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Sleep, Stress, and Symptoms Among People With Heart Failure During the COVID-19 Pandemic.
O'Connell, M, Jeon, S, Conley, S, Linsky, S, Redeker, NS
The Journal of cardiovascular nursing. 202301;38(2):E55-E60
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COVID-19 pandemic raised concerns about the effects of stress on mental health and sleep deficiency. Cognitive behavioural therapy for insomnia (CBT-I) has been shown to improve sleep quality and insomnia severity, as well as anxiety and depression, and may be protective during times of stress, including the COVID-19 pandemic. The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with heart failure (HF). This study was a randomised controlled trial of the effects of CBT-I compared with HF self-management education (attention-control condition), the “HeartSleep Study.” Results showed that improvements in insomnia severity, sleep quality, latency, and efficiency, sleep-related cognitions and stress, anxiety, and depression after participation in CBT-I or an HF self-management class were sustained during the pandemic. Authors conclude that their findings confirm the clinical benefits of CBT-I for people with HF and comorbidities and also suggest the potential benefits of HF self-management education.
Abstract
BACKGROUND The COVID-19 pandemic raised concerns about the effects of stress on sleep and mental health, particularly among people with chronic conditions, including people with heart failure (HF). OBJECTIVE The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with HF who participated in a randomized controlled trial of cognitive behavioral therapy for insomnia before the COVID-19 pandemic. METHODS Participants self-reported sleep characteristics, symptoms, mood, and stress at baseline, 6 months after cognitive behavioral therapy for insomnia or HF self-management education (attention control), and during the pandemic. RESULTS The sample included 112 participants (mean age, 63 ± 12.9 years; 47% women; 13% Black; 68% New York Heart Association class II or III). Statistically significant improvements in sleep, stress, mood, and symptoms that occurred 6 months post treatment were sustained during the pandemic. CONCLUSIONS Improving sleep and symptoms among people with HF may improve coping during stressful events, and cognitive behavioral therapy for insomnia may be protective.
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Effect of mindfulness-based stress reduction (MBSR) program on depression, emotion regulation, and sleep problems: A randomized controlled trial study on depressed elderly.
Javadzade, N, Esmaeili, SV, Omranifard, V, Zargar, F
BMC public health. 2024;24(1):271
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Depression and sleep issues are prevalent among elderly people due to cognitive and physical decline in old age which may affect the quality of their life. Psychological therapies such as Mindfulness-based stress reduction (MBSR) may help to reduce stress and improve emotional regulation and the quality of life in elderly people. This randomised controlled trial included sixty elderly patients with depression residing in nursing homes. After eight MBSR weekly intervention sessions, the elderly participants experienced significant improvement in depression, sleep issues and emotional regulation. Healthcare professionals can use the findings of this study to understand how MBSR can positively impact the psychological well-being of elderly individuals. Further robust studies are required to ensure the generalisability of the MBSR therapeutic strategies.
Abstract
BACKGROUND Entering old age is associated with various physical and psychological disabilities. Therefore, the aim of this study is to determine the effect of mindfulness-based stress reduction program on emotion regulation and sleep problems in depressed elderly. METHODS This study was a clinical trial conducted on 60 elderly individuals with depression using purposive sampling. These elderly were referred by geriatricians and were included in the study based on the inclusion criteria. The participants were randomly assigned to two groups: the Mindfulness-Based Stress Reduction (MBSR) group and the control group. Both groups completed the Geriatric Depression Scale (GDS), the Gratz and Roemer Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index before and after the intervention. The MBSR sessions were held for the experimental group in 8 sessions of 90 min each, once a week. Finally, all the data were analyzed using SPSS software version 26 through descriptive and analytical statistics such as mean and standard deviation, t-tests and mixed analysis of covariance (ANCOVA) with repeated measures. RESULTS The results showed that the MBSR intervention led to a significant reduction in depression symptoms (p < 0.001) and improvement in emotion regulation and sleep quality (p < 0.001) among the elderly participants with depression in the intervention group. DISCUSSION The results of this study showed that MBSR can be effective in reducing depression levels, improving emotion regulation, and sleep quality among depressed elderly individuals compared to the control group. Caregivers and psychotherapists of nursing homes can use care programs such as MBSR program to improve the physical and mental condition of the elderly. TRIAL REGISTRATION First Registration: 13/01/2022, Registration Number: IRCT20211118053099N1, Access: https://www.irct.ir/trial/61207 .
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The Effect of a Ketogenic Diet versus Mediterranean Diet on Clinical and Biochemical Markers of Inflammation in Patients with Obesity and Psoriatic Arthritis: A Randomized Crossover Trial.
Lambadiari, V, Katsimbri, P, Kountouri, A, Korakas, E, Papathanasi, A, Maratou, E, Pavlidis, G, Pliouta, L, Ikonomidis, I, Malisova, S, et al
International journal of molecular sciences. 2024;25(5)
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Psoriatic arthritis is an autoimmune disorder marked by persistent inflammation. Recent studies suggest a connection between obesity and psoriasis, as visceral fat contributes to systemic inflammation through the release of inflammatory cytokines and adipocytokines. Dietary approaches like the Mediterranean diet (MD) and Ketogenic diet (KD) can potentially aid in weight loss and inflammation reduction. This randomised crossover study examined the effectiveness of a classic Mediterranean diet and an isocaloric Ketogenic diet over twenty-two weeks in patients with psoriatic arthritis, obesity, and pre-existing psoriasis. The findings demonstrated significant improvements in weight, body mass index, waist circumference, total fat mass, and visceral fat with both the Mediterranean and Ketogenic diets. However, the Ketogenic diet showed a statistically significant improvement in psoriasis and psoriatic arthritis, as well as in the levels of inflammatory biomarkers, compared to the Mediterranean diet. Healthcare professionals can leverage the findings of this study to understand the beneficial effects of the Mediterranean and Ketogenic diets on metabolic markers, inflammatory markers, and psoriasis. However, additional robust studies are needed to confirm these results, as the existing research on this topic is limited.
Abstract
The effect of different diet patterns on psoriasis (PSO) and psoriatic arthritis (PSA) is unknown. Τhe aim of our study was to evaluate the effectiveness of a Mediterranean diet (MD) and Ketogenic diet (KD), in patients with PSO and PSA. Twenty-six patients were randomly assigned to start either with MD or KD for a period of 8 weeks. After a 6-week washout interval, the two groups were crossed over to the other type of diet for 8 weeks. At the end of this study, MD and KD resulted in significant reduction in weight (p = 0.002, p < 0.001, respectively), in BMI (p = 0.006, p < 0.001, respectively), in waist circumference (WC) (p = 0.001, p < 0.001, respectively), in total fat mass (p = 0.007, p < 0.001, respectively), and in visceral fat (p = 0.01, p < 0.001, respectively), in comparison with baseline. After KD, patients displayed a significant reduction in the Psoriasis Area and Severity Index (PASI) (p = 0.04), Disease Activity Index of Psoriatic Arthritis (DAPSA) (p = 0.004), interleukin (IL)-6 (p = 0.047), IL-17 (p = 0.042), and IL-23 (p = 0.037), whereas no significant differences were observed in these markers after MD (p > 0.05), compared to baseline. The 22-week MD-KD diet program in patients with PSO and PSA led to beneficial results in markers of inflammation and disease activity, which were mainly attributed to KD.
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Glycemic variability assessed using continuous glucose monitoring in individuals without diabetes and associations with cardiometabolic risk markers: A systematic review and meta-analysis.
Hjort, A, Iggman, D, Rosqvist, F
Clinical nutrition (Edinburgh, Scotland). 2024;43(4):915-925
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Chronic hyperglycaemia, assessed by HbA1c, is a risk factor for complications in individuals with diabetes. However, HbA1c does not reflect short-term fluctuations in blood glucose, which can vary a lot between individuals despite similar HbA1c. Glycaemic variability (GV) is a term used to describe such fluctuations, reflecting both hypoglycaemic events and postprandial spikes as well as fluctuations that are repeated at the same time on different days. The aim of this study was to assess whether GV is associated with cardiometabolic risk markers or outcomes in individuals without diabetes. Researchers examined data from continuous glucose monitoring studies. This study was a systematic review of 71 studies, primarily cross-sectional in design. Results showed that GV measures were higher in individuals with prediabetes compared to those without, potentially related to beta cell dysfunction. However, GV was not clearly associated with insulin sensitivity, adiposity, blood lipids, or blood pressure. Interestingly, GV may predict coronary atherosclerosis development and cardiovascular events, as well as type 2 diabetes. Authors concluded that although GV is elevated in prediabetes, its association with traditional risk factors remains less clear. Prospective studies are needed to explore GV’s predictive power in relation to incident disease.
Expert Review
Conflicts of interest:
None
Take Home Message:
Continuous glucose monitors are widely available. They could help nutritionists and nutritional therapists to personalise nutrition plans and reduce risk factors for cardiovascular disease and type 2 diabetes when working with a qualified health care practitioner.
Evidence Category:
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X
A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Introduction
Glycaemic variability (GV) has been associated with increased risk of cardiovascular disease (CVD) in individuals with type 2 diabetes (T2D). It is not known whether there are similar risks for individuals without T2D. Continuous blood glucose monitors (CGM) measure short-term GV and may be a potential tool for assessing these risks.
Methods
- 71 worldwide studies with diverse populations were included in this systematic review and meta-analysis. Most studies were cross sectional and included CGM use for 24 hours or longer.
- Measurement data included: standard deviation (SD) and coefficient of variation (CV) of GV, mean amplitude of glycaemic excursions (MAGE), mean of daily differences (MODD), continuous overlapping net glycaemic action (CONGA), M-value, lability index (L-index), J-index or glycaemic risk assessment in diabetes equation (GRADE).
- Outcome measurements were any associated with cardiometabolic risk markers.
Results
- Adults with prediabetes had greater SD (p <0.0001), CV (p =0.008) and MAGE (p<0.0001) values. SD, MODD, and MAGE were also higher in individuals with normal glucose tolerance (NGT) and a previous history of gestational diabetes.
- SD was higher in children and adolescents with prediabetes. SD and CV were also higher in adolescents with cystic fibrosis. An inverse association was found in adolescents for MAGE and soluble receptor of advanced glycation end-products (sRAGE) (P=<0.05).
- 6 studies found measures of beta-cell function were inversely associated with GV.
- Higher levels of MAGE were positively associated with a higher incidence of cardiovascular events (p=0.004), higher C-reactive protein and PAI-1 (p<0.001).
- No differences were found in GV between obese, overweight and normal weight individuals, nor correlations with body composition for all populations (p>0.05 for all).
Conclusion
This study found that GV is elevated in adults with prediabetes compared to individuals with NGT and may be linked with beta-cell dysfunction. The evidence for children and adolescents was less clear. GV was also positively associated with the development of atherosclerosis and an increased risk of cardiovascular events. GV may therefore be an effective proxy for cardiovascular risk in adults without diabetes.
Clinical practice applications:
- There is a large variability in postprandial response between individuals consuming the same foods.
- HbA1C does not include short term variability in blood glucose levels.
- CGMs are widely available and easily accessible and could help nutritionists and nutritional therapists to provide personalised nutrition plans.
- This study found that changes in GV were not associated with HbA1c, fasting glucose, homeostatic model assessment of insulin resistance or oral glucose tolerance test-derived measures.
- GV was also not associated with adiposity, blood pressure, blood fatty liver disease, blood lipid profile or oxidative stress.
Considerations for future research:
- Limitations of this study were the inclusion of mainly cross-sectional data as well as the heterogeneity between outcome measures, study durations, populations and sample sizes.
- Further prospective studies are needed in healthy individuals.
- Future studies should focus on measurements that specifically assess GV and cardiometabolic risk markers.
Abstract
BACKGROUND & AIMS Continuous glucose monitoring (CGM) provides data on short-term glycemic variability (GV). GV is associated with adverse outcomes in individuals with diabetes. Whether GV is associated with cardiometabolic risk in individuals without diabetes is unclear. We systematically reviewed the literature to assess whether GV is associated with cardiometabolic risk markers or outcomes in individuals without diabetes. METHODS Searches were performed in PubMed/Medline, Embase and Cochrane from inception through April 2022. Two researchers were involved in study selection, data extraction and quality assessment. Studies evaluating GV using CGM for ≥24 h were included. Studies in populations with acute and/or critical illness were excluded. Both narrative synthesis and meta-analyzes were performed, depending on outcome. RESULTS Seventy-one studies were included; the majority were cross-sectional. Multiple measures of GV are higher in individuals with compared to without prediabetes and GV appears to be inversely associated with beta cell function. In contrast, GV is not clearly associated with insulin sensitivity, fatty liver disease, adiposity, blood lipids, blood pressure or oxidative stress. However, GV may be positively associated with the degree of atherosclerosis and cardiovascular events in individuals with coronary disease. CONCLUSION GV is elevated in prediabetes, potentially related to beta cell dysfunction, but less clearly associated with obesity or traditional risk factors. GV is associated with coronary atherosclerosis development and may predict cardiovascular events and type 2 diabetes. Prospective studies are warranted, investigating the predictive power of GV in relation to incident disease. GV may be an important risk measure also in individuals without diabetes.
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Impact of Melatonin Supplementation on Sports Performance and Circulating Biomarkers in Highly Trained Athletes: A Systematic Review of Randomized Controlled Trials.
Celorrio San Miguel, AM, Roche, E, Herranz-López, M, Celorrio San Miguel, M, Mielgo-Ayuso, J, Fernández-Lázaro, D
Nutrients. 2024;16(7)
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Melatonin (N-acetyl-5 methoxytryptamine) is an indolic neurohormone known for its antioxidant, anti-inflammatory, and immunoregulatory properties. Highly demanding training exponentially increases physical and biochemical demands, particularly in the skeletal muscle and the liver. This study aimed to critically review the effects of melatonin supplementation on sports performance and circulating biomarkers in highly trained athletes. This study was a systematic review of twenty-one randomised controlled trials. The dose of melatonin supplemented in the trials ranged from 5 mg to 100 mg, administered before or after exercise. Results showed that melatonin supplementation improved antioxidant status and inflammatory response. Additionally, it reversed liver and muscle damage, and moderate effects were also observed in modulating glycaemia, total cholesterol, triglycerides, and creatinine. Authors concluded that melatonin has a high safety profile. In fact, melatonin supplementation could act indirectly to improve performance by preventing tissue damage, reduce inflammation caused by reactive oxygen and nitrogen species, and restore circulating biomarkers in highly trained athletes during demanding exercises.
Expert Review
Conflicts of interest:
None
Take Home Message:
- Diet and lifestyle modifications should always be made first to ensure that athletes have sufficient melatonin levels.
- Adequate light exposure at appropriate times and specific foods which contain melatonin may help.
- During periods of intense training, supplementation may be needed to reach adequate levels and to aid recovery.
Evidence Category:
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A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Introduction
- High-intensity exercise can disrupt inflammatory and immune processes within the body resulting in inflammation, poor immune function, and poor recovery.
- Melatonin is a neurohormone that has anti-inflammatory and antioxidant properties, and has the potential to be of benefit to recovery following strenuous exercise.
- This systematic review of randomised control trials aimed to determine the effect of melatonin on sports performance and circulating health biomarkers.
Methods
- This was a systematic review of randomised control trials (RCTs).
- The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
- Studies that were included looked at the use of melatonin by trained sports professional and athletes.
Results
- 21 RCTs were included in the review.
- Melatonin doses ranged from 5mg to 100mg in the studies.
- Melatonin was administered either acutely or for periods of 3 to 30 days pre and post exercise.
- None of the studies were rated low risk of bias.
- Seven studies had a high risk of bias.
- There was a high degree of heterogeneity, which prevented a meta-analysis being performed.
- The study showed that melatonin supplementation had some effect on white blood cell count levels and immunoglobulins but results were conflicting.
- Moderate effects were seen on blood glucose, cholesterol, triglycerides, and phospholipids but did not affect high density lipoprotein or low-density lipoprotein.
- Improvements were seen in antioxidant status and inflammation.
- Reversal of kidney and liver damage was reported following supplementation.
- Promising effects were seen on sports performance with some studies reporting improvements in aerobic capacity, agility, and sprint performance.
- No effects were apparent on hormonal response of cortisol, testosterone, or growth hormone.
- No adverse effects were seen following melatonin supplementation.
Conclusion
- Melatonin supplementation may mitigate some of the damaging effects of extreme exercise.
- However, it is unclear as to how this might occur.
Clinical practice applications:
- Sufficient melatonin levels may be necessary in highly trained athletes.
- This may limit inflammation and oxidative stress and help prevent tissue damage and aid recovery.
- During periods of intense training or when quick recovery is needed, melatonin supplementation may be of benefit.
Considerations for future research:
- More studies on the mechanisms through which melatonin may be supporting athletic performance and preventing liver and kidney damage are needed.
- Studies on the effects of melatonin on mitochondrial function may be of benefit.
Abstract
Melatonin (N-acetyl-5 methoxytryptamine) is an indolic neurohormone that modulates a variety of physiological functions due to its antioxidant, anti-inflammatory, and immunoregulatory properties. Therefore, the purpose of this study was to critically review the effects of melatonin supplementation in sports performance and circulating biomarkers related to the health status of highly trained athletes. Data were obtained by performing searches in the following three bibliography databases: Web of Science, PubMed, and Scopus. The terms used were "Highly Trained Athletes", "Melatonin", and "Sports Performance", "Health Biomarkers" using "Humans" as a filter. The search update was carried out in February 2024 from original articles published with a controlled trial design. The PRISMA rules, the modified McMaster critical review form for quantitative studies, the PEDro scale, and the Cochrane risk of bias were applied. According to the inclusion and exclusion criteria, 21 articles were selected out of 294 references. The dose of melatonin supplemented in the trials ranged between 5 mg to 100 mg administered before or after exercise. The outcomes showed improvements in antioxidant status and inflammatory response and reversed liver damage and muscle damage. Moderate effects on modulating glycemia, total cholesterol, triglycerides, and creatinine were reported. Promising data were found regarding the potential benefits of melatonin in hematological biomarkers, hormonal responses, and sports performance. Therefore, the true efficiency of melatonin to directly improve sports performance remains to be assessed. Nevertheless, an indirect effect of melatonin supplementation in sports performance could be evaluated through improvements in health biomarkers.
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Polyphenol supplementation boosts aerobic endurance in athletes: systematic review.
Cao, G, Zuo, J, Wu, B, Wu, Y
Frontiers in physiology. 2024;15:1369174
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Prolonged high-intensity endurance training and competition can lead to exercise-induced fatigue, muscle function decline, and oxidative stress. Natural plant extracts, including polyphenols, have gained attention for their potential to enhance athletic performance and aid recovery. This study aimed to examine the role of polyphenol supplementation in improving aerobic endurance among athletes and individuals with regular exercise habits. This study was a systematic review of 11 studies, focusing on the impact of polyphenols on aerobic endurance. Results showed that flavonoid-rich compounds, providing 208 mg of polyphenols and 14.4 mg of flavonoids per 40 g in a water-soluble form, showed the most noticeable improvement in exercise performance during a 6-week supplementation period. Authors concluded that even though polyphenol supplementation demonstrated enhancements in several indicators of aerobic endurance exercise performance, it’s essential to interpret these findings cautiously due to the limited number of available studies.
Expert Review
Conflicts of interest:
None
Take Home Message:
- Polyphenols may have specific benefits on exercise performance and metabolism in both performance and recreational athletes.
- It is important to understand that this is only seen at specific doses for sustained periods of time and compliance is essential for results.
Evidence Category:
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X
A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Introduction
Extreme exercise can lead to oxidative stress in the body, which can affect muscle function and impact training and performance in athletes. Polyphenols present in plants have antioxidant properties and have emerged as potential candidates to improve exercise performance. They also promote antioxidant defences and nuclear factor erythroid 2-related factor 2 (Nrf2) signalling, which is involved in mitochondrial biogenesis. Finally, they may also alter vascular function through promoting endothelial nitric oxide synthesis, which leads to vasodilation and increased blood flow. This systematic review aimed to summarise the current research on the effects of polyphenols on endurance exercise performance.
Methods
- The inclusion criteria involved randomised control trials on healthy athletes and sports people who were supplemented with polyphenols and compared to a placebo group both before and after tests of athletic or sports performance.
- No meta-analysis was conducted.
Results
- 11 studies with 220 participants were included in the systematic review. 164 were recreational and 56 professional athletes.
- Polyphenols assessed were grape seed extract, green tea extract, olive fruit water phytocomplex, Montmorency cherry powder, carob pods, Haskap berries, Vinitrox™ (polyphenols from grape and apple), Cardiose®, and grape juice.
- Substantial improvements were seen in the time taken to complete an exercise and fatigue times.
- Mixed results were seen in time to peak power output, endurance running distance, power output, exercise intensity, rate of perceived exertion, and speed.
- Improvements were seen in flow mediated dilation and tissue oxygenation index, but only one trial was found that assessed each of these.
- Heart rate and blood pressure showed no improvements with polyphenols and mixed results were seen with VO2, VCO2 lactate level, and carbohydrate oxidation.
- Prolonged use of polyphenols were shown to promote whole body fat oxidation.
- No improvements were seen in measures of antioxidant levels but only one study looked at these.
- Long-term rather than acute polyphenol supplementation was more beneficial.
Conclusion
Polyphenols improved aerobic endurance and exercise performance. However, there is insufficient evidence to support their use for improvements to several physiological and metabolic measures.
Clinical practice applications:
- Practitioners may like to consider the recommendation of long-term polyphenol supplementation to healthy athletes to improve aerobic endurance and promote fat oxidation.
- 208mg of polyphenols and flavonoids in a 14.4mg per 40g in a soluble form may have optimal effects.
- However, there may be limited effects on recovery times.
Considerations for future research:
- Further research could determine exercise specific dosage recommendations.
Abstract
In recent years, an increasing trend has been observed in the consumption of specific polyphenols, such as flavonoids and phenolic acids, derived from green tea, berries, and other similar sources. These compounds are believed to alleviate oxidative stress and inflammation resulting from exercise, potentially enhancing athletic performance. This systematic review critically examines the role of polyphenol supplementation in improving aerobic endurance among athletes and individuals with regular exercise habits. The review involved a thorough search of major literature databases, including PubMed, Web of Science, SCOPUS, SPORTDiscus, and Embase, covering re-search up to the year 2023. Out of 491 initially identified articles, 11 met the strict inclusion criteria for this review. These studies specifically focused on the incorporation of polyphenols or polyphenol-containing complexes in their experimental design, assessing their impact on aerobic endurance. The methodology adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the risk of bias was evaluated using the Cochrane bias risk assessment tool. While this review suggests that polyphenol supplementation might enhance certain aspects of aerobic endurance and promote fat oxidation, it is important to interpret these findings with caution, considering the limited number of studies available. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023453321.
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Effect of time restricted feeding on anthropometric measures, eating behavior, stress, serum levels of BDNF and LBP in overweight/obese women with food addiction: a randomized clinical trial.
Irani, H, Abiri, B, Khodami, B, Yari, Z, Lafzi Ghazi, M, Hosseinzadeh, N, Saidpour, A
Nutritional neuroscience. 2024;27(6):577-589
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The term “food addiction” is used to describe compulsive feeding behaviours associated with loss of control of eating. It is a significant behavioural factor in the pathogenesis of obesity. Feeding behaviour can be managed by both homeostatic (associated with energy demands/stores) and hedonic pathways (brain dopaminergic reward system) which controls energy intake and body weight. The aim of this study was to evaluate the impact of TRF on anthropometric measures, eating behaviour, stress levels, and serum brain-derived neurotropic factor (BDNF) and lipopolysaccharide-binding protein (LBP) levels in women with overweight/obesity and food addiction. This study was an 8-week double-blind randomised controlled trial. Participants were randomly divided into two groups receiving a low-calorie diet (n = 27) and a group receiving a low-calorie diet with TRF (n = 29). Results showed that: - the TRF group showed positive improvements in anthropometric indices and had a higher cognitive restriction score. - participants in the TRF group reported reduced snacking and improved adherence to meal timing. - cortisol levels, a marker of stress, declined in the TRF group. - the serum BDNF levels increased in the TRF group. Authors concluded that TRF could be a promising approach for managing weight in individuals with eating disorders, including food addiction.
Abstract
BACKGROUND & AIM: Food addiction (FA) as a specific food-related behavior may play an essential role in the pathogenesis of obesity. Brain-derived neurotrophic factor (BDNF) and gut microbiota (GM) alterations probably through fasting are closely related to brain function, affecting eating behaviors and body weight management. This study aimed to evaluate the effect of time-restricted feeding (TRF) on serum BDNF levels and eating behaviors in overweight and obese women with FA. METHODS AND DESIGN This clinical trial was performed with a 2-month follow-up on 56 obese and overweight women with FA. Participants were randomly divided into two groups receiving a low-calorie diet (n = 27) and a group receiving a low-calorie diet with TRF (n = 29). Anthropometric measurements, biochemical markers, eating behavior, and stress were assessed during the study period. RESULTS The reductions in weight, body mass index (BMI), waist circumference, and body fat mass were significantly higher in the TRF group compared to the control group at week 8 (P = 0.018, P = 0.015. P = 0.03, and P = 0.036, respectively). The cognitive restriction score was higher in the TRF as compared with the control group (P = 0.002). The food addiction criteria score was significantly reduced in both groups (P < 0.001). Serum levels of BDNF were significantly increased in the TRF group (P < 0.001). In addition, BDNF levels had a positive and significant correlation with the cognitive restriction score (r = 0.468 and P < 0.001), While the correlation with FA was not significant (β = 0.588 and P = 0.618). Lipopolysaccharide binding protein decreased significantly in both groups, but this decrease was significantly higher in the TRF group than in the control group (P < 0.001). CONCLUSION The results of this study showed that a low-calorie diet with TRF is more effective in weight management than a low-calorie diet alone, probably through further modulating the GM and improving BDNF levels. More effective weight loss in the TRF is probably related to better management of eating behavior than FA. TRIAL REGISTRATION Iranian Registry of Clinical Trials identifier: IRCT20131228015968N7.
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Yoga or Mindfulness on Diabetes: Scoping Review for Theoretical Experimental Framework.
Cangelosi, G, Acito, M, Grappasonni, I, Nguyen, CTT, Tesauro, M, Pantanetti, P, Morichetti, L, Ceroni, E, Benni, A, Petrelli, F
Annali di igiene : medicina preventiva e di comunita. 2024;36(2):153-168
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Diabetes is a prevalent chronic disease affecting millions of people worldwide. With the predicted rise in diabetes cases, alternative approaches to managing this condition are essential. This study aimed to evaluate yoga or mindfulness interventions on diabetic subjects. This study was a scoping review analysing qualitative-quantitative data from selected randomised controlled trials (12 on mindfulness, 9 on yoga, and 1 combining both disciplines). Results showed that yoga and mindfulness showed strong potential not only for stress management but also for improving clinical-metabolic parameters. In fact, practicing yoga was associated with better glycaemic control, lipid profiles, and overall body composition in adult diabetic patients. Authors concluded that alternative practices such as yoga and mindfulness could support traditional treatments and promote a holistic approach to self-care of diabetes.
Abstract
BACKGROUND About one in 11 adults worldwide suffers from diabetic disease with constantly increasing prevalence; from the 529 million patients registered in 2021, the number of people with diabetes was predicted to rise to approximately 1.31 billion in 2050. In Italy, 5.9% of the population is diabetic, with a higher prevalence with increasing age and in the South of the country. Yoga and Mindfulness could represent a valid support for the care of diabetic subjects especially in a stressful caring context such as the Covid-19 pandemic. STUDY DESIGN A scoping review was conducted to achieve the goals of the study. Yoga or Mindfulness interventions on diabetic subjects were specifically analyzed and qualitative-quantitative data collected in the selected randomized controlled trials were extensive for possible meta-analysis. METHODS The review was conducted by two independent practitioners and a third one was consulted in case of conflict. The PRISMA method was used for both the selection and reporting of the studies to be included. Specific PICOS and search strategies have been developed on PubMed, Embase and PsycINFO databases. Included in the review were: randomised controlled trials, full dissertation articles and papers in English with a time limit on May 31, 2022. RESULTS The Review included 22 studies; 12 on Mindfulness, 9 on Yoga and one about both disciplines; among these, one studied patients with Type 1 Diabetes, 14 with Type 2 Diabetes, 6 with both and one with Gestational Diabetes. Only one paper studied adolescent subjects while the other 21 focused on a range of adult subjects. The studies showed that Yoga and Mindfulness have strong potential not only on stress management, but also on clinical-metabolic parameters. CONCLUSIONS The recent Covid-19 pandemic has certainly redesigned a new way of treating and managing chronic diseases, such as diabetes. An increasingly fragile population, and with the growing need to reduce overall stress levels, could find alternative practices in Yoga and Mindfulness to support conventional therapies.
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The Influence of a Polyphenol-Rich Red Berry Fruit Juice on Recovery Process and Leg Strength Capacity after Six Days of Intensive Endurance Exercise in Recreational Endurance Athletes.
Valder, S, Habersatter, E, Kostov, T, Quenzer, S, Herzig, L, von Bernuth, J, Matits, L, Herdegen, V, Diel, P, Isenmann, E
Nutrients. 2024;16(10)
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Physical activity can lead to a shift in physiological homeostasis. Depending on the exercise intensity, volume, and load, exercise-induced muscle damage, inflammation, and reactive oxygen species accumulation can occur. This study aimed to investigate whether a red fruit juice drink with a chokeberry content of 25% and the associated polyphenol intake could already be an adequate natural sports beverage impacting exercise-induced muscle damage and strength in the lower body. This study was a randomised, double-blind trial with a crossover design. Eighteen recreational endurance athletes were enrolled for the study, and they were randomly assigned to one of the two groups: placebo or intervention group. Results showed that the designed endurance training protocol significantly increased creatine kinase (CK) [blood marker] serum concentration without sex differences, and there was repetitive loading training stimulation. However, the intake of the study beverages showed no significant effects on CK concentration. Authors concluded that their findings provide valuable insights into the complex interactions of polyphenol intake and exercise on athletes’ physiological responses during intensive endurance training, encouraging further exploration and methodological refinement in understanding the impact of polyphenols in athletes.
Abstract
BACKGROUND Various nutritional strategies are increasingly used in sports to reduce oxidative stress and promote recovery. Chokeberry is rich in polyphenols and can reduce oxidative stress. Consequently, chokeberry juices and mixed juices with chokeberry content are increasingly used in sports. However, the data are very limited. Therefore, this study investigates the effects of the short-term supplementation of a red fruit juice drink with chokeberry content or a placebo on muscle damage, oxidative status, and leg strength during a six-day intense endurance protocol. METHODS Eighteen recreational endurance athletes participated in a cross-over high intensity interval training (HIIT) design, receiving either juice or a placebo. Baseline and post-exercise assessments included blood samples, anthropometric data, and leg strength measurements. RESULTS A significant increase was measured in muscle damage following the endurance protocol in all participants (∆ CK juice: 117.12 ± 191.75 U/L, ∆ CK placebo: 164.35 ± 267.00 U/L; p = 0.001, η2 = 0.17). No group effects were detected in exercise-induced muscle damage (p = 0.371, η2 = 0.010) and oxidative status (p = 0.632, η2 = 0.000). The reduction in strength was stronger in the placebo group, but group effects are missing statistical significance (∆ e1RM juice: 1.34 ± 9.26 kg, ∆ e1RM placebo: -3.33 ± 11.49 kg; p = 0.988, η2 = 0.000). CONCLUSION Although a reduction in strength can be interpreted for the placebo treatment, no statistically significant influence of chokeberry could be determined. It appears that potential effects may only occur with prolonged application and a higher content of polyphenols, but further research is needed to confirm this.
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Effects of a Dietary Microalgae (Arthrospira platensis) Supplement on Stress, Well-Being, and Performance in Water Polo Players: A Clinical Case Series.
La Mantia, I, Maniaci, A, Scibilia, G, Scollo, P
Nutrients. 2024;16(15)
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Plain language summary
Dietary supplementation has become a popular strategy among athletes to enhance physical performance, reduce fatigue, and accelerate recovery. Spirulina (Arthrospira platensis), a blue-green microalga, has gained attention due to its high protein content, essential amino acids, vitamins, minerals, and antioxidant properties. The primary aim was to investigate the impact of the spirulina and copper supplement on stress, well-being, and performance in water polo players. This study was a clinical case series involving 20 male water polo players. The participants were divided into two groups: one group received the spirulina supplement, while the other group received a placebo. Results showed that the spirulina group showed a significant increase in their Athlete’s Subjective Performance Scale (ASPS) scores from baseline to follow-up, compared to the placebo group, which saw a slight decrease. Additionally, there was a positive correlation between spirulina supplementation and reduced severity of ASPS scores. However, the levels of creatine phosphokinase (CPK), a biomarker for muscle damage, showed only slight differences from baseline to follow-up in the spirulina group. The authors concluded that a dietary supplement containing spirulina and copper may improve subjective performance measures and reduce muscular tension in water polo players. However, larger, randomised controlled trials are needed to confirm these findings.
Abstract
BACKGROUND A common tactic used by athletes to improve performance, lessen tiredness, and hasten recovery is dietary supplementation. We aimed to assess the role of a microalgae dietary liquid supplement additivated with Copper 22.5% NRV in water polo players' performance. METHODS Twenty male water polo players were split into two groups: ten (spirulina group) took a twice-daily nutritional supplement containing 15 mL of spirulina liquid extract (titrated in Phycocyanin 1 mg/mL) and additivated with Copper 22.5% NRV for eight weeks, and ten (the placebo group) did not take the supplement. Subjective evaluations were finished using the Athlete's Subjective Performance Scale (ASPS). Levels of the biomarker creatine phosphokinase (CPK) were also assessed. RESULTS The spirulina group's mean total ASPS score increased significantly from baseline to follow-up and was significantly better than that of the placebo group (p < 0.001). Conversely, ASPS ratings in the placebo group slightly decreased. A positive correlation between spirulina supplementation and less severe ASPS was found using correlation matrix analysis. However, there was a slight difference in CPK levels from the baseline to the follow-up in the spirulina group. CONCLUSIONS A dietary supplement comprising spirulina and copper may help water polo players' subjective performance measurements by lowering muscular tension. Larger, randomized controlled trials are yet required.