Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Breast cancer survivors with obesity are at a high risk of cancer recurrence, comorbidity, and mortality. This review aims to systematically evaluate the effects of combined aerobic and resistance training (CART) on body composition, lipid homeostasis, inflammation, adipokines, cancer-related fatigue, sleep, and quality of life in breast cancer patients and survivors with overweight/obesity. An electronic search was conducted in PubMed, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases from inception up to January 8, 2024. Randomized controlled trials (RCTs) meeting the inclusion criteria were selected for the analysis. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the quality of evidence. A random-effects model was used, and data were analyzed using mean (MD) and standardized mean differences (SMD) for continuous variables with 95% confidence intervals (CI). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. A total of 17 randomized controlled trials were included in the systematic review involving 1,148 female patients and survivors (mean age: 54.0 ± 3.4 years). The primary outcomes showed significant improvements in body mass index (SMD -0.57 kg/m2, p = 0.04), body fat (SMD -0.50%, p = 0.02), fat mass (SMD -0.63 kg, p = 0.04), hip circumference (MD -3.14 cm, p = 0.02), and fat-free mass (SMD 1.03 kg, p < 0.001). The secondary outcomes indicated significant increases in high-density lipoprotein cholesterol (MD -0.05 mmol/L, p = 0.008), natural killer cells (SMD 0.42%, p = 0.04), reductions in triglycerides (MD -81.90 mg/dL, p < 0.01), total cholesterol (SMD -0.95 mmol/L, p < 0.01), tumor necrosis factor α (SMD -0.89 pg/mL, p = 0.03), and leptin (SMD -0.63 ng/mL, p = 0.03). Also, beneficial alterations were found in cancer-related fatigue (SMD -0.98, p = 0.03), sleep (SMD -1.17, p < 0.001), and quality of life (SMD 2.94, p = 0.02) scores. There was very low to low confidence in the estimated effect of most of the outcomes. The present findings reveal that CART could be considered an adjunct therapy in supporting the conventional clinical approach observed following exercise. However, further high-quality research is needed to evaluate whether CART would be a valuable intervention to lower aggressive pharmacologic use in breast cancer patients with overweight/obesity.

Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis.

Background: Structured aerobic or resistance training alone seems to be a beneficial tool for improving glucose homeostasis, chronic systemic inflammation, resting cardiovascular function, and mental health in people with obesity and type 2 diabetes mellitus (T2DM). The aim of the present study was to synthesize the available data on the effectiveness of combined aerobic and resistance training (CART) on glycemic control, blood pressure, inflammation, cardiorespiratory fitness (CRF), and quality of life (QoL) in overweight and obese individuals with T2DM. Methods: A database search was carried out in PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar from inception up to May 2023. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used, and data were analyzed using standardized mean differences and 95% confidence intervals. The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42022355612). Results: A total of 21,612 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants (mean age: 57 ± 7 years) who met the eligibility criteria. CART demonstrated significant improvements in body mass index, glycated hemoglobin, systolic and diastolic blood pressure, C-reactive protein, tumor necrosis factor-alpha, interleukin-6, CRF, and QoL compared to ST. These findings highlight the significance of exercise interventions such as CART as essential elements within comprehensive diabetes management strategies, ultimately enhancing overall health outcomes in individuals with T2DM and overweight/obesity.No differences were found in resting heart rate between CART and ST. An uncertain risk of bias and poor quality of evidence were found among the eligible studies. Conclusion: These outcomes show clear evidence considering the positive role of CART in inducing beneficial changes in various cardiometabolic and mental health-related indicators in patients with T2DM and concurrent overweight/obesity. More studies with robust methodological design are warranted to examine the dose-response relationship, training parameters configuration, and mechanisms behind these positive adaptations.

Physical activities pre- and post-COVID-19 vaccination and its implementations: A narrative review.

Coronavirus disease 2019 is a severe communicable pulmonary medical problem that has been a challenging disease for everyone in the globe, but vaccines development and administration against this severe acute respiratory syndrome-inducing disease (coronavirus disease 2019) are currently yielding fabulous results. The mean duration of the coronavirus disease 2019 pandemic for this study spanned from 2020 until 2022. These manifestations are accompanied by symptoms of respiratory tract illnesses such as non-productive cough, sore throat, and nasal discharge. Relevant reviews on coronavirus disease 2019 manifestations and outcomes, consisting mainly of the infections/outbreaks, experimental information, and pre- and post-serovaccination details that occurred, were described. After a typical vaccination course, the study aims to summarize and understand more about the effectiveness of exercise on the pre-and post-coronavirus disease 2019 vaccination and its implementations. Physical activity is an immunological function adjuvant to decrease communicable disease risk and enhance immunity post-viral infection vaccination. Moderate-intensity resistance exercisesession directly before getting the influenza vaccine decreases vaccine responses in older adults, such as redness, pain, or inflammation at the injection spot or other adverse consequences compared to the inactive circumstance. However, it was reported that exercise after a shot is generally safe as long as vaccinated people feel well enough. Though exercise before or after vaccination has no negative impact on the protection afforded by the vaccine, people can exercise immediately after receiving the vaccine, as any changes in blood flow will not affect the vaccine's response. One episode of light-to-moderate-intensifying exercise after vaccination may improve the antibody reactions to influenza or the coronavirus disease 2019 vaccine. Vaccination administered pre- and post-regular exercise is an effective approach for boosting antibody responses due to its immunostimulant effects. Future research should investigate how different vaccine antibodies respond to low, moderate, and high physical activity levels.

Effectiveness of Pulmonary Rehabilitation among COVID-19 Patients: A Systematic Review and Meta-Analysis.

Background: Many COVID-19 patients presented with detrimental features, such as impaired respiratory function, physical capacity, and overall poor quality of life. The present study evaluates the effectiveness of pulmonary rehabilitation on COVID-19 patients. Methods: We searched PubMed, Scopus, ScienceDirect, and Google Scholar from 2019 to 2021. The protocol was registered in PROSPERO with the registration number CRD42021273618. We performed statistical analyses via random effects and expressed the outcomes as standardized mean difference (SMD) for continuous variables, with 95% confidence intervals (CI). Results: We included six trials involving 432 patients. The primary outcome showed a significant improvement in physical function (SMD 0.83, 95% CI −0.58 to 1.09; p < 0.001; four trials, 266 participants; high-quality evidence). There was significant difference in anxiety (SMD −0.80, 95% CI −1.23 to −0.37; p = 0.003), physical activity intensity levels (SMD −1.27, 95% CI −2.23 to −0.32; p = 0.009), sleep quality (MD −0.05, 95% CI −0.83 to −0.16; p = 0.004), peripheral muscle performance of lower limbs (SMD 0.90, 95% CI −0.60 to 1.20; p < 0.001), and dyspnoea outcomes (SMD −0.55, 95% CI −0.87 to −0.23; p = 0.007). Conclusions: Pulmonary rehabilitation is an effective adjuvant therapy that minimizes COVID-19 severity in the intervention group compared to the conventional treatment. The findings of this study will need to be considered in the framework of the clinical outcome as observed in the intervention outcome. Additionally, safer data on guideline rehabilitation would be needed to examine whether pulmonary rehabilitation would be a fruitful intervention to reduce COVID-19 severity.

The Impact of COVID-19 on Physical Activity Patterns of Dental Students: A Multinational Survey.

BACKGROUND: The authorities of the world had to take extraordinary containment measures due to the coronavirus (COVID-19) pandemic spreading across the globe. The only way to stay active during the pandemic was at-home physical activity (PA). The current study evaluates how these preventative measures impacted the PA and well-being of students. METHODS: This study is multicentral and was conducted in Malaysia, India, Cambodia, and Saudi Arabia; participants were recruited from four different regions to answer the online questionnaire provided via a link shared using their personal WhatsApp, Facebook Messenger, and Twitter social media. RESULTS: The means of vigorous, moderate, and light PA (min/day) between the active and inactive groups were significantly different (p = 0.001, 0.007, and 0.001), respectively. In comparison with pre-COVID-19, the participants reported that it became more challenging to engage in regular exercise since the onset of social distance, associated with a lack of motivation followed by "less confidence", "less enjoyment", "less support, and fewer opportunities to engage in exercise"; moreover, it was "difficult to maintain close relationships" and "hard to voice their options on contentious matters" (p = 0.001). Public health measures affected the PA and well-being of active and inactive students; this demonstrates that health promotion strategies aimed at enhancing levels of PA in inactive students may be necessary to improve students' well-being.

Evaluation of physical activity among undergraduate students in Mogadishu Universities in the aftermath of COVID-19 restrictions.

Background: International restrictions were enacted during the COVID-19 pandemic to limit social interaction and viral transmission. These measures had a negative impact on physical activity (PA), creating changes in students' health and lifestyles. The present study aimed to evaluate the levels of PA among undergraduate students in three different universities in Mogadishu after the relaxation of COVID-19 lockdown using the international physical activity questionnaire-long version (IPAQ-L) and its potential associated factors. Methods: This study is a multicentral study conducted at Somali International University, Horn of Africa University, and Daha International University. A total of 1,189 respondents were asked to answer the online questionnaire provided via a link shared using their social media. Results: After COVID-19 restrictions approximately ≥ 150 minutes of PA per week was reported by 500 men (97.3%) and 652 women (96.6%) at work. While 7 (1.4%) of men and 20 (3%) of women participate in < 150 minutes each week, respectively. Furthermore, only seven (1.4%) of males and three (0.4%) of women reported to have not performed any PA at work. Conclusion: The majority of the undergraduate students at the selected universities in Mogadishu were physically active after the relaxation of COVID-19 rules in Somalia. Such a high level of PA is a significant advantage to public health.

Effects of Circuit Training on Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis.

The most prevalent joint disease is osteoarthritis (OA), which affects an estimated 240 million individuals worldwide. Knee osteoarthritis (KOA) is one of the top 10 causes of disability worldwide. The aim of this study is to systematically evaluate the effect of circuit training (CT) on patients with KOA. We searched through PubMed, Scopus, ScienceDirect, Cochrane, and Google Scholar up to 12 February 2022. We used random-effects statistical analysis for continuous variables and reported the results as a standardized mean difference (SMD) with 95 percent confidence intervals (CI). Seven trials involving 346 patients were included. A significant improvement in the intervention group was observed for the parameter, pain level (SMD -0.96, 95% CI -1.77 to -0.14; p = 0.02; seven trials, 346 participants; high quality evidence), while no significant improvement was found in physical function (SMD 0.03, 95% CI -0.44-0.50; p = 0.89; five trials, 294 participants; high-quality evidence), quality of life (SMD -0.25, 95% CI -1.18-0.68; p = 0.60; three trials, 205 participants; high-quality evidence), the activity of daily living (SMD 0.81, 95% CI -0.85-2.48; p = 0.34; three trials, 223 participants; high-quality evidence), and knee stiffness (SMD -0.65, 95% CI -1.96-0.66; p = 0.33; two trials, 71 participants; high-quality evidence). The findings in this meta-analysis suggest that CT could effectively complement the conventional treatment of KOA, particularly in alleviating pain. However, comprehensive data on the guidelines for the CT approach would be needed to adequately examine the effects of CT on quality of life and biochemical markers in patients with KOA.

Orlistat Mitigates Oxidative Stress-Linked Myocardial Damage via NF-κß- and Caspase-Dependent Activities in Obese Rats.

Oxidative stress contributes to major complications of obesity. This study intended to identify whether orlistat could mitigate myocardial damage in obese animal models. The tested rats were divided into two groups and fed either with normal chow (n = 6 per group) or with a high-fat diet (HFD) for 6 weeks to induce obesity (n = 12 per group). Obese rats were further subjected to treatment either with distilled water (OB group) or orlistat 10 mg/kg/day (OB + OR group). Key indices of oxidative stress, inflammation, and apoptosis were assessed using an immunohistochemical-based technique and real-time PCR. The OB group showed significant increases of oxidative stress markers (TBARs and PCO), with significant decreases of anti-oxidant markers (Nrf2, SOD, CAT, and GPx). Furthermore, mRNA expression of pro-inflammatory markers (TNF-α and NF-κß) and pro-apoptosis markers (Bax, Caspase-3, Caspase-8, and Caspase-9) were significantly upregulated in the OB group. Obese rats developed pathological changes of myocardial damages as evidenced by the presence of myocardial hypertrophy and inflammatory cells infiltration. Orlistat dampened the progression of myocardial damage in obese rats by ameliorating the oxidative stress, and by inhibiting NF-κß pathway and caspase-dependent cell apoptosis. Our study proposed that orlistat could potentially mitigate oxidative stress-linked myocardial damage by mitigating inflammation and apoptosis, thus rationalizing its medical usage.

Effectiveness of physical activity on immunity markers and quality of life in cancer patient: a systematic review.

Background: Cancer is a huge group of diseases that can affect various body parts of humans but also has a psychological, societal, and economic impact. Physical activity can improve the quality of life (QOL) and immunity, while moderate intensity exercise can reduce the probability of this lethal disease. The current study aimed to determine the effect of physical activity on immune markers and QOL in cancer patients as well as to evaluate cancer-related fatigue (CRF) and its association with physical activity. Methodology: Before starting the study, the study protocol was registered in PROSPERO (registration number CRD42021273292). An electronic literature search was performed by combining MeSH terminology and keywords used with the Boolean operators "OR" and "AND" to find relevant published studies on PubMed, Scopus, Cochrane, and ScienceDirect databases. The Joanna Briggs Institute (JBI) critical evaluation checklist was used to assess the quality of selected studies, while the GRADE approach was used to see the quality of evidence. Results: A total of 13,931 studies were retrieved after the search on databases. After the scrutiny of studies by reading the title of articles and the inclusion/exclusion criteria, a total of 54 studies were selected for further screening by reading the full texts. In the final, a total of nine studies were selected for the current systematic review and proceeded for data extraction. The patients who were doing different exercises showed improvements in immunity, QOL, and reduction in CRF. A significant reduction in tumour necrosis factor-α (TNF-α), C reactive protein (CRP), interleukin-8 (IL-8), IL-6, and an increase in natural killer (NK) cells levels was also observed. Conclusions: The exercise program is safe and beneficial to improve the quality of life and immunity markers before, during, and after cancer treatment. Physical exercise may also help patients to overcome the adverse effects of the treatment and to reduce the chance of developing new tumours in the future.

Bee bread attenuates the progression of atherosclerosis by activating Nrf2/Keap1 and modulating TNF-α/NF-κß-associated mast cell migration and a mitochondrial-dependent apoptotic pathway in the obese rat model.

This study explores the anti-atherosclerotic effects of bee bread in the context of oxidative stress, inflammation, and apoptosis phenomena in an obesity animal model, and its vitamin composition. Forty male Sprague-Dawley rats were administered with a normal diet (Normal group) and a high-fat diet (HFD) to induce obesity. After 6 weeks, obese rats that received the HFD were treated either with distilled water (Ob group), bee bread at 0.5 g per kg per day (Ob + Bb group), or orlistat at 10 mg per kg per day (Ob + Or group) concomitant with the HFD for another 6 weeks. Bee bread significantly improved atherosclerotic changes by enhancing the immunoexpressions of Nrf2/Keap1, impeding the immunoexpressions of NF-κß downstream proteins, and intensifying Bcl-2 upregulation, attributed to the improvement in mast cell adherence and collagen deposition in the aortic wall of the Ob + Bb group. We have demonstrated that the treatment with bee bread attenuates the progression of atherosclerosis through its inhibition of vascular oxidative stress, and retardation of inflammatory reaction and apoptosis in obese rats, indicating its potential therapeutic targets for obesity-related vascular diseases. This could be partly attributed to the components of vitamins such as vitamins A, C and E that are present in bee bread, which need further study for the exact molecular mechanism of action.

Bee Bread Ameliorates Vascular Inflammation and Impaired Vasorelaxation in Obesity-Induced Vascular Damage Rat Model: The Role of eNOS/NO/cGMP-Signaling Pathway.

Obesity and hyperlipidemia are major risk factors for developing vascular diseases. Bee bread (BB) has been reported to exhibit some biological actions, including anti-obesity and anti-hyperlipidemic. This study aims to investigate whether bee bread can ameliorate vascular inflammation and impaired vasorelaxation activity through eNOS/NO/cGMP pathway in obese rats. Forty male Sprague-Dawley rats were randomly divided into four groups (n = 10/group), namely: control (normal group), obese rats (OB group), obese rats treated with bee bread (0.5 g/kg/day, OB/BB group) and obese rats treated with orlistat (10 mg/kg/day, OB/OR group). The latter three groups were given a high-fat diet (HFD) for 6 weeks to induced obesity before being administered with their respective treatments for another 6 weeks. After 12 weeks of the total experimental period, rats in the OB group demonstrated significantly higher Lee obesity index, lipid profile (total cholesterol, triglyceride, low-density lipoprotein), aortic proinflammatory markers (tumor necrosis factor-α, nuclear factor-κß), aortic structural damage and impairment in vasorelaxation response to acetylcholine (ACh). Bee bread significantly ameliorated the obesity-induced vascular damage manifested by improvements in the lipid profile, aortic inflammatory markers, and the impaired vasorelaxation activity by significantly enhancing nitric oxide release, promoting endothelial nitric oxide synthase (eNOS) and cyclic guanosine monophosphate (cGMP) immunoexpression. These findings suggest that the administration of bee bread ameliorates the impaired vasorelaxation response to ACh by improving eNOS/NO/cGMP-signaling pathway in obese rats, suggesting its vascular therapeutic role.

Phenolic Compounds and the Anti-Atherogenic Effect of Bee Bread in High-Fat Diet-Induced Obese Rats.

This study was undertaken to determine the phenolic compounds and the anti-atherogenic effect of bee bread in high-fat diet (HFD)-induced obese rats. The presence of phenolic compounds in bee bread was determined by liquid chromatography-mass spectrometry. Thirty-two male Sprague Dawley rats were divided into four groups, (n = 8/group); i.e., Normal (N), HFD (high-fat diet), HFD + BB (high-fat diet and 0.5 g/kg/day bee bread), and HFD + O (high-fat diet and 10 mg/kg/day orlistat) groups. After 6 weeks of the experiment, rats were sacrificed. Five phenolic compounds were identified in bee bread; namely, caffeic acid, ferulic acid, kaempferol, apigenin, and isorhamnetin. Bee bread significantly reduced Lee obesity index and levels of total cholesterol (TC), low-density lipoprotein (LDL), fatty acid synthase (FAS) activity, atherogenic index, oxidised-LDL (oxLDL), and malondialdehyde (MDA), and significantly increased aortic antioxidant activities, such as those of superoxide dismutase (SOD) and glutathione peroxidase (GPx). Adipocyte sizes were found to be smaller in the HFD + BB group compared to the N group, and en face aortas showed an absence of atherosclerotic plaque in rats supplemented with bee bread. These changes might suggest an anti-atherogenic effect of bee bread in HFD-induced obese rats via its antioxidant and hypocholesterolaemic properties.