Current Obesity Reports最新文献

Purpose of review: To present the evidence base in support of high-income country investment in universal school-provided meals (SPMs) for the purposes of optimising child health and wellbeing, including obesity prevention.

Recent findings: Many countries provide some form of SPMs. Models (universal, free; targeted; subsidised) vary globally, however optimal growth and development of children as a potential outcome is a consistent feature. SPMs can positively impact diet quality, household food and nutrition security and potentially weight status but is dependent on the model. Universal school meals offered as part of whole-of-school approaches appear to be most effective in optimising children's growth and development. Critical elements for successful SPMs include being underpinned by enforceable nutrition and sustainability standards, offered in ways that are stigma-free, being embedded within a whole-school approach and conceptualising SPMS as part of transformative food systems. Weight status is only one of many potential outcomes of SPMs. Implementing universal SPMs is a triple duty action that can address the global syndemic of obesity, undernutrition and climate change. Attention needs to be paid to the model of implementation and key principles for success.

Purpose of review: Obesity is a global health crisis affecting individuals across all age groups, significantly increasing the risk of metabolic disorders such as type 2 diabetes (T2D), metabolic dysfunction-associated fatty liver disease (MAFLD), and cardiovascular diseases. The World Health Organization reported in 2022 that 2.5 billion adults were overweight, with 890 million classified as obese, emphasizing the urgent need for effective interventions. A critical aspect of obesity's pathophysiology is meta-inflammation-a chronic, systemic low-grade inflammatory state driven by excess adipose tissue, which disrupts metabolic homeostasis. This review examines the role of autolysosomal dysfunction in obesity-related metabolic disorders, exploring its impact across multiple metabolic organs and evaluating potential therapeutic strategies that target autophagy and lysosomal function.

Recent findings: Emerging research highlights the importance of autophagy in maintaining cellular homeostasis and metabolic balance. Obesity-induced lysosomal dysfunction impairs the autophagic degradation process, contributing to the accumulation of damaged organelles and toxic aggregates, exacerbating insulin resistance, lipotoxicity, and chronic inflammation. Studies have identified autophagic defects in key metabolic tissues, including adipose tissue, skeletal muscle, liver, pancreas, kidney, heart, and brain, linking autophagy dysregulation to the progression of metabolic diseases. Preclinical investigations suggest that pharmacological and nutritional interventions-such as AMPK activation, caloric restriction mimetics, and lysosomal-targeting compounds-can restore autophagic function and improve metabolic outcomes in obesity models. Autolysosomal dysfunction is a pivotal contributor to obesity-associated metabolic disorders , influencing systemic inflammation and metabolic dysfunction. Restoring autophagy and lysosomal function holds promise as a therapeutic strategy to mitigate obesity-driven pathologies. Future research should focus on translating these findings into clinical applications, optimizing targeted interventions to improve metabolic health and reduce obesity-associated complications.

Dermatological diseases such as acne, hidradenitis suppurativa (HS), and psoriasis are driven by chronic inflammation and oxidative stress. Emerging evidence highlights the role of nutrition in modulating these conditions, particularly through dietary patterns rich in antioxidants, polyphenols, and unsaturated fatty acids. RECENT FINDINGS: The Mediterranean diet (MedDiet) has demonstrated potential benefits due to its anti-inflammatory and immunomodulatory effects, while very low-energy ketogenic therapy (VLEKT) has shown promise in rapidly improving disease severity. Specific nutrients, including omega-3 fatty acids, probiotics, and micronutrients, may further contribute to disease management. However, the current literature is limited by small-scale studies and the lack of standardized dietary guidelines. PURPOSE OF REVIEW: This Consensus Statement, developed collaboratively by the Italian Association of Dietetics and Clinical Nutrition (ADI), the Italian Society of Dermatology and Sexually Transmitted Diseases (SIDeMaST), the Italian Society of Nutraceuticals (SINut), Club Ketodiets and Nutraceuticals "KetoNut-SINut" and the Italian Society of Endocrinology (SIE), Club Nutrition, Hormones and Metabolism, aimed to establish an evidence-based framework for medical nutrition therapy (MNT) of the most common inflammatory skin diseases, including acne, HS and psoriasis.

Purpose of review: To describe the recent literature on acceptance and commitment therapy (ACT) interventions for individuals with obesity. The review begins with a brief overview of the ACT model, describes seminal work in this area, and examines more recent literature on the use of ACT to improve outcomes among individuals with obesity.

Recent findings: Early trials established ACT's efficacy for weight loss among adults with obesity. More recent research has focused on testing efficacy among adolescents, measuring effects in "real world" settings, refining interventions to optimize outcomes and enhance scalability, and examining outcomes beyond weight (e.g., internalized weight stigma, eating regulation). Current data indicate that ACT-based interventions produce comparable, or, in some cases, superior weight loss compared to standard behavioral interventions. ACT has also shown promise for improving other outcomes of interest. ACT may improve a variety of obesity-related outcomes, although additional research is needed.

Purpose of review: Review recent research regarding the relationship between cannabis use, weight, eating behaviors, eating disorders, and physical activity.

Recent findings: Cannabis, particularly the cannabinoid Δ9-tegrahydrocannabinol (THC), is associated with increased appetite, food cravings, overconsumption, and decreased physical activity. Cannabidiol (CBD) appears to be associated with decreased appetite. While cannabis use is not correlated with binge eating, cannabis use disorder is associated with loss of control eating. Despite cannabis' association with unhealthy eating and sedentary behavior, most studies suggest that cannabis use is not associated with weight gain, or may even facilitate weight loss. The state of the literature regarding the relationship between cannabis, weight, and weight-related behaviors is complex. Most studies do not differentiate between cannabinoid profiles, routes of administration, or whether cannabis use is problematic. Patients presenting for weight management should be cautioned about cannabis, particularly THC, potentially increasing risk of unhealthy eating and activity patterns.

Purpose of review: To examine the evidence and continuing role of strategies for the primary prevention and treatment of obesity in the context of effective obesity pharmacotherapies, through a narrative review.

Recent findings: Global policies to improve nutritional labelling and reduce sugar-sweetened beverages consumption have been implemented worldwide (> 45 countries) with some success which varies by population and environment. Tailored behavioural interventions are effective and essential to reduce individual risk of progression from preclinical to clinical obesity. Pharmacotherapies are powerful treatment agents for clinical obesity but must consider nutritional and metabolic risks of use and discontinuation. The obesogenic environment continues to undermine individual agency to adopt healthier dietary and physical activity patterns. Population health informatics tools could inform tailored interventions based on real-time risk and contribute to obesity prevention and treatment. Efforts to rebalance investment towards obesity prevention must continue to improve population health and reduce healthcare burden.

Obesity is a heterogeneous and multifactorial disease with a strong genetic component. While polygenic obesity accounts for most common cases, rare monogenic variants contribute, particularly in severe, early-onset obesity. Among the lesser-studied candidates are UCP3 and PCSK1, genes involved in key metabolic pathways. RECENT FINDINGS: The UCP3 p.Val192Ile (c.574G > A) and PCSK1 p.Asn221Asp (c.661 A > G) variants have been independently associated with metabolic pathways, including fatty acid oxidation and hormone processing, as well as a modestly increased risk of obesity. Clinical and genetic characterization of two patients with severe early-onset obesity revealed the co-occurrence of these variants, which were associated with metabolic disturbances such as insulin resistance. PURPOSE OF THE REVIEW: This narrative review examined the functional and clinical significance of UCP3 and PCSK1 variants in severe obesity, presenting two case reports to illustrate their potential impact. Our findings support a potential model in which rare variants in distinct metabolic genes may interact synergistically to exacerbate disease severity. Further studies are needed to elucidate their combined functional effects and contributions to obesity pathogenesis.

Purpose of review: This systematic review evaluates the impact of obesity on both male and female reproductive health, assisted reproductive technology (ART) outcomes, and pregnancy-related complications, providing a comprehensive synthesis of the evidence.

Recent findings: Obesity is a critical factor adversely affecting reproductive health, ART success rates, and pregnancy outcomes. Recent studies indicate hormonal disruptions, metabolic syndrome, and epigenetic modifications as central mechanisms linking obesity to infertility and adverse pregnancy results. A systematic search adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines included 35 studies, focusing on obesity-related reproductive outcomes. The review highlights that obesity disrupts hormonal balance, including reductions in sex hormone-binding globulin (SHBG) and testosterone levels, alongside increased insulin resistance and chronic inflammation. These mechanisms impair ovarian function, endometrial receptivity, and sperm quality, resulting in prolonged time-to-pregnancy (TTP), reduced ART success rates, and increased miscarriage risk. During pregnancy, maternal obesity elevates risks of gestational diabetes mellitus (GDM), preeclampsia, and cesarean delivery while contributing to neonatal complications, such as macrosomia and neonatal intensive care unit (NICU) admissions. The findings emphasize the dual impact of maternal and paternal obesity on offspring health, particularly through epigenetic modifications leading to intergenerational metabolic dysfunction. This review underscores the necessity of preconception weight management, individualized ART protocols, and tailored antenatal care to mitigate obesity's adverse effects on reproductive outcomes. Future research should focus on understanding male infertility mechanisms, optimizing ART interventions for individuals with obesity, and conducting longitudinal studies on the intergenerational impacts of obesity on reproductive health. This synthesis provides actionable insights to guide clinical practices and future investigations.

Purpose of review: The primary goals of this pre-registered systematic review were to critically evaluate the existing randomized controlled trials targeting weight stigma/bias and identify promising avenues for future research.

Recent findings: Prior systematic reviews have highlighted intervention strategies such as shifting causal attributions of obesity, evoking empathy, deploying weight-inclusive approaches, increasing education, and combining these strategies. Here, we provide an updated systematic review of weight stigma interventions. A systematic search was conducted following the PRISMA guidelines and performed in PubMed/Medline, PubMed, PsycINFO, and Google Scholar until October 2024, yielding a final sample of 56 articles. In addition to previously established strategies, we identified several novel strategies, such as cognitive dissonance and connection building. Interventions can largely shift attitudinal outcomes, but future research should extend beyond attitude measures, assess weight bias over a longer term, and across more diverse populations.

Purpose of the review: This review aims to summarize the current scientific understanding on the complex interplay between sterol regulatory element-binding proteins (SREBPs) and metabolic dysfunction associated steatotic liver disease (MASLD) by critically examining a few significant molecular pathways. Additionally, the review explores the potential of both natural and synthetic SREBP inhibitors as promising therapeutic candidates for MASLD.

Recent findings: SREBPs are central regulators of lipid homeostasis, with SREBP-1c primarily controlling fatty acid synthesis and SREBP-2 regulating cholesterol metabolism. Dysregulation of SREBP activity, often triggered by excessive caloric intake, insulin resistance, or endoplasmic reticulum (ER) stress, contributes to the development of metabolic syndrome and MASLD. SREBP-1c overexpression leads to increased de novo lipogenesis (DNL), hepatic lipid accumulation, and insulin resistance, while SREBP-2 modulates cholesterol metabolism via miRNA-33 and ABCA1 regulation leading to the pathogenesis of MASLD. The PI3K-Akt-mTORC1 pathway plays a critical role in SREBP activation, linking nutrient availability to lipid synthesis. Synthetic SREBP inhibitors, such as fatostatin and 25-hydroxycholesterol, and natural compounds, including kaempferol and resveratrol, show promise in modulating SREBP activity in vivo.

Conclusion: While targeting SREBP pathways presents a promising avenue for mitigating MASLD, further scientific investigation is imperative to identify and validate potential molecular targets. Although current studies on synthetic and natural SREBP inhibitors demonstrate encouraging results, rigorous pre-clinical and clinical research is warranted to translate these findings into effective MASLD treatments.