Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 4 appraisals
Journal of affective disorders
Machine learning and SHAP-based interpretation of dietary antioxidants' impact on comorbid MDD and suicidal ideation.
OBJECTIVE: To develop and validate a machine learning model for predicting major depressive disorder (MDD) with suicidal ideation (SI) by incorporating dietary antioxidants, and to elucidate the specific contribution of these antioxidants in the prediction. METHODS: Data were obtained from NHANES 2007-2010. Dietary antioxidants, including vitamins, minerals, and polyphenols, were the primary predictors. Demographic, lifestyle, and health-related variables were also included. Collinear variables were removed, class imbalance was corrected, and data were normalized prior to modeling. Twelve machine learning algorithms were compared using a systematic benchmarking protocol within the sklearn framework: Random Forest (RF), LightGBM, AdaBoost, XGBoost, Extra Trees, CatBoost, Gradient Boosting Decision Trees, Support Vector Machine, Decision Tree, Gaussian Naïve Bayes, Stochastic Gradient Descent, and K-Nearest Neighbors. SHapley Additive exPlanation (SHAP) values were calculated to interpret feature contributions within the best-performing model. RESULTS: A total of 9306 participants were included, of whom 247 with MDD comorbid with SI. After preprocessing, 31 dietary antioxidants and 9 demographic and health-related variables were retained for modeling. The RF classifier achieved the highest performance with an accuracy of 83%, precision of 0.825, recall of 0.838, area under the ROC curve of 0.927, and F1 score of 0.831. SHAP analysis identified vitamin C, kaempferol, myricetin, peonidin, luteolin, eriodictyol, hesperetin, pelargonidin, and zinc as the most influential predictors. CONCLUSION: The RF model exhibited superior predictive capability for comorbid MDD and SI. SHAP analysis highlighted the critical roles of dietary antioxidants, particularly vitamin C and kaempferol, in predicting these outcomes.
15 May 2026
Read appraisal →PloS one
Effects of β-alanine supplementation on kickboxing-specific anaerobic performance, neuromuscular power, and strength endurance: A randomized, double-blind, placebo-controlled trial
β-Alanine (BA) elevates skeletal muscle carnosine and may improve repeated high-intensity performance; however, evidence in kickboxing is limited. This study investigated the effects of 4-week BA supplementation on sport-specific kickboxing anaerobic performance, neuromuscular power, and strength endurance in trained male kickboxers. Twenty-eight athletes were randomly assigned to BA (6.4 g·day ⁻ ¹; n = 14) or placebo (n = 14) in a double-blind, placebo-controlled design. Pre- and post-intervention assessments included the Kickboxing Anaerobic Speed Test (KAST₁-₅, KASTbest, KASTtotal, Performance Decrement Index [PDI]), neuromuscular power (countermovement jump [CMJ], squat jump [SJ]), and strength endurance tests (push-up, pull-up). Baseline differences were tested via t-tests, effect sizes calculated according to Hedges' g formula. Group × time effects were analyzed using two-way repeated-measures ANOVA with partial eta squared (ηp²) effect sizes. Baseline measures were comparable (all p > 0.05). After supplementation, no significant group × time interactions emerged for CMJ (p = 0.148), SJ (p = 0.717), KAST₁-₅ (all p > 0.05), KASTbest (p = 0.071), or PDI (p = 0.454). However significant improvements were observed in the BA group for KASTtotal (F(1,26) = 14.49, p < 0.001, ηp² = 0.358), push-ups (F(1,26) = 5.89, p = 0.023, ηp² = 0.185), and pull-ups (F(1,26) = 9.79, p = 0.004, ηp² = 0.274). Four weeks of BA supplementation enhanced total anaerobic performance (KASTtotal) and upper-body strength endurance (push-up, pull-up), while no significant changes were observed in neuromuscular jump performance (CMJ, SJ). BA appears to be a practical ergogenic aid for improving repeated-effort and strength-endurance capacity in kickboxing. Clinical trial registration ClinicalTrials.gov (NCT07319052).
15 May 2026
Read appraisal →Journal of the International Society of Sports Nutrition
Effects of eight weeks of eicosapentaenoic acid and medium-chain triacylglycerol structured lipid intake on EPA/AA ratio and muscle performance in young men
BACKGROUND: Structured triglycerides (STGs), in which eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are esterified with medium-chain triglycerides (MCTs), have demonstrated greater bioavailability and potential benefits in improving endurance and reducing post-exercise strength loss compared with physical mixtures (PMs) of EPA and MCTs. However, it remains unclear whether STGs have superior effects on blood EPA levels and muscular endurance and fatigue. This study compared the effects of 8-week STG and PM intake on blood EPA levels, muscular endurance, and fatigue following resistance exercise. METHODS: Twenty-eight healthy young men were randomly assigned to an STG group (n = 15) or a PM group (n = 13) in a double-blind, parallel-group, active comparator trial. Participants consumed 4,560 mg/day of the test oil (600 mg EPA, 260 mg DHA) for 8 weeks. After the intervention, the participants performed four sets of leg extensions to exhaustion at 40% of their body weight. Muscular endurance was assessed by the number of repetitions, and fatigue was evaluated by changes in maximal voluntary contraction, range of motion, thigh circumference, muscle thickness, echo intensity, and jump performance. RESULTS: The STG group showed a significantly greater increase in the serum EPA/arachidonic acid (AA) ratio compared with the PM group. However, no significant differences were found between groups in repetition counts or fatigue-related measures. CONCLUSION: Eight weeks of STG supplementation improved the blood EPA/AA ratio more than a PM, but did not yield superior effects on muscle endurance or fatigue.
18 Apr 2026
Read appraisal →Food & function
The effect of anthocyanins through diet and supplementation on cognitive function in older adults: a multi-centre randomised controlled clinical trial
Anthocyanins, a flavonoid subclass present in certain blue, purple and red fruits and vegetables, have potential neuroprotective properties due to their anti-inflammatory, antioxidant, and signalling effects. Clinical and epidemiological studies of anthocyanins provide promising evidence for attenuation of memory loss and improved cognitive function. We investigated the effects of anthocyanins, provided through diet or supplementation, on cognitive function and related parameters. A multi-centre, 24-week randomised, parallel 3-arm clinical trial was conducted in participants aged 60-85 years with self-reported memory complaints and scoring ≤13 on the Memory Index Score within the Telephone Montreal Cognitive Assessment (T-MoCA). Participants were randomised to high anthocyanin diet, freeze-dried product derived from blackcurrants (250 mg anthocyanins per day), or control (placebo). The primary outcome was auditory episodic memory functioning. Secondary outcomes were additional cognitive functions, subjective memory complaints and self-reported depression symptoms, blood pressure, inflammatory biomarkers, lipid profile, vascular and microvascular endothelial function tests. Mixed linear modelling evaluated changes over time using both intention-to-treat and completer analyses. Of 110 participants enrolled (mean age 69.2 years SD 6.7; 36 males, 74 females), 94 completed the study. There was no treatment × time effect on any primary or secondary outcomes. We postulate that the potential anti-inflammatory, antioxidant, and signalling effects of anthocyanins were insufficient to significantly modulate any outcomes due to participants' overall good health and lack of relevant cognitive decline. We recommend future interventional studies focus on subjects with diagnosed cognitive impairment, such as MCI and dementia, and those with more severe comorbidities, particularly chronic inflammatory conditions. Trial Sponsor: National Health and Medical Research Centre (NHMRC) Dementia Collaborative Research Centre.
15 Apr 2026
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