The ageing population is accompanied by increased rates of cognitive decline and dementia. Not only does cognitive decline have a profound impact on an individual’s health and quality of life, but also on that of their caregivers. The Mediterranean diet (MD) has been known to aid in reducing the risk of cardiovascular diseases, cancer and diabetes. It has been recently linked to better cognitive function in the elderly population. The purpose of this review was to compile evidence based data that examined the effect of adherence to the MD on cognitive function and the risk of developing dementia or Alzheimer’s disease. This review followed PRISMA guidelines and was conducted using four databases and resulted in 31 articles of interest. Cross-sectional studies and cohort studies in the non-Mediterranean region showed mixed results. However, cohort studies in the Mediterranean region and randomized controlled trials showed more cohesive outcomes of the beneficial effect of the MD on cognitive function. Although more standardized and in-depth studies are needed to strengthen the existing body of evidence, results from this review indicate that the Mediterranean diet could play a major role in cognitive health and risk of Alzheimer’s disease and dementia.

Purpose: 1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions.Methods: We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5–17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups.Results: Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment–insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups.Conclusion: School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings.Trial registration number: PROSPEROCRD42018117567.

The accurate assessment of energy intake in children and adolescents is an important outcome measure for clinical and population-based research. This systematic review aimed to determine the validity of dietary assessment methods to measure energy intake in children and adolescents who are classified as overweight or obese by comparison with doubly labelled water. Five electronic databases were searched using keywords. Of the 5263 papers identified, seven papers describing six studies met the inclusion criteria. Studies were included in the review if participants were classified as overweight or obese, aged 0–18 years old, if they estimated energy intake via a dietary assessment method and if they compared this to total energy expenditure measured via the doubly labelled water method. All studies were cross-sectional in nature, and each used one dietary assessment method, including 14-day-food record (FR; n = 1), 24 h dietary recall (n = 1), 8-day FR (n = 1), 9-day FR (n = 1), 3-day FR (n = 1) and diet history interview (n = 1). Sample sizes ranged from 9 to 59 participants, with the majority of studies including less than 30 participants (n = 4). Mis-reporting was evident in all of the studies, with under-reporting (n = 5) more frequent than over-reporting (n = 1). Findings from this review suggest that a 24-h dietary recall and diet history interview were the most accurate methods at the group level for children aged 4–14 years, where the parent or combined child and parent were the reporters.

The Mediterranean diet (MD) is linked to decreased risk of chronic disease, such as cardiovascular disease, obesity, hypertension, diabetes mellitus and cognitive disease. Given the health promoting aspects of this diet, we conducted a secondary analysis of data from the National Nutrition and Physical Activity Survey (NNPAS), which is the largest health study in Australia and the first nutrition-specific national-based study. The primary aim of this analysis was to determine the proportion of Australian adults adhering to the MD and to examine the association between adherence to the MD and markers of noncommunicable diseases, such as cardiovascular disease, diabetes mellitus and chronic kidney disease. Out of the 9435 participants included in the study (mean age = 48.6 ± 17.6 years), 65% were in the middle tertile of the MD score. Participants who were married, employed, of a high-socioeconomic level, nonsmokers, educated and had a healthy body mass index (BMI) and waist circumference were more likely to have higher adherence levels to the MD, which was associated with lower diastolic blood pressure (p < 0.05). Multivariate logistic regression analysis showed that, even after accounting for all possible confounders, higher adherence to the MD was associated with lower risk of dyslipidaemia, OR = 1.06 (1.01–1.10). In conclusion, this analysis is the first to assess adherence to the MD on a national level. Our results indicated that MD adherence may contribute to reducing the prevalence of dyslipidaemia, cerebrovascular disease and elevated blood pressure in a multi-ethnic, non-Mediterranean country.

There is a paucity of data concerning the energy requirements (ERs) of preschool-age children with cerebral palsy (CP), the knowledge of which is essential for early nutritional management. We aimed to determine the ERs for preschool-age children with CP in relation to functional ability, motor type, and distribution and compared with typically developing children (TDC) and published estimation equations. Thirty-two children with CP (63% male) of all functional abilities, motor types, and distributions and 16 TDC (63% male) aged 2.9-4.4 y participated in this study. The doubly labeled water method was used to determine ERs. Statistical analyses were conducted by 1-factor ANOVA and post hoc Tukey honestly significant difference tests, independent and paired t tests, Bland and Altman analyses, correlations, and multivariable regressions. As a population, children with CP had significantly lower ERs than did TDC (P < 0.05). No significant difference in ERs was found between ambulant children and TDC. Marginally ambulant and nonambulant children had ERs that were ∼18% lower than those of ambulant children and 31% lower than those of TDC. A trend toward lower ERs with greater numbers of limbs involved was observed. The influence of motor type could not be determined statistically. Published equations substantially underestimated ERs in the nonambulant children by ∼22%. In preschool-age children with CP, ERs decreased as ambulatory status declined and more limbs were involved. The greatest predictor of ERs was fat-free mass, then ambulatory status. Future research should build on the information presented to expand the knowledge base regarding ERs in children with CP. This trial was registered with the Australian New Zealand Clinical Trials Registry as ACTRN 12612000686808.