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Objective: This double-blind, parallel-group randomized controlled trial is the first to investigate the synergistic effects of interval resistance plus progressive aerobic training with fisetin supplementation on adipokines in obesity. Methods: Sixty sedentary men with obesity (BMI < 30 kg/m2) completed 12 weeks of thrice-weekly interval resistance training (eight exercises, 3 × 13 reps at 60% 1RM with 20% 1RM active rest), immediately followed by staged aerobic bouts (50–70% HRmax). Participants were randomized into the control-placebo (P), fisetin (F; 200 mg/day), training-placebo (TP), or training + fisetin (TF) groups. The primary outcomes were asprosin, MCP-1, and adiponectin; secondary outcomes included leptin and lipid profile. Data were analyzed via ANCOVA with Bonferroni post hoc tests. Results: Statistical analyses were conducted following the intention-to-treat (ITT) principle using an analysis of covariance (ANCOVA) model, which revealed extensive effects of the interventions on the participants’ anthropometric and biochemical indices. Regarding body composition, after adjusting for baseline values, a significant difference in mean body weight was observed between groups (F (3, 55) = 9.444, p < 0.001, ηp2 = 0.340); Bonferroni post hoc tests confirmed that the training plus fisetin (TF), training-placebo (TP), and fisetin (F) groups all achieved significant weight loss compared to the placebo (P) group. Furthermore, body mass index (BMI) showed a significant inter-group difference (p = 0.021), with post hoc analysis revealing that only the TF group reached a statistically significant reduction compared to the placebo (p = 0.024; 95% CI [−3.760, −0.172]). In the assessment of biochemical and inflammatory variables, the interventions exerted a highly significant effect on asprosin (F (3, 55) = 36.047, p < 0.001; ηp2 = 0.663) and MCP-1 (F (3, 55) = 29.570, p < 0.001; ηp2 = 0.617). The findings indicated that the TF group experienced the most substantial reductions in both asprosin (−60.71%) and MCP-1 (−46.50%) levels. Regarding adipokines, significant increases in adiponectin levels were observed in the TP (29.38%) and TF (27.67%) groups (p < 0.05), whereas changes in leptin were statistically significant only in the TF group relative to the placebo (p = 0.049). The lipid profile results indicated a statistically significant difference in the TF group in improving all markers; this group achieved greater reduction compared to other groups, including reductions in LDL-C, triglycerides (TG), and total cholesterol (TC) (p < 0.001), while simultaneously showing a significant elevation in HDL-C. Post hoc analyses confirmed robust statistical differences in all lipid parameters for both the TF and TP groups compared to the placebo group (p < 0.05), whereas the placebo group experienced a deterioration in status characterized by a significant increase in LDL-C (p = 0.027) and a significant decline in HDL-C concentrations (p = 0.006). Conclusions: In conclusion, 12 weeks of combined interval resistance–aerobic training and fisetin supplementation significantly reduced pro-inflammatory adipokines and improved lipid profiles in obese men. These findings suggest that asprosin serves as a potential modulator in metabolic risk reduction; however, since direct mechanistic assays were not conducted, these implications remain hypothetical. Future research employing molecular readouts is warranted to confirm the underlying pathways involved.

In recent decades, Food Literacy (FL) has gained significant attention in the fields of food and nutrition. It is considered a key determinant of public health and presents a promising approach to addressing health challenges like obesity and environmental sustainability. However, Lebanon currently lacks a validated tool to assess food literacy. In this context, the Short Food Literacy Questionnaire (SFLQ) offers potential for translation and cultural adaptation. Adapting an established tool for use in a new cultural setting enables cross-country comparisons and supports the development of cross-cultural study models. Therefore, this study aims to culturally adapt the SFLQ to assess food literacy among Lebanese adults, enhance their knowledge, and promote healthier lifestyle habits. A nationally representative sample of 450 adults was selected through probability cluster sampling from the eight Lebanese governorates. The SFLQ was administered between 11 December 2022 and 23 March 2023 to evaluate participants' food literacy. Confirmatory Factor Analysis was conducted using SPSS AMOS version 30, applying the maximum likelihood estimation method to obtain parameter estimates. The average age of the participants was 46.0 years, with women making up 59.0% of the sample. The one-factor model showed an acceptable fit after accounting for correlated residuals between items 4-5, 9-10 and 11-12 (RMSEA = 0.079 (90% CI 0.068, 0.091), SRMR = 0.053, CFI = 0.935, TLI = 0.916). Internal consistency was satisfactory (ω = .86/ α = .86). Measurement invariance across gender was confirmed at the configural, metric and scalar levels. Males had significantly higher average SFLQ scores than females (32.80 ± 7.91 vs 28.76 ± 9.26; p < 0.001, Cohen's d = 0.486). A significant negative correlation was observed between SFLQ and Household Food Insecurity Access scores (r = -0.28; p < 0.001). The SFLQ demonstrated strong internal consistency, indicating that it is a reliable tool for both research and clinical use. Expanding validation efforts to include a broader Arabic-speaking population, particularly individuals without internet access, would further strengthen the tool's applicability and cultural relevance across diverse contexts in the Arab world.

Background and Objectives: Obesity is a significant risk factor for cardiovascular disease. Physical exercise has been established as an effective intervention for reducing cardiovascular mortality. This systematic review aimed to investigate the effects of various exercise modalities on cardiovascular risk factors in men with obesity. Materials and Methods: This review included randomized controlled trials (RCTs) published between 2005 and November 2023. Studies were eligible if they assessed the impact of exercise interventions on blood pressure (BP), lipid profiles, and glucose/insulin regulation in males aged 18 years or older with a body mass index (BMI) of 25 kg/m2 or greater. The quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Results: A total of 25 RCTs were included in the analysis, with PEDro scores ranging from 3 to 7. High-intensity interval training (HIIT) was associated with significant reductions in BP, with an average decrease of 12.5 mmHg. However, the magnitude of BP reduction varied across studies, likely due to differences in training protocols and study quality. Resistance training (RT) was associated with modest improvements in glycemic control, with some studies reporting a reduction in fasting blood glucose levels by 5–10%. Combined exercise (CT) programs, which included both aerobic and resistance training, as well as aerobic exercise alone, were shown to improve lipid profiles, with some studies showing reductions in total cholesterol levels ranging from 10–15%. However, the findings were inconsistent, highlighting the need for further research to better understand the potential benefits and optimal exercise regimens. Conclusions: This systematic review supports the potential of exercise training in reducing cardiovascular risk factors in men with obesity, though the effectiveness varies depends on the type of exercise. Combined exercise programs have shown promise for lipid profiles, but further research is needed to confirm these effects. HIIT has been linked to BP reductions in some studies, although the results are inconsistent and depend on protocols and study quality. The limitations in study quality may impact the reliability of these findings.

Objective: This study evaluated the effects of a 12-week High-Intensity Functional Training (HIFT) program combined with thylakoid supplementation on plasma adipo-myokine levels (Decorin, Myostatin, Follistatin, Activin A, and TGF-β1) in men with obesity. Secondary outcomes included anthropometric indices, lipid profiles, and insulin resistance markers. Methods: Sixty men with obesity (age: 27.6 ± 8.4 years; BMI: 32.6 ± 2.6 kg/m2) were randomly assigned to four groups (n = 15 per group): Placebo (PG), Supplement (SG), HIFT + placebo (TPG), and HIFT + supplement (TSG). To ensure robustness against the 27% attrition rate, statistical analyses included both per-protocol and intention-to-treat (ITT) models. HIFT was performed for 3 sessions/week (Borg scale: 15–17). Results: Following Bonferroni correction for multiple endpoints, repeated-measures ANOVA showed significant Time × Group interactions for most adipo-myokines and metabolic markers. Both training groups (TPG and TSG) demonstrated improvements in body composition and insulin sensitivity compared to PG (p < 0.05). While no significant differences were observed between TPG and TSG for systemic metabolic markers, preliminary data suggested that thylakoid supplementation might provide modest complementary modulations in specific myokines (e.g., decorin and follistatin). However, these observed trends did not reach clinical superiority over exercise alone in the broader metabolic profile. Conclusions: Twelve weeks of HIFT is an effective primary driver for modulating the adipo-myokine network in obese men. Although thylakoid supplementation showed potential for selective complementary effects on certain myokines, these findings are exploratory given the small sample size. The clinical significance and long-term complementary value of thylakoid-exercise interactions require further validation in larger, more diverse cohorts.

Introduction: Nutrition literacy has garnered growing research attention worldwide, yet only a few instruments have been developed to specifically measure this construct among adolescents. Accordingly, the present research sought to examine the validity and reliability of the Adolescent Nutrition Literacy Scale (ANLS) within a group of Lebanese adolescents. Methods: A cross-sectional study was carried out from December 2022 to March 2023, targeting a nationally representative sample. Results: Fit indices of the three-factor structure were good. Internal reliability was adequate for the following three subscales: Functional Nutrition Literacy (FNL) (ω = 0.88/α = 0.88), Interactive Nutrition Literacy (INL) (ω = 0.87/α = 0.86) and Critical Nutrition Literacy (CNL) (ω = 0.89/α = 0.89). Invariance was established across genders at configural, metric, and scalar levels. A significantly higher mean FNL and INL scores were found in males compared to females, with no significant difference between the two genders in terms of CNL. Higher FNL, but not CNL and INL scores were significantly associated with lower child food security. Conclusions: The Arabic ANLS has exhibited robust psychometric reliability, validity, and cost-effectiveness as a tool for assessing nutrition literacy. By utilizing the Arabic version of the ANLS, we can more efficiently and accurately assess the nutritional literacy of adolescents.

Background/Objective Cellular immune markers of inflammation such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) are frequently used in patient care. The adoption of these markers to elite sports, e.g. soccer could be beneficial when monitoring training and aiming to maximize physical fitness. This study investigated cellular immune inflammation markers and physical fitness in elite male soccer players in relation to changes in training and match exposure during a congested match play period. Methods Fifteen elite male soccer players were evaluated three times (T1, T2, and T3) over 12 weeks (T1–T2: six weeks uncongested period of match play and T2–T3: six weeks congested period of match play). Players performed vertical jump tests (squat jumps [SJ], countermovement jumps [CMJ]), the 20-meter sprint test, and the Yo-Yo intermittent recovery test (YYIRL1) at T1, T2 and T3. Measurements included counts of leucocytes and its subtypes, as well as platelets. Cellular immune inflammation markers (NLR, PLR and SII) were calculatedat T1, T2, and T3. Training session rating of perceived exertion was also recorded on a daily basis. Results Significant increases in leucocyte, neutrophil, eosinophil, basophil and monocyte counts occurred at T3 compared with T2 (0.002 <  p  < 0.04, -0.56 < ES < -0.40) and T1 (-0.78 < ES < -0.49). Lymphocyte counts were lower at T3 as compared to T2 and T1 ( p  = 0.038, -0.48 < ES <-0.25), while NLR, PLR and SII were greater at T3 compared to T2 (0.001 <  p  < 0.015, -1.01 < ES < -0.44) and T1 (-0.99 < ES < -0.21). There was a negative correlation between YYIRL1 performance with NLR ( r = -0.56; p  = 0.02), PLR ( r =-0,44, p  = 0.015), and SII ( r = -0.63; p  = 0.01) after the congested period of match play (i.e., T3). Values for maximal oxygen uptake (VO 2max ), estimated from the YYIRL1 test, negatively correlated with NLR ( r = -0.56; p  = 0.02), PLR ( r =-0,44, p  = 0.015), and SII ( p  = 0.01; r = -0.63). There was a positive correlation between NLR, and SII with workload parameters. In addition, a clear positive correlation was observed between NLR and SII with competitive loadinstead (r= [0.59–0.64; p˂ 0.001), training load (TL) (r= [0.65–0.68]; p˂ 0.001), session rating of perceived exertion (S-RPE) (r= [0.65–0.68]; p  = 0.001), and training volume (r= [0.60–0.61; p  = 0.001). Conclusion An intensive period of congested match play significantly alterated immune cell counts and cellular markers of inflammation (NLR, PLR and SII). Changes in NLR and SII were related to workload parameters, suggesting the usefulness of these markers in regulating training intensity and competitive load. An association between physical fitness (YYIRL1, VO 2max ) and NLR, PLR and SII suggests that these biomarkers are promising tools to monitor aerobic physical fitness of elite soccer players during congested periods of match play.

This study investigated the combined effects of 12 weeks of high-intensity interval training (HIIT) and spirulina supplementation on adipokine levels, insulin resistance, anthropometric indices, and cardiorespiratory fitness in 44 obese males (aged 25–40 years). The participants were randomly assigned to one of four groups: control (CG), supplement (SG), training (TG), or training plus supplement (TSG). The intervention involved daily administration of either spirulina or a placebo and HIIT three times a week for the training groups. Anthropometric indices, HOMA-IR, VO 2peak , and circulating adipokines (asprosin and lipocalin2, omentin-1, irisin, and spexin) were measured before and after the 12-week intervention. Post-intervention analysis indicated differences between the CG and the three interventional groups for body weight, fat-free mass (FFM), percent body fat (%BF), HOMA-IR, and adipokine levels ( p  < 0.05). TG and SG participants had increased VO 2peak ( p  < 0.05). Spirulina supplementation with HIIT increased VO 2peak , omentin-1, irisin, and spexin, while causing decreases in lipocalin-2 and asprosin levels and improvements in body composition (weight, %fat), BMI, and HOMA-IR. Notably, the combination of spirulina and HIIT produced more significant changes in circulating adipokines and cardiometabolic health in obese males compared to either supplementation or HIIT alone ( p  < 0.05). These findings highlight the synergistic benefits of combining spirulina supplementation with HIIT, showcasing their potential in improving various health parameters and addressing obesity-related concerns in a comprehensive manner.

Aim: To investigate the synergistic effects of exercise training and Brassica oleracea var. italica (broccoli sprout) supplementation on Apolipoprotein A-I, B-100, and J levels in men with Type 2 diabetes mellitus (T2DM). Methods: Forty-four males with T2DM were randomly assigned to four groups: Control (CG), Supplement (SG), Training (TG), and Training + Supplement (TSG) groups. Participants in the supplement groups (SG and TSG) received 10 g of broccoli supplement after meals for 12 weeks, while those in the training groups (TG and TSG) participated in a structured exercise program (resistance and aerobic), performed three times per week for 12 weeks, at intensities of 60–70% one-repetition maximum (1RM) for resistance training and 60–70% peak oxygen uptake (VO2peak) for aerobic training. Results: Circulating levels of apolipoproteins improved after 12 weeks in the TSG, TG, and SG groups. However, the TSG group exhibited the most pronounced improvements across metabolic and lipoprotein markers, reflecting an additive effect of both interventions. Specifically, the TSG group demonstrated absolute reductions in ApoB-100 (−48.30 ± 7.20 mg/dL) and ApoJ (−44.05 ± 5.76 mg/dL), along with an increase in ApoA-I (+44.92 ± 6.05 mg/dL). Main effect analysis revealed that exercise training elicited the most substantial improvements across metabolic and lipoprotein markers, with large effect sizes for glucose (η2p = 0.787), insulin (η2p = 0.640), HOMA-IR (η2p = 0.856), ApoA-I (η2p = 0.685), ApoB-100 (η2p = 0.774), ApoJ (η2p = 0.848), and HDL-C (η2p = 0.535). Supplementation showed moderate effects, particularly on HOMA-IR (η2p = 0.370), ApoA-I (η2p = 0.383), and ApoB-100 (η2p = 0.334), supporting an additive but exercise-dominant benefit. The combined intervention group (TSG) showed the most pronounced improvements across all measured outcomes, with large effect sizes for ApoA-I (η2p = 0.883), glucose (η2p = 0.946), insulin (η2p = 0.881), HOMA-IR (η2p = 0.904), and ApoJ (η2p = 0.852). Conclusions: The effects of combining training and broccoli sprout supplementation on apolipoprotein levels are likely to result from the activation of two separate pathways, one from training and the other from supplementation. This dual-modality intervention could serve as an effective complementary strategy in managing metabolic and cardiovascular risk factors for individuals with T2DM. However, the magnitude of change induced by the combination of exercise training and broccoli supplementation was largely driven by the training component, with supplementation providing complementary but less consistent benefits.

Fasting is defined as the abstinence from consuming food and/or beverages for different periods of time. Both traditional and modern healthcare systems recommend fasting as a therapeutic intervention for the management of several chronic, non-infectious diseases. Exercising during a fasting state increases lipolysis in adipose tissue while also stimulating peripheral fat oxidation, resulting in increased fat utilization and weight loss. A key focus of this review is to assess whether endurance training performed while fasting induces specific training adaptations, where increased fat oxidation improves long-term endurance levels. Fasting decreases body weight, lean body and fat content in both trained and untrained individuals. Several studies indicate a broader impact of fasting on metabolism, with effects on protein and glucose metabolism in sedentary and untrained subjects. However, there are conflicting data regarding the effects of fasting on glucose metabolism in highly trained athletes. The effects of fasting on physical performance indicators also remain unclear, with some reporting a decreased performance, while others found no significant effects. Differences in experimental design, severity of calorie restriction, duration, and participant characteristics could, at least in part, explain such discordant findings. Our review of the literature suggests that there is little evidence to support the notion of endurance training and fasting-mediated increases in fat oxidation, and we recommend that endurance athletes should avoid high intensity training while fasting.

We review the effects of acute and long-term physical activity on adipokine levels in individuals with type 2 diabetes (T2D). Three electronic databases were searched. Studies made in animal models were excluded, while studies based on participants with and without T2D, and also studies with type 1 diabetes were included. Of the 2,450 citations, 63 trials, including randomised control trials, cross-sectional and longitudinal studies, met our inclusion criteria. Seventy and five percent of studies reported the effects of physical activity on tumor necrosis factor-alpha (TNFα), interleukin 6 (IL-6), adiponectin, visfatin, omentin-1, and leptin levels. There are no robust results due to variations in exercise modality, intensity, duration, and also differences in cohort characteristics in the literature. Only four studies described the effects of an acute session of physical activity on adipokine levels. Overall, physical activity improves diabetes status by regulating adipokine levels. However, long-term aerobic + resistance training combined with dietary modifications is likely to be a more effective strategy for improving adipokines profiles in patients with type 2 diabetes.