Search Results (209)

Child and adolescent obesity represents a growing public health crisis, with profound implications for physical and mental well-being. Despite the well-established benefits of physical activity, over 80% of adolescents fail to meet the World Health Organization’s (WHO) recommendations for daily exercise. This manuscript explores gym-based strength training as a tailored intervention for obese youth who often struggle with aerobic activities. This paper critically examines medical eligibility, safety protocols, and injury risks while also detailing personalized training regimens that prioritize neuromuscular adaptation, functional strength, and long-term engagement. Additionally, it integrates evidence-based dietary strategies and supplementation practices appropriate for this age group, highlighting the role of the Mediterranean diet, DASH, and the cautious use of supplementation, particularly probiotics and protein, while discouraging performance-enhancing substances in youth. Emphasis is placed on interdisciplinary approaches, combining exercise, nutrition, and medical oversight to support holistic treatment. This study identifies gaps in the current literature and provides practical recommendations for designing safe, effective, and sustainable gym-based interventions for children with obesity, encouraging further research to validate these protocols in clinical settings. A comprehensive search was conducted across multiple databases, including PubMed/MEDLINE, the Cochrane Library, Science Direct, and EBSCO, focusing on English-language meta-analyses, systematic reviews, randomized clinical trials, and observational studies. The websites of prominent scientific organizations such as WHO, APP, and AIS were also reviewed. The selection of articles was a collaborative effort among all authors. Full article

Metabolic syndrome (MetS) is characterized by central obesity, insulin resistance, hypertension, dyslipidemia, and chronic inflammation, significantly increasing the risk of cardiovascular disease and type 2 diabetes. Effective management of MetS is critical, with exercise being a key intervention. This review analyzed the effects of different exercise intensities—low, moderate, and high-intensity interval training (HIIT)—on metabolic health, oxidative stress (OS), inflammation, and cardiovascular function. A search of Medline, PEDro, and EBSCO identified 2251 articles, with 159 studies published between 1999 and 2025 included after screening. Low-intensity exercise improved insulin sensitivity, reduced OS markers (e.g., MDA, 8-OHdG), and enhanced antioxidant enzyme activity. Moderate-intensity exercise showed similar benefits with notable reductions in inflammatory markers (e.g., IL-1β, TNF-α). HIIT promoted fat loss and improved metabolic markers but temporarily increased OS and inflammation. Dietary strategies also play a critical role. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diets are well established, emphasizing nutrient-dense foods like unsaturated fats and fiber to reduce inflammation and manage weight. The ketogenic diet (KD), a high-fat, low-carbohydrate approach, has recently gained attention for its metabolic benefits. KD induces ketosis, improving insulin sensitivity, reducing triglycerides, and enhancing fat oxidation. Studies show KD effectively reduces body weight and glucose levels, though long-term adherence and nutrient deficiencies remain challenges. Intermittent fasting also showed potential benefits, though effects on glucose metabolism were inconsistent. This review underscores the need for tailored approaches combining exercise, diet, and fasting to optimize MetS outcomes, offering integrative strategies for prevention and management. Full article

Background/Objectives: This systematic review and meta-analysis evaluates the surgical, functional, and aesthetic outcomes of scapular free flaps in maxillary reconstruction. The primary objective is to assess early surgical complications, fistula formation, donor site morbidity, dental restoration, normal dietary intake, aesthetic compromise, and eye-related issues. Secondary objectives include total free flap necrosis, the need for revision procedures, and functional performance of the upper limb. Methods: A systematic review was conducted following the PRISMA guidelines. Eligible studies were identified by searching PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar, with the last search conducted on 10th February 2025. Inclusion criteria were studies reporting on patients undergoing maxillary reconstruction with scapular free flaps, and which provided data on at least one of the primary or secondary outcomes. A single-arm meta-analysis was performed to assess the outcomes of scapular free flap reconstruction. The risk of bias was assessed using the Newcastle–Ottawa Quality Assessment Scale, with two independent reviewers performing the assessment. Results: From an initial search of 310 articles, 6 studies were included in the qualitative and quantitative synthesis, encompassing 231 patients with a mean age of 52.9 years (95% CI 44.9–60.8). Early general surgical complications occurred in 24% (95% CI 13–40) of patients, while 12% (95% CI 4–31) experienced fistula formation. Donor site morbidity was reported in 10% (95% CI 6–17) of cases, with a mean DASH score of 10.49, indicating low upper limb impairment. Dental rehabilitation was achieved in 56% (95% CI 42–70), and 52% (95% CI 31–72) of patients resumed a normal diet. Aesthetic compromise was observed in 27% (95% CI 9–58), and 36% (95% CI 28–44) reported eye-related issues. Conclusions: Scapular free flap is a reliable option for maxillary reconstruction with favourable outcomes, particularly in complex composite defects requiring both bone and soft tissue reconstruction. However, the evidence is limited by risk of bias, significant heterogeneity, and imprecision due to the small number of studies and participants. Larger, more robust trials are needed to confirm these findings. Full article

Cardiovascular (CV) diseases remain a leading global health challenge, being influenced by diet and systemic inflammation. Adherence to healthy dietary patterns, such as the Mediterranean (MED), Dietary Approaches to Stop Hypertension (DASH), and Anti-inflammatory (AnMED) diets, may reduce the CV risk. Background/Objectives: We aimed to evaluate the association between the adherence to healthy dietary patterns and CV treatments. Methods: This cross-sectional study was conducted in the Valencian Community, Spain. Nutritional data were collected using a food frequency questionnaire to assess the adherence to MED, DASH, and AnMED dietary patterns. Statistical analyses, including Kruskal–Wallis tests and linear regression models, evaluated dietary adherence, nutrient intake, the Dietary Inflammatory Index (DII), and medication use. Results: Of 468 participants initially recruited, were included in the final analysis after applying inclusion and exclusion criteria (88.48% female, mean age: 66.16 ± 9.59 years). A significant association was observed between the DII and antihypertensive use (p-value < 0.001), with higher DII scores correlating with increased antihypertensive consumption. Among dietary patterns, the AnMED diet exhibited the strongest association with the DII (p-adjust < 0.001). Predictive modeling revealed a 14.28% increase in antihypertensive use per unit rise in the DII. The AnMED diet was the only pattern significantly linked to improved micronutrient intake, including calcium, magnesium, sodium, and potassium. Conclusions: The DII is a useful tool for assessing the inflammatory potential of diets. Diets with lower DII scores, such as the AnMED diet, may reduce systemic inflammation and improve CV health. Adherence to the AnMED diet may lower blood pressure and reduce reliance on antihypertensive medications, supporting anti-inflammatory dietary patterns for CV disease prevention and management. Full article

Diet has a profound impact on brain health, particularly in middle-aged and older adults, who are at increased risk of cognitive decline and neurodegenerative diseases. Various dietary patterns, including the Mediterranean diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets, have been linked to improved cognitive function. While the relative effectiveness of these diets on brain health is generally supported by evidence, variability in study results suggests that further research is needed to fully understand their effects across diverse populations. The objective of this descriptive narrative review is to examine the role of dietary patterns in supporting brain health in aging populations and to propose practical dietary strategies for promoting cognitive well-being. A comprehensive review of the existing literature was conducted on PubMed in October 2024, with no restrictions on language, publication date (1966–2024), or geographic location. A total of 18 articles were included in this review, covering the years 2013–2023. Studies assessing the impact of the MedDiet, DASH, MIND, and Western diets on cognitive function in middle-aged and older adults were prioritized. The research findings were synthesized to identify common and unique recommendations across these dietary patterns. The MedDiet consistently showed beneficial effects on cognitive health, including improved memory, processing speed, and long-term protection against neurodegenerative conditions. The DASH and MIND diets demonstrated potential benefits, particularly for specific cognitive domains, but the results were more mixed and inconclusive. In contrast, adherence to a Western diet was associated with negative cognitive outcomes, including cognitive decline and smaller brain volumes. These findings underscore the importance of adopting healthy dietary patterns as a modifiable lifestyle factor to support cognitive aging and inform future public health strategies and clinical guidelines. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a public health concern, linked with immune-metabolic dysfunction. While lifestyle and dietary modifications remain the cornerstone of MASLD management, the optimal dietary approach remains uncertain. Objectives: This systematic review aims to investigate the impact of model dietary patterns on metabolic outcomes in patients with MASLD and evaluate their effects in individuals with coexisting metabolic conditions, such as obesity, metabolic syndrome, and type 2 diabetes mellitus (T2DM). Methods: To conduct the review, PubMed, Scopus, Google Scholar, Cochrane CENTRAL, and ClinicalTrials.gov databases were searched for Randomized Controlled Trials (RCTs) on the adult population, published between January 2019 and September 2024, following PRISMA principles. The quality of the included RCTs was assessed qualitatively based on study characteristics. Results: The main findings of this review demonstrated that the use of interventions with dietary model based on Mediterranean diet (MED) and intermittent fasting (IF) approaches, such as alternative-day fasting (ADF) and time-restricted feeding regimens (TRF) may have potential in reducing body weight, BMI, and waist circumference, with additional benefits of improving glycemic control and reducing inflammation. The effects on hepatic functions, although limited, may be linked with reduced enzyme activity and liver stiffness. Additionally, the use of lacto-ovo-vegetarian diet (LOV-D) and the Dietary Approaches to Stop Hypertension (DASH) diet may offer additional health benefits, including blood pressure management. Conclusions: This review suggests that MED and IF-based strategies may reduce BW, improve glycemic control, and lower inflammation, with potential benefits for hepatic function. Further long-term studies are needed to confirm these effects and underlying mechanisms, which will allow for the optimization of protocols and ensure their safety in MASLD. Full article

Background/Objectives: Eggs, a nutritious and affordable food, are not widely consumed by adolescents, who show many nutrient inadequacies. Modeling dietary substitutions with eggs and their costs can provide dietary insights while considering economic constraints. This study theoretically modeled the impact of substituting an egg for another protein source, considering nutrient quality and cost, using exemplary menus with application to adolescents. Methods: The substitution was modeled in four different seven-day exemplary menus: (1) the Healthy U.S.-Style Dietary Pattern (HUSS), (2) Harvard Medical School’s Heathy Eating Guide, (3) the National Heart, Lung, and Blood Institute’s Dietary Approaches to Stop Hypertension (DASH) diet and (4) the Healthy U.S.-Style Vegetarian Dietary Pattern (HVEG). One egg replaced the gram amount and nutrient profile of a protein source food in each menu. Micronutrient quality was assessed using the Food Nutrient Index (FNI), scored 0–100. The Center for Nutrition Policy and Promotion Food Price Database informed the food prices. Pairwise t-tests compared the effects of egg substitution on micronutrient scores and daily costs. Results: The daily egg substitution increased FNI scores for choline and vitamin D in the HUSS (83 to 95 and 69 to 75, respectively), DASH (80 to 91 and 55 to 59, respectively), and HVEG (91 to 100 and 44 to 51, respectively), and choline alone (89 to 98) in the Harvard menu. Daily menu prices were not significantly different after the egg substitution (p > 0.01). Conclusions: Substituting one egg for another protein source food increased the micronutrient quality of choline and vitamin D in exemplary menus without increasing the cost; however, factors such as food preferences and the economic accessibility of eggs in different contexts should also be considered. Full article

Dyslipidemia, characterized by abnormal blood lipid levels, is a major public health concern due to its association with atherosclerotic cardiovascular disease (ASCVD) and other cardiometabolic disorders. In this context, appropriate nutrition patterns are pivotal as they represent the basic approach for providing a wide range of substantial advantages. The best evidence for dyslipidemia management is offered by the Mediterranean Diet, the Plant-Based Diet, the High-Fiber Diet and the Anti-inflammatory Diet, while the DASH Diet and the Ketogenic Diet have also been shown to target additional pathological features like hypertension and other comorbidities. The bioactive compounds that are enriched in these nutrition patterns and able to manage dyslipidemia include monounsaturated fatty acids such as ω-3, polyphenols such as oleuropein, resveratrol, flavonoids, and catechins, carotenoids, phytosterols and soluble and unsoluble fibers. Diets rich in these compounds can improve lipid profile by mitigating oxidative stress, reducing low-grade chronic inflammation, modulating macronutrient absorption and other mechanisms, thereby supporting cardiovascular health. Additionally, lifestyle interventions such as regular physical activity, weight loss, reduced alcohol consumption and smoking cessation further ameliorate lipid metabolism and manage circulated lipid profile. Furthermore, emerging insights from nutrigenomics underscore the potential for proper diet to address genetic factors and optimize treatment outcomes. The pivotal role of nutrition interventions in the context of dyslipidemia and its cardiometabolic implications is discussed in this review, emphasizing evidence-based and personalized approaches. Full article

Polycystic ovary syndrome (PCOS) is an endocrine disorder that causes cardiometabolic and reproductive disorders in women of reproductive age. Women with PCOS are more likely to have obesity, type 2 diabetes mellitus, and cardiovascular disease. There is an inconclusive consensus on which dietary modification could be most effective in PCOS prevention and treatment. This review aimed to examine the effects of diverse dietary patterns on PCOS in women according to randomized controlled trials (RCTs) with and without an isocaloric dietary design. A literature search was performed in the PubMed^®®/MEDLINE^®® database up to 14 November 2024. A total of 21 RCTs were reviewed after screening the records, including 15 RCTs with a calorie-restricted dietary design and 6 RCTs with a non-calorie-restricted dietary design. This review found beneficial effects of the calorie-restricted Dietary Approaches to Stop Hypertension (DASH) diet on weight loss and glucose control in women with PCOS in four RCTs with an isocaloric dietary design. The calorie-restricted low-glycemic index (GI) diets from three RCTs and high-protein diets from four RCTs with an isocaloric dietary design showed no significant differences in anthropometric parameters, glucose control, lipids, and gonadal parameters compared with the control diet in women with PCOS. Non-calorie-restricted low-carbohydrate diets from four RCTs with an isocaloric dietary design showed similar results to the calorie-restricted low-GI diets and high-protein diets. However, the existing number of RCTs is insufficient to conclude the association between dietary patterns and PCOS in women. Further, well-designed dietary intervention studies are needed to assess the role of dietary patterns in PCOS beyond calorie restriction. Full article

Background and Objectives: Cancer survival poses significant challenges in oncology, with lifestyle modifications increasingly recognized as crucial in modifying patient outcomes post-diagnosis. This meta-analysis aims to systematically evaluate the impact of various lifestyle interventions on cancer survival across different types of cancer. Methods: A comprehensive literature search of electronic databases including PubMed, Scopus and Cochrane was performed to identify relevant studies up to 30 November 2024. Relevant studies were chosen and data were extracted and analyzed using SPSS Version 29.0 software. Results: Our systematic review included data from 98 studies involving a total of 1,461,834 cancer patients to evaluate the impact of lifestyle factors on cancer survival. Out of these, 64 studies were included in the meta-analysis. Our meta-analysis demonstrates that adherence to specific dietary patterns significantly improves cancer-specific outcomes. The Healthy Eating Index (HEI) diet was associated with a reduction in cancer-specific mortality (pooled log HR: −0.22; 95% CI: [−0.32, −0.12]; p < 0.001). Similar benefits were observed with the Mediterranean diet (aMED), which also reduced cancer mortality and recurrence (pooled log HR: −0.24; 95% CI: [−0.40, −0.07]; p < 0.001), and the Dietary Approaches to Stop Hypertension (DASH) diet (pooled log HR: −0.22; 95% CI: [−0.33, −0.12]; p < 0.001). Additionally, general dietary improvements were beneficial for breast cancer-specific mortality across 17 cohort studies (pooled log HR: −0.15; 95% CI: [−0.25, −0.06]; p < 0.001). Engaging in any form of physical activity post-diagnosis was associated with significant improvements in cancer-specific mortality or recurrence (pooled log HR: −0.31; 95% CI: [−0.38, −0.25]; p < 0.001). Participants who ceased smoking after diagnosis exhibited more favorable cancer outcomes (pooled log HR: −0.33; 95% CI: [−0.42, −0.24]; p < 0.001), with smoking cessation notably reducing cancer-specific mortality among lung cancer survivors (pooled log HR: −0.34; 95% CI: [−0.48, −0.20]; p < 0.001). Additionally, reducing alcohol intake post-diagnosis significantly improved cancer outcomes (pooled log HR: −0.26; 95% CI: [−0.33, −0.19]; p < 0.001). Alcohol moderation in gastrointestinal tract cancer survivors specifically decreased both cancer-specific mortality and recurrence (pooled log HR: −0.22; 95% CI: [−0.29, −0.15]; p < 0.001). Conclusions: Lifestyle modifications after cancer diagnosis significantly improve cancer-specific outcomes. Specific dietary patterns, increased physical activity, smoking cessation, and reduced alcohol intake are all associated with lower cancer-specific mortality. Integrating these lifestyle changes into oncology care may enhance patient survival and quality of life. Full article

Alzheimer’s disease (AD) is one of the most common and severe forms of dementia and neurodegenerative disease. As life expectancy increases in line with developments in medicine, the elderly population is projected to increase in the next few decades; therefore, an increase in the prevalence of some diseases, such as AD, is also expected. As a result, until a radical treatment becomes available, AD is expected to be more frequently recorded as one of the top causes of death worldwide. Given the current lack of a cure for AD, and the only treatments available being ones that alleviate major symptoms, the identification of contributing factors that influence disease incidence is crucial. In this context, genetic and/or epigenetic factors, mainly environmental, disease-related, dietary, or combinations/interactions of these factors, are assessed. In this review, we conducted a literature search focusing on environmental factors such as air pollution, toxic elements, pesticides, and infectious agents, as well as dietary factors including various diets, vitamin D deficiency, social factors (e.g., tobacco and alcohol use), and variables that are affected by both environmental and genetic factors, such as dietary behavior and gut microbiota. We also evaluated studies on the beneficial effects of antibiotics and diets, such as the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) and Mediterranean diets. Full article

Background/Objectives: An elevated lipoprotein(a) [Lp(a)] level, which is a prevalent cardiovascular risk factor, is genetically determined by a size polymorphism of its apolipoprotein(a) [apo(a)] component. Despite its genetic control, Lp(a) level increases in response to dietary saturated fat (SFA) reduction. We tested the roles of apo(a) size and characteristics in modulating Lp(a) response to SFA reduction. Methods: We assessed apo(a) characteristics in 165 African Americans experiencing a 24% Lp(a) increase resulting from SFA reduction [16% at an average American Diet diet (AAD) to 6% at a DASH-type diet]. Apo(a) effects were tested based on the following factors: (1) the presence of a small atherogenic size (≤22 kringles), (2) phenotype (single or two isoforms), (3) isoform dominance, and (4) tertiles of combined kringle sizes. Results: There were no significant differences in Lp(a) increases between carriers vs. non-carriers of a small apo(a), between those with a single vs. two expressed isoforms, or in those with differing isoform dominance patterns (p > 0.05 for all). The extent of Lp(a) increase differed across increasing tertiles of combined kringle sizes (p = 0.006 for trend). In a multivariate model, the AAD Lp(a) level was a significant predictor of Lp(a) changes (p < 0.05). Relative increases in the allele-specific apo(a) level—an Lp(a) level associated with a defined apo(a) size—were similar across the apo(a) size spectrum. Conclusions: Reducing dietary SFA intake results in a 24% increase in Lp(a) level in African Americans across apo(a) sizes. Individuals with smaller apo(a) sizes reached an elevated Lp(a) level post-intervention compared to those with larger sizes, in some cases resulting in cardiovascular risk reclassification. Full article

Background/Objectives: Diet quality during early childhood significantly influences long-term health outcomes, including obesity and chronic disease risks. Parental feeding practices, dietary beliefs, and demographic factors have been shown to impact children’s diet quality. This study aimed to determine the extent to which the demographic characteristics and the factors of primary caregivers (dietary beliefs, intention to provide a healthy diet, feeding practices) can explain the variance in the diet quality of preschoolers in the US Methods: This descriptive correlational cross-sectional study was guided by the Theory of Planned Behavior (TPB). A total of 146 primary caregivers of preschool children (aged 3–5) were recruited through convenience and snowball sampling. Data were collected using a self-reported questionnaire and a structured telephone interview. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) score. Hierarchical multiple regression analyses were conducted to determine the factors associated with preschoolers’ diet quality. Results: The mean DASH score was 40.5 (SD = 10.1), reflecting moderate to low diet quality. The results showed that 16% of the variance in diet quality was significantly explained by race (non-White) and three caregiver feeding practices (food as a reward, restriction food for health, and restriction for weight control). Of these, race (non-White) and restriction food for health were significant predictors and associated with lower diet quality in preschoolers. Conclusions: These findings align with previous studies and suggest that the conceptual framework of this study might be further refined and tested in future studies. Full article

Background. The relationship between heart failure (HF) and Mediterranean and DASH diets is not well delineated. This meta-analysis aimed to assess the effectiveness of high adherence to Mediterranean and DASH diets compared to low adherence in reducing the risk of incident HF (primary prevention of HF) and reducing all-cause mortality in patients with HF (secondary prevention of HF). Methods. The reporting stages of this meta-analysis closely adhered to the PRISMA guidelines. A comprehensive literature search was undertaken for published papers in PubMed, Embase, EBSCO, ICTRP, and the NIH clinical trials databases. Results. A total of 16 reports from 14 studies were included in this paper. A significant inverse association was identified between high adherence to the Mediterranean diet model (compared to low adherence) and the risk of incident HF (OR = 0.77, 95% CI: 0.63–0.93, p = 0.007) among patients without previous diagnosis of HF. Similarly, there was a significant and inverse relationship between high adherence to the DASH diet (compared to low adherence) and the risk of incident HF (OR = 0.83, 95% CI: 0.70–0.98, p = 0.03) among patients without previous diagnosis of HF. High adherence to the Mediterranean diet model (compared to low adherence) was associated with lower all-cause mortality (OR = 0.88, 95% CI: 0.78–0.99, p = 0.03) among patients with HF. Conclusions. This paper demonstrated that high adherence to Mediterranean and DASH diets significantly reduced the risk of incident HF among individuals without a previous diagnosis of HF, whereas only high adherence to the Mediterranean diet was associated with lower all-cause mortality among patients with HF. Full article