Methods— Data were extracted and filtered from electronic databases PubMed (MEDLINE), CINAHL, Embase, PsycINFO, and Scopus. Intervention effects were represented by Hedges’ g and combined into pooled effect sizes using random effects models. Heterogeneity was evaluated using the Chi-squared (Q) and I-squared statistics.
Results— Five studies met inclusion criteria, representing data from 182 participants. The primary analysis produced a positive overall effect of aerobic exercise on cognitive performance (Hedges’ g [95% confidence interval]= 0.42 [0.007–0.77]). Effects were significantly different from zero for aerobic interventions combined with other physical activity interventions (Hedges’ g [CI] =0.59 [0.26 to 0.92]), but not for aerobic interventions alone (P= 0.40). In specific subdomains, positive moderate effects were found for global cognitive function (Hedges’ g [CI] =0.79 [0.31 to 1.26]) but not for attention and processing speed (P=0.08), executive function (P= 0.84), and working memory (P=0.92).
Conclusions— We determined that aerobic exercise combined with other modes of training produced a significant positive effect on cognition in adults after stroke in the subacute and chronic phases. Our analysis supports the use of combined training as a treatment option to enhance long-term cognitive function in adults after stroke. Further research is needed to determine the efficacy of aerobic training alone.
A brief history of the Mediterranean diet and its geographical origins as a meeting point for cultures will guide understanding of the construction of this specific dietary pattern. The nutrients and foods typical of the Mediterranean diet will be outlined as well as their health benefits, allowing for a deeper analysis of the ways in which the Mediterranean diet is associated with reducing the risk of certain chronic diseases. The lifestyle choices and physical activity practiced adjacently to the diet will establish the positive synergistic effects of conviviality and moderate exercise on general human health. Contemporary movements in the Mediterranean region, like Slow Foods, aim to preserve traditional dietary and lifestyle choices. In comparison, the U.S. food system seems to be most shaped by the influences of globalization and industrialization. Economic and health-cost perspectives as well as the role of modern-day media in diet trends, body image, and food marketing will establish and deepen the complexities of food choices and health disparities in Western societies. The diagnosis of the Mediterranean Diet in the U.S. as a solution to poor general population health will be challenged and holistic perspectives on eating will provide an exploratory lens for understanding health and food choice as a modern-day consumer.