This study aimed to explore whether health effects of dietary nitrate depend on its source, by investigating associations between plant and animal-sourced dietary nitrate groups with markers of inflammation and CVD risk factors. Among 100 non-smoking adults (mean age 49 (sd 13) years, 31 % male), dietary nitrate intake was assessed using FFQ (n 100) and 3-d food diary (n 89), combined with nitrate food composition databases. Nitrate intake was classified into plant, naturally occurring animal and additive-permitted meat-sourced groups. Associations between source-dependent nitrate intakes and lipoprotein-associated phospholipase A2 (Lp-PLA2), C-reactive protein (CRP), fasting plasma lipids, anthropometry and blood pressure were examined using multivariable linear regression, adjusted for socio-demographic, lifestyle and dietary confounders. Each 1 sd (∼57 mg/d) increment in plant-sourced nitrate intake was associated with a 0·191 sd lower LDL-cholesterol (β = -0·191, 95 % CI (-0·369, -0·004), P = 0·045; equivalent to -0·21 mmol/l) in primary models, though this association was attenuated in sensitivity analyses. Naturally occurring animal-sourced nitrate intake was not associated with any outcomes. A 1 sd (0·08 mg/d) increment in additive-permitted meat-sourced nitrate intake was associated with a 0·208 sd lower HDL-cholesterol (β = -0·208, (-0·362, -0·054), P = 0·009; equivalent to -0·10 mmol/l) and a 0·192 sd higher waist circumference (β = 0·192, (0·005, 0·380), P = 0·042; equivalent to +1·29 cm) but not with LDL-cholesterol, TAG, blood pressure, Lp-PLA2 or CRP. These preliminary findings suggest potential differential associations between nitrate source and cardiometabolic markers that warrant confirmation in larger studies.

Mental health disorders, including depression, pose a significant global health threat, particularly among specific populations, such as men with infertility. No published data on depression prevalence among men seeking fertility treatment in Sudan exist. Therefore, this study aimed to determine the prevalence of depression and identify associated factors within this vulnerable population. This cross-sectional study was conducted in Gadarif, Eastern Sudan. Data on sociodemographic characteristics, medical history, anthropometrics, and clinical history were collected using a questionnaire. Waist circumference (WC), weight, and height were measured using the standard methods. Body mass index (BMI) was calculated using the formula: weight (kg) / height (m2). Depression was assessed using the Patient Health Questionnaire (PHQ-9). Multivariate binary analysis was performed. A total of 250 men seeking fertility care services were enrolled in this study; 210 (84.0%) had primary fertility, and 40 (16.0%) had secondary fertility. The median (interquartile range, IQR) values for age, BMI, and WC were 34.0 (30.0–40.0) years, 24.5 (22.2–26.5) kg/m2, and 94.0 (85.0–104) cm, respectively. The median (IQR) of the PHQ-9 score was 4 (2–6). Of the participants, 45 (18.0%) had depression (PHQ-9 score ≥ 8). In the multivariate binary analysis, being a smoker was associated with depression (adjusted odds ratio, AOR = 2.40, 95% confidence interval, CI = 1.20–4.79), and WC was inversely associated with depression (AOR = 0.97, 95% CI = 0.94–0.99). Depression is a prevalent issue among men seeking fertility care in Eastern Sudan. The positive association between smoking and depression highlights a modifiable risk factor. The inverse association between WC and depression warrants further investigation. These findings underscore the importance of integrating routine mental health screening and smoking cessation into fertility care services for men in similar settings.

Adrenal insufficiency is conventionally treated with daily multiple-dose hydrocortisone, and once-daily low-dose prednisolone is an alternative for glucocorticoid replacement. Clinical trials comparing once-daily low-dose prednisolone with thrice-daily hydrocortisone are lacking. To examine the differences in metabolism and bone turnover in patients receiving hydrocortisone vs prednisolone for adrenal insufficiency. This double-blind, crossover randomized clinical trial of multiple-daily standard-dose hydrocortisone vs once-daily low-dose prednisolone (2-5 mg), performed from September 3, 2019, to December 14, 2023, involved adults with adrenal insufficiency. Anthropometrics, biochemical data for cardiometabolic and bone health, and subjective health survey data were collected at days 1, 30, and 120 of each study period for both medications. Individuals were randomized to receive 4 months of once-daily prednisolone in the morning (with placebos at noon and afternoon) or hydrocortisone at the same times. All participants were crossed over to the alternative treatment for an additional 4 months. The primary outcome was assessment of bone turnover, detected by change in carboxylated and undercarboxylated osteocalcin between days 1 and 120 in each treatment period. Secondary outcomes included change in weight, body mass index, waist circumference, glycated hemoglobin, and subjective heath survey responses. Forty-seven participants were randomized, with 46 participants included in the analysis (median [IQR] age, 55.0 [46.5-62.8] years; 24 [52.2%] male). Twenty-four received prednisolone first and 22 received hydrocortisone first. Bone turnover was significantly slowed with prednisolone compared with hydrocortisone as evidenced by a significantly lower level of multiple bone markers, including carboxylated osteocalcin (mean treatment difference, -1.22 ng/mL; 95% CI, -2.35 to -0.10 ng/mL; P = .04), undercarboxylated osteocalcin (mean treatment difference, -1.38 ng/mL; 95% CI, -2.32 to -0.44 ng/mL; P = .005) (to convert osteocalcin to micrograms per liter, multiply by 1), urinary N-terminal telopeptide (mean treatment difference, -9.34 nmol/mmol; 95% CI, -15.4 to -3.29 nmol/mmol; P = .002), and procollagen type 1 N-terminal propeptide (mean treatment difference, -13.8 ng/mL; 95% CI, -22.2 to -5.49 ng/mL; P < .001). The mean treatment group difference in weight reduction from baseline was -1.87 kg (95% CI, -3.02 to -0.72 kg; P = .002) for prednisolone treatment compared with hydrocortisone, and this was associated with concordant significantly greater reductions in body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters; treatment difference, -0.522; 95% CI, -1.01 to -0.04; P = .04), waist circumference (treatment difference, -2.26 cm; 95% CI, -3.97 to -0.56 cm; P = .01), and HbA1c (treatment difference, -0.12% [-1.23 mmol/mol; 95% CI, -1.95 to -0.51 mmol/mol]; P = .001). There were no differences in safety measures or subjective health outcomes, including all 36-Item Short-Form Health Survey domains and Addison's Disease-Specific Quality of Life Questionnaire. In this randomized clinical trial, once-daily low-dose prednisolone was associated with slower bone turnover and improvements in cardiometabolic health markers compared with multiple-dose hydrocortisone without compromising well-being. Studies assessing longer-term mortality and morbidity outcomes are needed. ClinicalTrials.gov Identifier: NCT03936517.

To evaluate the association between adherence to the Mediterranean Diet (MedDiet) and the risk of type 2 diabetes mellitus (T2D) in an urban Ecuadorian population, with emphasis on the protective role of specific dietary components and body composition. A cross-sectional analytical study was conducted with 1373 adults aged 18-75 years. Adherence to the MedDiet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), while T2D risk was estimated using the Finnish Diabetes Risk Scale (FINDRISC). Anthropometric and body composition parameters were measured using standardized procedures. Adjusted associations between exposure variables and T2D risk were estimated using Poisson regression with robust variance, and prevalence ratios were calculated after controlling for sociodemographic and lifestyle factors. Most participants showed low adherence to the MedDiet (85.2%), which was significantly associated with higher T2D risk. Multivariate analysis of individual dietary components showed relevant associations. Regular consumption of sofrito was associated with lower T2D risk (PR = 0.817; 95% CI: 0.682-0.979; p = 0.028). Similarly, low fruit consumption was associated with a substantially higher T2D risk (PR = 1.350; 95% CI: 1.146-1.589; p = 0.001). In addition, higher body mass index (BMI) and waist circumference (WC) were consistently related to greater T2D risk. Greater adherence to the MedDiet, particularly consumption of key components such as sofrito and fruits, was associated with lower T2D risk. These findings highlight the importance of preventive lifestyle interventions adapted to the Latin American context.

Background/Objectives: Liver fat represents an early metabolic lesion in the development of diabetes and its cardiometabolic complications. Diets high in free sugars, particularly from sugar-sweetened beverages (SSBs), are associated with abdominal obesity and increased cardiometabolic risk, prompting global guidelines to limit SSBs as a major public health strategy. Low-fat cow's milk is promoted as the preferred caloric replacement strategy for SSBs due to its high nutritional value and cardiometabolic advantages. Fortified soymilk is a plant-based alternative with approved health claims for cholesterol and coronary heart disease risk reduction that offers an equivalent nutritional value to cow's milk. However, given concerns about its classification as an ultra-processed food (UPF), it is unclear whether soymilk offers comparable metabolic health benefits to milk as part of clinical and public health strategies to reduce SSB intake. The Soy Treatment Evaluation for Metabolic (STEM) health trial seeks to evaluate the impact of replacing SSBs with either 2% soymilk or 2% cow's milk on liver fat and other cardiometabolic risk factors in habitual adult consumers of SSBs with obesity. Methods: The STEM trial is a 24-week, pragmatic, 3-arm, parallel, randomized trial. We recruited adults with obesity (high BMI plus high waist circumference based on ethnic specific cut-offs) consuming ≥1 SSB/day. Participants were randomized to one of three groups based on their usual SSB intake at baseline (servings/day): continued SSB (355 mL can) intake; replacement with fortified, sweetened 2% soymilk (250 mL); or replacement with 2% cow's milk (250 mL). The primary outcome is the change in intrahepatocellular lipid (IHCL) measured by 1H-MRS at 24 weeks. Hierarchical testing will be done to reduce the familywise error rate. The superiority of cow's milk to SSBs will be assessed first to establish assay sensitivity. If superiority is established, then the non-inferiority of soymilk to cow's milk will be assessed using a pre-specified non-inferiority margin of 1.5% IHCL units (assessed by difference of means using a 90% confidence interval [CI]). Analyses will be conducted according to the intention-to-treat (ITT) principle using inverse probability weighting (IPW) for superiority testing and per-protocol analyses for non-inferiority testing, using ANCOVA adjusted for age, sex, metabolic dysfunction-associated steatotic liver disease (MASLD) status, medication use, intervention dose, and baseline levels. We hypothesize that soymilk will be non-inferior to cow's milk (Clinicaltrials.gov NCT05191160). Results: Recruitment began in November 2021. A total of 3050 individuals were screened. We randomized 186 participants (62 per group) between 19 April 2022 and 16 April 2024. Participants are 57% male; with a mean [SD] age of 39.9 [11.8] years; BMI of 34.6 [6.1] kg/m2, waist circumference of 112.6 [13.8] cm; IHCL of 10.0 [8.2] % with 64.1% meeting the criteria for MASLD; and SSBs intake of 2.3 [1.3] servings/day. Conclusions: Baseline characteristics were balanced across the study arms, with participants representing adults with a high-risk metabolic phenotype, and 64.1% meeting the criteria for MASLD. Findings will contribute to evidence on the cardiometabolic benefits of soymilk, informing clinical practice guidelines and public health policy.

Waist-to-height ratio (WHtR) has been suggested as a superior marker of cardiometabolic risk compared to waist circumference (WC), but evidence in type 2 diabetes mellitus (T2DM) remains limited. A population-based cohort of 2 076 104 patients with T2DM who underwent the Korean national health checkup between 2015 and 2016 were followed until 2022. Multivariable Cox proportional hazards regression was performed to analyse the association between WHtR and the risk of incident myocardial infarction, stroke and mortality. Restricted cubic spline analyses were performed to evaluate continuous dose-response relationships, with additional stratification by abdominal obesity. During follow-up, 125 493 deaths (6.0%), 56 280 myocardial infarctions (2.7%) and 62 938 strokes (3.0%) occurred. WHtR showed increasing association with the risk of myocardial infarction and stroke, and a U-shaped association with all-cause mortality. Individuals with both abdominal obesity and WHtR ≥ 0.5 had higher risks of myocardial infarction (HR 1.12, 95% CI 1.07-1.17), stroke (HR 1.18, 95% CI 1.15-1.21) and mortality (HR 1.20, 95% CI 1.16-1.25). In those without abdominal obesity, WHtR ≥ 0.5 was also associated with increased cardiovascular risks but slightly lower mortality. In contrast, those with abdominal obesity but normal WHtR had no significantly increased risks for any outcomes. The associations were stronger in younger adults and individuals with new-onset T2DM for cardiovascular outcomes, and in those with long-standing T2DM for mortality. WHtR was independently associated with cardiovascular outcomes and mortality in individuals with T2DM, including those without abdominal obesity. This simple measurement may provide additional information beyond WC for evaluating cardiometabolic risk in this population.

Background: Diabetes Mellitus (DM) encompasses a complex of metabolic disorders with multiple risk factors and numerous genetic susceptibility variants. The purpose of the study is to investigate different clinical, biochemical, and genetic (TCF7L2 variants) parameters in lean, normal, obese (according to BMI) newly diagnosed T2DM patients in a North and Eastern part of India population. The genetic variants were also compared with 200 healthy non-diabetic individuals.Materials and Methods: We conducted a cross-sectional study involving 200 newly diagnosed T2DM patients above 18 years. We categorized them into lean, normal, and obese according to Body mass index. We collected the clinical data and biochemical tests were done by spectrophotometer with lab kits. TCF7L2 was analyzed by genotyping for TCF7LR_rs7903146(C>T) and TCF7LR_rs 12255372 (G>T) by using ARMS-PCR/PCR-RFLP.Results: In our study male to female ratio was found 3:2 with the mean age of the patients at 51.7 years. Obese patients had much higher average waist circumference (92.5 cm), and highest waist-to-hip ratio 0.89, and higher average fasting blood glucose (209 mg/dl) and postprandial blood glucose (259 mg/dl) than normal and lean BMI patients. Obesity is a risk factor for T2DM (p-value 0.00027) in comparison to lean and normal BMI. In TCF7LR_rs7903146 genetic variant T allele is a risk factor for T2DM when compared with healthy non-diabetic individuals (Chi-square (χ2): 25.747, p-value: 0.0000025), For CT genotypic allele OR=1.99, 95% CI=1.29-3.08 and TT allele, OR=7.04, 95% CI= 3.01-16.4. In the TCF7LR_rs 12255372 genetic variant also T allele is a risk factor for T2DM (Chi-square (χ2):14.924, p-value: 0.00057). The prevalence of the T allele is higher in obese BMI patients than in lean, normal BMI patients.Conclusion: The findings suggest that obesity is associated with poorer Metabolic control with elevated risk of T2DM. The genetic variants TCF7LR_rs7903146(C>T) and TCF7LR_rs 12255372 (G>T) both are associated with T2DM. The TCF7L2 gene-BMI interaction may play an important role in the risk for T2DM in the North-East Indian population.

Systemic arterial hypertension (SAH) shows a high prevalence among postmenopausal women and represents an important public health concern. To evaluate factors associated with SAH in postmenopausal women participating in a resistance training program. This observational, cross-sectional study included 55 postmenopausal women (66.0 ± 4.9 years) recruited from the "More Active Women" research project, an umbrella experimental and longitudinal study involving resistance training interventions. Cross-sectional data were collected during the baseline assessment (April-May 2025). Sociodemographic variables, nutritional status (body mass index and waist circumference), and behavioral and health-related variables obtained through structured interviews and anthropometric assessments were analyzed. Associations were tested using Pearson's chi-square test or Fisher's exact test, with effect size estimated by Phi or Cramer's V when appropriate, and binary logistic regression was performed for adjusted analyses. Significant associations were observed between SAH and elevated BMI (p = 0.03; φ = 0.30), waist circumference > 88 cm (p = 0.006; φ = 0.40), and lower educational level (p = 0.003; V = 0.47). In the adjusted analysis, waist circumference ≤ 88 cm was associated with a lower likelihood of SAH (OR = 5.54; 95% CI: 0.965-31.872; p = 0.007), whereas lower educational level was associated with a higher likelihood of hypertension (OR = 13.98; 95% CI: 1.505-129.833; p = 0.004). Excess central adiposity and lower educational level are associated with SAH in postmenopausal women, highlighting the importance of integrated health promotion strategies that address both cardiometabolic risk factors and social determinants of health during aging.

Inflammatory Bowel Disease (IBD) involves genetic and environmental factors, but the relationship between disease activity, adiposity, and diet remains unclear. To investigate the association between endoscopic/radiological activity of IBD, body adiposity, and the Dietary Inflammatory Index with or without adjustment for energy density (E-DII or DII). An observational, cross-sectional study was carried out. Endoscopic activity was defined by an endoscopic Mayo score >2, Crohn's Disease Endoscopic Index of Severity (CDEIS) > 5, and/or the presence of a deep ulcer in any intestinal segment. Body adiposity was estimated using the body mass index, waist circumference, and waist-hip ratio (WHR). The DII and E-DII scores were calculated from a validated quantitative food frequency questionnaire. According to the DII and E-DII, the patients were divided into three groups: the first with the least pro-inflammatory diet and the third with a predominantly pro-inflammatory diet. Of the 62 patients, 58.1% (n = 36) were in remission (RD) and 41.9% (n = 26) had active disease (AD). The proportion of patients with overweight/obesity was 69.4% (n = 25) in the RD group and 50.0% (n = 13) in the AD group. Patients in remission exhibited significantly higher WHR (p < 0.05) and a greater frequency of central obesity (p < 0.01). A predominantly pro-inflammatory diet was common across both groups; 58.3% (n = 21) of RD patients and 50.0% (n = 13) of AD patients were in the highest DII tertile. Similar results were found for the E-DII. Among patients with IBD, pro-inflammatory dietary patterns and excess adiposity are highly prevalent. Despite greater central adiposity in patients in remission, no significant associations were found between DII or EDII scores and endoscopic and radiological markers of disease activity.

Background To further assess the relationship between obesity and infertility, we employed a novel anthropometric index, specifically designed to assess the relationship between a body shape index (ABSI) and infertility in women of childbearing age. Furthermore, we examined the correlation between ABSI and visceral obesity index (VAI) in relation to infertility. Methods A total of 1989 female participants of childbearing age were included, based on National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2016. The ABSI is calculated by dividing waist circumference by body mass index (BMI) 2/3* height1/2. VAI was calculated using the following formula: waist circumference/(36.58 + (1.89*BMI)) x (triglycerides/0.81) × (1.52/HDL cholesterol). Infertility or fertility status was defined by interviewing female participants of childbearing age through a reproductive health questionnaire. Weighted multifactorial logistic regression analysis was used to explore the independent relationship between ABSI and infertility. Smoothed curve fitting, subgroup analyses and interaction tests were also performed. Results Among the 1989 participants, 183 (9.2%) women were categorized as infertile. Logistic regression modeling showed that ABSI was positively associated with infertility and remained significant even after adjusting for all confounders(OR = 1.31, 95% CI: 1.07–1.60, p = 0.0098). This association was consistent across all subgroups (age, race, smoking, alcohol consumption, hypertension, diabetes mellitus, and the regularity of menstruation over the previous 12 months), (p > 0.05 for all interactions). The results of the smooth curve fitting demonstrated a linear, positive association between ABSI and infertility. Conclusion There is a statistically significant positive correlation between body mass index and infertility. As a body shape index rises, women of childbearing age are at greater risk of infertility.

The eastern Indian state of West Bengal is home to a variety of tribes that contribute to the state's cultural, linguistic, and genetic diversity. The aim of this study was to determine gender based differences in the anthropometric and physiological characteristics of the tribal populations in West Bengal and their implications for health and nutrition. This study included 310 participants (150 males, 160 females) from Santhal, Oraon, Munda, and Mahali tribes from seven districts of West Bengal during 2023–2024. Height, weight, waist circumference (WC), and hip circumference (HC) were measured. Indices of Body Mass Index (BMI), Waist-to-Hip Ratio (WHR), and Conicity Index (CI) have been calculated. Physiological parameters including body fat percentage, visceral fat percentage, blood pressure, glucose levels, or resting metabolic rate-have also been measured. Large differences between males and females were obtained in the results. Males had a higher average height (162.93 ± 7.09 cm vs. 153.61 ± 7.49 cm) and weight (61.04 ± 1.82 kg vs. 52.74 ± 1.57 kg) compared to females. BMI values were similar between genders (22.78 ± 3.66 for males and 22.37 ± 0.94 for females). Females exhibited significantly higher body fat percentages (29.84 ± 1.11%) compared to males (23.49 ± 6.23%), whereas males had greater visceral fat (7.30 ± 4.06% vs. 5.34 ± 0.11%). Blood pressure was elevated in males (126.57 ± 14.57 mmHg systolic, 81.70 ± 1.45 mmHg diastolic) compared to females (120.81 ± 5.33 mmHg systolic, 79.91 ± 1.23 mmHg diastolic). Glucose levels, both fasting and postprandial, showed a slightly higher values in males compared to females: 82.58 ± 2.70 mg/dL versus 80.83 ± 1.33 mg/dL fasting levels, and 124.55 ± 11.72 mg/dL versus 119.65 ± 1.03 mg/dL postprandial glucose levels. The findings highlight gender-based disparities in health and nutrition arising from genetic, cultural, and lifestyle factors. The work provides insight into the health status of tribal populations and underscores the imperative and necessity for selective intervention in regard to the emerging health risks in the course of urbanization and socio-economic transitions.

Altered body image perception, associated with low self-esteem, contributes to lifestyle changes and may be associated with behaviors that jeopardize a person's health. The objective of this study is to evaluate the perception and satisfaction with body image among women participating in the "Healthy Citizen Physical Activity" program in the city of Estância/SE. This is a descriptive, cross-sectional study conducted with 53 women, aged between 18 and 59 years, who are users of the physical activity project in the municipality of Estância/SE. Weight, height, waist circumference (WC), and neck circumference (NC) were collected, and the Body Mass Index (BMI) was calculated and classified according to the criteria of the World Health Organization (WHO). The silhouette scale was used to assess perception and satisfaction. The study was approved by the Research Ethics Committee of the Federal University of Sergipe under opinion number 2.587.210. For data analysis, means, standard deviations, and Pearson correlations were calculated using SPSS version 22.0 for Windows. The results indicated that silhouette 11, corresponding to a BMI of 37.5 kg/m², was the most frequently selected silhouette to represent the desired body image, chosen by 15.1% of the participants; silhouette 6, corresponding to a BMI of 25 kg/m², was the most chosen silhouette to represent the desired body image, selected by 22.6% of the participants. Regarding dissatisfaction, it was found that 62.3% of the sample are dissatisfied with their body image. Regarding the type of body image distortion, 3.8% of the volunteers showed no distortion, 13.8% showed positive distortion, and 83% indicated negative distortion. Waist circumference showed that 37.7% have a high risk for cardiovascular disease, while neck circumference showed that 35.8% also fall into this category. The results obtained corroborate the literature and demonstrate high levels of dissatisfaction and altered perception of body image among the participants; this result may have an effect on behavioral patterns. It is concluded that the studied population demonstrates a high degree of body image dissatisfaction and predominantly negative distortion.

Soft tissue sarcomas (STSs) are rare malignancies with largely unknown etiology; the role of anthropometry and physical activity has been rarely explored. We analyzed 2011-2019 data of an Italian, multicenter, hospital-based case-control study including 498 incident, histologically confirmed STS cases and 969 controls. Self-reported height, weight, and physical activity data were collected; hip and waist circumferences were measured in 76% of cases and 61% of controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple-adjusted logistic regression models. Compared with BMI < 25 kg/m 2 , the ORs for BMI one year prior to diagnosis/interview were 1.05 (95% CI: 0.80-1.37) for 25-29.9 kg/m 2 and 1.28 (95% CI: 0.90-1.83) for ≥30 kg/m 2 . The OR was increased for BMI 25-29.9 kg/m 2 at age 30; no association emerged for BMI at age 50 years. For waist circumference, the ORs were 1.93 (95% CI: 1.38-2.70) for >102 cm in males or >88 cm in females, and 3.54 (95% CI: 2.40-5.22) for the highest versus the lowest tertile. For waist-to-hip ratio, the ORs were 1.18 (95% CI: 0.81-1.71) for the intermediate, and 2.81 (95% CI: 1.95-4.03) for the highest tertile. Subjects reporting ≥5 h/week of total or intermediate/high intensity leisure-time physical activity at age 30-39 years had ORs of 0.63 (95% CI: 0.40-1.00) and 0.56 (95% CI: 0.32-1.00), respectively. These findings show a positive association between abdominal adiposity and STS risk, and an inverse association with regular leisure-time physical activity.

IntroductionChronic diseases are the largest contributor to overall morbidity and mortality. The workplace lifestyle interventions have shown improvements in anthropometric, and cardiometabolic parameters. However, data related to workplace wellness programs in the United Arab Emirates (UAE) are scarce. The aim of this study was to evaluate the effectiveness of a workplace wellness intervention on anthropometric measures, functional capacity and cardiovascular fitness.MethodsWe conducted a 12-week workplace wellness intervention among employees of a leading UAE healthcare organization. The program included physical activity challenges targeting step count and calorie expenditure, with assessments conducted at baseline, day 45, and day 90. We used adjusted linear mixed-effects models to analyse the data.ResultsA total of 116 participants were included in the analysis [mean age 39.2 (SD 8.4) years, female sex 49.1%]. Compared with baseline values, we observed a significant improvement in weight, body mass index, and waist circumference both at day 45 [−0.52 (95% CI, −0.96 to −0.08) kg, −0.18 (−0.32 to −0.03) kg/m2, −2.53 (−3.93 to −1.14) cm, respectively], and at day 90 [−1.16 (−1.81 to −0.51) kg, −0.40 (−0.62 to −0.18) kg/m2, −3.73 (−5.84 to −1.59) cm, respectively]. The total functional movement score increased by 2.76 (2.23–3.30) and 4.99 (4.50–5.49) at day 45 and day 90, respectively. The systolic blood pressure was decreased by −2.58 (−5.09 to −0.07) mmHg and −4.76 (−7.09 to −2.43) mmHg, and Rockport 1-mile walking time was decreased by −2.06 (−2.57 to −1.55) minutes and −2.46 (−3.11 to −1.82) minutes at day 45 and day 90, respectively, compared with the baseline values. The predicted cardiorespiratory fitness (VO2) increased by 9.00 (7.28–10.73) mL·kg−1·min−1 at day 45, and by 7.24 (5.34–9.13) mL·kg−1·min−1 at day 90. Compared with week-1 levels, the activity wearable parameters of steps and calories per day showed reductions mid-intervention [−1,392 steps/day, (−2,233 to −550); −248 calories/day, (−404 to −92)], and by day 90 [−1,008 steps/day (−2,164 to 148); −157 calories/day (−310 to −5). The wearable-derived resting heart rate showed a modest decline with mean reductions of −1.41 bpm (−2.52 to −0.30) at mid-intervention, and −0.57 bpm (−1.79 to 0.66) by day 90.DiscussionOur findings show significant improvements in anthropometry, functional movement scores, and selected parameters of cardiovascular fitness associated with workplace wellness program. These results contribute important preliminary data for the UAE healthcare workforce, and suggest that incorporating workplace interventions into organizational health policies could play a crucial role in improving employee health.

Background: Diabetes mellitus is a global health challenge, especially among homeless people. Early prediction of diabetes can reduce treatment costs and improve interventions. This study aimed to identify predictors of diabetes among homeless adults by utilizing artificial intelligence and providing recommendations for diabetes prevention. Methods: A case-control study of 150 homeless adults in Giza, Egypt (99 diabetes cases and 51 controls), analyzed 43 variables collected through interviews and physiological measures, with missing data imputed. Feature selection using recursive feature elimination and univariate and correlation analyses reduced the predictors to 13 variables. The class imbalance was addressed using synthetic minority over-sampling on the training set. Six models and a stacking ensemble with XGBoost as a meta-learner were evaluated using 5-fold cross-validation and performance metrics, including the accuracy, precision, recall, F1-score, and AUC-ROC. Results: The key predictors included BMI, systolic blood pressure, triceps skinfold thickness, waist circumference, lifestyle factors, comorbidities, diastolic blood pressure, age, medication adherence, educational level, marital status, duration of residence, and diabetes knowledge. Individual classifiers achieved a moderate performance (accuracy: 56.7-70.0%, F1-score: 0.686-0.781). The stacking ensemble substantially outperformed individual models, achieving a 95.45% accuracy, a 100% precision, a 93.75% recall, a 0.968 F1-score, and a 0.979 AUC-ROC on the test set. Conclusions: Machine learning models can reliably predict diabetes. The proposed hybrid stacking model outperformed conventional classifiers in terms of the prediction performance, highlighting the benefits of ensemble learning and sophisticated resampling strategies in dealing with imbalanced medical data. It is recommended that healthcare institutions integrate AI-powered diagnostic assistance technology into clinical processes to aid in the early detection and treatment of diabetes.

Background: Dietary calcium and dairy products are hypothesized protective factors against metabolic syndrome (MetS), yet epidemiological evidence remains inconsistent. This systematic review and meta-analysis evaluated the association between total dietary calcium intake or dairy consumption and MetS prevalence in adults. Methods: Following PRISMA 2020 guidelines, PubMed, Cochrane Library, ClinicalTrials.gov, and SCOPUS were searched through to October 2025 for eligible cross-sectional studies assessing dietary calcium or dairy intake and MetS (NCEP ATP III, IDF, or JIS criteria). Longitudinal studies, non-English articles, and pediatric populations were excluded. Quality was assessed via an adapted Newcastle-Ottawa Scale. Random-effects meta-analyses pooled fully adjusted odds ratios (ORs) and 95% confidence intervals (CIs) comparing the highest versus lowest intake categories. Results: Twenty-four studies were included (12 for dietary calcium intake, 12 for dairy products). Higher dietary calcium intake was significantly associated with lower MetS odds (pooled OR: 0.85; 95% CI: 0.80-0.91), despite substantial heterogeneity (I2 = 70.1%). Higher dairy consumption was also inversely associated with MetS (pooled OR: 0.78; 95% CI: 0.72-0.85; I2 = 64.6%). While small-study effects were observed for dairy, trim-and-fill analysis confirmed the robustness of the findings. Higher calcium intake further correlated with favorable profiles in individual MetS components, including blood pressure, HDL cholesterol, waist circumference, triglycerides, and fasting glucose. Conclusions: Higher total dietary calcium intake and dairy product consumption are associated with a lower prevalence of MetS in adults. However, the cross-sectional nature of the included studies precludes any inference of causality between calcium intake and MetS. Therefore, although these findings suggest a protective role of calcium-rich diets, well-designed prospective and interventional studies are warranted to clarify whether this relationship is causal.

Polycystic ovary syndrome (PCOS) is characterised by insulin resistance and hyperandrogenism; whether novel antidiabetic drugs differentially improve these metabolic and reproductive disturbances remains uncertain. We performed a network meta-analysis to simultaneously rank the efficacy and safety of sodium–glucose cotransporter-2 inhibitors (SGLT-2i), GLP-1 receptor agonists (GLP-1RAs) and DPP-4 inhibitors (DPP-4i) in women with PCOS. We searched PubMed, Web of Science, Medline, Cochrane CENTRAL and Embase to 6 June 2025 for randomized controlled trials (RCTs) that compared SGLT-2i, GLP-1RAs or DPP-4i with placebo or active drugs in women ≥ 18 years with PCOS. Primary endpoints were Body Mass Index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR), total testosterone (TT) and free androgen index (FAI); secondary endpoints included waist circumference (WC), Sex Hormone Binding Globulin (SHBG), fasting blood glucose (FBG), lipids and gastrointestinal adverse events. A frequentist random-effects network meta-analysis was conducted in Stata 15.1; treatments were ranked with SUCRA (0–100%) and certainty was appraised with CINeMA. 29 RCTs (1771 participants) were eligible. SGLT-2i yielded the largest reduction in BMI (mean difference vs. placebo − 4.26 kg m⁻², 95% CI − 6.01 to − 2.52; SUCRA 91%) and HOMA-IR (–2.56, − 4.53 to − 0.59; SUCRA 89%). The metformin plus GLP-1RAs combination produced the greatest decrease in TT (–1.35 ng mL⁻¹ vs. placebo, − 2.22 to − 0.48; SUCRA 85%) and FAI (–1.91, − 3.43 to − 0.40; SUCRA 82%), and also led improvements in WC, SHBG and FBG. SGLT-2i ranked first for lowering triglycerides (TG) and total cholesterol (TC). GLP-1RAs monotherapy carried the highest risk of nausea (OR 6.26–9.20), vomiting (OR up to 26.56) and abdominal pain, whereas metformin/DPP-4i markedly increased diarrhoea (OR 2 704 vs. placebo). No statistical inconsistency or publication bias was detected; certainty was high for selected contrasts but moderate to very low for most comparisons. SGLT-2i provide the most favourable cardiometabolic profile as single agents for weight and insulin resistance in PCOS, whereas metformin combined with GLP-1RAs most effectively attenuates hyperandrogenism at the price of greater gastrointestinal intolerance. The low certainty of much of the evidence underscores the need for large, long-term RCTs to confirm these findings. CRD420251045700.

Antipsychotics-induced metabolic syndrome (APs-induced MetS) is a common side-effect of antipsychotics, significantly increasing the risk of cardiovascular diseases and mortality. However, the genetic risk factors underlying APs-induced MetS remain poorly understood. Thus, we conducted a sex-stratified genome-wide association study (GWAS) in 3067 patients from Schizophrenia In Non-Occidental participants (SINO) trial, and significant results were validated in an independent cohort (all samples = 200) and proteomic data. Post-GWAS analyses were used to further explore the genetic mechanisms involved in APs-induced MetS. Multi-omics prediction incorporating both polygenic risk and proteomic markers was conducted. After quality control, 1956 patients (965 males, 991 females) were included. We identified significant genetic variants (rs73762168; P = 1.77 × 10-8) on chromosome 6q21, associated with three highly linked genes, NR2E1, SNX3 and AFG1L/LACE1, which were correlated with APs-induced MetS in male patients. Top SNP genotype was validated in independent cohort, showing associations with increased weight and waist circumference. Enrichment analyses across genetic and proteomic data consistently highlighted the PPAR signaling pathway involved in oxidative stress and fatty acid metabolism as a key contributor to APs-induced MetS development. Proteomic analyses confirmed baseline SNX3 protein levels associated with weight gain (P = 0.03) and increased waist circumference (P = 8.87 × 10-3) following six-week antipsychotic treatment. The multi-omics prediction (R2 = 0.18) yielded better prediction of APs-induced metabolic side effects than using either marker alone(R2 = 0.13 or 0.07). This study provides novel genetic insights into the development of APs-induced MetS, particularly in males. The identified genetic variants and pathways offer potential targets for early risk prediction and personalized treatment strategies.

Obesity is a major independent risk factor for chronic kidney disease. High-Intensity Interval Training (HIIT) is recognized as an interesting therapeutic strategy in managing obesity and related disorders. However, there is still a lack of knowledge about its impact on kidney function. The study aimed to evaluate the impact of the HIIT program on kidney function and erythrocyte parameters in overweight/obese women. Thirty-three overweight/obese young women (age, 17.0 ± 1.15 yrs.; body mass index, 33.3 ± 4.77 kg/m2) were allocated into HIIT (n = 17) or control (n = 16) groups. The HIIT program was performed 3 times a week for nine weeks. Body composition parameters, blood creatinine, blood urea, estimated Glomerular Filtration Rate (eGFR), serum electrolytes (i.e., sodium, potassium, chloride, calcium, phosphorus, and magnesium), and red blood cell parameters (i.e., red blood cell count, hematocrit, hemoglobin and mean corpuscular volume) were collected before the start and after the completion of the training. Nine weeks of HIIT significantly improved (p < 0.01) body mass index, body fat, and waist circumference, but the auhtors found no statistically significant changes in blood creatinine, urea, eGFR, and red blood cell parameters (p > 0.05). No variable changed in the control group. HIIT improved body composition; however, no significant changes in renal function parameters were detected in this underpowered study.

The lipid accumulation product (LAP), which integrates waist circumference and triglyceride levels, is an effective indicator of excessive fat accumulation. This study aimed to investigate the association between LAP and the risk of incident stroke among adults aged 45 years and older. Using data from the China Health and Retirement Longitudinal Study (CHARLS), a total of 9,060 participants aged ≥ 45 years without a prior history of stroke were included. LAP was categorized into quartiles (Q1–Q4). Cox proportional hazards models were applied to evaluate the association between LAP and incident stroke. Model 1 was adjusted for sex, age, and residence, while Model 2 was further adjusted for education level, smoking, alcohol consumption, body mass index, diabetes, hypertension, dyslipidemia, and history of cardiovascular disease. During follow-up, 1,300 incident stroke cases were identified among the 9,060 participants. Cox regression analysis showed that, compared with the lowest LAP quartile, participants in the higher quartile had a significantly increased risk of incident stroke. The association remained robust after excluding participants using lipid-lowering medications in sensitivity analyses. Subgroup analyses demonstrated consistent associations across age, sex, smoking status, alcohol consumption, hypertension, and diabetes. Kaplan–Meier curves across LAP quartiles indicated a significantly higher cumulative incidence of stroke in the high-LAP group. Higher LAP was positively associated with an increased risk of incident stroke among adults aged 45 years and older. LAP may serve as a complementary indicator for stroke risk screening in community populations.