Analysis of the hikikomori phenomenon - an international infodemiology study of Twitter data in Portuguese.

BACKGROUND: Hikikomori refers to the extreme isolation of individuals in their own homes, lasting at least six months. In recent years social isolation has become an important clinical, social, and public health problem, with increased awareness of hikikomori around the globe. Portuguese is one of the six most spoken languages in the world, but no studies have analysed the content regarding this phenomenon expressed in Portuguese. OBJECTIVE: To explore the hikikomori phenomenon on Twitter in Portuguese, utilising a mixed-methods approach encompassing content analysis, emotional analysis, and correlation analysis. METHODS: A mixed methods analysis of all publicly available tweets in the Portuguese language using a specific keyword (hikikomori) between 1st January 2008 and 19th October 2022. The content analysis involved categorising tweets based on tone, content, and user types, while correlation analysis was used to investigate user engagement and geographical distribution. Statistical analysis and artificial intelligence were employed to classify and interpret the tweet data. RESULTS: Among the total of 13,915 tweets generated, in terms of tone 10,731 were classified as "negative", and 3184 as "positive". Regarding content, "curiosities" was the most posted, as well as the most retweeted and liked topic. Worldwide, most of the hikikomori related tweets in Portuguese were posted in Europe, while "individuals with hikikomori" were the users most active posting. Regarding emotion analysis, the majority of tweets were "neutral". CONCLUSIONS: These findings show the global prevalence of the discourse on hikikomori phenomenon among Portuguese speakers. It also indicates an increase in the number of tweets on this topic in certain continents over the years. These findings can contribute to developing specific interventions, support networks, and awareness-raising campaigns for affected individuals.

Effects of Withania somnifera (Ashwagandha) on Hematological and Biochemical Markers, Hormonal Behavior, and Oxidant Response in Healthy Adults: A Systematic Review.

PURPOSE OF REVIEW: Withania somnifera (L.) Dunal (Ws) is a common herb plant that has been used for centuries to treat a wide range of conditions, particularly certain chronic diseases due to its antidiabetic, cardioprotective, antistress, and chondroprotective effects, among many others. No conclusive evidence, however, exists about the potential health effects of Ws in adults without chronic conditions. We aimed to evaluate the current evidence on the health benefits of Ws supplementation in healthy adults. RECENT FINDINGS: Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed studies indexed in Web of Science, Scopus, and PubMed to assess the effects of Ws on hematological and biochemical markers, hormonal behavior, and oxidant response in healthy adults. Original articles published up to March 5, 2022, with a controlled trial design or pre-post intervention design, in which supplementation of Ws was compared to a control group or data prior to intervention were included. Among 2,421 records identified in the search, 10 studies met the inclusion criteria. Overall, most of the studies reported beneficial effects of the Ws supplementation, and no serious adverse events were reported. Participants supplemented with Ws displayed reduced levels of oxidative stress and inflammation, and counterbalanced hormone levels. No evidence of the beneficial effects of Ws supplementation on hematological markers was reported. Ws supplementation appears to be safe, may regulate hormone levels, and has potent anti-inflammatory and antioxidant effects. However, further studies are needed to elucidate the relevance of its application.

Efectos del rodillo de espuma o foam roller sobre el rango de movimiento, la flexibilidad, la fuerza y el dolor muscular de inicio retardado en deportistas de alto rendimiento / Effects of the use of foam rollers by high-performance athletes on range of motion, flexibility, strength and delayed onset muscle soreness

Introducción: El rodillo de espuma o Foam Roller (FR) es un instrumento de liberación miofascial autoinducida, para aplicarpresión de forma directa sobre la musculatura diana. FR es ampliamente empelado por deportistas como herramienta deauto-masaje. Objetivo: Evaluar la evidencia actual sobre el impacto del FR, sobre el sistema musculoesquelético, en deportistas, tratandode identificar los mecanismos que influyen sobre los tejidos miofasciales.Material y método: Basándonos en las directrices de los Elementos de Información Preferidos para Revisiones Sistemáticas yMetaanálisis (PRISMA), revisamos sistemáticamente estudios indexados en Web of Science, Cochrane y PubMed, para evaluarlos efectos del FR en el rango articular de movimiento (ROM), la flexibilidad, la fuerza y el dolor muscular de inicio retardado(DOMS) en deportistas de alto rendimiento. Se incluyeron artículos originales publicados desde el 2018 hasta el 30 de septiembre de 2022, con diseño de ensayo controlado o pre-post intervención, en los que se comparó la intervención de FR conun grupo control. Se utilizó la escala PEDro para evaluar de la calidad metodológica.Resultados: Entre los 141 registros identificados en la búsqueda, un total de 10 estudios cumplieron los criterios de inclusióny exclusión. En general, el uso de FR, en los deportistas de alto rendimiento, mostró mejoras significativas sobre el ROM yflexibilidad, y efectos notablemente beneficiosos sobre el DOMS y la fuerza, sin efectos adversos en el tejido miofascial. El FRpuede actuar mejorando la arquitectura tisular miofascial, atenuando el efecto inflamatorio y nociceptivo. Conclusión: El uso FR, parece seguro, es un instrumento efectivo para la mejora de las cualidades físicas de movilidad, fuerzay flexibilidad, y disminuir el DOMS incrementando del rendimiento deportivo.(AU)

Introduction: The Foam Roller (FR) is a self-induced myofascial release instrument to apply pressure directly on the targetmusculature. FR is widely used by athletes as a self-massage tool. Objective: We evaluate the current evidence on the impact of FR on the musculoskeletal system in athletes, trying to identifythe mechanisms that influence myofascial tissues.Material and method: Based on the Preferred Reporting Item Guidelines for Systematic Reviews and Meta-Analyses (PRISMA),we systematically reviewed studies indexed in Web of Science, Cochrane, and PubMed to evaluate the effects of FR on jointrange of motion (ROM), flexibility, strength, and delayed onset muscle soreness (DOMS) in high-performance athletes. Originalarticles published from 2018 through September 30, 2022, with controlled trial or pre-post intervention design, in which theFR intervention was compared to a control group, were included. The PEDro scale was used to assess methodological quality. Results: Among the 141 records identified in the search, a total of 10 studies met the inclusion and exclusion criteria. Ingeneral, the use of FR, in high performance athletes, showed significant improvements on ROM and flexibility, and markedlybeneficial effects on DOMS and strength, with no adverse effects on myofascial tissue. FR may act by improving myofascialtissue architecture, attenuating the inflammatory and nociceptive effect. Conclusion: The use of FR seems to be safe; it is an effective tool for the improvement of the physical qualities of mobility,strength, and flexibility, and to decrease DOMS and increase sports performance.(AU)

Association between an oxidative balance score and mortality: a prospective analysis in the SUN cohort.

PURPOSE: We aimed to prospectively investigate the association of an overall oxidative balance score (OBS) with all-cause death and cause-specific mortality among participants in the Seguimiento Universidad de Navarra (SUN) Study, a Mediterranean cohort of Spanish graduates. METHODS: Using baseline information on 12 a priori selected dietary and non-dietary lifestyle pro- and antioxidants exposures-vitamins C and E, ß-carotenes, selenium, zinc, heme iron, polyphenols, total antioxidant capacity, body mass index, alcohol, smoking, and physical activity-we constructed an equally weighted OBS categorized into quartiles, with higher scores representing greater antioxidant balance. Cox proportional hazards models were fitted to evaluate the association between the OBS and mortality. RESULTS: A total of 18,561 participants (mean [SD] age, 38.5 [12.4] years; 40.8% males) were included in the analysis. During a median follow-up of 12.2 years (interquartile range 8.3-14.9), 421 deaths were identified, including 80 deaths from cardiovascular disease (CVD), 215 from cancer, and 126 from other causes. After adjustment for potential confounders, the hazard ratios and 95% confidence interval (CIs) between the highest quartile (predominance of antioxidants) vs. the lowest quartile (reference category) were 0.35 (95% CI 0.22-0.54, P-trend < 0.001) for all-cause mortality, 0.18 (95% CI 0.06-0.51, P-trend = 0.001) for CVD mortality, 0.35 (95% CI 0.19-0.65, P-trend = 0.002) for cancer mortality, and 0.45 (95% CI 0.20-1.02, P-trend = 0.054) for other-cause mortality. CONCLUSION: Our findings suggest a strong inverse association between the OBS and all-cause, CVD, and cancer mortality. Individuals exposed to both antioxidant dietary and lifestyle factors may potentially experience the lowest mortality risk. STUDY REGISTRY NUMBER: Dynamic Mediterranean Prospective Cohort: the SUN Project; NCT02669602. https://clinicaltrials.gov/ct2/show/NCT02669602 . https://proyectosun.es.

Asociación entre la actividad física extraescolar con la condición física, estilo de vida y expediente / Impact/relationship of extracurricular physical activity practice on physical fitness, lifestyle, and academic record

Introducción: El deporte extraescolar representa una estrategia para aumentar las horas de actividad física (AF) y estimularhábitos saludables. El objetivo del estudio fue evaluar la asociación de la AF extraescolar con la condición física (CF), el estilode vida, la calidad de vida relacionada con la salud (CVRS), y el expediente. Material y método: Los participantes 199 escolares (51,3% niñas) con una edad media de 9,9 (desviación estándar [DE] 1,4)años de 3 colegios de Soria, cumplimentaron cuestionarios validados para recoger hábitos de práctica deportiva y el estilo devida. Se realizaron diferentes pruebas para evaluar la CF y el centro proporcionó información sobre el expediente académico. Resultado: La media de horas semanales de AF practicada por el total de la muestra fue de 3,3 (DE 1,6) horas, y el 51,3%de los escolares realizaban AF extraescolar. Los resultados del estudio demostraron diferencias significativas (p <0,05) en elíndice de masa corporal, las horas de pantalla, y el expediente académico entre los alumnos de que realizan AF extraescolary los que no la practicaban. Se observó una correlación negativa moderada entre las horas de AF semanales y las horas depantalla semanales (r=-0,46, p <0,001) y positiva moderadamente fuerte para el expediente académico (r=0,56, p <0,001). Elmodelo logístico de regresión multivariada determinó que los niños tienen una probabilidad más elevada de practicar AF(odds ratio [OR] 3,59, intervalo de confianza [IC] 95% 1,17-11,05) que las niñas. Además, la realización de AF extraescolar, seasoció significativamente con un menor número de horas de pantalla semanales (OR 0,68, IC 95% 0,57-1,81) y con un mejorexpediente académico (OR 3,63, IC 95% 2,07-6,37). Conclusión: Estos resultados refuerzan la necesidad de establecer estrategias de promoción y de gestión de entornos, quefavorezcan el aumento de la AF extraescolar.(AU)

Introduction: The practice of physical activity (PA) triggers positive adaptations on health. Extracurricular sport activitiesrepresent a strategy to increase hours of PA. The aim of this study was to evaluate the impact of extracurricular PA on physicalcondition (PC), health-related quality of life (HRQoL), screen time, and academic level. Material and method: In collaboration with three educational centers of Soria, the participants of the study completedseveral validated questionnaires related to PA information and lifestyle. Different physical tests were conducted to assesspupils’ PC and the centers provided information related to academics. Result: A total of 199 students (51.3% females), mean age 9.9 (standard deviation [ED] 1.4) years, were included in the study.Average weekly of PA hours was 3.3 (DE 1.6), and 51.3% of the pupils performed extracurricular sport activities. The resultsof the study showed statistically differences (P <0.05) on body mass index, screening time, and academic records betweenthose pupils that performed extracurricular sport activities and those that did not perform any extracurricular activity. Weobserved a moderate negative correlation between weekly PA hours and screen time (r = -0.46, P <0.001) and a moderatestrong positive correlation for academic records (r=0.56, P <0.001). The multivariate logistic regression model revealed thatboys had a higher likelihood (odds ratio [OR] 3.59, confidence interval [CI] 95% 1.17-11.05) of practicing extracurricular sportactivities compared to girls. Moreover, practicing extracurricular sport activities was significantly associated with lower screentime (OR 0.68, CI 95% 0.57-1.81) and better performance on academics (OR 3.63, CI 95% 2.07-6.37). Conclusion: Our results reinforce the need to develop strategies for the promotion and management of environments thatpromote extracurricular sport activities.(AU)

Longitudinal association of dietary carbohydrate quality with visceral fat deposition and other adiposity indicators.

BACKGROUND & AIMS: The quality of dietary carbohydrates rather than total carbohydrate intake may determine the accumulation of visceral fat; however, to date, few studies have examined the impact of diet on adiposity using specific imaging techniques. Thus, the aim of this prospective study was to investigate the association between concurrent changes in carbohydrate quality index (CQI) and objectively-quantified adiposity distribution over a year. METHODS: We analyzed a cohort of 1476 participants aged 55-75 years with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus randomized controlled trial. Dietary intake information was obtained at baseline, 6- and 12-months from a validated 143-item semi-quantitative food-frequency questionnaire, and CQI (range: 4 to 20) was calculated based on four dietary criteria: total dietary fibre, glycemic index, wholegrain/total grain carbohydrate ratio, and solid/total carbohydrate ratio. Overall and regional adiposity (total body fat, visceral fat and android-to-gynoid fat ratio) was quantified using dual-energy X-ray absorptiometry at all three time points. Multiple adjusted linear mixed-effects models were used to assess associations between concurrent changes in repeatedly measured CQI and adiposity over time. RESULTS: After controlling for potential confounding factors, a 3-point increment in CQI over 12-month follow-up was associated with a decrease in visceral fat (ß -0.067 z-score, 95% CI -0.088; -0.046, p < 0.001), android-to-gynoid fat ratio (-0.038, -0.059; -0.017, p < 0.001), and total fat (-0.064, -0.080; -0.047, p < 0.001). Fibre intake and the ratio of wholegrain/total grain showed the strongest inverse associations with all adiposity indicators. CONCLUSIONS: In this prospective cohort of older adults with overweight/obesity and MetS, we found that improvements in dietary carbohydrate quality over a year were associated with concurrent favorable changes in visceral and overall fat deposition. These associations were mostly driven by dietary fibre and the wholegrain/total grain ratio. TRIAL REGISTRATION: The trial was registered at the International Standard Randomized. CONTROLLED TRIAL: (ISRCTN: http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.

Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up.

Background: Metabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors. Objective: To assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial. Design: Prospective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55-75 years old) with overweight or obesity at baseline. Methods: The desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to -4.0 kg (T2, n = 1,903); ≤-4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed physical activity. The Framingham equation assessed cardiovascular risks. The changes in the severity of MetS were also assessed. The Beck Depression Inventory assessed depressive symptoms and the SF-36 assessed health-related quality of life. Data were analyzed using general linear models. Results: BMI decreased at T2 and T3 (T1: 0.3, T2: -0.7, T3: -1.9). The most significant improvement in diet quality was observed at T3. Cardiovascular risk decreased at T2 and T3. Mean reductions in MetS severity score were: -0.02 at T1, -0.39 at T2 and -0.78 at T3. The perception of physical health increases in successive tertiles. Conclusions: In older adults with MetS, more ambitious desired weight loss goals were associated with improvements in diet, cardiovascular health and perceived physical health during the first year of a healthy lifestyle intervention programme. Weight dissatisfaction needs to be considered by health professionals. Clinical trial registration: http://www.isrctn.com/ISRCTN89898870, identifier 89898870.

Effects of Tribulus terrestris L. on Sport and Health Biomarkers in Physically Active Adult Males: A Systematic Review.

Tribulus terrestris L. (TT) is a plant used in traditional Chinese medicine, Ayurvedic medicine, and sports nutrition to improve health and performance. However, no conclusive evidence exists about the potential beneficial effects of TT on sport and health biomarkers in physically active adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the modified McMaster Critical Review Form for methodological quality assessment, we systematically reviewed studies indexed in Web of Science, Scopus, and PubMed, to assess the effects of TT on immunological, hematological, biochemical, renal, lipidic, hormonal behavior, and anti-inflammatory response in physically active adult males. Among 340 records identified in the search, a total of 7 studies met the inclusion and exclusion criteria. Overall, participants supplemented with TT displayed significant improvements in lipid profile. Inflammatory and hematological biomarkers showed moderate beneficial effects with no significant changes on renal biomarkers. No positive effects were observed on the immune system response. Additionally, no TT-induced toxicity was reported. In conclusion, there was no clear evidence of the beneficial effects of TT supplementation on muscle damage markers and hormonal behavior. More studies are needed to confirm the benefits of TT due to the limited number of studies available in the current literature.

Association of ideal cardiovascular health with cardiovascular events and risk advancement periods in a Mediterranean population-based cohort.

BACKGROUND: The American Heart Association recommends Life's Simple 7 as ideal cardiovascular health (ICVH) to reduce cardiovascular risk. Rate advancement period (RAP), a useful tool to quantify and communicate exposure impact on risks, may enhance communication about the benefits of achieving ICVH. We aimed to examine whether greater adherence to ICVH metrics was associated with reduced incidence of cardiovascular risk in a population-based cohort and estimate its impact on the timing of occurrence using RAP. METHODS: Prospective analyses of 3826 participants, initially free from cardiovascular disease at baseline, enrolled in the Vascular Risk in Navarra Study (RIVANA), a Mediterranean population-based cohort of Spanish adults. ICVH metrics were defined using participants' baseline information as follows: never-smoker or quitting > 12 months ago, body mass index < 25 kg/m2, ≥ 150 min/week of moderate physical activity or equivalent, healthy dietary pattern (≥ 9 points on a validated 14-item Mediterranean diet adherence screener), untreated cholesterol < 200 mg/dL, untreated blood pressure < 120/80 mmHg, and untreated fasting blood glucose < 100 mg/dL. Participants were assigned 1 point for each achieved metric and were grouped according to their number of accumulated metrics in ≤ 2, 3, 4, and ≥ 5. The primary endpoint was major cardiovascular events (composite of myocardial infarction, stroke, or death from cardiovascular causes). Cox proportional hazard ratios (HRs) and RAPs with their corresponding 95% confidence intervals (95% CI) adjusted for potential confounders were calculated. RESULTS: During a median follow-up of 12.8 years (interquartile range 12.3-13.1), a total of 194 primary endpoints were identified. Compared to participants with ≤ 2 ideal metrics, HR (95% CI) for major cardiovascular events among participants meeting ≥ 5 metrics was 0.32 (0.17-0.60) with RAP (95% CI) of - 14.4 years (- 22.9, - 5.9). CONCLUSIONS: Greater adherence to ICVH metrics was associated with lower cardiovascular risk among Spanish adults of the RIVANA cohort. Adherence to ideal metrics may substantially delay cardiovascular risk.

Vitamin D and Risk of Obesity-Related Cancers: Results from the SUN ('Seguimiento Universidad de Navarra') Project.

Obesity is associated with a higher risk of several types of cancer, grouped as obesity-related cancers (ORC). Vitamin D deficiency is more prevalent in obese subjects, and it has been suggested to play a role in the association between obesity and cancer risk. The aim of the study was to analyze the association between vitamin D intake and the subsequent risk of ORC in a prospective Spanish cohort of university graduates. The SUN Project, initiated in 1999, is a prospective dynamic multipurpose cohort. Participants answered a 556-item lifestyle baseline questionnaire that included a validated food-frequency questionnaire. We performed Cox regression models to estimate the hazard ratios (HRs) of ORC according to quartiles of energy-adjusted vitamin D intake (diet and supplements). We included 18,017 participants (mean age = 38 years, SD = 12 years), with a median follow-up of 12 years. Among 206,783 person-years of follow-up, we identified 225 cases of ORC. We found no significant associations between vitamin D intake and ORC risk after adjusting for potential confounders: HRQ2vsQ1 = 1.19 (95% CI 0.81-1.75), HRQ3vsQ1 = 1.20 (95% CI 0.81-1.78), and HRQ4vsQ1 = 1.02 (95% CI 0.69-1.51). Dietary and supplemented vitamin D do not seem to be associated with ORC prevention in the middle-aged Spanish population.

Macronutrient quality index and cardiovascular disease risk in the Seguimiento Universidad de Navarra (SUN) cohort.

PURPOSE: To assess the association between a multi-dimensional Macronutrient Quality Index (MQI) and the risk of cardiovascular disease (CVD) in a Mediterranean cohort. METHODS: Prospective analyses among 18,418 participants (mean age 36 years, 60.8% women) of the Seguimiento Universidad de Navarra (SUN) cohort. Dietary intake information was obtained through a validated semi-quantitative food-frequency questionnaire (FFQ). The MQI (expressing high-quality macronutrient intake) was calculated based on three previously reported quality indices: the Carbohydrate Quality Index (CQI), the Fat Quality Index (FQI), and the Healthy Plate Protein source Quality Index (HPPQI). Adherence to the Mediterranean diet (MedDiet) and Provegetarian Diet was evaluated using the Trichopoulou index and the score proposed by Martínez-González, respectively. CVD was defined as new-onset stroke, myocardial infarction, or CVD death. RESULTS: After a median follow-up time of 14 years (211,744 person-years), 171 cases of CVD were identified. A significant inverse association was found between the MQI and CVD risk with multivariable-adjusted HR for the highest vs. the lowest quartile of 0.60 (95% IC, 0.38-0.96; Ptrend = 0.024). CONCLUSION: In this Mediterranean cohort, we found a significant inverse relationship between a multidimensional MQI (expressing high-quality macronutrient intake) and a lower risk of CVD.

Mediterranean Diet Social Network Impact along 11 Years in the Major US Media Outlets: Thematic and Quantitative Analysis Using Twitter.

BACKGROUND: Media outlets influence social attitudes toward health. Thus, it is important that they share contents which promote healthy habits. The Mediterranean diet (MedDiet) is associated with lower cardiovascular disease risk. Analysis of tweets has become a tool for understanding perceptions on health issues. METHODS: We investigated tweets posted between January 2009 and December 2019 by 25 major US media outlets about MedDiet and its components as well as the retweets and likes generated. In addition, we measured the sentiment analysis of these tweets and their dissemination. RESULTS: In total, 1608 tweets, 123,363 likes and 48,946 retweets about MedDiet or its components were analyzed. Dairy (inversely weighted in MedDiet scores) accounted for 45.0% of the tweets (723/1608), followed by nuts 19.7% (317/1608). MedDiet, as an overall dietary pattern, generated only 9.8% (157/1608) of the total tweets, while olive oil generated the least number of tweets. Twitter users' response was quantitatively related to the number of tweets posted by these US media outlets, except for tweets on olive oil and MedDiet. None of the MedDiet components analyzed was more likely to be liked or retweeted than the MedDiet itself. CONCLUSIONS: The US media outlets analyzed showed reduced interest in MedDiet as a whole, while Twitter users showed greater interest in the overall dietary pattern than in its particular components.

Análisis del potencial de la Elevation Training Mask sobrebiomarcadores, parámetros respiratorios, e indicadores derendimiento deportivo: ¿Qué mecanismos ergogénicos estánimplicados? Revisión sistemática / Analysis of the potential of Elevation Training Mask on biomarkers, respiratory parameters, and sports performance indicators: what ergogenic mechanisms are involved? Systematic review

Introducción: La Elevation Training Mask (ETM) es un dispositivo de carga muscular respiratoria que funciona reduciendo el flujo de aire a través de un sistema de valvular. La ETM fue originalmente pensada para simular la altitud permitiendo la aplicación de hipoxia durante el ejercicio y ha ido creciendo en popularidad entre los deportistas intentando maximizar su rendimiento deportivo. Objetivo: Revisar sistemáticamente los estudios que evalúan el efecto de ETM combinada con ejercicio sobre biomarcadores, parámetros respiratorios e indicadores de rendimiento deportivo en sujetos físicamente activos. Material y método: Se realizó una búsqueda estructurada siguiendo las directrices de los Elementos de Información Preferidos para Revisiones Sistemáticas y Metaanálisis (PRISMA) en la base de datos Medline (PubMed) hasta septiembre de 2021. Resultados: Se incluyen 6 estudios reportando que el uso de la ETM en comparación con el grupo control, presentó una mayor tendencia al aumento en la capacidad vital inspiratoria forzada, capacidad vital forzada, sin cambios significativos en la función pulmonar; no afectó al volumen total de carga entrenamiento de fuerza pero atenuó la velocidad de ejecución; no se observaron mejoras en el rendimiento deportivo; aumento significativamente la oxigenación cerebral y disminuyó la saturación de oxígeno; la frecuencia cardíaca fue mayor mientras que el intervalo entre latidos y el equilibrio simpaticovagal fueron menores; no se produjeron cambios en las variables hematológicas aunque se observó una tendencia a disminuir el daño muscular y atenuar el efecto catabólico directo derivado del ejercicio.(AU)

Introduction: The Elevation Training Mask (ETM) is a respiratory muscle loading device that works by reducing airflow through a valvular system. The ETM was originally intended to simulate altitude by allowing the application of hypoxia during exercise and has been growing in popularity among athletes. Objective: To systematically review studies evaluating the effect of ETM associated with exercise on biomarkers, respiratory parameters, and sports performance indicators in physically active subjects. Material and method: A structured search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed in the Medline database (PubMed) until October 2021. Results: Six studies are included reporting that the use of ETM in comparison with the control group, presented a greater tendency to increase in forced inspiratory vital capacity, forced vital capacity, without significant changes in pulmonary function; it did not affect the total load volume of strength training but attenuated the speed of execution; it significantly increased cerebral oxygenation and decreased oxygen saturation; heart rate was higher while inter-beat interval and sympatho-vagal balance were lower; there were no changes in hematological variables although there was a tendency to decrease muscle damage and attenuate the direct catabolic effect derived from exercise; no improvements in sports performance were observed.(AU)

Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial.

PURPOSE: Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. METHODS: Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. RESULTS: Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25-1.83; OR12-month: 1.66, 95% CI 1.37-2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07-2.46; OR12-month: 1.62, 95% CI 1.07-2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53-0.79; OR12-month: 0.76, 95% CI 0.62-0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64-0.99; OR12-month: 0.71, 95% CI 0.57-0.88). CONCLUSION: Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. TRIAL REGISTRATION: ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870 .

Sedentary behaviors and risk of depression in the Seguimiento Universidad de Navarra cohort: the SUN Project / Comportamientos sedentarios y riesgo de depresión en la cohorte de Seguimiento Universidad de Navarra: el Proyecto SUN / Comportamentos sedentários e risco de depressão na coorte Seguimiento Universidad de Navarra: o Projeto SUN

The study aimed to prospectively examine the association between different sedentary behaviors and the risk of depression. We included 12,691 Spanish university graduates (mean age: 36.7 year; SD: 11.5), participants of the Seguimiento Universidad de Navarra cohort (the SUN Project), initially free of depression who were followed-up for a median of 10.9 years. Based on items presented in our baseline questionnaire, time spent in four sedentary behaviors (hours/day) were evaluated: overall sitting time; TV-viewing; computer use; and driving. Participants were classified as incident cases of depression if they reported a physician diagnosis of depression in at least one of the follow-up assessments conducted after the first two years of follow-up. Cox regression models were used to assess the relationship between sedentary behaviors and depression. A total of 560 incident cases of depression were identified during follow-up. We found no significant association between overall sitting time, TV-viewing or driving and risk of depression. On the other hand, computer use was directly associated with the risk of developing depression during the follow-up (p-value for trend = 0.020), with the participants in the highest quartile of computer use (3.64 to 10 hours/week) having a higher risk of developing depression (HR = 1.33; 95%CI: 1.05-1.70) than those in the lowest quartile (0 to 0.25 hours/week) after adjusting for potential confounders. Prolonged use of computer was independently associated with an increased risk of developing depression among young middle-aged adult university graduates from a Spanish cohort.

El objetivo del estudio fue examinar prospectivamente la asociación entre diferentes comportamientos sedentarios y el riesgo de depresión. Incluimos a 12.691 graduados universitarios españoles (media de edad: 36,7 años; SD: 11,5), participantes en la cohorte de Seguimiento Universidad de Navarra (Proyecto SUN), que no sufrieran depresión inicialmente y a quienes se les realizó un seguimiento durante una mediana de 10.9 años. Basados en los ítems presentados en nuestro cuestionario de línea de base, se evaluó el tiempo transcurrido con cuatro comportamientos sedentarios (horas/día): tiempo sentado en general, tiempo viendo TV, usando el ordenador, y conduciendo. Los participantes se clasificaron como casos incidentes de depresión, si informaban de un diagnóstico médico de depresión, emitido por un doctor en al menos una de las evaluaciones de seguimiento llevadas a cabo tras los dos primeros años de seguimiento. Los modelos de regresión Cox se usaron para evaluar la relación entre comportamientos sedentarios y depresión. Se identificaron un total de 560 casos incidentes de depresión durante el seguimiento. No encontramos ninguna asociación significativa entre el tiempo sentado en general, tiempo viendo TV, o conduciendo y el riesgo de depresión. Por otro lado, el uso del ordenador estuvo directamente asociado con el riesgo de desarrollar depresión durante el seguimiento (valor de p para tendencia = 0,020), con los participantes en el cuartil más alto de uso del ordenador (3,64 a 10 horas/semana) teniendo un riesgo más alto de desarrollar depresión (HR = 1,33; IC95%: 1,05-1,70), respecto a quienes estaban en el cuartil más bajo (0 a 0,25 horas/semana) tras realizar un ajuste para potenciales factores de confusión. El uso prolongado del ordenador estuvo independientemente asociado con el mayor riesgo de desarrollar depresión entre adultos jóvenes de mediana edad, graduados universitarios, procedentes de una cohorte española.

O estudo buscou examinar prospectivamente a associação entre diversos comportamentos sedentários e risco de depressão. Incluímos 12.691 indivíduos espanhóis com nível universitário (média de idade: 36,7 anos; DP: 11,5), participantes da coorte Seguimiento Universidad de Navarra (Projeto SUN), inicialmente sem depressão, que foram seguidos por uma mediana de 10,9 anos. Com base nos itens apresentados no questionário da linha de base, foram avaliados os tempos gastos em quatro comportamentos sedentários (horas/dia): total de tempo sentado e tempo assistindo televisão, usando computador e dirigindo. Os participantes eram classificados como casos incidentes de depressão quando relatavam um diagnóstico de depressão feito por médico em pelo menos uma das avaliações de seguimento após os primeiros dois anos de seguimento. Foram usados modelos de regressão Cox para avaliar a relação entre comportamentos sedentários e depressão. Foram identificados 560 casos incidentes de depressão durante o seguimento. Não encontramos associação entre total de tempo sentado, tempo assistindo TV ou dirigindo e risco de depressão. Por outro lado, o uso de computador mostrou associação direta com o risco de desenvolver depressão durante o seguimento (valor de p para tendência = 0,020), no qual os participantes no quartil mais alto de uso de computador (entre 3,64 e 10 horas/semana) tiveram o risco maior de desenvolver depressão (HR = 1,33; IC95%: 1,05-1,70) comparados com aqueles no quartil mais baixo (0 a 0,25 horas/semana), depois de ajustar para potenciais fatores de confusão. O uso prolongado do computador esteve associado de maneira independente com risco aumentado de desenvolver depressão em adultos de meia idade com nível universitário em uma coorte espanhola.

Physical activity and metabolic syndrome severity among older adults at cardiovascular risk: 1-Year trends.

BACKGROUND AND AIMS: Modifiable lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease metabolic syndrome (MetS). The aim was to assess 1-year changes of leisure-time physical activity (LTPA), sedentary behavior, and diet quality according to MetS severity in older population at high cardiovascular risk. METHODS AND RESULTS: Prospective analysis of 55-75-year-old 4359 overweight/obese participants with MetS (PREDIMED-Plus trial) categorized in tertiles according to 1-year changes of a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, triglycerides and glucose index, dietary nutrient intake, biochemical marker levels, dietary inflammatory index, and depression symptoms were measured. Diet quality was assessed by 17-item MD questionnaire. PAs were self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire and 30-s chair stand test. Sedentary behaviors were measured using the Spanish version of the Nurses' Health Study questionnaire. After 1-year follow-up, decreasing MetSSS was associated with an anti-inflammatory dietary pattern, high intake of vegetables, fruits, legumes, nuts, whole grain cereals, white fish, and bluefish and low intake of refined cereals, red and processed meat, cookies/sweets, and snacks/ready-to-eat-meals. It resulted in high intake of polyunsaturated fatty acids, omega-3 fatty acids, protein, fiber, vitamins B1, B6, B9, C, D, potassium, magnesium, and phosphorus and low glycemic index and saturated fatty acid, trans fatty acid, and carbohydrates intake. Regarding PA and sedentary behavior, decreasing MetSSS was associated with increased moderate-to-vigorous LTPA, chair stand test, and decreased sedentary and TV-viewing time. CONCLUSION: Decreasing MetSSS was associated with an anti-inflammatory dietary pattern, high LTPA, high MD adherence, low sedentary time, and low depression risk.

Glycophosphopeptical AM3 Food Supplement: A Potential Adjuvant in the Treatment and Vaccination of SARS-CoV-2.

The world is currently experiencing the coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-2 (SARS-CoV-2). Its global spread has resulted in millions of confirmed infections and deaths. While the global pandemic continues to grow, the availability of drugs to treat COVID-19 infections remains limited to supportive treatments. Moreover, the current speed of vaccination campaigns in many countries has been slow. Natural substrates with biological immunomodulatory activity, such as glucans, may represent an adjuvant therapeutic agent to treat SARS-CoV-2. AM3, a natural glycophosphopeptical, has previously been shown to effectively slow, with no side effects, the progression of infectious respiratory diseases by regulating effects on innate and adaptive immunity in experimental models. No clinical studies, however, exist on the use of AM3 in SARS-CoV-2 infected patients. This review aims to summarize the beneficial effects of AM3 on respiratory diseases, the inflammatory response, modulation of immune response, and attenuation of muscle. It will also discuss its potential effects as an immune system adjuvant for the treatment of COVID-19 infections and adjuvant for SARS-CoV-2 vaccination.

Dietary vitamin D intake and colorectal cancer risk: a longitudinal approach within the PREDIMED study.

PURPOSE: We evaluated whether the intake of dietary vitamin D is associated with the incidence of both colorectal cancer (CRC) and colon cancer in the framework of the PREDIMED cohort of older adults at high cardiovascular risk. METHODS: We analyzed data from 7216 men and women (55-80 years) without CRC at baseline from the PREvención con DIeta MEDiterránea study. Baseline consumption of vitamin D was assessed using a validated 137-item food frequency questionnaire. Cox proportional hazards ratios (HRs) of CRC and colon cancer incidence were estimated for quartiles and per 1-SD of baseline vitamin D intake. RESULTS: During a median follow-up of 6 years, we documented 97 incident CRC cases after the exclusion of subjects with no baseline dietary data and/or outliers of energy intake. A non-significant HRs and 95% confidence intervals (CIs) of CRC for the comparison of extreme quartiles (4th vs 1st) of vitamin D intake were observed [0.55 (0.30-1.00), P for trend = 0.072], whereas it was significant for colon cancer incidence alone [0.44 (0.22-0.90), P for trend = 0.032]. However, this association became significant in CRC and colon cancer incidence, after excluding 391 subjects consuming baseline vitamin D and/or calcium medication or prescribed supplements [0.52 (0.28-0.96) and 0.41 (0.12-0.85), respectively]. CONCLUSION: A higher dietary intake of vitamin D was significantly associated with a reduced CRC risk in individuals at high cardiovascular risk.