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    Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis
    (Bmc, 2023) Al-Mhanna, Sameer Badri; Rocha-Rodriguesc, Silvia; Mohamed, Mahaneem; Batrakoulis, Alexios; Aldhahi, Monira I.; Afolabi, Hafeez Abiola; Yagin, Fatma Hilal
    Background Lifestyle modifications involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). The purpose of this review was to systematically evaluate the effects of combined aerobic exercise and diet (AEDT) on various cardiometabolic health-related indicators among individuals with obesity and T2DM.Methodology A comprehensive search of the PubMed/Medline, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. The Cochrane risk of bias tool was used to evaluate eligible studies, and the GRADE tool was used to rate the certainty of evidence. A random-effects model for continuous variables was used, and the results were presented as mean differences or standardised mean differences with 95% confidence intervals.Results A total of 16,129 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants. The findings revealed significant improvements in body mass index, body weight, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, fasting plasma insulin, glycated hemoglobin, leptin, interleukin-6, C-reactive protein, and adiponectin (p < 0.05) compared to the standard treatment (ST) group. No significant differences were observed between the AEDT and ST groups in fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and tumor necrosis factor-alpha. The present findings are based on low- to moderate-quality evidence.Conclusions AEDT may be a critical behavior for holistic cardiometabolic health-related benefits as a contemporary anti-obesity medication due to its significant positive impact on patients with obesity and T2DM. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for lowering cardiovascular and metabolic risk factors among individuals with obesity and T2DM.
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    Examining mindfulness and moral disengagement in doping: Perspective of Turkish wrestlers
    (Frontiers Media Sa, 2023) Ayyildiz, Erdem; Kayabesler, Hamza; Gulu, Mehmet; Yagin, Fatma Hilal; Aldhahi, Monira I.; Garcia-Grimau, Elena; Al-Mhanna, Sameer Badri
    Introduction: Studies related to attitudes toward the use of prohibited substances in Turkish athletes are scarce. The World Anti-Doping Agency (WADA) has implemented anti-doping educational policies emphasizing doping-related education in studies conducted among Turkish wrestlers. However, it is still unclear the extent to which the wrestlers comply and adhere to these anti-doping policies. No research has previously examined the effect of anti-doping education on athletes' mindfulness and moral disengagement in doping (MDD). Therefore, the present study has a two-fold objective: first, to examine whether doping-related education (DRE) and the status of being a national athlete (NA) have an effect on athlete mindfulness and MDD. Second, to analyze the relationship between each sub-dimensions of athlete mindfulness: awareness (ASD), judgment (JSD), and refocus (RSD) with MDD.Methods: A total of 409 male wrestlers participated in this study. MANOVA analysis showed that NA and DRE alone have no effect on MDD but have a general effect on mindfulness.Results: The highest effect was on the ASD of being an NA (?(2 )(p)= 0.173). When the interaction effect of NA*DRE was examined, significant difference in MDD (F = 8.218, p = 0.004), ASD (F = 8.476, p = 0.004), JSD (F = 5.844, p = 0.016), and RSD (F = 11.476, p = 0.001) were found. MDD has a weak negative relationship with ASD (r = -0.126) and RSD (r = -0.041) and a weak positive relationship with the JSD sub-dimension (r = 0.140). Those results suggest that being a NA and having received anti-doping education affect moral disengagement in doping and athletes' mindfulness.Discussion: As a conclusion, it is recommended to increase awareness and anti-doping education among national-standard Turkish wrestlers to prevent them from engaging in doping behaviors.
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    The insufficiency of recreational exercises in improving cardiovascular fitness: an investigation of ventricular systolic and diastolic parameters and left atrial mechanical functions
    (Bmc, 2023) Akgumus, Alkame; Kurtoglu, Ahmet; Aydin, Engin; Balun, Ahmet; Car, Bekir; Eken, Ozgur; Aldhahi, Monira I.
    AimThis study aimed to compare the left ventricular (LV) systolic and diastolic parameters and left atrial (LA) mechanical functions of individuals engaging in recreational sports and resistance exercises on a weekly basis.MethodsA total of 43 male amateur athletes were included in this study, of which 24 performed resistance exercises (REs) (29.70 +/- 8.74 year, weight: 81.70 +/- 12.64 kg, height: 176.05 +/- 7.73 cm, BMI: 27.64 +/- 4.97 kg/m2), and 19 participated in recreational football training and were included in the recreational sports group (31.73 +/- 6.82 year, weight: 86.00 +/- 18.52 kg, height: 178.62 +/- 4.95 cm, BMI: 25.55 +/- 3.42 kg/m2). The exercises were standardized according to the weekly exercise frequency and volume. After recording the participants' demographic information, the LV systolic and diastolic parameters and LA mechanical functions were measured using echocardiography (ECHO) and Tissue Doppler Imaging.ResultsSignificant differences were observed in various cardiac parameters between the recreational sports group (REG) and resistance exercise Group (RSG). Specifically, the left ventricular (LV) diastolic diameter, LV end diastolic volume index (LVEDVi), and stroke volume index were notably higher in the REG compared to the RSG (t = 2.804, p = .010, effect size (ES) = 2.10; t = 3.174, p = .003, ES = 0.98; t = 3.36, p = .002, ES = 1.02, respectively). Notably, the RSG exhibited higher values for LV mass index (LVMi) and isovolumic relaxation time (IVRT) than the REG (t = 2.843, p = .007, ES = 0.87; t = 2.517, p = .016, ES = 0.76) in terms of LV systolic and diastolic parameters. Regarding left atrial (LA) mechanics, the REG demonstrated increased LA total emptying volume index, LA maximum volume index, LA volume before systole measured at the onset of the p-wave index, and conduit volume index compared to RSG (t = 2.419, p = .020, ES = 0.75; t = 2.669, p = .011, ES = 0.81; t = 2.111, p = .041, ES = 0.64; t = 2.757, p = .009, ES = 0.84, respectively).ConclusionOur study revealed significant variations in LV and LA functions between REG and RSG. Our data suggest that REs led to substantial cardiac remodeling, altering myocardial structure and function. In contrast, the effect of recreational exercise on cardiac adaptation was less pronounced than that of resistance exercise. Consequently, we propose that individuals engaging in recreational exercise should consider modalities that impose higher cardiovascular demand for more effective cardiac conditioning.
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    Investigation of Factors Affecting Shuttle Walking Performance at Increased Speed for Patients with Chronic Obstructive Pulmonary Disease
    (Mdpi, 2023) Ciftci, Rukiye; Kurtoglu, Ahmet; Eken, Ozgur; Durmaz, Dilber; Eler, Serdar; Eler, Nebahat; Aldhahi, Monira I.
    The aim of this study was to examine the factors affecting the shuttle walking test (SWT) in patients with chronic obstructive pulmonary disease (COPD). A total of 29 patients with COPD (the COPD group) and a healthy group (HG) of 34 women aged between 55 and 74 years were included in the study. After the pulmonary function profiles of the participants were assessed, and the SWT was performed. Walking distances, walking speeds, and SWT levels (SWT-L) were determined with the SWT. Before and after the SWT, the heart rate (HR), oxygen saturation level (SPO2), and Borg scale (perceived exertion (BSe) and dyspnea (BSd)) results were analyzed with a paired sample t-test. The dyspnea levels during activity of daily living were determined with the Medical Research Council (MRC) dyspnea scale, and the relationship between MRC dyspnea (MRCD) and walking distance, speed, and SWT-L was tested using multiple linear regression and Pearson correlation analysis. The walking distance, speed, and SWT-L were lower in the COPD group (p < 0.001) than in the HG. The HR values before and after the SWT changed significantly in the COPD group and the HG (p< 0.001), and the effect size was higher in the COPD group. Although the BSe and BSd results before and after the SWT in the COPD group increased significantly (p < 0.001), they did not change in the HG. There was a highly negative correlation between MRCD and walking distance, speed, and SWT-L in the COPD group (p = 0.002, p = 0.000, and p = 0.001, respectively), but no correlation was found in the HG. The results showed that the HR, perceived exertion, and dyspnea levels of women with COPD whose respiratory functions were lower than the HG were significantly affected on the SWT.