A body shape index and cardiometabolic risk markers: age- and sex-specific patterns.

Background: Perimenopause is a hormonally dynamic transitional stage often accompanied by menstrual irregularity, vasomotor symptoms, mood disturbance, sleep problems, and increasing metabolic vulnerability. Emerging evidence suggests that gut dysbiosis may influence estrogen metabolism, symptom burden, and cardiometabolic health through the estrobolome and related inflammatory-metabolic pathways. Objective: To determine the association of gut dysbiosis with hormonal imbalance, menopausal symptom severity, and metabolic health in perimenopausal women attending a tertiary care hospital in Multan, Pakistan. Methods: This cross-sectional analytical study included 180 perimenopausal women aged 40 to 55 years recruited through non-probability consecutive sampling. Data were collected using a structured proforma covering sociodemographic, menstrual, gastrointestinal, lifestyle, and medical variables. Menopausal symptoms were assessed using the Menopause Rating Scale, hormonal status was evaluated through serum estradiol, follicle-stimulating hormone, and luteinizing hormone, and metabolic assessment included body mass index, waist circumference, fasting blood sugar, HbA1c, lipid profile, and blood pressure. Participants were categorized into dysbiosis and non-dysbiosis groups according to protocol-defined clinical and laboratory criteria. Results: Gut dysbiosis was identified in 104 of 180 women (57.8%). Compared with women without dysbiosis, affected women had significantly higher mean total Menopause Rating Scale score (15.8 ± 5.9 vs 11.2 ± 4.8), lower serum estradiol (58.6 ± 21.4 pg/mL vs 74.9 ± 24.7 pg/mL), and higher FSH and LH levels. They also had higher BMI, waist circumference, fasting blood sugar, HbA1c, triglycerides, LDL cholesterol, and systolic blood pressure, with lower HDL cholesterol. On multivariable analysis, severe menopausal symptoms, low estradiol, high waist circumference, diabetes mellitus, and low physical activity remained independently associated with dysbiosis. Conclusion: Gut dysbiosis was significantly associated with hormonal imbalance, greater menopausal symptom burden, and adverse metabolic health in perimenopausal women. These findings support a more integrated clinical approach to perimenopausal care and justify further prospective studies to clarify temporality and mechanism.

This study assessed oral health-related quality of life in individuals with and without obesity, and investigated its association with socioeconomic-demographic characteristics, lifestyle habits, health conditions, and clinical care. A cross-sectional study was conducted with 250 individuals (≥ 18 years) in Salvador-Brazil. Data were collected using structured questionnaires, anthropometric assessments, and clinical oral examinations. Oral health-related quality of life was measured using the Oral Health Impact Profile-14. Obesity was classified by waist circumference. Sequential blockwise multiple regression models were employed for data analysis. Impaired oral health-related quality of life was reported by 56.7% of the overall sample. Obese individuals showed worse Oral Health Impact Profile-14 scores compared to non-obese individuals, with greater impairment in physical pain, and physical, psychological, and social disability domains. In final multivariate models, female sex, cardiovascular disease, and the decayed, missing, and filled teeth index were associated with impaired oral health-related quality of life among obese individuals. Obese individuals showed lower oral health-related quality of life scores than non-obese individuals, linked to poor oral health. Female sex, cardiovascular disease, and high decayed, missing, and filled teeth index scores emerged as significant factors associated with worse outcomes.

This systematic review and meta-analysis evaluated the effects of probiotic and synbiotic supplementation on metabolic and hepatic outcomes in children and adolescents with obesity, including those with obesity-related metabolic dysfunction-associated steatotic liver disease (MASLD). A comprehensive literature search of PubMed, Scopus and Web of Science was conducted up to September 2025. Randomised controlled trials (RCTs) investigating probiotic or synbiotic supplementation in paediatric populations with obesity or MASLD were included. Data were pooled using a random-effects model, and the Cochrane Risk of Bias tool and GRADE framework were used for quality assessment. Thirteen RCTs (n = 848) were included. Pooled analyses demonstrated significant reductions in total cholesterol (WMD: -6.40 mg/dL, 95% CI: -8.78, -4.01), LDL-C (WMD: -2.68 mg/dL, 95% CI: -4.85, -0.50) and alanine aminotransferase (ALT) (WMD: -6.15 U/L, 95% CI: -10.14, -2.16). No significant improvements were observed in BMI z-score, waist circumference, triglycerides, HDL-C or fasting blood sugar. A significant increase in HOMA-IR was found (WMD: 0.68, 95% CI: 0.53, 0.83). Evidence certainty was high for lipid outcomes but low or very low for most other measures. Despite these mixed results, substantial heterogeneity and limited evidence quality underscore the need for well-designed, strain-specific trials. Probiotic and synbiotic supplementation show promise for specific metabolic outcomes in paediatric populations, though caution is warranted regarding glucose homeostasis, and personalised approaches should be considered in clinical practice.

Central obesity is a major risk factor for colorectal cancer (CRC) and may better reflect obesity-related risk than body mass index (BMI). Its global burden, however, remains poorly quantified. We aimed to estimate the number and proportion of CRC cases attributable to central obesity in 2022 across global, regional, and national levels. We estimated population attributable fractions (PAFs) by combining sex-specific prevalence of central obesity from national surveys with pooled relative risks from meta-analysis. Central obesity was defined as elevated waist circumference using standardised sex- and ethnicity-specific thresholds, accounting for variation in definitions via probabilistic modelling. We addressed missing data through multiple imputation. CRC incidence estimates for 2022 were obtained from GLOBOCAN for 185 countries. Monte Carlo simulations propagated uncertainty in exposure prevalence and risk estimates. In 2022, an estimated 311 418 (95% uncertainty interval 242 603-378 880) CRC cases were attributable to central obesity, corresponding to a global PAF of 16.2% (12.6-19.7). PAFs were higher in females (18.2%, 13.0-23.3) than in males (14.5%, 9.6-19.3), though age-standardised rates (ASRs) were slightly higher in males. The highest PAF was in North America, and the highest ASRs in Australia-New Zealand and northern Europe. PAFs and ASRs declined with decreasing income levels among males but not females. Regional variation in sex differences was substantial, with higher female PAFs in parts of Africa and Asia, and smaller or reversed gaps in high-income settings. In high-income countries, the estimated 10-year CRC risk at screening age (55-69years) was 1.32% in males with central obesity versus 0.90% in those without, and 0.92% versus 0.64% in females, corresponding to one excess CRC case per 236 (180-353) men and 357 (279-502) women. Central obesity accounts for a substantial share of the global CRC burden, with large geographical variability. Applying established waist circumference thresholds in surveillance and incorporating central obesity into individual risk stratification may inform more effective CRC screening and prevention strategies.

This study aimed to investigate the association between thyroid hormone disturbances, obesity-related parameters, and the expression profiles of Y-linked spermatogenic genes (AZFa, AZFb, and AZFc) in infertile men, and to determine whether endocrine and metabolic alterations predict AZF gene dysregulation. A case-control study included 150 infertile men and 150 fertile controls. Anthropometric indices and hormonal, biochemical, and inflammatory markers were assessed. Relative expression levels of AZFa, AZFb, and AZFc genes were quantified using qRT-PCR and the 2ˆ-ΔΔCT method. Correlation analysis, LASSO regression, and ROC curve modeling were performed to identify predictors of AZF gene downregulation. Infertile men had significantly higher BMI, waist circumference, and thyroid-stimulating hormone (TSH) levels, with reduced triiodothyronine (T3) and thyroxine (T4) concentrations (p<0.001). AZFa, AZFb, and AZFc expression levels were significantly decreased and negatively correlated with TSH, BMI, and inflammatory cytokines. A combined model of TSH, BMI, and interleukin-6 demonstrated the highest diagnostic accuracy (AUC=0.88), with 86 % sensitivity and 80 % specificity. Thyroid dysfunction, obesity, and systemic inflammation synergistically downregulate AZF gene expression and impair spermatogenesis. Integrating endocrine, metabolic, inflammatory, and molecular markers may improve diagnostic precision and personalized management of male infertility.

Background: Metabolic syndrome is associated with early impairments in cellular bioenergetics that are not fully captured by conventional body composition measures. Molecular hydrogen, produced endogenously through gut microbial fermentation and measurable in breath, has been implicated in redox and mitochondrial regulation. Whether breath hydrogen relates to preservation of intracellular, metabolically active tissue in metabolic syndrome remains unclear. Objectives: To examine the association between breath hydrogen concentration and an integrated cellular bioenergetic phenotype derived from intracellular body composition indices in sedentary adults with metabolic syndrome. Methods: Twenty-eight sedentary, middle-aged adults (51.2 ± 7.9 years, 19 females) with metabolic syndrome underwent fasting breath hydrogen assessment and multifrequency bioelectrical impedance analysis. A composite cellular bioenergetic phenotype was derived using principal component analysis of body cell mass, intracellular water, total body potassium, and glycogen. Associations between breath hydrogen and the composite phenotype were evaluated using Spearman correlation with bootstrapped confidence intervals, Theil-Sen regression, and Bayesian linear regression adjusted for age, sex, and waist circumference. Sensitivity analyses included fat-free mass. Results: A single principal component explained 98.6% of the variance across intracellular variables, indicating a highly coherent cellular bioenergetic phenotype. Breath hydrogen concentration was positively associated with this phenotype (ρ = 0.43, p = 0.021; BCa 95% CI 0.07–0.70). Theil-Sen regression confirmed a robust positive association (β = 0.017 per ppm hydrogen; 95% CI 0.002–0.046). Bayesian models showed posterior distributions centered on positive effect sizes, independent of central adiposity. In contrast, the association with fat-free mass alone was borderline. Conclusions: Breath hydrogen concentration reflects an integrated intracellular bioenergetic phenotype in sedentary adults with metabolic syndrome, tracking cellular quality rather than lean mass quantity. Breath hydrogen may serve as a non-invasive biomarker of cellular bioenergetic integrity and a potential tool for phenotype-guided metabolic interventions.

Cardiovascular diseases comprise a range of conditions affecting the heart and blood vessels, with numerous underlying modifiable determinants that raise the risk of heart disease, stroke, and peripheral vascular disease. Many of these risk factors could be mitigated through community-based health improvement interventions, which include physiological assessments, health behaviour coaching, psychosocial factors, and wider determinants of health support. Despite their potential, such interventions are seldom integrated into standard secondary care provision. This feasibility study aims to assess the feasibility and acceptability of the equality health-cardiovascular disease (Equality Health-CVD) intervention, a 12-week, place-based intervention for patients with vascular disease. The study will use a single-arm 12-week pilot study based in Wales, UK. A total of 20 participants will be recruited. Quantitative data (questionnaire and physical health assessments) will be collected at week 1 (baseline) and week 12. Questionnaires will include PROMIS 10, South Wales Social Wellbeing Scale and EuroQol-5D tools. Health assessments will collect data on body mass index, waist circumference, heart rate and blood pressure. One-to-one interviews will be conducted with a sub-sample of participants (n = 10-15) and intervention deliverers (n = 2). Data on participant recruitment and retention and the fidelity of intervention implementation will also be collected. This study will provide important findings on the feasibility and acceptability of the Equality Health-CVD. Findings are critical for guiding future directions on intervention implementation and efficacy. ISRCTN11889657.

Vascular aging is a significant factor in cardiovascular and cerebrovascular diseases and serves as a predictor of all-cause mortality. Although disturbances in lipid metabolism are known risk factors, their links with standardized stages of vascular aging have not been thoroughly assessed in the Chinese population. This multicenter study analyzed the distribution of vascular aging stages in theChina Standardized Vascular Aging Management Centers (VMCs). It investigated the relationships between lipid-adiposity-related indices and the progression of vascular aging. A total of 668 participants who underwent examinations at multiple VMCs between June 2023 and February 2025 were included. Baseline data were collected from standardized questionnaires, anthropometric measurements, and laboratory tests. The participants were classified into stage 1 (normal vessels), stage 2 (vascular injury), and stage 3 (vascular aging-related diseases). Multiple linear and logistic regression models were used to assess associations between lipid-adiposity-related indices and brachial-ankle pulse wave velocity (baPWV) or vascular aging stages. Restricted cubic spline analyses were used toexamine potential nonlinear relationships. After controlling for demographic factors, lifestyle behaviors, comorbidities, and medication use, most lipid-adiposity-related indices showed significant positive associations with baPWV. The bilateral baPWV measurements exhibited high consistency. According to the multivariable models, waist circumference (WC), A Body Shape Index (ABSI), waist-to-hip ratio (WHR), waist-height ratio (WHtR), triglyceride (TG), atherogenic index of plasma (AIP), and lipid accumulation product (LAP) were significantly linked to vascular aging stages, with several anthropometric indices (WC, ABSI, WHR, WHtR) increasing progressively across stages. No notable nonlinear relationships were observed. Standardized lipid-adiposity-related indices, especially WC, ABSI, WHR, and WHtR, were independently linked to baPWV and vascular aging stages.

Background/Objectives: Metabolic syndrome (MetS) causes significant oral manifestations that negatively impact oral health-related quality of life (OHRQoL). This randomized controlled trial evaluated the effects of combined dental interventions and lifestyle guidance on OHRQoL in patients with MetS. Methods: In total, 82 participants with MetS were randomized into an intervention group (IG; n = 39), receiving dental treatment plus lifestyle guidance, or a control group (CG; n = 43), receiving lifestyle guidance only. OHRQoL was assessed using GOHAI and OHIP-14 at baseline, 1 month, and 3 months. Data were analyzed using repeated-measures ANOVA and multivariable ANCOVA, adjusting for age, sex, baseline OHRQoL, and waist circumference. Pearson correlations examined the relationship between metabolic changes (Δ) and OHRQoL. Results: At 3 months, the IG demonstrated significantly superior OHIP-14 scores (p = 0.020) and a large effect size in social disability (ηp2 = 0.148, p < 0.001) compared to the CG. Within-group analysis showed the IG achieved highly significant longitudinal improvements in pain and psychological discomfort (all p < 0.001). Subgroup analysis confirmed these gains were primarily driven by participants with missing teeth (ηp2 = 0.447, p < 0.001), whereas the periodontitis-only subgroup showed non-significant shifts. Multivariable analysis identified age and baseline scores as primary predictors. Notably, OHRQoL improvements significantly correlated with reductions in body weight (r = 0.355, p = 0.001) and waist circumference (r = 0.238, p = 0.031). Conclusions: Integrated dental and lifestyle interventions significantly improved OHRQoL in MetS patients by enhancing psychosocial well-being and social reintegration. Gains were functionally driven by systemic metabolic success. Addressing "nutritional barriers" through dental rehabilitation, while targeting weight loss goals, was essential for holistic MetS management.

Background: There are numerous concerns that women have regarding menopause. The purpose of this study was to identify any changes in hormone levels or visceral fat that laser acupuncture could alleviate in postmenopausal women. Methods: This randomized controlled trial involved 40 menopausal women aged from 50 to 65 years with visceral obesity, body mass index (BMI) &gt; 30 Kg/m2, and waist-tohip ratio (WHR) &gt; 0.8. All cases were classified into two groups: Group A was given laser acupuncture in addition to traditional lifestyle change in a low-calorie diet and aerobic exercise, and Group B received traditional treatment only. Results: Pre-intervention (weight, BMI, waist circumference, WHR, serum insulin, and satiety-hunger zone) were insignificantly different in both groups (P &gt; 0.05); in contrast to Group B, Group A experienced a substantial decrease in post-intervention (P &lt; 0.05). The satiety zone was markedly lower at post-intervention in Group A compared to Group B (P &lt; 0.05). After-intervention BMI, weight, WHR, waist circumference, and serum insulin were significantly lower than pre-intervention values in both groups (P &lt; 0.05). Conclusion: Laser acupoints were associated with an improvement in visceral fat and serum insulin levels in postmenopausal women, demonstrating reduced satiety and increased hunger.

Overweight and obesity are major health challenges in children and adolescents that have gradually increased in prevalence in recent years. This study evaluated the effects of home-based regimes of high-intensity interval training (HIIT), resistance training (RT), or combined HIIT+RT on anthropometric indices and health-related quality of life (HRQoL) in children and adolescents with overweight or obesity. A randomized, single-blinded clinical trial was conducted in Isfahan, Iran. A total of 120 patients (aged 10-18 years) with overweight or obesity participated. Eligible participants were recruited using a simple sampling method and randomly assigned to one of four groups: three intervention groups (HIIT, RT, and combined HIIT+RT) or one non-exercising control group with dietary advice. The intervention groups received 24 home-based training sessions over 2 months. Anthropometric indices and the KIDSCREEN-27 questionnaire were assessed both pre- and post-intervention. After 2 months, body weight decreased significantly in the RT group compared with baseline measurements (P=0.010). Waist circumference (WC) also decreased significantly in the RT group (P=0.001), and hip circumference (HC) decreased significantly across the three intervention groups. Adjusted analyses revealed significant reductions in body weight (P=0.028), WC (P=0.024), and HC (P=0.006) across interventions. No significant changes were observed in waist-to-hip ratio or body mass index (BMI). In addition, an analysis of covariance showed no significant differences in the mean changes in HRQoL among the three intervention and control groups pre- and post-intervention. Home-based exercise was associated with improvements in anthropometric indices other than BMI, whereas HRQoL remained unchanged in children and adolescents with overweight or obesity.

Disrupted circadian rhythms are associated with cardiometabolic disease. We examined associations between rest-activity rhythms and cardiometabolic disease by race. In cross-sectional analysis of the CARDIA (Coronary Artery Risk Development in Young Adults) sleep ancillary study (2020-2023), 861 participants wore wrist actigraphy for 7 days. Sleep Regularity Index and rest-activity rhythm measures were calculated: interdaily stability, intradaily variability, relative amplitude, and most active 10-hour and least active 5-hour period start times. Cardiometabolic disease markers included body mass index, waist circumference, blood pressure, hypertension, fasting glucose, estimated insulin resistance, and diabetes. Linear regression models with interaction terms evaluated effect modification by race. Among 354 Black and 507 White participants, the most consistent associations were between anthropometric markers and rest-activity rhythms. Except for most active 10-hour start, remaining indices and Sleep Regularity Index were associated with body mass index with β coefficients ranging from -1.74 to 0.86, consistent with our hypothesis that weaker rest-activity rhythms relate to larger body mass index. There was some effect modification by race (P<0.01), with relative amplitude showing stronger associations with body mass index in White (β=-2.63 [95% CI, -3.34 to -1.93]) versus Black (β=-1.24 [95% CI, -1.97 to -0.50]) participants. Patterns, including effect modification for relative amplitude, were similar for waist circumference. Disrupted circadian indices were associated with glycemic markers, with findings generally consistent by race. Associations between rest-activity rhythms and blood pressure were less consistent overall and by race. Less robust rest-activity rhythms and irregular sleep were associated with less favorable anthropometric and glycemic markers but weakly associated with blood pressure, with few racial differences.

Physical activity plays a crucial role in preventing and managing obesity and its related comorbidities, with minimal side effects. Similarly, consuming a balanced diet is essential for maintaining good health and adequate nutrition. However, most adults fail to meet population-based dietary and physical activity guidelines. In this pilot cluster-randomized controlled trial, we aimed to evaluate the effectiveness of a video-based physical activity and dietary intervention among adults aged 30-59 years in Phnom Penh, Cambodia. A total of 63 adults participated in the 12-week program, with 31 assigned to the intervention group and 32 to the control group. The intervention group received a video-based program delivered via Telegram and YouTube, complemented by a 2-hour in-person session focusing on technical orientation and safety training. Standard care was provided to both the intervention and control groups and consisted of a single 60-minute in-person lifestyle education session and a printed booklet commonly used in Cambodian health center settings. The intervention group demonstrated greater improvements in physical activity adherence, healthy eating adherence, exercise self-efficacy, healthy eating self-efficacy, systolic blood pressure, body weight, body mass index, waist circumference, fasting blood glucose, and high-density lipoprotein cholesterol levels compared with the control group (p < 0.05). Given its high accessibility and ease of implementation, video-based content appears to be an effective approach and policy for improving health behaviours, even in resource-limited settings. These findings support the use of video and digital platforms as potential strategies and evidence-based policy for preventing and managing non-communicable diseases in low-resource settings.

Examine associations between sleep patterns (duration, timing, and regularity) and weight status and explore moderating effects of parenting/family functioning among children with mild sleep-disordered breathing (SDB) from the Pediatric Adenotonsillectomy Trial for Snoring. Two age groups (3-5 and 6-12-year-olds) were examined separately with waist circumference (WCz) and body mass index (BMIz) z-scores as the primary and secondary endpoints, respectively. Participants were 207 younger and 252 older children in a socio-demographically diverse sample. In adjusted models with older children, shorter sleep was associated with higher WCz, controlling for weekend mid-sleep timing (coefficient estimate beta = - 0.137, p = 0.027) with a similar finding for BMIz (beta = - 0.144, p = 0.041); later timing was related to higher WCz, controlling for sleep duration (beta = 0.122, p = 0.032). Shorter sleep duration was associated with higher WCz among the older children with greater parental distress (interaction p = 0.005), parent-child dysfunctional interactions (interaction p = 0.020), and less authoritative parenting (interaction p = 0.023) compared to those with more optimal parent-child relationships. There were no statistically significant associations or interactions among younger children. In school-aged children, shorter sleep duration and later midpoint, but not social jet lag, tended to be associated with weight status. When mutually adjusting for duration and midpoint, a stronger statistically significant association was observed. Children subject to less optimal parenting practices were at the greatest risk of shorter sleep. Accounting for sleep timing and parenting factors that might further increase children's biological propensity for obesity is recommended in future studies in this area. Initial evidence suggests that shorter sleep duration and sleep-disordered breathing (SDB) increase the risk of becoming overweight in later childhood. This study examined relationships of additional sleep patterns-timing and regularity-and possible moderating effects of parenting/family factors using a well-characterized cohort of children with mild SDB from the Pediatric Adenotonsillectomy Trial for Snoring. This study demonstrates that both shorter sleep duration and later timing relate to higher waist circumference and body mass index z-scores among school-aged children. Parenting factors (i.e., stress, parent-child dysfunctional relationships, and less use of an authoritative parenting style) may moderate sleep pattern-weight status relationships and therefore identify children most vulnerable to obesity because of insufficient sleep.

Studies frequently view Black populations as homogenous, disregarding important diversity within this population. Furthermore, nativity can be key to distinguishing health risks among this population. Yet few researchers have examined these distinctions using body roundness index (BRI), a measure of central adiposity. We assessed the relationship between nativity and BRI among non-Hispanic Black people in the United States (US) using cross-sectional data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). BRI was calculated using height, weight, and waist circumference. Nativity was categorized as US-born and foreign-born. Multilinear regression analysis was used to evaluate the relationship between BRI and nativity, controlling for demographic characteristics and Healthy Eating Index scores. The average age and BRI score of participants were 44.74 ± 0.46 and 5.36 ± 0.04, respectively. Among eligible participants (3341), 9.6% were foreign-born (n = 322). In multivariate regression models adjusting for covariates, men had significantly lower BRI scores than women (4.67 ± 0.04 versus 5.96 ± 0.05; β = -1.25; t61 = 24.60; P < 0.0001), and BRI increased with age (β = 0.02; t61 = 9.17; P < 0.0001). US-born Black people had significantly higher BRI scores compared to their foreign-born counterparts (5.40 ± 0.04 versus 5.00 ± 0.09; β = -0.36; t61 = -3.99; P = 0.0002). Results suggest that nativity is associated with central adiposity, with potential implications for cardiometabolic disease risk.

The revised Lancet Commission framework prioritizes excess adiposity over body mass index (BMI) alone for diagnosing obesity, emphasizing population-specific body fat assessments. However, body fat percentage (BFP) thresholds reflecting adiposity-defined obesity remain limited, particularly by sex and age in Asian populations. This study aims to compare BMI- and adiposity-defined obesity classifications and derive sex- and age-specific BFP thresholds in Korean adults. Data from 18 254 adults who underwent routine health examinations were analysed, with BFP assessed using multifrequency bioelectrical impedance analysis. Adiposity-defined obesity was classified per Lancet Commission criteria using waist circumference, waist-to-height ratio and BMI. BFP thresholds were derived from logistic regression as the values at which the predicted probability of metabolic syndrome matched its observed prevalence among individuals with adiposity-defined obesity. Confidence intervals (CIs) were estimated using bias-corrected and accelerated bootstrap. Adiposity-defined obesity was more prevalent than BMI-defined obesity, with discordance increasing with age, particularly among women. Overall, 6.6% were classified as obese solely by adiposity-based criteria, rising to 11.1% in men and 15.8% in women aged ≥ 65 years. Overall BFP thresholds were 27.8% (95% CI, 27.4%-28.2%) for men and 39.5% (38.9%-40.2%) for women, with minimal age variation in men but reaching 41.0% (38.8%-43.9%) among women aged ≥ 65 years. Adiposity-defined obesity identifies phenotypes missed by BMI, particularly in older adults. BFP thresholds derived from adiposity-defined obesity vary substantially by sex and age. These findings support adiposity-centred diagnostic approaches and provide sex- and age-specific BFP thresholds for Korean adults.

Enhancing Prediabetes and Diabetes Detection Through a Machine Learning-Enabled Self-Assessment Approach.

Understanding the association between movement behaviors and psychosocial well-being at a young age seems essential for effective interventions and moving friendly environments, particularly in the context of childhood obesity. to examine the association between adherence to movement behavior guidelines and psychosocial well-being, and whether obesity indices moderate this association. The IDEFICS/IFamily cohort followed European children aged 2-16 years over 6 years, including 7359 repeated observations across three waves. Longitudinal associations between adherence to movement behavior recommendations and psychological well-being were assessed using generalized linear models. Obesity indicators, z-score body mass index (z-BMI) and z-score waist circumference (z-BMI) were used to test their moderating role. Lower adherence to movement behaviors was negatively associated with psychosocial well-being (β = -0.39, 95%CI: -0.77, 0.00), with stronger effects in males (β = -0.70, 95%CI: -1.20, -0.20). Moreover, effects were larger in participants with overweight/obesity (β = -1.29, 95%CI: -2.21, -0.37). Obesity indices moderated the association between movement behaviors and psychosocial well-being (β = -0.40, 95%CI: -0.80, -0.06 for z-BMI; β = -0.36, 95%CI: -0.82, -0.03 for z-WC). Adherence to movement behavior guidelines was associated with psychosocial well-being, especially in males and individuals with overweight or obesity. These findings highlight the potential relevance of movement behavior patterns for psychosocial well-being and obesity prevention, while acknowledging the observational nature of the data.

Background/Objectives: Obesity is a chronic, relapsing disease in which lifestyle modification represents the cornerstone of treatment. Among dietary strategies, ketogenic diets can induce rapid weight loss, whereas the Mediterranean diet is associated with established cardiometabolic benefits but typically produces slower weight reduction. Very-low-calorie ketogenic diets (VLCKDs) are effective for weight loss but are often limited by cost, reliance on meal replacements, and reduced long-term feasibility. This study aimed to evaluate whether a whole-food Mediterranean ketogenic diet with moderate caloric restriction (MedKD) could represent a feasible and effective alternative to VLCKD for weight loss and metabolic improvement in adults with obesity. Methods: This 3-month prospective, real-world study compared VLCKD and MedKD in adults with obesity attending a clinical nutrition program. The primary outcome was percentage weight loss. Secondary outcomes included changes in waist circumference, waist-to-height ratio, insulin resistance (HOMA-IR), lipid profile, kidney function, and treatment tolerability. Clinical and biochemical parameters were assessed at baseline and after the intervention. Group differences and time-by-group interactions were analyzed to evaluate changes over the study period. Results: Sixty-two participants were enrolled, and 55 completed the study (27 VLCKD, 28 MedKD). Baseline characteristics were generally comparable, although the MedKD group had a higher prevalence of diabetes and higher baseline insulin resistance and triglyceride levels. Both dietary interventions resulted in substantial and comparable weight loss (approximately 15% of initial body weight), accompanied by significant reductions in waist circumference and waist-to-height ratio. Insulin resistance improved in both groups, with a greater reduction in HOMA-IR observed in the MedKD group (time × group p = 0.031). Serum creatinine decreased in the VLCKD group and slightly increased in the MedKD group (p = 0.025). Changes in lipid profile were not significantly different between groups. No severe adverse events were reported. Conclusions: A whole-food Mediterranean ketogenic diet with moderate caloric restriction achieved weight loss and metabolic improvements comparable to those observed with VLCKD over three months. These findings suggest that MedKD may represent a feasible alternative to formula-based ketogenic programs, supporting more flexible and personalized dietary strategies in the clinical management of obesity.