Introduction: The rising prevalence of obesity has led to growing interest in very low-calorie diets (VLCDs), which typically provide fewer than 800 kcal/day and limit carbohydrate intake to 20-50 g/day. These diets are promoted for their rapid weight loss effects; however, concerns have emerged regarding their long-term safety and physiological impact [1–3].

Methodology: A comprehensive review was conducted to assess the physiological and psychological effects of prolonged VLCD adherence. Studies published between 2009 and 2025 were retrieved from PubMed, ScienceDirect, and Google Scholar. Selection criteria focused on research examining outcomes related to bone health, lean body mass, liver function, cardiometabolic risk, and mental health.

Results: A total of 31 studies were included, with 14 addressing multiple complications. VLCDs were associated with reduced bone mineral density and quality, increasing the risk of osteoporosis [4]. Lean body mass loss, especially in older adults, was commonly reported and linked to sarcopenia, decreased physical function, and frailty [2]. Hepatic issues such as portal inflammation and fibrosis were observed, particularly with rapid weight loss [5]. Weight cycling, characterized by repeated loss and regain, was associated with insulin resistance, dyslipidemia, hypertension, and increased cardiometabolic risk [6]. In mental health, while short-term mood improvements may occur with behavioral support, long-term VLCD use has been linked to adverse effects on cognitive function, mood, and anxiety [3].

Conclusion: Although VLCDs can induce short-term weight loss, prolonged use raises significant safety concerns. This review highlights potential risks affecting skeletal, muscular, hepatic, metabolic, and psychological health. These findings support the need for individualized dietary planning, incorporation of physical activity, and professional supervision to ensure nutritional adequacy and minimize health risks.

Introduction: Malnutrition and cognitive decline are prevalent and interrelated conditions in older adults, both contributing to increased disability, frailty, and mortality. Evidence suggests that poor nutritional status may accelerate cognitive deterioration, particularly in domains related to executive function and memory. However, longitudinal data in community-dwelling populations remain limited. This study aimed to examine both the cross-sectional and longitudinal associations between malnutrition and cognitive performance in a large sample of older adults.

Methods: Data were drawn from the TOLEDO Study of Ageing, involving 963 community-dwelling older adults. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Cognitive performance was assessed using a comprehensive neuropsychological battery including the Mini-Mental State Examination, the Short- and Long-Term Memory Recalling Test, the Boston Naming Test, a Verbal Fluency Test, Digit Span Forward, the Go/No-Go Test, the Edinburgh Handedness Inventory, the Luria Orders Test, a Clock Drawing Test, and a Serial Word Learning Test.

Results: In the cross-sectional analyses, malnutrition was significantly associated with a poorer performance in tests assessing frontal lobe function, including the Luria and Go/No-Go tasks. Longitudinally, malnutrition at the baseline predicted lower scores over time in frontal lobe tasks, the Boston Naming Test (BNT), and global cognitive functioning.

Conclusion: Malnutrition is associated with a poorer cognitive performance, particularly in executive function and naming tasks, both at the baseline and over time. These findings underscore the importance of early nutritional screening and intervention to support cognitive health in aging populations.

Introduction: Sarcopenia is a chronic condition linked to aging-related neuromuscular decline, often defined by dynapenia, muscle atrophy, and impaired physical function. Although diagnostic criteria are debated, sarcopenia is associated with many adverse outcomes, such as falls. However, findings on its link to falls are inconsistent, possibly due to limited consideration of falls' multifactorial nature. Indeed, intrinsic (e.g., comorbidities) and extrinsic (e.g., home environment) factors both influence fall risk, yet few studies examine their combined effects. Hence, this study examined data from the ilSIRENTE cohort to explore how intrinsic and extrinsic factors moderate the cross-sectional and longitudinal relationship between sarcopenia and falls.

Methods: This prospective cohort study was conducted among octogenarians residing in the mountainous Sirente geographic area of Central Italy. Sarcopenia was defined according to the European Working Group on Sarcopenia. Data on fall history and incident falls were collected over a two-year period. A general linear model was used to assess whether intrinsic factors (i.e., multimorbidity, polypharmacy, cognitive function, vision status, and nutritional status) and extrinsic factors (i.e., social functioning and environmental characteristics) moderated the relationship between sarcopenia (independent variable) and falls (dependent variable).

Results: Results of the general linear model revealed that intrinsic factors, but not extrinsic ones, significantly influenced the associations between sarcopenia and falls. Specifically, multimorbidity and polypharmacy were associated with both fall history and incidence, while cognitive function and nutritional status emerged as significant moderators in the longitudinal analysis.

Conclusion: These findings underscore the importance of addressing specific intrinsic health-related factors in order to more effectively mitigate the risk of falls among older adults with sarcopenia.

Introduction: Sarcopenia and malnutrition are common among older adults, both characterized by the presence of low muscle mass. Early detection is essential to prevent adverse outcomes. Although international guidelines support the use of calf circumference (CC) as an alternative to gold-standard methods (e.g., dual-energy X-ray absorptiometry [DEXA]), supporting evidence remains limited. Moreover, CC values may be affected by clinical factors such as hypoalbuminemia, which alters oncotic pressure and may cause edema, potentially leading to false-negative results. This study examined the agreement between CC and DEXA in diagnosing sarcopenia and malnutrition, and assessed the moderating effect of albumin on CC.

Methods: Data from 1,048 older adult (>65) participants in Wave 2 of the National Health and Nutrition Examination Survey (NHANES) were analyzed. Appendicular skeletal muscle mass (ASM) was estimated using both CC and DEXA. Sarcopenia was defined by low muscle mass and reduced walking speed. Malnutrition was identified using GLIM criteria. Urinary albumin was measured via fluorescent immunoassay. Pearson’s correlation, Kappa analysis, and adjusted linear regression were used.

Results: CC (r = 0.592) and the ASM derived from CC (r = 0.592) showed a moderate correlation with DEXA-based ASM. This correlation weakened (r = 0.355) when values were adjusted for height² (skeletal muscle index). Regression analysis showed that each one-unit decrease in urinary albumin was associated with a 0.437 cm increase in CC. Kappa analysis showed moderate agreement for malnutrition (κ = 0.635) and poor agreement for sarcopenia (κ = 0.372) when comparing CC-based and DEXA-based assessments.

Conclusion: CC may not be a valid proxy for muscle mass in older adults, especially in the presence of hypoalbuminemia. Assessments based on CC and DEXA may classify different individuals as sarcopenic or malnourished.

Recent developed advancements in nutrigenomics have identified specific genetic markers that influence how fats and carbohydrates are metabolized, highlighting the role of the anti-aging gene Sirtuin 1 (SIRT1) gene. SIRT1 is crucial for the health of the brain, heart, lungs, kidneys, and liver. It plays a significant role in the regulation of fatty acids and glucose, which are key to preventing Non-Alcoholic Fatty Liver Disease (NAFLD) and Neurodegenerative Diseases (NDs) . By clearly understanding how SIRT1 interacts with dietary components, researchers can effectively develop personalized nutritional strategies that greatly enhance metabolic health and potentially delay the onset of age-related diseases. This approach points out in detail the extraordinary transformative potential of nutrigenomics in promoting good health and human longevity. For instance, in the brain, SIRT1 activation has been linked to neuroprotection and cognitive functioning, offering hope in considerably delaying neurodegenerative diseases such as Alzheimer's and Parkinson’s disease. In the liver, SIRT1 helps regulate lipid metabolism, which can prevent Non-Alcoholic Fatty Liver Disease (NAFLD) by reducing fat accumulation. In the heart, anti-aging gene Sirtuin 1 (SIRT1) supports cardiovascular health through pathways that effectively improve endothelial function and significantly reduce oxidative stress. Additionally, SIRT1's role in the kidneys involves modulating responses to stress and inflammation, which is crucial for preventing chronic kidney disease. Dietary components such as Resveratrol, found in red wine and certain berries, have been shown to activate SIRT1, highlighting the gene's nutrigenomic potential. By leveraging these insights, personalized nutrition plans can be developed to modulate SIRT1 activity, optimizing metabolic health and potentially delaying the onset of age-related diseases. This gene-centric approach illustrates how nutrigenomics can pave the way for innovative strategies to enhance overall health, well-being and lifespan.

Background: Individuals over 60 living with HIV (OPLWH) face a form of premature aging driven by multiple biological and clinical factors. This phenomenon increases their vulnerability to frailty, which in turn negatively impacts overall well-being and significantly diminishes quality of life.

Objective: This pilot study aims to assess the impact of a 6-month multidomain intervention on quality of life over a one-year follow-up in prefrail and frail OPLWH.

Materials and methods: This quasi-experimental study included OPLWH attending the Infectious Disease Unit at Hospital Universitario Clínico San Carlos who met at least one FRAIL criterion. After a comprehensive geriatric assessment, frailty according to Fried criteria, physical performance, sarcopenia, and quality of life (WHOQOL-VIH-Bref) were assessed at baseline and at 3 months. A multicomponent intervention (physical exercise, nutritional intervention, and pharmacological optimization), was conducted in prefrail and frail participants. Differences between pre- and post-intervention moments were examined using the independent t-test.

Results: A total of six robust (67.2 ± 6.2 years) and seven pre-frail (72.1 ± 1.8 years) OPLWH were included. At baseline, robust participants reported higher overall perception of quality of life compared to their pre-frail counterparts (3.6±1.5 vs. 2.8±0.4; p=0.006). Following the multicomponent intervention in prefrail individuals, no significant changes were observed in global quality of life or in its specific domains, including physical health, psychological well-being, independence, social relationships, environment, and spirituality.

Conclusions: Prefrail OPLWH have lower quality of life than robust counterparts. However, in this pilot study, a multidomain intervention in prefrail OPLWH does not improve quality of life.

Background: People living with HIV (PLWH) experience an accelerated aging due to different mechanisms (immune activation and chronic inflammation, greater loss of muscle mass due to both the disease itself and antiretroviral therapy, among other factors). This accelerated aging is characterized by an increased risk of developing frailty, leading to a higher likelihood of adverse events and worse quality of life.

Objective: The main goal of this pilot study is to evaluate the effect of a 6-month multidomain intervention on changes on functional performance over an one-year follow-up of pre-frail and frail PLWH aged 60 and above (OPLWH).

Materials and methods: OPLWH followed at the Infectious Disease Unit of Hospital Universitario Clínico San Carlos with ≥1 Fried criteria were included in this quasi-experimental study. Functional, physical performance (Short Physical Performance Battery-SPPB-, walking speed-WS), sarcopenia parameters (hand-grip-HG, dynamic muscle strength-DMS) and sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, nutritional (adherence to Mediterranean diet) and body composition variables (rectus femoris ultrasound), as well as quality of life were assessed at baseline and at 3 months. A multicomponent intervention, which included physical exercise, nutritional intervention, and pharmacological optimization, was conducted. Differences between pre- and post-intervention moments were examined using the independent t-test.

Results: Seven prefrail OPLWH (72.1±1.8yo) were included. At follow-up, 3 of them improved to a robust status and 4 remained prefrail. The multidomain intervention significantly increased DMS [16.33kg (95%CI 4.45-28-22; p=0.02)] and muscle thickness [1.77mm (95%CI 0.11-3.44; p=0.04)]. A clinically, although no statistically, significant difference was observed in SPPB [1 (95%CI 0.31-2.31; p=0.11)]. Nevertheless, significant improvements were detected when a sensitivity analysis was conducted examined only those with worse SPPB scores (<10) at baseline.

Conclusions: A multidomain intervention in prefrail OPLWH improves sarcopenia parameters (strength muscle and muscle mass) and physical performance.

Older adults living with HIV are highly susceptible to sarcopenia and frailty. Both conditions are linked to a higher risk of mortality, hospitalizations, loss of functional independence, and a worse quality of life. This research aims to evaluate the effect of a 6-month multicomponent intervention (nutritional education, pharmacological treatment optimization, and structured multicomponent physical exercise at home) on the sarcopenia risk and frailty progression in pre-frail and frail adults aged 60 and above with HIV. This quasi-experimental study will be conducted at Hospital Clínico San Carlos (Madrid, Spain) with 12 months of follow-up. It will assess functional performance (changes in the Short Physical Performance Battery (SPPB)); frailty according to Fried phenotype; sarcopenia, using the EWGSOP-2 criteria; and changes in handgrip strength, nutritional parameters (adherence to a Mediterranean diet, malnutrition according to the GLIM criteria, and body composition parameters: bioimpedance and muscle ultrasound), quality of life (EQ-5D-5L), and biomarkers (IL-6, TNF-α, HOMA-IR). The intervention includes personalized educational nutritional sessions, as well as oral nutritional supplementation when required, and a tailored multicomponent exercise program based on the Vivifrail® protocol, with regular in-person and telephone follow-ups. The expected outcomes include significant reductions in sarcopenia and frailty, improvements in physical function and quality of life, and fewer hospital admissions. The intervention also seeks to be a cost-effective strategy applicable in clinical settings. This proposal addresses key research gaps regarding integrated, long-term interventions in frail older adults with HIV and aims to generate evidence to optimize their clinical and functional management.

Introduction

Guillain–Barré Syndrome (GBS) is the prevalent acute paralytic neuropathy, occurring in around 100,000 individuals worldwide annually. It presents in various clinical forms, with 20–30% of patients experiencing respiratory failure. Established infectious causes are Campylobacter jejuni, Zika virus, and SARS-CoV-2, with molecular mimicry that triggers autoimmunity being common. Evidence is accumulating, pointing toward a link between GBS and novel viruses like Oropouche virus (OROV). Yet, differences in access to treatment and the heterogeneity of clinical presentation make diagnosis and management challenging.

Methodology

Recent clinical studies have underscored the necessity of more sensitive diagnostic procedures to address unusual GBS presentations. Diagnostic procedures like lumbar puncture and nerve conduction tests are essential, particularly in unusual presentations such as GBS linked with multiple myeloma (MM), whose symptoms can resemble bortezomib-induced neuropathy. Retrospective studies, such as one of 210 OROV-related GBS cases, help understand patterns of disease.

Results

Our results show that OROV infection has no notable impact on the severity of GBS disease or clinical outcomes. Poor prognosis is predicted by advanced age, the need for mechanical ventilation, and swift disease progression. Electrophysiological markers—such as diminished compound muscle action potentials and delayed F-wave latencies—additionally stratify patient outcomes.

Conclusion

Innovations in complement inhibitors and disease-modifying therapies are promising in current trials. International collaborative research is important for biomarker development and optimizing therapeutic approaches. Bridging global inequities in access to care continues to be an urgent priority to limit long-term disability from GBS.

Introduction. The development of isometric exercise (IE) protocols for the early rehabilitation of older adults following total hip replacement (THR) and molecular methods for assessing their efficacy was our aim.

Methods. Eight female patients aged 73-77 years were randomized before a THR into two groups of four patients each. During the first 12 days after the THR, the patients performed daily rehabilitation exercises following the standard protocol in the control group and following the standard protocol supplemented with a complex of IE in the experimental group. The clinical parameters of the blood, ESR, CRP, and the concentrations of certain pro-inflammatory interleukins in the blood were evaluated before the THR, as well as 1 day and 12 days after the THR, for each patient. At these times, rectus femoris biopsies of the operated limb were performed in each patient for a transcriptomic analysis.

Results. The indicators of the clinical blood analysis, ESR, muscle injury, and CRP did not reveal any significant difference between the groups. The concentrations of IL-6, IL-8, and IL-1b recovered to the normal range by 12 days after the THR in the experimental group but not in the control group. The transcriptomic analysis of the muscle biopsies revealed significant up-regulation of the processes associated with inflammatory and immune responses as compared to that in the preoperative state in both groups at day 1 and in the control group by 12 days after the THR, while there were no signs of such activation in the experimental group by 12 days after the THR.

Conclusions. The concentrations of IL-6 and IL-8 in the blood, as well as transcriptomic signatures of the processes and signaling pathways associated with inflammatory and immune responses, can be interpreted as molecular indicators of IE's efficacy for the early rehabilitation of older adults after a THR.