This study investigates the extent to which different genotypes can explain changes in body mass following an 8-week running program, in a UK population. Participants were randomly assigned to either a training (n = 17) or control group (n = 21). Participants' diets were not altered, only the exercise regime was manipulated to isolate effects. The exercise group completed a periodized running program consisting of 20-30 min, over an agreed route, three times per-week, whilst the control groups refrained from daily exercise. Participants were screened at the end of the study for 1,000 gene variants using a DNA test kit. Results demonstrated a significant reduction in body mass, within the exercise, compared to the control group (p = .002). This reduction in body mass varied significantly (p = .024) between individuals within the exercise group. Moreover, genetic analysis identified 17 single nucleotide polymorphisms (SNPs) associated with this variation (r2 = .74; p < .001). These findings indicate that individuals with specific alleles are better predisposed to weight-management, compared to their counterparts, following an exercise program. This study helps to bridge the gap between population health and exercise science and can inform research in the application of genetics to help develop individually tailored health interventions.

Metabolic syndrome increases the risk of developing noncommunicable diseases such as metabolic dysfunction-associated steatotic liver disease. The aim was to investigate the effects of sedentary behavior (SB) reduction on liver glucose uptake (LGU), endogenous glucose production (EGP), liver fat content (LFC), and liver enzyme levels [alanine aminotransferase (ALT), aspartate aminotransferase, and γ-glutamyltransferase]. Forty-four sedentary (daily SB time ≥ 10 h), physically inactive middle-aged adults with metabolic syndrome were randomized into intervention (INT; n = 23, 21 completed) and control (CON; n = 21, 19 completed) groups. For 6 mo, INT aimed to limit SB by 1 h/day, whereas CON aimed to maintain usual habits. SB and physical activity (PA) were measured continuously with hip-worn accelerometers. Before and at the end of the intervention, LGU was measured using positron emission tomography during the hyperinsulinemic-euglycemic clamp. EGP was calculated, and LFC was measured by magnetic resonance spectroscopy. INT reduced SB by 51 [95% confidence interval (CI): 22, 78] min/day and increased moderate-to-vigorous physical activity (MVPA) by 22 (95% CI: 12, 33) min/day, with no significant change in CON. Differences in liver health markers between the groups were not significant. However, according to the exploratory analyses among participants who successfully reduced SB, ALT decreased (-1.1 [95% CI: 0.93, 1.36] U/L) compared with the continuously sedentary participants (+0.8 [95% CI: 0.65, 1.05] U/L) (group × time, P = 0.006). To enhance liver health, reducing SB for longer durations and/or increasing the intensity of PA may be necessary. However, successfully reducing SB may lead to better levels of circulating ALT liver enzymes.NEW & NOTEWORTHY Aiming to reduce sedentary behavior (SB) by 1 h/day did not significantly influence liver health markers, suggesting that more substantial reductions or a different approach might be necessary to see improvements. However, achieving the desired behavioral change could lead to improvements in ALT levels. This study is the first to analyze how reducing SB and replacing it with nonguided physical activity impacts liver health in adults with metabolic syndrome, offering insights for future intervention strategies.

Most forms of obesity are associated with chronic diseases that remain a global public health challenge.

Despite significant advancements in understanding its pathophysiology, effective management of obesity is hindered by the persistence of knowledge gaps in epidemiology, phenotypic heterogeneity and policy implementation.

This consensus statement by the European Society for Clinical Investigation identifies eight critical areas requiring urgent attention. Key gaps include insufficient long-term data on obesity trends, the inadequacy of body mass index (BMI) as a sole diagnostic measure, and insufficient recognition of phenotypic diversity in obesity-related cardiometabolic risks. Moreover, the socio-economic drivers of obesity and its transition across phenotypes remain poorly understood.

The syndemic nature of obesity, exacerbated by globalization and environmental changes, necessitates a holistic approach integrating global frameworks and community-level interventions. This statement advocates for leveraging emerging technologies, such as artificial intelligence, to refine predictive models and address phenotypic variability. It underscores the importance of collaborative efforts among scientists, policymakers, and stakeholders to create tailored interventions and enduring policies.

The consensus highlights the need for harmonizing anthropometric and biochemical markers, fostering inclusive public health narratives and combating stigma associated with obesity. By addressing these gaps, this initiative aims to advance research, improve prevention strategies and optimize care delivery for people living with obesity.

This collaborative effort marks a decisive step towards mitigating the obesity epidemic and its profound impact on global health systems. Ultimately, obesity should be considered as being largely the consequence of a socio-economic model not compatible with optimal human health.

This systematic review and meta-analysis aimed to examine and critically analyze evidence on the effects of CrossFit® in individuals with overweight or obesity. A search was conducted in four databases (Scopus, WOS, SPORTDiscus, and MEDLINE/PubMed) covering publications from their inception to November 2024. Ten RCTs were analyzed. CrossFit® groups showed significant reductions in weight [six studies; n=161; Hedges' g: -0.76 (95%CI: -1.51, -0.02); p=0.008] and body mass index (BMI) [five studies; n=61; Hedges' g: -0.71 (95%CI: -1.45, 0.02); p=0.007]. However, changes in weight [six studies; n=320; 93% men; Hedges' g: 1.55 (95%CI: -0.66, 3.76); p=0.071] and BMI [five studies; n=120; Hedges' g: 1.24 (95%CI: -0.81, 3.29); p=0.094] were not significantly different compared to control groups. CrossFit® is a feasible option for improving body composition, metabolic health, and cardiorespiratory fitness in this population. However, its impact on blood pressure is inconclusive, and its effects on weight and BMI are comparable to traditional exercise modalities.

Due to the nature of their activities, housewives are often at higher risk of weight gain. Considering the importance of interventions and the role of housewives in the family, the present study was designed and conducted to examine the impact of training based on the Transtheoretical Model on increasing physical activity in overweight and obese housewives.

This quasi-experimental study was conducted on 120 overweight and obese housewives attending comprehensive health centers in Yazd, Iran. The sampling method was multi stage, and participants were randomly assigned to two groups: intervention (60 participants) and control (60 participants). The educational intervention consisted of six 90-minute sessions held over one and a half months (one session per week) in person. The educational content provided to the intervention group was based on the Transtheoretical Model. Data collection tools included standardized physical activity and behavior change questionnaires based on the Transtheoretical Model, Data were analyzed using SPSS version 27 with paired t-tests, independent t-tests, and chi-square tests.

Independent t-test results showed after the intervention, the differences between two group were statistically significant (P = 0.001). Additionally, independent t-test results showed no significant difference in physical activity levels between the intervention and control groups before the educational intervention (P = 0.312), whereas the difference became statistically significant after the intervention (P = 0.001).

The findings of this intervention demonstrated that interventions based on the Transtheoretical Model effectively improve behavior, identify barriers and benefits of physical activity, and enhance self-efficacy in overweight and obese housewives. This study revealed that the Transtheoretical Model, through identifying perceived barriers and benefits (via the training provided) and, most importantly, improving self-efficacy and behavior, led to an increase in physical activity among housewives.

Preclinical and clinical investigations have revealed the metabolic health benefits of gamma-aminobutyric acid (GABA) supplementation. Exercise training is widely acknowledged for its positive effects on the health of individuals with obesity.

To investigate the effects of combined GABA supplementation and exercise training on the body composition, nutritional intake, physical performance, and serum biomarkers of women with obesity.

Twenty-six women with obesity were investigated in this randomized, double-blind, placebo-controlled trial. They received daily GABA (200 mg) supplementation for 90 days alongside exercise training (3 days/week).

For intragroup comparisons hand grip improved in both groups (placebo, p = 0.00276; GABA, p = 0.00012), while sit-up performance increased only in the GABA group (p = 0.00664). Body mass index (p = 0.01273) and waist circumference (p = 0.01393) decreased in the GABA group. In the placebo group, body mass (p = 0.02956), fat-free mass (p = 0.00344), and basal metabolic rate (BMR) (p = 0.00386) decreased, while body fat increased (p = 0.02666). There were no differences in daily macronutrient intake, BMR, body mass, body fat, fat mass, fat-free mass, hip circumference, waist-hip ratio, blood pressure, heart rate, or serum levels of glucose, triglycerides, leptin, resistin, chemokine (C-C motif) ligand 2, chemokine ligand 16, and growth hormone between groups.

GABA supplementation combined with exercise training enhanced physical performance, accompanied by modest improvements in body composition, with no adverse effects on nutritional, physiological, or blood serum parameters.

https://ensaiosclinicos.gov.br/rg/RBR-8t7h259.

We assessed changes in body composition following tirzepatide treatment in a substudy of participants with obesity or overweight from the SURMOUNT-1 trial, overall and post hoc in clinically relevant subgroups.

Substudy participants (n = 160 of the 2539 in SURMOUNT-1) underwent dual-energy X-ray absorptiometry (DXA) at baseline and Week 72. Body composition parameters were evaluated by analysis of covariance, logistic regression or Fisher's exact test. Post hoc subgroup analyses were conducted by sex (female or male), age (<50, 50 to <65, or ≥65 years) and total body weight reduction tertiles (≤15.3 kg, >15.3 to ≤25.9 kg, or >25.9 kg).

The 160 participants (pooled tirzepatide doses n = 124, placebo n = 36) with baseline and end of study DXA data were 73% female and had a mean weight of 102.5 kg and body mass index of 38.0 kg/m2. The change in body weight, fat mass and lean mass from baseline to Week 72 was -21.3%, -33.9% and -10.9% with tirzepatide and -5.3%, -8.2% and -2.6% with placebo, respectively (p < 0.001 for all comparisons). Of the body weight lost, approximately 75% was fat mass and 25% was lean mass for both tirzepatide and placebo. These proportions remained consistent across most subgroup analyses.

In participants with obesity or overweight from the SURMOUNT-1 trial, tirzepatide treatment significantly reduced body weight, fat mass and lean mass compared with placebo, while in post hoc analyses, the proportion of body weight lost as fat or lean mass was relatively consistent including in clinically relevant subgroups.

Today, there are many discussions about the best way to maintain weight and prevent weight regain after a period of weight loss.

The aim of this study was to summarize, based on data from randomized clinical trials (RCTs), the impact of nonsurgical interventions for adults' weight loss maintenance.

The Medline (PubMed), Scopus, and Web of Science databases were reviewed during June 2023.

Meta-analyses assessing the impacts of nonsurgical interventions for weight loss maintenance were conducted. Effect sizes of nutritional interventions were recalculated by applying a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluation framework was implemented to determine evidence certainty.

Meta-analysis of data from a total of 56 RCTs (n = 13 270 participants) represented a significant weight reduction after behavior and lifestyle interventions (mean difference [MD], -0.64 kg [95% CI, -1.18 to -0.09]; I2 = 89.5%; P < .001 for heterogeneity). Pharmacological interventions had also a significant effect on weight change during the weight maintenance phase (MD, -2.57 kg [95% CI, -3.12 to -2.02]; I2 = 91.6%; P < .001 for heterogeneity). The weight loss reduction from pharmacological interventions was greater with sibutramine (MD, -2.57; 95% CI: -3.12 to -2.02). Additionally, diet intervention and dietary and physical activity strategies were associated with a negligible trending decrease in weigh regain (respectively: MD, -0.91 kg [95% CI, -2.18 to 0.36], I2 = 55.7%, P = .016 for heterogeneity; and MD, -0.3 kg [95% CI, -4.13 to 3.52], I2 =  94.1%, P < .001).

The findings of this review indicate there is a favorable impact of behavior-based interventions and antiobesity medications on weight maintenance.

PROSPERO registration no CRD42023468056.

Elevated blood pressure variability (BPV) is an emerging independent risk factor for increased cardiovascular diseases (CVD). Many studies are exploring the impacts of regular physical exercise on reducing BPV. This study aimed to investigate whether exercise can be an intervention to control for the short-term and long-term BPV. A literature search was conducted on MEDLINE, Embase, and PsycINFO on February 10, 2025. The clinical trials and other observational studies that investigated the effects of exercise on systolic and diastolic BPV were included. There were no limitations on age, blood pressure (BP) category, or the use of antihypertensive medication. Mean differences and standard deviations (SDs) of the BPV measurements were extracted to derive standardized mean differences (SMD) with a 95% confidence interval (CI). The heterogeneity was assessed by I2, and random-effect models were performed. Our search identified 8359 studies, of which 25 studies reported BPV outcomes. Fifteen clinical trials compared the short-term BPV among participants with or without exercise. Exercise interventions can significantly reduce both systolic BPV (SMD [95% CI] = -0.37[-0.61 to -0.12]) and diastolic BPV (-0.48 [-0.72 to -0.23]). The benefits are stronger for those with hypertension. Different types of exercise were compared in the network meta-analyses, and aerobic exercise showed more benefits than other types of exercise to improve BPV, especially on the diastolic BPV when it was compared with no exercise (-2.52 [-4.05 to -0.99]). No evidence was observed for the long-term BPV. Exercise interventions effectively reduce the variability of both systolic and diastolic blood pressure (DBP). Aerobic exercise is shown to be more effective in reducing diastolic BPV versus no exercise.

Alterations in sympathetic nervous activity are evident in response to changes in body weight. Sympathetic nervous activity and sympathetic responses to weight change are regionalized, with alterations in end organ function dependent on the changes occurring in the brain regulatory pathways invoked and in the effector organs engaged. The obesity-induced activation of the sympathetic nervous system likely contributes to the initiation and worsening of cardiometabolic risk factors, including elevated blood pressure, cardiac dysfunction, dyslipidaemia, increased fasting blood glucose, insulin resistance, and non-alcoholic steatohepatitis. Unintended weight loss, as occurs in cachexia, is driven, at least in part, by the activation of sympathetic nervous-stimulated thermogenesis. The complexity of sympathetic nervous regulation renders the use of global measures of sympathetic activity problematic and the development of targeted therapies difficult, but these are not without promise or precedent. Knowledge of the central and peripheral pathways involved in sympathetic nervous regulation has opened up opportunities for pharmacological, surgical, and device-based approaches to mitigating the burden of disease development and progression. In this narrative review, we elaborate on sympathetic activity in response to changes in body weight, the brain pathways involved, and the cardiovascular and metabolic risks associated with perturbations in regional sympathetic activity.

When it comes to nutritional status and physical performance, body composition is significant. Previous research has shown the correlation between body composition and the mismatch between nutrient intake and requirements. However, this paper aims to evaluate the crucial role of lifestyle factors, such as eating behavior and meal timing, in influencing body composition. Lifestyle variables are important because they affect hormone and growth factor imbalances, which can cause changes in protein synthesis or breakdown, insulin resistance, and overeating. These factors collectively affect muscle mass and fat mass, their influence being consistent across juvenile and adult groups, between men and women. Regarding food preferences, sexual dimorphism of adiposity between men and women seems to be a critical determinant. Additionally, chronic stress leads to emotional eating, while enough sleep plays a big role in affecting growth factors and hormone balances, although the research on this subject is as yet scant. Therefore, understanding and modifying lifestyle habits are essential for the improvement of body composition, irrespective of an individual's gender or age.

Physical inactivity is associated with reduced physical fitness (PF) in older women with impaired cardiometabolic health. Although exercise has been shown to improve PF, interindividual variability in response and adaptation changes over time remain unclear. This study evaluated the effects of eight weeks of resistance training (RT) and high-intensity interval training (HIIT) on body composition, isometric strength, and the 6-minute walk test (6MWT) in older women with impaired cardiometabolic health. Additionally, the study explored the reduction of non-responders (NRs) and adaptation changes over time.

This randomized clinical trial involved 36 older women (64 ± 8.4 years; BMI: 31.8 ± 5.5) with impaired cardiometabolic health, divided into RT-G (n = 12; 62 ± 7 years; BMI: 32.2 ± 4.1), HIIT-G (n = 12; 66 ± 10 years; BMI: 31.2 ± 4.1), and CG (n = 12; 64 ± 9 years; BMI: 31.8 ± 6) groups. RT-G performed elastic band exercises, and HIIT-G performed cycle ergometer intervals. BMI, body fat, lean mass, isometric strength, and 6MWT were measured at baseline and at four and eight weeks. The Student's t-test was applied for normally distributed variables and the Mann-Whitney U test for non-normal variables. Intra- and inter-group differences were analyzed using a two-way repeated measures ANOVA, considering group, time, and their interaction. Post-hoc comparisons were conducted using the Bonferroni test. Individual responses (IR) were calculated using the equation proposed by Hopkins: SDIR = √(SDExp2 - SDCon2). The prevalence of responders (Rs) and non-responders (NRs) was expressed as a percentage, and percentage changes from baseline to weeks four and eight were used to evaluate adaptations dynamics.

By week eight, isometric strength in RT-G significantly improved from 21.3 ± 4.4 to 24.37 ± 3.99 kg (p = 0.027; 95% CI: 1.8, 4.3 kg; Cohen's d = 0.731) and 6MWT distance in HIIT-G increased from 441.0 ± 48.9 to 480.0 ± 53.0 m. (p = 0.002; 95% CI: 22, 55 m; Cohen's d = 0.757). Both protocols reduced NRs for body fat, lean mass, and 6MWT. Responders showed greater adaptations in the first four weeks, stabilizing by week eight.

RT and HIIT improved PF in older women with impaired cardiometabolic health, reducing NRs in terms of body composition and 6MWT over eight weeks, with similar adaptation changes over time among the responders. These findings highlight the importance of individualized exercise interventions to maximize health benefits.

This study was part of a trial registered at ClinicalTrials.gov (ID: NCT06201273). Date: 22/12/2023.

Breast cancer treatments often lead to unfavourable changes in body composition, physical fitness, and quality of life (QoL). We compared the effects of resistance training (RT) and high-intensity interval training (HIIT) on these outcomes in survivors of breast cancer.

Twenty-eight survivors of breast cancer, post-treatment (Stage I-III), aged 55.5 ± 8.8 years and body mass index 27.9 ± 5 kg/m2 were randomly allocated to a 12-week supervised RT (n = 14) or HIIT (n = 14) intervention, 3 days per week. Body composition (dual energy x-ray absorptiometry), upper and lower body muscle strength (1-repetition maximum), cardiorespiratory fitness (CRF) (Ekblom Bak Cycle Test), and QoL domains (EORTC QLQ-C30 and EORTC QLQ-BR45) were assessed at baseline and 12 weeks.

There were no significant differences between groups at baseline. Exercise attendance ranged from 81 to 85%. Between groups, there were significant differences (p ≤ 0.001) after 12 weeks in chest press strength for RT (mean difference [MD] = 4.7 kg) and CRF for HIIT (MD = 1.9 ml/min/kg). Within groups, there were significant improvements (p < 0.05) for % lean mass and % fat mass in both RT and HIIT, as well as for upper and lower body muscle strength, CRF, and QoL domains. No major adverse events were noted.

Both exercise groups improved body composition, physical fitness, and QoL domains over 12 weeks of RT or HIIT, although mode-specific benefits were apparent with more substantial improvements in lean mass and muscle strength with RT and reductions in % fat mass and improved CRF with HIIT. Tailored exercise programs should address the specific health needs of each patient.

This systematic review and meta-analysis examined the relationship between postpartum exercise and maternal postpartum anthropometrics.

Systematic review with random-effects meta-analysis and meta-regression.

Online databases were searched from database inception until 12 January 2024. Randomised controlled trials (RCTs) written in any language were eligible if they contained information on the population (postpartum women and people); intervention (frequency, intensity, duration, volume or type of exercise, alone ('exercise-only') or in combination with other interventions (eg, dietary; 'exercise+cointervention')); comparator (no exercise) and outcomes (anthropometric measures including weight, postpartum weight retention (PPWR), body mass index (BMI), fat mass, lean body mass (LBM), body fat percentage, waist circumference, hip circumference or waist-hip ratio).

64 RCTs (n=12 684 participants) from 20 countries were included. Moderate to high certainty of evidence showed that exercise-only interventions reduced weight by 1.34 kg (18 studies, n=771; 95% CI -2.06 to -0.61, I2 0%), BMI by 0.73 kg/m2 (14 studies, n=662; 95% CI -1.21 to -0.25, I2 60%) and fat mass by 1.55 kg (5 studies, n=135; 95% CI -3.01 to -0.09, I2 0%) compared with no exercise. The duration of the exercise interventions ranged from 3 months to 3 years. Dose-response analysis found 560 MET-min/week of exercise (eg, 120 min/week of brisk walking) was associated with 1 kg/m2 reduction in BMI. Low certainty of evidence showed that exercise-only interventions had no effect on LBM (5 RCTs, n=135; standardised mean difference -0.13; 95% CI -0.48, 0.21, I2 0%) compared with no exercise.

These findings highlight physical activity as an effective intervention to improve postpartum anthropometrics and reduce PPWR.

CRD42022359282.

Population aging is a global phenomenon associated with challenges of physical and cognitive declines, reduced social interaction, and increased risk of mental health issues. Preventive measures to address potential health needs of aging population are essential to promote healthy aging. Physical exercise interventions designed with age-sensitive approach to enhance functional ability and quality of life are essential through community participatory approach. The study aimed evaluation of a multi-component age sensitive home-based physical exercise "Healthy and Active Aging Exercise Protocol (HAAEP)" intervention program on physical health, functional ability, and social interaction among middle-aged to old-aged adults.

A randomized control trial was performed applying a 16-week HAAEP program to evaluate functional health (FH) including anthropometric measures and social interaction among 270 community-based adults aged 40-90 years from rural Sangareddy district, Telangana, India.

The Intervention group (IG) and Control group (CG) exhibited differential progress over time, between the group analysis reported significant improvement in TUG (0.0018), 6MWT (0.0292), IPAQ -PA pattern, (0.0194) IPAQ-Sedentary behavior (0.04), BMI (0.0177), Fat percentage (0.0314), Muscle percentage (0.000), Bone and BMR (0.031). Group-based approach in community-friendly settings showed improvement in social interaction, DSSI (0.0120).

Age-sensitive HAAEP program on functional health with social wellbeing, have shown significant positive effect among adults of different age groups, and will be an effective holistic strategy for healthy and active aging.

Visceral adipose tissue (VAT) is strongly associated with metabolic diseases. Both high-intensity interval training (HIT) and moderate-intensity training (MIT) reduce VAT effectively; however, HIT might mediate greater VAT loss in females. The estrogen receptor α (ERα) pathway may play a key role. The aim of the present study was to confirm the role of adipose/hypothalamic ERα in HIT/MIT-mediated VAT loss, as well as the associated hypothalamic electrophysiology and body catabolism changes in pre- and post-menopausal animal models.

Ovariectomy (OVX) or sham surgeries were conducted to establish pre/postmenopausal female rat models. After distance-matched long-term HIT and MIT interventions, ERα expression in hypothalamic/VAT, as well as food intake, spontaneous physical activity (SPA), VAT mass and morphology, local field potential (LFPs) in paraventricular nuclei (PVN) and excessive post-exercise oxygen consumption (EPOC), were observed. A target chemical block during the post-exercise recovery period was executed to further verify the role of the hypothalamic ERα pathway.

HIT enhanced the expression of ERα in the hypothalamus rather than VAT in the pre-, but not the postmenopausal group, which was accompanied by elevated LFP power density in α and β bands, enhanced EPOC and larger VAT loss than MIT. Chemical blockade of ERα suppressed EPOC and VAT catabolism mediated by HIT.

During the post-exercise recovery period, the hypothalamic ERα pathway involved in HIT induced EPOC elevation and VAT reduction in premenopausal female rats.

Background/Objectives: Fasting and physical exertion positively affect body mass and composition. This study aimed to examine the effects of physical changes induced by eight days of water-only fasting and a physical exertion test and their influence on body satisfaction and body image parameters in middle-aged men. Methods: Fifteen participants were assessed for physical (height, body mass, and body composition) and psychological (body satisfaction, evaluation of body parts, and body image determinants) aspects before and after the fasting intervention, both at rest and post-exercise. Correlation and concordance coefficients were calculated for the analyzed variables. Results: It was found that the fasting intervention led to a reduction in body mass and a favorable shift in body composition, while also increasing satisfaction with one's body and its specific parts. This positively impacted volunteers' self-assessment of their health status. Selected body image parameters remained at an average level for the male population and did not change following the fasting. Attitudes toward body weight control methods and their perceived effectiveness did not change either. Participants favored reducing food intake and eliminating high-calorie products from their diet, rejecting the use pathological methods typically associated with eating disorders. A few associations between physical and psychological aspects of corporeality were observed, whereas significant correlations between satisfaction with body parts and parameters and a positive body image were confirmed. Conclusions: The above suggest that physical conditions and their changes resulting from fasting and physical exertion lead to a positive influence on body satisfaction and its components but do not alter body image.

The science of cardiac rehabilitation and the secondary prevention of cardiovascular disease has progressed substantially since the most recent American Heart Association and American Association of Cardiovascular and Pulmonary Rehabilitation update on the core components of cardiac rehabilitation and secondary prevention programs was published in 2007. In addition, the advent of new care models, including virtual and remote delivery of cardiac rehabilitation services, has expanded the ways that cardiac rehabilitation programs can reach patients. In this scientific statement, we update the scientific basis of the core components of patient assessment, nutritional counseling, weight management and body composition, cardiovascular disease and risk factor management, psychosocial management, aerobic exercise training, strength training, and physical activity counseling. In addition, in recognition that high-quality cardiac rehabilitation programs regularly monitor their processes and outcomes and engage in an ongoing process of quality improvement, we introduce a new core component of program quality. High-quality program performance will be essential to improve widely documented low enrollment and adherence rates and reduce health disparities in cardiac rehabilitation access.

This study aimed to evaluate the impact of Motor Quotient (MQ) physical fitness training on health-related fitness indicators and obesity risk in children aged 7-8 years in Tianjin, China. A total of 60 obese participants were randomly divided into an experimental group (N = 30) and a control group (N = 30). The intervention program focused on improving children's physical, behavioral, and task-related capabilities through structured MQ training. Key results indicated that the experimental group demonstrated significant improvements in Body Mass Index (BMI), with a reduction from 21.28 ± 1.15 kg/m² to 18.86 ± 1.24 kg/m² for boys (p < 0.001) and from 21.04 ± 1.54 kg/m² to 17.47 ± 1.07 kg/m² for girls (p < 0.001). Physical performance metrics improved substantially, including enhanced 2 × 30 m Shuttle Run times (boys: +12.97%, girls: +13.96%, both p < 0.001) and increased Plank duration (boys: +41.36%, girls: +35.26%, both p < 0.01), reflecting improved cardiovascular endurance and core strength. Significant gains were also observed in task-related motor skills, such as Hand-eye Coordination, Behavior Imitation, and Reaction capability (all p < 0.001). Behavioral adaptations included higher scores in exercise behavior (p < 0.01), while strong correlations were found between BMI and cardiovascular fitness indicators, such as the 20 m Backward Run (r = 0.974, p < 0.001). These findings highlight the effectiveness of MQ training in reducing obesity risk and improving multidimensional fitness outcomes. The program demonstrates significant potential as a practical and evidence-based strategy to promote health-related fitness and motor development in children.

This review highlights the impact of weight loss on metabolic dysfunction associated steatotic liver disease (MASLD), formally known as nonalcoholic fatty liver disease (NAFLD), and its progressive form of metabolic dysfunction associated steatohepatitis (MASH), formally known as nonalcoholic steatohepatitis (NASH). The effects of weight loss, as achieved through lifestyle modification, pharmacotherapy, bariatric surgery or endobariatric procedures on MASLD/MASH and hepatic fibrosis are discussed.

Although foundational in the treatment of MASLD/MASH, weight loss through life-style modification is challenging for most patients to achieve and sustain long-term. In patients with MASLD/MASH, a multidisciplinary approach may facilitate success with lifestyle modification, individualized consideration of pharmacotherapies and/or surgical approaches that have potential to lend an improvement in MASLD/MASH. Effective and sustained weight loss improves hepatic steatosis, steatohepatitis and potentially hepatic fibrosis. Improvement in hepatic fibrosis can improve patient-related outcomes associated with complications of advanced hepatic fibrosis or cirrhosis in patients with MASLD/MASH. Identifying risk factors that influence MASLD/MASH and early implementation of therapeutic weight loss strategies may improve chronic liver injury and decrease risk for adverse clinical outcomes related to progressive hepatic fibrosis attributable to MASLD/MASH.

The global prevalence of obesity has more than doubled over the past four decades, currently affecting more than a billion individuals. Beyond its recognition as a high-risk condition that is causally linked to many chronic illnesses, obesity has been declared a disease per se that results in impaired quality of life and reduced life expectancy. Notably, two-thirds of obesity-related excess mortality is attributable to cardiovascular disease. Despite the increasingly appreciated link between obesity and a broad range of cardiovascular disease manifestations including atherosclerotic disease, heart failure, thromboembolic disease, arrhythmias, and sudden cardiac death, obesity has been underrecognized and sub-optimally addressed compared with other modifiable cardiovascular risk factors. In the view of major repercussions of the obesity epidemic on public health, attention has focused on population-based and personalized approaches to prevent excess weight gain and maintain a healthy body weight from early childhood and throughout adult life, as well as on comprehensive weight loss interventions for persons with established obesity. This clinical consensus statement by the European Society of Cardiology discusses current evidence on the epidemiology and aetiology of obesity; the interplay between obesity, cardiovascular risk factors and cardiac conditions; the clinical management of patients with cardiac disease and obesity; and weight loss strategies including lifestyle changes, interventional procedures, and anti-obesity medications with particular focus on their impact on cardiometabolic risk and cardiac outcomes. The document aims to raise awareness on obesity as a major risk factor and provide guidance for implementing evidence-based practices for its prevention and optimal management within the context of primary and secondary cardiovascular disease prevention.

India's nutrition transition has led to an increased burden of overweight/obesity (body mass index of ≥23 kg/m2), driven by lifestyle factors like poor diet, inactivity, and substance use, prompting public health interventions. However, these interventions lack supporting evidence, especially in rural areas, hindering effective strategies for this population. To address this evidence gap, this study used cohort data (baseline: 2018-19, follow-up: 2022-23) from the Birbhum Population Project (West Bengal, India) to analyse lifestyle risk factors and their association with incidence and remission of overweight/obesity among adults aged ≥18 years (sample: 8,974). Modified Poisson regression model was employed to attain the study objective. From 2017-2018 to 2022-2023, the prevalence of overweight/obesity increased from 15.2% (95% CI: 14.1%-16.4%) to 21.0% (95% CI: 19.7%-22.3%) among men and from 24.1% (95% CI: 22.9%-25.2%) to 33.8% (95% CI: 32.5%-35.1%) among women. Overall, 23.0% (95% CI: 21.8%-24.3%) of adults experienced incidence of overweight/obesity, while 13.9% (95% CI: 12.4%-15.6%) experienced remission. Use of motor vehicles among unemployed participants was associated with incident overweight/obesity (relative risk or RR: 1.058; 95% CI: 1.023-1.095; P: 0.001). Vigorous activity at home (including gardening, yard work, and household chores) was linked to higher odds of recovering from overweight/obesity (RR: 1.065; 95% CI: 1.008-1.125; P: 0.025). Frequent tobacco use (often/daily vs. none) was inversely associated with remission of overweight-obesity (RR: 0.689; 95% CI: 0.484-0.980; P: 0.038), as was each 1 ml in alcohol consumption (RR: 0.995; 95% CI: 0.991-0.999; P: 0.022). Discouraging habitual motor vehicle use may help prevent overweight/obesity, while promoting home-based activities may aid remission, particularly for women who are at higher risk for overweight/obesity.

To evaluate the impact of the Mindless to Mindful intervention on fat mass loss in adults.

This was a single-group case study.

A fitness center delivered by certified fitness professionals.

222 adults who participated in M2M as a team or as individuals, and 195 completed the entire intervention (attrition rate = 12.16%).

M2M was an 8-week behavior change intervention with tailored coaching, group moderate-to-vigorous exercise (MVE) and self-regulation techniques.

Participants completed a demographic questionnaire, the Jackson-Pollock 4-site body fat measure, brief self-control scale, self-compassion scale, and a daily exercise log.

Paired sample t-tests were used to determine differences within groups and a one-way ANOVA was used to determine the differences between groups (P-value <.05).

Participants engaged in an average of 4.88 h (SD = 2.04) of MVE per week. There was a significant decrease in fat mass (M = £7.65; P < .001) and increase in self-control (t = 6.248, P < .001, d = .300) and self-compassion (t = 4.314, P < .001, d = .165).

Self-monitoring, group exercise, and individualized coaching can promote self-regulation and fat mass loss.

There are many false hopes around the impact of physical activity and exercise in obesity management, especially regarding weight loss. Narrowly focusing on weight loss only leads to disappointment for patients and practitioners. Indeed, in persons with overweight or obesity, exercise training, specifically aerobic (i.e. endurance) training, is associated with significant additional weight and fat loss compared to the absence of training. However the magnitude of this effect remains modest, amounting to only 2-3 kg additional weight or fat loss on average. We therefore argue that this conversation needs to be re-oriented towards the many potential health benefits of physical activity that can be seen beyond weight loss. Exercise training has been shown to improve the cardiometabolic risk profile by effects including decreasing abdominal visceral fat and improving insulin sensitivity. Aerobic, as well as combined aerobic and resistance (i.e. strength) training, increase cardiorespiratory fitness, a major risk factor for ill health. Resistance training improves muscle strength, another major component of physical fitness, even in the absence of a significant change in muscle mass. Beyond body mass loss, recognizing the broad value of physical activity/exercise in improving health and quality of life of people with obesity is a crucial perspective shift.

As the prevalence of obesity has reached epidemic proportions, its prevalence has also increased among adults living with type 1 diabetes mellitus. Unlike the pathophysiologic relationship between obesity and type 2 diabetes mellitus, the relationship between obesity and type 1 diabetes mellitus, and management of obesity in the setting of type 1 diabetes mellitus, have not been well reviewed. In this article, we discuss the comprehensive management of obesity in adults with type 1 diabetes mellitus, focusing on medical nutrition therapy and adjunct therapies such as weight loss-promoting medications and metabolic/bariatric surgery.

Obesity often coexists with thyroid diseases, and the prevalence of these disorders has been on the rise for years. While hypothyroidism can contribute to excess fat tissue, the relationship between Body Mass Index (BMI) and thyroid function hormones is bidirectional. Research confirms that fat tissue reduction can positively impact thyroid function. Thus, delaying the initiation of therapies beyond substitution treatment to achieve optimal weight reduction in individuals with thyroid dysfunction seems unwarranted. The authors summarize current knowledge on this topic in the article.

Football players require optimal nutrition and physical fitness to enhance their performance and maintain their health. Understanding the relationships among nutritional knowledge, dietary habits, physical health, and substance use in athletes is essential for developing effective strategies. This study investigates these factors in male football players aged 16-33 years.

The study involved 60 male football players from three teams in Liga4Arad. A mixed-methods approach was used, incorporating a self-developed pilot questionnaire and internationally validated instruments. The reliability of the questionnaire was confirmed using Guttman's λ2. The questionnaire assessed nutritional knowledge, eating habits, substance use, and physical health parameters, including body fat percentage and training frequency. Spearman's correlation was used to analyze the data and explore the interrelationships between these factors. It is important to note that the pilot questionnaire used in this study was self-developed and not previously validated in this specific context.

Nutritional knowledge was positively correlated with healthier eating habits (ρ = 0.675, p < 0.001). Intensive training and higher physical activity levels were both associated with improved body composition and lower body fat (ρ = 0.341, p = 0.006). Supplement use was moderately correlated with alcohol consumption (ρ = 0.548, p < 0.001) and weakly correlated with smoking (ρ = 0.348, p = 0.007).

The study highlights a strong relationship between nutritional knowledge and healthier eating habits among football players, as well as the significant role of frequent intense training in reducing body fat percentages and enhancing physical fitness. Additionally, the findings suggest a moderate association between dietary supplement use and alcohol consumption, underscoring the need for tailored interventions to address substance use and its impact on players' health behaviors and performance.

Diabetes is an independent risk factor for muscle mass loss, with possible mechanisms including impaired insulin signalling and chronic inflammation. The use of a glucagon-like peptide 1 (GLP-1) receptor-based agonist could lead to weight reduction, which might result from the loss of both fat and skeletal muscle. However, the body composition-modifying effects of GLP-1 receptor-based agonists have not been systematically characterized.

PubMed, EMBASE, the Cochrane Center Register of Controlled Trials for Studies and Clinicaltrial.gov were searched from inception to October 2023. Randomized controlled trials of GLP-1 receptor agonist or glucose-dependent insulinotropic polypeptide/GLP-1 receptor dual agonist, which reported the changes of body composition, were included. The results were computed as weighted mean differences (WMDs) and 95% confidence intervals (CIs) in a random-effects model.

In all, 19 randomized controlled trials were included. When compared with controls, substantial reductions in fat body mass were observed in patients using GLP-1 receptor-based agonist treatment (WMD = -2.25 kg, 95% CI -3.40 to -1.10 kg), with decrease in areas of both subcutaneous fat (WMD = -38.35 cm2, 95% CI, -54.75 to -21.95 cm2) and visceral fat (WMD = -14.61 cm2, 95% CI, -23.77 to -5.44 cm2). Moreover, greater reductions in lean body mass were also observed in GLP-1 receptor-based agonist users compared with non-users (WMD = -1.02 kg, 95% CI, -1.46 to -0.57 kg), while the changes in lean mass percentage were comparable between GLP-1 receptor-based agonist users and non-users.

Compared with the controls, GLP-1 receptor-based agonist users experienced greater reductions in fat body mass, with body shaping effects in terms of both subcutaneous fat mass and visceral fat mass. Although greater reductions in lean body mass were also observed in GLP-1 receptor-based agonist users, the changes in lean mass percentage were comparable between the users and non-users.

Exercise promotes immunometabolic health and is increasingly recognized as an effective depression treatment. Exercise may be beneficial for patients with immunometabolic depression (IMD), who experience inflammatory and metabolic dysregulations and may respond less to antidepressants. This secondary analysis of the MOTAR study compared the effects of running therapy and antidepressants on IMD features among patients with depression and/or anxiety disorder. We additionally assessed whether baseline IMD moderated intervention effects on depression.

Participants received 16 weeks of group-based running therapy (N = 96) or escitalopram/sertraline (N = 45) in a partially randomized patient preference design. IMD features included atypical, energy-related symptom (AES) severity, inflammation index (CRP, IFN-γ, IL-6, TNF-α), metabolic syndrome index, three metabolite principle components (PC) (derived from 73 metabolites) and a composite IMD index.

Interventions differed in changes in the metabolic syndrome index (d = 0.59, p = 0.026) and IMD index (d = 0.85, p < 0.001). While running therapy decreased both outcomes, the antidepressant group showed an increased IMD index. Although groups did not differ statistically significant in changes in AES severity, inflammation index, and metabolite PC1, results indicated a consistent trend towards greater improvement with running therapy across these outcomes as well (d = 0.38 to 0.52). Baseline IMD did not moderate intervention effects on depression outcomes.

This study suggests that exercise more effectively targets the IMD dimension than antidepressants. Patients with IMD did not benefit more from running therapy than antidepressants in terms of reductions in depression. Exercise should be considered an alternative or complementary treatment to particularly reduce IMD features in depressed patients.

Trialregister.nl Number of identification: NTR3460.

Premenopausal women and endurance-trained individuals of either sex have reduced cardiovascular disease (CVD) risk. Endurance training shifts fuel selection towards fats to spare carbohydrates; interestingly, women prioritize fats as an energy resource more than men do during exercise. Relying on fats during exercise drives whole-body lipolysis and promotes lipid uptake and oxidation capacity in skeletal muscles. These metabolic adaptations during exercise result in protection against diet-induced obesity, a healthy body fat distribution, and reduced plasma triacylglycerol (TG) concentrations. Here, we analyze how sex differences and endurance training mediate changes in skeletal muscles, including exercise-induced lipolysis, lipid uptake and β-oxidation, intramuscular TG storage, and postexercise lipid metabolism, and discuss how regulating this processes affects CVD risk.

This study examined the effect of obesity on lung ventilation function in middle-aged and older adults using data from the China Health and Retirement Longitudinal Study. Lung function was measured using peak expiratory flow, and obesity was assessed using waist circumference and body mass index (BMI). Logistic regression and the bivariate logit model were applied to analyze the data. Among the 5631 participants, 727 were obese, 1,801 had central obesity, and 2,859 had poor pulmonary function. Individuals with obesity had a higher risk of poor pulmonary ventilation (OR = 1.869, p < 0.001) and a 12.3% decrease in the probability of good lung function (dy/dx = -0.123, p < 0.001). Moreover, individuals with a higher abdominal circumference had an increased risk of poor pulmonary ventilation (OR = 1.842, p < 0.001) and a 12.1% decrease in the probability of good lung function (dy/dx = -0.121, p < 0.001). This study indicates a negative association between obesity and lung ventilation function.

Current guidance on the duration of aerobic exercise recommended in existing guidelines comes primarily from individual trials. Meta-analyses are lacking to examine the dose-response association of aerobic exercise with adiposity measures.

To clarify the dose-response association of aerobic exercise with adiposity measures.

PubMed, Scopus, the Cochrane Central Register of Controlled Trials, and gray literature sources (ProQuest and ClinicalTrials.gov) from inception to April 30, 2024.

Randomized clinical trials with intervention durations of at least 8 weeks evaluating the effects of supervised aerobic training on adults with overweight or obesity.

The PRISMA guidelines were followed to report the results of the meta-analysis. Data extraction was conducted by 2 teams of 2 reviewers each, working independently and in duplicate. Random-effects meta-analyses were performed to estimate mean differences and 95% CIs for each 30-minute per week aerobic exercise and to clarify the shape of the curvilinear associations.

Measures of body weight, waist circumference, body fat, adverse events, medication use reduction, and health-related quality of life score. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool, with a range from very low to high certainty.

In total, 116 randomized clinical trials involving 6880 participants (4199 [61%] female; mean [SD] age, 46 [13] years) with overweight or obesity were included. Each 30 minutes per week of aerobic exercise was associated with reduced body weight by 0.52 kg (95% CI, -0.61 to -0.44 kg; n = 109 trials, GRADE = moderate), waist circumference by 0.56 cm (95% CI, -0.67 to -0.45 cm; n = 62 trials, GRADE = high), body fat percentage by 0.37% (95% CI, -0.43% to -0.31%; n = 65 trials, GRADE = moderate), as well as the areas of visceral (mean difference, -1.60 cm2 [95% CI, -2.12 to -1.07 cm2]; n = 26 trials, GRADE = high) and subcutaneous (mean difference, -1.37 cm2 [95% CI, -1.82 to -0.92 cm2]; n = 27 trials, GRADE = moderate) adipose tissues. Aerobic exercise was associated with modestly increased physical (standardized mean difference, 1.69 SD [95% CI, 1.18-2.20 SD]) and mental (standardized mean difference, 0.74 SD [95% CI, 0.29-1.19 SD]) aspects of quality of life (1 trial with 80 participants, GRADE = low). It was associated with modestly increased mild to moderate adverse events, which were mostly musculoskeletal symptoms (risk difference, 2 more events per 100 participants [95% CI, 1 to 2 more]; GRADE = low). Dose-response meta-analyses indicated that body weight, waist circumference, and body fat measures decreased linearly or monotonically in association with increasing duration of aerobic exercise to 300 minutes per week, with aerobic exercise lasting 150 minutes per week at moderate to vigorous intensities resulting in clinically important reductions in waist circumference and body fat.

In this meta-analysis of randomized clinical trials, engaging in 30 minutes of aerobic exercise per week was associated with modest reductions in body weight, waist circumference, and body fat measures among adults with overweight or obesity. However, aerobic training exceeding 150 minutes per week at moderate intensity or greater may be needed to achieve clinically important reductions.

To explore the correlation between the risk of ischemic stroke and related risk factors in a health examination population.

This was a retrospective study. A total of 300 subjects undergoing health examination in the physical examination center of Baoding NO.1 Central Hospital were selected from January 2023 to December 2023, and divided into the normal group (Group-N) and the risk group according to the criteria of cerebral hemodynamic integral value(CVHI). The risk group was further subdivided into three groups, including the high-risk group(Group-H), the medium-risk population(Group-M), and the low-risk group(Group-L), with 75 subjects in each group. The general data, including BMI, smoking, and the incidence of hypertension, diabetes, and hyperlipidemia, were analyzed and compared between the two groups.

Multivariable logistic regression analysis was conducted using stroke risk factors as the dependent variables after assignment, and it was found that BMI, smoking, hypertension, diabetes, hyperlipidemia, and hyperuricemia were independent risk factors for ischemic stroke (P<0.05); the incidence of obesity and overweight, smoking, hypertension, hyperlipidemia, and hyperuricemia were significantly increased in Group-H compared with those in groups M, L, and N, with statistically significant differences(P<0.05). The chi square test showed statistically significant differences in the stroke risk factors among different age groups (P<0.05).

The incidence of ischemic stroke risk factors varies among different age groups in the health examination population, and is related to poor lifestyle and underlying diseases.

This research re-evaluates the prevalence of obesity in a cohort of 432 Slovenian adults two years after an initial population-based cross-sectional examination, utilizing the World Health Organization's body mass index (BMI) and total body fat percentage (FAT%) classifications. Herein, a medically approved electrical bioimpedance monitor was used to analyse body composition, and the results revealed a significant increase in the percentage of individuals classified as having overweight or obesity on the basis of BMI, from 40.7% initially to 45.2% at follow-up (FU); however, these percentages were notably higher in males than in females. The increases in body mass, BMI, fat mass, and FAT% were observed mainly in adult females, whereas in adult males, the increases in BM and BMI were attributed to fat-free mass (FFM) rather than fat mass. In this study, BMI was also compared with the FAT% obesity classification, and the BMI classification was shown to result in significantly fewer participants with obesity in both measures. However, the proportion of participants with obesity based on the two classifications did not differ substantially between the initial and FU measurements. In this study, mixed linear models were used to analyse overall trends and subgroup variations and highlight the importance of considering sex, age, and time of measurement when assessing body composition metrics. These findings emphasize the need for personalized health assessments and the importance of measuring body composition to evaluate adult obesity more accurately for both clinical assessments and public health policies. The state, in collaboration with social initiatives and industrial stakeholders, should prioritize these data and advance public health through innovative educational and awareness initiatives that are founded on robust scientific principles and that empower and promote the adoption of a healthy, active lifestyle.

This study aimed to compare the effects of high-intensity interval training (HIIT) combined with resistance training (RT) versus HIIT alone on body composition, cardiorespiratory fitness and glycolipid metabolism in young women with overweight/obesity.

This randomized controlled trial divided 40 subjects into an experimental group (HIIT+RT) and a control group (HIIT). Both groups underwent training three times per week for eight weeks. Body composition, cardiorespiratory fitness and glycolipid levels were assessed before and after the intervention.

The results revealed that compared to baseline, both the experimental and control groups showed significant improvements in body weight, body mass index (BMI), Body fat, waist circumference (WC), waist-hip ratio (WHR), peak oxygen uptake (VO2peak), vital capacity (VC), oxygen pulse (VO2/HR), minute ventilation, resting heart rate, blood oxygen saturation, blood pressure, fasting blood glucose, triglycerides and high-density lipoprotein cholesterol (p<0.05). Additionally, a significant increase in muscle mass and a significant reduction in 2-hour postprandial glucose were observed in the experimental group (p<0.05). Muscle mass (mean difference: 2.75%), VO2peak (mean difference: 1.61 mL/min/kg), VC (mean difference: 334mL), and VO2/HR (mean difference: 0.51mL/beat) showed greater improvement in the HIIT+RT group compared to the HIIT group (p<0.05).

In conclusion, an 8-week regimen of either combined HIIT and RT or HIIT significantly improves body composition, cardiorespiratory fitness and glycolipid metabolism in women with overweight/obesity. However, the combined training appears to offer more benefits than HIIT alone. Further research is needed to evaluate the long-term effects and feasibility of combined training.

https://www.chictr.org.cn/, identifier ChiCTR2300075961.

To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians.

We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool.

MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022.

The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi-experimental study, and one repeated cross-sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36-64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36-64%). Six studies reported changes in glycated haemoglobin (HbA1c) levels, of which two (both cohort studies) reported significantly lower mean HbA1c levels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta-analysis.

Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed.

PROSPERO CRD42021247496 (prospective).

This comprehensive review examines exercise as a therapeutic intervention for managing chronic diseases. It explores the physiological mechanisms behind physical activity's beneficial effects and its impact on various conditions, including cardiovascular disease, diabetes mellitus, obesity, and mental health disorders. Drawing from current literature and research findings, this review highlights how regular exercise significantly reduces mortality rates, improves disease outcomes, and enhances the overall quality of life for those with chronic illnesses. It discusses specific exercise recommendations for different conditions, emphasizing the importance of tailored physical activity programs. The review also addresses exercise's potential as a cost-effective and accessible treatment option, which may complement or, in some cases, reduce the need for pharmacological interventions. Ultimately, this review aims to equip healthcare professionals with a thorough understanding of exercise's therapeutic potential in chronic disease management, supporting the integration of physical activity into comprehensive treatment plans.

Although previous studies have illuminated associations between body mass and physical activity (PA), there have been scant insights regarding the physical, cognitive, and motivational determinants of PA in relationship to body mass. This study aimed to model courses of competencies for health-enhancing PA across the spectrum of BMI.

We used cross-sectional data of 3670 individuals (mean [SD]: BMI, 25.54 [5.71] kg/m2; age, 46.11 [14.96] years) from a large data pooling with 18 primary samples employing the PA-related health competence (PAHCO) instrument. ANCOVA determined differences in 10 PAHCO indicators by BMI categories (underweight, normal weight, overweight, and obesity). Covariate-adjusted multilevel models described the nonlinear courses of the PAHCO indicators across the BMI spectrum.

The levels of all 10 PAHCO indicators differed significantly among the BMI categories (F ≥ 14.8; p < 0.001). All competencies for health-enhancing PA could be best described by cubic functions having their maximum around normal weight while regressing with underweight and with increasing grades of obesity (0.02 ≤ R m arg 2  ≤ 0.31).

This study adds to associations between BMI and PA levels by specifying individuals' multidimensional requirements for health-enhancing PA. The present findings call for an integration of physical, motivational, and cognitive factors in practices of PA promotion and sustainable obesity treatment.

Recent studies have linked sarcopenia development to the hallmarks of diabetes, oxidative stress, and insulin resistance. The anti-oxidant and insulin sensitivityenhancing effects of incretin-based therapies may provide a promising option for the treatment of sarcopenia. This review aimed to unveil the role of oxidative stress and insulin resistance in the pathogenesis of sarcopenia and explore the potential benefits of incretin-based therapies in individuals with sarcopenia.

PubMed, the Cochrane Library, and Google Scholar databases were searched by applying keywords relevant to the main topic, to identify articles that met our selection criteria.

Incretin-based therapies manifested anti-oxidant effects by increasing the anti-oxidant defense system and decreasing free radical generation or by indirectly minimizing glucotoxicity, which was mainly achieved by improving insulin signaling and glucose homeostasis. Likewise, these drugs exhibit insulin-sensitizing activities by increasing insulin secretion, transduction, and β-cell function or by reducing inflammation and lipotoxicity.

Incretin-based therapies, as modulators of oxidation and insulin resistance, may target the main pathophysiological factors of sarcopenia, thus providing a promising strategy for the treatment of this disease.

The science of cardiac rehabilitation and the secondary prevention of cardiovascular disease has progressed substantially since the most recent American Heart Association and American Association of Cardiovascular and Pulmonary Rehabilitation update on the core components of cardiac rehabilitation and secondary prevention programs was published in 2007. In addition, the advent of new care models, including virtual and remote delivery of cardiac rehabilitation services, has expanded the ways that cardiac rehabilitation programs can reach patients. In this scientific statement, we update the scientific basis of the core components of patient assessment, nutritional counseling, weight management and body composition, cardiovascular disease and risk factor management, psychosocial management, aerobic exercise training, strength training, and physical activity counseling. In addition, in recognition that high-quality cardiac rehabilitation programs regularly monitor their processes and outcomes and engage in an ongoing process of quality improvement, we introduce a new core component of program quality. High-quality program performance will be essential to improve widely documented low enrollment and adherence rates and reduce health disparities in cardiac rehabilitation access.

Refugees may have an increased risk of developing overweight/obesity as they often experience a nutritional transition. Because maintaining good cardiorespiratory fitness can help reduce the negative impact of excess weight on overall health, the objective of this study was to examine whether fitness moderates the relationship between weight status and cardiovascular and mental health outcomes in forcibly displaced individuals living in a Greek refugee camp.

A sample of 142 forcibly displaced individuals were recruited. Cardiorespiratory fitness was assessed with the submaximal Åstrand-Rhyming bicycle ergometer test. Blood pressure, blood lipids, blood glucose, and hs-CRP were assessed as physical health outcomes, whereas post-traumatic stress disorder, depression and anxiety symptoms, pain, and quality of life were assessed as mental health outcomes. Main and interaction effects were tested via analyses of covariance (ANCOVAs).

Almost 50% of the participants were overweight/obese, more than 60% presented with very poor fitness levels, and the percentage of participants with very poor fitness levels was particularly high among overweight/obese participants. Whereas overweight/obesity was associated with a less favorable body composition and cardiovascular risk profile, poor fitness was associated with a higher percentage of body fat and a lower percentage of muscle mass. Cardiorespiratory fitness did not moderate the relationship between overweight/obesity and most of the assessed health outcomes.

Only limited support was found for the applicability of the fit-but-fat concept to our population of forcibly displaced individuals. Public health services should prioritize measures to prevent overweight/obesity and associated diseases in refugee camps. Moreover, efforts are needed to improve the fitness of camp residents via exercise/sport interventions.