Search Results (654)

Background: Cigarette smoking remains one of the most important preventable causes of respiratory morbidity, exerting detrimental effects even in young adults. Medical students represent a particularly relevant population, as the lifestyle habits they adopt during their training years may influence both their personal health and professional credibility. Methods: We conducted a cross-sectional analysis of 264 medical students from the University of Medicine, Pharmacology, Science and Technology of Târgu-Mures, aged 18–30 years, stratified according to smoking status, type of tobacco product used, and lifestyle characteristics (athletic vs. sedentary). Standardized spirometry was performed to assess FVC, FEV₁, FEV₁/FVC ratio, PEF, and small airway flow parameters (MEF₂₅, MEF₅₀, MEF₇₅). Statistical comparisons between groups were performed using t-tests, Mann–Whitney U tests, chi-square tests, and correlation analyses, with p < 0.05 considered statistically significant. Results: Smokers demonstrated significantly lower values for FEV₁, PEF, and MEF parameters compared with non-smokers, confirming early functional impairment of both large and small airways. Within the smoking group, users of e-cigarettes or heated tobacco products exhibited more favorable FEV₁ and small airway flow values than conventional cigarette smokers. However, differences in FVC were less pronounced. Significantly, athletes consistently outperformed their sedentary peers across all respiratory parameters, regardless of smoking status, with markedly higher FEV₁, FVC, and MEF values and a lower prevalence of obstructive patterns. Cumulative smoking exposure (pack-years) was inversely associated with small airway function, whereas higher levels of physical activity were independently linked to a pronounced protective effect. Conclusions: Even in early adulthood, smoking is related to measurable declines in lung function, particularly affecting small airway dynamics. Although alternative products may appear less harmful than conventional cigarettes, they cannot be considered risk-free. Conversely, regular physical activity demonstrated a protective association in the case–control analysis, attenuating functional decline and supporting the preservation of long-term respiratory health. These findings underscore the importance of integrated prevention strategies in medical universities, combining smoking cessation initiatives with the systematic promotion of physical activity to safeguard the health of future physicians and reinforce their role as credible health advocates. Full article

Background: Herpes zoster (HZ) represents a substantial public health concern among aging populations, yet regional variability in clinical patterns and risk determinants remains insufficiently documented. In southeastern Romania, epidemiological data are limited, and the combined influence of demographic, behavioral, and metabolic factors on disease severity has not been systematically evaluated. Methods: We performed a retrospective observational study including 100 consecutive patients diagnosed with HZ between 2019 and 2023 in a dermatology department in southeastern Romania. Demographic characteristics, lifestyle behaviors, anthropometric status, clinical manifestations, and outcomes were extracted from medical records. Associations between categorical variables were assessed using Chi-square tests and Cramer’s V, while interaction patterns were explored through log-linear modeling. Heatmaps were generated in Python (version 3.10) using the Matplotlib library (version 3.7.1) to visualize distribution patterns and subgroup relationships. Results: The cohort showed a marked age dependence, with 77% of cases occurring in individuals ≥ 60 years, consistent with immunosenescence-driven reactivation. Women represented 59% of cases, and 84.7% of female patients were postmenopausal. Urban residents predominated (91%). Vesicular eruption (84%) and acute pain (79%) were the most frequent symptoms. Localized HZ was observed in 81% of cases, while ophthalmic involvement (11%) and disseminated forms (8%) were less common. Lifestyle factors significantly influenced clinical severity: smokers, alcohol consumers, and sedentary individuals exhibited higher proportions of postherpetic neuralgia (PHN) and ocular complications (p < 0.001). Overweight and obese patients demonstrated a higher burden of PHN, suggesting a role for metabolic inflammation, although BMI was not associated with incidence. No significant association between age category and complication type was detected, likely due to small subgroup sizes despite a clear descriptive trend toward increased severity with advanced age. Conclusions: These findings support a multifactorial model of HZ severity in southeastern Romania, shaped by age, lifestyle behaviors, hormonal status, and metabolic risk. While incidence patterns align with international data, the strong impact of modifiable factors on complication rates highlights the need for targeted prevention and individualized risk assessment. Results offer a regional perspective that may inform future multicenter investigations. Full article

Background/Objectives: To examine trends in tobacco and alcohol consumption among individuals with and without diabetes mellitus (DM) in Spain from 2014 to 2020 and identify sociodemographic, lifestyle, and comorbidity-related predictors of consumption. Methods: Population-based cross-sectional study using data from the 2014 and 2020 European Health Interview Surveys for Spain. Participants’ self-reported tobacco and alcohol consumption were analyzed based on DM status. Results: This study included 7854 participants (3927 participants with DM and 3927 participants without DM). Among participants with DM, tobacco and alcohol consumption remained stable over the study period, with tobacco from 15.2% in 2014 to 14.8% in 2020 (p = 0.761) and alcohol from 37.2% to 39.8% (p = 0.088), respectively. Tobacco consumption did not differ significantly between those with and without DM (15.0% vs. 15.2%, p = 0.777). However, alcohol consumption was significantly lower among those with than without DM (38.6% vs. 48.7%, p < 0.001). In those with DM, predictors of tobacco consumption included male sex, younger age, alcohol consumption, living without a partner, and DM, and predictors of alcohol consumption included male sex, active smoking, higher education, and sedentary lifestyle. Conclusions: Between 2014 and 2020, both tobacco and alcohol consumption remained stable among individuals with DM. The prevalence of alcohol consumption was lower among those with than without DM. Key predictors of tobacco and alcohol consumption included sex, lifestyle behaviors, and socioeconomic factors. These findings highlight the need for targeted public health interventions to reduce harmful substance use in DM populations and mitigate associated health risks. Full article

Background/Objectives: Spexin (SPX) is a bioactive peptide involved in the regulation of appetite, lipid metabolism, and glucose homeostasis. This systematic review and meta-analysis aimed to evaluate exercise-induced changes in SPX levels and their implications for metabolic health. Methods: This systematic review and meta-analysis aimed to synthesize evidence retrieved from PubMed, Web of Science, and Scopus databases, without restrictions on publication year, with the final literature search completed on 10 September 2024 and conducted in line with PRISMA 2020 reporting standards. The search strategy employed the keywords exercise, metabolic health, obesity, spexin and diabetes yielding 42 eligible records. Eligible studies included human or experimental animal populations exposed to acute or chronic exercise interventions. Exercise interventions included aerobic, resistance, combined, and high-intensity interval training protocols, with exercise intensity reported using heterogeneous metrics. The primary focus was on circulating SPX, alongside the assessment of related metabolic and endocrine parameters. Six studies satisfied the eligibility criteria and were included in the review. Results: The included studies were conducted in overweight or obese sedentary populations. Plasma SPX levels remained unchanged following acute (<3 weeks) aerobic exercise, whereas increased SPX levels were reported after chronic (≥3 weeks) exercise interventions. Elevated SPX concentrations were observed across different exercise modalities, including aerobic exercise, combined aerobic–resistance training, treadmill running, swimming, and HIIT. In addition to SPX, the included studies reported changes in metabolic and endocrine markers, including lipid-related variables, insulin-associated indices, adipokines, hormones, and selected metabolic proteins. Conclusions: This systematic review and meta-analysis indicate that exercise-related increases SPX are reported alongside changes in adiposity and metabolic–endocrine markers. Full article

Maximal fat oxidation (MFO) rate and the intensity at which it occurs (Fatmax) are key indicators of metabolic flexibility, yet their assessment in obese populations poses methodological challenges. This scoping review synthesizes evidence from 23 studies investigating protocols for determining Fatmax and MFO during cycle ergometry. Across studies, obese and sedentary participants followed testing procedures, typically involving lower initial workloads, smaller workload increments, and longer stage durations than those used for fitter individuals. In obese populations, Fatmax generally occurred at 30–50% of VO₂ peak, compared with values exceeding 60% in trained participants. While the reliability of Fatmax was acceptable, greater variability was observed for MFO rate. Fitness level appeared to exert a stronger influence than adiposity on fat oxidation, with obesity often associated with a left-shifted fat oxidation curve. Additional factors such as gender, developmental stage, insulin resistance, and type 2 diabetes further modulated these responses. Importantly, short-term training interventions, including moderate-intensity exercise, high-intensity interval training, and Fatmax-targeted protocols, consistently enhanced MFO and shifted Fatmax toward higher intensities, with favorable effects on insulin sensitivity and metabolic health. In contrast, nutritional and supplementation studies provided limited evidence of additional benefits. Overall, Fatmax assessment is feasible in obese populations when appropriate methodological adjustments are applied, and exercise interventions can rapidly enhance fat oxidation capacity. Future research should focus on protocol standardization, mechanistic exploration, and long-term interventions to clarify the role of Fatmax in obesity management and its potential clinical applications. Full article

Background: Childhood obesity continues to pose a major global health challenge, and schools offer a structured and scalable setting for implementing physical activity programs. However, the effectiveness of these interventions remains inconsistent. This systematic review synthesizes evidence from school-based physical activity interventions and evaluates their impact on obesity-related parameters, physical activity levels, physical fitness, and cardiorespiratory fitness among children. Methods: A comprehensive search of PubMed, Scopus, and the Cochrane Library identified randomized controlled trials published between January 2015 and March 2025. Eligible studies included children aged 5–18 years and assessed school-based physical activity interventions. Outcomes included BMI, body fat percentage, physical activity levels (including MVPA), physical fitness, and cardiorespiratory fitness. Due to methodological heterogeneity, a narrative synthesis was conducted. Results: A total of 28 studies met inclusion criteria. Among the 16 studies reporting obesity-related outcomes, 7 demonstrated statistically significant improvements in BMI or BMI z-scores, while 6 of 16 (37.5%) showed no measurable effect. Reductions in body fat percentage were more consistently observed (5 of 6 studies). Both short-term (<6 months) and long-term (>12 months) interventions showed comparable proportions of studies with statistically significant BMI improvements (~50%). For physical activity outcomes, 5 of 11 studies reported increased MVPA, whereas others showed no significant change. Sedentary behavior outcomes were mixed, with only 2 of 6 studies demonstrating significant reductions. Improvements in physical fitness were reported in two-thirds of studies, while cardiorespiratory fitness improvements were inconsistent, with significant gains observed primarily in higher-intensity or well-structured programs. Across outcomes, several findings were statistically significant but modest in clinical magnitude. Conclusions: School-based physical activity interventions have the potential to improve select obesity-related parameters, particularly body fat percentage and BMI in a subset of studies. However, effects on MVPA, sedentary time, overall activity levels, and cardiorespiratory fitness remain variable. The effectiveness of these programs appears influenced by intervention structure, intensity, and adherence rather than duration alone. Future interventions should incorporate tailored, multi-component approaches to enhance both clinical relevance and long-term sustainability. While several effects were statistically significant, most were modest in magnitude. However, even modest improvements in BMI z-score, body fat percentage, and fitness can be meaningful at a population level, particularly when delivered through universal, scalable school platforms that reach large numbers of children. Full article

Background: Sedentary behavior is prevalent among female college students and may negatively affect motor competence—a key component of physical literacy and lifelong health. However, limited research has compared motor proficiency across distinct physical activity patterns in this population. This study aimed to examine differences in motor proficiency between sedentary and regularly active female college students. Methods: A cross-sectional study was conducted with 292 female undergraduates (aged 18–21 years). Participants were retrospectively classified into a sedentary behavior group (SBG; n = 124) and a regular exercise group (REG; n = 168) according to the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Motor proficiency was evaluated using the Bruininks–Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Group differences were analyzed using multivariate analysis of variance (MANOVA) and independent-samples t-tests. Results: The REG demonstrated significantly higher scores in manual coordination, body coordination, and strength and agility (all p < 0.01), whereas no significant difference was observed in fine motor control. The REG also exhibited a higher total BOT-2 score (p < 0.01; Cohen’s d = 0.56). Conclusions: Regular physical activity was associated with higher motor proficiency among female college students. As this study used a cross-sectional design, causal relationships cannot be inferred. Nonetheless, these findings highlight the potential importance of promoting active lifestyles in higher education to enhance motor competence and contribute to long-term public health. Full article

Background/Objectives: Physical activity alleviates symptoms and may slow Parkinson’s disease (PD) progression, yet many individuals with PD remain sedentary. Kinesiophobia, the fear of movement, may represent a significant but underexplored psychological barrier to physical activity in this population. Virtual reality (VR), already effective in phobias, may represent a promising approach to address this challenge. This review initially aimed to systematically examine exposure-based interventions in VR (E-IVR) directly targeting kinesiophobia in PD. Methods: Database searches using keywords such as “kinesiophobia,” “fear of movement,” and “VR” combined with “PD” yielded no eligible studies. Consequently, the scope was broadened to include populations with neurological or musculoskeletal conditions, and a narrative review format was adopted to synthesize the available evidence. Furthermore, relevant studies of interventions in VR applied in PD, although not specifically addressing kinesiophobia, are detailed to provide evidence of efficacy and feasibility of VR interventions in PD. Finally, directions are offered to support the creation of E-IVR targeting kinesiophobia in individuals with PD. Results: Meta-analyses in neurological and musculoskeletal populations demonstrate moderate to large reductions in kinesiophobia following VR interventions, although effects vary depending on assessment tools, degree of immersion, and exposure design. In PD, VR has been applied to rehabilitation, anxiety reduction, and quality of life enhancement. These interventions achieved high adherence (≥90%), were well tolerated, and reported no major adverse events. Conclusions: Kinesiophobia is prevalent in PD and could contribute to physical inactivity. E-IVR appears feasible, safe, and innovative for addressing kinesiophobia in people living with PD. Full article

Overweight and obesity are major public health concerns among children and adolescents worldwide. The most prevalent form is exogenous–constitutional obesity, which is driven by a sedentary lifestyle and an unhealthy diet in which caloric intake exceeds energy expenditure. Beyond their association with chronic disease, these factors are closely linked to deficits in cognitive development and executive functions essential for learning (including working memory, sustained attention, planning, behavioral self-regulation, and cognitive flexibility). Oxidative stress (OS), characterized by the accumulation of reactive oxygen species (ROS) in cells and extracellular fluids, is a significant potential mediator in childhood obesity and an important contributor to its comorbidities. The antioxidant defense system (AOD)’s activity largely depends on levels of trace element cofactors, which determine the body’s resistance to adverse environmental factors (the “maladaptation phenomenon”). OS and trace element deficiencies contribute to the development of morphological changes in the brain, thus serving as a critical connecting link between childhood obesity and cognitive impairment. Non-pharmacological interventions are the most accessible and effective approach for prevention and treatment. Bioactive compounds derived from food and natural plants, classified as antioxidants and phytopreparations, may represent a promising complementary approach. These compounds are most effective when used in combination with sustained lifestyle modifications in children. Research in this area can help define future directions for study and develop targeted intervention strategies in the pediatric population. The aim of this review is to examine the relationship between OS, antioxidant cofactor micronutrients, and cognitive outcomes in childhood obesity and to explore mechanisms, evidence, and therapeutic opportunities. Full article

Background/Objectives: University students are a population vulnerable to psychological distress due to academic and lifestyle transitions. This study examined the relationships between physical activity (PA), sedentary behavior, and subjective well-being among Slovak university students, with attention to gender-specific and non-linear patterns. Methods: A total of 1314 first-year students (69.5% women; mean age = 20.7 ± 1.4 years) completed the IPAQ-Short Form and the Bern Questionnaire on Subjective Well-Being (BSW/A). PA levels were categorized as low, moderate, or high according to standard MET thresholds. Group differences were analyzed using nonparametric tests with Benjamini–Hochberg FDR correction. Results: Higher PA levels were associated with more favorable well-being outcomes, particularly higher self-esteem and joy of life and lower depressed mood and somatic complaints. Effect sizes ranged from small to moderate. Gender-specific patterns emerged: among men, well-being indicators tended to plateau beyond moderate PA, whereas among women, moderate PA showed an inverse association with self-esteem despite slightly higher median scores in the moderate-activity group. Sedentary time showed weak and mostly non-significant associations after FDR correction. Conclusions: Physical activity was positively associated with subjective well-being in a non-linear, gender-dependent manner. These findings suggest that approaches to supporting student well-being may benefit from considering gender differences, individual activity patterns, and motivational context. Full article

Non-alcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease worldwide, with an increasing prevalence, mainly due to the increase in childhood obesity and sedentary lifestyle. The pathogenesis of NAFLD is multifactorial, but the mechanisms by which the factors involved, namely the genetic, intrauterine and environmental factors responsible for its onset and progression to NASH, are not fully known. Children with NAFLD are usually asymptomatic or show nonspecific symptoms, and NAFLD is generally diagnosed incidentally by screening tests in overweight or obese children. NAFLD is associated with severe metabolic deficiencies that may progress to cirrhosis and hepatocellular carcinoma, with the consequent need for liver transplantation. Current treatment of NAFLD in children consists of lifestyle changes to decrease caloric intake and increase physical activity, with no currently approved pharmacological medication for the pediatric population. Although pediatric studies that focus on alternative treatments targeting key pathogenic factors are promising, no pharmacological agent is currently approved for children, validated non-invasive fibrosis biomarkers remain limited, and long-term outcome data are scarce. Further validation through large prospective pediatric cohorts and phase III trials is urgently needed. Full article

Background: Type 2 diabetes mellitus (T2DM) remains one of the most significant public health problems, and its incidence rate is steadily increasing worldwide despite scientific and technological progress in the field of medicine. The focus of research in this area is gradually shifting from classic risk factors—such as obesity, sedentary lifestyle and genetic predisposition—toward additional, potentially modifiable contributors such as micronutrient imbalances; among them are disturbances in zinc homeostasis that may influence glucose metabolism and oxidative stress. Objective: This systematic review with narrative synthesis aims to examine the bidirectional relationship between zinc status and T2DM and to evaluate whether zinc screening and personalized nutritional support could contribute to comprehensive metabolic management. Methods: A literature search was conducted in the PubMed database and the Cochrane library for studies published between 2010 and 2024. Studies assessing zinc status or supplementation in relation to the risk, progression, or management of T2DM were included. Data were synthesized narratively, focusing on clinical and mechanistic evidence. Results: Thirty studies met the inclusion criteria. Evidence indicates that zinc imbalance (both deficiency and excess) is associated with T2DM risk and outcomes. Zinc deficiency may impair insulin synthesis and signaling, promote oxidative stress and inflammation, while excessive zinc intake may induce metabolic disturbances. T2DM itself may lead to reduced zinc status via altered absorption and increased excretion. While some studies suggest modest improvements in glycemic or lipid parameters following zinc supplementation, findings remain inconsistent and context-dependent. The prevalence of suboptimal zinc status in certain populations supports the rationale for targeted screening rather than routine supplementation. Conclusions: Zinc is mechanistically involved in insulin synthesis, antioxidant defense, and inflammation control, but current clinical evidence does not justify its use as a therapeutic agent in T2DM. Instead, assessment of zinc status and individualized correction of deficiency may represent a component of personalized nutritional support, particularly for patients with long disease duration, poor dietary quality, or genetic predispositions affecting zinc metabolism. Full article

Background/Objectives: This systematic review aimed to evaluate the effectiveness and feasibility of “exercise snacks,” brief, intermittent bouts of physical activity designed to interrupt prolonged sedentary behavior. The review synthesized findings across metabolic, cardiovascular, cognitive, and functional health domains to identify consistent patterns of benefit and determine their practical applicability across populations. Methods: A total of 26 studies met inclusion criteria, encompassing diverse populations such as healthy adults, older adults, and individuals with obesity, type 2 diabetes, or PCOS. Following the PRISMA 2020 guidelines, comprehensive searches were conducted across PubMed, Scopus, Web of Science, and CINAHL databases for studies published between 2012 and 2025. Eligible studies included randomized controlled trials, crossover trials, and feasibility studies assessing health outcomes following exercise snack interventions in adults. Data were extracted using standardized protocols, and methodological quality was evaluated using the Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale. Narrative synthesis was prioritized due to intervention heterogeneity. Results: Exercise snacks consistently improved postprandial glucose, insulin, and triglyceride responses, reduced blood pressure, preserved endothelial and cerebral blood flow, and enhanced cardiorespiratory fitness. Older adults demonstrated significant gains in lower-limb strength and mobility. Emerging evidence also indicated improvements in mood, fatigue, and cognitive performance. Feasibility trials confirmed high acceptability and adherence across settings and age groups. Conclusions: Exercise snacking represents a time-efficient, feasible, and evidence-based strategy to mitigate the health risks of sedentary behavior. By incorporating brief, frequent activity bouts into daily routines, individuals can achieve meaningful benefits in metabolic regulation, cardiovascular health, physical function, and cognitive well-being. Future research should refine optimal protocols and explore long-term sustainability across varied populations. Full article

Urban environments play an important influence in influencing healthy lifestyles and reducing sedentary behaviour (SB), particularly as facilitators of physical activity (PA). Urban spaces often do not support healthy lifestyles. A Community of Practice (CoP) could be a valuable strategy for co-designing proposals to enhance healthy and active urban environments. We aimed to develop strategies through a CoP to promote PA and reduce SB in the urban setting of a multicultural population based in the Barcelona Metropolitan Area, with a particular focus on people with chronic diseases. A three-session CoP involving 25 participants (community members with chronic conditions, health professionals, urban planners, and local authorities) was implemented as a participatory research approach to identify barriers and facilitators to PA and co-design feasible urban improvement proposals. Ethical approval was obtained from Bellvitge University Hospital’s Ethics Committee. Participants provided informed consent and image release forms. Participants highlighted the importance of accessible, adaptable, and interconnected urban spaces to address barriers and leverage facilitators to PA. Proposed interventions targeted four selected areas of the neighbourhood and included expanding shaded areas, creating pedestrian-friendly routes and enhancing green spaces. This study highlights the effectiveness of a CoP in identifying and addressing barriers to PA within urban environments for people with chronic diseases. Findings emphasise the impact of neighbourhood design and accessibility on reducing SB and promoting active lifestyles. The participatory approach offers a replicable model for other urban settings aiming to foster health, although its qualitative and local nature limits generalisability. Full article

Aging entails concurrent declines in physical and cognitive domains, contributing to reduced independence, higher fall risk, and lower quality of life. Understanding how motor performance relates to cognition is crucial for prevention in community-dwelling older adults. This cross-sectional study investigated associations between physical fitness—including strength, endurance, balance, and aerobic capacity—and cognitive outcomes assessed by Trail Making Tests (TMT-A, TMT-B), the Digit Symbol Substitution Test (DSST), and dual-task cost in the Timed Up & Go Test (TUG_DTC). Thirty-four sedentary but cognitively healthy adults aged ≥60 years were evaluated. Quadriceps strength was significantly related to TUG_DTC and executive function (TMT-B), while upper-limb endurance correlated with both attentional and executive measures. Dynamic balance, particularly in posterior directions, was linked to DSST and TMT-B, and 6-min walk test performance was associated with executive functioning and processing speed. TUG_DTC itself showed strong correlations with cognitive outcomes, underscoring its sensitivity to motor–cognitive interference. These findings highlight selective motor–cognitive relationships and suggest that simple, field-based tests may serve as early markers of cognitive vulnerability. Targeting lower-limb strength, balance, and aerobic capacity could represent cost-effective strategies to promote mobility and cognitive resilience in aging populations. Full article