Meeting multiple sclerosis-specific physical activity guidelines (PAGs) has been associated with numerous benefits in people with multiple sclerosis (PwMS). However, the characteristics of PwMS predictive of meeting PAGs are unknown. This study aimed to examine which sociodemographic and clinical characteristics are associated with meeting the Canadian MS PAGs. A retrospective chart review of all PwMS referred to physiatry at the largest Canadian tertiary MS clinic between December 2021-December 2023 (n=455) was conducted. Physical activity, sociodemographic, and clinical characteristics were collected. Physical activity levels were categorized into one of three groups: no activity, some activity but not meeting PAGs, and meeting PAGs. Physical activity was further categorized by type of activity (aerobic and strength training). Associations between characteristics and physical activity levels were examined using multinomial logistic regression. PwMS who did not drive (OR=0.53, 95%CI=0.29-0.97) and were non-ambulatory (OR=0.34, 95%CI 0.11-0.99) were significantly less likely to meet PAGs. Higher Expanded Disability Status Scale (OR=0.80, 95% CI=0.70-0.91), gait aid use (OR=0.55, 95%CI=0.34-0.88), incoordination (OR= 0.52, 95% CI=0.33-0.82), progressive MS phenotype (OR=0.60, 95% CI=0.37-0.95), and smoking (OR=0.31, 95% CI=0.13-0.76) were associated with lower odds of doing any aerobic activity. Those with cognitive symptoms (OR=1.93, 95%CI=1.22-3.04) and greater muscle strength (OR=1.04, 95% CI=1.01-1.07) were more likely to do aerobic activity. Only employment status was associated with strength training, with those employed more likely to do some strength training (OR=1.73, 95% CI=1.04-2.89). Physical disability, cognitive symptoms, adverse health behaviours may drive which type and amount of activity a PwMS participates in.
The perception exertional dyspnoea is greater in females than males at absolute, but not relative, levels of minute ventilation (VE). The mechanisms of sex differences in exertional dyspnoea are unclear, but since dyspnoea perception is influenced by psychological, social, and cultural factors, it is possible that gender-related characteristics confound the assessment of sex differences in exertional dyspnoea. We sought to determine the association between gender-related characteristics and dyspnoea during exercise in males and females. Forty-six healthy adults (n=22 males, n=24 females) completed the Stanford Gender-related Variables for Health Research questionnaire to assess their gender-related characteristics (i.e., caregiver strain, work strain, independence, risk-taking, emotional intelligence, social support, and discrimination), spirometry, and an incremental cycle exercise test. Throughout exercise, standard cardiorespiratory parameters were monitored, and dyspnoea perception was assessed using the Borg scale. Females had significantly higher scores than males for emotional intelligence (p=0.029) and social support (p=0.049); whereas other gender-related characteristics were similar between the sexes (all p>0.05). Females reported significantly higher dyspnoea intensity and unpleasantness ratings than males at a V̇E of 80 l·min-1 (both p<0.05); however, males had higher dyspnoea intensity ratings at 20 and 40 % of maximum voluntary ventilation (MVV; both p<0.05). After adjusting for sex, height, body mass, and age, emotional intelligence was significantly associated with dyspnoea intensity at a V̇E of 50 l·min-1 and 50 %MVV (R2=0.14-0.18, all p<0.05). Our findings suggest that gender-related characteristics influence the perception of exertional dyspnoea, and may confound the assessment of sex differences in exertional dyspnoea perception.
This systematic review aimed to evaluate the representation of female participants in resistance training (RT) studies investigating hypertrophy and to assess associations between participant sex, methodological features, authorship, and temporal trends. This review included RT studies published in peer-reviewed journals that assessed hypertrophy outcomes in young adults. Reviewers independently screened studies and extracted data on participant sex, menstrual cycle phase reporting/consideration, use of molecular or biopsy analyses, and gender/sex of first and last authors. A total of 570 studies were included. Of these, 72.2% recruited male participants, 11.0% female participants, and 16.8% included both sexes. Among studies including female participants, 8.5% reported or accounted for menstrual cycle phase, while 87.3% did not mention it. Molecular analyses were nearly four times more frequent in studies with only male participants (23.6%) than those including female participants (6.5%; χ²=9.45; p<0.009). No association was found between participant sex and use of muscle biopsies or author gender/sex. A 10-fold increase in RT publications occurred in the 21st vs. 20th century, yet the sex gap persisted. Studies published in 2020–June 2023 showed modest improvement versus 2001–2019, with fewer male-only and more female-only and mixed-sex samples (χ²=16.43; p=0.00027; Cramér’s V=0.18). Despite growing evidence that females and males exhibit broadly similar relative hypertrophy and molecular responses to RT, substantial sex bias persists in hypertrophy research. Although studies published since 2020 show modest improvement in sex-inclusive recruitment, male-only designs still predominate, and limited menstrual cycle phase reporting/accounting continues to constrain transparency and generalizability.
Dietary protein consumption in optimization strategies for supporting muscle are shifting from isolated nutrient models to integrated food-first frameworks. This perspective examines the role of food matrix integrity in regulating the primary locus of control of muscle mass in health adults: muscle protein synthesis (MPS). We propose that food processing techniques alter the matrix's physical and chemical architecture, thereby modulating the anabolic potential of whole protein foods. Consequently, identifying optimal feeding strategies requires combining mechanistic insights with food-first approaches, acknowledging that food matrix integrity is a regulatory variable in MPS regulation in support of muscle health.
We aimed to evaluate the impact of calcium supplementation on bone mineral density (BMD), osteoporosis, and site-specific fracture risk in adults. We conducted a systematic search of MEDLINE, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews (CDSR), and CINAHL from inception to February 13, 2025, to identify systematic reviews with meta-analyses assessing calcium supplementation and fracture or osteoporosis outcomes in adults (≥18 years). Primary-study data from eligible meta-analyses were extracted to assess pooled estimates. Certainty of evidence was assessed using the GRADE framework. Twenty-two meta-analyses were included, comprising 69 unique primary studies and 286,584 participants. Calcium supplementation, with or without vitamin D, was associated with small but statistically significant increases in BMD at the total body, hip, lumbar spine, and femoral neck, although heterogeneity was substantial. Calcium supplementation was associated with reduced risk of total, vertebral, and non-vertebral fractures, but not hip or wrist fractures. Subgroup analyses by intervention type, sex, and age showed no consistent differential effects. Certainty of evidence ranged from moderate for vertebral and non-vertebral fractures to low or very low for other outcomes. Overall, calcium supplementation confers modest skeletal benefits. Further high-quality long-term trials are still needed. (PROSPERO Registration Number: CRD420251082510)
