The Traditional Mediterranean Physical Activity (TMPA) pattern, characterized by daily, incidental, and socially embedded movement, represents a core yet understudied component of the Mediterranean lifestyle. Unlike structured exercise, TMPA encompasses activities such as walking for transportation, agricultural work, gardening, household chores, and participation in cultural events. With global declines in functional daily movement and an increase in sedentary behavior, understanding the health impact of TMPA is increasingly relevant. A systematic literature search was conducted across major databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Scopus, and ProQuest) from inception to present. Of 6037 records identified, 27 studies met all inclusion criteria involving adult populations from Mediterranean countries and reporting physical activity-related health outcomes. Both quantitative and qualitative research, as well as systematic and narrative reviews, were included. A narrative synthesis of the 38 studies was undertaken due to heterogeneity in study design, outcomes, and TMPA definitions. Evidence consistently demonstrated that TMPA contributes to broad physical health benefits, including reduced cardiovascular and all-cause mortality, improved metabolic profiles, healthier body composition, enhanced musculoskeletal strength, and greater functional capacity in older adults. Its integration with other lifestyle pillars, such as diet, rest, and social engagement, appears to amplify these effects. TMPA was also associated with improved mental health outcomes, including reduced depressive symptoms, lower stress, enhanced emotional resilience, and greater life satisfaction. Studies emphasized that the social, outdoor, and culturally meaningful context of TMPA distinguishes its health effects from conventional exercise. However, substantial methodological variability, reliance on self-reported measures, and limited longitudinal research constrain the strength of causal inferences. Conclusions: TMPA emerges as a culturally embedded and sustainable form of daily movement with significant physical and mental health benefits. Its holistic, lifelong nature positions it as a valuable model for public health strategies aimed at counteracting sedentary lifestyles. Future research should prioritize standardized definitions, objective measurement tools, and longitudinal or interventional designs to clarify causal pathways. Incorporating TMPA principles into modern environments may offer innovative, culturally grounded approaches to promoting population health.

Obesity is an important risk factor for the development of metabolic syndrome disorders. We previously showed that the liver fatty acid-binding protein null mouse (LFABP−/−) becomes obese upon high-fat diet (HFD) feeding but remains metabolically healthy. Here, we find that the obese LFABP−/− mouse increases subcutaneous adipose tissue (SAT) mass by markedly increasing the number rather than the size of adipocytes, as is typical with HFD. Indeed, while HFD-fed LFABP−/− mice had almost double the fat mass of WT, SAT adipocyte size was >4-fold smaller and adipocyte number was 5-fold higher in the LFABP−/−. Transcriptomic analysis of SAT revealed that Lfabp deletion alters the expression of multiple pathways that modulate adipose expansion and function including cholesterol biosynthesis, adipogenesis, and extracellular matrix remodeling. LFABP is expressed in the liver and small intestine but not in adipose tissues; thus, its ablation may promote interorgan crosstalk that drives the hyperplastic expansion of metabolically beneficial SAT, contributing to the healthy obese phenotype of the LFABP−/− mouse.

The Mediterranean lifestyle has attracted significant research attention in recent years. This lifestyle is supported by several key pillars, including dietary habits, social and spiritual engagement, and physical activity. Although much of the research has focused on the health benefits of the Mediterranean diet, physical activity has received comparatively less emphasis. Nevertheless, physical activity remains a vital component of the Mediterranean lifestyle, deeply embedded in cultural traditions and daily routines. This paper examines the defining features, movement patterns, and cultural foundations of physical activity within the traditional Mediterranean lifestyle. By drawing on historical sources, anthropological studies, and contemporary research, we characterize Traditional Mediterranean Physical Activity (TMPA) as a set of habitual, non-structured movement patterns integrated into daily life. These activities include farming, fishing, manual labor, dancing, and walking for transportation, all reflecting a functionally active lifestyle shaped by environmental and occupational demands. The study also explores how TMPA has evolved and its potential alignment with modern physical activity paradigms. The key components of TMPA include functional movements, outdoor engagement, and communal participation, reflecting a culturally embedded approach to physical activity in Mediterranean societies. This study provides a foundation for understanding TMPA as a distinct movement model shaped by tradition and sustainability and offers insights into how these activity patterns have persisted or adapted in contemporary settings.

Growing evidence has linked both the onset and symptoms of various mental disorders to lifestyle factors such as diet, exercise and sleep. The link between diet and mental health, in particular in depressive disorders, has gained interest in recent years. Previous reviews assessing the link between the Mediterranean diet (MedDiet) and mental health predominantly focused on depression, whilst others failed to integrate a summary of possible underlying mechanisms related to a link between MedDiet and mental health to complement their findings. In the present review, we provide a comprehensive synthesis of evidence on the MedDiet and diverse mental health outcomes complemented by narration of the potential mechanisms involved. A literature search was conducted across MEDLINE, PsycINFO, Scopus, Cochrane library, Google Scholar, CINAHL and Embase databases. A total of 10 249 articles were found through the primary literature search and 104 articles (88 observational and 16 interventional studies) were eligible for inclusion. The MedDiet has been associated with favourable mental health outcomes in adult populations, including reduced depressive and anxiety symptoms, lower perceived stress, and improved quality of life and overall wellbeing, both in healthy individuals and those with comorbidities, across diverse geographical settings. Mechanisms involved include the antioxidant, anti-inflammatory potential of the MedDiet and its effect on gut microbiota. Further research is warranted to rigorously establish causal inferences and to guide the optimal incorporation of Mediterranean diet principles into comprehensive prevention and treatment strategies aimed at improving mental health outcomes.

BACKGROUND This study aimed to investigate the dietary habits from early childhood to adolescence among participants from all regions of the country and living areas (rural/urban) and assess potential associations between dietary habits and obesity in both sexes. METHODS Population data were derived from a cross-sectional health survey on a representative sample of 177,091 children aged 6-18 years. Dietary habits were considered via a self-completed questionnaire (Mediterranean diet quality index for children and adolescents [KIDMED]). Trained investigators assessed the anthropometric data. RESULTS KIDMED scores were 6.7 f 2.4 and 6.8 f 2.3 for boys and girls, respectively, whereas a percentage of almost 10% of the total study population had insufficient dietary habits. Dietary habits peaked around age 11 years and then gradually worsened until the end of adolescence in both sexes, with an annual trend equal to-0.28 f 0.02 (p < 0.001) for boys and-0.31 f 0.03 (p <0.001) for girls. Schoolchildren who are overweight/obese presented higher percentages in all unhealthy dietary habits (e.g., skipping breakfast, going often to a fast food restaurant, and consuming a lot of sweets) than children with a normal weight (all p-values < 0.001). Dietary habits did not noteworthy differ by area of living, that is, urban versus rural, of participants in both sexes. In addition, no noticeable differences in the values of the KIDMED index were found among all regions of Greece, with the highest values in Attica and Crete in both sexes. CONCLUSIONS Because Greek schoolchildren do not fully adopt the traditional cardio-protective Mediterranean diet, it could be helpful to provide certain recommendations, especially for adolescents, to decrease the risk for future adverse health consequences. (Hellenic Journal of Cardiology 2025;85:3-11) (c) 2024 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

The purpose of this study was to examine vegetable consumption and its relationship with lifestyle characteristics among children and adolescents. Data from a health survey administered to a representative sample of 177,091 schoolchildren between the ages of 8 and 17 were employed in this observational, cross-sectional investigation. Physical activity level, screen time, and sleeping patterns were assessed using self-completed questionnaires. Vegetable consumption and dietary habits were analyzed using the Mediterranean Diet Quality Index for Children and Adolescents. Participants consuming vegetables more than once daily were categorized as consumers vs. non-consumers. Physical education teachers measured anthropometric and physical fitness factors. Descriptive statistics and binary logistic regression analysis were conducted, and the odds ratio with the corresponding 95% confidence interval was calculated and adjusted for confounders. Vegetables were consumed once or more times a day by more females than males (25.5% vs. 24.0%, p < 0.001). In both sexes, vegetable consumers slept more, ate healthier, spent less time on screens, and had better anthropometric and aerobic fitness measurements than non-consumers. Healthy eating practices, such as regularly consuming fruits, legumes, nuts, and dairy products, were strongly correlated with vegetable intake. For every one-year increase in age, the odds of being a vegetable consumer decreased by 8% and 10% in boys and girls, respectively. Overweight/obese participants had lower odds of being a vegetable consumer by 20%. Increased screen time, inadequate physical activity, and insufficient sleeping hours decreased the odds of being a vegetable consumer by 22%, 30%, and 25%, respectively (all p-values < 0.001). Overall, a healthier lifestyle profile was associated with higher vegetable intake for both sexes among children and adolescents.

Although the Mediterranean Diet (MedDiet) may appear simple and locally inspired based on the provided definitions, mounting evidence reveals that adopting a dietary pattern aligned with MedDiet principles can yield numerous health benefits. Also, the MedDiet stands as the gold standard in preventive medicine, so it is not a simplistic diet centered around specific ingredients or cooking methods; instead, it emerges from a distinctive way of life (lifestyle) inherent to the Mediterranean region. This lifestyle encapsulates essential components of a balanced diet and life, including frugality and moderation in food consumption, the utilization of seasonal and traditional products, a focus on locally sourced, eco-friendly, and biodiverse items, personal engagement in culinary preparation, the emphasis on conviviality and social activities during meal consumption, regular engagement in physical activity, adequate hydration, and sufficient rest. In this review, we will establish the interconnections and links between the various aspects of the Mediterranean diet, how these pillars reflect the Mediterranean region's distinctive lifestyle, and how each element is a necessary part of the others. Finally, the seamless integration of social involvement, sufficient rest, regular physical exercise, and diet will be explored to provide a holistic view of the Mediterranean lifestyle and its inherent harmony.

INTRODUCTION:Studies have shown an inverse association between the risk of breast cancer in women and physical activity. However, information on the association between cardiorespiratory fitness (CRF) assessed objectively by a standardized test and the risk of developing breast cancer is limited. PURPOSE:To examine the CRF-breast cancer risk association in healthy females. METHODS:This retrospective study was derived from the Exercise Testing and Health Outcomes Study cohort ( n = 750,302). Female participants ( n = 44,463; mean age ± SD; 55.1 ± 8.9 yr) who completed an exercise treadmill test evaluation (Bruce protocol) at the Veterans Affairs Medical Centers nationwide from 1999 to 2020 were studied. The cohort was stratified into four age-specific CRF categories (Least-fit, Low-fit, Moderate-fit, and Fit), based on the peak METs achieved during the exercise treadmill test. RESULTS:During 438,613 person-years of observation, 994 women developed breast cancer. After controlling for covariates, the risk of breast cancer was inversely related to exercise capacity. For each 1-MET increase in CRF, the risk of cancer was 7% lower (HR, 0.93; 95% CI, 0.90-0.95; P < 0.001). When risk was assessed across CRF categories with the Least-fit group as the referent, the risk was 18% lower for Low-fit women (HR, 0.82; 95% CI, 0.70-0.96; P = 0.013), 31% for Moderate-fit (HR, 0.69; 95% CI, 0.58-0.82; P < 0.001), and 40% for Fit (HR, 0.60; 95% CI, 0.47-0.75; P < 0.001). CONCLUSIONS:We observed an inverse and graded association between CRF and breast cancer risk in women. Thus, encouraging women to improve CRF may help attenuate the risk of developing breast cancer.

ABSTRACTIntroductionThe term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”MethodsMajor medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”ResultsThis proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”ConclusionsThis definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well‐being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.

Brown adipose tissue (BAT) in rodents appears to be an important tissue for the clearance of plasma branched-chain amino acids (BCAAs) contributing to improved metabolic health. However, the role of human BAT in plasma BCAA clearance is poorly understood. Here, we evaluate patients with prostate cancer who underwent positron emission tomography-computed tomography imaging after an injection of 1$ F-fluciclovine (L-leucine analog). Supraclavicular adipose tissue (AT; primary location of human BAT) has a higher net uptake rate for 1$ F-fluciclovine compared to subcutaneous abdominal and upper chest AT. Supraclavicular AT 1$ F-fluciclovine net uptake rate is lower in patients with obesity and type 2 diabetes. Finally, the expression of genes involved in BCAA catabolism is higher in the supraclavicular AT of healthy people with high BAT volume compared to those with low BAT volume. These findings support the notion that BAT can potentially function as a metabolic sink for plasma BCAA clearance in people.

BackgroundThis study aimed to investigate the dietary habits, from early childhood to adolescence, among participants from all regions of the country and living areas (rural/urban) and to assess potential associations between dietary habits and obesity, in both sexes.MethodsPopulation data were derived from a cross-sectional, health survey on a representative sample of 177091 children aged 6 to 18 years. Dietary habits were considered via a self-completed questionnaire (KIDMED index). Trained investigators assessed anthropometric data.ResultsKIDMED scores were 6.7±2.4 and 6.8±2.3 for boys and girls, respectively, while a percentage of almost 10% of the total study population had insufficient dietary habits. Dietary habits peaked around age 11 and then gradually worsened until the end of adolescence, among both sexes, with an annual trend equal to -0.28±0.02 (p<0.001), for boys and 0.31±0.03, (p<0.001), for girls. Overweight/obese schoolchildren presented higher percentages in all unhealthy dietary habits (e.g. skipping breakfast, going often to a fast-food restaurant, and consuming a lot of sweets) than normal-weight ones (all p-values<0.001). Dietary habits did not noteworthy differ by area of living, i.e. urban versus rural, of participants, in both sexes. Also, no noticeable differences in the values of the KIDMED index were found among all regions of Greece, with the highest values in Attica and Crete, in both sexes.ConclusionsAs Greek schoolchildren do not fully adopt the traditional cardio-protective Mediterranean diet, it could be helpful to provide certain recommendations, especially for adolescents, to decrease the risk for future adverse health consequences.

Nutrition affects both body composition and, consequently, athletic performance. Only a few studies have assessed the nutritional behavior and knowledge of elite players. The present study aimed to assess the dietary intake, body composition, and nutritional knowledge of elite handball players. Thirty-nine handball players (age: 23.2 ± 2.7 years, weight: 88.2 ± 10.1 kg, height: 1.87 ± 0.07 m, and years of training: 13 ± 2) participated in the study. The athletes completed a set of anthropometric measurements, a 24 h food recall, and a translated edition of Abridged Nutrition for Sport Knowledge Questionnaire (A-NSKQ). The average body fat percentage was 16.7 ± 3.8%, while the average fat free mass was 73.9 ± 8.5 kg. The athletes’ average daily energy intake was 2606.6 ± 756 kcal, while the average daily intake for carbohydrates, proteins, and fats was 243.85 ± 107.79 g [2.8 ± 1.3 g/kg BW/d—37.2 ± 10.5% of Total Energy Intake (TEI)], 131.59 ± 53.28 g (1.51 ± 0.7 g/kg BW/d—20.3 ± 6.9% of TEI), and 117.65 ± 40.52 g (40.9 ± 9.9% of TEI), respectively. For iron, calcium, and vitamin D, the average daily intakes were 19.33 ± 10.22 mg, 1287.7 ± 676.42 mg, and 3.22 ± 3.57 mcg respectively. The average success rate on the A-NSKQ was only 38.5 ± 10.7% out of 100. Elite handball players exhibit inadequate dietary intake and sports nutrition knowledge. Nutritional education should be a primary concern towards the amelioration of their athletic performance.

Background: Fruit intake is important for school-age children's health since it is linked to a lower risk of obesity, cancer, heart disease, stroke, and hypertension and it also improves gastrointestinal health. The purpose of this study was to look at the prevalence of increased fruit consumption as well as any relationships between it and sedentary behavior, obesity, diet, and physical fitness (PF) in children and adolescents. Methods: Data from a national health survey, which was performed in 2015 on a representative sample of 177,091 Greek schoolchildren aged 8 to 17 years old, were used in this cross-sectional observational analysis. The study employed the Mediterranean Diet Quality Index in children and adolescents (KIDMED) index to evaluate fruit consumption and nutritional patterns, and self-completed questionnaires were utilized to assess physical activity, sedentary time, and sleeping habits. Teachers of physical education measured anthropometric and PF parameters. The Student's t-test examined differences in mean values, while the chi-square test evaluated differences between categorical variables. The impact of lifestyle factors on increased fruit consumption, adjusted for confounders (e.g., age, anthropometric variables, etc.), was found through binary logistic regression analysis. Results: A marginally higher percentage of boys as compared to girls ate two or more fruits, daily (51.2% vs. 48.8%, P=0.74). Fruit consumers (>= 2 fruits or juices), in both genders, had reduced sedentary time, healthier eating habits, better anthropometric and aerobic fitness assessments, and more sleep than nonconsumers (all P values <0.01). Consuming fruit was positively correlated with maintaining a healthy diet [odds ratio (OR) =6.60; 95% confidence interval (CI): 6.02-6.98], which includes eating fish, vegetables, legumes, dairy products, and olive oil regularly. For both boys and girls, the likelihood of eating fruit fell by 8% (OR =0.92; 95% CI: 0.91-0.92) and 10% (OR =0.90; 95% CI: 0.89-0.91) with every year of age growth, respectively. Compared to normal weight, those who were overweight or obese had a 20% decreased chance of eating more fruit (OR =0.80; 95% CI: 0.73-0.87). Increased sedentary time and inadequate sleeping hours decreased the odds of being an increased fruit consumer by 25% (OR =0.75; 95% CI: 0.72-0.78) and 22% (OR =0.78; 95% CI: 0.68-0.79) respectively. Conclusions: Among schoolchildren of both genders, increased fruit consumption was positively correlated with healthy eating practices, lower rates of obesity and sedentary behavior, and improved PF. Adolescents and children should be encouraged to eat fresh fruits as part of public health initiatives.

PURPOSE: Metformin therapy has been associated with reduced all-cause and cardiovascular mortality. Cardiorespiratory fitness (CRF) is also associated with favorable health outcomes. However, the combined effects of metformin and CRF have not been examined. Thus, the current study aimed to assess the independent and combine effects of metformin therapy and CRF on all-cause mortality risk in type 2 diabetes (T2D) patients. METHODS: From the Exercise Testing and Health Outcomes Study (ETHOS) cohort (n = 750,302), we identified 227,506 patients (mean age 62.7 ± 8.4) diagnosed with T2D prior to an exercise treadmill test (ETT) with peak exercise capacity ≥2.0 metabolic equivalent (METs) and no evidence of overt cardiac disease. Of those, 153,734 were treated with metformin and 73,772 were not. We established five age-specific CRF categories according to quintiles of peak METs achieved (Q1-Q5). RESULTS: During follow-up (median 10.7 years, 2,453,703 person-years of observation), 64,068 died, for an annual mortality rate of 26.1 events per 1,000-person years. Mortality risk was 24% lower in those treated with metformin (Hazard ratio [HR] 0.76; 95% Confidence Interval [CI] 0.75-0.78). We then assessed the CRF-metformin interaction within the CRF categories using the least-fit individuals (Q1) on metformin therapy as the referent. For Q1 individuals not treated with metformin, mortality risk was 30% higher (HR 1.30; 95% CI 1.27-1.33). The risk then declined progressively with increased CRF and was 24% lower for those in Q3 category (HR 0.74; 95% CI 0.72-0.77), 46% lower for Q4 (HR 0.54; 95% CI 0.52-0.56) and 62% lower (HR 0.38, 95% CI 0.35-0.40) for Q5 individuals. For metformin-treated individuals, the decline in risk followed a similar pattern, but was more pronounced across all CRF categories, especially for individuals with relatively low CRF. CONCLUSIONS: An increased mortality risk was observed only in T2D patients not treated with metformin and with poor CRF. Mortality risk declined progressively with increased fitness, regardless of metformin therapy status, but was more pronounced when CRF and metformin were combined. These findings suggest that both CRF and metformin therapy lower mortality risk independently. However, the combination of both therapies was more effective than either therapy alone.

Background/Aim: Bone response to exercise depends on the type and size of the mechanical stimulus. In rowing, athletes are exposed to low mechanical but large compression loads mainly on the trunk. Thus, this study aimed to investigate the impact of rowing on total and regional bone quality and bone turnover parameters in elite rowing athletes vs. control subjects. Materials and Methods: Twenty world-class rowers and twenty active, but not athletic, men participated in the study. Bone mineral density (BMD) and body mineral content (BMC) were assessed by dual-energy X-ray absorptiometry (DXA). Bone turnover markers (OPG and RANKL) in serum were assessed by Elisa method. Results: The current research revealed no statistical difference in total bone mineral density (TBMD) and total body mineral content (TBMC) between elite-level rowers and control subjects. Nevertheless, Trunk BMC (p=0.02) and Trunk BMC/TBMC ratio (p=0.01) were significantly higher in rowers than those in the control group. In contrast, in the control group, the Lower limbs BMC/TBMC ratio (p=0.007) was statistically higher. Furthermore, RANKL (p=0.011) and OPG (p=0.03) were statistically significantly higher in rowers, whereas the OPG/RANKL ratio (p=0.012) was statistically higher in the control group. Conclusion: Rowing, as a non-weight-bearing exercise, did not alter total bone density but induced a remarkable redistribution of bone density from the lower limbs to the trunk. In addition, the current evidence suggests that the underlying molecular mechanism is based on turnover of intermediates, rather than solely bone redistribution.

ABSTRACTObjectives(1) To develop reference values for health-related fitness European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multi-language fitness platform (FitBack); (2) To provide comparisons across European countries.MethodsThis study builds on a previous large fitness reference study in European youth by: (1) widening the age demographic, (2) identifying the most recent and representative country-level data, and (3) including national data from existing fitness surveillance and monitoring systems. We used the ALPHA test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity, and health-related predictive validity: the 20-m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index, and waist circumference (anthropometry). Percentile values were obtained using the GAMLSS method.ResultsA total of 7,966,693 data points from 34 countries (106 datasets) were used to develop sex- and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting, and European fitness maps, is provided and freely available at www.fitbackeurope.eu.ConclusionsThis study discusses the major implications of fitness assessment in youth from a health, educational and sport perspective, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.What is already known on this topic-Fitness testing in youth is important from a health, educational and sport point of view.-The EU-funded ALPHA project reviewed the existing evidence and proposed a selection of field-based fitness tests that showed the highest test-retest reliability, criterion/construct validity, and health-related predictive validity among available tests.What this study adds-The FitBack project provides the most up-to-date and geographically diverse reference fitness values for 6-to 18-year-old Europeans.-This study introduces the first web-based, open-access, and multi-lingual fitness reporting platform (FitBack) providing interactive information and visual mapping of the European fitness landscape.How this study might affect research, practice, or policy-From a health perspective, very low fitness levels are a non-invasive indicator of poor health at both the individual and group level (e.g., school, region), which have utility for health screening and may guide public health policy. There are already examples of regional and national fitness testing systems that are integrated into the healthcare systems.-From an educational perspective, fitness testing is part of the school curriculum in many countries, and the FitBack platform offers physical education teachers an easy-to-use tool for interpreting fitness test results by sex and age.-From a sport perspective, these reference values can help identify young individuals who are talented in specific fitness components.

Objective. Aging is associated with several physiological changes that can increase the risk of disorders such as sarcopenia. The objective of this cross-sectional study was to screen the risk of sarcopenia and related factors in elderly men. Methods. A total of 450 men over the age of 60 years voluntarily participated in the study. Anthropometric indicators and body composition were measured. The timed up and go test (TUG) was used to evaluate physical performance and screen for sarcopenia. The physical activity scale for the elderly (PASE) questionnaire and mini nutritional assessment were used to evaluate physical activity levels and nutritional status. Results. The study found a significant negative correlation between TUG and total PASE scores (p<0.01) and a positive correlation between TUG and age (p<0.01). Linear regression analysis revealed that about 17% of the alterations in TUG scores (p<.001) could be attributed to PASE scores. Additionally, the results of the T-test demonstrated that sarcopenic subjects had significantly higher age (p<0.01) and lower physical activity levels. Our findings suggest that physical activity is an important factor in preventing sarcopenia in the elderly. Conclusion. In conclusion, this study highlights the importance of physical activity in preventing sarcopenia in elderly men. Maintaining an active lifestyle may reduce the risk of sarcopenia and related geriatric syndromes.

Background: Whether older immigrant populations from the Mediterranean region, continue to follow the MD long after they immigrated is not known. Aim: Compare adherence to the MD and successful aging levels between Greeks living in Greece (GG) and Greeks living abroad (GA). Methods: Anthropometrical, clinical, psychological, sociodemographic, dietary and lifestyle parameters were assessed in a cross-sectional manner in a sample of 252 GG and 252 GA. Mediterranean Diet Score (MedDietScore range 0-55) was used to assess adherence to the MD. Successful aging was evaluated with the validated successful aging index (SAI range 0-10). Results: GA presented higher adherence to MD (p < 0.001); they were consuming significantly more cereals, legumes, vegetables, and fruits compared to GG. GG consumed significantly more dairy (3.8 ± 2.9 vs. 1.9 ± 2.2, p < 0.001) and potatoes (2.4 ± 1.6 vs. 1.9 ± 1.5, p < 0.001) compared to GA. Meat (p = 0.27), poultry (p = 0.72), fish (p = 0.68), olive oil (p = 0.16) and alcohol consumption (p = 0.05) were comparable between the two groups (all p’s > 0.05). MedDietScore was positively associated with SAI among both groups after adjusting for possible confounders (0.041 ± 0.014, p = 0.003 GG and 0.153 ± 0.035, p < 0.001 GA). Also, legumes, cereals, fruits and vegetables were found to be beneficial for successful aging. Conclusion: Adherence to the MD is associated with higher levels of successful aging among people of the same genetic background living in different environments. However, traditional dietary habits are gradually abandoned in their native countries, when, at the same time, are considered cultural heritage and preserved accordingly among immigrants.

Background: Recent research indicates that both endocannabinoids (eCB) and heart rate variability (HRV) are associated with stress-induced experiences. However, these underlying mechanisms are not elucidated. The present study aims to investigate whether exposure to acute and chronic stress conditions can give rise to measurable changes, both to the peripheral eCB ligands and HRV. Methods: Thirteen candidates under intense preparation for their enlistment in the Hellenic Navy SEALs (HNS) participated in the study. All subjects underwent mental state examination, while HRV variables in time and frequency domain recordings were acquired. Furthermore, at baseline and 30 days after prolonged and intensive physical exercise, hair was collected to measure eCB ligands, such as anandamide (AEA), 2-arachidonoylglycerol (2-AG), and the N-acyl ethanolamine (NAE) molecules: palmitoylethanolamide (PEA) and oleoylethanolamide (OEA). Results: Comparing basal hair concentrations of eCB ligands before and after intense physical exercise, we found that AEA, PEA, and OEA were notably increased, whereas no differences were observed regarding the ligand 2-AG. Furthermore, there were observed associations between the concentrations of peripheral eCB ligands, both at baseline and after the prolonged physical exercise and the time and frequency domains of HRV. Conclusions: These findings suggest that endocannabinoid–HRV interrelations might share a short-term, and long-term adaptability of the changes in self-regulation associated with stress. Further studies will be required to determine the validity of peripheral eCB signaling and HRV as a biomarker for different aspects of the stress response.