João Rafael Valentim-Silva

Exercise is commonly classified by external dose or metabolic demand, yet each bout also imposes spatially patterned mechanical loads on muscle, vessels, extracellular matrix, stromal niches, and mobile immune cells. This review asks whether that mechanical dimension can be organised into a testable framework linking exercise to immune biology. We conducted a critical mechanistic narrative synthesis of exercise physiology, mechanotransduction, immunometabolism, immune mechanobiology, and exercise epigenetics, with structured searches updated through 31 August 2026 and targeted citation checks through 8 September 2026; the studies underpinning the principal causal claims were appraised in duplicate, and their study-level basis is reported in a supplementary evidence table. Throughout, we label whether a mechanism has been demonstrated during exercise in vivo or only in non-exercise mechanical systems. Exercise-specific mechanosensing is well supported in skeletal muscle and endothelium and supported in stromal compartments, including Piezo1-dependent muscle stromal sensing and mechanosensitive bone-marrow niches, both currently demonstrated in mice. Immune cells also possess force-sensitive machinery, but this has been established almost entirely outside exercise, and direct human evidence for durable immune-cell epigenetic change after exercise is limited, short in duration, and does not establish a mechanical mechanism. We therefore propose the Mechanometabolic Immune Interface Model of Exercise (MIIM-E), a multiroute, falsifiable model that separates endothelium-mediated from leukocyte-intrinsic haemodynamic exposure, tissue-niche mechanotransduction, and systemic biochemical signalling, and that distinguishes tests of necessity, sufficiency, mediation, and incremental explanatory value. Persistence of an immune phenotype and its attribution to a mechanical cause are treated as separate hypotheses to be tested, not as assumed consequences of exercise. Mechanical information may contribute to immune adaptation, but its causal role depends on cell type, route, exposure, and persistence.

Objective: Lack of time is the main barrier to physical exercise routines. This study evaluated the impact of whole-body, low-cost, high-intensity interval training (HIIT) using bodyweight exercises on old subjects with metabolic syndrome (MetS). Material and methods: Forty participants (mean age: 72.4 ± 5.9 years; 36 women) with MetS admitted to a public health service center were randomized into control and HIIT groups. The 40-min HIIT protocol consisted of 60-s exercises at 75%–85% maximum heart rate monitored by finger oximeter, followed by 120 s of passive rest, performed three times weekly for eight weeks. We assessed exercise capacity (VO ₂ max), blood pressure, biochemical parameters, and the triglyceride-glucose (TyG) index at baseline, four and eight weeks after exercise. The TyG index was used as a biomarker for insulin resistance and cardiometabolic health, and the MetS-Z to Metabolic Syndrome to severity of this condition. Results: HIIT improved VO ₂ max (∼20%), reduced systolic and diastolic blood pressure, fasting glucose (−32%), HbA1c (−35%), triglycerides (−39%), and TyG index (−12%) compared to controls. Conclusions: The low-cost bodyweight HIIT protocol is an easy and effective strategy for improving cardiometabolic health in the elderly with MetS. Our results highlight the importance of introducing this approach into public health programs, particularly in resource-limited settings, to manage metabolic disorders and promote healthy aging.

To investigate the effects of Jatobá sap for eight weeks as an immunometabolic modulator in male soccer athletes. Phase 1: Phytochemical characterization (HPLC); Phase 2: (Jatobá) x (placebo). C-reactive protein (CRP), creatine phosphokinase (CPK), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT), urea, creatinine, cortisol, and testosterone were evaluated. The present study identified propelargonidin dimer and the flavonoids proanthocyanidin dimer, proanthocyanidin trimer, catechin, taxifolin, and caffeoylquinic acid glycoside. The placebo group showed a significant decrease in testosterone levels after the game about the pre-game time, a fact that did not occur in the supplemented group. Also, the supplemented group showed a significant increase in the levels of this variable in the 24-hour time about the post-game time, which was not observed in the placebo group. Regarding cortisol, both groups showed an increase in the post-game time with a return to basal levels in 24 hours. However, the stress of the match caused the placebo group to increase blood concentrations of this hormone by 150.5%, while the supplemented group increased blood concentrations by 59.3%. Supplementation modulated the testosterone/cortisol hormonal balance, with significant anabolic control between the groups after the match, and increase testosterone, reduced cortisol levels, and positively modulated the testosterone/cortisol ratio.

Background: In recent years, interest has grown in complementary therapies to support athletic performance and recovery, with acupuncture showing potential to influence physiological responses during high-intensity exercise. Traditionally applied for pain management and stress reduction, acupuncture’s effects on exercise-related factors, such as perceived exertion, lactate levels, and heart rate, remain less examined. This study explores the immediate impact of acupuncture on physical performance and perceived exertion in amateur athletes, aiming to provide initial insights into its possible role as a supportive tool in sports training contexts. Aims: To determine the acute effects of acupuncture on physical performance and perceived exertion in amateur athletes. Methodology: A crossover and quantitative study was proposed. The sample was acquired at Estácio de Sá University, Cabo Frio, Rio de Janeiro, between April and May 2020. Fifteen competitive males engaged in HIIT (31.61 ± 7.02 years old; heart rate reserve: 59.71 ± 4.10; lactate: 3.31 ± 0.63 mM/DL) were subjected to two exercise sessions. Both sessions were performed at an intensity of 85-95% of maximum heart rate. Acupuncture points used: ST36, LI4, LI11, LR3. Lactate, heart rate, systolic blood pressure, and perceived exertion were assessed immediately after the exercise challenge, with or without acupuncture pre-conditioning. The Student’s t-test and Shapiro-Wilk test were applied for statistical analysis, with Pearson correlation tests conducted. A significance level of 5% was used. Results: A significant reduction in perceived exertion was observed after acupuncture (PES1: 19.4 ± 1.14; PES2: 16.8 ± 0.84; p = 0.001). Acupuncture also led to higher lactate accumulation and heart rate during the session. Conclusion: Acupuncture improved lactate clearance and reduced perceived exertion, suggesting it may be a useful intervention to enhance athletic performance. Limitations include the small sample size and the absence of direct VO2 max measurement.

Aims: To investigate the acute effects of resistance exercise (RE) inter-set rest intervals on the repetition performance and perceived exertion in multi- and single-joint exercises with near-maximal loads in women. Study Design: A quasi-experimental controlled trial. Place and Duration of Study: The recruiting was performed in Petropolis city, and the conduction occurred between December of 2023 and February of 2024. Methodology: Fifteen trained women performed eight sessions (2 exercises, 4 inter-set rest periods); each consisting of 5 sets with a 3-RM load for each exercise. The exercises tested were leg extension (LE) for the single-joint exercise and the leg press (LP) for the multi-joint exercise with 1-, 2-, 3- and 5-minute conditions. Results: The total number of repetitions in LP was significantly higher for the 3- (14.63±0.67 reps; p= 0.0002) and 5-minute conditions (14.90±0.32 reps; p= 0.0001) vs. the 1-minute condition (12.90±0.83 reps); and, similarly, the 3- (p= 0.0014) and 5-minute conditions (p= 0.0002) vs the 2-minute condition (13.54±1.13 reps), however, to 1- and 2-minute rest conditions no significant differences were found. For the LE, a significantly higher total number of repetitions was completed for 3- (14.91±0.30 reps; p= 0.0004) and 5-minute conditions (14.90±0.31 reps; p= 0.0005) vs. the 1-minute condition (13.18±1.72 reps). Conclusions: Both exercises showed decreasing repetition performance with all rest protocols over the last three sets. Regardless of exercise type, 1- and 2-minute rests led to higher perceived exertion. To enhance repetition consistency in women, prioritize longer rests (3 and 5 minutes) for multi-joint exercises like LP, and 2 minutes for single-joint exercises like LE which provides valuable insights into the maximum training load capacity for trained women, offering a foundation for future practical recommendations.

Aims: To analyze the use of anti-inflammatory drugs and the associated factors, including educational level, number of prenatal visits, and food insecurity, during pregnancy. Study Desing: Population-based cross-sectional study. Place and Durationof Study: The sample were recruited in two maternity hospitals of Rio Branco, Acre, Brazil. The Santa Juliana Hospital and Maternity (HSJ) and the Bárbara Heliodora Maternity in April 6 and July 10, 2015 Methodology: Demographic, socioeconomic, reproductive, maternal habits, prenatal care, and newborn status were investigated. Multivariate analysis with logistic regression was performed, considering pResults: 1190 postpartum women were interviewed. Anti-inflammatories were not used by only 13.2% of pregnant women. The prevalence of dipyrone use was 72.7%, paracetamol 50.3%, nimesulide 16.1%, and diclofenac 5.2%. Women with lower educational levels (up to high school OR=1.55, 95% CI 1.07-2.25), those who consumed alcohol (OR=1.96, 95% CI 1.03-3.73), and those with a higher number of living children (more than 4 children OR=1.6, 95% CI 1.06-2.24, 2 to 3 children OR=1.52, 95% CI 1.10-2.27) had a higher chance of using anti-inflammatories during pregnancy. Primiparous women (OR=0.66, 95% CI 0.47-0.93), those with more than eight prenatal visits (OR=0.55, 95% CI 0.35-0.85), and those experiencing moderate to severe food insecurity (OR=0.42, 95% CI 0.25-0.69) had a lower chance of using anti-inflammatories during pregnancy. After adjusted analysis, alcohol consumption and the number of living children lost statistical significance and were not included in the final model as independent variables. Conclusion: The prevalence of anti-inflammatory use was high. Alternative therapies and restricting prescriptions to necessary cases could be proposed to reduce the use of non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy.

Aims: To investigate the impact of different inter-set rest periods on blood glucose levels and insulin sensitivity (IS) in children with type 1 diabetes. Study Design: An experimental randomized crossover trial. Place and Duration: Recruitment took place in the public health network of Rio Branco, Acre, Brazil. Methodology: Twenty subjects participated in three different HIIT protocols with varying rest intervals. The first protocol consisted of 20 seconds of exercise followed by 10 seconds of rest (HIIT20-10), the second with 20 seconds of rest (HIIT20-20), and the third with 60 seconds of rest (HIIT20-60). The exercise used in all protocols was the burpee, performed at maximum effort for a total of 12 minutes, comprising 24 sets. Blood glucose levels were measured through finger-prick tests before exercise, immediately after, and at 15, 30,60,and120 minutes post-exercise. For insulin sensitivity, 4 ml of venous blood was drawn before, immediately after, and at 30, 60, and 120minutes post-exercise, and the TyG Index was used to calculate IS. Results: No significant differences were observed between the HIIT20-20 and HIIT20-60 groups (p>0.05) regarding glucose levels. However, the HIIT20-10 protocol showed significantly lower glucose levels from 15 minutes to 120 minutes post-exercise (pConclusion: The inter-set rest period influences glucose metabolism during HIIT in children with type 1 diabetes.

Aims: This study examines the effects of high-intensity body weight interval training (PMED) on brain-derived neurotrophic factor (BDNF) and phosphorylated-TAU protein (p-TAU) in Alzheimer's disease (AD) and their relation to blood lactate concentration. Study Design: An experimental randomized control trial was conducted. Place and Duration of Study: The study took place at Vila Vicentina Community Center, the Elderly Support Center of the University of Pará (UEPA), the Senior Living Center (CCI), and SESC Porto Velho, Brazil, between 2016 and 2018. Methodology: Seventy-eight seniors diagnosed with AD were divided into three groups: HIIT, MICT, and a sedentary control group. The HIIT group engaged in 30 minutes of exercise at 80-90% of maximal heart rate, while the MICT group walked for 30 minutes at 60% of maximal heart rate. Both exercise groups performed their respective activities three times per week for three months, composing 36 exercise sessions. Pre- and post-intervention measurements of BDNF and p-TAU were conducted and the lactate correlation were done. Results: The HIIT group showed a significant increase in BDNF and a decrease in p-TAU concentrations (pConclusion: This study underscores the potential of HIIT as a viable intervention for mitigating neurodegeneration in AD by enhancing BDNF and reducing p-TAU levels. The findings also highlight the importance of exercise intensity in achieving these neurobiological benefits and suggest a muscle/brain crosstalk interaction in response the exercise.

Introduction: Food insecurity (FI) experienced during pregnancy represents a relevant public health problem, as it negatively affects maternal and child health. Objective: To investigate the prevalence of FI among pregnant women during the COVID-19 pandemic and determine associated factors. Methods: A cross-sectional study was carried out in the period from 2021 to 2022, with a representative sample of 423 women resulting from a sample calculation based on the average (2912 births) that occurred in the years 2016 to 2020 in the only maternity hospital in the municipality. After analyzing the medical records, interviews were carried out with the postpartum women using a standardized questionnaire and the Brazilian Food Insecurity Scale. Poisson regression with robust variance was used to calculate prevalence ratios and 95% confidence intervals to measure associations. Results: FI was observed in 57.0% of cases and was associated with age under 20 years (PR = 1.52; 95% CI 1.29; 1.79), receipt of government assistance (PR = 1.31; 95% CI 1.10; 1.55), loss of family employment (PR = 1.40; 95% CI 1.20; 1.64), greater number of residents (PR = 1.17; 95% CI 1.00; 1.37), and prenatal care in a public institution (PR = 1.53; 95% CI 1.04; 2.26). Conclusion: There was a high prevalence of FI cases, associated with socioeconomic, demographic, and prenatal care characteristics during the COVID-19 pandemic.

Background: Alzheimer's Disease (AD) is a progressive and incurable condition that prompts the exploration of interventions to slow its advancement and enhance the quality of life. The cortical brain waves could have a role in the process of executive function deterioration, increasing dementia symptoms. Objective: To interrogate the effects of physical exercise, and non-invasive brain stimulation, both in electrophysiological behavior of the brain, the executive functions, and dementia symptoms in older adults with AD. Methods: One hundred and sixteen older adults were grouped (n=22 each): GAE (AD, PMED+NIBS), GCP (AD, PMED), GCN (AD, NIBS), GCS (control, no intervention). Binaural beats were used as a non-invasive brain stimulation, physical exercise, or both, were applied during 16 weeks. Pre/post measurements included Alpha Band, and SMR Rhythms, executive functions, and dementia symptoms. Results: GCS showed no significant changes (p>0.05). GCN and GCS slightly enhanced inhibitory control (p>0.05) and working memory (p>0.05). In contrast, GCP and GAE improved executive function (p