Increasing Rates Of Obesity Research Articles

The cost of obesity and related NCDs in Brazil: An analysis of hospital admissions, disability retirement benefits, and statutory sick pay

ObjectivesThis study analyses the prevalence of overweight/obesity in Brazil, and its costs regarding hospital admissions (HA), disability retirement benefits (DRB), and statutory sick pay (SSP) associated with obesity-related non-communicable diseases (NCDs). Study designTime-series study. MethodsThis study analyses data from the VIGITEL system (2010–2019) to calculate the body-mass index (BMI) of adult residents in Brazil's state capitals. Data on HA, DRB, and SSP were obtained from Brazil's SIH/SUS and AEPS Infologo systems. Pearson's correlation and linear regression models were applied. The study selected 23 diseases of the International Classification of Disease (ICDs) belonging to chapters C; E; I; and K. Cost values in BRL were deflated using IPCA. ResultsThe results showed a significant increase in overweight and obesity rates in Brazil, with BMI rising by 0.09 kg/m2 annually. Regression analysis revealed that each 1-point increase in the average BMI of the population is associated with an increase of 81,772 (BRL 237.51 million/year) new HA per year, 5541 (BRL 18.8 million/year) new DRB granted per year, and 42,360 (BRL 131 million/year) new SSP per year. Also, every 1 % increase in the share of the Brazilian population with obesity is associated with an increase of 16,973 (BRL 48.8 million/year) new HA per year, 1202 (BRL 3.97 million/year) new DRB granted per year, and 8686 (BRL 26.8 million/year) new SSP per year. Regressions for deflated values showed lower significance, suggesting a strong impact of inflation on health costs in Brazil. ConclusionsObesity prevalence in Brazil implies high direct and indirect costs for the Brazilian government, especially considering circulatory system diseases.

7529 A Silent Menace Of Mounjaro: Acute Renal Failure Associated With Tirzepatide

Abstract Disclosure: F. farhat: None. P. Gonzalez: None. A.B. Ravin: None. F.F. Foo: None. S. Patel: None. J. Cheng: None. S.W. Holland: None. A. Chinnici: None. A. Abu Homoud: None. Introduction: Obesity and metabolic syndrome are serious conditions resulting in high morbidity and mortality. Approximately 70% of Americans suffer from obesity. In light of increasing obesity rates, many new medications, including GLP1 receptor agonists, have been approved by the FDA. Tirzepatide injection, known as Mounjaro, is a new medication for diabetes mellitus which offers additional benefits of weight loss. Mounjaro’s side effects can range from mild symptoms including nausea, vomiting, and diarrhea, to more severe symptoms like pancreatitis, and allergic reaction. In this report we present a rare case of renal failure after initiation of Mounjaro. Case presentation:This is a 59 year old male with past medical history significant for hypertension, dysglycemia who presented to the Emergency Department (ED) after two near syncopal events. He was started on Mounjaro a month ago. One week prior to presentation, the patient received his 6th dose of Mounjaro and shortly after he began experiencing generalized weakness associated with nausea, vomiting, diarrhea, and lower extremity cramps. His symptoms continued to worsen which prompted him to come to the hospital. Moreover, he had not voided in 4 days. In the ED, he was severely hyponatremic and AKI with a sodium of 115 and creatinine of 6.62.Patient was admitted to the ICU for further treatment and monitoring. He was evaluated by a nephrologist and determined that dialysis was not necessary as his AKI was resultant from volume depletion due to severe diarrhea as creatinine improved to 3.89 after resuscitation. He was discharged with no further complications.Discussion:This case report brings attention to a potential serious adverse effect from the use of a GLP1, Mounjaro, that has not been described before. Previous reports have described AKI caused by GLP1 treatment but none to our knowledge have discussed renal failure in patients without underlying renal disease. Patients with Chronic Kidney Disease and use of medications such as NSAIDs, diuretics, or angiotensin receptor blockers are more likely to develop renal complications.Mounjaro and other GLP1 medications have gained popularity among patients as they are effective in weight loss and simple to administer.. Additionally, more practitioners are now prescribing these medications for diabetics as they offer a more favorable safety profile compared to other available medications. Although GI side effects are well known, patients should be warned about the potential of severe dehydration leading to renal complications. Conclusion: Mounjaro has been associated with gastrointestinal adverse effects which include nausea, vomiting and diarrhea, and if severe, can lead to AKI and possible renal failure even without underlying renal disease. Monitoring renal functions after initiating or escalating the dose of Mounjaro should be a routine workup by all providers. Presentation: 6/2/2024

Influence of Obesity and Sociodemographic Features on the Physical Fitness of Breast Cancer Survivors.

Obesity is a chronic, relapsing, and progressive disease. The issue of obesity affects 50 to 80% of patients who have been diagnosed with breast cancer. The aim of this study is to assess the scale of the problem of obesity among breast cancer survivors (BCS) older than 60 years, evaluate their physical fitness, and study the relationship between the occurrence of obesity and levels of fitness among breast cancer survivors. The relationship between fitness and sociodemographic factors has also been analyzed. This original epidemiological clinical study included a cohort of 88 female breast cancer survivors treated in 2022 in Holycross Cancer Center, Kielce, Poland. A questionnaire involving demographic information and medical data was utilized. The Senior Fitness Test (SFT) battery has been used to assess the physical fitness of the patients. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were also analyzed. More than 70% of the studied breast cancer survivors were classified as overweight or obese, according to BMI and WC indices. Depending on the SFT trial, the regression coefficients indicated worse results in participants who were older, lived in urban areas, were professionally active, less educated, and had higher obesity indices. The analysis of the relationship between obesity indices and fitness components revealed that all obesity indices were significantly associated with lower body flexibility (BMI p = 0.0118, WC p = 0.0092, WHR p = 0.0364, WHtR p = 0.0095). Upper body flexibility was significantly correlated with BMI indices (p = 0.0091, p = 0.0193) and WHtR (p = 0.0095). Agility and balance were significantly associated with WC (p = 0.0193), WHR (p = 0.098), and WHtR (p = 0.0095). Lower body strength was significantly correlated with the WHR index (p = 0.0487). Significant differences were found in upper body strength depending on the WHtR category. In the studied group of breast cancer survivors, there is a high prevalence of overweight and obesity. With increasing obesity rates, older age, and lower education levels, physical activity measured by the SFT decreases. Living in urban areas and being professionally active also predispose to lower physical activity levels. As obesity indices increase, physical fitness decreases in trials assessing upper and lower body strength, upper and lower body flexibility, as well as agility and dynamic balance.

CHANGES IN SECONDARY STRUCTURE OF PROTEIN IN SKELETAL MUSCLE DUE TO HIGH-CARBOHYDRATE OR HIGH-FAT DIETS

Objective: Obesity, which arises from changes in lifestyle and feeding habits, is a threat to human health. One essential contributor to the increase in obesity rates is the popularity of high-calorie diets. This study aims to investigate high-fat (HFD) and high-carbohydrate (HCD) diet-induced molecular changes in protein secondary structure in longissimus dorsi skeletal muscle tissues of female inbred C57BL/6J mice by utilizing Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy. Materials and Methods: Mice were fed a control diet, HCD, or HFD for 24 weeks. Their skeletal muscle tissues were collected, and their spectra were recorded using a Bruker Invenio S ATR-FTIR spectrometer in the 4000-400 cm-1 region. Results: The protein secondary structure profiles of the HCD group demonstrated a significant rise in antiparallel β-sheet and β-turn and a decline in parallel β-sheets together with the insignificant increase in aggregated β-sheets and a decrease in α-helix. The impact of an HFD on protein conformation is less pronounced than HCD. The HFD diet led to an increase in antiparallel β-sheets and a decrease in parallel β-sheets. Although it was not significant, an increase was observed in β-turn and α-helix. Conclusion: These results propose the appearance of protein aggregation and/or formation of protein-protein intermolecular interaction in skeletal muscle tissues of female inbred C57BL/6J mice. Collectively, these data suggest that both high-calorie diets impair secondary structures of protein in skeletal muscle that may affect its metabolic function.

Prevalence of Childhood Obesity Among Children and Adolescents in Saudi Arabia: A Systematic Review.

Childhood obesity is a growing public health concern worldwide, with significant implications for long-term health outcomes. Thus, the aim of this study is to highlight the prevalence and trend of obesity among children and adolescents in Saudi Arabia over the last 24 years.This systematic review included participants aged 2 to 19 years without systemic disease, reporting the prevalence of obesity using the Centers for Disease Control and Prevention (CDC) classification and BMI calculation, from studies in English or Arabic published between January 2000 and April 2024. We conducted a comprehensive search across multiple databases including ProQuest, Google Scholar, ISI Web of Science, Embase via Ovid, and MEDLINE via Ovid, and reviewed references of included studies. Data were extracted and quality assessed independently by two authors, with any disagreements resolved through discussion with a third reviewer, using the Newcastle-Ottawa Scale modified for this study. This systematic review included 21 studies from Saudi Arabia, published between 2006 and 2023, with participants aged 2 to 19 years. The studies involved a total of 63,512 subjects. Among children, the prevalence of overweight ranged from 5% to 29%, while obesity ranged from 3.8% to 49.7%, classified using CDC criteria. Quality assessment rated 10 studies as Very Good, 10 as Good, and one as Unsatisfactory.The systematic review of childhood obesity prevalence in Saudi Arabia over the past 24 years highlights alarming trends and significant public health implications. Our analysis emphasizes an increase in obesity rates among children and adolescents, revealing a complex link of socioeconomic, cultural, and lifestyle factors contributing to this epidemic.

Evaluation of MRI proton density fat fraction in hepatic steatosis: a systematic review and meta-analysis.

Amidst the global rise of metabolic dysfunction-associated steatotic liver disease (MASLD), driven by increasing obesity rates, there is a pressing need for precise, non-invasive diagnostic tools. Our research aims to validate MRI Proton Density Fat Fraction (MRI-PDFF) utility, compared to liver biopsy, in grading hepatic steatosis in MASLD. A systematic search was conducted across Embase, PubMed/Medline, Scopus, and Web of Science until January 13, 2024, selecting studies that compare MRI-PDFF with liver biopsy for hepatic steatosis grading, defined as grades 0 (< 5% steatosis), 1 (5-33% steatosis), 2 (34-66% steatosis), and 3 (> 66% steatosis). Twenty-two studies with 2844 patients were included. The analysis showed high accuracy of MRI-PDFF with AUCs of 0.97 (95% CI = 0.96-0.98) for grade 0 vs ≥ 1, 0.91 (95% CI = 0.88-0.93) for ≤ 1 vs ≥ 2, and 0.91 (95% CI = 0.88-0.93) for ≤ 2 vs 3, diagnostic odds ratio (DOR) from 98.74 (95% CI = 58.61-166.33) to 23.36 (95% CI = 13.76-39.68), sensitivity and specificity from 0.93 (95% CI = 0.88-0.96) to 0.76 (95% CI = 0.63-0.85) and 0.93 (95% CI = 0.88-0.96) to 0.89 (95% CI = 0.84-0.93), respectively. Likelihood ratio (LR) + ranged from 13.3 (95% CI = 7.4-24.0) to 7.2 (95% CI = 4.9-10.5), and LR - from 0.08 (95% CI = 0.05-0.13) to 0.27 (95% CI = 0.17-0.42). The proposed MRI-PDFF threshold of 5.7% for liver fat content emerges as a potential cut-off for the discrimination between grade 0 vs ≥ 1 (p = 0.075). MRI-PDFF is a precise non-invasive technique for diagnosing and grading hepatic steatosis, warranting further studies to establish its diagnostic thresholds. This study underscores the high diagnostic accuracy of MRI-PDFF for distinguishing between various grades of hepatic steatosis for early detection and management of MASLD, though further research is necessary for broader application. MRI-PDFF offers precision in diagnosing and monitoring hepatic steatosis. The diagnostic accuracy of MRI-PDFF decreases as the grade of hepatic steatosis advances. A 5.7% MRI-PDFF threshold differentiates steatotic from non-steatotic livers.

ThP4.5 - The challenges of the emergency laparoscopic cholecystectomy in the obese patient

Abstract It’s well documented that obesity is a positive predictor of surgical morbidity and with increasing obesity rates it is becoming a challenge for patients presenting with obesity related surgical conditions such as acute cholecystitis. This study aims to assess the impact of the class of obesity on the outcomes following laparoscopic cholecystectomy for acute cholecystitis. Methods A retrospective observational study was performed on patients undergoing emergency laparoscopic cholecystectomy at UHNM from January 2022 to January 2023. These patients were then stratified by their class of obesity as defined by the WHO; Healthy weight (BMI &amp;lt;25), Overweight (BMI 25 – 30), ClassI Obesity (BMI 30-35), ClassII Obesity (BMI 35-40), and ClassIII Obesity (BMI &amp;gt;40). Primary outcomes included LOS, mortality, 30 day readmission rates and postoperative complications. Secondary outcomes included total operative time. Results A total of 643 patients were identified. The classes of obesity were on average a younger cohort (median age, Healthy Weight = 60 [32–82], Overweight = 62 (28-86), Class I = 56 (27-80) ClassII = 50 (22-83) and ClassIII = 47 (28-90); p &amp;lt; 0.001). Length of hospital stay, mortality and operative duration, were similar between groups. However readmission rates were higher for the obese groups (Healthy Weight 8% vs Overweight 8% vs ClassI = 7% vs ClassII = 14% vs ClassIII 16%; p &amp;lt; 0.001) and postoperative complications (p = 0.067). Conclusions Emergency laparoscopic cholecystectomy can be performed safely on patients with higher classes of obesity but an appreciation of the class of obesity needs to be taken into consideration and higher class of obesity is associated with increasing risk of post operative complications.

The Influence of Lifestyle on Cholesterol Levels

The Epidemic of Non-Communicable Diseases (NCD) Obesity has doubled since the 1980s, rapidly becoming the largest global public health challenge. Obesity is the third leading cause of death in the world. The increase in obesity rates is associated with an individual's habit of consuming food with more energy than the body needs. Risk factors that can influence the increase in the prevalence of heart disease involve individuals with hypertension, diabetes mellitus, dyslipidemia, lack of physical activity, poor lifestyle habits such as consuming fast food, an unhealthy diet, and experiencing prolonged stress. This can be changed with a better lifestyle, while some risks that cannot be changed are congenital or genetic heart disease. Research Objective: reduce the death rate caused by heart disease by reducing the risk of heart disease. The sampling technique used is random sampling with a cross-sectional approach, and the examination sample consists of capillary blood, measurements, and interviews using questionnaires. Out of 130 people in Nisa Village, a significant relationship was found between an increase in cholesterol levels and respondents who frequently consume fast food. Subjects who were active/passive smokers had a significance value of 0.65 (p&gt;0.05), indicating a strong relationship according to correlation guidelines. Subjects who frequently experienced stress also had a strong relationship with an increase in blood cholesterol levels, with a significance value of 0.34 (p&gt;0.05). The variable of subjects who rarely exercised was found to have a significance value of 0.38 (p&gt;0.05), meaning that the habit of infrequent exercise has a strong relationship with an increase in cholesterol levels.

Obesity-Related Glomerulopathy: Epidemiology, Pathogenesis, and Current Treatments

Obesity-related glomerulopathy (ORG) is a kidney disease characterized by glomerulomegaly with or without focal segmental glomerulosclerosis. With the increase in worldwide obesity rates, the number of ORG patients has also risen rapidly. Approximately 10% of ORG patients have been found to progress to the end stage of renal disease 6.2 years after diagnosis. The pathogenesis of ORG is complex, involving altered renal hemodynamics, activation of the renin–angiotensin–aldosterone system, insulin resistance, and abnormal lipid metabolism and adipokines. Despite the numerous strategies to lose weight as treatment for ORG, ranging from lifestyle and diet changes to bariatric surgery and medications, approved and marketed weight-loss drugs often have potential side effects and perform below expectations. Recently, new glucose-lowering drugs that also reduce body weight and improve kidney function have garnered attention. In particular, several large clinical trials have confirmed the efficacy and safety of sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in reducing weight and preserving kidney function. This article provides a brief review of the epidemiology, pathogenesis, and treatment strategies of ORG.

Influence of patient body weight on the probability of return of spontaneous circulation following out-of-hospital cardiac arrest: an exploratory analysis.

In addition to key interventions, including bystander CPR and defibrillation, successful resuscitation of out-of-hospital cardiac arrest (OHCA) is also associated with several patient-level factors, including a shockable presenting rhythm, younger age, Caucasian race and female sex. An additional patient-level factor that may influence outcomes is patient weight, yet this attribute has not been extensively studied within the context of OHCA, despite globally increasing obesity rates. To assess the relationship between patient weight and return of spontaneous circulation (ROSC) during OHCA. This retrospective study included adult patients from a national emergency medical services (EMS) patient record, with witnessed, non-traumatic OHCA prior to EMS arrival from January to December 2020. Logistic regression was used to evaluate the relationship between patient weight and ROSC. Complete records were available for 9096 patients, of which 64.3% were males and 25.3% were ethnic minorities. The mean age of the participants was 65.01 years (SD = 15.8), with a mean weight of 93.52 kg (SD = 31.5). Altogether, 81.8% of arrests were of presumed cardiac aetiology and 30.3% presented with a shockable rhythm. Bystander CPR and automated external defibrillator (AED) shock were performed in 30.6% and 7.3% of cases, respectively, and 44.0% experienced ROSC. ROSC was less likely with patient weight >100 kg (OR = 0.709, p <0.001), male sex (OR = 0.782, p <0.001), and increasing age and EMS response time (OR = 0.994 per year, p <0.001 and OR = 0.970 per minute, p <0.001, respectively). Patients with shockable rhythms were more likely to achieve ROSC (OR = 1.790, p <0.001), as were patients receiving bystander CPR (OR = 1.170, p <0.001) and defibrillation prior to EMS arrival (OR = 1.658, p <0.001). Although the mean first adrenaline dose (mg/kg) followed a downward trend due to its non-weight-based dosing scheme, the mean total adrenaline dose administered to achieve ROSC demonstrated an upward linear trend of 0.05 mg for every 5 kg of body weight. Patient weight was negatively associated with ROSC and positively associated with the total adrenaline dose required to attain ROSC.

The Prevention of Childhood Obesity Is a Priority: The Preliminary Results of the "EpPOI: Education to Prevent Childhood Obesity" Project.

The increase in childhood obesity rates represents a serious public health problem. The project "EpPOI: Education to prevent childhood obesity" is aimed at a multidisciplinary approach to raise awareness of the importance of preventing childhood obesity through lifestyle education. Two actions by experts were performed: an intervention with children in schools and a meeting for both parents and school staff. Participants completed a questionnaire structured as a Likert scale. The sample size was 96 people, and awareness of the childhood obesity problem as well as the need for obesity prevention was high among respondents. We also found great interest among participants in having more information on pediatric nutrition and physical activity, with a positive correlation with age. Furthermore, the multivariate regression model configured interest in having more information on nutrition and physical activity as an independent and statistically significant predictor of awareness of childhood obesity as a current issue. The results highlight the need to act on childhood obesity through lifestyle prevention strategies early in life.

Global food value chains and obesity in low- and middle-income countries

Low- and middle-income countries (LMICs) are experiencing disproportional increases in overweight or obesity rates. Parallel to this trend, many LMICs are witnessing significant growth in their participation in global food value chains (GFVCs). This paper aims to shed light on the public health implications of increasing participation in GFVCs. Leveraging macro- and micro-level data spanning 25 years, we study the relationship between countries’ participation in GFVCs and women’s overweight or obesity rates. We explore heterogeneous implications by disaggregating countries’ participation into backward and forward linkages in GFVCs, as well as across rural and urban areas. We find that temporal increases in countries’ participation in GFVCs are significantly associated with increasing overweight or obesity rates, primarily when countries participate in backward linkages and for urban populations. Participation in GFVCs involving forward linkages appears to have negligible implications, and the relationship between participation in GFVCs and obesity disappears for rural women. Furthermore, we find that an increase in countries’ participation in GFVCs is associated with an increase in consumption of energy-dense foods such as sugar, commonly linked with obesity. Our findings have important implications for informing public policies aimed at addressing the increasing obesity rates and associated economic and health burdens in LMICs.

Metabolic score for insulin resistance (METS-IR) predicts all-cause and cardiovascular mortality in the general population: evidence from NHANES 2001–2018

BackgroundThe prevalence of obesity-associated insulin resistance (IR) is increasing along with the increase in obesity rates. In this study, we compared the predictive utility of four alternative indexes of IR [triglyceride glucose index (TyG index), metabolic score for insulin resistance (METS-IR), the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and homeostatic model assessment of insulin resistance (HOMA-IR)] for all-cause mortality and cardiovascular mortality in the general population based on key variables screened by the Boruta algorithm. The aim was to find the best replacement index of IR.MethodsIn this study, 14,653 participants were screened from the National Health and Nutrition Examination Survey (2001–2018). And TyG index, METS-IR, TG/HDL-C and HOMA-IR were calculated separately for each participant according to the given formula. The predictive values of IR replacement indexes for all-cause mortality and cardiovascular mortality in the general population were assessed.ResultsOver a median follow-up period of 116 months, a total of 2085 (10.23%) all-cause deaths and 549 (2.61%) cardiovascular disease (CVD) related deaths were recorded. Multivariate Cox regression and restricted cubic splines analysis showed that among the four indexes, only METS-IR was significantly associated with both all-cause and CVD mortality, and both showed non-linear associations with an approximate “U-shape”. Specifically, baseline METS-IR lower than the inflection point (41.33) was negatively associated with mortality [hazard ratio (HR) 0.972, 95% CI 0.950–0.997 for all-cause mortality]. In contrast, baseline METS-IR higher than the inflection point (41.33) was positively associated with mortality (HR 1.019, 95% CI 1.011–1.026 for all-cause mortality and HR 1.028, 95% CI 1.014–1.043 for CVD mortality). We further stratified the METS-IR and showed that significant associations between METS-IR levels and all-cause and cardiovascular mortality were predominantly present in the nonelderly population aged < 65 years.ConclusionsIn conjunction with the results of the Boruta algorithm, METS-IR demonstrated a more significant association with all-cause and cardiovascular mortality in the U.S. population compared to the other three alternative IR indexes (TyG index, TG/HDL-C and HOMA-IR), particularly evident in individuals under 65 years old.

Microalgae and cyanobacteria as natural sources of antioxidant enzymes and enzyme inhibitors for Alzheimer's and diabetes

Microalgae and cyanobacteria biomass can be cultivated in large amounts, producing a variety of bioactive compounds. As a result, various industries have begun to study the potential of this biomass in a wide range of applications such as biofuel production, environmental remediation for contaminated soil and water, food supplements, and as a source of feed for aquaculture. The cultivation conditions have a profound impact on microalgae biochemical composition. Therefore, the culture conditions must be tailored to the specific application of the biomass. This entails careful control of factors such as light exposure, nutrient concentration, and the application of stress conditions. To further enhance the value of microalgae biomass beyond its nutritional analysis, this review aims to explore the potential of the biomass as biofactories for producing antioxidant enzymes and inhibitors targeting Alzheimer's and diabetes diseases. Both chronic diseases are a growing concern due to an aging population and an increase in obesity rates. Microalgae when exposed to stressful conditions enhance the activity of antioxidant enzymes. However, further studies in the isolation and storage of these enzymes need to be performed. From the literature reviewed microalgae exhibited great potential in inhibiting key enzymes involved in Alzheimer's and Diabetes. The inhibitory potential was observed both in vitro and at a cellular level making them a promising natural alternative to current medication used to inhibit these enzymes.

The potential effect of α7 nicotinic receptors modulation on palatable food-induced dependence-like behaviors

BackgroundThe recent global increase in obesity rates, coupled with excessive palatable food (PF) consumption, has become a serious societal concern. Literature indicates that rewarding PF, especially upon cessation, can lead to overeating, binge eating, and compulsive eating, potentially resulting in obesity. Challenges in dietary paradigms, alongside limitations in approved treatments for eating disorders and anti-obesity medications, underscore the need to explore novel targets. In this context, α7nAChR (alpha-7 nicotinic acetylcholine receptor) may serve as a promising therapeutic target in combating food dependence and obesity. The present study aims to assess the role of α7nAChR in palatable food-induced dependence-like behaviors. MethodThe study involved male C57BL/6J mice exposed to three different feeding paradigms over 6 weeks to induce obesity and food addiction. On day 43, palatable food was replaced with standard chow, and the mice received treatments (vehicle, PNU-282987 [α7nAChR agonist], or methyllycaconitine citrate [MLA; α7nAChR antagonist]). Addiction-like behaviors, including craving for palatable food, motivation-effort interaction tests, and compulsive eating-like behavior, were measured during abstinence with and without treatment. ResultsThe present study shows that chronic intermittent and continuous exposure to palatable food induces craving, motivation, and effort interaction behaviors as well as compulsive eating-like behaviors in palatable food-abstinent mice. Administration of the α7nAChR agonist, PNU-282987, significantly attenuated the craving behavior only in mice continuously fed palatable food (reduced calorie intake from 63.19 % to 48.21 %; p = 0.0053). Also, PNU-282987 suppressed the effort behaviors in either intermittently or continuously fed mice (significant reduction in the Δ number of active events per minute; p-values = 0.038 and 0.0098, respectively). However, it attenuated the compulsive-like eating behavior exclusively in the continuously fed group (p = 0.0433). Active and total interaction efforts were reversed by the MLA. These findings indicate the involvement of α7nAChR in dependence-like behaviors toward palatable food in mice. ConclusionOur findings demonstrate that dependence-like behaviors toward palatable food can emerge after prolonged exposure. Mice fed on palatable food continuously exhibited more dependence-like behaviors toward palatable food, and activation of α7nAChR signaling attenuated the vulnerability to develop such behaviors.

Intergenerational care and rural childhood obesity in the digital era: Based on screen exposure perspective

BackgroundRural Chinese children are experiencing increasing obesity rates, yet studies often neglect the impact of IT and screen media growth on obesity risks in the context of intergenerational care, leading to incomplete strategies for the digital era. MethodsBy comprehensively utilizing the data on rural children aged 6–17 from the China Family Panel Studies (CFPS) and the China Health and Nutrition Survey (CHNS), this study aims to test the logical chain and specific mechanisms regarding “intergenerational care - screen exposure - rural childhood obesity”. We employ the Propensity Score Matching (PSM) and Generalized Propensity Score Matching (GPSM) methods to respectively address the self-selection biases associated with inter-generational care and children's screen exposure behaviors. Results1) Intergenerational care significantly increases screen exposure among rural children. 2) Gender bias increases the risk of screen exposure for rural boys under intergenerational care. 3) Children with higher screen exposure levels are more affected by intergenerational care, which further undermines parental supervision. 4) Children's screen exposure leads to increased sedentary time and higher probability of purchasing unhealthy foods, thereby exacerbating obesity. This process is facilitated by enhancing preferences for snacks, fast food, and beverages, and weakening preferences for physical activity. 5) GPSM analysis indicates that children's screen exposure has an inverted “U"-shaped impact on unhealthy dietary preferences and a “U"-shaped impact on activity preferences. It results in a nonlinear positive impact of screen exposure on obesity. This study reveals a positive association between screen exposure and obesity, offering new insights into how intergenerational care in the digital era may elevate obesity prevalence through excessive screen time for rural children.

Impact of the Sewol Ferry Disaster on Physical Changes: Focused on BMI

This study aims to empirically verify whether disasters affect physical changes, linking research on the effects of disasters on psychology and the effects of psychology on physical changes. It focused on the Sewol ferry disaster, and physical changes were tracked from 2010 to 2018, including the four years before and after the disaster in 2014. We constructed panel data on obesity rates from 229 local governments and used longitudinal data to analyze the impact of large disasters on changes in obesity rates over time. The results indicated that the Sewol Ferry Disaster had a long-term effect on the increase in obesity rate over time. In the directly affected areas of Ansan and Jindo, there was not only a long-term increase but also an immediate increase in the obesity rate. The findings of this study provide an opportunity to expand our understanding of the impact of disasters on society, and can also serve as foundational data for national and local disaster-related long-term impact support policies.

The rising prevalence of type 2 diabetes among the youth in southern India-An ancillary analysis of the Secular TRends in DiabEtes in India (STRiDE-I) study.

We studied the prevalence and incidence of type 2 diabetes (T2DM) and its associated risk factors in younger (20 and 39 years) and older individuals (≥40 years) over a 10-year period. Epidemiological surveys in 2006 (n = 7066) and 2016 (n = 9848) were conducted in similar urban and rural locations of southern India among people aged ≥20 years. Diagnosis of T2DM was made using World Health Organization criteria. Self-reported diabetes was verified from medical records. Age and gender standardized prevalence and incidence rates, percentage change in obesity, hypertension, and dyslipidemia were calculated. Prevalence ratios (PR) were calculated using Poisson regression analyses. Primary study was registered on www. gov. Identifier: NCT03490136. In 10 years, the prevalence of T2DM increased in younger (7.8% vs. 4.5%, p < 0.0001) and older individuals (34% vs. 28.4%, p < 0.0001). After adjusting for age, family history of diabetes, and waist circumference, younger individuals showed a higher percentage increase in prevalence than the older group (PR = 1.36 [95% confidence interval [CI], 1.14-1.62], p = 0.001) versus (PR = 1.11 [95% CI, 1.02-1.20], p = 0.02). Increase in rates of obesity and dyslipidemia was also higher in the younger than in the older individuals. In 10 years, incidence of T2DM increased by 120% (1.1% vs. 0.5%, p < 0.0001) and 150% (5% vs. 2%, p < 0.0001) in the younger and older individuals, respectively. Higher percentage increase in prevalence of T2DM was seen among younger individuals over a 10-year period. Obesity and family history of diabetes were shown to be the primary contributing factors for the rise in prevalence.

The signaling pathways in obesity-related complications.

Obesity, a rapidly expanding epidemic worldwide, is known to exacerbate many medical conditions, making it a significant factor in multiple diseases and their associated complications. This threatening epidemic is linked to various harmful conditions such as type 2 diabetes mellitus, hypertension, metabolic dysfunction-associated steatotic liver disease, polycystic ovary syndrome, cardiovascular diseases (CVDs), dyslipidemia, and cancer. The rise in urbanization and sedentary lifestyles creates an environment that fosters obesity, leading to both psychosocial and medical complications. To identify individuals at risk and ensure timely treatment, it is crucial to have a better understanding of the pathophysiology of obesity and its comorbidities. This comprehensive review highlights the relationship between obesity and obesity-associated complications, including type 2 diabetes, hypertension, (CVDs), dyslipidemia, polycystic ovary syndrome, metabolic dysfunction-associated steatotic liver disease, gastrointestinal complications, and obstructive sleep apnea. It also explores the potential mechanisms underlying these associations. A thorough analysis of the interplay between obesity and its associated complications is vital in developing effective therapeutic strategies to combat the exponential increase in global obesity rates and mitigate the deadly consequences of this polygenic condition.

Metabolic syndrome in children and adolescents

Background: Metabolic syndrome is a serious condition associated with multiple diseases. The prevalence of metabolic syndrome is increasing caused by an increase in obesity rates among children and adolescents.Current Concepts: Owing to the various definitions used, there is lack of consensus regarding the diagnostic criteria for metabolic syndrome in children and adolescents. Although the exact pathogenesis remains unclear, insulin resistance and subsequent inflammation are key mechanistic contributors. Metabolic syndrome is characterized by overweight and obesity accompanied by abnormalities in glucose metabolism, dyslipidemia, and hypertension and is associated with other conditions such as fatty liver, polycystic ovary syndrome, and a pro-inflammatory state. Prevention and management of metabolic syndrome can be achieved through lifestyle modifications, behavioral interventions, pharmacotherapy, and surgical interventions.Discussion and Conclusion: Childhood and adolescent obesity serves as a risk factor for metabolic syndrome during later life. Early identification and intervention are important to prevent the progression of metabolic syndrome. Clinicians must identify at-risk children and adolescents and provide guidance for the prevention and management of metabolic syndrome.