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Background Ghrelin is a peptide hormone predominantly produced by the stomach. It exerts a wide range of functions including stimulating growth hormone release and regulating appetite, food intake, and glucose and lipid metabolism. Since physical exercise affects all these aspects, a particular interest is accorded to the relationship between ghrelin and exercise. This systematic review aimed to summarize the current available data on the topic for a better understanding of the relationship. Methods An extensive computerized search was performed in the PubMed and SPORTDiscus databases for retrieving relevant articles. The search contained the following keywords: ghrelin, appetite-related peptides, gastrointestinal peptides, gastrointestinal hormones, exercise, acute exercise, chronic exercise, training, and physical activity. Studies investigating the effects of acute/chronic exercise on circulating forms of ghrelin were included. Results The initial search identified 840 articles. After screening, 80 articles were included. Despite a heterogeneity of studies and a variability of the findings, the review suggests that acute exercise suppresses acyl ghrelin production regardless of the participants and the exercise characteristics. Long- and very long-term exercise training programs mostly resulted in increased total and des-acyl ghrelin production. The increase is more noticeable in overweight/obese individuals, and is most likely due to weight loss resulting from the training program. Conclusion The review suggests that exercise may impact ghrelin production. While the precise mechanisms are unclear, the effects are likely due to blood flow redistribution and weight loss for acute and chronic exercise, respectively. These changes are expected to be metabolically beneficial. Further research is needed for a better understanding of the relationship between ghrelin and exercise.

The ergogenic effect of pre-selected warm-up music with the tempo and loudness variations on the performance of combat sports’ athletes as well as the difference between sexes is not well established. The present study aimed to assess the effects of listening to music with different tempos and loudness during warm-up on perceived exertion, physical enjoyment and physical performances in young taekwondo athletes. In a randomized study design, 20 taekwondo athletes (10 males, mean ± SD: age: 17.5 ± 0.7 years, taekwondo experience: ≥ 6 year) performed the taekwondo specific agility test (TSAT) and the 10s and multiple frequency speed of kick test (FSKT-10s and FSKT-mult) after warming-up with or without music. The music was played at high (140 beats·min -1 ) or very high (200 beats·min -1 ) tempo combined with low (60 dB) or high (80 dB) loudness, resulting in four experimental and control conditions. The ratings of perceived exertion (RPE) and physical activity enjoyment scale (PACES) were assessed after each condition. After normality, homogeneity and sphericity checks, two-way (or multivariate) analysis of variance and Bonferrroni (or Friedman’s and Wilcoxon’s test) post-hoc test were operated when necessary. For TSAT, 140 beats·min -1 +80 dB induced better performance compared with 200 beats·min -1 +80 dB, 200 beats·min -1 +60 dB, control and the 140 beats·min -1 +60 dB conditions. For FSKT-10s, 140 beats·min -1 +80 dB condition induced higher performance compared with 200 beats·min -1 +60 dB, 200 beats·min -1 +80 dB, 140 beats·min -1 +60 dB and the control conditions. For FSKT-mult, 140 beats·min -1 +80 dB induced higher number of techniques compared with 200 beats·min -1 +60 dB, 140 beats·min -1 +60 dB, control and the 200 beats·min -1 +80 dB conditions. Moreover, 140 beats·min -1 +80 dB induced lower decrement index (DI) compared with the other conditions and lower DI in 140 beats·min -1 +60 dB compared with 200 beats·min -1 +80 dB and control conditions. Moreover, 140 beats·min -1 +80 dB resulted in greater PACES scores compared with 200 beats·min -1 +80 dB and control conditions. Better performance was found for males compared with females in TSAT, FSKT-10s and FSKT-mult (i.e., techniques’ number), as well as lower DI and higher RPE post-FSKT-10s. Pre-selected warm-up music played at 140 beats·min -1 and 80 dB is an efficient strategy to enhance physical activity enjoyment and specific performances in taekwondo.

Ghrelin, a gastric-derived peptide, regulates appetite, food intake, and energy homeostasis. Body weight plays a crucial role in modulating circulating ghrelin levels. Since exercise training is one of the most valuable tools for controlling body weight, it is relevant to consider whether exercise can influence total ghrelin secretion. This study aims to perform a systematic review of the effect of acute/chronic exercise on plasma ghrelin levels. An extensive literature search was carried out on various databases, including PubMed, ScienceDirect, and Google Scholar. The search was conducted using English keywords such as acute-exercise, transient-exercise, exercise, chronic-exercise, training, physical-activity, physical-training, exercise training, and total-ghrelin, ghrelin, appetite-related-peptides, gastrointestinal-peptides, gastrointestinal-hormones, and appetite-regulating-hormone. Initially, 2104 studies were identified. After evaluating study quality, data from 61 relevant studies were extracted for inclusion in this review. Most studies indicated that short-term acute aerobic exercise did not affect total ghrelin levels regardless of exercise intensity, characteristics, or growth hormone (GH) secretion. However, long and very-long aerobic/chronic exercise increased total ghrelin levels, mainly in overweight/obese individuals. Acute/chronic exercise may differentially influence total ghrelin secretion. Short-term acute aerobic exercise induces stable plasma ghrelin concentrations, independent of GH secretion. Long-term aerobic training increased its levels mainly in overweight/obese individuals through body composition and oxidative stress reduction. Additionally, total ghrelin secretion is more sensitive to exercise/training duration than exercise/training intensity.

Postmenopausal obesity is an important public health concern, accompanied by increased systemic inflammation that heightens the risk of liver disease. Exercise improved both inflammatory and hepatic function. Moderate‐intensity intermittent‐walking training (MIWT) is considered a feasible approach for postmenopausal women with obesity. This study aimed to investigate whether MIWT could reduce the risk by modulating hepatic enzymes and selected inflammatory markers. Thirty‐six sedentary postmenopausal women with obesity (mean age 55.7 ± 3.5 years; mean weight: 86.9 ± 12.2 kg; mean BMI: 34.0 ± 5.0 kg/m2) were randomly assigned to a training group (TG, n = 18) or a control group (CG, n = 18). The TG completed a 10‐week MIWT protocol (4 sessions/week, ∼85 min/session), involving repeated walking intervals at 60%–80% of the 6MWT distance with active recovery. As a secondary objective, changes in body composition and aerobic capacity were also assessed. Significant improvements were observed in the TG group in liver enzymes alanine‐transaminase (ALT), (p = 0.002, d = 0.29), aspartate‐transaminase (AST) (p = 0.013, d = 0.29), gamma‐glutamyl‐transferase (GGT) (p = 0.036, d = 0.25), total bilirubin (p = 0.009, d = 0.13), and C‐reactive‐protein (CRP) (p = 0.007, d = 0.49). Additionally, significant reductions were found in body mass (p < 0.001), BMI (p < 0.001), body fat (p = 0.001), and waist circumference (p < 0.001), along with increased aerobic capacity (p = 0.031). These findings indicate that MIWT is a feasible and effective intervention for inducing favorable changes in liver‐related biochemical markers and systemic inflammation, with additional benefits for body composition and aerobic fitness in postmenopausal women with obesity. Summary Moderate‐intensity intermittent walking (MIWT) significantly improved liver enzymes (ALT, AST, GGT) and increased total bilirubin, indicating enhanced hepatic function in postmenopausal women with obesity. Systemic inflammation was reduced, as evidenced by significant decreases in C‐reactive protein (CRP) following the 10‐week MIWT program. MIWT also improved body composition by reducing body mass, BMI, body fat, and waist circumference, while enhancing aerobic capacity. MIWT represents a feasible, low‐cost, non‐pharmacological intervention that can be integrated into community‐ or primary care–based programs to improve metabolic health in postmenopausal women with obesity.

Background: Neuromuscular determinants such as maximal force, maximal velocity, and upper-body power are recognized as key contributors to competitive swimming performance. However, despite the relevance of these dry-land qualities, their relationships with the physiological mechanisms underpinning in-water performance, particularly aerobic and anaerobic capacities, remain insufficiently established. Purpose: This study aimed to investigate the relationships between upper-body load–velocity profile parameters (theoretical maximal force: F0; theoretical maximal velocity: V0; and maximal power: Pmax), aerobic capacity expressed through critical velocity, and anaerobic capacity in trained swimmers. Methods: Thirty competitive male swimmers (age = 16.50 ± 0.31 years) completed an upper-body load–velocity profile test using the bench press exercise to determine F0, V0, and Pmax. Swimming performances in the 100, 200, and 400 m freestyle events were used to calculate critical velocity and anaerobic capacity based on a linear distance–time model. Pearson correlation coefficients and linear regression analyses were conducted to examine the relationships between variables. Results: Pmax (r = 0.493, p = 0.006) and V0 (r = 0.697, p < 0.001) showed moderate to strong correlations with critical velocity, whereas F0 showed no significant association (r = 0.152, p = 0.422). Conversely, anaerobic capacity was strongly correlated with F0 (r = 0.842, p < 0.001) but not with V0 (p = 0.119). Regression models indicated that F0 explained 71% of the variance in anaerobic capacity, while V0 explained 48% of the variance in critical velocity. Conclusion: The findings demonstrated distinct contributions of neuromuscular qualities: speed and power-oriented parameters are associated with critical velocity, whereas maximal strength strongly associated with anaerobic capacity. Monitoring the upper-body load–velocity profile appears to be a relevant tool for individualizing dry-land training according to the aerobic and anaerobic demands of swimmers.

Background and Objectives: Hyperthermia significantly limits endurance performance in hot environments. To enhance heat loss and optimize athletic performance, pre-cooling interventions can be employed to accelerate body cooling. Therefore, the aim of this study was to evaluate the effects of an internal pre-cooling intervention combined with external pre-cooling or hydrogen-rich water on endurance performance in the heat. Materials and Methods: In a double-blind crossover with counterbalanced trials, all participants underwent a shuttle run test after 30 min under the following conditions: (1) hydrogen-rich cold water ingestion (HRCW); (2) cold water ingestion and external pre-cooling (IEPC); and (3) cold-water ingestion (control). Maximal aerobic speed (MAS), number of shuttle run repetitions, dehydration, temperature, heart rate (HR), rate of perceived exertion (RPE), blood lactate, and feeling scale (FS) were measured during the 20 m shuttle run test. Results: Our results revealed a significant variation in dehydration, MAS, number of shuttle run repetitions, blood lactate, RPE, and FS (p = [0.001–0.036]); additionally, a significant group × time interaction was found for body temperature (p = 0.021). Post hoc tests revealed a significant change for MAS (HRCW: p < 0.001), number of shuttle run repetitions (HRCW: p < 0.001), dehydration (HRCW: p= 0.009; IEPC: p = 0.008), blood lactate (HRCW: p < 0.001; IEPC: p < 0.001), RPE (HRCW: p = 0.05; IEPC: p = 0.004), and FS (HRCW: p = 0.05; IEPC: p = 0.004), as well as a significant decrease in body temperature (IEPC: p < 0.001; HRCW: p = 0.028) compared to the control condition after the test. However, no significant differences were reported in HR among the different conditions. Conclusions: In conclusion, findings from this study suggest that ingesting hydrogen-rich cold water effectively mitigates the effects of heat stress, thereby improving endurance performance, enhancing mood, and reducing ratings of perceived exertion.

This study investigated the comparative effects of small-sided games (SSG) and Hoff circuit (HC) training on physical, technical, and psychophysiological parameters in highly trained youth soccer players. Twenty-six youth players from a professional team were randomly allocated to either an SSG group (n = 13, age = 17.53 ± 0.49 years) or an HC group (n = 13, age = 17.54 ± 0.5 years). The six-week intervention comprised two additional training sessions per week alongside regular team training. Pre- and post-program assessments evaluated physical performance (Vameval test, 5-Jump Test, 10 m and 30 m sprints, and Illinois agility test), technical skills (passing accuracy, possession, interceptions, tackling, and heading). Perceptual responses (RPE and PACES) were evaluated after each session. The HC protocol involved a 290 m dribbling circuit performed at 90–95% HRmax, whereas the SSG emphasized ball possession and tactical gameplay under game-like conditions. The results showed that both training modalities significantly improved maximum aerobic speed (MAS) ( p  < 0.05). However, the SSG group demonstrated superior improvements in sprint performance (10 m and 30 m; p  < 0.01) and agility (Illinois test; p  < 0.01) compared to the HC group. SSG training was also more effective in enhancing technical skills, particularly passing accuracy ( p  < 0.05) and interceptions ( p  < 0.05). No significant between-group differences were observed in heart rate responses ( p  > 0.05) or RPE ( p  > 0.05). Notably, SSG participants reported significantly higher enjoyment levels ( p  < 0.05), suggesting enhanced motivation and training adherence. SSG training offers superior benefits for sprint performance, agility, technical skill development, and player enjoyment compared to circuit-based training in youth soccer players. These findings support the integration of SSG as a primary training methodology for coaches seeking to optimize athletic performance, technical proficiency, and player engagement in youth soccer development programs.

Repeated multidirectional jumps are highly specific movements in basketball, which may be important to integrate the training routine. Accordingly, this study aimed to assess the effects of three different multidirectional plyometric jumping sequences on shooting, balance, and neuromuscular performance in professional, male basketball players. Eighteen players underwent familiarization and baseline performance assessments in an initial session. Players then completed 21 visits in a randomized, counterbalanced manner. Each visit involving 10 repetitions of one of three different multidirectional plyometric protocols followed by a single performance test (countermovement jump (CMJ), squat jump (SJ), five jump (FJT), change-of-direction T-test (CoD T), Stork balance (SBT), Y-balance (YBT), three-point shooting (3pts) tests). The first plyometric protocol (P1) consisted of a combination of vertical and horizontal jumps, the second protocol (P2) consisted of a combination of drop, lateral, and vertical jumps, and the third protocol (P3) consisted of a combination of drop, single-leg step-up, and horizontal jumps. Each session was separated by at least 48 h of rest and recovery time between repetitions was 20 s. Neuromuscular (CMJ, SJ, FJT and CoD T), body balance (SBT and YBT), and Shooting performances were significantly worse following each plyometric protocol compared to baseline (p < 0.001; d = 0.23-2.21). In addition, the majority of the measured performances were significantly lower following P3 compared to P1 and P2. Basketball-specific performance was adversely influenced by repeated multidirectional plyometric routines. Incorporating these particular strategies into the training regimen to counteract the induced tiredness will be intriguing.

The present study assessed the effects of listening to preferred music during warm-up at different frequencies (440 Hz vs. 432 Hz) on the physical performance and psychophysiological responses in male athletes. In a double-blind crossover study design, twenty-two male athletes (Mean ± SD: age: 22.4 ± 1.6 years; body mass: 71.8 ± 8.3 kg; height: 1.83 ± 0.1 m; BMI: 22.7 ± 1.9 kg. m − 2 randomly performed the 3-min all out test (3MT), repeated sprint test (RST), squat jump (SJ) and countermovement jump (CMJ) tests after listening to preferred music at 440 Hz–432 Hz frequencies or without music during warm-up. Heart rate was measured during 3MT, Also, rating of perceived exertion (RPE) and feeling scale (FS) were measured just after 3MT and RST tests. Results showed that no music condition induced lower performance compared to listening to preferred music at 440 Hz (mean speed: p  < 0.001, d = 0.82; peak speed: p  < 0.001, d = 0.85; total distance covered: p  < 0.001, d = 0.83; FS: p  < 0.001, d = 1.21) and music 432 Hz (mean speed: p  < 0.001, d = 0.75; peak speed: p  < 0.001, d = 0.58; total distance covered: p  < 0.001, d = 0.76, FS: p  = 0.004, d = 0.77) during 3MT. In addition, a significant decrease in Total time and Fast time indices of RST, FS, SJ and CMJ values was recorded with music at 440 Hz compared to music 432 Hz (total time: p  < 0.001, d = 0.65; fast time: p  < 0.001, d = 0.53; FS: p  = 0.018, d = 0.59; SJ: p  = 0.031, d = 0.3; CMJ: p  = 0.007, d = 0.41) and no music condition (total time: p  < 0.001, d = 0.89; fast time: p  < 0.001, d = 0.57; FS: p  < 0.001, d = 1.21; SJ: p  < 0.001, d = 0.64; CMJ: p  < 0.001, d = 0.54). However, no significant change was observed in heart rate, fatigue index of the RST, or RPE. Listening to preferred music at a fast tempo and moderate volume during warm-up sessions improved physical performance and positive mood irrespective of whether it was tuned to 440 Hz–432 Hz. The benefits were more noticeable at 440 Hz.

Background: Malnutrition in adolescents remains a significant public health issue worldwide, with undernutrition and overweight often coexisting. Accurate nutritional screening during adolescence is complicated by variability in biological maturation and class imbalance, particularly among underweight adolescents. Objective: This study aims to develop and validate machine learning models for classifying the nutritional status of adolescents, accounting for class imbalance and biological maturation, and to evaluate model stability and variable importance at different stages of peak height velocity (PHV). Methods: In this cross-sectional study, 4232 adolescents aged 11 to 18 years were recruited from nine educational institutions in Tunisia. Their nutritional status was classified according to the International Obesity Task Force (IOTF) BMI thresholds into three categories: underweight (14.4%), normal weight (68.3%), and overweight (17.2%). Ten anthropometric, behavioral, and maturation-related predictors were analyzed. Six supervised machine learning algorithms were evaluated using a 70/30 stratified split between training and test sets, with five-fold cross-validation. Class imbalance was addressed by ROSE combined with cost-sensitive learning. Model performance was assessed using accuracy, Cohen’s kappa coefficient, macro F1 score, sensitivity, specificity, and AUC. Results: The cost-sensitive Random Forest (RF) model achieved the best overall performance, with an accuracy of 0.830, a macro F1 score of 0.767, a macro-AUC of 0.921, and a macro- sensitivity of 0.743. The class-specific sensitivities were 0.70 (underweight), 0.91 (normal weight), and 0.62 (overweight), with no major misclassification between the extreme categories. Performance remained stable across the different maturation phases (accuracy from 0.823 to 0.839), with optimal discrimination in the pre-PHV (macro-AUC = 0.936; sensitivity for underweight = 0.82) and post-PHV (macro-AUC = 0.931) periods. Body mass was the main predictor (importance = 1.00), followed by waist circumference (0.34–0.53). The importance of age for classifying underweight increased significantly from the pre-PHV (0.10) to the post-PHV (0.75) period. A two-stage hierarchical model further improved underweight detection (stage 1 AUC = 0.911; sensitivity = 0.732). Conclusions: A cost-sensitive RF model, combined with ROSE, provides robust classification of adolescents’ nutritional status maturation, significantly improving underweight detection while preserving overall accuracy. This approach is particularly well-suited to public health screening in schools as a first-stage assessment that requires clinical confirmation and promotes a maturation-aware interpretation of nutritional risk among adolescents.