Search Results (2,459)

Background: Obesity among Saudi adolescents has risen sharply, yet whether school athletic participation is associated with students showing improved dietary habits and better anthropometric profiles compared to those of their non-athlete peers remains unclear. This study compared anthropometric indices and dietary habits between school athletes and non-athletes in Riyadh. Methods: A cross-sectional study was conducted with 124 male secondary school students (70 athletes and 54 non-athletes aged 16–17 years) in Riyadh, Saudi Arabia. Athletes were defined as students who reported engaging in vigorous-intensity sport for ≥3 days/week for ≥60 min/session. BMI, body weight, and waist circumference were measured objectively. Dietary habit frequencies across ten food categories were assessed using the validated Arab Teens Lifestyle Study (ATLS) questionnaire. Independent samples t-tests and chi-square tests were used; effect sizes were calculated as Cohen’s d. A Bonferroni-corrected threshold (p < 0.005) was applied for multiple dietary comparisons. Results: Athletes had significantly lower BMI (23.64 ± 5.39 vs. 30.28 ± 7.25 kg/m²; p < 0.001, d = 1.06), body weight (p < 0.001, d = 0.93), and waist circumference (85.46 ± 12.61 vs. 95.50 ± 17.89 cm; p < 0.001, d = 0.66). Obesity prevalence was 15.7% among athletes versus 51.9% among non-athletes. Of ten dietary variables, only fresh fruit consumption showed a between-group difference (62.9% vs. 40.7% high-frequency; p = 0.010), which did not survive Bonferroni correction. Conclusions: School athletes demonstrated substantially better anthropometric profiles than their non-athlete peers, but dietary habit frequencies were largely similar across both groups. The high obesity prevalence among non-athletes underscores the need for school-based programs that combine structured physical activity with targeted nutrition education. Full article

Choking in sport is both a highly researched phenomenon and a colloquial term for performance collapse, which has been at the centre of much debate. The past four decades of study continue to present challenges with its definition that have stifled progression with both research and applied intervention. This study adopted a functional contextual approach, with the aim of exploring how conceptualising choking through this lens might better serve practitioners and researchers, to build more impactful and meaningful processes for behaviour change. A purposive sample of 12 athletes, who identified as having experienced choking, took part in one of four focus groups. Thematic analysis provided four themes that explain choking from this functional contextual perspective, as a process of creating maladaptive personal narratives, responding to symbolic cues, rule-following, and strategies to alleviate the discomfort of challenging inner experiences associated with the experience. Findings provide preliminary support for functional contextualism as a worthwhile research lens for choking, with the suggestion that returning to observable definitions of choking may offer practitioners greater insight into relational processes underpinning choking. Full article

Data on menstrual health, energy availability, and injury risk in women undertaking extreme ultra-endurance expeditions remain limited. We conducted a prospective cohort study of the first all-female UK military team competing in a 3000-mile transatlantic rowing race, aiming to characterize menstrual function, low energy availability (LEA) risk, eating disorder (ED) risk, and injury profiles. Four female British Army personnel completed the 46-day race. Menstrual symptoms, injuries, and illnesses were recorded daily, while reproductive, inflammatory, biochemical, and hematological markers were assessed before and after the race. LEA and ED risk were evaluated using the Low Energy Availability in Females Questionnaire and Brief Eating Disorder in Athletes Questionnaire, respectively. Analyses were primarily descriptive. Three athletes experienced amenorrhea during the expedition, including one with previously regular cycles. The fourth reported intermittent abnormal bleeding associated with injury and illness and screened positive for LEA risk before and after the race. Another athlete screened positive for ED risk at both time points. Most biomarkers remained stable post-race, whereas reproductive hormones showed consistent reductions in follicle-stimulating hormone and luteinizing hormone in all four participants, alongside increased oestradiol. These findings, based on a sample of four athletes, suggest that menstrual function may be sensitive to sustained physiological stress in extreme ultra-endurance settings, and support prospective monitoring in female ultra-endurance, military, and expeditionary populations. Full article

Background: In the context of population aging and the growing burden of chronic conditions, promoting exercise participation has become an important strategy for supporting healthy aging. However, older adults with chronic conditions often face multiple constraints related to symptom burden, risk perception, and everyday life. A theory-informed understanding of the determinants of exercise participation in this population is therefore needed. Methods: This study adopted a theory-informed qualitative descriptive design and conducted face-to-face semi-structured interviews with 30 community-dwelling older adults with chronic conditions. Purposive sampling was used to ensure variation in age, sex, chronic condition type, and exercise participation. Data were analyzed using the framework method guided by the Theoretical Domains Framework (TDF), and the resulting themes were subsequently mapped onto the Capability, Opportunity, Motivation–Behavior (COM-B) model. Results: Participants were aged 60–86 years, and most were women, had low educational attainment, came from rural backgrounds, and lived with multimorbidity. Participants described exercise participation as a day-to-day process of negotiating symptoms, risk, functional boundaries, and everyday responsibilities rather than as a simple matter of willingness. Although most participants recognized the value of exercise, many lacked disease-specific knowledge about suitable exercise types, safe intensity, progression, and warning signs. Symptom burden and functional limitations constrained exercise, but many participants used symptom-based self-regulation strategies, such as resting, slowing down, or modifying activity when discomfort occurred. Family members, peers, health professionals, and community resources could either facilitate exercise or restrict it, depending on their accessibility, continuity, specificity, and practical relevance. Continued participation was closely linked to perceived benefits, controllable risk, self-efficacy, positive emotional experience, and immediate bodily feedback. Conclusions: Exercise promotion for older adults with chronic conditions should move beyond general advice and provide disease-adapted exercise education, symptom-based self-regulation strategies, family and peer support, professional guidance, age-friendly community resources, and feedback mechanisms that support long-term maintenance. Full article

Although exercise interventions have been shown to alleviate core symptoms of Autism Spectrum Disorder (ASD), the neural mechanisms underlying these improvements, particularly those involving the White Matter Network (WMN), remain poorly understood. This study investigated the effects of a Mini-Basketball Training Program (MBTP) on core symptoms and WMN in children with ASD. This study adopted a two-site cluster-Randomized Controlled Trial (cRCT) design. Participants from two special education centers in China were randomly assigned to either an intervention group (MBTP) or a control group (CON). The participants underwent a 12-week MBTP. Core symptom assessments and a Diffusion Tensor Imaging (DTI) scan were conducted before and after the intervention. The individual WMNs were constructed using Deterministic Fiber Tracking (DFT). Graph theoretical analysis was applied to examine changes in WMN topological properties after MBTP. The MBTP significantly improved core symptoms in children with ASD, alongside the decreased normalized clustering coefficient (Gamma, γ), characteristic path length (Lambda, λ), small-world attributes (Sigma, σ), and increased global efficiency (E_glob). The nodal clustering coefficient (NCC) increased in the left cuneus (CUN.L) and left cerebellum 9 (CRBL9.L). Notably, the increased NCC in CRBL9.L was significantly correlated with improvements in core symptoms following the MBTP. The improvement in core symptoms in children with ASD following exercise intervention is associated with the remodeling of the WMN, highlighting the cerebellum as a key node in this neural mechanism. Full article

Background: Exercise training is known to improve metabolic health in individuals with obesity; however, its role in facilitating transitions between metabolically unhealthy obesity (MUO) and metabolically healthy obesity (MHO), as well as the associated metabolic adaptations, remains incompletely understood. Methods: A total of 84 young adults with obesity were enrolled and classified MUO (n = 55) or MHO (n = 29) based on baseline metabolic profiles. All participants completed an 8-week supervised exercise intervention. Anthropometric parameters, body composition, cardiometabolic markers, and VO₂max were assessed before and after the intervention. Targeted metabolomics of 30 amino acid-related metabolites was performed in the MHO-R (remained MHO) and MUO-C (conversion from MUO to MHO) groups to explore exercise-associated metabolic adaptations following intervention. Results: Exercise training improved cardiometabolic risk profiles, including reductions in adiposity and improvements in insulin resistance-related markers. A proportion of participants transitioned from metabolically unhealthy to metabolically healthy obesity following the intervention. No significant between-group differences in amino acid metabolite changes were observed between MHO-R and MUO-C groups. Exploratory metabolomic analyses identified exercise-responsive alterations in amino acid-related metabolites, particularly involving arginine biosynthesis and histidine metabolism. Conclusions: Combined aerobic and resistance training is associated with improvements in metabolic health and phenotype transition in young adults with obesity. Observed alterations in arginine and histidine metabolism may reflect metabolic adaptations to exercise rather than transition-specific or causal mechanisms underlying phenotype conversion. Full article

Patellofemoral pain (PFP) in athletes is associated with lower-limb kinetic-chain constraints, yet rehabilitation strategies targeting both hip and ankle mobility remain insufficiently examined. This assessor-blinded randomized controlled trial investigated the effects of a 6-week hip and ankle mobility-based rehabilitation program in male collegiate athletes with PFP. Forty-eight participants were assigned using computer-generated 1:1 randomization to an intervention group (n = 24) or a control group (n = 24). The intervention group completed supervised hip and ankle mobility rehabilitation three times weekly, whereas the control group maintained regular sport-specific training only. Co-primary outcomes were pain intensity assessed using a 10-cm visual analog scale (VAS) and knee-related function assessed using the Kujala score. Secondary outcomes included hip rotation range of motion, weight-bearing ankle dorsiflexion, vastus medialis–vastus lateralis (VM–VL) onset timing, Y-Balance Test (YBT) composite score, and countermovement jump (CMJ) height. Significant group × time interactions favored the intervention group for VAS (p < 0.0001; partial η² = 0.436; change difference: −1.54 cm; 95% CI: −2.06 to −1.02) and Kujala score (p < 0.0001; partial η² = 0.285; change difference: 8.00 points; 95% CI: 4.24 to 11.76). Significant interactions were also observed for hip internal and external rotation range of motion, weight-bearing ankle dorsiflexion, VM–VL onset timing during a controlled squat task, and YBT composite score (all p ≤ 0.0405; partial η² = 0.088–0.374). No significant group × time interaction was observed for CMJ height (p = 0.0511; partial η² = 0.080). These findings suggest that, compared with regular sport-specific training alone, adding a supervised hip and ankle mobility-based rehabilitation program may improve pain, knee-related function, targeted mobility outcomes, VM–VL onset timing during a controlled squat task, and dynamic balance in the short term. However, because the control group did not receive an active or attention-matched intervention, these findings should be interpreted as the added effect of the supervised rehabilitation program rather than as definitive evidence of mobility-specific treatment effects. In addition, because patellar tracking, knee kinematics, joint kinetics, and patellofemoral joint loading were not directly measured, the findings should be interpreted as clinical and functional outcome changes rather than direct evidence of a confirmed biomechanical mechanism. Trial registration: NCT07542236. Full article

Objectives: This study aimed to identify core genes associated with mitochondria-related transcriptomic signatures and evaluate their potential as computational biomarkers, immune characteristics, regulatory mechanisms, and potential therapeutic relevance. Methods: Obesity-related transcriptome datasets were obtained from the GEO database. Differentially expressed genes (DEGs) were intersected with mitochondria-related genes (MRGs) to identify obesity-related MRGs. Functional enrichment, protein–protein interaction (PPI) analysis, CytoHubba, LASSO and random forest algorithms were used to screen core genes. External validation, ROC analysis, immune infiltration analysis, regulatory network construction, candidate drug prediction, and molecular docking were further performed. Results: A total of 527 DEGs and 15 differentially expressed MRGs were identified. Enrichment analysis suggested that these mitochondria-related genes were mainly associated with disrupted mitochondrial energy metabolism, lipid metabolic remodeling, and altered substrate utilization. ECHDC2, FASN, NAT8L, and AASS were identified as core MRGs; these genes are respectively associated with mitochondrial metabolic regulation, de novo fatty acid synthesis, N-acetylaspartate-related mitochondrial metabolism, and lysine degradation. These genes were significantly downregulated in obesity and showed good diagnostic performance. Immune infiltration analysis revealed alterations in the immune microenvironment, and the core genes were negatively correlated with multiple immune cell types. Molecular docking showed that Genistein had the lowest predicted binding free energy with NAT8L (−8.89 kcal/mol), suggesting relatively favorable binding among the tested ligand–target pairs. Conclusions: ECHDC2, FASN, NAT8L, and AASS may serve as candidate computational biomarkers, among which FASN represents a known lipid metabolism-related gene, supporting the biological plausibility of the workflow. Full article

Background: Low back pain (LBP) is a major cause of disability in later life. We aimed to assess the population-level burden, demographic and epidemiological drivers, GBD-defined risk attribution, and future trajectory of LBP among Chinese adults aged 45 years and older. Methods: Using population-level estimates from the Global Burden of Disease Study 2023 (GBD 2023), we analyzed incidence, prevalence, and years lived with disability (YLDs) among Chinese adults aged 45 years and older from 1990 to 2023. We assessed temporal trends, decomposed changes in burden, evaluated age–period–cohort patterns, quantified YLDs attributable to three GBD-defined risk factors—high body mass index, occupational ergonomic factors, and smoking—and projected burden to 2040 using Bayesian age–period–cohort models. Results: In 2023, population-level GBD estimates indicated that LBP accounted for 30.29 million incident cases, 71.54 million prevalent cases, and 7.90 million YLDs among Chinese adults aged 45 years and older. Compared with 1990, these numbers increased by 101.54%, 97.08%, and 96.11%, respectively, despite declining age-restricted age-standardized incidence, prevalence, and YLD rates. Expansion of the population aged 45 years and older was the main driver of the increasing absolute burden, whereas favorable epidemiological change offset part of this increase. High body-mass index showed the largest increase in attributable burden and was the only risk factor with rising age-standardized attributable YLD rates. Model-based projections suggested that age-restricted age-standardized burden would continue to decline through 2040. Conclusions: LBP remains a growing absolute burden among middle-aged and older adults in China despite declining age-restricted age-standardized rates. Future disability reduction will require integrated strategies combining risk-factor control, rehabilitation, functional support, and age-sensitive care. Full article

Acute cardiovascular events driven by atherosclerosis primarily originate from thrombosis triggered by vulnerable plaque rupture or endothelial erosion. Endothelial barrier destabilization—characterized by glycocalyx impairment, intercellular junction disassembly, and abnormal cytoskeletal tension—is a core upstream pathological stage that promotes atherogenic lipoprotein leakage, inflammatory cell infiltration, and matrix degradation. Hemodynamics, primarily through wall shear stress (WSS), shape the spatial distribution and plaque phenotypes of atherosclerosis; notably, low or oscillatory shear stress is associated with, and in experimental systems can promote, pro-inflammatory, pro-oxidant and pro-permeability endothelial phenotypes that contribute to plaque initiation and vulnerability. Conversely, regular exercise training, as an intervention that modulates hemodynamics, is widely suggested to promote anti-inflammatory, antioxidant, and antithrombotic endothelial phenotypes by significantly increasing antegrade shear stress and reducing detrimental retrograde/oscillatory shear stress. With a central focus on the axis of “exercise-shear stress-glycocalyx-cytoskeleton/junction-permeability-plaque stability,” this review integrates evidence from in vitro flow chambers, animal models and human studies to critically discuss: (1) the spatiotemporal heterogeneity of WSS and its relationship with plaque vulnerability; (2) the composition, barrier function, and plasticity of the glycocalyx as the primary interface for shear stress; (3) the mechanosensory complexes at the glycocalyx and junctions that transduce shear stimuli to protective pathways such as Phosphoinositide 3-kinase (PI3K)-Akt-endothelial nitric oxide synthase (eNOS) and Krüppel-like factor 2 (KLF2), thereby stabilizing adherens/tight junctions; (4) how improved barrier homeostasis promotes the maintenance of the fibrous cap collagen scaffold by reducing lipoprotein leakage and dampening the inflammation–matrix metalloproteinase (MMP) axis. Finally, this review highlights the boundary conditions of the biological effects of shear stress: low/oscillatory shear stress is primarily associated with plaque initiation and susceptible sites, whereas focal, extremely high WSS in established stenotic lesions may contribute to late-stage high-risk remodeling. Therefore, the protective hemodynamic adaptations induced by exercise should not be simply equated with the pathologically high WSS found at stenotic sites. Full article

Background/Objectives: Adolescent idiopathic scoliosis (AIS) is a multifactorial condition with an unclear etiology. Previous studies have reported associations of scoliosis with female sex, lower body mass index (BMI), and lower physical activity levels. This study examined factors associated with suspected scoliosis identified through school screening, with emphasis on BMI and sports participation. Methods: A cross-sectional study was conducted during the 2019/2020 school year and included 18,216 adolescents. Suspected scoliosis was identified using the forward bend test (FBT). Logistic regression analysis assessed associations between suspected scoliosis and sex, grade, BMI, participation in the seven most frequently reported sports, and training frequency. Results: Higher BMI (odds ratio (OR) = 0.91, p < 0.001), participation in soccer (OR = 0.64, p < 0.001), gymnastics (OR = 0.58, p = 0.05), martial arts (OR = 0.66, p = 0.02), and higher recreational training frequency (OR = 0.92, p < 0.001) were associated with lower odds of suspected scoliosis. Female sex (OR = 2.49, p < 0.001) and higher grade level (6th: OR = 1.54; 8th: OR = 2.98; p < 0.001) were associated with increased odds of suspected scoliosis. Conclusions: Suspected scoliosis identified through school screening was more frequently observed among females and adolescents with lower BMI. Participation in certain sports and greater recreational physical activity were associated with lower prevalence and odds of suspected scoliosis. These findings reflect screening-based associations and do not imply causal relationships. The results support the importance of school-based screening and consideration of body composition and physical activity patterns in the early identification of adolescents with suspected scoliosis. Full article

Visual discomfort or visual stress is an uncomfortable subjective experience that occurs in response to specific visual stimuli. It affects a large proportion of the population to various degrees, disproportionately impacting those with heightened sensory sensitivities, particularly neurodivergent individuals. We argue that this might stem from a mismatch between the statistical properties of visual stimuli in human-made environments and those in natural environments that the visual system can process efficiently. We discuss the inefficiency with which images with certain spatial, chromatic and temporal characteristics are processed by the visual system and propose a cerebral mechanism to account for the discomfort they induce. The mechanism offers a potential explanation for the large individual differences in susceptibility to discomfort. We highlight two avenues for intervention: (1) environmental modifications aimed at reducing the prevalence of visually stressing stimuli in urban settings, and (2) individual-level strategies, such as personalised optical treatments. Addressing these challenges requires an interdisciplinary effort bridging neuroscience, vision science, interior and urban design and typography to create visually accessible and inclusive environments. Full article

Background: Upper-limb strength characteristics are considered important determinants of shooting stability in precision sports; however, the specific relationships between upper-limb strength variables and shooting performance in elite air pistol athletes remain insufficiently understood. Therefore, this study aimed to investigate the associations between upper-limb-specific strength characteristics and shooting performance in elite air pistol shooters. Methods: A prospective observational cohort study was conducted using a purposive total population sample from an elite training camp. Isometric peak force and rate of force development of nine upper-limb muscle actions, including handgrip, elbow flexion and extension, and shoulder joint movements, were assessed using a Vald Dynamo handheld dynamometer. Official scores from an international selection competition were used as indicators of shooting performance. Ridge regression analysis was applied to examine the relationships between strength variables and shooting performance while addressing multicollinearity among predictors. Results: Twenty-four elite air pistol athletes at national master level or above were recruited. Ridge regression revealed distinct coefficient patterns between upper-limb task-specific strength characteristics and total shooting score. After within-sex standardization of strength predictors, larger positive ridge coefficients were observed for handgrip RFD, elbow flexion peak force, shoulder external rotation RFD, elbow extension peak force, and selected shoulder variables, whereas negative coefficients were observed for shoulder internal rotation RFD, handgrip peak force, shoulder extension RFD, elbow extension RFD, and selected shoulder variables. These findings suggest that shooting performance is associated with the balance and coordination of task-specific upper-limb strength characteristics rather than maximal strength alone. Conclusions: These findings suggest that coordinated upper-limb task-specific strength balance is associated with shooting performance in elite air pistol athletes. These findings may help inform individualized conditioning and monitoring strategies; however, longitudinal intervention studies are needed to determine whether modifying upper-limb strength balance can improve shooting outcomes. Full article

Background: Rifle shooting performance depends on precise postural control, rifle stability, and coordinated upper-limb force production. Although previous studies have examined postural balance and aiming stability in rifle shooters, the role of upper-limb inter-limb strength asymmetry across different shooting positions remains unclear. This study explored the association between joint-specific upper-limb strength asymmetry and rifle shooting performance in elite athletes across prone, kneeling, and standing positions. Methods: Thirteen elite rifle shooters completed a 20-shot series in each position according to ISSF rules. Bilateral maximal isokinetic strength of the wrist, elbow, and shoulder was assessed at 60°/s using a Biodex System 4 dynamometer, and handgrip strength was measured with a handheld dynamometer. Inter-limb asymmetry indices were calculated for each joint action. Position-specific shooting scores and good-10 hits (≥10.0) were recorded. Associations between asymmetry indices and performance outcomes were examined using Spearman correlation analyses and simple linear regression models. Results: In exploratory analyses, greater asymmetry in selected shoulder actions showed large negative associations with lower prone, kneeling, and standing scores, and standing performance also showed a negative association with wrist flexion asymmetry. Good-10 hits were negatively associated with selected shoulder and wrist asymmetry indices. Exploratory regression models showed large apparent proportions of explained variance for selected position-specific associations, but these estimates should be interpreted cautiously because of the small sample size and the absence of validation. Conclusions: Position-specific upper-limb strength asymmetry, particularly at the shoulder and wrist, was associated with rifle shooting performance and may represent a relevant consideration for training and monitoring in elite rifle athletes. Full article

Background: The use of sports supplements among adolescents is rising globally, driven by fitness trends and social media influence, yet knowledge gaps persist. This study aimed to assess supplement usage patterns, knowledge, attitudes, information sources, and the impact of a social media educational intervention among Serbian secondary school students. Methods: A single-group pre–post educational intervention study was conducted in secondary school students (aged 14–18) in Vojvodina, Serbia. A 21-question anonymous questionnaire was distributed to 1000 students along with parental informed consent forms. Pre-intervention survey assessed sociodemographics, physical activity and social media habits, supplement use information sources, and awareness of risks and banned substances. Based on the initial findings, an educational campaign delivered 56 short videos (≈70 s each) on Instagram and TikTok covering most frequently used supplements (e.g., creatine, proteins, caffeine, energy drinks). After, the intervention survey was repeated. The data were analyzed using the McNemar–Bowker test of symmetry. Results: In this study, 65% of Serbian secondary school adolescents reported being physically active, engaging predominantly in gym workouts and team sports. The majority of participants initiate dietary supplement use independently, without consulting healthcare professionals or adults. The most commonly used supplements were vitamins and minerals, while energy drinks ranked notably high. Social media intervention had a limited impact due to its short duration; however, certain changes were detected. Conclusions: Serbian adolescents frequently use sports supplements without adequate professional guidance. Long-term TikTok/Instagram interventions could be used in the future in order to influence behaviors and improve knowledge about sport supplement use. Full article