Objective: To evaluate the effects of resistance training on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus (T2DM) and overweight/obesity. Design: Systematic review and meta-analysis of randomised controlled trials (RCTs). Data sources: PubMed, Web of Science, Scopus, Science Direct, Cochrane Library and Google Scholar databases were searched from inception up to May 2024. The search strategy included the following keywords: diabetes, resistance exercise and strength training. Eligibility criteria for selecting studies: RCTs published in English comparing resistance training alone with non-exercising standard treatment. Participants were adults diagnosed with T2DM and concurrent overweight/obesity (body mass index (BMI) ≥25 kg/m²). Results: A total of 18 RCTs qualified involving 1180 patients (48.6/51.4 female/male ratio; 63.3±7.0 years; 29.3±4.3 kg/m²). Waist circumference (standardised mean differences (SMD) −0.85 cm, 95% CI −1.66 to −0.04), waist-to-hip ratio (SMD −0.72, 95% CI −1.30 to −0.15), high-density lipoprotein cholesterol (SMD +0.40 mg/dL, 95% CI 0.07 to −0.72), triglycerides (SMD −0.54 mg/dL, 95% CI −1.06 to −0.02), fasting blood glucose (SMD −0.65 mmol/L, 95% CI −1.19 to −0.12), fasting insulin (SMD −0.74 uIU/mL, 95% CI −1.12 to −0.36) and glycated haemoglobin (SMD −0.32%, 95% CI −0.63 to −0.01) improved compared with standard treatment. The risk of bias was low to unclear, and the quality of evidence was very low to moderate. Conclusions: Resistance training as a standalone exercise intervention in the management and treatment of T2DM with concurrent overweight/obesity is associated with many cardiometabolic benefits when compared with standard treatment without exercise. PROSPERO registration number: CRD42022355612.

Objective: This study aimed to determine the prevalence of knee osteoarthritis (OA) in Saudi Arabia and the association between knee OA and modifiable and non-modifiable risk factors. Methods: A self-reported, population-based, cross-sectional survey between January 2021 and October 2021 was conducted. A large, population-representative sample (n = 2254) of adult subjects aged 18 years and over from all regions of Saudi Arabia was collected electronically using convenience sampling. The American College of Rheumatology (ACR) clinical criteria were used to diagnose OA of the knee. The knee injury and osteoarthritis outcome score (KOOS) was used to investigate the severity of knee OA. This study focused on modifiable risk factors (body mass index, education, employment status, marital status, smoking status, type of work, previous history of knee injury, and physical activity level) and non-modifiable risk factors (age, gender, family history of OA, and presence of flatfoot). Results: The overall prevalence of knee OA was 18.9% (n = 425), and women suffered more compared to their male counterparts (20.3% vs. 13.1%, p = 0.001). The logistic regression analysis model showed age (OR: 1.06 [95% CI: 1.05–1.07]; p < 0.01), sex (OR: 2.14 [95% CI: 1.48–3.11]; p < 0.01), previous injury (OR: 3.95 [95% CI: 2.81–5.56]; p < 0.01), and obesity (OR: 1.07 [95% CI: 1.04–1.09]; p < 0.01) to be associated with knee OA. Conclusions: A high prevalence of knee OA underlines the need for health promotion and prevention programmes that focus on modifiable risk factors to decrease the burden of the problem and the cost of treatment in Saudi Arabia.

A range of natural products have been extensively studied for their chemopreventive potential for cancer, including those that inhibit growth and induce apoptosis. Sidr honey derived from the Ziziphus or Lote tree (Ziziphus spina-christi, Ziziphus lotus, or Ziziphus jujuba) is used in a wide range of traditional medicine practices. In the current study, the Saudi Sidr honey was analyzed by means of a GC–MS chromatogram and investigated for its antiproliferative effects on colorectal cancer cells (HCT-116), breast cancer cells (MCF-7), and lung cancer cells (A-549), as well as its apoptosis induction and cell cycle arrest potentials against human colorectal cancer cells (HCT-116). The effects of Saudi Sidr honey on cells were determined using the MTT assay and the clonogenic assay. The induction of apoptosis was studied using Annexin V-FITC flow cytometry analysis. The propidium iodide staining method was used to detect cell cycle arrest via flow cytometry. By means of performing GS–MS and HR-LCMS analysis, 23 different chemical components were identified from Saudi Sidr honey. A dose–response analysis showed that Saudi Sidr honey was more effective against HCT-116 (IC₅₀ = 61.89 ± 1.89 µg/mL) than against MCF-7 (IC₅₀ = 78.79 ± 1.37 µg/mL) and A-549 (IC₅₀ = 94.99 ± 1.44 µg/mL). The antiproliferation activity of Saudi Sidr honey has been found to be linked to the aggregation of cells during the G1 phase, an increase in early and late apoptosis, and necrotic cell death in HCT-116 cells. Considering these promising findings that highlight the potential use of Saudi Sidr honey as an antitumor agent, further research should be carried out with the aim of isolating, characterizing, and evaluating the bioactive compounds involved in Sidr honey’s antiproliferative activity to better understand the mechanism of their action.

Total knee arthroplasty (TKA) is the gold-standard treatment for end-stage knee osteoarthritis, and the primary expectations are reduced pain and improved function. However, there is conflicting evidence regarding functional changes post-TKA. Commonly, functional changes are measured using Oxford Knee Score (OKS). No previous study has investigated physical behaviour (PB) changes in terms of volume and patterns post-TKA. The aims of this study were to explore volume and pattern changes in PB following TKA using an objective tool and to assess the correlation between this and OKS. An activPAL measured the PB of individuals on a waiting list for TKA for a period of 7–8 days pre-TKA, and for the same length of time at 12 months post-TKA. OKS was completed at similar follow-up time points. Thirty-three individuals completed the study, where stepping time, the number of steps and the time spent on moderate to vigorous physical activity (MVPA) (>100 steps/minute) improved significantly post-TKA p = 0.0001. Steps at 12 months post-TKA improved by 45.6% (from 4240 to 6174) and stepping time increased by 38.8% (from 0.98 to 1.36 h). MVPA improved by 35 min at 12 months (from 6.6 to 41.7 min). There were no significant correlations between PB and OKS. This is the first study to explore PB volumes and event-based patterns post-TKA. Activity improved in terms of volume and patterns. No correlation was found between OKS and ActivPAL, which emphasises the need to use objective methods in addition to patient-reported outcome measures.

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of aerobic exercise on cardiometabolic health-related indices in patients with type 2 diabetes and concurrent overweight/obesity (diabesity). PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception to October 2024. The search strategy included the following keywords: diabetes, aerobic exercise, and endurance training. RCTs comparing aerobic exercise training ≥2 weeks in duration to standard treatment were considered eligible. Participants were adults with diabesity. A total of 1391 middle-aged/older adult patients (55 % females) were included in 34 RCTs. Body mass index [standardized mean differences (SMD) -0.18 kg/m², 95 % confidence intervals (CI) -0.36 to -0.01]. waist circumference (SMD -0.23 cm, 95 % CI -0.44 to -0.03), body fat (SMD -0.30 %, 95 % CI -0.59 to -0.01), fasting blood glucose (SMD -0.49 mmol/L, 95 % CI -0.72 to -0.27), glycated hemoglobin (SMD -0.79 %, 95 % CI -1.17 to -0.41), fasting insulin (SMD -0.44 mIU/L, 95 % CI -0.72 to -0.15), homeostatic model assessment for insulin resistance (SMD -0.72, 95 % CI -1.09 to -0.35), high-density lipoprotein cholesterol (SMD 0.32 mg/dL, 95 % CI 0.01 to 0.63), triglycerides (SMD -0.33 mg/dL, 95 % CI -0.63 to -0.04), and total cholesterol (SMD -0.28 mg/dL, 95 % CI -0.47 to -0.10) improved compared with standard treatment. These results underscore the beneficial role of aerobic exercise as a non-pharmacological intervention in managing and treating patients with diabesity when compared to standard treatment, despite the presence of considerable uncertainty in several outcomes.