Search Results (932)

Background: The relationship between sports participation and food preferences in adults, as well as the influence of gender, is still unclear. Objective: The objective of this study was to investigate the association between sports participation and individual food preferences and to explore potential gender differences among sports participants in a large group of Italian adults. Methods: This cross-sectional study involved 2665 adults (aged ≥ 18 years) who lead normal lives and underwent a routine lifestyle and dietary assessment at a clinical centre specialising in nutrition, metabolic health, and lifestyle counselling in Rome. Participants completed an online questionnaire on food preferences (19 foods) and sports practice. Multivariate logistic regression models, adjusted for age, sex, and smoking, were used to assess associations. Results: Sports participation was defined as engaging in structured physical activity at least once per week and was reported by 53.5% of subjects (men: 60.1%; women: 49.0%; p < 0.0001). After adjustment, active individuals were significantly more likely to prefer plant-based drinks, low-fat yoghurt, fish, cooked and raw vegetables, fruit, whole grains, tofu, and dark chocolate (all p < 0.05) and less likely to prefer cow’s milk (p = 0.018). Among sport participants, males were more likely to prefer meat (general, white, red, processed) and eggs, while females preferred plant-based drinks. No significant gender differences were observed for dairy products, legumes, or fish. Differences in food preferences were also observed according to the type of sport, with bodybuilders showing higher preference for tofu and dark chocolate. The strongest associations were found in the 25–44 age group. Conclusions: Sports participation is independently associated with specific food preferences, characterised by greater preference for plant-based and fibre-rich foods, and gender differences in food choices persist even among active adults. These findings highlight the need to consider both sports participation and gender when designing nutritional interventions. Full article

Colorectal cancer (CRC) constitutes a major global health concern, ranking as the third most common cancer and the second leading cause of cancer-related mortality. The current review explores sex-based differences in CRC epidemiology, risk factors, tumor biology, and clinical outcomes. Males exhibit a higher incidence and mortality rate, with left-sided (distal) CRC predominating, while females are more frequently diagnosed with right-sided (proximal) tumors, which tend to be more aggressive and less responsive to conventional chemotherapy. Genetic disparities, including microsatellite instability and X-chromosome tumor suppressor genes, contribute to sex-specific differences in tumor progression and treatment response. Immune variations also influence disease outcomes, with females exhibiting stronger immune surveillance but higher exhaustion markers. Lifestyle factors such as body mass index (BMI), smoking, and hormonal influences further modulate CRC risk. While males are more vulnerable to obesity-related CRC, central obesity (waist-to-hip ratio) emerges as a stronger predictor in females. Additionally, smoking increases CRC risk differentially by tumor location. These findings underscore the importance of sex-specific approaches in CRC prevention, screening, and treatment, advocating for personalized medicine strategies tailored to gender-based biological and clinical distinctions. Full article

Tennis is a demanding sport that requires physical abilities and optimal body composition. The aim of this study was to investigate the anthropometric characteristics, body composition, and somatotype development of young Slovenian tennis players (754 boys and 514 girls aged 12 to 18 years) over the last two decades. Using standardised anthropometric measurements and the Heath-Carter method, somatotypes were calculated and analysed by age and gender. The results showed clear age- and gender-specific trends and differences in both somatotype profiles and detailed anthropometric characteristics. Significant differences were found in height, body mass, BMI, skinfolds, girths, and limb lengths, with gender differences becoming more pronounced in the older age groups. In boys, mesomorphy increased with age, reflecting an increase in musculature, while in girls, a shift from ectomorphic to endomorphic profiles was observed during adolescence, probably influenced by pubertal and hormonal changes. Significant sex-specific differences were observed in all three somatotype components in most age groups, especially in fat mass and muscle. The longitudinal design provides valuable data and insights into the evolving physical profiles of adolescent tennis players that support more effective talent identification and training. Despite the changes that have taken place in tennis over time, standardised measurement protocols ensured comparability, making the results relevant for practitioners working with adolescents in tennis development. Full article

Background/Objectives: Frailty is a multifactorial clinical syndrome characterized by diminished physiological reserves and increased vulnerability to stressors. It is increasingly recognized as a predictor of poor outcomes in cardiac rehabilitation (CR). However, how frailty is defined, assessed, and addressed across outpatient CR programmes remains unclear. This scoping review aimed to map the extent, range, and nature of research examining frailty in the context of outpatient CR, including how frailty is measured, its impact on CR participation and outcomes, and whether sex and gender considerations or participation barriers are reported. Methods: Following the PRISMA-ScR guidelines, we conducted a comprehensive search across six electronic databases (from inception to 15 May 2025). Eligible peer-reviewed studies included adult participants assessed for frailty using validated tools and enrolled in outpatient CR programmes. Two reviewers independently screened citations and extracted data. Results were synthesized descriptively and narratively across three domains: frailty assessment, sex and gender considerations, and barriers to CR participation. The protocol was registered with the Open Science Framework. Results: Thirty-nine studies met inclusion criteria, all conducted in the Americas, Western Pacific, or Europe. Frailty was assessed using 26 distinct tools, most commonly the Kihon Checklist, Fried’s Frailty Criteria, and Frailty Index. The median pre-CR frailty prevalence was 33.5%. Few studies (n = 15; 38.5%) re-assessed frailty post-CR. Sixteen studies reported sex or gender data, but none applied sex- or gender-based analysis (SGBA) frameworks. Only eight studies examined barriers to CR participation, identifying physical limitations, emotional distress, cognitive concerns, healthcare system-related factors, personal and social factors, and transportation as key barriers. Conclusions: The literature on frailty in CR remains fragmented, with heterogeneous assessment methods, limited global representation, and inconsistent attention to sex, gender, and participation barriers. Standardized frailty assessments and individualized CR programme adaptations are urgently needed to improve accessibility, adherence, and outcomes for frail individuals. Full article

Background/Objectives: Thyroid nodules are commonly found through sensitive imaging methods like ultrasonography. While most nodules are benign and asymptomatic, certain characteristics may indicate malignancy, prompting fine needle aspiration biopsy. Factors like age and gender affect cancer risk, complicating ultrasound-based risk systems. We aimed to determine whether the cytological malignancy rate of thyroid nodules could be adjusted for several clinical parameters. Methods: Data from patients aged 18 and above with thyroid nodules assessed via fine needle aspiration (FNA) were retrospectively reviewed. Malignancy classification was based on cytopathology and histopathology results. The study examined how various clinical parameters, adjusted for the ACR TI-RADS category, affected thyroid nodule malignancy rates, including age, sex, Body Mass Index (BMI), nodule size, presence of autoimmunity, and thyroxine therapy. Additionally, we analyzed the performance of ACR TI-RADS in predicting malignant cytology across different age subgroups of thyroid nodules. Results: The study included 1128 thyroid nodules from 1001 adult patients, with a median age of 48 years and predominantly female (76.68%). Malignancy rates varied across ACR TI-RADS categories, with higher rates associated with larger nodules and younger age groups. Age emerged as a significant predictor of malignancy, with a consistent decrease in the odds ratio for malignant cytology with advancing age across all ACR TI-RADS categories, indicating its potential utility in risk assessment alongside nodule size and sex. Conclusions: Raising the size threshold for recommending FNA of TR3-3 nodules and incorporating patients’ age and gender into the evaluation process could enhance the system’s accuracy in assessing thyroid nodules and guiding clinical management decisions. Full article

In a society that advocates for human rights, a moralistic, needs-based approach is incompatible with policies and practices that ensure educational inclusion for all individuals regardless of gender identity or sexual orientation. This study analyses the perspectives of members of the educational community on sex–gender diversity. Specifically, it presents the views of 32 individuals from four primary schools located in southern Andalusia. A qualitative methodology based on interviews and content analysis was employed, supported by NVIVO12 software. The findings reveal differing understandings of sex–gender diversity; the school’s stance on such diversity and, particularly, on LGBTIQ+phobia; as well as the role of initial teacher training in this area. Full article

Metabolic analysis systems require binary sex input, conflating biological sex with gender, limiting inclusivity. This study aimed to determine whether sex input altered metabolic or pulmonary variables during self-paced walking and running. Twenty adults completed two 5-min walking and running trials under both female (FC) and male (MC) input conditions in randomized order. Dependent t-tests determined differences between conditions; p-values < 0.05 were considered significant, and effect sizes were calculated. No significant within-participant differences were found between FC and MC for any variable. During walking, mean relative VO₂ (mL/kg/min) was 11.13 ± 2.73 (FC) and 10.81 ± 2.39 (MC), p = 0.08, R² = 0.93; mean energy expenditure (kcal) was 18.28 ± 4.74 (FC) and 17.86 ± 4.33 (MC), p = 0.12, R² = 0.94. During running, mean relative VO₂ was 28.80 ± 5.89 (FC) and 28.82 ± 6.06 (MC), p = 0.90, R² = 0.98; mean energy expenditure was 45.79 ± 13.08 (FC) and 45.55 ± 12.26 (MC), p = 0.99, R² = 0.98. Binary sex input in the TrueOne 2400 system did not affect variables, supporting inclusive sex and gender data collection to improve research ethics, accuracy, and representation of gender-diverse people without compromising integrity. Full article

Background/Objectives: The prognostic uncertainty of Mild Cognitive Impairment (MCI) imposes comprehensive neuropsychological evaluations beyond mere memory assessment. However, previous investigations into other cognitive domains, such as attention, have yielded divergent findings. Furthermore, while evidence suggests the presence of sex differences across the spectrum of dementia-related conditions, no study has systematically explored attentional disparities between genders within this context. The current study aims to investigate differences in the attentional subcomponents, i.e., alerting, orienting, and executive control, between patients with MCI and healthy older controls (HOCs), emphasizing interactions between biological sex and cognitive impairment. Methods: Thirty-six participants (18 MCI, and 18 HOCs) were evaluated using the Attention Network Test (ANT). Raw RTs as well as RTs corrected for general slowing were analyzed using Generalized Mixed Models. Results: Both health status and sex influenced ANT performance, when considering raw RTs. Nevertheless, after adjusting for the baseline processing speed, the effect of cognitive impairment was no longer evident in men, while it persisted in women, suggesting specific vulnerabilities in females not attributable to general slowing nor to the MCI diagnosis. Moreover, women appeared significantly slower and less accurate when dealing with conflicting information. Orienting and alerting did not differ between groups. Conclusions: To the best of our knowledge, this is the first study investigating sex differences in attentional subcomponents in the aging population. Our results suggest that previously reported inconsistencies about the decline of attentional subcomponents may be attributable to such diversities. Systematically addressing sex differences in cognitive decline appears pivotal for informing the development of precision medicine approaches. Full article

The Relative Age Effect (RAE) refers to the advantage that relatively older athletes within the same age group may have in sports. While this phenomenon has been widely documented in numerous disciplines, its presence in orienteering remains largely unexplored. This study aimed to analyse the existence of RAE among Spanish orienteers selected for international competitions organised by the International Orienteering Federation (IOF) between 1987 and 2023. A total of 384 participations (225 male, 159 female) were examined across the European Youth Orienteering Championships (EYOC), Junior World Orienteering Championships (JWOC), and the European and World Orienteering Championships (EOC + WOC). The distribution of birth dates by quartiles and semesters was compared using chi-square tests, Cramér’s V, Z-tests, and odds ratios with 95% confidence intervals. The results revealed a significant RAE in male athletes, particularly in JWOC, where those born in the first quartile were up to 3.77 times more likely to be selected than those in the third quartile. In contrast, no significant associations were found in female athletes, which may reflect structural or developmental differences related to sex. These gender-based disparities highlight the importance of integrating sex-specific considerations into selection policies. Overall, the findings suggest a selection bias favouring relatively older males, which may hinder the development of late-born talent. Therefore, it is recommended that selection criteria be reassessed to ensure fairer and more inclusive talent identification and development in youth and elite orienteering. Full article

Despite advances in cancer care, disparities persist. The collection of the social determinants of health (SDOH) is fundamental to addressing disparities. However, SDOH are inconsistently collected in many regions of the world. This two-phase multiple methods study examined patient and community perspectives regarding SDOH data collection in Canada. In phase 1, a survey was administered to patients at a cancer centre (n = 549) to assess perspectives on an SDOH data collection tool. In phase 2, broader perspectives were sought through a community consultation with patient partners experiencing structural inequality (n = 15). Most participants were comfortable with SDOH data collection. Of survey respondents, 95% were comfortable with the collection of language, birthplace, sex, gender, education, and disability, and 82% to 94% were comfortable with SES, sexual orientation, social support, and race/ethnicity. Discomfort levels did not differ across subgroups, except women were more uncomfortable disclosing SES (OR: 2.00; 95%CI: 1.26, 3.19). Most (71%) preferred face-to-face data collection with a healthcare professional and only half were comfortable with storage of SDOH in electronic health records. Open-ended survey responses (n = 1533) and the community consultation revealed concerns about privacy, discrimination, relevance to care, and data accuracy. SDOH data collection efforts should include a clear rationale for patients, training for providers, strong data privacy and security measures, and actionable strategies to address needs. Full article

Background: This literature review examines the prevalence and severity of depression and anxiety symptoms in adolescents following ACL injury, with a focus on gender-disaggregated data. Methods: An electronic search was conducted across databases, including Ovid MEDLINE (R), PUBMED, and the Cochrane Library, covering articles from 1964 to 13 February 2024. Primary search terms were “ACL,” “depression,” “anxiety,” and “adolescent,” expanded using medical subject headings (MeSH). Manual searches of the references supplemented the database search. Inclusion criteria included studies on depression or anxiety post-ACL injury in adolescents. The exclusion criteria were studies without adolescent participants or those focusing exclusively on one sex. Results: The search identified 62 studies, of which 5 were ultimately selected for comprehensive analysis. Four studies reported on depression using various scales, and three measured anxiety symptoms. No studies provided gender-disaggregated data. One study found no significant difference in depression scores between adolescent and adult patients. Another study noted that socioeconomic disadvantage correlated with increased depressive and anxiety symptoms post-surgery. An additional study highlighted a significant increase in depression scores from pre- to post-injury among ACL-injured participants compared to uninjured controls. Conclusions: Our understanding of the psychological consequences of ACL rupture on female adolescent patients is incomplete. Given the high incidence of ACL injuries in this patient group and their potential psychological vulnerability, improving the evidence base in this area could address a previously neglected aspect of care, with positive impacts on returning to sport and quality of life. Future studies of high methodological quality are needed to address this gap in the literature. Full article

Gender-independent, intersex, non-binary, and transgender (GIaNT) youth have puberty health and sex education needs that are different from cisgender youth. Unfortunately, this population has historically been excluded from curricula pertaining to these issues in schools throughout the U.S. and Canada. While sex education programs are limited for all youth, and navigating puberty can range from exciting to scary for all youth, GIaNT youth are particularly vulnerable to facing negative outcomes by being omitted from such curricula. Because they are not able to access adequate information in schools and in their family/friend networks, a majority of GIaNT youth turn to the internet to seek out resources for education on puberty health and sex education. To this end, our team is in the process of creating an online educational resource (OER) that is age-appropriate and affirming for GIaNT youth to be provided with resources that are personalized to users’ unique needs. This literature review discusses content suggestions for inclusion of comprehensive puberty health and sex education that caters to GIaNT youth and their unique needs. Full article

Background: Magnesium (Mg²⁺) plays a fundamental role in various physiological processes, including neuromuscular function, glucose metabolism, cardiovascular regulation, and bone health. Despite its significance, the influence of sex on magnesium metabolism, requirements, and health outcomes remains unexplored. The aim of this review is to analyze sex-based differences in magnesium homeostasis, with a particular focus on hormonal regulation, body composition, and disease susceptibility. Methods: This narrative review, based on a non-systematic MEDLINE search conducted in January 2025, prioritized clinical trials from the past 15 years on human subjects and explored gender-specific aspects of magnesium intake, status, metabolism, and supplementation. Results: Hormonal fluctuations, particularly variations in estrogen levels, affect magnesium absorption, distribution, and retention, thereby influencing magnesium balance across different life stages such as puberty, pregnancy, and menopause. Additionally, dietary intake and lifestyle factors often differ between men and women, further impacting magnesium status. Emerging evidence suggests that suboptimal magnesium levels may differentially contribute to conditions such as osteoporosis, cardiovascular disease, and metabolic disorders in each sex. Conclusions: In conclusion, acknowledging sex-specific differences in magnesium metabolism is essential for developing personalized dietary guidelines and therapeutic strategies. Tailored nutritional approaches could significantly improve magnesium status, enhance overall health, and reduce the burden of chronic diseases linked to magnesium imbalance. Full article

Background: Pulmonary arterial hypertension (PAH) is a rare and severe condition characterized by increased pulmonary arterial pressure and vascular resistance. Women are more susceptible to PAH yet have higher survival rates than men, a phenomenon called the “estrogen paradox”. This study aims to investigate the sex-based differences in PAH using plasma untargeted metabolomics. Methods: Plasma samples were collected from 43 PAH patients and 37 healthy controls. The samples were analyzed using two complementary analytical techniques: gas chromatography–mass spectrometry (GC-QqQ/MS) and liquid chromatography–mass spectrometry (LC-Q-ToF/MS). The metabolic differences between male and female PAH patients and controls were identified using multivariate statistical analyses. Results: Our results show changes in the lipid, fatty acid, and amino acid metabolism in both sexes. Women presented additional changes in the carbohydrate, bile acid, and nucleotide metabolism. The metabolites affected by PAH in women included decreased threonine, tryptophan, and lipid intermediates and elevated bile acids. Men were found to have additional changes in the heme catabolism, cholesterol synthesis, and lipoxygenase pathways. The metabolites affected by PAH in men included decreased branched-chain amino acids and increased bilirubin, phospholipids, and oxidized fatty acids. Conclusions: The gender differences observed in the development of PAH are likely multifactorial. While estrogens and potentially other sex hormones have been implicated in modulating relevant biological pathways, their exact role in disease progression and pathogenesis remains to be fully elucidated. The specific metabolic changes in women and men point to distinct disease mechanisms, potentially explaining the differences in prevalence, prognosis, and treatment response of patients with PAH. The obtained results should be validated with the use of targeted quantitative analyses and larger numbers of patients. Full article

Background/Objectives: Plant-based diets are associated with reduced chronic disease risk, though regional variations persist. In Zhejiang, China, where plant-based food intake is high, this study aimed to explore the association between plant-based diets and metabolic syndrome (MetS) in adults aged 35–75. Methods: This cross-sectional study utilized data from the 2024 Zhejiang Nutrition and Health Survey (ZJNHS). Three plant-based diet indices were calculated: the overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Multivariate logistic regression models evaluated associations between diet index quintiles and MetS and its components. Results: Among the 4695 participants included in the study, 23.9% (n = 1122) had MetS. After adjusting for demographic and lifestyle factors, individuals in the highest uPDI quintile showed a significantly higher MetS risk compared to the lowest quintile (OR = 1.37, 95% CI: 1.08–1.73, p-trend = 0.013). Subgroup analyses revealed significant gender interaction (p for interaction < 0.001), with women exhibiting elevated MetS risk (OR = 1.03, 95% CI: 1.01–1.04, p < 0.001). For MetS components, the highest uPDI quintile was associated with increased risks of abdominal obesity (OR = 1.32, 95% CI: 1.05–1.66; p-trend = 0.032), elevated blood pressure (OR = 1.41, 95% CI: 1.12–1.78; p-trend = 0.003), and elevated fasting glucose (OR = 1.27, 95% CI: 1.01–1.59; p-trend = 0.037). Conclusions: Unhealthy plant-based foods are associated with increased MetS risk, particularly in women. Reducing intake of such foods, considering sex differences, and implementing precision nutrition interventions are essential. Full article