Resveratrol (RSV), a natural polyphenol, has been suggested to influence glucose and lipid metabolism. However, the underlying molecular mechanism of its action remains largely unknown due to its multiple biological targets and low bioavailability. In this study, we demonstrate that RSV supplementation ameliorates high-fat-diet (HFD)-induced gut microbiota dysbiosis, enhancing the abundance of anti-obesity bacterial strains such as Akkermansia, Bacteroides and Blautia. The critical role of gut microbiota in RSV-mediated anti-obesity effects was confirmed through antibiotic-induced microbiome depletion and fecal microbiota transplantation (FMT), which showed that RSV treatment effectively mitigates body weight, histopathological damage, glucose dysregulation and systematic inflammation associated with HFD. Metabolomics analysis revealed that RSV supplementation significantly increases the levels of the gut microbial flavonoid catabolite 4-hydroxyphenylacetic acid (4-HPA). Notably, 4-HPA was sufficient to reverse obesity and glucose intolerance in HFD-fed mice. Mechanistically,4-HPA treatment markedly regulates SIRT1 signaling pathways and induces the expression of beige fat and thermogenesis-specific markers in white adipose tissue (WAT). These beneficial effects of 4-HPA are partially abolished by EX527, a known SIRT1 inhibitor. Collectively, our findings indicate that RSV improve obesity through a gut microbiota-derived 4-HPA-SIRT1 axis, highlighting gut microbiota metabolites as a promising target for obesity prevention.

Obesity is characterized by macrophage infiltration into adipose tissue. White adipose tissue remodelling under inflammatory conditions involves both hypertrophy and adipogenesis and is regulated by transcription factors, which are influenced by bone morphogenetic protein (BMP) signalling. MicroRNAs (miRNAs) regulate gene expression and are involved in obesity-related processes such as adipogenesis. Therefore, we identified differentially expressed miRNAs in the epididymal white adipose tissue (eWAT) of mice fed a normal diet (ND) and those fed a high-fat diet (HFD). The expression of miR-6402 was significantly suppressed in the inflamed eWAT of HFD-fed mice than in ND-fed mice. Furthermore, Bmpr2, the receptor for BMP4, was identified as a target gene of miR-6402. Consistently, miR-6402 was downregulated in the inflamed eWAT of HFD-fed mice and in 3T3-L1 cells (preadipocytes) and differentiated 3T3-L1 cells (mature adipocytes) , and BMPR2 expression in these cells was upregulated. Adipogenesis was induced in WAT by BMP4 injection (in vivo) and in 3T3-L1 cells by BMP4 stimulation (in vitro), both of which were inhibited by miR-6402 transfection. Inflamed eWAT showed higher expression of BMPR2 and the adipogenesis markers C/EBPβ and PPARγ, which was suppressed by miR-6402 transfection. Our findings suggest that miR-6402 is a novel anti-adipogenic miRNA that combats obesity by inhibiting the BMP4/BMPR2 signalling pathway and subsequently reducing adipose tissue expansion.

The cardioprotective effects of semaglutide 2.4 mg reported in the SELECT cardiovascular (CV) outcomes trial (ClinicalTrials.gov NCT03574597) provide clinical benefit for subjects with overweight or obesity and established CV disease without type 2 diabetes (T2D). We assessed cost-effectiveness of semaglutide 2.4 mg in this population against the American College of Cardiology/American Heart Association value framework.

A cohort-level Markov-state cost-effectiveness model using trial-derived data with outcomes from a healthcare sector perspective measured over a lifetime horizon was developed. Treatment costs were based on US list prices; scenario analyses used literature-reported estimated rebates. Healthcare costs and benefits were discounted at 3.0%. A simulated cohort of 100,000 subjects was aligned to the SELECT trial population baseline characteristics and time-on-treatment. Subjects received either semaglutide 2.4 mg or placebo in addition to standard of care (SoC). Modelled outcomes included clinical events (CV events, progression to T2D, chronic kidney disease [CKD]) and health economic measures, including direct costs and quality-adjusted life years (QALYs).

Mean semaglutide 2.4 mg treatment duration was 2.79 years. Per 100,000 subjects, treatment avoided 2,791 non-fatal myocardial infarctions, 3,000 coronary revascularizations, 487 non-fatal strokes, and 115 CV deaths over the modeled lifetime horizon. Average per-subject lifetime treatment costs were $47,353; savings arose from avoided T2D ($14,431), CKD ($2,074), and CV events ($1,512). Semaglutide 2.4 mg was associated with increased lifetime costs ($29,767), additional QALYs gained (0.218) and an incremental cost-effectiveness ratio of $136,271/QALY at list price; a scenario using an empirically estimated 48% rebate predicted $32,219/QALY.

The generalizability of observations from SELECT to a broader US population is unknown. Our model does not capture all outcomes nor costs that may be affected by weight loss. Modeling assumptions may present limitations.

Semaglutide 2.4 mg use as in SELECT is cost-effective at list price, using a $150,000/QALY willingness-to-pay threshold.

This study aimed to investigate the association of novel obesity indicators (lipid accumulation product [LAP] and cardiometabolic index [CMI]) with asymptomatic intracranial arterial stenosis (aICAS), particularly in different obesity statuses.

The study included 1994 participants (aged ≥ 40 years) from the Rose Asymptomatic Intracranial Artery Stenosis (RICAS) study, free of stroke or transient ischemic attack. Participants with aICAS were screened using transcranial Doppler ultrasound and diagnosed via magnetic resonance angiography. Multivariate logistic regression and receiver operating characteristic (ROC) curves were used to explore the association of LAP or CMI with aICAS.

A total of 146 participants were diagnosed with aICAS. Higher levels of LAP and CMI were associated with aICAS, particularly with moderate-to-severe aICAS. Notably, LAP was significantly associated with aICAS (OR 1.58; 95 % CI, 1.00-2.49; P = 0.048), and was showed the highest area under the curve (AUC, 0.654) among the three indicators (LAP, CMI, and BMI) in underweight and normal weight participants (Body mass index [BMI] ≤23.9 kg/m²). In the obesity population (BMI ≥28.0 kg/m2), CMI was significantly associated with aICAS (OR 1.40; 95 % CI, 1.11-1.77; P = 0.005), and was showed the highest AUC (0.610).

This study found a positive association between elevated levels of LAP or CMI and aICAS. Furthermore, LAP was significantly correlated with aICAS in underweight and normal weight individuals, while CMI was associated with aICAS in obesity individuals. Our findings may provide additional risk stratification information for aICAS.

Number needed to treat (NNT), an outcome measure derived from the estimated risk results of clinical trials, is widely used to demonstrate value to stakeholders by identifying how many patients require treatment to avoid one event of interest. However, NNTs calculated for primary trial endpoints may underestimate a treatment's value by not considering other outcomes. In this secondary analysis of data from the SELECT cardiovascular (CV) outcomes trial, we aimed to determine the NNT for semaglutide for major adverse cardiovascular events (MACE), in addition to NNTs when other clinically and payer-relevant outcomes are included.

This study is a secondary analysis of data from the randomized, double-blind SELECT trial (ClinicalTrials.gov NCT03574597) of once-weekly subcutaneous administration of semaglutide compared with placebo in 17,604 patients with overweight or obesity and with established cardiovascular disease (CVD) (39.8 months mean follow-up). The outcomes were NNT3P-MACE (based upon the trial's composite primary endpoint of death from cardiovascular causes, non-fatal myocardial infarction, non-fatal stroke), NNTEXTENDED (inclusive of NNT3P-MACE, hospitalization for any cause, coronary revascularization, and non-CV death), and NNTCKM (inclusive of NNTEXTENDED, glycated hemoglobin level [HbA1c] ≥ 6.5%, and a 5-point nephropathy composite).

The relative risk reductions observed for the events comprising the NNTs were 20% (NNT3P-MACE), 20% (NNTEXTENDED), and 41% (NNTCKM). At 1 and 4 years post initiation of semaglutide, NNT3P-MACE was 125 and 58, NNTEXTENDED was 49 and 25, and NNTCKM was 20 and 11, respectively.

When clinically and payer-relevant outcomes from the SELECT trial are included in calculations of NNT, semaglutide was associated with greater risk reductions and lower estimates of NNT than for the primary endpoint alone. Our findings suggest that including the broader effects of semaglutide beyond the primary trial endpoint recognizes additional value to stakeholders.

Limited literature addresses the association between pollution, stress, and obesity, and knowledge synthesis on the associations between these three topics has yet to be made. Two reviewers independently conducted a systematic review of MEDLINE, Embase, and Web of Science Core Collection databases to identify studies dealing with the effects of semi-volatile organic compounds, pesticides, conservatives, and heavy metals on the psychosocial stress response and adiposity in humans, animals, and cells. The quality of papers and risk assessment were evaluated with ToxRTool, BEES-C instrument score, SYRCLE's risk of bias tool, and CAMARADES checklist. A protocol for the systematic review was registered on PROSPERO. Of 1869 identified references, 63 were eligible after title and abstract screening, 42 after full-text reading, and risk of bias and quality assessment. An important body of evidence shows a positive association between pollution, stress response, and obesity. Pollution stimulates the hypothalamic-pituitary-adrenal axis by activating the glucocorticoid receptor signaling and transcriptional factors responsible for adipocyte differentiation, hyperphagia, and obesity. Endocrine-disrupting chemicals also alter the Peroxisome Proliferator-activated Receptor gamma pathway to promote adipocyte hyperplasia and hypertrophy. However, these associations depend on sex, age, and pollutant type. Our findings evidence that pollution promotes stress, leading to obesity.

To quantitatively synthesize published evidence on the association between 24-hour movement behavior composition with adiposity in children and adolescents aged 3-18 years.

Systematic literature searches were conducted in five electronic databases to identify papers published between January 2015 and January 2024. A machine learning-assisted systematic review was conducted to identify studies applying compositional data analysis to examine the association between 24-hour movement behaviors and adiposity in children and youth. Random effect meta-analyses were estimated to examine the relative association between each component of the 24-hour movement behavior composition and body mass index z-score (zBMI), waist circumference, fat mass percentage, and fat mass index (FMI).

A total of 16 studies reporting on 15,230 children and youth were included in the review. Most studies reported on zBMI (k = 14), followed by waist circumference (k = 5), body fat percentage (k = 3), and FMI (k = 2). Spending more time sleeping and engaged in moderate-to-vigorous intensity physical activity (MVPA) relative to other behaviors was associated with lower adiposity, while spending more time sedentary and engaged in light-intensity physical activity was associated with higher adiposity.

These results provide support for most recommendations of the 24-hour movement behavior guidelines, including getting an adequate amount of sleep, limiting sedentary time, and engaging in MVPA, to improve adiposity outcomes.

High body mass index (BMI) is a well-established cancer risk factor. Reliable, updated data are essential for guiding public health policies and designing effective interventions to reduce the cancer burden associated with high BMI.

Data from the Global Burden of Disease Study 2021 on cancer burden attributable to high BMI were analysed globally, stratified by sex, age, geographic region, cancer type, and socio-demographic index (SDI). Temporal trends in age-standardized rates from 1990 to 2021 were evaluated using estimated annual percentage changes.

In 2021, cancer attributable to high BMI resulted in 356.74 thousand deaths (95% uncertainty interval: 146.12-581.01) and 8.89 million (3.75-14.38) Disability-Adjusted Life Years (DALYs), with females bearing the largest burden. From 1990 to 2021, age-standardized rates of high BMI-related cancer deaths increased by 0.35% annually, while DALYs rose by 0.42% annually. In 2021, the burden of cancer deaths and DALYs attributable to high BMI varied considerably across geographical regions. Low-middle SDI regions experienced the largest increases in death and DALY rates attributable to high BMI, while these rates declined in high SDI regions. Colon and rectum cancers accounted for the greatest number of deaths and DALYs, while pancreatic cancer showed the most rapid growth in attributable burden.

High BMI is a major contributor to the global cancer burden, with significant variation by sex, cancer type, region, and SDI level. Targeted public health strategies are urgently needed to mitigate the growing impact of overweight and obesity on cancer.

The aim of this study was to assess the prevalence of body mass index (BMI) documentation by general practitioners (GPs) in Germany and identify associated patient characteristics and determinants.

A retrospective cross-sectional analysis was conducted using data from the IQVIA Disease Analyzer database, which provides anonymized medical data from over 3000 office-based GPs and specialists in Germany. The study included 989 955 patients aged ≥18 years who visited their GP in 2023 and were categorized based on whether they had documented BMI. The prevalence and likelihood of BMI documentation were assessed across age group, sex, health insurance and several health disorders. Associations were analysed using multivariable logistic regression.

BMI documentation was recorded for only 10.8% of the patients. The prevalence increased with age (7.3% for ≤40 years to 13.8% for those >70 years) and with the number of health disorders (7.3% for patients with no disorders to 23.2% for patients with more than four disorders). No notable differences were observed between sexes or insurance. Multivariable logistic regression revealed that older age groups (61-70 years: OR = 1.46, 95% CI: 1.43-1.49) and disorders such as obesity (OR = 2.15, 95% CI: 2.01-2.21) and type 2 diabetes mellitus (OR = 2.12, 95% CI: 2.08-2.17) had the strongest association with BMI documentation.

BMI is not documented routinely by GPs in Germany. However, older age and the presence of several disorders increase the likelihood of recording this information. These findings underscore a need to prioritize obesity assessment and management in primary care settings in Germany.

Obesity during childhood is a critical public health issue. The summer break from school is a time when children are prone to accelerated weight gain. We aimed to investigate how obesity prevention or treatment programs implemented over the summer affect anthropometric measures or weight-related behaviors.

Published studies examining the impact of obesity prevention/treatment interventions targeting the summer with anthropometric or weight-related behaviors in children (5-18 years old) were identified using systematic searches of Medline, Cochrane, Scopus, CINAHL, PsycINFO, and EMBASE until April 2024. The summarized effect estimate was computed by applying the random-effects approach. The evidence certainty was assessed using GRADE.

Forty-seven studies were identified for inclusion. The majority of studies identified focused on physical activity and dietary habits. Only six studies that examined the effects of prevention interventions on weight, body mass index (BMI), and waist circumference (WC) were meta-analyzed. There was no evidence that prevention interventions impacted children's weight, BMI, and WC. However, most of the studies included in the systematic review indicated beneficial effects of interventions for anthropometric measures.

There was no evidence that summertime obesity interventions targeting physical activity and dietary intake were effective in the prevention of obesity in children.

Healthy adults are consistently falling below national and international recommendations for physical activity and dietary intake across Europe. This study took a co-creative approach with adult samples from five European countries to qualitatively and quantitatively establish motivators, barriers and sustaining factors for positive health behaviour change. Stage 1 delivered a newly-designed online programme, creating a community who identified challenges, motivators and solutions to sustaining positive healthy eating and physical activity behaviours. Stage 2 administered an online survey (developed from Stage 1 findings) to a larger sample to quantify the relative importance of these motivators and barriers. Results from both stages indicated enjoyment, positive emotions, and reward as key motivators for both behaviours across all five countries. Barriers included habit-breaking difficulties, temptation and negative affective states. Those with a high BMI placed more importance on social pressure than those with healthy BMI. Participants' reports of motivators and barriers reflected relevant approaches from consumer science, behavioural economics, and psychology. Interventions supporting adults who are not chronically ill but would benefit from improved diet and/or physical activity should not focus exclusively on health as a motivating factor. Emphasis on enjoyable behaviours, social engagement and reward will likely improve engagement and sustained behaviour change.

Obesity and its complications contribute to the burden of cardiovascular disease (CVD). Here, we characterised individuals with high body mass index (BMI) and established CVD by assessing healthcare resource utilisation (HCRU) and costs, incidence of cardiovascular (CV) events and mortality.

This was a retrospective open cohort study using UK Discover data (study period: January 2004 to December 2019). Included were individuals aged ≥45 years with BMI ≥ 27 kg/m2, without type 1 or type 2 diabetes, and with established CVD (previous myocardial infarction, stroke or peripheral artery disease). Serial annual cross sections were assembled to generate prevalence and incidence cohorts and for mapping of HCRU, costs and the incidence of selected events. CVD and mortality trajectories were modelled using a Markov model. HCRU and costs were layered onto this model to obtain associated trajectories.

In 2019, annual per-person healthcare costs for individuals with high BMI and established CVD (n = 27 313) were £3364. During 2015-2019, the incidence of major adverse CV events was 2812 per 100,000 person-years; the incidences of all-cause and CV mortality were 2896 and 774 per 100,000 person-years, respectively. Over 2022-2031, this population is projected to accrue estimated healthcare costs of £40.8 million. HCRU trajectory drivers included a history of CV events, older age, and multimorbidity.

Owing to a high disease and treatment burden, people with a history of CVD living with high BMI incur substantial healthcare costs and are at risk of mortality.

Metabolic bariatric surgery (MBS) reduces the risk of new-onset hypertension; however, it is unclear whether this effect varies according to patient sex, age, or socioeconomic background. This study aimed to assess the risk of new-onset arterial hypertension after MBS, with a special focus on these patient characteristics.

This follow-up study with matched controls was nested in a large employee cohort, the Finnish Public Sector study, consisting of individuals with no hypertension at baseline. For each patient who underwent laparoscopic MBS between 2008 and 2016, two propensity-score matched controls were selected from individuals hospitalized with a diagnosis of obesity or individuals with self-reported severe obesity [body mass index (BMI) ≥ 35 kg/m 2 ] but no recorded history of MBS. Cases of new-onset hypertension were identified via linked electronic health records from the national health registries until December 31, 2016.

The study included 912 patients and 1780 matched controls. The rate of new-onset hypertension per 1000 person-years was 2.8 in the surgery group and 9.6 in the control group, with a rate ratio of 0.29 (95% confidence intervals 0.15-0.57) and a rate difference of -6.8 (95% confidence intervals -9.6 to -4.0) per 1000 person-years. No significant differences in rate reduction after MBS were observed to be associated with patient sex, age, or socioeconomic status.

Metabolic bariatric surgery reduces the risk of new-onset arterial hypertension across all age-, sex-, and socioeconomic subgroups.

Dectin-1, a key innate immune receptor, plays a critical role in cellular responses and is implicated in chronic inflammation and metabolic syndromes. This study addresses a pivotal gap in elucidating the regulatory mechanism governing Dectin-1 expressionin obesity and diabetes, hypothesizing that hyperglycemia and TNF-α synergistically upregulate Dectin-1 in adipose tissue (AT), thereby exacerbating inflammatory responses and contributing to metabolic dysfunction.

The study included 95 overweight and obese Kuwaiti individuals, categorized into prediabetic (HbA1c < 6.5%) and diabetic (HbA1c ≥ 6.5%) groups. Anthropometric and clinical measurements were recorded. AT biopsies were obtained for RNA extraction and immunohistochemistry. Pre-adipocytes from lean and obese individuals were cultured, differentiated into adipocytes, and treated with TNF-α under normal or high-glucose conditions to assess Dectin-1 expression. Chromatin immunoprecipitation (ChIP) assays analyzed NF-κB binding to the Dectin-1 promoter. Wildtype and TNF-α-/- mice were used to evaluate TNF-α's effect on Dectin-1 expression in AT.

Our data demonstrate that hyperglycemic obesity significantly induces Dectin-1 expression in AT through the TNF-α/NF-κB signaling pathway. In a cohort of 95 obese individuals, subdivided into prediabetics (HbA1c < 6.5%, n = 49) and diabetics (HbA1c ≥ 6.5%, n = 46), a strong positive correlation was observed between AT Dectin-1 transcripts and plasma HbA1c levels exclusively in diabetic participants, underscoring the specificity of Dectin-1 upregulation in hyperglycemic conditions. Elevated Dectin-1 expression was consistently associated to increased inflammation markers. Immunohistochemical analysis revealed co-localization and concurrent upregulation of Dectin-1 and TNF-α proteins in hyperglycemic AT. Functional assays in TNF-α deficient mice and human adipocytes further validated that TNF-α and hyperglycemia act cooperatively to regulate Dectin-1 expression. Mechanistically, we demonstrated that NF-κB directly binds to the Dectin-1 promoter, mediating its transcriptional activation in response to glucose and TNF-α.

This study significantly advances the understanding of upregulation Dectin-1 in metabolic inflammation, filling a crucial niche in diabetes research and suggesting new therapeutic targets for obesity-related metabolic disorders.

To examine the relationship between body mass index (BMI) growth rates, body composition, and cardiometabolic markers in preschool children.

Three-year-old children were recruited for this cohort study. BMI and body composition measurements were obtained at enrollment, with multiple BMI measurements spanning ages 1 month to 3 years extracted from medical records. Levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), uric acid (UA), and fasting plasma glucose were measured at 3 years. Data analyses employed piecewise linear mixed models and logistic regression models.

Out of 3822 children recruited, 3015 were included in the analysis. The accelerated BMI z-score growth rate between 6 and 24 months was positively correlated with high TG and LDL-C levels, with sex, birthweight, and size for gestational age disparities. Obesity increased the risks of high TG level and the highest RC quartile in boys. Fat mass index and percentage of fat mass were linked with high UA level and dyslipidemia, particularly high TG and non-HDL-C levels, in boys. Fat-free mass index showed negative associations with high levels of TC and non-HDL-C in boys and high LDL-C level in girls (P < .05).

This study underscores the significant impact of BMI growth rates and body composition on cardiometabolic markers in 3-year-old children. The effects of BMI growth rates in specific periods varied by sex, birthweight, and size for gestational age, and boys exhibited a higher susceptibility to adverse outcomes.

Both cardiorespiratory fitness (CRF) and obesity have been well-established as predictors of cardiometabolic risk and mortality. This study sought to investigate the joint association of CRF and adiposity measures with all-cause and cardiovascular (CVD) mortality in a cohort of patients with stable CVD.

Data were extracted from the ITER registry. The sample was composed of 2860 cardiac patients involved in an exercise-based secondary prevention program between 1997 and 2023. Patient CRF was estimated using the 1-km treadmill walking test, and measures of body mass index (BMI) and predicted body fat percentage (pBF%) were determined. Cox proportional hazard models were used to determine associations with mortality. All results were adjusted for demographic and clinical confounders.

A total of 1034 deaths (463 of CVD) occurred over a median of 11 years. Each of the fitness-fatness combinations was associated with an increased risk of mortality as compared with normal weight-fit or low pBF%-fit groups. As regards BMI, compared to the reference group, higher mortality risks were observed for overweight-unfit (HR = 1.93: 95% CI, 1.55-2.41; P < .0001), and obese-unfit patients (HR = 1.63: 95% CI, 1.28-2.08; P < .0001). Similar magnitudes were detected in the moderate pBF%-unfit (HR = 2.47: 95% CI, 1.99-3.06) and high pBF%-unfit (HR = 2.07: 95% CI, 1.69-2.54; P < .0001) groups. A similar pattern was observed for CVD mortality.

While overweight and obesity have been associated with an increased risk of death, maintaining CRF can mitigate this risk. These findings support the fundamental role of CRF in exercise assessment and prescription in secondary prevention programs.

The aim was to establish the community prevalence of central obesity in Botswana and assess its association with HIV status.

We performed a one-time central obesity assessment nested within a community-based cluster-randomised controlled HIV treatment and prevention trial (Botswana Combination Prevention Project (BCPP)) conducted in Botswana.

The BCPP enrolled consenting adults from a random sample of 20% of households in 30 rural/peri-urban communities.

A subset of participants from 22 communities was selected for a nested central obesity study.

Central obesity was defined as a waist-to-hip ratio (WHR)>0.90 for males and >0.85 for females or as a waist circumference (WC) ≥94 cm for males and ≥80 cm for females. A modified Poisson regression model was used to ascertain the association between central obesity and HIV status. Additionally, the same model was used to estimate the adjusted prevalence ratio (aPR) for central obesity among participants with missing waist and hip measurements by applying inverse probability weighting, and then adjusting for sex and age in the final multivariate models.

Of the 3981 adults, 2039 (51%) completed central obesity assessment (67% female, 29% people living with HIV and median age 35.4 years (IQR 26.4-48.3 years). Central obesity prevalence was 43.5% (95% CI 41.4% to 45.7%) and 50.8% (95% CI 48.6% to 52.9%) as defined by WHR and WC, respectively, and was higher among females than males by WHR (46.9% (95% CI 44.2% to 49.5%) vs 36.7% (95% CI 33.1% to 40.4%)) and WC 68.5% ((95% CI 65.9% to 70.9%) vs 15.1% (95% CI 12.4% to 17.8%)) and increased with age. In fully adjusted models, there was no difference in central obesity by HIV status for both WHR and WC, aPR 0.99 (95% CI 0.90 to 1.09), p value 0.88, and 0.93 (95% CI 0.85 to 1.01), p value 0.06, respectively.

Over two-thirds of adult females in Botswana had central obesity; however, living with HIV was not consistently associated with central obesity.

NCT01965470.

Poor dietary intake during young adulthood can increase the risk of chronic diseases, which are rising concerns in low- and middle-income countries (LMICs). This scoping review examined dietary intake among young adults in LMICs, highlighting their energy and nutrient intakes. Ovid MEDLINE, PubMed, Scopus, Web of Science, and EBSCOhost databases were searched to identify observational studies published in English from January 1, 2014 to July 31, 2024. Rayyan.ai was used to remove duplicates and facilitate the selection process, which two researchers independently carried out. Studies that reported on the energy and nutrient intake of healthy young adults aged 18 to 30 years in LMICs were included. A total of 14 studies were included (nine from upper-middle-income countries, five from lower-middle-income countries, zero from low-income countries). Most of the studies are cross-sectional studies (71.4%). The energy intake of young adults from upper-middle-income countries ranges from 1700 to 2400 kcal/day, while young adult women in lower-middle-income countries showed trends of low-energy intake and insufficient micronutrient intake. Most of the energy intake reported came from carbohydrates, followed by fat and protein. The findings highlighted a significant gap in data from low-income countries, underscoring the need for further research to inform policies and design effective interventions.

Coronary artery disease (CAD) outcomes are influenced by social determinants, including marital status. However, research on the sex-specific effects of marital status on CAD outcomes is limited. This study aimed to evaluate the relationship between marital status and clinical outcomes of patients with CAD stratified according to sex in Korea.

A total of 3476 patients with CAD who underwent percutaneous coronary intervention (PCI) were enrolled in this retrospective observational study. Patients were categorized into married and nonmarried groups based on demographic data at the time of admission. The primary endpoint was all-cause mortality.

Among the study population, 20.7% of women and 11.5% of men who underwent PCI for CAD were nonmarried. For 87.1% of nonmarried women, the cause of being nonmarried was the death of a spouse, whereas for 48.3% of unmarried men, the most common cause was being unmarried. During a median follow-up of 53.3 months, in analysis using the Cox proportional hazard regression model, nonmarried status was associated with higher all-cause [adjusted hazard ratio (HR): 2.24, 95% confidence interval (CI): 1.22-4.09, P = 0.009] and cardiovascular (adjusted HR: 2.63, 95% CI: 19.91-5.80, P = 0.017) deaths in men but not in women.

Marital status independently predicted the adverse outcomes in men with CAD but not in women, highlighting the importance of sex-specific approaches to the assessment of social determinants in cardiovascular care. Future studies should explore broader social and economic factors to inform targeted interventions.

Aboriginal and Torres Strait Islander (Indigenous) Australians experience a disproportionately higher prevalence of obesity compared with non-Indigenous Australians. We aimed to describe existing research into lifestyle, pharmacological or surgical interventions for preventing or treating obesity in Indigenous Australians.

A systematic review of published and grey literature was performed. Medline, Embase, Emcare (on the OVID platform), Web of Science and website searches were conducted to April 2024. Observational and randomised studies of adult Indigenous Australians were included if an intervention was implemented to prevent and/or treat obesity and post-intervention results were reported. The PRISMA systematic review reporting methods was used to collate data.

Of 1019 records screened, 17 were included; most described educational initiatives or lifestyle programs for improving diet and exercise. There were no reports of pharmacotherapies for weight management. The effect of lifestyle programs on weight reduction was modest (∼2-4 kg after 4-12 months). There were five reports on short-term (12 week) structured exercise programs. Two non-randomised studies of structured exercise showed reduction in weight in the highest weight groups whilst the two randomised trials showed ∼2 kg weight reduction compared with control. One observational study described mean ∼26 kg weight reduction at two years after laparoscopic adjustable gastric banding in 26 Indigenous Australians.

Community-based lifestyle interventions to manage excess weight can be successfully conducted in Indigenous Australians, but with generally limited efficacy. Providing background community-based lifestyle programs may facilitate the conduct of randomised trials of newer, effective anti-obesity pharmacotherapy in this high priority population.

Metabolic dysfunction-associated fatty liver disease (MAFLD), a condition that stems from hepatic lipid accumulation in the absence of liver damage and overt inflammation, has become the most common hepatic disorder worldwide. Hydrogen sulfide (H2S), a gasotrasmitter, endogenously generated mainly by cystathionine-γ lyase (CTH), cystathionine-β synthase (CBS) and 3-mercaptopyruvate sulfurtransferase (MPST) enzymes, exhibits protective effect in steatosis. Herein, we have demonstrated that CTH and MPST play a central role in MAFLD pathogenesis. Young Cth/Mpst knockout (Cth/Mpst-/-) mice, fed a normal diet, had increased liver mass caused by enhanced hepatic lipid accumulation. Decreased insulin and glucose sensitivity was observed in CTH/MPST-deficient mice. At the cellular level, CTH/MPST inhibition resulted in increased lipid deposition and glucose uptake in hepatocytes. Transcriptome analysis revealed significant upregulation of cholesterol biosynthesis and SREBP-related genes in the liver of Cth/Mpst-/- mice. Transcription factor enrichment analysis of differentially expressed genes between two genotypes, revealed a major impact of LXR, RXR and PPARA in the observed phenotype. Sulfide donor (SG1002) treatment attenuated the fatty liver disease of CTH/MPST-deficient mice. Our findings underline the importance of endogenously produced H2S in the pathogenesis of MAFLD and introduce the Cth/Mpst-/- mouse as a new animal model of early onset hepatic steatosis.

Comparing the effects of 8 weeks of aerobic (AE) and resistance exercise (RE) on cardiovascular function in obese young adults. Exploring the mechanisms of resistance exercise on cardiovascular function. 44 subjects (22.4 ± 2.7 years, female/male: 26/18) were randomly divided into the AE and RE group. AE group performed platform running with 70-75% heart rate max. RE group performed deep squat, bench press, and hard pull training in sequence with 70-75% 1 repetition maximum. Body composition, cardio-vascular function indicators were measured before and after the interventions. After eight weeks, body fat percentage was reduced in both groups (AE: P < 0.0001, RE:P = 0.03). Hemodynamic indices (P < 0.05), endothelium-dependent diastolic function (AE:P = 0.01, RE:P = 0.024) and endothelial nitric oxide synthase (P < 0.0001) were increased. Both AE and RE exercise increased cardiac function (P < 0.05). The RE group (P = 0.002) had a significantly higher muscle mass. Brachial-ankle pulse wave conduction velocity (left: P = 0.006; right: P < 0.0001) was significantly lower in the AE group. Both AE and RE significantly reduced the body fat percentage, improved cardiac function, hemodynamic, and vascular endothelial function in obese young adults. AE has a stronger effect on reducing arterial stiffness, whereas resistance exercise has a stronger effect on building muscle, but does not change arterial stiffness.

Features of neighbourhoods affect body mass index (BMI) but this has been poorly acknowledged within the highly heterogeneous and unequal contexts of Latin American cities. We evaluated associations between social, built, and natural environment characteristics of neighbourhoods with BMI, and investigated whether these associations were modified by individual socioeconomic position (SEP).

We linked individual data (n = 43 968) from national health surveys to data on neighbourhoods (n = 3428) and cities (n = 165) in Argentina, Chile, Colombia, and Mexico. Linear mixed models were used to estimate associations between neighbourhood education, intersection density, and greenness with BMI, adjusting for individual- and city-level characteristics.

Associations between neighbourhood education and BMI varied by country, in both magnitude and direction. In Argentina and Chile, higher neighbourhood education was associated with lower BMI. This negative association was also observed among women in Colombia and Mexico, although it was weaker. Among men in Colombia and Mexico, however, the association was positive. Associations of neighbourhood intersection density and greenness with BMI were less robust. In general, we did not find strong evidence of effect modification by individual SEP.

Neighbourhood education is associated with BMI beyond individual and city characteristics, although the associations are heterogenous across countries and by gender. Associations with built and natural features were less clear. Our results highlight the relevance of context-specific analysis for planning interventions that are aimed to reduce BMI and its unequal distribution in Latin American cities.

Obesity is a major public health crisis associated with high mortality rates. Previous genome-wide association studies (GWAS) investigating body mass index (BMI) have largely relied on imputed data from European individuals. This study leveraged whole-genome sequencing (WGS) data from 88,873 participants from the Trans-Omics for Precision Medicine (TOPMed) Program, of which 51% were of non-European population groups. We discovered 18 BMI-associated signals (P < 5 × 10-9), including two secondary signals. Notably, we identified and replicated a novel low-frequency single nucleotide polymorphism (SNP) in MTMR3 that was common in individuals of African descent. Using a diverse study population, we further identified two novel secondary signals in known BMI loci and pinpointed two likely causal variants in the POC5 and DMD loci. Our work demonstrates the benefits of combining WGS and diverse cohorts in expanding current catalog of variants and genes confer risk for obesity, bringing us one step closer to personalized medicine.

This research seeks to evaluate the worldwide burden, health inequities, and projected trends of pediatric urolithiasis from 1990 through 2021. We calculated age-standardized incidence rates, prevalence rates, and disability-adjusted life years rates from the 2021 Global Burden of Disease database. Joinpoint regression was applied for time-trend analysis. Health disparities were measured by using Spearman correlation analysis, Relative Concentration Index, and Slope Index of Inequality. Bayesian Age-Period-Cohort models predicted future global age-standardized incidence rates trends. Global age-standardized incidence rates declined from 79 (95% confidence interval [CI], 38-132) cases per 100,000 population in 1990 to 75 (95% CI, 37-124) cases per 100,000 in 2021, although the total number of cases rose. Age-standardized incidence rates decrease sharper in high Socio-Demographic Index regions. Geographical differences reveal significant health disparities, with age-standardized disability-adjusted life years rates higher in countries with a low Socio-Demographic Index. Bayesian Age-Period-Cohort models forecast a slight rise in global age-standardized incidence rates.

While global age-standardized incidence rates for pediatric urolithiasis have shown a downward trend, the increasing number of cases and persistent age-standardized disability-adjusted life years rates burden in low-SDI regions underscore pressing concerns. Efforts focused on prevention, early detection, and equitable access to healthcare are critical to bridging these gaps and improving global outcomes.

• Pediatric urolithiasis imposes a significant global burden, with higher recurrence rates and long-term impacts on kidney function. • The incidence of urolithiasis in children varies greatly in different countries or regions around the world.

• This study provides the comprehensive analysis of global trends and health inequalities in pediatric urolithiasis from 1990 to 2021 using GBD 2021 data. • Persistent inequalities remain, with disadvantaged regions bearing heavier burdens despite global improvements.

Roux-en-Y gastric bypass (GBP) surgery is an effective treatment for reducing body weight and correcting metabolic dysfunction in individuals with severe obesity. Herein, we characterize the differences between very low energy diet (VLED) and GBP induced weight loss by multi-omic analyses of microbiome and host features in a non-randomized, controlled, single-center study. Eighty-eight participants with severe obesity were recruited into two arms - GBP versus VLED with matching weight loss for 6 weeks and 2-years of follow-up. A dramatic shift in the distribution of gut microbial taxa and their functional capacity was seen in the GBP group at Week 2 after surgery and was sustained through 2 years. Multi-omic analyses were performed after 6 weeks of matching weight loss between the GBP and VLED groups, which pointed to microbiome derived metabolites such as indoxyl sulphate as characterizing the GBP group. We also identified an inverse association between Streptococcus parasanguinis (an oral commensal) and plasma levels of tryptophan and tyrosine. These data have important implications, as they reveal a significant robust restructuring of the microbiome away from a baseline dysbiotic state in the GBP group. Furthermore, multi-omics modelling points to potentially novel mechanistic insights at the intersection of the microbiome and host.

Obesity, a main driver of cardiovascular morbidity, contributes to endothelial dysfunction and inflammation in adipose tissues. Perivascular adipose tissue (PVAT) surrounds arteries and influences vascular function. In obesity, immune cells, including myeloperoxidase (MPO)-releasing myeloid cells, accumulate in PVAT. In this study, we show MPO levels to correlate with body weight and endothelial function in obese patients (n = 33) and mice. In addition, MPO deficiency reduces immune cell frequency, enhances PVAT beiging via soluble guanylyl cyclase β1 (sGC-β1), and increases oxygen consumption in vivo. Further, nitrotyrosine formation and inflammatory cytokine release are attenuated in obese Mpo-/- mice. Mechanistically, adiponectin (APN) secretion improves endothelial function and reduces arterial stiffness. In vitro, MPO-treated human white adipocytes show lower APN and brown adipocyte marker expression but increased inflammation. Thus, MPO impairs vascular function via PVAT inflammation and suppression of vasoprotective mediators, making it a potential therapeutic target in obesity-related cardiovascular disease.

Produce prescription programs may improve dietary quality and health but have not been well tested among adults with food insecurity and obesity.

Our aim in this pilot randomized controlled trial was to examine the feasibility and preliminary effects of ProduceRx, a produce program combined with behavioral weight loss counseling, compared with wait-list control (WLC).

Adults with obesity and food insecurity (N = 32) were randomly assigned to ProduceRx or WLC. ProduceRx had weekly counseling sessions and received $20 of produce vouchers weekly, whereas WLC had a 12-week wait period before enrolling in the program. All participants completed assessments at baseline and 12 weeks.

The retention rate was 90.6%. Groups did not differ significantly in changes in dietary quality, food security, mood, and stress. ProduceRx lost 2.4% ± 0.7% of initial body weight, which was more than WLC who gained 0.4% ± 0.7% (P = .01). Compared with WLC, ProduceRx had significantly greater improvements in eating self-efficacy (P = .04).

Produce prescriptions combined with behavioral weight loss demonstrated preliminary feasibility and efficacy in helping adults with food insecurity and obesity.

Obesity and overweight problems in public health have substantial impacts which affect the health status of individuals and community well-being and healthcare service provision worldwide. This scoping review aims to identify and classify factors from social, technological, environmental, economic and political domains which influence obesity and overweight conditions. The systematic analysis of determinants in this study generates usable information to guide public health intervention design and obesity epidemic management strategies.

The study utilized the ProQuest, ISI Web of Science, PubMed, and Scopus databases, and it also included grey literature in its analysis. The research objectives focused on identifying factors that contribute to overweight or obesity issues. The researchers used framework analysis to examine the qualitative data collected from these studies.

The synthesis incorporated 121 research studies which satisfied the established criteria. This comprised 98 studies from 46 different countries, 17 studies conducted at the international level, and 6 studies involving multiple countries. Eighty-two factors influencing overweight and obesity were identified as determinants and categorized into five main categories: sociocultural, economic, technological, environmental, and political. Most of the identified determinants belong to the socio-cultural category, which demonstrates their substantial impact on lifestyle and health behaviors.

The implementation of public health prevention and intervention programs depends on complete knowledge of all factors that affect overweight and obesity rates. This issue needs a comprehensive approach which analyzes sociocultural aspects together with economic, technological, environmental, and political factors, as well as other policy goals within defined societal challenges. Effective solutions to resolve this situation depend on multi-sectoral collaboration to tackle obesity and promote health-enhancing factors for the entire community.