Current Obesity Reports最新文献

Purpose of review: This systematic review aims to elucidate the effects of (poly)phenols (PPs) on mature 3T3-L1 adipocytes via the regulation of lipid and glucose metabolism.

Recent findings: PPs can modulate glucose uptake, reduce intracellular lipid content and enhance lipolytic activity in mature 3T3-L1 adipocytes. These effects are mediated through changes at both gene expression level (e.g. Ppara and Sirt1) and protein level (e.g. activation of AMPK and adiponectin levels). However, there is no consensus on the concentrations at which PPs exert their anti-lipogenic activity, and it remains unclear whether different PPs activate distinct molecular pathways. PPs are a diverse group of plant-derived secondary metabolites with recognized anti-obesogenic potential. While their inhibitory effects on adipogenesis are well established, their role in modulating lipid metabolism in fully differentiated adipocytes remains less well understood. Emerging evidence from studies on mature 3T3-L1 adipocytes indicates that PPs can influence key metabolic processes, including lipid storage and mobilization. These findings highlight the potential of PPs as modulators of adipose tissue metabolism, while also emphasizing the need for translational research to clarify their mechanisms of action and therapeutic efficacy in vivo.

Background: Obesity is a growing global health issue, linked to chronic conditions like type 2 diabetes, hypertension, and cardiovascular diseases. Nursing staff could play a significant role in managing obesity, with telemedicine being a potentially effective tool for monitoring weight and caloric intake. However, the effectiveness of telemedicine-based nursing interventions in managing obesity and overweight remains unclear.

Objective: This systematic review with meta-analysis aimed to evaluate the effectiveness of nursing telemedicine interventions in managing overweight and obesity in adults.

Method: This review followed PRISMA guidelines and involved a literature search in Scopus, PubMed, and Web of Science. Eligible studies were in English, involved adults with a BMI over 25, and evaluated nursing-led telemedicine interventions (non-randomized and randomized controlled studies). Study quality was assessed using the Down and Black checklist. A random-effects model was used for the meta-analysis.

Results: Four moderate-quality articles were included. The nursing-led telemedicine interventions, delivered through digital platforms, mobile apps, and remote monitoring, focused on health education and motivational strategies to promote self-regulation and dietary improvements. The meta-analysis showed that, compared to traditional approaches, nursing-led interventions resulted in an average weight loss of 2.59 kg (95% CI: - 3.09 to - 2.08), a reduction of 1.05 kg/m² in BMI (95% CI: - 1.50 to - 0.60), and a decrease of 2.52 cm in waist circumference (95% CI: - 2.96 to - 2.09).

Conclusion: Nursing telemedicine interventions are effective in promoting short-term weight loss and lifestyle changes. However, further research is needed to assess long-term effects and the impact of different interventions.

Purpose of review: This review examines the role of adipokines and gene polymorphisms in the development of depression and obesity. It is of great importance to understand the mechanisms that may be effective in the development of obesity and depression as their incidence increases.

Recent findings: Adipokines are released from adipose tissues and primarily regulate the connection between the metabolic and inflammatory effects of obesity and the brain cells and adipose tissue. Adipokines may potentially contribute to the pathophysiology of depression by influencing the HPA axis and neurotransmitters. According to some estimates, the genetic overlap between obesity and depression is as high as 12 percent. Furthermore, these genes may be linked to significant interconnected signaling networks that have a role in the etiology of both disorders. Obesity and depression are both on the rise globally, and it is thought that there is a bidirectional relationship between these two conditions. Obesity and obesity-induced depression seriously limit the psychosocial functionality of individuals and impair their quality of life. Having a high body mass index (BMI) raises the likelihood of developing depression. On the other hand, as the BMI elevates in people suffering from depression, the possibility of developing obesity also rises.

Purpose of review: The increasing prevalence of obesity among individuals with type 1 diabetes mellitus (T1DM) presents a significant clinical challenge, as it exacerbates insulin resistance, impairs glycemic control, and increases cardiometabolic risk. While obesity in T1DM is influenced by both genetic and environmental factors, recent evidence highlights the role of the gut-brain axis in metabolic regulation. This review explores the complex relationship between obesity and T1DM, the role of the gut-brain axis in metabolic dysregulation, and current weight management strategies, highlighting the need for further research to optimize treatment outcomes in this unique patient population.

Recent findings: Key gastrointestinal hormones, including glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and amylin, play essential roles in appetite control, energy balance, and glucose metabolism, yet their dysregulation in T1DM remains poorly understood. Addressing obesity requires a multifaceted approach, including lifestyle modifications, pharmacotherapy with GLP-1 receptor agonists (GLP-1RAs), and bariatric surgery (BS). Although limited, accumulating evidence regarding the use of liraglutide, semaglutide and tirzepatide in T1DM begin to highlight the safety and effectiveness of these molecules in this subset of patients as well. Lifestyle modifications, GLP-1 RAs based pharmacotherapy and BS have emerged as potential strategies to address obesity in patients with T1DM. Initial findings point to potential improvements in both metabolic health and glycemic control, but further exploration of their role in the co-occurrence of obesity and T1DM remains limited. Ongoing research is crucial to better understand how the gut-brain axis influences weight regulation in T1DM and to determine the sustained benefits and risks of these emerging therapies.

Purpose of the review: To examine evidence for factors that program and impact regulation of energy intake in infancy.

Recent findings: Infants regulate energy intake within a narrow margin, and this capacity may degrade with age as volume-based regulation emerges. However, feeding frequency, milk/formula protein content and/or structure, portion size, and caregiver encouragement can interrupt this regulation. Emerging evidence also suggests that some infants exhibit signs of reward-driven eating, which may also affect energy intake. Despite emphasis on obesity prevention in infancy, few studies directly examine milk/formula, food, or energy intake and even fewer use experimental methods to assess causation. Existing experimental evidence suggests a limited and diminishing regulation of energy intake through infancy and beyond. More research is needed to understand individual differences between infants in regulation of energy intake and propensity for reward-driven eating.

Purpose of review: (1) Summarize the recent research literature on weight stigma in the metabolic bariatric surgery (MBS) context, (2) Propose a conceptual model, (3) Discuss future directions for researchers and clinicians.

Recent findings: There has been an explosion of research on weight stigma since the joint international consensus statement for ending stigma of obesity in 2020. The MBS literature has also expanded, with improvements in methodological rigor, international focus, and mixed-methods approaches. Our proposed conceptual model is derived from research and clinical experience on the patient impacts of weight stigma in the MBS context. Weight stigma should be conceptualized as affecting every stage of MBS, including the development and exacerbation of obesity, access to care, the peri-operative process, and long-term biopsychosocial health. Future directions include countering stigma through public health and systems-level messaging, strengths-focused approaches, bridging divides across fields, and adapting evidence-based paradigms to address stigma internalization.

Purpose of review: Many physiological models have been put forth to explain the pathogenesis of obesity. All causes must eventually act by altering energy intake, energy expenditure, or the metabolic handling of ingested nutrients to favor storage over oxidation. These mechanisms culminate in two apparently competing models-the Energy Balance Model (EBM) and the Carbohydrate Insulin Model (CIM). In the EBM, eating more precedes increased adiposity, whereas in the CIM, increased adiposity precedes eating more.

Recent findings: Epidemiological observations on energy intake and obesity prevalence during the last 50 years have often become the source of controversy between models. Here, I present a hypothesis, which borrows key elements from the EBM and CIM, and offers a framework that traces the root cause of obesity outside of the modern food environment and aligns with historical, 100-year-long trends in metabolic rate, food intake, physical activity, and adiposity. Body weight has been steadily increasing throughout the previous century, in conjunction with reductions in resting metabolic rate. This, superimposed with varying changes in dietary energy intake and physical activity energy expenditure resulted in an accelerated rise in obesity prevalence after the 1970s. Obesity is a multifactorial disease and alterations in the underlying metabolic pathways that synergize to promote net fat deposition in the body have likely been operating for many decades, if not centuries, and involve both food-related and non-food-related factors.

Purpose of review: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, with its severity often exacerbated by obesity. The bidirectional relationship between PCOS and obesity contributes to a self-reinforcing and deleterious cycle. This review evaluates the effects of various weight loss interventions on reproductive, hormonal, and metabolic outcomes in overweight or obese women with PCOS. The objective is to provide evidence-based guidance for clinically relevant weight management strategies in this population.

Recent findings: Lifestyle modification is the first-line intervention for polycystic ovary syndrome (PCOS). High-intensity interval training (HIIT) has demonstrated potential in improving insulin resistance (IR) in affected women. Time-restricted feeding (TRF) may also improve hyperandrogenism, menstrual irregularities, and IR. The ketogenic diet (KD) has shown beneficial effects on both reproductive and metabolic outcomes. Among pharmacological therapies, glucagon-like peptide-1 receptor agonists (GLP-1RAs), particularly when combined with metformin, have exhibited notable efficacy in managing hyperandrogenism and menstrual disturbances. Bariatric surgery appears to be more effective than conventional pharmacologic treatments for PCOS; however, data on its mechanisms and direct comparisons with GLP-1RAs remain limited. Weight loss interventions exert differential effects on PCOS-related symptoms. Future studies should focus on optimizing combination strategies to enhance treatment efficacy. Currently, evidence on the impact of these interventions on pregnancy rates and long-term reproductive outcomes in overweight or obese women with PCOS is limited. In addition, the absence of systematic, head-to-head comparisons across different weight loss modalities underscores the need for well-designed comparative trials.

Purpose of review: The aim of this paper is to provide an overview of metabolic dysfunction-associated steatotic liver disease (MASLD) pathogenesis, focusing on how incretin analogues might affect liver function and disease. It also summarizes the latest preclinical studies and clinical trials evaluating the impact of incretin analogues (single or multi-agonists) on metabolic dysfunction-associated steatohepatitis (MASH) and liver fibrosis.

Recent findings: Incretin analogues have recently been added to the therapeutic arsenal of diabetologists, and their therapeutic effects on insulin resistance and T2DM are now well established. These treatments have also demonstrated beneficial effects on cardiovascular complications. In addition, the weight loss associated with these molecules has recently extended their indication to the treatment of obesity. On the other hand, pharmacological treatments for MASLD are still very limited, and mainly target liver functions. As weight loss is the cornerstone of MASLD treatment, studies evaluating these analogues and combinations with other compounds are very promising. Incretin analogues appear to be effective treatments for MASH and fibrosis in a large number of clinical trials. Phase 3 studies are currently ongoing to confirm these results. Further treatments may emerge, such as double and triple receptor agonists. A multidisciplinary approach, involving diabetologists and hepatologists, is optimal for the management of MASLD.

Purpose of review: To provide and consider evidence for the role of food advertising in childhood obesity development and reflect on the efficacy of current policy interventions to restrict children's food advertising exposure.

Recent findings: Children are exposed to extensive advertising for unhealthy foods, particularly online. Visually appealing techniques and salient themes are employed by food marketers to capture children's attention and provoke engagement and emotionally driven responding. Food advertising exposure adversely affects children's food behaviors, and the relationship with obesity meets established criteria for causality. Theoretical models proposing likely pathways underpinning observed behavioral effects have gathered empirical support. Implemented restrictive food advertising policies have achieved reductions in exposure, persuasive power, and purchasing of unhealthy foods, though no country has yet implemented comprehensive regulations across all forms of food advertising and marketing. Actions to reduce children's food advertising exposure, and the persuasive power of that exposure, are an important part of an effective approach to preventing childhood weight gain and obesity and reducing health inequalities. Tackling digital food marketing is challenging but essential to public health efforts given its ubiquitous and influential presence in children's lives.