BACKGROUND Diet is widely recognized as a significant contributor to the development and exacerbation of gastroesophageal reflux disease (GERD) symptoms. However, evidence on the impact of specific dietary factors remains inconsistent. AIM To identify the dietary and nutritional correlates of GERD symptoms in Sri Lankan adults. METHODS A cross-sectional analytic study was conducted on 1200 adults aged 18-70 years, recruited through stratified random cluster sampling across all 25 districts of Sri Lanka. Data was collected using interviewer-administered, country-validated tools: A GERD symptom screening tool and a food frequency questionnaire. Anthropometric measures (weight, height, abdominal and hip circumferences) were obtained using calibrated and sensitive instruments. Subjects having heartburn and/or regurgitation at least once per week were diagnosed to have GERD. They were compared with those without GERD (controls). RESULTS In our population (n = 1200, mean +/- SD age: 42.7 +/- 14.4 years, 46.1% males), significant dietary triggers of GERD symptoms included oily foods, bread, wheat, coffee, and sour or vinegar-based foods (P < 0.001, chi(2) test). Meal-related behaviors such as skipping breakfast, consuming late-night snacks (P < 0.001), and lying down within two hours after eating (P = 0.038) were also associated with GERD. No significant differences were observed between GERD and control groups in anthropometric measures, food portion sizes, or overall caloric and nutrient intake (P > 0.05). Total daily fat and fiber intake showed no correlation with GERD symptoms; however, bloating was associated with higher fat and fiber intake, greater fruit and vegetable consumption, and higher body mass index. These findings highlight dietary patterns and habits distinctive to the Sri Lankan population, where frequent consumption of oily and wheat-based foods may contribute to GERD symptom prevalence. CONCLUSION Some dietary items, such as oily foods, wheat, coffee, and sour/vinegar foods, and diet-related habits, such as fat intake, skipping breakfast, and lying down after meals, have a significant association with GERD symptoms as previously reported around the world. Bread is significantly associated with GERD symptoms in Sri Lankan adults, which has not been reported previously. Contrary to common belief, there was no significant association between GERD and nutrient intake or obesity. In addition, not only participants fulfilling criteria for GERD, but even controls were affected by food items triggering heartburn. Thus, lifestyle modifications based on diet and dietary habits are integral to managing GERD symptoms.

Muscular strength that can be improved through maximal, explosive, and reactive training reduces injury risk and enhances performance in athletes. In team sports, increased strength boosts physical and neuromuscular function, delays fatigue and speeds recovery. This scoping review aims to map and synthesize evidence from randomized controlled trials (RCTs) examining the role of strength training (ST) in injury prevention, performance enhancement, or their combined effects in team sports. A comprehensive search was conducted in five databases (SciVerse Scopus, PubMed, Web of Science, SPORTDiscus, and CINAHL) from 2015 to 2026. Keywords related to ST, injuries, and team sports were used in the search. We included RCTs assessing the effectiveness of ST in preventing injuries and enhancing performance in team sports. The methodological and content quality of the included studies were evaluated using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX) scale. This review included 17 RCTs involving team sports: soccer (n = 11), volleyball (n = 3), and one each for football, handball, and rugby. Participants had a mean age range of 12.7–25.8 years, with sample sizes varying from 20 to 652 athletes. Six studies reported concurrent improvements in injury-related and performance-related outcomes, suggesting that ST may influence biomechanical alignment, muscle balance, and sport-relevant function. Three RCTs focusing on injury outcomes indicated that ST was associated with lower injury incidence, including hamstring strains, groin injuries, and overall injury occurrence. Across eight studies, ST was associated with improvements in sprint speed, jump height, muscular strength, and endurance. Thirteen of the 17 studies were rated ‘Good’, while the remaining studies were rated ‘Fair’. Evidence from RCTs suggests that structured ST is associated with improvements in injury-related and performance outcomes in team-sport athletes; however, intervention heterogeneity and sport-specific concentration warrant cautious interpretation. Review registration: PROSPERO # CRD42024610812.

Background Track and field athletes are vulnerable to injury due to numerous intrinsic and extrinsic factors, such as previous injuries, high training loads, inadequate recovery, and psychological stress. However, there is limited information about the lived experiences of athletes from low- and middle-income countries. Objective This study aimed to explore perceptions of risk factors for sports injuries among Sri Lankan track and field athletes and key stakeholders. Methods This qualitative study employed convenience sampling to recruit elite athletes, their parents, and diverse stakeholders, including doctors, physiotherapists, coaches, sports administrators, and academics. Face-to-face, semi-structured interviews were audio-recorded, transcribed, and analysed using reflexive thematic analysis. Results Thirty-two participants completed the study (12 athletes, 17 stakeholders, and 3 parents). Five overarching themes related to injury occurrence and persistence were apparent among participants, including: (i) recurrent injuries due to inadequate recovery and load management; (ii) nutritional deficits, limited recovery, and psychological stress increasing vulnerability; (iii) environmental and equipment limitations elevating biomechanical load and fatigue-related risk; (iv) fragmented injury-management pathways and non-standardised return-to-play decisions; and (v) minimal injury monitoring and documentation, which limited prevention and continuity of care. Lower-limb injuries were most common, often associated with high training loads, poor recovery, technique errors, suboptimal ground conditions, and unsuitable equipment. Stakeholders highlighted nutrition, hydration, recovery strategies, and mental stress as key contributors. Injury management was inconsistent, with many athletes self-managing or relying on coaches rather than multidisciplinary healthcare. Formal surveillance systems were largely absent, prompting stakeholder calls for a coordinated digital record-keeping approach. Conclusions Sports injury prevention and management in Sri Lanka are constrained by limited facilities, suboptimal nutrition and recovery practices, and insufficient injury monitoring systems. Addressing these challenges requires integrated, multidisciplinary strategies that strengthen nutrition, recovery, psychological support, and record-keeping systems to optimise athlete health and performance.

BACKGROUND:Optimal body composition (BC) is essential for athletic success, influencing performance outcomes. Athlete-specific nutrition interventions are important for improving BC and enhancing performance, but evidence is limited, especially in track and field athletes. This study aimed to assess the effect of athlete-specific dietary guidance on BC in Sri Lankan track and field athletes. METHODS:A 16-week trial was conducted with 30 athletes, 15 in each group: intervention (IG) and control (CG). The IG received athlete-specific dietary guidance through individual consultations at weeks 0, 4, and 8, along with weekly nutrition advice. BC was assessed using anthropometry, bioelectrical impedance analysis (BIA), and dual-energy X-ray absorptiometry (DEXA). Muscle strength, as a component of physical fitness, was assessed via handgrip strength (HGS). RESULTS:Fourteen participants from each group completed the study. The IG demonstrated a significant decrease in fat mass percentage (FM) derived from BIA (Pre: 21.80 ± 7.0% vs. Post: 17.25 ± 5.8%; Change: -4.55 ± 1.2%; p = 0.003), while the CG demonstrated a no significant change (Pre: 18.87 ± 7.84% vs. Post: 19.60 ± 5.84%; Change: + 0.73 ± 3.0%; p = 0.475). The body fat percentage derived from DEXA also demonstrated significant reductions in the IG (Pre: 21.60 ± 7.1% vs. Post: 17.30 ± 6.0%; Change: -4.30 ± 1.1%; p = 0.005), and the CG exhibited a no significant change (Pre: 18.84 ± 3.9% vs. Post: 19.61 ± 6.5%; Change: + 0.77 ± 0.4%; p = 0.367). Fat-free mass (FFM) derived from DEXA increased in IG (Pre: 42.29 ± 6.0 kg vs. Post: 46.57 ± 6.4 kg; Change: +4.28 ± 0.4 kg; p < 0.001) when compared to CG (Pre: 39.13 ± 11.4 kg vs. Post: 38.05 ± 11.7 kg; Change: -1.08 ± 0.3 kg; p = 0.051). The IG showed significantly better HGS. CONCLUSIONS:Athlete-specific dietary guidance significantly improved BC and physical fitness among track and field athletes. TRIAL REGISTRATION:This trial was registered in the Sri Lanka Clinical Trials Registry (SLCTR/2024/013) under Universal Trial Number (UTN) U1111-1304-8890 on 10 April 2024.

This review aimed to systematically synthesize qualitative evidence on the perceptions, experiences, and practices of athletes and stakeholders regarding sports injuries, with a primary focus on risk factors, consequences, injury reporting, rehabilitation, and prevention strategies. A systematic review of qualitative studies was conducted in accordance with PRISMA guidelines and prospectively registered in PROSPERO. Six databases were searched from 2000 to July 2025. Eligible studies explored the lived experiences of sports injuries in athletes and stakeholders. Data were extracted, appraised using the CASP checklist, and synthesized thematically. Thirty-five studies were included, spanning a range of sports and competitive levels. Five overarching themes were identified: (i) risk factors including excessive training loads, poor recovery, early specialization, and psychosocial stressors; (ii) consequences of injury such as disrupted performance, long-term disability, financial costs, and significant psychological distress; (iii) rehabilitation highlighting both the challenges of self-management and the importance of interdisciplinary support; (iv) injury reporting and monitoring where normalization of pain, fear of deselection, and cultural pressures inhibited disclosure; and (v) injury prevention and performance sustainability emphasizing load management, evidence-based practices, collaborative monitoring, and contextual barriers such as limited resources and fixture congestion. Athletes and stakeholders perceive sports injuries as complex biopsychosocial phenomena shaped by cultural norms, resource availability, and interpersonal dynamics. Sustainable prevention requires both individualized and systemic approaches, combining tailored training plans, athlete-centered care, and structured surveillance systems. Qualitative insights highlight the necessity of embedding prevention and rehabilitation strategies within the lived realities of athletes, thereby enhancing health protection and long-term performance sustainability. REVIEW REGISTRATION: This review was prospectively registered on the Open Science Framework in March 2025 (registration DOI: https://doi.org/10.17605/OSF.IO/V79D2).

OBJECTIVES:This study explored perspectives of practitioners providing weight management support for urban-dwelling young adults (18-35 years) with obesity in Sri Lanka, addressing an important evidence gap in understanding obesity management from a provider perspective. STUDY DESIGN:This descriptive qualitative study employed face-to-face semi-structured interviews, and the data were analysed using a framework approach within thematic analysis. STUDY SETTING AND PARTICIPANTS:Eight purposively selected practitioners involved in weight management in the Colombo District, Sri Lanka, were interviewed. Participants represented key domains of comprehensive obesity management, including dietary, physical activity, behaviour and medical management. Recruitment continued until thematic saturation was achieved. RESULTS:Two key themes emerged from the data: (1) Barriers to effective weight management and (2) Strategies to improve weight management. Within the first theme, five subthemes emerged, including limited knowledge and confidence among practitioners, provider attitudes towards clients, resource and service limitations, client motivation and adherence challenges and cultural and religious influences and myths. The second theme comprised four subthemes: early detection with a proper referral system, comprehensive and individualised care approach, continuous follow-up and self-monitoring and supportive social environment. CONCLUSIONS:The findings indicate that obesity management is hindered by fragmented care, with provider, client and system-level factors constraining practitioners' weight management efforts and limiting opportunities for improved care. These findings suggest the potential value of strengthening interdisciplinary referral pathways and targeted training to support more coordinated care.

Plyometric training (PT) is widely used in track and field to improve stretch-shortening cycle efficiency, sprint speed, and explosive power. However, no systematic review has synthesized randomized controlled trials (RCTs) examining the effects of PT on both injury-related and performance outcomes in track and field athletes. We aimed to evaluate the effects of PT on performance-related metrics in this population. PubMed®, Web of Science®, Scopus®, and SPORTDiscus® were systematically searched to identify RCTs involving track and field athletes of any competitive level. Eligible studies compared PT with participants continuing their usual routine training without the inclusion of plyometric exercises and reported performance-related outcomes. A meta-analysis was conducted using RevMan 5.4.1 software to evaluate the effects of PT on sports performance. The methodological quality was evaluated using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX) scale, while risk of bias was evaluated using the Cochrane RoB 2 tool. Thirty RCTs met inclusion criteria, with 27 contributing to meta-analyses. Out of 30 studies, one RCT assessed the impact of PT on injuries and reported a significant reduction in lower limb injury incidence following PT. Meta-analyses showed significant improvements in 30 m sprint performance (-3.53

Musculoskeletal injuries are widespread among youth track and field athletes, largely due to the combined effects of growth, maturation, and escalating training loads. Yet, inconsistent definitions and measurement approaches for injuries, and for the factors that may increase or reduce risk, limit the comparability of findings across studies and impede progress toward effective prevention strategies. To identify risk and protective factors for musculoskeletal injuries in youth track and field athletes, and to examine how these injuries and associated factors have been defined, measured, and aligned with consensus methodological standards. This scoping review was conducted in accordance with Joanna Briggs Institute methodology and PRISMA-ScR reporting standards. Five databases (PubMed®, Web of Science®, Scopus®, SPORTDiscus®, and Embase®) were systematically searched from inception to March 2026. Studies were eligible if they included youth track and field athletes (mean age 15-24 years) and reported injury characteristics and/or risk or protective factors. Data were extracted on injury definitions, surveillance methods, exposure metrics, and factor measurement approaches. Methodological alignment with the athletics consensus statement by Timpka et al. was assessed using a structured framework. A total of 54 studies were included. Injury definitions varied widely, encompassing time-loss, medical-attention, symptom-based, and diagnosis-confirmed approaches, with substantial heterogeneity in surveillance methods and exposure quantification (48 studies). Factors associated with musculoskeletal injury outcomes spanned intrinsic (e.g., previous injury, biomechanics, strength, bone health) and extrinsic domains (e.g., training load, footwear, environment), with diverse measurement techniques (27 studies). Reporting of consensus-based methodological components varied across studies. Injury-definition elements were reported in a greater proportion of studies than exposure and surveillance elements. Variation was observed in the reporting of exposure metrics, prospective monitoring approaches, and the inclusion of overuse injuries across studies. Considerable methodological heterogeneity exists in youth track and field injury research. Greater adoption of consensus-based definitions, standardised exposure measures, and robust surveillance systems may improve comparability and support the development of injury prevention strategies. Open Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/U4BSY).

Background Poor dietary habits and insufficient nutrient intake pose significant global challenges. This study examines the nutrient intake of Sri Lankan adults and its association with selected socio-demographic characteristics during the economic crisis from 2020 to 2023. It also examines the validity of a subjective 24-hour dietary recall (24HDR) questionnaire using blood and urine biomarkers. Methods Data were collected from 164 twins and 138 adult offspring of the twins in the Colombo District of Sri Lanka. Nutrient intake was calculated using a 24HDR and, then compared with the recommended dietary allowances (RDA) in Sri Lanka. Blood and urine samples were analyzed for biomarker detection to assess dietary validity. Results Participants did not reach the recommended energy intake (mean for females: 1954.93 Kcal; mean for males:2507.04 Kcal). Participants also failed to meet the RDA for fat and dietary fiber. However, 71% of participants achieved the recommended carbohydrate intake. Micronutrient deficits were also evident; for example, most participants had low intakes of vitamins B2, B3, B12, C, and calcium. Regression analysis comparing questionnaire-based nutrient intake with biomarker data showed positive associations between serum beta-carotene, zeaxanthin, and vitamin D intake, as well as between urinary phenolic content, serum zeaxanthin, and vitamin A intake. Age significantly influenced portion size and the intake of energy, fat, and vitamins. Conclusion Our findings support the validity of the 24HDR as a dietary and nutritional assessment tool in Sri Lanka. These results offer valuable insights for public health policymakers, highlighting the importance of revising dietary recommendations to enhance dietary diversity and promote routine nutritional assessments in Sri Lanka.

South Asians are more prone to obesity and prediabetes due to a combination of non-modifiable and modifiable risk factors. While non-modifiable factors are largely unchangeable, addressing modifiable factors particularly dietary patterns is crucial for intervention. As South Asian dietary practices differ substantially from other populations, international dietary recommendations may not always be appropriate. Therefore, this review synthesizes South Asian-specific nutrition advice. Evidence was drawn from interventional studies involving South Asians identified through a systematic search, and from country-specific guidelines, recommendations, and consensus statements from South Asian countries. In total, 10 interventional studies and 14 guidelines were included. The main recommendations included a reduction of total energy intake by approximately 15% or 500 kcal/day, carbohydrate intake ranging from 49% to 65% of total energy, fat intake of, 19-32%, protein intake of 15-19%, incorporation of pre-meal nut consumption and achieving a target weight loss of .5-7%.

Low consumption of fruits and vegetables (FV) is a major preventable contributor to cardiovascular disease (CVD). Insufficient FV intake has been estimated to account for nearly 3 million CVD deaths and more than 70 million disability-adjusted life years worldwide. This review examines global patterns of FV intake; evidence linking FV consumption to cardiovascular outcomes; underlying biological mechanisms determined through in vitro and in vivo studies; serving size frameworks; current global recommendations; barriers to FV intake; and practical advice to increase FV intake. Although global FV intake has modestly increased in recent decades, consumption remains substantially below recommended levels in all regions, and marked disparities exist among countries. Evidence from meta-analyses of randomized controlled trials and intervention studies of individual fruits and vegetables has shown that FV intake improves cardiometabolic risk factors, and large prospective cohort studies have consistently demonstrated inverse associations between FV intake and CVD incidence and mortality. Experimental mechanistic studies have further supported these findings by identifying shared cardioprotective mechanisms mediated by FV-derived bioactive compounds. However, several practical and theoretical constraints limit the recommendation of adequate FV intake. This review proposes a practical serving-size framework based on macronutrient content, wherein one serving of fruit provides approximately 15 g carbohydrates (~60 kcal), and one serving of vegetables provides approximately 5 g carbohydrates (~25 kcal). By addressing key barriers and presenting practical dietary strategies, this review highlights the importance of promoting FV consumption at both the individual and population levels to decrease CVD risk and improve cardiovascular health outcomes.

With global obesity on the rise, driven in part by high added-sugar consumption, non-caloric sweeteners are proposed to reduce sugar intake. However, limited studies have investigated whether tolerance to sweetness differs between caloric and non-caloric sweeteners across overweight and normal weight groups, a question that is essential for evaluating the feasibility of sugar substitution strategies. This study explores the role of sweet rejection thresholds (RjT) to caloric (i.e., sucrose) and non-caloric (i.e., sucralose) sweeteners on BMI-related high sugar intake. A total of 148 participants (final 105; 18-30 years, females = 63) underwent psychophysical assessments for sucrose and sucralose, in terms of rejection and detection thresholds. Dietary intake was assessed using a Food Frequency Questionnaire to calculate total and added sugar intake, while BMI was calculated from anthropometric measurements. The results revealed an average daily sugar intake was 1263 kJ (16.6 % of total energy), with added sugars at 11.5 %, exceeding the WHO's recommended 5 % limit. BMI was positively correlated with both total and added sugar intake (r = 0.26-0.38, p < 0.05). Furthermore, participants in the overweight group exhibited higher RjT for sucrose than those with normal weight (F-((1,103))= 8.35, p = 0.019), which in turn predicted greater sugar intake; specifically, each unit increase in sucrose RjT corresponded to 19.7 kJ of total sugar and 11.0 kJ of added sugar intake. These findings indicate that tolerance to caloric and non-caloric sweeteners differs, as do their associations with sugar consumption and adiposity, suggesting that substituting non-caloric sweeteners may not fully mirror the patterns observed with caloric sugars.

Track and field athletes experience a high injury burden affecting physical health, psychological wellbeing, and career progression. While quantitative studies have documented injury incidence and risk factors, limited qualitative research explains how cultural norms, communication practices, and system-level constraints shape injury experiences, particularly in low- and middle-income country (LMIC) settings. This study aimed to explore how cultural expectations, social relationships, communication networks, and structural conditions influence injury reporting, training behaviours, and recovery experiences among Sri Lankan track and field athletes. This qualitative analysis drew on in-depth, semi-structured interviews with elite and highly trained track and field athletes and key stakeholders, including coaches, physiotherapists, sports medicine practitioners, sports administrators, and parents. All interviews were conducted face-to-face or online, audio-recorded, and transcribed verbatim. Data were analysed using reflexive thematic analysis and interpreted within the socio-ecological model (SEM). SEM mapping revealed that injury experiences were shaped by influences across individual, interpersonal, organisational, community, and system levels, captured in five interrelated themes: (I) social and cultural pressures shaping injury behaviour; (II) injury underreporting and overtraining; (III) barriers and facilitators to injury prevention; (IV) quality of athlete support and communication networks; and (V) system-level challenges in injury management. Athletes described a performance-oriented culture that normalised pain, leading to injury concealment and continued training despite inadequate recovery. Coach-centred and fragmented communication, financial insecurity, limited access to specialised care, and weak organisational infrastructure further constrained prevention and rehabilitation. Effective injury prevention in LMIC contexts requires context-sensitive, multidisciplinary strategies that strengthen communication, address structural barriers, and prioritise athlete health alongside performance.

Country-specific Food Composition Data (FCD) could support nutritional research, and aid in making informed decisions to develop food and nutrition policies in a country. Sri Lanka is ethnically diverse, and its food culture and trends are driven by this diversity, resulting in a varied pattern of food consumption. This study aimed to develop a comprehensive food composition database (FCDB) specific to Sri Lanka including cooked food as a crucial component. A list of 243 food items was selected to be included in the FCDB. The FCD was compiled using data extraction, cooking according to local recipes, followed by recipe calculation. Compiled FCD was included in an open-access website using a Database Management System. The Sri Lankan FCDB consists of the nutritional content of 243 food items, with values for 30 components. The FCDB mainly comprises raw food, raw mixed dishes, cooked food dishes, and packaged products, which include traditional/ cultural food items of Sri Lanka. Findings indicated that different rice cultivars had different food compositions depending on the rice variety and the yield factor. The development of the FCDB marks the initial availability and accessibility to FCD for the most popular Sri Lankan food dishes. Sri Lankan FCBD will support future nutritional studies and diet-related education and interventions within Sri Lanka.

Athletes in Sri Lanka face significant barriers when attempting to adhere to sports nutrition recommendations (SNR), despite the potential for these strategies to optimize performance. This study examines the perceptions and experiences of athletes and coaches regarding barriers and challenges to nutrition interventions in the context of a resource-limited environment. In-depth interviews with 15 track and field athletes and their coaches, who completed a 16-week personalized sports nutrition intervention, were analyzed using reflexive thematic analysis with NVIVO v10.0. A data-driven, inductive approach to coding was employed, allowing themes to emerge organically from the data rather than being pre-determined by existing frameworks. Thematic analysis followed an iterative process of familiarization, open coding, theme refinement, and synthesis. The athletes had a mean age of 23.4 ± 2.8 years. The four male coaches had a mean age of 50.4 ± 6.41 years. Three key themes were identified: (I) Intrinsic challenges, (II) Extrinsic challenges faced by athletes, and (III) Recommendations and insights to improve the efficiency of the sports nutrition intervention. We identified financial constraints, knowledge gaps, and taste preferences as intrinsic challenges, while residential limitations and other practical difficulties—such as limited access to recommended foods, time management challenges, barriers to adhering to meal timings, and psychosocial stressors—were identified as extrinsic challenges. Key insights for improvement included increasing the frequency of consultations and involving coaches in these consultations, enabling them to actively support athletes in adhering to nutritional recommendations. Athletes expressed a preference for guidelines in both printed and digital formats. Participants also emphasized the need for enhanced medical support through more frequent doctor-athlete interactions and investing in young athletes by extending the program to school-level athletes, offering structured guidance, nutritional support, and sustained monitoring to foster long-term success. Personalized sports nutrition interventions in Sri Lanka are hindered by multifaceted barriers, but opportunities for transformative change exist through collaboration among athletes, coaches, sports organizations, and policymakers. A systems-oriented approach, addressing both individual and structural challenges, is essential for improving adherence to nutritional recommendations.

Background: Optimal nutrition is vital for recovery, performance, and well-being of athletes. However, Sri Lankan track and field athletes often fall short of dietary recommendations due to the lack of personalized nutrition guidance. This study evaluated the effectiveness of culturally appropriate, evidence-based, personalized dietary advice on the nutritional status of these athletes. Methods: This 16-week parallel-group randomized controlled trial included 30 national-level track and field athletes (15 in the intervention group [IG], 15 in the control group [CG]). The IG received personalized dietary prescriptions based on detailed nutritional assessments, while the CG received no advice. Outcomes included dietary intake, assessed via seven-day food diaries, and biochemical parameters measured using standard techniques. Results: Twenty-seven athletes (IG: 13, CG: 14) completed the study. The IG showed significant increases in energy intake (Pre: 2766.0 ± 494.0 kcal, Post: 3972.9 ± 934.4 kcal, Change: +1206.9 kcal; p = 0.007) compared to the CG (Pre: 2733.7 ± 635.5 kcal, Post: 2676.5 ± 319.2 kcal, Change: -57.2 kcal; p = 0.739; p for IG vs. CG = 0.004). Protein intake also improved significantly in the IG (Pre: 95.56 ± 30.2 g, Post: 116.81 ± 41.8 g, Change: +21.25 g; p = 0.003) versus the CG (Pre: 94.54 ± 32.8 g, Post: 84.24 ± 16.4 g, Change: -10.30 g; p = 0.162; p for IG vs. CG = 0.001). The IG exhibited improved vitamin and mineral intakes, and serum vitamin D levels in the IG increased significantly (Pre: 30.55 ± 10.2 ng/ml, Post: 42.02 ± 9.6 ng/ml; Change: +11.47 ± 0.6 ng/ml; p < 0.001), while the CG showed no change. Serum ferritin levels also increased in the IG (Pre: 44.76 ± 29.3 ng/ml, Post: 51.54 ± 28.4 ng/ml, Change: +6.78 ± 0.9 ng/ml; p < 0.001), along with positive changes in haemoglobin and other haematological parameters. Conclusions: A culturally appropriate, personalized dietary prescription significantly improved the nutritional status among Sri Lankan track and field athletes.

Background and objective: Valid and cost-effective approaches are essential to assess physical activity and sedentary behaviors in individuals of all ages. This study aimed to validate a physical activity recall questionnaire (PAR-Q) and a physical activity log against the doubly labelled water (DLW) technique in 11-13-year-old Sri Lankan children. Method: Total energy expenditure (TEE) was determined using the criterion DLW technique (TEEDLW) and physical activity energy expenditure (PAEEDLW) was estimated. Subsequently, physical activity assessment methods were validated in a group of children (n=96). PAR-Q was adapted from the adolescent physical activity questionnaire and the physical activity log from the Bouchard activity diary. The youth physical activity compendium was used to calculate PAEE from both PAR-Q (PAEEPAR-Q) and activity log (PAEEPALog). Statistical analysis included Spearman’s correlation coefficient and Bland-Altman analyses. Results: Mean age of the study sample was 12.0 ± 0.8 years where the greater proportion were males (51.9%, n=41). PAEEPAR-Q and PAEEPALog were significantly correlated with the PAEEDLW (r=0.63 and r=0.49, p < 0.05). PAR-Q and activity log underestimated PAEE by 304.2 ± 1223.8 kJ/day and 375.3 ± 1087.4 kJ/day, respectively. Using Bland-Altman analysis, the majority of data points were within the limits of agreement in both PAR-Q and activity log. Conclusion: PAR-Q is a valid tool for predicting PAEE in Sri Lankan children whereas the physical activity log was not. Researchers and practitioners can confidently use the PAR-Q to assess physical activity in this population, with potential applications in various research and intervention settings.

BACKGROUND:The search for novel antihyperglycemic agents from herbal medicines has highlighted cinnamon, which contains biologically active compounds with insulin-mimetic effects in-vitro. We assessed the efficacy and safety of Cinnamomum zeylanicum (CZ) extract in individuals with Type 2 Diabetes. METHODS:A total of 210 individuals with Type 2 Diabetes were randomly assigned in equal numbers to two CZ extract groups (250 mg or 500 mg) and one placebo group. The primary outcome was change in glycaemic control (HbA1c and fasting plasma glucose \[FPG]) from baseline. Secondary outcomes included serum lipids, insulin resistance and β-cell function, systolic (SBP) and diastolic (DBP) blood pressure, and anthropometric parameters. Multiple regression analyses were conducted with change in FPG or HbA1c from baseline as the dependent variables and treatment group and covariates as predictors. RESULTS:The mean age of participants was 58.6 ± 8.2 years, with 42.9 % (n = 90) being male; 186 completed the four-month follow-up. Both FPG and HbA1c significantly declined in the CZ extract groups compared to baseline, accompanied by reduced insulin resistance and improved β-cell function (p < 0.05). At four months, total and LDL cholesterol were significantly lower in the 500 mg CZ extract group (p < 0.05). Regression analyses identified CZ extract treatment as a significant predictor of changes in both FPG and HbA1c. CONCLUSIONS:This randomized controlled trial developed and tested a CZ-based intervention for Type 2 Diabetes, demonstrating its promising efficacy and safety. Further studies are warranted to explore its potential as a pharmaceutical agent for diabetes management. TRIAL REGISTRATION:Sri Lanka Clinical Trials Registry, identifier: SLCTR/2017/010 (http://slctr.lk/trials/714). Registered on April 05, 2017; Study protocol version 3.1 (March 21, 2017).

Objectives This study explored the barriers to and facilitators of weight reduction among urban, young adults with obesity in Sri Lanka.Design A qualitative descriptive study, using the framework method in thematic analysis to identify key themes for barriers and facilitators.Setting An urban community setting in Sri Lanka in January–March 2022.Participants 62 young adults (18–35 years) with obesity (body mass index ≥25 kgm-2) representing different socio-demographic characteristics were recruited into the focus group discussions (n=10).Results The majority of participants were women (n=40; 64.5%). More than 70% (n=45) of the participants were classified as having class I obesity. Inconsistent knowledge, emotions and mood, poor self-control, inadequate support from others, lack of time, lack of resources and facilities and unsafe environment for physical activities were the identified barriers. The desire to improve appearance and body image, health-related concerns, limitations to day-to-day activities, previous positive experiences, support from others and weight-related victimisation were identified as facilitators.Conclusions A multitude of factors were found to interfere with weight-reduction attempts. Due consideration of these barriers and facilitators is important when planning weight management programmes targeting young adults with obesity.

Background Muscular strength that can be improved through maximal, explosive, and reactive training, reduces injury risk and enhances sport-specific performance in athletes. In team sports, increased strength boosts physical and neuromuscular function, delays fatigue, speeds recovery and optimizes technical execution and decision-making during competition. Therefore, this scoping review aims to explore existing intervention studies to understand the role of strength training (ST) as an effective strategy for preventing injuries and enhancing performance in team sports. Methods A comprehensive search was conducted in five databases (SciVerse Scopus, PubMed, Web of Science, SPORTDiscus, and CINAHL) from 2015 to 2024. Keywords related to strength training, injuries, and team sports were used in the search. We included randomized controlled trials (RCTs) assessing the effectiveness of ST in preventing injuries and enhancing performance in team sports. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. Results This review included 15 RCTs involving team sports: soccer (n = 9), volleyball (n = 3), and one each for football, handball, and rugby. Participants had a mean age range of 12.7 to 25.8 years, with sample sizes varying from 20 to 652 athletes. Four studies demonstrated dual benefits, highlighting the ability of ST to simultaneously enhance biomechanical alignment, address muscle imbalances, and optimize both injury prevention and performance outcomes. Three RCTs focused solely on strengthening interventions for injuries reported that ST effectively reduced the incidence of sports injuries, including hamstring strains (n = 2), groin injuries (n = 1), and overall injuries (n = 4). Performance metrics such as sprint speed, jump height, muscle strength, and endurance were significantly improved with ST in eight studies. Conclusions ST can be considered an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports across different age groups and genders, as suggested by high-quality RCTs.