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As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine the relationship between abdominal hernia and obesity. Although obesity is frequently cited as a risk factor for abdominal hernia, few studies have confirmed this association (Menzo et al. Surg Obes Relat Dis 14:1221-1232. 10.1016/j.soard.2018.07.005, 2018). METHODS: A cross-sectional study of primary care ambulatory patients aged older than 16 years treated at UCLA Health from 01/01/2018 to 06/06/2023. Abdominal hernia was identified by clinic encounter ICD-10 codes (K40-K46). RESULTS: There were 41,703 hernias identified among 1,362,440 patients (306.1 per10,000) with a mean age of 62.5 ± 16.1 years, and 57.6% were men. Nearly half (44.7%) of all abdominal hernias were diaphragmatic. There was an approximately equal distribution of the ventral (28.7%) and inguinal (24.3%) hernia. Each hernia type had a different relationship with obesity: The odds of having a ventral hernia increased with BMI in both sexes: BMI 25-29.9 kg/m2 odds ratio (OR) = 1.65, (CI 1.56-1.74); BMI 30-39.9 kg/m2 OR = 2.42 (CI 2.29-2.56), BMI 40-49.9 kg/m2 OR = 2.28 (CI 2.05-2.54) and BMI >  = 50 kg/m2 OR = 2.54 (CI 2.03-3.17) all relative to normal BMI. In contrast, the odds of having an inguinal hernia decreased with obesity relative to normal weight [obesity (BMI 30-39.9 kg/m2): OR = 0.60 (CI 0.56-0.65)], morbid obesity (BMI 40-49.9 kg/m2): OR = 0.29 (CI 0.23-0.37). The OR for diaphragmatic hernia peaks with obesity in women and overweight status in men but was found to decrease with morbid obesity [OR = 1.18 (CI 1.07-1.30)]. There was no significant difference between men and women in the prevalence of femoral hernia (men: 0.7/per10,000, women: 0.9/per10,000, p = 0.19). CONCLUSIONS: The relationship between hernia and obesity is complex with some hernias decreasing in prevalence as obesity increases. Further research is needed to better understand this paradoxical relationship.

INTRODUCTION: Cardiometabolic diseases are associated with greater COVID-19 severity; however, the influences of cardiometabolic health on SARS-CoV-2 infections after vaccination remain unclear. Our objective was to investigate the associations between temporal blood pressure and total cholesterol patterns and incident SARS-CoV-2 infections among those with serologic evidence of vaccination. METHODS: In this prospective cohort of blood donors, blood samples were collected in 2020-2021 and assayed for binding antibodies of SARS-CoV-2 nucleocapsid protein antibody seropositivity. We categorized participants into intraindividual pattern subgroups of blood pressure and total cholesterol (persistently, intermittently, or not elevated [systolic blood pressure 0.05). CONCLUSIONS: Our findings underscore that the benefits of cardiometabolic health, particularly blood pressure, include a lower risk of SARS-CoV-2 infection after vaccination.

Food is fundamental to survival, and our brains are highly attuned to rapidly process food stimuli. Neural signals show that foods can be discriminated as edible or inedible as early as 85 ms after stimulus onset, 1 distinguished as processed or unprocessed beginning at 130 ms, 2 and as high or low density from 165 ms. 3 Recent evidence revealed specialized processing of food stimuli in the ventral visual pathway, 4,5,6 an area that underlies perception of faces and other important objects. For many visual objects, perception can be biased toward recent perceptual history (known as serial dependence 7,8). We examined serial dependence for food in two large samples (n > 300) who rated sequences of food images for either "appeal" or "calories." Ratings for calories were highly correlated between participants and were similar for males and females. Appeal ratings varied considerably between participants, consistent with the idiosyncratic nature of food preferences, and tended to be higher for males than females. High-calorie ratings were associated with high appeal, especially in males. Importantly, response biases showed clear positive serial dependences: higher stimulus values in the previous trials led to positive biases, and vice versa. The effects were similar for males and females and for calories and appeal ratings and were remarkably consistent across participants. These findings square with recently found food selectively in the visual temporal cortex, reveal a new mechanism influencing food decision-making, and suggest a new sensory-level component that could complement cognitive strategies in diet intervention. • Ratings of food images for calories or appeal are not serially independent • Both rating types show an "attraction" bias toward the previously seen food • For appeal ratings, the bias declined with hunger and age and increased with BMI • This perceptual bias in food appraisal could augment existing clinical interventions Alais et al. show that ratings of food images for appeal or calories are biased toward foods previously seen, with current ratings being higher after a highly rated food (and vice versa). Many visual stimuli show this bias, thought to arise at sensory levels. This bias could be used to nudge sensory food responses higher or lower to moderate food behaviors. [ABSTRACT FROM AUTHOR]

Background: Currently, it remains unknown whether there is an association between body mass index (BMI) and complications during screening colonoscopy; hence, it remains unclear whether BMI should be considered a risk factor in pre-procedural assessments. The aim of this study was to compare mortality and unplanned hospitalization rates before and after colonoscopy stratified by patients' BMI. Material and methods: This was a retrospective cohort study of individuals who underwent screening colonoscopy as part of the Polish Colonoscopy Screening Program (PCSP). The included individuals were followed up for mortality and hospitalization episodes from 42 days prior to colonoscopy to 30 days after the procedure. Rates for the endpoints were calculated, compared, and adjusted for available data. Weighted averages of stratum-specific rates were calculated. Additional subanalyses were performed for sex and procedure type (screening colonoscopy without biopsy, colonoscopy with biopsy, or colonoscopy with polypectomy). Results: A total of 55390 individuals who underwent colonoscopy between years 2012–2015 were included. Obese individuals had significantly more hospitalizations than non-obese patients (1.94% versus 0%, p =.038). Analysis of adjusted hospitalization rates stratified by sex revealed that obese males had significantly higher related hospitalizations' rates before or after and after colonoscopy. Unadjusted and adjusted mortality rates after screening colonoscopy did not reveal significant differences between BMI categories. Conclusions: Overweight and obesity are not clinically relevant risk factors for mortality and hospitalization six weeks before or 30 days after screening colonoscopy. Obese males may be more likely to require hospital care after colonoscopy. [ABSTRACT FROM AUTHOR]

• Observational cohort study including 5115 participants over 30 years. • Current cannabis was associated with lower BMI, probably due to residual confounding. • Cannabis cessation or cumulative cannabis exposure were not associated with BMI. With increasing use of cannabis, we need to know if cannabis use and Body Mass Index (BMI) are associated. The Coronary Artery Risk Development in Young Adults Study followed Black and White adults over 30 years with assessments every 2 to 5 years in four centers in the USA. We assessed self-reported current and computed cumulative cannabis exposure at every visit, and studied associations with BMI, adjusted for relevant covariables in mixed longitudinal models. We also applied marginal structural models (MSM) accounting for the probability of having stopped cannabis over the last 5 years. At the Year 30 visit, 1,912 (58 %) identified as women and 1,600 (48 %) as Black, mean age was 56 (SD 2) years. While 2,849 (85 %) had ever used cannabis, 479 (14 %) currently used cannabis. Overall, participants contributed to 35,882 individual visits over 30 years. In multivariable adjusted models, mean BMI was significantly lower in daily cannabis users (26.6 kg/m2, 95 %CI 26.3 to 27.0) than in participants without current use (27.7 kg/m2, 95 %CI 27.5 to 27.9, p < 0.001). Cumulative cannabis use was not associated with BMI. The MSM showed no change in BMI when stopping cannabis use over a 5-year period (β=0.2 kg/m2 total, 95 %CI -0.2 to 0.6). Current cannabis use was associated with lower BMI, but cumulative cannabis use and cessation were not. This suggests that recreational cannabis use may not lead to clinically relevant changes in BMI and that the association between current cannabis use and lower BMI is likely due to residual confounding. [ABSTRACT FROM AUTHOR]

Purpose: Cancer represents the leading cause of mortality in high-income countries. In the last years, the rate of emergency department (ED) visits by cancer patients has increased 5.5-fold. These ED visits impose a significant economic burden and may indicate the progression of the oncologic disease. The goal of this retrospective study was to identify patient-derived risk factors, especially focusing on serum albumin and body mass index (BMI) for 90-day mortality following unplanned ED visits by cancer patients. Methods: A retrospective chart review of all patients with an ICD-10 diagnosis for cancer undergoing palliative treatment presenting at the ED between 2016 and 2018 at the General Hospital of Vienna was performed. Laboratory values, emergency severity index (ESI), and BMI were collected at the ED presentation. 90-day mortality (90MM) was calculated from the ED presentation. Results: A total of 448 cancer patients were included. Lung cancer (19.2%) and pancreaticobiliary cancer (15.6%) were the most frequent diagnoses. The main reasons for ED visits were pain (20.5%) and fever (17.4%). Sixty-nine percent of patients had to be admitted and 17.5% of patients died during hospitalization. 90MM was highest for patients with low albumin (< 35 g/L vs. > 35 g/L: 60.4% vs. 31.4%; p <.0001). When incorporating albumin levels and BMI, patients with both values below the cutoff had the highest risk for death (HR 4.01, 95% CI 2.30–7.02). Conclusion: Cancer patients face a high risk for hospitalization when presenting at the ED. The 90MM rate is highest in patients with low BMI and albumin levels. This highlights an especially vulnerable cohort of cancer patients for whom supportive care and palliative care have to be optimized. [ABSTRACT FROM AUTHOR]

An area of rehabilitation research in burns is the impact of co-morbidities on disease trajectory. Obesity is a comorbidity of increasing public health concern, but its role remains controversial regarding burn injury and physical recovery. Our aim was to evaluate the association between body mass index (BMI) categories as a measure of obesity at discharge and self-reported physical function (PF) during recovery of adult burn survivors. This is a retrospective study on data collected by four major US burn centers, which contribute to the Burn Model System National Database. The data included BMI obtained at hospital discharge and self-reported PF-mobility, using the PROMIS measures assessed at 6, 12, and 24 months after burn. Subjects were classified into weight status categories based on BMI: underweight (BMI <18.5), normal weight (18.5 ≤ BMI <25), overweight (25 ≤ BMI <30), obesity class 1 (30 ≤ BMI <35), obesity class 2 (35 ≤ BMI <40), and obesity class 3 (BMI ≥40). Mixed-effects linear regression models were used to assess the association between BMI categories and PF scores over time, adjusted for patient and injury characteristics. A total of 496 adult burn patients aged 47 ± 16 years were included, with mean total body surface area (TBSA) burned of 18 ± 19 % and mean BMI at discharge of 28 ± 7 kg/m2. PROMIS PF scores significantly improved over time in the recovery phase after burn (time effect, p < 0.001). Compared to overweight burn patients, normal-underweights exhibited lower PF score by an average of 4.06 units (p = 0.001) but scores increased linearly by an estimated 0.17 units per month (p = 0.01) over the 24 months after discharge. Similarly, compared to overweight burn patients, class 1 obese reported lower PF score by a mean 2.67 units (p = 0.07) but PF increased linearly by 0.15 units per month (p = 0.07) over the 24 months after discharge. These findings were independent of the effects of age at discharge, sex, TBSA burned, and hand and leg burn. Being overweight was associated with improved and faster recovery of PF scores compared to normal, underweight, and obese burn patients during long-term recovery. Hence, our data suggests that long-term recovery and restoration of PF in adult burn survivors is not compromised by a small excess in body weight. • The association between body mass index and self-perceived physical recovery in adult burn patients remains underresearched. • Body mass index has a significant effect on physical function scores after burns. • Being overweight is associated with faster recovery of physical function in long-term recovery after burns. [ABSTRACT FROM AUTHOR]

Purpose: To investigate sleep duration and sleep loss during antenatal period and assess associative factors, including maternal characteristic and mood symptoms. Methods: A cohort of 3038 women was enrolled. Self-reported sleep duration and sleep loss, the latter being calculated from preferred sleep need and actual sleep duration, were measured in early, mid- and late pregnancy, and at delivery. The associations with age, BMI, parity, education, smoking, napping, and depressive and anxiety symptoms were evaluated. Results: Sleep duration was longest in early pregnancy and shortest at delivery (7.93 h–7.76 h, p < 0.001). The proportion of short sleepers (< 6 h) increased from 1.4% to 5.9% throughout the studied period (p < 0.001). Mean sleep loss remained stable in early- and mid-pregnancy, lowering in late pregnancy (p < 0.001) and increasing again until delivery (p = 0.003). The number of women with notable sleep loss (> 2 h) was similar during the first three measurement points (9.4%, 8.9% and 9.5%), but increased until delivery (14.1%, p < 0.001). Older, multiparous, and more-depressive women slept less (p < 0.001, p < 0.001, p = 0.017). Women with higher BMI were more likely to sleep < 6 h in late pregnancy (p = 0.012). Multiparous, more-depressive, and higher-BMI women reported more sleep loss (p < 0.001, p < 0.001, p = 0.049). Conclusion: We confirmed earlier reported decrease in sleep duration at the end of pregnancy. As a novel finding, we showed a notable increase in sleep loss during the last month of pregnancy. Various factors were associated with both short sleep and sleep loss, especially multiparity, napping and depressive symptoms. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the effect of baseline body mass index (BMI) and glycated hemoglobin (HbA1c) on the effectiveness and safety of initiating iGlarLixi (insulin glargine 100 U/ml and lixisenatide) in people with type 2 diabetes (T2D) in routine clinical practice. Methods: We pooled patient-level data from 1406 people with inadequately controlled T2D, initiating a 24-week iGlarLixi treatment. Analysis sets were based on baseline BMI and HbA1c. In the BMI set, 894 (64%) people had a BMI ≥ 30 kg/m2 and 510 (36%) a BMI < 30 kg/m2; in the HbA1c set, 615 (44%) people had an HbA1c >9%, 491 (35%) between 8 and 9%, and 298 (21%) < 8%. Results: After initiating iGlarLixi, HbA1c decreased in all participants, with the greatest least-squares mean reduction at 2.15% from baseline to week 24 in those with baseline HbA1c > 9% (using a mixed model for repeated measures). Overall, mean ± standard deviation body weight decreased by 1.9 ± 4.8 kg, with the most prominent loss of 2.6 ± 4.9 kg recorded in people presenting with obesity. Reported hypoglycemia rates were low across all groups. Conclusions: Initiation of iGlarLixi in people with uncontrolled T2D is effective and safe in clinical practice, across different baseline HbA1c and BMI categories. [ABSTRACT FROM AUTHOR]

Summary: Obesity represents a major public health emergency worldwide, and its etiology is shaped by a complex interplay of environmental and genetic factors. Over the last decade, polygenic risk scores (PRS) have emerged as a promising tool to quantify an individual's genetic risk of obesity. The field of PRS in obesity genetics is rapidly evolving, shedding new lights on obesity mechanisms and holding promise for contributing to personalized prevention and treatment. Challenges persist in terms of its clinical integration, including the need for further validation in large‐scale prospective cohorts, ethical considerations, and implications for health disparities. In this review, we provide a comprehensive overview of PRS for studying the genetics of obesity, spanning from methodological nuances to clinical applications and challenges. We summarize the latest developments in the generation and refinement of PRS for obesity, including advances in methodologies for aggregating genome‐wide association study data and improving PRS predictive accuracy, and discuss limitations that need to be overcome to fully realize its potential benefits of PRS in both medicine and public health. [ABSTRACT FROM AUTHOR]

Summary: Childhood obesity represents a significant public health concern, imposing a substantial burden on the healthcare system. Furthermore, weight‐loss programs often exhibit reduced effectiveness in adults who have a history of childhood obesity. Therefore, early intervention against childhood obesity is imperative. Presently, the primary method for diagnosing childhood obesity relies on body mass index (BMI), yet this approach has inherent limitations. Leptin, a satiety hormone produced by adipocytes, holds promise as a superior tool for predicting both childhood and subsequent adulthood obesity. In this review, we elucidate the tools employed for assessing obesity in children, delve into the biological functions of leptin, and examine the factors governing its expression. Additionally, we discuss maternal and infantile leptin levels as predictors of childhood obesity. By exploring the relationship between leptin levels and weight loss, we present leptin as a potential indicator of the effectiveness of obesity interventions. [ABSTRACT FROM AUTHOR]

Background: Oral isotretinoin causes changes in serum lipid values. These changes are not seen in every patient, regardless of dose. It is unclear what causes these changes and how often serum lipid values should be followed up. Aims: We aimed to evaluate the relationship between the change in serum lipid values and personal and familial risk factors. Methods: Serum lipid values at baseline (0th), 1st, 3rd, and 6th months of isotretinoin treatment of acne patients aged 16 years and over using oral isotretinoin at a dose of 0.5-1 mg/kg/day between January 2017 and December 2019 were recorded retrospectively. The relationship between personal and familial risk factors and changes in serum lipid values were evaluated statistically. Results: In pairwise comparison, a significant difference was detected between the 0th and 1st month, 0th and 3rd month, 0th and 6th month, and 1st and 6th month in the average serum lipid (Low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), total cholesterol, triglyceride) levels. However, no significant difference was detected between 3rd and 6th month. The change in LDL levels between the 0th and the 3rd month was significantly higher in those with a family history of atherosclerosis than those without a family history of atherosclerosis (p = 0.034). The change in VLDL levels between the 0th and 6th month was significantly higher in those with a family history of atherosclerosis than those without a family history of atherosclerosis (p = 0.022). It was observed that the changes in total cholesterol and VLDL levels between the 0th and 3rd month increased as body mass index (BMI) increased (p = 0.03, p = 0.014, respectively). Similarly, the changes in triglyceride and VLDL levels between 0th and 6th month and between 1st and 6th month increased by an increase in BMI (respectively; p = 0.006, p = 0.019; p = 0.016, p = 0.022). The increase in the levels of VLDL between the 1st and the 6th month was found to be significantly higher in smokers than in non-smokers (p = 0,032). Conclusion: We recommend evaluation of serum lipids values in the 0th, 1st, and 3rd month in all acne patients using oral isotretinoin and that these values have to be checked monthly in the following months for smokers, those with a history of atherosclerosis, and those with a BMI above normal. [ABSTRACT FROM AUTHOR]

Context Obesity is a risk factor for coronavirus disease 2019 (COVID-19)-related outcomes; however, the mechanism remains unclear. Objective The objective of this analysis was to determine whether inflammation mediates the association between obesity and COVID-19 outcomes. Methods The International Study of Inflammation in COVID-19 (ISIC): A Prospective Multi-Center Observational Study Examining the Role of Biomarkers of Inflammation in Predicting Covid-19 Related Outcomes in Hospitalized Patients, was conducted at 10 hospitals in the United States and Europe. Participants were adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022. Inflammatory biomarkers, including soluble urokinase plasminogen activator receptor (suPAR), were measured at admission. Associations were examined between body mass index (BMI, kg/m2) and a composite of death, need for mechanical ventilation, and renal replacement therapy, stratified by pre- and post-Omicron variants. The contribution of inflammation to the relationship between obesity and outcomes was assessed. Results Among 4644 participants (mean age 59.3, 45.6% male, 21.8% BMI ≥ 35), those with BMI > 40 (n = 485) had 55% higher odds of the composite outcome (95% CI, 1.21-1.98) compared with nonobese individuals (BMI < 30, n = 2358) in multivariable analysis. In multiple mediation analysis, only suPAR remained a significant mediator between BMI and composite outcome. Associations were amplified for participants younger than 65 years and with pre-Omicron variants. Conclusion Obesity is associated with worse outcomes in COVID-19, notably in younger participants and in the pre-Omicron era. Inflammation, as measured by suPAR, is a significant mediator of the association between obesity and COVID-19 outcomes. [ABSTRACT FROM AUTHOR]

Objective: Obesity is a complex chronic metabolic disease characterized by excessive body fat accumulation, resulting from an imbalance between energy intake and energy expenditure. The aim of this study was to determine the effectiveness of acceptance and commitment group therapy on cognitive fusion, mindfulness, and body mass index in individuals with obesity. Methods and Materials: This quasi-experimental research was conducted using a pre-test and post-test design with a control group. The statistical population included all women who visited a beauty clinic in West Tehran during the first six months of 2020. Sampling was done through convenience sampling. Out of the women who visited the beauty clinic, 40 were selected. The Cognitive Fusion Questionnaire by Gillanders et al. and the Five Facet Mindfulness Questionnaire were administered to the participants. The subjects were then randomly assigned to an experimental group and a control group. The experimental group received 12 sessions of 120-minute acceptance and commitment therapy. Post-tests were administered to both the experimental and control groups after the intervention. Findings: The results indicated that acceptance and commitment therapy was effective in reducing cognitive fusion and increasing mindfulness in individuals with obesity (P < 0.05). Conclusion: Given the confirmed effectiveness of acceptance and commitment therapy in treating obesity, it is recommended that therapists consider this therapy to improve cognitive fusion and mindfulness in overweight individuals. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Depression and obesity are two diseases that have a profound impact on global health. The relationship between obesity and depression is strongly comorbid, tending to exacerbate metabolic and depressive symptoms. Research also shows that there are complex interactions between obesity, depression symptoms, and food addiction (FA). The aim of the study was to investigate the relationship between body mass index (BMI), self‐rated depression, and FA. The study sample consisted of 735 subjects (90.2% female, MBMI = 27.58 kg/m2, standard deviation (SD)BMI = 6.58 kg/m2) aged 18–70 years (M = 39.01, SD = 14.07). The prevalence of FA symptoms was measured using the Yale Food Addiction Scale 2.0 and self‐rated depression was assessed using the Zung Self‐Rating Depression Scale. The prevalence of FA in the group was 41% and self‐rated depression was present in 34.1% of the participants. It was found that the higher the BMI of the subjects, the higher the severity of FA, but the BMI was not significantly correlated with the severity of depression. In addition, the greater the severity of self‐rated depression, the greater the severity of FA. This correlation was stronger for men than for women in the 18–30 and 31–45 age groups. The severity of self‐rated depression and FA was significantly higher in people with an eating disorders. This study adds to the growing body of evidence suggesting that the presence and severity of FA are associated with the severity of self‐rated depression, particularly in younger adults. In addition, people with a high BMI, indicating obesity, are more likely to have FA, especially severe FA. [ABSTRACT FROM AUTHOR]

Summary We aimed to examine the effects of isocaloric fructose restriction on adipose tissue distribution and serum adipokines. Individuals with BMI >28 kg/m2 (n = 44) followed a 6‐week fructose‐restricted diet and were randomly allocated to (double‐blind) oral supplementation with fructose (control) or glucose (intervention) powder three times daily. Visceral (VAT) and subcutaneous (SAT) adipose tissue was quantified with MRI. Serum interleukin 6 and 8, tumour necrosis factor alpha and adiponectin levels were measured with sandwich immunoassay. BMI decreased in both groups, but the change did not differ between groups (−0.1 kg/m2, 95%CI: −0.3; 0.5). SAT decreased statistically significantly in the control group (−23.2 cm3, 95%CI: −49.4; −4.1), but not in the intervention group. The change in SAT did not differ between groups (29.6 cm3, 95%CI: −1.2; 61.8). No significant differences in VAT were observed within or between study arms. The VAT/SAT ratio decreased statistically significantly in the intervention group (−0.02, 95%CI: −0.04; −0.003) and the change was significantly different between groups (−0.03, 95%CI: −0.54; −0.003). Serum adipokine levels were not affected by the intervention. This study shows that a fructose‐restricted diet resulted in a favourable change in adipose tissue distribution, but did not affect serum adipokines. Further studies are warranted to clarify the underlying mechanisms how fructose affects adipose tissue distribution. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is a global health issue that significantly increases morbidity and mortality when the Body Mass Index (BMI) reaches values ≥ 50. While metabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity, it carries risks. Robotic surgery is promising but not extensively studied in Mexico, which presents an opportunity for research at a National Hospital with an academic program. Methods: This retrospective study reviewed 44 patients who underwent robotic MBS using the da Vinci surgical system from January 2018 to August 2023 at Centro Médico Nacional 20 de Noviembre, ISSSTE. Data collected included surgery type, duration, complications, and weight loss metrics over 54 months post-operatively. Results: The study involved 44 patients with severe obesity including BMI ≥ 50–59.9 kg/m2 for group 1 and BMI ≥ 60 kg/m2 for group 2. The average initial BMI was 54.7 kg/m2 for group 1 and 68 kg/m2 for group 2. The average operative times for group 1 were 10.09 min for docking, 86.23 min for robotic console time, and 95.73 min for total intraoperative time. Group 2 had average times of 9.80 min for docking, 82.4 min for robotic console time, and 92.2 min for total intraoperative time. Follow-up showed significant weight loss initially, with weight recurrence after 24 months due to different factors. No serious complications or mortality were observed. Conclusion: Robotic MBS at a national academic medical center in Mexico shows promising outcomes for patients with BMI ≥ 50–59.9 and BMI ≥ 60, with significant weight and BMI improvements at 54 month follow-up. Further studies with larger cohorts and longer follow-up are needed to strengthen these findings. [ABSTRACT FROM AUTHOR]

Objective: Exploring changing trends in the burden caused by overweight and obesity among children and adolescents from 1990 to 2019 at the global, regional, and national levels, based on data from the Global Burden of Disease study (GBD) 2019. Methods: The annual number and rate of deaths and disability-adjusted life years (DALYs) associated with a high BMI among children and adolescents at global, regional, and national levels by age groups, sexes, and the sociodemographic index from 1990 to 2019 were collected from the GBD study 2019. Change percentage for number, and the estimated annual percentage changes (EAPCs) for rate were calculated to determine the temporal trends. Results: From 1990 to 2019, global high BMI-related deaths decreased by 34% but DALYs increased by 48%. Death rates in females were higher than in males, although both showed decreasing trends. For the rate of DALYs, both sexes showed increasing trends, but since 1999, the rate in males has surpassed that in females. A high BMI had the greatest impact on children under 5 years of age, and the burden in other age groups continued to increase. Regionally, High-income Asia Pacific experienced the fastest decrease in death rate (EAPC=-9.57), and East Asia saw the fastest increase in the DALYs rate (EAPC= 3.47). Globally, as age increases, the proportion of disease burden attributed to a high BMI in females generally increases. Conclusions: Our findings emphasize the urgent need to improve efforts to prevent children and adolescents becoming overweight and obese. [ABSTRACT FROM AUTHOR]

Background: Obesity has a significant impact on healthcare resources with limited accessible support available through the NHS. This service evaluation determines 24-month efficacy of referral to an open-group behavioral program by BMI category and socioeconomic status. Methods: This retrospective, longitudinal study examined weight outcomes of adults living in England referred by healthcare professionals to Slimming World during 2016 who recorded at least 1 weight change. Primary outcome was % weight change at 3, 6, 12, and 24 months. Socioeconomic status was measured using the Index of Multiple Deprivation (IMD). Data from a post-referral questionnaire investigated self-reported changes in dietary and activity behaviors. Results: Twenty-seven thousand five hundred sixty (15.6% male) records were analyzed. Mean (SD) age and BMI on joining were 48.6 (14.80) years and 37.1 (6.31) kg/m2; 91.7% had a BMI > 30 kg/m2. Mean (SD) % weight change was −5.6 (3.79), −7.1 (5.71), −7.5 (6.88), and −7.3 (6.88) at 3, 6, 12, and 24-months, respectively. At 24- months, differences in weight loss between BMI category were significant, ranging from 0.29% (35-<40 vs 40+) to 1.33% (25-<30 vs 40+). For IMD quintile only comparisons against Q1 and Q2 were significant, ranging between 0.36% (Q2 vs Q3) to 0.94% (Q1 vs Q5). Five thousand eight hundred sixty-two (21.2%) completed the post-referral questionnaire. There were no BMI category effects on dietary behaviors but changes in physical activity behaviors were lower within the higher categories albeit effect sizes were small (all ges < 0.001). IMD quintile influenced changes for sugary drinks, watching TV and avoiding moderate activity although effect sizes were small (all ges < 0.01). Conclusion: Following 12-week referral to a commercial weight management organization, a mean weight loss of over 7% was reported at 24-months. Adults with higher BMIs and a greater level of deprivation can benefit from the practical support offered as part of the referral, supporting weight loss and weight loss maintenance albeit with some inequality. [ABSTRACT FROM AUTHOR]

Background: Hyperuricaemia is common among obese children and adolescents, and is closely related to insulin resistance. The aim of this study was to explore the relationships between youth insulin resistance and hyperuricaemia, as well as their relationships with lifestyle factors in youths, to provide early guidance on the risk factors for hyperuricaemia in adolescents. Methods: This study included 233 adolescents aged 10 to 20 years. Insulin resistance was evaluated via the homeostasis model assessment-insulin resistance (HOMA-IR) method. Binary logistic regression analysis was used to assess the associations of HOMA-IR with hyperuricaemia status and serum uric acid (UA) levels. The participants were subsequently divided into two groups, the noninsulin resistant group (HOMA-IR ≤ 3.2) and the insulin resistant group (HOMA-IR > 3.2), to further explore the factors that may affect the serum UA level. Finally, the predictive ability of different indicators of hyperuricaemia was evaluated via the ROC curve. Results: Binary logistic regression analysis revealed a significant increase in the risk of developing hyperuricaemia for individuals with elevated HOMA-IR (p < 0.001) and insulin resistance (p < 0.01). Spearman's correlation analysis revealed a significant positive linear correlation between HOMA-IR and serum UA levels (r = 0.4652, p < 0.001). Among insulin-resistant adolescents, UA levels were positively correlated with weight ratings, frequency of staying up late, and sugary beverages intake. Notably, individuals who engaged in 1–3 h of weekly exercise had the lowest UA levels. The area under the ROC curve for HOMA-IR was 0.847 (cut-off value = 2.165, p < 0.001), and the optimal prediction model included HOMA-IR, BMI z-score, and other lifestyle factors (AUC: 0.870, p < 0.001)). Conclusion: HOMA-IR was identified as an independent risk factor for the development of hyperuricaemia and could be used as a sensitive indicator for the prediction its development in adolescents. In insulin-resistant adolescents with hyperuricaemia, maintaining normal weight, engaging in physical exercise for 1–3 h per week, avoiding staying up late and limiting sugary beverages intake are recommended to reduce the prevalence of hyperuricaemia among adolescents. [ABSTRACT FROM AUTHOR]

Summary Current data evaluating outcomes of valve replacement surgery in patients with overweight/obesity is contradictory. There is a scarce study comparing outcomes of valve surgery considering the type of valve involved in the procedure. We followed outcomes in patients with overweight and obesity after valve replacement surgery with or without coronary artery bypass graft (CABG) and also patients with aortic valve replacement (AVR) and mitral valve replacement (MVR), separately to compare their mid‐term prognosis in each group. Consecutive patients who had undergone cardiac valve surgery with or without CABG in Tehran Heart Center were enrolled. We enrolled 3158 patients. Median survival was 125.71 ± 82.20 weeks in patients with overweight/obesity. We found a significantly higher LVDd, LVDs and RVDd in patients with CABG (51.85 ± 7.31, 36.80 ± 8.81 and 30.04 ± 3.58, respectively) compared to the valve group (50.10 ± 6.35 mm, 35.08 ± 7.29 mm and 29.76 ± 4.07 mm, respectively). All‐cause mortality is significantly higher in patients with AVR (5.7%) than those with MVR (3.3%). Patients with CABG are at higher risk of myocardial infarction (MI) compared to the ones without CABG (0.8% vs. 0.1%). No significant interaction was observed between the type of valve surgery (AVR/MVR) or valve surgery combinations (valve/valve + CABG) (p‐values = .81 vs. .97, respectively). Post‐operative outcomes in patients with overweight/obesity depend on several factors such as type of valve involved and presence of CABG. Risk management can lower the rate of mortality and morbidity in these patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Obesity increases the risk of several cancers, including breast cancer. With global obesity rates rising, it is important to understand how excess fat accumulation influences cancer development and progression. This study examined how overweight/obesity affects the breast adipose tissue around triple-negative breast cancer (TNBC), a particularly aggressive type of breast cancer. Therefore, tissue samples from overweight/obese and normal weight patients with TNBC were compared. We found that overweight/obese TNBC patients had larger fat cells, more immune cells that could support cancer growth, and fewer cells related to new blood vessel formation in the tumor-surrounding environment. Overweight/obese patients also showed higher numbers of special fibroblast cells with potential tumor-promoting functions. Moreover, tumor cells at the invasive front, which are in close contact with fat cells, showed higher levels of proteins that metabolize fatty acids, suggesting altered lipid handling in cancer cells in overweight/obese TNBC patients. Together, these findings imply that obesity is associated with distinct changes in the tumor-adjacent adipose tissue in TNBC, potentially affecting cancer aggressiveness. Understanding these changes may help to develop more effective treatment strategies for obese TNBC patients, which may improve their prognosis and overall health outcomes. Background: Obesity is a risk factor of several types of cancer, including breast cancer. In this study, we aimed to histologically characterize the adipose tissue of the tumor microenvironment (TME) of triple-negative breast cancer (TNBC) in overweight/obese versus normal-weight patients. Methods: TNBC tissue sections from normal-weight (BMI<25) and overweight/obese patients (BMI≥25) were stained with antibodies against CD68, CD163, CD31, CD34, and vimentin. At the invasive tumor front, positive cells were counted in tumor adjacent adipose tissue (AT) and within cancer tissue (CT). Further, the size of the tumor-adjacent and distant mammary adipocytes was determined in perilipin stained sections. Expression of ANGPTL4, CD36 and FABP4, proteins involved in fatty acid metabolism, was analyzed in marginal tumor cells using an immune reactive score. Results: Overweight/obese TNBC patients had significantly larger adipocytes, higher numbers of CD163+ macrophages (BMI<25: 2.80 vs. BMI≥25: 10.45; p = 0.011) and lower numbers of CD31+ (BMI<25: 4.20 vs. BMI≥25: 2.40; p = 0.018) and CD34+ (BMI<25: 14.60 vs. BMI≥25: 5.20; p = 0.045) cells as markers of angiogenesis in the AT as well as a higher frequency of cancer-associated-fibroblast-like cells in the AT and CT (BMI<25: 7.60 vs. BMI≥25: 25.39 in total; p = 0.001). Moreover, expression of CD36 (BMI<25: 2.15 vs. BMI≥25: 2.60; p = 0.041) and ANGPTL4 (BMI<25: 6.00 vs. BMI≥25: 9.80; p = 0.026) was elevated in the TNBC cells of overweight/obese patients. Conclusions: Our data suggest BMI-related changes in the TME of overweight/obese TNBC patients, including hypertrophied adipocytes, reduced vascularization, more M2-like macrophages and CAF-like cells, and an increase in the expression of fatty acid metabolizing proteins in marginal tumor cells, all contributing to a more tumor-promoting, immunosuppressive environment. [ABSTRACT FROM AUTHOR]

Background: Obesity has become a significant global health issue. This multifaceted condition is influenced by genetic, environmental, and lifestyle factors, significantly influenced by nutrition. Aim: The study's objective is to elucidate the relationship between obesity-related genes, nutrient intake, and the development of obesity and the importance of other metabolic diseases. Methods: A comprehensive literature review spanning the past two decades was conducted to analyze the contributions of genetic variants—including FTO, MC4R, and LEPR—and their associations with dietary habits, highlighting how specific nutrients affect gene expression and obesity risk and how the coexistence of metabolic diseases such as type 2 diabetes and osteoporosis may modulate these factors. Moreover, the role of epigenetic factors, such as dietary patterns that encourage the development of obesity, was explored. Discussion and Conclusions: By understanding the intricate relationships among genetics, nutrients, and obesity development, this study highlights the importance of personalized dietary strategies in managing obesity. Overall, an integrated approach that considers genetic predispositions alongside environmental influences is essential for developing effective prevention and treatment methodologies, ultimately contributing to better health outcomes in diverse populations. [ABSTRACT FROM AUTHOR]

Background: Although many people have concerns about their body image, weight, and eating behaviors these issues are not usually discussed in a productive manner with medical providers. Thus, we examined nursing and medical students' willingness to discuss patients' weight, body image, and eating disorders and reasons why they may do so. Method: One hundred and eighty-three nursing and medical students (Mage = 25.06, SD = 5.43) participated in this study. Participants completed open-ended questions pertaining to their willingness to discuss body image, eating, and weight-related issues with future patients. We further queried students' perspective on body mass index (BMI) as a measure of weight status and sought to determine if participants' own weight, weight concerns, appearance evaluation, body appreciation, and experiences of stigma were associated with their willingness to discuss weight-related issues with prospective patients. Results: Coding of qualitative data indicated that nursing and medical students were "sometimes" willing to discuss prospective patients' weight, body image, and eating disorders, especially if a health concern was evident. Nursing students seemed somewhat more willing to discuss weight issues than medical students and willingness to discuss one of these issues (e.g., body image) was positively associated with willingness discuss the others. Plans for future discussions of body image and weight were marginally associated with personal experiences of weight stigma. The majority of participants indicated that BMI was not a valid measure of health. Conclusions: Taken together, findings suggest that future providers' conversations with patients about these sensitive topics are less likely to be associated with their own experiences and more with the relevance of these topics to specific patients. Plain English Summary: The aim of this study was to better understand nursing and medical students' interest and willingness to discuss body image, eating behaviors, and weight with their patients. Although medical organizations and training suggest the importance of talking with patients about these issues, providers often do not feel comfortable doing so or do not know how to best broach these sensitive topics. Our results revealed that nursing students seemed somewhat more comfortable discussing these issues with patients than medical students. Nursing and medical students were more apt to feel they would discuss these issues if a patient had an obvious health concern that was relevant (e.g., sudden weight loss). Medical and nursing students who had experiences with weight stigma were more apt to try to discuss these issues with patients. [ABSTRACT FROM AUTHOR]

Background: Satisfaction with birth and healthcare provider experiences have long-term effects for maternal health. Research has shown that mothers who report more trust, respect, and self-efficacy in their relationship with their healthcare providers are more likely to report positive birthing experiences. Further, individuals with obesity, including pregnant mothers, are more likely to experience weight-related stigma from healthcare providers which may negatively impact satisfaction with this relationship. Thus, the current study examines maternal pre-pregnancy body mass index (BMI) as a moderator between birth and provider satisfaction. Methods: A sample of 94 women (ages 16–38) were recruited during pregnancy. Participants completed surveys about their satisfaction with their birth experience, provider satisfaction, height, weight, and demographics including age and education. A moderation analysis was used to examine pre-pregnancy BMI as a moderator between birth and provider satisfaction. Results: Results show that provider satisfaction is positively associated with birth satisfaction among mothers with moderate (overweight) to high (obese) pre-pregnancy BMI scores in our sample. Conclusions: Findings suggest that strengthening the patient-provider relationship may promote satisfaction with birth experiences. [ABSTRACT FROM AUTHOR]

Summary Background Objectives Methods Results Conclusions Early life socioeconomic disadvantage and adverse experiences may lead to overeating, which is in turn associated with increased body mass index (BMI). However, recent evidence indicated that the association between childhood BMI and overeating might be bidirectional. This bidirectionality prompts the need for further investigation of early life predictors of BMI in childhood.To longitudinally assess the directionality of the association between childhood BMI and perceived overeating and to investigate their antecedent early life predictors.The sample included data from 5151 children from the ELSPAC study, collected between 18 months and 11 years of child age. The outcomes were child BMI and mother‐reported overeating, assessed at the age of 3, 5, 7 and 11 years. Predictors included maternal BMI, maternal education, single parenthood, financial difficulties and adverse childhood experiences (ACEs) reported by parents and paediatricians. The random intercept cross‐lagged panel model was applied.The mean child's BMI at age 3 was 15.59 kg/m2 and increased to 17.86 kg/m2 at age 11. The percentage of parent‐reported overeating increased in the following period, from about 12% at age 3 to 17% at age 11. The results showed temporal stability in perceived overeating and BMI, with a bidirectional relationship strengthening over time. The child's BMI was associated with maternal BMI. Maternal BMI was positively associated with child‐perceived overeating, but a stronger effect was found for ACEs. ACEs mediated the impact of maternal education, financial difficulties and single parenthood on overeating.We observed stable bidirectional associations between BMI and perceived overeating. The results indicated two main pathways: one linked to maternal BMI and early childhood BMI increase followed by perceived overeating and the second associated with ACEs mediating the effect of early childhood social factors on perceived overeating, leading to gradual BMI gain. [ABSTRACT FROM AUTHOR]

Background Objectives Materials and methods Results Discussion Conclusion Recurrent pregnancy loss is characterized by three or more consecutive pregnancy losses. Although the causes of recurrent pregnancy loss are often unknown, chromosomal defects and fetal anomalies account for a significant proportion of cases. Previous research has primarily focused on maternal factors, but recent attention has shifted to the role of male lifestyle factors.This study examined how male lifestyle factors and chronic illnesses affect recurrent pregnancy loss in a Danish cohort. Objectives included analyzing demographic and clinical features, as well as assessing lifestyle factors and pregnancy outcomes.We included 741 males referred to the Danish recurrent pregnancy loss unit between 2009 and 2021, alongside a control group of 1173 males from the PREGCO study. Data on demography, clinical features, lifestyle factors, and pregnancy outcomes were collected and analyzed.The recurrent pregnancy loss group had a higher mean age compared to the controls. Although there was a trend suggesting a higher prevalence of obesity in the recurrent pregnancy loss group, statistical significance was not reached. The prevalence of chronic illnesses was similar in both groups. In the recurrent pregnancy loss group, a higher body mass index and history of previous or current smoking were associated with a lower pregnancy rate, and men who never smoked had an increased likelihood of achieving pregnancy. However, these associations lost significance after adjusting for potential confounders.The study suggests an association between male obesity and smoking, and decreased pregnancy rates after referral for recurrent pregnancy loss. However, further research is needed to understand the underlying mechanisms and establish causality in this association.The study reveals potential associations between male smoking, male obesity, and reduced pregnancy rates in individuals referred for recurrent pregnancy loss. These findings emphasize the importance of considering male lifestyle factors in the evaluation and management of recurrent pregnancy loss. [ABSTRACT FROM AUTHOR]

Introduction: Chronic hyperglycemia in type 2 diabetes mellitus is associated with macrovascular and microvascular complications. Peripheral neuropathy is one of the known complications of type 2 diabetes. Objective: To assess correlation between glycemic parameters and age and duration of diabetes with peripheral neuropathy in type 2 diabetes mellitus. Material and methods: In this observational study, correlation of vibration perception threshold (VPT) was estimated with glycemic parameters i.e. fasting blood glucose (FBG), post-prandial blood glucose (PPG) and glycosylated hemoglobin le (HbA1c) and age and duration of diabetes in patients with type 2 diabetes. Patients were categorized into normal (VPT <15 mV), mild (VPT >15-25 mV), moderate (VPT 26-40 mV), and severe (VPT > 40 mV) types of peripheral neuropathy. Results: One hundred and ten patients [mean age 59.55 years; mean body mass index (BMI) 24.21 kg/m2; males 63.64%] were included. Significantly higher percentage of patients with BMI >30 kg/m2 had moderate to severe abnormality in VPT compared to those with BMI <30 kg/m2 (p=0.0347). There was no significant difference in the severity of results based on the duration of diabetes less than or more than 10 years (p=0.367). Significant difference in VPT was observed in patients with FBG < 160 mg/dl versus > 160 mg/dl (p=0.049), PPG <250 mg/dl versus > 250 mg/dl (p<0.0001) and HbA1 c <10% versus > 10% (p=0.00039). Conclusion:BMI and glycemic parameters (FBG, PPG and HbA1c) are significantly associated with severity of VPT in patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: Health checkups are important in patients with chronic kidney disease (CKD), which is not easily accompanied by subjective symptoms. CKD can be caused or aggravated by factors that have not yet been identified. Methods: This retrospective cohort study included 7 483 patients who underwent specific annual health checkups at a medical institution in Tama City, did not have CKD in 2012, and continued to undergo checkups (aged 40–74 years). We examined the risk factors for new-onset CKD and 1.5-fold increase in serum creatinine levels among laboratory values from 2012 to 2020. Results: Age, body mass index (BMI), triglyceride levels, atrial fibrillation, and medication for hypertension (HT) and diabetes mellitus were independent risk factors for proteinuria, whereas current smoking, BMI, systolic blood pressure (SBP), and medication for HT were independent risk factors for estimated glomerular filtration rate < 60 mL/min/1.73 m2. SBP, triglyceride levels and medication for HT were risk factors for a 1.5-fold increase in serum creatinine levels during course of the study. The cut-off values of BMI for eGFR < 60 mL/min/1.73 m2 were 22.2 (men 24.7, women 22.1) kg/m2 and fasting triglyceride levels for a 1.5-fold increase in serum creatinine level were 171 (men 247, women 170) mg/dL, respectively. Conclusions: Health checkups provide information to prevent new-onset CKD and worsening of renal function. It is necessary to increase the rate of health checkups and visits to medical institutions after health checkups as well as to use these results for health guidance. [ABSTRACT FROM AUTHOR]

Objectives: Obesity is a chronic, multifaceted, leading health problem causing numerous non-communicable diseases with a huge burden on the global healthcare system and economies. Worldwide, multiple interventions have been familiarized for weight reduction strategies, however, in recent years, mobile health applications (mHealth apps) for reshaping weight reduction have been introduced. Therefore, this study aimed to investigate the role of mobile health applications in reducing weight among users in Riyadh, Saudi Arabia. Methods: This questionnaire-based cross-sectional study was conducted in the Department of Family and Community Medicine, and Medical Education, College of Medicine, King Saud University, Riyadh from May 2019 to December 2022. A total of 502 participants, 332 (66.1%) females and 170 (33.9%) males aged 18-50 years, using smartphones, residing in Riyadh, Saudi Arabia were recruited. The questionnaire was distributed via social media platforms including WhatsApp, and emails and information were recorded. Results: Among 502 participants, 221 (44.02%) were using mobile health applications and 281 (55.98%) did not use mobile health applications. The results revealed that the participants who have been using mHealth apps for the last six months had significantly decreased body weight compared to those who did not use the mHealth apps (p=0.001). Conclusions: The study participants using mobile health applications (mHealth apps) had significantly reduced their body weight and felt healthier. The mHealth apps provide health-related information regularly to individuals to track their weight, monitor diet, and physical activity, and information about their overall health. [ABSTRACT FROM AUTHOR]

Background & Objective: Type-2 Diabetes Mellitus (T2DM) is one of the most common chronic non-communicable diseases and a serious health issue worldwide because of its rising prevalence amongst the young adults. Dietary diversity, rapid economic development and sedentary lifestyle are amongst the common factors contributing for the rapid rise of diabetes. Our objective was to assess the average carbohydrate (CHO) and caloric consumption and its association with obesity and disease status in patients with Type-2 diabetic patients in an outpatient setting. Methods: This study was performed at an outpatient department (OPD), of Hayatabad Medical Complex, Peshawar. Patients with T2DM were interviewed who completed dietary assessment using 24 hours dietary recall method. Results: A total of 150 patients with Type-2 diabetes were interviewed. The mean carbohydrate intake was 400.3±106 mg/day, out of which 43.3 % participant’s had carbohydrate intake above recommendations. The mean energy intake for all participants was 2504.5±587.4 Kcal/day. Majority of the participants were overweight and obese with mean BMI of 28kg/m² ± 4.4. There was no significant difference in energy and carbohydrate intake between male and female participants. Conclusions: Majority of Pakistani patients with Type-2 diabetes consume foods rich in carbohydrate as well as have high caloric value. These finding were more in patients with no formal education compared to those who were well educated with a degree. [ABSTRACT FROM AUTHOR]

Background: Gait analysis is a vital tool for evaluating overall health and predicting outcomes such as mortality and cognitive decline. This study explores how normal and obese BMI categories impact gait dynamics, addressing gaps in understanding the effect of body composition on specific gait parameters. Research Question: The primary objective is to investigate differences in spatiotemporal gait parameters—specifically, gait speed, step length, cadence, and double support time—between normal and obese BMI groups to understand the effects of obesity on gait. Methods: This observational case-control study analyzed spatiotemporal gait metrics from 163 participants, using inertial measurement units (IMUs) to collect data on various gait parameters. Statistical analyses explored the relationship between BMI categories and these metrics. Results: No significant differences were found in gait speed, cadence, stride duration, or double support time between the normal and obese groups. However, significant differences were identified in age, hypertension prevalence, balance problems, and the incidence of falls, emphasizing the complex effects of obesity on factors influencing gait stability. Significance: This study contributes to our understanding of obesity's impact on gait by highlighting the need to consider associated health and stability parameters. These findings prompt a re-evaluation of how BMI is integrated into clinical gait assessments and emphasize the necessity for personalized healthcare strategies. This research highlights the importance of future studies with larger, more diverse populations and a wider array of biomechanical measures to dissect the relationship between BMI, body composition, and gait dynamics. [ABSTRACT FROM AUTHOR]

Morbid obesity, as characterized by BMI, is often utilized as an exclusion criterion for VV-ECMO because of presumed poor prognosis and technically complex cannulation. However, the "obesity paradox" suggests obesity may be protective during critical illness, and BMI does not capture variations in body type, adiposity, or fluid balance. This study examines relationships between BMI and patient outcomes. Adult VV-ECMO patients with BMI ≥ 35 kg/m2 admitted January 2012 to June 2021 were identified from an institutional registry. BMI and outcomes were analyzed with Mann-Whitney U tests and Pearson correlations with Bayesian post-hoc analyses. 116 of 960 ECMO patients met inclusion criteria. Median (Q1, Q3) BMI was 42.3 (37.3, 50.8) and min, max of 35.0, 87.8 with 9.0 (5.0, 15.5) ECMO days. BMI was not significantly correlated with ECMO days (r = −0.102; p =.279). Bayesian analyses showed moderate evidence against BMI correlating with ECMO days. In-hospital mortality (27%) was significantly associated with ECMO days (p =.014) but not BMI (p =.485). In this cohort of high-BMI patients, BMI was not associated with survival or time on ECMO. BMI itself should not be used as an exclusion criterion for VV-ECMO. [ABSTRACT FROM AUTHOR]

Objective: New indices of dyslipidemia, such as the Atherogenic Index of Plasma (AIP) or Castelli Risk Index I and II (CR‐I/II), have been tested to predict erectile dysfunction (ED). The aim of this study was to assess the role of these lipidic scores in predicting severe ED and erectile function (EF) worsening in patients who underwent robot‐assisted radical prostatectomy (RARP). Methods: Data from 1249 prostate cancer patients who underwent RARP at our single tertiary academic referral center from September 2021 to April 2023 were reviewed. RARP patients with a complete lipid panel were included in the final analysis. Two independent multivariable logistic regression models (LRMs) were fitted to identify predictors of ED severity and worsening in RARP patients. Results: Among the 357 RARP patients, the median age was 70 (interquartile range [IQR]: 65–74), and the median BMI was 28.4 (IQR: 26–30.4). According to the preoperative IIEF5, 115 (32.2%), 86 (24.5%), 26 (7.3%), and 40 (11.2%) were mild, mild‐moderate, moderate, and severe ED patients, respectively. After multivariable LRMs predicting severe ED, only the nerve‐sparing (NS) approach (odds ratio [OR]: 0.09) as well as the preoperative IIEF5 score (OR: 0.32) were independent predictors (p < 0.001). After LRMs predicting EF worsening, only preoperative IIEF5 was an independent predictor (OR: 1.42, p < 0.001). Conclusion: The power of novel lipidic scores in predicting severe ED and EF worsening in RARP patients was low, and they should not be routinely applied as a screening method in this patient subgroup. Only preoperative IIEF5 and nerve‐sparing approaches are relevant in EF prediction after RARP. [ABSTRACT FROM AUTHOR]

Objectives: Children with Tourette syndrome (TS) have been shown to exhibit high levels of food selectivity; however, its association with nutritional status has yet to be explored. The current study explored macro and micronutrient intake and food selectivity among children with and without TS, using 24-hour dietary recall and the Child Eating Behaviour Questionnaire.Method: Parents of 43 children diagnosed with TS and 38 age-matched children without a clinical diagnosis completed an online 24-hour food diary.Results: Fifty-eight per cent of children with TS were identified as falling outside of the healthy BMI range (underweight = 24.2%; overweight = 27.3%; obese = 6.1%). Children with TS also consumed fewer portions of fruit and vegetables along with meeting the daily reference nutrient intake guidelines significantly less often for vitamins B3, B6 and C, selenium and phosphorus compared to children without TS.Conclusions: Understanding the nutritional risk of children with TS relative to other children is important to clinicians and health care professionals who oversee nutritional inspection in primary care, and caregivers who are worried about the impact of limited or restricted diets. [ABSTRACT FROM AUTHOR]

To identify modifier loci underlying variation in body mass index (BMI) in persons with cystic fibrosis (pwCF), we performed a genome-wide association study (GWAS). Utilizing longitudinal height and weight data, along with demographic information and covariates from 4,393 pwCF, we calculated AvgBMIz representing the average of per-quarter BMI Z scores. The GWAS incorporated 9.8M single nucleotide polymorphisms (SNPs) with a minor allele frequency (MAF) > 0.005 extracted from whole-genome sequencing (WGS) of each study subject. We observed genome-wide significant association with a variant in FTO (FaT mass and Obesity-associated gene; rs28567725; p value = 1.21e−08; MAF = 0.41, β = 0.106; n = 4,393 individuals) and a variant within ADAMTS5 (A Disintegrin And Metalloproteinase with ThromboSpondin motifs 5; rs162500; p value = 2.11e−10; MAF = 0.005, β = −0.768; n = 4,085 pancreatic-insufficient individuals). Notably, BMI-associated variants in ADAMTS5 occur on a haplotype that is much more common in African (AFR, MAF = 0.183) than European (EUR, MAF = 0.006) populations (1000 Genomes project). A polygenic risk score (PRS) calculated using 924 SNPs (excluding 17 in FTO) showed significant association with AvgBMIz (p value = 2.2e−16; r2 = 0.03). Association between variants in FTO and the PRS correlation reveals similarities in the genetic architecture of BMI in CF and the general population. Inclusion of Black individuals in whom the single-gene disorder CF is much less common but genomic diversity is greater facilitated detection of association with variants that are in LD with functional SNPs in ADAMTS5. Our results illustrate the importance of population diversity, particularly when attempting to identify variants that manifest only under certain physiologic conditions. [Display omitted] A GWAS reveals that BMI variation in persons with CF (pwCF) is determined by loci operating in the general population (e.g., FTO) and a unique locus containing ADAMTS5. Interaction with exocrine pancreatic status (sufficient or insufficient) in pwCF suggests that ADAMTS5 operates in the context of severe nutritional stress. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most frequent female malignancy in the UK. Around 20% of cases are linked to weight gain, excess weight and health behaviours. We designed a weight gain prevention, health behaviour intervention for young women at increased risk. Methods: The study comprised a single arm observational study over 2 months testing acceptability and usability of the intervention: online group welcome event, app and private Facebook group. Females aged 18–35 years at moderate or high risk of breast cancer (>17% lifetime risk) were recruited via invite letters and social media posts. The app included behaviour change techniques and education content. Online questionnaires were completed at baseline, as well as at 1 and 2 months. We also assessed feasibility of study procedures. Results: Both recruitment methods were successful. Thirty‐five women were recruited, 26% via social media posts. Median age was 33 (interquartile range = 28.2–34.5) years, the majority (94.1%) were of White ethnicity. Thirty‐four participants were included in the analyses, of which 94% downloaded the app. Median self‐monitoring logs per participant during the study period was 10.0 (interquartile range = 4.8–28.8). App quality mean (SD) score was 3.7 (0.6) at 1 and 2 months (scale: 1–5). Eighty‐nine per cent rated the app at average or above at 1 month and 75.0% at 2 months. Nineteen women (55.9%) joined the Facebook group and there were 61 comments and 83 reactions and votes from participants during the study period. Conclusions: This first iteration of the app and intervention was well received and is suitable to progress to the next stage of refining and further testing. Highlights: The newly developed intervention that focused on weight gain prevention and health behaviour change was tested in young women at increased risk of breast cancer and was well‐received by the target population.Both recruitment methods, by mailshot and social media, were successful.The study was unable to recruit and ethnically diverse population.Future research should retest the intervention in a larger population, after making refinements. [ABSTRACT FROM AUTHOR]

Background and aim: To investigate the prognostic implication of body mass index (BMI) on clinical outcomes after acute ischemic and hemorrhagic stroke. Methods: The subjects of the study included adult patients with available baseline body weight and height data who had suffered an acute stroke and were registered in the Japan Stroke Data Bank—a hospital-based, multicenter stroke registration database—between January 2006 and December 2020. The outcome measures included unfavorable outcomes defined as a modified Rankin Scale (mRS) score of 5–6 and favorable outcomes (mRS 0–2) at discharge, and in-hospital mortality. Mixed effects logistic regression analysis was conducted to determine the relationship between BMI categories (underweight, normal weight, overweight, class I obesity, class II obesity; <18.5, 18.5–23.0, 23.0–25.0, 25–30, ⩾30 kg/m2) and the outcomes, after adjustment for covariates. Results: A total of 56,230 patients were assigned to one of the following groups: ischemic stroke (IS, n = 43,668), intracerebral hemorrhage (ICH, n = 9741), and subarachnoid hemorrhage (SAH, n = 2821). In the IS group, being underweight was associated with an increased likelihood of unfavorable outcomes (odds ratio, 1.47 (95% confidence interval (CI):1.31−1.65)) and in-hospital mortality (1.55 (1.31−1.83)) compared to outcomes in those with normal weight. Being overweight was associated with an increased likelihood of favorable outcomes (1.09 (1.01−1.18)). Similar associations were observed between underweight and these outcomes in specific IS subtypes (cardioembolic stroke, large artery stroke, and small-vessel occlusion). Patients with a BMI ⩾30.0 kg/m2 was associated with an increased likelihood of unfavorable outcomes (1.44 (1.01−2.17)) and in-hospital mortality (2.42 (1.26−4.65)) in large artery stroke. In patients with ICH, but not those with SAH, being underweight was associated with an increased likelihood of unfavorable outcomes (1.41 (1.01−1.99)). Conclusions: BMI substantially impacts functional outcomes following IS and ICH. Lower BMI consistently affected post-stroke disability and mortality, while higher BMI values similarly affected these outcomes after large artery stroke. [ABSTRACT FROM AUTHOR]

There is a growing body of research on improving health behaviours through future thinking but that in improving eating behaviour remains unclear. Hence, we conducted a systematic review and meta-analysis on the effectiveness of time perspective manipulation in improving adult eating behaviours. Articles published from inception through 17 March 2022 were retrieved from eight databases (CINAHL, Embase, ProQuest, PsycINFO, PubMed, Scopus, The Cochrane library, and Web of Science). Meta-analysis was conducted using random effects models with effect sizes reported in Hedges' g. Sixteen experimental studies were included, representing 1,914 participants with mean ages ranging from 20.5 to 44.1 years old and mean baseline BMI of 22.0 kg/m2 to 37.2 kg/m2. The interventions included were episodic future thinking (EFT; n = 12), message framing (n = 2), and varying inter-meal intervals (IMI; n = 2) in improving food choices, food intake and portion size. Two studies reported significant interventional effectiveness for domain-specific EFT while all studies on message framing and IMI reported significant interventional effectiveness. Message framing seemed to be more effective when both temporal distance and valence frames were manipulated. However, the pooled effect sizes of all the interventions did not result in a significant interventional effect (n = 5; g = −0.49; 95% confidence interval (CI) = −1.44, 0.47; p = 0.23; I2=87.2%). More rigorous research is needed to ascertain the effectiveness of manipulating time perspective in improving eating behaviours before such interventions are more widely used. [ABSTRACT FROM AUTHOR]

Background: Sarcopenic obesity (SO) is defined as a decrease in lean body mass and an increase in body fat mass (BFM) due to aging. Detecting SO in elderly women is important from the perspective of extending healthy life expectancy. While various indices of SO are currently used, there is no global consensus regarding diagnostic criteria for SO. This study aimed to examine the relationship between obesity indices (waist circumference (WC), body mass index (BMI), and body fat percentage (BFP)) and sarcopenia indices (total body muscle mass (TBM), appendicular lean mass (ALM), skeletal mass index (SMI)), and physical function (gait speed (GS), handgrip strength (HGS)). Methods: Subjects were 170 community-dwelling healthy elderly women aged 65–79 years (mean: 72.7 ± 5.78 years) who underwent measurements for WC, BMI, and BFP. A WC of ≥ 90cm was defined as the obese group, BMI was determined as weight (kg) divided by height squared (m2) and a cutoff of ≥ 25 kg/m2 was used to define the obesity group. BFM was measured using the bioelectrical impedance analysis (BIA) method and BFP was calculated from body weight and a cutoff of ≥ 30% was used to define the obesity group. TBM and ALM (kg) were measured using the BIA method, ALM (kg) was corrected for height (m2) to obtain SMI (kg/m2). Physical function was assessed by GS and HGS, which were measured by the 5-m walk test and a digital grip strength meter, respectively. Results: When obesity was assessed using BMI, WC and BFP, obese individuals had higher TBM, ALM and SMI, and lower GS among the sarcopenia indicators. HGS did not differ significantly between the non-obese and obese groups. Conclusion: Our findings suggest HGS is thought to reflect muscle strength without being affected by obesity indices, suggesting that it may be useful in detecting possible sarcopenia in obese individuals. [ABSTRACT FROM AUTHOR]

Background: Health of children plays an indispensable role in the development of the country. Nutrition and health of the tribal children continue to be a pressing concern in India. Biochemical and hematological examination of children is an essential tool for assessment of health status, early identification of preventable risk factors and for diagnosis of various diseases. Objective: To assess the health status of Hakki Pikki tribal school children by evaluating the biochemical and haematological parameters. Materials and Methods: This was a community based cross sectional study of 76(Boys-32 and Girls-44) Hakki Pikki tribal children studying at Government Higher Primary School, Hakki Pikki Colony, Gowripura, Bengaluru Karnataka, India. Biochemical and haematological parameters were determined in accordance with standard operating procedures followed by good laboratory practices Results: The study group consisted of children aged between 6 to 17 years, among them 32 students were males and 44 were females.21(11-boys and 10-girls) children were under weight and 02 girls were overweight. The common ailments found were, dental carries (2.63%), ear discharge (2.63%), anaemia (3.94%), Impetigo (7.89%). Comparing between Boys and Girls less than or equal to 10 years of age there was a significant difference in Creatinine as p-value< 0.05. There was a significant difference in Creatinine, Uric acid, AST, ALT, total protein, albumin, HbA1C and Haemoglobin when comparing between Boys and Girls of age greater than 10 years p-value < 0.05.In these tribal children the distribution of biochemical and haematological parameters values considerably follows the reported reference values Conclusions: This study highlights a puzzling situation of health status among these Hakki Pikki tribal children due to apparent change in socio cultural, lifestyle, nutrition, and urbanization. Under weight has emanated as a solemn problem unless addressed. [ABSTRACT FROM AUTHOR]

A number of health issues, including high serum uric acid (SUA) and cardiovascular disease (CVD), have been linked to obesity based on observational evidence, though it's currently unclear how these issues are causally related. In order to determine whether obesity mediates this association, we set out to investigate the causal relationship between SUA, obesity, and CVD. From publicly available genome-wide association studies, we acquired instrumental variables that had a strong correlation to SUA and body mass index (BMI). We employed multiple two-step Mendelian randomization (MR) analyses, using genetic and clinical data from various publicly available biological databases. The mediating role of BMI was examined through mediation analysis. SUA was genetically correlated with BMI [OR = 1.080, 95% CI: 1.024–1.139, P = 0.005]. There was a positive causal effect of SUA on AF [OR = 0.892, 95% CI: 0.804–0.990, P = 0.032], CAD [OR = 0.942, 95% CI: 0.890–0.997, P = 0.037], and EHT [OR = 1.080, 95% CI: 1.024–1.139, P = 0.005]. Among them, BMI mediated the effects of SUA on AF (42.2%; 95% CI, 35.3%–51.9%), CAD (76.3%; 95% CI, 63.4%–92.0%), and EHT (10.0%; 95% CI, 0%–20.0%). Our research revealed a causal relationship between high SUA exposure and an increased risk of obesity. Additionally, a high SUA level was linked to an increased risk of various CVDs. Given that individuals with high SUA are more likely to be susceptible to AF, CAD, and EHT, attention must be given to their weight status. • This study applied a two-step MR analysis to confirm the causal relationship among serum uric acid, BMI and six different cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Introduction: There is a relationship between excess body weight and the risk of a number of infectious diseases, including urinary tract infections (UTIs). This study aimed to investigate the correlation between body mass index (BMI) and UTIs among Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. Methods: This cross‐sectional study was conducted on 10,520 individuals aged 35–70 years from PGCS. The demographical data and clinical characteristics of the participants were recorded. Microscopic examination of the urine samples was performed to detect the presence of bacteria or white blood cells (WBC) as indicators of infection. UTI was defined as the presence of bacteria in the urine (Few, moderate, and many) and a value of ≥10 WBC/high power field (HPF) by light microscopy. Results: The prevalence of UTIs in this study was 8.8%, with a higher incidence in females compared to males (12.2% vs. 4.7%, p < 0.001). Among participants, the prevalence of UTIs across different weight categories was as follows: underweight/normal weight, 7.1%; overweight, 8.1%; and obesity, 10.9%. According to the unadjusted model, subjects with obesity were at significantly higher odds for UTIs than subjects with underweight/normal BMI (OR = 1.62, 95% CI: 1.35–1.93, p < 0.001). However, this association was no longer significant after adjusting for demographic and clinical variables. Conclusion: The findings of this study provide evidence supporting a higher prevalence of UTIs among individuals with obesity. [ABSTRACT FROM AUTHOR]