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Diabetes, Obesity & Metabolism Jul 2024To perform a meta-analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body... (Review)
Review
AIM
To perform a meta-analysis to investigate the effects of intermittent fasting (IF), as compared with either a control diet (CON) and/or calorie restriction (CR), on body composition and cardiometabolic health in individuals with prediabetes and type 2 diabetes (T2D).
METHODS
PubMed, Web of Science, and Scopus were searched from their inception to March 2024 to identify original randomized trials with parallel or crossover designs that studied the effects of IF on body composition and cardiometabolic health. Weighted mean differences (WMDs) or standardized mean differences with 95% confidence intervals (CIs) were calculated using random-effects models.
RESULTS
Overall, 14 studies involving 1101 adults with prediabetes or T2D were included in the meta-analysis. IF decreased body weight (WMD -4.56 kg [95% CI -6.23 to -2.83]; p = 0.001), body mass index (BMI; WMD -1.99 kg.m [95% CI -2.74 to -1.23]; p = 0.001), glycated haemoglobin (HbA1c; WMD -0.81% [95% CI -1.24 to -0.38]; p = 0.001), fasting glucose (WMD -0.36 mmol/L [95% CI -0.63 to -0.09]; p = 0.008), total cholesterol (WMD -0.31 mmol/L [95% CI -0.60 to -0.02]; p = 0.03) and triglycerides (WMD -0.14 mmol/L [95% CI -0.27 to -0.01]; p = 0.02), but did not significantly decrease fat mass, insulin, low-densitiy lipoprotein, high-density lipoprotein, or blood pressure as compared with CON. Furthermore, IF decreased body weight (WMD -1.14 kg [95% CI -1.69 to -0.60]; p = 0.001) and BMI (WMD -0.43 kg.m [95% CI -0.58 to -0.27]; p = 0.001), but did not significantly affect fat mass, lean body mass, visceral fat, insulin, HbA1c, lipid profiles or blood pressure.
CONCLUSION
Intermittent fasting is effective for weight loss and specific cardiometabolic health markers in individuals with prediabetes or T2D. Additionally, IF is associated with a reduction in body weight and BMI compared to CR, without effects on glycaemic markers, lipid profiles or blood pressure.
PubMed: 38956175
DOI: 10.1111/dom.15730 -
Clinical Nutrition (Edinburgh, Scotland) May 2024A dysfunctional hypothalamus may result in decreased feelings of satiety (hyperphagia), decreased energy expenditure, and increased fat storage as a consequence of...
BACKGROUND & AIMS
A dysfunctional hypothalamus may result in decreased feelings of satiety (hyperphagia), decreased energy expenditure, and increased fat storage as a consequence of hyperinsulinemia. Hypothalamic dysfunction may thus lead to morbid obesity and can be encountered in childhood as a consequence of congenital, genetic, or acquired disorders. There is currently no effective treatment for hypothalamic obesity (HO). However, comparable to alimentary obesity, dietary and lifestyle interventions may be considered the cornerstones of obesity treatment. We questioned the effect of dietary or lifestyle interventions for HO and systematically searched the literature for evidence on feasibility, safety, or efficacy of dietary or lifestyle interventions for childhood hypothalamic overweight or obesity.
METHODS
A systematic search was conducted in MEDLINE (including Cochrane Library), EMBASE, and CINAHL (May 2023). Studies assessing feasibility, safety, or efficacy of any dietary or lifestyle intervention in children with hypothalamic overweight or obesity, were included. Animal studies, studies on non-diet interventions, and studies with no full text available were excluded. Because the number of studies to be included was low, the search was repeated for adults with hypothalamic overweight or obesity. Risk of bias was assessed with an adapted Cochrane Risk of Bias Tool. Level of evidence was assessed using the GRADE system. Descriptive data were described, as pooled-data analysis was not possible due to heterogeneity of included studies.
RESULTS
In total, twelve studies were included, with a total number of 118 patients (age 1-19 years) of whom one with craniopharyngioma, one with ROHHAD-NET syndrome, 50 with monogenic obesity, and 66 with Prader-Willi syndrome (PWS). Four studies reported a dietary intervention as feasible. However, parents did experience difficulties with children still stealing food, and especially lowering carbohydrates was considered to be challenging. Seven studies reported on efficacy of a dietary intervention: a well-balanced restrictive caloric diet (30% fat, 45% carbohydrates, and 25% protein) and various hypocaloric diets (8-10 kcal/cm/day) were considered effective in terms of weight stabilization or decrease. No negative effect on linear growth was reported. Four studies reported on specific lifestyle interventions, of which three also included a dietary intervention. Combined dietary and lifestyle intervention resulted in decreased BMI, although BMI returned to baseline values on long-term. One additional study was identified in adults after brain trauma and showed a significant reduction in BMI in one out of eight patients after a combined dietary and lifestyle intervention.
CONCLUSIONS
Hypocaloric diet or restrictive macronutrient diet with lower percentage of carbohydrates seems feasible and effective for childhood HO, although most of the studies had a high risk of bias, small cohorts without control groups, and were conducted in children with PWS only, compromising the generalizability. Lifestyle interventions only resulted in BMI decrease in short-term, indicating that additional guidance is needed to sustain its effect in the long-term. Literature on feasibility and efficacy of a dietary or lifestyle intervention for hypothalamic overweight or obesity is scarce, especially in children with acquired HO (following treatment for a suprasellar tumor). There is need for prospective (controlled) studies to determine which dietary and lifestyle intervention are most helpful for this specific patient group.
PubMed: 38955055
DOI: 10.1016/j.clnu.2024.05.028 -
European Journal of Pediatrics Jul 2024The purpose of this study is to investigate the diagnostic and prognostic role of cerebrospinal fluid (CSF) biomarkers in the diagnostic work-up of glucose transporter 1... (Review)
Review
The purpose of this study is to investigate the diagnostic and prognostic role of cerebrospinal fluid (CSF) biomarkers in the diagnostic work-up of glucose transporter 1 (GLUT1) deficiency. Reported here is a systematic review according to PRISMA guidelines collecting clinical and biochemical data about all published patients who underwent CSF analysis. Clinical phenotypes were compared between groups defined by the levels of CSF glucose (≤ 2.2 mmol/L versus > 2.2 mmol/L), CSF/blood glucose ratio (≤ 0.45 versus > 0.45), and CSF lactate (≤ 1 mmol/L versus > 1 mmol/L). Five hundred sixty-two patients fulfilled the inclusion criteria with a mean age at the diagnosis of 8.6 ± 6.7 years. Patients with CSF glucose ≤ 2.2 mmol/L and CSF/blood glucose ratio ≤ 0.45 presented with an earlier onset of symptoms (16.4 ± 22.0 versus 54.4 ± 45.9 months, p < 0.01; 15.7 ± 23.8 versus 40.9 ± 38.0 months, p < 0.01) and received an earlier molecular genetic confirmation (92.1 ± 72.8 versus 157.1 ± 106.2 months, p < 0.01). CSF glucose ≤ 2.2 mmol/L was consistently associated with response to ketogenic diet (p = 0.018) and antiseizure medications (p = 0.025). CSF/blood glucose ratio ≤ 0.45 was significantly associated with absence seizures (p = 0.048), paroxysmal exercise-induced dyskinesia (p = 0.046), and intellectual disability (p = 0.016) while CSF lactate > 1 mmol/L was associated with a response to antiseizure medications (p = 0.026) but not to ketogenic diet.Conclusions:This systematic review supported the diagnostic usefulness of lumbar puncture for the early identification of patients with GLUT1 deficiency responsive to treatments especially if they present with co-occurring epilepsy, movement, and neurodevelopmental disorders. What is Known: • Phenotypes of GLUT1 deficiency syndrome range between early epileptic and developmental encephalopathy to paroxysmal movement disorders and developmental impairment What is New: • CSF blood/glucose ratio may predict better than CSF glucose the diagnosis in children presenting with early onset absences • CSF blood/glucose ratio may predict better than CSF glucose the diagnosis in children presenting with paroxysmal exercise induced dyskinesia and intellectual disability. • CSF glucose may predict better than CSF blood/glucose and lactate the response to ketogenic diet and antiseizure medications.
PubMed: 38954008
DOI: 10.1007/s00431-024-05657-6 -
Physiotherapy Theory and Practice Jul 2024Whole body vibration (WBV) exercise is a therapy used for individuals with low tolerance to conventional exercises, such as patients with chronic obstructive pulmonary... (Review)
Review
Effects of whole-body vibration exercise on functional capacity, muscle strength, and quality of life in individuals with severe chronic obstructive pulmonary disease: a systematic review and meta-analysis.
BACKGROUND
Whole body vibration (WBV) exercise is a therapy used for individuals with low tolerance to conventional exercises, such as patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess the impact of WBV exercise on the functional capacity, muscle strength, and health-related quality of life (HRQoL) in severe COPD patients.
METHODS
Studies published until March 2024 were reviewed, encompassing randomized clinical trials (RCTs) without temporal or linguistic constraints, comparing WBV exercise with other interventions. The PubMed/MEDLINE, Scopus, Cochrane Airways Trials Register, and CINAHL databases were queried. The Revised Cochrane risk-of-bias tool for randomized trials 2.0A was employed for quality assessment.
RESULTS
Among 351 screened studies, 7 met the criteria, totaling 356 participants (WBV group, = 182; control group, = 174). Meta-analysis revealed a significant mean difference of 41.36 m [95%CI (13.28-69.44); = .004] in the 6-minute walk test distance favoring the WBV group for functional capacity. Lower limb muscle strength improved in 57.14% of included studies. HRQoL meta-analysis demonstrated a 1.13-point difference [95%CI -1.24-3.51; = .35] favoring WBV, although group differences were not significant. A mean difference of 2.31 points favored the control group in health condition [95%CI (-1.32-5.94); = .021].
CONCLUSION
WBV exercise is recognized as a promising therapeutic modality for severe COPD patients, notably enhancing functional capacity. Although heterogeneous study protocols weaken the evidence for clinically relevant outcomes, improvements in lower limb muscle strength and HRQoL were also observed, differences between groups were not significant.
PubMed: 38953511
DOI: 10.1080/09593985.2024.2374053 -
Biology of Sport Jul 2024The aim of this study is to determine the acute effects of resistance and plyometric training on sprint and change of direction (COD) performance in healthy adults and... (Review)
Review
The aim of this study is to determine the acute effects of resistance and plyometric training on sprint and change of direction (COD) performance in healthy adults and adolescents. A systematic literature search was conducted via Medline, Cinahl, Scopus and SportDiscus databases for studies that investigated: 1) healthy male, female adults, or adolescents; and 2) measured sprint or change of direction performance following resistance and plyometric exercises. Studies were excluded if: 1) resistance or plyometric exercises was not used to induce muscle damage; 2) conducted in animals, infants, elderly; 3) sprint performance and/or agility performance was not measured 24 h post muscle damaging protocol. Study appraisal was completed using the Kmet Quality Scoring for Quantitative Study tool. Forest plots were generated to quantitatively analyse data and report study statistics for statistical significance and heterogeneity. The included studies ( = 20) revealed sprint and COD performance was significantly impaired up to 72 hr following resistance and plyometric exercises; both protocols significantly increased creatine kinase (CK), delayed-onset muscle soreness (DOMS) and decreased countermovement jump (CMJ) up to 72 hr. The systematic review of 20 studies indicated that resistance and plyometric training significantly impaired sprint and COD performance up to 72 hours post-exercise. Both training protocols elevated exercise-induced muscle damage (EIMD) markers (CK, DOMS) and decreased CMJ performance within the same timeframe.
PubMed: 38952917
DOI: 10.5114/biolsport.2024.131823 -
Biology of Sport Jul 2024This systematic review aims to provide a summary of the results from individual studies that specifically focused on overweight or obese populations, regardless of age... (Review)
Review
This systematic review aims to provide a summary of the results from individual studies that specifically focused on overweight or obese populations, regardless of age or sex. The goal is to determine the effects of structured recreational team sports interventions (TSG) on metabolic health, body composition and physical fitness parameters when compared to passive or active control groups. This study adhered to the PRISMA guidelines for reporting a systematic review. A thorough examination of relevant literature was conducted on November 06, 2023, using three prominent databases: PubMed, Scopus, and the Web of Science. Inclusion criteria considered overweight (e.g., BMI 25.0-29.9 kg/m) and obese (e.g., BMI > 30 kg/m) populations exposed to training interventions using recreational team sports, while the comparator group consisted of the same populations not exposed to exercise (passive controls) or exposed to alternative training methods. The primary outcomes of interest were metabolic health parameters (glucose, waist circumference, blood pressure, cholesterol, triglycerides), body composition (e.g., fat mass, lean mass), as well as physical fitness parameters (e.g., aerobic fitness, muscular fitness). Only studies with two- or multi-arm designs, whether randomized or not, were eligible for inclusion. The PEDro scale was used to assess the methodological bias of the included studies. Out of the initial 275 titles retrieved, we deemed ten eligible for our study. In terms of body composition, TSG demonstrated a significant decrease in body mass index across three studies (-2.3 to -5.1%) and a significant reduction in waist circumference in four studies (-4.6% to -8.4%). Regarding blood pressure, TSG exhibited a significant decrease in systolic blood pressure in two studies (-3.9% to -8.3%), while diastolic blood pressure showed a significant decrease in only one study (-7.3%). Cholesterol levels saw a significant decrease in TSG in three studies (-7.0% to -9.7%), and triglyceride levels showed a significant reduction in four studies (-16.4% to -20.1%). In terms of aerobic fitness, TSG demonstrated within-group improvements in the field-based tests in three studies (8.1% to 79.0%), and within-group improvements in maximal oxygen uptake in four studies (6.5% to 31.0%), with significant favoring of TSG in most studies. Overall, TSG demonstrated significant benefits for overweight and obese populations compared to the control group, particularly in terms of improvements in body mass index, systolic blood pressures, cholesterol and triglyceride levels, and aerobic fitness. Future research ought to concentrate on tailoring responses to varying training volumes on an individualized basis.
PubMed: 38952914
DOI: 10.5114/biolsport.2024.134762 -
Biology of Sport Jul 2024This systematic review and meta-analysis aimed to determine the effect of combined beta-alanine (BA) and sodium bicarbonate (SB) supplementation on exercise capacity and... (Review)
Review
This systematic review and meta-analysis aimed to determine the effect of combined beta-alanine (BA) and sodium bicarbonate (SB) supplementation on exercise capacity and performance. Four databases (PubMed, SPORTDiscus, Web Of Science and MEDLINE) were searched using relevant terms for studies involving healthy (e.g. no chronic diseases or conditions) male or female adults of any training status (athletes, physically active and non-athletes) and that investigated BA and SB in isolation and combination at any dose on an exercise outcome. Ten studies, totalling 243 individuals, met the criteria with 12 outcomes for each nutritional supplement. No ergogenic effect was detected in this meta-analysis for BA (SMD = 0.18, 95% CI: -0.06; 0.43, p = 0.13, tau = 0, tau = 0, I = 0.0%) or SB (SMD = 0.17, 95% CI: -0.08; 0.41, p = 0.16, tau = 0, tau = 0, I = 0.0%) in isolation. However, there was a beneficial effect for the combination of BA and SB (SMD = 0.32, 95% CI: 0.07; 0.57, p = 0.02, tau = 0, tau = 0, I = 0.0%). Meta-regression identified no differences between supplementing with BA or SB separately (F = 0.58; p = 0.57). Combining BA and SB improved exercise performance, however, there was no benefit in taking these supplements individually.
PubMed: 38952910
DOI: 10.5114/biolsport.2024.132997 -
Biology of Sport Jul 2024The aim of this study was to systematically review the current literature on blood flow restriction (BFR) as a post-exercise recovery strategy. Experimental studies... (Review)
Review
The aim of this study was to systematically review the current literature on blood flow restriction (BFR) as a post-exercise recovery strategy. Experimental studies investigating the effect of BFR on recovery after exercise were included. Only studies meeting the following inclusion criteria were selected: (a) studies investigating about BFR as a post-exercise recovery strategy in athletes and healthy individuals; (b) the full text being available in English; (c) experimental research study design. Studies that exclusively analyzed BFR as a recovery strategy during the exercise (e.g., recovery strategy between bouts of exercise) were excluded. A literature review was conducted on the PubMed, Cochrane, and Web of Science electronic databases up until May 7, 2023. The main findings were that (i) 9 studies investigated passive BFR as a post-exercise recovery strategy, which shows a significant lack of research in both team and individual sports (especially in female populations), and only 2 studies used active BFR protocols; (ii) although a high quality range of studies was observed, there were methodological limitations such as BFR interventions that were usually conducted after fatiguing protocols or fitness tests, which may not represent the real exercise (e.g., a sprint session of 6 sets of 50 m may induce muscle damage but it does not represent the demands of a team sport like rugby or soccer); (iii) there is a lack of consistency in BFR protocols (e.g., number of cycles or duration of the occlusion-reperfusion periods) for recovery; (iv) some studies showed beneficial effects while others found no positive or detrimental effects of BFR as a post-exercise recovery strategy in comparison with the control/SHAM group. In conclusion, only 11 studies investigated BFR as a post-exercise recovery strategy and there is not any significant amount of evidence in team or individual sports (especially in female populations). BFR could be a potential post-exercise recovery strategy, but practitioners should use caution when applying this method of recovery for their athletes and clients. In addition, it would be of interest for high performance-related practitioners to have a better understanding of the benefits of BFR interventions combined with either active or passive forms of exercise as a post-exercise recovery strategy.
PubMed: 38952909
DOI: 10.5114/biolsport.2024.133664 -
Frontiers in Psychology 2024Aerobic exercise (AE) interventions are beginning to be used as an emerging adjunctive treatment modality in the treatment of children with Attention Deficit...
OBJECTIVE
Aerobic exercise (AE) interventions are beginning to be used as an emerging adjunctive treatment modality in the treatment of children with Attention Deficit Hyperactivity Disorder (ADHD). However, to date, there is no substantial evidence to support the improved effects of aerobic exercise intervention in children with ADHD aged 6-12 years. This study aims to investigate the effect of aerobic exercise therapy on executive function in children with attention deficit hyperactivity disorder aged 6-12 years.
METHOD
We conducted a systematic review and meta-analysis using PubMed and Web of Science. The cut-off date was June 1, 2023. The aim was to assess the impact of aerobic exercise interventions on children with ADHD and all randomized controlled trials eligible for aerobic exercise interventions for children with ADHD were included. Nine randomized controlled trials were screened for eligibility for systematic evaluation, and the nine studies were assessed for risk of bias using the PEDro score and the GRADE Quality of Evidence Evaluation System for quality grading of outcome indicators. After testing for heterogeneity, a random-effects model was selected for analysis. Finally, meta-analyses and regression analyses were performed on the core functions (inhibitory control, cognitive flexibility, and working memory) and subgroups of the nine studies on executive function using Revman 5.4 and Stata 16.0.
RESULTS
The risk of bias evaluation showed a mean PEDro score of 7.78, and of the nine studies, two were rated as having excellent methodological quality, while the remaining seven had a good level of evidence, and the GRADE evidence evaluation showed that the outcome indicators were all of moderate quality. Inhibitory control [SMD = 0.83,95% CI (0.37-1.29), Z = 3.51, = 0.0005], cognitive flexibility [SMD = 0.65,95% CI (0.37-0.93), Z = 4.58, < 0.00001], and working memory [SMD = 0.48,95% CI (0.02-0.95), Z = 2.03, = 0.04] were statistically significant, with effect sizes of moderate or higher; furthermore, in subgroup analyses type of intervention, duration, intensity, and medication use had different effects on inhibitory control and cognitive flexibility, and the combined IC, CF statistic found that a single category of aerobic exercise ( = 0.867, < 0.001), moderate intensity ( = 0.928, < 0.001), 6-12 weeks (β = 0.804, < 0.001), 60-90 min ( = 0.894, < 0.001), and the use of medication ( = 1.202, = 0.002) were better for overall improvement in EF.
CONCLUSION
Aerobic exercise therapy significantly improved executive functioning in children with ADHD, showing above moderate effect sizes especially in inhibitory control, cognitive flexibility, and working memory. Aerobic exercise therapy can be used as a reference in improving executive function in children with ADHD, but given the limitations of this study, it should be used with caution when applied in clinical settings.
PubMed: 38952825
DOI: 10.3389/fpsyg.2024.1376354 -
Health Science Reports Jul 2024Multicomponent exercise interventions are recommended for older adults and for those with chronic diseases. While multiple programs have been tested, no one has yet...
BACKGROUND AND AIMS
Multicomponent exercise interventions are recommended for older adults and for those with chronic diseases. While multiple programs have been tested, no one has yet explored how these programs were developed. This review set out to determine what development steps multicomponent exercise intervention studies that include older adults with multimorbidity have taken.
METHODS
Systematic review and narrative synthesis.
RESULTS
One hundred and thirty-eight studies meeting review criteria (: adults ≥60 years with multimorbidity; : exercise interventions with ≥2 components; : any considered; : any considered) were retrieved. Most studies (70%) do not report intervention development actions as suggested by available guidance. Notable deviations from recommendations include limited performance of systematic review of previously published evidence, lack of engagement with theory, and few examples of design then refine.
CONCLUSIONS
Exercise interventions for older adults with multimorbidity do not appear to follow best practice in terms of their developing. Disregard of development recommendations risks contributing to research redundancy and/or avoidable waste, as important steps that make sure the intervention is warranted, suitable for the population in question, and tested using optimal methods and outcome measures are overlooked.
PubMed: 38952403
DOI: 10.1002/hsr2.2190