Obesity is a growing global health concern. Some evidence suggests that exposure to polychlorinated biphenyls (PCBs) and dioxins, may play a role in weight gain, but human prospective data are limited and have shown inconsistent results. Therefore, this study investigate the association between dietary exposure to dioxins and PCBs and changes in weight and in waist circumference after 5 years of follow-up in a large prospective cohort. We included 215,556 participants recruited between 1992 and 2000; of whom 99,046 provided data on waist circumference. Body weight or waist circumference were measured at recruitment and self-reported at follow-up. Intakes of dioxins and PCBs were estimated using country-specific dietary questionnaires collected at baseline, and food contamination concentrations based on a European Food Safety Authority database. Associations were estimated using multilevel mixed linear regression models. Higher intake of both dioxins and dioxin-like PCBs (dioxins + DL-PCBs) (Q4vsQ1 = 0.07kg/5-years (95%CI 0.01, 0.13)), and non-dioxin like PCBs (NDL-PCBs) (Q4vsQ1 = 0.27kg/5-years (95%CI 0.20, 0.35), p-trend<0.001)) were associated with weight gain. Inverse associations were observed between dietary intake of dioxins + DL-PCBs and NDL-PCBs and waist circumference change (Q4vsQ1 = -0.44cm/5-years (95%CI -0.56, -0.31), p-trend<0.001 and Q4vsQ1 = -0.21cm/5-years (95%CI -0.34, -0.07), p-trend<0.001, respectively). These inverse associations were primarily caused by a subset of participants from one country who provided most of the waist circumference data. Results were consistent across stratified and sensitivity analyses. Results obtained in this large prospective study show a positive association between dietary intake of both dioxins + DL-PCBs and NDL- PCBs and weight gain. Although the observed associations were small and there may be measurement errors, the consistency of these associations across multiple stratified analyses and sensitivity analyses strengthens the validity of the findings. The findings suggest that the effect of dioxins and PCBs are still present in the food chain despite regulatory bans. Efforts should be strengthened to reduce the exposure levels in the general population not only to lower the risk of obesity, but also to prevent various chronic conditions.

To investigate sex-stratified associations between 4-year weight loss and risk of incident atrial fibrillation (AF) in a prospective cohort study and the potential benefits of sustained weight management. We analysed 60 402 participants from the Kailuan Study free of AF, with body mass index (BMI) and waist circumference (WC) measured in 2006-2007 and 2010-2011. Reductions in BMI, body weight, and WC were used to define weight loss. Cox proportional hazards models assessed the association between weight loss and incident AF, adjusting for relevant covariates. During a median follow-up of 13.0 years (interquartile range: 12.5-13.3), 582 participants developed AF (484 men, 98 women). In men, BMI reduction >2.5 kg/m2 (hazard ratio [HR] 0.663, 95% confidence interval [CI] 0.467-0.940), body weight loss >5 kg (HR 0.662, 95% CI 0.468-0.936), and WC reduction >4 cm (HR 0.768, 95% CI 0.601-0.982) were associated with a lower risk of incident AF. In women, WC reduction >4 cm (HR 0.499, 95% CI 0.279-0.892) was associated with a lower risk. Similar patterns were observed among participants with overweight or obesity. Formal tests for sex interaction were not statistically significant. Reductions in BMI, body weight, and WC were associated with lower risk of incident AF, particularly in overweight or obese participants. The magnitude of association differed by anthropometric measure and sex, with BMI change showing stronger associations in men and WC change in women. Anthropometric changes may aid risk stratification and inform prevention efforts in higher-risk groups.

To evaluate real-world clinical use of semaglutide in obese patients, focusing on titration, tolerability and short-term efficacy. This retrospective study included obese patients treated with the weekly injectable semaglutide. Data on body weight, waist circumference, lipid profile, doses, reasons for maintenance, adverse events, and discontinuations were collected at 3 and 6 months. A total of 111 patients were included (80% women; mean age 51.12; median body mass index (BMI) 35.56 kg/m2; median body weight 97.00 kg). About 81.1% of patients initiated therapy at 0.25 mg, while 72.1% increased to 1 mg after 3 months. By 6 months, 2% remained on 0.5 mg, 40% on 1 mg, and 26% on 2.4 mg. The main reasons for maintaining the dose were satisfaction with the outcomes, followed by cost and adverse events. Significant reductions in weight, BMI, waist circumference and waist-to-height ratio were observed at both time points, with greater improvements seen in patients with a baseline BMI of ≥35. Weight loss of ≥5%, ≥10%, ≥15% and ≥20% was achieved by 23.5%, 34.6%, 30.8% and 11.1% of patients, respectively. There were no differences by sex, previous treatment or final dose. Adverse events occurred in 56.8% of patients at 3 months, leading to discontinuation in three patients. This percentage halved by 6 months (a 32.6% rate), with two cases leading to discontinuation. The rate of early discontinuation was 6.3% at 3 months, rising to 10.5% at 6 months due to cost, adverse events, or inefficacy. This real-world analysis provides valuable insights into the use of semaglutide in routine clinical practice, confirming a favourable efficacy profile with flexible dosing patterns.

Introduction: Physicians are at heightened risk for unhealthy lifestyles owing to occupational pressures, despite their expertise in health promotion. This dissonance between knowledge and personal practice represents a critical, under-addressed issue within the medical community. Aim: To evaluate the Knowledge, Attitude, and Practice (KAP) regarding healthy lifestyles among doctors and examine their association with cardiometabolic parameters. Materials and Methods: This cross-sectional study was conducted at the Department of Physiology, Jawaharlal Nehru Medical College (JNMC), Belagavi, India, from March 2025 to October 2025. Using convenience sampling, 83 practising doctors from various clinical specialities within Belagavi district were enrolled. A structured KAP questionnaire was developed through literature review and expert validation. Knowledge was scored across 10 items (correct/incorrect). Attitudes and practices were assessed using 10 items each on 5-point Likert and frequency scales, with total scores calculated per domain. A composite KAP index was derived by standardising and summing the three domain scores. Anthropometric {Body Mass Index (BMI), waist circumference), physiological-Blood Pressure (BP) and biochemical- Random Blood Glucose (RBG)} parameters were measured using standardised protocols. Relationships were assessed using Pearson’s correlation and multivariable linear regression, with adjustment for confounders including age, experience, and medication use. Results: The mean age of participants was 49.4±9.46 years, with 21.24±9.26 years of experience. Participants demonstrated moderate knowledge (mean 6.86±1.59/10) and positive attitudes (mean 40.76±3.64/50), but only moderate practice engagement (mean 33.61±6.45/50). The mean Body Mass Index (BMI) of participants was 24.48±2.37 kg/m², waist circumference 82.7±6.78 cm, Systolic Blood Pressure (SBP) 116.76±6.57 mmHg, Diastolic Blood Pressure (DBP) 76.27±4.7 mmHg, and Random Blood Glucose (RBG) 98.8±15.01 mg/dL. Practice scores showed significant inverse correlations with BMI (r=-0.232, p-value=0.035), DBP (r=-0.354, p-value=0.001), and RBG (r=-0.272, p-value=0.013). Adjusted regression models confirmed that the 28 doctors (33.7%) in the highest composite KAP tertile had significantly lower diastolic blood pressure (β=-3.14, 95% CI: -5.68, -0.59) and random blood sugar (β=-8.54, 95% CI: -16.62, -0.46) compared to those in the lowest tertile. Conclusion: A significant KAP gap persists among physicians regarding healthy lifestyles. Notably, self-reported practices, rather than knowledge or attitudes, were independently associated with better cardiometabolic health outcomes.

Simple anthropometric indicators compared with DXA-assessed visceral adiposity for screening brown adipose tissue activity in adult women.

Effects of 24-Week Almond Supplementation on Executive Function and Processing Speed in Middle-Aged Asian Indians with Prediabetes: An Open-Label Randomized Controlled Trial.

Effect of different types of exercise interventions on cardiometabolic risk factors: An umbrella review of systematic reviews and meta-analyses.

This study aimed to establish cut-points for cardiorespiratory fitness, muscular strength, and speed-agility and to evaluate their ability to detect general and central obesity risk in preschool children aged 3-5 years. Briefly, 3179 Spanish preschoolers (52.8% boys) were evaluated. Physical fitness was assessed with the PREFIT battery. Anthropometry included BMI and waist circumference. Obesity risk was defined using age- and sex-specific percentiles according to criteria established by the World Health Organization and the International Diabetes Foundation. Receiver operating characteristic curve analyses were used to identify fitness cut-points. Age- and sex-specific cut-points were established. For cardiorespiratory fitness, cut-points ranged from 9.5 to 23.5 laps in boys and 6.5 to 21.5 in girls across the 3- to 5-year age range. Muscular strength cut-points ranged from z-scores of -1.5 to 2.2 in boys and -1.6 to 1.9 in girls. Speed-agility cut-points ranged from 18.8 to 14.9 s in boys and 19.9 to 15.3 s in girls. Predictive accuracy was moderate-to-high (AUC range: 0.61-0.74 for cardiorespiratory fitness, 0.59-0.80 for strength, 0.49-0.71 for speed-agility). This study provides fitness cut-points for detecting general and central obesity risk in preschoolers. Early integration of physical fitness assessments into health monitoring may facilitate early identification of obesity risk.

To determine the association of insulin resistance, assessed using the estimated glucose disposal rate (eGDR), and the risk of adverse clinical outcomes, and determine any effect modification on the efficacy of glucose- and blood pressure (BP)-lowering treatments. Briefly, 11 140 participants with type 2 diabetes (T2D) were recruited from 20 countries for the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial. eGDR was derived from waist circumference, hypertension status and glycated haemoglobin, calculated in 11 081 participants. Multivariable Cox models were used to estimate hazard ratios (HRs) of the association of eGDR with clinical events. Over a median of 5 years of follow-up, 2117 participants (19.1%) experienced a major macrovascular or microvascular event. Compared with individuals in the lowest quarter of eGDR, those in the highest quarter had significantly lower risks of a composite major macrovascular and microvascular event (HR 0.72, 95% CI 0.62-0.84). Similar associations were seen for major macrovascular events (HR 0.68, 95% CI 0.55-0.85), major microvascular events (HR 0.78, 95% CI 0.63-0.96), all-cause mortality (HR 0.69, 95% CI 0.55-0.86), and cardiovascular mortality (HR 0.62, 95% CI 0.45-0.85). No significant effect modification was observed across eGDR quarters for the efficacy or safety of intensive glucose control (vs. standard control) or BP-lowering treatment (vs. placebo). These findings highlight the value of eGDR as a prognostic marker for T2D. Intensive glucose- and BP-lowering treatments remain beneficial regardless of insulin resistance status. ClinicalTrials.gov identifier: NCT00145925.

Obesity is a well-documented cardiovascular risk factor. Here, we sought to investigate whether obesity causes subclinical cardiac remodeling and heart failure (HF), and if so, to perform a systematic scan of the plasma protein for novel drug targets. We leveraged visceral adipose tissue (VAT), waist circumference (WC), and waist-to-hip ratio (WHR)-all adjusted for body mass index (BMI)-as indicators of obesity. Two-sample Mendelian randomization (MR) analyses were used to estimate the independent, causal effects of obesity on cardiovascular magnetic resonance (CMR)-derived cardiac traits and HF risk. Mediation analyses followed by druggability assessment were conducted to identify promising protein targets for therapeutic translation. Genetically determined VATadjBMI, WCadjBMI, and WHRadjBMI presented broad causal associations with alterations of distinct cardiac phenotypes, most of which remained significant after controlling for obesity-induced cardiometabolic risk factors, including hypertension, type 2 diabetes, and adverse lipid profiles. By contrast, WHRadjBMI is the only independent causal predictor for HF risk. Of 142 proteins with mediating effects, scavenger receptor class A member 5 (SCARA5), membrane cofactor protein (CD46), and alpha-1-antichymotrypsin (SERPINA3) may contribute to the early-stage adverse cardiovascular effect of obesity, whereas apolipoprotein C-III (APOC3), mitochondrial aldehyde dehydrogenase 2 (ALDH2), and chordin-like protein 2 (CHRDL2) may further promote the development of obesity-driven HF. Medications targeted at these candidate proteins are either approved or under evaluation in clinical trials. Our MR findings provided genetic evidence for the direct, causal associations of obesity with cardiac remodeling and HF, while also outlining druggable proteins as promising therapeutic targets.

Obesity metrics and fall severity in older adults: A cross-sectional analysis of weight-adjusted waist index and conventional anthropometric measures.

Associations between estimated cardiorespiratory fitness and mortality risk in stroke survivors: a population-based study.

To investigate the oral semaglutide use among Mexican adults with type 2 diabetes. PIONEER REAL was a multinational, open-label study evaluating oral semaglutide in patients without prior injectable glucose-lowering treatment. This analysis focuses on data from Mexico. Of 177 patients, 139 (78.5%) completed the study and 111 (62.7%) remained on treatment at the end. The mean (SD) age was 54.0 (10.96) years, 57.6% were women, 59.3% had obesity, and 44.6% had a medical history of cardiovascular disease. The average T2D duration was 5.7 years (SD 6.45), with mean HbA1c at 8.1% (SD 1.85). At week 38, mean HbA1c had decreased to 6.8% (estimated mean [SE] change in HbA1c, -1.3% [0.11]; p < 0.0001), and body weight had decreased from 87.8 kg (19.34) to 85.3 kg (estimated mean [SE] change in body weight, -4.3 kg [0.56]; p < 0.0001), as had waist circumference (estimated mean [SE] change, -3.7 cm [0.54]; p < 0.0001). Additionally, satisfaction with treatment increased over time. Only 6.2% of patients had adverse events leading to withdrawal of semaglutide. According to this real-world study, starting oral semaglutide treatment in Mexico is associated with notable decreases in both HbA1c levels and body weight among patients with type 2 diabetes. Satisfaction with treatment also improved significantly. Moreover, the safety profile is consistent with that of previous studies. ClinicalTrials.gov registration NCT04601753.

The relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and acromegaly is unclear due to the complex metabolic effects of growth hormone (GH). GH stimulates gluconeogenesis, glycogenolysis, and lipolysis, increasing free fatty acids, a risk factor for MASLD, but may also protect against hepatic fat accumulation. In this study, we aimed to evaluate the impact of acromegaly and GH levels on liver steatosis and fibrosis using non-invasive FibroScan imaging. This cross-sectional study included 58 patients with acromegaly, 61 age- and sex-matched metabolically comparable controls, and 82 healthy controls. Hepatic steatosis and fibrosis were assessed via controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) by vibration-controlled transient elastography. Moderate to severe steatosis was defined as CAP > 260 dB/m, and significant fibrosis as LSM ≥ 8.0kPa. Both acromegaly patients and metabolically healthy individuals exhibited lower CAP (241.8 ± 50.0 and 231.7 ± 51.9 dB/m) and LSM (4.7 ± 1.4 and 4.8 ± 1.8kPa) scores than metabolically matched controls (CAP 281.7 ± 61.2 dB/m; LSM 5.5 ± 1.8kPa; CAP p < 0.001; LSM p = 0.012). Moderate-to-severe steatosis was observed in 36.2% of acromegaly patients, 27.7% of healthy individuals, and 68.8% of metabolically matched controls (p < 0.001), while significant liver fibrosis occurred in 5.2%, 7.3%, and 14.7%, respectively (p = 0.154). GH levels were lower in acromegaly patients with MASLD (p < 0.001) compared to those without. CAP correlated negatively with GH and positively with BMI, waist circumference, and triglycerides, whereas LSM correlated positively with age, BMI, and triglycerides. Hepatic steatosis was less frequent in acromegaly than in metabolically comparable individuals, and GH was inversely associated with hepatic steatosis scores, possibly suggesting a protective role of GH independent of metabolic comorbidities.

Lifestyle interventions induce remission in people with type 2 diabetes (T2D) and those with impaired glucose tolerance (IGT). We examined the long-term remission of IGT in the participants of the Finnish Diabetes Prevention Study and evaluated factors predicting remission during extended follow-up. 505 participants were included in analyses. The median duration of lifestyle intervention was four years, and follow-up lasted up to 18years. Remission was defined as normoglycaemia (fasting plasma glucose<5.6mmol/L, 2-h post-load glucose<7.8mmol/L, HbA1c<39mmol/mol). We examined predictors of remission (weight, fat distribution, physical activity, diet, and insulin sensitivity and insulin secretion based on repeated oral glucose tolerance tests). Remission rates were 32% at least once, 13%, 12%, and 11% at year 1, year 3, and the first post-intervention follow-up visit (median 5years, range 4 - 8years). Short-term predictors of remission included weight loss, reduction in waist circumference, higher intake of fibre and lower intake of saturated fats, physical activity, enhanced insulin sensitivity, and recovery of insulin secretion. In the longer term, only insulin secretory and sensitivity indices were associated with remission. IGT may be normalised in the long term through weight loss and healthier lifestyles choices.

The consumption of live microbes beyond probiotics is associated with health benefits. Despite growing interest in live microbe intake, comprehensive data on its dietary sources and research on their potential health effects in Korean populations remain limited. This study aimed to quantify live microbe intake in the 2016-2020 Korea National Health and Nutrition Examination Survey (KNHANES) and to investigate the associations between live microbe intake and cardiometabolic health outcomes. We developed a KNHANES live microbe classification system based on the Sanders system and divided KNHANES food codes that overlapped with NHANES into 4 categories: no live microbes and low (<104 Colony Forming Units (CFU)/g), medium (104-107 CFU/g), and high (>107 CFU/g) amounts. Microbial data on various types of kimchi were obtained from the World Kimchi Institute, and data on other nonoverlapping food codes were derived from the literature and authoritative reviews. We conducted descriptive analyses of live microbe intake among adults aged ≥19 y. We then conducted survey-weighted adjusted regression analyses to evaluate the relationship between live microbe intake and cardiometabolic health outcomes (cholesterols, triglycerides, blood pressure, fasting blood sugar, C-reactive protein [CRP], and waist circumference), controlling for age, sex, body mass index, household income, physical activity level, current smoking status, and alcohol intake. The mean daily intake of medium-amount live microbe foods was 180.24 g in the Korean population, whereas that of high-amount live microbe foods was 122.89 g. Kimchi contributed a significant portion, with a mean intake of 102.76 g. Although no significant association was found between total live microbe intake and CRP concentrations, a significant association was observed for kimchi foods: higher intake was associated with a greater reduction in CRP (coefficient: -0.037; 95% confidence interval: -0.043, -0.032 mg/dL). The association with total cholesterol was positive and statistically significant, albeit small in magnitude, and was therefore not considered clinically significant. No significant associations were found with other outcomes. This study provides new data on dietary intake of live microbes and their potential health benefits from a nationally representative dataset of Korean adults.

Waist Circumference Measurements in Primary Care: A Scoping Review

From non-specific biomarker to targeted action: transdiagnostic and sex-specific drivers of high-CRP status in severe mental illness across the FondaMental Advanced Centers of Expertise (FACE) cohorts.

Cardiometabolic risk in adolescents: prevalence and associated factors from a population-based survey (2008-2015).

Metabolic and osteogenic susceptibility in DISH: A prognostic index from propensity score modelling.