Regular Physical Activity Research Articles

Obesity Control and Supplementary Nutraceuticals as Cofactors of Brain Plasticity in Multiple Sclerosis Populations.

Multiple sclerosis (MS) is an immune-mediated disease characterized by inflammation, demyelination, and neurodegeneration within the central nervous system. Brain plasticity, the brain's ability to adapt its structure and function, plays a crucial role in mitigating MS's impact. This paper explores the potential benefits of lifestyle changes and nutraceuticals on brain plasticity in the MS population. Lifestyle modifications, including physical activity and dietary adjustments, can enhance brain plasticity by upregulating neurotrophic factors, promoting synaptogenesis, and reducing oxidative stress. Nutraceuticals, such as vitamin D, omega-3 fatty acids, and antioxidants like alpha lipoic acid, have shown promise in supporting brain health through anti-inflammatory and neuroprotective mechanisms. Regular physical activity has been linked to increased levels of brain-derived neurotrophic factor and improved cognitive function. Dietary interventions, including caloric restriction and the intake of polyphenols, can also positively influence brain plasticity. Integrating these lifestyle changes and nutraceuticals into the management of MS can provide a complementary approach to traditional therapies, potentially improving neurological outcomes and enhancing the quality of life for the MS population.

Genetic Signature of a Healthy Lifestyle: New Horizons for Preventing Noncommunicable Chronic Diseases by Modulating MicroRNA-155.

The development and progression of several noncommunicable diseases (NCDs) are associated with microRNA (miR) 155 (miR-155) activation, which promotes inflammation and oxidative stress. In particular, miR-155 regulates nuclear transcription factor-kappa B (NF-κB) by silencing gene expression of proteins involved in NF-κB suppression, such as suppressor of cytokine signaling 1 (SOCS1) and SH-2 containing inositol 5' polyphosphate 1 (SHIP1), increases the production of reactive oxygen species, and suppresses gene expression of antioxidant enzymes through nuclear factor erythroid 2-related factor 2 (Nrf2) inhibition. In this context, a healthy lifestyle based on a diet rich in nutrients and bioactive compounds as well as regular physical activity may modulate the activity of several miRs. Following this concept, studies involving nutrients, bioactive compounds, and physical activity have been developed to modulate miR-155 activation. This narrative review aims to discuss how a healthy lifestyle based on a diet rich in nutrients, bioactive compounds, and physical activity may modulate the miR-155 pathway and consequently prevent the development and progression of NCDs. Nutrients and bioactive compounds from food may act by inhibiting pathways that promote miR-155 activation such as NF-κB and promote activation of pathways that are associated with the downregulation of miR-155, such as Nrf2, and SOCS1 pathways. Regular physical activity also seems to influence miR-155 levels through an improvement in the immune system during muscle recovery. There is relevant evidence that shows a positive effect of nutrients, bioactive compounds, and physical activity with the modulation of miR-155, which can potentially provide benefits in the clinical setting in cases of NCDs.

Self-Care Practices Regarding Eating Habits, Knowledge of Diet and Exercise for Type II Diabetic Patients

Background: Diabetes is an incurable condition. Adopting lifestyle modifications, including dietary adjustments and regular physical activity, plays a crucial role in effectively managing type-2 diabetes (T2DM) and preventing its potential long-term consequences. The aim of this article is to assess sociodemographic characteristics and self-care practices with eating habits patterns among T2DM.. Materials and Methods: The study chose a cross-sectional design, and the non-probability (purposive) method was used to identify participants. The total sample consisted of 150 participants who suffer from type 2 diabetes and who have patient records and files within the Diabetes Center at Marjan Medical City from June 20th, 2023, to November 10th, 2023. Results: The study findings indicated that the study showed good knowledge at Mean± SD= 2.35±0.0.46. , according to their levels of education the significance at (p<0.024 ).. Results: The study results indicate that the patients’ adherence increased as the education levels increased and vice versa. while the study showed partial adherence to diet and exercises at Mean± SD= 1.55±0.17 as well the study also found a highly significant association between the self-care practice for patients regarding the diet and exercise and some sociodemographic variables such as education levels, at a statistically significant level (p < 0.006). Conclusion: According to the results, the study concluded There was partial adherence to diet and exercise among patients with type II diabetes. However, factors such as the educational status of participants were found to influence the chance to self-care practice recommendations.

Physical activity combined with tea consumption could further reduce all-cause and cancer-specific mortality

The study aimed to comprehensively assess the separate and combined effects of physical activity (PA) and tea consumption on all-cause mortality and cancer-specific mortality among 21,350 participants from The National Health and Nutrition Examination Survey (NHANES) between 2009 and 2018. PA and tea consumption were evaluated through self-reported questionnaires and dietary recall interviews at baseline, with mortality data from the National Death Index. Cox regression analyses yielded hazard ratios (HR) and 95% confidence intervals (CI). Results indicated that both tea consumption and PA independently reduced all-cause mortality. In the physically active group, tea consumption further decreased mortality risk, while this effect was not significant in the inactive group. Jointly, the highest tea consumers who exercised the most exhibited the lowest mortality risk compared to non-tea drinkers who exercised the least. Tea consumption alone does not significantly impact cancer-specific mortality; it is only in physically active group that tea consumption significantly lowers the risk of cancer-specific mortality. These findings underscore the potential benefits of regular tea consumption and PA in promoting longevity and reducing premature death risks.

Exaggerated Blood Pressure Response to Exercise Is a Risk of Future Hypertension Even in Healthy, Normotensive Young Individuals—Potential Preventive Strategies for This Phenomenon?

Physical activity and regular exercise are well known to reduce the risks of cerebrovascular and cardiovascular diseases, leading the American College of Sports Medicine to endorse the concept that “exercise is medicine”. However, a single bout of exercise temporarily raises arterial blood pressure (BP) to meet the metabolic demands of working muscle, and this BP response is particularly exaggerated in older adults and patients with cardiovascular conditions, such as hypertension, resulting in an exaggerated BP response during exercise. This presents a paradox: while regular exercise is crucial for preventing these diseases, excessively high BP responses during exercise could increase the risk of vascular damage. The mechanisms underlying this exaggerated BP response during exercise remain unclear, and effective exercise regimens for these populations have yet to be established. Currently, low-intensity exercise is recommended; however, its efficacy in disease prevention is uncertain. Notably, even among healthy individuals, there is significant variation in the BP response to exercise. Some healthy individuals, despite having normal resting BP, exhibit an exaggerated BP response during physical activity. Importantly, these individuals are often unaware that their BP becomes excessively elevated during physical activity. Repeated exposure to these heightened BP responses through regular physical activity may increase their long-term risk of cardiovascular disease. How can we prevent disease development in these individuals while still ensuring the effectiveness of exercise? Some studies have shown that individuals with a family history of hypertension may experience this phenomenon even in children and adolescents. Additionally, left ventricular hypertrophy contributes to an exaggerated BP response to exercise, suggesting a possible genetic influence. Conversely, other reports indicate that factors such as arterial stiffness, obesity, and low exercise capacity also contribute to this exaggerated response. Our recent preliminary data suggest that the cognitive benefits of exercise may be diminished in individuals who exhibit an exaggerated BP response during exercise. This implies that individuals with an exaggerated BP response, despite having normal resting BP, may not fully benefit from exercise. In this perspective paper, we review the physiological aspects of this phenomenon and explore strategies to address it. Additionally, we discuss BP responses in athletes within this content. Our goal is to prevent disease while maximizing the benefits of exercise for healthy individuals with an exaggerated BP response, as well as for elderly and cardiovascular patients.

A Behavioral Change-Based Mobile Intervention for Promoting Regular Physical Activity in Medical Rehabilitation Maintenance of Patients With Coronary Artery Disease: Controlled Trial.

Cardiac rehabilitation is known to reduce coronary artery disease (CAD) severity and symptoms, but adoption of a healthy postrehabilitation lifestyle remains challenging. Innovative eHealth solutions could help, but behavioral change-based eHealth maintenance programs for patients with CAD are scarce. RehaPlus+ aims to improve postrehabilitation outcomes with a personalized eHealth intervention built on behavioral change concepts emphasizing healthy lifestyle changes, especially regular physical activity (PA). This study aims to evaluate the effectiveness of the personalized eHealth program RehaPlus+ for promoting regular PA against usual care. A total of 169 patients with CAD who had undergone stent implantation or bypass surgery were recruited after completing center-based phase II rehabilitation. They were then divided, without blinding, into 2 groups using a quasi-experimental approach: a case manager-assisted 24-week eHealth program (RehaPlus+; n=84) and a conventional physician-assisted outpatient program (usual care; n=85). The study was designed as a noninferiority trial. RehaPlus+ participants received motivational messages twice weekly for 6 months, and the usual care group engaged in a 6-month outpatient program (twenty-four 90-minute strength and endurance training sessions). The primary outcomes, evaluated using the self-assessed Bewegungs- und Sportaktivität questionnaire, were regular PA (≥150 min/wk) and weekly activities of daily living (ADLs) 6 months after rehabilitation. Secondary outcomes involved PA during work and floors climbed weekly (measured by Bewegungs- und Sportaktivität questionnaire), psychological well-being (assessed by the 5-item World Health Organization Well-Being Index), cardiac self-efficacy, health-related quality of life (measured by the 36-Item Short Form Survey), and work ability (using the Work Ability Index). Data of 105 patients (RehaPlus+: n=44, 41.9%; usual care: n=61, 58.1%; male patients: n=80, 76.2%; female patients: n=25, 23.8%; mean age 56.0, SD 7.3 years) were available at the 6-month follow-up. At 6 months after discharge from phase II cardiac rehabilitation, the RehaPlus+ group exhibited 182 (SD 208) minutes per week of PA and the usual care group exhibited 119 (SD 175) minutes per week of PA (P=.15), with no interaction effect (P=.12). The RehaPlus+ group showed an ADL level of 443 (SD 538) minutes per week compared to the usual care group with 308 (SD 412) minutes per week at the 6-month follow-up, with no interaction effect (P=.84). The differences observed in PA and ADL levels between the RehaPlus+ and usual care groups were within the predefined 1-sided noninferiority margin, indicating that the RehaPlus+ intervention is not inferior to usual care based on these outcomes. There were no differences between the groups for all secondary outcomes (P>.05). RehaPlus+ is not inferior to the usual care program, as both groups improved PA and ADLs to a similar extent. These findings emphasize the potential of eHealth interventions to assist in maintaining healthy lifestyles after rehabilitation. ClinicalTrials.gov NCT06162793; https://clinicaltrials.gov/study/NCT06162793.

Investigating the impact of lifestyle factors on kidney patients: insights from epidemiological studies

This paper investigates the impact of lifestyle factors on kidney patients, drawing insights from various epidemiological studies. Chronic kidney disease (CKD) has emerged as a global health concern, with millions affected worldwide, highlighting the need for a deeper understanding of modifiable risk factors that can influence the onset and progression of the disease. Lifestyle factors such as diet, physical activity, smoking, alcohol consumption, and stress management play a crucial role in either exacerbating or mitigating the risk of kidney disease. Through an examination of key epidemiological studies, this paper explores how these factors contribute to kidney health and disease management. Research indicates that diets high in sodium and protein, particularly from animal sources, are associated with worsening kidney function, whereas plant-based diets, low in sodium, may have protective effects. Similarly, regular physical activity has been shown to improve kidney function, while a sedentary lifestyle may lead to its decline. Smoking and excessive alcohol consumption have long been identified as significant contributors to the progression of CKD, as epidemiological studies reveal a clear link between these behaviors and kidney health deterioration. In addition to physical health factors, the paper highlights the importance of mental health, noting that stress and psychological well-being can also affect kidney function, with chronic stress contributing to poor outcomes in patients with kidney disease. Based on these findings, the paper discusses potential lifestyle modification strategies that could serve as preventive and management tools for kidney patients. These include dietary interventions, tailored exercise programs, smoking cessation, reduced alcohol consumption, and stress reduction techniques.

Affective response to daily physical activity in younger and older adults.

Many older adults do not meet the physical activity recommendations of the American Heart Association; hence, it is important to understand the factors that can facilitate regular physical activity in older adults. Notably, the role of affective response has been understudied. Mixed findings have been reported in terms of age effects in affective response to daily physical activity. This study aimed to determine age differences in affective response to daily physical activity and whether these differences are associated with overall physical activity levels. Further, the role of contextual factors in age differences in affective response following daily physical activity was examined. Younger (n = 59) and older adults (n = 60) completed 1 week of experience sampling during which they responded to daily prompts about their affect and physical activity. Overall physical activity levels were estimated via actigraphy. In both age groups, daily physical activity was similarly associated with greater high-arousal positive (HAP) affect relative to other activities. Across age groups, participants reported more HAP affect when engaging in daily physical activity in a group compared to alone. Greater duration and enjoyment of daily physical activity were more strongly associated with greater HAP affect in younger adults relative to older adults. Affective responses following bouts of daily physical activity did not predict overall physical activity levels for either age group. Overall, older adults may experience similar positive affective response to younger adults following daily physical activity relative to other activities. These affective responses may have a limited role in physical activity engagement in daily life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The influence of assistance in home-based exercise programmes for individuals with intellectual disabilities.

Regular physical activity (PA) decreases the risk of comorbidities associated with a sedentary lifestyle in individuals with intellectual disabilities (IDs). They also may experience additional barriers that may prevent PA, including access, proper instruction and support. At-home PA programming is a feasible alternative to long-term adherence. This study aimed to determine (1) how an at-home DVD programme affects PA adherence and (2) the extent to which caregiver support influences PA. Thirty-one adolescent or adult-aged participants with mild or moderate ID were randomised into a DVD or control group exercise intervention. Participants were given autonomy to choose what type of PA modality from the intervention they would like to participate in. Caregiver support during the PA was also measured. The two-way repeated-measures MANOVA demonstrated that the intervention DVD group was statistically significant, with a large effect size in PA minutes (P=0.014, ηP2=0.236) and rate of perceived exertion (P=0.002, ηP2=0.342) compared with the control group. The findings demonstrated that using an adapted DVD increased PA minutes and the rate of perceived exertion without high levels of caregiver support.

Dietary pattern and menstrual disorders among female university students.

Assessment of the relationship between dietary patterns and menstrual disorders among female medical and paramedical students at Beni-Suef University, Egypt. Beni-Suef University conducted a cross-sectional analytical questionnaire-based study. Three hundred fifty two female medical and paramedical students agreed to participate in the study. The collected data about demographics, physical activity, menstrual history, and dietary assessment were transferred to SPSS version 26 for statistical analysis. A p value≤0.05 was considered statistically significant. The prevalence of irregular cycles, heavy blood flow, severe dysmenorrhea, and premenstrual syndrome (PMS) was found to be (21.9 %), (13.1 %), (35.5 %), and (68.9 %), respectively. Poor adherence to the Mediterranean diet (40.1 %) and physical activity (69.9 %) was present. Females with irregular cycles (p=0.472), heavy menstrual blood flow (p=0.007), and severe dysmenorrhea (p=0.029) reported lower adherence to the Mediterranean diet. Mothers' educational level (p=0.034), family income (p=0.005), and family size (p=0.009) were significantly associated with dietary adherence. Poor adherence to regular physical activity and the Mediterranean diet is highly prevalent in our research and is highly associated with menstruation disorders. So, it is critical to support health education programs emphasizing healthy dietary habits and regular physical activity to improve menstrual health and women's quality of life.

The Relationship between Consumption Patterns of Macronutrients, Fiber, and Physical Activity with the Incidence of Obesity at Nuris Jember High School

Obesity is one of the global health problems whose incidence is expected to continue to increase every year. Obesity in adolescents is caused by many factors including changes in lifestyle, physical activity, diet with food intake that exceeds the body's needs, improper eating behavior by consuming more fast food, packaged food, and food with unbalanced nutrients. The purpose of this study was to determine the relationship between macronutrient diet, fiber, and physical activity with the incidence of obesity at Nuris Jember High School. This method is an observational study with a case-control design. Sample selection using purpose sampling of as many as 81 respondents consisting of 27 cases and 54 controls. The research instruments used were weight measurement, height, SQ-FFQ form, and PAL. Data were processed using statistical applications using the chi-square test and if not eligible, the Fisher's exact test was performed with a significant value of p less than 0.005. The results of macronutrient consumption patterns and physical activity have a significant relationship with the incidence of obesity (p less than 0.005). While the study could not analyze fiber consumption patterns due to homogeneous results, the existing findings provide a solid foundation for targeted nutrition education programs and public health strategies. This study concludes that there is a relationship between macronutrient consumption patterns and physical activity with the incidence of obesity. This conclusion underscores the importance of balanced diets and regular physical activity in preventing and managing obesity among adolescents.

The health action process approach to promote regular physical activity among people with disabilities: A hierarchical regression analysis.

People with disabilities continue to cope with high levels of stress, such as disability-related stress and sociopolitical stress. Helping people with disabilities engage in regular physical activity to improve health and reduce stress is more important than ever. This study evaluated demographic covariates, the health action process approach (HAPA) constructs (action self-efficacy, outcome expectancy, risk perception, intention/commitment, maintenance and recovery self-efficacy, and action and coping planning), and positive person-environment variables (autonomous motivation, resilience, hope, and social support) as motivators for regular physical activity in a sample of people with disabilities. People with disabilities participated in an online study (N = 266). Hierarchical regression analysis was used to determine the incremental variance in physical activity scores accounted for by variables in the regression model. Demographic covariates, HAPA constructs, and positive person-environment variables accounted for 38% of the total variance in physical activity scores (a large effect size). Low income was a risk factor that significantly and negatively associated with regular physical activity, while self-efficacy, action and coping planning, and social support were significantly and positively associated with reular physical activity after controlling for other variables. Autonomous motivation, resilience, and hope were significantly associated with regular physical activity at the zero-order correlation level, but not significant in the regression model. This study provides strong empirical support for the HAPA constructs, which can be used to inform the development of theory-driven and empirically supported physical activity interventions to improve health, stress management, and well-being of people with disabilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Regular Physical Activity Seems to Eliminate Lower Limb Perfusion Asymmetries in Sedentary Non-Healthy Older Individuals.

Perfusion asymmetries have been associated with vascular pathology. Physical activity is a component of vascular health. Here, we investigate the impact of a thirty-day regular home-based physical activity program in older individuals with multiple age-related comorbidities. Eleven participants of both sexes were included. Skin perfusion was assessed in both feet by laser Doppler flowmetry (LDF, for deeper perfusion) and polarized light spectroscopy (PSp, for superficial perfusion). At baseline, participants had significant perfusion differences between right and left feet (p = 0.005 with LDF; p = 0.028 with PSp), which disappeared with activity and reappeared in recovery. After 30 days, both feet showed significant perfusion increases as assessed with LDF (p = 0.005) compared to D0. At this point, the perfusion asymmetry observed at D0 was no longer present. However, the superficial perfusion asymmetry assessed by PSp persisted at D30 (p = 0.028). Data show that regular physical activity positively altered the lower limb perfusion pattern. Systolic pressure and mean arterial pressure were also significantly reduced at D30. These impacts seem to be directly related to the physical activity program introduced in the day-by-day routines of these participants. These also encourage further research on the role of symmetry-asymmetry in prevention, treatment, and rehabilitation in vascular medicine.

Factors associated with physical and psychological wellness of American adults with asthma

Objective: The study objective was to investigate the factors associated with the physical and psychological wellness of United States (US) adults with asthma.Methods: This cross-sectional analysis used a sample of 2329 US adults with asthma in the 2021 Medical Expenditure Panel Survey data. A logistic regression model investigated the association of the following factors and the dependent variables (physical wellness and psychological wellness): age, sex, race, ethnicity, education, employment, healthcare provision, marriage, income, regular physical activity, current smoker, pain, and limitations. Nationally representative estimates were produced through a weighted analysis. The data structure was maintained using cluster and strata variables. The alpha limit was 0.05.Results: Factors associated with higher odds of reporting good physical wellness included: private (versus no) healthcare provision (odds ratio [OR] = 2.63, 95% confidence interval [CI] = 1.10–6.26), good (versus poor) psychological wellness (OR = 6.83, 95% CI = 4.35–10.72), regular (versus no regular) physical activity (OR = 2.18, 95% CI = 1.42–3.34), little/moderate (versus quite a bit/extreme) pain (OR = 3.51, 95% CI = 2.38–5.15) and no (versus any) limitation (OR = 3.73, 95% CI = 2.30–6.06). In the psychological wellness model, those aged ≥70 (OR = 6.18, 95% CI = 2.72–14.07), 60–69 (OR = 4.64, 95% CI = 2.13–10.10), and 50–59 (OR = 4.96, 95% CI = 2.24–11.02) versus those aged 18–29, and good (versus poor) physical wellness (OR = 6.89, 95% CI = 4.34–10.94) were associated with higher odds of reporting good versus poor psychological wellness.Conclusion: These results may be helpful at targeting resources to optimize the wellness of US adults with asthma. Additional studies are needed to determine any temporal associations between these findings.

Reassessing the non-linear causal link between long-duration commuting and self-rated health: do behavioral preferences and built environment matter?

Long-duration commuting is widely recognized for its significant influence on health. However, while research has traditionally focused on direct impacts, there remains a critical need to explore the nonlinear dynamics of this relationship. This study aims to deepen our understanding of how behavioral preferences and built environments contribute to these complex interactions. This study was conducted in Jinan, China's most congested city, using data from the "Jinan Residents Commuting Survey" of 1,755 participants aged 19 to 59. We applied Generalized Propensity Score Matching (GPSM) to explore the nonlinear effects of commuting time on self-rated health, adjusting for participants' sociodemographic characteristics. Variables related to active commuting, physical activity, and perceived built environment were also examined for their potential moderating effects. Commuting for less than 21 minutes enhances health, but negative effects intensify and peak at 60 minutes. Heterogeneity analysis reveals that women and older adults, especially those with higher incomes, are more susceptible to long commutes, experiencing a delayed onset of adverse effects. While active commuting offers health benefits, it may exacerbate health issues if prolonged. Conversely, regular physical activity consistently improves health outcomes related to commuting. Additionally, factors like residential greenery and walkability help alleviate commuting-related stress, improving the overall commuting-health dynamic. This study clarifies the commuting-health relationship by identifying key time thresholds and the positive effects of active commuting and physical activity on mitigating longer commute impacts. The findings inform healthier commuting behaviors and offer practical guidelines for urban planning and policy-making to enhance commuter well-being.

Factors associated with acquiring exercise habits through health guidance for metabolic syndrome among middle-aged Japanese workers: A machine learning approach

ObjectivePhysical inactivity increases the risk of mortality and chronic morbidity. Therefore, it is crucial to establish strategies to encourage individuals to increase their physical activity and develop exercise habits. The objective of this study was to explore factors associated with acquiring exercise habits using machine learning algorithms. MethodsThe analyzed dataset was obtained from the Specific Health Guidance for metabolic syndrome systematically implemented by the Japanese Ministry of Health, Labor, and Welfare. We selected target individuals for health guidance without exercise habits in 2017 and assessed whether the participants acquired exercise habits through health guidance in 2018. We applied ten machine learning algorithms to build prediction models for acquiring exercise habits. ResultsThis study included 16,471 middle-aged Japanese workers (age, 49.5 ± 6.2 years). Among the machine learning algorithms, the Boosted Generalized Linear Model was the best for predicting the acquisition of exercise habits based on the receiver operating characteristic curve on the test set (ROC-AUCtest, 0.68). According to the analyses, the following factors were associated with the acquisition of exercise habits: being in the maintenance or action stage of changing exercise and eating behaviors based on the transtheoretical model; regular physical activity or walking; normal high-density lipoprotein cholesterol; and high alcohol consumption. ConclusionsOur findings can be used to establish an efficient strategy for encouraging individuals to acquire exercise habits through Specific Health Guidance or other health guidance. However, the lower ROC-AUCtest suggests that additional variables are necessary to enhance the prediction model.

A high adherence level to nutritional recommendations minimizes protein and minerals loss while maximizes visceral fat loss in bariatric surgery patients

BackgroundMetabolic bariatric surgeries are considered the finest and most appropriate treatment option for patients with severe obesity. Besides the surgical procedure, many factors appear to be associated with improved postoperative outcomes such as compliance to the postoperative diet and supplementation, regular physical activity, medical and nutritional follow-up, and modifications in dietary habits. The objectives of this study were to investigate the effect of adherence to post-operative recommendations on anthropometric measurements and body composition and assess the percentage of total weight loss (%TWL) and excess weight loss (%EWL) 3 months post-operative. Material and MethodsFifty-two participants who underwent a Roux-en-Y gastric bypass or sleeve gastrectomy were included. Participants have filled out a pre-operative questionnaire. Anthropometric measurements were obtained pre-operative and 3 months post-operative using a Body Impedance Analyzer (Inbody 270). The adherence to post-operative recommendations was assessed by the Bariatric Surgery Self-management Questionnaire 3 months post-operative and classified to three adherence levels. ResultsMost anthropometric measurements decreased 3 months post-operative in the three adherence groups (p≤0.05). No significant differences were observed between groups in anthropometric measurements and body composition, except for minerals and visceral fat levels. The mineral loss has decreased in both the high and intermediate adherence groups (-0.09 ± 0.22 kg, and -0.09 ± 0.18 kg, respectively). Also, the high adherence group showed less loss in protein amount post-operatively (p=0.06). Visceral fat level decreased in the high adherence group (p≤ 0.05). ConclusionAdherence to post-operative behavioral and nutritional recommendations was associated with less protein and mineral loss and enhanced visceral fat reduction post-operatively.

Physical activity intensity and older adolescents’ stress: The ‘STress-Reactivity after Exercise in Senior Secondary EDucation’ (STRESSED) 3-arm randomised controlled trial

ObjectivesLate adolescence (15–19 years) is a period of heightened susceptibility to stress, but regular physical activity may attenuate reactivity to stressors. We aimed to explore the effects of physical activity intensity on older adolescents’ stress-reactivity and self-reported mental health. Design and MethodsThree-arm randomised controlled trial in New South Wales, Australia (April–June 2021). Thirty-seven older adolescents (16.1 ± 0.2 years, 59.5 % female) were randomised to: i) non-active control (CON), ii) light-intensity physical activity (LPA), or iii) moderate-to-vigorous-intensity physical activity (MVPA). Physical activity groups participated in 2 x 20-min sessions/week for 6 weeks. Salivary cortisol (sCort) reactivity to induced stress was assessed using the Trier Social Stress Test for Groups and quantified as area under the curve (sCortAUC; Primary outcome). Secondary outcomes included peak cortisol (sCortPeak), subjective-reactivity, perceived stress, and non-specific psychological distress. Group differences were assessed using multiple linear regression and quantified using Cohen’s d. ResultsNo statistically significant effects were observed for sCortAUC or sCortPeak and the pattern of effects for subjective-reactivity was inconsistent. Effects for self-reported mental health were also non-significant (p > .05 for all) but of meaningful magnitude, favouring LPA and MVPA over CON (d’s = −0.38 to −0.54). Delivery fidelity was high, satisfaction was moderate-to-high, and there was no evidence of harm. However, recruitment, retention for sCort measures, and adherence were lower than expected. ConclusionSuboptimal recruitment, retention, and adherence limited our ability to conclude on the effect of physical activity intensity on older adolescents’ sCort-reactivity to induced stress. We observed potentially meaningful effects on self-reported mental health for both physical activity conditions, which could be confirmed in a future powered trial.

Protective effect of regular physical activity against diabetes-related lower extremity amputation.

Foot ulcers are a major complication of diabetes mellitus that increase morbidity and mortality in patients with diabetes, affect their quality of life, and increase the overall social burden. A considerable number of patients with diabetic foot ulcers (DFUs) require amputations every year. This nation population-based study included 1 923 483 patients with diabetes who underwent regular health screening through the National Health Insurance Service during January 2009 and December 2012. We investigated the association between changes in physical activity (PA) status and the incidence of lower extremity amputation (LEA). Based on changes in PA status, participants were categorized into four groups: "remained inactive," "remained active," "active-to-inactive," and "inactive-to-active." Regular PA is an independent factor associated with a decreased risk of LEA in patients with diabetes. During the follow-up period, 0.23% (n = 4454) of the patients underwent LEA. Compared with the "remained inactive" group, the "remained active" group were at the lowest risk of LEA (adjusted hazard ratio 0.5888; 95% confidence interval 0.524-0.66). A protective effect of regular PA against LEA was observed in the "remaining active" group. Our findings suggest a protective role of PA against LEA in individuals with diabetes. This highlights the importance of recommending appropriate levels of PA for patients with diabetes. The study also showed a dose-response relationship, indicating that engaging in vigorous-intensity PA was most beneficial, and higher amounts of PA may provide additional benefits.

Estrategia terapéutica en el paciente diabético (I). Empoderamiento del paciente y educación. Objetivos terapéuticos. Estilo de vida, alimentación y control de los factores de riesgo cardiovascular. Sistemas de control glucémico

Managing type 2 diabetes (DM2) requires a multifactorial approach. The foundation of treatment is lifestyle modification and diabetes education. Patients must be involved in decision making and be given tools to help them manage their disease. The four basic pillars of DM2 management are: a) glycemic control; b) blood pressure management; c) lipid management; and d) use of drugs with proven cardiovascular and renal benefits. In terms of lifestyle, it is recommended to combine a diet that contributes to weight maintenance and glycemic control as well as the incorporation of regular moderate physical activity (at least 150minutes per week). Cholesterol and blood pressure targets should be individualized for each patient with DM2 based on the presence of cardiovascular disease or cardiovascular risk. Smoking cessation is recommended. There are two main glycemic control systems: blood glucose monitoring (capillary glycemia) and continuous glucose monitoring.