Background: Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is the accumulation of fat in the liver without excessive alcohol consumption or other known liver diseases. MASLD is the most common liver disease in adolescents with obesity. The aims of this study were as follows: (i) to determine which index (waist circumference BMI, WHtR, VAI, METS-IR, METS-VF, HSI, FLI, or MetS_zscore) best explains the prevalence of MASLD in adolescents with obesity; (ii) to determine whether there was a specific index that was most strongly associated with MASLD; (iii) to assess which liver function indexes were most strongly correlated with MASLD. Methods: A total of 758 adolescents with severe obesity (BMI z-score > 2) admitted at the Division of Auxology, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania for a 3-week multidisciplinary body weight reduction program were selected. Anthropometric parameters (stature, body mass, BMI, and waist and hip circumference) were collected, and body composition (lean and fat mass) was determined using the tetrapolar bioimpedance analysis (BIA) technique. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (gamma GT), alkaline phosphatase (ALP), bilirubin, glucose, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglycerides (TG), and C-reactive protein (CRP) were measured using standard techniques. MASLD was diagnosed based on abdominal ultrasound results. Results: WHtR (65.76%) was the most sensitive compared with other indexes. The HSI (AUC: 0.67 (0.63–0.71, 95% CI), p-value < 0.05) showed the best performance in predicting MASLD, with the threshold for having MASLD considered at 48.22. The indexes that showed the worst performance in predicting MASLD were the MetS z-score (AUC: 0.56 (0.52–0.60)) and the VAI (AUC: 0.57 (0.52–0.61)). ALT (OR: 2.92 (2.29–3.77); 95% CI) and AST (OR: 2.52 (2.03–3.20)) were the parameters with a stronger correlation with MASLD. Conclusions: The most sensitive index for diagnosing MASLD was the WHtR, based exclusively on anthropometric parameters. HSI was the index that correlated the most with MASLD, while the parameters of liver function (ALT and AST) were the most strongly correlated with the disease and its severity.

Purpose: This study investigated the relationship between training-load (TL) metrics and the acute performance decrement (APD) measured immediately after 4 training sessions performed by well-trained runners. Methods: On a treadmill, 12 well-trained runners (10 men and 2 women) performed an incremental test, a baseline time-to-exhaustion (TTE) test at maximal aerobic speed, and 4 randomized training sessions followed by a TTE test to measure APD. The training sessions were matched for external load (60 arbitrary units) but differed in the time spent in the 3 intensity domains. The TL metrics used were based on training impulse, heart-rate variability, ratings of perceived exertion, and the NASA Task Load Index (NASA-TLX) rating scale. Results: TTE was significantly shorter after all the training sessions compared with baseline (P < .001). While APD was higher (+16%, P = .035) for long-duration high-intensity training (HIT_long) compared with low-intensity training (LIT), most TL metrics showed higher values (P < .001) in LIT than in HIT_long. Conversely, NASA-TLX values were higher (P < .001) in HIT_long than in LIT and were significantly associated with APD values (P < .001, β = 0.54). Physiological parameters showed that less time was spent above 90% of O₂max during LIT compared with the other training sessions (P < .01), while average respiratory frequency and mean respiratory exchange ratio were higher during HIT_long compared to LIT (P < .01). Conclusion: APD was observed after the 4 running training sessions, and it was not associated with most of the TL metrics. Only NASA-TLX was associated with APD, suggesting that this TL metric could be leveraged for training monitoring.

(1) Background: Individuals with obesity tend to stop exercising after the completion of a structured training program. Thus, the aim of the present study was to assess adherence and body composition, cardiorespiratory fitness, physical activity levels, and physical and mental health after a 12-month exercise program and an 18-month follow-up period in a group of male adults with obesity. (2) Methods: Thirty-four adults with obesity were evaluated before (T0) and after (T3) a 3-month combined training (COMB). After that, they followed a maintenance program with low-intensity aerobic activity for three months. Then, they were recalled for a 6-month training program including thresholds (THR) training until the end of the study (T12). Finally, they participated in a 18-months follow-up period that included suggestions for healthy lifestyles, which ended with assessments (T30). Thus, the assessments were carried out at the beginning and end of the first training protocol (T0 and T3), at the beginning and end of the second training protocol (T6 and T12) and 18 months after the end of the training program (T30). At all time points, body composition (i.e., BMI, fat mass [FM] and fat-free mass [FFM]), physical capacities (i.e., V̇O₂max), and physical habits (i.e., International Physical Activity Questionnaire (IPAQ) and Short-Form 12 (SF-12, for physical, P, and mental, M, indices) were measured. (3) Results: Fifteen out of thirty-four participants (42.8%) (age 42.8 ± 8.1 y) completed this study. At T30, participants increased their V̇O₂max (3.07 ± 0.46 vs. 3.67 ± 0.60 L·min⁻¹, p < 0.001), IPAQ TOT score (396 (2888) vs. 1356 (9144), p = 0.006), and SF12_MI score (41.1 ± 8.9 pt vs. 48.6 ± 11.0 pt) compared to T0. Furthermore, multivariate analysis showed that decrease in BMI was largely associated with the increase in the SF 12_PI questionnaire (0.032). Similarly, the decrease in %FM and the increase in V̇O₂max were related with the increase in IPAQ tot (p < 0.001) and SF 12_MI (p < 0.001) scores. (4) Conclusions: 42.8% (15 out of 34) of the initial participants completed the follow-up test at T30 and maintained higher V̇O₂max values than at T0. Conversely, their physical characteristics returned to baseline. The improvement in V̇O₂max, compared to T0, correlated with maintaining high activity levels and with improved physical and mental well-being. In summary, it is recommended that people with obesity follow a structured physical activity program, as this leads to an improvement in physical capacities and physical and mental well-being. A personalized and monitored approach can lead to greater adherence to treatment and more effective long-term outcomes.

Background: Lower limb motor output contributes to determining functional performance in many motor tasks. This study investigated the effects of non-invasive spinal cord transcutaneous stimulation (scTS) applied during an exercise-based priming protocol on lower limb muscle force and power generation. Methods: Twelve young, physically active male volunteers (age: 22.7 ± 2.1 years) participated in this randomized crossover, sham-controlled study. The maximal voluntary contraction and low-level torque steadiness of knee extensors, as well as the maximal explosive extension of lower limbs, were assessed before and after the priming protocol with scTS or sham stimulation over a total of four experimental sessions. Further, characteristics of evoked potentials to scTS related to spinal circuitry excitability were assessed in the supine position before and after the scTS priming protocol. The exercise component of the ~25 min priming protocol consisted of low-volume, low- and high-intensity lower limb motor tasks. Results: scTS priming protocol tended to increase or maintain maximum isometric torque during knee extension (4.7%) as well as peak force (0.2%) and rate of force development (6.0%) during explosive lower limb extensions, whereas sham priming protocol tended to decrease them (−4.3%, −3.3%, and −15.1%, respectively). This resulted in significant interactions (p = 0.001 to 0.018) and medium–large differences between scTS and sham protocols. These findings were associated with meaningful trends of some neurophysiological variables. Conversely, priming protocols did not affect low-level torque steadiness. Conclusions: scTS counteracted the unexpected fatigue induced by the exercise-based priming protocol, supporting lower limb performance during maximal efforts. Future studies are warranted to assess the implementation of scTS with optimized exercise-based priming protocols during training and rehabilitation programmes that include high-intensity neuromuscular efforts.