Tag: Physical Activity

  • A plant-based diet and its relationship with oxidative biomarkers in footballers

    A plant-based diet and its relationship with oxidative biomarkers in footballers

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    In a recent study published in Scientific Reports, researchers investigated the association between plant-based diets and oxidative biomarkers by calculating the plant-based diet index score and determining the levels of urinary biomarkers for oxidative stress in professional footballers.

    Study: Effect of a plant-based diet on oxidative stress biomarkers in male footballers. Image Credit: zi3000/Shutterstock.com
    Study: Effect of a plant-based diet on oxidative stress biomarkers in male footballers. Image Credit: zi3000/Shutterstock.com

    Background

    The accumulation of reactive oxygen species in the body leads to the damage of protein, lipids, and deoxyribonucleic acid (DNA), which is known as oxidative stress. The concentrations of 8-hydroxy-2′-deoxyguanosine (8-OHdG) and F2alpha-isoprostane (F2a-IP) in urine have often been used as markers of oxidative stress. Diets that are largely plant-based have been thought to reduce oxidative stress and protect against reactive oxygen species.

    Plant-based diets are also becoming increasingly popular, especially among athletes who have high energy and endurance requirements. These diets are categorized based on the proportion of plant to animal-based components in the diet. They range from completely plant-based, such as vegan diets, to semi-vegetarian diets that include some animal-based components.

    Given that football is a sport that consists of activities such as intense bursts of running, jumps, and sprints that require high energy levels, adherence to nutritional diets is vital to the performance of footballers. They provide an ideal group to investigate how plant-based diets are associated with oxidative stress.

    About the study

    In the present study, the researchers compared the levels of urinary biomarkers F2a-IP and 8-OHdG and the plant-based diet index scores between professional male footballers and matched non-athlete controls to examine whether plant-based diets were associated with decreased oxidative stress.

    Footballers who had at least two years of professional experience and had strict training schedules were included in the study if their metabolic equivalent of the task was greater than 3000 minutes per week. They were also required to be non-smokers and not consume alcohol or take any antioxidant supplements. Healthy males with matched ages and body mass index (BMI) measures who had a metabolic equivalent of task between 600 and 3000 minutes per week were included as controls.

    Interviews were conducted to determine the medical history, food intake data, physical activity levels, and general information on nutrition from all the participants. Anthropometric measurements such as height and weight were measured to calculate the BMI, and urine samples were obtained to measure the oxidative stress biomarker levels. A questionnaire was also used to determine physical activity levels.

    A semi-quantitative food-frequency questionnaire was used to determine the food intake of all the participants over the previous year, including the consumption of specific items being determined in terms of grams per day. The plant-based diet index score was calculated using this information, and the results were used to classify the diets into three major groups — healthy plant foods, less healthy plant foods, and animal foods.

    The healthy plant foods diets consisted of vegetables, fruits, nuts, whole grains, legumes, coffee, tea, and vegetable oils, while the less healthy plant food diets consisted more of refined grains and sugar-sweetened beverages and desserts. The diets that were predominantly animal food-based consisted mainly of meat, eggs, seafood, fish, dairy, and animal fat.

    Results

    The results showed that the plant-based diet index score of the footballers was significantly higher than that of the matched non-athlete controls, but the healthy and unhealthy plant-based diet index scores that were separately calculated based on the diet groups were not significantly different for the footballers and non-athletes.

    Furthermore, plant-based diets were found to be linked to lower levels of the oxidative stress biomarker F2a-IP in the urine samples of all participants, indicating improved antioxidant status due to plant-based diets. Compared to non-athletes, footballers were also found to be more adherent to plant-based diets, as hypothesized by the researchers.

    Footballers were found to consume more vegetables, fruits, legumes, and nuts than non-athletes, while the consumption of total and animal fats was lower among footballers than non-athletes.

    The researchers also discussed the potential role of antioxidants and polyphenols present in plant-based diets in lowering oxidative stress. They also discussed findings from other studies that found inverse associations between F2a-IP concentrations and vegetable components such as lycopene, beta-carotene, and lutein, suggesting that diets rich in vegetables lower oxidative stress.

    Furthermore, dietary fats are known to increase the production of F2a-IP and influence the concentrations of F2a-IP transporters in plasma, which could potentially explain why diets low in dietary fats were associated with lower F2a-IP levels in the urine.

    Conclusions

    Overall, the results suggested that adherence to plant-based diets among footballers was linked to lower levels of the oxidative stress biomarker F2a-IP in urine. Additionally, the plant-based diet scores also showed that footballers were more likely to adhere to nutritional plant-based diets than non-athletes.

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  • Prenatal Mediterranean diet reduces offspring obesity

    Prenatal Mediterranean diet reduces offspring obesity

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    In a recent study published in Nutrients, researchers determined the relationship between maternal Mediterranean diet (MedDiet) adherence during gestation and overweight or obese offspring risk at four years.

    Study: Close Adherence to a Mediterranean Diet during Pregnancy Decreases Childhood Overweight/Obesity: A Prospective Study. Image Credit: Marian Weyo/Shutterstock.comStudy: Close Adherence to a Mediterranean Diet during Pregnancy Decreases Childhood Overweight/Obesity: A Prospective Study. Image Credit: Marian Weyo/Shutterstock.com

    Background

    The childhood obesity epidemic is a global health concern affecting millions of children under five, causing psychological comorbidities, low self-esteem, behavioral and emotional disorders, and long-term cardiovascular morbidity and cancer.

    In addition, the World Health Organization’s (WHO) report emphasizes the importance of antenatal nutritional balance in preventing childhood obesity. 

    Close maternal adherence to a Mediterranean-style diet during gestation could be a promising strategy for determining potential obesity risks in childhood. Greater adherence to the diet has multiple health benefits for both mother and child.

    However, studies examining the impact of prenatal diet on offspring obesity are scarce and yield varied results, warranting further research.

    About the study

    In the present study, researchers investigated whether maternal MedDiet adherence was associated with offspring obesity at four years and evaluated the impact of maternal factors on the association.

    The team included 272 mother-child dyads from the Ensayo CLInico Para Suplementar con Hierro a EmbarazadaS (ECLIPSES) study for analysis.

    The primary study outcome was offspring overweight or obese based on sex- and age-specific body mass index (BMI) z-scores above the 85th percentile using the WHO child growth standards.

    The researchers obtained baseline maternal data from questionnaires during face-to-face interviews at recruitment, including medical history, age, educational level, socioeconomic status, physical activity, smoking status, and alcohol intake.

    In addition to the gestational age at birth and delivery type, they obtained data on child-related variables, including sex, length, and weight at birth.

    The team assessed prenatal diet using standardized 45-component food-frequency questionnaires (FFQs) at gestational weeks 12, 24, and 36 and calculated relative MedDiet (rMedDiet) scores. They measured offspring height and weight at four years.

    They estimated the total daily calorie intake using the REGAL food table and determined household socioeconomic status using the Catalan classification of occupations (CCO-2011).

    The researchers assessed physical exercise using the International Physical Activity Questionnaire (IPAQ) and categorized gestational weight gain (GWG) using the 2009 Institute of Medicine (IOM) recommendations.

    They performed multivariate logistic regression modeling to determine the odds ratios (OR) for the association between prenatal diet and childhood obesity.

    The ECLIPSES randomized clinical trial was conducted in Tarragona, Spain, from 2013 to 2017 to evaluate the efficacy of maternal iron supplementation in different dosages, adjusting for the initial hemoglobin levels during early gestation, on maternal iron status at the end of gestation.

    Primary care midwives recruited 791 expecting women aged ≥18 years for the study during the initial prenatal visit (before week 12 of gestation).

    Results

    The mean maternal age was 32; 70% were aged ≥30, and 42% were obese or overweight, with body mass index values ≥25 kg m-2.

    Most (86%) mothers were from Spain, 44% received university-level education, 22% had high socioeconomic status, and 17% practiced smoking during pregnancy. Among the mothers, 29% showed low MedDiet adherence, whereas 23% were highly adherent.

    The mean prenatal rMedDiet score was 9.80, and 26% of offspring were overweight or obese at four years, with a higher obesity prevalence among males (63%) than females (37%).

    The team found significant anthropometric differences (height, weight, and body mass index) by sex. The mean body mass index and body weight of offspring at four years were 16 kg m-2 and 18 kg, respectively.

    Males had higher weight (19 versus 17 kg), BMI (16 versus 15.6), weight-for-age z scores (0.5 versus 0.1), and body mass index z-scores (0.7 versus 0.2) than females.

    Overweight/obesity was less prevalent among offspring of mothers with university-level education, higher socioeconomic status, and higher gestational rMedDiet scores.

    After adjusting for potential confounding variables, the team found higher prenatal MedDiet adherence related to a reduced risk of offspring being overweight or obese (OR for the highest versus lowest quartile, 0.3).

    They obtained similar findings, stratifying by maternal age, early gestational BMI, educational attainment, smoking status, socioeconomic status, and GWG.

    After confounder adjustment, the team found that each point increase in the prenatal MedDiet was associated with a 19% lower risk of children being overweight or obese at four years (OR, 0.8).

    Smoking (OR, 2.5), pre-pregnancy overweight (OR, 2.5) or obesity (OR, 2.6), and excessive GWG (OR, 2.9) were considerably associated with offspring overweight or obese at four years.

    The protective effects of MedDiet on offspring weight were higher among expecting women aged below 30 years with overweight or obese during initial gestation, those who did not smoke, and those with low socioeconomic status.

    Conclusion

    Overall, the study findings showed higher prenatal MedDiet adherence associated with lower reduced offspring overweight/obesity at four years, especially among university-educated mothers aged below 30 years from low socioeconomic backgrounds who did not smoke. Future studies could investigate whether the association persists across life stages.

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  • Flexitarian diet linked to lower cardiovascular risk, study finds

    Flexitarian diet linked to lower cardiovascular risk, study finds

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    A new study published in BMC Nutrition examines the cardiovascular risk associated with different dietary patterns.

    Study: Plant-based diets and cardiovascular risk factors: a comparison of flexitarians, vegans and omnivores in a cross-sectional study. Image Credit: Antonina Vlasova / Shutterstock.com Study: Plant-based diets and cardiovascular risk factors: a comparison of flexitarians, vegans and omnivores in a cross-sectional study. Image Credit: Antonina Vlasova / Shutterstock.com

    How different diets impact cardiovascular health

    Omnivorous diets are often rich in meat and meat products, with the average intake in Germany being above the recommended limit of 600 grams each week. High meat intake has been associated with an increased risk of obesity, high blood pressure, insulin resistance, abnormally high blood lipids, and arterial stiffening, all of which are risk factors for cardiovascular disease (CVD).

    In contrast, less than 40% of people in Germany are physically active, most of whom spend less than 2.5 hours every week in physical activity. However, moderate activity could reduce the risk of atherosclerosis, a prime risk factor for CVD.

    CVD is the leading cause of death around the world, as it accounts for over half of all deaths. Both modifiable and non-modifiable risk factors contribute to the development of CVD, the latter of which include a poor diet and unhealthy lifestyle.

    Ecologists claim that a plant-based diet is ideal for the earth’s human population in terms of health, sustainability, animal welfare, and cost-effectiveness. However, rather than an all-or-nothing approach, there could be a happy medium with people mainly eating plant-based food coupled with occasional meat and processed meat intake. In contrast to vegetarians, this type of individual is referred to as a flexitarian.

    While the typical omnivore diet has been associated with an increased CVD risk, a plant-based diet appears to reduce the risk of CVDs. However, little research to date has evaluated the impact of a flexitarian diet on CVD risk.

    About the study

    Study participants between 25 and 45 years old were divided into three groups. The first group comprised long-term flexitarians (FXs) who ingested 50 grams of meat or meat products each day, whereas the second group consisted of vegans who did not eat any foods of animal origin, and the third group included omnivores, whose diet included 170 grams of meat and meat products every day.

    The researchers examined blood samples for various markers of CVD, blood pressure, arterial wall compliance, and whether the individual had metabolic syndrome (MetS), characterized by insulin resistance, high blood glucose levels, and an increased weight circumference. These measurements were compared with dietary patterns using multiple tools to characterize diet quality, food intake, and physical activity levels.

    What did the study show?

    Body mass index (BMI) values were similar for all three groups; however, FX women had lower body fat than omnivore women, with this difference not observed in men. Vegan women had the lowest body fat percentage of all study participants.

    Vegetable intake increased from omnivores to vegans, with FXs and vegans consuming twice and three times as much vegetables as omnivores, respectively. Both vegans and FXs consumed twice as many fruits as omnivores.

    FXs consumed significantly fewer plant-based milk or dairy alternatives, with neither favored among omnivores. Similar patterns were observed for nuts and legumes.

    Meat intake was lowest among vegans and significantly less among FXs as compared to omnivores. Plant-based meat alternatives were primarily consumed among vegans, with some intake reported among FXs. Egg intake was double among omnivores as compared to FXs.

    The best diet quality was observed among vegans, followed by FXs, which correlates with previous reports.

    All CVD markers were at similar levels in all groups, whereas the lowest fasting glucose levels were observed in vegans. MetS marker scores were significantly better in vegans and FXs than omnivores; however, all groups were associated with low-risk score levels.

    Meat and dairy intake were closely associated with total cholesterol levels; however, dairy intake was negatively correlated with fruit and vegetable intake, including legumes and meat substitutes. Soft drinks, sweets, and meat consumption were correlated with increasing low-density lipoprotein (LDL) cholesterol.

    MetS scores were related to processed meat and meat consumption and sweets intake but negatively associated with fruit intake. Total inflammation was not correlated with any group.

    What are the implications?

    Dietary choices are crucial to reducing CVD risk, as confirmed by this pilot study on the flexitarian diet in relation to CVD risk factors. Although not an intervention study, the current study allowed for direct observation of several parameters in three distinctive groups, especially MetS scores and arterial stiffness.

    A vegan diet appears to be associated with the best cardiovascular health; however, MetS and arterial stiffness were more favorable in flexitarians than in the other groups. Thus, flexitarian diets also confer significant benefits compared to omnivorous eating patterns.

    Reducing meat and processed meat products intake, as in flexitarianism, may contribute to CVD risk factor advantages.”

    Journal reference:

    • Bruns, A., Greupner, T., Nebl, J., & Hahn, A. (2024). Plant-based diets and cardiovascular risk factors: a comparison of flexitarians, vegans and omnivores in a cross-sectional study. BMC Nutrition. doi:10.1186/s40795-024-00839-9.

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  • Physical activity may help alleviate pain intensity for cancer survivors

    Physical activity may help alleviate pain intensity for cancer survivors

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    People who have had cancer often experience ongoing pain, but a new study reveals that being physically active may help lessen its intensity. The study is published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

    Although physical activity has been shown to lessen various types of pain, its effects on cancer-related pain are unclear. To investigate, a team led by senior author Erika Rees-Punia, PhD, MPH, of the American Cancer Society, and first author Christopher T.V. Swain, PhD, of the University of Melbourne, in Australia, analyzed information pertaining to 51,439 adults without a history of cancer and 10,651 adults with a past cancer diagnosis. Participants were asked, “How would you rate your pain on average,” with responses ranging from 0 (no pain) to 10 (worst pain imaginable). Participants were also asked about their usual physical activity.

    U.S. guidelines recommend 150 minutes (2 hours 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour 15 minutes) to 150 minutes (2 hours 30 minutes) a week of vigorous-intensity aerobic physical activity.

    Based on participants’ responses, the investigators found that, for individuals who had cancer in the past as well as for those without a history of cancer, more physical activity was linked with lower pain intensity. The extent of the association was similar for both groups of individuals, indicating that exercise may reduce cancer-related pain just as it does for other types of pain that have been studied in the past.

    Among participants with a past cancer diagnosis, those exceeding physical activity guidelines were 16% less likely to report moderate-to-severe pain compared to those who failed to meet physical activity guidelines. Also, compared with people who remained inactive, those who were consistently active or became active in older adulthood reported less pain.

    “It may feel counterintuitive to some, but physical activity is an effective, non-pharmacologic option for reducing many types of pain. As our study suggests, this may include pain associated with cancer and its treatments,” said Dr. Rees-Punia. 

    Source:

    Journal reference:

    Swain, C. T. V., et al. (2024) Physical activity and pain in people with and without cancer. Cancer. doi.org/10.1002/cncr.35208.

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  • Limiting screen time and returning to school early may speed up recovery after a concussion

    Limiting screen time and returning to school early may speed up recovery after a concussion

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    Researchers at Nationwide Children’s Hospital have found that when it comes to concussion recovery, activity type matters. In a study published today in British Journal of Sports Medicine, researchers found that limiting screen time and returning to school early following a concussion may speed up recovery.

    Increased time spent in the classroom, participating in some after-school activities or working a job was associated in our study with faster symptom resolution, especially for participants with lower post-acute symptom scores. However, when activities involved significant screen time – like surfing the internet or playing video/computer games – during the first week post-injury, symptoms resolved more slowly.”


    Jingzhen Ginger Yang, PhD, MPH, lead author, principal investigator in the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s

    While some research on pediatric concussion has suggested an earlier introduction of physical activity promotes recovery, little is known about the intensity and duration of cognitive activity post-concussion and its potential influence on concussion recovery outcomes.

    This new study, conducted by experts in Nationwide Children’s Center for Injury Research and Policy, division of Sports Medicine, Center for Biobehavioral Health, and division of Emergency Medicine evaluated the intensity and duration of daily cognitive activity reported by adolescents (age 11-17 years) following concussion and examined the connections between these activities and symptom duration. Participants reported increases in low-intensity cognitive activities – such as listening to music, reading, watching television, and making or receiving phone calls – and total minutes of overall cognitive activities as their symptoms resolved.

    Previous clinical guidelines for youth with concussions have recommended complete physical and mental rest until symptoms resolve to avoid re-injury and reduce the demands on injured tissue. However, recent clinical and experimental data have demonstrated that prolonged physical rest does little to improve functional outcomes, and the resulting isolation and withdrawal can have unintended physical, social and educational consequences.

    “Children and teens should be encouraged to get back to their routines and take part in activities like clubs, jobs and homework after experiencing concussion, but keep in mind that for some patients, prolonged screen time in non-school activities such as gaming or internet scrolling can affect recovery if it is worsening their symptoms,” said co-author Thomas Pommering, DO, division chief and director of concussion clinics of Nationwide Children’s division of Sports Medicine. “We recommend concussion patients pick their screen activity wisely, focusing on school demands first.”

    According to the study, the average time children returned to school after a concussion was almost one week. Symptoms resolved more slowly when returning to school was delayed. Additionally, participating in club activities was associated with faster symptom resolution.

    “Having a better understanding of the appropriate ‘dosing’ and timing of introducing cognitive activity is critically needed for our patients,” explains co-author James MacDonald, MD, MPH, sports medicine physician at Nationwide Children’s. “Increased engagement in the classroom during the first week post-concussion, especially for youth with lower post-concussion symptom scores, can mean symptoms resolve faster and teens get back to normal life.”

    The relationship between level of cognitive activity and symptom resolution may be bidirectional, with improving post-concussion symptoms prompting higher levels of cognitive activity and vice versa. Thus, controlling for current symptom levels when assessing associations between cognitive activity and symptom resolution, as this study did, is crucial.

    This study has several important clinical implications:

    • Adolescents with concussion, especially those with relatively less severe post-acute symptoms, may benefit from moderate- to high-intensity cognitive activity as early as the first week post-injury.
    • Limiting (but not prohibiting) moderate-intensity activities involving significant screen time (e.g., surfing the internet or video/computer gaming) during the first-week post-injury may help speed recovery.
    • Early introduction of returning to school following concussion is an important consideration that may hasten timelines for recovery.

    Families should collaborate with their child’s care team to develop a plan based on injury severity and recovery milestones.

    Source:

    Journal reference:

    Yang, J., et al. (2024). Exploring the association between cognitive activity and symptom resolution following concussion in adolescents aged 11–17 years. British Journal of Sports Medicine. doi.org/10.1136/bjsports-2023-107601.

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  • Trial investigates efficacy of online supervised group mental and physical rehabilitation program for long COVID patients

    Trial investigates efficacy of online supervised group mental and physical rehabilitation program for long COVID patients

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    In a recent study published in the BMJ, researchers evaluated the efficacy of an online supervised group mental and physical rehabilitation program in adults with long COVID.

    Study: Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial. Image Credit: Dmitry Demidovich/Shutterstock.com
    Study: Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial. Image Credit: Dmitry Demidovich/Shutterstock.com

    Background

    Over 17 million people in the European region of the World Health Organization (WHO) may have experienced coronavirus disease 2019 (COVID-19) symptoms longer than four weeks. Common symptoms of this multisystem condition, known as long COVID or post-COVID-19 condition, include muscle aches, fatigue, dyspnea, and cognitive dysfunction that can profoundly impact quality of life, societal participation, and economic productivity. The pathophysiology of long COVID has not been fully characterized.

    As such, current medical management and treatments have limited efficacy. The biopsychosocial care model may improve outcomes for long COVID patients. Multicomponent mental and physical rehabilitation could improve fatigue, quality of life, and breathlessness. So far, few quasi-experimental studies evaluated exercise-based interventions for individuals with long COVID, with no definitive, high-quality evidence.

    About the study

    In the present study, researchers evaluated the clinical effectiveness of a group rehabilitation program for people with long COVID. The rehabilitation exercise and psychological support after COVID-19 infection (REGAIN) was a multi-center, parallel-group, pragmatic, randomized controlled trial. Participants were recruited in England and Wales. Adults (26-86 years) discharged at least three months after hospitalization with COVID-19 who had ongoing mental and physical sequelae were recruited.

    Subjects were excluded if they had severe mental health problems, contraindications to exercise training, or were enrolled in other rehabilitation programs. A baseline questionnaire was administered before randomization to REGAIN or usual care. Usual care participants received the best practice usual care; this involved an online consultation with a trained practitioner, wherein generic advice was provided on recovery and physical activity.

    The REGAIN intervention was an eight-week, supervised, home-based, group rehabilitation program, providing online consultation with a REGAIN practitioner. REGAIN participants joined weekly live online group exercise and psychological support sessions. Equipment-free, supervised, personalized exercise sessions were delivered in online groups to improve fatigue, cardiovascular fitness, balance, and strength and restore confidence in daily living activities.

    Psychological support sessions were aimed at augmenting psychological capability and increasing COVID-19-related knowledge and its impact on everyday life. The primary outcome of the study was health-related quality of life, determined using the patient-reported outcomes measurement information system (PROMIS). Secondary outcomes included dyspnea, cognitive function, physical activity, anxiety, depression, and general health, among others. Outcomes were assessed at three, six, and 12 months.

    Findings

    Of over 39,000 people invited to participate between January 2021 and July 2022, 1,043 expressed interest. Following exclusions, 298 and 287 subjects were randomized to REGAIN and usual care, respectively. Most participants were female (52%), White (88%), and obese/overweight (88%). One-third of participants required intensive care during COVID-19 hospitalization.

    The average time from discharge to randomization was 323 days. The baseline health-related quality of life was low; around 40% had low physical activity. More than a third of participants could not work due to long COVID. Primary outcome data were available for 80% of REGAIN and 86% of usual care participants. The health-related quality of life improved more for REGAIN participants than usual care recipients at three months.

    There was a significant group difference in health-related quality of life, primarily driven by three PROMIS sub-scores – fatigue, depression, and pain interference. While the effect of the intervention was not evident at six months, it was sustained at 12 months. REGAIN participants had increased odds of being more physically active than usual care recipients. At three months, 7% more REGAIN subjects met the physical activity guideline (> 150 minutes of moderate-intensity activity per week).

    Furthermore, more REGAIN participants reported feeling much better compared to three months than usual care subjects. Adverse events were reported in both groups. Most serious adverse events were related to hospitalization or extended stay at the hospital. Two adverse events were related to the REGAIN intervention. One serious adverse event was possibly related to the intervention. Post-exertional exacerbation of symptoms was not observed.

    Conclusions

    In sum, the REGAIN intervention was clinically effective in improving health-related quality of life for adults with post-COVID-19 condition compared to usual care at three months post-randomization. This effect was mainly due to improvements in pain interference, fatigue, and depression. Moreover, the effect was sustained at 12 months. In both groups, there were improvements in the overall quality of life and other well-being indices.

    Journal reference:

    • Gordon McGregor, Harbinder Sandhu, Julie Bruce, et al. Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial. BMJ, 2024. doi: 10.1136/bmj-2023-076506
      https://www.bmj.com/content/384/bmj-2023-076506
       

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  • Air Force cadets’ nutrition knowledge linked to success in gravitational acceleration test, study finds

    Air Force cadets’ nutrition knowledge linked to success in gravitational acceleration test, study finds

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    In a recent study published in Scientific Reports, researchers explored how nutrition knowledge, physical strength and activity, and body composition are related to whether Air Force cadets lose consciousness during the Gravitational Acceleration Test (G-test).

    The findings indicate that cadets who remained conscious and passed the test had better nutrition knowledge and were more physically active; these learnings have applications in improving training and test outcomes for cadets in the coming years.

    Study: Physical strength, body composition, and G-test results of air force cadets based on nutrition knowledge differences. Image Credit: John Hoffman/Shutterstock.comStudy: Physical strength, body composition, and G-test results of air force cadets based on nutrition knowledge differences. Image Credit: John Hoffman/Shutterstock.com

    Background

    Research in sports nutrition and training has applications in military training and nutritional management to maintain optimal physical and mental functioning while preventing disease. This requires an interdisciplinary approach that includes exercise, rest, recovery, and diet.

    Soldiers in the Air Force work under extreme physiological stress in aerial environments, where they may suffer from hypoxia, hearing loss, flight illusion, cognitive dissonance, and gravity-induced loss of consciousness (G-LOC).

    Enduring G-tests requires adequate nutrition and physical strength, but further understanding is required of how physical activity and strength can be improved among Air Force cadets.

    About the study

    Participants in the study were male senior cadets at the Air Force Academy in the Republic of Korea who took the G-test in 2022.

    Those who were injured or unwilling to participate were excluded from the study. All sampled participants followed the same training, sleep, meal, and work schedules.

    The G-test involved participants sitting in a cockpit-style seat of a high-speed centrifugal motion gondola for 30 seconds at an acceleration of 5 G.

    Losing consciousness before 30 seconds meant failing the test. Based on their test results, participants were divided into those who passed the 30 s G-test (GP) and those who failed (GF).

    Body strength was measured three months before the G-test, while body composition was assessed five days prior on an empty stomach. The strength test included a three-kilometer run, sit-ups, and push-ups.

    Participants were asked to avoid high-intensity activities and sleep sufficiently on the previous day. Measures taken included skeletal muscle mass, body fat percentage, body fat mass, body mass index, height, and weight.

    Participants also completed questionnaires assessing their physical activity levels and knowledge of nutrition-related topics. The data were analyzed using independent sample t-tests and logistic regressions at a significance level of 5%.

    Findings

    Of the 105 male cadets who participated in the study, those who passed the G-test weighed, on average, 3.5 kg more than those who failed and had a slightly higher BMI (24.05 compared to 23.08 on average).

    Skeletal muscle mass, though higher in the GP group, was not significantly different. Similarly, GP cadets had lower body fat mass and body fat ratio, but the difference was not significant.

    Cadets who passed were more physically active, working out for 22.2 minutes daily and 1.1 more reps each week on average. However, they did not perform significantly better in the physical strength evaluation.

    Cadets in the GP group performed significantly better in the general nutrition knowledge questionnaire, with an overall score of 6.6 points higher on average.

    The logistic regression showed significantly higher results for two sections (daily recommendation and food group) out of the four in the test questionnaire.

    There were no significant differences for the sections on healthy food choices and diet, disease, and weight associations.

    Conclusions

    Cadets who passed the G-test were significantly different in terms of their weight and BMI, with indications that higher skeletal muscle mass and lower body fat mass may be beneficial during the test.

    Specifically, higher muscle mass may facilitate better blood supply to the brain and prevent cadets from losing consciousness during the G-test. This indicates the need for a program design that balances aerobic and muscle training.

    The GP cadets were also more physically active and more knowledgeable on nutrition-related topics.

    While their food intake, energy metabolic rate, and activity were not measured, and how this knowledge translates into practice could not be observed, previous research indicates that people who understand nutrition benefits make more informed health decisions in terms of dietary intake. The authors recommend the introduction of a nutrition education program at the academy to address this.

    The findings indicate that nutritional knowledge and overall physical condition promote better performance at an acceleration equivalent to five times that of the Earth’s gravitational pull.

    In addition to continuous technological research, systematic nutrition management and education can improve and maintain optimal body composition, improving health outcomes under extreme physiological stress in aerial environments.

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  • Nutrition labels lead to healthier eating in teens, study finds

    Nutrition labels lead to healthier eating in teens, study finds

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    In a recent study published in Nutrients, researchers at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in Austin explored how nutrition labels affect eating behaviors among middle-school and high-school students in Texas.

    Dissatisfied young woman wearing casual outfit and earphones holding two packs of pasta looking at label while standing in grocery department in supermarket
    Study: Using the Nutrition Facts Label to Make Food Choices Is Associated with Healthier Eating among 8th and 11th-Grade Students: An Analysis of Statewide Representative Data from the 2019–2020 Texas School Physical Activity and Nutrition Survey. Image Credit. progressman/Shutterstock.com

    Based on self-reported information, their results indicate that improving nutrition literacy and using food labels could significantly enhance the quality of diet for school-going adolescents.

    Background

    Nutrition labels can help people compare different food items and inform healthier decision-making. In recent years, the use of food labels has increased dramatically among American adults, with around 80% making purchase decisions based on label information. Using labels is related to better dietary quality and health outcomes.

    Adolescent health is a policy priority since this period of life is critical for well-being in adulthood. Today, nearly one in four American adolescents are categorized as obese, but studies on nutrition label use among this group have shown contradictory results.

    While one study found high levels of label use among adolescents, this did not translate to having a healthier diet. Another found far lower levels of label use. These conflicting results highlight a critical need for further research to understand how best to address and prevent adolescent obesity.

    About the study

    In this study, researchers used a cross-sectional design with data collected through the Survey of Physical Activity and Nutrition in Texas from 2019 to 2020. During the academic year, students in the eighth and eleventh grades filled out survey questionnaires and answered questions about demographic information, physical activity, nutrition, dental habits, and screen time.

    Their weight and height were also assessed to calculate their body mass index (BMI). Students were also asked whether they used food labels to inform their food choices. They were asked to respond on a Likert scale with five points ranging from ‘Always’ to ‘Never.’ This was the primary predictor.

    The students’ dietary behavior was assessed using questions on how frequently they reported consuming various food items the previous day. The list contained 13 healthy foods, such as brown rice, vegetables, whole fruit, and baked meat, and 13 unhealthy foods, such as flavored milk, fried meat, caffeinated beverages, and frozen desserts. To include weekday consumption, the food consumption surveys were administered from Tuesday to Friday.

    This information informed the calculation of the healthy eating index (HEI) and the health foods index (HFI) from 0 to 100, where a higher score indicated a healthier diet. The study’s primary outcomes were the HEI, HFI, and unhealthy foods index (UFI). The data was analyzed using adjusted and weighted linear and logistic regression models.

    Findings

    The sample included 4,730 students, of whom 49% were female, more than half were Hispanic, and had an average age of 14.7 years old. Most students were not economically advantaged, and nearly 15% had limited English proficiency. About 60% reported that they never or rarely used food labels to make decisions about eating. Only 11% said they always relied on labels to make food choices.

    The regression analyses showed that using food labels was significantly positively associated with HEI and HFI scores and negatively associated with UFI scores. The researchers observed a dose-response relationship where stronger associations were observed as the frequency of label use increased.

    Individuals who consistently or almost always used the food labels were likelier to eat healthy foods such as nuts, brown bread, baked meat, fruit, and vegetables; they also reported consuming lower amounts of chips, soda, and candy.

    Conclusions

    The findings from this study clearly showed a dose-response relationship. The benefits of using food labels were greater for those who used them more frequently, and students who always used food labels had significantly healthier diets than other groups. However, only 11% of the students made use of food labels all the time, indicating that not many are utilizing this resource.

    Despite these benefits, many adolescents may struggle to understand the complex nutritional information on the labels. Using this information to guide food-related decision-making requires comprehending and responding to information on which nutrients should be avoided or limited (sodium, added sugars, and saturated fats) and those that are healthy (e.g., minerals and dietary fibers).

    The strengths of this study included its state-level representative design; however, the study was also observational, which did not allow for causal inference, and relied on self-reported data, which is subject to recall and social desirability biases.

    Future studies can explore the mechanisms behind the associations observed, how to encourage food literacy and label use among the youth, and explore possible sex-based differences to address the specific needs of female and male students.

    Journal reference:

    • Pfledderer C, Ranjit N, Perez A, et al. (2024). Using the nutrition facts label to make food choices is associated with healthier eating among 8th and 11th-grade students: an analysis of statewide representative data from the 2019-2020 Texas school physical activity and nutrition survey. Nutrients. doi: 10.3390/nu16020311. https://www.mdpi.com/2072-6643/16/2/311

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  • Exploring the dynamic between dog ownership and child activity levels

    Exploring the dynamic between dog ownership and child activity levels

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    In a recent study published in the International Journal of Behavioural Nutrition and Physical Activity, a group of researchers examined the longitudinal effects of changes in dog ownership on children’s physical activity and movement behaviors using data from the Play Spaces and Environments for Children’s Physical Activity (PLAYCE) cohort study.

    Study: Longitudinal effects of dog ownership, dog acquisition, and dog loss on children’s movement behaviours: findings from the PLAYCE cohort study. Image Credit: Dmytro Vietrov/Shutterstock.com
    Study: Longitudinal effects of dog ownership, dog acquisition, and dog loss on children’s movement behaviours: findings from the PLAYCE cohort study. Image Credit: Dmytro Vietrov/Shutterstock.com

    Background 

    Despite the importance of physical activity for children’s health, many fail to meet activity guidelines. Dog ownership in places like Australia is linked to higher physical activity levels in children, as owning a dog encourages more walking and play. Yet, the impact of dog ownership on children’s screen time and sleep remains unclear, and there’s a lack of longitudinal research. Ethical constraints limit the feasibility of randomized trials, underscoring the value of natural experiments or observational studies to explore this relationship. There is a crucial need for further study using advanced methods to accurately assess the effects of dog ownership on various aspects of children’s movement behaviors.

    About the study 

    The present study, initiated in Perth, recruited children aged 2 to 5 from early childhood education and care services. The study sought participation from a diverse socio-economic background, collecting baseline data from 2015 to 2018. As these children transitioned to full-time school, they were followed up until 2021, provided they met the eligibility criteria, resulting in a sample of 641 children aged 5 to 7 for wave 2, with 600 children having complete data on dog ownership across both waves. This setup created a natural experiment with four distinct groups based on dog ownership changes, allowing for a comparison of physical activity levels and other movement behaviors over time.

    Children’s physical activity was rigorously measured using ActiGraph GT3X+ accelerometers, processed through a machine learning model to categorize activity intensity accurately. Additionally, parents reported on screen time, sleep duration, and physical activity, offering a comprehensive view of the children’s movement behaviors. The study also considered various covariates like parental education and household characteristics to adjust for potential confounders.

    Analytical approaches included linear mixed effects models to explore differences in movement behaviors over time and by dog ownership status, adjusting for a range of variables and the context of the coronavirus disease 2019 (COVID-19) pandemic. 

    Study results 

    The PLAYCE cohort study detailed the characteristics and movement behaviors of children across different dog ownership statuses. Approximately half of the participants were girls, with a median age of 3.2 years at the study’s outset. Notably, socioeconomic factors such as the mother’s education level, employment status, and living conditions varied significantly across dog ownership groups, influencing the study’s context.

    Initial assessments revealed no significant differences in movement behaviors measured by devices among the dog ownership groups. However, when looking at unstructured physical activity, children in the dog owner and dog loss groups engaged in more physical activities than their counterparts without dogs. Interestingly, these differences were primarily due to dog-related activities. Screen time and sleep duration also varied, indicating nuanced influences of dog ownership on children’s daily routines.

    As children transitioned from preschool to full-time school, changes in their movement behaviors were observed, with variations depending on whether they acquired or lost a dog during this period. For girls, acquiring a dog positively impacted light intensity activities, whereas losing a dog led to reductions in both light intensity activities and total physical activity. Conversely, boys in the dog owner group saw an increase in energetic play, highlighting the gender-specific effects of dog ownership on children’s physical activities.

    The acquisition of a dog also positively affected both girls’ and boys’ unstructured physical activity, emphasizing the role of dog-facilitated activities in promoting physical engagement. These findings suggest that changes in dog ownership status can significantly impact children’s movement behaviors, with the loss of a dog particularly affecting girls’ physical activity levels.

    Screen time trends further illustrated these effects, with no significant changes observed in girls who acquired or lost a dog, but a distinct trajectory for girls in the dog owner group compared to non-dog owners. This divergence underscores the complex relationship between dog ownership and screen time, possibly reflecting lifestyle or behavioral adjustments associated with having a pet.

    Lastly, the study highlighted significant shifts in physical activity and screen time among children experiencing changes in dog ownership status. These results point to the potential of dog ownership to positively influence children’s physical activity, with implications for public health strategies aimed at enhancing physical engagement among young populations. 

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  • Exercise shapes our gut health, study finds

    Exercise shapes our gut health, study finds

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    In a recent study published in the journal EBioMedicine,  a team of scientists investigated the association between physical activity levels and gut microbiota using accelerometer-based assessments of sedentary, moderate, and vigorous physical activity levels.

    Study: Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS. Image Credit: Zhanna Mendel / ShutterstockStudy: Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS. Image Credit: Zhanna Mendel / Shutterstock

    Background

    A growing body of evidence shows that optimal levels of physical activity lower the risk of type 2 diabetes, cardiovascular disease, and mental health conditions such as depression. Furthermore, sedentary habits involving activities that include extensive periods of sitting or lying down have been known to increase the risk of cardiovascular mortality and type 2 diabetes, and these risks can be lowered through high-intensity exercise. Recent studies have also shown that the positive effects of exercise on health might be mediated through gut microbiome changes.

    Substantial research also indicates that the gut microbiome plays a significant role in developing various diseases and mental health problems. Apart from the interactions with the host in the gastrointestinal tract, the gut microbiota is also thought to produce neurotransmitters that can influence the immune system, central nervous system, and brain homeostasis through various neuronal pathways and the microbiota-gut-brain axis. Physical activity and resulting changes in circulation, enterohepatic movement of bile acids, intestinal permeability, and gut immunity can influence the gut microbiota.

    About the study

    In the present study, the researchers used data from a cardiopulmonary bioimage study from Sweden to determine if sedentary, moderate, and vigorous levels of physical activity were associated with gut microbiome changes. While quite a few previous studies have examined this association, most of them have used self-reported levels of physical activity, which is subject to bias. Furthermore, the authors believe that the taxonomic resolution of the gut microbes had been limited in these studies.

    This study used data from a hip-worn accelerometer to obtain a more reliable and accurate measure of physical activity levels. Additionally, the use of deep shotgun metagenomics was thought to provide high-resolution taxonomic information about the gut microbial communities.

    The participants in the study were required to answer a detailed questionnaire about health and medical history, diet, and lifestyle habits. They underwent a series of physical and clinical examinations such as lungs, coronary artery, and abdominal computed tomography (CT). Participants also provided fecal samples that were used for the gut microbiome analysis. An accelerometer was worn on the hip by all the participants for one week, at all hours except while involved in water-based activities or sleeping.

    The data from the accelerometer was converted to counts per minute, which was then used to define sedentary, low, moderate, and vigorous levels of physical activity according to cut-offs validated from previous studies. Deoxyribonucleic acid (DNA) extraction was carried out for all the fecal samples, and the extracted DNA was then used to identify the metagenomic species.

    Various indices of species diversity, such as the inverse Simpson index, Shannon diversity index, and species richness, were calculated to determine the alpha diversity. Additionally, the dissimilarity in the microbe composition between the samples was determined by calculating the beta diversity.

    Results

    The results showed that the association between sedentary habits or very low levels of physical activity and the abundance of various gut microbe species was converse to the association between moderate or vigorous physical activity levels and the abundance of gut microbiome species.

    The abundance of Escherichia coli was found to be high in association with sedentary physical activity levels, while moderate physical activity levels were linked to a lower abundance of E. coli. The abundance of butyrate-producing bacteria such as those belonging to the Roseburia genus, and Faecalibacterium prausnitzii was high in individuals with moderate and vigorous physical activity levels.

    Furthermore, differences were also observed in the abundance of species, such as Prevotella copri, between individuals with moderate physical activity levels and those in the vigorous physical activity group. The abundance of P. copri was higher in association with moderate levels of exercise, but vigorous exercise showed no association with P. copri abundance.

    The functional potential of the gut microbiome was also found to differ in association with differing physical activity levels. Moderate levels of physical activity were found to be associated with higher acetate and butyrate synthesis. Vigorous exercise was found to be linked to higher propionate synthesis, and sedentary activity levels were associated with a lower capacity for carbohydrate degradation by the gut microbiota.

    Conclusions

    Overall, the findings suggested that physical activity levels were strongly linked to the abundance of specific gut microbes. Furthermore, the diversity and abundance of the gut microbiota, and subsequently its functional potential, changed according to different levels of physical activity. Sedentary habits and higher levels of physical activity exhibited converse associations with gut microbiome abundance and diversity.

    Journal reference:

    • Baldanzi, G., Sayols-Baixeras, S., Ekblom-Bak, E., Ekblom, Ö., Dekkers, K. F., Hammar, U., Nguyen, D., Ahmad, S., Ericson, U., Arvidsson, D., Börjesson, M., Johanson, P. J., Gustav, S. J., Bergström, G., Lind, L., Engström, G., Ärnlöv, J., Kennedy, B., Orho-Melander, M., & Fall, T. (2024). Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS. EBioMedicine, 100. DOI: 10.1016/j.ebiom.2024.104989, https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(24)00024-0/fulltext

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