Nishan Sudheera Kalupahana

Cardiovascular diseases (CVD) are the leading cause of global mortality, responsible for 17.8 million deaths and 423 million prevalent cases annually. While the etiology of CVD is multifactorial, evidence confirms that multicomponent behavioral interventions regarding diet and lifestyle can substantially reduce risk. This study aimed to evaluate the effectiveness of a 12-month mHealth intervention, i.e., public health practice supported by mobile devices in reducing the 10-year CVD risk among overweight and obese adults aged 35 to 64 in an urban Sri Lankan population. A two-group parallel-arm randomized control trial (RCT) was conducted with 1,200 participants from the Colombo district, assigned either to an intervention arm (n=600) or a usual care control arm (n=600). The intervention group received automated text and voice messages in their native language at a frequency of two of each per week over 12 months. The primary outcome, 10-year CVD risk, was assessed using the WHO CVD risk prediction score. The intervention significantly reduced the proportion of participants with a 10-year CVD risk from 10.0% to 6.2% (p=0.003), whereas no significant change was observed in the control group (11.0% to 9.7%). Participants in the mHealth arm demonstrated substantial behavioral improvements, including increasing daily fruit and vegetable servings from 3.6 to 5.5 and reducing daily salt intake from 7.64g to 5.62g. Physical activity levels also improved, with 89.6% meeting minimum daily requirements compared to 77.4% at baseline. These findings suggest a potentially beneficial effect on predicted cardiovascular risk. The study concludes that an automated mHealth intervention is an effective, feasible, and acceptable approach to reducing cardiovascular risk in an urban South Asian setting. The findings provide a robust evidence base for integrating digital health strategies into national non-communicable disease (NCD) prevention policies. While the 12-month results are promising, further longitudinal research is required to evaluate the long-term sustainability of these behavioral changes and their ultimate impact on mortality rates. Competing interests: There are no competing interests Author Approval: All authors have seen and approved the manuscript.

Personalized nutrition interventions for athletes are essential for enhancing performance and well-being, yet their effects on competition outcomes remain

Athletes with strong sports nutrition knowledge are believed to have sound nutritional practices and better performance. This study aimed to evaluate the effectiveness of a dual-method personalized nutrition education program in improving sports nutrition knowledge (SNK) among Sri Lankan track and field athletes. This parallel-group, randomized controlled trial recruited national-level track and field athletes aged 18 and above. The intervention group (IG) received personalized sports nutrition consultations at 0, 4^th, and 8^th weeks, along with online educational materials via WhatsApp from weeks 10 to 16, while the control group (CG) did not receive any intervention. A per-protocol analysis was followed, and t-tests were used to compare the means. Of the 30 participants enrolled, 13 from IG and 14 from CG completed the study. Following the 16-week intervention, the IG demonstrated significant improvements in total nutrition knowledge (TNK) relative to the CG (IG: 34.41 ± 4.15 vs. CG: 20.96 ± 4.38; p = 0.01), with significant increases in general nutrition knowledge (GNK) (IG:24.54 ± 3.66 vs. CG:15.64 ± 2.33; p = 0.004) and SNK (9.87 ± 3.87 vs. 5.32 ± 4.07; p = 0.006). Changes in TNK were also significantly greater in the IG compared to the CG; (IG:9.45 ± 0.10 vs. CG: -2.63 ± 0.37; p < 0.0001), GNK (IG:4.47 ± 0.08 vs. CG: -1.28 ± 0.09; p < 0.0001), and SNK (IG:4.99 ± 0.72 vs. CG: -1.25 ± 0.74; p < 0.0001). The 16-week dual-method nutrition education intervention was effective in improving TNK, GNK, and SNK among track and field athletes in Sri Lanka. This trial is registered at the Sri Lanka Clinical Trials Registry (SLCTR/2024/013), Universal Trial Number (UTN): U1111-1304-8890 on 10 April 2024.

Alzheimer’s disease (AD) is a complex neurodegenerative disorder characterized by progressive cognitive decline, memory loss, and behavioral changes. It poses a significant global health challenge. AD is associated with the accumulation of amyloid-β (Aβ) plaques and neurofibrillary tangles (NFTs) in the brain, along with chronic inflammation, dysfunctional neurons, and synapse loss. While the prevalence of AD continues to rise, the current FDA-approved drugs offer only limited effectiveness. Emerging evidence suggests that obesity, insulin resistance (IR), and type 2 diabetes mellitus (T2DM) are also implicated in AD pathogenesis, with epidemiological studies and animal models confirming the impact of IR on Aβ accumulation, and high-fat diets also exacerbating Aβ accumulation. Since neuroinflammation activated by Aβ involves the nuclear factor kappa-light-chain-enhancer of the activated B cell (NF-κB) pathway, the inhibition of NF-κB and NLRP3 inflammasome activation are potential therapeutic strategies in AD. Bioactive compounds, including polyphenols (resveratrol, epigallocatechin-3-gallate, curcumin, and quercetin), and omega-3 polyunsaturated fatty acids, show promising results in animal studies and clinical trials for reducing Aβ levels, improving cognition and modulating the signaling pathways implicated in AD. This review explores the interplay between obesity, IR, inflammation, and AD pathology, emphasizing the potential of dietary compounds and their role in reducing inflammation, oxidative stress, and cognitive decline, as viable strategies for AD prevention and treatment. By integrating epidemiological findings, observational studies, and clinical trials, this review aims to provide a comprehensive understating of how metabolic dysfunctions and bioactive compounds influence AD progression.

Sports nutrition plays a crucial role in providing the fuel to meet the energy demands of athletes’ training programmes, enhancing adaptations associated with training, and ensuring rapid recovery between workouts. However, evidence suggests that the dietary habits of many athletes are unsatisfactory when compared to sport-specific nutrition recommendations. This discrepancy is mainly due to a lack of up-to-date, evidence-based nutritional knowledge. Hence, this parallel-group, randomized controlled clinical trial aims to evaluate the effectiveness of a 16-week evidence-based, culturally appropriate, personalized sports nutrition intervention on the sports nutrition knowledge and nutritional status of track and field athletes in Sri Lanka, in comparison to a control group that does not receive this intervention. Elite and highly trained track and field athletes, competing at the national level and/or representing Sri Lanka in international competitions, will be randomly allocated to either the intervention group (IG) (n = 15) or the control group (CG) (n = 15). Participants in the IG will receive an evidence-based, culturally acceptable, personalized sports nutrition intervention from the principal investigator through one-to-one consultations at three-time points (zeroth, fourth, and eighth weeks), while participants in the CG will be followed up throughout the period without receiving the intervention. The primary outcome measure is the number of participants who achieve at least a 10% increase in mean sports nutrition knowledge (SNK) score at the end of the 16th week, compared to the CG. Secondary outcomes include nutrition status and sports performance-related measures at the beginning and end of the intervention. While the primary objective is to enhance SNK, it is anticipated that improvements in nutritional status and overall health may significantly impact sports performance and career longevity of the athletes. Sri Lanka Clinical Trials Registry, SLCTR/2024/013. Registered on 10th April 2024. Universal Trial Number (UTN), U1111-1304–8890.

Background/Objectives: Obesity is a major public health concern that increases the risk of chronic diseases. In obesity, adipose tissue undergoes remodeling, which is associated with chronic low-grade inflammation and disruption of its homeostatic mechanisms including endoplasmic reticulum (ER) function and autophagy. Fish oil (FO) and tart cherry (TC) have known anti-inflammatory properties. We hypothesized that while TC and FO individually decrease inflammation, their combined effects will be greater and will be either synergistic or additive in regulating inflammation and other adipose tissue functions. Methods: Here, we conducted gene expression analyses, using qRT-PCR, on gonadal white adipose tissues from a previous study where male and female C57BL/6J (B6) and TALLYHO/Jng (TH) mice were fed low fat (LF), high fat (HF), or HF diets supplemented with TC, FO, or TC + FO for 14 weeks from weaning. Data was statistically analyzed by one or two-way ANOVA, using GraphPad Prism. Results: HF diet increased adiposity and upregulated markers of inflammation, ER stress, and autophagy compared to the LF diet in both mouse models. While both TC and FO supplementation individually reduced the expression of inflammatory, ER stress, and autophagy markers on HF diet, their combination showed no consistent additive or synergistic effects. Conclusions: Overall, our findings suggest that although TC and FO effectively mitigate inflammation in white adipose tissue, their combined use did not result in synergistic or additive effects of the two interventions.

While several validated sports nutrition knowledge questionnaires exist, none are specifically designed to assess the sports nutrition knowledge (SNK) of Sri Lankan track and field athletes. This study aims to validate the Sri Lankan Sports Nutrition Knowledge Questionnaire (SLn-SNKQ), tailored for this athlete group, to provide more accurate and meaningful insights for research and practice. This will enable health professionals and coaches to confidently assess athletes’ nutrition knowledge, which directly influences their food choices. The validity of the questionnaire was established through a multi-step approach. Content validity was achieved via ratings from nutrition experts, all of whom had specialized training in human nutrition and experience of working with athletes. Face validity was evaluated through in-depth telephone interviews with elite or highly trained athletes, using a retrospective think-out-loud protocol to gather feedback on the clarity and relevance of the questions. Construct validity involved nutrition-trained doctors (NTG), non-nutrition-trained professionals (NNTG), and elite-level athletes’ groups (AG). Internal consistency was assessed using Cronbach’s alpha, and test-retest reliability was evaluated. The final tool comprised 123 individual statements or prompts (items) that were organized into 32 broader questions, spanning 12 sub-sections. Content validity was confirmed by fully integrating 49 out of 70 comments and partially integrating four comments received from nutrition experts for each sub-section. Face validity was established by fully integrating 33 out of 40 comments received from 16 elite and highly trained athletes. Construct validity was confirmed, indicating significant differences in the total scores achieved as a percentage of the SLn-SNKQ among the NTG (462.5, 92.5%), NNTG (223.5, 44.7%), and AG (235, 47.0%; p < 0.001). Reproducibility was established by strong test-retest reliability between individuals’ scores on two test attempts, three weeks apart (spearman’s correlation; ρ = 0.99, p < 0.05). Internal reliability for each sub-section met psychometric reliability requirements (Cronbach’s α > 0.7). The SLn-SNKQ has been validated and demonstrates robust psychometric properties, offering a reliable tool for assessing SNK among Sri Lankan track and field athletes.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that impacts women of reproductive age. In addition to reproductive and psychological complications, women with PCOS are also at a higher risk of developing metabolic diseases such as obesity, type 2 diabetes and cardiovascular disease. While weight reduction can help manage these complications in overweight or obese women, many weight loss interventions have been ineffective due to weight stigma and its psychological impact on women with PCOS. Therefore, exploring alternative dietary strategies which do not focus on weight loss per se is of importance. In this regard, omega-3 polyunsaturated fatty acids of marine origin (n-3 PUFAs), which are known for their hypotriglyceridemic, cardioprotective and anti-inflammatory effects, have emerged as a potential therapy for prevention and reversal of metabolic complications in PCOS. Several clinical trials showed that n-3 PUFAs can improve components of metabolic syndrome in women with PCOS. In this review, we first summarize the available clinical evidence for different dietary patterns in improving PCOS complications. Next, we summarize the clinical evidence for n-3 PUFAs for alleviating metabolic complications in PCOS. Finally, we explore the mechanisms by which n-3 PUFAs improve the metabolic disorders in PCOS in depth.