Adaptogens on Depression-Related Outcomes: A Systematic Integrative Review and Rationale of Synergism with Physical Activity.

Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) Hypericum perforatum (St. John's Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by Crocus sativus L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John's Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression.

Nutritional Strategies in the Rehabilitation of Musculoskeletal Injuries in Athletes: A Systematic Integrative Review.

It is estimated that three to five million sports injuries occur worldwide each year. The highest incidence is reported during competition periods with mainly affectation of the musculoskeletal tissue. For appropriate nutritional management and correct use of nutritional supplements, it is important to individualize based on clinical effects and know the adaptive response during the rehabilitation phase after a sports injury in athletes. Therefore, the aim of this PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science PERSiST-based systematic integrative review was to perform an update on nutritional strategies during the rehabilitation phase of musculoskeletal injuries in elite athletes. After searching the following databases: PubMed/Medline, Scopus, PEDro, and Google Scholar, a total of 18 studies met the inclusion criteria (Price Index: 66.6%). The risk of bias assessment for randomized controlled trials was performed using the RoB 2.0 tool while review articles were evaluated using the AMSTAR 2.0 items. Based on the main findings of the selected studies, nutritional strategies that benefit the rehabilitation process in injured athletes include balanced energy intake, and a high-protein and carbohydrate-rich diet. Supportive supervision should be provided to avoid low energy availability. The potential of supplementation with collagen, creatine monohydrate, omega-3 (fish oils), and vitamin D requires further research although the effects are quite promising. It is worth noting the lack of clinical research in injured athletes and the higher number of reviews in the last 10 years. After analyzing the current quantitative and non-quantitative evidence, we encourage researchers to conduct further clinical research studies evaluating doses of the discussed nutrients during the rehabilitation process to confirm findings, but also follow international guidelines at the time to review scientific literature.

Profiling Physical Fitness of Physical Education Majors Using Unsupervised Machine Learning.

The academic curriculum has shown to promote sedentary behavior in college students. This study aimed to profile the physical fitness of physical education majors using unsupervised machine learning and to identify the differences between sexes, academic years, socioeconomic strata, and the generated profiles. A total of 542 healthy and physically active students (445 males, 97 females; 19.8 [2.2] years; 66.0 [10.3] kg; 169.5 [7.8] cm) participated in this cross-sectional study. Their indirect VO2max (Cooper and Shuttle-Run 20 m tests), lower-limb power (horizontal jump), sprint (30 m), agility (shuttle run), and flexibility (sit-and-reach) were assessed. The participants were profiled using clustering algorithms after setting the optimal number of clusters through an internal validation using R packages. Non-parametric tests were used to identify the differences (p < 0.05). The higher percentage of the population were freshmen (51.4%) and middle-income (64.0%) students. Seniors and juniors showed a better physical fitness than first-year students. No significant differences were found between their socioeconomic strata (p > 0.05). Two profiles were identified using hierarchical clustering (Cluster 1 = 318 vs. Cluster 2 = 224). The matching analysis revealed that physical fitness explained the variation in the data, with Cluster 2 as a sex-independent and more physically fit group. All variables differed significantly between the sexes (except the body mass index [p = 0.218]) and the generated profiles (except stature [p = 0.559] and flexibility [p = 0.115]). A multidimensional analysis showed that the body mass, cardiorespiratory fitness, and agility contributed the most to the data variation so that they can be used as profiling variables. This profiling method accurately identified the relevant variables to reinforce exercise recommendations in a low physical performance and overweight majors.