BACKGROUND AND AIMS:The influence of perimenopause on changes in resting and postprandial energy metabolism remains unclear. The main objective of the present study was to compare energy metabolism in resting and postprandial states between pre, peri and postmenopausal women, in considering the individual's body composition characteristics and movement behaviors. METHODS AND RESULTS:Twenty-one premenopausal women (38.9 ± 5.0 years), twenty-two perimenopausal women (49.5 ± 3.8 years) and twenty-one postmenopausal women (55.4 ± 3.7 years) were included in the analyses. Body composition (fat mass (FM) and fat-free mass (FFM)) was assessed by dual-energy X-ray absorptiometry and movement behaviors by accelerometry. Energy expenditure and substrate oxidation rates were measured by indirect calorimetry at rest (20 min) and postprandially 3h after a calibrated and balanced meal, expressed in absolute terms and relative to FFM. The thermic effect of food (TEF) was calculated. There were no significant differences in resting and postprandial energy metabolism based on menopausal status. TEF was significantly higher in peri compared to premenopausal women (p = 0.03), but no other differences were observed between groups. Significant and positive correlations were found between FFM, energy expenditure and substrate use both at rest and postprandially (from p = 0.049 to p < 0.001). Postmenopausal women displayed an altered cardiometabolic profile compared to pre and perimenopausal women (p < 0.001). CONCLUSION:When they have similar body composition and movement behaviours, perimenopausal women do not exhibit differences in resting or postprandial energy metabolism compared to pre and postmenopausal women.

BACKGROUND:Childhood obesity interventions have shown modest and often unsustainable effects, with frequent weight regain driven by physiological and behavioral compensatory mechanisms. While nutritional adaptations have been relatively well described, energetic adaptations remain insufficiently explored in pediatric populations. This study aimed to investigate the temporal dynamics of resting energy expenditure (REE), substrate oxidation, thyroid hormones, leptin concentrations, and adaptive thermogenesis (AT) throughout a 10-month weight loss intervention in adolescents with obesity. METHODS:Forty adolescents with obesity (13.9 ± 1.4 years; 20 boys) were recruited from a pediatric rehabilitation center and participated in a 10-month multidisciplinary intervention combining physical activity, nutritional education, and psychological support. Participants completed up to nine assessment visits at 4-5-week intervals. At each visit, anthropometry (weight, height, BMI z-score), fasting REE, substrate oxidation (indirect calorimetry), and blood sampling (TSH, triiodothyronine, thyroxine, leptin) were performed. Body composition was assessed by DXA at baseline, mid- and post-intervention. RESULTS:Among the 38 adolescents analyzed, the intervention induced significant changes in body composition, with a reduction in fat mass and BMI z-score over time (all p < 0.001) and a transient increase in fat-free mass (FFM) (p < 0.001), while body weight initially decreased (p < 0.040) before partially increasing at later stages (p ≤ 0.001). REE remained unchanged throughout the intervention, and no statistically significant difference between REEm and REEp (AT) was not observed, while respiratory quotient increased significantly (p < 0.001) over time. CONCLUSION:This longitudinal study reveals that, despite moderate weight loss, REE remained stable and AT was not clearly apparent, while the shift toward greater carbohydrate oxidation indicates ongoing and dynamic metabolic remodeling. Overall, these exploratory findings may suggest that metabolic adaptations to weight loss may be more variable than previously assumed, although confirmation in larger cohorts is still required.

Objective Obesity is a major independent risk factor for chronic kidney disease. High-Intensity Interval Training (HIIT) is recognized as an interesting therapeutic strategy in managing obesity and related disorders. However, there is still a lack of knowledge about its impact on kidney function. The study aimed to evaluate the impact of the HIIT program on kidney function and erythrocyte parameters in overweight/obese women. Methods Thirty-three overweight/obese young women (age, 17.0 ± 1.15 yrs.; body mass index, 33.3 ± 4.77 kg/m2) were allocated into HIIT (n = 17) or control (n = 16) groups. The HIIT program was performed 3 times a week for nine weeks. Body composition parameters, blood creatinine, blood urea, estimated Glomerular Filtration Rate (eGFR), serum electrolytes (i.e., sodium, potassium, chloride, calcium, phosphorus, and magnesium), and red blood cell parameters (i.e., red blood cell count, hematocrit, hemoglobin and mean corpuscular volume) were collected before the start and after the completion of the training. Results Nine weeks of HIIT significantly improved (p < 0.01) body mass index, body fat, and waist circumference, but the auhtors found no statistically significant changes in blood creatinine, urea, eGFR, and red blood cell parameters (p > 0.05). No variable changed in the control group. Conclusions HIIT improved body composition; however, no significant changes in renal function parameters were detected in this underpowered study.

INTRODUCTION:Systematic reviews (SR) and meta-analyses (MA) of randomized controlled trials (RCTs) have reported the benefits of carbohydrate (CHO) consumption in various endurance athletes, mainly cyclists or runners. Gathering existing reviews, the present systematic review tends to determine the best conditions and characteristics of this CHO ingestion to optimize athletes' performance. EVIDENCE ACQUISITION:A comprehensive search was conducted on five databases (from inception up to September 05, 2024) to identify related SR and MA of RCTs investigating the association between CHO consumption and performance. The quality of SRs was evaluated using the AMSTAR2. EVIDENCE SYNTHESIS:Fifteen SR, including 8 MA were included, gathering 262 RCTs and 521 single trials. The overall reviews' quality was rated low or critically low (11 reviews, 73%). All the measurements performance were conducted in the form of a Time Trial (69%) or a Time to Exhaustion (31%). A total of 102 studies (44%) revealed significant positive effect of CHO consumption on performance, with no difference between the performance modalities or sports practices. Consumption of complex CHO (fructose + glucose) improved performance compared with simple CHO or other combinations. Consumption introduced during efforts lasting 1 to 2 hours (57 trials) and 2 to 4 hours (70 trials) seem to favor better performances. CONCLUSIONS:The present review of SR and meta-analysis clarifies the conditions of CHO ingestion to optimize endurance athletes' performances, especially pointing its interest for efforts lasting 1 to 4 hours and of complex CHO formulations. More rigorous research remains however needed to transfer research results to the real practise of athletes.

The purpose of the study was to compare the energy metabolism responses at different walking speeds among pre, peri and postmenopausal women, with consideration for individual's body composition characteristics and movement behaviors. Twenty-one premenopausal women (38.9 ± 5.0 years), twenty-two perimenopausal women (49.5 ± 3.8 years) and twenty-one postmenopausal women (55.4 ± 4.1 years) were included in the data analysis. Body composition (fat mass (FM) and fat-free mass (FFM)) was assessed by dual-energy X-ray absorptiometry and movement behaviors by accelerometry. Fasting blood samples were collected to determine pituitary and ovarian hormones concentrations. Energy cost of walking (gross and net Cw), expressed both in absolute terms and relative to FFM, as well as substrate oxidation rates, was measured by indirect calorimetry during five 5-minute treadmill walking bouts at 2, 3, 4, 5, and 6 km.h-1, each separated by 3 min of seated rest. Results indicate that there were no significant differences in body composition, movement behaviors, and in Cw and substrate oxidation rates during walking among the three groups. Negative correlations were found between moderate-to-vigorous physical activity and both gross and net Cw relative to FFM at 5 km·h⁻¹ and 6 km·h⁻¹ (from p = 0.04 to p = 0.007). No correlations were found between estradiol concentration and Cw or substrate oxidation rates, at any walking speed. Women experiencing the menopausal transition do not exhibit differences in energy metabolism during walking compared with pre and postmenopausal women when they have a similar body composition and movement behaviors.

Cervical cancer remains the second most prevalent malignancy in terms of both incidence and mortality among women of reproductive age globally. Emerging evidence suggests that physical activity and structured exercise interventions may exert distinct influences across the cancer continuum. These include reducing the risk of cancer onset, mitigating treatment-related declines in muscle mass, enhancing quality of life, and improving post-treatment survival outcomes. This state-of-the-art review aims to synthesize the current body of literature regarding the role of physical activity and exercise in: (i) the primary prevention of cervical cancer, and (ii) supportive care during and following oncological treatment. Additionally, we propose future research directions to advance understanding and optimize exercise-based strategies in cervical cancer care.

BACKGROUND:Cirrhosis induces multi-organ dysfunction, yet the specific physiological determinants underlying reduced cardiorespiratory fitness (CRF) remain poorly defined. AIM:To compare patients with cirrhosis to healthy controls to assess and identify their major CRF physiological contributors. METHODS:Forty-five patients with cirrhosis and 45 age- and sex-matched controls underwent incremental cardiopulmonary exercise testing (CPET) on a cycle ergometer. The pulmonary, cardiac, vascular, and muscular components of CRF were measured, including peak oxygen uptake (VO2Peak), ventilatory efficiency (VE/VCO2), oxygen uptake efficiency slope (OUES), and chronotropic response. Non-invasive hemodynamic monitoring (Physioflow) was used to estimate cardiac output and arteriovenous oxygen difference (a-vO2). RESULTS:Patients with cirrhosis exhibited markedly reduced CRF compared with controls (VO2Peak: 15.4 ± 5.5 vs. 29.3 ± 7.5 mL.min-1.kg-1, p < 0.001) and the decline was proportional to Child-Pugh score. Kinetic parameters (OUES, Lowest VE/VCO2, Wilkoff index) were also significantly impaired and chronotropic incompetence was highly prevalent (89%). Cardiac output was preserved but a-vO2 was lower (10.7 ± 3.0 vs. 14.1 ± 1.1 mlO2.dL-1, p = 0.002), indicating a defective peripheral oxygen extraction in patients with cirrhosis. Multivariate regression analysis (r2 = 0.79) identified maximal heart rate and muscle performance (5-sit to stand) as independent predictors of VO2Peak. CONCLUSION:Reduced CRF in cirrhosis appears to primarily result from impaired skeletal muscle oxygen utilization, compounded by chronotropic incompetence. These findings emphasize the value of integrative functional evaluation in cirrhosis management.

INTRODUCTION:Cirrhosis is associated with significant risk of comorbidity and early mortality. Cardiopulmonary exercise testing has the advantage of allowing cardiac, pulmonary and muscle function assessment and could have a better prognosis value than the usual assessment of cardiorespiratory function often evaluated at rest in patients with cirrhosis. METHODS:We reviewed electronic databases (PubMed, Scopus, Embase, Google Scholar) for relevant literature running up to April 2024. RESULTS:This review gathers the data from 3029 patients with cirrhosis from 62 studies. Patients with cirrhosis had lower cardiorespiratory fitness (CRF) than age-matched healthy subjects and reference values were meta-analyzed. VO2Peak (mL.min-1.kg-1) and anaerobic threshold (mL.min-1.kg-1) were significantly lower in Child-Pugh C compared to A (p = 0.009) and B (p < 0.001). Supervised exercise proved effective for improving VO2Peak (p < 0.001) before and after transplantation (p < 0.001), but not when conducted in a home-based setting (p = 0.569). Liver transplantation initially (at three months) results in a minor decrease in CRF, but over time (at 12 months) leads to an improvement in CRF. CONCLUSION:This meta-analysis provides reference values for CRF in patients with cirrhosis and shows the benefits of supervised physical exercise before and after liver transplantation. CRF could help clinicians to prioritize patients on the LT waiting list.

BACKGROUND:While acute exercise has been shown to alter subsequent energy intake in adolescents with obesity, the role of the exercise-induced energy expenditure and substrate oxidation remains unknown. The present study investigates the effect of energy expenditure and substrate oxidation rates during an acute walking exercise on subsequent appetitive responses in adolescents with obesity. METHODS:Body composition and maximal aerobic capacities were assessed in 25 adolescents [8 males, 12-16 years] with obesity. They then realized a control condition without exercise [CON] and an exercise session [EX, 40-min walking at 4 km h-1] in a randomized order. Energy expenditure and substrate use were assessed at rest and during exercise using indirect calorimetry. Subsequent ad libitum energy intake, appetite sensations and food reward were assessed. RESULTS:Post-exercise energy intake was reduced on EX compared with CON [1083 ± 253 vs. 950 ± 226 kcal; p = 0.041], with reduced absolute protein intake [p = 0.011]. None of the appetite sensations differed between conditions. Pre-lunch explicit liking for fat decreased on EX compared with CON [p = 0.045], the implicit and explicit wanting for fat [p = 0.047 and p = 0.025 respectively] and explicit wanting for taste [p = 0.012] decreased from pre to post lunch after exercise. Energy Expenditure, fat and carbohydrate oxidation rates during exercise were not associated with subsequent appetitive measurements. CONCLUSION:Exercise-induced energy expenditure and substrate might not be associated with the short-term control of appetite and energy intake in adolescents with obesity, which remains to be confirmed by further studies evaluating the effect of various exercises inducing specific predominant fuel sources.

Background: Despite the promising efficacy of gamified digital interventions in promoting physical activity, we currently have limited evidence on the theory-based mechanisms responsible for effects of these interventions on behavior change. Objectives: As part of the DIPPAO intervention randomized controlled trial, we examined the effects of a digital, gamified adapted physical activity program (KiplinTM) on autonomous motivation and weight stigma processes among obese patients with type 2 diabetes and tested candidate psychological mechanisms underlying these effects based on self-determination theory and the social identity approach. Methods: Participants (N = 50, M age = 47.90 years, SD = 12.49; 74% female) were randomized to either the KiplinTM digital intervention program or a usual care control group and followed the program for three months. Outcome measures of device-assessed physical activity and psychological variables (motivation, need satisfaction, in-group identification, weight stigma) were assessed at baseline and 6-month follow-up. Data were analyzed using mixed-effects models and partial least squares structural equation modeling. Results: Autonomous motivation increased significantly in both groups, but with no significant between-group differences. Structural equation modeling did not support the proposed theory-based mechanisms for intervention effects. Conclusion: Current data do not support motivation and weight stigma changes as potential mechanisms for the efficacy of the digital intervention over traditional programs. Future research should investigate additional candidate psychological mechanisms that account for program effects using designs with adequate statistical power and sufficiently sensitive measures, consider psychological mediators representing reflective and automatic behavioral determinants, and employ appropriate control or comparison groups. Trial Registration: ClinicalTrials.gov NCT04887077; https://clinicaltrials.gov/study/NCT04887077

Cirrhosis is associated with significant risk of comorbidity and early mortality. Low physical function is common in patients with cirrhosis and could predict prognosis. Cardiorespiratory fitness (CRF), determined by maximal exercise with gas exchange measurement, has proven to predict the risk of mortality and disability in other chronic diseases. In patients with cirrhosis, it could help to inform prognostic stratification to improve care and management in clinical practice. This systematic review aims to determine the association between CRF (VO2Peak, percentage of predicted VO2Peak, Anaerobic Threshold (AT)) and mortality prediction, as well as morbidity prediction in cirrhosis. We reviewed the main electronic databases (PubMed, Scopus, Embase, Google Scholar) for all relevant literature running up to April 2024. Two independent researchers applied predefined inclusion criteria to assess articles for eligibility, and ultimately included 15 studies (seven studied mortality alone, six morbidity alone and two both). Eight out of nine studies reported CRF variables as a predictor of mortality, and eight studies found that CRF predicted occurrence of events associated with morbidity (sepsis, length of hospital stay and length of stay in critical care). VO2Peak below 17 mL.min-1.kg-1 (5 METS) is an independent predictor of mortality and morbidity. AT can be reached by the large majority of patients with cirrhosis after a moderate-intensity physical exercise, lasts 15 minutes, can be repeated and could be the best choice. AT inferior to 9 ml.min-1.kg-1 or 2.5 METS (metabolic-equivalent tasks defined as the amount of oxygen consumed while sitting at rest) can predict mortality risk and 10 ml.min-1.kg-1 (3 METS) the sepsis risk. VO2Peak below 17 mL.min-1.kg-1 (5 METS) or an AT under 9 mL.min-1.kg-1 (2.5METS), consistently indicate worse outcomes. Assessing CRF could help to improve mortality and morbidity prediction and AT seems to be the best tool to predict the prognosis in patients with cirrhosis.

While there is an increasing prevalence of individuals with “normal weight” engaged in diet-induced weight loss, few studies have examined the effects of these practices on appetitive profile in this population. This study aimed to explore energy intake, appetite sensations, food reward, and eating behaviour profile in response to diet-induced weight loss in males and females with normal weight. We hypothesized that normal-weight individuals would experience an increase in appetite feelings and food reward in response to weight loss. Participants completed experimental visits at baseline (T0, n = 35), after 3% WL (T1, n = 32), and 6% WL (T2, n = 18). Energy intake was measured by a 3-day food record and eating behaviour profile by validated questionnaires. Food reward was assessed in a fasted state using the Leeds Food Preferences Questionnaire. Subjective appetite sensations were measured before and after a standardized meal using visual analogue scales and satiety quotients were calculated. Fasting hunger and desire to eat increased at T1 (p < 0.01) and T2 (p < 0.001) while satiety quotients were improved at T1 (p < 0.05) and T2 (p < 0.001) compared to T0. At T2, while there was an increased explicit wanting for high-fat savoury foods compared to T0 (p < 0.001), correlation analyses showed that higher fat mass loss, increased cognitive restraint, and decreased energy intake were associated with greater changes in food reward (|Rho| > 0.45, p < 0.05). To conclude, diet-induced weight loss generated a rise in drive to eat accompanied by a greater meal-induced satiety in individuals with normal weight.

Despite a considerable prevalence of normal-weight individuals engaged in dieting practices, energetic adaptations in response to weight loss are poorly studied in this population. This study aimed to examine the changes in energy expenditure and substrate oxidation rates during resting and exercise conditions, as well as the hormonal and metabolic profiles, after a diet-induced weight loss. The participants completed 3 identical experimental visits: baseline (T0, n = 35), 3% weight loss (T1, n = 32), 6% weight loss (T2, n = 18). During each visit, blood sample was performed at rest and indirect calorimetry measurements were performed in resting state and during walking exercise. While there was no change in resting energy expenditure, exercise energy expenditure decreased at T1 and T2 (p < 0.001). After weight loss, absolute carbohydrate oxidation rate was reduced at rest (p = 0.04) and during exercise (p < 0.001). The total cholesterol, triglyceride and leptin concentrations were reduced at T2 compared to T0 (p = 0.04, p = 0.008 and p = 0.02, respectively). This study highlighted changes in substrate use during weight loss, and the reduced energy expenditure during walking exercise observed during weight loss may promote weight (re)gain in normal-weight individuals.

Introduction The use of artificial intelligence (AI), particularly conversational agents such as ChatGPT, is expanding in the healthcare industry. We aimed to assess the responses provided by ChatGPT regarding the prevention of frailty in the elderly. Methods The responses provided by ChatGPT 3.5 were evaluated by a panel of 29 experts in the field of geriatric care, comprising geriatricians, geriatric nurses, preventionists, and educators specializing in adapted physical activity. Each proposal was rated on a numerical scale from 0 (not at all appropriate) to 10 (very appropriate) in terms of items relevance, formulation, exhaustiveness and with an overall rating. Results ChatGPT created 17 themes for a total of 24 items. The 17 themes proposed by the conversational agent are very similar to those proposed in the literature on the prevention of frailty in the elderly. For each theme, the overall rating was consistently higher than the exhaustivity (8, IQR 8 to 10 vs 7, 6 to 8; p < 0.05). The relevance of the items was systematically and significantly higher than their wording (p < 0.05). There were no significant differences in the global evaluation or item exhaustivity based on expert characteristics (gender, age, profession, and seniority). Conclusion Despite ChatGPT exhibits some shortcomings and inconsistencies, AI could be a useful tool for healthcare professionals in the prevention of frailty in the elderly, but it should be used with caution. Further research is required to gain a deeper understanding of the role and potential applications of this tool in the healthcare sector.

Contexte Malgré de nombreuses méta-analyses sur les effets de la sédentarité pendant les loisirs, l’impact de la sédentarité au travail sur la santé mentale reste largement controversé. Notre objectif était d’identifier et de synthétiser systématiquement la littérature examinant l’association entre la sédentarité au travail et la santé mentale. Méthode Les bases de données PubMed, Embase, Cochrane et PsycINFO ont été consultées afin de recenser les articles rapportant les risques pour la santé mentale liés à la sédentarité professionnelle. Nous avons réalisé une méta-analyse à effets aléatoires en prenant en compte l’ensemble des risques et les niveaux intermédiaires et sévères de troubles mentaux. Une analyse de sensibilité a ensuite été menée sur les troubles mentaux sévères, en utilisant : (1) l’ensemble des risques ; puis (2) les risques les plus faibles, entièrement ajustés ; (3) les risques les plus faibles, bruts ou moins ajustés (modèles pessimistes) ; et (4) les risques les plus élevés, entièrement ajustés ; et (5) les risques les plus élevés, bruts ou moins ajustés (modèles optimistes). Une méta-régression a été effectuée sur les facteurs d’influence potentiels. Résultats Nous avons inclus 12 études dans la revue systématique et 7 dans la méta-analyse, soit un total de 40 314 travailleurs (35 ans, 65,5 % d’hommes). L’exposition à la sédentarité au travail a augmenté le risque de troubles mentaux modérés et sévères de 34 % (IC à 95 % : 18–49 %). Toutes les analyses de sensibilité relatives aux troubles mentaux sévères étaient également significatives, quel que soit le modèle : +35 % (12–58 %) avec l’ensemble des risques, 39 % (15–63 %) avec le modèle pessimiste entièrement ajusté, +36 % (13–59 %) avec le modèle pessimiste brut ou moins ajusté, 85 % (27–143 %) avec le modèle optimiste entièrement ajusté et +85 % (26–143 %) avec le modèle optimiste brut ou moins ajusté. L’âge pourrait être un facteur de risque accru de troubles mentaux en cas d’exposition à la sédentarité professionnelle, tandis qu’un niveau d’études élevé réduirait ce risque. Conclusion Notre méta-analyse montre que la sédentarité professionnelle augmente le risque de troubles de santé mentale. L’hétérogénéité des résultats n’a pas permis de tirer de conclusions définitives quant aux variables susceptibles d’influencer davantage ce risque.

BACKGROUND AND HYPOTHESIS:While physical activity (PA) is associated in observational studies with cardiovascular and renal protection few interventional studies have assessed its long-term effect on renal outcomes. This study is the first to specifically evaluate the impact of high-intensity PA on the slowing of renal function decline in type 2 diabetes (T2D) patients at high risk for kidney disease. METHODS:ActiDiaNe is an open, randomized controlled trial involving patients with T2D (pT2D) and rapid renal function decline (eGFR slope < -5 ml/min/year over 6-24 months). Participants were randomized to high-intensity PA (HIPA) or standard PA counseling (STPA) for two years. The primary endpoint was the slope of decline in cystatin C-derived eGFR (cys-eGFR). RESULTS:Across 21 centers, 178 patients were screened, 122 randomized, and 103 (29 women/74 men) analyzed for the primary endpoint (59 HIPA vs. 44 STPA). At baseline, mean age was 66 ± 8 years, median cys-eGFR was 54 ml/min/1.73m² (37; 65), and median eGFR decline was -9 ml/min/year (-12; -7). The primary endpoint showed a decline of -2.05 ml/min/year (95% CI: -3.46 to -0.64) in HIPA vs. -2.77 ml/min/year (95% CI: -4.40 to -1.14) in STPA (P = 0.512). Cardiovascular events and deaths occurred in 10 (17%) HIPA vs. 6 (14%) STPA patients (P = 0.646), with 3 deaths in HIPA (none of them protocol-related). Hypoglycemia was reported in 32 HIPA vs. 26 STPA patients (P = 0.623). CONCLUSION:In pT2D with rapid renal function decline, HIPA did not significantly alter renal function decline compared to STPA.

Le vieillissement de la population active conduit à une présence accrue de travailleurs âgés sur des postes parfois exigeants physiquement et cognitivement. Cependant, le vieillissement entraîne des modifications multisystémiques pertinentes pour la santé au travail. Il s’accompagne de modifications musculosquelettiques : diminution de la masse musculaire, baisse de la force et de la puissance musculaires responsables d’une moindre tolérance aux charges lourdes, gestes répétitifs, postures prolongées. Les conséquences sont l’augmentation des TMS, lombalgies, troubles de l’équilibre. Sur le plan cardiorespiratoire, la capacité en endurance diminue et la tolérance aux efforts intenses et prolongés est diminuée avec une capacité de récupération plus lente. La thermorégulation est altérée d’où un plus grand risque de déshydratation, une plus grande sensibilité au travail en ambiances chaudes (chantiers, cuisines, fonderies…). Au niveau sensoriel, presbytie, sensibilité aux contrastes caractérisent les principales modifications de la vision tandis que pour l’audition la presbyacousie rend la compréhension plus difficile dans le bruit. En termes d’équilibre, l’atteinte proprioception/vestibule augmente le risque de chute. Au niveau cognitif, il est rapporté un ralentissement de la vitesse de traitement et une plus grande difficulté à avoir des activités multitâches et les changements rapides d’une activité cognitive à une autre sont plus difficiles. Avec l’avancée en âge, le sommeil est fragmenté avec une avancée de phase, et il existe une moindre tolérance au travail posté et de nuit. Il existe aussi une augmentation de la prévalence des maladies chroniques et de la polymédication avec les risques d’effets secondaires (somnolence, hypotension orthostatique…). Au final la capacité de travail est un équilibre entre les exigences du poste (physiques, cognitives, psychosociales) et le ressources du salarié (santé, compétences, expérience). En conclusion, les spécificités physiologiques du travailleur vieillissant nécessitent une approche individualisée et anticipée en santé au travail. Elles impliquent une adaptation des postes (ergonomie, réduction des charges, assistances mécaniques), des horaires flexibles (préférence pour début de journée, prévention de la privation de sommeil), une gestion des expositions thermiques et chimiques, une vigilance sur une éventuelle polymédication et les risques d’interactions, un dépistage régulier (fonction cardiorespiratoire, audition, vision, mobilité). Mais le mieux serait une prévention dès 40–50 ans (TMS, risques psychosociaux, nutrition, programmes d’exercice combinant résistance+endurance). Le médecin du travail joue donc un rôle-clé à toutes ces étapes.

BACKGROUND:Despite the effectiveness of lifestyle multidisciplinary (LMD) weight loss interventions in pediatric obesity, outcomes remain variable between individuals. Machine learning (ML), capable of capturing complex relationships between variables, offer a promising avenue to better understand and predict this variability. METHODS:This study aimed to identify baseline predictors of 9-month LMD success in adolescents with obesity. A pooled database of 471 adolescents (42.9% males, 13.6 ± 1.4 years, BMI z-score 3.06 ± 0.51) from 21 clinical trials was used. Five ML models (Random Forest (RFC), XGBoost, LightGBM, Logistic Regression, and Support Vector Machine) were developed and evaluated to predict treatment response using both binary and multiclass classification RESULTS: Mean BMI z-score reduction at 9 months was -0.53 ± 0.34. For binary classification, RFC achieved the highest performance (accuracy = 0.97; AUC-ROC = 0.97). For multiclass prediction, XGBoost performed best (accuracy = 0.80; AUC-ROC = 0.90). CONCLUSION:The most influential predictors consistently belonged to two main domains: (1) functional aptitudes, (e.g. forced vital capacity, maximal aerobic power, vertical jump height, resting VO2) and (2) dietary profiles (e.g. total energy intake, protein intake, hunger/fullness scores). Metabolic markers (eg. Insulin, cholesterol) also contributed to multiclass prediction. ML shows promise for personalizing adolescent weight loss strategies and deserves further study. IMPACT:While many fields of healthcare utilize artificial intelligence-based (AI) methods to achieve personalized and patient-centered care, these methods remain underexplored in the field of pediatric obesity. Identifying baseline predictors of lifestyle multidisciplinary weight loss interventions (LMD) would further improve the effectiveness of such interventions, currently hindered by inter-individual variability in response to treatment. Machine learning models were successful in predicting LMD's success in adolescents with obesity with high accuracy, and uncovered a novel, promising dietary factors. Machine learning is a promising tool for personalization of weight management strategies in the field of pediatric obesity.