Validity, reliability, and calibration of the physical activity unit 7 item screener (PAU-7S) at population scale.

BACKGROUND: Validation of self-reported tools, such as physical activity (PA) questionnaires, is crucial. The aim of this study was to determine test-retest reliability, internal consistency, and the concurrent, construct, and predictive validity of the short semi-quantitative Physical Activity Unit 7 item Screener (PAU-7S), using accelerometry as the reference measurement. The effect of linear calibration on PAU-7S validity was tested. METHODS: A randomized sample of 321 healthy children aged 8-16 years (149 boys, 172 girls) from the nationwide representative PASOS study completed the PAU-7S before and after wearing an accelerometer for at least 7 consecutive days. Weight, height, and waist circumference were measured. Cronbach alpha was calculated for internal consistency. Test-retest reliability was determined by intra-class correlation (ICC). Concurrent validity was assessed by ICC and Spearman correlation coefficient between moderate to vigorous PA (MVPA) derived by the PAU-7S and by accelerometer. Concordance between both methods was analyzed by absolute agreement, weighted kappa, and Bland-Altman statistics. Multiple linear regression models were fitted for construct validity and predictive validity was determined by leave-one-out cross-validation. RESULTS: The PAU-7S overestimated MVPA by 18%, compared to accelerometers (106.5 ± 77.0 vs 95.2 ± 33.2 min/day, respectively). A Cronbach alpha of 0.76 showed an acceptable internal consistency of the PAU-7S. Test-retest reliability was good (ICC 0.71 p < 0.001). Spearman correlation and ICC coefficients of MVPA derived by the PAU-7S and accelerometers increased from 0.31 to 0.62 and 0.20 to 0.62, respectively, after calibration of the PAU-7S. Between-methods concordance improved from a weighted kappa of 0.24 to 0.50 after calibration. A slight reduction in ICC, from 0.62 to 0.60, yielded good predictive validity. Multiple linear regression models showed an inverse association of MVPA with standardized body mass index (ß - 0.162; p < 0.077) and waist to height ratio (ß - 0.010; p < 0.014). All validity dimensions were somewhat stronger in boys compared to girls. CONCLUSION: The PAU-7S shows a good test-retest reliability and acceptable internal consistency. All dimensions of validity increased from poor/fair to moderate/good after calibration. The PAU-7S is a valid instrument for measuring MVPA in children and adolescents. TRIAL REGISTRATION: Trial registration number ISRCTN34251612 .

Influence of different types of compression garments on exercise-induced muscle damage markers after a soccer match.

There is not enough evidence of positive effects of compression therapy on the recovery of soccer players after matches. Therefore, the objective was to evaluate the influence of different types of compression garments in reducing exercise-induced muscle damage (EIMD) during recovery after a friendly soccer match. Eighteen semi-professional soccer players (24 ± 4.07 years, 177 ± 5 cm; 71.8 ± 6.28 kg and 22.73 ± 1.81 BMI) participated in this study. A two-stage crossover design was chosen. Participants acted as controls in one match and were assigned to an experimental group (compression stockings group, full-leg compression group, shorts group) in the other match. Participants in experimental groups played the match wearing the assigned compression garments, which were also worn in the 3 days post-match, for 7 h each day. Results showed a positive, but not significant, effect of compression garments on attenuating EIMD biomarkers response, and inflammatory and perceptual responses suggest that compression may improve physiological and psychological recovery.

Using testosterone and cortisol as biomarker for training individualization in elite basketball: a 4-year follow-up study.

The purpose of this study was to determine the responses of testosterone and cortisol, with special reference to playing positions, playing time (PT), and phase of the season. We performed a follow-up study during 4 consecutive seasons to investigate the effects of PT, positional role, and phase of the season on anabolic-catabolic biomarkers (plasma total testosterone -TT- and cortisol -C-) on 20 professional male basketball players (27.0 ± 4.2 years; 24.4 ± 1.2 kg·m). First blood samples were collected right after the off-season period and considered as baseline. Samples were taken periodically every 4-6 weeks, always after a 24- to 36-hour break after the last game played. Statistical procedures were nonparametric mainly. Hormonal status was playing position-dependent, power forward (PF) showed the lowest TT values (median ± interquartile range [IQR]; PF: 18.1 ± 4.9; nmol·L), and small forwards showed the highest ones of cortisol (0.55 ± 0.118 µmol·L). Players who played between 13 and 25 minutes per game showed the highest values of TT (22.8 ± 6.9 nmol·L) and TT/C (47.1 ± 21.2). March and April showed the most catabolic or stressed hormonal state (low TT/C values and high ones of cortisol) and that is necessary to take into account according to PT (>25-minute per game) and specific playing position. Monitoring plasma TT and cortisol is recommended to prevent excessive stress caused by professional basketball season requirements.

Next-generation sequencing reveals that miR-16-5p, miR-19a-3p, miR-451a, and miR-25-3p cargo in plasma extracellular vesicles differentiates sedentary young males from athletes.

A sedentary lifestyle and Olympic participation are contrary risk factors for global mortality and incidence of cancer and cardiovascular disease. Extracellular vesicle miRNAs have been described to respond to exercise. No molecular characterization of young male sedentary people versus athletes is available; so, our aim was to identify the extracellular vesicle miRNA profile of chronically trained young endurance and resistance male athletes compared to their sedentary counterparts. A descriptive case-control design was used with 16 sedentary young men, 16 Olympic male endurance athletes, and 16 Olympic male resistance athletes. Next-generation sequencing and RT-qPCR and external and internal validation were performed in order to analyze extracellular vesicle miRNA profiles. Endurance and resistance athletes had significant lower levels of miR-16-5p, miR-19a-3p, and miR-451a compared to sedentary people. Taking all together, exercise-trained miRNA profile in extracellular vesicles provides a differential signature of athletes irrespective of the type of exercise compared to sedentary people. Besides, miR-25-3p levels were specifically lower in endurance athletes which defines its role as a specific responder in this type of athletes. In silico analysis of this profile suggests a role in adaptive energy metabolism in this context that needs to be experimentally validated. Therefore, this study provides for the first time basal levels of circulating miRNA in extracellular vesicles emerge as relevant players in intertissue communication in response to chronic exercise exposure in young elite male athletes.

Walkability and socio-economic status in relation to walking, playing and sports practice in a representative Spanish sample of youth: The PASOS study.

PURPOSE: Physical activity (PA) provides multiple health-related benefits in children and adolescents, however, at present, the majority of young people are insufficiently physically active. The aim of this study was to evaluate if neighborhood walkability and/or socio-economic status (SES) could affect the practice of walking, play outdoors and sports practice in a representative sample of Spanish children and adolescents. METHODS: A sample of 4092 youth (aged 8-16 years old) from 245 primary and secondary schools in 121 localities from each of the 17 Spanish autonomous communities participated in the study. Walk Score was used to evaluate walkability of the neighborhood and household income was used as an indicator of SES. A 7-item self-reported validated questionnaire, was used to assess PA levels, and in a subsample of 10% of the participants, randomly selected from the entire sample, PA was objectively measured by accelerometers. RESULTS: Youth from more walkable areas reported more minutes walking per day compared with those from less walkable neighborhoods (51.4 vs 48.8 minutes, respectively). The lowest average minutes spent in playing outdoors was found among participants from low-SES and low-walkable neighborhoods. Neighborhood SES influenced on the participation in team sports during the weekend, being this participation higher in high SES neighborhoods. CONCLUSION: Providing high walkable environments seems a good strategy to promote PA regardless SES levels. It seems that improving the walkability is a key component to partially overcome the SES inequalities, especially in urban areas with low SES. High-SES environments can offer better sports facilities and more organized physical activities than low-SES ones.

Circulating plasma levels of miR-106b-5p predicts maximal performance in female and male elite kayakers.

Introduction: Plasma miR-106b-5p levels have been described as an exercise performance predictor in male amateur runners, although no information is available about female athletes. The aim of this study was to analyze the predictive value on sports performance of plasma miR-106b-5p levels in elite female and male kayakers at the beginning and at the end of a training macrocycle, as well as the potential underlying molecular mechanisms using an in silico approach. Materials and Methods: Eight elite male (26.2 ± 3.6 years) and seven elite female (17.4 ± 0.5 years) kayakers from the Spanish national team. Two fasting blood samples were collected, starting point of the season (A) and maximum fitness level (B). Circulating plasma levels of miR-106b-5p were analyzed by RT-qPCR. Maximal 500 m performance was recorded at B. Results and Discussion: miR-106b-5p levels had no differences between A and B neither in women nor in men. In men but not in women, miR-106b-5p levels showed a negative significant correlation with performance in B which highlights its predictive value for performance. However, in women, progesterone emerged as a determinant and the ratio miR-106b-5p/progesterone showed a significant negative correlation with performance. In silico analysis reveals potential targets in a number of genes of relevant to exercise. Conclusions: miR-106b-5p emerges as a biomarker of athletic performance in men and in women, if the menstrual cycle is considered. This highlights the need to analyze molecular response to exercise in men and women separately, and considering the stage of the menstrual cycle in women as a relevant factor.

Independent and Joined Association between Socioeconomic Indicators and Pediatric Obesity in Spain: The PASOS Study.

Childhood obesity is a public health problem worldwide. An important determinant of child and adolescent obesity is socioeconomic status (SES). However, the magnitude of the impact of different SES indicators on pediatric obesity on the Spanish population scale is unclear. The aim of this study was to assess the association between three SES indicators and obesity in a nationwide, representative sample of Spanish children and adolescents. A total of 2791 boys and girls aged 8 to 16 years old were included. Their weight, height, and waist circumference were measured. SES was assessed using two parent/legal guardian self-reported indicators (educational level -University/non-University- and labor market status -Employed/Unemployed-). As a third SES indicator, the annual mean income per person was obtained from the census section where the participating schools were located (≥12.731€/<12.731€). The prevalence of obesity, severe obesity, and abdominal obesity was 11.5%, 1.4%, and 22.3%, respectively. Logistic regression models showed an inverse association of both education and labor market status with obesity, severe obesity, and abdominal obesity (all p < 0.001). Income was also inversely associated with obesity (p < 0.01) and abdominal obesity (p < 0.001). Finally, the highest composite SES category (University/Employed/≥12.731€ n = 517) showed a robust and inverse association with obesity (OR = 0.28; 95% CI: 0.16-0.48), severe obesity (OR = 0.20; 95% CI: 0.05-0.81), and abdominal obesity (OR = 0.36; 95% CI: 0.23-0.54) in comparison with the lowest composite SES category (Less than University/Unemployed/<12.731€; n = 164). No significant interaction between composite SES categories and age and gender was found. SES is strongly associated with pediatric obesity in Spain.

Trends in Adherence to the Mediterranean Diet in Spanish Children and Adolescents across Two Decades.

Unhealthy dietary habits determined during childhood may represent a risk factor to many of the chronic non-communicable diseases (NCDs) in adulthood. Mediterranean Diet (MD) adherence in children and adolescents (8-16 years) living in Spain was investigated using the KIDMED questionnaire in a comparative analysis of two cross-sectional nationwide representative studies: enKid (1998-2000, n = 1001) and PASOS (2019-2020, n = 3540). Taking into account the educational level of pupils, as well as the characteristics of the place of living, a significant association was found between a KIDMED score ≥ 8 (optimal MD adherence) and primary education as well as residency in an area of <50,000 inhabitants, while living in the southern regions was associated with non-optimal MD adherence (p < 0.001). Participants of the 2019-2020 study showed an increase in the consumption of dairy products (31.1% increase), pasta/rice (15.4% increase), olive oil (16.9% increase), and nuts (9.7% increase), as well as a decreased sweets and candies intake (12.6% reduction). In contrast, a significantly lower MD adherence was found when comparing the 2019-2020 (mean ± SE: 6.9 ± 0.04) and the 1998-2000 study (7.37 ± 0.08); p < 0.001), due to less consumption of fish (20.3% reduction), pulse (19.4% reduction), and fruits (14.9% reduction), and an increased intake of commercial goods/pastries or fast-food intake (both 19.4% increase). The lowest adherence was recorded for adolescents also in the most recent study, where 10.9% of them presented a KIDMED score ≤ 3. This study shows that eating habits are deteriorating among Spanish children and adolescents. Such findings point out the urgency of undertaking strong measures to promote the consumption of healthy, sustainable, and non-ultra-processed food, such as those available in an MD, not only at a scientific and academic level, but also at a governmental one.

Urine citrate and 6-sulfatoximelatonin excretion during a training season in top kayakers.

The effects of high training loads during the competitive kayaking season may be reflected in urinary citrate and 6-sulfatoxymelatonin ((α)MT6S) excretion. The present study aims to evaluate the influence of a training program on citrate and (α)MT6S excretion in 12 elite kayakers. Urine samples were collected (before bedtime and again in the morning, at first voiding) at the beginning of the season (second half of October), during the macrocycle (specific training period; first week of June), and tapering (precompetitive training period; first week of July) stages. During the training season, urine citrate values (mg/L) were higher in the evening than in the morning in all stages (p < 0.01). The data obtained in the evening showed the lowest significant values (p < 0.05) in the beginning stage compared with the macrocycle and tapering stages. The values obtained in the morning showed the lowest significance (p < 0.05) in the macrocycle stage compared to the beginning and the tapering stages. In all stages, (α)MT6S (ng/mL) evening values were significantly lower (p < 0.05) than the morning values. The morning/evening ratio, total sum, and nocturnal increment of (α)MT6S did not vary across the training stages. From these results, it can be deduced that the pineal function is unaltered and that citrate turnover is good in elite kayakers during the training season. It was found that urine citrate and (α)MT6S obtained by non-invasive techniques may be used as major markers to evaluate metabolic recovery and stress produced by the training season workload in elite kayakers.

Match Loads May Predict Neuromuscular Fatigue and Intermittent-Running Endurance Capacity Decrement after a Soccer Match.

How the match-derived load metrics relate to post-match fatigue in soccer is scarcely researched. Thus, the aim of this study was to determine the associations between soccer match-related internal and external loads, neuromuscular performance decrease and intermittent-running endurance capacity decrement immediately post-match. Vertical jump (countermovement jump), straight-line sprinting (10- and 20-m sprint), change of direction ability (T-test) and intermittent-running endurance capacity (YO-YO intermittent recovery level 2) were measured one day before and immediately after a friendly match in male soccer players. During the match, players' internal and external loads were also monitored, including heart rate-derived indices, total distance at various speed thresholds, average running velocity, maximal running velocity, number of sprints and number of accelerations and decelerations at various intensity thresholds. The results show that match-induced fatigue was reflected on neuromuscular performance and intermittent-running endurance capacity immediately post-match (p < 0.05). The quantification of percentage change of match external-load metrics, particularly accelerations and decelerations, provides a useful non-invasive predictor of subsequent neuromuscular fatigue status in soccer players immediately post-match (p < 0.05). However, only internal load metrics present a practical application for predicting intermittent-running endurance capacity impairment (p < 0.05). In summary, internal and external load metrics may allow for predicting the extent of acute fatigue, and variability between halves may represent a valuable alternative to facilitate the analysis of match-related fatigue both for research and applied purposes.

Biochemical and Physical Performance Responses to a Soccer Match after a 72-Hour Recovery Period.

The physiological and neuromuscular responses at 72 h post-match are not widely researched, despite evidence showing substantial changes in recovery markers at 72 h post-match. Consequently, the aim of this study was to determine the biochemical and physical performance responses to a soccer match after a 72-h recovery period. Male soccer players of a semiprofessional team participated in this study. Before playing a friendly match, blood values of testosterone, cortisol, the testosterone-to-cortisol ratio and urea were collected and the squat jump and the Bangsbo Repeated Sprint Ability test were performed. These measurements were considered as baseline (pre match) and were obtained again after a 72-h recovery period. Results indicate that physical performance at 72 h post-match was similar to baseline (squat jump: p = 0.974; total Repeated Sprint Ability time: p = 0.381; Repeated Sprint Ability fatigue index: p = 0.864). However, perturbations in the biochemical milieu derived from the soccer match metabolic and physiological stress were still evident at this time point. While no significant differences compared to pre match were obtained in testosterone and urea concentrations after the recovery period, cortisol and testosterone-to-cortisol ratio values were significantly higher (14.74 ± 3.68 µg/dL vs. 17.83 ± 2.65 µg/dL; p = 0.045; ES 0.92 [0.00; 1.84], very likely) and lower (39.08 ± 13.26 vs. 28.29 ± 7.45; p = 0.038; ES -0.96 [-1.89; -0.04], very likely), respectively. In conclusion, soccer players have similar physical performance to the pre match after a 72-h recovery period, even with signs of biochemical and physiological stress.

Injury in CrossFit®: A Systematic Review of Epidemiology and Risk Factors.

OBJECTIVE: To review the characteristics of the injuries among CrossFit® practitioners, including prevalence and incidence, nature, location, and risk factors. METHODS: PubMed/MEDLINE, EMBASE, Web of Science, Scopus, and SPORTDiscus databases were searched from inception through August 2020, and English-language articles reporting on CrossFit®-related injuries were included. Data including sample (sex, age, and demographics) and injuries' characteristics (prevalence, incidence rate, nature, location, percentage of injuries requiring surgery and risk factors) were extracted. RESULTS: Overall, twenty-five studies involving a total of 12,079 CrossFit® practitioners met the inclusion criteria. The mean prevalence of injuries among the included studies was 35.3%, with an incidence rate varying between 0.2 and 18.9 per 1000 hours of training. The most injured areas were shoulder (26%), spine (24%), and knee (18%). Among the studies that reported the injuries requiring surgery, the mean percentage was 8.7%. Regarding the risk factors associated with injuries, older age, male sex, a greater body mass index, the existence of previous injuries, the lack of coach supervision, the experience on CrossFit® and the participation in competitions were reported by the studies. CONCLUSIONS: CrossFit® training has an injury incidence rate similar to weightlifting and powerlifting. Findings from the studies suggest that the most affected areas are shoulder, spine, and knee. The limited quality of the studies prevents us from drawing solid conclusions about injury risk factors.

Injury Characteristics among Young Adults during and Immediately after the COVID-19 Lockdown.

The lockdown due to the COVID-19 pandemic inherently changed people's lifestyles. Forty-eight days of isolation led to worsening physical fitness in addition to the development of other unhealthy habits. The aim of this study was to describe sport-related injuries in the active general population. Physical therapy centres and sports medicine clinics were contacted via e-mail, seeking patients who had sustained an injury during or immediately (up to two weeks) after the lockdown. Patients who agreed to participate completed an online survey that followed the International Olympic Committee Statement. The questionnaire focused on physical exercise habits, type of injury, location and tissue affected. A total of 51 females and 67 males (30.5, SD = 8.8 years) participated in the study. Eighty percent of the participants performed aerobic training sessions, while the rest dedicated their workouts to strength training. Two in every three injuries were located in the lower limbs, and 80% affected the musculoskeletal tissue. Of all the injuries recorded, 67% occurred during the first week after lockdown. The number of aerobic exercise sessions was positively correlated with lower limb injuries (χ2 = 17.12, p < 0.05). Exercise habits should be considered when planning to return to a sport after a period of confinement to avoid injury.

Determinants of Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study.

A progressive shift away from traditional healthy dietary patterns, such as the Mediterranean diet (MedDiet), has been observed in recent decades. The aim of this study was to assess determinants of optimal adherence to the MedDiet in Spanish children and adolescents. A cross-sectional analysis was included in the PASOS nationwide representative study in Spain. Participants were 3607 children and adolescents; 8-16 years old. Primary and secondary outcome measures of weight and height were measured. Adherence to the MedDiet, physical activity, and sedentary behavior in children and adolescents, as well as parental physical activity and dietary habits, were assessed. Optimal adherence to the MedDiet was observed in 45.5% of primary school students and 34.8% of secondary school students (OR: 0.65; 95%CI: 0.56-0.75). Optimal adherence to the MedDiet was higher in children/adolescents meeting daily recommended moderate and vigorous physical activity (OR: 2.39, 95%CI: 1.97-2.89) and in those meeting daily recommended screen time on weekdays (OR: 2.05, 95%CI: 1.77-2.38) and weekends (OR: 1.76, 95%CI: 1.48-2.10). Participants with optimal adherence to the MedDiet were more likely to have mothers with a high-level education and high-tercile of SDQS, mothers who never smoked or were former smokers, and mothers who met the recommended physical activity and screen time. It can be concluded that a low prevalence of optimal adherence to the MedDiet was found among current Spanish children and adolescents. Optimal adherence to the MedDiet was associated with reaching the recommendations on physical activity and screen time, with the highest maternal educational level, and healthier maternal lifestyles.

Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study.

BACKGROUND AND AIMS: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. METHODS: Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. RESULTS: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% 'increased risk', 9.7% 'high risk', 14.3% 'very high risk'). Participants in the 'very high risk' group were less likely to be females (odds ratio 0.63; 95% CI: 0.52-0.76) and adolescents (0.60; 95% CI: 0.49-0.72), to practice ≥60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57-0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49-0.76). Mothers of participants in the 'very high risk' group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the 'increased' and 'high risk' categories had mothers with normal weight and ≥60 min/day of MVPA. Participants in the 'high risk' group did not achieve ≥60 min/day of MVPA and showed lower adherence to the Mediterranean diet. CONCLUSIONS: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring's childhood and adolescence, is associated with low BMI-WHtR disease risk.

Evidence-based post exercise recovery in combat sports: a narrative review.

INTRODUCTION: Some methods such as ergo nutritional aids, cooling or massage among others could improve recovery in combat sports (CS). The effects, doses, duration, and timing of these methods remains unknown. Nowadays, there is no clear consensus regarding the recovery strategies and it is necessary to understand the type of fatigue induced in CS and its underlying mechanisms. The main aim of this article is to review the update literature related to recovery strategies in CS. EVIDENCE ACQUISITION: A literature search was conducted following preferred reporting items for review statement on the topic of: "combat sports," "recovery," "nutrition," "fatigue," "ergogenic aids," "weight cutting" and "hydration." EVIDENCE SYNTHESIS: The initial search of the literature detected 369 articles about CS. Later, 307 were excluded after being determined unrelated to recovery or after failure to fulfill the inclusion criteria. Of the 80 included articles, 19 satisfied the final inclusion criteria. CONCLUSIONS: To optimize CS performance, adequate recovery is required during training and competition processes. Traditional ergo nutritional supplementation of carbohydrates and proteins combined. Besides, the consumption of evidence supported supplementation (green tea, beetroot gels, creatine or alkaline water) improve recovery processes. Further methods of recovery including physical (cold water immersion, massage or photobiomodulation) and physiological (types of active recovery, sleep and rest) therapies have also been shown useful. This narrative review elucidates the important role of recovery techniques in CS.

Post-exercise Recovery Methods Focus on Young Soccer Players: A Systematic Review.

Background: Prescription of post-match or post-training recovery strategies in young soccer players is a key point to optimize soccer performance. Considering that the effectiveness of recovery strategies may present interindividual variability, scientific evidence-based recovery methods and protocols used in adults are possibly not applicable to young soccer players. Therefore, the current systematic review primarily aimed to present a critical appraisal and summary of the original research articles that have evaluated the effectiveness of recovery strategies in young male soccer players and to provide sufficient knowledge regarding the effectiveness of the recovery methods and strategies. Methodology: A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines until November 31, 2020, using the next data bases: WOS, PubMed, Cochrane Library, Evidence Database (PEDro), Evidence Based Medicine (EBM) Search review, EMBASE, and Scopus. There were no filters applied. Results: A total of 638 articles were obtained in the initial search. After the inclusion and exclusion criteria, the final sample was 10 articles focusing on recovery in young male players. Conclusions: Neuromuscular performance can be recovered using WVB but not with SS, and water immersion protocols may also be useful, but their positive effects are not significant, and it is unable to distinguish the best water immersion method; match running performance maintenance may be achieved using water immersion protocols but no other recovery methods have been investigated; EIMD and inflammatory responses could be positively affected when water immersion and AR are applied, although SS seems to be ineffective; perceptual responses also seem to be better with CWI and WVB, but contradictory results have been found when AR is applied, and SS had no positive impact. Finally, it is important to consider that AR strategies may modify HR response and soccer-specific performance.

The Recovery Umbrella in the World of Elite Sport: Do Not Forget the Coaching and Performance Staff.

In the field of sports science, the recovery umbrella is a trending topic, and even more so in the world of elite sports. This is evidenced by the significant increase in scientific publications during the last 10 years as teams look to find a competitive edge. Recovery is recognized to be an integral component to assist athlete preparation in the restoration of physical and psychological function, and subsequently, performance in elite team sports athletes. However, the importance of recovery in team staff members (sports coaches and performance staff) in elite sports appears to be a forgotten element. Given the unrelenting intense nature of daily tasks and responsibilities of team staff members, the elite sports environment can predispose coaches to increased susceptibility to psycho-socio physiological fatigue burden, and negatively affect health, wellbeing, and performance. Therefore, the aim of this opinion was to (1) develop an educational recovery resource for team staff members, (2) identify organizational task-specific fatigue indicators and barriers to recovery and self-care in team staff members, and (3) present recovery implementation strategies to assist team staff members in meeting their organizational functions. It is essential that we do not forget the coaching and performance staff in the recovery process.

Screen Time and Parents' Education Level Are Associated with Poor Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study.

The aim of this study is to evaluate if screen time and parents' education levels are associated with adherence to a Mediterranean dietary pattern. This cross-sectional study analyzed a representative sample of 3333 children and adolescents (8 to 16 years) included in the Physical Activity, Sedentarism, lifestyles and Obesity in Spanish youth (PASOS) study in Spain (which ran from March 2019 to February 2020). Data on screen time (television, computer, video games, and mobile phone) per day, Mediterranean diet adherence, daily moderate or vigorous physical activity, and parents' education levels were gathered using questionnaires. A descriptive study of the variables according to sex and parents' education level was performed. Logistic regression models (adjusted by sex and weight status) were fitted to evaluate the independent association between screen time and Kids' level of adherence to the Mediterranean diet (KIDMED) index, as well as some of its items. A greater amount of screen time was associated with worse adherence to the Mediterranean diet; a lower consumption of fruit, vegetables, fish, legumes, and nuts; and a greater consumption of fast food, sweets, and candies. A lower parents' education level was associated with worse adherence to the Mediterranean diet. It is necessary to promote the responsible, limited use of screen time, especially in children with parents with a lower education level.

Urine melatonin and citrate excretion during the elite swimmers' training season.

The objectives of the study were to evaluate the influence of a whole training season on 6-sulfatoxymelatonin (αMT6s) and citrate excretion in 12 elite swimmers. Urine samples were obtained (before bedtime and after waking up) at the beginning of the season, basic training, macrocycle I, tapering and macrocycle II stages. For αMT6s, at basic training, mainly with aerobic training, the evening concentrations were significantly lower (P < 0.01; P < 0.05) than at the beginning, tapering and macrocycle II stages. At macrocycle II stage, with the maximal training workload, the total sum (evening plus morning) was significantly higher (P < 0.05) than at the beginning, basic training and macrocycle I stages. The ratio (morning/evening) that represents the capacity to produce melatonin at night depending on the evening values at the basic training stage and the nocturnal increment at the macrocycle II stage were significantly higher (P < 0.01) than at all other stages. Citrate morning values at basic training and tapering stages were significantly lower (P < 0.01) than in the evening indicating that a metabolic recuperation took place. The total sum significantly decreased (P < 0.05) as the aerobic training progressed from the beginning to macrocycle I. The basic training ratio (morning/evening) was significantly lower compared to the beginning and macrocycle II stages, and the nocturnal increment was significantly higher (P < 0.05) compared to the beginning. Melatonin and citrate represent complementary markers that could be used to evaluate the assimilation of the training workload by noninvasive methods.