Current Obesity Reports最新文献

Purpose of review: This review investigates the relationship of paternal smoking and overweight/obesity during pregnancy and up to one-year post-birth with childhood overweight/obesity up to age 12. Both exposures were analysed separately and together, if appropriate.

Recent findings: Included studies indicate that paternal overweight/obesity is consistently associated with increased risk of childhood overweight/obesity, suggesting a robust intergenerational link. Conversely, findings on paternal smoking are less consistent. Five out of six studies suggest that paternal smoking during pregnancy may contribute to increased risk but one found no association. Children of fathers with overweight/obesity are at higher risk of overweight/obesity in childhood. Paternal smoking was associated with higher risk of child overweight/obesity in most studies. Trajectories of overweight and obesity are likely to be transgenerational and systemic changes to tackle their socioeconomic determinants may be required to address these.

Purpose of review: This review aimed to highlight the known role of histone deacetylases (HDACs) and lysine acetyltransferases (KATs) in individuals with obesity, better understand the role of HDACs and KATs enzymes in obesity and related metabolic disorders.

Recent findings: Numerous cellular activities, including DNA replication, DNA repair, cell cycle regulation, RNA splicing, signal transmission, metabolic function, protein stability, transportation, and transcriptional regulation, are influenced by lysine acetylation. Protein lysine acetylation serves several purposes, which not only contribute to the development of metabolic disorders linked to obesity but also hold promise for therapeutic approaches. The current study demonstrates that HDACs and KATs control lysine acetylation. This review details the advancements made in the study of obesity, related metabolic diseases, and protein lysine acetylation. It contributes to our understanding of the function and mechanism of protein lysine acetylation in obesity and MS and offers a fresh method for treating these diseases.

Purpose of review: Polycystic Ovary Syndrome (PCOS) affects 10-15% of women of reproductive age and is associated with a heightened risk of metabolic morbidity, exacerbated by insulin resistance and obesity. Current weight management strategies have limited effectiveness in reducing metabolic morbidity in this subgroup. This review examines the potential of Intensive Weight Management Programmes (IWMPs) and Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to reduce metabolic risks in women with PCOS, drawing from studies in both PCOS-specific and related populations.

Recent findings: IWMPs, including total diet replacement, achieve substantial and sustained weight loss (5-15% over 1-5 years) in individuals with obesity and type 2 diabetes, alongside improvements in metabolic markers like blood pressure and glycemic control. GLP-1 RAs, particularly semaglutide, similarly deliver significant weight loss (10-15% over 1-2 years) and metabolic benefits. While there is limited data specifically targeting PCOS, emerging studies suggest GLP-1 RAs can improve weight, insulin sensitivity, and menstrual regularity in this group. However, evidence for both interventions in PCOS remains insufficient. Women with PCOS face unique metabolic challenges, including heightened insulin resistance, compounded by obesity. While IWMPs and GLP-1 RAs are promising interventions, evidence for their effectiveness in PCOS-specific populations is insufficient. Addressing this research gap through targeted trials is essential to improve outcomes in individuals affected by PCOS and metabolic disorders.

Purpose of review: This review explores the complex interplay between genetic predispositions to obesity, circadian rhythms, metabolic regulation, and sleep. It highlights how genetic factors underlying obesity exacerbate metabolic dysfunction through circadian misalignment and examines promising interventions to mitigate these effects.

Recent findings: Genome-wide association Studies (GWAS) have identified numerous Single Nucleotide Polymorphisms (SNPs) associated with obesity traits, attributing 40-75% heritability to body mass index (BMI). These findings illuminate critical links between genetic obesity, circadian clocks, and metabolic processes. SNPs in clock-related genes influence metabolic pathways, with disruptions in circadian rhythms-driven by poor sleep hygiene or erratic eating patterns-amplifying metabolic dysfunction. Circadian clocks, synchronized with the 24-h light-dark cycle, regulate key metabolic activities, including glucose metabolism, lipid storage, and energy utilization. Genetic mutations or external disruptions, such as irregular sleep or eating habits, can destabilize circadian rhythms, promoting weight gain and metabolic disorders. Circadian misalignment in individuals with genetic predispositions to obesity disrupts the release of key metabolic hormones, such as leptin and insulin, impairing hunger regulation and fat storage. Interventions like time-restricted feeding (TRF) and structured physical activity offer promising strategies to restore circadian harmony, improve metabolic health, and mitigate obesity-related risks.

Purpose of the review: This review summarizes recent evidence for a role of the clock in adipose tissue physiology and the impact of circadian desynchrony on the development of obesity.

Recent findings: Circadian disruptions due to shift work, late time eating and nighttime light exposure are associated with obesity and its metabolic and cardiovascular consequences. Studies in mice harboring tissue-specific gain/loss of function mutations in clock genes revealed that the circadian clock acts on multiple pathways to control adipogenesis, lipogenesis/lipolysis and thermogenesis. Time-restricted eating (TRE), aligning feeding with the active period to restore clock function, represents a promising strategy to curb obesity. While TRE has shown clear benefits, especially in participants at higher cardiometabolic risk, current studies are limited in size and duration. Larger, well-controlled studies are warranted to conclusively assess the effects of TRE in relation to the metabolic status and gender. Field studies in shift-workers, comparing permanent night shift versus rotating shifts, are also necessary to identify the optimal time window for TRE.

Purpose of review: Obesity is strongly associated with cardiometabolic disorders and certain malignancies, emphasizing the key role of adipose tissue in human health. While incretin mimetics have shown effectiveness in glycemic control and weight loss, a holistic strategy for combating obesity and associated comorbidities remains elusive. This review explores peroxisome proliferator-activated receptor gamma (PPAR-γ) agonism as a potential therapeutic approach, highlighting its benefits, addressing its limitations, and outlining future directions for developing more effective treatment strategies.

Recent findings: Both natural and synthetic PPAR-γ agonists hold significant therapeutic potential as insulin sensitizers, while also demonstrating anti-inflammatory properties and playing a critical role in regulating lipid metabolism. However, the clinical use of natural agonists is limited by poor bioavailability, while synthetic agents like thiazolidinediones are associated with adverse effects, including fluid retention, weight gain, and bone loss. Current research is focused on developing modified, tissue-specific PPAR-γ agonists, as well as dual PPAR-α/PPAR-γ agonists, with improved safety profiles to mitigate these side effects. Nanotechnology-based drug delivery systems also hold promise for enhancing bioavailability and therapeutic efficacy. Furthermore, the transformative potential of machine learning and artificial intelligence offers opportunities to accelerate advancements in this field. PPAR-γ agonists exhibit significant potential in addressing metabolic syndrome, cardiovascular disease, and cancer. However, their clinical use is restricted by safety concerns and suboptimal pharmacokinetics. Innovations in modified PPAR-γ agonists, nanotechnology-based delivery systems, and computational tools hold promise for creating safer and more effective therapeutic options for obesity and its associated disorders.

Purpose of review: This narrative review examines the potential implications of the expanded use of novel medications for obesity, particularly the GLP-1 receptor agonists, on weight stigma and societal attitudes towards pharmacologically induced weight loss. It analyses how these medications may potentially contribute to both reducing and exacerbating stigma and discusses strategies to reduce weight bias.

Recent findings: The introduction of GLP-1 receptor agonists has demonstrated effectiveness in reducing weight and lead to improved health outcomes for individuals living with obesity. However, while these medications may reduce stigma by framing obesity as a medical issue rather than a personal failure, disparities in access and use related to high costs may inflate existing biases against those who cannot afford treatment. Also, a few studies indicate that users of these medications may feel stigmatised for taking what is perceived as an "easy way out" to lose weight, mirroring historical attitudes towards bariatric surgery. The new medications for obesity may have the potential to reduce obesity stigma by reframing it as a medical condition rather than a moral failing. However, taking legal actions to build a more inclusive society including ensuring equitable access to these medications will be essential in mitigating stigma and help fostering a supportive environment for those living with obesity. Lessons from reducing stigma surrounding other medical conditions suggest that supportive health care and educational campaigns that promote the understanding of obesity as a complex health issue are needed to reshape negative perceptions towards individuals with obesity.

Purpose of review: In this review, we summarize the molecular effects of time-restricted eating (TRE) and its possible role in appetite regulation. We also discuss the potential clinical benefits of TRE in obesity.

Recent findings: TRE is an emerging dietary approach consisting in limiting food intake to a specific window of time each day. The rationale behind this strategy is to restore the circadian misalignment, commonly seen in obesity. Preclinical studies have shown that restricting food intake only during the active phase of the day can positively influence several cellular functions including senescence, mitochondrial activity, inflammation, autophagy and nutrients' sensing pathways. Furthermore, TRE may play a role by modulating appetite and satiety hormones, though further research is needed to clarify its exact mechanisms. Clinical trials involving patients with obesity or type 2 diabetes suggest that TRE can be effective for weight loss, but its broader effects on improving other clinical outcomes, such as cardiovascular risk factors, remain less certain. The epidemic proportions of obesity cause urgency to find dietary, pharmacological and surgical interventions that can be effective in the medium and long term. According to its molecular effects, TRE can be an interesting alternative to caloric restriction in the treatment of obesity, but the considerable variability across clinical trials regarding population, intervention, and follow-up duration makes it difficult to reach definitive conclusions.

Introduction: Long-term data indicate that patients who underwent metabolic bariatric surgery have a higher risk of developing nutritional complications. Therefore, it is of utmost importance to monitor their nutritional status.

Methods: A scoping literature search was conducted in MEDLINE, EMBASE, CINAHL, and TRIP database to identify clinical practice guidelines for nutritional screening before and after metabolic bariatric surgery from learned societies. For full coverage, all websites of learned societies affiliated with the World Obesity Federation were searched. Clinical practice guidelines were eligible if they contained recommendations for nutritional screening before and after sleeve gastrectomy or Roux-en-Y gastric bypass. Content was screened by two reviewers for timing, biochemical markers and cut-off values, and biochemical assays for nutritional screening.

Results: Nine eligible clinical practice guidelines co-authored by 26 learned societies were identified. All guidelines provided recommendations for both bariatric procedures except for one. Majority of guidelines endorsed nutritional screening before surgery and at 3, 6, 12, and 24 months after surgery, and annually thereafter. Pre- and postoperative screening recommendations were available for iron, vitamin B₁₂, folate, calcium and vitamin D, but in a lesser extent for vitamin A, vitamin E, vitamin K, zinc, vitamin B₁, copper and magnesium. Two clinical practice guidelines provided cut-off values for the diagnosis of nutritional deficiencies.

Discussion: The clinical practice guidelines exhibited a high level of consistency for timing of screening, but not for the applied biochemical markers. Going forward, the primary focus should be on harmonizing recommendations for biochemical markers, and cut-off values.