High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain. This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression. PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms. Two authors extracted the data independently. The Sidik-Jonkman estimator, the I² metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration’s Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively. In total, 1507 participants (mean age range: 22.0 years–53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: –0.53; 95% confidence interval: –0.90 to –0.16; I² = 87.1%). The prediction interval ranged from –1.86 to 0.81. The overall risk of bias was within the range of “some concerns” to “high,” while the certainty of evidence was low. MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs. PROSPERO registration no. CRD42022341895.

Objective: To estimate the association between daytime napping and cognitive and physical sport performance and fatigue after normal sleep and partial sleep deprivation (less sleep duration than necessary). Design: Systematic review and meta-analysis. Data sources: The PubMed, Scopus, Web of Science, Cochrane Central, SportDiscus and PsycINFO databases. Eligibility criteria for selecting studies: Randomised controlled trials on the effect of daytime napping on sport performance and fatigue available from inception to 2 December 2022. Standardised mean differences (SMD) and their 95% compatibility intervals (CI) were estimated with the DerSimonian-Laird method through random effect models. Results: In the 22 included trials, 291 male participants (164 trained athletes and 127 physically active adults) aged between 18 and 35 years were studied. When performed after a normal night of sleep, napping from 12:30 hours to 16:50 hours (with 14:00 hours being the most frequent time) improved cognitive (SMD=0.69, 95% CI: 0.37 to 1.00; I²=71.5%) and physical performance (SMD=0.99, 95% CI: 0.67 to 1.31; I²=89.1%) and reduced the perception of fatigue (SMD=−0.76, 95% CI: −1.24 to –0.28; I²=89.5%). The positive effects of napping were also confirmed after partial sleep deprivation. Overall, the benefits were higher with a nap duration between 30 and <60 min and when the time from nap awakening to test was greater than 1 hour. Conclusions: After a night of normal sleep or partial sleep deprivation, a daytime nap between 30 and <60 min has a moderate-to-high effect on the improvement of cognitive performance and physical performance and on the reduction of perceived fatigue. PROSPERO registration number: CRD42020212272.

This systematic review and meta-analysis synthesize the evidence on the prospective bidirectional associations between sleep-related problems (SRP) and chronic musculoskeletal pain (CMP). A literature search for cohort studies available in the PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library databases as of July 19, 2022, was performed. Pooled odds ratios and effect sizes were calculated through random effects meta-analysis. Subgroup and meta-regression analyses were performed to explore differences by follow-up time, proportion of each sex, and mean age. The Meta-analysis Of Observational Studies in Epidemiology guidelines were strictly followed. Twenty studies with a total of 208 190 adults (aged 34.4–71.7 years) were included, with 17 of them being used in the meta-analysis. Individuals with SRP at baseline had a 1.79-fold higher incidence (odds ratio, OR = 1.79; 95% confidence interval, 95% CI : 1.55–2.08; I²=84.7%; p<0.001) and a 2.04-fold higher persistence (OR = 2.04; 95% CI : 1.42–2.94; I²=88.5%; p<0.005) of CMP than those without SRP. In the subgroup analysis of the association between SRP and CMP, the longer the follow-up time of the studies, the higher the heterogeneity between them. In the corresponding meta-regression, no significant effect was observed for follow-up time, sex proportion, or age. Individuals with CMP at baseline had a 2.02-fold higher incidence of SRP (OR = 2.02; 95% CI : 1.62–2.53; I²=90.0%; p<0.001) than those without CMP. This study provides robust evidence concerning the longitudinal association between SRP and incidence-persistence of CMP in adults. In addition, the available prospective studies support the existence of a bidirectional relationship between CMP and SRP. CRD42020212360

Background: High‐intensity interval training (HIIT) has emerged as an alternative training method to increase brain‐derived neurotrophic factor (BDNF) levels, a crucial molecule involved in plastic brain changes. Its effect compared to moderate‐intensity continuous training (MICT) is controversial. We aimed to estimate, and to comparatively evaluate, the acute and chronic effects on peripheral BDNF levels after a HIIT, MICT intervention or a control condition in adults.Methods: The CINAHL, Cochrane, PubMed, PEDro, Scopus, SPORTDiscus, and Web of Science databases were searched for randomized controlled trials (RCTs) from inception to June 30, 2023. A network meta‐analysis was performed to assess the acute and chronic effects of HIIT versus control condition, HIIT versus MICT and MICT versus control condition on BDNF levels. Pooled standardized mean differences (SMDs) and their 95% confidence intervals (95% CIs) were calculated for RCTs using a random‐effects model.Results: A total of 22 RCTs were selected for the systematic review, with 656 participants (aged 20.4–79 years, 34.0% females) and 20 were selected for the network meta‐analysis. Network SMD estimates were significant for HIIT versus control condition (1.49, 95% CI: 0.61, 2.38) and MICT versus control condition (1.08, 95% CI: 0.04, 2.12) for acutely BDNF increase. However, pairwise comparisons only resulted in a significant effect for HIIT versus control condition.Conclusions: HIIT is the best training modality for acutely increasing peripheral BDNF levels in adults. HIIT may effectively increase BDNF levels in the long term.

Although prior research has synthesized the relationships between the Mediterranean diet (MD) and components of physical fitness (PF) in adults, they are limited and inconclusive. This study aimed to synthesize the associations between high (vs. low) MD adherence and PF levels along with each of its components (cardiorespiratory, motor, and musculoskeletal) in adulthood. We conducted a systematic search in five databases from inception to January 2022. Observational studies and randomized controlled trials (RCTs) were included. Pooled odds ratios (ORs) and effect sizes (Cohen's d index) with their 95% CIs were calculated using a random-effects model. A total of 30 studies (19 cross-sectional in young, middle-aged, and older adults, 10 prospective cohort in older adults, and one RCT in young adults) involving 36,807 individuals (mean age range: 20.9–86.3 years) were included. Pooled effect sizes showed a significant cross-sectional association between higher MD adherence scores (as a continuous variable) and overall PF (d = 0.45; 95% CI: 0.14, 0.75; I² = 91.0%; n = 6). The pooled ORs from cross-sectional data showed that high adherence to MD was associated with higher cardiorespiratory fitness (OR = 2.26; 95% CI: 2.06, 2.47; I² = 0%; n = 4), musculoskeletal fitness (OR = 1.26; 95% CI: 1.05, 1.47; I² = 61.4%; n = 13), and overall PF (OR = 1.44; 95% CI: 1.20, 1.68; I² = 83.2%; n = 17) than low adherence to MD (reference category = 1). Pooled ORs from prospective cohort studies (3–12-year follow-up) showed that high adherence to MD was associated with higher musculoskeletal fitness (OR = 1.20; 95% CI: 1.01, 1.38; I² = 0%; n = 4) and overall PF (OR = 1.14; 95% CI: 1.02, 1.26; I² = 9.7%; n = 7) than low adherence to MD (reference category = 1). Conversely, no significant association was observed between MD and motor fitness. High adherence to MD was associated with higher PF levels, a crucial marker of health status throughout adulthood.