Search Results (85)

Background: Childhood obesity represents the most common nutritional and metabolic disorder in industrialized countries and constitutes a major public health concern. In Italy, 20–25% of school-aged children are overweight and 10–14% are obese, with marked regional variability. Excess adiposity in childhood is frequently associated with hypertension, dyslipidemia, insulin resistance, and non-alcoholic fatty liver disease (NAFLD), predisposing to future cardiovascular disease (CVD). Objective: To investigate anthropometric indicators of cardiometabolic risk in 810 children and adolescents aged 7–17 years who underwent assessment for competitive sports eligibility at the Sports Medicine Unit of Modena, evaluate baseline knowledge of cardiovascular health aligned with ESC, AAP (2023), and EASO guidelines. Methods: 810 children and adolescents aged 7–17 years undergoing competitive sports eligibility assessment at the Sports Medicine Unit of Modena underwent evaluation of BMI percentile, waist circumference (WC), waist-to-height ratio (WHtR), and blood pressure. Cardiovascular knowledge and lifestyle habits were assessed via a previously used questionnaire. Anthropometric parameters, blood pressure (BP), and lifestyle-related knowledge and behaviors were assessed using standardized procedures. Overweight and obesity were defined according to WHO BMI-for-age percentiles. Elevated BP was classified based on the 2017 American Academy of Pediatrics age-, sex-, and height-specific percentiles. Statistical analyses included descriptive statistics, group comparisons, chi-square tests with effect size estimation, correlation analyses, and multivariable logistic regression models. Results: Overall, 22% of participants were overweight and 14% obese. WHtR > 0.5 was observed in 28% of the sample and was more frequent among overweight/obese children (p < 0.001). Elevated BP was detected in 12% of participants with available measurements (n = 769) and was significantly associated with excess adiposity (χ² = 7.21, p < 0.01; Cramér’s V = 0.27). In multivariable logistic regression analyses adjusted for age and sex, WHtR > 0.5 (OR 2.14, 95% CI 1.32–3.47, p = 0.002) and higher sedentary time (OR 1.41 per additional daily hour, 95% CI 1.10–1.82, p = 0.006) were independently associated with elevated BP, whereas BMI percentile lost significance when WHtR was included in the model. Lifestyle knowledge scores were significantly lower among overweight and obese participants compared with normal-weight peers (p < 0.01). Conclusions: WHtR is a sensitive early marker of cardiometabolic risk, often identifying at-risk children missed by BMI alone. Baseline cardiovascular knowledge was suboptimal. The observed gaps in cardiovascular knowledge underscore the importance of integrating anthropometric screening with structured educational interventions to promote healthy lifestyles and long-term cardiovascular prevention. Full article

The integration of omics technologies, including genomics, proteomics, metabolomics, and microbiomics, has transformed sports science, particularly soccer, by providing new opportunities to optimize player performance, reduce injury risk, and enhance recovery. This systematic literature review was conducted in accordance with PRISMA 2020 guidelines and structured using the PICOS/PECOS framework. Comprehensive searches were performed in PubMed, Scopus, and Web of Science up to August 2025. Eligible studies were peer-reviewed original research involving professional or elite soccer players that applied at least one omics approach to outcomes related to performance, health, recovery, or injury prevention. Reviews, conference abstracts, editorials, and studies not involving soccer or omics technologies were excluded. A total of 139 studies met the inclusion criteria. Across the included studies, a total of 19,449 participants were analyzed. Genomic investigations identified numerous single-nucleotide polymorphisms (SNPs) spanning key biological pathways. Cardiovascular and vascular genes (e.g., ACE, AGT, NOS3, VEGF, ADRA2A, ADRB1–3) were associated with endurance, cardiovascular regulation, and recovery. Genes related to muscle structure, metabolism, and hypertrophy (e.g., ACTN3, CKM, MLCK, TRIM63, TTN-AS1, HIF1A, MSTN, MCT1, AMPD1) were linked to sprint performance, metabolic efficiency, and muscle injury susceptibility. Neurotransmission-related genes (BDNF, COMT, DRD1–3, DBH, SLC6A4, HTR2A, APOE) influenced motivation, fatigue, cognitive performance, and brain injury recovery. Connective tissue and extracellular matrix genes (COL1A1, COL1A2, COL2A1, COL5A1, COL12A1, COL22A1, ELN, EMILIN1, TNC, MMP3, GEFT, LIF, HGF) were implicated in ligament, tendon, and muscle injury risk. Energy metabolism and mitochondrial function genes (PPARA, PPARG, PPARD, PPARGC1A, UCP1–3, FTO, TFAM) shaped endurance capacity, substrate utilization, and body composition. Oxidative stress and detoxification pathways (GSTM1, GSTP1, GSTT1, NRF2) influenced recovery and resilience, while bone-related variants (VDR, P2RX7, RANK/RANKL/OPG) were associated with bone density and remodeling. Beyond genomics, proteomics identified markers of muscle damage and repair, metabolomics characterized fatigue- and energy-related signatures, and microbiomics revealed links between gut microbial diversity, recovery, and physiological resilience. Evidence from omics research in soccer supports the potential for individualized approaches to training, nutrition, recovery, and injury prevention. By integrating genomics, proteomics, metabolomics, and microbiomics data, clubs and sports practitioners may design precision strategies tailored to each player’s biological profile. Future research should expand on multi-omics integration, explore gene–environment interactions, and improve representation across sexes, age groups, and competitive levels to advance precision sports medicine in soccer. Full article

Precision medicine, which relies on genomic, multi-omic, phenotypic, and environmental data, has the potential to transform healthcare from population-focused heuristics to individualized prevention, diagnosis, and treatment. Moreover, recent advances in sequencing, molecular profiles, wearable sensors, and machine learning have created opportunities for rapid translational innovation: rapid genomic diagnosis in neonatal and paediatric rare diseases, targeted oncology, pharmacogenomic-based prescribing strategies, and individual sport performance. Nevertheless, the vast majority of innovations remain in centers of specialism or pilot programs, rather than routinely or equitably integrated into clinical or athletic practice. This narrative review synthesizes translational evidence across the life course—in pregnancy, paediatrics, adult medicine, geriatrics, and sportomics—to find reproducible clinical and performance examples which enable precision-based alternative approaches to management, outcome, or preparation; and to reshape those examples into pragmatic, scalable priorities which minimize inequity, and maximize benefit. We undertook a structured narrative synthesis of peer-reviewed literature, trials, clinician translation programs, implementation studies, and sportomics reports, prioritizing examples that demonstrate utility, reproducibility, and impact. Important findings suggest that multi-omics and rapid sequencing improve diagnostic yield and time to diagnosis. Molecular profiling and circulating tumor DNA help realize adaptive treatment selection. Integrated genomics, metabolomics, wearable physiology, and AI analytics facilitate individualized training, injury-risk stratification, and recovery optimization. But systematic value is limited by insufficient representative validation, dataset bias, poor interoperability, regulatory uncertainty, workforce preparedness, and inequities of access. Converting a promise into population- and performance-level value requires coordinated action across four fronts: representative validation; interoperable, privacy-preserving infrastructures; clinician- and coach-centered implementation; and templates for scalable, cost-sensitive deployment. Full article

Regular assessment of aerobic capacity is important in sports medicine and preventive health; however, cardiopulmonary exercise testing (CPX) is often impractical in field or clinical settings. Phase angle (PhA), derived from bioelectrical impedance analysis (BIA), has been proposed as a practical indicator of cellular health and membrane integrity; however, its relevance to aerobic capacity relative to skeletal muscle mass percentage (SMM%) in healthy young adults remains unclear. This cross-sectional study investigated the independent associations of PhA and SMM% with peak oxygen uptake (VO₂peak) and oxygen uptake at the anaerobic threshold (VO₂AT). Forty-one adults underwent same-day BIA and CPX using a cycle ergometer. VO₂peak was obtained from 37 participants who achieved maximal effort, while VO₂AT was identified in all. In multiple regression analyses adjusted for sex, PhA was independently associated with both VO₂peak and VO₂AT, whereas SMM% showed no independent association. These findings indicate that PhA may serve as a stronger determinant of aerobic capacity than SMM% in healthy young adults and highlight its potential utility in settings such as routine health check-ups or preliminary screening of aerobic capacity when CPX is impractical. Full article

Background: Oral health problems are common among elite athletes, yet the evidence remains fragmented and inconsistent. Objectives: To estimate the prevalence and severity of oral conditions in elite athletes through a systematic review and meta-analysis. Methods: Studies published in English, Spanish, or Portuguese, with observational design, available in PubMed, Embase, CINAHL, Web of Science, Scopus, Dentistry & Oral Science Source, and LILACS databases until 5 January 2025, were included. A narrative synthesis was used to describe the studies, and a meta-analysis of prevalences was performed using a random-effects model. Study quality assessment was performed using the Joanna Briggs Institute Critical Appraisal tools. Results: A total of 10 articles were included in the systematic review and meta-analysis. The overall combined prevalence of caries was found to be 44.4% (95%CI: 33.9–55.1%), the prevalence of dental erosion was 36.5% (95%CI: 22.6–51.7%), the prevalence of gingivitis was 41.4% (95%CI: 14.7–71%), the prevalence of pericoronitis was 18.7% (95%CI: 2.3–45.4%), the prevalence of periodontitis was 10.8% (95%CI: 2.7–23.3%) and the prevalence of orofacial trauma was 15.6% (95%CI: 5.3–29.7%). High heterogeneity was observed across studies. Most studies presented limitations related to participant recruitment and sample size adequacy. Conclusions: Dental caries, gingivitis, and dental erosion are highly prevalent among elite athletes, underscoring the importance of integrating oral health assessments into sports medicine care. High heterogeneity across studies limits the precision of prevalence estimates, emphasizing the need for standardized methodologies in future research. Full article

Inhaled medications, commonly prescribed for respiratory conditions such as asthma and exercise-induced bronchoconstriction, are increasingly scrutinized in sports medicine due to their potential performance-enhancing effects. Bronchodilators, in particular, may improve lung function, increase oxygen delivery, and influence muscle contractility, potentially enhancing athletic performance. However, supratherapeutic use raises concerns about cardiovascular risks, including tachyarrhythmias and altered autonomic balance, as well as muscle hypertrophy and sprint capacity gains. These effects blur the line between therapeutic use and doping, creating challenges for fair competition. This review explores the mechanisms by which inhaled drugs affect the cardiovascular and muscular systems, summarizes notable doping cases, and evaluates current detection methods. Despite regulatory thresholds established by the World Anti-Doping Agency, assay interpretation remains complicated by inter-individual variability, short drug half-lives, and enantiomeric differences. Addressing these gaps requires refined pharmacokinetic modeling, enantioselective assays, and metabolomic fingerprinting to safeguard both athlete health and the integrity of sport. Full article

Nutritional assessment and intervention in athletes, a central focus of sports medicine and healthcare, has increasingly shifted in recent years toward precision nutrition—an approach that individualizes dietary recommendations according to genetic profile, microbiome composition, lifestyle factors, and health status. Despite its promising potential, this approach faces significant limitations, including the challenge of integrating complex and dynamic interactions among multilevel indicators, and the relatively high costs associated with omics technologies. The aim of this paper is to propose a nutritional assessment and intervention model grounded in the Network Physiology of Exercise, an emerging scientific field that investigates the horizontal and vertical dynamic interactions among nested physiological levels and conceptualizes athletes as complex adaptive systems (CAS). The proposal integrates social, environmental, behavioral and psychobiological information, extracted particularly from semi-structured interviews based on CAS properties. Accordingly, the traditional dietary assessment tools are replaced by open and guided interviews that allow professionals and practitioners to co-construct meaningful insights and extract qualitative data through a reflexive thematic analysis. From a CAS perspective, the multidimensional and multi-timescale personal and environmental constrains affecting their eating behavior were integrated through a hierarchically nested organization. Eliciting the dynamics of emotional contexts, behavioral patterns, and psychophysiological states, the interviews become both a method of assessment and an intervention in itself. Full article

Physical activity is widely recognized for its health benefits; however, it also increases the risk of musculoskeletal soft tissue injuries, with muscle-related cases constituting a considerable proportion. These injuries impair well-being, athletic performance, and career longevity while creating substantial social and economic burdens. Their multifactorial etiology involves internal and external risk factors, and evidence suggests a heritable component influencing tissue integrity, recovery, and overall susceptibility. While genetic contributions to ligament and tendon damage are relatively established, knowledge regarding muscle injuries remains limited. This review critically summarizes current evidence on polymorphisms associated with sport-related muscle injury susceptibility. A systematic search of PubMed, Scopus, and Web of Science identified studies examining genetic markers in physically active individuals with documented muscle injuries. To date, 37 single nucleotide polymorphisms in 32 genes have been significantly linked to injury risk, recurrence, severity, and recovery. These genes cluster into categories involving muscle structure, growth and regeneration, metabolism, inflammatory and stress responses, membrane stability, signaling, and vascular regulation. By integrating available findings and outlining knowledge gaps, this review highlights promising directions for advancing personalized prevention and rehabilitation strategies in sports medicine. Full article

Football (soccer) is the world’s most widely played sport, but it carries a high incidence of traumatic injuries, particularly to the head, face, and lower limbs. Once regarded as a low-equipment discipline, the role of protective devices has expanded substantially in recent decades, both in injury prevention and in return-to-play strategies. This review provides a comprehensive overview of the historical evolution, typology, and materials of football protective equipment, with additional focus on regulatory frameworks, cultural acceptance, and illustrative cases from elite athletes. Shin guards remain the only mandatory device, yet the use of facial masks, headgear, braces, and orthoses is increasing, particularly following high-profile injuries. Advances in carbon fiber composites, thermoplastics, viscoelastic foams, and additive manufacturing have enabled lightweight, customized devices that balance protection with comfort and adherence. Beyond biomechanics, psychological reassurance, esthetics, durability, and hygiene strongly influence player compliance and perception. Despite this progress, critical challenges remain. Football lacks standardized testing protocols, clear certification pathways, and longitudinal studies on long-term outcomes. Evidence is particularly limited for youth athletes and newer categories of equipment. Looking ahead, the integration of wearable technologies, systematic hygiene and durability testing, and sustainable materials could transform protective gear into multifunctional tools for safety, monitoring, and performance optimization. Protective equipment in football has thus evolved into a multidisciplinary field at the intersection of medicine, engineering, psychology, and regulation. Future advances will depend on stronger collaboration between clinicians, researchers, governing bodies, and manufacturers to ensure safe, effective, and widely accepted protective solutions at all levels of the game. Full article

The increasing use of artificial intelligence (AI) in athlete health monitoring and injury prediction presents both technological opportunities and complex ethical challenges. This narrative review critically examines 24 empirical and conceptual studies focused on AI-driven injury forecasting systems across diverse sports disciplines, including professional, collegiate, youth, and Paralympic contexts. Applying an IMRAD framework, the analysis identifies five dominant ethical concerns: privacy and data protection, algorithmic fairness, informed consent, athlete autonomy, and long-term data governance. While studies commonly report the effectiveness of AI models—such as those employing decision trees, neural networks, and explainability tools like SHAP and HiPrCAM—few offers robust ethical safeguards or athlete-centered governance structures. Power asymmetries persist between athletes and institutions, with limited recognition of data ownership, transparency, and the right to contest predictive outputs. The findings highlight that ethical risks vary by sport type and competitive level, underscoring the need for sport-specific frameworks. Recommendations include establishing enforceable data rights, participatory oversight mechanisms, and regulatory protections to ensure that AI systems align with principles of fairness, transparency, and athlete agency. Without such frameworks, the integration of AI in sports medicine risks reinforcing structural inequalities and undermining the autonomy of those it intends to support. Full article

Sports-associated traumatic brain injury is emerging as an under-recognized driver of acute and chronic cardiovascular diseases. Larger population-based studies show that individuals with moderate-to-severe traumatic brain injury experience up to a two-fold excess risk of incident hypertension, coronary artery disease, myocardial infarction, and stroke that persists for at least a decade. Among former professional American-style football players, a higher lifetime concussion burden is uniquely related to a more atherogenic cardiometabolic profile and greater long-term stroke risk. Mechanistically, an acute “sympathetic storm” triggered by cerebral injury provokes catecholamine surges, endothelial dysfunction, and myocardial stunning, manifesting as neurogenic stunned myocardium or Takotsubo-like cardiomyopathy and malignant arrhythmias. Sub-acute to chronic phases are characterized by persistent autonomic imbalance, reflected by reduced heart-rate variability and impaired baroreflex sensitivity weeks to months after concussion, coupled with neuroinflammation, hypothalamic–pituitary–adrenal axis dysregulation, and lifestyle changes that accelerate atherosclerosis. The interplay of these pathways accounts for the elevated burden of cardiovascular disease observed long after neurological function has been restored. Despite robust evidence linking TBI to adverse cardiac outcomes, contemporary sports–cardiology risk stratification prioritizes hemodynamic load, genetics, and performance-enhancing substances, largely overlooking brain injury history. This review integrates epidemiological, clinical, and mechanistic data to (i) delineate acute neurocardiac complications secondary of sports-related traumatic brain injury, (ii) synthesize evidence for chronic cardiovascular risk, (iii) highlight emerging autonomic and inflammatory biomarkers, and (iv) propose surveillance and therapeutic strategies, ranging from heart-rate-variability-guided return-to-play decisions to aggressive cardiometabolic risk modification aiming to mitigate long-term morbidity in this athletic population. By framing sports-related traumatic brain injury as a modifiable cardiovascular risk factor, we aim to foster interdisciplinary collaboration among neurologists, cardiologists, and sports medicine practitioners, ultimately improving both neurological and cardiovascular outcomes across the athlete’s lifespan. Full article

The advancement of sports science has heightened demands for precise monitoring of athletes’ technical movements, physiological status, and performance. Optical fiber sensing (OFS) technology, with its unique advantages including high sensitivity, immunity to electromagnetic interference, capability for distributed sensing, and strong biocompatibility, demonstrates significant application potential in sports science. This review systematically examines the technical principles, innovative breakthroughs, and practical application cases of optical fiber sensors in various domains: monitoring key human physiological parameters such as respiration, heart rate, and body temperature; capturing motion and analyzing movement covering muscle activity, joint angles, and gait; integrating within smart sports equipment and protective gear; and monitoring sports apparatus and environments. The value of OFS technology is further analyzed in areas including sports biomechanics analysis, training load monitoring, injury prevention, and rehabilitation optimization. Concurrently, current technical bottlenecks such as the need for enhanced sensitivity, advancements in flexible packaging technologies, cost control, system integration, and miniaturization are discussed. Future development trends involving the integration of OFS with artificial intelligence, the Internet of Things, and new materials are explored, aiming to provide a theoretical foundation for sports medicine and training optimization. Full article

Introduction: Paramedics are increasingly being recognized as essential contributors to sports medicine, where their role extends beyond emergency response to prevention, planning, and collaboration with other medical professionals. Yet their scope of practice and effectiveness across sporting levels and regions remain insufficiently synthesized. Methods: This scoping review mapped international evidence on paramedics in sports medicine. Literature published in English between 2013 and 2023 was systematically searched in PubMed, Scopus, and ScienceDirect, and eligible studies were analyzed thematically. Thirty studies were included, spanning professional and amateur sports in North America, Europe, Asia, Oceania, and Africa. Results: The findings demonstrate that paramedics provide critical value across six domains. First, rapid emergency response, supported by innovations such as motorcycle-based ambulances, significantly reduced access times and improved survival rates. Second, preparedness and ongoing training, including physical fitness and interprofessional education, were shown to enhance effectiveness in demanding sporting environments. Third, collaboration with athletic trainers and other professionals improved on-field care and reduced unnecessary hospital transfers. Fourth, paramedics contributed to injury prevention programmes that lowered injury incidence and healthcare costs. Fifth, their involvement at mass gatherings ensured safety, streamlined triage, and reduced pressure on hospitals. Finally, evidence indicates that paramedic-led initiatives are cost-effective, generating both clinical and economic benefits. Conclusions: Paramedics play a multifaceted role in athlete care, emergency response, and injury prevention. Strengthening their integration through targeted training, protocol standardization, and equitable resource allocation can improve both athlete safety and system efficiency. Future research should focus on grassroots contexts and the use of paramedic-generated data to inform prevention and policy. Full article

Background/Objectives: Intense physical exercise leads to oxidative stress, causing cellular and DNA damage in athletes. Melatonin (MLT), a hormone with antioxidant and anti-inflammatory properties, is increasingly used to counteract these effects. However, its specific role in protecting DNA integrity and modulating repair mechanisms post-exercise remains unclear. This systematic review aimed to synthesize clinical evidence on the effects of exogenous MLT supplementation in reducing exercise-induced oxidative stress, reducing DNA damage, and influencing DNA integrity in healthy, physically active individuals. Methods: A comprehensive search was conducted in PubMed and Scopus up to 25 March 2025, for randomized or controlled clinical trials assessing exogenous MLT in healthy, physically active adults, with outcomes related to oxidative stress, DNA damage, or DNA repair. Risk of bias was evaluated using the RoB2 tool. Due to heterogeneity in study designs and outcomes, results were synthesized narratively. Results: Six clinical trials met the inclusion criteria, with MLT administered as a single dose (6–10 mg) or in repeated doses over 6 days to 4 weeks. Across the studies, MLT consistently reduced oxidative stress markers (malondialdehyde, advanced oxidation protein products), muscle damage indicators (creatine kinase, LDH), and inflammation, while increasing antioxidant enzyme activity (SOD, GPx). Only one study directly assessed DNA damage, reporting significantly reduced DNA fragmentation (comet assay) in the MLT group compared to placebo. No studies directly evaluated DNA repair pathways. Conclusions: Exogenous MLT supplementation appears effective in attenuating exercise-induced oxidative stress and may reduce DNA damage in athletes. While findings support its antioxidant and cytoprotective roles, further rigorous trials are needed to clarify its direct effects on DNA repair mechanisms in sports medicine. Funding: This review received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Registration: This review was prospectively registered in the PROSPERO database (CRD420231039805). Full article