopus, and Web of Science up to April 2026, combining contextual evidence with studies evaluating combined exercise and nutritional strategies. Current evidence suggests that structured and supervised exercise, particularly resistance and combined aerobic–resistance training, is feasible and safe, and may improve cardiorespiratory fitness, muscle strength, functional capacity, and body composition. Nutritional care should be individualized, prioritizing adequate protein intake, micronutrient status, periodic reassessment of energy requirements, and body composition rather than relying on BMI alone. Nevertheless, available findings remain limited by small sample sizes, heterogeneous protocols, variable supervision, inconsistent outcome assessment, and limited long-term follow-up. Integrating exercise, nutrition, and regular monitoring into pediatric oncology care may help mitigate treatment-related functional and metabolic complications. Future studies should prioritize adequately powered randomized trials, standardized intervention protocols, objective monitoring of exercise intensity, harmonized body composition and functional outcomes, and longer follow-up to define clinically applicable multimodal care models. Full article

Background: Sexual health is a fundamental pillar of well-being during the perinatal period. However, many studies suffer from scoring bias associated with zero values by failing to distinguish between women who are sexually inactive and those with physiological dysfunction. This study aimed to identify the distinct sociodemographic and psychological determinants of sexual inactivity versus sexual dysfunction quality in a Romanian perinatal cohort. Methods: An observational, cross-sectional study was conducted with 100 women (52% sexually active, 48% inactive). Participants were evaluated using the Female Sexual Function Index (FSFI), Patient Health Questionnaire-9 (PHQ-9), RSES (Rosenberg Self-Esteem Scale), and Generalized Anxiety Disorder-7 (GAD-7). Data were analyzed using binary logistic regression for activity status and multiple linear regression for functional quality. Results: Among sexually active women, 84.6% met the clinical criteria for sexual dysfunction (median FSFI = 21.6). Binary logistic regression revealed that self-esteem (RSES) was the sole independent predictor of sexual activity status (aOR = 1.144; 95% CI: 1.028–1.217, p = 0.016). Conversely, multiple linear regression showed that depression (PHQ-9) was the only significant independent predictor of functional quality (B = −0.73, p = 0.006). Maternal age, residence, and obstetric history did not significantly predict either outcome. Conclusions: Based on the findings of our preliminary, exploratory study, we propose a conceptual interpretation, framing perinatal sexuality as a potential two-stage process, where self-esteem appears to serve as a primary behavioral barrier for the resumption of intimacy, while depression serves as the primary disruptor of functional quality. Clinical interventions may benefit from moving beyond physical recovery to include psychological screening for body image and mood disorders to restore sexual quality of life. Full article

Sarcopenia, characterized by progressive loss of muscle mass and function, is highly prevalent among patients with heart failure (HF) and contributes to frailty, disability, and poor prognosis. Shared mechanisms—chronic inflammation, neurohormonal dysregulation, mitochondrial dysfunction, inactivity, and inadequate nutrition—promote anabolic resistance and accelerate muscle wasting. This narrative review summarizes current evidence on the interplay between HF and sarcopenia, focusing on practical strategies for integrated management. Exercise training, particularly combined aerobic and resistance programs, improves physical performance and quality of life, while targeted nutritional interventions ensure adequate energy and protein intake and mitigate malnutrition. Emerging evidence supports the synergistic benefit of coupling tailored dietary support with structured rehabilitation. Despite robust data, implementation of person-centered, multidisciplinary care remains limited. Routine screening for sarcopenia and nutritional risk should be embedded in HF pathways to enable early intervention, functional recovery, and improved long-term outcomes. Full article

Physical inactivity and declining health-related physical fitness among college students are growing global public health concerns. High-intensity interval training (HIIT) is a time-efficient strategy to improve multiple components of health-related physical fitness. Emerging evidence suggests that exercise timing may influence physiological responses and adherence through circadian rhythm regulation; however, its feasibility in college settings, particularly in China, remains unclear. This study aims to evaluate the feasibility and preliminary effectiveness of an eight-week time-specific HIIT programme among Chinese college students, and to compare outcomes between morning and evening training. In this mixed-methods feasibility randomized controlled trial, approximately 72 students with low physical activity levels and intermediate chronotype will be randomly assigned to a morning HIIT group, evening HIIT group, or control group. Intervention groups will complete three HIIT sessions per week for eight weeks. Primary outcomes include feasibility indicators (recruitment, retention, adherence, and data completeness). Secondary outcomes assess changes in body composition, cardiorespiratory fitness, muscular strength, endurance, and flexibility. Quantitative data will be analysed using descriptive and repeated-measures methods, while qualitative interviews will be thematically analysed. Findings will inform the feasibility and design of future large-scale trials and contribute to chrono-exercise research in college populations. Full article

Chronic obstructive pulmonary disease (COPD) imposes a substantial physical and psychosocial burden, yet the role of loneliness remains under-recognised in clinical practice. Loneliness, defined as a subjective discrepancy between desired and actual social relationships, has emerged as a clinically relevant determinant of patient outcomes. This narrative review synthesises current evidence on the epidemiology, mechanisms, and clinical consequences of loneliness in COPD, and evaluates its implications for disease management. Available evidence indicates that loneliness affects a considerable proportion of individuals with COPD, with prevalence estimates ranging from approximately 18% to over 30%, particularly among patients with greater symptom burden, functional limitation, and oxygen dependence. Dyspnoea and advancing disease severity reduce social participation and increase vulnerability to perceived social disconnection. Loneliness influences COPD outcomes through interconnected behavioural, biological, and healthcare engagement pathways, including systemic inflammation, neuroendocrine stress responses, physical inactivity, impaired self-management, and reduced engagement with healthcare services. These mechanisms contribute to poorer clinical trajectories, as loneliness is consistently associated with reduced health-related quality of life, increased exacerbations, higher healthcare utilisation, greater risk of hospitalisation, and elevated mortality, independent of depression and anxiety. Despite this, loneliness is rarely assessed in routine respiratory care, and targeted interventions remain limited. Emerging strategies, including pulmonary rehabilitation, peer support, and digital health interventions, show promise in reducing loneliness and improving outcomes. Loneliness represents a modifiable and clinically actionable risk factor in COPD, and its integration into routine assessment and management may enhance patient engagement, optimise treatment effectiveness, and reduce healthcare burden. Addressing loneliness represents a critical opportunity to advance more effective and comprehensive COPD care. Full article

Background/Objectives: Sarcopenia—the progressive loss of skeletal muscle mass and function—is a growing public health challenge in ageing populations. Island territories face compounded vulnerabilities due to distinct epidemiological and socio-economic profiles. This study examines sarcopenia risk prevalence among community-dwelling older adults in Tenerife (Canary Islands, Spain) and estimates the economic burden alongside the cost-effectiveness of evidence-based interventions. Methods: A cross-sectional study was conducted among 374 community-dwelling older adults (mean age 80.4 years, SD 4.8; 51.1% female) recruited from primary care health centres across three health zones in Tenerife. Participants were stratified into a control group without established chronic disease-related functional decline (Group 1; n = 274) and a case group with multimorbidity and functional limitations (Group 3; n = 100). Sarcopenia risk was assessed using the SARC-F questionnaire (threshold ≥ 4). A comprehensive geriatric battery—including the Barthel Index, FRAIL scale, MNA-SF, Pfeiffer test, SPPB, handgrip dynamometry, and IPAQ—characterised multidimensional vulnerability. Annual direct and indirect costs were estimated using unit costs from Spanish national health accounts, and intervention cost-effectiveness was modelled using published meta-analytic data. Results: Overall sarcopenia risk prevalence was 36.4% (n = 136; SARC-F ≥ 4), rising to 83.0% in the case group versus 19.3% in controls (OR ≈ 21.5, p < 0.001). Prevalence was 42.1% in males and 30.9% in females. Diabetes was independently associated with elevated risk (44.8% vs. 29.9%; OR 1.90, 95% CI 1.23–2.92; p = 0.003). Health Zone 1 exhibited the highest prevalence (63.0%) versus Zones 2 (23.5%) and 3 (32.8%). Multidimensional vulnerability was pervasive: 28.6% of participants were frail, 75.7% had nutritional compromise, 11.5% showed moderate cognitive impairment, and 89.8% reported low or no physical activity. The estimated annual socio-economic cost of sarcopenia in Tenerife is approximately EUR 88.9 million (Spain nationally: EUR 12.1 billion). Combined exercise–nutrition interventions yield cost-per-QALY ratios of EUR 3800–7000, far below Spain’s EUR 25,000/QALY threshold. Conclusions: Sarcopenia constitutes a major, multidimensionally compounded health burden in Tenerife’s older population, concentrated among frail, diabetic, nutritionally compromised, and physically inactive individuals. The economic case for universal SARC-F screening and multicomponent intervention is compelling, exceeding cost-effectiveness thresholds by a wide margin. Territorial disparities in burden call for equity-oriented, place-based resource allocation within the Canarian health system. Full article

Background: Diabetes mellitus (DM) is an emerging public health challenge in Africa, driven by rapid urbanisation, changing lifestyles and socio-economic transitions. As the global prevalence rises, evidence on the burden and determinants of DM across African countries remains fragmented and inconsistent. Objective: We aimed to synthesize evidence from existing systematic reviews and meta-analyses on the prevalence and determinants of diabetes mellitus across African populations, thereby informing targeted interventions and policy actions. Methods: This umbrella review followed the PRISMA guidelines and included systematic reviews and meta-analyses of studies, published up to December 2024, that reported on DM prevalence and/or risk factors for DM in adults across four African countries. The literature was retrieved from PubMed, Scopus, Web of Science and African Journals Online (AJOL). Quality assessment was conducted using the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews, version 2) tool, and only moderate- to high-quality reviews were retained. Random-effects models were used to estimate the pooled prevalence and odds ratios (ORs), while heterogeneity, publication bias and sensitivity analyses were also conducted. Findings: Seven reviews were included, covering four countries: Ethiopia, South Africa, Nigeria and Ghana. The pooled prevalence of diabetes mellitus was 9.0% (95% CI: 6.0–12.0%), with significant heterogeneity (I² = 99.8%). Among the determinants, only family history of DM (OR:5.11, 95% CI: 2.96–8.85), hypertension (OR: 2.52; 95% CI: 1.65–3.83), obesity (OR: 3.04; 95% CI: 1.92–4.82), physical inactivity (OR: 3.32; 95% CI: 1.99–5.54), smoking (OR: 2.59; 95% CI: 1.23–5.47), unhealthy diet (OR: 4.77; 95% CI: 1.73–13.18) and urban residence (OR: 5.81; 95%CI: 4.41–7.65), showed a statistically significant association. Sensitivity analysis confirmed the robustness of pooled prevalence, and no significant publication bias was detected. Conclusions: Diabetes mellitus prevalence in Africa is rising and approaching the global averages. The heterogeneity in risk factors underscores the need for localised, context-specific strategies. Full article

Background: Physical inactivity among Saudi Arabian adolescents is a critical public health concern due to its contribution to the rising prevalence of overweight, obesity, and non-communicable diseases. Despite this, the motivational profiles and perceived barriers that differentiate athletic from non-athletic adolescents remain understudied in the Saudi literature, particularly within the school Physical Education (PE) context. Grounded in Self-Determination Theory (SDT), the present study examined the factors preventing and motivating Saudi adolescents to engage in physical activity (PA) and discusses findings in terms of their implications for PE teachers and school-based intervention. Method: A cross-sectional study was conducted with 124 male high school students in Riyadh (mean age: 16.79 ± 0.66 years). Participants were categorized as either athletes (n = 70) or non-athletes (n = 54) based on pre-defined engagement criteria: athletes were required to report vigorous-intensity sport participation on three or more days per week for a minimum of 60 min per session. Anthropometric measurements, lifestyle behaviors (diet, screen time, sleep), motivations, and barriers were assessed using the validated Arab Teens Lifestyle Study (ATLS) questionnaire. Independent samples t-tests and chi-square tests were used to compare between-group differences; effect sizes are reported. Result: Non-athletes had a significantly higher mean BMI (29.40 ± 6.77 kg/m²) and waist circumference (98.65 ± 21.63 cm) compared to athletes (BMI: 22.19 ± 4.44 kg/m²; waist: 78.84 ± 9.51 cm; both p < 0.001). No significant differences were observed in screen time, sleep duration, or dietary habits. The primary motivations for PA among athletes were health benefits (27.1%), recreation (25.7%), and competition (20.0%), reflecting an autonomous motivational profile consistent with SDT. Among non-athletes, the predominant barriers were the lack of suitable facilities (25.9%) and the absence of an exercise partner (22.2%); reflecting unmet SDT needs for competence and relatedness respectively, while only 9.3% cited having a lack of time. Conclusions: Non-athletic participants face a significant health disadvantage characterized by higher rates of overweight and central obesity. In contrast to global trends, where academic commitments dominate barriers to PA, the principal barriers in this population are environmental and social, reflecting unmet psychological needs that PE teachers are uniquely positioned to address. Rather than focusing solely on infrastructure, PE promoters should implement need-supportive teaching practices, including competence-building tasks and cooperative peer structures, to foster the intrinsic motivational profile observed in the athletes and promote long-term PA adherence among non-athletic students, in alignment with the health objectives of Saudi Vision 2030. Full article

Background/Objectives: Nutritional rickets is a childhood bone disorder leading to skeletal deformities and life-long disabilities. Early-stage diagnosis remains challenging due to the limited availability of non-invasive tools. This study explores metabolic variation associated with the active disease stages and with etiological factors, such as nutritional deficiencies and biochemical alterations. Methods: Untargeted ¹H NMR spectroscopy-based metabolomics were performed on urine and plasma samples collected from Bangladeshi children with radiologically active rickets (AR; n = 24; aged 2.98 ± 1.19 years), inactive rickets (IR; n = 36; aged 3.39 ± 1.87 years), and healthy matched controls (n = 58; aged 3.58 ± 1.59 years). This analysis also integrated corresponding clinical biochemistry and dietary intake data previously collected from the cohort. Results: Orthogonal Partial Least Squares-Discriminant Analysis (OPLS-DA) identified the 24 h urinary excretion of 13 metabolites to vary with AR, including those previously associated with bone metabolism such as β-aminoisobutyrate, N-methylnicotinamide, taurine and hypoxanthine. Biochemically, AR was strongly characterized by increased plasma alkaline phosphatase and decreased iFGF23. The multi-block integration of metabolomic, biochemical, and nutritional data achieved an 18.6% classification error rate. Children with IR exhibited metabolic profiles similar to healthy controls, aligning with their clinical resolution. Conclusions: Active nutritional rickets presents a distinct metabolic profile, highlighting novel biologically relevant metabolites. These exploratory signals provide insights into the physiological impact of the disease and warrant further targeted investigation to assess their potential for informing early non-invasive detection and preventive interventions. In the long term, such tools are vital to prevent irreversible skeletal damage and to help mitigate lifelong physical disability and the resulting social vulnerability for affected children. Full article

Heart failure (HF) is a clinical syndrome characterized by structural or functional cardiac abnormalities that impair ventricular filling or ejection, leading to inadequate systemic perfusion and elevated intracardiac pressures. Current epidemiological estimations declare approximately 26 million patients affected worldwide are living with HF. While ischemic heart disease remains the primary etiology, there is a wide range of behavioural factors that significantly influence disease onset and progression. This review focuses on the evidence for established risk factors, including smoking, excessive alcohol consumption, obesity, physical inactivity, poor diet, sleep disorders, and psychological stress. Furthermore, we discuss other novel determinants such as electronic nicotine delivery systems (ENDS), cannabis, high-dose caffeine, and psychostimulants. The basic mechanistic pathways, including endothelial dysfunction, oxidative stress, neurohormonal activation, and direct myocardial toxicity, are also pointed out and reviewed in this paper. The aim of this study is to integrate epidemiological data with pathophysiological insights to identify priority targets for primary prevention and highlight areas for future research. Full article

Background: Smoking cessation outcomes vary widely across individuals, yet clinic-based services often rely on uniform intervention strategies. Understanding heterogeneity in smoking behaviors, co-occurring health behaviors, and cessation-related psychological profiles may help refine community-based cessation services. This study aimed to identify distinct subgroups of smokers enrolled in public health center-based smoking cessation clinics and to examine differences in cessation outcomes and related characteristics across subgroups. Methods: Data from 21,105 newly enrolled adults attending 16 public health center-based smoking cessation clinics in C Province were drawn from the Smoking Cessation Service Integrated Information System of the National Tobacco Control Center. Latent class analysis was conducted using five indicators: time to first cigarette, cigarettes per day, prior quit attempts, alcohol use, and physical activity. Associations between latent class membership, covariates, and distal outcomes were examined using a three-step approach. Results: Four distinct latent classes were identified: Sedentary heavy smokers (46.8%), Active social heavy smokers (34.6%), Inactive-nicotine addictive-light smokers (13.6%), and Active lifestyle light smokers (5.0%). The latent classes showed different socioeconomic, smoking-related, and cessation-related confidence. Six-month cessation successes differed across classes, with higher abstinence among light-smoking classes and among Sedentary Heavy Smokers relative to Active Social Heavy Smokers. Conclusion: These findings highlight the value of person-centered profiling for informing more precise, context-sensitive cessation strategies and support the integration of behavioral and environmental considerations into community-based tobacco control programs. Full article

Physical inactivity among adults is a major contributor to the escalating global burden of neurodegenerative diseases and mental disorders. The “Weekend Warrior” (WW) pattern—characterized by condensing the recommended volume of physical activity (PA) into one or two days—has emerged as a potential strategy for time-constrained adults. However, a systematic synthesis comparing the potential association of the WW pattern on neuropsychological outcomes (e.g., neurodegenerative diseases, mental health conditions and cognitive function) with those of inactive (IA) and regular exercise (RE) patterns remains limited. This systematic review aimed to assess the associations of the WW pattern with neurodegenerative diseases (e.g., dementia, Parkinson’s disease), mental health conditions (e.g., depression, anxiety, psychological distress), and cognitive function (CF), and to compare these neuropsychological outcomes with those associated with IA and RE patterns. A systematic search of PubMed, Web of Science, ScienceDirect, and Chinese databases (CNKI, Wanfang) was conducted for observational studies published from inception to October 2025. Thirteen studies (5 cohort and 8 cross-sectional studies) involving adults were included. The assessment of methodological quality was conducted using the Agency for Healthcare Research and Quality (AHRQ) methodology and the Newcastle–Ottawa Scale (NOS). The majority of included studies indicated that the WW pattern was inversely associated with the risks of neurodegenerative diseases and mental health conditions and enhanced CF, exhibiting associations of a similar magnitude to those of RE. Furthermore, the synthesis highlighted prevailing gaps in the extant literature, particularly regarding the lack of randomized controlled trials, insufficient control for confounding variables such as social context, and the limited investigation into the neurobiological mechanisms underlying these associations. This systematic review emphasizes the WW pattern as a viable and time-efficient strategy that promotes positive neuropsychological outcomes, exhibiting associations of a similar magnitude to those observed with RE. The findings substantiate the flexibility inherent in PA guidelines, underscoring that adhering to recommended PA volumes is highly beneficial, even when accumulated within a condensed timeframe. Future research should prioritize randomized controlled trials and investigations into neurobiological mechanisms to further validate causal relationships and elucidate the underlying mechanisms driving these associations. Full article

Purpose: Purchased/Referred Care Delivery Area (PRCDA) counties are those where resident American Indian and Alaska Native (AIAN) people are eligible for Indian Health Service care. Due to concerns about racial misclassification, cancer statistics for AIAN people are often restricted to PRCDA counties. Differences in sociodemographic characteristics may exist between PRCDA and non-PRCDA counties, but have not been described; therefore, the potential selection bias associated with the restriction to PRCDA counties remains unknown. Methods: We used data from the University of California, San Francisco Health Atlas to explore ecological differences in county-level demographic, socioeconomic, healthcare access, and health outcomes data between PRCDA and non-PRCDA counties (n = 3152 counties). We tested for statistical differences in mean levels of demographics between PRCDA and non-PRCDA counties using Pooled or Welch t-tests. Results: We observed small, but statistically significant differences between PRCDA and non-PRCDA counties in county-level demographic and socioeconomic characteristics (age, poverty, utility services threat, unemployment, educational attainment, computer access, and median income), neighborhood and environment characteristics (overcrowding, severe mortgage/rent burden), healthcare access and utilization (uninsured, annual checkup, annual dental visit, mammography, binge drinking, smoking, physical inactivity, social isolation), and health outcomes (poor mental health, arthritis, poor self-rated health, high blood pressure, diabetes, high cholesterol, and obesity). Conclusions: These results indicate variability in county-level measures between PRCDA and non-PRCDA counties. While these data do not speak specifically to AIAN peoples’ experiences, they provide critical contextual information to understand how exclusion of AIAN people residing in non-PRCDA counties from cancer statistics may bias risk estimates. Full article