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Preschool children spend a large part of their day at school, and a large part of that time they spend in sedentary time. Although sedentary time negatively affects regions of the brain responsible for cognition, it is believed that the type of sedentary time performed can favor executive functions' performance. The present study explored the associations between sedentary time inside and outside preschools with executive function (EF) tasks in preschoolers. Seventy-three preschool children (60% girls; 55.0 ± 9.1 months of age) were objectively assessed for sedentary time and physical activity (PA) using accelerometers (wGT3X). EF was evaluated using the Go/No-Go paradigm through the Early Years Toolbox - YET. Go's inverse efficiency (IE) and the No-Go accuracy were analyzed. To establish possible associations between EF and sedentary time, a structural equation model was conducted after adjustments for sex, age, body mass index, and moderate-to-vigorous PA. A significant and positive association between sedentary time on weekend days and IE (b = 0.61; p  < .001) was observed. The general model explained 52% of the variation in IE and 2.1% in the accuracy of No-Go. The sedentary time on weekend days seems to be related to worse EI. This result emphasizes a context-dependent association between time being sedentary and preschoolers' EF. Further investigations should focus on exploring the type of sedentary behavior children are engaged in different contexts.

Background: Cardiovascular disease (CVD) is a major cause of death and recent studies have highlighted the potential role of dietary carbohydrate indices in cardiovascular health. Given the controversial results in this field, the aim of this study was to investigate the association between low carbohydrate dietary score (LCDS) and CVD risk factors in a population of Iranian adults., Methods: This cross-sectional study was conducted within the framework of the Shiraz Heart Study (SHS) including 1982 adults. The validated 168 items food frequency questionnaire (FFQ) was used to assess participants' dietary intakes. To investigate the association between LCDS and cardiometabolic risk factors, logistic regression, was conducted., Results: During 5 years of follow-up, a total of 1982 adults, with a mean age of 53.07 ± 8.38 years, were included to the analysis. The adjusted model based on known confounding factors (age, sex, smoking, physical activity, energy intake and body mass index) revealed a significant decrease in a body shape index (ABSI) (OR = 0.70, 95% CI= (0.50 to 0.98), P = 0.038) comparing highest LCDS tertile vs. the reference. In contrast, risk of hypertension (HTN), body mass index (BMI), waist-hip ratio (WHR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), atherogenic index of plasma (AIP), and fasting blood sugar (FBS) were not significantly associated with LCDS., Conclusion: Current findings suggest that adherence to a low carbohydrate diet reduces ABSI, a main indicator of central obesity., (© 2024. The Author(s).)

Background and Aims: The existing literature on the effects of green coffee bean extract (GCBE) consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) is equivocal. This study aimed to summarize the effects of GCBE consumption on SBP, DBP and HR in adults., Methods: Data were pooled using a random-effects model and expressed as weighted mean difference (WMD) and 95 % confidence intervals (95 % CIs)., Results: Out of 1624 records, 10 studies that enrolled 563 participants were included. GCBE consumption significantly decreased SBP (WMD: -2.95 mmHg; 95 % CI: -4.27 to -1.62; p < 0.001) and DBP (WMD: -2.15 mmHg; 95 % CI: -2.59 to -1.72; p < 0.001). However, there was no significant effect on HR (WMD: -1.20 bpm; CI: -2.93 to 0.51; p = 0.170). Subgroup analysis showed that GCBE consumption had a more significant effect on SBP and DBP in participants with high SBP and DBP and had no effect on blood pressure in females. Linear and non-linear dose-response analyses were conducted to find the optimum GCBE dosage and duration of intervention. However, no significant associations were observed for SBP, DBP, and HR in linear meta-regression and non-linear dose-response based on the dose and duration of the intervention., Conclusion: GCBE has the potential as a hypertension-reducing supplement in hypertensive patients. However, GCBE did not significantly change HR., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Published by Elsevier Ltd. All rights reserved.)

Background: Strength training (ST) primarily enhances physical fitness (e.g., muscle strength, power, speed) and bone density in female soccer players. Less information is available on the injury preventive effects of ST in female athletes. Accordingly, this study aimed to investigate the effects of a 12-week in-season ST on measures of physical fitness and injury occurrence in young elite female soccer players., Methods: Thirty elite female soccer players (15.4 ± 1.9 years; maturity offset + 2.3 ± 1.1 years) participated in this study, and were randomly assigned to a strength training group (STG, n = 14) or an active control (CG, n = 16) group. ST lasted twelve weeks and included full body muscle strengthening exercises using primarily weight machines at progressive intensities ranging between 40 and 85% of the one-repetition-maximum (1-RM). The CG practiced a traditional soccer training program. Overall, training volumes of the two groups were similar with a training load (rating of perceived exertion × time) of 1158.4 ± 67.7 arbitrary unity (AU) for the STG and 1188.8 ± 44.1 AU for the CG. Pre and post training, the following physical fitness tests were applied: dynamic muscle strength (relative [to body mass] and absolute 1-RM bench/leg press, lat-pull down), jump performance (countermovement jump [CMJ], squat jump [SJ], five-jump-test [5JT]), linear-sprint speed (5-m, 10-m, 30-m), change-of-direction speed (T-test with and without ball), sport-specific performance (Yo-Yo Intermittent Level1 [YYIRTL1], and repeated shuttle sprint ability [RSSA]). The injury rate per 1000-h exposure was monitored throughout the soccer season., Results: No significant baseline differences were observed between groups. Statistically significant group-by-time interactions were found for absolute (p < 0.001, d = 2.59) and relative 1-RM bench press (p < 0.001, d = 2.39), absolute 1-RM lat-pull down (p < 0.001, d = 1.68), and relative 1-RM leg press (p < 0.001, d = 1.72). Significant group-by-time interactions were observed for CMJ (p = 0.005, d = 1.27), RSSA mean (p = 0.007, d = 0.81), and RSSA total (p < 0.001, d = 1.90). Post-hoc tests indicated that the STG group demonstrated greater improvements in all tested variables compared to CG (1.2 < d < 2.5). However, no significant interaction effects were noted for measures of linear sprint speed and YYIRTL1 performance. Additionally, non-contact injuries during the season were significantly lower (p = 0.003, d = 1.31) in the STG (0.48/1000 h of exposure) than the CG (2.62/1000 h of exposure)., Conclusions: Twelve weeks of an in-season ST resulted in larger physical fitness improvements and fewer injuries compared with an active control in elite young female soccer players. Accordingly, ST should be systematically applied in female soccer to enhance performance and prevent injuries., (© 2024. The Author(s).)

The current systematic review and meta-analysis was conducted to evaluate the effects of kiwifruit intake on anthropometric indices and key cardiometabolic parameters. Related articles were found by searching PubMed, ISI Web of Science, and Scopus to detect relevant Randomized Clinical Trials (RCTs) and novel systematic reviews relating to kiwi consumption in adults, up to August 2023. The weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity, sensitivity analysis, and publication bias were assessed and reported using standard methods. Six RCTs were included in the meta-analysis. Analyzing overall effect sizes demonstrated a significant reduction in low-density lipoprotein cholesterol (LDL) levels (WMD: -9.30 mg/dL; 95% CI: -17.56 to -1.04, p  = .027), whereas no significant alterations of triglycerides (TG) (WMD: -12.91 mg/dL; 95% CI: -28.17 to 2.34, p  = .097), total cholesterol (TC) (WMD: -7.66 mg/dL; 95% CI: -17.85 to 2.52, p  = .141), high-density lipoprotein cholesterol (HDL) (WMD: 2.87 mg/dL; 95% CI: -0.36 to 6.11, p  = .141), fasting blood glucose (FBG) (WMD: 1.06 mg/dL; 95% CI: -1.43 to 3.56, p  = .404), C-reactive protein (CRP) (WMD: 0.15 mg/dL; 95% CI: -0.40, 0.70, p  = .0598), body weight (BW) (WMD: 0.85 kg; 95% CI: -1.34 to 3.04, p  = .448), body mass index (BMI) (WMD: 0.04 kg/m 2 ; 95% CI: -0.75 to 0.83, p  = .920), and waist circumference (WC) (WMD: 0.18 cm; 95% CI: -1.81 to 2.19, p  = .855) were found. Our findings suggest that consuming kiwifruit does not have a significant impact on anthropometric indices and cardiometabolic factors, except for LDL-C levels., Competing Interests: Not applicable., (© 2024 The Author(s). Food Science & Nutrition published by Wiley Periodicals LLC.)

Background & Aims: Recent research has suggested that adherence to plant-based dietary index (PDI) may reduce the risk of type 2 diabetes and related complications like diabetic nephropathy (DN). Therefore, the aim of this study was to investigate the possible association of PDI with the odds of DN., Methods: We enrolled 105 eligible women with DN and 105 controls without DN (30-65 years). A 147-item food frequency questionnaire was used to evaluate an overall PDI, healthy plant-based dietary index (hPDI), and unhealthful PDI. Biochemical variables and anthropometric measurements were assessed for all patients using predefined protocols., Results: According to our final analyses, after controlling for potential confounders, participants with greater adherence to overall PDI (OR: 0.29; 95% CI: 0.15-0.56; P < .001) and hPDI (OR: 0.30; 95% CI: 0.15-0.56; P < .001) had 71% and 70% lower odds of DN compared to those with a low adherence, respectively. Conversely, subjects with a higher adherence to the unhealthful PDI had a positive association with increased odds of DN in the crude (OR = 5.00; 95% CI = 2.78-8.98; P < .001) and adjusted models (OR = 4.27; 95% CI = 2.24-8.14; P < .001), respectively., Conclusion: The results of this study showed that greater adherence to overall PDI and hPDI was inversely associated with the odds of DN. However, further prospective studies are warranted to confirm these results., (Copyright © 2024 National Kidney Foundation, Inc. All rights reserved.)

Background : There is increasing awareness of the physiological effects of Ramadan intermittent fasting (RIF) in obese subjects. However, there are no data on the effects of RIF on plasma volume changes (ΔPV) in individuals with different body weights. Background and Objectives : This study investigated the effects of RIF on ΔPV in normal-weight (NW) and overweight (OW) adult men, and adult men with obesity (OB) and severe obesity (SO). Materials and Methods : Thirty-two male subjects (32) were divided into four groups ( n = 8 per group) according to their body mass index (BMI): normal weight (NW) (BMI < 25 kg/m 2 ; age = 27.4 ± 3.8), overweight (OW) (BMI between 25 and 29.9 kg/m 2 ; age = 26.8 ± 3.7), obese subjects (OB) (BMI between 30 and 34.9 kg/m 2 ; age = 25.6 ± 2.9), and severely obesity (SO) (BMI between 35 and 40 kg/m 2 ; age = 24.0 ± 4.1). Blood samples were collected for 24 h on 4 different occasions, at T0 before the start of the Ramadan month, at T1 15 days after the start of Ramadan, at T2 one day after the end of Ramadan, and at T3 on the 21st day after the end of Ramadan to determine ΔPV. All groups completed their fasting rituals for the 30 days of Ramadan. Results : A significant group × time effect occurred for body mass ( p = 0.001; ES = 0.53), BMI ( p = 0.001; ES = 0.53), and body fat percentage ( p = 0.001; ES = 0.52). Post hoc tests indicated reductions in body mass in OB and SO at T1 ( p = 0.03; ES = 0.21 and p = 0.002; ES = 0.12) and T2 ( p = 0.03; ES = 0.31 and p = 0.02; ES = 0.23), reductions in BMI in OB and SO at T1 ( p = 0.04; ES = 0.35 and p = 0.03; ES = 0.42) and T2 ( p = 0.03; ES = 0.52 and p = 0.005; ES = 0.48), and reductions in body fat percentage only in OB AT T1 ( p = 0.002; ES = 0.31) and T2 ( p = 0.001; ES = 0.17). A significant group × time effect occurred for hematocrit ( p = 0.02; ES = 0.34), hemoglobin ( p = 0.01; ES = 0.35), and ΔPV ( p = 0.02; ES = 0.18). Post hoc tests indicated increases in hematocrit in OB at T2 ( p = 0.03; ES = 0.36) and hemoglobin in OB and SO at T1 ( p = 0.03; ES = 0.35 and p = 0.002; ES = 0.32) and T2 ( p = 0.003; ES = 0.21 and p = 0.002; ES = 0.33). There were also increases in ΔPV in OB at T1 and T2 ( p = 0.002; ES = 0.25 and p = 0.003; ES = 0.22) and in SO only at T2 ( p = 0.02; ES = 0.37). Contrast analysis indicated that NW was significantly lower than the grand mean of OW, Ob, and SO for all anthropometric and PVV variables (all p < 0.05). Conclusions : The effects of RIF on ΔPV and anthropometric characters was greater in obese individuals compared to normal-weight and overweight participants, suggesting that the improvements in body composition and ΔPV produced by RIF could positively influence obesity.

Background: The pre-season preparatory period is considered key for optimizing the physical fitness levels needed to withstand congested match periods and preventing injuries during the regular soccer season. This study contrasted the effects s of neuromuscular training (NMT) versus an endurance-dominated training (ET) program conducted during the preseason on measures of physical fitness and injury occurrence in female soccer players., Methods: Twenty-four female soccer players aged 17.0 ± 1.3 years from a professional soccer club participated in this study. Players were randomly assigned to NMT (n = 12) or ET (n = 12) groups according to their playing position. The preseason intervention program lasted six weeks, with three weekly sessions with a duration of 45-60 min per session. Exercises in the NMT group included muscle strengthening exercises, plyometrics, agility and dynamic stability exercises, while the ET group practiced a traditional pre-season training program consisting of running and sprinting exercises, fartlek, and high-intensity interval training. The training volumes were similar in the two study groups. Anthropometric measurements, physical fitness tests (i.e., linear and change-of-direction speed, muscle strength and power tests) and the overall injury rate per 1000 h of exposure (training, match) were recorded throughout the season., Results: No between group differences were found at pre (T1). Significant group-by-time interactions were observed for the 5, 10, and 30-m linear sprint speed tests (p < 0.001, 2.16 < d < 2.58), the T-test (p = 0.024, d = 1.03), the squat (p < 0.001, d = 4.04), and the countermovement jump test (p < 0.001, d = 2.21), the Loughborough soccer passing test (LSPT) (p = 0.019, d = 1.08), and the 1-RM back squat test (p < 0.001, d = 2.53). Post-hoc tests indicated that NMT provided larger improvements for SJ, CMJ, 1-RM back squat, the 5-m sprint, 10-m sprint, 30-m sprint, T-test and LSPT compared to ET (1.07 > d > 2.77). The injury rate across the season was significantly lower in the NMT (5.1/1000 h exposure) compared to ET (11.8/1000 h exposure) (p = 0.014)., Conclusions: The findings support that six-weeks of preseason NMT versus ET induced larger performance improvements, and significantly reduced injury occurrence in elite female soccer players., (© 2024. The Author(s).)

There is equivocal evidence that psyllium can prevent or attenuate increases in fasting blood sugar. Therefore, this systematic review and meta-analysis sought to investigate the influence of psyllium on hemoglobin A1C (HbA1c), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA IR). We searched PubMed, ISI Web of Science (WOS), and Scopus for eligible publications, up to 15 July 2022, including randomized controlled trials (RCT) assessing the effect of psyllium on HbA1c, FBS, insulin, and HOMA IR levels in adults. Using a random effects model, we report the weighted mean differences (WMD) with 95% confidence intervals (CI). In this article, 19 RCT studies, consisting of 962 participants, were included. Psyllium significantly decreased FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo (FBS: WMD): -6.89; 95% CI: -10.62, -3.16; p < .001), HbA1c: (WMD: -0.75; 95% CI: -1.21, -0.29; p < .001), HOMA IR: (WMD: -1.17; 95% CI: -2.11, -0.23; p < .05), and insulin: (WMD: -2.08; 95% CI: -4.21, -0.035; p > .05)). Subgroup analyses illustrated differences in the effects of psyllium on FBS: dosages less than and more than 10 g/d showed significant differences (p value < 0.05). However, it was not significant in intervention durations less than 50 days (p value > 0.05). For HbA1c: psyllium consumption less than 10 g/d (p value > 0.05) was non-significant. For HOMA IR and insulin: no significant changes were noted with psyllium consumption less than vs. more than 10 g/d. In conclusion, we found that psyllium could significantly decrease FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo., (© 2024. The Author(s).)

Aim of Study: This study aimed to explore the effects of different types of resistance training using kettlebells versus the own body mass, in comparison to a passive control, on key physical fitness and physiological parameters in young, obese adults., Methods: Data from 60 sedentary, obese male college students, aged 17-26, were used for final analyses. Participants were randomly assigned to one of three groups: a control group (CG, n = 20, no training), a kettlebell resistance training group (KRTG, n = 20), or a bodyweight resistance training group (BWRTG, n = 20). Selected measures of physical fitness were tested using the 12-minutes run test, the push-up test, the sit-up test, and the sit-and-reach test. Physiological measures included vital capacity, resting and maximum heart rate (HRmax), mean arterial blood pressure, breath holding time, and respiratory rate. Biochemical variables were measured in the morning, in a fasted state, and comprised high and low density lipoprotein, total cholesterol, and triglycerides. The 12-weeks progressive KRTG and BWRTG were specifically tailored using sets, repetitions, and intensity levels., Results: Notable findings include significant body fat reductions in BWRTG (p < 0.001; d = 1.53) and KRTG (p < 0.001; d = 1.43), and a substantial increase in VO2max for BWRTG (p < 0.001; d = 1.32) and KRTG (p < 0.001; d = 1.34) compared to CG. KRTG also showed significant improvements in vital capacity (p < 0.001; d = 1.61) and reductions in resting heart rate (p = 0.024, d = 1.05) and respiratory rate (p = 0.001, d = 1.55), with BWRTG showing similar trends (resting heart rate: p = 0.041, d = 1.35; respiratory rate: p = 0.001, d = 1.98). Both intervention groups significantly improved breath holding time (KRTG: p = 0.001, d = 1.58; BWRTG: p < 0.001, d = 1.98) and reduced total cholesterol and low-density lipoprotein levels compared to CG., Conclusions: This study demonstrates that both KRTG and BWRTG are effective in improving body composition and selected fitness and physiological measures. Thus, resistance training using kettlebells or bodyweight training are recommended if the goal is to improve body composition and fitness in obese male adults., Trial Registration: OSF, September, 28th 2023. https://doi.org/10.17605/OSF.IO/Z6Y9Gosf.io/2mb98., (© 2024. The Author(s).)

Diabetic nephropathy (DN) is one of the most prevalent and severe complications of diabetes mellitus (DM) and is associated with increased morbidity and mortality. We aimed to investigate the associations between red, processed, and white meat consumption and the odds of developing kidney damage and DN in women. We enrolled 105 eligible women with DN and 105 controls (30-65 years). A validated and reliable food frequency questionnaire (FFQ) was used to evaluate the consumption of red, processed, and white meat. Biochemical variables and anthropometric measurements were assessed for all patients using pre-defined protocols. Binary logistic regression was conducted to examine possible associations. The results of the present study showed that there was a direct significant association between high consumption of red meat and processed meats and odds of microalbuminuria (red meat 2.30, 95% CI 1.25, 4.22; P-value = 0.007, processed meat: OR 2.16, 95% CI 1.18, 3.95; P-value = 0.01), severe albuminuria (red meat OR 3.25, 95% CI 1.38, 7.46; P-value = 0.007, processed meat: OR 2.35, 95% CI 1.01, 5.49; P-value = 0.04), BUN levels (red meat: OR 2.56, 95% CI 1.10, 5.93; P-value = 0.02, processed meat: OR 2.42, 95% CI 1.04, 5.62; P-value = 0.03), and DN (red meat 2.53, 95% CI 1.45, 4.42; P-value = 0.001, processed meat: OR 2.21; 95% CI 1.27, 3.85; P-value = 0.005). In summary, our study suggests that higher consumption of red and processed meat sources may be associated with microalbuminuria, severe albuminuria, higher BUN level, and higher odds of DN., (© 2024. The Author(s).)

Colorectal adenomas (CRAs) are epithelial lesions of the large bowel that can develop into colorectal cancer. Some studies have shown an inverse association of the Mediterranean diet (MED) with adenoma, but the extent of the association is equivocal. Owing to the lack of meta-analytical evidence in the literature, we sought to assess the association between MED and CRAs by conducting a systematic review and meta-analysis. A comprehensive systematic literature search of observational studies was conducted via PubMed, Scopus, Google Scholar and Web of Sciences up to May 2023. Studies were included in our review if they evaluated the association between MED and CRA, following an observational study design. Six studies were included in this study. We found that adherence to MED was inversely associated with CRA risk (odds ratio, 0.79; confidence interval, 0.73-0.85); implying that higher adherence to MED could reduce the risk of CRA by ~21%. Stratification by the year of studies, sex, study design, country and exposure showed a significant association between MED and CRA. The results of the current study provide evidence of an inverse association between adherence to MED and CRAs., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Existing research underscores the positive influence of consistent physical activity, fitness, and motor coordination on school-aged children's cognitive and academic performance. However, a gap exists in fully understanding this relationship among preschoolers, a critical age group where the development of cognitive functions is significant. The study aims to expand upon existing evidence that connects motor and cognitive development by examining the correlation between specific motor coordination and physical fitness skills and the development of constructive and conceptual thinking in preschool-aged children., Methods: Data from 56 children aged 4-5 years (mean age 4.5 ± 0.36y), comprising 30 girls and 26 boys, participated in this study. We assessed muscular strength (via standing long jump, wall toss test, flexibility), agility (4 × 5 m shuttle), cardiorespiratory fitness (20 m pacer test), and motor coordination (lateral jumping, platform shifting). Cognitive abilities were measured using the IDS-P., Results: Linear regression models showed that significant predictors of constructive thinking scores were observed solely for flexibility ( p  = 0.02) and shifting platforms ( p  = 0.01). Notably, flexibility exhibited a negative relationship ( β  = -1.68). In the context of conceptual thinking, significant predictors ( p  < 0.05) included standing long jump ( p  = 0.01), jumping laterally ( p  = 0.005), shifting platforms ( p  = 0.001), throwing ( p  = 0.02)., Conclusion: Coordination-demanding activities seem to be related considerably to conceptual thinking in preschoolers. Integrating such motor activities into preschool curricula that demand cognitive engagement can positively influence the development of cognitive functions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Malambo, Klepačová, Brodská, Clark and Musálek.)

The rise of artificial intelligence (AI) applications in healthcare provides new possibilities for personalized health management. AI-based fitness applications are becoming more common, facilitating the opportunity for individualised exercise prescription. However, the use of AI carries the risk of inadequate expert supervision, and the efficacy and validity of such applications have not been thoroughly investigated, particularly in the context of diverse health conditions. The aim of the study was to critically assess the efficacy of exercise prescriptions generated by OpenAI's Generative Pre-Trained Transformer 4 (GPT-4) model for five example patient profiles with diverse health conditions and fitness goals. Our focus was to assess the model's ability to generate exercise prescriptions based on a singular, initial interaction, akin to a typical user experience. The evaluation was conducted by leading experts in the field of exercise prescription. Five distinct scenarios were formulated, each representing a hypothetical individual with a specific health condition and fitness objective. Upon receiving details of each individual, the GPT-4 model was tasked with generating a 30-day exercise program. These AI-derived exercise programs were subsequently subjected to a thorough evaluation by experts in exercise prescription. The evaluation encompassed adherence to established principles of frequency, intensity, time, and exercise type; integration of perceived exertion levels; consideration for medication intake and the respective medical condition; and the extent of program individualization tailored to each hypothetical profile. The AI model could create general safety-conscious exercise programs for various scenarios. However, the AI-generated exercise prescriptions lacked precision in addressing individual health conditions and goals, often prioritizing excessive safety over the effectiveness of training. The AI-based approach aimed to ensure patient improvement through gradual increases in training load and intensity, but the model's potential to fine-tune its recommendations through ongoing interaction was not fully satisfying. AI technologies, in their current state, can serve as supplemental tools in exercise prescription, particularly in enhancing accessibility for individuals unable to access, often costly, professional advice. However, AI technologies are not yet recommended as a substitute for personalized, progressive, and health condition-specific prescriptions provided by healthcare and fitness professionals. Further research is needed to explore more interactive use of AI models and integration of real-time physiological feedback., Competing Interests: The authors declare no conflict of interest. The authors wish to affirm that this research was executed with complete academic integrity, free of any commercial or financial biases. Specifically, while we employed the paid version of ChatGPT 4.0 for its advanced capabilities in exercise prescription, this was not done with any intention to promote or encourage its use. Our choice of this platform was strictly to assess its potential in the realm of exercise prescription, without any sponsorship or incentives from the developers or associated entities of ChatGPT. No author has affiliations with OpenAI or any other commercial entities related to the content of the manuscript. Our sole commitment remains to transparent, unbiased evaluations that serve to advance the intersection of sports medicine and artificial intelligence., (Copyright © Biology of Sport 2024.)

Background: Nutritional status during pregnancy can have a significant impact on infant and maternal health outcomes. To maintain maternal homeostasis and support fetal growth, adequate macronutrient and energy intake during pregnancy is essential. Therefore, this study sought to systematically review and meta-analyze macronutrient and energy intakes during pregnancy., Methods: A systematic review and meta-analysis was carried out based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The required data were collected from four databases including: Web of Sciences, ProQuest, Scopus, and PubMed, from 1 January 1980 to 30 May 2023, by using a combination of search terms (dietary pattern" OR "diet quality" OR "food habits" OR "nutrition surveys" OR "diet surveys" OR "food-frequency questionnaire" OR "diet record" OR "dietary recall") AND ( "pregnancy" OR "reproduction" OR "maternal health" OR "neonatal outcomes") among interventional and observational studies. Excel and STATA version 11 were used for data analysis., Results: Among 7081 published articles, 54 studies were included in the review. Most of the 33 (61%) studies were cohort studies and a total of 135,566 pregnant women were included. The overall average of energy, carbohydrate, fat, and protein intake was 2036.10 kcal/day, 262.17 gr/day, 74.17 gr/day, and 78.21 gr/day, respectively. Also, energy intake during pregnancy was higher in American (2228.31 kcal/day, CI95%: 2135.06-2325.63) and Eastern Mediterranean regions (2226.70 kcal/day, CI95%: 2077.23-2386.92) than other regions (P < 0.001). Energy intake was higher in the third trimester than others (2115.64 kcal/day, CI95%: 1974.15-2267.27). Furthermore, based on the findings, there was a significant difference between energy intake in different World Health Organization (WHO) regions (P < 0.05)., Conclusions: According to the results of meta-analysis, the average total energy was below than average total energy required during pregnancy. More efforts are needed to encourage women to adopt healthy eating habits during pregnancy to support healthy fetal and infant development., (© 2024. The Author(s).)

Introduction: There is a growing interest in the considerable benefits of grape products intake, as some studies have indicated that they may improve cardiometabolic risk factors. However, the widespread impact of grape products on the anthropometric indices is not fully resolved., Method: The purpose of this systematic review and meta-analysis was to examine the effects of grape products intake on anthropometric indices in adults. Randomized controlled trials (RCT) examining the effects of grape products intake on anthropometric indices, published up to December 2021, were identified through PubMed, SCOPUS, and ISI Web of Science databases. 30 studies with 35 effect sizes, including 1284 participants (708 cases and 576 controls), were included and analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence interval (CI)., Result: The outcomes have revealed grape products intake to significantly decrease body weight (p = 0.001) and body mass index (p = 0.004) in obese participants, and also, a greater effect was observed when grape seed extract was used., Conclusion: Our study suggests that grape products intake may help to decrease body weight in obese participants. Future large RCTs with longer duration and obese populations are needed to expand our findings., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Purpose: When examining the underlying processes of obesity, evaluation of gut flora and energy homeostasis can be crucial since disruption of the normal gut microbiota community and energy imbalances are significant factors in the development of obesity. Therefore, this study aimed to compare the relative abundance of important obesity modulator gut microbiota (including Firmicutes, Bacteroidetes, Bifidobactrium spp. , Lactobacillus spp. , Bacteroides fragilis , Faecalibacterium prausnitzii , Akkermansia muciniphila , and Escherichia coli ) in fecal samples of normometabilic and hypometabolic overweight/obese individuals., Methods: This matched case-control study conducted on 36 healthy women aged 18-50 years old. An indirect calorimeter and impedance body analyzer were used to assess resting metabolic rate (RMR) and body composition, respectively. Dietary intake and physical activity were assessed using questionnaires. To determine the abundance of the abovementioned gut microbiota, quantitative polymerase chain reaction (qPCR) method was performed. Moreover, ELISA kits were used to assess leptin, ghrelin, and insulin hormones., Results: The results highlighted higher load of Firmicutes ( p  = 0.02), F. prausnitzii ( p  < 0.001), and B. fragilis ( p  = 0.02) in the normometabolic individuals compared to the hypometabolic ones. Besides, the positive correlation between the abundance of Firmicutes (β = 7.76 × 10 -1 , p  = 0.01), F. prausnitzii (β = 1.29 × 10 -5 , p  = 0.01), and B. fragilis (β = 4.13 × 10 -6 , p  = 0.04) with the RMR have been shown. Whereas the abundance of Bacteroidetes, A. muciniphila , Lactobacillus spp. , Bifidobactrium spp. , and E. coli showed no significant difference ( p  > 0.05) and no significant correlation with the RMR except Lactobacillus spp. (β = 1.73 × 10 -4 , p  = 0.01)., Conclusion: It seems that gut microbiota can be a potential target for refining host energy homeostasis and treating obesity and its consequences., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Recent studies have addressed the possible role of long non-coding RNAs ( lnc-RNAs), Metastasis-Associated Lung Adenocarcinoma Transcript 1 (MALAT1), and Taurine Upregulated Gene 1 (TUG1), in modulating the underlying mechanisms of obesity-related metabolic abnormalities. However, studies are limited and contradictory. Hence, we sought to investigate the relationship of the transcript level of these two lnc-RNAs with metabolic syndrome (MetS)-related parameters in women with obesity and overweight., Method: This cross-sectional study was conducted on 342 women with obese and overweight. We conducted assessments encompassing anthropometric measurements, body composition analysis, fasting blood sugar (FBS) levels, lipid profile analysis, insulin levels, HOMA-IR index, and liver enzyme profiling. A quantitative real-time polymerase chain reaction (PCR) was used to evaluate transcript levels of MALAT1 and TUG1. Also, a 147-question semi-quantitative food frequency questionnaire (FFQ) and the International Physical Activity Questionnaire (IPAQ) were used to evaluate food intake and physical activity, respectively., Results: There was a significant association between FBS and MALAT1 transcript level (β: 0.382; 95% CI: 0.124, 0.640; P  = 0.004). Also, there was a significant association between triglyceride (TG) and MALAT1 transcript level (β: 4.767; 95% CI: 2.803, 6.731; P  < 0.0001). After adjusting for age, BMI, energy intake, and physical activity, an inverse significant association was observed between high-density lipoprotein cholesterol (HDL-c) and MALAT1 transcript level (β: -0.325; 95% CI: -0.644, -0.006; P  = 0.046)., Conclusions: Our findings indicated positive associations between mRNA levels of MALAT1 and MetS-related parameters, including FBG, TG, HDL, and systolic blood pressure in overweight and obese women. However, large prospective studies are needed to further establish this concept., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01367-2., Competing Interests: Conflict of interestThere are no competing financial interests in the current study., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Inflammation plays an important role in Cardiovascular disease (CVD) pathogenesis as the main cause of mortality in hemodialysis (HD) patients. Despite the relevance of nutrition and dietary intakes for inflammation status, the role of dietary protein sources remains unclear. The aim of this study was to evaluate the association between the different types of dietary protein and pentraxin 3 (PTX3) levels in HD patients. In this multi-center cross-sectional study, 227 adult patients undergoing HD for a minimum 90 days were recruited. A validated 168-item food frequency questionnaire was used to assess dietary intakes. Also, 5 ml blood samples were collected from each patient to measure the concentration of serum PTX3. Overall, 227 patients, including 63 women and 164 men, with a mean age of 58 years, participated in this study. There was a greater intake of animal protein per kilogram dry weight among patients with higher levels of PTX3 (0.46 vs. 0.54 g/kg; P = 0.035). In contrast, consumption of total protein and plant protein per kilogram dry weight was not different across PTX3 levels. Moreover, the chance of increased PTX3 concentration was directly associated with a one-unit increase in animal protein intake per kilogram dry weight, after adjusting for confounders. We did not observe any association between one-unit increases in plant protein intake per kilogram dry weight and chance of increased PTX3. In conclusion, animal protein intake was directly associated with circulating PTX3., (© 2023. The Author(s).)

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.

Background: Acquired brain injury (ABI) can lead to biopsychosocial changes such as depression, low self-esteem and fatigue. These changes can cause, and be caused by, sexual issues affecting relationships and wellbeing. Given the relationship between sexual wellbeing and mental health, it is feasible that supporting sexual wellbeing will benefit psychological wellbeing. However, neurorehabilitation is inconsistent and often fragmented across the UK, and psychological, sexual and social support are lacking. Research shows that self-management and peer-support programmes can improve quality of life, self-efficacy and psychological wellbeing after brain injury. This protocol describes a feasibility randomised controlled trial (RCT) of a digital self-management programme to support mental and sexual wellbeing (known as HOPE4ABI), co-designed with and for people with ABI., Methods: This mixed-methods feasibility RCT has two parallel trial arms of the 8-week digital HOPE4ABI self-management programme. Eligibility criteria include age > 18 years, diagnosed or suspected ABI > 3 months prior to trial entry, access to an Internet-enabled device and ability to engage with the intervention. Referrals to the study website will be made via the National Health Service (NHS), social media and partnering organisations. Sixty eligible participants will be randomised at a ratio of 1:1 to peer-supported (n = 30) or self-directed (n = 30) HOPE4ABI programmes. Primary feasibility outcomes include recruitment and retention rates, engagement, adherence and usage. Secondary outcomes related to standardised measures of quality of life, sexual wellbeing and mental wellbeing. Participants and peer facilitators will be interviewed after the course to assess acceptability across both trial arms., Discussion: This feasibility trial data is not sufficiently powered for inferential statistical analyses but will provide evidence of the feasibility of a full RCT. Quantitative trial data will be analysed descriptively, and participant screening data representing age, ethnicity and gender will be presented as proportions at the group level. These data may indicate trends in reach to particular demographic groups that can inform future recruitment strategies to widen participation. Progression to a definitive trial will be justified if predetermined criteria are met, relating to recruitment, retention, engagement and acceptability., Trial Registration: ISRCTN46988394 registered on March 1, 2023., (© 2023. The Author(s).)

Previous surveys suggests that body mass index (BMI) may be positively related to development of chronic kidney disease (CKD). However, this association might be altered by metabolic syndrome. Therefore, we aimed to evaluate the association of metabolic health status with CKD. The present cross-sectional study was carried out on 3322 representative sample of Iranian adults. Metabolic syndrome was identified based on the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) and BMI was assessed by anthropometric measurements. Estimated glomerular filtration rate (eGFR) was calculated by modification of diet in renal disease-Chronic Kidney Disease Epidemiology Collaboration (MDRD-EPI) formula. Subjects were categorized into four phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight and obesity (MHO), metabolically unhealthy normal weight (MUHNW), and metabolically unhealthy overweight and obesity (MUHO). Based on multivariate-adjusted models, the risk of CKD was significantly higher in MUHO compared with MHNW (OR: 1.48; p < 0.05). Although MUHNW and MUHO were associated with lower eGFR and albuminuria, the significant association was not observed in case of hematuria. Furthermore, subjects with kidney stones tended to be in MHO (OR: 1.42; p < 0.05) and MUHO phenotypes (OR: 1.64; p < 0.05), in comparison to the MHNW phenotype. The odds of kidney disorders were higher in adults with metabolic syndrome, regardless of BMI. However, this relationship might be strengthened by the concomitance of metabolic syndrome and obesity. To verify our findings, clarify the causality, and elucidate the underlying mechanisms, further research are warranted., (© 2023. The Author(s).)

Objective: We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices., Design: Mixed-method study., Participants: Mothers of school children between the ages of 6-12 years., Setting: In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome., Results: The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84)., Conclusion: The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories. Clinical trial registration : The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Seyedhamzeh, Nedjat, Shakibazadeh, Doustmohammadian, Hosseini, Kazemi, Azizolahi, Chamary, Clark and Motlagh.)

Background: Migraine is a complex, chronic, and debilitating multifactorial disorder characterized by recurrent episodes of headache and related symptoms. It typically begins in early ages and is more prevalent in women than in men. Recently, the gut-brain axis has emerged as a new candidate that may be linked to neurological diseases. We hypothesize that selective modulation of the intestinal microbiota, oxidative stress, and inflammation through inulin supplementation may improve clinical outcomes in these patients. Therefore, this study aims to examine the effects of high-performance inulin supplementation on clinical symptoms, mental health, quality of life (QOL), intestinal permeability, and inflammatory and oxidative stress factors in women with migraine., Methods: This is a randomized, double-blind, placebo-controlled clinical trial involving 80 women with migraine who meet the inclusion criteria (aged between 20 and 50 years with a diagnosis of migraine by a neurologist based on the ICDH-3). Participants will be assigned to receive a daily dose of 10 g of inulin for 12 weeks (intervention group, n = 40) or 10 g of maltodextrin as a placebo for the same duration (control group, n = 40). The primary outcome will measure the variations in the frequency of headache experienced by the patients. Secondary outcomes will encompass serum levels of zonulin, high-sensitive C-reactive protein, total antioxidant capacity, total oxidant status, nitric oxide, mental status, QOL, duration, and severity of migraine attacks., Discussion: This clinical trial aims to evaluate the effect of inulin supplementation on inflammatory status, oxidative stress, intestinal permeability, clinical symptoms, mental health, and QOL in women with migraine. The findings of this trial could contribute to the identification of mechanistic action and evidence-based clinical guidelines that address gut microbiota manipulation to maximize health benefits in the management of clinical outcomes in migraine patients., Trial Registration: Iranian Registry of Clinical Trials ( www.irct.ir ) (ID: IRCT20121216011763N58). Registration date: 23 April 2023., Trial Status: The protocol is version 3.0, September 17, 2023. Recruitment began August 21, 2023, and is anticipated to be completed by March 22, 2024., (© 2023. The Author(s).)

One of the most prevalent ovulation disorders is polycystic ovarian syndrome (PCOS). According to the anti-inflammatory and beneficial effects of propolis, this triple-blind controlled trial was designed to evaluate the effect of propolis on metabolic factors, high-sensitivity C-reactive protein, and testosterone in women with PCOS. Recruited patients from the gynecologist clinic were randomized based on a stratified permuted four-block randomization procedure to supplement with propolis tablets, two tablets/day (500 mg propolis/day) (n = 30) or identical placebo tablets (n = 30) for 12 weeks in 2021 until 2022. Data were collected using a demographic questionnaire, blood samples, and a checklist to record the measured parameters. A total of 57 patients completed the trial. ANCOVA test showed that hip circumference (HC)) p = 0.03), fasting insulin (p = 0.007), homeostatic model assessment for insulin resistance (p = 0.004), testosterone (p = 0.004), and low-density lipoprotein (LDL)/high-density lipoprotein (HDL) (p = 0.02) were significantly decreased in the propolis versus the placebo group after adjustment for confounders. Although fasting blood glucose (p = 0.04) decreased significantly in the propolis group compared to the placebo, after adjusting for confounders, significance was lost (p = 0.09). Supplementation with propolis elicited positive effects on fasting insulin and insulin resistance, in addition to reducing the testosterone level, LDL/HDL, and HC, in PCOS women., (© 2023 John Wiley & Sons Ltd.)

Background: considering the diet, as a whole (dietary patterns), can provide more information regarding dietary guidelines to decrease health problems and improve quality of life (QoL) of industrial workers.Therefore, the aims of this study were to identify major dietary patterns and to evaluate their association with quality of life among Iranian industrial employees., Methods: This cross-sectional study was conducted on 3,063 employees of Isfahan Steel Company, Isfahan, Iran, in 2015. Dietary data were evaluated through a validated form of a food frequency questionnaire. Exploratory factor analysis was used to extract major dietary patterns,. To assess the QoL, Euro-QoL five- dimension questionnaire was used. Latent class analysis was used to classify participants based on QoL. Multivariable logistic regression was employed to evaluate the association between dietary patterns and QoL., Results: Three dietary patterns, i.e. western, healthy and traditional, and two classes, i.e. high and low quality of life. were identified from study participants. Lower adherence to the healthy dietary pattern increased the risk of being in low QoL class in which subjects in the lowest tertile of healthy dietary intake had higher odds of being in low QoL class (adjusted OR (AOR): 1.51, 95% CI: 1.19-1.91). However, subjects in the lowest tertile of traditional diet, low adherence, had 30% lower risk of belonging to the low QoL class (AOR:0.70, 95% CI: 0.55-0.88). Higher adherence to western dietary pattern increased the risk of low quality of life, but it was not statistically significant., Conclusion: Higher adherence to a healthy diet and lower adherence to traditional dietary pattern were associated with better QoL in manufacturing employees., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background and Aims: An emerging body of evidence has demonstrated the beneficial effects of probiotics on various mental health conditions. In this systematic review and meta-analysis, we sought to examine the effects of probiotics supplementation on brain-derived neurotrophic factor (BDNF) in adults., Methods: PubMed, Scopus, ISI Web of Science, and the Cochrane Library were searched, from database inception to April 2021, for eligible randomized controlled trials (RCTs). We pooled mean differences and standard deviations from RCTs using random-effect models., Results: Overall, meta-analysis of 11 trials ( n  = 648 participants) showed no significant changes in serum level of BDNF following probiotics. However, subgroup analysis revealed that probiotics increased BDNF levels in individuals suffering from neurological disorders ( n  = 214 participants; WMD = 3.08 ng/mL, 95% CI: 1.83, 4.34; P  = 0.001; I 2  = 7.5%; P-heterogeneity 0.34), or depression ( n  = 268 participants; WMD = 0.77 ng/mL, 95% CI: 0.07, 1.47; P  = 0.032; I 2  = 88.4%; P-heterogeneity < 0.001). Furthermore, a significant increase in BDNF levels was found in studies that administered the mixture of Lactobacillus and Bifidobacterium genera , and were conducted in Asia ., Conclusion: Our main findings suggest that probiotics may be effective in elevating BDNF levels in patients with depression and neurological disorders, and a mixed of Lactobacillus and Bifidobacterium appear to show greater efficacy than the single genus supplement. The low quality of evidence reduces clinical advocacy, and indicates that more large-scale, high-quality, RCTs are needed to facilitate reliable conclusions.

Background: The prevalence of obesity and metabolic syndrome (MetS) during childhood and adolescence is rising significantly worldwide. Previous studies have shown that following a healthy dietary pattern, like the Mediterranean diet (MD), might be an efficacious approach for the prevention and management of MetS during childhood. In the present study, we aimed to examine the effect of MD on inflammatory markers and components of MetS among adolescent girls with MetS., Methods: This randomized controlled clinical trial was conducted on 70 girl adolescents with metabolic syndrome. Patients in the intervention group followed a prescribed MD, while participants in the control group received dietary advice according to the food pyramid. The length of intervention was 12 weeks. Participants' dietary intakes were evaluated using three 1-day food records throughout the study. Anthropometric measures, inflammatory markers, systolic and diastolic blood pressure, and hematological factors were assessed at the baseline and end of the trial. An intention-to-treat approach was taken into account for the statistical analysis., Results: After 12 weeks, participants in the intervention group had lower weight (P time*group  ≤ 0/001), body mass index (BMI) (P time*group  ≤ 0/001), and waist circumference (WC) (P time*group  ≤ 0/001) compared with those in the control group. In addition, MD resulted in a significantly reduced systolic blood pressure compared to the those in the control group (P time*group  ≤ 0/001). In terms of metabolic variables, MD led to a significant decrease in fasting blood glucose (FBS) (P time*group  ≤ 0/001), triglycerides (TG) (P time*group  ≤ 0/001), low-density lipoprotein (LDL) (P time*group  ≤ 0/001), homeostatic model assessment of insulin resistance (HOMA-IR) (P time*group  = 0/02) and a meaningful increase in serum levels of high-density lipoprotein (HDL) (P time*group  ≤ 0/001). In addition, adherence to the MD resulted in a significant reduction in serum levels of inflammatory markers including Interleukin 6 (IL-6) (P time*group  = 0/02) and high-sensitivity C-reactive protein (hs-CRP) (P time*group  = 0/02). However, no significant effect was seen on serum levels of tumor necrosis factor α (TNF-α) (P time*group  = 0/43)., Conclusion: Overall, the findings of the present study revealed that consumption of MD for 12 weeks resulted in a favorable effect on anthropometric measures, components of MetS, as well as on some inflammatory biomarkers., (© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).)

Breast cancer is one of the most prevalent and deadly cancers among women worldwide. Recently, natural compounds have been widely used for the treatment of breast cancer. Present study evaluated antiproliferative and anti-metastasis activities of two natural compounds of dandelion and all-trans-retinoic acid (ATRA) in human MCF-7 and MDA-MB231 breast cancer cells. We also evaluated the expression of MMP-2, MMP-9, IL-1β, p53, NM23 and KAI1 genes. Data showed a clear additive cytotoxic effect in concentrations of 40 μM ATRA with 1.5 and 4 mg/ml of dandelion extract in MCF-7 and MDA-MB231 cells, respectively. In both cell lines, compared with the untreated cells, the expression levels of MMP-9 and IL-1β were significantly decreased while p53 and KAI1 expression levels were increased. Besides, MMP-2 and NM23 had different expressions in the two studied cell lines. In conclusion, dandelion/ATRA co-treatment, in addition to having strong cytotoxic effects, has putative effects on the expression of anti-metastatic genes in both breast cancer cells., (© 2023. Springer Nature Limited.)

Metabolic acidosis (MA) may play a key role in the pathogenesis of protein-energy wasting (PEW) in patients with chronic kidney disease (CKD). To present a comprehensive synthesis of the effect of oral sodium bicarbonate (SB) supplementation on anthropometric measures in patients with CKD, a systematic review was undertaken in PubMed/MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar, of relevant articles published prior to September 2022. The summary statistics of effect size, nonstandardized weighted mean difference (WMD), and 95% confidence interval (CI) were used to compare the effects of SB supplementation on anthropometric parameters vs. control group. To detect probable sources of heterogeneity, a series of predefined subgroup analyses were conducted. In total, 17 studies with 21 treatment arms, including 2203 participants (1149 cases, 1054 controls), met our inclusion criteria and were included in the meta-analysis. SB supplementation had no significant effect on body weight (BW), midarm muscle circumference (MAMC), or lean body mass (LBM) in patients with CKD. There was a significant increase in body mass index (BMI) (MD: 0.59 kg/m 2 , 95% CI: 0.25 to 0.93, p  = 0.001) after SB supplementation in the overall analysis. In subgroup analysis, LBM was increased in studies that were ≥ 24-week duration (MD: 1.81 kg, 95% CI: 0.81 to 2.81) and in participants with BMI lower than 27 kg/m 2 (MD: 1.81 mg/L, 95% CI: 0.81 to 2.81). SB supplementation may yield increases in BMI in predialysis CKD patients. However, our findings did not support the beneficial effects of SB supplementation on other anthropometric outcomes. There is an evident need for long-term high-quality interventions to confirm these findings., Competing Interests: None., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Coronavirus disease 2019 (COVID-19) can result in prolonged and severe damage to the lungs and quality of life (QoL). This study was designed to investigate the effects of 8-week Pilates and Aqua-Pilates training on pulmonary function and QoL in patients with COVID-19., Hypothesis: Pilates and Aqua-Pilates training promotes similar changes on pulmonary function and QoL in people with a history of COVID-19., Study Design: Randomized controlled trial., Level of Evidence: Level 3., Methods: A total of 45 participants (24 men and 21 women) with a history of COVID-19 were assigned randomly to 3 groups: Pilates training (standard Pilates), Aqua-Pilates training (Pilates in water), and Control. The training protocol was performed for 8 weeks (3 sessions per week). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and the ratio of FEV1 to the FVC (FEV1/FVC) indices were measured by a spirometer. The 26-item questionnaire World Health Organization Quality of Life (WHOQOL) BREF was used to assess QoL. Data were analyzed using paired-sample t test and analysis of covariance with an alpha level <0.05., Results: The mean age of the participants was 49.9 ± 6.4 years. After 8 weeks of Pilates and Aqua-Pilates training, there were significant increases in FVC (21.4% for Pilates and 22.1% for Aqua-Pilates, P < 0.05), FEV1 (32.3% for Pilates and 34.7% for Aqua-Pilates, P < 0.05), and FEV1/FVC% (9% for Pilates and 10.3% for Aqua-Pilates, P < 0.05) for the experimental groups, but not for control. Changes for Pilates and Acqua-Pilates were significantly higher than for control. The QoL scores were significantly different within and between the experimental groups, with greater improvements in the Aqua Pilates group than in the Pilates group., Conclusion: An 8-week Pilates or Aqua-Pilates training can improve pulmonary function as much as 34%, depending on the parameter, and QoL in people with a history of COVID-19. Aqua-Pilates training appears to be preferable to standard Pilates., Clinical Relevance: The findings provide important insights into how healthcare professionals can prescribe exercise for COVID-19 survivors.

This study was performed to determine the impact of sex and sport-discipline on physical fitness and bone markers in young sub-elite track and field athletes. One hundred and forty-four track and field sub-elite athletes (78 males aged 17.8±1.6 years; 66 females aged 17.2±1.9 years) volunteered to participate in this study and were categorized according to their disciplines in endurance (EG: n=67) or power athletes (PG: n=77). A significant main effect of sex was observed for C-telopeptide type I collagen (CTx) (F=11.37; p<0.001; η 2 =0.10, moderate), for osteocalcin (OC) (F=8.58; p<0.004; η 2 =0.09, moderate) and for N-terminal propeptide of procollagen type I (PINP) (F=7.96; p<0.05; η 2 =0.07, moderate). The average CTx, OC and P1NP levels were significantly higher in males compared with females (0.05< p <0.001; η2= 0.07 to 0.10, moderate). In addition, a significant main effect of sport-discipline was observed only for P1NP values (F=10.16; p<0.002; η 2 =0.09, moderate) with EG showing higher levels than PG. For jumping and sprinting tests, the PG performed better than the EG. For the endurance test, EG had better performance than PG. Endurance and power exercise practices can increase bone formation markers (P1NP, OC), but only anaerobic training (PG group) appears to positively impact on male track and field athletes., Competing Interests: The authors have no conflicts of interest to declare., (Thieme. All rights reserved.)

Background: Migraine is a common brain disorder characterized by recurrent seizures lasting between 4 and 72 h. Dietary factors can affect migraine headaches. The Alternative Healthy Diet Index (AHEI) is a measure of diet quality and adherence to healthy dietary patterns. This study aimed to assess the association of adherence to AHEI and severity, disability, duration, and frequency of migraine headaches., Methods: In this cross-sectional study, 266 women who suffered from migraines were selected. Usual dietary intakes were assessed using a semi-quantitative, 147-item, food frequency questionnaire (FFQ). AHEI was calculated based on FFQ. The Migraine Disability Assessments (MIDAS) and Visual Analog Scale (VAS) questionnaires were used to evaluate migraine disability, severity and the pain, duration and frequency of headaches., Results: People with high adherence to AHEI, compared with low adherence, had a 43% reduction in headache duration in the crude model (OR = 0.57; 95% CI 0.34, 0.97; P = 0.03), which remained significant after adjusting for potential confounders (OR = 0.56; 95% CI 0.31, 0.99; P = 0.04). No association was found between the frequency of migraine and AHEI in both crude and adjusted models (OR = 1.19; 95% CI 0.66, 2.14; P = 0.55). In addition, no significant association was found between high adherence of AHEI and odds of severe and moderate headaches (P > 0.05)., Conclusion: The results of our study showed that people with high adherence of AHEI had a 43% reduction in duration of migraine. More studies are needed to evaluate and better understand this relationship., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Metabolic syndrome (MetS) is associated with increased inflammation. Diet plays an important role in the prevention and management of MetS, while some dietary factors can also increase or decrease markers of systemic inflammation. In this study, we aimed to determine the mediated association of inflammatory markers induced by dietary insulin index (DII) and dietary insulin load (DIL) with MetS and its components., Methods: This cross-sectional study was conducted with 219 women aged 18-28 years. Dietary intake was assessed by a 147-item food frequency questionnaire (FFQ). DII and DIL were calculated using the standard formula. The guidelines of the National Cholesterol Education Program's Adult Treatment Panel III were used to define MetS. Biochemical parameters and anthropometric and blood pressure measures were evaluated by standard protocols., Results: After the adjustment for potential confounders, a marginally significant association was found between DII and MetS (OR = 2.11; 95% CI = 0.93-4.82; P  = 0.06). However, we did not find a significant association between DIL and MetS. Furthermore, DII was significantly associated with waist circumference (WC) (OR = 1.67; 95% CI = 1.09- 4.03; P  = 0.03) and marginally associated with triglyceride (TG) (OR = 1.10; 95% CI = 0.92-2.33; P  = 0.07) and systolic blood pressure/diastolic blood pressure (SBP/DBP) (OR = 1.84; 95% CI = 0.85-3.99; P  = 0.07). Moreover, there was a significant association between DIL and SBP/DBP (OR = 1.74; 95% CI = 1.54-5.61; P  = 0.04). Also, we found that MCP-1 may have a mediatory role in the association between DII and DIL with MetS and several components of MetS. Hs-CRP did not have mediatory role in the association between DII and MetS. However, hs-CRP had a mediatory role in several MetS components. Furthermore, hs-CRP may have a mediatory role in the association of DIL with MetS and with some of its components., Conclusions: A higher DII score may increase the odds of MetS and its components. DIL was not significantly associated with the odds of MetS, but the association of DIL and SBP/DBP was significant. MCP-1 may have a mediatory role in associations between DII and DIL with MetS. In addition, hs-CRP may have a mediatory role in the association between DIL and MetS., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2023 Melika Darzi et al.)

Background: We examined the cross-sectional associations of dietary Glycemic Index (GI), Glycemic Load (GL), Dietary Insulin Index (DII), and Dietary Insulin Load (DIL) with cardiovascular disease (CVD) factors in subjects with atherosclerosis., Methods: The present cross-sectional study was conducted on subjects with atherosclerosis. Regular dietary intake was assessed using a 168-item semi-quantitative food frequency questionnaire (FFQ) and GI, GL, DIL, and DII were also calculated. Odds Ratio (OR) and 95% Confidence Intervals (CIs) were estimated for general and central obesity according to the GI, GL, DII, and DIL., Results: According to the continuous score of GL, there was a significant positive association between GL and central obesity for women in all models. Regarding the association between DIL score and biochemical variables, there was a significant positive association between Na and Aspartate transaminase (AST) with DII. Moreover, there was a significant positive association between LDL-c(p = 0.03) and AST (p = 0.04)with DIL score in all 3 models., Conclusion: In this study, GL was associated with greater odds of central obesity in women, but not in men. Neither dietary DII nor DIL was associated with BMI and central obesity. GI, GL, DII, and DIL were significantly associated with some CVD risk biomarkers in subjects with atherosclerosis., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The aim of the present study was to investigate the association between dietary patterns, derived through latent class analysis (LCA), with visceral adiposity index (VAI), Triglyceride-Glucose Index (TyG), inflammation biomarkers, and body composition in overweight and obese Iranian women. For this cross-sectional study, dietary exposure was assessed using a validated 147-item semi-quantitative food frequency questionnaire (FFQ). Dietary patterns were derived through LCA. Binary logistic was performed to test the associations of dietary patterns with VAI, TyG, inflammation biomarkers, and body composition. Health centers in Tehran, Iran. 376 obese and overweight women, aged > 18 years. Two dietary patterns were identified using LCA modeling: healthy and unhealthy. Women in the unhealthy class were characterized by higher consumption of fast food, sweetened beverages, grains, unhealthy oils, butter and margarine, and snacks. Compared with the healthy class, the unhealthy class was associated with an increased risk of higher fasting blood sugar (FBS) (OR = 6.07; 95% CI: 1.33-27.74, P value = 0.02), c-reactive protein (CRP) (OR = 1.72; 95% CI: 1.05-2.80; P value = 0.02), and lower fat free mass index (FFMI) (OR = 0.56; 95% CI: 0.35-0.88, P value = 0.01), after adjusting for confounders. We found that adherence to an unhealthy dietary pattern was associated with decreased FFMI and increased FBS and CRP using LCA, but not with the rest of the variables. Further studies should be conducted to confirm the veracity of these findings., (© 2023. Springer Nature Limited.)

Background: Nutrition plays an important role in diabetes self-management. Web-based diabetes care, driven by artificial intelligence (AI), enables more personalized care., Objective: This study aimed to examine the usability and preliminary efficacy of a web-based AI-driven nutrition platform to support people with diabetes and their carers in identifying healthy recipes, meal planning, and web-based shopping., Methods: Diabetes UK signposted people with diabetes and their carers to the platform's study-specific portal through its website, social media, and newsletters. A total of 73 adult participants with prediabetes or diabetes or their carers completed the baseline web-based survey. Of these 73 participants, 23 (32%) completed a web-based survey after 8 weeks of platform use. Web-based semistructured interviews were conducted with platform users (7/23, 30%) who agreed to be followed up and diabetes experts (n=3) who had nutrition and platform knowledge. The intervention consists of a web-based platform that incorporates AI to personalize recipes, meal planning, and shopping list experiences and was made available for 8 weeks. Baseline characteristics, satisfaction, system usability, and diabetes-related and general health indicators were assessed before and after using the platform for 8 weeks., Results: Reductions in weight (mean difference 4.5 kg/m 2 , 95% CI 1.0-12.0; P=.009; Cliff δ=0.33) and waist size (mean difference 3.9 cm, 95% CI 2.0-6.5; P=.008; Cliff δ=0.48) were found. Most of the participants (151/217, 69.6%) did not regularly use the platform and had low or very low engagement scores. However, the platform was perceived as accessible with no need for additional assistance (11/21, 52%), user-friendly (8/21, 38%), and easy to use (8/21, 38%), regardless of some usability issues. Saving recipes was the most popular feature, with 663 saved recipes., Conclusions: This study indicated that the usability of the nutrition platform was well perceived by users and their carers. As participants managed their diabetes well, adding an education component would be specifically relevant for people less familiar with the role of diet in diabetes management. To assess the platform's effectiveness in improving diabetes-related health indicators, controlled studies with a larger and more diverse participant sample are recommended., (©Kim Bul, Nikki Holliday, Mohammad Rashed Alam Bhuiyan, Cain C T Clark, John Allen, Petra A Wark. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 09.08.2023.)

Background: The coronavirus disease 2019 (COVID-19) pandemic elicited the general population to use various dietary supplements (DSs) and nutraceuticals as a protective means against the disease. The present study aimed to evaluate changes and certain determinants of DS intake during the COVID-19 lockdown among Iranian households., Methods: This nationwide cross-sectional study was conducted from April 4 to April 25, 2020, during which Iran was in lockdown. To collect data, a web-based electronic self-administered questionnaire was created. The data were compared among provinces based on their food security situations., Results: A total of 21,290 households were included in the analyses. Approximately 27% of the households were using DSs after the epidemic. The most common DSs used were vitamin D (42%) and vitamin C (20%), followed by multi-vitamin (16%), zinc (9%), omega-3 (6%), vitamin A (4%), and probiotics (3%). Logistic regression analysis revealed that DS intake was directly associated with the household income but inversely with household size and the food security status of the provinces. DS intake was positively associated with the presence of high-risk persons in the households, the education of the households' head, and the presence of a person with a history of COVID-19 within the household., Conclusions: During epidemic lockdown, DS use was remarkably increased among the Iranian households. Apart from the debatable usefulness of DSs against COVID-19, the inverse association of DS use with a household's income and provincial food security well indicates inequity in accessibility to DS. Actions to improve the nutritional status of the under-privileged populations including targeted supplementation are strongly recommended., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 International Journal of Preventive Medicine.)

We aimed to evaluate the effect of spirulina sauce on glycemic indices, lipid profile, oxidative stress markers, and anthropometric measurement in type 2 diabetic patients. Forty patients were randomly assigned to receive 20 g/day spirulina sauce (containing 2 g of spirulina) or placebo for 2 months. Anthropometric and biochemical indices were measured at the beginning and end of the intervention. Fasting blood glucose (mean difference (MD): -15.3 mg/dL, 95% confidence (CI): -44.2 to 13.60, p  = .26), HbA1c (MD: 0.13%, 95% CI: -0.83 to 0.57, p  = .75), insulin (MD: -1.46 μIU/mL, 95% CI: -4.0 to 1.09, p  = .28), and HOMA-IR (MD: -0.35, 95% CI: -2.0 to 1.32, p  = .68) did not change significantly between groups. QUICKI increased significantly (MD: 0.025, 95% CI: 0.006 to 0.045, p  = .03). Among the lipid profile, triglyceride (TG) (MD: -68.6 mg/dL, 95% CI: -107.21 to -29.98, p  < .001), total cholesterol (MD: -29.55 mg/dL, 95% CI: -55.28 to -3.81, p  = .02), and LDL (MD: -17.7 mg/dL, 95% CI: -33.24 to -2.15, p  = .01) were significantly decreased in the spirulina group compared to the control; whereas, the change in HDL was non-significant. No significant change was observed in body composition and anthropometric measurements, except waist circumference, which was reduced (MD: -2.65 cm, 95% CI: -3.91 to -1.38, p  = .001). Hunger index significantly decreased and fullness increased marginally significantly. Although malondialdehyde was significantly reduced, no change was observed in total antioxidant capacity (TAC). Spirulina sauce was not effective for glycemic control in type 2 diabetes; however, could be useful for controlling appetite and ameliorating lipid profile., Competing Interests: No conflicts of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Obesity and overweight status increase the risk of cardiovascular disease. Diet quality can also predict the risk of cardiovascular diseases in obese and overweight patients. Therefore, in this study, we sought to examine the relationship between diet quality index (DQI) and cardiometabolic risk factors in obese and overweight women., Method: A cross-sectional study was conducted on 197 Iranian women with a Body Mass Index (BMI) > 25, 18-48 years, and recruited from 20 Tehran Health Centers. Nutrition intake and DQI were assessed using a 147-item semi-quantitative food frequency questionnaire (FFQ). Additionally, anthropometric measurements, body composition, biochemical evaluations, and cardiometabolic risk factors were evaluated., Results: There was an association between DQI and waist-to-hip ratio (WHR), atherogenic index of plasma (AIP), and CHOLINDEX in obese women, after adjusting for potential confounders. Whereas, there were no significant associations of the tertiles of DQI compared with the first tertile in other cardiometabolic risk factors, before and after adjustment., Conclusion: This study provides evidence that dietary intake and DQI are associated with cardiometabolic risk factors and that dietary modification may be a predictor for reducing WHR, AIP, and CHOLINDEX. However, more research is needed to develop a DQI that reflects changes in cardiometabolic risk factors by considering women's eating habits and patterns., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mohamadi, Shiraseb, Mirzababaei, AkbarySedigh, Ghorbani, Clark, Aali and Mirzaei.)

Diet can affect the inflammatory state of the body. Accordingly, the dietary inflammatory index (DII) has been developed to quantify the inflammatory properties of food items. This study sought to investigate the association between dietary inflammation index (DII) and the odds ratio of elevated CRP (E-CRP) through a systematic review and meta-analysis study. The International electronic databases of PubMed, Web of Science (ISI), and Scopus were searched until May 2023 to find related articles. From 719 studies found in the initial search, 14 studies, with a total sample size of 59,941 individuals, were included in the meta-analysis. The calculated pooled odds ratio (OR) of E-CRP in the highest DII category was 1.39 (95% CI: 1.06, 1.14, test for heterogeneity: p  = .63, and I 2  = .0%) in comparison with the lowest DII category. Also, the results of this study showed that each unit increase in DII as a continuous variable generally elicited a 10% increase in the odds of E-CRP (OR 1.10, 95% CI 1.06, 1.14, test for heterogeneity: p  = .63, and I 2  = .0%). Subgroup meta-analyses showed that there is a higher E-CRP odds ratio for the articles that reported energy-adjusted DII (E-DII) instead of DII, the studies that measured CRP instead of hs-CRP, and the studies that used 24-h recall instead of FFQ as the instrument of dietary intake data collection. Individuals with a higher DII were estimated to have higher chances of developing elevated serum CRP. This value was influenced by factors such as the participants' nationality, instruments of data collection, methods used to measure inflammatory biomarkers, study design, and data adjustments. However, future well-designed studies can help provide a more comprehensive understanding of the inflammatory properties of diet and inflammatory serum biomarkers., Competing Interests: The authors declare that they have no conflict of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

This study aimed to examine the impact of 40-min and 90-min naps on performance in the 5-m shuttle run test (5mSRT) and on various physiological and perceptual measures. Sixteen male athletes (20 ± 3 years, 173 ± 7 cm, 67 ± 7 kg) performed the 5mSRT after a 40-min nap (N40), after a 90-min nap (N90), and in a no-nap, control condition (N0). The 5mSRT involves six repetitions of 30 s of all-out exercise. Total distance (in the six repetitions) and highest distance (in a single repetition) in the 5mSRT were greater after naps than in N0 (p < 0.001), and the total distance, which reflects the anaerobic capacity, was greater in N90 than in N40 (p < 0.05). Physiological and perceptual responses were favourable in both nap conditions (p < 0.01), more so in N90 than in N40 (p < 0.05). Together, the results support the contention that physiological/perceptual responses after napping contribute to improved exercise performance and that longer naps are more effective.