Browsing by Author "Loyce Nahwera"

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    Exercise as a preventive and therapeutic strategy for non- communicable diseases in people living with HIV: evidence, mechanisms and clinical implications
    (BMJ Open Sport & Exercise Medicine, 2026-03-30) Mwebaze, Nicholas; Timothy Makubuya; Loyce Nahwera; Annet Nankwanga; Denis Bwayo; Evert Verhagen
    Objective To synthesise evidence on exercise for preventing and managing non- communicable diseases (NCDs) among HIV clients, emphasising sub- Saharan Africa. Design Narrative review. Data sources Meta- analyses, randomised trials, cohort studies, mechanistic investigations and implementation reports involving adolescents and adults aged 15+ Priority was given to cardiometabolic, musculoskeletal, neurocognitive, immunological, behavioural, safety, feasibility and low- and middle- income country outcomes. Rationale People living with HIV face elevated risk of cardiovascular disease, heart failure and type 2 diabetes due to persistent immune activation, chronic inflammation and treatment related metabolic effects. Exercise is a scalable, low- cost intervention with broad benefits. Results Aerobic and combined aerobic plus resistance training performed ≥3 times weekly for ≥5 weeks improves cardiorespiratory fitness and functional capacity with moderate effects, without adverse effects on CD4 or viral load. Resistance and concurrent training increase strength and lean mass and may attenuate bone mineral density loss. Exercise reduces depressive symptoms, improves quality of life and benefits attention and executive function. Mechanistic studies report reduced pro inflammation, improved endothelial function, enhanced mitochondrial capacity and greater antioxidant defence. Feasibility is high with appropriate screening and progression and with adaptations for neuropathy, frailty, pregnancy, low bone density and multimorbidity. Task shifting, digital or community delivery improve uptake despite limited evidence. Conclusions Exercise should be integrated into HIV and NCD care using frequency, intensity, time and type principles. Programmes require risk stratification, age and sex sensitivity and behaviour change support. Further research should evaluate mechanistic endpoints, high- intensity interval training dosing, pragmatic delivery models and economic outcomes in low- and middle- income countries.
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    Physiological sex differences in response to exercise
    (Turkish Journal of Kinesiology, 2025-08-31) Nicholas, Mwebaze; Timothy Makubuya; Mark Kamwebaze; Matia Mwase; Ricky Richard Ojara; Paul Opio; Linika Lumbuye; Loyce Nahwera
    Physiological sex differences influence how males and females respond to exercise due to variations in hormonal profiles, muscle mass distribution, cardiovascular capacity, and training load tolerance. Males typically have 10–15% greater hemoglobin concentrations and higher maximal oxygen uptake of (VO₂max) relative to body weight, enhancing aerobic performance, while females generally possess higher body fat percentage, lower absolute muscle mass, and greater reliance on lipid metabolism during submaximal exercise. Estrogen supports membrane stability, antioxidant defense, and fat oxidation, whereas testosterone drives hypertrophy, strength gains, and red blood cell production. Hormonal fluctuations across the menstrual cycle alter performance, with the follicular phase favoring endurance and the luteal phase potentially increasing fatigue. Females often experience greater GI discomfort but lower sweat rates than males, who lose more body fluid and require more aggressive hydration strategies. Males show greater creatine kinase and myoglobin responses, reflecting more structural muscle damage and delayed on set of muscle soreness severity, while females benefit from faster recovery via estrogen-mediated protection. Training load thresholds also differ: males tolerate higher absolute external loads but risk overtraining without sufficient recovery; females may face higher relative internal loads and greater susceptibility to endocrine disruption such as relative energy deficiency in sport. Tailoring exercise programming to these sex-specific cardiovascular, metabolic, hormonal, thermoregulatory, inflammatory, and recovery profiles can optimize performance, minimize injury risk, and improve long-term adaptation.