Registered dietitian nutritionists (RDN) should be essential contributors to weight management and diabetes care for people using glucagon-like peptide-1 receptor agonist-based therapy (GLP-1 RA-based therapy), as they provide education, prevent and manage side effects, and address nutritional deficiencies. Little is known about the practice behaviors of RDNs , providing care to people using these medications. To determine demographic, professional characteristics, and practice behaviors of RDNs who provide medical nutrition therapy (MNT) to people using GLP-1 RA-based therapy diagnosed with either obesity or diabetes. An online, cross-sectional survey was distributed from May 28, 2025, through June 25, 2025, consisting of 55 questions covering topics such as screening for eating disorders and malnutrition, nutrition assessment, diagnosis, intervention, monitoring, and evaluation within the nutrition care process. The sample included 212 RDNs who were members of the Weight Management Dietetic Practice Group and/or the Diabetes Dietetic Practice Group of the Academy of Nutrition and Dietetics and had experience working with people receiving GLP-1 RA-based therapy. Survey data were analyzed via descriptive statistics. Respondents were female (95.3%), with 20.4 (SD + 11.9) years of experience, 64.1% held a master's degree, and 61.5% worked in an outpatient or ambulatory clinic. Regarding assessment practices, 26.4% screen for eating disorders, 42.9% perform a nutrition-focused physical exam, and 31.1% routinely assess body composition. The RDN respondents most commonly recommend monitoring for Vitamin D (78.2%) and iron (75%) deficiencies. Over 80% of respondents "strongly agree" (62.0%) or "somewhat agree" (22.4%) that there is a need to create specific GLP-1 RA-based therapy MNT practice guidelines. This survey not only identifies key patterns of consistency and variation in practice among RDNs but also reinforces the integral role that RDNs play in supporting and managing people on GLP-1 RA-based therapy. A majority of RDNs indicated a need to develop dietetic-specific MNT guidelines for GLP-1 RA-based therapy.
Non-pharmacological and non-surgical interventions are increasingly recognised as essential components of management of Parkinson's disease (PD). However, as PD progresses to its advanced stages, limited mobility, cognitive impairment, treatment-refractory symptoms, and increasing dependence on care partners dominate. However, the evidence base for therapies in this stage becomes scarce. Most clinical practice guidelines and systematic reviews address PD as a whole, without highlighting specific recommendations tailored to advanced disease stage. This narrative review examines the current evidence for non-pharmacological and non-surgical therapies specifically in the context of advanced PD. This includes physiotherapy and exercise, freezing of gait management, dysphagia rehabilitation, nutrition and dietetics, neuropsychiatric care, autonomic dysfunction, pain management, and palliative care. We synthesised evidence from recent systematic reviews of clinical practice guidelines, scoping reviews of rehabilitation interventions in advanced PD, systematic reviews and meta-analyses of non-pharmacological treatments for specific symptom domains, the published literature on advanced PD management, and expert consensus. A recent systematic review identified 40 summary statements for non-pharmacological interventions in PD, yet these were developed without stage-specific differentiation. A scoping review of rehabilitation interventions specifically targeting advanced PD identified only 13 studies, predominantly focused on physical functioning. On the other hand, while interventions for freezing of gait, swallowing therapies, cognitive behavioural therapy for neuropsychiatric symptoms, non-invasive brain stimulation, non-pharmacological autonomic management, and multimodal exercise have demonstrated promise in PD, robust evidence for advanced PD remains largely absent. People with advanced PD represent a neglected population in non-pharmacological therapy research. There is a clear need for inclusion of people with advanced PD in guideline development and a holistic approach addressing factors such as demoralisation, caregiver strain, autonomic dysfunction, and spiritual wellbeing alongside physical rehabilitation.
This study aimed to explore the experiences of Māori dietitians and students in Aotearoa New Zealand, with a focus on how racism, marginalism and tokenism affect their training, workplaces and wellbeing. A kaupapa Māori community research approach was undertaken in partnership with Te Kāhui Manukura o Kai Ora (Māori Dietitians Association). A focus group was held with Māori dietitians and students in March 2024. Data were analysed using reflexive thematic analysis, guided by kaupapa Māori research principles. Candidate themes were then shared with participants in March 2025, and a dissemination strategy was co-designed to protect anonymity. Composite narratives were then developed to illustrate how individual experiences connect to systemic issues. Three composite narratives were developed to highlight shared experiences of racism, tokenism and marginalism across the dietetic journey. Participants described culturally unsafe training environments where deficit stereotypes and staff silence placed additional burdens on Māori students. In workplaces, participants observed Māori patients being subject to inequitable care shaped by racialised assumptions, while Māori dietitians often carried the cultural load of being positioned as 'the Māori voice' without adequate support. These pressures contributed to isolation, burnout and challenges to professional identity, belonging and wellbeing. Systemic racism underpins these experiences, creating culturally unsafe environments and unsustainable cultural loading for Māori dietitians and students. Addressing these issues requires profession-wide action to strengthen cultural safety, support the retention and wellbeing of Māori within dietetics.
The period during pregnancy to postnatal is vital for developing of mother-infant bond. A mother suffering from depression may have issues with forming effective bonding. An evaluation of whether perinatal depression influences mother-infant bonding has scarcely been studied in Kenya. This study aimed to evaluate the relationship between perinatal depression and impaired maternal bonding among postpartum mothers. A total of 225 postpartum mothers aged between 18-49 years at 6-12 weeks postpartum at a ratio of 1:2 (cases: controls) were selected. Women who had MIBD were enrolled as cases while mothers without MIBD were controls. Two self-report scale tools; the Postpartum Bonding Questionnaire scale and the Edinburg Postnatal Depression scale were used at 6-12 weeks postpartum to obtain data on depression and bonding. A semi-structured questionnaire collected information on specific risk factors. The proportion of women with perinatal depression was 40% in the case group and 9.3% in the control group. The odds of having perinatal depression were 6.48 more in the cases than the controls (OR: 6.48, (95% C.I: 3.16, 13.28) and P-value <0.001. Perinatal depression is associated with impaired maternal bonding at 6-12 weeks postpartum.
Malnutrition, encompassing undernutrition, overnutrition, and micronutrient deficiency represents a global public health challenge with substantial implications for the development and clinical progression of type 2 diabetes mellitus (T2DM). The bidirectional relationship between nutritional status and glycemic regulation remains incompletely characterized across diverse geographic and socioeconomic settings worldwide, warranting a systematic synthesis of the available observational evidence. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted across PubMed/MEDLINE, EMBASE, and the Cochrane CENTRAL register from inception through December 2024. Twenty primary studies were included from multiple high-, middle-, and low-income countries across Asia, Europe, Africa, the Americas, and the Middle East, encompassing a total of more than 25,000 participants. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist; 45% of studies were assessed as high confidence and 55% as moderate confidence, following structured qualitative domain-level appraisal. Malnutrition prevalence, assessed by multiple validated instruments, ranged substantially across study populations and settings. Nutritional risk, defined by Geriatric Nutritional Risk Index criteria, was identified in 30.3% of participants in one Chinese cross-sectional study (n=551). Malnutrition prevalence, assessed using heterogeneous validated instruments across clinically and geographically diverse populations, ranged from 18.5% to 83.8% across included studies; this wide range reflects substantial variation in assessment instrument, patient acuity, clinical setting, and population demographics rather than a uniform epidemiological estimate. Indicators of undernutrition - including hypoalbuminemia, low BMI, and micronutrient deficiency - were associated with impaired glycemic regulation, greater complication burden, and elevated mortality risk. Adjusted odds ratios for diabetic retinopathy associated with malnutrition ranged from 1.67 (95% CI: 1.04-2.70) to 2.24 (95% CI: 1.07-4.69) depending on nutritional index used. Severe malnutrition was associated with 8.91-fold higher adjusted mortality odds (95% CI: 1.04-76.18) compared with moderate malnutrition among hospitalized T2DM patients. Conversely, indicators of overnutrition including elevated BMI and increasing waist circumference - were consistently associated with incident T2DM and adverse cardiometabolic profiles across multiple prospective and cross-sectional studies. Early-life famine exposure was associated with elevated adjusted odds of hyperglycemia in adulthood (aOR range: 1.34-1.57), emphasizing the relevance of developmental nutritional programming to adult T2DM risk. A dual burden of malnutrition concurrent undernutrition and overnutrition within the same populations and study samples - was observed across multiple geographic settings, consistent with patterns documented during nutritional transition. This systematic review identifies broadly consistent observational associations, with variability in association strength and direction by outcome domain and clinical context between malnutrition in both its under- and overnutrition forms and adverse clinical outcomes in T2DM across diverse global populations. These findings should be interpreted as associative rather than causal, given the predominance of observational cross-sectional and case-control designs, substantial heterogeneity in malnutrition definitions and outcome measures, and inherent risks of reverse causality and residual confounding. Future research should prioritize longitudinal and mechanistic study designs to clarify temporal pathways, and contextually appropriate nutritional screening should be integrated into T2DM prevention and management frameworks globally. https://www.crd.york.ac.uk/prospero/, identifier, CRD42024559848.
Malnutrition is common among older adults and is associated with adverse outcomes, yet its impact and relationship with geriatric vulnerability in emergency department (ED) patients remain underrecognized. To determine the prevalence, associated factors, and prognostic impact of malnutrition in noncritically ill older adults in the ED. We conducted an observational study of patients aged ≥ 65 years presenting to the ED. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF) and categorized as normal, at risk of malnutrition, or malnourished. Comprehensive geriatric assessment included functional status (activities of daily living (ADL)), frailty, cognitive function, and handgrip strength. Multivariable logistic regression identified factors associated with malnutrition. Kaplan-Meier survival analysis and multivariable Cox proportional hazards regression were performed to evaluate the association between nutritional status and 30- and 90-day all-cause mortality. Among 1487 patients, 23.3% were malnourished and 46.4% were at risk, with 59.7% overall having impaired nutritional status. Malnourished patients had significantly worse functional status, cognition, and physical performance. Independent factors associated with malnutrition included lower ADL, frailty, and decreased handgrip strength. Malnutrition was associated with significantly lower 30- and 90-day survival (both log-rank p < 0.001) and remained independently associated with both 30-day mortality (adjusted HR, 5.32; 95% CI, 1.36-20.73) and 90-day mortality (adjusted HR, 6.92; 95% CI, 2.16-22.13) after multivariable adjustment. Malnutrition is highly prevalent among older ED patients and is independently associated with increased short-term mortality. Functional decline, frailty, and reduced muscle strength are closely linked to both malnutrition and nutritional risk. Integrating nutritional screening with functional and physical assessment in the ED may improve early identification of high-risk patients and support timely interventions.
Early gut microbiota development plays an important role in lifelong human health, and meconium offers a unique matrix to understand prenatal microbial exposures. This study from the LIMIT cohort aimed at investigating associations between maternal pre-pregnancy body mass index (pre-BMI) and gestational weight gain (GWG), as well as other maternal lifestyle and environmental factors, with the structure of meconium microbiota at delivery. Two hundred pregnant women were enrolled during the pre-hospital care before birth at Fondazione IRCCS Policlinico San Matteo (Pavia), according to the inclusion/exclusion criteria. Mothers were grouped based on their GWG gain category according to the IOM guidelines. 168 meconium samples were analyzed using a targeted long-reads sequence approach. Bacterial 16S rRNA (V1-V8) amplicons were sequenced using the Oxford Nanopore PromethION platform. Supervised analyses assessed associations between maternal variables and bacterial diversity, while an unsupervised learning approach based on the Partitioning Around Medoids (PAM) clustering algorithm was applied to identify specific microbial clusters unrelated to the cohort's metadata. No significant associations were observed between GWG, pre-BMI or other lifestyle factors and overall microbial diversity. Unsupervised learning revealed five distinct meconium microbial clusters, i.e. "microbiota-types", related to different taxonomic profiles, determined by the variations in specific bacterial species. No significant influence of the studied variables was observed on meconium microbiota. However, the meconium microbial communities appear to organize into enterotype-like structures, highlighting the need for longitudinal studies to identify key determinants of early colonization.
Nitric oxide (NO) preservation suffers from instability and safety issues via conventional single-exposure treatments, while wet-casting methods cause substantial NO donor loss. This study developed metal-organic framework (MOF)-mediated controlled-release patches to address these limitations. Three MOFs (Cu-MOF, Zn-MOF, Fe-MOF) with distinct pore structures were synthesized, achieving 26.9%-38.2% L-arginine loading. The resulting gelatin-polyacrylic acid sodium hydrogel patches exhibited tensile strength of 3.03-4.84 MPa and elongation at break of 131.3%-240.1%, and dissolution rates of 12.4%-17.2%. They also showed significant antimicrobial activity against E. coli, S. aureus, and A. niger. MOF loading elevated precursor utilization efficiency to 70%-82.5%. The patches achieved sustained release of H₂O₂ (8.0-9.6 mmol/g) and NO (41.7-50.6 ppm) over 12 days, extending cherry tomato shelf life to 12 days at room temperature while maintaining total bacterial levels within safe limits. This work establishes MOF-mediated controlled release for green preservative gas utilization.
To (1) support athletic trainers (ATs) as they help athletes and other active individuals navigate dietary supplement use while prioritizing health, safety, legality, performance, and a food-first but not always food-only approach and (2) ensure that ATs have the reliable resources they need to provide general education and evaluate the use of dietary supplements. While the market continues to expand, the quality of dietary supplements worldwide is poorly regulated. At the same time, many active individuals report consuming multiple dietary supplements to improve health or performance or both. Athletic trainers are well positioned to proactively educate athletes on concerns that arise with taking dietary supplements. In many cases, the AT is the first health care professional asked to review the safety, effectiveness, and legality of a dietary supplement that an athlete is consuming. Our mission with this position statement is to provide ATs with the tools and resources needed to educate tactical operators and tactical athletes and to know when to refer the individual to a Sports Registered Dietitian Nutritionist and Board-Certified Specialist in Sports Dietetics. An individual's overall dietary pattern and habits should be considered first, but we encourage a food-first but not always food-only approach to dietary supplement education and review. The AT should use reliable resources to understand the risks and benefits of using dietary supplements.
Given the limited knowledge of probiotic effects on clock genes, this study investigated whether probiotics that regulate gut integrity and microbiota balance influence central circadian clock gene expression. In this study conducted on three groups [control group (CG), shifted group (SG), and shifted and probiotic supplement group (SPG)] of eight BALB/c mice each, Clock, Bmal1, and Per2 gene expressions and weight gain were evaluated. Although body weights at baseline, week 8, and week 16 were similar among groups, weight gain over time was significantly higher in the SG and SPG groups (p<0.05). Significant differences were observed between CG and SG at week 8 and between SG and SPG at week 16. Gene expression analyses revealed no significant differences in Clock expression. However, Bmal1 expression at ZT18 was significantly different between the CG and SPG groups (p = 0.045). These findings demonstrate the regulatory effect of probiotic supplementation on circadian disruption and weight gain, suggesting a potential role in circadian rhythm management. Nevertheless, the results should be interpreted cautiously because they are based on limited gene expression changes and require confirmation in larger studies.
Cyclophosphamide (CP) is an effective chemotherapeutic agent whose clinical use is limited by nephrotoxicity associated with oxidative stress and inflammation. This study investigated the potential nephroprotective effects of quercetin (QUE) and hesperidin (HSP) against CP-induced renal injury in rats. Thirty-six male Wistar albino rats were randomly assigned to six groups (n = 6): Control, QUE, HSP, CP, QUE + CP, and HSP + CP. QUE and HSP were administered orally at a dose of 100 mg/kg/day for 15 days. CP (200 mg/kg) was administered intraperitoneally on the final day to induce nephrotoxicity. Renal function was assessed using serum biochemical parameters (urea, uric acid, creatinine, blood urea nitrogen [BUN], albumin, and total protein), oxidative stress was evaluated by measuring renal antioxidant enzyme activities (superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GPx], and glutathione S-transferase [GST]) together with malondialdehyde (MDA) levels, and histopathological alterations were examined using hematoxylin-eosin staining. CP administration significantly increased serum urea, uric acid, creatinine, blood urea nitrogen, and total protein levels (all p < 0.05). It also increased renal MDA levels (p < 0.001) while reducing SOD (p < 0.05), CAT (p < 0.05), GPx (p < 0.001), and GST (p < 0.001) activities, accompanied by marked histopathological damage characterized by glomerular degeneration, tubular injury, hemorrhage, and inflammatory cell infiltration. Pretreatment with QUE or HSP significantly attenuated these alterations (all p < 0.05). Both flavonoids improved renal biochemical parameters, restored antioxidant defense mechanisms, reduced MDA levels, and ameliorated histopathological alterations compared with the CP group. Although QUE showed numerically greater improvements across several outcomes, direct statistical superiority over HSP was not demonstrated. QUE and HSP exert protective effects against CP-induced nephrotoxicity by reducing oxidative damage and preserving renal tissue integrity. These findings suggest that flavonoid-based adjunctive interventions may represent a promising strategy for reducing chemotherapy-associated renal injury and warrant further mechanistic and translational investigation.
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Tailored carbohydrate-counting (CC) resources are helpful for diabetes self-management from an educator and patient perspective. Because these resources are unavailable in Malawi, we developed both pictorial paper-based and mobile app CC resources and explored clinical dietitians' perceptions of these resources after using them in routine clinical practice. The initial pictorial paper-based CC resource was developed using foods informed by a previous study and input from clinical dietitians.Nutrient composition of foods was determined from the Malawi Food Composition Table and similar sources. We collaborated with clinical dietitians and app developers through a user-centered design/user experience approach, an iterative process to develop the mobile app CC. Five clinical dietitians then integrated both the pictorial paper-based and mobile app CC resources into routine clinical care for patients with diabetes, both inpatient and outpatient, for 10 working days. Subsequently, we conducted in-depth interviews to elicit their perceptions and analyzed the data using thematic analysis. Pictures of portioned foods were displayed alongside standardized utensils, food names in English and Chichewa, net weight, carbohydrate content, and the number of carbohydrate counts. The mobile app featured the following tabs: patient profile, carbohydrate information, food comparison, carbohydrate count, and meal planning. Four themes emerged from the in-depth interviews: ease and feasibility of use; benefits to dietetic practice; challenges with using the pictorial paper-based and mobile app; and perceived areas requiring improvement. The pictorial paper-based and mobile app CC resources were deemed easy to use and feasible for routine diabetes counseling, hence useful in low-resource settings.
While the Mediterranean diet shows promise in headache management, research on dietary interventions for pediatric patients remains scarce. This study evaluated the impact of a Mediterranean diet-based nutritional education intervention on headache severity, migraine-related disability, and quality of life in children and adolescents. In this 3-month, single-arm intervention study, 17 pediatric patients with primary headache were recruited from a Pediatric Neurology Outpatient Clinic (November 2022 - April 2023). Participants received comprehensive nutritional education emphasizing the Mediterranean diet. Outcomes were assessed preintervention and postintervention using the Mediterranean Diet Quality Index (KIDMED; dietary adherence), Pediatric Migraine Disability Assessment (PedMIDAS; disability), and Pediatric Quality of Life Inventory (quality of life) scales, alongside anthropometric and headache severity measurements. Postintervention, KIDMED scores significantly increased (P < 0.001). Notably, migraine disability scores decreased by approximately 45% (P = 0.001), and headache severity declined (P = 0.024), independent of significant changes in body mass index. Crucially, migraine-related disability (PedMIDAS) decreased significantly (P = 0.001), accompanied by a reduction in headache severity (P = 0.024). Furthermore, significant improvements were observed in quality of life, particularly in physical and psychosocial health domains (P < 0.05). Nutritional education focused on the Mediterranean diet is an effective strategy to improve dietary habits, reduce disability, and enhance quality of life in pediatric headache patients. To our knowledge, this is the first study to demonstrate a relationship between KIDMED and PedMIDAS scores, underscoring the clinical potential of dietary interventions in this population.
Acculturative stress, arising from cultural and psychological changes following intercultural contact, may increase vulnerability to maladaptive coping behaviors, including emotional eating. Evidence suggests that the association between acculturative stress and disordered eating differs by sex; however, Arab migrant populations remain underrepresented in this field. This study aimed to examine sex-stratified, migration-related predictors of emotional eating among Arab migrants living in Türkiye. This cross-sectional research was conducted between June 2022 and March 2024 and included 528 adults who migrated to Türkiye from Arab countries. Sociodemographic and migration-related characteristics were collected. Acculturative stress was assessed using the Acculturative Stress-Social, Attitudinal, Familial, and Environmental-Revised Short Form (SAFE-Short), and emotional eating was evaluated with Emotional Eating Scale (EES). Body mass index (BMI) was calculated from self-reported weight and height. Sex-stratified regression analyses were performed. BMI was positively associated with all EES subscales in both female and male participants. However, among male participants, the overall regression models for the Anger and Anxiety subdimensions were not statistically significant. Also, no sociodemographic or migration-related variables were associated with emotional eating among male participants. In females, higher age was associated with lower depression-related emotional eating, while single marital status was associated with higher anger-related emotional eating. Employment was associated with lower anger- and anxiety-related emotional eating. Migration due to personal safety concerns, living with individuals from different countries, and higher acculturative stress were associated with higher emotional eating scores in females. These findings may indicate that in social contexts where direct emotional expression is less acceptable for females, emotions are more likely to be regulated through eating-related behaviors.
Older adults experience high rates of chronic disease that reduce quality of life and independence. In South Texas, these challenges are compounded by limited access to culturally aligned care and a high burden of chronic conditions. Addressing these disparities requires infrastructure that bridges research and practice to support the translation of evidence into real-world care. This manuscript describes the establishment of the Supporting Older Adults through Research Network (SOARNet), a population-specific practice-based research network (PBRN) and reports early lessons from its development and recruitment strategies. SOARNet employs a multi-level leadership structure and an Advisory Board to guide research priorities, review member-initiated proposals, and facilitate collaboration among clinical, research, and community stakeholders. Recruitment strategies included informational materials, clinic visits, and targeted email outreach. Since inception, SOARNet has enrolled 61 members representing healthcare clinicians (55.7%), researchers (18.0%), community members (32.8%), and organizations (8.2%), with targeted email outreach proving most effective (n = 56). SOARNet has supported a collaborative research study, facilitated member consultations, and contributed to dissemination activities. These findings demonstrate the value of population-specific PBRNs in advancing community-engaged translational research to improve care for older adults. Future priorities focus on expanding partnerships and strengthening culturally responsive, bidirectional research.
The purpose of this review was to summarise recent relevant studies examining refeeding syndrome risk and related outcomes in patients provided with enteral nutrition and discuss considerations for clinical practice and future research. Recent studies investigating enteral nutrition and refeeding syndrome were heterogeneous. With the exception of physical indicators of nutritional status, there was no agreement across studies regarding commonly agreed upon risk factors including periods of fasting, feeding rates, or specific medical conditions. Comparisons of three different recommended risk criteria had highly variable results in one study. Confounding factors were evident across studies. Management of refeeding syndrome risk is becoming increasingly debated. Recent research has questioned the need for prolonged high thiamin dosages in adult patients with eating disorders. Conservative feeding practices are also called into question when serum electrolyte levels can be monitored and replaced assertively. Clinical practice and research in refeeding syndrome is slowly changing, with a focus on preventing unnecessary and prolonged underfeeding in malnourished patients and in children during critical stages of growth. Future research should ensure risk criteria is specific to the clinical conditions and/or age groups being investigated. Refeeding syndrome and its subsequent management should also be considered along a spectrum, rather than as an all or nothing event. By incorporating these recommendations, research in the field will evolve to advance knowledge and enhance clinical practice.
Interrupting evening sedentary time with activity breaks in a laboratory setting improves postprandial metabolism and sleep duration. This pilot study aimed to assess if a theory-informed intervention was able to increase the number of activity breaks performed in the evening at home, and to describe changes in movement patterns, glycaemic response and blood pressure. Twenty participants (mean age 34 ± 12 years, female n = 18) completed a 2-week intervention which supported them to perform 2-3 min activity breaks every 30 min during periods of prolonged sitting in the evening. The intervention utilised behaviour change techniques and a mobile application. The number of activity breaks performed was assessed via self-report, mobile app data, and accelerometer data. Other outcomes included: glycaemic control; 24-h movement patterns; blood pressure; self-reported sleep and capability, opportunity and motivation to interrupt evening sitting. Data was collected at baseline, 2-weeks (immediately post-intervention) and 4-weeks (following a 2-week follow-up period). On average, participants self-reported completing 3.6 activity breaks per evening during the intervention. There was little change in objective measures of sedentary time, sleep, physical activity, and glycaemic outcomes. A reduction in sleep disturbances (-0.35, 95% CI -0.6 to -0.1), as measured by the PSQI, was observed. Participants reported improved automatic motivation to interrupt evening sitting, but capability, opportunity and reflective motivation were unchanged. Increases in the number of activity breaks performed in the evening can be achieved and were accompanied by small improvements in sleep quality. A full-scale effectiveness RCT based on this intervention is warranted.
The present systematic review and meta-analysis aimed to investigate the effect of fenugreek supplementation on key liver enzymes, including alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). PubMed, Web of Science, and Scopus databases were searched from 1990 up to April 2025. Clinical trials examining the effects of fenugreek supplements on liver enzymes, specifically ALP, ALT and AST, were included in the study if they met the inclusion criteria. Random-effects meta-analysis was employed to calculate pooled weighted mean differences (WMD) and standardized mean differences (SMD) with 95% confidence intervals (95% CI). To evaluate statistical heterogeneity, the I-squared (I2) statistic was used. Sixteen studies were included, involving a total of 1171 participants. Results indicated that fenugreek supplementation had no significant effect on ALP (SMD = -0.21, 95% CI = -0.44, 0.03), AST (WMD = 0.03 IU/L, 95% CI = -0.12 to 0.18), and ALT (WMD = -1.41 IU/L, 95% CI = -3.07, 0.26). However, a significant reduction in ALP was observed for a dose of more than 1 g/day. Fenugreek didn't affect ALT and AST. However, there is potential benefit at doses ≥ 1 g/day regarding ALP. Further research should investigate effective doses in homogeneous populations and evaluating safety.
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