Search

Background The aim of this study was to review, systematically, evidence concerning the link between the ACTN3 R577X polymorphism and the rates and severity of non-contact injuries and exercise-induced muscle damage in athletes and individuals enrolled in exercise training programs. Methods A computerized literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus, from inception until November 2020. All included studies compared the epidemiological characteristics of non-contact injury between the different genotypes of the ACTN3 R577X polymorphism. Results Our search identified 492 records. After the screening of titles, abstracts, and full texts, 13 studies examining the association between the ACTN3 genotypes and the rate and severity of non-contact injury were included in the analysis. These studies were performed in 6 different countries (Spain, Japan, Brazil, China, Republic of Korea, and Italy) and involved a total participant pool of 1093 participants. Of the studies, 2 studies involved only women, 5 studies involved only men, and 6 studies involved both men and women. All the studies included were classified as high-quality studies (≥6 points in the Physiotherapy Evidence Database (PEDro) scale score). Overall, evidence suggests there is an association between the ACTN3 R577X genotype and non-contact injury in 12 investigations. Six studies observed a significant association between ACTN3 R577X polymorphism and exercise induced muscle damage: two with non-contact ankle injury, three with non-contact muscle injury, and one with overall non-contact injury. Conclusion The present findings support the premise that possessing the ACTN3 XX genotype may predispose athletes to a higher probability of some non-contact injuries, such as muscle injury, ankle sprains, and higher levels of exercise-induced muscle damage.

The aim of this systematic review was to summarize the evidence on the acute and long-term effects of exercise training on PV, in both trained and untrained individuals and to examine associations between changes in %PVV and change in physical/physiological performance. Despite the status of participants and the exercise duration or intensity, all the acute studies reported a significant decrease of PV (effect size: 0.85

Abstract. Objective: While it has been reported that both foods and nutrients for individuals are connected with sleep, there is no evidence regarding the association of dietary patterns, identified by factor analysis, with primary insomnia. The present study sought to evaluate the association between major dietary patterns and the chance of having primary insomnia. Methods: The present case-control study was performed using 444 people (111 cases and 333 control), aged 18 to 60 years, referred to Isfahan health centers. Dietary intake was assessed via a food frequency questionnaire in a case-control study in Isfahan, Iran. Principal component analysis was used to determine major dietary patterns. The presence of primary insomnia was measured via the insomnia severity index questionnaire, and the subjects were grouped as healthy or insomniac. Results: Three major dietary patterns were recognized, and named; Western, Iranian Traditional and Healthy, respectively. The cumulative percentage of variance explained by three dietary patterns was 48.2%. Those in second (OR = 0.30; 95%CI: 0.2–0.46) and third (OR = 0.22; 95%CI: 0.15–0.35) tertiles of healthy dietary pattern were less likely suffer with insomnia. This association remained significant only in the highest tertile after adjusting potential confounders (OR = 0.45; 95%CI: 0.32–0.95). We found no significant association between greater adherence to Western or Iranian traditional dietary patterns and primary insomnia. Conclusions: The findings showed that although no statistically significant association was observed between both Western and Iranian traditional dietary patterns with primary insomnia, people with greater adherence to the healthy dietary pattern are less likely to have primary insomnia.

Objective This study aimed to examine the association between physical education classes and PA among adolescents from 50 low- and middle-income countries (LMICs). Methods A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences. Results Included adolescents aged from 13 to 17 years (n = 187,386, %boys = 51.7; mean age = 14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day = 1.34, 2 days = 1.66, 3 days = 1.67, 4 days = 1.79, 5 days or more = 2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I2 = 53%, p Conclusions Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors.

This systematic review was conducted to summarize and clarify the evidence on the association between 25-hydroxyvitamin-D [25(OH)D] concentrations and coronavirus disease 2019 (COVID-19) risk and outcomes. PubMed, Scopus, and Web of Science databases and Google Scholar were searched up to 26 November 2020. All retrospective and prospective cohort, cross-sectional, case-control, and randomized controlled trial studies that investigated the relation between 25(OH)D and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and COVID-19 severity were included. Thirty-nine studies were included in the current systematic review. In studies that were adjusted (OR: 1.77; 95% CI: 1.24, 2.53; I2: 44.2%) and nonadjusted for confounders (OR: 1.75; 95% CI: 1.44, 2.13; I2: 33.0%) there was a higher risk of SARS-CoV-2 infection in the vitamin D deficiency (VDD) group. Fifteen studies evaluated associations between VDD and composite severity. In the studies that were adjusted (OR: 2.57; 95% CI: 1.65, 4.01; I2 = 0.0%) and nonadjusted for confounders (OR: 10.61; 95% CI: 2.07, 54.23; I2 = 90.8%) there was a higher severity in the VDD group. Analysis of studies with crude OR (OR: 2.62; 95% CI: 1.13, 6.05; I2: 47.9%), and adjusted studies that used the Cox survival method (HR: 2.35; 95% CI: 1.22, 4.52; I2: 84%) indicated a significant association of VDD with mortality, while in adjusted studies that used logistic regression, no relation was observed (OR: 1.05; 95% CI: 0.63, 1.75; I2: 76.6%). The results of studies that examined relations between VDD and intensive care unit (ICU) admission, pulmonary complications, hospitalization, and inflammation were inconsistent. In conclusion, although studies were heterogeneous in methodological and statistical approach, most of them indicated a significant relation between 25(OH)D and SARS-CoV-2 infection, COVID-19 composite severity, and mortality. With regard to infection, caution should be taken in interpreting the results, due to inherent study limitations. For ICU admission, inflammation, hospitalization, and pulmonary involvement, the evidence is currently inconsistent and insufficient.

We aimed to assess the dietary composition of lunch meal using a posteriori-derived dietary patterns and to determine the association of lunch composition with obesity in a sample of Iranian adults. This cross-sectional study was conducted on 850 men and women in Tehran (aged 20–59 years). Dietary intakes were assessed using three 24-h dietary recalls, and dietary patterns were identified via principal component factor analysis. For each identified pattern, scores were calculated for each participant and then classified into tertiles. Central obesity was defined WHO criteria. General obesity was defined as a BMI of more than 30 kg/m2. Three major dietary patterns were identified at lunch meal using twelve food groups: ‘Bread, grains and fat’, ‘Western’ and ‘Potato and eggs’. After adjustment for potential confounders, participants at the top tertile of the ‘Bread, grains and fat’ dietary pattern had greater odds for a higher waist-to-hip ratio (WHR), compared with those in the lowest tertile (OR: 1·44, 95 % CI 1·01, 2·07). However, we found no association between ‘Western’ or ‘potato and eggs’ patterns and WHR (OR: 0·89, 95 % CI 0·62, 1·28 and OR: 1·16, 95 % CI 0·69, 1·42, respectively). None of the identified dietary patterns was associated when defining obesity with waist circumference or BMI. In conclusion, participants had a greater chance of central obesity defined based on WHR following a lunchtime pattern with a higher and positive loading factor for ‘Bread, grains and fat’.

Summary Background The current evidence-base regarding the effect of hesperidin (a flavanone found in citrus fruits) on body composition is equivocal. Objective We conducted a meta-analysis on the effect of orange juice and/or hesperidin supplementation on anthropometric measures in randomized controlled trials (RCTs). Materials and methods A systematic search of PubMed and Scopus was performed up to February 2020. The overall estimates and their 95% confidence intervals (CIs) were calculated using a random-effects model. Results Eleven eligible RCTs, with 512 individuals, were included in this study. The meta-analysis showed that orange juice and/or hesperidin had no significant effect on body weight [weighted mean difference (WMD) = −0.31 kg; 95% CI, −1.44 to 0.82, P = 0.592], body mass index [WMD = 0.11 kg/m2; 95% CI, −0.33 to 0.56, P = 0.617], fat mass [WMD = 0.14 kg; 95% CI, −0.95 to 1.22, P = 0.807], percentage body fat [WMD = −0.70%; 95% CI, −2.58 to 1.18, P = 0.463] and waist circumference [WMD = 0.07 cm; 95% CI, −1.16 to 1.30, P = 0.588]. Conclusion The present study revealed that there is no significant beneficial effect of orange juice and/or hesperidin supplementation on anthropometric measures. The authors advocate that more high-quality clinical trials are needed to better discern the potential efficacy of orange juice and/or hesperidin.

Purpose The purpose of this systematic review and meta-analysis was to investigate the efficacy of propolis on glycemic indices in type 2 diabetic patients. Design/methodology/approach Web of science (ISI), Embase, Scopus and PubMed were systematically searched to find randomized controlled trials (RCTs) assessing the effects of propolis intake on glycemic controls in type 2 diabetic patients, from inception up to September 1, 2020. A random-effects model was used to pool weighted mean difference (WMD). Meta-regression was performed to detect the potential sources of inter-study heterogeneity. Findings Seven trials were included in the meta-analysis. Compared to controls, propolis intake significantly improved serum fasting blood sugar (FBS) (WMD = −13.62 mg/dl, 95% CI = [−23.04, −4.20], P = 0.005, I2 = 58.5%) and hemoglobin A1C (HbA1c) (WMD = −0.52%, 95% CI = [−0.86, −0.18], P = 0.002, I2 = 64.0%). In contrast, receiving propolis did not change serum insulin (WMD = −1.46 (uIU/ml), 95% CI = [−2.94, 0.02], P = 0.05, I2 = 75.0%) and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = −0.98 (%), 95% CI = [−2.00, 0.04], P = 0.06, I2 = 82.3%) compared to controls. Originality/value The present meta-analysis demonstrated that propolis intake significantly reduces serum FBS and HbA1c in diabetic patients but does not alter serum insulin and HOMA-IR. Further large-scale RCT’s are needed to approve these effects.

Peritoneal adhesion represents a severe complication following surgery. Punica granatum (pomegranate) possesses several anti-oxidative and anti-inflammatory properties. Pomegranate peel extract (PPEx) can alleviate the production of various inflammatory factors and cytokines. Thus, we sought to evaluate the anti-adhesion effects of pomegranate in rats. Thirty male Wistar rats (6-week-old, 220 ± 20 g) were divided into five groups (n = 6): normal group without any surgical procedures, control group, and experimental groups receiving 2 ml of 1%, 2%, and 4% w/v PPEx, respectively. Peritoneal adhesions were examined macroscopically. Furthermore, we evaluated inflammatory cytokines levels [interleukin 6 (IL-6), and tumour necrosis factor-α (TNF-α)], growth factors [transforming growth factor- β1 (TGF-β1), and vascular endothelial growth factor (VEGF)], and oxidative stress parameters [nitric oxide metabolites (NO), and malondialdehyde (MDA), and glutathione (GSH)] using biochemical methods. Our results showed that the adhesion score and IL-6, TNF-α, TGF-β1, VEGF, NO, and MDA levels were increased in the control group. In contrast, the GSH level was diminished in the control group compared with the normal group (P

Summary Background Although several randomized controlled trials (RCTs) have supported the beneficial effects of higher meal frequency (MF) on cardiometabolic risk factors, the putative effects of higher MF on health remain inconclusive. This study systematically reviewed the evidence from RCTs of the effect of higher compared with lower MF on the blood lipid profile, glucose homeostasis, and adipokines. Methods PubMed, Scopus, ISI Web of Science, and the Cochrane database were searched up to October 2020 to retrieve relevant RCTs. A DerSimonian and Laird random effects model was used to pool mean differences and 95% CI for each outcome. The quality of studies and evidence was assessed through standard methods. Results Twenty-one RCTs (686 participants) were included in this meta-analysis. Overall results showed a significant improvement in total cholesterol [weighted mean difference (WMD) = −6.08 mg/dl; 95% CI: −10.68, −1.48; P = 0.01; I2 = 88%], and low-density cholesterol (LDL-C) (WMD = −6.82 mg/dl; 95% CI: −10.97, −1.60; P = 0.009; I2 = 85.7%), while LDL-C to high-density cholesterol ratio (LDL-C: HDL-C) increased (WMD = 0.22; 95% CI: 0.07, 0.36; P = 0.003; I2 = 0.0%) in higher MF vs. lower MF. No significant effects were found on measures of glycemic control, apolipoproteins-A1 and B, or leptin. In subgroup analyses, higher MF significantly reduced serum triglyceride (TG), and increased HDL-C, compared with lower MF in interventions > 12 weeks, and decreased serum TC and LDL-C in healthy participants. A significant reduction in LDL-C also was observed in studies where the same foods given both arms, simply divided into different feeding occasions, and in feeding studies, following higher MF compared to lower MF. Conclusion Our meta-analysis found that higher, compared with lower MF may improve total cholesterol, and LDL-C. The intervention does not affect measures of glycemic control, apolipoproteins-A1 and B, or leptin. However, the GRADE ratings of low credibility of the currently available evidence highlights the need for more high-quality studies in order to reach a firm conclusion.

Background: Several studies assessed the level of knowledge and general public behavior on human immunodeficiency virus/acquired immuno-deficiency syndrome (HIV/AIDS) in India. However, comprehensive scrutiny of literature is essential for any decision-making process. Our objective was to perform a systematic review and meta-analysis to examine the level of knowledge and attitude towards HIV/AIDS in India. Methods: A systematic search using Medical Subject Headings (MeSH) and free terms was conducted in PubMed/Medline, Scopus, Embase, and Google Scholar databases to investigate the level of knowledge and attitude of HIV/AIDS in India population. Cross-sectional studies published in English from January 2010 to November 2020 were included. The identified articles were screened in multiple levels of title, abstract and full-text and final studies that met the inclusion criteria were retrieved and included in the study. The methodological quality was assessed using the Joanna Briggs Institute’s checklist for cross-sectional studies. Estimates with corresponding 95% confidence intervals (CIs) for each domain were pooled to examine the level of knowledge and attitude towards HIV/AIDS in India. Results: A total of 47 studies (n= 307 501) were identified, and 43 studies were included in the meta-analysis. The overall level of knowledge about HIV/AIDS was 75% (95% CI: 69-80%; I2 = 99.8%), and a higher level of knowledge was observed among female sex workers (FSWs) 89% (95% CI: 77-100%, I2 = 99.5%) than students (77%, 95% CI: 67-87%, I2 = 99.6%) and the general population (70%, 95% CI: 62-79%, I2 = 99.2%), respectively. However, HIV/AIDS attitude was suboptimal (60%, 95% CI: 51-69%, I2 = 99.2%). Students (58%, 95% CI: 38-77%, I2 = 99.7%), people living with HIV/AIDS (57%, 95% CI: 44-71%, I2 = 92.7%), the general population (71%, 95% CI: 62-80%, I2 = 94.5%), and healthcare workers (HCWs) (74%, 95% CI: 63-84%, I2 = 0.0%) had a positive attitude towards HIV/AIDS. The methodological quality of included studies was "moderate" according to Joanna Briggs Institute’s checklist. Funnel plots are asymmetry and the Egger’s regression test and Begg’s rank test identified risk of publication bias. Conclusion: The level of knowledge was 75%, and 40% had a negative attitude. This information would help formulate appropriate policies by various departments, ministries and educational institutions to incorporate in their training, capacity building and advocacy programs. Improving the knowledge and changing the attitudes among the Indian population remains crucial for the success of India’s HIV/AIDS response.

This study examined dose-response effects of the Badminton World Federation (BWF) Shuttle Time programme on fundamental movement skills (FMS) and perceived FMS competence in 6–9-year olds. Children (n = 158, 83 boys, 75 girls, Mean ± SD age = 7.6 ± .97) were randomly allocated into three conditions: Shuttle Time 2Xweek; Shuttle Time 1Xweek; 3) control (CON) group. The intervention groups undertook the BWF Shuttle Time programme over a 10-week period in place of both or one of their statutory Physical Education lessons. FMS was assessed from the Test of Gross Motor Development 2. Perceived competence was assessed via the Pictorial Scale of Perceived Movement Skill Competence. Assessments were undertaken pre, post and 10 weeks post intervention. For FMS, a significant time X group interaction (P = .001) was evident. There was no significant difference in FMS between groups at pre (P > .05). Post intervention there were significant differences in FMS between 2X week and 1XWeek (P = .007), 2Xweek and control (P = .0001) and 1X Week and control (P = .007). From post to 10-weeks post there were significant improvements in FMS (P = .001) for the 2X week group. A significant time X group interaction (P = .0001) also indicated that perceived competence increased significantly pre to post for 1Xweek and 2Xweek groups, but not CON groups and was maintained at 10 weeks post (all P = .001).

Symptoms of psychological distress and disorder have been widely reported in people under quarantine during the COVID-19 pandemic;in addition to severe disruption of peoples’ daily activity and sleep patterns This study investigates the association between physical-activity levels and sleep patterns in quarantined individuals An international Google online survey was launched in April 6th, 2020 for 12-weeks Forty-one research organizations from Europe, North-Africa, Western-Asia, and the Americas promoted the survey through their networks to the general society, which was made available in 14 languages The survey was presented in a differential format with questions related to responses “before” and “during” the confinement period Participants responded to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the short form of the International Physical Activity Questionnaire 5056 replies (59 4% female), from Europe (46 4%), Western-Asia (25 4%), America (14 8%) and North-Africa (13 3%) were analysed The COVID-19 home confinement led to impaired sleep quality, as evidenced by the increase in the global PSQI score (4 37 ± 2 71 before home confinement vs 5 32 ± 3 23 during home confinement) (p

The aim of the study was to compare the effects of a lacto-ovo-vegetarian diet (LOV-D) vs. a standard weight-loss diet (SWL-D) on obese/overweight adults with NAFLD. Present randomised clinical trial recruited 75 overweight/obese adults with NAFLD, who were randomly assigned into LOV-D and SWL-D groups for 3 months. The LOV-D was designed based on eliminating meat, poultry, and fish; while including dairy products and eggs. The SWL-D was planned according to the standard food pyramid, which was free in all sources of food. Adherence to LOV-D significantly outperformed SWL-D in reducing levels of alanine aminotransferase (ALT), body weight, waist circumference, BMI, fasting blood sugar, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triacylglycerol (TG), cholesterol, low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP). Furthermore, ultrasonography revealed a higher alleviation in NAFLD grade among LOV-D, compared with SWL-D. This study suggests that adherence to LOV-D for 3 months has beneficial effects on NAFLD improvement, anthropometric measures, glycaemic-related markers, and lipid profiles.

PURPOSE: The aim of the present study was to investigate the effect of spirulina on lipid profiles and glycemic related markers in type 2 diabetes patients. METHODS: PubMed, Scopus, Cochrane Library, ISI Web of Science, and Google Scholar were searched from inception to August 2020. All clinical trials which investigated the effect of spirulina supplementation on glycemic related markers and lipid profile among type 2 diabetes patients were included. Random effects modeling was utilized for pooling analysis to compensate for the between-study heterogeneity. RESULTS: Eight studies (9 arms) were included in the meta-analysis. We found a significant reduction in fasting blood glucose (−17.88 mg/dl; 95% CI: −26.99, −8.78; I(2): 25%), triglyceride (−30.99 mg/dl; 95% CI: −45.20, −16.77; I(2): 50%), total-cholesterol (−18.47 mg/dl; 95% CI: −33.54, −3.39; I(2): 73%), LDL-C (−20.04 mg/dl; 95% CI: −34.06, −6.02; I(2): 75%), VLDL (−6.96 mg/dl; 95% CI: −9.71, −4.22; I(2): 33%), in addition to a significant increase in HDL-C (−6.96 mg/dl; 95% CI: −9.71, −4.22; I(2): 33%), after spirulina administration. No significant effect was observed on HbA1C or post prandial blood sugar following spirulina consumption. CONCLUSION: The present study suggests that spirulina supplementation can elicit beneficial effects on fasting blood glucose and blood lipid profiles. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00760-z.

The present study sought to evaluate the effect of resveratrol supplementation on mRNA expression levels of peroxisome proliferator-activated receptor alpha (PPARα), p53, p21, p16, and serum levels of cluster of differentiation 163 (CD163) to TNF-like weak inducer of apoptosis (TWEAK) ratio in patients with type 2 diabetes. In this double-blind randomized controlled trial, 71 patients were randomly assigned to receive either 1,000 mg of trans-resveratrol or placebo (methyl cellulose) for 8 weeks. Expression levels of genes of interest, and serum levels of sCD163 and sTWEAK were assessed at baseline and at the end of the study. Resveratrol supplementation significantly increased mRNA expression levels of p53 and p21 genes, compared with the placebo group (fold change of p53 = 1.29, p = .04; fold change of p21 = 1.46, p = .006). However, no significant effect on expression levels of PPARα and p16 genes was observed after supplementation. In addition, resveratrol significantly reduced serum levels of sCD163/sTWEAK ratio compared with the placebo group (p = .003). Resveratrol supplementation resulted in significant changes in p53 and p21 genes expression, while serum levels of sCD163/sTWEAK ratio also improved in the resveratrol group, without any significant change in adjusted sCD163 levels. More research is needed to confirm the beneficial effects of resveratrol for patients with diabetes.

The central governor model putatively explains the mechanism of endurance exercise-induced central fatigue, however high-intensity exercise-induced central fatigue strategies have not been investigated yet. This study aimed to examine how central fatigue affects neural response alterations, as measured by electroencephalographic (EEG) recordings, in intermittent high-intensity cycling. Neural responses were assessed by measuring the alteration of brainwaves based on spectral energy band estimates during an intermittent, high-intensity, 60-min exercise bout on a cycle ergometer. The cycle ergometer incline was changed every 10 min in an intermittent pattern (10-20-5-20-5-10°). EEG was used to analyze altering brain function. Heart rate (HR), blood lactate (BL), and rating of perceived exertion (RPE) were measured after the participants completed each change in incline. The results showed that HR, BL, and RPE increased at an incline of 20° in comparison to a 5° incline. The spectral power of EEG was significantly increased (P ˂ 0.01) in the alpha and beta frequency ranges with a change in inclines between 5 and 20°. The spectral power of the EEG was significantly increased (P ˂ 0.01) over the whole frequency range from rest (theta + 251%, alpha + 165%, beta + 145%). Higher, relative intensities (10 and 20°) increased brain function, regardless of fatigue occurrence. HIIT (high-intensity interval training) led to an alteration in the neural response. Further work investigating the usefulness of HIIT to improve brain function is warranted.

The objective of this study is to analyze the association between combinations of adherence to movement behaviour recommendations and fundamental movement skills (FMS) in preschoolers. This is a cross-sectional study. Participants of the study were 212 preschool children (M = 3.97 years old; 51.4% male), who provided objectively assessed physical activity (PA) data (Actigraph wGT3X), and completed FMS assessments (TGMD-2). Sleep time and screen time were parent-reported through face-to-face interview. Associations between the combination of two or three movement behaviours and FMS were analyzed using structural equation modeling (Mplus; 8.0; p < 0.05). Positive and significant associations were found between adherence to screen + sleep recommendations and locomotor skills (β = 0.23; p = 0.027); and between adherence to PA + screen + sleep recommendations with object control skills (β = 0.28; p = 0.014). Negative and significant associations were found between screen + sleep with object control skills (β = − 0.28; p = 0.007). The adherence to the 24-h movement behaviour recommendations explained locomotor and object control skills variability by 5% and 7%, respectively. Conclusion: The adherence to the combined movement behaviour recommendations may be a more important influence on FMS in preschoolers compared to any single movement behaviour in isolation.

A limited number of trials have evaluated the efficacy of a fixed-dose combination of bempedoic acid and ezetimibe for the treatment of hypercholesterolemia. The aim of this meta-analysis of existing studies was to evaluate the efficacy and safety of fixed-dose bempedoic acid and ezetimibe combination therapy for the treatment of hypercholesterolemia. A systematic literature search was conducted to identify randomized controlled trials (RCTs) comparing bempedoic acid and ezetimibe, versus placebo or ezetimibe alone, to 30 August 2020. A meta-analysis was conducted to investigate the efficacy of bempedoic acid and ezetimibe on lipid parameters and highly sensitive C-reactive protein (hsCRP) levels in patients with hypercholesterolemia or established atherosclerotic cardiovascular disease (ASCVD). Mean differences (MDs) or relative risk (RR) with their corresponding 95% confidence intervals (CIs), using random-effects models, were used to provide pooled estimates. A total of three phase II and III RCTs, comprising 388 patients, of whom 49.2% were treated with bempedoic acid and ezetimibe, and 197 controls, were identified. The duration of treatment was 12 weeks. Bempedoic acid and ezetimibe significantly reduced low-density lipoprotein cholesterol (MD − 29.14%, 95% CI − 39.52 to − 18.76; p

This meta-analysis was performed to assess the effect of L-carnitine supplementation on lipid profile. A systematic search were conducted in PubMed and Scopus to identify randomized clinical trials (RCTs) which evaluated the effects of L-carnitine on lipid profile. Pooled effect sizes were measured using random-effect model (Dersimonian-Laird). Meta-analysis showed that L-carnitine supplementation significantly reduced total cholesterol (TC) (weighted mean difference [WMD]: -8.17 mg/dL; 95% CI,-14.68 to -1.65, I2=52.2%, P = 0.041). Baseline level of TC was a source of heterogeneity, with a greater effect in studies with a baseline level of more than 200 mg/d (WMD: -11.93 mg/dL; 95% CI, -20.80 to-3.05). L-carnitine also significantly decreased low-density lipoprotein-cholesterol (LDL-C) (WMD:-5.22 mg/dL; 95% CI, -9.54 to -0.91, I2=66.7%, P = 0.010), and LDL-C level

Introduction: Findings of studies on the association between evening meal and obesity are inconclusive. Thus, we sought to investigate the association between major dietary patterns at evening meal and obesity among apparently healthy adults in Tehran. Methods: This cross-sectional research was conducted using 833 adult men and women who lived in Tehran (age range: 20-59 years). Their dietary intake was evaluated by three, 24-h dietary recalls(24hDRs), and major patterns were identified using exploratory factor analysis. The association between major dietary patterns at dinner with general and central obesity was assessed using logistic regression analysis. Results: We identified 3 major dietary patterns at dinner including "prudent", "potatoes and eggs" and"Western" patterns. There was no significant relationship between prudent and general obesity (OR:0.76, 95% CI = 0.21, 1.15, P value = 0.20), and, a significant association was not observed between potatoes and eggs and general obesity (OR: 0.89, 95% CI = 0.60, 1.32, P value = 0.57) also, there was no significant relationship between Western dietary pattern and general obesity in this study (OR: 0.95,95% CI = 0.63, 1.43, P value = 0.82). Further analyses showed that there was no significant relationship between central obesity with any of the dietary patterns. Conclusion: The results of this study do not support a possible relationship between major dietary patterns at dinner with general and central obesity. However, the presented findings should be confirmed in prospective studies.

The present study evaluates the effect of partial sleep restriction on postural control in judokas. Fourteen elite-level judokas performed three static postural control tests (the Unilateral Stance...

Children with hemophilia are an enhanced risk of modifiable cardiovascular and metabolic abnormalities. There is currently no nutritional guideline to prevent or manage cardiometabolic risk factors in these patients. Therefore, the present study sought to investigate the effect of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiovascular and metabolic risk factors among children with hemophilia. In this parallel randomized clinical trial, 40 children (all male) with hemophilia were randomly allocated to the DASH group (n = 20) or control group (n = 20) for 10 weeks. The intervention group received the DASH diet (50%–55% of energy from carbohydrate, 27%–30% of energy from fat and 16%–18% energy from protein), and the control group received nutritional recommendations based on healthy eating practices. Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), low‐density lipoprotein (LDL), and high‐density lipoprotein (HDL) were measured at the beginning and end of the study. Serum vitamin C was measured as a biomarker of compliance with the DASH diet. Study was registered at IRCT.ir (IRCT20130903014551N6). A significant increase in serum vitamin C in the DASH diet group was observed compared to the control group (p = .001), indicating good compliance with the DASH diet. There was a significant reduction in SBP (−0.48 mmHg), DBP (−0.48 mmHg), FBS (−5.86 mg/dl), TC (−16.07 mg/dl), TG (−17.21 mg/dl), and LDL‐C (−9.79 mg/dl), and a significant increase in HDL‐C (3.39 mg/dl), in the DASH diet group compared with the control group. Adherence to the DASH diet in children with hemophilia yielded beneficial effects in blood pressure, lipid profiles, and FBS., Forty adolescents with hemophilia were assigned to the DASH group or control group. After 10 weeks, beneficial changes were observed in blood pressure, lipid profile, and FBS among adolescents in the DASH group.

Objective: Inconsistent results regarding the association between the Body Mass Index (BMI) and brain disorders have been reported. We performed this study to investigate the association between BM...

BACKGROUND & OBJECTIVE(S): The current evidence base regarding the impact of propolis consumption on lipid profile in humans is equivocal. Thus, we sought to investigate the impact of propolis consumption on anthropometric indices and lipid profile in this meta-analysis. METHODS: Cochrane Library, Scopus, PubMed, and Web of Science electronic databases were searched up to December 2019. A random-effects model used to pool effect size. The leave-one-out method used to conduct sensitivity analysis. RESULTS: Five RCTs were included in this study. Our findings indicated a significant decrease in triglyceride (TG) (WMD: −3.91 mg/dl, 95% CI: −4.22, −3.60), and a significant increase in high-density lipoprotein (HDL) (WMD: 3.41 mg/dl, 95% CI: 0.05, 6.76), however, for body mass index, weight, cholesterol (CL), and low-density lipoprotein (LDL), no significant alterations were evident. CONCLUSION: This study revealed that consumption of propolis is associated with a reduction in TG levels, in addition to an increase in HDL levels. Nevertheless, additional research is required to further delineate the relationship between propolis consumption and lipid profile. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40200-020-00604-2) contains supplementary material, which is available to authorized users.

Background The relationship between body mass index (BMI) and risk of venous thromboembolism (VTE) and pulmonary embolism (PE) is a controversial issue. This dose-response meta-analysis was performed to investigate the association between BMI and risk of VTE and PE incidence based on cohort studies. Method A comprehensive systematic search was conducted up to August 2019 in MEDLINE/PubMed, SCOPUS, and Cochrane. DerSimonian and Laird random-effects models were run to estimate combined hazard ratios (HRs) with 95% confidence intervals (CIs). Dose-response analysis was also carried out based on BMI values. Results Eleven articles with 16 arms and 3,910,747 participants were eligible for inclusion in this systematic review and meta-analysis. Pooled results showed a positive association between BMI and risk of VTE in the obese participants compared to participants classified in the normal BMI category (HR: 1.62, 95% CI: 1.29–2.04, I2 = 95%). Furthermore, results showed a significant association between lower BMI (underweight versus normal BMI category) and reduced risk of PE (HR: 0.80, 95% CI: 0.70–0.92, I2 = 9%) and higher risk of PE in obese versus normal BMI participants (HR: 2.24, 95% CI: 1.93–2.60, I2 = 0%). There was a significant linear relationship between BMI and risk of VTE (p Conclusions This systematic review and dose-response meta-analysis with 3,910,747 participants highlights obesity as a significant risk factor related to the incidence of VTE and PE.

Aims: Accelerometers are becoming increasingly commonplace for assessing physical activity; however, their use in patients with cardiovascular diseases is relatively substandard. We aimed to systematically review the methods used for collecting and processing accelerometer data in cardiology, using the example of heart failure, and to provide practical recommendations on how to improve objective physical activity assessment in patients with cardiovascular diseases by using accelerometers. Methods and results: Four electronic databases were searched up to September 2019 for observational, interventional, and validation studies using accelerometers to assess physical activity in patients with heart failure. Study and population characteristics, details of accelerometry data collection and processing, and description of physical activity metrics were extracted from the eligible studies and synthesized. To assess the quality and completeness of accelerometer reporting, the studies were scored using 12 items on data collection and processing, such as the placement of accelerometer, days of data collected, and criteria for non-wear of the accelerometer. In 60 eligible studies with 3500 patients (of those, 536 were heart failure with preserved ejection fraction patients), a wide variety of accelerometer brands (n=27) and models (n=46) were used, with Actigraph being the most frequent (n=12), followed by Fitbit (n=5). The accelerometer was usually worn on the hip (n=32), and the most prevalent wear period was 7days (n=22). The median wear time required for a valid day was 600min, and between two and five valid days was required for a patient to be included in the analysis. The most common measures of physical activity were steps (n=20), activity counts (n=15), and time spent in moderate-to-vigorous physical activity (n=14). Only three studies validated accelerometers in a heart failure population, showing that their accuracy deteriorates at slower speeds. Studies failed to report between one and six (median 4) of the 12 scored items, with non-wear time criteria and valid day definition being the most underreported items. Conclusions: The use of accelerometers in cardiology lacks consistency and reporting on data collection, and processing methods need to be improved. Furthermore, calculating metrics based on raw acceleration and machine learning techniques is lacking, opening the opportunity for future exploration. Therefore, we encourage researchers and clinicians to improve the quality and transparency of data collection and processing by following our proposed practical recommendations for using accelerometers in patients with cardiovascular diseases, which are outlined in the article.

Introduction:The objective of this study was to evaluate the association between the consumption of an energy-dense diet and cardiometabolic risk factors in Iranian older adults.Methods:This cross-sectional study was conducted on 226 older adults who were living in Tehran, Iran. Dietary energy density (DED) was calculated as energy per weight of food, kcal/g. The usual intake of participants was measured using a validated semi-quantitative food frequency questionnaire. Anthropometric measurements, fasting blood sugar, serum lipid profile and blood pressure and were assessed. The metabolic syndrome was defined according to National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP III).Results:Those who were in the third tertile of DED compared to the first tertile had 19% lower odds of having the cardiometabolic risk factors and metabolic syndrome (MetS) 0.81 (0.39,1.68) but the association was no significant (P=0.58). There was a significant inverse association between DED and systolic blood pressure (SBP) (β=-0.14,P=0.03) and diastolic blood pressure (DBP) (β=-0.17,P=0.01). We did not find any significant association between intake of energy-dense foods and serum levels of triglyceride (TG) (P=0.62), fasting blood sugar (FBS) (P=0.06), high-density lipoprotein (HDL) (P=0.72) and waist circumference (WC) (P=0.28).Conclusion:DED is negatively associated with SBP and DBP in Iranian older adults. Prospective studies are needed to establish a causal link between DED and MetS and risk factors of cardiovascular disease (CVD).

To identify the association between the dietary carbohydrate indexes, such as dietary glycemic index (DGI) and load (DGL), dietary insulin index (DII) and load (DIL), with the possibility of cataract.This case-control study consisted of 101 new cases of cataract and 202 controls. DGI and DGL were computed through DGI values previously published. DII was also calculated based on dietary insulin index data published previously.There was a significant positive association between the highest quartiles of DGI (OR = 6.56; 95% CI = 2.67-16.06; P 0.001), DGL (OR = 6.17; 95% CI = 1.93-19.37; P = 0.002) and DIL (OR = 4.17; 95% CI = 1.41-12.27; P = 0.004) with risk of cataract, compared to those on the lowest quartile, but not for DII (OR = 0.85; 95% CI = 0.39-1.86; P = 0.82). Furthermore, after stratifying groups by BMI, a significant direct association between highest quartile of DGI (OR = 6.76; 95% CI = 2.49-18.38; P 0.001) and DGL (OR = 3.45; 95% CI = 0.96-12.37; P = 0.05) with risk of cataract was evident in individuals with elevated BMI (BMI≥25).We found a significant, direct, relationship between DGI, DGL and DIL with risk of cataract. However, the association between DII and the risk of cataract was not significant, even after adjusting for related confounders.

Studies regarding the influence of green coffee extract (GCE) on blood glucose levels are conflicting. Thus, we sought to conduct a meta-analysis and systematic review of all available randomized controlled trials (RCTs) to quantify the effects of GCE and CGA intervention on blood glucose and insulin levels. We performed systematic online searches in Scopus, Web of science, and PubMed databases, from inception to July 2019. Data were combined analyzed using a random effects model (Der Simonian-Laird method) and reported as weighted mean differences (WMD). Ten trials reported the influences of GCE on FBS and insulin and were subsequently entered into the meta-analysis. Combined results highlighted that FBS was significantly altered after GCE consumption (WMD: -1.791 mg/dl, 95% CI -3.404, -0.177), with no significant heterogeneity among the studies (I2 = 35.0%, p = .128). However, overall results demonstrated that GCE administration did not result in any significant alteration in insulin levels (WMD: -0.925 μU/ml, 95% CI:-1.915, 0.064), with significant heterogeneity found across studies (I2 = 87.9%). In sub-group analysis, insulin levels were significantly reduced when GCE was supplemented in dosages of ≥400 mg/day (WMD:-1.942 mg/dl, 95% CI:-1.184, -0.975; I2 = 0.0%). The results of present study support the use of GCE for the enhancement of blood glucose, while subgroup analysis highlighted significant improvements in insulin levels when GCE is supplemented in doses ≥400 mg/day.

The present study sought to investigate the effect of micronized resveratrol supplementation on serum levels of asymmetric de-methyl-arginine (ADMA) and paraoxonase-1 (PON1) activity in patients with type 2 diabetes (T2D). In this double-blinded randomized trial, 76 patients with T2D were recruited. Participants were randomly assigned to consume 1,000 mg resveratrol or placebo capsules (methylcellulose) per day, for 8 weeks. Serum levels of ADMA and PON1 enzyme activity were measured at the beginning and end of the intervention using the enzyme-linked immunosorbent assay method. In total, 71 participants completed the study. Our results showed that resveratrol significantly decreased serum levels of ADMA (-0.16 ± 0.11, p < .001) and improved PON1 enzyme activity (15.39 ± 13.99, p < .001) compared with placebo, after adjusting for confounding factors (age, sex, and baseline body mass index). Our findings suggest that 8-week resveratrol supplementation may produce beneficial effects on serum levels of ADMA and PON1 enzyme activity in patients with T2DM. However, further research is needed to confirm the veracity of these results.

Background/Aims Global incidence of hypertension is estimated to be, in excess of, one billion people, and given the efficacy of soluble dietary fibers, in particular, Psyllium, to positively impact blood pressure in patients with hypertension, it is of clinical importance that consensus on its supplementation be established. Therefore, the aim of the study was systematically review and meta-analyze the effect of psyllium supplementation on blood pressure of hypertensive patients in randomized controlled trials. Methods We searched six universal databases including; Pubmed/Medline, Ovid, Cochrane Library, Google Scholar, Embase, and Scopus until November 2018. Both combined and stratified analyzes were conducted. A fixed-effects or random- effects model was used to assess the mean effect sizes. Results An eventual 11 trials with 592 participants were considered as eligible for inclusion in the present meta-analysis. The meta-analysis revealed a significant reduction of 2.04 mmHg in systolic blood pressure (weighted mean difference, –2.04; 95% confidence interval, –2.82 to –1.63; p < 0.001). Whilst meta-regression highlighted that the hypotensive effect of psyllium was stronger in subjects with higher baseline blood pressure. Conclusions Given the overarching benefits and lack of reported side effects, particularly for hypertensive patients, health care providers and clinicians should consider the use of psyllium supplementation for the treatment or abatement of hypertension, or hypertensive symptoms.

Made available in DSpace on 2020-12-12T02:10:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Endophytic fungi are promising sources of bioactive substances; however, their secondary metabolites are toxic to plants, animals, and humans. This study aimed toevaluate the toxic, cytotoxic, mutagenic and oxidant/antioxidant activities of acetonitrile extract (AEPc), citrinin (CIT) and dicitrinin-A (DIC-A) of Penicillium citrinum. For this, the test substances at 0.5; 1.0; 1.5 and 2 μg/mLwere exposed for 24 and 48 h in Artemia salina, and 48 h in Allium cepa test systems. The oxidant/antioxidant test was evaluated in pre-, co- and post-treatment with the stressor hydrogen peroxide (H2O2) in Saccharomyces cerevisiae. The results suggest that the AEPc, CIT and DIC-A at 0.5; 1.0; 1.5 and 2 μg/mL showed toxicity in A. saline, with LC50 (24 h) of 2.03 μg/mL, 1.71 μg/mL and 2.29 μg/mL, and LC50 (48 h) of 0.51 μg/mL, 0.54 μg/mL and 0.54 μg/mL, respectively.In A. cepa, the test substances also exerted cytotoxic and mutagenic effects. The AEPc, CIT and DIC-A at lower concentrations modulated the damage induced by H2O2 in the proficient and mutant strains of S. cerevisiae for cytoplasmic and mitochondrial superoxide dismutase. Moreover, the AEPc at 2 μg/mL and CIT at the two highest concentrations did not affect the H2O2-induced DNA damage in the test strains. In conclusion, AEPc, CIT and DIC-A of P. citrinum may exert their toxic, cytotoxic and mutagenic effects in the test systems possibly through oxidative stress induction pathway. Northeast Biotechnology Network (RENORBIO) Postgraduate Program in Biotechnology Federal University of Piauí–IFPI Nucleus of Applied Research to Sciences (NIAC) Federal Institute of Education Science and Technology of Maranhão–IFMA Nucleus of Bioassays Biosynthesis and Ecophysiology of Natural Products (NuBBE) Department of Organic Chemistry Institute of Chemistry São Paulo State University (UNESP) Laboratory of Research in Toxicological Genetics–LAPGENIC Federal University of Piauí Laboratory of Genetics and Molecular Biology Federal University of Maranhão Postgraduate Program in Pharmaceutical Sciences Federal University of Piauí Laboratory of Theoretical and Computational Biophysics Ton Duc Thang University Faculty of Pharmacy Ton Duc Thang University Centre for Sport Exercise and Life Sciences Coventry University Nucleus of Bioassays Biosynthesis and Ecophysiology of Natural Products (NuBBE) Department of Organic Chemistry Institute of Chemistry São Paulo State University (UNESP)

This study examined proficiency levels in fundamental motor skills (FMS) in children within Key Stage 1 and 2 of the English school system. Four hundred and ninety-two children aged 6–9 Years old (245 boys, 247 girls) from school Years Two ( n = 130), Three ( n = 154) and Four ( n = 208) participated in this study. FMS for the run, jump, throw and catch were assessed using the Test of Gross Motor Development – 2. The proportion of children who achieved mastery or near mastery of the skills was determined. For the whole sample, 18.5% ( n = 91) did not achieve mastery in any of the four skills. A similar proportion (18.7%, n = 92) achieved mastery in all four of the FMS examined in this study. The proportion of children achieving mastery of all four skills was lower for Year Two children (0%) compared to children in years Three (24%) and Four (25%). More boys (25.7%) achieved mastery in all four of the FMS compared to girls (11.7%). Individual behavioural components in skill performance were also examined. The results of the present study highlight that less than one-fifth of children aged 6–9 years old have mastered the four key FMS identified by the physical education (PE) curriculum despite having the developmental potential to become fundamentally competent by six years of age. Fostering positive trajectories of FMS development presents a challenge for PE specialists given the association between FMS mastery in childhood and physical activity, weight status and health.

The aim of the present study is to evaluate the effect of Ramadan observance (RAM) on decision-making in Kung-Fu athletes. Fourteen male Kung-Fu athletes (mean age = 19 ± 3 years) completed two test sessions: before Ramadan (BR) and at the end of Ramadan (ER). In the afternoon of each session (between 16:00 h and 18:00 h), participants completed: Epworth Sleepiness Scale (ESS), Profile of Mood States (POMS), and Pittsburg Sleep Quality Index (PSQI). Subjects also reported subjective fatigue, alertness, and concentration. Additionally, all participants performed video-based decision-making tasks (i.e., reaction time and decision-making). Results indicated that reaction time decreased by 30% at ER vs. BR (p &lt, 0.01). However, decision-making decreased by 9.5% at ER vs. BR (p &lt, 0.05). PSQI results indicated sleep quality score, sleep duration, and sleep efficiency were negatively affected at ER compared to BR (p &lt, 0.05). ESS was higher at ER compared to BR (p &lt, 0.05). In addition, fatigue scores, estimated by the POMS and current subjective feelings (i.e., fatigue, concentration, and alertness), were also negatively affected at ER compared to BR (p &lt, 0.05). In conclusion, Ramadan observance was associated with an adverse effect on sleep and decision making, as well as feelings of fatigue, alertness, and concentration.

Background An emerging body of evidence has highlighted the protective role of spirulina in human health. Thus, we conducted a randomized controlled trial to discern the effects of spirulina supplementation on anthropometric indices, blood pressure, sleep quality, mood, fatigue status, and quality of life among ulcerative colitis patients. Methods Eighty participants with ulcerative colitis were randomly allocated to receive, either, 1 g/day (two 500 mg capsules) spirulina (n=40) or placebo (n=40), in a clinical trial for eight weeks. Dietary intake, physical activity, sleep quality, mental health, fatigue status, and quality of life were assessed for each participant at baseline and trial cessation. Anthropometric indices and blood pressure were also assessed. Results Seventy-three participants completed the intervention. Our results revealed that spirulina supplementation significantly reduced sleep disturbances (p=0.03), while no significant changes occurred in the sleep quality score or other sleep parameters, vs. the placebo group (p> 0.05). Furthermore, a significant reduction in stress score (p=0.04) and increase in quality of life (p=0.03) was detected; but not anxiety, depression, or fatigue scores (p> 0.05). Additionally, anthropometric indices and blood pressure did not significantly change (p> 0.05). Conclusion An improved quality of life was observed among ulcerative colitis patients following spirulina supplementation, which could be attributed to improved sleep disturbance and stress status. Further clinical studies, with longer duration interventions and suitably powered sample sizes, are necessary to elucidate the veracity of our findings.

The aim of the present study was to evaluate the impact of Ramadan fasting on sleep quality and daytime sleepiness in team sport referees. Seventy-eight male amateur team sport referees (age: 31.1 ± 10.8 years) participated in this study. Participants responded to the Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth sleepiness scale (ESS) questionnaires before (10-days prior) and during (last 7-days) the month of Ramadan.PSQI and ESS scores increased significantly during Ramadan (both p .001, ES = 0.56 and 0.54, respectively) with 83.3% of participants scoring ≥5 in the PSQI. The percentage of participants suffering from severe excessive daytime sleepiness (ESS score ≥ 16) was 3.8% before

Background and Objectives: The aim of this study was twofold: (i) to analyze the relationships between fitness status (repeated-sprint ability (RSA), aerobic performance, vertical height jump, and hip adductor and abductor strength) and match running performance in adult women soccer players and (ii) to explain variations in standardized total distance, HSR, and sprinting distances based on players’ fitness status. Materials and Methods: The study followed a cohort design. Twenty-two Portuguese women soccer players competing at the first-league level were monitored for 22 weeks. These players were tested three times during the cohort period. The measured parameters included isometric strength (hip adductor and abductor), vertical jump (squat and countermovement jump), linear sprint (10 and 30 m), change-of-direction (COD), repeated sprints (6 × 35 m), and intermittent endurance (Yo-Yo intermittent recovery test level 1). Data were also collected for several match running performance indicators (total distance covered and distance at different speed zones, accelerations/decelerations, maximum sprinting speed, and number of sprints) in 10 matches during the cohort. Results: Maximal linear sprint bouts presented large to very large correlations with explosive match-play actions (accelerations, decelerations, and sprint occurrences, r = −0.80 to −0.61). In addition, jump modalities and COD ability significantly predicted, respectively, in-game high-intensity accelerations (r = 0.69 to 0.75, R2 = 25%) and decelerations (r = −0.78 to −0.50, R2 = 23–24%). Furthermore, COD had significant explanatory power related to match running performance variance regardless of whether the testing and match performance outcomes were computed a few or several days apart. Conclusion: The present investigation can help conditioning professionals working with senior women soccer players to prescribe effective fitness tests to improve their forecasts of locomotor performance.

Background: Lockdown measures have been enforced globally in response to the COVID-19 pandemic. Given the comorbidity burden in women with polycystic ovary syndrome (PCOS), these lockdown measures may have a particularly negative impact on sleep health, quality of life (QoL), and depression/stress levels in this population. The aim of this study was to explore whether such potential problems were present in women with PCOS during the COVID-19 lockdown in the UK.Methods: UK women with PCOS were recruited through social media into a cross-sectional study during the COVID-19 lockdown. The study survey was delivered online, and included demographic and COVID-19 relevant questions, as well as validated questionnaires/scales, namely the Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale (DASS-21), and PCOSQOL questionnaire.Results: Three hundred and thirty-three women with PCOS [median age: 30.0 (9.0) years] were recruited. Participants were dichotomized based on responses regarding the impact of COVID-19 restrictions on their sleep [negative (N = 242) vs. no/positive (N = 91) impact]. No differences were noted between groups regarding age, time since PCOS diagnosis, body mass index, or number of comorbidities. Based on the ISI, 44.2% of participants reporting a negative impact on sleep exhibited at least moderately severe clinical insomnia. Compared to those who reported no/positive effect on sleep, the participants reporting a negative impact on sleep also reported poorer QoL, based on the total PCOSQOL score, with a greater impact of PCOS and poorer mood in the corresponding PCOSQOL domains. Based on the DASS-21, the latter also had statistically higher depression and stress levels compared to the former. Finally, for this cohort significant inverse correlations were noted between the ISI and PCOSQOL scores (total and domain scores), whilst the DASS-21 and ISI scores were positively correlated (all p-values Conclusion: The majority of recruited UK women with PCOS reported that the COVID-19 lockdown had a negative impact on their sleep, which was also associated with impaired QoL and higher depression/stress levels. Whilst further research is required, women with PCOS should be considered a vulnerable population that may experience an adverse impact on sleep, QoL and mental health well-being due to lockdown measures during the COVID-19 pandemic.

Background Elevated lipid profiles and impaired glucose homeostasis are risk factors for several cardiovascular diseases (CVDs), which, subsequently, represent a leading cause of early mortality, worldwide. The aim of the current study was to conduct a systematic review and meta-analysis of the effect of apple cider vinegar (ACV) on lipid profiles and glycemic parameters in adults. Methods A systematic search was conducted in electronic databases, including Medline, Scopus, Cochrane Library, and Web of Knowledge, from database inception to January 2020. All clinical trials which investigated the effect of ACV on lipid profiles and glycemic indicators were included. Studies were excluded if ACV was used in combination with other interventions or when the duration of intervention was Results Overall, nine studies, including 10 study arms, were included in this meta-analysis. We found that ACV consumption significantly decreased serum total cholesterol (− 6.06 mg/dL; 95% CI: − 10.95, − 1.17; I2: 39%), fasting plasma glucose (− 7.97 mg/dL; 95% CI: − 13.74, − 2.21; I2: 75%), and HbA1C concentrations (− 0.50; 95% CI: − 0.90, − 0.09; I2: 91%). No significant effect of ACV consumption was found on serum LDL-C, HDL-C, fasting insulin concentrations, or HOMA-IR. The stratified analysis revealed a significant reduction of serum TC and TG in a subgroup of patients with type 2 diabetes, those who took ≤15 mL/day of ACV, and those who consumed ACV for > 8-weeks, respectively. Furthermore, ACV consumption significantly decreased FPG levels in a subgroup of studies that administered ACV for > 8-weeks. Further, ACV intake appeared to elicit an increase in FPG and HDL-C concentrations in apparently healthy participants. Conclusion We found a significant favorable effect of ACV consumption on FPG and blood lipid levels.

Objective There is compelling clinical evidence implicating certain dietary components in the development and clinical course of progression in ulcerative colitis (UC). This study aimed to assess whether any association exists between ulcerative colitis and scores on a healthy eating index. Methods In this case-control study patients with UC were recruited and assessed together with healthy controls. The participants completed a validated 168-item food frequency questionnaire, the results of which were subsequently used to generate individual healthy eating index (HEI-2015) scores. Results Altogether 58 patients with UC and 123 healthy controls were recruited. After controlling for confounding factors, participants who were in the highest quartile of the HEI-2015 had a 66% lower odds ratio (OR) of UC than the lowest quartile (OR = 0.34, 95% confidence interval 0.12-0.96). Conclusion HEI-2015 was associated with UC in this cohort. Further elucidation of the role of key dietary elements is now warranted.

The aim of this study was to develop international standards for evaluating strength endurance with the use of the 3‐Minute Burpee Test. The results of 3862 women (Poland – 2502, Great Britain – 500, Hungary – 412, Serbia – 448) and 5971 men (Poland – 4517, Great Britain – 500, Hungary – 451, Serbia – 503) aged 18‐25 (mean age of 20.36 ± 0.94 and 20.05 ± 1.25 y, respectively) were collated between 2004 and 2018. The students’ strength endurance was evaluated in the 3‐Minute Burpee Test. The results were expressed on a uniform scale with the 3‐sigma rule which was used to develop the T‐score scale for the 3‐Minute Burpee Test. Men completed 56.69 cycles/3 min and women – 48.84/3 min on average. The best male participant completed 82 burpees, and the best female participant – 73 burpees. The majority of male and female participants (66.71% and 68.18%, respectively) were characterized by average strength endurance in the 3‐Minute Burpee Test (range of scores: 47‐66 and 37‐60 cycles/3 min, respectively). Very good strength endurance (76‐85 and 72‐83 cycles/3 min, respectively) was noted in the smallest percentage of male and female participants (0.52% and 0.26%, respectively). Similar studies should be carried out in other countries and in different age groups to develop objective international classification standards for variously‐aged individuals.

Aims Intensive lifestyle, dietary interventions and patient education have been recommended as key milestones in to facilitate the management of Diabetes and contain the growing incidence. We performed a systematic review and meta-analysis to assess the health benefits of medical nutrition therapy among patients with diabetes. Design A systematic search was performed in MEDLINE/PubMed, SCOPUS, and Cochrane library from onset up to February 2019 to identify trials investigating the health effect of Medical nutrition (MNT) in patients with diabetes. Random-effects models were used to calculate the effect sizes as weighted mean difference (WMD) and 95% confidence intervals (CI). Results Eleven studies containing 1227 participants were included in the meta-analysis. Pooled results showed a significant reduction in Fasting blood sugar (FBS) (WMD= −8.85 mg/dl, 95% CI: −14.41, −3.28), HbA1c (WMD: −0.43%, 95% CI: −0.69, −0.17), weight (WMD: −1.54 kg, 95% CI: −2.44, −0.64), Body mass index (BMI) (WMD: −0.34 Kg/m2, 95% CI: −0.52, −0.17), waist circumference (WMD: −2.16 cm, 95% CI: −4.09, −0.23), cholesterol (WMD: −4.06 mg/dl, 95% CI: −7.31, −0.81), Systolic blood pressure (SBP) (WMD: −7.90 mmHg, 95% CI: −13.03, −2.77). Results of meta-regression analysis based on age of participants and duration of intervention were not significant. Conclusions Patients with diabetes who received medical nutrition therapy showed significant improvements in outcome measures of FBS, HbA1c, weight, BMI, waist circumference, cholesterol, and SBP.

Given the proliferation in studies investigating green coffee bean extract (GCBE) supplementation, the purpose of this study was to determine the efficacy and effectiveness of GCBE supplementation on indices of blood pressure. The literature search was performed in four databases, namely, PubMed/Medline, Scopus, the Cochrane Library, and Google Scholar, to identify clinical trials that examined the effects of green coffee supplements on systolic blood pressure (SBP) and diastolic blood pressure (DBP) up to February 2019. Mean change and standard deviation (SD) of the outcome measures were used to estimate the mean difference between the intervention group and the control group at follow-up. Nine studies reported SBP and DBP as an outcome measure. Results revealed significant reduction in SBP (weighted mean difference: -3.093 mmHg, 95% confidence interval [CI]: -3.914, -2.273; I2 = 0.0%) and DBP (-2.170 mmHg, 95% CI: -2.749, -1.590; I2 = 46.5%) after green coffee supplementation with low heterogeneity among the studies. In addition, in subgroup analysis, a significant reduction in SBP and DBP in studies with hypertensive patients, green coffee dosage

Objective Evidence on the efficacy ofNigella sativa supplementation is equivocal, thus the aim of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to examine the effect of Nigella sativa (N. sativa) supplementation on plasma C-reactive protein (CRP) concentrations. Methods PubMed, Scopus, ISI Web of Science, Cochrane library, and Google Scholar databases were searched (up to April 2019) to identify RCTs investigating the effects of N. sativa seed and seed oil supplementation on CRP. Weighted mean differences (WMD) was pooled using a random-effects model. Standard methods were also used for assessment of heterogeneity, sensitivity analysis, and publication bias. Results Eventually only five articles which reported data of interest entered for data analysis. The meta-analysis showed a significant reduction in serum CRP (WMD: -0.55 mg/L, 95% CI: -1.02, -0.08, P = 0.02), with significant heterogeneity between selected studies (I2 = 77.3%). Between-study heterogeneity disappeared following subgroup analysis, stratified by baseline BMI (≥30 kg/m2: I2 = 2.8%). However, the effect of N. sativa seed and seed oil supplementation on CRP was only significant in studies that were conducted on participants with BMI ≥ 30 kg/m2 (WMD: -0.50 mg/L, 95% CI: -0.85, -0.15). Conclusions This meta-analysis suggests thatN. sativa seed and seed oil supplementation can significantly reduce serum CRP level. However, RCTs with a larger sample size and longer follow-up periods should be conducted for future investigations to confirm the veracity of these results.

Moran, J, Clark, CCT, Ramirez-Campillo, R, Davies, MJ, and Drury, B. A meta-analysis of plyometric training in female youth: its efficacy and shortcomings in the literature. J Strength Cond Res 33(7): 1996-2008, 2019-This meta-analysis characterized female youths' adaptability to plyometric training (PT). A second objective was to highlight the limitations of the body of literature with a view to informing future research. Fourteen studies were included in the final analysis. The effect size (ES = Hedges' g) for the main effect of vertical jump performance was "small" (ES = 0.57, 95% confidence interval: 0.21-0.93). Effect sizes were larger in younger (15 years; ES = 0.78 [0.25-1.30] vs. 0.31 [-0.18 to 0.80]), shorter (163 cm; ES = 1.03 [0.38-1.68] vs. 0.25 [-0.20 to 0.70]), and lighter (54 kg; ES = 1.14 [0.39-1.89] vs. 0.26 [-0.15 to 0.67]) participants. Programming variables seemed to influence adaptive responses with larger effects in interventions which were longer (8 weeks; ES = 1.04 [0.35-1.72] vs. 0.24 [-0.11 to 0.59]), had greater weekly training frequency (2; ES = 1.22 [0.18-2.25] vs. 0.37 [0.02-0.71]), and whose sessions were of longer duration (≥30 minutes ES = 1.16 [0.14-2.17] vs. 0.33 [0.03-0.63]). More than 16 sessions per program (0.85 [0.18-1.51]) was more effective than exactly 16 sessions (0.46 [0.08-0.84]) which, in turn, was more effective than less than 16 (0.37 [-0.44 to 1.17]). These findings can inform the prescription of PT in female youth.

Plant derivatives, such as anthocyanin-rich phytochemicals, have been reported to elicit a positive effect on lipid profile. Therefore, the aim of this study was to systematically review and meta-analyze the effects of Aronia consumption on lipid profiles, blood pressure, and biomarkers of inflammation in randomized controlled trials. A systematic search was performed in PubMed/MEDLINE, Cochrane, and SCOPUS up to December 2018. Seven studies were identified and analyzed in this meta-analysis. Our study found a significant increase in high-density lipoprotein (HDL; weighted mean difference [WMD]: 1.48 mg/dl, 95% confidence interval, CI, [1.29, 1.68]) and diastolic blood pressure (WMD: 2.55 mmHg, 95% CI [0.63, 4.47]) following Aronia consumption. There was no significant effect on systolic blood pressure and C-reactive protein, tumor necrosis factor, and interleukin-1. Furthermore, subgroup analysis showed that cholesterol (WMD: -7.18, 95% CI [-13.90, -0.46]) and low-density lipoprotein (LDL; WMD: -5.84, 95% CI [-6.91, -4.77]) decreased more significantly in interventions less than 10 weeks in duration. Dose-response analysis demonstrated a significant reduction in triglyceride levels when dose of Aronia was increased to 300 mg/day. In conclusion, the results demonstrated a significant increase in HDL and reduction in total cholesterol and LDL among patients supplementing with Aronia.

Introduction. The aim of this study was to evaluate sex differences in anthropometric indicators, body composition, physical fitness, and physiological parameters in young women and men performing extremely strenuous exercise during the 3-Minute Burpee Test (3-MBT). Post-exercise recovery during a 6-minute break was determined in the tested subjects. Material and methods. Ninety-six university students volunteered to take part in this study (45 women aged 20.05 ± 1.81 years and 51 men aged 20.20 ± 2.71 years). Endurance-strength abilities were determined during the 3-MBT motor fitness test, and body composition was determined with an InBody720 analyser. Data were analysed using a Mann-Whitney U test, with statistical significance accepted at p ≤ 0.05. Results. The anthropometric indicators, body composition parameters, physical fitness levels (47.22 cycles/3 min), and physiological parameters measured during the 3-MBT were significantly higher in men (VO2avg – 41.57 mL/kg/min, VO2max – 49.67 mL/kg/min, EPOCavg – 11.02mL/kg, and EPOCpeak – 27.84mL/kg) than in women. Women were characterised by significantly higher (p < 0.05) body fat mass (BFM = 18.80 kg) and percent body fat (PBF 28.26%) than men. Conclusions. Male subjects were characterised by higher values of anthropometric indicators, body composition parameters (excluding body fat), motor fitness levels, and physiological parameters than women, and endurance-strength abilities were 23.75% higher, on average, in men than women.

Introduction Previous studies on laboratory animals have evaluated the effects of CGA (chlorogenic acids) rather than GCBE (green coffee bean extract), and few studies have been conducted on human models. Thus, the purpose of the present study was to assess the effect of GCBE consumption on serum oxidized LDL-cholesterol (OX-LDL) and total antioxidant capacity (TAC) on patients with dyslipidemia. Method In this randomized, placebo-controlled, clinical trial, 70 male participants (age range 30–55 years) were assigned from the outpatient clinic of Arvand Petrochemical Company in Mah-shahr, Ahwaz, Iran to use 800 mg/day GCBE supplements or placebo for 8 weeks. Serum TAC and OX-LDL were determined by enzyme-linked immunosorbent assay. Results Compared with the placebo, GCBE intake led to a significant reduction in OX-LDL (−31.18 ng/ml) (P-value = Conclusions The current trial showed that the intake of 800 mg per day of GCBE may have favorable effects on TAC, and OX-LDL in patients with dyslipidemia. However, further studies are required to confirm the veracity of these results.

Breast cancer is a leading cause of cancer mortality in developed countries. We performed a meta-analysis of randomized clinical trials to investigate the effect of metformin on biomarkers associated with breast cancer outcomes and to explore the dose–response relationship. A systematic search was performed from onset of the database to January 2019 in MEDLINE/PubMed, SCOPUS, and Cochrane library to identify randomized clinical trials investigating the impact of metformin on insulin, glucose, CRP, leptin, body mass indices (BMI), cholesterol, Ki-67, and Homeostatic Model Assessment for Insulin-Resistance (HOMA-IR). Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI) using a random-effects models. Nine studies providing 1,363 participants were included in the meta-analysis. Pooled results showed a significant reduction in insulin (WMD: − 0.99 U/ml, 95% CI − 1.66, − 0.33), glucose (WMD: − 1.78 ml/dl, 95% CI − 2.96, − 0.60), CRP (WMD: − 0.60 mg/l, 95% CI − 0.88, − 0.33), HOMA-IR (WMD: − 0.45, 95% CI − 0.77, − 0.11), leptin (WMD: − 2.44 ng/ml, 95% CI − 3.28, − 1.61), BMI (WMD: − 0.55 kg/m2, 95% CI − 1.00, − 0.11), and Ki-67 (WMD: − 4.06, 95% CI − 7.59, − 0.54). Results of the subgroup analyses showed that insulin, glucose, and BMI decreased more significantly when the duration of administering metformin intervention was above 4 weeks. We did not observe non-linear changes in the dose–response relationship between metformin and biomarkers as outcomes. Breast cancer patients receiving metformin as treatment for diabetes showed significant reduction in levels of insulin, fasting glucose, CRP, HOMA, leptin, BMI, and Ki-67.