There is limited evidence on secular trends in adiposity among high-altitude children.

To describe secular trends in body mass index (BMI), excess weight and body fat skinfolds (SKF) among Peruvian children living at high altitude and to investigate the risk for excess weight in 2019 relative to 2009.

We sampled 1585 Peruvians aged 6-11 years from the Junín region. Height and weight were measured, and BMI was calculated. WHO cut-offs were used to classify children by weight status. The sum of SKF was used for analysis. BMI and sum SKF were log-transformed. Two-factor ANOVA and post-hoc contrasts were used together with trend plots for BMIlog and SKFlog. Relative risks for excess weight were estimated with 95% confidence intervals. All analyses were done in STATA.

BMIlog and SKFlog means increased in both sexes from 2009 to 2019, with age-specific variation. Between 2009 and 2019, BMI values shifted from near P50 to P75 on WHO percentiles for both sexes in most age groups. The risk of excess weight was not significantly higher for most children in 2019 compared to 2009.

Positive secular trends in BMIlog and SKFlog were observed, with significant increases at specific ages.

Our study aimed to report the burden of diseases attributable to high body mass index (BMI) in Asia from 1990 to 2019.

Utilizing data from the Global Burden of Disease (GBD) Study 2019, we calculated disability-adjusted life years (DALYs) and deaths, with trends quantified by the estimated annual percentage change (EAPC). We also made projections for selected countries and estimated the relationship between the Sociodemographic Index (SDI) and high BMI-related disease burden.

From 1990 to 2019, high BMI-related diseases observed significant increases in the absolute number of deaths and DALYs, with EAPCs of 4.62 and 4.69, respectively, while the age-standardized rates of both deaths and DALYs also showed upward trends, with EAPCs of 1.39 and 1.80. Cardiovascular diseases, diabetes and kidney diseases, and neoplasms were the major contributors to the high BMI-related burden. The burden of high BMI-related diseases generally tended to be greater among males and older age groups. Predictions for selected countries indicated a continued rise in the number of deaths and DALYs for high BMI-related diseases, with a stabilization in the age-standardized rate. There was no significant association between SDI levels and the burden of high BMI-related diseases in Asia (coefficient=0.13, p = 0.39).

The burden of high BMI-related diseases, a major public health issue, was increasing in Asia. To address this problem, coordinated action by governments, civil society and other key stakeholders should be taken to enhance awareness of the risks associated with high BMI and effectively reduce its impact.

To investigate the correlation between skeletal muscle mass to visceral fat area ratio (SVR), neutrophil/lymphocyte ratio (NLR) and insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM).

246 T2DM patients who attended the outpatient clinics and wards of the Department of Endocrinology of the Seventh People's Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2022 to March 2023 were selected as study subjects. General information of the study subjects was collected, body measurements were determined: height, weight, waist circumference, hip circumference, body mass index and waist-hip ratio (WHR) were calculated; biochemical indices were determined: NLR, fasting glucose (FPG), fasting insulin (FINS), and the homeostatic modeling was evaluated. Homeostatic Model Assessment of Insulin Resistance(HOMA-IR), and calculation of insulin sensitivity index (ISI). Skeletal muscle content (ASM), body fat mass(BMI), visceral fat area(VFA), and basal metabolism were determined by multifrequency bio resistive resistance method, and SVR were calculated. 82 cases in each group (50 males and 32 females) were divided into 3 groups according to the SVR level in three equal parts. Differences between groups were analyzed by one-way ANOVA. The correlation between NLR and SVR, HOMA-IR, ISI was analyzed using Pearson/Spearman correlation. Multiple linear regression analysis was used to analyze the relationship between SVR and IR.

Compared with the Q3 group, NLR, FINS, HOMA-IR were elevated in the Q1 and Q2 groups (P < 0.005), and ISI and SVR were decreased (P < 0.005). Correlation analysis showed that NLR was negatively correlated with SVR, and ISI (P < 0.005) and positively correlated with HOMA-IR (P < 0.005). Multiple linear regression analysis showed that SVR and HOMA-IR were independently correlated (F = 25.584,P < 0.001); and SVR and HOMA-IR were independently correlated (F = 46.105,P < 0.001).

SVR is correlated with IR in T2DM patients, suggesting that SVR has some clinical value for early warning of IR in T2DM.

Obesity is a primary global health concern that negatively affects the outcomes of total knee arthroplasty (TKA). To mitigate complications, both cemented and uncemented fixation techniques have been considered. However, there remains no consensus in the literature regarding the optimal fixation method for obese patients despite the renewed interest in uncemented fixation. This systematic review aims to compare the survival rates, causes of failure, and patient-reported outcome measures (PROMs) between cemented TKA (cTKA) and uncemented TKA (uTKA) in the obese population.

A comprehensive literature search was conducted according to PRISMA guidelines across five databases-PubMed, Scopus, Embase, Medline, and Cochrane-focusing on studies directly comparing cTKA and uTKA in obese patients. The ROBINS-I tool was used to assess the risk of bias, while the PRISMA flow diagram guided the study selection process based on predefined inclusion and exclusion criteria. This systematic review was registered on PROSPERO.

Four retrospective studies encompassing 1622 patients met the inclusion criteria and were included in the final qualitative analysis. Among these, 50 % of patients underwent uTKA, with three studies exclusively analyzing individuals with at least class II obesity (BMI ≥35 kg/m2). All four studies reported higher rates of aseptic loosening in the cemented fixation group. However, only two studies demonstrated a statistically significant improvement in implant survival, reduced aseptic loosening, and lower revision rates with cementless fixation in the short-to mid-term follow-up. Regarding clinical outcomes, only one study reported a significant improvement in Knee Society Score (KSS) function, range of motion (ROM), and pain scores in the cementless group compared to the cemented group, particularly in the subgroup analysis of posterior-stabilized constrained TKA.

This systematic review suggests that in obese patients, particularly those with BMI ≥35 kg/m2, cementless fixation offers comparable or superior implant survival rates and lower rates of aseptic loosening compared to cemented fixation in the short-to mid-term follow-up. Furthermore, cementless fixation may provide similar or enhanced clinical outcomes in this high-risk and growing patient population.

Adiposity rebound (AR) corresponds to the start of the second rise in the body mass index curve during infant growth. Early AR (before age 5) confers increased risk of adiposity and metabolic disorders but is less likely to occur in breastfed infants. Although lipids in breast milk are important in child growth, information is limited regarding which lipids are involved in AR. The object of this study was to explore the association between breast milk lipids and AR status in children.

We designed a case-control study of 184 mother-child pairs (AR cases: n = 93; controls: n = 91) included from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Breast milk was collected 1 month postpartum and comprehensive lipid analysis was performed. Partial least square-discriminant analysis was used to explore candidate lipids, and multivariable logistic regression analysis was used to evaluate associations with the AR status of children.

We detected 667 lipid molecules in 12 lipid classes in breast milk. Partial least square-discriminant analysis revealed the association of fatty acid-hydroxy fatty acid (FAHFA) and cholesterol ester (ChE) with AR status. Multivariable logistic regression analysis showed that in pairs with exclusive breastfeeding at 1 month postpartum, FAHFA (odds ratio 1.57 [95% confidence interval, 1.06-2.32]) was positively associated with early AR, and ChE (odds ratio 0.55 [95% confidence interval, 0.36-0.86]) was negatively associated.

Breast milk lipids (FAHFA, ChE) associated with the AR status of children, indicating the potential to regulate a child's adiposity and possible metabolic disorders in adulthood.

The aim of this cross-sectional study was to develop new regression equations for estimating fat mass (FM) and skeletal muscle mass (SMM) in a heterogeneous Caucasian population, using the phase angle (PhA) as a bioelectrical parameter and DXA as the reference method. We also aimed to cross-validate the new equations, and to compare them with the manufacturers' equations.

The 212 healthy Caucasian participants aged 20-65 years were randomly distributed into two groups: development group (n = 141) and validation group (n = 71). Bioelectrical parameters were obtained with a 50 kHz foot-to-hand phase-sensitive body composition analyzer. The new FM percentage (FM%) and SMM percentage (SMM%) equations were developed by performing multiple forward regression analyses. Agreement between DXA and the different equations was assessed by mean differences, coefficient of determination, standard error of the estimate (SEE), concordance correlation coefficient (CCC), and Bland-Altman plots.

The proposed equations explained 89.2% of the variance in the DXA-derived FM% and 91.8% in the DXA-derived SMM%, with low random errors (SEE = 3.04% and 1.92%, respectively), and a very strong agreement (CCC = 0.93 and 0.94, respectively). In addition, they demonstrated no fixed bias and a relatively low individual variability. However, the manufacturer's equations described a lower percentage of the variance, with higher random errors, obtained fixed bias of -5.77% for FM% and 4.91% for SMM%, as well as higher individual variability.

The new regression equations, which include the PhA as a bioelectrical parameter, can accurately predict DXA-derived FM% and SMM% in a heterogeneous Caucasian population, and are better options than the manufacturer's equations.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affected health, economies, and lifestyles, but little is known about its impact on children. We aimed to investigate changes in 24-hour (h) movement behaviours of pre-school children before and during COVID-19, and factors that influenced these. Children aged 3-6 years were recruited in Beijing in 2019, and their movement behaviours over 24 ​h assessed by questionnaire, as part of the International Study of Movement Behaviors in the Early Years (SUNRISE) study. We conducted the survey again during COVID-19, and compared the children's movement behaviours before and during COVID-19 and associated factors. Overall, 196 parents completed the survey at both time points. The percentage of children meeting movement guidelines decreased during the pandemic (p ​< ​0.01). Total physical activity decreased less among children getting good quality sleep or with more adults in the household (p ​< ​0.01). Children who were not cared for primarily by their mother had a greater decrease in moderate to vigorous intensity physical activity (p ​= ​0.02), but the decrease was smaller among children whose parents used the internet to support their physical activity and/or screen time (p ​< ​0.05). Children who used electronic screen devices in the 2 ​h before bedtime or whose parents reported body temperature in webchats had a greater increase in sedentary screen time (p ​< ​0.05). Children spending more time outdoors showed a smaller decrease in sleep (p ​< ​0.01). Overall, children's movement behaviours changed significantly during the pandemic.

Metabolic syndrome (MetS) is recognized as a group of metabolic abnormalities, characterized by clustered interconnected traits that elevate the risks of obesity, cardiovascular and atherosclerotic diseases, hyperlipidemia, and type 2 diabetes mellitus. Non-nutritive sweeteners (NNS) are commonly consumed by those with imbalanced calorie intake, especially in the perinatal period. In the past, accumulating evidence showed the transgenerational and mediated roles of human microbiota in the development of early-life MetS. Maternal exposure to NNS has been recognized as a risk factor for filial metabolic disturbance through various mechanisms, among which gut microbiota and derived metabolites function as nodes linking NNS and MetS in early life. Despite the widespread consumption of NNS, there remain growing concerns about their transgenerational impact on metabolic health. There is growing evidence of NNS being implicated in the development of metabolic abnormalities. Intricate complexities exist and a comprehensive understanding of how the gut microbiota interacts with mechanisms related to maternal NNS intake and disrupts metabolic homeostasis of offspring is critical to realize its full potential in preventing early-life MetS. This review aims to elucidate the effects of early-life gut microbiota and links to maternal NNS exposure and imbalanced offspring metabolic homeostasis and discusses potential perspectives and challenges, which may provide enlightenment and understanding into optimal perinatal nutritional management.

The prevalence of overweight, obesity, and low physical fitness is associated with minimal engagement in physical exercise (PEx) and has increasingly affected children and adolescents in rural areas. This study examines the effects of a 15-minute PEx intervention on the levels of physical fitness and anthropometric indicators of overweight and obesity among rural school students.

A total of 245 school students (135 boys and 110 girls), aged between 11 and 17 years, were randomly allocated into intervention and comparator groups. The intervention lasted for 12 weeks, comprising 24 PEx sessions. Physical fitness was measured through cardiorespiratory fitness, muscular strength/endurance, handgrip strength, lower limb power, flexibility, speed, and agility. The measured anthropometric indicators of overweight and obesity included body mass index, waist circumference, and the sum of subscapular and triceps skinfolds.

Generalized estimating equations analysis, performed with an intention-to-treat approach, indicated significant group × time interaction (P < .05) for flexibility, muscular strength/endurance, handgrip strength, cardiorespiratory fitness (only for boys), and waist circumference. For these 5 variables, there were no differences between groups at the baseline (P > .05), and the intervention group showed significantly greater improvements compared with the comparator group at the postintervention time (P < .05).

An intervention program consisting of 15 minutes of PEx during PE classes, conducted twice a week for 12 weeks, improves cardiorespiratory fitness, flexibility (only for boys), muscular strength/endurance, handgrip strength, body mass index (only for girls), and waist circumference of rural adolescent school students.

The global increase in childhood overweight and obesity presents significant public health concerns due to its long-term health implications. Emerging evidence suggests that exposure to endocrine disrupting chemicals, such as per- and polyfluoroalkylated substances (PFAS), may be obesogenic and contribute to adiposity. This study aimed to investigate the association between prenatal PFAS exposure and markers of adiposity in 7-year-old children, focusing on potential sex-specific differences. Data was analyzed from 881 mother-child pairs in the Odense Child Cohort, Denmark. Maternal serum concentrations of perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) were measured in early pregnancy. At age 7, body composition, including body mass index (BMI), lean mass and fat distribution (total, gynoid, and android), was assessed using dual-energy X-ray absorptiometry (DXA). The median (25th;75th percentile) concentrations of PFHxS, PFOS, PFOA, PFNA, and PFDA were 0.4 (0.2;0.5), 7.6 (5.6;10.4), 1.7 (1.1;2.3), 0.6 (0.5;0.8), and 0.3 (0.2;0.4) ng/mL, respectively. Multiple linear regressions were used to assess sex specific associations between maternal PFAS concentrations and markers of adiposity. In girls, 1 ng/mL increase in maternal PFOA was associated with 2.0 % (95 % confidence interval: 0.3; 3.7) increase in total fat, 1.3 % (-0.3; 2.9) increase in gynoid fat, and 3.8 % (0.6; 7.0) increase in android fat. Associations for PFNA and PFDA followed similar trends, whereas higher maternal PFOS concentrations were associated with lower BMI among both girls and boys. These findings suggest that prenatal exposure to certain PFAS may influence the accumulation of excess fat in girls. Our findings highlight the importance of studying sex specific differences and using accurate measures of body composition as BMI may not adequately reflect body fat in children during growth.

Background: Malnutrition, encompassing underweight (UW) and overweight or obesity (OW/OB), is a global health challenge that significantly impacts children's physical fitness and motor development. Purpose: As limited research exists on these relationships in young children, this study investigated differences in health-related physical fitness (HRPF), motor-related physical fitness (MRPF) and motor skills (MS) in UW and OW/OB children and associations between these fitness characteristics and body composition parameters. Research Design: A cross-sectional study design was used. Sample: 298 children (150 boys, 148 girls; mean age 6.84 ± 0.96 years) was drawn from the ExAMIN Youth SA and the BC-IT studies in the North-West Province of South Africa. Data Collection and Analysis: Measurements included anthropometric measures, body composition assessed using bioelectrical impedance analysis, and evaluations of HRPF, MRPF, and MS). Data were analysed using SPSS (v. 26.0). Results: In the group, 26% were underweight, 11.1% overweight, and 8% obese. OW/OB children had poorer physical and motor fitness (p < .05) and motor skills (p > .05) than normal-weight (NW) peers, while underweight children significantly outperformed both OW and OB and normal-weight children. All body composition parameters were largely and negatively associated with strength, aerobic capacity (r > 0.5), speed, agility and balance in obese children. Fat-free mass, body mass index (BMI), and waist circumference revealed positive, more minor and inconsistent associations (r > 0.2) in NW and UW children. Waist circumference (WC) and FFM correlated positively with balance and catching in UW and NW children, with negative correlations between balance and BMI and WC in overweight and obese groups. Conclusions: These different degrees of associations with physical and motor fitness and motor skills in under- and overweight children are important when designing early interventions to prevent childhood obesity.

Pharmacological treatment of malignant tumors in obese patients has been reported from several perspectives. Physiological changes may affect the kinetics of anticancer drugs (e.g., lipophilicity, distribution volume, and metabolism), consequently affecting their efficacy and safety profile. However, specific guidelines for antineoplastic agent dose adjustment according to body weight, mainly due to the under-representation of obese patients in clinical trials, are currently lacking. Moreover, considering that certain tumor development is associated with obesity, the clinical management of obese patients is often complex. We herein report the antitumor treatment options of three obese patients with malignant tumors and review relevant literature to analyze the dosage of antitumor drugs in this setting. This study aims to provide additional data for the clinical treatment of obese patients with malignant tumors.

In Case 1, carboplatin was administered at a fixed dose, mainly because of neurotoxicity risk. A maximum creatinine clearance rate (glomerular filtration rate) of 125 mL/min is recommended to prevent carboplatin overdose and toxicity. The maximum carboplatin dose was calculated using the following formula: maximum dose = area under the curve (AUC) × (125 + 25). Methotrexate dose was calculated based on the actual body weight of Cases 2 and 3. While receiving methotrexate, the blood drug concentration was within the reference range (24-h reference concentration ≤ 10 μmol/L), and no serious adverse reactions occurred. As seen in the three cases, considering the particularity of some drugs, for example, more than 90% of carboplatin is excreted through the kidney, carboplatin should be administered at a fixed dose, while other chemotherapy drugs can be administered according to the actual body weight as much as possible according to the patient's condition.

The toxicity of chemotherapy has traditionally been assessed based on the actual body weight of obese and non-obese patients. In clinical practice, overweight and obese cancer patients often receive reduced doses of chemotherapy drugs. According to the guidelines set by the American Society of Clinical Oncology, the positive association between the use of chemotherapy and treatment-related toxicity in obese patients lacks evidence. After comprehensive consideration of complications, chemotherapy dose should be determined based on the body surface area(BSA) calculated based on actual body weight, rather than estimated or idealized body weight.

Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide. Epidemiological data demonstrate that the overlap between CVD, Type 2 Diabetes (T2DM), chronic kidney disease (CKD) and heart failure (HF) is becoming increasingly apparent, with aging populations making these patient cohorts more difficult to treat. In the last decade, three standout drug classes have emerged with the potential to broaden the treatment options for patients with multi-morbid CVD and heart failure. These are sodium-glucose cotransporter 2 (SGLT2) inhibitors, non-steroidal mineralocorticoid receptor antagonists (MRAs), e.g., Finerenone, and glucagon-like peptide 1 receptor agonists (GLP-1RAs). These medications are now entering UK and European guidelines for the treatment of CVDs including HF whilst crucially providing associated prognostic benefits for patients with T2DM and CKD. The future of these agents for CVD risk stratification may involve primary care at the forefront, alongside tailored, patient-specific medication regimens. This review article aims to discuss these three main drug classes (SGLT2 inhibitors, GLP-1RAs and non-steroidal MRAs) in detail by exploring their current evidence base across heart failure (HF) and CVD management and future clinical implications of their usage as mainstream medical therapies.

Various types of liver or hepatic diseases cause the death of about 2 million people worldwide every year, of which 1 million die from the complications of cirrhosis and another million from hepatocellular carcinoma and viral hepatitis. Currently, the second most common solid organ transplant is the liver, and the current rate represents less than 10% of global transplant requests. Hence, finding new approaches to treat and prevent liver diseases is essential. In liver diseases, the interaction between the liver, gut, and immune system is crucial, and probiotics positively affect the human microbiota. Probiotics are a non-toxic and biosafe alternative to synthetic chemical compounds. Health promotion by lowering cholesterol levels, stimulating host immunity, the natural gut microbiota, and other functions are some of the activities of probiotics, and their metabolites, including bacteriocins, can exert antimicrobial effects against a broad range of pathogenic bacteria. The present review discusses the available data on the results of preclinical and clinical studies on the effects of probiotic administration on different types of liver diseases.

Excessive weight gain in childhood has been associated with poor health outcomes throughout life span and has a strong tracking effect in adulthood. This study aimed to investigate trends in the prevalence of overweight, obesity and severe obesity among Chinese children from 2010 to 2020.

A total of 42 982 Chinese children aged 2-18 years were included in the Chinese Family Panel Studies carried out every 2 years from 2010 to 2020. Height and mass were reported by them or by their guardians and body mass index was calculated. The prevalence was estimated according to the International Obesity Task Force cut-offs.

There was no significant trend in the prevalence of overweight. The prevalence of obesity and severe obesity for the total population decreased from 8.3% and 3.7% in 2010 to 7.1% and 2.6% in 2020, respectively (p < 0.001). However, these decreases were attributed mostly to children aged 2-6 years and the prevalence increased among children aged 13-18 years. Male, rural residential area and younger age were risk factors for overweight and obesity.

A decrease in the prevalence of excessive weight was a positive finding, but strategies that promote the health and well-being of priority populations were needed.

To analyze the relationship between body fat (BF), motor skills, and physical fitness in children and adolescents.

In total, 216 children and adolescents (143 males and 73 females, aged 5-15 years) from a social project composed this study. Body mass and height were measured to calculate the body mass index (BMI). DXA was used to estimate the percentage of BF and lean soft tissue. The Körperkoordinationstest für Kinder (KTK) was used to assess motor skills (jumping sideways test corresponds to speed, walking backwards to balance, and moving sideways to laterality), modified pull-ups to measure upper limb strength and the 1-mile run/walk test to estimate maximal oxygen uptake.

In the unadjusted models, BF was a significant negative predictor for almost all motor skills and physical fitness variables measured; jumping sideways (β = -0.168, 95%CI = -0.402; 0.039), walking backwards (β = -0.010, 95%CI = -0.011; -0.008), modified pull-ups (β = -0.045, 95%CI = -0.052; -0.037), and 1-mile run/walk (β = -0.18, 95%CI = -0.39; -0.06), but not moving sideways (β = -0.05, 95%CI = -0.12; 0.05). In the model considering sex and age, the significance remained the same as in the model without adjustment. When we added lean soft tissue to these adjustments, all variables were significant; jumping sideways (β = -0.544, 95%CI = -0.834; -0.253), walking backwards (β = -0.007, 95%CI = -0.010; -0.004), modified pull-up (β = -0.020, 95%CI = -0.028; -0.013), 1-mile run/walk (β = -0.386, 95%CI = -0.505; -0.267), and moving sideways (β = -0.07, 95%CI = -0.14; -0.01).

In children and adolescents from a socially assisted background, BF was negatively related to motor skills and physical fitness, regardless of age, sex, and lean soft tissue.

We investigated the effect that increased physical activity (PA) sessions had on the blood pressure of school-aged children who were overweight and obese.

This Polish pilot, prospective study followed up 148 children from six elementary schools from 10 to 12 years of age. They were divided into two groups, based on parental preferences. The 88 children in the standard group received 4 h of compulsory PA sessions a week, and the 60 in the extended group received 10 h. Their height, body mass and blood pressure were measured and their body mass index (BMI) was calculated.

The mean BMI of the standard group remained at the 92nd percentile and decreased in the extended group, from the 95th to the 85th percentile. Between 10 and 12 years of age, the percentage of prehypertensive and hypertensive children in the standard group increased from 39.7% to 48.5% in children who were overweight and from 50.7% to 56.0% in those who were obese. In the extended group, it decreased from 41.4% to 37.0% in those who were overweight and from 51.5% to 45.0% in those who were obese.

Increasing organised school PA sessions reduced blood pressure and decreased hypertension and obesity in children aged 10-12 years.

To evaluate time trends in the incidence and prevalence of neovascular age-related macular degeneration (nAMD) and its treatments, associated factors, and effects on vision in Finland during 2000-2017.

We used three nationwide health examination surveys representing the Finnish population aged 30 years or older. All three surveys were linked to the national care register covering nAMD diagnoses and intravitreal injections between 2000 and 2017. All three surveys included a health examination in which distance and near visual acuity (VA) were measured, as well as self-reported and register-based information on socio-demographic status and lifestyle, health care use, co-morbidities, and quality of life. The data included two cross-sectional time points in 2011 and 2017 and two 11 year longitudinal follow-ups during 2000-2011 and 2006-2017.

The incidence and prevalence of nAMD were two times higher in women than in men. The annual prevalence of nAMD increased from 0.51% to 0.70% and from 0.22% to 0.46% in treated nAMD between 2011 and 2017. Treated nAMD patients had an average of 4 intravitreal injections per treatment year. nAMD patients showed significantly poorer distance and near VA than persons without any AMD in 2011 and 2017 (p < 0.001). However, near VA was significantly better in 2017 than in 2011 among nAMD patients (p = 0.036). The duration of nAMD showed weak negative correlation with distance and near VA. After adjusting for age and sex, nAMD patients showed significantly higher univariable odds ratios for lower distance VA, low consumption of vegetables, living in central Finland, a higher number of hospitalisations per year, and older age compared with persons without any AMD.

Since nAMD is an increasing burden for public health with gender discrepancy and a detrimental impact on vision, we should better find patients who have a high risk of developing nAMD and try to optimise their preventive intervention. Once nAMD is developed, we should understand treatment and follow-up demands at the personalised level. The nationwide register data help us in those challenges.

The LEPR gene is a key focus in obesity research, with studies linking its polymorphisms to various diseases like polycystic ovarian syndrome and energy intake disorders. This study aims to investigate the prevalence of the rs2025804 variant within LEPR and its distribution among healthy individuals across diverse ethnic groups in Iran.

The frequency of the rs2025804 genotype in the LEPR gene was analyzed in 1142 healthy adults representing different ethnicities in Iran. Saliva samples were randomly collected, and genomic DNA was extracted using a standard kit. Genotyping was performed using the Illumina Infinium Global Screening Array-24 BeadChip. Genotype and allele frequencies were calculated using SPSS software version 22, with a 95% confidence level.

Among the 1142 individuals surveyed across 29 provinces, 683 (59.81%) had genotype AA, 408 (35.73%) had genotype AG, and 51 (4.47%) had genotype GG. The allele frequencies for A and G were found to be 1774 (77.67%) and 510 (22.32%), respectively. Our findings show a unique allele distribution compared to other ethnic groups, with genotype AA being the most prevalent (59.81%), followed by AG (35.73%) and GG (4.47%). Allele frequencies are A (77.67%) and G (22.32%).

This study documents the genotype and allele frequencies of rs2025804 in the LEPR gene among healthy Iranians for the first time. Routine LEPR genotyping could potentially serve as a screening tool for obesity-related disorders, given these results. This enhances our understanding of genetic diversity and holds promise for targeted healthcare interventions.

Obesity and aging share biological processes, but their relationship remains unclear, especially in late life. Understanding how body mass index (BMI) and biological aging influence each other can guide strategies to reduce age- and obesity-related health risks. We examined the bidirectional, longitudinal association between changes in BMI and biological aging, measured by frailty index (FI) and functional aging index (FAI), across late life.

This longitudinal cohort study used data from the Swedish Twin Registry substudies, GENDER, OCTO-Twin and SATSA, collected via in-person assessments from 1986 to 2014 at 2- to 4-year intervals. We analysed 6216-6512 evaluations from 1902 to 1976 Swedish twins. Dual change score models were applied to assess the bidirectional, longitudinal association between BMI and FI or FAI from ages 60.0-91.9. FI measured physiological aging, while FAI assessed functional aging through a composite score of functional abilities.

At first measurement, mean age was 74 ± 8, and 41% were males. BMI-FI relationship was bidirectional (p value ≤ 0.001): Higher BMI predicted a greater increase in FI over time (coupling effect [γ] = 0.86, 95% confidence interval [CI] = 0.65-1.06, p value ≤ 0.001), and higher FI predicted steeper decline in BMI (γ = -0.04, 95% CI = -0.05 to -0.03, p value ≤ 0.001). When including coupling from FI, BMI showed a nonlinear trajectory with a mean intercept of 26.32 kg/m2 (95% CI = 25.76-26.88), declining more rapidly after age 75. When including BMI coupling, FI increased from a mean intercept of 7.91% (95% CI = 6.41-9.42), with steeper growth from ages 60-75. BMI-FAI relationship was unidirectional (p value ≤ 0.001): Higher FAI predicted a steeper BMI decline (γ = -0.02, 95% CI = -0.02 to -0.01, p value ≤ 0.001). By including FAI coupling, BMI had a mean intercept of 26.10 kg/m2 (95% CI = 25.47-26.74), declining rapidly after age 75. FAI increased exponentially from a mean intercept of 36.49 (95% CI = 34.54-38.43).

Higher BMI predicted a steeper increase in FI, substantiating the hypothesis that obesity accelerates biological aging. Higher biological aging, measured as FI and FAI, drove a steeper BMI decline in late life, signalling that late-life weight loss may result from accelerated aging. Higher BMI may accelerate aspects of the aging process, and the aging process, in turn, accelerates late-life BMI decline, necessitating an integrated approach to manage both obesity and unintentional weight loss among older adults.

Obesity is a worldwide health crisis and poses significant challenges in critical care. Many studies suggest an 'obesity paradox', in which obesity, defined by body mass index (BMI), is associated with better outcomes. However, the inability of BMI to discriminate between fat and muscle or between visceral adipose tissue and subcutaneous adipose tissue, limits its prediction of metabolic ill health. We suggest that the 'obesity paradox' may be more reflective of the limitations of BMI than the protective effect of obesity. We explore the biological processes leading to visceral fat accumulation, and the evidence linking it to outcomes in critical illness. In the 'spillover' hypothesis of adipose tissue expansion, caloric excess and impaired expansion of storage capacity in the subcutaneous adipose tissue lead to accumulation of visceral adipose tissue. This is associated with a chronic inflammatory state, which is integral to the link between visceral adiposity, type 2 diabetes mellitus, and ischaemic heart disease. We review the current evidence on visceral adiposity and critical illness outcomes. In COVID-19, increased visceral adipose tissue, irrespective of BMI, is associated with more severe disease. This is mirrored in acute pancreatitis, suggesting visceral adiposity is linked to poorer outcomes in some hyperinflammatory conditions. We suggest that visceral adiposity's chronic inflammatory state may potentiate acute inflammation in conditions such as COVID-19 and acute pancreatitis. Further work is required to investigate other critical illnesses, especially sepsis and acute respiratory distress syndrome, in which current evidence is scarce. This may give further insights into pathophysiology and inform tailored treatment and nutrition strategies based on body fat distribution.

The mismatch between chronobiological predispositions and social demands makes it difficult for adolescents with an evening chronotype to maintain healthy habits. This study aimed to explore the interrelationships among chronobiological factors, health practices, and anthropometry in adolescents attending morning and afternoon class shifts. In this cross-sectional study, 925 adolescents (14-19 years old) completed an online questionnaire covering food practices, chronotype, sleep duration, social jetlag, screen time, socioeconomic data, physical activity, school shift, and anthropometric measurements. The interrelationships among these variables were analyzed through structural equation modeling using six path models. Food practices were categorized into "complete meals" (breakfast, lunch, dinner, and bean consumption) - as healthy practices, "unhealthy foods" (sweets, fried snacks, soft drinks, salty ultra-processed foods, and fast food) and "vegetables and fruits," stratified by shift (morning or afternoon), with body mass index by age (BMI/age) as the main outcome. Among students in the morning shift, reduced sleep time was directly associated with increased BMI/age, while longer screen time was negatively associated with complete meal practices and physical activity. In the afternoon shift, a greater tendency towards an evening chronotype among adolescents was associated with reduced complete meal practices and lower regular fruit and vegetable consumption. Sleep duration was positively associated with a greater likelihood of a complete meal practices and regular fruit consumption. Moreover, longer screen time was positively associated with unhealthy food consumption. In both shifts, physically active adolescents consumed fruits more regularly. The practice of regular consumption of complete meals, fruits, vegetables, or unhealthy foods, in addition to being directly influenced by chronotype and other variables, was also influenced by shift. Adolescents with shorter sleep duration were at a higher risk of being overweight, suggesting a direct influence of sleep on anthropometric measurements. Our findings underscore the importance of considering study shifts in future interventions.

Feeding increases plasma bile acid levels while the nucleus of the solitary tract (NTS) and area postrema (AP) of the brain detect changes in hormones to regulate feeding. However, whether an increase in bile acids activates Takeda G protein-coupled receptor 5 (TGR5) in the NTS and/or AP to lower feeding through a negative feedback pathway is unknown. Here, we discover that infusion of TGR5 agonist CCDC in the NTS of male rats lowered food intake without causing conditional taste avoidance in short-term high fat (HF) fed male rats in association with HF-induced increase in TGR5 expression in the NTS. In contrast, CCDC infusion into the AP failed to lower food intake in HF rats with a reduction in TGR5 expression in the AP. CCDC infusion in the NTS activates TGR5 to reverse HF-induced leptin resistance by enhancing a leptin-leptin receptor-STAT3 signaling axis selectively in the NTS to lower feeding. Finally, metabolomic analysis indicated that HF impaired a refeeding-induced rise of endogenous TGR5 ligand deoxycholic acid in the plasma and subsequently in the NTS in association with hyperphagia, while direct infusion of deoxycholic acid in the NTS of HF rats activated TGR5 to lower feeding and enhanced leptin-STAT3 signaling, thereby altogether demonstrating physiological and pharmacological activation of TGR5 in the NTS regulates food intake. In summary, we discover that an activation of TGR5 in the NTS enhances leptin-STAT3 signaling to lower food intake. Our findings highlight the potential of targeting TGR5 to reverse leptin resistance in the NTS.

Early menarche is associated with lifelong health implications, including heightened risks for obesity, type 2 diabetes (T2D), cardiovascular disease, and overall mortality. This study explored the associations that link early menarche, major adiposity indices, and T2D in a group of multi-ethnic Asian women.

A prospective, hospital-based study was conducted in Singapore. Two thousand seven hundred fifteen women were recruited from 2014 to 2016 (45-69 years old) and 1201 women were followed up from 2021 to 2023. At baseline, age at menarche (AAM) was divided into sub-categories: < 12 (early AAM), 12-13, 14-15 (reference), > 15 years. Major adiposity indices and glycemic profiles were assessed, including fat mass index (FMI), visceral adipose tissue (VAT), and HOMA-IR (homeostatic model assessment for insulin resistance). At the 6.6-year follow-up, T2D was assessed. One-way ANOVA and chi-square were performed for continuous and categorical variables, respectively. Multivariable regression analysis was performed to determine the association between AAM and primary outcomes, including adiposity measurements (FMI, VAT) and metabolic assessments (HOMA-IR) at baseline. Modified Poisson regression was performed to assess relative risk (RR) between AAM and T2D at follow-up. Serial mediation analysis was performed to determine potential mediators underlying the link between AAM and T2D. All analyses accounted for major confounders including age, ethnicity, and education.

Women with early AAM had significantly greater values in adiposity assessments, including increments in FMI (10.9 vs 10.3, p < 0.001), VAT (134 vs 113 cm2, p = 0.05) and HOMA-IR (1.20 vs 1.03, p = 0.08) at baseline. Early AAM (< 12 vs. 14-15 years) was associated with a 60% increased risk of developing T2D (RR 1.60 (95%CI: 1.04, 2.45)). Serial mediation analysis suggested a significant pathway underlying early AAM and T2D, which was firstly mediated by FMI, followed by VAT and lastly by HOMA-IR (p < 0.05).

Our study provided valuable insight into the pathophysiology of T2D development amongst mid-life women with early AAM. The findings could potentially indicate strategies to target FMI and VAT among Asian women in the menopausal phase with early AAM, to prevent the development of T2D.

The prevalence and incidence of young-onset type 2 diabetes is increasing globally, especially in low- and middle-income countries, and predominantly affects non-White ethnic and racial populations. Young-onset type 2 is heterogeneous in terms of the genetic and environmental contributions to its underlying pathophysiology, which poses challenges for glycemic management. Young at-risk individuals remain underrepresented in clinical trials, including diabetes prevention studies, and there is still an insufficient evidence base to inform practice for this age group. Improvements in diabetes care delivery have not reached young people who will progress to have disabling complications at an age when they are most productive. This review summarizes recent studies on the epidemiology of young-onset type 2 diabetes and its complications. We discuss the genetic and environmental risk factors that act in concert to promote glycemic dysregulation and early onset of type 2 diabetes. We provide perspectives on diabetes prevention and management, and propose strategies to address the unique medical and psychosocial issues associated with young-onset type 2 diabetes. The Precision Medicine to Redefine Insulin Secretion and Monogenic Diabetes Randomized Controlled Trial (PRISM-RCT) is the first large-scale clinical trial designed to evaluate the effect of a structured care model that integrates biogenetic markers with communication and information technology on attaining strict metabolic targets and improving clinical outcomes in individuals with young-onset type 2 diabetes. The results of this study will inform the scientific community about the impact of multifactorial intervention and precision care in young patients, for whom the legacy effect is particularly significant.

Boys' pubertal overweight associates with future offspring's asthma and low lung function. To identify how paternal overweight is associated with offspring's DNA methylation (DNAm), we conducted an epigenome-wide association study of father's body silhouette (FBS) at three timepoints (age 8, voice break and 30) and change in FBS between these times, with offspring DNAm, in the RHINESSA cohort (N = 339). We identified 2005 differentially methylated cytosine-phosphate-guanine (dmCpG) sites (FDR < 0.05), including dmCpGs associated with offspring asthma (119), lung function (178) and BMI (291). Voice break FBS associated with dmCpGs in loci including KCNJ10, FERMT1, NCK2 and WWP1. Change in FBS across sexual maturation associated with DNAm at loci including NOP10, TRRAP, EFHD1, MRPL17 and NORD59A;ATP5B and showed strong correlation in reduced gene expression in loci NAP1L5, ATP5B, ZNF695, ZNF600, VTRNA2-1, SOAT2 and AGPAT2. We identified 24 imprinted genes including: VTRNA2-1, BLCAP, WT1, NAP1L5 and PTPRN2. Identified pathways relate to lipid and glucose metabolism and adipogenesis. Father's overweight at puberty and during reproductive maturation was strongly associated with offspring DNA, suggesting a key role for epigenetic mechanisms in intergenerational transfer from father to offspring in humans. The results support an important vulnerability window in male puberty for future offspring health.

Paediatric psoriasis is a chronic inflammatory skin disease that poses unique challenges in diagnosis and management. While studies from high-income countries have reported increasing trends in incidence, data regarding the incidence of paediatric psoriasis worldwide remain scarce.

To provide a comprehensive description of the incidence of paediatric psoriasis at the global, regional and national levels.

We used data from the Global Burden of Disease Study 2021 to analyse trends in the incidence of paediatric psoriasis between 1990 and 2021. Incidence rates were stratified by age, sex and sociodemographic index (SDI). The estimated annual percentage change (EAPC) was used to quantify the temporal trends.

In 2021, there were 664 100 cases of paediatric psoriasis globally, with an incidence rate of 33.0 per 100 000 children. Over the study period, the global incidence increased by 0.21% (95% confidence interval 0.18-0.25%) per year, with more pronounced increases observed in regions categorized as low SDI and middle SDI. The highest incidence rates were recorded in regions categorized as high SDI, such as High-income North America (70.5 per 100 000) and Western Europe (67.5 per 100 000). Notably, the largest increases in incidence occurred in regions such as sub-Saharan Africa. At the national level, 189 countries/territories experienced significant increases in the incidence of paediatric psoriasis, while only 5 countries saw a decline. Incidence was higher in girls across all age groups, and the most pronounced increase was seen in children aged less than 5 years.

The incidence of paediatric psoriasis has increased significantly in recent years, particularly in regions categorized as low SDI and middle SDI, underscoring the need for improved diagnosis, early intervention and targeted public health strategies.

Obesity poses serious health risks and is trending younger, developing effective strategies to prevent obesity is crucial. Calcium intake is a potential strategy to reduce weight/fat, as it generally enhances the body's energy metabolism. However, calcium's effects on appetite and its specific mechanisms remain unclear. To investigate these questions, we administered calcium orally to fasted mice and found that calcium inhibited food intake during the first 3 h. Long-term calcium supplementation in water decreased HFD intake, weight gain, and fat deposition while increasing energy metabolism in young mice. Mechanistically, calcium activated the vagal afferent nerves and inhibited ARCAgRP neurons-key appetite regulation neuron. What's more, these effects are blunted by chemogenetic inhibition of gastrointestinal intestinal vagal afferent nerves or activation of ARCAgRP neuronal activity. Overall, we showed that ingested calcium activates vagal afferent nerves, inhibiting the activity of ARCAgRP neurons, thereby reducing food intake. This study supports calcium's role in obesity dietary therapy.

To investigate how four different prediabetes definitions (by fasting plasma glucose (FPG), glycosylated haemoglobin (HbA1c), FPG-or-HbA1c, or FPG-and-HbA1c) affect prediabetes prevalence estimates and their association with cardiometabolic risk in Danish children and adolescents referred for tertiary obesity treatment.

This cross-sectional study included 5-18-year-olds with BMI SDS above 1.28 and blood samples taken within 30 days of obesity treatment initiation. Anthropometric measurements, blood pressure, and blood samples were analysed to determine prediabetes prevalence and calculate odds ratios for hypertension, dyslipidaemia, abdominal obesity, high alanine aminotransferase (ALT), and BMI SDS ≥99th percentile.

Among 2,849 children and adolescents, prediabetes prevalence was 12.8 %, 6.6 %, 17.2 %, and 2.2 % when applying the FPG, HbA1c, FPG-or-HbA1c, and FPG-and-HbA1c definitions, respectively. Hypertension, dyslipidaemia, abdominal obesity, high ALT, and BMI SDS ≥99th percentile phenotypes were common, with increased prevalence among individuals with prediabetes defined from FPG-or-HbA1c. The FPG-derived definition of prediabetes was associated with hypertension and abdominal obesity, while the HbA1c-derived definition of prediabetes was associated with dyslipidaemia, high ALT, and BMI SDS ≥99th percentile. The strongest association was between the FPG-derived definition and hypertension.

The FPG-derived definition identified more individuals with prediabetes than the HbA1c-derived definition. Children and adolescents with prediabetes defined from FPG-or-HbA1c exhibited a high burden of hypertension, dyslipidaemia, abdominal obesity, high ALT, and BMI SDS ≥99th percentile. No single diagnostic test proved superior, as each associated with different cardiometabolic risk factors.

To develop a standardized percentile curve of waist circumference and abdominal obesity cutoff points for children and adolescents aged 6 to 20 in Macao, the study established a reference for screening abdominal obesity in this population.

The waist circumference data of 10,095 children and adolescents from the 2015-2020 Macao People's Physical Fitness Surveys were used for modeling. The GAMLSS model with four parameters of "median, standard deviation, kurtosis and skewness" was used to construct the standardized percentile curve of waist circumference. Then, the percentile curve-joining adult method was applied to establish the critical value of high waist circumference. Finally, the curves of this study were compared with relevant domestic and international data.

(1) Standard curves of waist circumference percentile and standard deviation unit curves were obtained for children and adolescents aged 6-20 years in Macao. (2) Waist circumference of children and adolescents in Macao increased with age. After the age of 12, waist circumference growth gradually decreased. The waist circumference of males was larger than that of females. (3) Analysis of different percentile curves revealed a divergence in growth rates between P50 and P90. Specifically, from ages 6-11 in boys and 6-10 in girls, the annual increase in waist circumference at P90 exceeded that at P50. After these ages, the growth rate at P50 surpassed that at P90.

The standardized curves constructed for the percentile waist circumference of Macao's children and adolescents were smooth and tests showed good validity. We recommend using these standardized percentile curves (applicable to ages 6-20 years) and abdominal obesity thresholds (applicable to ages 6-18 years), combined with the other evaluation commonly used indicator of obesity, to identify abdominal obesity in Macao's children and adolescents and therefore, to improve the well-being of Macao's children and adolescents.

We compared ability of five adiposity indicators [body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-by-height0.5 (WHT.5R), and a body shape index (ABSI)] to identify current diabetes and their prospective associations with diabetes.

Baseline data were from 7,979 participants of UK Whitehall II study, of whom 7,488 diabetes-free participants were followed-up (median = 16.0 years) for incident diabetes (n = 940). According to five indices' cut-points, participants were separately classified into low-value groups and high-value groups. We cross-sectionally investigated ability of the indicators to identify existing diabetes by receiver operating characteristic curve analysis, and explored prospective associations between elevated indices and diabetes using Cox regression analysis.

Waist-based indicators were superior to BMI in identifying diabetes. High WHtR (≥0.5) demonstrated the highest multivariable-adjusted HR [2.64 (95 % CI 2.29, 3.03)]. Across all indicators, associations between elevated indicators and diabetes were stronger in younger participants. In combined analyses, "low BMI but high WHtR" had higher risk for diabetes [2.20 (95 % CI 1.65, 2.95)] than "high BMI but low WHtR" [1.34 (95 % CI 1.05, 1.70)].

Waist-based indicators are more strongly associated with diabetes than BMI. WHtR, an easy-to-calculate, waist-based index with a sex- and race-independent cut-point, may be useful for diabetes prevention.

Papuan people inhabiting the island of New Guinea are the most ancient population living outside Africa, having resided in the region for at least 50,000 years. The arrival of Austronesian speakers and other group from mainland Asia around 3000 years or so created a peculiar genetic mixture, particularly in lowland/coastal areas. We investigated the anthropometric and blood chemical differences alongside the population structure of the ABCG2 rs2231142 genetic variant of West Papuans from lowland/coastal and highland areas to understand metabolic risk differences between these two populations.

We studied West Papuan students from lowland/coastal areas (n = 78, 45 males, 33 females) and from highland areas (n = 65, 40 males, 25 females). We found the following: (1) The lowland/coastal Papuans were taller, with lower BMI, central obesity, and triceps. Contrarily, highland Papuans have a more gynoid body shape, with higher WC, HC, WHR, and WHtR. The skinfolds were significantly thicker in women from the highlands. (2) There was actually a negative correlation between BMI and central adiposity with UA and FBG to those from the highlands. The lowland/coastal Papuans indicated an Asian-type metabolic traits, with higher fasting glucose levels at lower BMI and lower central adiposity. (3) UA concentration and DBP were strongly correlated with obesity of the Papuans from lowlands/coasts and not in the Papuans from highlands. (4) There was a striking difference in the ABCG2 rs2231142 > T allele frequency in those from the lowlands/coasts (22%) compared to those from the highlands of West Papua (7%). The T variant in the latter is all heterozygous.

The higher adiposity and thicker skinfolds observed in highland Papuans are thought to be adaptive responses to the high-altitude environment, enabling greater adipose tissue expandability and energy storage capacity while maintaining metabolic homeostasis. In contrast, the lowland/coastal Papuans exhibit an Asian metabolic phenotype, which is more prone to metabolic derangements at lower adiposity. Our findings on the population distribution of the ABCG2 rs2231142 > T variant support the idea that its presence in the Papuan highlands is through demic diffusion of the variant from ISEA, indicating that the two populations are separate entities displaying differences in metabolic risks.

Childhood and adolescent obesity is a growing global health issue linked to noncommunicable diseases such as cardiovascular disease and type 2 diabetes. Digital health technologies, including mobile apps and web-based programs, offer scalable tools to improve health behaviors, but their effectiveness in young populations remains unclear.

This systematic review aimed to evaluate the effectiveness of mobile and web-based digital interventions in promoting healthy diets, reducing obesity risk, increasing physical activity, and improving nutrition-related knowledge and attitudes among children and adolescents.

A systematic search was conducted across PubMed, Scopus, Web of Science, and Google Scholar databases, along with hand-searching reference lists of key systematic reviews. The search encompassed records published up to September 30, 2024. Eligible studies were randomized controlled trials targeting dietary intake, anthropometric measurements, physical activity, or nutrition-related attitudes and knowledge among participants aged ≤18 years. Screening, full-text eligibility assessment, and data extraction were done partly in duplicate (20%; κ=0.86 for title or abstract screening, κ=0.71 for full-text eligibility assessment, and κ=0.78 data extraction). Risk of bias was evaluated using the Cochrane Risk-of-Bias tool (κ=0.71 for interrater reliability of 20% duplicate evaluation). Data were synthesized narratively.

From 300 records screened, a total of 37 articles (34 studies) were included. Interventions included games, (in 21/34 studies, 62%), mobile apps, web-based programs, and other digital tools. Among the 34 included studies, 23 (68%) studies reported positive outcomes for at least 1 measured variable. Fruit intake improved in 17 of 34 studies (50%) assessing fruit intake, while 7 of 34 studies (21%) targeting sugar-sweetened beverage consumption showed reductions. Improvements in nutrition knowledge were reported in 23 of 34 (68%) studies, but changes in anthropometric measures and physical activity outcomes showed no effect. Risk of bias was low for random sequence generation but high or unclear in other domains for many studies.

Mobile- and web-based interventions, particularly game-based tools, show promise for promoting healthy dietary behaviors and increasing nutrition knowledge in children and adolescents. However, the evidence for long-term sustainability and impact on anthropometric and physical activity outcomes remains limited. Future research should focus on understanding which digital features drive effectiveness, extending follow-up periods, and exploring the role of family involvement in interventions.

PROSPERO CRD42023423512; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=423512.

Background: The increasing prevalence of overweight and obesity among young people poses a significant public health challenge. Childhood and adolescence are critical periods for establishing long-term health habits. Diet plays a central role in maintaining a healthy weight, and adherence to the Mediterranean diet has been consistently linked to numerous health benefits, including improved weight management and overall well-being. Understanding the factors that influence Mediterranean diet adherence in adolescents can help design effective interventions to promote healthier eating behaviors. Objectives: This study sought to explore the association between following the Mediterranean diet and key physiological factors, including age, sex, body mass index, and pubertal status. Additionally, it explored how Mediterranean diet adherence relates to lifestyle behaviors such as sleep quality and physical activity levels, using data from a sample of 668 Spanish adolescents. Method: Participants completed validated questionnaires assessing dietary habits, physical activity, sleep quality, and pubertal status (Tanner scale). Results: The findings revealed significant associations between Mediterranean diet adherence and body mass index, pubertal status, and physical activity level, while sex, age, and sleep quality showed no significant influence. Adolescents with lower body mass index tended to adhere more to the Mediterranean diet, reinforcing its role in weight management. Additionally, greater adherence was observed in later pubertal stages, suggesting increased nutritional awareness. Conclusions: Healthy eating patterns are associated with a strong promotion of physical activity, highlighting the link between an active lifestyle and adherence to the Mediterranean diet. This positive multifactorial synergy requires further research to better understand its mechanisms and to design effective strategies for promoting healthy habits among adolescents.

Genome-wide association studies (GWASs) have identified thousands of genetic loci associated with cardiometabolic disorders. However, the functional interpretation of these loci remains a daunting challenge. This is particularly true for adipose tissue, a critical organ in systemic metabolism and the pathogenesis of various cardiometabolic diseases. We discuss how variant-to-function (V2F) approaches are used to elucidate the mechanisms by which GWAS loci increase the risk of cardiometabolic disorders by directly influencing adipose tissue. We outline GWAS traits most likely to harbor adipose-related variants and summarize tools to pinpoint the putative causal variants, genes, and cell types for the associated loci. We explain how large-scale perturbation experiments, coupled with imaging and multi-omics, can be used to screen variants' effects on cellular phenotypes and how these phenotypes can be tied to physiological mechanisms. Lastly, we discuss the challenges and opportunities that lie ahead for V2F research and propose a roadmap for future studies.

We explored the changes in the prevalence and distribution of excess body adiposity in urban Colombia after the COVID-19 pandemic and associated lockdown.

We executed a population-based, stratified, multi-stage study of individuals aged 2-80 years from five Colombian cities, between November and December 2022. We explored the prevalences of excess adiposity measures and their association with socioeconomic variables and contrasted the results with the previous wave of the study, conducted in 2018.

We studied 2115 individuals (83.5% adults, 51.7% female). Between 2018 and 2022, the adult prevalence of excess body weight (EBW, body mass index >25 kg/m2) increased by 4.5% in males and decreased by 0.6% in females. Women had almost twice the prevalence of obesity as men. The prevalence of obesity for underage females soared from 7.6% in 2018 to 18.4% in 2022. Abdominal obesity increased by 10.3% in men, up to 39.8%. Adult female obesity was negatively associated with socioeconomic status (SES) (OR 2.01 (95% CI 1.33 to 3.04) for lowest SES relative to highest). Abdominal obesity among women in the lowest SES reached 55.2% in 2022. There was a strong negative relationship between education and EBW among women, the OR of obesity for women with only primary education relative to college graduates was 2.48 (95% CI 1.52 to 4.06).

The obesity epidemic worsened in urban Colombia after the COVID-19 pandemic and associated lockdown, especially among adult males and underage females. The burden of excess adiposity is concentrated in women from disadvantaged groups.