Search Results (364)

Diabetes mellitus constitutes a significant global public health problem. It is a chronic disease characterized by persistent hyperglycemia, which is a consequence of inadequate insulin secretion, deficient insulin action, or a combination of both factors. A crucial component in the effective management of this pathology is therapeutic adherence, as it helps prevent complications, improve patient quality of life, reduce associated mortality, and decrease the need for hospitalization. In this context, it is crucial to implement a comprehensive care model that offers continuous support and a multidisciplinary approach. Primary care should be central, coordinating the entire care process. Understanding the clinical and social characteristics of people with diabetes is key to guiding more effective interventions. Objective: The objective of this study was to describe the sociodemographic and anthropometric characteristics, degree of metabolic control, and treatment adherence in patients with diabetes mellitus enrolled in primary care programs in Ceuta. Materials and Methods: This was a descriptive, observational, and cross-sectional study conducted during the second half of 2024. The study population included individuals enrolled in the primary care diabetes program in Ceuta. We analyzed sociodemographic variables with a self-administered questionnaire, the level of therapeutic adherence using the MMAS-8 scale, and glycemic control through glycosylated hemoglobin (HbA1c) values. Results: The sample consisted of 370 individuals, with 50.3% being men. The average age was 62.82 years (SD = 13.46). A significant portion of participants, 61.07%, had no formal education or had only received primary education. Additionally, 84.9% of the participants had at least one other associated chronic pathology. Regarding adherence, 36.8% of the patients showed a high level, and for all patients, the mean HbA1c value was 7.5% (SD = 1.55). Furthermore, our analysis revealed statistically significant associations between cultural background and both therapeutic adherence (weak positive correlation: r = 0.213, p ≤ 0.001; multivariate significance: sig: <0.001; Exp(B) = 2.448) and glycemic control (multivariate significance: sig: <0.001; Exp(B) = 2.686). Conclusions: We observed high treatment adherence in the study population, with HbA1c values within the limits recommended by the World Health Organization for older adults. Furthermore, a relationship between cultural background and both treatment adherence and glycemic control was identified. This suggests a need for further research into these and other social determinants, like study level or monthly income, in future studies. Full article

Background/Objectives: Childhood obesity is associated with early metabolic complications, particularly insulin resistance (IR), which significantly elevates the long-term risk for type 2 diabetes and cardiovascular disease. Standard measures such as BMI may inadequately capture metabolic risk, particularly in children with atypical phenotypes such as TOFI (Thin Outside, Fat Inside). This study aimed to evaluate the prevalence and predictors of IR in a pediatric population with overweight and obesity, using both conventional biomarkers and bioelectrical impedance analysis (BIA). We also examined the predictive value of lipid ratios and fasting glucose and applied Principal Component Analysis (PCA) to identify underlying body composition dimensions. Methods: A retrospective cohort of 210 children aged 1–18 years, assessed in a tertiary pediatric endocrinology center in Romania, was analyzed. Clinical data included anthropometric measures, fasting laboratory results, and body composition parameters obtained via Tanita PRO DC430 MA BIA. Insulin resistance was defined as HOMA-IR > 2. ROC analysis assessed the predictive performance of triglyceride-to-HDL (Tg/HDL) ratio, fasting glucose, and BIA metrics. PCA was applied to BIA variables to explore dimensional structure. Results: Insulin resistance was present in 54.8% of the cohort. It was significantly associated with higher age, pubertal status, ALT, LDL-cholesterol, triglycerides, and BIA-derived fat-free mass (FFM), TBW, and PMM. ROC analyses showed moderate predictive power for Tg/HDL (AUROC = 0.645) and triglycerides (AUROC = 0.656) in identifying IR. BIA metrics had comparable discriminatory performance (AUROC~0.61). PCA reduced eight BIA parameters into two components: a fat-free mass axis (TBW, FFM, PMM, WATERM) and an adiposity axis (BMI, FATP, FATM, WATERP). Conclusions: This study highlights the high burden of insulin resistance among children with excess weight and supports the integration of BIA and composite biomarkers into early screening protocols. PCA-derived components may improve metabolic phenotyping in pediatric obesity. Full article

Background/Objectives: Metabolic dysfunction-associated steatosis liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver related morbidity and mortality affecting 38% of the adult global population. As of now, there is no clear consensus on a standardized pharmacological treatment for MASLD; therefore, lifestyle interventions particularly diet and exercise remain the first-line approach for both prevention and management. Extra virgin olive oil (EVOO), the primary source of fat in the Mediterranean diet. (MD) is widely recognized as a key contributor to its well-documented health benefits. As a central component of this dietary pattern, EVOO has demonstrated promising therapeutic potential due to its high phenolic content. The primary aim of this review is to synthesize existing human studies examining the effects of olive oil primarily EVOO on key pathological features of MASLD. Methods: A systematic search of human clinical and observational studies was conducted across major databases. Key outcomes assessed include hepatic steatosis, inflammation, oxidative stress, fibrosis, liver enzymes, and anthropometric measures. Study quality was evaluated using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Results: This review included 25 high-quality studies, 12 of which assessed olive oil alone and 13 evaluated the MD emphasizing extra virgin olive oil (EVOO). EVOO-rich interventions consistently improved hepatic steatosis, liver enzyme levels (ALT, AST), and inflammatory markers in MASLD patients, particularly when paired with calorie-restricted or MD patterns. Benefits were dose- and type-dependent, with EVOO showing superior effects compared to refined olive oils. Modest improvements in lipid profiles and insulin resistance were observed. Longer study durations and higher EVOO intake (>30–50 g/day) yielded greater improvements. Findings suggest EVOO may exert beneficial effects on liver health through its anti-inflammatory and antioxidant properties. Future studies on EVOO’s role in MASLD should use well-characterized oils with known polyphenol and bioactive compound levels and include clear biomarkers of oxidative stress, inflammation, and liver health outcomes on humans. Overall, EVOO represents a promising, non-pharmacological strategy for MASLD prevention and management. Conclusions: Current evidence suggests that EVOO, particularly when rich in phenolic compounds, is a promising dietary strategy for managing MASLD due to its hepato-protective effects, especially within a Mediterranean diet framework. However, findings are limited by study heterogeneity and a lack of high-quality randomized controlled trials, highlighting the need for future research to refine optimal dosing, assess long-term outcomes, and clarify underlying mechanisms. Full article

Background: Anthropometric tests and scales used to predict difficult intubation in people with obesity have limited sensitivity and specificity. A thyromental height test (TMHT) is based on the height between the anterior border of the thyroid cartilage and the anterior border of the mentum. Objectives: The aim of this study was to assess the usefulness of TMH in the prediction of difficult intubation in patients with obesity scheduled for elective surgical procedures. Methods: A prospective, observational cohort study in adult patients with BMI ≥ 30 kg⋅m⁻² scheduled for elective surgical procedures under general anesthesia, direct laryngoscopy, and intubation was conducted in a university hospital between June 2020 and June 2021. The primary outcome measure was thyromental height, and the secondary outcome measures were thyromental distance (TMD), sternomental distance (SMD), score in the modified Mallampati test (MMT), Cormack–Lehane grade (CL), neck circumference (NC), and mouth opening (MO) distance. As a secondary outcome, a composite score was developed and analyzed for its predictive performance. Results: In 77 patients (56 females, 72.7%) aged 43.21 ± 9.39 years with a mean BMI of 37.18 (34.6–42.8) kg⋅m⁻², difficult intubation was found in 18 patients (23.38%). Sleep apnea was present in 14 (23.75) patients with easy intubation vs. 9 (50%) patients with difficult intubation (p = 0.033). There were no statistically significant differences in thyromental height test, thyromental distance, neck circumference, and mouth opening scores. Male sex, TMD ≤ 175 mm, and MO ≤ 60.5 mm were predictors of difficult laryngoscopy. The OPERA Score (range 0–5) demonstrated superior predictive value (AUC = 0.8 p < 0.01), outperforming its individual components. Conclusions: Male sex, TMD ≤ 175 mm, and MO ≤ 60.5 mm are predictors for difficult laryngoscopy in patients with obesity. The results of our study indicate that TMH may not be a good predictor of difficult intubation in patients with obesity. However, when integrated into a composite score, it contributes meaningfully to a multifactorial risk assessment. Full article

Objectives: This cross-sectional study assessed the nutritional knowledge of Saudi mothers and their children. Then, it examined the association between the nutritional knowledge of mothers and the nutritional knowledge and weight status of their schoolchildren in Makkah City, Saudi Arabia. Methods: The mothers’ nutritional knowledge was assessed using the validated Arabic version of the General Nutrition Knowledge Questionnaire (GNKQ). The children’s nutritional knowledge was assessed through an interviewer-administered questionnaire, and their weight status was determined based on their Body Mass Index (BMI) Z-score, which was calculated according to their anthropometric measurements. Results: One hundred children and sixty mothers were included in this study. Only 6.67% of the mothers had a high level of nutrition knowledge. A total of 54% of their children had low nutritional knowledge scores, and approximately 27% was classified as having excess weight. More than 40% of the children reported consuming fruits and vegetables 4–5 times/week, whereas 50% of the children consumed fast foods 1–3 times/week. Multiple linear regression analyses showed that higher nutritional knowledge scores among the children were significantly associated with higher mothers’ knowledge scores [(0.06 (95%CI: 0.0.03, 0.0.08)] and older age among these children [0.61 (95%CI: 0.44, 0.77)], as the older children had higher knowledge scores. The children’s nutritional knowledge, however, was not associated with the child’s sex, mothers’ age, or mothers’ education. The maternal knowledge scores were not associated with the child’s weight status. Conclusions: Given that the nutrition knowledge scores of Saudi mothers are significantly associated with those of their children, but not with their weight status, it can be concluded that nutrition knowledge alone may not be sufficient to address the overweight and obesity epidemic in Saudi Arabia. However, it remains a crucial component of multifaceted interventions that also enhance physical activity and promote behavior change to improve health outcomes and weight status in the Saudi population. Full article

Background: In Mexico, research on somatotypes in athletes has primarily focused on team sports, taekwondo, climbing, and triathlon. However, the available evidence remains limited. Therefore, the purpose of this study was to determine the somatotype of Mexican athletes by sex, and to compare somatotype and body composition across sport macro-categories in 43 disciplines. Methods: Anthropometric measurements were conducted according to the International Society for the Advancement of Kinanthropometry (ISAK) protocol. Athletes who participated in regional, national, or international competitions between 2008 and 2024 were included. Results: A total of 889 Mexican athletes (477 males and 412 females) across 43 disciplines were evaluated. Among male athletes, the predominant somatotype was endomorphic mesomorph (52.4%), followed by balanced mesomorph (17.6%) and ectomorphic mesomorph (13.6%). Among female athletes, the most reported somatotypes were endomorphic mesomorph (24.5%), mesomorphic endomorph (24.0%), and mesomorph-endomorph (21.4%). Athletes in endurance sports showed significant differences for both sexes compared to those in power and skill-based sports for both sexes (p < 0.05). Among males, team sports showed the highest values for body mass, height, and body fat percentage (%BF), while mesomorphy was greatest in track and field and ectomorphy in sprint events. Among females, track and field athletes presented the highest values for body mass, height, %BF, mesomorphy, and endomorphy, whereas endurance athletes exhibited the highest ectomorphy values. Conclusions: The findings suggest that, compared to international athletes, Mexican athletes exhibited a higher endomorphic component. It is recommended that somatotype assessments should be incorporated into regular monitoring protocols at national sports centers and considered in physical training programs to optimize performance and reduce the risk of injury. Full article

Background/Objectives: The decrease in estrogen levels during menopause is associated with an increase in visceral fat accumulation, which can contribute to the development of metabolic syndrome (MetS). While some studies have suggested a link between the Mediterranean diet (MedDiet) and the reduced incidence of MetS and its components in the general population, these findings have not been confirmed among postmenopausal women. Therefore, this study investigated the association between the adherence to the MedDiet and the odds of having MetS, and established the food groups responsible for this effect in postmenopausal women. Methods: This cross-sectional study involved 312 postmenopausal women who underwent anthropometric measurements and blood parameter assessment. Adherence to the MedDiet was assessed using the Alternate Mediterranean Diet score (the aMED score), and MetS was defined based on the updated 2022 criteria. Results: After adjusting for potential confounders, adherence to the MedDiet was inversely associated with central obesity and hypertension. For each one-point increase in the aMED score (indicating a better adherence to the MedDet), the odds of central obesity and hypertension were significantly reduced by 33% (OR = 0.669, 95% CI: 0.518; 0.866, p = 0.002) and by 18% (OR = 0.817, 95% CI: 0.689; 0.969, p = 0.020), respectively. A greater consumption of nuts and fish was associated with lower odds of central obesity (OR = 0.972, 95% CI: 0.950; 0.995; p = 0.016) and (OR = 0.989, 95%CI: 0.979; 1.000; p = 0.043), respectively, whereas high processed red meat consumption was associated with hypertension (OR = 1.004, 95% CI: 1.000; 1.008, p = 0.048). Conclusions: A greater adherence to the MedDiet was associated with lower odds of central obesity and hypertension among postmenopausal women; however, it did not translate to a reduced likelihood of having MetS. A higher consumption of nuts and fish was associated with lower odds of central obesity, whereas a higher consumption of red, processed meats was associated with higher odds of hypertension. Longitudinal studies are needed to determine the causality of these relationships. Full article

Background: The increasing prevalence of overweight and obesity worldwide is one of the most serious public health challenges, reaching epidemic proportions. Excessive body weight is often accompanied by metabolic disorders such as insulin resistance, atherogenic dyslipidaemia and hypertension—collectively known as metabolic syndrome. This cross-sectional study aimed to identify predictors of metabolic syndrome in women using logistic regression analysis based on selected sociodemographic, anthropometric, and lifestyle variables. Methods: The study included 250 women aged 23–85 recruited in the Podkarpackie region of Poland. Data on sociodemographic characteristics and smoking status were collected via a questionnaire. Physical activity and sedentary behaviours were assessed using the Global Physical Activity Questionnaire. Body composition was measured using bioelectrical impedance analysis. Fasting capillary blood samples and blood pressure measurements were obtained by qualified medical staff in accordance with standard procedures. Results: Obesity was strongly associated with metabolic syndrome components, particularly abnormal blood pressure (66.3%) and fasting glucose (64%), both of which were statistically significant (p < 0.01). Age was a significant predictor of metabolic syndrome (OR = 1.06; p < 0.01) and its components, including hypertension, dysglycaemia and dyslipidaemia. Waist-to-hip ratio was strongly linked to metabolic syndrome (OR = 356.97; p < 0.01) and obesity (OR = 5.89 × 10³⁰; p < 0.001); however, these exceptionally high values should be interpreted with caution, as they may reflect statistical artifacts due to model instability or sample characteristics, rather than a meaningful or generalizable association. Higher body fat mass was associated with an increased risk of obesity, hypertension and dysglycaemia (OR = 1.42, 1.06 and 1.06 respectively; p < 0.01). Conclusions: These results emphasise the significant role of obesity as a risk factor for metabolic syndrome in women, highlighting the need for personalised preventive strategies that consider lifestyle and sociodemographic factors, such as targeted health education, promotion of physical activity, and dietary counselling adapted to the needs of women at risk. Full article

Background: Rational dietary patterns and adequate nutritional status support athlete health and performance, while unhealthy habits may impair these outcomes. This study aimed to identify dietary patterns among Polish professional athletes using a food frequency questionnaire and assess their correlations with nutritional status indicators. Methods: Participants included 226 elite Polish athletes (aged 16–39 years; 87 women, 139 men) from various sports disciplines. Dietary intake was assessed using a food frequency questionnaire, and dietary patterns were identified through principal component factor analysis. Nutritional status was evaluated using anthropometry, bioelectrical impedance, and selected blood biochemical markers. Spearman’s rho correlations were applied to explore associations between dietary patterns and nutritional status. Results: Eight dietary patterns were identified: ‘High-fat’, ‘Sweets and beverages’, ‘Potentially rational’, ‘Vegetables and fruits’, ‘Meat and flour’, ‘Low-fat’, ‘Dairy’, and ‘Juices’. Of the two patterns considered unhealthy, ‘High-fat’ was associated with anthropometric indices—positively with the slenderness index and negatively with body mass index, particularly among men. Positive correlations with favorable nutritional indicators were observed for the ‘Vegetables and fruits’ pattern (arm muscle circumference, BMI, serum uric acid, hydration status), ‘Low-fat’ (body fat percentage), ‘Dairy’ (serum creatinine), and ‘Juices’ (serum creatinine, total protein, chlorine, uric acid). Conclusions: Our findings suggest that the identified dietary patterns are original and specific to Polish professional athletes. Determining the relationships between nutritional factors and anthropometric and biochemical indices may inform dietary modifications among athletes to ensure optimal nutritional status. Full article

Objective: To evaluate the predictive risk factors associated with the prevalence of metabolic syndrome (MetS) in adolescents from the western region of Mexico. Materials and Methods: An analytical cross-sectional study was conducted with a sample of 516 adolescents. Anthropometric data, blood pressure, and biochemical determinations were obtained. The diagnosis of MetS was based on the criteria proposed by de Ferranti in 2004. The triglyceride–glucose index (TyG index) was calculated, where a value >4.68 indicates insulin resistance (IR). Risk factors associated with MetS were evaluated using a logistic regression model. The statistical analysis was performed with the level of statistical significance established was p < 0.05. Results: The MetS prevalence was 17.2% among adolescents. One out of every two adolescents with obesity presented with MetS. Abdominal obesity and dyslipidemia are the most common components. Predictors of MetS included male sex, early adolescence, waist-to-height ratio (WHtR) > 0.5, increased body fat percentage, and TyG Index > 4.68 (IR). In the sex-specific analysis, a WHtR > 0.5 and IR were associated with MetS in female adolescents. In male adolescents, IR and body fat percentage were associated with MetS. The WHtR was associated with IR, and hypertriglyceridemia was associated with elevated alanine aminotransferase. Conclusions: In this study, two out of ten adolescents presented with MetS. In boys, a high prevalence of abdominal obesity, hypoalphalipoproteinemia, insulin resistance and MetS was observed. The risk of developing MetS is greater in preadolescent boys with abdominal obesity, high levels of body fat, and a TyG index > 4.68. Full article

Objectives: This study aimed to evaluate the effect of nutritional education on nutritional knowledge, nutritional status, and quality of life in patients with liver cirrhosis. Methods: Thirty patients participated. At baseline, assessments were conducted to collect data on demographics, physical activity, anthropometric and biochemical measures, dietary habits, 24 h food intake, nutritional status, quality of life, and nutritional knowledge. Participants received a 30 min face-to-face nutritional education session by a registered dietitian, repeated after one month. A follow-up phone call was conducted one month later to reinforce the education. Final evaluations were completed one month after the call. Results: A significant upward trend was detected in nutritional knowledge scores after the intervention period (from 7.4 ± 2.76 to 9.2 ± 3.45). The physical component of quality of life improved, while the mental component showed a slight decline. Dietary changes included reduced energy and protein intake among females and increased protein intake in males. In both genders, fat intake increased and carbohydrate intake decreased. Biochemical improvements were observed, including significant reductions in gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, and triglycerides in females and alanine aminotransferase and gamma-glutamyl transferase in males. Conclusions: Structured nutritional education may improve nutritional knowledge, dietary behavior, and biochemical markers in cirrhosis patients. Longer follow-up durations may further enhance these improvements. Full article

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

Sex determination is a fundamental component of forensic identification and medicolegal investigations. Several studies have investigated sexual dimorphism through mandibular osteometric measurements, including the position of anatomical foramina such as the mandibular and mental foramen (MF), reporting population-specific discrepancies. This study assessed the reliability and predictive ability of specific anthropometric mandibular measurements for sex estimation using three-dimensional (3D) cone beam computed tomography (CBCT) surface reconstructions. Methods: CBCT scans from 204 Greek individuals (18–70 years) were analyzed. Records were categorized by sex and age. Five linear measurements were traced on 3D reconstructions using ViewBox 4 software: projections of the inferior points of the right and left mental and mandibular foramina and the linear distance between mental foramina projections. A binary logistic regression (BLR) model was employed. All measurements showed statistically significant sex differences, with males presenting higher mean values. The final model achieved accuracy of 66.7% in sex prediction, with two vertical measurements—distances from the right mandibular foramen and the left mental foramen—identified as the strongest predictors of sex. The positions of the mandibular and mental foramina demonstrate sex-related dimorphism in this Greek sample, supporting their forensic relevance in population-specific applications. Full article

Background: Currently, there is a lack of data regarding the reliability of different anthropometric, instrumental, and biochemical indexes in detecting metabolic syndrome (MetS) in pediatric patients with Prader–Willi syndrome (PWS). Therefore, this study aimed to compare the accuracy of different indices to identify the simplest and most accurate predictor of MetS in this at-risk population. Methods: We conducted a multicenter study involving 124 children and adolescents with PWS (61 males and 63 females), aged 13.6 ± 3.7 years. For each participant, we assessed all components of MetS, defined according to either the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study or the International Diabetes Federation (IDF) criteria, based on age. The following indexes were calculated: Body Mass Index (BMI), BMI standard deviation score (BMI-SDS), tri-ponderal mass index, body mass fat index, fat mass index, fat-free mass index, body shape index, visceral adiposity index, waist-to-height ratio, cardiometabolic index, total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, and triglycerides/HDL-C (TG/HDL-C) ratio. Results: MetS was identified in 24 subjects (9 females and 15 males), representing 19.4% of the sample. When comparing the receiver operating characteristic (ROC) curves, the TG/HDL-C ratio and cardiometabolic index demonstrated significantly better performance than the other indices in detecting MetS, with no difference between the two. As a result, we focused on the TG/HDL-C ratio since it is the simplest measure, requiring no additional anthropometric data compared to the cardiometabolic index. Additionally, applying age- and gender-specific thresholds can further improve its accuracy. Conclusions: The TG/HDL-C ratio, which requires only two standard biochemical markers, provides the same accuracy as more complex indexes in detecting MetS in children and adolescents with PWS, making it the optimal predictor for MetS in this population. Full article

Background/Objectives: Plyometric training is a method of increasing soccer performance which leverages the muscle stretch-shortening cycle. This study aimed to evaluate the safety and effectiveness of plyometric training in prepubertal soccer players. Methods: Twenty-three young athletes (age 9.4 ± 0.3 years) from an elite club, training three times per week, were enrolled. During one of the weekly training sessions, twelve players formed the experimental group (PLYO), incorporating a 45 min plyometric training component into their routine, while the control group (CON), consisting of eleven players continued with their usual training program. At baseline and after 12 weeks, anthropometric parameters, flexibility, lower limb strength, and agility were assessed. Results: At baseline, no differences were observed between the two groups in anthropometric or physical performance parameters. No injuries occurred during the study. After 12 weeks, both groups showed significant growth and performance improvements. However, the PLYO showed a significantly greater increase in lower limb strength (Δ + 10.7%) compared to the CON (Δ + 6.0%). Conversely, although not statistically significant, agility improvements were greater in the CON (Δ + 12.4%) than in the PLYO (Δ + 8.6%). Conclusions: Plyometric training appears to be a safe and effective method for enhancing lower limb strength in prepubertal athletes. However, this strength gain did not directly translate into greater agility, which may benefit more from sport-specific training during this developmental stage. Full article