Considering that both olfactory training (OT) and physical activity in older adults positively affect their olfactory function, cognitive performance and affective state, the exact relationship between these two components requires more profound investigation. Hence, we examined whether OT would affect a) olfactory function; b) depression score; and c) cognitive performance in 71 participants, aged from 52 to 86 years (M = 63.3, SD = 8.5; 43 women) who reported low and high level of physical activity based on the Freiburg Physical Activity Questionnaire. After 3 months, OT enhanced total olfactory function and, on a trend level, odor discrimination. Physical activity level, when used alongside OT, had little or no effect on olfactory, cognitive, or affective outcomes, although greater enhancement of physical activity were correlated with larger improvements in odor threshold. This finding should be interpreted cautiously, as the physical activity level measurement emphasized total monthly volume of activity and may not fully capture the consistency of habitual activity highlighted in prior studies.

Fatigue is a common long-term complaint in childhood cancer patients and survivors. Treatment of pediatric bone sarcomas is intensive and can lead to physical, functional and psychosocial challenges; however, little is known about fatigue in this group. This study aimed to gain insight into fatigue and related demographic, medical, psychosocial, and lifestyle factors in pediatric bone sarcoma patients and survivors. Patients treated for pediatric bone sarcoma, ≥ 2years post-diagnosis and after completion of treatment with no evidence of disease, completed PedsQL™ Multidimensional Fatigue Scale and PROMIS® fatigue measures. Prevalence and mean scores were compared with Dutch normative data using binomial tests, one-sample t-tests, and ANOVA. Linear regression analyses examined associations of fatigue with demographic and medical factors, psychological difficulties (measured with emotion thermometers), pain (measured with a numeric rating scale), and physical activity (using an accelerometer). In total, 139 patients participated. In children (N = 44), 51.6% (95% CI 34.0-69.2) reported moderate to severe fatigue, significantly higher than the weighted norm (29.8%), while adults (N = 95) (11.5%, 95% CI 4.4-18.6) did not differ from the weighted norm (12.1%). Children scored worse than the norm on all fatigue measures (Cohen's d range = 0.58 to 1.10); adults did not significantly differ. Longer time since end of treatment was associated with less cognitive fatigue. More psychological difficulties and pain were associated with more fatigue, while higher levels of physical activity were associated with less fatigue. Children after pediatric bone sarcoma experience more fatigue than the norm. More psychological difficulties, more pain, and less physical activity are associated with more fatigue. Medical factors are limited to time since end of treatment, where a longer time is associated with less cognitive fatigue. Screening for fatigue and associated factors during treatment and follow-up may help identify and support patients at risk.

Introduction: High physical activity levels are critical for weight maintenance after clinically significant weight loss (CWL). Few studies have evaluated the effect of exercise level on weight and risk factors after CWL. Methods: Adults (body mass index (BMI): 25.0–39.9 kg/m 2 ) ( N = 39) achieved CWL (≥7%) in a 10-week OPTIFAST ® weight loss program. Participants were then randomized to aerobic exercise at the minimum physical activity recommendations (PA-REC, ~550 Metabolic Equivalent of Task (MET) minutes/week) or weight maintenance recommendations (WM-REC, ~970 MET minutes/week) for 18 additional weeks. Weight, body composition, fitness, blood pressure, and other risk factors (glucose, insulin, and lipids) were measured at baseline, after CWL (Week 10), and at follow-up (Week 28). Results: Thirty-three participants achieved CWL (~85%). Due to the COVID-19 pandemic, complete data were available for a subset of the participants who achieved CWL (PA-REC: 12, WM-REC: 9). Larger increases in estimated METs (1.7 vs 0 METs, P = 0.01) and relative (2.3 vs 0.5 mL/kg/min, P = 0.04) were observed in the WM-REC compared to the PA-REC group. Changes in waist circumference, visceral fat, and absolute approached significance between the WM-REC and the PA-REC group. No group differences were observed for weight or other risk factors ( P > 0.05). Discussion: Aerobic exercise at the weight maintenance guidelines did not result in larger improvements in weight or major traditional cardiometabolic risk factors compared with the minimum public health recommendations. After CWL, aerobic exercise at WM-REC guidelines has benefits for fitness (as measured by estimated METs) and has promise for improving central adiposity compared with the minimum PA-REC.

Associations between physical activity, psychosocial adjustment and prosthesis satisfaction in people with lower limb amputation.

Joint association of physical activity and tea consumption with all-cause and cause-specific mortality: The Rural Chinese Cohort Study.

Exercise is a promising strategy associated with improved cancer-related outcomes through multiple biological mechanisms. However, current exercise guidelines largely adopt a one-size-fits-all approach and overlook inter-individual variability in response. Given the heterogeneity of breast cancer, precision exercise prescriptions may better target biological pathways linked to therapeutic efficacy and long-term prognosis. Observational studies consistently show that higher physical activity levels are associated with improved survival outcomes, including reduced all-cause and breast cancer-specific mortality. In contrast, evidence from interventional trials remains limited and inconsistent, with effects on tumour response and survival largely derived from secondary or exploratory analyses. These discrepancies likely reflect differences in study design, exercise dose, adherence and treatment-related factors, and may indicate that null findings are partly attributable to an insufficient or inconsistent exercise stimulus rather than a true biological non-response. Exercise influences key pathways involved in tumour progression and treatment response, including immune function, inflammation, metabolism, tumour perfusion and the gut microbiome. As these responses may vary according to tumour subtype, treatment context and host characteristics, a uniform approach to exercise prescription may fail to optimise its therapeutic potential. This review proposes a precision exercise framework that integrates tumour, treatment and patient-specific factors such as genetic and epigenetic profiles, metabolic status and body composition, systemic inflammation and the gut microbiome to guide precision exercise strategies. It also highlights the potential of digital tools, including wearable technologies and artificial intelligence, to enable data-driven personalisation and real-time adaptation, alongside key considerations for safe clinical implementation. While this framework is supported by biological plausibility, whether variability in these upstream biological responses translates into differences in cancer-related outcomes remains unknown. As such, this approach remains hypothesis generating. Future research should focus on adequately powered trials and mechanistic studies to determine whether precision exercise can meaningfully improve cancer-related outcomes in breast cancer.

Psoriatic arthritis (PsA) and low physical activity (PA) negatively influence body composition. We examined the relative strength of associations of PA and PsA with body composition in individuals with PsA compared to controls, and comparing PA assessment by self-report versus a device. We analyzed data from 142 individuals with PsA and 23858 controls who participated in the fourth survey of the Trøndelag Health study (HUNT4, 2017-2019). Standardized multivariable linear regression models were used to assess the relative strength of associations of PsA (CASPAR criteria) and PA with visceral fat mass and percentage body fat measured by bioelectrical impedance analysis. PA was either self-reported (exercise frequency, duration and intensity) or device-measured using accelerometers. Model fit was compared using Akaike's Information Criterion and the Bayesian Information Criterion. Standardized regression coefficients for PsA had much smaller absolute values than those for performing PA in explaining variations in body composition (visceral fat mass: PsA: 0.017 to 0.019, PA: -0.14 to -0.31; percentage body fat: PsA 0.013 to 0.015, PA: -0.12 to -0.29). Unstandardized models showed that performing moderate to high levels of PA could compensate for the unfavorable body composition associated with PsA. Models with device-measured PA had substantially better fit than those with self-report, indicating that they better captured the variations in body composition. PA explained larger variations in body composition than PsA. Individuals with PsA should be informed that engaging in PA has a greater positive impact on body composition than the negative consequences of having PsA. Key Points • Low physical activity was more strongly associated with an unfavourable body composition than psoriatic arthritis. • Device-measured physical activity more accurately captured the associations between physical activity and body composition than self-reported measures. • Promoting physical activity and perhaps use of wearable devices to record it may potentially help individuals with psoriatic arthritis mitigate the unfavorable body composition associated with their arthritis.

The aim of this study is to compare occupational balance, physical fitness, and body composition parameters according to physical activity levels in older adults and to examine the relationships between occupational balance and other variables. This cross-sectional study included a total of 150 older adults aged 65-75 years. Participants were classified according to their International Physical Activity Questionnaire-Short Form (IPAQ-SF) scores as inactive (n = 51), minimally active (n = 50), and active (n = 49). Occupational balance was assessed using the Occupational Balance Questionnaire-11 Turkish (OBQ11-T). Physical fitness level was assessed using the Timed Up and Go Test (TUG) and hand grip strength measured with a Jamar dynamometer (Sammons Preston, USA). For body composition assessment, skeletal muscle mass and body mass index (BMI) were measured using an InBody 120 device (InBody Co., Ltd., Seoul, Korea). Occupational balance, physical fitness, and body composition parameters were compared among older adults according to their physical activity levels. In addition, the relationships between occupational balance, physical activity, physical fitness, and body composition were examined in all participants. According to IPAQ-SF classification, significant differences were found in occupational balance, physical fitness, and body composition among inactive, minimally active, and active older adults (p < 0.001). Older adults with higher levels of physical activity demonstrated higher occupational balance, greater hand grip strength, greater skeletal muscle mass, shorter TUG durations, and lower BMI values. Regression model results showed that physical activity level, functional mobility, and skeletal muscle mass together explained approximately 52% of the total variation in occupational balance level (Adjusted R² = 0.520). In addition, physical activity level, TUG duration, and skeletal muscle mass were found to be independently associated with OBQ11-T scores (p < 0.05). Older adults with higher levels of physical activity were found to have higher occupational balance levels, hand grip strength, functional mobility, and skeletal muscle mass, while their BMI values were lower. Furthermore, physical activity level, functional mobility, and skeletal muscle mass were found to be significantly associated with occupational balance. The findings indicate that occupational balance is an important parameter that should be assessed in older adults along with physical health, physical fitness, and activity participation.

Beyond surgical risk: Multidimensional predictors of postoperative arm morbidity after breast cancer treatment.

Background and AimsRestrictions during the COVID‐19 pandemic significantly affected the global population, particularly those with chronic conditions such as hypertension and diabetes, where lifestyle changes could have disrupted disease management. This study analyzes the association between reduced physical activity (PA) and variations in physical parameters, treatment adherence, and health‐related quality of life (HRQoL).MethodsA pre‐post study design was conducted from March 2019 to June 2021 in a Basic Health Area of central Spain. Clinical parameters (blood pressure, BMI, and HbA1c), PA levels, treatment adherence, and HRQoL (SF‐12) were measured in 152 patients before and after the lockdown. Analysis of covariance (ANCOVA) was used to compare mean differences across PA categories (quartiles), controlling for age and sex.ResultsOne year after the start of the lockdown, participants showed an increase in systolic blood pressure (p = 0.030) and significant decreases in PA (p = 0.004), treatment adherence (p < 0.001), and the mental component of HRQoL (p < 0.001). ANCOVA results indicated that the effect size (partial eta squared, ηp2) for differences in treatment adherence was 0.260, while for mental HRQoL, it was 0.040, suggesting a more moderate clinical relevance for the latter.Subjects in the lowest physical activity category exhibited the poorest outcomes after adjusting for age and sex:Mental HRQoL difference: mean = −8.13 (95% CI: −11.11 to −5.15).Adherence difference: mean = −4.80 (95% CI: −5.94 to −3.65).In contrast, participants with high PA demonstrated an improvement in treatment adherence (mean = 1.69; 95% CI: 0.31–3.06).ConclusionsNegative consequences of the pandemic remain observable 1 year after the lockdown in this population. Higher levels of physical activity are associated with mitigating some of these effects. However, due to the study design, caution is required when making direct causal interpretations.

To evaluate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in Korean postmenopausal women and determine whether this relationship differs according to the presence of chronic diseases. This population-based, cross-sectional study used data from 7,846 postmenopausal women who participated in the 2016-2020 Korean National Health and Nutrition Examination Survey. PA was assessed using the Global Physical Activity Questionnaire and categorized according to total intensity (low, moderate, and high) and domains (occupational, leisure time, and commuting). The HRQoL was evaluated using the EuroQol 5-dimension index and its five domains. Multivariate logistic regression was used to estimate the odds ratios and 95% CIs for high HRQoL according to the PA levels and domains stratified according to chronic disease status. Higher PA levels were significantly associated with better HRQoL, particularly in women with chronic diseases (moderate PA: odds ratio = 1.35, 95% CI =1.17-1.57). In this group, greater walking time and lower sedentary time were positively associated with HRQoL, whereas occupational PA showed an inverse relationship. Leisure time and commuting PA were positively correlated with HRQoL, whereas no significant associations were observed among healthy women, except in the mobility domain. Among postmenopausal women, PA, particularly light-to-moderate activities such as walking and active commuting, was associated with higher HRQoL; stronger effects were observed in those with chronic diseases. These findings highlight the importance of promoting feasible and context-appropriate PA and reducing sedentary behaviors in postmenopausal women to improve their overall well-being.

Few studies have shown the impact of learning environment interventions on improving well-being among medical students. We report a longitudinal study in which a class of medical students was followed during their undergraduate medical course (six years). We developed a program based on yearly evaluation of physical and mental health, followed by orientation toward physical activity, and toward mental and physical health care. Our hypothesis was that a program of support for medical students could have a positive impact on the resilience and mental health of these students. First-year medical students were invited to participate in a longitudinal study that involved an evaluation every year during the medical course. We evaluated anxiety, depression, quality of life, physical activity and resilience. All the results were presented to the students by one of the researchers, who discussed with each student the results of each evaluation and provided orientations and incentives for physical activities and, if necessary, oriented the students to seek academic and/or psychological support, provided by the medical school. Students were oriented to have additional meetings with the researcher during the year, if necessary. Eighty-four students were followed for six years. Students presented low scores for anxiety and depression symptoms during medical program and high levels of physical activity. The resilience scores increased significantly during the medical course: 27.4% to 63.0% of medical students had high or very high resilience scores (p < 0.001). Qualitative analysis performed at the end of the study demonstrated a positive impact of the program on professional values and self-care. A program designed for periodic physical and mental health evaluation followed by the support and care of medical students resulted in low anxiety and depression scores and increased resilience during medical school. In addition, this program highlighted the importance of self-care for medical students and well-being for both medical students and their patients. Our results suggest that medical schools must develop programs for the comprehensive care of their medical students.

Type 1 diabetes is a chronic autoimmune disease driven by immune-mediated destruction of pancreatic β-cells. While technological advances in insulin delivery and glucose monitoring have improved glycemic management, they do not address the underlying autoimmune process. Identifying low-risk adjunct strategies that can modulate immune dysfunction therefore remains a clinical and translational priority. Physical exercise is a cornerstone of type 1 diabetes management for its metabolic benefits, yet its potential role as an immunomodulatory intervention has received comparatively little attention. This review critically examines current evidence on exercise-induced immune modulation in type 1 diabetes. We first summarize the effects of exercise on innate and adaptive immunity, including changes in immune-cell phenotypes, cytokine and chemokine profiles, and muscle-derived mediators. We then synthesize preclinical data from rodent models and human β-cell systems showing that exercise reduces islet inflammation, limits immune-cell infiltration, protects β-cells from cytokine-induced injury, and induces anti-inflammatory exerkines such as meteorin-like protein and irisin. Finally, we review available clinical evidence in individuals with type 1 diabetes, including observational and interventional studies linking higher levels of physical activity to longer partial remission, reduced progression of islet autoimmunity, and anti-inflammatory immune signatures. Overall, although direct clinical evidence remains limited, converging preclinical and early human data support a biologically plausible immunoregulatory role for exercise in type 1 diabetes. We discuss therapeutic perspectives where structured exercise may act as a low-risk cotherapy, particularly early after diagnosis or in combination with emerging immunotherapies, and highlight key priorities for future clinical trials.

Low levels of physical activity among university students have become a persistent public health concern. Although regular exercise is well known to benefit both physical and mental health, substantial individual differences remain in exercise affective experiences and participation behaviors. Prior research has not sufficiently clarified how university students differ in their exercise intensity preference and tolerance, nor how such differences relate to exercise affective experiences and physical activity. This study aimed to identify latent profiles of exercise intensity preference and tolerance among university students and to examine differences across profiles in physical activity levels and exercise affective experiences. A total of 1,274 university students (Mage = 19.5years, SD = 1.21) from a university in China were recruited. Participants completed online self-report measures assessing exercise intensity preference and tolerance, physical activity levels, and exercise affective experiences. Five latent profiles were identified based on the Preference for and Tolerance of Exercise Intensity Questionnaire: Low-Intensity Rejection Type (LIRT, 4.5%), High-Intensity Inclined Type (HIIT, 57.8%), Extreme Low-Intensity Avoidance Type (ELAT, 4%), High-Intensity Dominant Type (HIDT, 5.7%), and Moderate Balanced Type (MBT, 27.9%). Compared with other profiles, the High-Intensity Dominant Type showed the highest levels of physical activity, competence, vitality, pleasure, and attraction, and the lowest level of tension. The Extreme Low-Intensity Avoidance Type scored lowest on most positive affective indicators. The Low-Intensity Rejection Type had the lowest physical activity level, with no significant difference from the Extreme Low-Intensity Avoidance Type. Focusing on two psychological characteristics-exercise intensity preference and tolerance-this study examined their associations with physical activity behavior and exercise affective experiences. The findings offer a new perspective for understanding insufficient physical activity among university students and provide empirical support for more targeted exercise interventions, differentiated instruction, and personalized exercise guidance.

ABSTRACTBackground and AimsSmartphone addiction (SA) is highly prevalent among first‐year university students and has significant consequences. Physical activity (PA), known to benefit both physical and mental health, has shown inconsistent associations with SA across studies. Moreover, the distinct sociocultural context of Iran with respect to PA and SA suggests that these associations may differ from those observed in other populations. Given these inconsistencies, this study aimed to examine the relationship between PA and SA among first‐year students at Tehran University of Medical Sciences (TUMS).MethodsIn this cross‐sectional study, baseline data from 397 first‐year TUMS students were analyzed. SA was measured using the Smartphone Addiction Scale‐Short Version (SAS‐SV) and PA with the Global Physical Activity Questionnaire (GPAQ‐v2). Associations were examined using multivariable linear regression and dose‐response analysis.ResultsParticipants engaged in sufficient moderate leisure‐time physical activity (LTPA) had the strongest inverse association with SA (adjusted β = −5.04, 95% CI: −8.57 to −1.52, p = 0.005) compared to other PA domains. In addition, trend analysis revealed that LTPA exhibited a significant trend in the level of PA and severity of SA. Additionally, the dose‐response analysis revealed that higher PA levels were associated with lower levels of SA, with this relationship being most pronounced at lower PA amounts.ConclusionThe current association between LTPA and SA could suggest that promoting LTPA may be particularly effective in mitigating smartphone addiction among first‐year university students.

The aging process is accompanied by a decline in brain volume, which represents a significant risk factor for the onset of dementia in older adults. Evidence demonstrates that physical activity (PA) can help prevent and attenuate this reduction in brain volume. However, there is no consensus in the scientific literature regarding which specific brain regions and structures are most affected by PA. This systematic review aimed to summarize observational cross-sectional studies examining the association between PA and brain volume in healthy older adults, and to highlight the regions and structures most consistently impacted. This review (PROSPERO: CRD420251002199) encompassed the PubMed, Web of Science, and Embase databases and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies met the following criteria: observational design, PA assessment (via questionnaires or device-based measures), brain volume quantification, and participants aged 60years or older. Nineteen studies, totaling 2,684 older adults (mean age = 70 ± 6years), were included. Across the included studies, 76 brain regions or structures were analyzed, with white matter hyperintensities, total brain volume, white matter, intracranial volume, and total hippocampal volume being the most frequently evaluated. The studies demonstrated moderate methodological quality, with an average score of 4.6 ± 0.9 out of 9 points on the Newcastle-Ottawa Scale. Accelerometers were the predominant method for assessing PA, and all studies used magnetic resonance imaging to evaluate brain structures. The evidence synthesized in this review indicates a substantial body of observational research demonstrating an association between higher levels of PA and greater brain volume in specific regions among healthy older adults.

This study aimed to characterize the clinical features of women with PLO and to identify key risk factors using self-reported data from an online patient support group. A cross-sectional study was conducted among 52 women diagnosed with PLO, identified via a patient support group on WhatsApp. Data were collected through an online survey assessing demographics, fracture characteristics, bone mineral density (BMD), treatment approaches, and potential risk factors. Participants were stratified into two groups (with vs. without fractures) for comparative analysis. The mean age of participants was 33.8 ± 4.7years. Fractures occurred in 78.8% of participants, predominantly involving the spine (90.2%). The mean T-scores were -2.9 ± 0.8 at the spine and -1.8 ± 1.3 at the femoral neck. Key reported risk factors were vitamin D deficiency, heparin use during pregnancy, and a family history of osteoporosis. Women with fractures reported significantly higher levels of physical activity during pregnancy (p = 0.026). Anti-osteoporotic medications were used by 58% of participants, and teriparatide was the most frequently prescribed agent (44.8%). PLO is an underrecognized and disabling complication of pregnancy, most often resulting in vertebral fractures. Greater clinical awareness, targeted screening, and individualized management are crucial to reduce preventable maternal morbidity in high-risk women.

Sedentary work environments may contribute to unhealthy dietary behaviors and increase the risk of non-communicable diseases among white-collar employees.This cross-sectional study examined the diet quality and its associations with physical activity while exploratorily examining health-related quality of life (HRQoL) among 208 white-collar workers in Istanbul.Data were collected using an online survey including self-reported anthropometric measures, a three-day dietary record analyzed with the Healthy Eating Index-2015 (HEI-2015), the SF-36 questionnaire, and the International Physical Activity Questionnaire (IPAQ).Mean daily energy, protein, and fiber intakes were below recommended levels, and 65% of participants had poor diet quality (HEI < 51). Higher HEI-2015 scores were correlated with greater fiber, vitamin C, potassium, and iron intake. In multiple regression analysis, older age (β = 0.19, p = 0.007) and high physical activity level (β = 0.17, p = 0.015) were significantly associated with higher HEI-2015 scores, however, the model explained a limited proportion of variance (Adjusted R² = 0.041).Age and physical activity were modestly associated with diet quality, highlighting the potential relevance of workplace health promotion strategies in sedentary occupational settings.

Self-efficacy theory proposes that confidence to engage in a health behavior is associated with engaging in that specific behavior. Most research examining self-efficacy has been conducted with white young adult populations. This cross-sectional analysis examined the association of self-efficacy (i.e., confidence) for healthy eating and physical activity in two immigrant communities. At enrollment into the Healthy Immigrant Community study, a clinical weight management and cardiovascular risk reduction intervention set in southeastern Minnesota, 475 participants completed assessments about their confidence for healthy eating and physical activity. Measurements also included self-reports of dietary quality and intake, physical activity, quality of life, and biometric assessments. Study materials were available in English, Spanish, and Somali. In total, 450 adults (Hispanic/Latinx = 267; Somali = 183) completed measures at baseline and were included for analysis. Their average age was 45 years (range 18-87) and 59% were female. Confidence for healthy eating was significantly correlated with self-report of eating healthy snacks (p = < 0.0001) and less consumption of high-calorie drinks (p = 0.02) and regular soda (p = < 0.0001). Confidence to be physically active was significantly correlated with more self-reported physical activity (p = < 0.01). Confidence to eat healthy and be physically active appears to be correlated with having a healthier diet and higher levels of physical activity. Given the large sample size and strength of the associations, it also appears that the theoretical model of self-efficacy can be effectively measured and applied within these immigrant populations. Self-efficacy theory may be useful in understanding potential mediating mechanisms when designing future interventions with immigrant communities.ClinicalTrials.gov registration: NCT05136339; April 23, 2022.

Instrumental activities of daily living and objective physical activity in people with cardiovascular disease.