Background/Objectives: Nutritional therapy is an essential part of oncologic care, yet patients with brain tumors-especially those with glioblastoma-remain underserved by disease-specific dietary guidelines. This cross-sectional study compares energy and macronutrient intake, as well as body composition, between brain tumor patients, including a glioblastoma subgroup, and patients with gastrointestinal (GI) cancer. Methods: A total of 95 brain tumor patients and 109 GI cancer patients completed standardized three-day estimated food records and underwent bioelectrical impedance analysis and hand-grip strength measurements. Anthropometric parameters, as well as energy and macronutrient intake, were compared between groups. Results: Energy intake was lower in brain tumor patients compared with GI cancer patients (22.8 kcal/kg/day vs. 31.2 kcal/kg/day), as were protein (1.01 g/kg/day vs. 1.34 g/kg/day) and carbohydrates (182.8 g/day vs. 246.8 g/day; all p < 0.01). Despite the lower intake, brain tumor patients exhibited higher BMI scores, body fat percentages, and visceral fat levels (p < 0.05), while fat-free mass and skeletal muscle mass were comparable between groups. The phase angle was higher in brain tumor patients (p = 0.002), whereas the ECW/TBW ratio was lower (p = 0.003). In the glioblastoma subgroup, protein intake did not differ significantly compared with the GI cancer group. However, carbohydrate intake (190.9 g/day vs. 246.8 g/day; p = 0.01), as well as energy intake (25.7 kcal/kg/day vs. 31.2 kcal/kg/day; p = 0.05), remained significantly lower. Conclusions: Brain tumor patients were found to have energy intake levels below ESPEN recommendations for cancer patients (25-30 kcal/kg/day), and their protein intake was at the lower ESPEN threshold (1.0 g/kg/day), coupled with increased adipose tissue. The observed caloric deficit was accompanied by reduced carbohydrate intake, particularly in the glioblastoma subgroup. These findings highlight the need for individualized nutritional approaches in neuro-oncology. Until disease-specific recommendations are available, general dietary guidelines such as those by ESPEN offer a pragmatic interim orientation.

Background/Objectives: Although discrepancies between bioelectrical impedance analysis (BIA) devices are well documented, their clinical relevance in vulnerable populations remains unclear. This study aims to assess the impact of device choice on muscle mass classification criteria in patients with cancer or obesity and to identify modifiers of device variability. Methods: BIA data from 224 adults (85 with cancer, 139 with obesity) measured with two segmental multi-frequency devices (seca mBCA 515 and InBody 970) were analyzed. Device differences were assessed using the Wilcoxon signed-rank test and agreement analyses. Differences in classification of body composition cut-offs cited in the GLIM criteria for malnutrition and the ESPEN and EASO criteria for sarcopenic obesity were evaluated using McNemar's test. The impact of disease type, sex, and age on device differences was examined through multivariable models. Results: Significant device differences were found for all parameters (all p ≤ 0.005). Discrepancies were largest for skeletal muscle mass (kg and %), with effect sizes r > 0.8 and poor agreement (Lin's CCC < 0.90). A significant impact of device choice on muscle mass classification was observed for both cancer and obesity patients (p < 0.001), with seca classifying more patients as having low fat-free mass (50% vs. 20%) and as having a body composition consistent with sarcopenic obesity (90% vs. 50%) than InBody. Discrepancies were more pronounced in cancer patients and females. Conclusions: Muscle mass assessment by BIA is highly dependent on device choice, potentially leading to clinically relevant discrepancies in classification when rigid cut-offs are applied. An individualized interpretation of BIA data and further validation of prediction equations in disease-specific subpopulations is warranted.

Background/Objectives: Nutritional medicine remains underrepresented in medical education despite its relevance across specialties. Online learning offers a resource-efficient option to address this gap, yet evidence on the effectiveness and acceptability of online learning modules (OLMs) is limited. Methods: In this exploratory randomized controlled single post-test trial, medical students were assigned to either an OLM or an in-person lecture (IPL) on nutritional medicine (n = 91, no a priori sample size calculation performed). After course completion, students took a knowledge test and completed a questionnaire on their learning experience. Group differences were analyzed using permutation Welch t-tests, Wilcoxon-Mann-Whitney tests, or Fisher's exact tests, depending on variable characteristics, with α = 0.05. Results: OLM students achieved significantly higher test scores than IPL students (mean difference: 2.4 points on a 0-40 scale), resulting in differences in grade classification (p < 0.05). OLM was further rated more favorably regarding content delivery, overall course evaluation, and exam preparation (all p < 0.05), while self-reported attention, concentration, and involvement did not differ between groups. Flexibility, time savings, and convenience were the most frequently reported advantages of OLM over IPL. Conclusions: This study suggests that OLM in nutritional medicine may be associated with higher test performance and more favorable student evaluations compared to IPL. These findings highlight the potential of online learning as a scalable, resource-efficient approach that may help address persistent gaps in nutritional medicine education. Building on this evidence, future work should examine how such modules can be optimally integrated into medical curricula to complement existing teaching structures.

BACKGROUND/OBJECTIVES:Evidence supports the benefits of concurrent training (CT), which combines endurance and resistance exercises, for enhancing health and physical fitness. Recently, low-volume, time-efficient exercise approaches such as low-volume high-intensity interval training (LOW-HIIT), whole-body electromyostimulation (WB-EMS), and single-set resistance training (1-RT) have gained popularity for their feasibility and efficacy in improving various health outcomes. This study investigated the effects of low-volume CT, focusing on (1) whether exercise order affects cardiometabolic health, inflammation, and fitness adaptations and (2) which combination, LOW-HIIT plus WB-EMS or LOW-HIIT plus 1-RT, yields better results. METHODS:Ninety-three obese metabolic syndrome (MetS) patients undergoing caloric restriction were randomly assigned to four groups performing the different low-volume CT protocols over 12 weeks. Outcomes included cardiometabolic, inflammatory, and fitness parameters. RESULTS:In both combinations, no significant differences were found regarding exercise order. However, the pooled LOW-HIIT and 1-RT group achieved superior improvements in blood pressure, blood lipids, inflammation markers (CRP, hsCRP), the MetS severity score, and overall fitness compared to the LOW-HIIT and WB-EMS combination. Compared to previous studies using these modalities individually, LOW-HIIT plus 1-RT appeared to further reduce inflammation, whereas LOW-HIIT combined with WB-EMS was less effective for cardiometabolic health, potentially due to interference effects between modalities. CONCLUSIONS:While LOW-HIIT plus WB-EMS appears to be a viable option for individuals unable to perform traditional resistance training, the findings suggest prioritizing LOW-HIIT plus 1-RT to maximize health outcomes. These findings highlight the importance of tailored exercise prescriptions and the need for further research into optimizing CT protocols for diverse populations.

Ballaststoffe spielen in der Prävention und Therapie von Adipositas und assoziierten Folgeerkrankungen, wie die mit metabolischer Dysfunktion assoziierte steatotische Lebererkrankung (MASLD), eine wichtige Rolle. Sie fördern die Sättigung und intestinale Motilität, modulieren postprandiale Glukosespitzen und senken den Low-density-Lipoprotein(LDL)-Cholesterin-Spiegel. Epidemiologische Studien zeigen zudem eine protektive Wirkung von Ballaststoffen gegen kardiovaskuläre Erkrankungen und kolorektale Karzinome. Präbiotisch wirksame Ballaststoffe, wie z. B. Inulin, beeinflussen positiv das Mikrobiom, das über immunmodulatorische Mechanismen systemische Effekte auf den Gesamtorganismus ausübt. Empfohlen wird eine tägliche Zufuhr von ≥ 30 g, bevorzugt über die Integration von Vollkornprodukten, Hülsenfrüchten sowie frischem Obst und Gemüse. Zur Minimierung gastrointestinaler Beschwerden sollten Ballaststoffe schrittweise in den Ernährungsplan integriert werden. Neben der Ernährung ist körperliche Aktivität eine zentrale Komponente für die Förderung der kardiometabolischen Gesundheit. Niedrigvolumiges hochintensives Intervallausdauertraining (LOW-HIIT) stellt eine evidenzbasierte, zeiteffiziente Alternative zum klassischen Ausdauertraining dar. Es kombiniert kurze intensivere Belastungsphasen mit Regenerationsintervallen in Einheiten von maximal 15-minütiger Dauer. Bereits nach wenigen Wochen kann LOW-HIIT positive Effekte auf die kardiopulmonale Fitness, Inflammation und kardiometabolische Risikomarker induzieren. Ballaststoffreiche Ernährung und regelmäßiges LOW-HIIT sind daher vielversprechende Ansätze für die Prävention und Therapie von Adipositas und metabolischem Syndrom.

Der Einsatz der Komplementärmedizin wächst in allen Bereichen der Onkologie. In diesem Artikel soll die Bedeutung der Integration von Komplementärmedizin in die Uroonkologie dargestellt werden. Es wird anhand der aktuellen Literatur ein Überblick über den derzeitigen Stand der Komplementärmedizin und deren Bedeutung beim Therapiemanagement in der Uroonkologie gegeben sowie zukünftige Chancen und Herausforderungen beleuchtet. Die Komplementärmedizin bietet in der Uroonkologie eine wertvolle Ergänzung zur konventionellen Medizin. Während für einige Verfahren eine sehr gute Evidenz vorliegt, die in der S3-Leitlinie Komplementärmedizin für onkologische Patient:innen abgebildet ist, fehlen für andere Verfahren wissenschaftliche Belege. Klassische Naturheilverfahren wie Phytotherapie, Hydrotherapie, Ernährung und Bewegung können dazu beitragen, die physische und psychische Verfassung der Patient:innen zu verbessern, Komplikationen und Nebenwirkungen zu reduzieren und Therapieziele zu erreichen. In den letzten Jahren hat sich die Komplementärmedizin in der Onkologie etabliert. Sie bietet die Chance, die Lebensqualität und das Therapiemanagement in der Uroonkologie zu verbessern. Deswegen wird sie in den nächsten Jahren weiter an Bedeutung gewinnen.

BACKGROUND:The use of complementary medicine is growing in all fields of oncology. OBJECTIVES:This article aims to highlight the importance of integrating complementary medicine into uro-oncology. METHODS:Based on current literature, an overview of the current state of complementary medicine and its importance in treatment management in uro-oncology is provided, as well as future opportunities and challenges. RESULTS:Complementary medicine offers a valuable complement to conventional medicine in uro-oncology. While there is very good evidence for some procedures, which is reflected in the S3 guideline on complementary medicine for oncology patients, scientific evidence is lacking for others. Classic natural healing modalities, such as phytotherapy, hydrotherapy, nutrition, and exercise, can help improve patients' physical and psychological well-being, reduce complications and side effects, and achieve treatment goals. CONCLUSION:In recent years, complementary medicine has become established in oncology. It offers the opportunity to improve quality of life and treatment management, including in uro-oncology. It will continue to gain importance in the coming years.

The beneficial impact of physical training in lowering cancer risk is well known. However, the precise mechanisms linking physical training and cancer are not fully understood. Skeletal muscle releases various myokines that seem to possess a direct anti-tumor effect. Although breast cancer (BC) is the prevalent form of cancer among women on a global scale, only limited data are available about the secretion of myokines following exercise in patients with BC. To study the effects of exercise on BC, the blood samples of patients with varied stages of BC were analyzed after 12 weeks of resistance training with whole-body electromyostimulation (WB-EMS). Following the training period, we observed that resistance training helps these patients to improve their physical characteristics and performance function by increasing skeletal muscle mass and strengthening their hand grip. Notably, the patient’s serum was found to inhibit the growth and promote the apoptosis of BC cells in vitro. Moreover, the conditioned medium collected from in vitro stimulated human myotubes using electric pulse stimulation (EPS), an in vitro simulation of WB-EMS training, induced the cell death of BC cells. These results highlighted the direct cancer-protective effects of activated skeletal muscle. In line with our observed effects of serum from exercise-trained pancreatic and prostate cancer patients, the growth of BC cells was notably inhibited when supplemented directly with recombinant myokines C-X-C motif ligand 1 (CXCL1), Interleukin 10 (IL10), and C-C motif chemokine ligand 4 (CCL4). Notably, treatment with these myokines also increased the expression of caspase 3/7 (Casp3/7), resulting in enhanced BC cell death. Our data strongly suggest that physical exercise has a positive impact on skeletal muscle mass and hand grip strength in BC patients, along with a significant anti-tumor effect in BC cells. This shows promising potential for considering sports and physical training as supportive therapies for achieving more impactful cancer treatment.

Combined endurance and resistance training, also known as “concurrent training”, is a common practice in exercise routines. While concurrent training offers the benefit of targeting both cardiovascular and muscular fitness, it imposes greater physiological demands on the body compared to performing each modality in isolation. Increased protein consumption has been suggested to support adaptations to concurrent training. However, the impact of protein supplementation on responses to low-volume concurrent training is still unclear. Forty-four untrained, healthy individuals (27 ± 6 years) performed two sessions/week of low-volume high-intensity interval training on cycle ergometers followed by five machine-based resistance training exercises for 8 weeks. Volunteers randomly received (double-blinded) 40 g of whey-based protein (PRO group) or an isocaloric placebo (maltodextrin, PLA group) after each session. Maximal oxygen consumption (VO2max) and overall fitness scores (computed from volunteers’ VO2max and one-repetition maximum scores, 1-RM) significantly increased in both groups. The PRO group showed significantly improved 1-RM in all major muscle groups, while the PLA group only improved 1-RM in chest and upper back muscles. Improvements in 1-RM in leg muscles were significantly greater in the PRO group versus the PLA group. In conclusion, our results indicate that adaptations to low-volume concurrent training, particularly leg muscle strength, can be improved with targeted post-exercise protein supplementation in untrained healthy individuals.

Cancer cachexia is a multifaceted syndrome that impacts individuals with advanced cancer. It causes numerous pathological changes in cancer patients, such as inflammation and metabolic dysfunction, which further diminish their quality of life. Unfortunately, cancer cachexia also increases the risk of mortality in affected individuals, making it an important area of focus for cancer research and treatment. Several potential nutritional therapies are being tested in preclinical and clinical models for their efficacy in improving muscle metabolism in cancer patients. Despite promising results, no special nutritional therapies have yet been validated in clinical practice. Multiple studies provide evidence of the benefits of increasing muscle protein synthesis through an increased intake of amino acids or protein. There is also increasing evidence that exercise can reduce muscle atrophy by modulating protein synthesis. Therefore, the combination of protein intake and exercise may be more effective in improving cancer cachexia. This review provides an overview of the preclinical and clinical approaches for the use of amino acids with and without exercise therapy to improve muscle metabolism in cachexia.

Background: Patients suffering from chronic inflammatory bowel disease (IBD) are a heterogenous patient group with varying symptoms and complications. Concerning disease activity, one has to differentiate between acute flare-ups and remission phases. Aim: The present publication describes the practice of nutritional therapy in IBD patients, focusing on aspects that have to be considered during this treatment. In addition, the potential positive impact of exercise and physical activity on the course of disease in IBD patients is addressed in part 2 of this article. Materials and methods: In this publication, we describe how the nutritional status of IBD patients is evaluated at the beginning of the nutritional therapy and how we then proceed with nutritional therapy, based on this evaluation and adapted to the actual disease progress. The recommendations given in the latest guidelines are presented, considering IBD-associated symptoms and complications. Results and conclusion: We recommend anti-inflammatory nutrition, based on a Mediterranean diet, for IBD patients. Specific nutritional concepts for the respective disease phases have to be adapted to the individual nutritional status of the patient. Diagnosis of nutritional deficiencies, concomitant symptoms, or food intolerances should be checked before starting nutritional therapy. The individual treatment has to consider these results and select appropriate dietetic recommendations for each patient.

Patient*innen mit chronisch-entzündlichen Darmerkrankungen (CED) stellen eine heterogene Gruppe mit unterschiedlichen Symptomen und Komplikationen dar. In Bezug auf die Krankheitsaktivität ist zwischen der Phase des akuten Entzündungsschubs und der Remissionserhaltung zu unterscheiden. Die vorliegende Arbeit beschreibt die Vorgehensweise und die zu berücksichtigenden Aspekte bei der ernährungstherapeutischen Behandlung von CED-Patient*innen. In Teil 2 dieses Beitrags wird darauf eingegangen, inwieweit Sport- und Bewegungstherapie für diese Patient*innengruppe einen positiven Einfluss auf den Krankheitsverlauf aufweisen können. Die Erfassung des Ernährungszustands wird als Ausgangspunkt der Ernährungstherapie erläutert und anschließend wird die darauf abgestimmte Vorgehensweise zur ernährungstherapeutischen Behandlung in der jeweiligen Krankheitsphase geschildert. Die in den aktuellen Leitlinien vorhandenen Empfehlungen werden unter Berücksichtigung von CED-assoziierten Begleitsymptomen sowie Komplikationen dargestellt. Für CED-Patient*innen ist eine antientzündliche Ernährungsweise auf der Basis einer mediterranen Ernährung empfehlenswert. Dabei stehen für die unterschiedlichen Krankheitsphasen spezifische Ernährungskonzepte zur Verfügung, die im Hinblick auf den individuellen Ernährungszustand anzupassen sind. Das Vorliegen von Mangelzuständen und Begleitsymptomen wie Nahrungsmittelunverträglichkeiten sollte vor Einleitung der Ernährungstherapie diagnostisch abgeklärt werden und die individuelle Behandlung darauf abgestimmt sein.

SummaryDie Tumorkachexie (TK), eine mit Inflammation assoziierte Mangel­ernährung mit dem Hauptmerkmal des Verlusts an Muskelmasse, -kraft und -funktion (= Sarkopenie), ist eine stark prävalente, die Lebensqualität einschränkende sowie prognoserelevante Komorbidität einer Tumorerkrankung. Eine supportive, kombinierte Ernährungs- und Bewegungstherapie, die möglichst früh im Krankheitsverlauf initiiert und individualisiert ausgestaltet wird, kann effektiv dazu beitragen, den Muskelstatus zu erhalten bzw. wiederaufzubauen. Dies kann den Krankheitsverlauf und die Prognose signifikant verbessern. Sie sollte daher immer als integraler Teil eines multimodalen onkologischen Behandlungskonzepts berücksichtigt werden.Ein frühzeitiger, individualisierter Ernährungssupport mit Sicherstellung einer adäquaten Energie- und Proteinzufuhr stellt die Grundvoraussetzung für den Erhalt bzw. Wiederaufbau von Muskelmasse dar. Neben der erhöhten Proteinmenge ist zur Überwindung der anabolen Resistenz, wie sie unter TK vorliegt, besonders auch die Proteinqualität, d. h. eine ausreichende Zufuhr unentbehrlicher ­Aminosäuren, zu berücksichtigen. Es gibt Hinweise darauf, dass Omega-3-Fettsäuren bei TK als antiinflammatorische Substrate dazu beitragen können, einen progredienten Muskelabbau zu stoppen und den Wiederaufbau von Muskulatur zu fördern.Aufgrund ihrer multifaktoriellen Genese lässt sich die Tumorkachexie allein durch konventionelle ernährungstherapeutische Maßnahmen nicht vermeiden bzw. umkehren. Vielmehr wird der frühzeitige Einsatz multimodaler Therapiekonzepte gefordert, um den drohenden Muskelschwund zu verhindern oder zu verzögern. Jede Ernährungsintervention sollte zum Aufbau der Muskelmasse von bewegungstherapeutischen Maßnahmen begleitet werden, um durch die synergistischen Wirkungen maximale Effektivität zu erzielen.Regelmäßige körperliche Aktivität kann die Muskelmasse und -kraft bei Krebspatient*innen steigern, immunologische Prozesse positiv beeinflussen sowie den funktionellen Status und die Lebensqualität verbessern. Unterschiedliche Trainingsmodalitäten werden diskutiert, darunter konventionelles Krafttraining und progressives Widerstandstraining mit elastischen Bändern, genauso wie innovative Ansätze wie die Ganzkörper-Elektromyostimulation (WB-EMS). Auch sollte die Verbesserung der Leistungsfähigkeit des Herz-Kreislauf-Systems mittels Ausdauertrainings angestrebt werden. Bei der Erstellung des Trainingsplanes sind die individuellen Bedürfnisse, Gesundheitszustände und potenziellen Bewegungseinschränkungen (z. B. durch Knochenmetastasen oder Lymphödeme) der Krebspatient*innen zu berücksichtigen.

Background: The prevalence of inflammatory bowel disease (IBD) is increasing worldwide. Besides nutritional factors, reduced physical activity is also recognized as a significant influencing factor, leading to a reduction in muscle mass and an increase in fat reserves and a deterioration of the cardiovascular system. These factors can increase the risk of developing IBD and/or have an adverse impact on disease progression.Aim: The goal of this paper is to explain the approach and aspects to be considered when using exercise and physical activity in the treatment of IBD.Materials and methods: In addition to the intestinal and extraintestinal findings and the inflammatory activity, the physical constitution of patients with IBD is of tremendous importance for treatment that includes exercise and physical activity. Although the positive influence of exercise and physical activity on patients with IBD is a proven fact, there are no specific guidelines regarding the extent and type exercise and physical activity. Therefore, recommendations based on study results are given as guidelines for exercise interventions in patients with IBD.Results and conclusion: Exercise and physical activity adapted to the disease state can positively influence the patient's quality of life and the course of the disease. The combination of endurance and strength training can improve body composition and physical performance. In view of the heterogeneity of patients, however, physical exercise interventions must also be individualized.

Malnutrition and cancer cachexia are highly prevalent comorbidities of cancer, limiting patients' quality of life and being relevant to prognosis. International and national clinical guidelines recommend supportive nutrition and exercise therapy for cancer patients. However, there is little current epidemiological evidence on the implementation of these guideline recommendations in clinical routine. To close this data gap, a national survey in Germany using an online questionnaire was conducted. There were 261 of a total of 5074 contacted hospitals and medical offices who participated in the survey (5.1% response rate). The data indicated that nutrition and exercise therapy for cancer patients is so far inadequately implemented, with 59% of the respondents reporting nutrition therapy as an integral part of oncological treatment, 66.7% having a nutrition specialist/team, and 65.1% routinely conducting a screening for nutritional status. Only half of the participants stated that there are defined goals in nutrition therapy. The majority of respondents (85.8%) generally recommend exercise therapy, but only a few of them provide specific offers at their own institution (19.6%) or at cooperation partners (31.7%). In order to implement the recommended combined nutrition and exercise therapy as part of regular care, there is a need for nationwide availability of multidisciplinary nutrition teams and targeted offers of individualized exercise therapy. Health policy support would be important to create the structural, financial, and staff conditions for appropriate guideline implementation in order to achieve the optimal treatment of cancer patients.

Exercise is an integral part of metabolic syndrome (MetS) treatment. Recently, low-volume high-intensity interval training (LOW-HIIT) has emerged as a time-efficient approach to improving cardiometabolic health. Intensity prescriptions for LOW-HIIT are typically based on maximum heart rate (HRmax) percentages. However, HRmax determination requires maximal effort during exercise testing, which may not always be feasible/safe for MetS patients. This trial compared the effects of a 12-week LOW-HIIT program based on: (a) HRmax (HIIT-HR), or (b) submaximal lactate threshold (HIIT-LT), on cardiometabolic health and quality of life (QoL) in MetS patients. Seventy-five patients were randomized to HIIT-HR (5 × 1 min at 80–95% HRmax), HIIT-LT (5 × 1 min at 95–105% LT) groups, both performed twice weekly on cycle ergometers, or a control group (CON). All patients received nutritional weight loss consultation. All groups reduced their body weight (HIIT-HR: −3.9 kg, p < 0.001; HTT-LT: −5.6 kg, p < 0.001; CON: −2.6 kg, p = 0.003). The HIIT-HR and HIIT-LT groups similarly, improved their maximal oxygen uptake (+3.6 and +3.7 mL/kg/min, p < 0.001), glycohemoglobin (−0.2%, p = 0.005, and −0.3%, p < 0.001), homeostasis model assessment index (−1.3 units, p = 0.005, and −1.0 units, p = 0.014), MetS z-score (−1.9 and −2.5 units, p < 0.001) and QoL (+10 points, p = 0.029, and +11 points, p = 0.002), while the CON did not experience changes in these variables. We conclude that HIIT-LT is a viable alternative to HIIT-HR for patients who are not able/willing to undergo maximal exercise testing.

Oxidative stress (OS) and inflammation are features of metabolic syndrome (MetS) that can contribute to the shortening of telomere length (TL), a marker of cellular ageing. Research indicates that exercise can positively influence MetS-associated conditions and TL. However, the effects of low-volume exercise types on TL are still unknown. We investigated the impact of very-low-volume high-intensity interval training (LV-HIIT), one-set resistance training (1-RT), and whole-body electromyostimulation (WB-EMS) on TL, inflammation, and cardiometabolic indices in 167 MetS patients. Data were derived from two randomized controlled trials where patients were allocated to an exercise group (2 sessions/week, for 12 weeks) or a control group. All groups received standard-care nutritional weight loss counselling. TL was determined as the T/S ratio (telomere to single-copy gene amount). All groups significantly reduced body weight (p < 0.05), but the T/S-ratio (p < 0.001) only increased with LV-HIIT. OS-related inflammatory markers (C-reactive protein, interleukin-6, and lipopolysaccharide-binding protein) only decreased (p < 0.05) following LV-HIIT. The MetS severity z-score improved with LV-HIIT (p < 0.001) and 1-RT (p = 0.014) but not with WB-EMS. In conclusion, very-low-volume exercise modalities have differential effects on telomeres, inflammation, and cardiometabolic health. Only LV-HIIT but not strength-based low-volume exercise increased TL in MetS patients, presumably due to superior effects on OS-related inflammatory markers.

Einen wichtigen Einflussfaktor für die weltweit zunehmende Prävalenz von chronisch-entzündlichen Darmerkrankungen (CED) stellt neben ernährungsrelevanten Faktoren auch die verminderte körperliche Aktivität dar, die zu einem Rückgang der Muskelmasse, zu einer Zunahme der Fettmasse und Verschlechterung des Herz-Kreislauf-Systems führen kann. Dies kann das Risiko für eine CED erhöhen und/oder sich ungünstig auf den Krankheitsverlauf auswirken. Ziel dieses Beitrags ist es, die Vorgehensweise und die Aspekte zu erläutern, die beim Einsatz von Sport- und Bewegungstherapie zur Behandlung von Patienten mit CED zu berücksichtigen sind. Neben der Erfassung der intestinalen und extraintestinalen Manifestationen, der entzündlichen Aktivität und der Ernährungssituation ist die körperliche Konstitution der Patient*innen mit CED für die Sport- und Bewegungstherapie von großer Bedeutung. Obwohl der positive Einfluss von Sport und Bewegung festgestellt wurde, gibt es keine spezifischen Leitlinien für die Dosierung und die Vorgehensweise. Daher werden im Folgenden Empfehlungen auf der Grundlage von Studienergebnissen als Leitfaden für Bewegungsinterventionen bei Patienten mit CED gegeben. Eine an den Erkrankungszustand angepasste Sport- und Bewegungstherapie kann die Lebensqualität des Patienten verbessern und den Krankheitsverlauf positiv beeinflussen. Durch die Kombination aus Ausdauer- und Krafttraining kann es zur Verbesserung der Körperzusammensetzung und der körperlichen Leistungsfähigkeit kommen. Angesichts der Heterogenität der Patient*innen sind die sport- und bewegungstherapeutischen Interventionen individuell anzupassen.

Background & aims: Teduglutide is a Glucagon-like peptide-2 (GLP-2) agonist indicated for the treatment of patients with parenteral support (PS) dependent short bowel syndrome (SBS) with chronic intestinal failure (cIF). Its application is accompanied by a structured nation-wide home-care service program in Germany. We investigated care characteristics and outcome parameters in a clinical real-world obser-vational setting.Methods: Data generated within a therapy-accompanying home-care service program for adult SBS-cIF patients were analyzed retrospectively for patients treated up to 1 year (data cut: April 2020).Results: In total, 52 teduglutide-treated patients were included by 6 German cIF centers. At teduglutide administration start, 49/52 patients were on PS, 3 of them without macronutrients. The majority of patients received individualized parenteral nutrition (PN) (n = 32/46), while 13/46 were on commercial premixed bags. PS application was done by patients themselves (37%), home-care nurses (19%), relatives (8%) or by a combination of those (16%). In patients with PS dependency at baseline and available follow-up data (n = 40-44), teduglutide treatment resulted in significantly reduced PN days, caloric needs, infusion time, and infusion volume after 6 and 12 months. After 1 year, reduction of infusion time was positively correlated with a reduction of PN calories and volume; 30 patients (68%) were responders (PS-volume reduction >= 20%), and 6 pa-tients (14%) were completely weaned off PS. Sleep disturbances per night were significantly reduced after 3 months of treatment and stool characteristics improved in consistency and significantly in frequency, while meal frequency remained stable.Conclusions: Teduglutide treatment associated reduction in PS volume and calories was accompanied by reduced infusion days, infusion times, sleep disturbances, stable oral intake surrogates, and improved stool characteristics, all of these potential parameters for improving quality of life. Furthermore, analyzed care characteristics reflect SBS-cIF treatment as a complex, resource-intensive and demanding task for both, healthcare system and patients.(c) 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Exercise is a cornerstone in metabolic syndrome (MetS) treatment. However, the effects of low-volume exercise modalities on MetS-associated low-grade inflammation are unclear. A total of 106 MetS patients (53.7 ± 11.4 years) were randomized to low-volume high-intensity interval training (LOW-HIIT, 14 min/session), single-set resistance training (1-RT, ~15 min/session), whole-body electromyostimulation (WB-EMS, 20 min/session), three-set resistance training (3-RT, ~50 min/session), each performed 2 ×/week for 12 weeks, or a control group (CON). All groups received nutritional counseling for weight loss. Inflammatory and cardiometabolic indices were analyzed pre- and post-intervention. All groups significantly reduced body weight by an average of 3.6%. Only LOW-HIIT reduced C-reactive protein (CRP) (−1.6 mg/L, p = 0.001) and interleukin-6 (−1.1 pg/mL, p = 0.020). High-sensitivity CRP and lipopolysaccharide-binding protein decreased following LOW-HIIT (−1.4 mg/L, p = 0.001 and −2.1 ng/mL, p = 0.004) and 3-RT (−0.6 mg/L, p = 0.044 and −2.0 ng/mL, p < 0.001). MetS severity score improved with LOW-HIIT (−1.8 units, p < 0.001), 1-RT (−1.6 units, p = 0.005), and 3-RT (−2.3 units, p < 0.001). Despite similar effects on body weight, low-volume exercise modalities have different impact on inflammatory and cardiometabolic outcomes in MetS patients. LOW-HIIT has superior efficacy for improving inflammation compared to 1-RT and WB-EMS. Resistance-based exercise appears to require a higher volume to promote beneficial impact on inflammation.