Normal Weight Research Articles

This study aimed to investigate the impact of premature birth on the locomotor exploration of infants with up to six months of independent walking experience. Participated in this study, 16 preterm infants (PT) (32.5 ± 3.59 weeks gestational age) with low birth weight (1.91 ± 0.66kg) and low- and lower middle income (75%); and 15 full-term infants (FT) (38.93 ± 0.94 weeks gestational age) with normal birth weight (≥ 2.5kg) and middle- or upper middle income (73.3%). Both groups had similar walking experience and motor development stages and they did not present any physical or mental impairments. Non-object-oriented natural locomotor exploration was measured by recording 20min in a multidisciplinary laboratory room. Five toys were spread around the room to stimulate upright locomotion, without interaction from the caregiver. Real-time analyses of spontaneous locomotion were coded offline using Datavyu software. PT and FT infants showed similar locomotor exploration, spending most of their time in standing locomotion (PT: 24.93%, FT: 35.46%) and exhibiting similar locomotor behaviors (i.e. average PT: 623 steps and 2 falls, FT: 995 steps and 3.27 falls). Spearman correlation across all infants showed that greater walking experience (measured in months) was moderately associated with more time in standing locomotion (r = 0.546, p = 0.001), a greater number of bouts (r = 0.543, p = 0.003), and less time in a sitting position (r = -0.636, p = 0.00). Linear regression showed that for infants in the FT group, there was a positive trend between walking experience and time spent in standing locomotion, number of bouts, and number of total steps. The greater the walking experience, the greater the locomotor exploration for FT infants. However, such a relation was not observed in the PT group . Walking experience can predict developmental changes in the exploratory locomotor behavior of FT infants, but not in PT infants, who exhibit different developmental trends compared to their peers. Opportunities gained with the increase in independent walking experience in the first six months of age do not seem to minimize the subtle impacts associated with being born prematurely on locomotor exploration, which reinforces the necessity for monitoring these infants in early intervention programs, even without motor or mental impairments.

Elevated maternal pre-pregnancy body mass index (BMI) has been suggested to increase risk of offspring autism spectrum disorder (ASD) but evidence is mixed across heterogeneous studies and robust estimates spanning the full BMI range are lacking. This study examined the association between maternal BMI and offspring ASD in a harmonized, two-nation study and across the full BMI range. We included all singleton children born in Denmark 2004-2018 and Sweden 1998-2019 to parents of Nordic origin (n = 2,072,445), with follow-up from age 2 until 31 December 2021, or 2022, respectively. Maternal BMI recorded at the first antenatal visit was obtained from the Swedish and Danish Medical Birth Registers and was analyzed as a continuous variable and in World Health Organization-defined categories of underweight (BMI < 18.5), normal weight (18.5-24.9), overweight (25-29.9), obese class I (30-34.9), and obese class II-III (≥ 35). The relative risk of ASD was estimated as hazard ratios (HR) from Cox regression models, adjusted for birth year and parental age, educational level, income, and psychiatric history at time of childbirth, using data from national health and population registers. Both country-specific and pooled analyses were conducted. Subgroup and sensitivity analyses, including a sibling comparison, were performed to address the specificity and robustness of findings. A total of 58,416 (2.8%) children were diagnosed with ASD during follow-up. The risk of ASD exhibited a J-shaped association with BMI, which gradually increased for mothers with both lower and higher BMI compared to BMI 22 (mid-normal range) (HR = 1.16 [95% CI 1.06-1.27] for BMI 15, and HR = 1.50 [95% CI 1.46-1.53] for BMI 30 in the fully adjusted model). Adjustment for familial factors in a sibling comparison attenuated associations. Both high and low maternal BMI are associated with an increased risk of ASD in the offspring. Familial factors, including genetic and environmental components consistent between siblings, may explain part of the association.

Influence of Obesity on Outcomes of Traction Therapy for Women With Chronic Low Back Pain: An Observational Study.

Obesity increases the risk of hyperuricemia. Recent studies have shown that normal-weight central obesity increases the risk of cardiometabolic disease. In this study, we examined the relationship between normal-weight central obesity and asymptomatic hyperuricemia in Korean adults aged > 20 years. This cross-sectional study included 14,501 adults who visited the health checkup center at a university hospital in 2021. The participants were classified based on sex, and were divided into four groups according to their body mass index and waist-to-height ratio as follows: normal weight, normal-weight central obesity, obesity, and obesity central obesity groups. The odds ratios and 95% confidence intervals for asymptomatic hyperuricemia were analyzed separately using logistic regression models. Regardless of sex, the prevalence of asymptomatic hyperuricemia was higher in the central obesity groups than in the normal weight group. The odds ratios for asymptomatic hyperuricemia were higher in the normal-weight central obesity group than in the normal weight group, even after adjusting for confounding factors (p < 0.05). In Korean adults aged over 20 years, normal-weight central obesity was significantly associated with asymptomatic hyperuricemia. Therefore, screening tests and proper management of asymptomatic hyperuricemia in normal-weight central obesity individuals are necessary.

Background Regular exercise, such as that obtained through badminton, can effectively improve health issues associated with insufficient physical activity among adults with intellectual disabilities (ID). However, there is a paucity of research exploring tailored interventions and post-exercise outcomes among adults with ID based on body mass index (BMI) stratifications. This study compared the effects of a 12-week badminton intervention on health-related physical fitness in adults with ID across three BMI levels, providing a theoretical reference for developing targeted exercise prescriptions for this population. Methods In total, 60 adults (39 male and 21 female) 25–45 years of age with mild to moderate ID were included and allocated to one of three analysis groups based on their BMI (20 per group): normal weight (BMI: 18.5–24.99 kg/m²), overweight (BMI: 25.0–29.9 kg/m²), and obesity (BMI ≥30.0 kg/m²). A systematic 12-week badminton training intervention was conducted, with two 65-minute sessions per week. Health-related physical fitness assessments were performed before and after the intervention. Key outcome measures included (1) aerobic capacity (assessed using the 2-minute step test, resting heart rate, and vital capacity), (2) muscle strength and endurance (assessed through grip strength, standing long jump, sit-ups, and the 30-second chair stand test), and (3) flexibility and coordination (assessed via the sit and reach test, back scratch test, and timed up-and-go test). Data were analyzed using SPSS 22.0 for within-group and between-group comparisons. Results Baseline health-related physical fitness indicators showed no significant differences among the normal weight, overweight, and obesity groups pre-intervention (p &amp;gt; 0.05). Completion of the badminton exercise program resulted in differential improvements. Significant enhancements were observed for all three groups in aerobic capacity (2-minute step test, resting heart rate, and vital capacity), muscle strength and endurance (right-hand grip strength, standing long jump, and 30-second chair stand test), and coordination (timed up-and-go test), after undergoing pre-and post-tests (p &amp;lt; 0.05). Multivariate analysis of variance (MANOVA) indicating differences between groups showed that compared with the overweight group, the normal weight group had greater improvements in right-hand grip strength; compared with the obesity group, the normal weight group exhibited greater improvements observed in right-hand grip strength and performance in the timed up-and-go test; and compared with the obesity group, the overweight group demonstrated more pronounced reductions in resting heart rate and better timed up-and-go test performance (p &amp;lt; 0.05). There was no significant change in flexibility (sit and reach test, back scratch test) between pre-test and post-test performances. MANOVA results for intergroup analyses showed no significant improvements in the 2-minute step test, lung capacity, left grip strength, sit-ups, standing long jump, sit and reach test, and back scratch test. Conclusion Badminton exercise significantly improved aerobic capacity, muscle strength and endurance and coordination in adults with ID across all BMI categories. Core fitness indicators (right-hand grip strength, timed up-and-go test, and resting heart rate) exhibited a gradient improvement pattern: normal weight greater improvement than overweight, which was greater than obesity. Therefore, although badminton is an appropriate exercise intervention for adults with ID, BMI and BMI-related factors should be taken into consideration when designing personalized exercise programs to optimize training effects.

NOVA food group consumption has received significant attention recently for assessing the quality of dietary intake and has been linked to weight gain and obesity. to examine the ultra-processed foods (UPFs) and different NOVA food groups among Jordanian adults in various body mass index (BMI) categories. A cross-sectional study was conducted among 537 Jordanian adults (aged 19-64) from February to April 2024. Anthropometric data were collected, and habitual dietary intake was assessed using a validated Arabic food frequency questionnaire (FFQ). Foods were classified according to the NOVA system into minimally or unprocessed foods (MUPF), processed culinary ingredients (PCI), processed foods (PF), and UPFs. The total energy from each group was analyzed using ESHA's Food Processor software. UPFs contributed approximately 52% of daily energy intake; however, total energy intake was not significantly different across BMI categories (p = 0.870). Obese individuals had a higher MUPF intake (% of total Kcal) (31.97% ± 10.63%) and a lower UPF intake (50.57% ± 12.17%) compared to normal-weight individuals (MUPF: 29.85% ± 9.78%; UPF: 53.52% ± 10.99%; p < 0.05). Excess-weight participants also showed a higher MUPF intake (32.32% ± 10.03 vs. 29.74% ± 9.64) and lower UPF intake (50.27% ± 11.32 vs. 53.65% ± 10.86) than those with normal weight (p < 0.01). No significant differences were found for PCI or PF intake. Despite generally high UPF consumption, individuals with higher BMI consume more energy from MUPF and less from UPF, suggesting a potential shift toward healthier food choices as body weight increases. Therefore, interventions should also focus on energy balance and portion control in normal-weight people within MUPF, not just UPFs.

Reprometabolic syndrome is associated with relative hypogonadotropic hypogonadism, reduced fecundability, and increased pregnancy loss in women with obesity. Does a eucaloric, high-fat diet (HFD) decrease gonadotropins, urinary estrogen and progesterone metabolites, characteristic of Reprometabolic Syndrome, in healthy women of normal BMI? Interventional study. University Medical Center. 18 healthy, eumenorrheic women with normal BMI (18-24.9kg/m²), age 29.1±6.3. A four-month study including a prescribed 30-day, eucaloric, HFD (48% calories from fat). Women collected daily first-voided morning urine for 4 menstrual cycles: pre-diet, on-diet, and 2 post-diet. Urinary LH, FSH, estrone conjugate (E1c) and pregnanediol-3-glucuronide (Pdg) levels were measured daily before, during and after HFD. Cycles were aligned by LH peak and standardized to a 28-day cycle. Peak and integrated hormone levels were compared across cycles using generalized estimating equations. Participants were weight-stable with no change in BMI. Peak E1c, Pdg, FSH and LH were significantly lower during and after the HFD compared to pre-diet levels (p< 0.05). Post-diet luteal phase urinary FSH and LH (area under the curve) were also significantly lower than pre-diet (p< 0.01). No significant changes in menstrual cycle length were observed. Consumption of a one-month HFD was sufficient to induce a significant and sustained reduction in LH and FSH, and lower E1c and Pdg characteristic of the Reprometabolic Syndrome of obesity, in normal weight, eumenorrheic women. This indicates that dietary intervention may be an effective strategy to mitigate reproductive hormone deficiencies in women with obesity-related subfertility.

The social media trend #fitspiration aims to positively impact its users' health, but studies have shown detrimental effects, as it mainly involves stereotypical and barely achievable body images and health behaviors. During puberty, adolescents form their identity and body image, making it essential to examine social media's influence on their health. The exploratory investigation study, part of the mixed methods study in the project FIVE (#Fitspiration Image Verification), sought initial insights into how #fitspiration consumption may affect adolescents' body image perception, dieting, and exercise behaviors. In total, 86 adolescents (N=310, age range 14-18 years; n=42 females) attending upper secondary schools in Eastern Austria took part in an online questionnaire concerning the use of #fitspiration, body image perception, and body-shaping behaviors (dieting and working out) and bioelectrical impedance measurements to assess body composition. Participants have been classified as #fitspiration users (n=27), nonusers (n=51), and former users (n=8). We compared body image perceptions and body-shaping behaviors of #fitspiration user groups sex-specifically with the fat mass index (FMI) and the fat-free mass index (FFMI). The results indicated that the amount of muscularity was of greater importance for all participants than thinness because, and even though the majority were of normal weight (76/86, 88%) and had an average to high FFMI (62/86, 92%), only 6% (5/86) of all participants thought that their amount of muscle mass was appropriate, while 43% (37/86) of all participants rated their body weight as okay. However, this outcome seemed to be of greater significance for #fitspiration users, especially males. While male participants seemed to be more dissatisfied with their amount of muscularity and worked out more often (female: 24/42, 57%, male: 35/44, 80%), female participants seemed to be more dissatisfied with their body weight and were dieting (female: 10/42, 24%; male: 6/44, 14%). Generally, none of the #fitspiration users (0/27, 0%) answered that her or his amount of muscle mass was okay, although all of them had an average or high FFMI (27/27, 100%). Participants assessed their body weight and body fat more precisely (54/86, 63% matched FMI) than their muscle mass (27/86, 31% matched FFMI). Our findings regarding the body ideals of adolescents are in line with the results of large-scale cross-sectional studies, indicating that they aspire to achieve a toned (and, for females, thin) body. The fact that none of the #fitspiration users were satisfied with their level of muscle mass raises the question of whether #fitspiration may perpetuate this ideal. The line between eating disorders and body dysmorphia might be very thin, especially during puberty. Therefore, our findings can be used to raise awareness of the speculated impact of #fitspiration on adolescents as a source for body ideals and consequently for body image perception and body-shaping behavior.

Immune checkpoint inhibitors (ICIs) have radically changed the therapeutic landscape of several cancers. However, only a limited number of predictive factors are currently available in clinical practice to select patients for immunotherapy. The impact of excess weight on ICI toxicity and efficacy is presently under debate. This study was aimed at evaluating the occurrence of immune-related adverse events (irAEs) among cancer patients on ICI therapy according to baseline body mass index (BMI) and gender. The association with clinical outcomes was also analyzed. Patients and methods One-hundred thirty patients (93 males, 37 females, median age 67 years) with diverse types of advanced cancer treated with ICIs at a single university hospital were included in the study. Patients with a previously diagnosed thyroid dysfunction were excluded from this analysis. Results A number of irAEs occurred in 51 patients (39.2%; 33 males, 18 females). Their development significantly correlated to BMI. Overweight/obese patients experienced a higher (59.5% vs 40.5%; p&amp;lt;0.001), and earlier (8 vs 10.6 weeks; p=0.003) occurrence of irAEs than normal weight patients. About 65% of overweight/obese patients had an associated dysmetabolic state (i.e., hypertension, glycemic disturbances and/or dyslipidemia) and displayed higher prevalence of irAEs than those without comorbidities (p=0.019). At multivariate regression analyses, BMI was confirmed as an independent predictor of risk for developing AEs (p&amp;lt;0.001), with an odds ratio (OR) of 3.182 for overweight/obese patients. No differences in BMI or gender emerged in progression-free survival (PFS) and overall survival (OS) rates. Conclusions irAEs occurred more frequently in overweight/obese patients, mainly with metabolic abnormalities. These data underline the importance of a comprehensive clinical assessment, including weight and dysmetabolic comorbidities, of patients at baseline and during ICI therapy.

Normal Weight obesity, characterized by normal-range body mass index accompanied by elevated adiposity, poses a potential health challenge among female college students. This demographic exhibits heightened susceptibility to psychological disturbances and sleep disorders. High-Intensity Interval Training (HIIT) appears to have potential in managing metabolic dysregulation. However, its efficacy in improving mental health and sleep quality in individuals with normal weight obesity remains uncertain. This randomized controlled trial enrolled female college students (N = 35) who met the criteria for normal weight obesity, defined as a body mass index between 20 and 23kg/m² and a body fat percentage greater than 30%. The intervention group (n = 17) participated in a 4-week HIIT protocol, consisting of five sessions per week at greater than 90% VO2max, while the control group (n = 18) received standard health education. Validated instruments were utilized to assess depression (PHQ-9), anxiety (GAD-7), and sleep quality (PSQI). ChiCTR2100050711 Registered 3 September 2021 Retrospectively registered, https//www.chictr.org.cn/showproj.html? proj=132,914. The HIIT intervention significantly reduced PHQ-9 scores from 5.8 ± 4.2 to 3.2 ± 2.7 (p < 0.01) and GAD-7 scores from 5.1 ± 5.3 to 2.8 ± 2.9 (p < 0.05), while also improving PSQI scores from 5.1 ± 3.4 to 3.5 ± 2.5 (p < 0.01). Post-intervention analyses revealed a strong correlation between sleep quality and levels of depression (R = 0.813, p < 0.001) and anxiety (R = 0.739, p < 0.001) in the HIIT group, whereas no significant change in sleep quality was observed among the control group. This study demonstrates the therapeutic efficacy of HIIT in improving psychological disturbances and sleep architecture in female students with normal weight obesity. It may serve as a time-efficient intervention. The observed correlation between sleep quality and psychological parameters warrants further investigation into the underlying mechanisms.

Mounting evidence has suggested the probable involvement of infections in obesity-associated type 2 diabetes. This study aims to evaluate the association between acute inflammation and type 2 diabetes risk and to examine whether this association is modified by adiposity status. This study analysed 82 314 participants without pre-existing diabetes from a real-life, prospective cohort in China. Acute immune response was defined as high-sensitivity C-reactive protein (hsCRP) ≥10 mg/L, and overweight/obesity as body mass index (BMI) ≥24 kg/m2. Multivariable Cox regression models estimated diabetes risk, and both multiplicative and additive interactions were evaluated. During a median follow-up of 11 years, 14 189 participants developed diabetes. Both elevated hsCRP and overweight/obesity independently increased diabetes risk. Acute inflammation was associated with a higher diabetes risk [hazard ratio (HR): 1.14; 95% confidence interval (CI): 1.04-1.22], particularly among those with excess adiposity [HR: 1.24 (1.13-1.36)] compared to those with normal weight [HR: 1.00 (0.83-1.21); P-interaction = 0.0112]. A supra-additive interaction was observed (relative excess risk due to interaction: 0.27; 95% CI: 0.02-0.52), with stronger synergistic effects seen in individuals under 60 and differences noted by sex. Acute inflammation significantly elevates diabetes risk in overweight/obese individuals but not in those with normal weight, highlighting the synergistic role of adiposity and immune activation in diabetes pathogenesis and the importance of weight control in prevention strategies.

Introduction: Overweight has traditionally been considered an intermediate, relatively benign stage between normal weight and obesity; however, recent evidence suggests that it may already be associated with structural and functional cardiac alterations preceding overt cardiovascular disease. Early cardiac remodeling, defined as subclinical changes in left ventricular geometry, mass, and diastolic function, may represent the earliest manifestation of myocardial maladaptation in this population. Objective: The primary objective of this systematic review was to synthesize current evidence on early cardiac remodeling among overweight individuals (body mass index 25–29.9 kg/m²) compared with normal-weight controls. Secondary objectives included identifying the most sensitive imaging parameters for early detection, analyzing the modifying role of metabolic health and demographic variables, and evaluating the overall certainty of evidence. Methods: A comprehensive search was performed in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP for studies published between January 2015 and October 2025. Observational, cross-sectional, and interventional human studies assessing structural or functional cardiac changes in overweight individuals without pre-existing cardiovascular disease were eligible. Two reviewers independently screened titles, abstracts, and full texts, extracted data in duplicate, and assessed risk of bias using RoB 2, ROBINS-I, or QUADAS-2, with overall certainty rated by GRADE. Results and Discussion: 18 studies met inclusion criteria, encompassing 27,800 participants. Most studies reported that overweight individuals exhibited increased left ventricular mass index, concentric remodeling, higher left atrial volume index, and impaired myocardial strain or diastolic function compared with normal-weight subjects. These alterations persisted even after adjusting for blood pressure and metabolic factors, suggesting an independent effect of adiposity. Despite consistent findings across imaging modalities, heterogeneity in study design, populations, and definitions of overweight limited pooled synthesis. Certainty of evidence was graded as moderate for structural outcomes and low for functional outcomes. Conclusion: Overweight status is not metabolically or structurally innocuous. Evidence indicates that early cardiac remodeling can occur before the threshold of obesity, underscoring the importance of early risk assessment and lifestyle interventions. Standardized imaging criteria and longitudinal studies are needed to clarify reversibility and prognostic significance.

Stunting remains a major public health problem in developing countries, including Indonesia, due to its long-term impact on child growth and the quality of future human resources. One frequently cited risk factor associated with stunting is low birth weight (LBW), which reflects impaired fetal growth during pregnancy. This study aims to determine the relationship between birth weight and the incidence of stunting in children under five years of age. A cross-sectional method was applied to explore the relationship between the studied variables, and 763 toddler respondents were included from the working area of the Kintamani VI Community Health Center. The independent variable assessed was birth weight, categorized as normal (≥ 2,500 grams) and LBW (&lt; 2,500 grams), while the dependent variable was stunting status, categorized as stunted or not stunted based on WHO standards. Data analysis was performed using Fisher's Exact Test, which showed a significant relationship between birth weight and stunting (p = 0.002), where toddlers with a history of LBW had a 4.45 times higher risk of experiencing stunting compared to toddlers with normal birth weight. These findings highlight the importance of preventing LBW through adequate maternal nutrition and health interventions during pregnancy as a strategic effort to reduce the incidence of stunting in the community.

Childhood obesity is a significant public health challenge, with Mediterranean countries showing high prevalence rates. While genetic factors play a role, diet and physical activity (PA) are critical modifiable influences. Emphasizing healthy dietary patterns, like the Mediterranean diet, and promoting regular PA can help mitigate obesity risk. MELI-POP is a randomized controlled multi-center clinical trial in a cohort of children aged 3 to 6years at baseline and being at obesity risk. The main objective consists on assessing the efficacy of an intervention during early childhood, considering a healthy lifestyle based on the promotion of a Mediterranean dietary pattern and regular PA, compared with a control group, on decreasing obesity incidence 5 and 10years after the beginning of the intervention. It is expected to include 310 children, aged 3 to 6years, having at baseline a normal weight or overweight according to the International Obesity Task Force (IOTF) criteria, and at least one parent having a body mass index > 25kg/m2. The clinical trial has two arms and is performed in Spanish Primary Health Care centers. The control group receive usual care by healthcare professionals. The intervention group receive education on Mediterranean diet and PA, combined with the provision of extra-virgin olive oil and fish, in order to be consumed at least 2 times per week. Free PA sessions with a physical education teacher are also offered for the children (3 sessions of 60min of moderate-vigorous PA per week). The participants' adherence to the intervention is periodically monitored. The study primarily focuses on adiposity as the main outcome, with secondary outcomes encompassing dietary intake and eating habits, physical activity and lifestyle behaviors (including extracurricular sports, screen time, and sleep duration), physical fitness, biochemical parameters (such as inflammation and cardiometabolic biomarkers, fatty acids, and oxidation), as well as microbiota, genetic, omic and metabolomic analyses. Beneficial results are expected by preventing obesity during childhood, and associated comorbidities. ClinicalTrials.gov, ID: NCT04597281.

Background/Objectives: Eating disorders (EDs) and body image disturbances are increasingly recognized as important health issues among young athletes. Sports participation may both support healthy development and simultaneously increase vulnerability to disordered eating due to performance pressures and cultural ideals. The aim of this study was to assess the risk of eating disorders and body image among 17–20-year-old athletes. Methods: The study included 428 participants (215 women and 213 men) actively engaged in sports. Standardized psychometric tools were applied, including the Eating Attitudes Test (EAT-26) and the Body Esteem Scale (BES). Statistical analyses examined differences across gender, BMI categories, and sports disciplines, as well as predictors of ED risk. Results: The analysis showed that 32.9% (n = 141; 95% CI: 28.3–37.8%) of respondents were at risk of developing eating disorders, with women being significantly more vulnerable than men (p &lt; 0.001; V = 0.27). Underweight athletes demonstrated a higher risk compared with those of normal weight (OR = 2.86, 95% CI: 1.48–5.55, p &lt; 0.001). The type of sport was also associated with risk (p &lt; 0.001, V = 0.323); the highest prevalence of ED risk occurred among dancers (48.1%) and swimmers (38.9%). Body esteem differed markedly between groups: participants at risk scored lower in Weight Control (p &lt; 0.001, Cohen’s d = 0.94) and Physical Attractiveness (p = 0.072) but higher in Physical Condition (p &lt; 0.001). Regression analyses indicated that gender (β = −3.35, p &lt; 0.001) and Body Esteem—Weight Control (β = −0.45, p &lt; 0.001) were the strongest predictors of EAT-26 scores. Conclusions: The findings confirm the multidimensional nature of eating disorder risk among young athletes, highlighting the role of body image imbalance and gender differences. Early screening, preventive interventions, and multidisciplinary support are essential to protect both the physical and mental health of young athletes. Future research should include objective physiological measures and broader samples to improve generalizability.

Evidence and clinical guidelines on methylphenidate dosing in different weight status groups are limited. This study aimed to evaluate real-world methylphenidate dosing practices and treatment discontinuation rates in children and adolescents in relation to weight status. We used data from the BMI Epidemiology Study Gothenburg cohort, which includes weight and height measurements linked to national registers. Exposures included body weight, standardised body mass index (zBMI), and body mass index (BMI) status. The main outcome was the dose and weight-adjusted dose of methylphenidate for the baseline and follow-up prescriptions. We used a logistic regression model to evaluate treatment discontinuation in relation to weight status, sex, and age. The study included 1741 children and adolescents who initiated methylphenidate treatment and had BMI available. Among them, 612 had a follow-up prescription with BMI available. Children and adolescents with overweight and obesity received slightly higher absolute doses of methylphenidate at baseline prescriptions, but lower weight-adjusted doses. Children and adolescents with underweight received higher weight-adjusted doses. Absolute dose increases between treatment initiation and follow-up were highest in children and adolescents with obesity and lowest in children and adolescents with underweight. Girls received higher absolute and weight-adjusted doses than boys at follow-up, while children over 12 years of age received higher absolute but lower weight-adjusted doses than children under 12 years. A significantly higher proportion of children and adolescents with baseline underweight discontinued treatment during the first year, compared with the normal weight group. Beside lower baseline zBMI, female sex and higher age were also significantly associated with treatment discontinuation during the first year. Our findings suggest that weight status, sex, and age are significantly associated with differential methylphenidate dosing and treatment discontinuation in children and adolescents.

Introduction. Currently, there are few publications in the literature addressing the peculiarities of organizing the preoperative period for obese cancer patients undergoing abdominal surgery. Despite the growing prevalence of obesity and its known impact on surgical outcomes, this aspect of perioperative care remains understudied. The aim of this study is to determine the specific features of organizing the preoperative period in obese patients undergoing abdominal surgery for oncological pathology. Materials and Methods. To identify potential differences in the psychological state of patients with normal body weight and those with obesity prior to surgery, a structured patient survey was conducted. A specially designed anonymous questionnaire was administered prior to discharge. Patients were asked to respond to several questions, including: what body weight they consider to be normal; whether body weight affects the technical aspects of a surgical procedure; whether they experienced fear before the operation (and if so, the reasons behind it), among others. Results. The survey included 80 respondents (29 men and 51 women). The mean age of male participants was 57.04 ± 4.26 years, while that of female participants was 59.90 ± 5.12 years. All participants underwent assessment of body mass index (BMI). There were 13 respondents with a body mass index of 18.5 to 24.9 (normal body weight), 40 with a body mass index of 25.0 to 29.9, 14 with a body mass index of 30.0 to 34.9, 9 with a body mass index of 35.0 to 39.9, and 4 with a body mass index of 40 and more. To the main question “Were you afraid before the surgery?” patients gave their scores from 1 to 10, where 1 meant that they were not afraid at all, and 10 meant that they were extremely afraid. The level of anxiety in patients with normal body weight averaged 3.86±0.78, overweight patients - 4.96±0.56, and obese patients - 5.76±0.98 points. If the number of anxiety level of 3.86 is taken as “1”, then the corresponding increase will be not significant, but 1.35 and 1.42 times higher (p≤0.05), respectively. That is, with an increase in body weight, there is a tendency to increase the level of anxiety of patients. When answering the question “Were you afraid of knowing your diagnosis?” opinions were divided. In particular, 5 patients with normal body weight answered “yes” and 8 - “no”, 22 overweight patients - “yes” and 18 - “no”, and 15 obese patients - ‘yes’ versus 12 “no”. To compare the data, we built a mathematical relationship between “yes” and “no” to determine the anxiety index. Thus, in patients with normal body weight, this index was 0.63, in overweight people - 1.22, and in obese respondents - 1.25. Again, if 0.63 is taken as “1”, then this index in overweight patients increased 1.94 times, and in obese people 1.98 times, respectively (p≤0.05). Discussion. The findings suggest that individuals with normal body weight exhibit greater psychological resilience when facing surgical interventions. In contrast, obese patients tend to experience heightened preoperative anxiety and often hold less realistic expectations regarding the technical aspects of surgery. These psychological patterns necessitate specialized approaches to preoperative preparation in this patient group. Importantly, obese patients undergoing abdominal surgery for oncological conditions face a “triple burden of psychological preparation”. This includes: the psychological stress associated with a cancer diagnosis, the inherent anxiety related to the surgical intervention itself, and specific behavioral and emotional responses typical for individuals with obesity. Conclusions. The preoperative period for obese patients requiring abdominal surgery due to oncological pathology represents a particularly complex and critical phase in the overall treatment process. This stage requires tailored medical and psychological preparation, aimed at addressing not only the physical but also the emotional and cognitive challenges faced by this vulnerable group of patients.

Background: Obesity is a major risk factor for cardiovascular disease (CVD), but individuals can differ in their metabolic health status, leading to varying CVD risks. Metabolic health is not static and can change over time; however, the impact of these changes on CVD remains poorly understood, particularly in aging populations. This study examines how transitions in metabolic obesity phenotypes are associated with CVD risk using data from two large national cohort studies. Methods: We conducted parallel analyses using data from the China Health and Retirement Longitudinal Study (CHARLS) and the English Longitudinal Study of Ageing (ELSA). At baseline, participants were classified into four metabolic obesity phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obesity (MHOO), and metabolically unhealthy overweight/obesity (MUOO). These phenotypes were reassessed approximately four years later. Transitions between phenotypes were tracked, focusing on changes in metabolic health and BMI status. Associations with incident CVD were analyzed using multivariable-adjusted Cox proportional hazards models. Results: Among 10,675 participants, 2,436 (23.19%) developed CVD during follow-up. In multivariable-adjusted models, baseline MUOO, MHOO, and MUNW were each linked to higher CVD risk versus MHNW (HRs: 1.75, 1.46, and 1.38; all p &lt; 0.001). Among 6,272 participants, 1,361 CVD events occurred. Compared with stable MHNW, individuals transitioning from MHOO to MUOO had the highest risk increase (HR: 1.858; p &lt; 0.001), followed by those remaining MHOO (HR: 1.436; p = 0.002). Transition from MHOO to MUNW nearly doubled CVD risk (HR: 2.236; p = 0.007). Among individuals initially classified as MUNW or MUOO, transitions toward metabolically unhealthy phenotypes further elevated risk (HRs: 1.940–2.360; p &lt; 0.01). Stable MUOO individuals had the most events and over two-fold higher risk (HR: 2.039; p &lt; 0.001). Conclusions: Metabolic transitions from healthy to unhealthy states are linked to elevated CVD risk, even in normal-weight individuals. Preserving metabolic health despite obesity is associated with lower risk, highlighting its importance beyond BMI. These findings support dynamic monitoring and early intervention to reduce CVD risk in aging populations, especially among those with obesity.

Background. Papillary thyroid carcinoma (PTC) is a malignant neoplasm originating from thyroid follicular cells and accounts for up to 80% of all thyroid cancer cases. It is the most common endocrine malignancy both in Ukraine and worldwide. Aim. The aim of this study was to investigate and evaluate the macroscopic invasive features of papillary thyroid carcinoma in overweight and obese patients, and to compare them with those in patients of normal weight. Participants and Methods: A total of 91 patients diagnosed with papillary thyroid carcinoma who underwent surgical treatment at Verum Expert Clinic (Kyiv, Ukraine) were included in the study. The cohort was divided based on body mass index (BMI): 26 patients with normal weight (BMI &lt; 23.9 kg/m²); 45 patients with overweight (BMI 24.0–29.9 kg/m²); 20 patients with obesity (BMI ≥ 30.0 kg/m²). Clinical and pathohistological parameters were retrieved from archived medical records. All patients underwent standard preoperative evaluation, including thyroid hormone testing, clinical chemistry, and ionized calcium analysis. Results. A statistically significant difference in the frequency of macroscopic invasion into surrounding thyroid structures was observed across the BMI-based groups. Macroscopic invasion was identified in 6 patients with obesity (30%), 1 patient with overweight (2.2%), and in 4 patients with normal weight (15%) (p = 0.041). Further statistical analysis confirmed a significantly higher rate of macroscopic tumor spread in patients with obesity compared to other BMI categories (p = 0.019), suggesting a possible link between increased body weight and more aggressive local tumor behavior. Conclusions. Patients with papillary thyroid carcinoma and obesity demonstrate a higher incidence of macroscopic invasion into adjacent tissues, which may reflect a more aggressive biological behavior of the tumor. These findings highlight the importance of preoperative risk assessment in overweight and obese patients, the potential need for more radical surgical intervention (e.g., extended neck dissection), and careful long-term follow-up due to the increased risk of disease progression.

To investigate the associations of general and central obesity with premature mortality in a Chinese population. A total of 162 776 participants from the China Cardiometabolic Disease and Cancer Cohort Study were included in the current analysis. General and central obesity were assessed using body mass index (BMI) and waist-to-hip ratio (WHR), respectively. Premature mortality was defined as all-cause mortality occurring before the age of 75 years, including cardiovascular disease (CVD)-related and non-CVD-related premature mortality. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 10.1 years, 5477 (3.36%) premature deaths were documented. Compared with normal weight (18.5 to <24 kg/m2), those with general obesity (BMI ≥28 kg/m2) were associated with elevated risk of CVD-related premature mortality (HR: 1.53; 95% CI: 1.30-1.82). Central obesity (WHR ≥0.95 for men or ≥0.90 for women) was associated with increased risks of all-cause (HR: 1.20; 95% CI: 1.11-1.31), CVD-related (HR: 1.51; 95% CI: 1.29-1.77) and non-CVD-related premature mortality (HR: 1.11; 95% CI: 1.01-1.22). These associations persisted after mutual adjustment for BMI and WHR. A significant interaction between BMI and WHR on the risk of premature mortality was observed (p for interaction = 0.028). Individuals with normal weight but central obesity exhibited the highest risk of all-cause premature death (HR: 1.21; 95% CI: 1.06-1.37), whereas the highest risk of CVD-related mortality was observed in those with both general and central obesity (HR: 1.89; 95% CI: 1.50-2.39). The combination of normal weight and central obesity significantly increases premature mortality risk, emphasizing the importance of integrating WHR into obesity assessments to improve risk stratification and prevention strategies among Chinese adults.