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Hassan BK, Silva de Moraes VL, Mais LA, Thomaz Maya Martins AM, Fragano Baird M, Albiero MS, Johns P, Paes de Carvalho CM. Disputes over the agenda to promote adequate and healthy eating - How the agri-food sector interfered in the Brazilian Tax Reform. Soc Sci Med 2025; 371:117747. [PMID: 40073520 DOI: 10.1016/j.socscimed.2025.117747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 01/13/2025] [Accepted: 01/20/2025] [Indexed: 03/14/2025]
Abstract
BACKGROUND while the Brazilian Tax Reform (TR) is underway, this study aimed to identify the main food taxes events and to map corporate political activities (CPA) of the agri-food sector. METHODS We gathered bibliographical and documentary research from January 2023 to April 2024 of the TR and the CPA from agri-food companies, trade associations and front groups. RESULTS We found 78 CPA action strategies and 32 framing strategies. In 2024, CPA strategies occurred 20 times. The most frequent CPA action strategy was 'Manufacture public support for corporate positions'', by the mechanism 'Maximize corporate-favorable media content'. The most frequent CPA framing strategy was 'The 'trivial' and 'individual' problem: created by a minority of consumers', by the mechanism 'Health harms are not caused by Industry's products/services'. DISCUSSION CPA strategies resulted in UPFP off the excise tax. Civil society drove the UPFP debate, and the soda tax and the National Basic Food Basket were included in the TR. CONCLUSION This study shares industry interference learnings and can help to develop mechanisms that address Commercial Determinants of Health.
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Affiliation(s)
| | | | - Laís Amaral Mais
- Consumer Protection Institute (Idec), São Paulo, São Paulo, Brazil
| | | | | | | | - Paula Johns
- ACT Health Promotion, Rio de Janeiro, Rio de Janeiro, Brazil
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Houben K, Dibbets P. Taming temptations: Comparing the effectiveness of counterconditioning and extinction in reducing food cue reactivity. Appetite 2025; 208:107932. [PMID: 40020972 DOI: 10.1016/j.appet.2025.107932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 01/06/2025] [Accepted: 02/25/2025] [Indexed: 03/03/2025]
Abstract
In today's "obesogenic" environment, Pavlovian cues signaling the availability of high-calorie foods may elicit strong expectancies of eating and food cravings. Such cue-elicited appetitive responses, collectively referred to as food cue reactivity, may foster overeating and weight gain. Moreover, food-related cues may also elicit instrumental actions aimed at obtaining those foods via Pavlovian-to-Instrumental Transfer (PIT). This study compared extinction and counterconditioning in reducing food cue reactivity, measured by outcome expectancies, craving, and liking, as well as in decreasing outcome-specific PIT. We used a three-phase PIT paradigm: In the first two phases, participants learned Pavlovian associations between two conditioned stimuli (CSs+) and two food outcomes, and instrumental associations between two responses and the same outcomes. An additional stimulus was never paired with food outcomes (CS-). Participants then underwent either extinction or counterconditioning for one CS+ while the other CS+ remained unchanged, or received no additional learning (control). In the test phase, instrumental responding was measured in the presence and absence of Pavlovian stimuli. In all phases, we measured outcome expectancies, craving and liking of the Pavlovian stimuli. Both extinction and counterconditioning reduced cue-elicited outcome expectancies, but only counterconditioning significantly decreased CS+ liking. Neither procedure effectively reduced cue-elicited craving. Outcome-specific PIT was observed across conditions, though counterconditioning lead to a general decrease in instrumental responding to all stimuli in the test phase. These findings suggest that counterconditioning more effectively targets the affective value of conditioned stimuli and reduces food cue reactivity compared to extinction, though its impact on PIT warrants further investigation.
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Affiliation(s)
- Katrijn Houben
- Clinical Psychological Science, Maastricht University, the Netherlands.
| | - Pauline Dibbets
- Clinical Psychological Science, Maastricht University, the Netherlands
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3
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Ichikawa T, Hashimoto Y, Okamura T, Obora A, Kojima T, Okada H, Hamaguchi M, Fukui M. Relationship between anthropometric measures and the risk of incident Metabolic dysfunction-associated steatotic liver disease: a longitudinal study. BMC Gastroenterol 2025; 25:202. [PMID: 40140744 PMCID: PMC11948872 DOI: 10.1186/s12876-025-03780-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 03/12/2025] [Indexed: 03/28/2025] Open
Abstract
BACKGROUND Waist circumference (WC) and body mass index (BMI) are considered useful for the diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to investigate the association between the body roundness index (BRI) and a body shape index (ABSI) with incident MASLD, in comparison to WC and BMI. METHODS Retrospective cohort data from a Japanese health check-up program were analyzed. Logistic regression model was used to evaluate the associations between anthropometric measure quartiles and MASLD, and receiver operating characteristic (ROC) analysis was performed to evaluate the associations between anthropometric measures and incident MASLD, stratified by sex. RESULTS A total of 10,561 males and 7,187 females were included, of whom 3,182 males and 914 females developed MASLD. Multivariate analysis revealed that higher WC, BMI, and BRI were associated with incident MASLD in both sexes, whereas higher ABSI was significantly associated with incident MASLD only in females. Among males, the area under the ROC curve (AUC) of BMI was higher than that of WC, BRI, and ABSI. Conversely, among females, the AUC of BMI was higher than that of ABSI, whereas it was comparable to that of WC or BRI. The AUC and the optimal cut-off values of BMI for predicting incident MASLD were 0.77 and 23.9 kg/m2 in males, and 0.86 and 22.2 kg/m2 in females. The optimal cut-off values of WC were 82.0 cm for males and 76.3 cm for females, respectively. CONCLUSIONS We demonstrated the strongest association between BMI and incident MASLD compared to other measures, particularly in males, while also showing a strong association in females. Additionally, specific WC criteria for Asians to improve MASLD diagnosis are needed.
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Affiliation(s)
- Takahiro Ichikawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi, 570-8540, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Akihiro Obora
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Takao Kojima
- Department of Gastroenterology, Asahi University Hospital, Gifu, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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Hâncean MG, Lerner J, Perc M, Molina JL, Geantă M, Oană I, Mihăilă BE. Processed food intake assortativity in the personal networks of older adults. Sci Rep 2025; 15:10459. [PMID: 40140615 PMCID: PMC11947270 DOI: 10.1038/s41598-025-94969-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 03/18/2025] [Indexed: 03/28/2025] Open
Abstract
Existing research indicates that dietary habits spread through social networks, yet the impact on populations in Eastern Europe, particularly in rural areas, is less understood. We examine the influence of personal networks on the consumption of high-salt processed foods among individuals in rural Romania, with a specific focus on older adults. Using a personal network analysis, we analyze data from 83 participants of varying ages and their social contacts through multi-level regression models. The inclusion of participants across a wider age range allows us to capture the broader dynamics of social networks, reflecting the intergenerational nature of rural communities. Our findings reveal assortativity in dietary habits, indicating that individuals cluster with others who share similar food consumption patterns. Our results underscore the need for public health interventions that account for the influence of social networks on dietary behavior, as addressing high salt intake and its associated health risks may require considering the broader social context beyond older adults. The study contributes to understanding the social determinants of dietary behaviors and highlights the role of personal networks in shaping food choices in vulnerable populations.
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Affiliation(s)
- Marian-Gabriel Hâncean
- Department of Sociology, University of Bucharest, Panduri 90-92, Bucharest, 050663, Romania.
- Center for Innovation in Medicine, Theodor Pallady Blv. 42J, Bucharest, 032266, Romania.
| | - Jürgen Lerner
- Department of Computer and Information Science, University of Konstanz, 78457, Konstanz, Germany
| | - Matjaž Perc
- Faculty of Natural Sciences and Mathematics, University of Maribor, Koroška cesta 160, Maribor, 2000, Slovenia
- Community Healthcare Center Dr. Adolf Drolc Maribor, Vošnjakova ulica 2, Maribor, 2000, Slovenia
- University College, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- Department of Physics, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - José Luis Molina
- GRAFO-Department of Social and Cultural Anthropology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, 08193, Spain
| | - Marius Geantă
- Center for Innovation in Medicine, Theodor Pallady Blv. 42J, Bucharest, 032266, Romania
| | - Iulian Oană
- Department of Sociology, University of Bucharest, Panduri 90-92, Bucharest, 050663, Romania
- Center for Innovation in Medicine, Theodor Pallady Blv. 42J, Bucharest, 032266, Romania
| | - Bianca-Elena Mihăilă
- Department of Sociology, University of Bucharest, Panduri 90-92, Bucharest, 050663, Romania
- Center for Innovation in Medicine, Theodor Pallady Blv. 42J, Bucharest, 032266, Romania
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Roser P, Aberle J. [Obesity as a chronic disease]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2025:10.1007/s00108-025-01883-8. [PMID: 40140054 DOI: 10.1007/s00108-025-01883-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 02/24/2025] [Indexed: 03/28/2025]
Abstract
The global prevalence of obesity has more than tripled since 1975 and represents a substantial public health challenge. Obesity is a chronic disease with a high tendency to recurrence and is associated with numerous comorbidities, such as diabetes mellitus, high blood pressure and cardiovascular diseases. Every year around 2.8 million people die from the sequelae. Obesity is defined as the excessive accumulation of fatty tissue. In routine clinical practice obesity is diagnosed by measuring the body mass index (BMI); however, there are numerous professional associations that recommend the additional determination of another biometric parameter (waist to height ratio or waist circumference). This not only reduces inaccuracies in the BMI but also makes it easier to identify patients with a particularly high risk of cardiovascular and metabolic diseases. Regardless of the definitions and diagnostics of obesity, the aim of treatment for those affected is not just to reduce weight but more to improve the quality of life, overall survival and the improvement or prevention of obesity-related diseases.
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Affiliation(s)
- Pia Roser
- III. Medizinische Klinik, Sektion Endokrinologie und Diabetologie, Universitäres Adipositas-Centrum des UKE, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Jens Aberle
- III. Medizinische Klinik, Sektion Endokrinologie und Diabetologie, Universitäres Adipositas-Centrum des UKE, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
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Gomez-Donoso C, Kelly B, Martino F, Cameron AJ, Richter APC, Sacks G, Vanderlee L, White CM, Hammond D, Backholer K. Public support for unhealthy food marketing policies in Australia: A cross-sectional analysis of the International Food Policy Study 2022. Aust N Z J Public Health 2025:100231. [PMID: 40155292 DOI: 10.1016/j.anzjph.2025.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Revised: 02/04/2025] [Accepted: 02/19/2025] [Indexed: 04/01/2025] Open
Abstract
OBJECTIVE This study aimed to explore public opinion towards food marketing policies. METHODS In 2022, a cross-sectional online survey was completed by 3,923 adults in Australia, including 1,152 caregivers of children aged <18 years. Concern about children's exposure to unhealthy food marketing was assessed among caregivers. Public support for seven policy options to restrict unhealthy food marketing in different media and settings (broadcast, online, outdoors, packaging and retail) was quantified. Multivariable regression analyses were conducted to examine sociodemographic differences. RESULTS Most caregivers (85%) reported some degree of concern about their child's exposure to unhealthy food marketing. Among all respondents, there was a high level of support or neutrality (>70%) for all policies aimed at restricting unhealthy food marketing. Respondents who were female, older, highly educated, who identified as Aboriginal and/or Torres Strait Islander, perceived their monthly income as adequate or had at least one child living in the household reported higher support/neutrality towards several of the assessed policies. CONCLUSIONS Most Australian adults were supportive or neutral towards policies restricting unhealthy food marketing. The level of support varied depending on the policy's target group and its setting. IMPLICATIONS FOR PUBLIC HEALTH Implementing unhealthy food marketing policies in Australia would most likely have broad public support and minimal opposition.
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Affiliation(s)
- Clara Gomez-Donoso
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Bridget Kelly
- Early Start, School of Health & Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Florentine Martino
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Adrian J Cameron
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Ana Paula C Richter
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia; Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, United States of America
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, santé et société, Université Laval, Québec, Canada
| | - Christine M White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Kathryn Backholer
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
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Hawton K, Shirodkar D, Siese T, Hamilton-Shield JP, Giri D. A recent update on childhood obesity: aetiology, treatment and complications. J Pediatr Endocrinol Metab 2025:jpem-2024-0316. [PMID: 40105362 DOI: 10.1515/jpem-2024-0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 02/22/2025] [Indexed: 03/20/2025]
Abstract
Obesity is a complex, chronic condition characterised by excess adiposity. Rates of obesity in childhood and adolescence are increasing worldwide, with a corresponding increase in adulthood. The aetiology of obesity is multifactorial and results from a combination of endocrine, genetic, environmental and societal factors. Population level approaches to reduce the prevalence of childhood obesity worldwide are urgently needed. There are wide-ranging complications from excess weight affecting every system in the body, which lead to significant morbidity and reduced life expectancy. Treatment of obesity and its complications requires a multi-faceted, biopsychosocial approach incorporating dietary, exercise and psychological treatments. Pharmacological treatments for treating childhood obesity have recently become available, and there is further development of new anti-obesity medications in the pipeline. In addition, bariatric surgery is being increasingly recognised as a treatment option for obesity in adolescence providing the potential to reverse complications related to excess weight. In this review, we present an update on the prevalence, aetiology, complications and treatment of childhood obesity.
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Affiliation(s)
- Katherine Hawton
- 156596 Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust , Bristol, UK
- University of Bristol, Bristol, UK
| | - Diksha Shirodkar
- 156596 Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust , Bristol, UK
- University of Bristol, Bristol, UK
| | | | - Julian P Hamilton-Shield
- 156596 Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust , Bristol, UK
- NIHR Biomedical Research Centre (Nutrition Theme), University Hospitals Bristol and Weston NHS Foundations Trust, Bristol, UK
| | - Dinesh Giri
- 156596 Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust , Bristol, UK
- University of Bristol, Bristol, UK
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Lin F, Gilbertson TA. Fat taste responsiveness, but not dietary fat intake, is affected in Adipor1 null mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2025:2025.03.12.642880. [PMID: 40161824 PMCID: PMC11952482 DOI: 10.1101/2025.03.12.642880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/02/2025]
Abstract
Taste is a major driving force that influences food choices and dietary intake. Adiponectin has been shown to selectively enhance cellular responses to fatty acids by mediating the activation of AMPK and translocation of CD36 in taste cells via its receptor AdipoR1. Whether Adipor1 gene knockout affects fat taste responsiveness and dietary fat intake in animals remains unclear. In the present study, we evaluated cellular, neural, and behavioral responses to fat, as well as the dietary fat intake in global Adipor1 knockout mice and their WT controls. Sex-specific changes in cellular and behavioral responses to fatty acid were observed in Adipor1 knockout mice. Linoleic acid (LA)-induced calcium responsiveness appears to be reduced in taste cells from Adipor1-deficient males and increased in taste cells from Adipor1-deficient females. Brief-access taste testing revealed a loss of fat taste behavioral responsiveness in naïve Adipor1 -/- animals. Fat taste loss found in Adipor1 -/- males was restored after fat exposure and showed no significant differences in taste behavioral responses to fatty acids with WT controls in two-bottle preference and conditioned taste aversion tests. Adipor1 -/- females were found to have diminished preference for LA in two-bottle preference tests, lower intralipid/water lick ratio in a brief-access assay, and reduced avoidance for LA in conditioned taste aversion assay. Furthermore, the taste nerve responses to intralipid and the dietary fat intakes appeared to be the same between Adipor1 -/- and WT mice. In the high-fat diet feeding study, Adipor1 -/- females gained more weight, while no differences in body weight gain were found in males. Together, we show that adiponectin/AdipoR1 signaling plays crucial sex-specific roles in the modulation of fat taste and the maintenance of healthy body weight primarily by regulating energy expenditure rather than dietary fat intake in mice.
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Affiliation(s)
- Fangjun Lin
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, USA
- Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | - Timothy A. Gilbertson
- Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL 32827, USA
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9
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Cui Y, Qi Q, Sun Y, Liu R, Yin W, Liu H. Nutrition literacy is associated with general obesity, abdominal obesity, and body fat percentage obesity. Front Nutr 2025; 12:1555725. [PMID: 40144565 PMCID: PMC11936784 DOI: 10.3389/fnut.2025.1555725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2025] [Accepted: 02/27/2025] [Indexed: 03/28/2025] Open
Abstract
Background Obesity is associated with unhealthy eating behavior among adults. Nutrition literacy (NL) is an important determinant of eating behavior. This study investigated the association of NL with general obesity, abdominal obesity, and body fat percentage (BFP) obesity among adults. Methods This study was a cross-sectional survey on the Nutrition Literacy and Obesity, conducted in Bengbu City, China (May to July 2023). The Short-Form Nutrition Literacy scale was used to evaluate the NL of adults. General obesity was defined as a body mass index of ≥28 kg/m2. Abdominal obesity was defined as a waist circumference of ≥90 cm in men and ≥85 cm in women. BFP obesity was defined as a BFP of ≥30% in men and ≥42% in women. Binary logistic regression analysis was performed to identify the correlations of NL with general obesity, abdominal obesity, and BFP obesity in adults. Subgroup analyses and interaction tests were also performed. Results Participants with a high level of NL had low odds of general obesity (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.43-0.99), abdominal obesity (OR: 0.63; 95% CI: 0.46-0.87), and BFP obesity (OR: 0.55; 95% CI: 0.35-0.87). In subgroup analyses and interaction tests, age significantly influenced the negative correlations of NL with abdominal obesity and BFP obesity (p for interaction <0.05), but not general obesity (p for interaction >0.05). Moreover, sex and smoking status significantly influenced the negative correlations of NL with general obesity and abdominal obesity (p for interaction <0.05), but not BFP obesity (p for interaction >0.05), and drinking status significantly influenced the negative correlations of NL with abdominal obesity (p for interaction <0.05), but not general obesity and BFP obesity (p for interaction >0.05). However, marital status did not significantly influence the correlation of NL with obesity (p for interaction >0.05). Conclusion Our findings highlight that adults with high levels of NL have low odds of general obesity, abdominal obesity, and BFP obesity. Age, sex, smoking status, and drinking status influence the correlation between NL and obesity. The results indicate the importance of NL in the prevention and management of obesity in adults. To effectively address the challenges of adult obesity management, public health practitioners should tailor nutrition education and skill training programs to specific demographic profiles.
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Affiliation(s)
- Yan Cui
- School of Public Health, Bengbu Medical University, Bengbu, Anhui, China
| | - Qi Qi
- Huainan Maternal and Child Health and Family Planning Service Centre, Huainan, Anhui, China
| | - Yuhui Sun
- School of Public Health, Bengbu Medical University, Bengbu, Anhui, China
| | - Rumeng Liu
- School of Public Health, Bengbu Medical University, Bengbu, Anhui, China
| | - Wending Yin
- School of Public Health, Bengbu Medical University, Bengbu, Anhui, China
| | - Huaqing Liu
- School of Public Health, Bengbu Medical University, Bengbu, Anhui, China
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Ng M, Gakidou E, Lo J, Abate YH, Abbafati C, Abbas N, Abbasian M, Abd ElHafeez S, Abdel-Rahman WM, Abd-Elsalam S, Abdollahi A, Abdoun M, Abdulah DM, Abdulkader RS, Abdullahi A, Abedi A, Abeywickrama HM, Abie A, Aboagye RG, Abohashem S, Abtahi D, Abualruz H, Abubakar B, Abu Farha RK, Abukhadijah HJ, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Adams LC, Adane MM, Addo IY, Adedokun KA, Adegoke NA, Adepoju AVV, Adesola RO, Adeyeoluwa TE, Adiga U, Adnani QES, Afaghi S, Afzal S, Afzal MS, Agampodi TC, Aghamiri S, Agostinis Sobrinho C, Agyemang-Duah W, Ahlstrom AJ, Ahmad D, Ahmad S, Ahmad A, Ahmad MM, Ahmad F, Ahmad N, Ahmed H, Ahmed MB, Ahmed A, Ahmed MS, Ahmed MS, Ahmed SA, Ajami M, Akhtar S, Akkaif MA, Akrami AE, Alalwan TA, Al-Aly Z, Alam K, Al-amer RM, Alansari A, Al-Ashwal FY, Albashtawy M, Aldhaleei WA, Alemayehu BA, Algammal AM, Alhabib KF, Al Hamad H, Al Hasan SM, Alhuwail D, Ali R, Ali A, Ali W, Ali MU, Alif SM, Al-Jabi SW, Aljunid SM, Alkhatib A, Al-Marwani S, Alomari MA, Alqahtani SA, Al-Raddadi RMM, Alrawashdeh A, Alrimawi I, Alrousan SM, Alshahrani NZ, Al Ta'ani O, Al Ta'ani Z, Altaany Z, Altaf A, Al Thaher Y, Alvis-Guzman N, Al-Wardat M, Al-Worafi YM, Aly S, Aly H, Alzahrani H, Alzoubi A, Alzoubi KH, Al-Zubayer MA, Amiri S, Amu H, Amugsi DA, Amusa GA, Ananda RA, Ancuceanu R, Andrei CL, Anjana RM, Ansari S, Ansari MT, Antony CM, Anuoluwa IA, Anuoluwa BS, Anvari S, Anwar S, Anyasodor AE, Apostol GLC, Arab JP, Arabloo J, Arafat M, Aravkin AY, Areda D, Arifin H, Arkew M, Armocida B, Ärnlöv J, Arooj M, Artamonov AA, Artanti KD, Arumugam A, Asghari-Jafarabadi M, Ashraf T, Asiamah-Asare BKY, Asrat AA, Astell-Burt T, Athari SS, Atorkey P, Atreya A, Aumoldaeva ZM, Awad H, Awoke MA, Awotidebe AW, Aychiluhm SB, Azargoonjahromi A, Azimi A, Aziz SA, Aziz S, Azzam AY, Azzolino D, Azzopardi PS, Babashahi M, Babu GR, Badiye AD, Bagheri N, Bahurupi Y, Bai R, Baig AA, Bakkannavar SM, Balakrishnan S, Baltatu OC, Bam K, Banach M, Banik R, Bardhan M, Barqawi HJ, Barquera S, Barua L, Basharat Z, Bashir S, Bastan MM, Basu S, Bayat R, Bayih MT, Beeraka NM, Begum T, Bello UM, Bello AB, Belo L, Bensenor IM, Bergami M, Berhe K, Berihun AA, Bhadoria AS, Bhagavathula AS, Bhala N, Bhalla JS, Bharadwaj R, Bhardwaj P, Bhardwaj N, Bhaskar S, Bhat AN, Bhattacharjee P, Bhattacharjee S, Bhatti JS, Bhatti GK, Bikov A, Bilgin C, Bisignano C, Biswas B, Bizzozero Peroni B, Bjertness E, Bjørge T, Bolla SR, Borhany H, Bosoka SA, Bouaoud S, Boyko EJ, Braithwaite D, Brazo-Sayavera J, Brenner H, Britton G, Bryazka D, Bugiardini R, Bui LP, Busch F, Bustanji Y, Butt NS, Butt ZA, Calina D, Campos LA, Campos-Nonato I, Cao S, Cao Y, Capodici A, Carvalho AF, Carvalho M, Catapano AL, Cattafesta M, Cattaruzza MS, Cegolon L, Cembranel F, Cenko E, Cerin E, Cernigliaro A, Chadwick J, Chakraborty C, Chan RNC, Chang JC, Chattu VK, Chaudhary AA, Chaurasia A, Chen G, Chen AT, Chen H, Cheng ETW, Chew NWS, Chi G, Chimoriya R, Ching PR, Choi DW, Chong B, Chopra H, Chopra S, Chou HI, Choudhari SG, Chu DT, 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Willeit P, Wojewodzic MW, Wonde TE, Wongsin U, Xia Q, Xie W, Xu S, Xu X, Yamagishi K, Yano Y, Yao H, Yarahmadi A, Yaribeygi H, Yesuf SA, Yin D, Yon DK, Yonemoto N, Yu C, Yuan CW, Yuce D, Yunusa I, Zaman SB, Zare I, Zastrozhin M, Zeariya MGM, Zhang X, Zhang L, Zhang J, Zhang Z, Zhang CJP, Zheng DX, Zheng P, Zhong A, Zhong CC, Zhou J, Zhu B, Zhumagaliuly A, Zielińska M, Zoghi G, Zou Z, Zweck E, Zyoud SH, Murray CJL, Sawyer SM, Vollset SE. Global, regional, and national prevalence of adult overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021. Lancet 2025; 405:813-838. [PMID: 40049186 PMCID: PMC11920007 DOI: 10.1016/s0140-6736(25)00355-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 12/06/2024] [Accepted: 02/20/2025] [Indexed: 03/10/2025]
Abstract
BACKGROUND Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050. METHODS Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends. FINDINGS Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989-1·01) adult males and 1·11 billion (1·10-1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397-407] individuals), followed by India (180 million [167-194]) and the USA (172 million [169-174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8-160·3) in males and 104·9% (95% UI 100·9-108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39-4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4-269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121-162) by 2050, making it the country with the fourth-largest population with overweight and obesity. INTERPRETATION No country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels. FUNDING Bill & Melinda Gates Foundation.
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Kerr JA, Patton GC, Cini KI, Abate YH, Abbas N, Abd Al Magied AHA, Abd ElHafeez S, Abd-Elsalam S, Abdollahi A, Abdoun M, Abdulah DM, Abdulkader RS, Abdullahi A, Abeywickrama HM, Abie A, Abiodun O, Abohashem S, Abtahi D, Abualruz H, Abubakar B, Abu-Gharbieh E, Abukhadijah HJ, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Adams LC, Adane MM, Addo IY, Adedokun KA, Adegoke NA, Adesola RO, Adetunji JB, Adeyeoluwa TE, Adiga U, Adnani QES, Afify AY, Afolabi AA, Afzal MS, Afzal S, Agampodi SB, Aghamiri S, Agostinis Sobrinho C, Agyemang-Duah W, Ahinkorah BO, Ahlstrom AJ, Ahmad A, Ahmad D, Ahmad F, Ahmad MM, Ahmad N, Ahmad S, Ahmed A, Ahmed H, Ahmed LA, Ahmed MS, Ahmed MS, Ahmed SA, Ajami M, Akkaif MA, Akrami AE, Al Hamad H, Al Hasan SM, Al Ta'ani Z, Al Thaher Y, Alalwan TA, Al-Aly Z, Alam K, Al-amer RM, Alansari A, Al-Ashwal FY, Albashtawy M, Alemayehu BA, Algammal AM, Alhabib KF, Alhuwail D, Ali A, Ali EA, Ali MD, Ali MU, Ali R, Ali W, Alif SM, Alimohamadi Y, Al-Jabi SW, Aljofan M, Aljunid SM, 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D'Amico E, Dandona L, Dandona R, D'Anna L, Danpanichkul P, Darcho SD, Darvishi Cheshmeh Soltani R, Dash NR, Davletov K, Dehghan A, Denova-Gutiérrez E, Derbew Molla M, Dergaa I, Desale AT, Devanbu VGC, Devegowda D, Dhali A, Dhungel B, Diaz D, Dinu M, Do TC, do Prado CB, Dodangeh M, Doegah PT, Dohare S, Dokova KG, Doku PN, Dolatkhah N, D'Oria M, Dorostkar F, Doshi OP, Doshi RP, Dowou RK, Du M, Dumith SC, Dumuid D, Duncan BB, Dutta S, Ebrahimi A, Edvardsson K, Eighaei Sedeh A, Ekholuenetale M, El Arab RA, El Bayoumy IF, Eladl MA, El-Ashker S, Elbarazi I, Elgendy IY, Elhadi M, El-Metwally AA, Elmonem MA, Elnaem MH, Elsheikh R, Eltaha C, Emeto TI, Eslami M, Fabin N, Fadavian H, Fagbamigbe AF, Fakhradiyev IR, Faraji SN, Farinha CSES, Faris MEM, Faris PS, Farjoud Kouhanjani M, Farooque U, Farrokhpour H, Fasusi SA, Fazeli P, Fazylov T, Feizkhah A, Fekadu G, Feng X, Fernandez-Jimenez R, Ferreira N, Foigt NA, Folayan MO, Fomenkov AA, Foroumadi R, Fortuna Rodrigues C, Foschi M, Francis KL, Franklin RC, Gába A, Gadanya MA, Gaidhane AM, Galali Y, Gallus S, Ganesan B, Gangachannaiah S, Gebregergis MW, Gebrehiwot M, Getacher L, Getie M, Ghadirian F, Ghazy RM, Gil AU, Gill TK, Gillum RF, Girmay AA, Golechha M, Goleij P, Goulart AC, Grada A, Grivna M, Grover A, Guan Z, Guarducci G, Gubari MIM, Guha A, Gulati S, Gunawardane DA, Guo Z, Gupta B, Gupta R, Gupta R, Gupta V, Gutiérrez-Murillo RS, Guzman-Esquivel J, Hadi NR, Hadian Z, Hamdy NM, Hamidi S, Hanif A, Hanifi N, Hankey GJ, Haq A, Haro JM, Hasan F, Hashempour R, Hashempur MH, Hasnain MS, Hassan A, Hassan N, Hassanipour S, Hassanzade Rad A, Havmoeller RJ, Hay SI, Hebert JJ, Hezam K, Hiraike Y, Hoang M, Holla R, Hossain A, Hosseinzadeh H, Hostiuc M, Hostiuc S, Htay ZW, Hu M, Hu Y, Humayun A, Hundie TG, Husseiny MI, Hussien FM, Huynh HH, Hwang BF, Ibrahim R, Ibrayeva A, Ikeda N, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Inok A, Iqbal K, Islam MS, Islam MF, Islam MR, Islam SMS, Ismail NE, Iso H, Isola G, Ituka MC, Iwagami M, Iwu-Jaja CJ, Iyasu AN, Jacob L, Jaffar S, Jahrami H, Jain A, Jain R, Jairoun AA, Jakovljevic M, Javaid SS, Jayapal SK, Jayaram S, Jebasingh FK, Jee SH, Jema AT, Jeswani BM, Jonas JB, Joseph N, Joshua CE, Jozwiak JJ, Jürisson M, Kaambwa B, Kabir A, Kadashetti V, Kakkar AK, Kalra S, Kanaan SF, Kankam SB, Kanmanthareddy AR, Kanmodi KK, Kantar RS, Kar D, Karajizadeh M, Karakasis P, Karimi Behnagh A, Karimzadhagh S, Kassebaum NJ, Kauppila JH, Kayode GA, Kedir S, Kehagias D, Keshwani A, Kesse-Guyot E, Keykhaei M, Khajuria H, Khalili P, Khalilian A, Khalis M, Khan A, Khan M, Khan MAS, Khan MJ, Khan MAB, Khan MS, Khan N, Khanal V, Khanmohammadi S, Khatatbeh MM, Kheirkhah M, Khidri FF, Khokhar M, Khosla AA, Khosravi S, Khosrowjerdi M, Khusun H, Kim GR, Kim J, Kim J, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kishore L, KM S, Kokkorakis M, Kompani F, Korzh O, Kostev K, Koulmane Laxminarayana SL, Kretchy IA, Kua CH, Kuate Defo B, Kuddus M, Kulimbet M, Kulkarni V, Kumar GA, Kumar V, Kundu S, Kunutsor SK, Kurmi OP, Kurniasari MD, Kusuma D, Kytö V, La Vecchia C, Lacey B, Lahariya C, Lai DTC, Landires I, Larijani B, Lassi ZS, Le HTT, Le NHH, Lee HA, Lee M, Lee PH, Lee SW, Lee WC, Li A, Li MC, Li W, Li Y, Lim SS, Lin J, Lin Q, Lindholm D, Lindstedt PA, Liu J, Lo J, López-Gil JF, Lorkowski S, Lucchetti G, Lugo A, Lutambi AM, Ma ZF, Magaña Gómez JA, Maghbouli N, Mahalleh M, Mahmood NH, Majeed A, Makris KCC, Malakan Rad E, Malekzadeh R, Malhotra K, Malik AA, Malik I, Malta DC, Mamun AA, Manu E, Marateb HR, Marino M, Marjani A, Martinez-Piedra R, Martorell M, März W, Marzouk S, Masrouri S, Mathangasinghe Y, Matozinhos FP, Matthias T, Mattiello R, Maugeri A, Mazidi M, McPhail SM, Mechili EA, Medel Salas MP, Mehmood A, Mehrabani-Zeinabad K, Mekene Meto T, Meles HN, Mendoza W, Menezes RG, Mengistie EA, Meo SA, Mestrovic T, Mettananda CDK, Mettananda S, Miao H, Miller TR, Ming WK, Mirrakhimov EM, Misganaw A, Mitiku H, Mittal M, Mohamed J, Mohamed MG, Mohamed NS, Mohammad T, Mohammad-Alizadeh-Charandabi S, Mohammadian-Hafshejani A, Mohammadzadeh I, Mohammed S, Mokdad AH, Monasta L, Mondello S, Moni MA, Montazeri Namin S, Moodi Ghalibaf A, Moradi Y, Morrison SD, Motappa R, Mubarik S, Mulita F, Mullany EC, Munkhsaikhan Y, Murillo-Zamora E, Murray CJL, Musa S, Mustafa G, Muthu S, Mwita JC, Myung W, Nafiu AB, Nagel G, Naik GR, Naik H, Nambi G, Nangia V, Nargus S, Nascimento GG, Nassar M, Nauman J, Naureen Z, Navaratna SNK, Nawsherwan, Nayak BP, Nazri-Panjaki A, Negahdary M, Negoi I, Negoi RI, Nematollahi S, Nepal S, Netsere HB, Ng M, Ngunjiri JW, Nguyen D, Nguyen PT, Nguyen PT, Niazi RK, Nieddu L, Niknam M, Nikolouzakis TK, Nikoobar A, Nkeck JR, Nomura S, Noor STA, Noreen M, Noubiap JJ, Nouri M, Nri-Ezedi CA, Nugen F, Nuñez-Samudio V, Nur A, Nyande FK, Nzoputam CI, Oancea B, O'Connell EM, Odetokun IA, Ofakunrin AOD, Oguta JO, Oh IH, Okati-Aliabad H, Okeke SR, Okekunle AP, Okonji OC, Olagunju AT, Olalusi OV, Olasehinde TA, Oliveira AB, Oliveira GMM, Oluwafemi YD, Omar HA, Omar Bali A, Omer NA, Ong SK, Ordak M, Ortiz A, Osborne A, Osman WMS, Otoiu A, Oumer A, Ouyahia A, Owolabi MO, Owusu IA, Oyebola K, Oyelade T, P A MP, Padron-Monedero A, Padubidri JR, Palicz T, Panda SK, Panda-Jonas S, Pandey A, Pandi-Perumal SR, Pant S, Pardhan S, Parekh U, Parija PP, Parikh RR, Park EC, Passera R, Patel J, Patoulias D, Paudel S, Peprah P, Pereira M, Perico N, Perna S, Petcu IR, Petermann-Rocha FE, Pham HN, Pham TT, Pirouzpanah S, Polibin RV, Popovic DS, Potani I, Pourghazi F, Pourshams A, Pradhan J, Pradhan PMS, Prasad M, Prashant A, Prates EJS, Puvvula J, Qattea I, Qiao Y, Radhakrishnan V, Radojˇić MR, Raggi C, Rahman FM, Rahman MM, Rahman MHU, Rahman M, Rahman MA, Rahmanian M, Rahmanian V, Rahmati M, Rai RK, Raimondo I, Raj JP, Rajput P, Ramadan MM, Ramasamy C, Ramasamy SK, Ramazanu S, Rana K, Ranabhat CL, Rao M, Rao SJ, Rashedi S, Rashidi MM, Rasouli-Saravani A, Rathish D, Rauniyar SK, Rautalin I, Rawaf DL, Rawaf S, Redwan EMMM, Rege S, Rehman AU, Reis-Mendes A, Remuzzi G, Rezaei N, Rezaeian M, Rhee TG, Rocha-Gomes JR, Rodrigues da Silva TP, Rodriguez JAB, Roever L, Rohloff P, Romadlon DS, Rony MKK, Roshandel G, Rout HS, Roy N, Rwegerera GM, Saad AMA, Saber-Ayad MM, Sabzmakan L, Sadarangani KP, Saddik BA, Sadeghi M, Saeed U, Sagoe D, Saheb Sharif-Askari F, Sahebkar A, Sahoo SS, Sajadi SM, Sajid MR, Salami AA, Salaroli LB, Saleem S, Saleh MA, Salem MR, Salihu D, Salimi S, Samy AM, Santric-Milicevic MM, Sarkar T, Sarmadi M, Sarode GS, Sarode SC, Sassano M, Saulam J, Sawhney M, Saxena S, Saya GK, Schinckus C, Schmidt MI, Schuermans A, Selvaraj S, Sendekie AK, Sengupta P, Senol YC, Senthilkumaran S, Sepanlou SG, Sethi Y, Seylani A, Shafie M, Shah S, Shahid S, Shahwan MJ, Shamim MA, Shams-Beyranvand M, Shamsutdinova A, Shanawaz M, Shannawaz M, Sharath M, Sharifan A, Sharma M, Sharma U, Sharma V, Sheida F, Shenoy RR, Shetty PH, Shiferaw D, Shin MJ, Shirani Lapari M, Shiri R, Shittu A, Shool S, Shorofi SA, Shrestha G, Shrestha R, Shuval K, Si Y, Sibuyi NRS, Siddig EE, Siervo M, Silva DAS, Silva LMLR, Singh A, Singh B, Singh H, Singh JA, Singh K, Singh L, Singh M, Singh PS, Singh S, Skryabina AA, Smith AE, Smith G, Soliman SSM, Soraneh S, Spartalis M, Srichawla BS, Stanikzai MH, Starodubova AV, Straif K, Stubbs P, Subramaniyan V, Suleiman Odidi MO, Sulkowski A, Sultan Meo A, Sun Z, Sunny S, Sunuwar DR, Swain CK, Szarpak L, T Y SS, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabaei Malazy O, Tabatabaeizadeh SA, Tabatabai S, Tabche C, Tabish M, Taiba J, Tampa M, Tamuzi JL, Tan KK, Tanwar M, Tariq S, Tat NY, Temsah MH, Temsah RMH, Teramoto M, Terefa DR, Tewari J, Thangaraju P, Thapar R, Thavamani A, Thirunavukkarasu S, Thomas J, Tiruneh SA, Tiruye TY, Titova MV, Tiwari K, Tomo S, Tonelli M, Touvier M, Tovani-Palone MR, Trabelsi K, Tran NH, Tran TH, Tran Minh Duc N, Trico D, Truyen TTTT, Tsegay GM, Tumurkhuu M, Tye SC, Udoakang AJ, Ullah A, Ullah S, Ullah S, Umair M, Umar L, Umar UM, Unim B, Upadhya D, Upadhyay E, Usman JS, Ustunsoz D, Vaezghasemi M, Vaithinathan AG, Van den Eynde J, Varghese J, Vasankari TJ, Vaziri S, Vellingiri B, Venketasubramanian N, Verma M, Verras GI, Villalobos-Daniel VE, Vladimirov SK, Vlassov V, Vollset SE, Vukovic R, Wahiduzzaman M, Wang C, Wang S, Wang X, Wang Y, Weerakoon KG, Wei FL, Wicaksana AL, Wickramasinghe DP, Wickramasinghe ND, Willeit P, Wojewodzic MW, Xia Q, Xiao G, Xie W, Xu S, Xu X, Yahya G, Yamagishi K, Yano Y, Yao H, Yarahmadi A, Yaribeygi H, Ye P, Yesuf SA, Yin D, Yon DK, Yonemoto N, Yu C, Yuan CW, Yuce D, Yunusa I, Zamagni G, Zastrozhin M, Zeariya MGM, Zhang CJP, Zhang H, Zhang J, Zhang L, Zhang X, Zhang Z, Zhao H, Zheng DX, Zhong A, Zhong CC, Zhou J, Zhu B, Zhumagaliuly A, Zielińska M, Zitoun OA, Zoghi G, Zou Z, Zyoud SH, Gakidou E, Sawyer SM, Azzopardi PS. Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021. Lancet 2025; 405:785-812. [PMID: 40049185 PMCID: PMC11920006 DOI: 10.1016/s0140-6736(25)00397-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 11/13/2024] [Accepted: 02/24/2025] [Indexed: 03/10/2025]
Abstract
BACKGROUND Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. METHODS Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5-14 years, typically in school and cared for by child health services) and older adolescents (aged 15-24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990-2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. FINDINGS Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6-96·6) individuals aged 5-14 years and 80·6 million (78·2-83·3) aged 15-24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15-24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5-14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7-17·2) of those aged 5-14 years are forecasted to have obesity by 2050 (186 million [141-221]), compared with 14·2% (11·4-15·7) of those aged 15-24 years (175 million [136-203]). We forecasted that by 2050, there will be more young males (aged 5-14 years) living with obesity (16·5% [13·3-18·3]) than overweight (12·9% [12·2-13·6]); while for females (aged 5-24 years) and older males (aged 15-24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041-50: children and adolescents (males and females aged 5-24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5-14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5-14 years in Australasia; females aged 15-24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15-24 years in high-income North America. INTERPRETATION Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis. FUNDING Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.
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Hashemi Javaheri FS, Nasiri Jounaghani M, Sahebkar A, Norouzzadeh M, Delgarm P, Shahinfar H, Mirdar Harijani A. The effect of fermented dairy intake and abdominal obesity in adults: a systematic review and dose-response meta-analysis of cohort studies. Eat Weight Disord 2025; 30:23. [PMID: 40055253 PMCID: PMC11889060 DOI: 10.1007/s40519-025-01733-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Accepted: 02/23/2025] [Indexed: 03/12/2025] Open
Abstract
OBJECTIVES Diverse analysis has analyzed the potential efficacy of consuming foods created through the fermentation of dairy in mitigating abdominal obesity. The current meta-analysis aims to determine the impacts of consuming fermented dairy foods and the occurrence of abdominal obesity. METHODS Web of Science, PubMed, and Scopus databases were queried for records published before January 13, 2023, to investigate proportionate cohort studies. We employed a random-effects model to appraise the relative risk (RR); effect size was assessed through the 95% confidence interval (CI). Additionally, a one-stage dose-response analysis was executed, quality assessment was conducted through the ROBINS-E tool. RESULTS Consequently, five publications, comprising 41,430 cases, were included as selected studies. The pooled effect shows an effect on the abdominal obesity risk; however, the effect was not significant. Subgroup analyses revealed a potential risk reduction effect in high- and low-fat and fermented dairy productions, although the findings were not statistically significant. Furthermore, the dose-response analysis indicated a linear decrease in risk with increasing consumption of high-fat fermented yogurt, with an HR of 0.84 (95% CI 0.71, 0.99) by 8 servings/week and an HR of 0.37 (95% CI 0.19, 0.71) by 21 servings/week. CONCLUSION These findings imply the potential effectiveness of fermented dairy products, particularly high-fat yogurt, in diminishing the obesity risk. However, further research addressing the limitations of previous studies is essential to confirm these results. Evidence-based medicine level: No level of evidence: Level of evidence III. PROSPERO registration number: CRD42023387538 ( http://www.crd.york.ac.uk/PROSPERO ).
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Affiliation(s)
- Fatemeh Sadat Hashemi Javaheri
- Department of Clinical Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Milad Nasiri Jounaghani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Amirhossein Sahebkar
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveentha University, Chennai, India
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Norouzzadeh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Faculty of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Pedram Delgarm
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Shahinfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Faculty of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Artemiss Mirdar Harijani
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Jensen DEA, Ebmeier KP, Akbaraly T, Jansen MG, Singh-Manoux A, Kivimäki M, Zsoldos E, Klein-Flügge MC, Suri S. Association of Diet and Waist-to-Hip Ratio With Brain Connectivity and Memory in Aging. JAMA Netw Open 2025; 8:e250171. [PMID: 40072438 PMCID: PMC11904738 DOI: 10.1001/jamanetworkopen.2025.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2025] Open
Abstract
Importance Epidemiological studies suggest that lifestyle factors are associated with risk of dementia. However, few studies have examined the association of diet and waist to hip ratio (WHR) with hippocampus connectivity and cognitive health. Objective To ascertain how longitudinal changes in diet quality and WHR during midlife are associated with hippocampal connectivity and cognitive function in later life. Design, Setting, and Participants This cohort study analyzed data from participants in the Whitehall II Study at University College London (study inception: 1985) and Whitehall II Imaging Substudy at the University of Oxford (data collection: 2012-2016). Healthy participants from the Whitehall II Imaging Study with a mean age of 48 years at baseline to 70 years at magnetic resonance imaging (MRI) were included if they had information on diet from at least 1 wave, information on WHR from at least 2 waves, and good-quality MRI scans. Study analyses were completed from October 2019 to November 2024. Exposures Diet quality was measured in participants(mean age, 48 years at baseline to 60 years) using the Alternative Healthy Eating Index-2010 score, which was assessed 3 times across 11 years. WHR was measured 5 times over 21 years in participants aged 48 to 68 years. Main Outcomes and Measures White matter structural connectivity assessed using diffusion tensor imaging, hippocampal functional connectivity assessed using resting-state functional MRI, and cognitive performance measures. Brain imaging and cognitive tests were performed at a mean (SD) age of 70 (5) years. Results The final diet quality sample comprised 512 participants (403 males [78.7%]; mean [SD] age, 47.8 [5.2] years), and the final WHR sample included 664 participants (532 males [80.1%]; mean [SD] age, 47.7 [5.1] years). Better diet quality in midlife and from midlife to late life was associated with higher hippocampal functional connectivity to the occipital lobe and cerebellum (left hippocampus: 9176 mm3, P < .05; left hippocampus and to the right cerebellum: 136 mm3, P = .04) and better white matter integrity as measured by higher fractional anisotropy (FA; 19 432 mm3, P < .05) and lower diffusivity (mean diffusivity [MD]: 5560 mm3, P < .05; axial diffusivity [AD]: 2600 mm3, P < .045; AD in fornix: β [SE] = 0.26 [0.11], false discovery rate-corrected P = .02). Higher WHR in midlife was associated with higher MD and radial diffusivity (covering 26.4% [333 088 mm3, P < .001] and 23.1% [291 888 mm3, P < .05], respectively, of the total white matter tracts in the cingulum and superior and inferior longitudinal fasciculus) and lower FA in the corticospinal tract (covering 4.9% of the white matter skeleton), including the inferior longitudinal fasciculus and cingulum (61 272 mm3, P < .05). Associations between midlife WHR, working memory, and executive function were partially mediated by diffusivity (eg, digit span was mediated by global FA: β = -2.96-03; 95% CI, -5.56-03 to -1.01-03; P < .001). Conclusions and Relevance This cohort study found that healthier diets and lower WHR throughout midlife were associated with better brain and cognitive health in older age. The findings suggest that interventions to improve diet and manage central obesity might be most effective between ages 48 and 70 years.
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Affiliation(s)
- Daria E A Jensen
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - Klaus P Ebmeier
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Tasnime Akbaraly
- UCL Brain Sciences, University College London, London, United Kingdom
- Desbrest Institute of Epidemiology and Public Health, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
| | - Michelle G Jansen
- Donders Centre for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Archana Singh-Manoux
- UCL Brain Sciences, University College London, London, United Kingdom
- Epidemiology of Ageing and Neurodegenerative Diseases, Université Paris Cité, INSERM U1153, Paris, France
| | - Mika Kivimäki
- UCL Brain Sciences, University College London, London, United Kingdom
| | - Eniko Zsoldos
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Miriam C Klein-Flügge
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
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Piana K, Ziomber-Lisiak A, Ruszczycki B, Bugajski A, Szczerbowska-Boruchowska M. Effects of high-calorie diet-induced obesity on molecular structures of lipids and proteins - A multi-organ study using FTIR spectroscopy. Arch Biochem Biophys 2025; 765:110325. [PMID: 39894381 DOI: 10.1016/j.abb.2025.110325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 01/19/2025] [Accepted: 01/31/2025] [Indexed: 02/04/2025]
Abstract
In the presented study, we evaluated changes in the molecular structures of lipids and proteins in organs/tissues at the early stage of obesity induced by a high-calorie diet (HCD), using animal models. We examined several different molecular parameters and the organs most affected by obesity. Fourier transform infrared (FTIR) spectroscopy combined with Principal Component Analysis (PCA) and Receiver Operating Characteristic (ROC) analysis were used to evaluate molecular changes in tissues taken from HCD-induced obese Wistar rats and their lean counterparts. We observed that at the early stage of obesity, changes occurred mainly in lipid structures, primarily affecting white epididymal adipose tissue (WAT) and the liver (Lr). No changes in protein molecular structures were observed in any of the examined organs. PCA showed distinctly different organ/tissue compositions, in terms of molecular parameters, for both groups. In turn, ROC analysis indicated that fatty acid chain length (FACL), lipid unsaturation (L_Unsat), and carbonyl/lipid ratio (Carb/L) for WAT, and FACL and lipid/protein ratio (L/P) for Lr, were the molecular parameters, whose levels differentiated the most between both groups. We demonstrated that studies using FTIR spectroscopy combined with advanced data mining methods could deepen the current knowledge about obesity and the biochemical changes occurring in the organs affected by this disease. Thus, they can help in the future with better and faster diagnosis and prevention of obesity and its complications.
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Affiliation(s)
- Kaja Piana
- AGH University of Krakow, Faculty of Physics and Applied Computer Science, Al. A. Mickiewicza 30, 30-059, Krakow, Poland
| | - Agata Ziomber-Lisiak
- Chair of Pathophysiology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121, Krakow, Poland
| | - Blazej Ruszczycki
- AGH University of Krakow, Faculty of Physics and Applied Computer Science, Al. A. Mickiewicza 30, 30-059, Krakow, Poland
| | - Andrzej Bugajski
- Chair of Pathophysiology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121, Krakow, Poland
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15
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Yu J, Chen S, Yang J, Zhang X, Xue H, Ni X, Du W, Fan L, Zhang F, Wang Y. Childhood and Adolescent Overweight/Obesity Prevalence Trends in Jiangsu, China, 2017-2021: An Age-Period-Cohort Analysis. Public Health Nurs 2025; 42:754-761. [PMID: 39737852 DOI: 10.1111/phn.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 11/04/2024] [Accepted: 12/11/2024] [Indexed: 01/01/2025]
Abstract
OBJECTIVES To investigate temporal trends in childhood and adolescent overweight/obesity in Jiangsu Province, China, evaluating the effects of age, period, and birth cohort. DESIGN Cross-sectional study. SAMPLE Participants were 210,168 students aged 6-17 years from the five waves of the consecutive cross-sectional Jiangsu provincial surveillance project in 2017-2021. MEASUREMENTS Overweight/obesity was assessed according to the sex- and age-specific body mass index. We used age-period-cohort (APC) analysis to explore the temporal trends of overweight/obesity and to estimate the effects of age, period, and birth cohort on the prevalence. RESULTS The overall prevalence of overweight/obesity has increased from 32.08% to 38.60% between 2017 and 2021. The 6-9-year-old group and the 10-13-year-old group were significantly associated with a higher risk of overweight/obesity, in contrast to 14-17-year-olds. The pandemic was also significantly associated with a much higher risk. The cohort 2000-2003 was associated with higher risk, and such association continued until the cohort 2012-2015, denoting a significantly lower risk. CONCLUSIONS Despite an increasing trend in the prevalence of overweight/obesity, especially during the COVID-19 pandemic, the latest cohort effect was significantly associated with a lower risk. We recommend continuous efforts on preventive interventions and more research about prevalence trends.
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Affiliation(s)
- Jinxia Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Sunan Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Jie Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiyan Zhang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hui Xue
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Xiaoyan Ni
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Wei Du
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Lijun Fan
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Fengyun Zhang
- Department of Child and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Yan Wang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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16
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Cook TM, Fuller KNZ, Sandoval DA. Insights into the neurobiology of weight loss after bariatric surgery and GLP-1R agonists. Neuropharmacology 2025; 265:110269. [PMID: 39675463 PMCID: PMC11702201 DOI: 10.1016/j.neuropharm.2024.110269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 11/18/2024] [Accepted: 12/13/2024] [Indexed: 12/17/2024]
Abstract
Obesity and its related complications are growing in prevalence worldwide, with increasing impact to individuals and healthcare systems alike. Currently, the leading treatment approaches for effective and sustained weight loss are bariatric surgery and gut peptide therapeutics. At a high level, both treatment strategies work by hijacking gut-brain axis signaling to reduce food intake. However, we predict that each modality has distinct neuronal mechanisms that are responsible for their success and complications. This review compares the neurobiology of feeding behavior between these two weight loss strategies via a discussion of both clinical and pre-clinical data. The most compelling evidence points to signaling within the hindbrain, hypothalamus, and reward circuits contributing to weight loss. Considerations for treatment, including differing complications between the two treatment approaches, will also be discussed. Based on the data, we pose the hypothesis that these two interventions are acting via distinct mechanisms to induce weight loss. Both interventions have variable degrees of weight loss across the patient population, thus, understanding these distinct mechanisms could help drive individualized medicine to optimize weight loss. This article is part of the Special Issue on "Food intake and feeding states".
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Affiliation(s)
- Tyler M Cook
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kelly N Z Fuller
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Darleen A Sandoval
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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17
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Rubino F, Cummings DE, Eckel RH, Cohen RV, Wilding JPH, Brown WA, Stanford FC, Batterham RL, Farooqi IS, Farpour-Lambert NJ, le Roux CW, Sattar N, Baur LA, Morrison KM, Misra A, Kadowaki T, Tham KW, Sumithran P, Garvey WT, Kirwan JP, Fernández-Real JM, Corkey BE, Toplak H, Kokkinos A, Kushner RF, Branca F, Valabhji J, Blüher M, Bornstein SR, Grill HJ, Ravussin E, Gregg E, Al Busaidi NB, Alfaris NF, Al Ozairi E, Carlsson LMS, Clément K, Després JP, Dixon JB, Galea G, Kaplan LM, Laferrère B, Laville M, Lim S, Luna Fuentes JR, Mooney VM, Nadglowski J, Urudinachi A, Olszanecka-Glinianowicz M, Pan A, Pattou F, Schauer PR, Tschöp MH, van der Merwe MT, Vettor R, Mingrone G. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol 2025; 13:221-262. [PMID: 39824205 PMCID: PMC11870235 DOI: 10.1016/s2213-8587(24)00316-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 09/15/2024] [Accepted: 10/07/2024] [Indexed: 01/20/2025]
Abstract
Current BMI-based measures of obesity can both underestimate and overestimate adiposity and provide inadequate information about health at the individual level, which undermines medically-sound approaches to health care and policy. This Commission sought to define clinical obesity as a condition of illness that, akin to the notion of chronic disease in other medical specialties, directly results from the effect of excess adiposity on the function of organs and tissues. The specific aim of the Commission was to establish objective criteria for disease diagnosis, aiding clinical decision making and prioritisation of therapeutic interventions and public health strategies. To this end, a group of 58 experts—representing multiple medical specialties and countries—discussed available evidence and participated in a consensus development process. Among these commissioners were people with lived experience of obesity to ensure consideration of patients’ perspectives. The Commission defines obesity as a condition characterised by excess adiposity, with or without abnormal distribution or function of adipose tissue, and with causes that are multifactorial and still incompletely understood. We define clinical obesity as a chronic, systemic illness characterised by alterations in the function of tissues, organs, the entire individual, or a combination thereof, due to excess adiposity. Clinical obesity can lead to severe end-organ damage, causing life-altering and potentially life-threatening complications (eg, heart attack, stroke, and renal failure). We define preclinical obesity as a state of excess adiposity with preserved function of other tissues and organs and a varying, but generally increased, risk of developing clinical obesity and several other non-communicable diseases (eg, type 2 diabetes, cardiovascular disease, certain types of cancer, and mental disorders). Although the risk of mortality and obesity-associated diseases can rise as a continuum across increasing levels of fat mass, we differentiate between preclinical and clinical obesity (ie, health vs illness) for clinical and policy-related purposes. We recommend that BMI should be used only as a surrogate measure of health risk at a population level, for epidemiological studies, or for screening purposes, rather than as an individual measure of health. Excess adiposity should be confirmed by either direct measurement of body fat, where available, or at least one anthropometric criterion (eg, waist circumference, waist-to-hip ratio, or waist-to-height ratio) in addition to BMI, using validated methods and cutoff points appropriate to age, gender, and ethnicity. In people with very high BMI (ie, >40 kg/m2), however, excess adiposity can pragmatically be assumed, and no further confirmation is required. We also recommend that people with confirmed obesity status (ie, excess adiposity with or without abnormal organ or tissue function) should be assessed for clinical obesity. The diagnosis of clinical obesity requires one or both of the following main criteria: evidence of reduced organ or tissue function due to obesity (ie, signs, symptoms, or diagnostic tests showing abnormalities in the function of one or more tissue or organ system); or substantial, age-adjusted limitations of daily activities reflecting the specific effect of obesity on mobility, other basic activities of daily living (eg, bathing, dressing, toileting, continence, and eating), or both. People with clinical obesity should receive timely, evidence-based treatment, with the aim to induce improvement (or remission, when possible) of clinical manifestations of obesity and prevent progression to end-organ damage. People with preclinical obesity should undergo evidence-based health counselling, monitoring of their health status over time, and, when applicable, appropriate intervention to reduce risk of developing clinical obesity and other obesity-related diseases, as appropriate for the level of individual health risk. Policy makers and health authorities should ensure adequate and equitable access to available evidence-based treatments for individuals with clinical obesity, as appropriate for people with a chronic and potentially life-threatening illness. Public health strategies to reduce the incidence and prevalence of obesity at population levels must be based on current scientific evidence, rather than unproven assumptions that blame individual responsibility for the development of obesity. Weight-based bias and stigma are major obstacles in efforts to effectively prevent and treat obesity; health-care professionals and policy makers should receive proper training to address this important issue of obesity. All recommendations presented in this Commission have been agreed with the highest level of consensus among the commissioners (grade of agreement 90–100%) and have been endorsed by 76 organisations worldwide, including scientific societies and patient advocacy groups.
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Affiliation(s)
- Francesco Rubino
- Metabolic and Bariatric Surgery, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK; King's College Hospital, London, UK.
| | - David E Cummings
- University of Washington, Seattle, WA, USA; Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Robert H Eckel
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ricardo V Cohen
- Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - John P H Wilding
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
| | - Wendy A Brown
- Monash University Department of Surgery, Central Clinical School, Alfred Health, Melbourne, VIC, Australia
| | - Fatima Cody Stanford
- Neuroendocrine Unit, Division of Endocrinology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Endocrinology, Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel L Batterham
- International Medical Affairs, Eli Lilly, Basingstoke, UK; Diabetes and Endocrinology, University College London, London, UK
| | - I Sadaf Farooqi
- Institute of Metabolic Science and National Institute for Health and Care Research, Cambridge Biomedical Research Centre at Addenbrookes Hospital, Cambridge, UK
| | - Nathalie J Farpour-Lambert
- Obesity Prevention and Care Program, Department of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Louise A Baur
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Weight Management Services, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada; McMaster Children's Hospital, Hamilton, ON, Canada
| | - Anoop Misra
- Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, India; National Diabetes Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation New Delhi, India
| | | | - Kwang Wei Tham
- Department of Endocrinology, Woodlands Health, National Healthcare Group, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Priya Sumithran
- Department of Surgery, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
| | - W Timothy Garvey
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John P Kirwan
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - José-Manuel Fernández-Real
- CIBER Pathophysiology of Obesity and Nutrition, Girona, Spain; Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain; Hospital Trueta of Girona and Institut d'Investigació Biomèdica de Girona, Girona, Spain
| | - Barbara E Corkey
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Hermann Toplak
- Division of Endocrinology and Diabetology, Department of Medicine, University of Graz, Graz, Austria
| | - Alexander Kokkinos
- First Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Robert F Kushner
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Francesco Branca
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Jonathan Valabhji
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK; Department of Diabetes and Endocrinology, Chelsea and Westminster Hospital National Health Service Foundation Trust, London, UK
| | - Matthias Blüher
- Helmholtz Institute for Metabolic, Obesity and Vascular Research of Helmholtz Munich, University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Stefan R Bornstein
- Department of Internal Medicine III, Carl Gustav Carus University Hospital Dresden, Technical University Dresden, Dresden, Germany; School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Harvey J Grill
- Institute of Diabetes, Obesity and Metabolism, University of Pennsylvania, Philadelphia, PA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Edward Gregg
- School of Population Health, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland; School of Public Health, Imperial College London, London, UK
| | - Noor B Al Busaidi
- National Diabetes and Endocrine Center, Royal Hospital, Muscat, Oman; Oman Diabetes Association, Muscat, Oman
| | - Nasreen F Alfaris
- Obesity Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ebaa Al Ozairi
- Clinical Research Unit, Dasman Diabetes Institute, Dasman, Kuwait
| | - Lena M S Carlsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karine Clément
- Nutrition and Obesities: Systemic Approaches, NutriOmics Research Group, INSERM, Sorbonne Université, Paris, France; Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hospital of Paris, Paris, France
| | | | - John B Dixon
- Iverson Health Innovation Research institute, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Gauden Galea
- Regional Office for Europe, World Health Organization, Geneva, Switzerland
| | - Lee M Kaplan
- Section on Obesity Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Blandine Laferrère
- Division of Endocrinology, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seoul, South Korea
| | | | - Vicki M Mooney
- European Coalition for people Living with Obesity, Dublin, Ireland
| | | | - Agbo Urudinachi
- Department of Community Health, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Nigeria
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Science, Medical University of Silesia, Katowice, Poland
| | - An Pan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Francois Pattou
- Translational Research for Diabetes, Lille University, Lille University Hospital, Inserm, Institut Pasteur Lille, Lille, France; Department of General and Endocrine Surgery, Lille University Hospital, Lille, France
| | | | - Matthias H Tschöp
- Helmholtz Munich, Munich, Germany; Technical University of Munich, Munich, Germany
| | - Maria T van der Merwe
- University of Pretoria, Pretoria, South Africa; Nectare Waterfall City Hospital, Midrand, South Africa
| | - Roberto Vettor
- Internal Medicine, Center for the Study and the Integrated Treatment of Obesity, Department of Medicine, University of Padova, Padua, Italy; Center for Metabolic and Nutrition Related Diseases,Humanitas Research Hospital, Milan, Italy
| | - Geltrude Mingrone
- Division of Diabetes & Nutritional Sciences, School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London, UK; Catholic University of the Sacred Heart, Rome, Italy; University Polyclinic Foundation Agostino Gemelli IRCCS, Rome, Italy
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18
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Queral J, Wargers A, Llauradó E, Jansen W, Solà R, Tarro L, Mölenberg FJM. Effectiveness of Participatory Research Interventions on Obesity and Obesity-Related Behaviors in Adolescents: A Systematic Review and Meta-analysis. Nutr Rev 2025; 83:e904-e930. [PMID: 38976588 DOI: 10.1093/nutrit/nuae067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
CONTEXT Adolescence is an optimal period to promote healthy lifestyles because behavior patterns are established in this stage. It has been suggested that engaging youth increases the effectiveness of interventions, but an overview is lacking. OBJECTIVE This study aims to evaluate the effectiveness of participatory research (PR) interventions, where adolescents (11-18 years old) from high-income countries had a significant role in the intervention development and/or delivery, compared with no (PR) intervention control groups on obesity-related outcomes and healthy lifestyle behaviors (HLBs). DATA SOURCES Eight databases (Embase, Medline ALL, Web of Science Core Collection, PsycINFO, ERIC, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials) and Google Scholar were searched from 1990 to 2024 for randomized controlled trials (RCTs) and non-RCTs (in English). DATA EXTRACTION Two researchers independently performed the data extraction and risk-of-bias assessment. DATA ANALYSIS Sixteen studies were included and outcomes have been narratively described. Seven studies evaluated youth-led interventions, 3 studies evaluated co-created interventions, and 6 studies evaluated the combination of both. Six studies focused on physical activity (PA), 2 on nutrition, and 8 on a combination of PA, nutrition, and/or obesity-related outcomes. Ten studies presented at least 1 significant effect on PA, nutrition, or obesity-related outcomes in favor of the intervention group. Additionally, 12 studies were pooled in a meta-analysis. Whereas a small desired effect was found for fruit consumption, a small undesired effect was found for vegetable consumption. The pooled analysis found no significant effects on moderate-vigorous PA, total PA, and PA self-efficacy. CONCLUSION We found some evidence that youth empowerment in research may have positive effects on obesity-related HLBs, specifically an increased fruit consumption. However, the overall evidence was inconclusive due to limited studies and the heterogeneity of the studies included. This overview may guide future public health interventions that aim to engage and empower adolescents. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration Nº CRD42021254135.
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Affiliation(s)
- Judit Queral
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Annemieke Wargers
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Elisabet Llauradó
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Wilma Jansen
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Social Development, City of Rotterdam, 3000 LP Rotterdam, The Netherlands
| | - Rosa Solà
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
- Internal Medicine, Hospital Universitari Sant Joan de Reus, Reus, 43204, Spain
| | - Lucia Tarro
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Famke J M Mölenberg
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
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19
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Li B, Swinburn B. Shifting the way we conceptualise, research and intervene childhood obesity in China and Southeast Asian countries. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2025; 56:101502. [PMID: 40092587 PMCID: PMC11910098 DOI: 10.1016/j.lanwpc.2025.101502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 02/03/2025] [Accepted: 02/13/2025] [Indexed: 03/19/2025]
Affiliation(s)
- Bai Li
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
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20
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Lan Y, Song R, Feng D, He J. Bioinformatic analysis of molecular expression patterns during the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). Sci Rep 2025; 15:7294. [PMID: 40025132 PMCID: PMC11873118 DOI: 10.1038/s41598-025-90744-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 02/14/2025] [Indexed: 03/04/2025] Open
Abstract
The global incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to rise, primarily driven by the escalating obesity epidemic worldwide. MASLD, a spectrum of liver disorders, can progress to more severe conditions, metabolic dysfunction-associated steatohepatitis (MASH), ultimately culminating in hepatocellular carcinoma (HCC). Given the complex nature of MASLD, there is an urgent need to develop robust risk prediction models and design specialized cancer screening initiatives tailored specifically for individuals with MASLD. This study aimed to identify genes exhibiting trending expression patterns that could serve as potential biomarkers or therapeutic targets. Our approach involved analyzing expression patterns across the five stages of MASLD development and progression. Notably, we introduced an innovative two-phase classification-MASLD occurrence and MASLD progression-instead of categorizing differentially expressed genes (DEGs) into multiple types. Leveraging LASSO regression models, we demonstrated their relatively strong capability to predict and distinguish both MASLD occurrence and progression. Furthermore, our analysis identified CYP7A1 and TNFRSF12A as significantly associated with the prognosis of MASLD progressing to HCC. These findings contribute to the understanding of gene expression dynamics in MASLD and may pave the way for the development of effective prognostic tools and targeted therapies in the realm of liver disease.
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Affiliation(s)
- Yuanfeng Lan
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, Beijing, People's Republic of China
| | - Ran Song
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, Beijing, People's Republic of China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, People's Republic of China
| | - Duiping Feng
- Department of Interventional Radiology, First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
| | - Junqi He
- Beijing Key Laboratory for Tumor Invasion and Metastasis, Department of Biochemistry and Molecular Biology, Capital Medical University, Beijing, People's Republic of China.
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, People's Republic of China.
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21
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Northcott T, Lawrence M, Parker C, Reeve B, Baker P. Regulatory responses to ultra-processed foods are skewed towards behaviour change and not food system transformation. NATURE FOOD 2025; 6:273-282. [PMID: 39794395 DOI: 10.1038/s43016-024-01101-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/26/2024] [Indexed: 01/13/2025]
Abstract
Growing evidence suggests that diets high in ultra-processed foods (UPFs) are harming human and planetary health. UPFs therefore pose a complex regulatory challenge, yet, to date, little research has systematically assessed how governments have responded to UPFs in national food policies. Here we analyse data from the NOURISHING database to assess the scope and strength of UPF-related regulatory interventions worldwide, using three frameworks-namely, NOURISHING, the Nuffield Ladder and the Modalities of Control framework. Of the 417 UPF-related measures identified, most imply food processing or mention UPF examples rather than refer to processing or UPFs specifically. The scope of action is narrow; 85.9% of interventions change the food environment, largely represented by nutrition labelling. The strength of action is limited; interventions are skewed towards informational measures to influence consumer choice, and 47.1% of measures use consensus to shape food business conduct. These findings highlight an opportunity to broaden the scope and strength of UPF-related regulation.
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Affiliation(s)
- Tanita Northcott
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Mark Lawrence
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Christine Parker
- Melbourne Law School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Belinda Reeve
- The University of Sydney Law School, The University of Sydney, Sydney, New South Wales, Australia
| | - Phillip Baker
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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22
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Henney AE, Wilding JPH, Alam U, Cuthbertson DJ. Obesity pharmacotherapy in older adults: a narrative review of evidence. Int J Obes (Lond) 2025; 49:369-380. [PMID: 38710803 DOI: 10.1038/s41366-024-01529-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024]
Abstract
The prevalence of obesity in older adults (people aged >60 years) is increasing in line with the demographic shift in global populations. Despite knowledge of obesity-related complications in younger adults (increased risk of type 2 diabetes, liver and cardiovascular disease and malignancy), these considerations may be outweighed, in older adults, by concerns regarding weight-loss induced reduction in skeletal muscle and bone mass, and the awareness of the 'obesity paradox'. Obesity in the elderly contributes to various obesity-related complications from cardiometabolic disease and cancer, to functional decline, worsening cognition, and quality of life, that will have already suffered an age-related decline. Lifestyle interventions remain the cornerstone of obesity management in older adults, with emphasis on resistance training for muscle strength and bone mineral density preservation. However, in older adults with obesity refractory to lifestyle strategies, pharmacotherapy, using anti-obesity medicines (AOMs), can be a useful adjunct. Recent evidence suggests that intentional weight loss in older adults with overweight and obesity is effective and safe, hence a diminishing reluctance to use AOMs in this more vulnerable population. Despite nine AOMs being currently approved for the treatment of obesity, limited clinical trial evidence in older adults predominantly focuses on incretin therapy with glucagon-like peptide-1 receptor agonists (liraglutide, semaglutide, and tirzepatide). AOMs enhance weight loss and reduce cardiometabolic events, while maintaining muscle mass. Future randomised controlled trials should specifically evaluate the effectiveness of novel AOMs for long-term weight management in older adults with obesity, carefully considering the impact on body composition and functional ability, as well as health economics.
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Affiliation(s)
- Alex E Henney
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK.
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK.
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK.
| | - John P H Wilding
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Uazman Alam
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
| | - Daniel J Cuthbertson
- Department of Cardiovascular & Metabolic Medicine, University of Liverpool, Liverpool, UK
- Metabolism & Nutrition Research Group, Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
- Liverpool Centre for Cardiovascular Sciences, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, Merseyside, UK
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23
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Novella-Navarro M, Van Den Rym A, López-Pedrera C, Martínez-Feito A, Nieto-Carvalhal B, Reche K, López-Medina C, Escudero-Contreras A, Nozal P, Miranda-Carús ME, Monjo I, De Miguel E, Balsa A, Pérez-De Diego R, Plasencia-Rodríguez C. Do Obesity and Adipose Tissue Cytokines Influence the Response to Janus Kinase Inhibitors in Rheumatoid Arthritis? Nutrients 2025; 17:820. [PMID: 40077690 PMCID: PMC11901994 DOI: 10.3390/nu17050820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2025] [Revised: 02/20/2025] [Accepted: 02/24/2025] [Indexed: 03/14/2025] Open
Abstract
Background: Obesity is a frequent comorbidity in rheumatoid arthritis (RA). This condition may lead these patients to have poorer disease control and a worse response to some of the available treatments. Objectives: We aim to analyze the role of body mass index (BMI) in the clinical response to Janus kinase inhibitors (JAKis) in patients with RA. We aim to perform an in-depth analysis of the pathophysiology of obesity by assessing serum adipokine levels, their potential influence in disease activity and their changes with treatment. Methods: This study involved 81 patients with RA treated with JAKis from Hospital La Paz and Hospital Reina Sofía. Patients were classified according to their BMI as normal weight and overweight/obesity. The clinical response to treatment was assessed by the Clinical Disease Activity Index (CDAI) and Disease Activity Score-28 (DAS28) 6 months after the initiation of JAKis. Serum adipokines (leptin and adiponectin) were determined using a commercial immunoassay kit in samples obtained before the initiation of JAKis and after 6 months of treatment. Results: Leptin levels showed a significant positive correlation with BMI at baseline (r = 0.59, p < 0.01) and at 6 months (r = 0.56, p < 0.01) in the whole cohort, but no correlation was found between BMI and adiponectin. No correlation between disease activity and BMI was found in the whole cohort at baseline and at 6 months measured by both the CDAI and DAS28. Fifty patients (61.7%) achieved low disease activity (LDA)/remission at 6 months, regardless their BMI, and no differences in serum adipokine levels were observed at baseline and at 6 months in patients who achieved LDA vs. no-LDA. Conclusions: In this study, we did not find an association between obesity and the extent of LDA in patients treated with JAKis; therefore, this mechanism of action could be suitable for overweight/obese patients with RA.
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Affiliation(s)
- Marta Novella-Navarro
- Rheumatology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (M.E.M.-C.); (I.M.); (E.D.M.); (A.B.); (C.P.-R.)
- Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Ana Van Den Rym
- Laboratory of Immunogenetics of Human Diseases, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain; (A.V.D.R.); (R.P.-D.D.)
| | - Chary López-Pedrera
- Rheumatology Department, Hospital Reina Sofía, IMIBIC, University of Córdoba, 14071 Córdoba, Spain; (C.L.-P.)
| | - Ana Martínez-Feito
- Immunology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (A.M.-F.)
| | - Beatriz Nieto-Carvalhal
- Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Keren Reche
- Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
| | - Clementina López-Medina
- Rheumatology Department, Hospital Reina Sofía, IMIBIC, University of Córdoba, 14071 Córdoba, Spain; (C.L.-P.)
| | | | - Pilar Nozal
- Immunology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (A.M.-F.)
| | - Maria Eugenia Miranda-Carús
- Rheumatology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (M.E.M.-C.); (I.M.); (E.D.M.); (A.B.); (C.P.-R.)
- Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Irene Monjo
- Rheumatology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (M.E.M.-C.); (I.M.); (E.D.M.); (A.B.); (C.P.-R.)
- Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Eugenio De Miguel
- Rheumatology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (M.E.M.-C.); (I.M.); (E.D.M.); (A.B.); (C.P.-R.)
- Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Alejandro Balsa
- Rheumatology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (M.E.M.-C.); (I.M.); (E.D.M.); (A.B.); (C.P.-R.)
- Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Rebeca Pérez-De Diego
- Laboratory of Immunogenetics of Human Diseases, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain; (A.V.D.R.); (R.P.-D.D.)
| | - Chamaida Plasencia-Rodríguez
- Rheumatology Department, Hospital Universitario La Paz, 28046 Madrid, Spain; (M.E.M.-C.); (I.M.); (E.D.M.); (A.B.); (C.P.-R.)
- Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, 28046 Madrid, Spain;
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24
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Anastasiou IA, Kounatidis D, Vallianou NG, Skourtis A, Dimitriou K, Tzivaki I, Tsioulos G, Rigatou A, Karampela I, Dalamaga M. Beneath the Surface: The Emerging Role of Ultra-Processed Foods in Obesity-Related Cancer. Curr Oncol Rep 2025:10.1007/s11912-025-01654-6. [PMID: 40014232 DOI: 10.1007/s11912-025-01654-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2025] [Indexed: 02/28/2025]
Abstract
PURPOSEOF REVIEW Ultra-processed foods (UPFs) are becoming more and more important in daily diets around the world; in some cases, they can account for as much as 60% of daily energy intake. Epidemiological evidence suggests that this shift toward high levels of food processing may be partially responsible for the global obesity epidemic and the rise in the prevalence of chronic diseases. RECENT FINDINGS Few prospective studies have examined the relationship between UPF consumption and cancer outcomes. According to currently available information, UPFs may increase the risk of cancer due to their obesogenic properties and exposure to substances that can cause cancer, such as certain food additives and pollution from product processing. The complex relationship between obesity and cancer involves factors such as immune dysregulation, altered adipokine and sex hormone levels, abnormal fatty acid metabolism, extracellular matrix remodeling, and chronic inflammation. Addressing cancer risk associated with UPF consumption could involve a multifaceted approach, including consumer behavior modification programs and robust public health regulations aimed at enhancing food environments. Improved knowledge of the potential dual negative impacts of UPFs on the environment and cancer risk is one of the priority areas we identify for future research and policy implications. Various approaches could be used to prevent cancers associated with UPF consumption, such as consumer behavior change programs and stricter public health regulations needed to improve the food environment. This review examines for the first time the potential role of UPFs in cancer risk associated with obesity, exploring underlying biological mechanisms and identifying key areas for future research and policy action, including the dual environmental and health impact of UPFs.
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Affiliation(s)
- Ioanna A Anastasiou
- Diabetes CenterDepartment of Propaedeutic Internal MedicineMedical School, Laiko General Hospital, National and Kapodistrian University of Athens, FirstAthens, Greece
- Department of Pharmacology, National and Kapodistrian University of Athens, 11527, Athens, Greece
| | - Dimitris Kounatidis
- Diabetes CenterDepartment of Propaedeutic Internal MedicineMedical School, Laiko General Hospital, National and Kapodistrian University of Athens, FirstAthens, Greece
| | - Natalia G Vallianou
- First Department of Internal Medicine, Sismanogleio General Hospital, 15126, Athens, Greece
| | - Alexandros Skourtis
- Department of Internal Medicine, Evangelismos General Hospital, 10676, Athens, Greece
| | - Krystalia Dimitriou
- Second Department of Internal Medicine, Medical School, National &, Hippokratio General Hospital, Kapodistrian University of Athens, 11527, Athens, Greece
| | - Ilektra Tzivaki
- First Department of Internal Medicine, Sismanogleio General Hospital, 15126, Athens, Greece
| | - Georgios Tsioulos
- Fourth Department of Internal Medicine, Medical School, Attikon General University Hospital, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Anastasia Rigatou
- First Department of Internal Medicine, Sismanogleio General Hospital, 15126, Athens, Greece
| | - Irene Karampela
- Second Department of Critical Care, Medical School, Attikon General University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Dalamaga
- Department of Biological Chemistry, National and Kapodistrian University of Athens, 11527, Athens, Greece.
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25
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Apostolopoulou M, Lambadiari V, Roden M, Dimitriadis GD. Insulin Resistance in Type 1 Diabetes: Pathophysiological, Clinical, and Therapeutic Relevance. Endocr Rev 2025:bnae032. [PMID: 39998445 DOI: 10.1210/endrev/bnae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Indexed: 02/26/2025]
Abstract
People with type 1 diabetes (T1D) are usually considered to exclusively exhibit β-cell failure, but they frequently also feature insulin resistance. This review discusses the mechanisms, clinical features, and therapeutic relevance of insulin resistance by focusing mainly on human studies using gold-standard techniques (euglycemic-hyperinsulinemic clamp). In T1D, tissue-specific insulin resistance can develop early and sustain throughout disease progression. The underlying pathophysiology is complex, involving both metabolic- and autoimmune-related factors operating synergistically. Insulin treatment may play an important pathogenic role in predisposing individuals with T1D to insulin resistance. However, the established lifestyle-related risk factors and peripheral insulin administration inducing glucolipotoxicity, hyperinsulinemia, hyperglucagonemia, inflammation, mitochondrial abnormalities, and oxidative stress cannot always fully explain insulin resistance in T1D, suggesting a phenotype distinct from type 2 diabetes. The mutual interaction between insulin resistance and impaired endothelial function further contributes to diabetes-related complications. Insulin resistance should therefore be considered a treatment target in T1D. Aside from lifestyle modifications, continuous subcutaneous insulin infusion can ameliorate insulin resistance and hyperinsulinemia, thereby improving glucose toxicity compared with multiple injection insulin treatment. Among other concepts, metformin, pioglitazone, incretin-based drugs such as GLP-1 receptor agonists, sodium-glucose cotransporter inhibitors, and pramlintide can improve insulin resistance, either directly or indirectly. However, considering the current issues of high cost, side effects, limited efficacy, and their off-label status, these agents in people with T1D are not widely used in routine clinical care at present.
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Affiliation(s)
- Maria Apostolopoulou
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, 40225 Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibnitz Center for Diabetes Research at Heinrich-Heine University, 40225 Düsseldorf, Germany
- German Center of Diabetes Research (DZD), Partner Düsseldorf, 85764 München-Neuherberg, Germany
| | - Vaia Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens Medical School, 12462 Athens, Greece
| | - Michael Roden
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, 40225 Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center, Leibnitz Center for Diabetes Research at Heinrich-Heine University, 40225 Düsseldorf, Germany
- German Center of Diabetes Research (DZD), Partner Düsseldorf, 85764 München-Neuherberg, Germany
| | - George D Dimitriadis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens Medical School, 12462 Athens, Greece
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26
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Toorang F, Amiri P, Pouraram H, Takian A. Addressing childhood obesity in Iran: exploring a multifaceted conceptual model in a low/middle income country through stakeholder lens. BMC Public Health 2025; 25:772. [PMID: 40001077 PMCID: PMC11853819 DOI: 10.1186/s12889-024-21221-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 12/26/2024] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Despite significant global efforts to control childhood obesity (CO), its prevalence continues to rise, particularly in low- and middle-income countries. This study aims to identify the determinants of CO in Iran. METHODS This qualitative study employed a purposive snowball sampling method to interview 30 stakeholders from various specialities and disciplines. They included scientists, government and industry authorities, representatives from international organizations, and members of civil society. The data analysis was conducted using MAXQDA 2020, employing inductive content analysis. The credibility and dependability of the data were ensured by using Lincoln and Guba's criteria. We used the consolidating criteria for reporting qualitative studies. RESULTS The main determinants of childhood obesity control in Iran can be categorized into three levels: local, national, and international. At the local level, home and school environments are influential in shaping unhealthy lifestyles and energy imbalances. The national determinants are the triad of governance, dominant social structure, and national policies/regulations. Governance factors such as inappropriate policy-making processes, Low responsiveness and accountability, and Low collaboration and parallel working between stakeholders; impact childhood obesity control. Dominant social structures including cultural norms, urban design, air pollution, social transitions, and inequalities also contribute to the issue. National policies and regulations exhibit shortcomings in fiscal and food promotion aspects. At the international level, the World Health Organization's approach to Ending Childhood Obesity (ECHO), trade policies, political sanctions, climate change, and the COVID-19 pandemic have significant implications for childhood obesity control. CONCLUSION This study provides valuable insights into the determinants of childhood obesity (CO) in Iran. It can inform evidence-based policymaking not only in Iran but also in other countries with similar socio-economic statuses.
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Affiliation(s)
- Fatemeh Toorang
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
- Cancer Research Center, Cancer Institute, Tehran University of Medical Science, Tehran, Islamic Republic of Iran
- Departments of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box: 19395-4763, Tehran, IR, Islamic Republic of Iran.
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Amirhossein Takian
- Departments of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran.
- Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences, P. O. Box: 1455-6119, Tehran, IR, Iran.
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27
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Lafontaine J, Hanson I, Wild C. The impact of the social media industry as a commercial determinant of health on the digital food environment for children and adolescents: a scoping review. BMJ Glob Health 2025; 10:e014667. [PMID: 39971584 PMCID: PMC11840902 DOI: 10.1136/bmjgh-2023-014667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/03/2025] [Indexed: 02/21/2025] Open
Abstract
INTRODUCTION There is emerging evidence that the social media industry contributes to adverse health outcomes by shaping the digital food environment for children and adolescents (aged 0-18). The aim of this scoping review was to determine the extent of research on how the social media industry, including the broader online landscape, influences the digital food environment and affects child and adolescent health. METHODS A scoping review was conducted in the electronic databases of PubMed, Scopus and PsycINFO, along with forward and reverse citation searching for peer-reviewed articles published in English between 2000 and May 2023. A qualitative descriptive synthesis of the included articles was performed to identify trends, themes and research gaps in the current literature. RESULTS The review identified 36 articles for inclusion. Most research was conducted in high-income countries and publications have increased since 2021. The review found most children and adolescents are exposed to food advertisements on social media and most advertised food is ultra-processed. Heightened by a lack of social media advertising awareness, digital food marketing influences children and youth's consumption and food behaviour. Voluntary children's food marketing regulations are ineffective for the online environment. Countering unhealthy food marketing will require media literacy and government regulation. CONCLUSION The social media industry may act as a commercial determinant of health to shape the digital food environment as an extension of the obesogenic environment. Further research should explore approaches to monitor unhealthy food marketing practices and understand social media's role in the digital food environment.
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Affiliation(s)
- Jesse Lafontaine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Isabel Hanson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Cervantée Wild
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
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28
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Craveiro C, Lopes M, Freitas P, Lopes A. Neighborhood Vulnerability and the Consumer Food Environment in an Urban Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:303. [PMID: 40003528 PMCID: PMC11855928 DOI: 10.3390/ijerph22020303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 02/11/2025] [Accepted: 02/14/2025] [Indexed: 02/27/2025]
Abstract
The consumer food environment is an important medium for understanding complex interactions regarding food consumption, health outcomes and social vulnerability. We aimed to analyze the diversity, variety and quality of natural and ultra-processed foods in a Brazilian metropolis. We performed a cross-sectional study, analyzing food stores within a buffer (1600 m) area around 18 randomly selected Health Promotion Program units. We used descriptive analyses and regression models, adjusted by the area's population, to examine associations of consumer food environment variables with the health vulnerability (HVI) of the territory and store type. Low HVI areas had higher fruits and vegetables variety adequacy and better quality, when compared to medium and high/very high HVI areas (p-value < 0.001 and p-value = 0.001). Supermarkets in low HVI areas had almost twice the prevalence of adequate vegetable variety (65.2% vs. 33.3% in high/very high HVI areas, p-value = 0.005). Adjusted by population, areas with high/very high HVI had lower odds of adequate fruit variety when compared to low HVI areas (OR = 0.06; CI 95% = 0.01-0.44; p-value = 0.006). Although consumer preference is important in food acquisition, disparities in quality, diversity and variety within the consumer food environment could lead to difficulties in access to healthy options for vulnerable populations.
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Affiliation(s)
- Cecilia Craveiro
- Grupo de Pesquisa de Intervenções em Nutrição, Departamento de Nutrição, Campus I, Centro de Ciências da Saúde, Universidade Federal da Paraíba, Cidade Universitária, João Pessoa 58051-900, PB, Brazil; (C.C.); (M.L.)
| | - Mariana Lopes
- Grupo de Pesquisa de Intervenções em Nutrição, Departamento de Nutrição, Campus I, Centro de Ciências da Saúde, Universidade Federal da Paraíba, Cidade Universitária, João Pessoa 58051-900, PB, Brazil; (C.C.); (M.L.)
| | - Patricia Freitas
- Grupo de Pesquisa de Intervenções em Nutrição, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Nutrition Building JK Campus, Highway BR 367, Km 583, s/n, Alto da Jacuba District, Diamantina 39100-000, MG, Brazil;
| | - Aline Lopes
- Grupo Pesquisa de Intervenções em Nutrição, Departamento de Nutrição, Universidade Federal de Minas Gerais, Escola de Enfermagem, de 190 Alfredo Balena Avenue, Room 316, Santa Efigênia, Belo Horizonte 30130-100, MG, Brazil
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29
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Wu MC, Nfor ON, Liaw YP, Su YJ, Ho CC. Associations of cigarette smoking with general and abdominal obesity risks among men in Taiwan. BMC Public Health 2025; 25:649. [PMID: 39962411 PMCID: PMC11834593 DOI: 10.1186/s12889-025-21821-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 02/06/2025] [Indexed: 02/20/2025] Open
Abstract
Obesity and smoking are two major public health challenges that both significantly contribute to morbidity and mortality worldwide. This study investigated the associations between smoking behaviors and obesity among men in Taiwan, with a focus on body mass index (BMI) and waist circumference (WC) as indicators of general and abdominal obesity. The sample consisted of 27,908 men categorized into five groups based on their specific smoking statuses: never smoker (NS), former smoker (FS), light-intensity smoker (LIS), moderate-intensity smoker (MIS), and heavy-intensity smoker (HIS). Our findings revealed a significant association between smoking behaviors and increased obesity risk, particularly among heavy-intensity smokers. Socioeconomic factors such as education and income levels were also found to influence these behaviors. These results underscore the importance of integrated public health strategies that address both smoking cessation and obesity prevention.
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Affiliation(s)
- Min-Chen Wu
- Office of Physical Education, Chung Yuan Christian University, Taoyuan City, Taiwan
- Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Oswald Ndi Nfor
- Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
| | - Yung-Po Liaw
- Department of Public Health, Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Yan-Jhu Su
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | - Chien-Chang Ho
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan.
- Sports Medicine Center, Fu Jen Catholic Hospital, New Taipei City, Taiwan.
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30
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Wu K, Yin W, Liang X, Yang Z. Association of oral health status with overweight and obesity in older adults aged ≥ 65 years- evidence from Chinese communities. BMC Public Health 2025; 25:605. [PMID: 39948557 PMCID: PMC11827303 DOI: 10.1186/s12889-025-21546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 01/20/2025] [Indexed: 02/16/2025] Open
Abstract
OBJECTIVES To evaluate the association of poor oral health conditions, such as caries, tooth loss, and tooth loss, with overweight and obesity in older adults and to complement evidence from the Chinese community to confirm this association. Additionally, we evaluated the sociodemographic characteristics, health status, and impact of health-related behavior on the BMI of older adults. METHODS This retrospective study involved health examination and follow-up data of 953 older adults from the Sichuan Province of China from 2021 to 2023. The caries status assessed by the Decayed, Missing, and Filled Teeth (DMFT) index, was used as the exposure factor, whereas body mass index (BMI) was used as the outcome indicator. The influence of confounding variables, namely the sociodemographic characteristics, health status, and oral health-related behavior, was controlled. BMI changes in older adults with different levels of oral health over 3 years were retrospectively followed up. Additionally, a Cox proportional hazard model was used to determine the association. RESULTS Overweight and obesity were prevalent in 29.3% and 20.4% of older adults with poor and good oral health status, respectively (P < 0.01). After controlling for the confounding factors, the Cox proportional hazards model demonstrated that the DMFT index was associated with overweight or obesity (BMI) (hazards ratio = 1.86, 95% confidence interval: 1.52-2.28). Overweight and obesity were less prevalent in older adults with fewer chronic diseases, higher frequency of physical exercise, and better oral health-related behaviors. CONCLUSIONS Oral health status is positively associated with overweight and obesity in older adults, particularly in older adults presenting with caries, missing teeth, and tooth loss as their primary symptoms.
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Affiliation(s)
- Kan Wu
- Department of Medical Affairs, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Yin
- Department of Preventive, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinhua Liang
- Department of Medical Affairs, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zheng Yang
- Department of Dental General Stomatology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Yazdi M, Abdollahpour I, Qorbani M, Karimi S, Motlagh ME, Khademian M, Kelishadi R. Estimating population attributable risk fraction of determinants of pediatric obesity. BMC Public Health 2025; 25:517. [PMID: 39920703 PMCID: PMC11806531 DOI: 10.1186/s12889-025-21723-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Accepted: 01/31/2025] [Indexed: 02/09/2025] Open
Abstract
OBJECTIVES Childhood obesity imposes a remarkable socio-economic and health-related burden, with an increasing worldwide trend. We aimed to assess the relationship between modifiable factors and obesity in Iranian children and adolescents along with to determine the population attributable risk fraction (PARF) for the risk factors of obesity in Iranian children and adolescents. METHODS This is a nationwide cross-sectional study involving 14,400 school-aged students. In addition to physical examination, a self-administered questionnaire was completed to obtain the study variables including dietary behavior, physical activity, screen time, sleep duration, socioe-conomic status (SES), and passive smoking. Logistic regression models were applied to assess the relationship between modifiable risk factors and obesity. Population attributable risk fractions (PARFs) were used to estimate the prevalence of obesity if demonstrated modifiable risk factors would be removed. RESULTS Of 14,400 recruited students, data on 12,153 subjects were analyzed in the current study. The mean (SD) age of participants was 12.3 (3.16) years, and 49.1% were female. Overall prevalence of obesity was 10.4%. In total, 33.2% of obesity in Iranian children and adolescents might be attributed to unhealthy dietary habits, moderate or high familial SES, body shape dissatisfaction, and prolonged screen time. CONCLUSIONS Considering the inherent limitations of the cross-sectional studies, our findings suggest that a notable proportion of obesity in children and adolescents might be attributable to unhealthy dietary habits, prolonged screen time as well as higher family SES. These findings may provide insights for planning and optimizing future obesity intervention endeavors.
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Affiliation(s)
- Maryam Yazdi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Hezar Jarib Ave, Isfahan, 8174674419, Iran
| | - Ibrahim Abdollahpour
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Hezar Jarib Ave, Isfahan, 8174674419, Iran.
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Karimi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Hezar Jarib Ave, Isfahan, 8174674419, Iran
| | - Mohammad Esmail Motlagh
- MD, Bureau of Family, Population, Youth and School Health, Ministry of Health and Medical Education, Isfahan, Iran
- Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Khademian
- Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Science, Hezar Jarib Ave, Isfahan, 8174674419, Iran
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Cui K, Teng X, Liu W, Zhao X, Xu S, Bai L. L-shaped association of body mass index with prognosis in individuals with sepsis: a multicenter cohort study. Diabetol Metab Syndr 2025; 17:43. [PMID: 39901292 PMCID: PMC11789304 DOI: 10.1186/s13098-025-01607-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 01/22/2025] [Indexed: 02/05/2025] Open
Abstract
OBJECTIVE The relationship between body mass index (BMI) and sepsis prognosis remains highly controversial and uncertain. This study investigated the association between BMI and prognosis in patients with sepsis. METHODS This retrospective observational cohort study included adult patients admitted to the intensive care unit (ICU) with sepsis from Medical Information Mart for Intensive Care-IV version 2.2 (MIMIC-IV V2.2) and eICU Collaborative Research Database (eICU-CRD). The cut-off value of BMI was identified by the restricted cubic spline (RCS) curve and included patients were categorized into two groups: the low BMI group (< 28 kg/m2) and the high BMI group (≥ 28 kg/m2). The primary outcome was ICU mortality, and secondary outcomes were in-hospital and 28-day mortality. We performed the log-rank test to detect whether there is a difference in prognosis among different groups in two different cohorts. Multiple distinct models were used to validate the robustness of the results. RESULTS There were 18,385 and 38,713 patients in the MIMIC-IV 2.2 and eICU-CRD cohorts, respectively. An L-shaped relationship was observed between BMI and ICU mortality in the primary analysis from MIMIC-IV 2.2. Similar relationships were found in eICU-CRD. When BMI was less than the cut-point, the risk of ICU mortality increased rapidly with decreasing BMI. When BMI was greater than the cut-point, the risk of ICU mortality levelled off as BMI increased. Sepsis patients with higher BMI values exhibited decreased ICU all-cause mortality rates (MIMIC-IV cohort: HR: 0.81, 95% CI 0.75-0.88, p < 0.001; eICU-CRD cohort: HR: 0.75, 95% CI 0.71-0.80, p < 0.001). Consistent trends were observed for both in-hospital mortality and 28-day mortality rates. The results remained robust in multiple distinct models and subgroup analyses. CONCLUSION An L-shaped relationship was observed between BMI and prognosis in septic patients, indicating that lower BMI values are significantly linked to increased mortality. Targeted nutritional interventions and close monitoring for patients with low BMI could potentially enhance their prognosis. Therefore, BMI can also be utilized to categorize the risk levels of patients with sepsis and effectively predict their prognosis.
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Affiliation(s)
- Kunping Cui
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xiangnan Teng
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Wei Liu
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xiaoxiao Zhao
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Shanling Xu
- Department of Medical Oncology, School of Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, 610041, Sichuan, People's Republic of China.
| | - Lang Bai
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
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Stone G, Papadaki A. Exploring the lived experience of economic insecurity and health among people accessing charity-run food provision services in Bristol, UK. J Biosoc Sci 2025:1-16. [PMID: 39895221 DOI: 10.1017/s002193202500001x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2025]
Abstract
The UK has experienced alarming increases in the number of individuals living with food insecurity as a result of the rise in the cost of living. The mechanisms linking household economic insecurity to food insecurity, and perceived health outcomes, are not well understood. The aim of this study was to explore how individuals with lived experience of food insecurity are coping with the rise in the cost of living, the trade-offs they might be making between food and other household expenses, and how these might impact eating behaviours and health outcomes. Using a qualitative inductive approach rooted in hermeneutic phenomenology, nine semi-structured interviews were conducted among individuals using charity-run food provision services in Bristol, UK. Narrative accounts from these interviews were analysed thematically. Almost all participants were recipients of benefits at the time of interviews and were living under high levels of economic insecurity. The rise in the cost of living forced complex budget management strategies, including relying on donated food and shoplifting. It also influenced eating behaviours through altered cooking strategies to save energy, substituting food for cheaper, less-nutritious, alternatives, and rationing meals. Food insecurity was experienced as a form of psychosocial violence, engendering high levels of stress, particularly for individuals with diet-related chronic diseases. There is therefore an urgent need for policies that tackle structural causes of overall household economic insecurity, and improve economic access to adequate nutritious foods, to prevent further entrenching social inequalities.
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Affiliation(s)
- Geneviève Stone
- Centre for Exercise, Nutrition, and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- Department of Anthropology & Archaeology, University of Bristol, Bristol, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition, and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
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Capoccia D, Milani I, Colangeli L, Parrotta ME, Leonetti F, Guglielmi V. Social, cultural and ethnic determinants of obesity: From pathogenesis to treatment. Nutr Metab Cardiovasc Dis 2025:103901. [PMID: 40087047 DOI: 10.1016/j.numecd.2025.103901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2025] [Revised: 01/28/2025] [Accepted: 01/28/2025] [Indexed: 03/16/2025]
Abstract
AIMS Obesity is a multifactorial disease influenced by several factors including poor diet, physical inactivity, and genetic predisposition. In recent years, the social and environmental context, along with race/ethnicity and gender, have been recognized as factors influencing obesity risk beyond traditional risk factors. This review aims to increase knowledge of these causal determinants and their implications for the treatment and management of obesity, addressing not only the individual but also the societal sphere. DATA SYNTHESIS A growing body of evidence emphasizes the interaction between the physical and social environments in shaping personal behaviors related to obesity. Social disparities, such as socioeconomic status (income, education, employment), racial/ethnic differences, and gender, contribute significantly to weight gain from childhood to adulthood. These factors increase the risk of obesity and related cardiovascular risk factors, independent of clinical and demographic variables, and may lead to stigma and discrimination against those affected. CONCLUSIONS Obesity prevention solutions, from community programs to national policies, may be more effective if they address social, gender, and ethnic barriers. Understanding obesity requires a comprehensive approach that includes social, environmental, and psychological factors, as well as biological causes, to help obesity experts develop more effective interventions tailored to obesity and related diseases.
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Affiliation(s)
- Danila Capoccia
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Diabetes Unit, S.M. Goretti Hospital, Latina, Italy.
| | - Ilaria Milani
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Diabetes Unit, S.M. Goretti Hospital, Latina, Italy
| | - Luca Colangeli
- Department of Systems Medicine, University of Rome Tor Vergata, Obesity Medical Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Maria Eugenia Parrotta
- Department of Systems Medicine, University of Rome Tor Vergata, Obesity Medical Center, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Frida Leonetti
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Diabetes Unit, S.M. Goretti Hospital, Latina, Italy
| | - Valeria Guglielmi
- Department of Systems Medicine, University of Rome Tor Vergata, Obesity Medical Center, University Hospital Policlinico Tor Vergata, Rome, Italy
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Masip G, Goerdten J, Asif T, Hebestreit A, Hunsberger M, Lissner L, Molnar D, Pala V, Russo P, Tornaritis M, Veidebaum T, Wolters M, Moreno LA, Bogl LH. Development and Validation of Healthy and Unhealthy Plant-Based Diet Propensity Scores in European Children, Adolescents and Adults From the I.Family Study. J Hum Nutr Diet 2025; 38:e70021. [PMID: 39910699 DOI: 10.1111/jhn.70021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 01/20/2025] [Accepted: 01/21/2025] [Indexed: 02/07/2025]
Abstract
INTRODUCTION Plant-based dietary patterns may reduce the risk of chronic diseases, but their benefits and risks in younger populations remain unclear due to variations in diet quality and nutrient adequacy. Robust tools to assess adherence to these patterns are essential. The aim of this study was to develop and validate three plant-based diet propensity (PBDP) scores - overall, healthy and unhealthy - to capture plant-based dietary patterns and assess their associations with nutrient intakes and health indicators in children, adolescents and adults. METHODS This cross-sectional study of children, adolescents and adults used data from the I.Family study (n = 15,780 participants) from eight European countries. Dietary intake was assessed using a food frequency questionnaire. The overall PBDP score was constructed by categorising all plant-based food groups as positive and animal-based food groups as negative. The healthy PBDP emphasised healthy plant-based food groups, whereas the unhealthy PBDP emphasised less healthy plant-based food groups. Validity was assessed through correlations with nutrient intakes and comparison across demographic groups. Associations with health indicators were also analysed. RESULTS PBDP scores showed expected associations with nutrient intakes. Higher overall and healthy PBDP scores were observed in females, adults, individuals with higher parental educational levels and those from Belgium and Spain. The healthy PBDP score was associated with higher HDL cholesterol, improved bone stiffness and lower triglycerides. The unhealthy PBDP score was associated with lower HDL cholesterol in adults, but not in children or adolescents. CONCLUSION PBDP scores describe plant-based dietary patterns across demographic groups and are valid and reliable in adults. The findings highlight challenges in assessing dietary patterns in children and adolescents. Future research should address these challenges to enhance the validity of PBDP scores in younger populations and further explore their potential in guiding dietary recommendations across all age groups.
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Affiliation(s)
- Guiomar Masip
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
- Finnish Institute for Molecular Medicine FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Jantje Goerdten
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tooba Asif
- Department of Public Health and Primary Care (GE39), Ghent University Unit Public Health Nutrition, Ghent, Belgium
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Monica Hunsberger
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Denes Molnar
- Department of Paediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | | | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Leonie H Bogl
- Finnish Institute for Molecular Medicine FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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Biswas P, Kumar A, Upreti M, Kumar G, Saikia P. Kolkata's green oasis: a comprehensive analysis of urban green spaces for ecosystem sustainability. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2025; 32:5040-5061. [PMID: 39894878 DOI: 10.1007/s11356-024-35756-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/06/2024] [Indexed: 02/04/2025]
Abstract
In the present study, the impact of urban growth on green spaces in Kolkata Metropolitan City (KMC) was evaluated using the multi-temporal satellite observations spanning the last four decades (1990-2022). The study exhibited a rapid rise in urban areas (178.38% growth; net increase 498 sq.km), leading to a significant conversion of areas into moderate to very high built-up density zones. This urbanization has markedly altered the green-blue infrastructure, notably causing a 27% decline in urban green space (UGS) resulting a net loss of 254 sq.km. Fragmentation analysis exhibited a trend of compact, infill development in urban regions, contrasting with outgrowth, which has influenced both the cluster size and quality of UGS over the decades. The multi-indices and biophysical characterization of UGS concluded a deteriorating trend in terms of quantity (- 27.9%) and quality as well with reference. However, the existing UGS are primarily scattered and having less dense. Spatial estimation of above ground biomass (AGB) of UGS using regression analysis of field-derived AGB and L-band SAR backscatter depicted a dominance of low AGB (< 30 t/ha-1) across KMC, while the certain zones with improved UGS exhibited moderate AGB levels (50-100 t/ha-1). The fuzzy AHP-based multi-criteria analysis of urban ecological quality exhibited severe ecological deterioration in the central urban areas, moderate to high in peri-urban regions, and comparatively improved ecological conditions in the peripheral rural parts of KMC. The study also identified major native tree species for plantation strategies comprising urban afforestation, rooftop gardens, and the development of green corridors in ecologically deficient hotspot zones to improve the ecological quality within the urban landscape.
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Affiliation(s)
- Poushali Biswas
- Department of Geoinformatics, Central University of Jharkhand, Ranchi, 835205, India
| | - Amit Kumar
- Department of Geography, Institute of Science, Banaras Hindu University, Varanasi, 221005, India.
- Department of Forestry & Natural Resources, Purdue University, West Lafayette, IN, 47906, USA.
- Commission of Ecosystem Management, IUCN, Gland, Switzerland.
| | - Manjari Upreti
- Department of Geoinformatics, Central University of Jharkhand, Ranchi, 835205, India
| | - Gajendra Kumar
- Department of Geoinformatics, Central University of Jharkhand, Ranchi, 835205, India
| | - Purabi Saikia
- Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
- Commission of Ecosystem Management, IUCN, Gland, Switzerland
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Riley DR, Henney A, Anson M, Hernadez G, Zhao SS, Alam U, Wilding JPH, Craig S, Cuthbertson DJ. The cumulative impact of type 2 diabetes and obstructive sleep apnoea on cardiovascular, liver, diabetes-related and cancer outcomes. Diabetes Obes Metab 2025; 27:663-674. [PMID: 39529454 DOI: 10.1111/dom.16059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 10/24/2024] [Accepted: 10/28/2024] [Indexed: 11/16/2024]
Abstract
AIM A bidirectional relationship exists between obstructive sleep apnoea (OSA) and type 2 diabetes (T2D). We aimed to examine the cumulative impact of having both OSA and T2D on patient outcomes, relative to having either condition alone. MATERIALS AND METHODS Using TriNetX, a global federated research network (n = 128 million), we undertook two retrospective cohort studies, using time-to-event analysis. Analysis 1 compared OSA with T2D versus OSA alone; analysis 2 compared T2D with OSA versus T2D alone. Propensity score matching using greedy nearest neighbour (calliper 0.1) balanced the cohorts (1:1) for significant covariates. Primary outcomes were cardiovascular, liver, diabetes-related (microvascular) and cancer events over 1-5 years. RESULTS Analysis 1 (n = 179 688): A codiagnosis of T2D/OSA significantly increased risk of all-cause mortality (hazard ratio [HR] 1.52; confidence interval [CI]: 1.48, 1.57), dementia (HR 1.19; CI: 1.12, 1.26), liver (HR 2.20; CI: 1.77, 2.73), pancreatic (HR 1.62; CI: 1.35, 1.93), colon, renal and endometrial cancers; all cardiovascular, microvascular and liver related outcomes versus OSA alone over 1-5 5 years following OSA diagnosis. Analysis 2 (n = 240 094): A codiagnosis of OSA/T2D significantly increased the risk of peripheral (HR 1.39; CI: 1.36, 1.43) and autonomic (HR 1.63; CI: 1.51, 1.75) neuropathy; retinopathy (HR 1.13; CI: 1.09, 1.18), CKD (HR 1.21; CI: 1.18, 1.23); all cardiovascular and liver outcomes; all-cause mortality and several obesity related cancers versus T2D alone. CONCLUSIONS T2D significantly potentiates risk of cardiovascular, malignancy and liver-related outcomes in individuals with OSA. OSA, in individuals with T2D, significantly potentiates risk of cardiovascular disease, malignancy, death and several microvascular complications (retinopathy, CKD, peripheral/autonomic neuropathy).
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Affiliation(s)
- David R Riley
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Department of Diabetes, Obesity and Endocrinology, University Hospital Aintree, Liverpool University NHS Foundation Trust, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Alex Henney
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Department of Diabetes, Obesity and Endocrinology, University Hospital Aintree, Liverpool University NHS Foundation Trust, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Matthew Anson
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Department of Diabetes, Obesity and Endocrinology, University Hospital Aintree, Liverpool University NHS Foundation Trust, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | | | - Sizheng S Zhao
- Centre for Musculoskeletal Research at University of Manchester, Manchester, UK
| | - Uazman Alam
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Department of Diabetes, Obesity and Endocrinology, University Hospital Aintree, Liverpool University NHS Foundation Trust, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - John P H Wilding
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Department of Diabetes, Obesity and Endocrinology, University Hospital Aintree, Liverpool University NHS Foundation Trust, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Sonya Craig
- Liverpool Sleep & Ventilation Unit, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Daniel J Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK
- Department of Diabetes, Obesity and Endocrinology, University Hospital Aintree, Liverpool University NHS Foundation Trust, Liverpool, UK
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
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Aguiar A, Rajah JK, Conway-Moore K, Savona N, Knai C, Vlad I, Samdal O, Rutter H, Lien N, Kopainsky B. Converging perspectives on the processes exacerbating adolescent obesity: An integrative systems approach. Soc Sci Med 2025; 367:117706. [PMID: 39904295 DOI: 10.1016/j.socscimed.2025.117706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 01/07/2025] [Accepted: 01/13/2025] [Indexed: 02/06/2025]
Abstract
Adolescent obesity is a complex public health challenge with steadily increasing and variable prevalence among countries. This paper synthesises the driving feedback mechanisms of adolescent obesity studied in the CO-CREATE project, furthering our understanding of the complexity of this issue. Using systems thinking principles and causal loop diagramming, we integrated the following knowledge and perspectives derived from diverse sources into a causal loop diagram (CLD): a systems map generated by adolescents through participatory modelling workshops, a comprehensive literature review, and input from subject-matter experts during validation workshops. We used a structured and iterative approach to include drivers and to identify feedback loops exacerbating adolescent obesity. The CLD identified 27 key feedback loops across four themes: twelve related to the commercial food environment, six to the physical activity environment, four to mental wellbeing and five to social norms. These loops indicate not only diet and physical activity as drivers of obesity but also stress and other emotional and social pressures. Recognising the imperative need to integrate the perspectives and experiences of adolescents into our analysis, this work advocates for the synthesis of experiential insights with empirical research. The integrated CLD can be used as a visual tool that fosters collaboration among stakeholders and engenders a more comprehensive and inclusive system understanding that can provide holistic intervention considerations to tackle adolescent obesity. Additionally, the CLD lays a foundation for subsequent quantitative modelling works to further address this issue and develop context-based approaches to prevention and evaluation of adolescent obesity.
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Affiliation(s)
- Anaely Aguiar
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway.
| | - Jefferson K Rajah
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway.
| | - Kaitlin Conway-Moore
- Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Natalie Savona
- Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Cécile Knai
- Faculty of Public Health Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Ioana Vlad
- Policy and Public Affairs Department, World Cancer Research Fund International, London, UK.
| | - Oddrun Samdal
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | - Harry Rutter
- Department of Social & Policy Sciences, University of Bath, Bath, UK.
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Birgit Kopainsky
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway.
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Şeref B, Yıldıran H. A new perspective on obesity: perception of fat taste and its relationship with obesity. Nutr Rev 2025; 83:e486-e492. [PMID: 38497969 DOI: 10.1093/nutrit/nuae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024] Open
Abstract
Background: Obesity, which results from a long-term positive energy balance, is affected by many factors, especially nutrition. The sensory properties of foods are associated with increased food intake through hedonic appetite. Taste perception, a component of flavor, is also responsible for increased consumption, through reward and hedonic mechanisms. Foods with high fat and energy content are among the foods that create the reward perception. The perception of fat taste, the primary taste that has recently entered the literature, may also be associated with increased food consumption and body weight. Therefore, in this review, the relationship between fat taste and obesity is examined, using the latest literature. RESULTS Different hypotheses have been proposed regarding the mechanism of the relationship between fat-taste perception and obesity, such as hedonic appetite, microbiota, decreased taste perception, and increased taste threshold level. In addition, some studies examining this relationship reported significant associations between the level of fat-taste perception and obesity, whereas others did not find a significant difference. CONCLUSION Considering the prevalence and contribution to obesity of Western-style nutrition, characterized by high amounts of fat and sugar consumption, elucidating this relationship may be an essential solution for preventing and treating obesity.
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Affiliation(s)
- Betül Şeref
- Department of Nutrition and Dietetics, Karamanoğlu Mehmetbey University, Karaman, Türkiye
| | - Hilal Yıldıran
- Department of Nutrition and Dietetics, Gazi University, Ankara, Türkiye
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Kay E, Kemps E, Prichard I. A systematic review and meta-analysis of visual cues and primes for nudging consumption-related behaviours. Appetite 2025; 206:107813. [PMID: 39643083 DOI: 10.1016/j.appet.2024.107813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 11/01/2024] [Accepted: 12/03/2024] [Indexed: 12/09/2024]
Abstract
Healthy diets are crucial for maintaining overall well-being and reducing risk of health complications. Visual cues and primes are popular implicit nudging techniques for promoting healthier consumption habits. The present review and meta-analysis was conducted and reported according to PRISMA guidelines. It aimed to evaluate the effectiveness of these cues and primes for nudging consumption-related behaviours. Six electronic databases were comprehensively searched for experimental studies on the use of non-marketing-based visual cues/primes on food/beverage consumption. Sixty-six studies from 52 articles were included, resulting in 205 comparisons categorised into seven groups for separate analyses: (1) healthy food- and (2) body-related nudges, and (3) unhealthy food- and (4) body-related nudges, versus neutral controls; (5) mixed-health food- and (6) body-related comparisons; and (7) nudges not inherently health-related. Overall, nudges effectively influenced consumption-related behaviours. Healthier food- and body-nudges encouraged healthier behaviours relative to neutral controls and less healthy nudges, and unhealthy food-nudges, relative to neutral controls. Non-health-related nudges influenced behaviours in the expected direction, relative to comparison/control conditions. Nudge effectiveness, especially for unhealthy food-nudges, was moderated by participant age and weight, nudge timing (prime/cue) outcome measure (intake/choice), health (mixed/healthy/unhealthy), and whether the outcome was real or hypothetical. A range of participant, nudge, and outcome-related mechanisms proposed to underlie nudge effectiveness were also identified. Findings supported the efficacy of visual cues and primes for eliciting changes in consumption-related behaviours, indicating they may be effective for encouraging healthier consumption, when the right nudges are used. Results also indicated that different forms of nudges may be more appropriate in different circumstances (e.g., for different types of participants or food-related outcomes). Further research is needed to thoroughly comprehend the mechanisms underlying these nudges and their effectiveness.
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Affiliation(s)
- Enola Kay
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia; Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia.
| | - Eva Kemps
- Flinders University, College of Education, Psychology and Social Work, Flinders Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Ivanka Prichard
- Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, Australia
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Shaaban Abdelgalil M, El-Farargy SH, Dowidar MA, Abd-ElGawad M. Exploring socio-demographic determinants of obesity in Jordanian women of reproductive age: insights from a nationwide survey. BMC Public Health 2025; 25:394. [PMID: 39885451 PMCID: PMC11783968 DOI: 10.1186/s12889-025-21431-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Accepted: 01/13/2025] [Indexed: 02/01/2025] Open
Abstract
BACKGROUND In Jordan, obesity has emerged as a significant public health concern, particularly among females, with a prevalence of 43.1%. This rising trend, exacerbates the burden of non-communicable diseases and places increasing strain on the healthcare system. AIM We aimed to explore the predictors associated with obesity among adult ever-married Jordanian women aged 20-49 years based on the Jordanian Population and Family Health Survey (JPFHS). METHOD Our study analyzed data from the JPFHS conducted in 2017-18, which initially included 14,689 ever-married women. We performed multivariable analyses to determine the socio-demographic predictors of obesity among these women. RESULT We included 4,339 Jordanian women in our study, of whom 2,189 were classified as obese and 2,150 had a normal body mass index (BMI). Multivariable analysis indicated that increasing age and living in Tafilahwere significantly associated with higher odds of developing obesity (p < 0.05). Conversely, factors such as being in the wealthiest category, residing in Ma'an and Aqaba, and smoking every day were significantly linked to reduced odds of obesity (p < 0.05). Additionally, no significant associations were found between obesity development and variables such as the type of place of residence, educational level, frequency of reading newspapers or magazines, radio listening, television watching, or internet use in the past month (p > 0.05). CONCLUSION Appropriate and targeted interventions should be developed for Jordanian women to address obesity and its related health issues. Policymakers should adopt a multilevel approach that focuses on high-risk subgroups, including older women, and those living in Tafilh. Efforts should be made to raise awareness and provide preventative measures tailored to these groups to effectively reduce obesity and its associated complications.
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Affiliation(s)
| | - Sara Hosny El-Farargy
- Faculty Of Medicine, Benha University, Benha, Egypt
- Research Insights Arab Network, Cairo, Egypt
| | - Mohamed Adel Dowidar
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman
- Research Insights Arab Network, Cairo, Egypt
| | - Mohamed Abd-ElGawad
- Faculty of Medicine, Fayoum University, Fayoum, Egypt
- Research Insights Arab Network, Cairo, Egypt
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Heo JH. The Impact of Obesity Treatments on Bone Health: Insights from Recent Research. J Obes Metab Syndr 2025; 34:1-3. [PMID: 39814406 PMCID: PMC11799602 DOI: 10.7570/jomes25001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Revised: 01/13/2025] [Accepted: 01/13/2025] [Indexed: 01/18/2025] Open
Affiliation(s)
- Ji Hye Heo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
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Long KZ, Traoré SG, Kouassi KB, Coulibaly JT, Gba BC, Dao D, Beckmann J, Lang C, Seelig H, Probst-Hensch N, Pühse U, Gerber M, Utzinger J, Bonfoh B. Micronutrient status, food security, anaemia, Plasmodium infection, and physical activity as predictors of primary schoolchildren's body composition in Côte d'Ivoire. Front Nutr 2025; 11:1524810. [PMID: 39944253 PMCID: PMC11816671 DOI: 10.3389/fnut.2024.1524810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Accepted: 12/27/2024] [Indexed: 02/17/2025] Open
Abstract
Background Stunting and overt malnutrition remain prevalent among school age children in rural areas of Côte d'Ivoire while obesity is increasing in urban areas. Associations of children's nutritional status, Plasmodium infection, physical activity and household characteristics with body composition were analyzed to identify what factors might be contributing to this dual burden of disease. Methods Longitudinal growth curve models (LGCM) evaluated associations of micronutrient status, household food security, Plasmodium falciparum prevalence and physical activity assessed at three time points with fat free mass and fat mass. Results More severe anaemia was inversely associated with FFM and TrFFM trajectories overall and among girls. P. falciparum infection had an indirect inverse association with FFM trajectories through anaemia among girls and through reductions of vitamin A directly associated with FFM. Changes in zinc concentrations were positively associated with FM trajectories overall and among boys. Food insecurity was inversely associated with FFM among boys from lower socio-economic status (SES) households while increased MVPA was associated with reduced fat mass among girls. Conclusions The integration of Malaria control programs with efforts to improve household healthy diet and promote physical activity can lead to improvements in body composition and overall child health and wellbeing.
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Affiliation(s)
- Kurt Z. Long
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sylvain G. Traoré
- Université Peleforo Gon Coulibaly, Korhogo, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Kouadio B. Kouassi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Nangui Abrogoua, Abidjan, Côte d'Ivoire
| | - Jean T. Coulibaly
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Bomey C. Gba
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Daouda Dao
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
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Yin L, Li J, Tai X, Zhang G, Luan M, Zhong B, Li F. Mechanisms of combined deer antler polysaccharides and postbiotics supplementation for regulating obesity in mice. Food Nutr Res 2025; 69:11634. [PMID: 39974837 PMCID: PMC11836782 DOI: 10.29219/fnr.v69.11634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 12/14/2024] [Accepted: 12/17/2024] [Indexed: 02/21/2025] Open
Abstract
Objective This study investigated the mechanisms related to lipid metabolism regulation after combined supplementation with deer antler polysaccharides and postbiotics. Methods Thirty-two male mice were divided into high-fat diet, HD + deer antler polysaccharides, HD + Bacillus coagulans postbiotics, and HD + deer antler polysaccharides + B. coagulans postbiotics groups. The diets contained 60% fat. After 9 weeks, the effects of deer antler polysaccharides and postbiotics on lipid metabolism were assessed through blood biochemical, histological tissue staining, and polymerase chain reaction analyses. Results Supplementation with deer antler polysaccharides and postbiotics significantly inhibited weight gain in obese mice, reduced serum total cholesterol, triglyceride, and low-density lipoprotein levels and markedly increased the serum high-density lipoprotein level. Additionally, hepatic lipid droplet accumulation and adipocyte hypertrophy improved. The expressions of the lipid synthesis genes, sterol regulatory element-binding protein 1 (i.e. SREBP-1c), and fatty acid synthase (i.e. FAS), significantly decreased, while peroxisome proliferator-activated receptor alpha (i.e. PPAR-α) and acyl-CoA oxidase 1 (i.e. ACOX1) expression significantly increased. The expressions of the inflammation-related genes, tumor necrosis factor-alpha (i.e. TNF-α), interleukin (IL)-6, and IL-1 also significantly decreased. Conclusion Thus, combined deer antler polysaccharides and postbiotic supplementation regulated obesity in mice, potentially by modulating lipid synthesis and inflammation-related gene expression.
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Affiliation(s)
- Lanyue Yin
- College of Food Science and Nutrition Engineering, Jilin Agricultural Science and Technology University, Jilin, China
| | - Jiating Li
- School of Public health, Jilin Medical University, Jilin, P.R. China
| | - Xueyue Tai
- College of Food Science and Nutrition Engineering, Jilin Agricultural Science and Technology University, Jilin, China
- College of Food Science and Engineering, Changchun University, Changchun, China
| | - Guoqi Zhang
- College of Food Science and Nutrition Engineering, Jilin Agricultural Science and Technology University, Jilin, China
- College of Food Science and Engineering, Changchun University, Changchun, China
| | - Mingran Luan
- College of Food Science and Nutrition Engineering, Jilin Agricultural Science and Technology University, Jilin, China
| | - Bao Zhong
- College of Food Science and Nutrition Engineering, Jilin Agricultural Science and Technology University, Jilin, China
| | - Fenglin Li
- College of Food Science and Nutrition Engineering, Jilin Agricultural Science and Technology University, Jilin, China
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Wierda JJ, van Nassau F, Djojosoeparto SK, Poelman MP. Which factors influence the transition towards a healthy and sustainable food environment in Dutch hospitals? A qualitative view from stakeholders. BMC Med 2025; 23:45. [PMID: 39871337 PMCID: PMC11773854 DOI: 10.1186/s12916-025-03872-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2024] [Accepted: 01/14/2025] [Indexed: 01/29/2025] Open
Abstract
BACKGROUND Hospitals fulfill an important exemplary role in promoting health and well-being. It is therefore crucial to have a supportive food environment that stimulates healthy and sustainable food choices of patients, staff, and visitors. This qualitative study aimed to identify factors influencing the implementation of long-lasting actions to enhance the healthiness and sustainability of the food environment in the hospital setting in the Netherlands, from the perspective of different stakeholders. METHODS Semi-structured interviews were conducted in hospitals realizing a healthy and sustainable food environment. Verbatim transcripts were thematically analyzed, guided by the Consolidated Framework for Implementation Research. Data were organized and interpreted per theme as well as stakeholder group. RESULTS In three hospitals, 29 semi-structured interviews were conducted with 30 stakeholders from a wide spectrum of stakeholder groups (i.e., facility professionals, healthcare professionals, project coordinators, and board of directors). Identified themes and subthemes were: 1 the outer setting, with momentum for change, government-established policies and guidelines, collaboration and networks outside the hospital, and caterers' and suppliers' food offerings, interests, and contracts; 2 the innovation domain, with familiarity and compliance with the TEH program; 3 support at all levels, achieving organizational buy-in with communication as a strategy, and end user interests; 4 the inner setting, with key priority in policy and having a vision, available resources, infrastructure within the hospital, ambassadors, and gradual process with continuous effort; and 5 the individual domain with personal drive. CONCLUSIONS The results revealed an interplay of perceived factors that influence the enhancement of a healthy and sustainable food environment and underscored the importance of addressing various facilitators and barriers across multiple domains within and outside the hospital setting. To ensure successful integration of a healthy and sustainable food environment in hospitals, throughout the entire organization it is crucial to engage diverse stakeholders at all levels and address their barriers with tailored implementation strategies. We suggest verification of our findings in more hospitals.
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Affiliation(s)
- Joline J Wierda
- Consumption & Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands.
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sanne K Djojosoeparto
- Consumption & Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Maartje P Poelman
- Consumption & Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
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Lei H, Ruan Y, Ding R, Li H, Zhang X, Ji X, Wang Q, Lv S. The role of celastrol in inflammation and diseases. Inflamm Res 2025; 74:23. [PMID: 39862265 DOI: 10.1007/s00011-024-01983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 10/04/2024] [Accepted: 10/18/2024] [Indexed: 01/27/2025] Open
Abstract
Celastrol is one of the main active ingredients extracted from the plant Tripterygium wilfordii Hook F. A growing number of studies have shown that celastrol has various pharmacological effects, including anti-inflammation, anti-rheumatism, treatment of neurodegenerative diseases, and anti-tumor. This article systematically summarized the mechanism and role of celastrol in lipid metabolism and obesity, rheumatoid arthritis (RA), osteoarthritis (OA), gouty arthritis, inflammatory bowel disease, neurodegenerative diseases, and cancer and other diseases (such as diabetes, respiratory-related diseases, atherosclerosis, psoriasis, hearing loss, etc.). The celastrol played roles in inflammation response, cell apoptosis, autophagy, ferroptosis, and lipid metabolism mainly by acting on chondrocytes, macrophages, mitochondria, and endoplasmic reticulum (ER) through NF-κB, STAT, MAPK, TLR, PI3K-AKT-mTOR, and other signal pathways. This review could provide a reference for the clinical application and further development and utilization of celastrol.
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Affiliation(s)
- Han Lei
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, Henan, China
| | - Yantian Ruan
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, Henan, China
| | - Ruidong Ding
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, Henan, China
| | - Haotian Li
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, Henan, China
| | - Xiaoguang Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Henan University, Henan University, Kaifeng, 475001, Henan, China
| | - Xinying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, Henan, China
- Center for Molecular Medicine, Faculty of Basic Medical Subjects, Shu-Qing Medical College of Zhengzhou, Mazhai, Erqi District, Zhengzhou, 450064, Henan, China
| | - Qi Wang
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, Henan, China.
| | - Shuangyu Lv
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, Henan, China.
- Department of Neurosurgery, The First Affiliated Hospital of Henan University, Henan University, Kaifeng, 475001, Henan, China.
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Yimer W, Asmare L, Gebeyehu FB, Alemu T, Mehamed A, Yeshanew Ayele F. Factors influencing waist circumference among urban bank employees in Northeast Ethiopia: a cross-sectional study. Front Nutr 2025; 11:1414930. [PMID: 39912059 PMCID: PMC11794093 DOI: 10.3389/fnut.2024.1414930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 12/30/2024] [Indexed: 02/07/2025] Open
Abstract
Introduction A widely recognized public health issue affecting people worldwide is central obesity. Numerous chronic conditions, such as type 2 diabetes mellitus, cardiovascular disease, and malignancies are linked to this syndrome. There is limited information about waist circumference (WC) and its related variables among urban bank workers in Ethiopia. Therefore, the purpose of this study was to evaluate waist circumference and the factors associated with it among bank workers in Northeast Ethiopia. Methods An institution-based cross-sectional study was carried out in Dessie, Northeast Ethiopia, between 2 October 2023 and 24 October 2023. A random selection method was employed to select 363 bank workers. STATA version 17 was used for analysis after the data were imported into EpiData version 4.4.2.0. Univariate and multivariate linear regression analyzes were performed to identify factors related to waist circumference. Normality, homoscedasticity, significant outliers, and multicollinearity were assessed, and a p-value of less than 0.05, along with a 95% confidence interval, was considered statistically significant. Results A total of 345 participants were included in the final analysis, with a 95% response rate. The overall mean ± standard deviation (SD) of the waist circumference of the employees was 81.7 ± 6.8 cm, with 82.4 ± 6.5 cm for men and 80.7 ± 7.2 cm for women. The overall prevalence of central obesity was 57.7%, with 48.2% for the men and 70.3% for the women. The overall mean ± SD of the waist-to-hip ratio (WHR) was 0.90 ± 0.05, with 0.91 ± 0.04 for men and 0.89 ± 0.05 for women. The average waist circumference was significantly associated with the participants' age (0.2 cm per year (SE: 0.1)) and MET hours (0.2 cm (SE: 0.1)). The mean waist circumference was 2.7 cm (SE:0.8) higher in the married women, 4.6 cm (SE:1.9) higher in the participants with non-communicable diseases (NCDs), and 1.7 cm (SE:0.8) higher in the participants who consumed discretionary calories for 4 days/week. Conclusion The mean waist circumference among bank employees was higher, with more than half of the participants having central obesity. Age, marital status, discretionary calorie intake, non-communicable diseases, and metabolic equivalence task hours were the significant factors of waist circumference. Therefore, promoting activities aimed at preventing non-communicable diseases, such as leisure-time physical activity, and reducing discretionary calorie intake are essential for reducing high waist circumference measurements.
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Affiliation(s)
- Woynshet Yimer
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Lakew Asmare
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fikre Bayu Gebeyehu
- Department of Anatomy, School of Public Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tihtna Alemu
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Anisa Mehamed
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Wollo, Ethiopia
| | - Fanos Yeshanew Ayele
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Zhang J, Wang B, Zou C, Wang T, Yang L, Zhou Y. Low back pain trends attributable to high body mass index over the period 1990-2021 and projections up to 2036. Front Nutr 2025; 11:1521567. [PMID: 39906897 PMCID: PMC11790459 DOI: 10.3389/fnut.2024.1521567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Accepted: 12/31/2024] [Indexed: 02/06/2025] Open
Abstract
Background High body mass index (BMI) is a crucial determinant in low back pain (LBP) incidence and progression. However, the effect of increased BMI on LBP has been largely overlooked at the global, regional, and national levels. This research aimed to use data from the 2021 global burden of disease (GBD) study to determine trends associated with LBP due to high BMI from 1990 to 2021, thereby providing evidence for developing targeted policies. Methods Epidemiological data on the association between high BMI and LBP is obtained from the GBD 2021. Disability-adjusted life-years (DALYs) attributable to high BMI-related LBP are stratified by year, age, country, and socio-demographic index (SDI). The estimated annual percentage change (EAPC) was calculated to evaluate the trends from 1990 to 2021. A Bayesian age-period cohort (BAPC) model was used to assess the corresponding trends from 2022 to 2036. Additionally, statistical models, such as decomposition analysis and frontier analysis, were used. Results According to the GBD 2021, the number of DALYs caused by LBP attributed to high BMI reached 8,363,759 in 2021, which is an increase of 170.97% since 1990. The age-standardized rate of disability-adjusted life years (ASDR) for LBP caused by high BMI has been increasing from 1990 to 2021, with an EAPC of 1.14%. Among the five SDI regions, ASDR has increased. High-income North Americans exhibited the highest risk of LBP caused by high BMI, with Hungary being the most affected. Frontier analysis highlights the urgent need for intervention in countries such as the Netherlands, Germany, and Canada. Finally, the burden of LBP related to high BMI will continue to rise from 2022 to 2036. Conclusion Between 1990 and 2021, there was a global increase in lower back pain due to high BMI, with a projected continuation of this trend. Monitoring BMI is crucial for developing region-specific and national strategies, and research emphasizes the urgency of reducing the health burden of high BMI and improving the quality of life for the global population.
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Affiliation(s)
- Jiling Zhang
- Department of Clinical Laboratory, Beijing Shunyi District Hospital, Beijing, China
| | - Baodong Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Congying Zou
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Tianyi Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lihui Yang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yu Zhou
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Chavez-Ugalde Y, De Vocht F, Jago R, White M, Toumpakari Z. Using group model building to frame the commercial determinants of dietary behaviour in adolescence - findings from online system mapping workshops with adolescents, policymakers and public health practitioners in the Southwest of England. BMC Public Health 2025; 25:144. [PMID: 39806350 PMCID: PMC11730463 DOI: 10.1186/s12889-025-21320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/03/2025] [Indexed: 01/16/2025] Open
Abstract
BACKGROUND In England, 23% of children aged 11 start their teenage years living with obesity. An adolescent living with obesity is five times more likely to live with obesity in adult life. There is limited research and policy incorporating adolescents' views on how they experience the commercial determinants of dietary behaviour and obesity, which misses an opportunity to improve services and policies that aim to influence the prevalence of childhood obesity. This study reports the findings from online Group Model Building system mapping workshops in which we explored the mechanisms by which commercial drivers influence adolescents' dietary behaviour. METHODS We ran a series of 3 online Group Model Building workshops with adolescents and one Group Model Building workshop with policymakers and public health practitioners. Adolescents portrayed their views on how food and beverage industries influence what they choose to buy and eat in a system map, and then proposed a set of policy actions to promote healthier food environments. We shared the system map created by adolescents with policymakers and public health practitioners to reflect on how current policy interventions match adolescents' views on the most influential factors. RESULTS The system map contains 37 elements connected by 70 hypothesised causal links and five feedback loops. These elements were grouped into six themes that portray the complexity of factors that influence adolescents' food choices in their physical and digital environments, disproportionately encouraging the consumption of unhealthy products. Policymakers and public health practitioners reflected on the power and the deep level of influence food companies exert on adolescents' behaviour. They recognised that the coexisting influence of food marketing and social media on mental health and body image is not well reflected in current policy and research efforts. CONCLUSIONS This study highlights the need for public health policymaking processes to provide youth with a space to voice influential elements and consequences, thereby co-creating policies and designing interventions to buffer risk factors and increase well-being in this critical transitional stage.
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Affiliation(s)
- Yanaina Chavez-Ugalde
- National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Newcastle, UK.
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.
- MRC Epidemiology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
| | - Frank De Vocht
- National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Newcastle, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (NIHR ARC West), Bristol, UK
| | - Russell Jago
- National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Newcastle, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (NIHR ARC West), Bristol, UK
- Centre for Exercise, School for Policy Studies, Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Martin White
- National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Newcastle, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Zoi Toumpakari
- National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Newcastle, UK
- Centre for Exercise, School for Policy Studies, Nutrition and Health Sciences, University of Bristol, Bristol, UK
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Haganes KL, Devlin BL, Orr RK, Moholdt T. Impact of Time-Restricted Eating and High-Intensity Exercise on Nutrient Intake in Women with Overweight/Obesity: Secondary Analysis of a Randomized Controlled Trial. Nutrients 2025; 17:218. [PMID: 39861348 PMCID: PMC11767901 DOI: 10.3390/nu17020218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Revised: 01/02/2025] [Accepted: 01/06/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND/OBJECTIVES Inadequate micronutrient intakes are common in individuals with overweight/obesityand can exacerbate cardiovascular and metabolic disease risk. Diet and exercise are primary strategies for managing overweight and may influence nutrient intakes. In this secondary analysis of dietary data collected in a randomized controlled trial (RCT, ClinicalTrials.gov (NCT04019860), 15 June 2019) of time-restricted eating (TRE), high-intensity interval training (HIIT), a combination (TREHIIT), or a control group (CON), we investigated intervention effects on energy and nutrient intakes in women with overweight/obesity. METHODS We randomized 131 women (body mass index (BMI) ≥ 27 kg/m2) to 7 weeks of TRE (≤10-h daily eating window with ad libitum energy intake), HIIT (3 sessions/week, performed at ≥90% maximal heart rate), TREHIIT, or CON. Participants recorded all energy intake in an online food diary during a baseline week (week 0) and at the end of the study (week 6 and week 7). We investigated between-group differences in changes in mean energy, macronutrient, and micronutrient intakes. RESULTS TRE had reduced intakes of potassium, magnesium, and phosphorus compared with CON (p < 0.01). TREHIIT had non-significant reduced intakes of potassium, thiamine, magnesium, copper, and phosphorus (0.01< p < 0.05). HIIT alone did not negatively impact micronutrient intakes. TRE and TREHIIT induced suboptimal intakes for a greater number of micronutrients compared with HIIT and CON. CONCLUSIONS A ≤10-h TRE window might increase the risk of micronutrient inadequacy in women with overweight/obesity. Future research is needed to investigate the effects of integrating nutritional guidelines with TRE interventions to mitigate the risk of micronutrient inadequacy in individuals with overweight/obesity.
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Affiliation(s)
- Kamilla L. Haganes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway;
- Women’s Clinic, St. Olav’s Hospital, 7006 Trondheim, Norway
| | - Brooke L. Devlin
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia; (B.L.D.); (R.K.O.)
| | - Rosalie K. Orr
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia; (B.L.D.); (R.K.O.)
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway;
- Women’s Clinic, St. Olav’s Hospital, 7006 Trondheim, Norway
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