High density lipoprotein cholesterol level is a robust predictor of lipid peroxidation irrespective of gender, age, obesity, and inflammatory or metabolic biomarkers

BackgroundObesity related dyslipidemia, chronic inflammation and oxidative stress were associated with atherosclerotic sequels. We analysed oxidized low-density lipoprotein (oxLDL) plasma levels of 797 participants of the STyrian Juvenile OBesity (STYJOBS) / Early DEteCTion of Atherosclerosis (EDECTA) Study cohort aged from 5 to 50 years. The rationale of STYJOBS/EDECTA is to investigate the preclinical phase of obesity by a well defined cohort of young and middle aged overweight/obese and normal weight subjects.Methods and ResultsPlasma oxLDL was analysed by ELISA (Mercodia, Sweden). In the overweight/obese (OW/OB) study group, oxLDL levels were significantly increased compared to normal weighted controls (p < 0.001). Probands with metabolic syndrome (MS) had significantly higher oxLDL levels than probands without MS; between overweight and obese participants, and between females and males, no significant difference was seen. In a multiple stepwise regression analysis including all study subjects, age, gender, anthropometric data, presence of metabolic syndrome, systolic, diastolic blood pressure, carotis communis intima media thickness, lipids, adipokines, metabolic, and inflammatory biomarkers, decreased high-density lipoprotein (HDL-cholesterol) and increased total cholesterol were the best predictors for increased oxLDL levels.ConclusionDecreased HDL-cholesterol is an important determinant of lipid peroxidation irrespective of obesity, age, gender, SAT distribution, and inflammatory/metabolic biomarkers.     

The effect of unilateral training on contralateral limb strength in young,older, and patient populations: a meta-analysis of cross education

Background: Cross education is the contralateral strength gain following unilateral training of the ipsilateral limb. This phenomenon provides an ideal rehabilitation model for acute or chronic rehabilitation; however, previous cross education meta-analyses have been limited to a handful of studies.

Objectives: The present meta-analysis aimed to (1) be as inclusive as possible, (2) compare cross education in young able-bodied, older able-bodied, and patient populations, (3) compare cross education between training modalities, and (4) detail the impact of methodological controls on the quantification of cross education.

Methodology: A review of English literature identified studies that employed unilateral resistance training and reported contralateral strength results. Studies were separated to examine the effect of population, training modality, limb, sex, and familiarization on the magnitude of cross education. The percent strength gain and effect size were calculated for ipsilateral and contralateral limbs.

Results: A total of 96 studies fit the predetermined inclusion criteria and were included in the analysis. The included studies were further divided into 141 units employing separate unilateral training paradigms. These were separated into young, able-bodied (n?=?126), older, able-bodied (n?=?9), and neuromuscular patients (n?=?6). Cross education was an average of 18% (standardized mean difference (SMD)?=?0.71) in young, able-bodied participants, 17% (SMD?=?0.58) in healthy able-bodied participants, and 29% (SMD?=?0.76) in neuromuscular patients.

Conclusion: Cross education was present in young, older, and patient populations and similar between upper and lower limbs and between males and females. Electromyostimulation training was superior to voluntary training paradigms.     

Body fat and skeletal muscle mass,but not body mass index,are associated with pressure hyperalgesia in young adults with patellofemoral pain

BackgroundYoung adults with patellofemoral pain (PFP) have a high prevalence of being overweight or obese, which is associated with impaired lower limb function and muscle weakness. However, the impact of being overweight or obese on pain sensitivity has not been explored.ObjectivesWe investigated the association between body fat, skeletal muscle mass, and body mass index (BMI) with pressure hyperalgesia and self-reported pain in young adults with PFP.Methods114 adults with PFP (24 ± 5 years old, 62% women) were recruited. Demographics and self-reported pain (current and worst knee pain intensity in the previous month - 0–100 mm visual analog scale) were recorded. Body fat and skeletal muscle mass were measured using bioelectrical impedance. Pressure hyperalgesia was measured using a handheld algometer (pressure pain threshold) at three sites: center of patella of the painful knee, ipsilateral tibialis anterior, and contralateral upper limb. The association between body fat, skeletal muscle mass, and BMI with pressure hyperalgesia and self-reported pain were investigated using partial correlations and hierarchical regression models (adjusted for sex, bilateral pain, and symptoms duration).ResultsHigher body fat and lower skeletal muscle mass were associated with local, spread, and widespread pressure hyperalgesia (ΔR²=0.09 to 0.17, p ≤ 0.001; ΔR²=0.14 to 0.26, p<0.001, respectively), and higher current self-reported pain (ΔR²=0.10, p<0.001; ΔR²=0.06, p = 0.007, respectively). Higher BMI was associated with higher current self-reported pain (ΔR²=0.10, p = 0.001), but not with any measures of pressure hyperalgesia (p>0.05).ConclusionHigher body fat and lower skeletal muscle mass help to explain local, spread, and widespread pressure hyperalgesia, and self-reported pain in people with PFP. BMI only helps to explain self-reported pain. These factors should be considered when assessing people with PFP and developing their management plan, but caution should be taken as the strength of association was generally low.     

全身振动训练对延迟性肌肉酸痛影响的Meta分析

目的:系统评价全身振动训练(WBVT)对延迟性肌肉酸痛(DOMS)的临床疗效.方法:系统检索Scoups、Springer link、Web of Science、ProQuest等中英文数据库,搜索关于全身振动训练治疗延迟性肌肉酸痛的随机对照试验(RCT).根据Cochrane手册对纳入文献进行风险偏倚评价,并在数据...     

Effects of Tai Chi on Lower Limb Proprioception in Adults Aged Over 55: A Systematic Review and Meta-Analysis

ObjectiveTo summarize and critically evaluate the effects of Tai Chi on lower limb proprioception in adults older than 55.Data SourcesSeven databases (Scopus, PubMed, Web of Science, SPORTDiscus, Cochrane Library, Wanfang, CNKI) were searched from inception until April 14, 2018.Study SelectionEleven randomized controlled trials were included for meta-analysis.Data ExtractionTwo independent reviewers screened potentially relevant studies based on the inclusion criteria, extracted data, and assessed methodological quality of the eligible studies using the Physiotherapy Evidence Database (PEDro).Data SynthesisThe pooled effect size (standardized mean difference [SMD]) was calculated while the random-effects model was selected. Physiotherapy Evidence Database scores ranged from 5 to 8 points (mean=6.7). The study results showed that Tai Chi had significantly positive effects on lower limb joint proprioception. Effect sizes were moderate to large, including ankle plantar flexion (SMD=−0.55; 95% confidence interval [95% CI], −0.9 to −0.2; P=.002; I²=0%; n=162), dorsiflexion (SMD=−0.75; 95% CI, −1.11 to −0.39; P<.001; I²=0%; n=162), nondominant or left knee flexion (SMD=−0.71; 95% CI, −1.10 to −0.41; P<.001; I²=25.1%; n=266), dominant or right knee flexion (SMD=−0.82; 95% CI, −1.06 to −0.58; P<.001; I²=33.8%; n=464).ConclusionsThere is moderate to strong evidence that suggests that Tai Chi is an effective intervention to maintain and improve lower limb proprioception in adults older than 55. More robust multicenter studies including oldest-old participants, with longer follow-ups and validated outcome measures, are needed before a definitive conclusion is drawn.     

Effect of Resistance Exercise on Body Structure and Function,Activity, and Participation in Individuals With Parkinson Disease: A Systematic Review

ObjectiveTo investigate the effects of resistance exercise (RE) on body structure and function, activity, and participation in individuals with Parkinson Disease (PD) in the mild to moderate stages.Data SourcesMedline, Embase, Web of Science, The Cochrane Library, Lilacs, and PEDro were searched from inception until June 2020 using the terms “Parkinson Disease,” “Exercise,” “Resistance Training,” “Muscle Strength,” “Cardiorespiratory Fitness,” “Postural Balance,” “Gait,” and “Quality of Life.”Study SelectionWe included studies conducted in individuals with PD involving RE compared with a control group. Two independent reviewers performed the selection process based on titles, abstracts, and full-text reading. In total, 270 individuals with PD were included from 10 selected studies.Data extractionTwo reviewers independently extracted characteristics related to participants, intervention and control types, and results. The PEDro scale was used to assess the methodological quality, and the level of evidence was analyzed and synthesized using the Grading of Recommendation, Assessment, Development, and Evaluations approach.Data SynthesisThe level of evidence for body structure and function was low and without effect for lower limb muscle strength; very low and with effect for upper limb muscle strength, cardiorespiratory fitness, and postural balance; and very low and without effect for flexibility after RE training. For activity, the evidence was very low and with effect for gait and very low and without effect for mobility. For participation (ie, quality of life) the evidence was very low and without effect.ConclusionsAlthough the level of evidence was low to very low, RE was shown to promote improvements in body structure and function (upper limb muscle strength, cardiovascular function, postural balance) and activity (gait). In contrast, RE did not significantly improve participation (quality of life). However, based on the present findings, the practice of RE can be recommended for individuals with PD in the mild to moderate stages.     

Effects of pro-/synbiotic supplementation on anthropometric and metabolic indices in overweight or obese children and adolescents: A systematic review and meta-analysis

Background & aimsExisting evidence on the possible effects of pro-/synbiotics on overweight or obese children and adolescents has not been fully established. Therefore, the present review was undertaken to evaluate the overall effects of pro-/synbiotics supplementation on anthropometric indices and metabolic indices in overweight or obese children and adolescents.MethodsA systematic computerized literature search of PubMed, Scopus, ISI Web of science and Google Scholar databases was conducted up to November 2018. All RCTs using pro-/synbiotics supplements in overweight or obese children and adolescents included in this systematic review and meta-analysis.ResultsOverall 9 randomized trials including 410 subjects were identified for the present meta-analysis. Pooled analysis did not illustrate any significant changes in BMI z-score, waist circumference, weight, body fat, fasting blood sugar and lipid profiles (triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol) after supplementation with pro-/synbiotics for 4–16 weeks. However, subgroup analysis by intervention type revealed a significant reduction of BMI z-score in synbiotic subgroups.ConclusionBased on our findings, modulation of gut microbiota composition through pro-/ synbiotic supplements did not have favorable effects to manage overweight or obese children and adolescents. Further large-scale studies are warranted to confirm present findings.     

Overweightness,obesity and arterial stiffness in healthy subjects: a systematic review and meta-analysis of literature studies

Objective: The relationship between overweightness, obesity and arterial stiffness remains unclear. We performed a meta-analysis evaluating the impact of obesity/overweightness on arterial stiffness in healthy subjects.

Methods: Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies evaluating the relationship between obesity/overweightness and cfPWV, baPWV, and AIx were systematically searched. A total of 10 studies (1,124 obese/overweight subjects, 1,884 controls) were included.

Results: Compared to controls, obese/overweight subjects showed a significantly higher cfPWV (SMD 0.50 m/s; 95%CI 0.15, 0.86; P = 0.005), baPWV (SMD 0.41 m/s; 95% CI 0.08, 0.74; P = 0.014), and AIx (SMD 1.02;95%CI 0.16, 1.87; P < 0.0001). When analyzing ‘high quality’ studies, the difference in arterial stiffness among obese/overweight subjects and controls remain (SMD 0.73 m/s; 95%CI 0.16, 1.30; P = 0.013).

Conclusion: Arterial stiffness, a recognized marker of cardio vascular risk, is increased in obese/overweight subjects without overt cardiovascular diseases.     

The effects of adiposity,muscular strength,cardiorespiratory fitness,and fatigue on gait biomechanics in overweight and obese children

BackgroundObesity rates continue to increase in the child population. Muscular strength, cardiorespiratory fitness, and fatigue can potentially affect joint stresses in obese children. The purposes are to examine: (1) the relationship between cardiorespiratory fitness and the change in joint stress pre- to post-fatigue; (2) the predictive value of fitness, adiposity, and muscular strength on joint stresses in fatigued and non-fatigued states; and, (3) the relationships between % body fat from skinfold and air displacement plethysmography.MethodsTwenty-seven children, with body mass index above the 85th percentile for their age participated in this study. Lower limb joint moments were recorded before and after a fatiguing Progressive Aerobic Cardiovascular Endurance Run protocol. Linear regression was used to assess the relationship between (1) fitness and change in joint stress pre- to post-fatigue, and (2) measures of %body fat using skinfold and plethysmography. Furthermore, Bland-Altman analysis quantified the agreement between measured adiposity using the two methods.FindingsThe strongest relationship was observed between fitness and the change in the knee extensor moment pre- to post-fatigue (R² = 0.24). Regardless of fatigue state, adiposity and strength were identified as the strongest predictors of joint moments. Skinfold estimates were moderately predictive (R² = 0.56) of %body fat from air displacement plethysmography, and these two measures demonstrated instrument agreement with no proportional bias.InterpretationFitness level is not related to changes in biomechanics pre- to post-fatigue in overweight and obese children. Adiposity and lower extremity strength most strongly influenced joint moments in the frontal and sagittal planes.     

Cardiometabolic Health of Chinese Older Adults With Diabetes Living in Beijing, China

ABSTRACT Objectives: Using the PRECEDE-PROCEED model, this study examined the presence of metabolic syndrome and modifiable cardiovascular disease (CVD) risk factors associated with metabolic syndrome among Chinese adults with diabetes living in Beijing, China.
Design and Sample: The cross-sectional study collected data through face-to-face interviews. The study included 73 Chinese older adults with diabetes. Their mean age was 68 years (±7.66), with a range from 52 to 90 years.
Measurements: Data were collected on demographic characteristics, blood pressure (BP), body mass index (BMI), waist circumference, lipid profile and fasting glucose, physical activity, diet, and health status.
Results: The great majority (85%) had metabolic syndrome; 65% had hypertension; 52% had high levels of low-density lipoproteins, and 80.6% had a high level of fasting glucose. Half of the participants (51.4%) were overweight, 16.7% were obese, and 86.3% had central obesity. Age, gender, BMI, income, insurance, smoking history, physical activity, and diet explained 23% of the variance in the metabolic syndrome component, systolic blood pressure.
Conclusions: The association of predisposing and enabling factors and health behavior with the metabolic syndrome needs to be further explored. Persons with diabetes should have regular health screenings to check for blood pressure, BMI, cholesterol, glucose, and triglycerides in order to decrease the risks associated with metabolic syndrome and CVD.     

The Effectiveness of Instrument-Assisted Soft Tissue Mobilization in Athletes,Participants Without Extremity or Spinal Conditions,and Individuals with Upper Extremity,Lower Extremity,and Spinal Conditions: A Systematic Review

ObjectiveTo assess the effectiveness of instrument-assisted soft tissue mobilization (IASTM) to other treatments or placebo in athletes or participants without extremity or spinal conditions and individuals with upper extremity, lower extremity, and spinal conditions.Data SourcesThe MEDLINE, EMBASE, CINAHL, and PEDro electronic databases were searched from January 1998 to March 2018.Study SelectionRandomized controlled trials of participants without extremity or spinal conditions or athletes and people with upper extremity, lower extremity, or spinal conditions, who revived IASTM vs other active treatment, placebo, or control (no treatment), to improve outcome (function, pain, range of motion).Data ExtractionTwo independent review authors extracted data, assessed the trials for risk of bias using the Cochrane Risk of Bias tool in included studies, and performed the rating of quality of individual trials per outcome across trials was also performed using the Grading of Recommendations, Assessment, Development, and Evaluations guidelines.Data SynthesisNine trials with 43 reported outcomes (function, pain, range of motion, grip strength), compared the addition of IASTM over other treatments vs other treatments. Six trials with 36 outcomes reported no clinically important differences in outcomes between the 2 groups. Two trials with 2 outcomes displayed clinically important differences favoring the other treatment (without IASTM) group. Six trials with 15 reported outcomes (pressure sensitivity, pain, range of motion, muscle performance), compared IASTM vs control (no treatment). Three trials with 5 outcomes reported no clinically important differences in outcomes between the 2 groups. Furthermore, in 1 trial with 5 outcomes, IASTM demonstrated small effects (standard mean difference range 0.03-0.24) in terms of improvement muscle performance in physically active individuals when compared to a no treatment group.ConclusionThe current evidence does not support the use of IASTM to improve pain, function, or range of motion in individuals without extremity or spinal conditions or those with varied pathologies.     

Adipose Tissue,Muscle, and Function: Potential Mediators of Associations Between Body Weight and Mortality in Older Adults With Type 2 Diabetes

OBJECTIVEStudies in type 2 diabetes report both increased mortality for normal weight and no evidence of an obesity paradox. We aimed to examine whether adipose tissue, muscle size, and physical function, which are known to vary by weight, mediate associations between BMI and mortality.RESULTSThe median follow-up was 6.66 years, and there were 85, 59, and 44 deaths among normal weight, overweight, and obese participants, respectively. There was no mortality risk for obese participants and an increased risk among normal weight compared with overweight participants (HR 1.72 [95% CI 1.12–2.64]). Associations remained with adjustment for adipose tissues and knee extensor strength; however, mortality risk for normal weight was attenuated following adjustment for thigh muscle (HR 1.36 [95% CI 0.87–2.11]) and gait speed (HR 1.44 [95% CI 0.91–2.27]). Linear regression confirmed with bootstrapping indicated that thigh muscle size mediated 46% of the relationship between normal weight and mortality.CONCLUSIONSNormal weight participants had elevated mortality risk compared with overweight participants. This paradoxical association was mediated in part by muscle size.     

Relationships between Body Mass Index and Social Support,Physical Activity,and Eating Habits in African American University Students

PurposeWe aimed to examine the relationships between obesity and the level of social support for healthy behaviors, amount of physical activity (PA), and dietary habits in African Americans.MethodsThe subjects were 412 university students who visited a health promotion center at North Carolina A&T State University, Greensboro, NC, USA between September 1, 2009 and April 30, 2010. We administered a social support survey, the National Institutes of Health Fruit, Vegetable, and Fat Screener, the Paffenbarger PA Questionnaire, and measures of body mass index, waist circumference (WC), and blood pressure. Data were analyzed using a one-way analysis of variance and logistic regression analyses.ResultsResults showed that men in the overweight group had WC and systolic blood pressure (SBP) measurements associated with increased risk of cardiovascular disease (CVD) and below average PA; those in the obese group had WC, SBP, and diastolic blood pressure (DBP) measurements associated with CVD risk and below average PA. Women in the overweight group had WC and SBP measurements associated with CVD risk, and those in the obesity group had WC, SBP, and DBP measurements associated with CVD risk and below average PA. Logistic regression analysis showed that increasing PA by 1,000 kcal/week decreased the prevalence of obesity by 9.3% in men and 9.0% in women.ConclusionThus, low PA was a significant risk factor for obesity among African Americans. However, the level of social support and consumption of fruits, vegetables, and fat were not found to be significant risk factors in this study.     

Use of Virtual Reality in Burn Rehabilitation: A Systematic Review and Meta-analysis

ObjectivesWe systematically reviewed published clinical trials to evaluate the effectiveness of virtual reality (VR) technology on functional improvement, pain relief, and reduction of mental distress among burn patients undergoing rehabilitation.Data SourcesSystematic searches were conducted in 4 databases, including PubMed, the Cochrane Library, Embase, and Web of Science, from inception to August 2021.Study SelectionRandomized controlled trials (RCTs) evaluating any type of VR for the rehabilitation in burn patients with dysfunction were included.Data ExtractionTwo reviewers evaluated the eligibility, and another 2 reviewers used the Cochrane risk of bias assessment tool to assess the risk of bias. The extracted data included the main results of rehabilitation evaluation (quality of life [QOL], work performance, range of motion [ROM] of joints, hand grip and pinch strength, pain, fun, anxiety), the application performance of VR (realness and presence), adverse effects (fatigue and nausea), and characteristics of the included studies. Heterogeneity was evaluated using the chi-square tests and I² statistics. Random- or fixed-effects models were conducted to pool the effect sizes expressed as standardized mean differences (SMDs).Data SynthesisSixteen RCTs with 535 burn patients were included. VR-based interventions were superior to usual rehabilitation in QOL and work performance of burn patients and produced positive effect on the average gain of ROM (SMD=0.72) as well. VR was not associated with improved hand grip and pinch strength (SMD=0.50, 1.22, respectively) but was associated with reduced intensity, affective, and cognitive components of pain (SMD=−1.26, −0.71, −1.01, respectively) compared with control conditions. Ratings of fun in rehabilitation therapy were higher (SMD=2.38), and anxiety scores were lower (SMD=−0.73) than in control conditions.ConclusionsVR-based burn rehabilitation significantly improves the QOL and work performance of burn patients, increases the ROM gain in the joints, reduces the intensity and unpleasantness of pain and the time spent thinking about pain, increases the fun in the rehabilitation therapy, reduces the anxiety caused by the treatment, and has no obvious adverse effects. However, it did not significantly improve hand grip or pinch strength.     

Walking Activity,Body Composition and Blood Pressure in Adults with Intellectual Disabilities

Background Individuals with intellectual disabilities engage in limited physical activity which places their health at risk. This study examined the walking activity, body composition and blood pressure of adults with intellectual disabilities. Methods A group of male and female adults (n = 103) wore a pedometer for 7 days and were categorized into walking levels based on step counts. Measures of health variables were also taken. Results Mean blood pressure was 126/82 mmHg and 125/79 mmHg for males and females, respectively. Approximately 80% of the sample was overweight or obese. Most participants accumulated 5000–7999 steps/day while the fewest accumulated >10 000 steps/day. Individuals who walked more did not have significantly lower blood pressure or healthier body composition. Conclusion The intensity of walking may have been inadequate for individuals in the higher walking levels to achieve health benefits. Furthermore, intake of high‐fat food may have contributed to blood pressure and body composition and countered the benefits of walking.     

Cardiac markers of multisystem inflammatory syndrome in children (MIS-C) in COVID-19 patients: A meta-analysis

ObjectiveA meta-analysis of laboratory cardiac markers for multisystem inflammatory syndrome in children (MIS-C) was performed in patients with coronavirus disease 2019 (COVID-19).MethodsEight databases were searched until April 10, 2021, for studies on cardiac markers, including B-type natriuretic peptide (BNP)/N-terminal pro-BNP (NT-proBNP), troponin, aspartate aminotransferase (AST), in MIS-C patients.ResultsOf the 2583 participants enrolled in 24 studies, 1613 patients were diagnosed with MIS-C. MIS-C patients exhibited higher BNP levels than patients with non-severe COVID-19 [SMD (95% CI): 1.13 (0.48, 1.77), p < 0.05]. No significant differences in BNP levels were observed between patients with MIS-C and severe COVID-19 [SMD (95% CI): 0.29 (−0.07, 0.65), p = 0.117]. Comparisons of MIS-C patients to all COVID-19 patients revealed no significant differences in levels of troponin [SMD (95% CI): 0.13 (−0.07, 0.32), p = 0.212] or AST [SMD (95% CI): 0.10 (−0.11, 0.31), p = 0.336]. Compared to patients with non-severe MIS-C, those with severe MIS-C exhibited higher levels of BNP [SMD (95% CI): 0.26 (0.04, 0.48), p < 0.05], but no differences in troponin [SMD (95% CI): 0.05 (−0.06, 0.16) p = 0.387] or AST [SMD (95% CI): 0.19 (−0.34, 0.71), p = 0.483] were observed. Moreover, there was no significant difference in BNP [SMD (95% CI): −0.21 (−1.07, 0.64), p = 0.624] or troponin [SMD (95% CI): −0.07 (−0.45, 0.31), p = 0.710] between MIS-C with and without coronary artery abnormality. Sensitivity analyses were performed to assess stability. No publication bias was detected based on Begg's test.ConclusionsThe key cardiac marker that showed differences between patients with MIS-C/non-severe COVID-19 and between patients with severe/non-severe MIS-C was BNP. Other markers, such as troponin and AST, did not exhibit notable differences in indicating cardiac injury between patients with MIS-C and COVID-19.     

Mindfulness-based stress reduction for overweight/obese women with and without polycystic ovary syndrome: Design and methods of a pilot randomized controlled trial

IntroductionMindfulness-based stress reduction (MBSR) may be beneficial for overweight/obese women, including women with polycystic ovary syndrome (PCOS), as it has been shown to reduce psychological distress and improve quality of life in other patient populations. Preliminary studies suggest that MBSR may also have salutary effects on blood pressure and blood glucose. This paper describes the design and methods of an ongoing pilot randomized controlled trial evaluating the feasibility and effects of MBSR in PCOS and non-PCOS women who are overweight or obese (NCT01464398).Methods and designEighty six (86) women with body mass index ≥ 25 kg/m², including 31 women with PCOS, have been randomized to 8 weeks of MBSR or health education control, and followed for 16 weeks. The primary outcome is mindfulness assessed with the Toronto Mindfulness Scale. Secondary outcomes include measures of blood pressure, blood glucose, quality of life, anxiety and depression.DiscussionOur overall hypothesis is that MBSR will increase mindfulness and ultimately lead to favorable changes in blood pressure, blood glucose, psychological distress and quality of life in PCOS and non-PCOS women. This would support the integration of MBSR with conventional medical treatments to reduce psychological distress, cardiovascular disease and diabetes in PCOS and non-PCOS women who are overweight or obese.