Obesity Intervention Research Articles

Macronutrient interactions and models of obesity: Insights from nutritional geometry.

The global obesity epidemic results from a complex interplay of genetic and environmental factors, with diet being a prominent modifiable element driving weight gain and adiposity. Although excess intake of energetic macronutrients is implicated in causing obesity, ongoing debate centers on whether sugar or fat or both are driving the rising obesity rates. This has led to competing models of obesity such as the "Carbohydrate Insulin Model", the "Energy Balance Model", and the "Fructose Survival Hypothesis". Conflicting evidence from studies designed to focus on individual energetic macronutrients or energy rather than macronutrient mixtures underlies this disagreement. Recent research in humans and animals employing the nutritional geometry framework (NGF) emphasizes the importance of considering interactions among dietary components. Protein interacts with carbohydrates, fats, and dietary energy density to influence both calorie intake ("protein leverage") and, directly and indirectly, metabolic physiology and adiposity. Consideration of these interactions can help to reconcile different models of obesity, and potentially cast new light on obesity interventions.

Innovative Approaches to Managing Postoperative Complications in Laparoscopic Sleeve Gastrectomy: A Scoping Review.

Background: Laparoscopic sleeve gastrectomy (LSG) is an effective surgical intervention for obesity, but managing complications post LSG remains crucial. Given the global prevalence of obesity, innovative approaches are needed to improve patient outcomes. Objective: This scoping review aimed to comprehensively map the existing literature on innovative approaches for managing complications in adult patients undergoing LSG to treat morbid obesity. This management strategy may include surgical techniques, perioperative care, nutritional support, or other relevant strategies. Methods: A systematic search of PubMed and Scopus databases was conducted to identify relevant studies. The prespecified inclusion criteria were applied through a two-stage screening process. Studies involving adult patients who underwent LSG for morbid obesity (body mass index > 35) and those investigating interventions related to complications were included. The scoping review process adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The results were summarized using a narrative approach. Results: This review included 31 studies with 4547 participants, showing diverse study designs, patient demographics, and surgical locations. Among them, 6 were case reports, 18 were randomized controlled trials, and 7 were retrospective studies. Complications of LSG include staple-line leaks, stenosis, hemorrhage, infection, gastric volvulus, and nutrient malabsorption. Innovative interventions, such as staple-line reinforcement, plication methods, and the Over-the-Scope Clip system, have been investigated for effective management. Conclusion: This scoping review provides valuable insights into innovative interventions for managing complications post LSG. This review highlights the need for further research to explore long-term outcomes, compare different interventions, and address the existing gaps in the literature.

Identification of sensitive periods of weight status transition over the lifespan in Chinese population

BackgroundThe prevalence of high body mass index (BMI) is increasing in both children and adults worldwide. However, it is unclear whether vulnerabilities to maintenance and transition of weight status vary throughout the lifespan.ObjectiveWe aimed to characterize dynamic transitions of weight statuses across different life stages and to identify the sensitive periods for maintenance, onset, and resolution of obesity.MethodsThis longitudinal study included a total of 23,179 participants aged 6–80 years with 95,994 BMI measurements from the China Health and Nutrition Survey 1989–2015. To examine the heterogeneity in transitions of weight statuses across different life stages, we divided participants into 8 sub-cohorts based on baseline ages by 10-year intervals, i.e., 6–10 years, 11–20 years, 21–30 years, 31–40 years, 41–50 years, 51–60 years, 61–70 years, and 71–80 years. We estimated the probabilities of transitioning between weight statuses at a given follow-up year by baseline age using generalized linear mixed-effects models.ResultsThe predicted prevalence of obesity decreased from 6 years, bottomed at around 20 years, increased thereafter, peaked at around 55 years, and then decreased gradually. In general, participants with underweight had lower probabilities of maintaining the same status compared to those with normal weight, overweight, or obesity for all age groups. For 10-year follow-up, individuals aged 21–30 years had the highest probabilities of transitioning from normal weight to obesity and transitioning from overweight to obesity compared to those in other age groups. Individuals aged 6–20 years had the highest probabilities of transitioning from obesity to normal weight and transitioning from overweight to normal weight. Individuals in all adult age groups had higher probabilities of maintaining obesity status than children and adolescents.ConclusionsYoung adulthood is the most sensitive period for obesity onset, whereas childhood and adolescence are the most sensitive periods for obesity resolution. The findings suggest the heterogeneity of susceptibilities to weight status transitions across different life stages and highlight the importance of the development of age-appropriate approaches for the prevention and intervention of obesity.

Usability and engagement of web application on parental behaviors for child obesity intervention

Background: Childhood obesity is a growing global health issue, with increasing prevalence in Asian countries, including Malaysia. Web applications such as JEJAK BMI offer an alternative intervention to address this concern by targeting parental behaviors that could influence their children’s weight. The usability and engagement of the app used are important elements that could influence the intervention outcome. Objective: To assess the engagement and usability of JEJAK BMI apps that could affect parental use of apps in child obesity interventions. Methods: To evaluate the app’s usability, three criteria were evaluated which were ease of use, visual appeal and functionality, post-intervention questionnaires were completed by the parents. Results: The study found that most parents considered the app practical, easy to use, visually engaging and functional. However, the impact on children's BMI over the short term was inconclusive. Conclusion: The JEJAK BMI web application demonstrated strong usability and positive effects on parental behaviors. Nonetheless, significant changes in children's BMI may require longer-term interventions and additional strategies.

Robotic Single Anastomosis Duodenal-ileal Bypass With Sleeve Gastrectomy (SADI-S) for Morbid Obesity: A Systematic Review.

The global obesity epidemic has seen a dramatic increase in prevalence since 1975, posing significant health and economic challenges worldwide. Robotic-assisted single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) has emerged as a promising surgical intervention for morbid obesity, offering potential advantages over traditional laparoscopic approaches in terms of precision, safety, and recovery outcomes. This study aimed to evaluate the efficacy and safety of robotic-assisted SADI-S, focusing on perioperative and postoperative outcomes including intraoperative complications, operative time, conversion rates, mortality, length of hospital stay, weight loss, and postoperative complications. A comprehensive literature search was conducted on PubMed, Scopus, and Cochrane Library, adhering to inclusion and exclusion criteria focused on obese adult humans undergoing robotic SADI-S. Seven studies, published between 2015 and 2024, involving 204 patients, were ultimately included for analysis. The analysis revealed a low rate of intraoperative complications (0.49%), no mortality, and varied operative times (138 to 205.7 min). The median hospital stay ranged from 2 to 6.7 days, with minimal readmission rates. Postoperative complications occurred in 6.37% of patients, but no late complications (>30 days) were reported. Notably, significant weight loss outcomes were documented, with mean excess weight loss (EWL) up to 113.74% at 24 months follow-up. Robotic-assisted SADI-S demonstrates a favourable safety profile with promising weight loss outcomes, highlighting its potential as a primary or revisional treatment for morbid obesity. Further research, including randomized controlled trials, is needed to establish its long-term efficacy and cost-effectiveness compared to traditional laparoscopic methods.

Shaping childhood obesity: behavioral and environmental risk factors associated with body mass index trajectories between 2 and 9 years in Samoan children.

Pacific children are at high obesity risk, yet the behavioral and environmental factors that contribute to obesity development in this setting remain poorly understood. We assessed associations between childhood risk factors for obesity with body mass index (BMI) trajectories between ages 2-9 years in Samoa. In a prospective cohort of 485 children from 'Upolu, we measured weight and height at ages 2-4 (2015), 3.5-8 (2017-18), and 5.5-11 years (2019-20). Modern dietary pattern adherence was assessed using factor analysis of primary caregiver-reported food frequency questionnaire data. Physical activity was estimated with the Netherlands Physical Activity Questionnaire. Socioeconomic resources were assessed using an 18-item household asset score. Urbanicity was based on village residence. Associations of these risk factors with predicted weight, height, and BMI (at 1-year intervals and velocity) were assessed using multilevel cubic spline regressions. Females had greater adjusted weight velocity with high modern dietary pattern adherence compared to low (p-value for interaction with age spline term 1 = 0.028 and age spline term 2 = 0.007). Starting at age 3 years, children with higher physical activity had higher BMI, but this association was not meaningful up to age 9 (all p-value > 0.05). Males with very high compared to low household assets had higher BMI from age 2 to 4 years (95% CI: 0.26-1.53 kg/m2, p = 0.006) and greater BMI velocity (p-value for interaction with age spline term 2 = 0.001). Males in the urban region had the greatest BMI gain after age 5 compared to the rural region (p-value for interaction with age spline term 2 = 0.014). High, centile-crossing BMI trajectories suggest that obesity prevention and intervention are needed among Samoan children before age 9 years. Positive associations between high modern dietary pattern adherence, greater asset ownership, and urbanization offer initial insights into who, and which behavioral risk factors, should be prioritized in implementing public health solutions.

Use of Biomarkers in Nutrition Intervention Studies of Children: A Scoping Review

Obesity in youth is an increasingly prevalent public health concern worldwide. Lifestyle interventions aim to help participants establish healthy habits and reduce obesity-related disease risk by targeting physical activity and dietary habits. Most studies assess weight loss, but biomarkers may enable more rapid and comprehensive assessment of intervention success. This scoping review aims to synthesize the published literature on which biomarkers are assessed during interventions for pediatric obesity to inform future use. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search of five databases conducted in February 2022 returned 1579 unique and relevant articles published between 2006 and 2021. After screening titles, abstracts, and full text, four reviewers determined that 43 studies met eligibility requirements. Quality screening was conducted, and 97.7% of papers were of fair or good quality. Of the 43 studies, 47% reported measures of adipose-related signaling molecules inclusive of adipokines, 74% included insulin-related biomarkers, 63% reported lipid-related biomarkers, 40% reported proinflammatory cytokine biomarkers, 12% reported measures of skin and/or plasma carotenoids, 40% measured blood pressure, and 21% included liver enzymes. Sixty-seven percent of studies measured biomarkers in whole blood, 40% measured biomarkers in plasma, 56% measured biomarkers in serum, and 2% measured biomarkers in urine. This work summarizes the current use of biomarkers in lifestyle intervention studies enrolling children. These biomarkers could be clinically relevant for pediatric weight management interventions.

Sharing the motherload: A review and development of the CO-Parent conceptual model for early childhood obesity prevention.

Fathers remain under-represented in early childhood obesity prevention research and interventions, despite growing evidence that paternal biopsychosocial factors and behaviors from pre- and post-conception can influence lifelong offspring health. Informed by a literature review of high-quality evidence, "CO-Parent" (childhood obesity-Parent) is a new conceptual model underpinned by couple interdependence theory and a socioecological framework. Literature was searched for the concepts parental AND weight-related behaviors AND child weight or weight-related behaviors, in databases including MEDLINE, PsycINFO, Global Health, Scopus, and SocINDEX. Prior evidence syntheses were prioritized as source data to inform model development. "CO-Parent" illustrates the interdependent and independent effects of maternal and paternal weight, weight-related behaviors, and well-being, across preconception, pregnancy, postpartum, and the early years on child weight-related behaviors and weight up to age five. The influences of public policy, social, environmental, economic, community, and other complex modifiable mediating factors are included in the model. The "CO-Parent" conceptual model paves the way for a paradigm shift by recognizing fathers as key figures in early childhood obesity prevention initiatives, encouraging them to "share the motherload." It highlights both the independent and interdependent roles fathers play in the epidemiology of obesity starting from preconception. CO-Parent also provides the foundations necessary to guide future theory and research to be more inclusive of fathers to further understanding of the independent and interdependent influences of parents in early childhood obesity prevention.

Effectiveness of Universal Community Engagement Childhood Obesity Interventions at Improving Weight-Related and Behavioral Outcomes among Children and Adolescents: A Systematic Review and Meta-Analysis

Background: Universal community engagement interventions can address childhood obesity. Objectives: This review aimed to evaluate the effectiveness of these interventions in improving body mass index (BMI) (primary outcome) as well as dietary choices and activity levels (secondary outcomes) among children and adolescents. Methods: Eight electronic databases were searched from inception dates to January 2024. A meta-analysis was conducted using the random-effect model, when appropriate; otherwise, the findings were narratively synthesized. Heterogeneity was determined by the I2 statistics and Cochran’s Q chi-squared test. The Cochrane ROB tool and the GRADE approach were used to assess the quality appraisal at the study and outcome levels, respectively. Results: Twenty-two studies were included in this review. The results showed that these interventions had a limited effect in improving children’s standardized BMI (BMI-z) scores post-intervention. A meta-analysis on BMI-z scores showed that the intervention group had a statistically non-significantly lower BMI-z score than the control group (MD = −0.02, 95%CI = [−0.07, 0.03], Z = 0.83, p = 0.40) at immediate post-intervention. It was also reported that universal community engagement interventions had a limited effect in improving children’s dietary choices and activity levels. Only the meta-analysis on children’s daily sugar-sweetened beverage intake measured using continuous data reported a statistically significant small effect favoring the intervention group (SMD = −0.25, 95%CI = [−0.38, −0.13], Z = 3.98, p < 0.0001) at immediate post-intervention. Conclusions: Universal community engagement interventions have the potential to address childhood obesity. Children and adolescents could benefit more from interventions that focus on implementing both environmental and behavioral changes, and interventions that include parental involvement.

Comparative analysis of post-procedural symptom patterns after intragastric balloon and endoscopic sleeve gastroplasty

Aim: Endoscopic bariatric and metabolic therapies (EBMTs) offer minimally invasive approaches for obesity management, with intragastric balloon (IGB) and endoscopic sleeve gastroplasty (ESG) being amongst the most prominent interventions. While both are effective, their comparative impact on post-procedural gastric symptoms remains underexplored. Methods: Single-center retrospective study was designed to evaluate the incidence of post-procedure symptoms in patients undergoing IGB and ESG. Incidence and severity of gastric symptoms were assessed using visual analog scales at various time points. Weight outcomes and medication usage were also recorded. Changes at different time points (baseline, one and four months) were compared by means of Mann-Whitney U Test. Bivariate correlations were carried out through Pearson correlation. Results: Thirty patients undergoing IGB placement and 13 patients undergoing ESG were included in the analysis. ESG group showed a significant reduction in BMI at four months compared to IGB (32.2 ± 4.2 vs . 34.4 ± 5.3, P = 0.05). ESG demonstrated significantly lower rates of post-procedural gastric symptoms compared to IGB, including nausea, regurgitation, vomiting, and abdominal cramps and greater satiety (P < 0.001) in the early postoperative period. Medication usage differed between groups, with higher usage of antispasmodics and antiemetics among IGB patients during the first week (P < 0.001). Symptom severity correlated with the need for antiemetics and antispasmodics. Conclusion: This study provides insights into the management of gastric symptoms following two prominent EBMTs. While both endoscopic interventions offer viable options for obesity management, ESG emerges as a favorable choice due to its significantly lower incidence of early post-procedural gastric symptoms. Further research is warranted to refine symptom management strategies and elucidate differences in symptom profiles between IGB and ESG procedures, ultimately aiming to optimize treatment efficacy and patient satisfaction in the field of endoscopic obesity interventions.

Trends and key disparities of obesity among US adolescents: The NHANES from 2007 to 2020.

This study aimed to estimate the trends in the body mass index (BMI) and prevalence of obesity among United States (U.S.) adolescents (10-19 years) and to examine the associations between sociodemographic factors and both BMI and obesity prevalence. The 2007-2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative repeated cross-sectional survey data (n = 9,826) were used. Outcomes included: 1) Mean BMI and 2) obesity (yes/no; defined as BMI ≥95% percentile). Sociodemographic variables included age, sex, race/ethnicity, and poverty income ratio (PIR; low-income <1.3, middle-income ≥1.3 and <3.5, high-income ≥3.5). By accounting for the complex survey design, weighted generalized linear/Poisson models were used to conduct the analyses. Girls constituted 49% of the sample. From 2007-2008 to 2017-2020, there was an increase in BMI and obesity prevalence, particularly among Black and Hispanic adolescents, and those from low- and middle-income families. Additionally, there was an increase in obesity prevalence among both boys and girls. However, there were no significant changes in BMI and obesity prevalence in the other race and ethnic adolescents. Girls had a 12% (Adjusted Prevalence Ratio [APR] = 0.88; 95% CI, 0.81-0.96) lower likelihood of being obese than boys. Compared to White adolescents, Black and Hispanic adolescents had 22% (APR = 1.22; 95% CI, 1.06-1.40) and 19% (APR = 1.19; 95% CI, 1.05-1.36) greater risk of being obese. Compared to high-income families, adolescents from low- and middle-income families had 62% (APR = 1.62; 95% CI, 1.39-1.90) and 47% (APR = 1.47; 95% CI, 1.24-1.76) greater risk of being obese, respectively. The results indicated persistent disparities in obesity prevalence among different race/ethnic and sociodemographic groups. Future obesity intervention should address key disparities by targeting specific race/ethnic adolescents from low-income families and promoting health equality.

Recorded diagnosis of overweight/obesity in primary care is linked to obesity care performance rates.

Periodical BMI measurement during visits with primary care pediatricians (PCP) can be central to diagnosing, managing, and treating overweight/obesity. The aim was to evaluate among children and adolescents with similar BMI percentiles, whether recording a formal diagnosis by PCP, of overweight/obesity is associated with improved performance rates of obesity-related care. The electronic database of the largest health maintenance organization in Israel was searched for all patients aged 2-18 years with BMI recorded at a visit with the PCP during 2017-2023. Among children with BMI percentiles consistent with overweight/obesity, performance rates of obesity care were compared between those with a recorded diagnosis of "overweight"/"obesity" placed by the PCP, and those with similar BMI percentiles without these recorded diagnoses. Among children with versus without recorded diagnoses of overweight/ obesity, rates were higher of referrals for screening measurements for obesity-related comorbidities, for dietitian and endocrine counseling, of performing subsequent BMI measurements, and of prescribing anti-obesity medications (p < 0.001 for all). Obesity-related comorbidities were more prevalent among those with than without recorded diagnoses (P < 0.001). Beyond BMI measurement, a recorded diagnosis of overweight/obesity by a PCP is linked to higher rates of obesity care performance and interventions, which may improve clinical outcomes. BMI measurement during visits with primary care pediatricians (PCP) can be central to diagnosing, managing, and treating overweight/obesity. We evaluated among children and adolescents with similar BMI percentiles, whether recording a formal diagnosis by PCP, of overweight/obesity is associated with improved performance rates of obesity-related care. We found that among children with versus without recorded diagnoses of overweight/obesity, rates were higher of referrals for screening measurements for obesity-related comorbidities, for dietitian and endocrine counseling, and of prescribing anti-obesity medications. Therefore, PCP should increase rates of recording diagnoses of overweight/obesity, to promote screening for obesity-related comorbidities, and aim to treat obesity as a chronic disease.

Neddylation and Its Target Cullin 3 Are Essential for Adipocyte Differentiation.

The ongoing obesity epidemic has raised awareness of the complex physiology of adipose tissue. Abnormal adipocyte differentiation results in the development of systemic metabolic disorders such as insulin resistance and diabetes. The conjugation of NEDD8 (neural precursor cell expressed, developmentally downregulated 8) to target protein, termed neddylation, has been shown to mediate adipogenesis. However, much remains unknown about its role in adipogenesis. Here, we demonstrated that neddylation and its targets, the cullin (CUL) family members, are differentially regulated during mouse and human adipogenesis. Inhibition of neddylation by MLN4924 significantly reduced adipogenesis of 3T3-L1 and human stromal vascular cells. Deletion of NAE1, a subunit of the only NEDD8 E1 enzyme, suppressed neddylation and impaired adipogenesis. Neddylation deficiency did not affect mitotic cell expansion. Instead, it disrupted CREB/CEBPβ/PPARγ signaling, essential for adipogenesis. Interestingly, among the neddylation-targeted CUL family members, deletion of CUL3, but not CUL1, CUL2, or CUL4A, largely replicated the adipogenic defects observed with neddylation deficiency. A PPARγ agonist minimally rescued the adipogenic defects caused by the deletion of NAE1 and CUL3. In conclusion, our study demonstrates that neddylation and its targeted CUL3 are crucial for adipogenesis. These findings provide potential targets for therapeutic intervention in obesity and metabolic disorders.

Effectiveness and Side Effect Incidence in a Real-World Digital Weight-Loss Service Using Compounded Semaglutide: A Retrospective Comparative Study

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were originally developed in the late 1980s as a class of antidiabetic medication. However, research over the past decade has found them to be a safe and effective weight-loss agent, which has led to the approval of GLP-1 RAs such as Semaglutide as a supplement to lifestyle obesity interventions in multiple countries. When Semaglutide has become commercially unavailable, digital weight-loss services (DWLSs) have prescribed a compounded form of the medication—a practice in which health professionals formulate a replica of the commercial medication to serve ongoing patient needs. Although compounding has been relatively common over the past century, prominent medical bodies have argued that compounding a relatively novel medication such as Semaglutide represents a major safety risk. This study retrospectively compared the weight and side effect outcomes of patients from a large Australian DWLS whose lifestyle coaching was supplemented with either compounded or pure Semaglutide (both groups following the same titration schedule). All data were extracted from the service’s central data repository. To be included in the weight loss analysis, patients needed to have received a minimum of four monthly medication orders between June 2023 and May 2024 and have submitted weight data between 90 and 150 days after the arrival of their first order. All patients who received at least one medication order within the same period were included in the side effect analysis. The mean four-month weight loss percentage was statistically lower in the compounded Semaglutide group (N = 923, M = 9.11, SD = ±5.76) compared to those in the pure Semaglutide group (n = 1858, M = 9.87, SD = ±6.46), t (2032) = −3.15, p = 0.0017. A statistically lower proportion of patients in the compounded Semaglutide group (71.61%) reported at least one side effect than patients in the pure Semaglutide group (77.40%) during the study period, X2 (1, N = 7683) = 32.32, p &lt; 0.001. When side effects were disaggregated into severity categories, a statistical difference was only observed in mild side effects, X2 (1, N = 7683) = 59.16, p &lt; 0.001. A significantly higher rate of patients from the pure Semaglutide group achieved the ten (50.54% vs. 44.64%), X2 (1, N = 7683) = 10.34, p &lt; 0.001, and fifteen (21.42% vs. 12.78%), X2 (1, N = 7683) = 30.43, p &lt; 0.001, percent weight loss thresholds than patients from the compounded Semaglutide group. The findings indicate that compounded Semaglutide can be used as a component of tightly controlled DWLSs with slightly less effectiveness and but with slightly lower side effect incidence when compared to pure Semaglutide.

Myeloid PGC1β attenuates high-fat-diet induced inflammation via mitochondrial fission/mtDNA/Nlrp3 pathway

Peroxisome proliferator-activated receptor gamma coactivators 1β (PGC1β) is essential in mitochondrial oxidative phosphorylation and alternative macrophages activation. To determine the contribution of PGC1β in obesity induced inflammation, Ppargc1b (PGC1β coding gene) myeloid conditional knockout mice (cKO) were fed with high fat diet (HFD) to examine the following effects. We found that HFD-fed cKO mice gained more fat with increased serum triglyceride (TG), low density lipoprotein (LDL), adiponectin, and leptin. Adipogenesis was stimulated while lipolysis was retarded in HFD-fed cKO mice adipose. Gluconeogenesis, lipogenesis, and fatty acid uptake were provoked while lipolysis was inhibited in HFD-fed cKO liver. Serum alanine transaminase (ALT) level, indicating fatty liver, also increased. Inflammatory cytokine including tumor necrosis factor-α (TNF-α), IL-1β, and IL-6 was elevated in cKO mice, accompanied with glucose intolerant and insulin resistance. Energy expenditure was decreased in HFD-fed cKO mice. Further evidence showed that cKO macrophages were prone to repolarize into M1 inflammatory type in vitro. In addition to mitochondrial biogenesis and oxidative respiration, PGC1β also modulated mitochondrial fission and cytosolic mitochondrial DNA (mtDNA) release, contributing to NLR family pyrin domain containing 3 (Nlrp3) inflammasome priming and activation. Treatment of mitochondrial fission inhibitor abolished the increased mRNA levels of Nlrp3 and IL-1β induced by PGC1β depletion. Nlrp3 knockdown restored the induced IL-1β mRNA expression by PGC1β deficiency. Myeloid PGC1β regulated adipocyte adipogenesis and lipolysis. PGC1β loss-of-function and mtDNA abundance correlated with obesity and diabetes. These observations uncovered the protective role of PGC1β against obesity induced systemic inflammation. Enhancing myeloid PGC1β function may be a potential strategy for the intervention of obesity and related diseases.

Feasibility of a culturally adapted technology-delivered, family-based childhood obesity intervention for Latino/Hispanic families in rural Nebraska: the Hispanic Family Connections study protocol

IntroductionAddressing childhood obesity risk factors like home environment, parental roles, excess weight, physical activity and healthy eating among Latino/Hispanic (L/H) families living in rural communities is an important priority. However,...

Cost-effectiveness of mandating calorie labels on prepared foods in supermarkets

The US has required chain food establishments-including supermarkets-to display calorie labels on prepared (i.e., ready-to-eat) foods since 2018. Implementation of this supermarket calorie labeling policy reduced purchases of prepared foods from supermarkets, but it remains unknown whether the policy is cost-effective. In 2023-2024, this study applied the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) microsimulation model to estimate the effects of the supermarket calorie labeling policy on health, costs, and cost-effectiveness over 10 years (2018-2027) for the US population. The model projected benefits overall and among racial, ethnic, and income subgroups. Sensitivity analyses varied assumptions about the extent to which consumers replace calorie reductions from prepared foods with calories from other sources (i.e., caloric compensation). From 2018-2027, the supermarket calorie labeling policy was projected to save $348 million in healthcare costs (95% Uncertainty Interval [UI]: $263-426 million), prevent 21,700 cases of obesity (95% UI: 18,200-25,400), including 3,890 cases of childhood obesity (95% UI: 2,680-5,120), and lead to 15,100 quality-adjusted life years (QALYs) gained across the US population (95% UI: 10,900-20,500). The policy was projected to prevent cases of obesity and childhood obesity across all racial, ethnic, and income groups. The policy was projected to be cost-saving when assuming low and moderate caloric compensation and cost-effective when assuming very high caloric compensation. A policy requiring calorie labels on prepared foods in supermarkets was projected to be cost-saving or cost-effective and lead to reductions in obesity across all racial, ethnic, and income groups.

Growth hormone attenuates obesity and reshapes gut microbiota in high-fat diet-fed mice

Growth hormone (GH) and gut microbiota are key regulators of metabolism and have been linked to the development and treatment of obesity. Although variations in GH levels are associated with changes in gut microbiota composition, the specific effects of GH on gut microbiota and its role in obesity remain unclear. This study explored the effects of various GH doses (0.25, 0.75 and 1.5 IU/kg) on adipose tissue mass and gut microbiota in high-fat diet-induced obese mice. Notably, high-dose GH (1.5 IU/kg) significantly reduced the adipose tissue mass. This dose also reversed high-fat diet-induced gut microbiota dysbiosis, restoring microbial diversity and increasing the abundance of beneficial genera such as Ruminococcaceae and Muribaculaceae. Additionally, high-dose GH normalized several obesity-related gut microbiota pathways, including starch and sucrose metabolism, galactose metabolism, and secondary bile acid biosynthesis. GH therapy also improved intestinal barrier function, a key determinant of gut microbial homeostasis. These findings underscore the therapeutic potential of GH in obesity management through its effects on gut microbiota, providing new avenues for obesity interventions.

Impact of BMI on childhood growth, pubertal timing, and bone maturation: A comprehensive review and clinical implications

Introduction: Childhood obesity and undernutrition significantly affect growth patterns, pubertal timing, and bone maturation, leading to long-term health implications. Materials and Methods: A comprehensive literature review was conducted using databases such as PubMed, Google Scholar, and Scopus. Twenty-four studies, including a total of 40,732 patients, were analyzed from two tables examining the impact of BMI, growth patterns, pubertal timing, and bone maturation. Results: Children with high BMI exhibit accelerated linear growth during early childhood, that may be driven by elevated leptin levels, which stimulate growth before puberty. Despite early growth advantages, these children experience reduced height gain during adolescence due to advanced bone maturation and earlier closure of growth plates. High BMI is strongly linked to early puberty, especially in girls, as increased adipose tissue raises leptin levels, triggering early pubertal onset. Boys, however, show variability in pubertal timing, with severe obesity sometimes delaying puberty. In contrast, children with low BMI or undernutrition demonstrate delayed linear growth and delayed puberty. Nutritional deficits lead to reduced growth velocity, delayed pubertal onset, and extended pubertal periods due to a lack of adipose tissue and hormonal deficiencies in leptin and kisspeptin. Nutritional rehabilitation promotes catch-up growth, allowing for extended growth potential by delaying growth plate closure. However, full recovery may not occur in cases of prolonged or severe undernutrition. Advanced bone age in high BMI children shortens the pubertal growth spurt, while delayed bone maturation in undernourished children offers a prolonged period for potential growth, contingent on timely nutritional support. Conclusion: Timely interventions for childhood obesity and undernutrition are critical to improving growth outcomes and preventing long-term developmental delays. Early identification, nutritional rehabilitation, and lifestyle modifications can help optimize growth and pubertal development by addressing both advanced and delayed growth trajectories.

The Role of Stress in Obesity and Relevant Interventions

The prevalence of obesity is on the rise, which significantly increases the burden on global healthcare expenditures and profoundly impacting both physical and mental health. It has become a major public health challenge that urgently needs to be addressed in todays society. Obesity is influenced by multiple factors, including stress, genetics, hormones, and neuroendocrine elements, with lifestyle and epigenetic changes also playing significant roles. Stress impacts various physiological systems, including the brain, memory, cognition, immune response, cardiovascular health, and endocrine function. It can also trigger obesity by affecting appetite regulation, reward sensitivity, and hormonal balance. Understanding the relationship between stress and obesity is crucial for developing effective interventions. Recent research highlights that stress significantly affects eating behaviors, leading to weight gain, while obesity can exacerbate stress and disrupt life balance. Effective interventions include mindfulness training, which improves self-awareness, positive emotions, and psychological flexibility, and reduces stress, anxiety, and depression. Stress management programs and physical activity are also beneficial for weight loss and overall health. However, the limitations of small sample sizes, short intervention periods, limited participant diversity, and reliance on self-reported measures may undermine the generalizability and accuracy of the findings of previous research. Future research should focus on larger, diverse samples, long-term studies, and incorporate both objective measures of stress and self-reported data to better understand and manage obesity and stress.