Pub Date : 2025-11-29DOI: 10.1038/s41366-025-01972-6
Eilon Heyman, Gabriel Chodick, Noga Fallach, Gal Dubnov-Raz
Background and objective: The role of the microbiome and gut flora alterations in childhood obesity has drawn increasing scientific attention. However, large-scale, long-term cohort studies with real-world data on exposure and outcomes are lacking. We aimed to examine the association between exposure to antibiotics during infancy and the development of overweight and obesity during childhood and adolescence.
Methods: We conducted a historical cohort study using data from a large Israeli health provider (Maccabi Healthcare Services, MHS). Eligible patients born between 1998-2002 who received antibiotics before age 2 years were compared with unexposed infants. Valid body mass index (BMI) data were available for 76,840 eligible infants, including 65280 exposed to antibiotics (52.2% males) and 11,560 unexposed (46.1% males). Study outcomes were overweight and obesity during childhood/ adolescence.
Results: Compared to unexposed, antibiotic-exposed infants had significantly higher mean ( ± SE) BMI percentiles in all age groups: childhood (57.8 ± 0.1 vs 55.0 ± 0.2), early adolescence (58.2 ± 0.1 vs. 55.1 ± 0.3), and late adolescence (57.4 ± 0.2 vs. 55.0 ± 0.4), all p < 0.001. The odds of overweight and obesity versus unexposed infants increased significantly (p < 0.001) with the number of dispensed narrow-spectrum antibiotic packs, from an odds ratio of 1.15 (95%CI: 1.02-1.29) for 1-2 packs, to 1.52 (95%CI: 1.13-2.05) among those exposed to 10 or more packs. No such association was found for broad-spectrum antibiotics.
Conclusions: Exposure to narrow spectrum antibiotics during infancy was associated with a higher BMI and an increased likelihood of overweight and obesity in childhood and adolescence.
背景与目的：微生物组和肠道菌群改变在儿童肥胖中的作用已引起越来越多的科学关注。然而，关于暴露和结果的大规模、长期队列研究缺乏真实数据。我们的目的是研究婴儿期接触抗生素与儿童期和青春期超重和肥胖发展之间的关系。方法：我们进行了一项历史队列研究，使用来自以色列一家大型医疗服务机构（马卡比医疗服务，MHS）的数据。在1998-2002年间出生并在2岁前接受抗生素治疗的符合条件的患者与未接受抗生素治疗的婴儿进行了比较。76840名符合条件的婴儿获得了有效的体重指数（BMI）数据，其中65280名暴露于抗生素（52.2%男性），11560名未暴露于抗生素（46.1%男性）。研究结果是儿童/青少年时期超重和肥胖。结果：与未暴露抗生素的婴儿相比，暴露抗生素的婴儿在所有年龄组的平均（±SE） BMI百分位数均显着升高：儿童期（57.8±0.1 vs 55.0±0.2），青春期早期（58.2±0.1 vs 55.1±0.3）和青春期晚期（57.4±0.2 vs 55.0±0.4），均为p结论：婴儿期暴露于窄谱抗生素与较高的BMI以及儿童期和青春期超重和肥胖的可能性增加有关。
{"title":"The association between antibiotic use in infancy and overweight during childhood and adolescence: a historical cohort study.","authors":"Eilon Heyman, Gabriel Chodick, Noga Fallach, Gal Dubnov-Raz","doi":"10.1038/s41366-025-01972-6","DOIUrl":"https://doi.org/10.1038/s41366-025-01972-6","url":null,"abstract":"<p><strong>Background and objective: </strong>The role of the microbiome and gut flora alterations in childhood obesity has drawn increasing scientific attention. However, large-scale, long-term cohort studies with real-world data on exposure and outcomes are lacking. We aimed to examine the association between exposure to antibiotics during infancy and the development of overweight and obesity during childhood and adolescence.</p><p><strong>Methods: </strong>We conducted a historical cohort study using data from a large Israeli health provider (Maccabi Healthcare Services, MHS). Eligible patients born between 1998-2002 who received antibiotics before age 2 years were compared with unexposed infants. Valid body mass index (BMI) data were available for 76,840 eligible infants, including 65280 exposed to antibiotics (52.2% males) and 11,560 unexposed (46.1% males). Study outcomes were overweight and obesity during childhood/ adolescence.</p><p><strong>Results: </strong>Compared to unexposed, antibiotic-exposed infants had significantly higher mean ( ± SE) BMI percentiles in all age groups: childhood (57.8 ± 0.1 vs 55.0 ± 0.2), early adolescence (58.2 ± 0.1 vs. 55.1 ± 0.3), and late adolescence (57.4 ± 0.2 vs. 55.0 ± 0.4), all p < 0.001. The odds of overweight and obesity versus unexposed infants increased significantly (p < 0.001) with the number of dispensed narrow-spectrum antibiotic packs, from an odds ratio of 1.15 (95%CI: 1.02-1.29) for 1-2 packs, to 1.52 (95%CI: 1.13-2.05) among those exposed to 10 or more packs. No such association was found for broad-spectrum antibiotics.</p><p><strong>Conclusions: </strong>Exposure to narrow spectrum antibiotics during infancy was associated with a higher BMI and an increased likelihood of overweight and obesity in childhood and adolescence.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magnet-assisted bariatric surgery (MABS) represents a novel advancement in minimally invasive surgical techniques. It addresses challenges associated with obesity-related anatomical complexities, such as hepatomegaly and fatty liver disease, by enhancing surgical exposure and site visualization. This systematic review aimed to: (1) compare the efficacy of MABS and conventional bariatric surgery for weight loss and postoperative outcomes; (2) assess their safety profiles; and (3) evaluate perioperative recovery, hospital stay, and patient-reported outcomes like quality of life and satisfaction. A comprehensive literature search was conducted across PubMed, Web of science, Google scholar and Cochrane databases. Data were extracted and synthesized to provide quantitative assessment of MABS’s performance. A total of 12 articles comprising 1305 participants were included. The findings confirmed MABS’s feasibility and safety, with significant advantages across varying BMI ranges. Notable benefits included improved surgical exposure, shorter or comparable operative times, reduced postoperative pain, shorter hospital stays, low complication rates and no procedure-related mortality. MABS demonstrated strong potential as an innovative tool in minimally invasive bariatric surgery, offering significant benefits for both patients and surgical teams. Its ability to address obesity-related challenges and enhance surgical outcomes supports its continued use and refinement. Future research should focus on stratified analyses, long-term outcomes, and economic evaluations to establish standardized criteria for patient selection and expand its applicability to other minimally invasive procedures.
背景：磁辅助减肥手术（MABS）代表了微创手术技术的新进展。它解决了与肥胖相关的解剖复杂性相关的挑战，如肝肿大和脂肪肝疾病，通过增强手术暴露和部位可视化。目的：本系统综述旨在：(1)比较MABS与传统减肥手术在减肥和术后预后方面的疗效；(2)评估其安全概况；(3)评估围手术期恢复、住院时间和患者报告的生活质量和满意度等结局。方法：对PubMed、Web of science、谷歌scholar和Cochrane数据库进行综合文献检索。提取并综合数据，对MABS的性能进行定量评价。结果：共纳入12篇文献，1305名受试者。研究结果证实了MABS的可行性和安全性，在不同的BMI范围内具有显著的优势。显著的益处包括改善手术暴露、缩短或类似的手术时间、减少术后疼痛、缩短住院时间、低并发症发生率和无手术相关死亡率。结论：MABS作为一种微创减肥手术的创新工具显示出强大的潜力，为患者和手术团队提供了显著的好处。其解决肥胖相关挑战和提高手术效果的能力支持其继续使用和改进。未来的研究应侧重于分层分析、长期结果和经济评估，以建立患者选择的标准化标准，并将其应用于其他微创手术。
{"title":"Current evidence and future perspectives on magnet-assisted bariatric surgery (MABS): a systematic review","authors":"Yuhan Chen, Dong Shiliang, Yang Liu, Xiaodie Zhou, Bian Wu, Xiaoguan Zhang, Wenhui Chen, Zhiyong Dong","doi":"10.1038/s41366-025-01966-4","DOIUrl":"10.1038/s41366-025-01966-4","url":null,"abstract":"Magnet-assisted bariatric surgery (MABS) represents a novel advancement in minimally invasive surgical techniques. It addresses challenges associated with obesity-related anatomical complexities, such as hepatomegaly and fatty liver disease, by enhancing surgical exposure and site visualization. This systematic review aimed to: (1) compare the efficacy of MABS and conventional bariatric surgery for weight loss and postoperative outcomes; (2) assess their safety profiles; and (3) evaluate perioperative recovery, hospital stay, and patient-reported outcomes like quality of life and satisfaction. A comprehensive literature search was conducted across PubMed, Web of science, Google scholar and Cochrane databases. Data were extracted and synthesized to provide quantitative assessment of MABS’s performance. A total of 12 articles comprising 1305 participants were included. The findings confirmed MABS’s feasibility and safety, with significant advantages across varying BMI ranges. Notable benefits included improved surgical exposure, shorter or comparable operative times, reduced postoperative pain, shorter hospital stays, low complication rates and no procedure-related mortality. MABS demonstrated strong potential as an innovative tool in minimally invasive bariatric surgery, offering significant benefits for both patients and surgical teams. Its ability to address obesity-related challenges and enhance surgical outcomes supports its continued use and refinement. Future research should focus on stratified analyses, long-term outcomes, and economic evaluations to establish standardized criteria for patient selection and expand its applicability to other minimally invasive procedures.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 2","pages":"309-318"},"PeriodicalIF":3.8,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-28DOI: 10.1038/s41366-025-01968-2
De-An Chen, Raul Herrera Pena, Niki Oldenburg, Qi Wang, Erika Helgeson, Brad Yentzer, Abdisa Taddese, Nicole LaPage, Emily N. C. Manoogian, Satchinananda Panda, Lisa S. Chow
Rising obesity rates necessitate sustainable weight management strategies. Current lifestyle guidelines focus on reducing caloric intake through personalized interventions to promote compliance. This secondary analysis evaluated post-intervention sustainability of time-restricted eating (TRE) versus caloric restriction (CR), hypothesizing that TRE’s “watching the clock” approach may be more sustainable than CR’s “watching calories.” Following a 12-week supervised intervention (TRE: 8-h eating window, n = 29; CR: 15% caloric reduction, n = 26), 41 participants (75%; 24 F/17 M; 23 TRE/18 CR; age 43.1 ± 11.6 years; BMI 34.7 ± 5.4 kg/m²) completed follow-up surveys at 1, 3, and 6 months. TRE participants maintained weight across all follow-ups compared to final intervention weight. CR participants showed significant loss at 1 month (−1.6 ± 2.5 kg, p = 0.02), returning to baseline by 3 months. Both interventions had similar continuation rates (1,3,6 months: TRE: 52%, 36%, 47%; CR: 63%, 57%, 50%; p = 0.60) and recommendation rates (TRE: 81%, 85%, 86%; CR: 88%, 86%, 80%; p = 0.72). TRE participants reported improved sleep, energy, and digestion but experienced morning hunger and scheduling challenges. CR participants noted increased food mindfulness but reported tracking anxiety, cravings, and potential binge eating. Despite limitations including small sample size and self-reported weight, both self-sustained TRE and CR showed similar acceptability and weight maintenance at 3–6 months post-intervention. Clinical Trial Registration: Clinicaltrials.gov NCT04259632.
{"title":"Post-intervention sustainability of time-restricted eating versus caloric restriction: a secondary analysis","authors":"De-An Chen, Raul Herrera Pena, Niki Oldenburg, Qi Wang, Erika Helgeson, Brad Yentzer, Abdisa Taddese, Nicole LaPage, Emily N. C. Manoogian, Satchinananda Panda, Lisa S. Chow","doi":"10.1038/s41366-025-01968-2","DOIUrl":"10.1038/s41366-025-01968-2","url":null,"abstract":"Rising obesity rates necessitate sustainable weight management strategies. Current lifestyle guidelines focus on reducing caloric intake through personalized interventions to promote compliance. This secondary analysis evaluated post-intervention sustainability of time-restricted eating (TRE) versus caloric restriction (CR), hypothesizing that TRE’s “watching the clock” approach may be more sustainable than CR’s “watching calories.” Following a 12-week supervised intervention (TRE: 8-h eating window, n = 29; CR: 15% caloric reduction, n = 26), 41 participants (75%; 24 F/17 M; 23 TRE/18 CR; age 43.1 ± 11.6 years; BMI 34.7 ± 5.4 kg/m²) completed follow-up surveys at 1, 3, and 6 months. TRE participants maintained weight across all follow-ups compared to final intervention weight. CR participants showed significant loss at 1 month (−1.6 ± 2.5 kg, p = 0.02), returning to baseline by 3 months. Both interventions had similar continuation rates (1,3,6 months: TRE: 52%, 36%, 47%; CR: 63%, 57%, 50%; p = 0.60) and recommendation rates (TRE: 81%, 85%, 86%; CR: 88%, 86%, 80%; p = 0.72). TRE participants reported improved sleep, energy, and digestion but experienced morning hunger and scheduling challenges. CR participants noted increased food mindfulness but reported tracking anxiety, cravings, and potential binge eating. Despite limitations including small sample size and self-reported weight, both self-sustained TRE and CR showed similar acceptability and weight maintenance at 3–6 months post-intervention. Clinical Trial Registration: Clinicaltrials.gov NCT04259632.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 2","pages":"474-477"},"PeriodicalIF":3.8,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-025-01968-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-27DOI: 10.1038/s41366-025-01943-x
Iman Elahi Vahed, Erfan Shahir-Roudi, Sina Nojumi, Samieh Golmohammadi, Mehdi Moradi Shahrebabak, Niloofar Sharafi Tafreshi Moghadam, Amir Sajad Bagheryan, Maryam Moftakhar, Fateme Shamsipour, Mahla Jafari, Hossein Soltaninejad, Mohammad Rahmanian
Obesity is an already identified risk factor for various noncommunicable diseases. Berberine is an alkaloid that has manifested a significant effect in the treatment of obesity and its complications. The aim of this systematic review and meta analysis is to evaluate the effect of berberine on obesity indices. We conducted a comprehensive search of Scopus, PubMed, Web of Science, and Google Scholar for randomized controlled trials (RCTs) investigating berberine’s impact on obesity indices in adults. Eligible studies included human trials with quantitative outcomes for weight, BMI, WC, or WHR. Animal studies, reviews, and non-RCTs were excluded. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. A random-effects meta-analysis was performed to calculate mean differences (MDs) and 95% confidence intervals (CIs). Heterogeneity was evaluated using I² statistics. A total of 23 articles were included. Berberine significantly reduced body weight (MD of -0.88 kg, 95% CI: -1.36 to -0.39, p = 0.0003), BMI (MD of -0.48 kg/m², 95% CI: -0.89 to -0.07, p < 0.0216), and WC (MD of -1.32 kg/m², 95% CI: -2.24 to -0.41, p < 0.0046). However, berberine did not significantly reduce WHR compared to control groups (MD of -0.01, 95% CI: -0.03 to 0.01). Meta-regression revealed no association between berberine use and age. Berberine use significantly reduces body weight, BMI, and WC but does not significantly reduce WHR. Future trials should focus on improving reporting standards for biochemical characterization (such as purity, potency and gram amounts) and address common biases such as lack of blinding and randomization to enhance the reliability of the evidence.
背景和目的：肥胖是多种非传染性疾病的危险因素。小檗碱是一种生物碱，在治疗肥胖及其并发症方面表现出显著的效果。本系统综述和荟萃分析的目的是评估小檗碱对肥胖指数的影响。方法：我们对Scopus、PubMed、Web of Science和谷歌Scholar进行了全面的检索，以研究小檗碱对成人肥胖指数的影响的随机对照试验（rct）。符合条件的研究包括具有体重、BMI、腰围或腰宽比定量结果的人体试验。排除了动物研究、综述和非随机对照试验。两位审稿人独立筛选研究，提取数据，并使用Cochrane RoB 2工具评估偏倚风险。随机效应荟萃分析计算平均差异（MDs）和95%置信区间（ci）。采用I²统计量评估异质性。结果：共纳入23篇文献。黄连素显著降低体重（MD为-0.88 kg, 95% CI: -1.36 ~ -0.39, p = 0.0003）， BMI （MD为-0.48 kg/m²，95% CI: -0.89 ~ -0.07, p）。结论：黄连素可显著降低体重、BMI和WC，但不能显著降低腰臀比。未来的试验应侧重于改善生化表征（如纯度、效力和克量）的报告标准，并解决常见的偏见，如缺乏盲法和随机化，以提高证据的可靠性。
{"title":"The effect of berberine on obesity indices: a systematic review and meta-analysis","authors":"Iman Elahi Vahed, Erfan Shahir-Roudi, Sina Nojumi, Samieh Golmohammadi, Mehdi Moradi Shahrebabak, Niloofar Sharafi Tafreshi Moghadam, Amir Sajad Bagheryan, Maryam Moftakhar, Fateme Shamsipour, Mahla Jafari, Hossein Soltaninejad, Mohammad Rahmanian","doi":"10.1038/s41366-025-01943-x","DOIUrl":"10.1038/s41366-025-01943-x","url":null,"abstract":"Obesity is an already identified risk factor for various noncommunicable diseases. Berberine is an alkaloid that has manifested a significant effect in the treatment of obesity and its complications. The aim of this systematic review and meta analysis is to evaluate the effect of berberine on obesity indices. We conducted a comprehensive search of Scopus, PubMed, Web of Science, and Google Scholar for randomized controlled trials (RCTs) investigating berberine’s impact on obesity indices in adults. Eligible studies included human trials with quantitative outcomes for weight, BMI, WC, or WHR. Animal studies, reviews, and non-RCTs were excluded. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. A random-effects meta-analysis was performed to calculate mean differences (MDs) and 95% confidence intervals (CIs). Heterogeneity was evaluated using I² statistics. A total of 23 articles were included. Berberine significantly reduced body weight (MD of -0.88 kg, 95% CI: -1.36 to -0.39, p = 0.0003), BMI (MD of -0.48 kg/m², 95% CI: -0.89 to -0.07, p < 0.0216), and WC (MD of -1.32 kg/m², 95% CI: -2.24 to -0.41, p < 0.0046). However, berberine did not significantly reduce WHR compared to control groups (MD of -0.01, 95% CI: -0.03 to 0.01). Meta-regression revealed no association between berberine use and age. Berberine use significantly reduces body weight, BMI, and WC but does not significantly reduce WHR. Future trials should focus on improving reporting standards for biochemical characterization (such as purity, potency and gram amounts) and address common biases such as lack of blinding and randomization to enhance the reliability of the evidence.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 1","pages":"53-73"},"PeriodicalIF":3.8,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-27DOI: 10.1038/s41366-025-01960-w
Kübra Tel Adıgüzel, Ayşegül Yaman, Nilgün Seremet Kürklü, Emre Adıgüzel
Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat accumulation, pain, and low-grade systemic inflammation, primarily affecting women. This study investigated the relationship between the Dietary Inflammatory Index (DII), adherence to the Mediterranean diet scores (MDS), inflammatory biomarkers (TNF-α and IL-6), and clinical outcomes in women with lipedema. A cross-sectional study was conducted on 60 female participants with stage 2–3 lipedema and BMI between 30–40 kg/m². Using three-day dietary records, DII was calculated. MDS was measured by Mediterranean Diet Adherence Screening Tool. Pain and quality of life were evaluated using the Visual Analog Scale (VAS) and the Short Form-12 (SF-12), respectively. Body composition was measured via bioelectrical impedance analysis, and serum TNF-α and IL-6 levels were measured using ELISA. DII score was positively associated with elevated TNF-α and IL-6 concentration (p < 0.001). DII was moderately and positively correlated with both inflammatory markers, while MDS showed moderate negative correlations. Multiple linear regression models identified DII, MDS, and body mass index (BMI) as significant predictors of TNF-α and IL-6 concentration. No significant associations were observed between DII or MDS and pain (VAS) or quality of life (SF-12) scores, although mental component scores were slightly higher in participants with moderate DII levels compared to those with higher DII levels. Higher DII and BMI were linked to increased inflammation, while higher MDS was associated with lower biomarker levels. Age and disease duration were not significant in any model. A pro-inflammatory diet, as reflected by higher DII, is associated with increased systemic inflammation in lipedema. These findings highlight the potential role of anti-inflammatory dietary patterns, particularly the Mediterranean diet, as part of non-pharmacological strategies for managing inflammation in lipedema. These findings suggest that while dietary inflammatory potential influences systemic inflammation, its relationship with pain and quality of life remains unclear and warrants further interventional studies.
{"title":"Dietary Inflammatory Index and Mediterranean Diet Score are associated with systemic inflammation in women with lipedema","authors":"Kübra Tel Adıgüzel, Ayşegül Yaman, Nilgün Seremet Kürklü, Emre Adıgüzel","doi":"10.1038/s41366-025-01960-w","DOIUrl":"10.1038/s41366-025-01960-w","url":null,"abstract":"Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat accumulation, pain, and low-grade systemic inflammation, primarily affecting women. This study investigated the relationship between the Dietary Inflammatory Index (DII), adherence to the Mediterranean diet scores (MDS), inflammatory biomarkers (TNF-α and IL-6), and clinical outcomes in women with lipedema. A cross-sectional study was conducted on 60 female participants with stage 2–3 lipedema and BMI between 30–40 kg/m². Using three-day dietary records, DII was calculated. MDS was measured by Mediterranean Diet Adherence Screening Tool. Pain and quality of life were evaluated using the Visual Analog Scale (VAS) and the Short Form-12 (SF-12), respectively. Body composition was measured via bioelectrical impedance analysis, and serum TNF-α and IL-6 levels were measured using ELISA. DII score was positively associated with elevated TNF-α and IL-6 concentration (p < 0.001). DII was moderately and positively correlated with both inflammatory markers, while MDS showed moderate negative correlations. Multiple linear regression models identified DII, MDS, and body mass index (BMI) as significant predictors of TNF-α and IL-6 concentration. No significant associations were observed between DII or MDS and pain (VAS) or quality of life (SF-12) scores, although mental component scores were slightly higher in participants with moderate DII levels compared to those with higher DII levels. Higher DII and BMI were linked to increased inflammation, while higher MDS was associated with lower biomarker levels. Age and disease duration were not significant in any model. A pro-inflammatory diet, as reflected by higher DII, is associated with increased systemic inflammation in lipedema. These findings highlight the potential role of anti-inflammatory dietary patterns, particularly the Mediterranean diet, as part of non-pharmacological strategies for managing inflammation in lipedema. These findings suggest that while dietary inflammatory potential influences systemic inflammation, its relationship with pain and quality of life remains unclear and warrants further interventional studies.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 2","pages":"442-449"},"PeriodicalIF":3.8,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145632976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-25DOI: 10.1038/s41366-025-01922-2
Salim Al Busaidi, Juhaina Salim Al-Maqbali, Jawahar Al Nou’mani, Thuraiya Al Harthi, Abdullah M. Al Alawi, Amira Al Kharusi
The global rise in obesity has prompted the need to explore population-specific Body Mass Index (BMI) thresholds. Current international guidelines may not reflect the cardiometabolic risks in Arab and Middle Eastern populations. This systematic review and meta-analysis aim to identify optimal BMI cut-offs associated with cardiometabolic morbidity and mortality in these populations. A systematic search of Medline and Embase databases identified observational and experimental studies focusing on BMI thresholds linked to cardiometabolic outcomes, including Diabetes Mellitus (DM), hypertension (HTN), dyslipidemia (DLP), cardiovascular diseases (CVD), and metabolic syndrome. Data extraction followed PRISMA guidelines, and random-effects models were used to calculate pooled estimates of optimal BMI cut-offs. Subgroup and sensitivity analyses were performed to address heterogeneity. Fifty-five studies involving 677,587 participants met the inclusion criteria. Optimal BMI cut-offs ranged from 26.22 to 27.45 kg/m². For DM, the BMI threshold was 27.39 kg/m² (95% CI: 26.70–28.09), while HTN and MetS were associated with thresholds of 27.00 kg/m² and 27.45 kg/m², respectively. Gender differences were observed, with females showing higher BMI cut-offs than males. The sensitivity and specificity of these cut-offs were moderate, with high between-study heterogeneity (I² > 90%). Publication bias was minimal for most outcomes, except DLP. This study demonstrates that lower BMI thresholds are associated with cardiometabolic risks in Arab and Middle Eastern populations compared to global reports. Findings support the need for region-specific BMI cut-off guidelines and public health interventions targeting early diagnosis and management.
{"title":"Optimal BMI cut-offs associated with cardiometabolic risks in Arab and Middle Eastern populations: a systematic review and meta-analysis","authors":"Salim Al Busaidi, Juhaina Salim Al-Maqbali, Jawahar Al Nou’mani, Thuraiya Al Harthi, Abdullah M. Al Alawi, Amira Al Kharusi","doi":"10.1038/s41366-025-01922-2","DOIUrl":"10.1038/s41366-025-01922-2","url":null,"abstract":"The global rise in obesity has prompted the need to explore population-specific Body Mass Index (BMI) thresholds. Current international guidelines may not reflect the cardiometabolic risks in Arab and Middle Eastern populations. This systematic review and meta-analysis aim to identify optimal BMI cut-offs associated with cardiometabolic morbidity and mortality in these populations. A systematic search of Medline and Embase databases identified observational and experimental studies focusing on BMI thresholds linked to cardiometabolic outcomes, including Diabetes Mellitus (DM), hypertension (HTN), dyslipidemia (DLP), cardiovascular diseases (CVD), and metabolic syndrome. Data extraction followed PRISMA guidelines, and random-effects models were used to calculate pooled estimates of optimal BMI cut-offs. Subgroup and sensitivity analyses were performed to address heterogeneity. Fifty-five studies involving 677,587 participants met the inclusion criteria. Optimal BMI cut-offs ranged from 26.22 to 27.45 kg/m². For DM, the BMI threshold was 27.39 kg/m² (95% CI: 26.70–28.09), while HTN and MetS were associated with thresholds of 27.00 kg/m² and 27.45 kg/m², respectively. Gender differences were observed, with females showing higher BMI cut-offs than males. The sensitivity and specificity of these cut-offs were moderate, with high between-study heterogeneity (I² > 90%). Publication bias was minimal for most outcomes, except DLP. This study demonstrates that lower BMI thresholds are associated with cardiometabolic risks in Arab and Middle Eastern populations compared to global reports. Findings support the need for region-specific BMI cut-off guidelines and public health interventions targeting early diagnosis and management.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 1","pages":"23-32"},"PeriodicalIF":3.8,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1038/s41366-025-01942-y
Gabriela Hurtado-Alvarado, Rebeca Mendez-Hernandez, Karol Iliana Avila-Soto, Alberto Salazar-Juárez, Mónica Espinoza-Rojo, Carolina Escobar, Miguel Vázquez-Moreno, Miguel Cruz
Circulating S100 β and neuron-specific enolase (NSE) have been used to explore brain damage in adults with obesity. Nonetheless, the subtle increase of these molecules can be found in non-pathological conditions in healthy subjects, indicating possible disturbances in brain function. We aimed to compare serum levels of S100β and NSE between children with and without obesity. We analyzed circulating S100β and NSE and performed correlations with anthropometry and biochemical parameters from 80 children between 6 and 11 years old, divided into two groups: children with obesity (Body mass index ≥97th percentile) and children with normal body weight (between the 5th and 85th percentile). Our results show that children with obesity have approximately 50% more circulating levels of S100β and NSE. Furthermore, we found a positive correlation between S100β and circulating resistin and a positive correlation between NSE and Body mass index, waist circumference, and waist-to-hip ratio. Conversely, NSE and adiponectin showed a negative correlation. S100β and NSE levels in blood were associated with indicators of metabolic impairment. Future studies are needed to determine if the increase of S100β and NSE in children with obesity is related to cognitive function.
{"title":"Serum S100β and neuron-specific enolase correlate with obesity parameters in Mexican children","authors":"Gabriela Hurtado-Alvarado, Rebeca Mendez-Hernandez, Karol Iliana Avila-Soto, Alberto Salazar-Juárez, Mónica Espinoza-Rojo, Carolina Escobar, Miguel Vázquez-Moreno, Miguel Cruz","doi":"10.1038/s41366-025-01942-y","DOIUrl":"10.1038/s41366-025-01942-y","url":null,"abstract":"Circulating S100 β and neuron-specific enolase (NSE) have been used to explore brain damage in adults with obesity. Nonetheless, the subtle increase of these molecules can be found in non-pathological conditions in healthy subjects, indicating possible disturbances in brain function. We aimed to compare serum levels of S100β and NSE between children with and without obesity. We analyzed circulating S100β and NSE and performed correlations with anthropometry and biochemical parameters from 80 children between 6 and 11 years old, divided into two groups: children with obesity (Body mass index ≥97th percentile) and children with normal body weight (between the 5th and 85th percentile). Our results show that children with obesity have approximately 50% more circulating levels of S100β and NSE. Furthermore, we found a positive correlation between S100β and circulating resistin and a positive correlation between NSE and Body mass index, waist circumference, and waist-to-hip ratio. Conversely, NSE and adiponectin showed a negative correlation. S100β and NSE levels in blood were associated with indicators of metabolic impairment. Future studies are needed to determine if the increase of S100β and NSE in children with obesity is related to cognitive function.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 2","pages":"378-385"},"PeriodicalIF":3.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-025-01942-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-24DOI: 10.1038/s41366-025-01946-8
Yujie Ma, Zijie Zhang, Erika Thalia Ramos, Elias Martin, Rahul Gunukula, Kara Sprabary, Heejin Jun
Subcutaneous white adipose tissue (WAT) is crucial for systemic metabolic homeostasis, with beige adipocytes in this depot contributing to energy metabolism through inducible thermogenesis. Differentiated adipocyte cultures derived from mouse inguinal WAT are a widely used system to study beige adipose biology and identify therapeutic targets, as they retain the genetic and epigenetic traits of native adipocytes while providing experimental flexibility. However, variability during the adipocyte induction and differentiation poses a challenge, impacting beige adipogenesis and experimental outcomes. This study conducted an unbiased analysis of four distinct adipogenic cocktails to evaluate their effects on beige adipogenesis in inguinal stromal vascular fraction cells from wild-type and genetically modified mice, as well as on the thermogenic activation of differentiated adipocytes. Different combinations of adipogenic inducers, including dexamethasone, 3-isobutyl-1-methylxanthine, insulin, triiodothyronine, indomethacin, and rosiglitazone (Rosi), recruited beige adipocytes with varying levels of thermogenic characteristics. The peroxisome proliferator-activated receptor gamma agonist, Rosi, emerged as a key inducer, maximizing beige adipocyte biogenesis during the differentiation phase rather than the induction phase. However, Rosi-enhanced beige adipocyte differentiation exhibited limited thermogenic activation at the transcriptional level but not at the rapid signal transduction and real-time functional level in response to a β-adrenergic receptor agonist. These findings underscore the importance of optimizing adipogenic cocktails, as they significantly influence experimental outcomes. This study offers valuable guidance for selecting effective combinations of adipogenic inducers tailored to specific research objectives and relevant in vitro models of beige adipose biology.
{"title":"Optimizing adipogenic cocktail composition to enhance beige adipogenesis and evaluate thermogenic potential in primary mouse subcutaneous fat cell cultures","authors":"Yujie Ma, Zijie Zhang, Erika Thalia Ramos, Elias Martin, Rahul Gunukula, Kara Sprabary, Heejin Jun","doi":"10.1038/s41366-025-01946-8","DOIUrl":"10.1038/s41366-025-01946-8","url":null,"abstract":"Subcutaneous white adipose tissue (WAT) is crucial for systemic metabolic homeostasis, with beige adipocytes in this depot contributing to energy metabolism through inducible thermogenesis. Differentiated adipocyte cultures derived from mouse inguinal WAT are a widely used system to study beige adipose biology and identify therapeutic targets, as they retain the genetic and epigenetic traits of native adipocytes while providing experimental flexibility. However, variability during the adipocyte induction and differentiation poses a challenge, impacting beige adipogenesis and experimental outcomes. This study conducted an unbiased analysis of four distinct adipogenic cocktails to evaluate their effects on beige adipogenesis in inguinal stromal vascular fraction cells from wild-type and genetically modified mice, as well as on the thermogenic activation of differentiated adipocytes. Different combinations of adipogenic inducers, including dexamethasone, 3-isobutyl-1-methylxanthine, insulin, triiodothyronine, indomethacin, and rosiglitazone (Rosi), recruited beige adipocytes with varying levels of thermogenic characteristics. The peroxisome proliferator-activated receptor gamma agonist, Rosi, emerged as a key inducer, maximizing beige adipocyte biogenesis during the differentiation phase rather than the induction phase. However, Rosi-enhanced beige adipocyte differentiation exhibited limited thermogenic activation at the transcriptional level but not at the rapid signal transduction and real-time functional level in response to a β-adrenergic receptor agonist. These findings underscore the importance of optimizing adipogenic cocktails, as they significantly influence experimental outcomes. This study offers valuable guidance for selecting effective combinations of adipogenic inducers tailored to specific research objectives and relevant in vitro models of beige adipose biology.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 2","pages":"386-396"},"PeriodicalIF":3.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-025-01946-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-22DOI: 10.1038/s41366-025-01964-6
Emma Farrell, Joseph Nadglowski, Eva Hollmann, Carel W le Roux, Deirdre McGillicuddy
{"title":"Correction: The nature of the relationship between obesity and mental health: an IMI2 SOPHIA qualitative study.","authors":"Emma Farrell, Joseph Nadglowski, Eva Hollmann, Carel W le Roux, Deirdre McGillicuddy","doi":"10.1038/s41366-025-01964-6","DOIUrl":"10.1038/s41366-025-01964-6","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145581974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-19DOI: 10.1038/s41366-025-01956-6
Beatrice Leyaro, Lyz Howie, Abdulmajid Ali, Raymond Carragher
Rationale: The long-term trajectories of weight loss and glycemic outcomes for patients who undergo bariatric surgery remain underexplored, particularly when comparing individuals who undergo surgery to those who are eligible but do not proceed after referral.
Methods: This retrospective cohort study examined 411 patients with type 2 diabetes and obesity who were referred for consideration of metabolic bariatric surgery (MBS) at University Hospital Ayr, Ayrshire & Arran, between January 2009 and December 2020. The primary outcomes were change in percentage total weight loss (%TWL) and Glycosylated Hemoglobin (HbA1c) from baseline to five years.
Results: Of the 411 patients included, 225 (54.7%) did not undergo bariatric surgery. There were no significant differences between the surgery and non-surgery groups with respect to age, BMI or sex. 260 (63%) of the patients were female, the mean age of patients was 48.3 years (SD = 8.5), and the mean BMI was 47.4 kg/m² (SD = 7.9). At five years, patients who underwent surgery maintained a 22.0% TWL reduction compared to 8.6% in the non-surgery group (p < 0.001). HbA1c decreased by 1.0% (95% CI: -1.31, -0.70) in the surgery group but increased by 0.4% (95% CI: 0.09, 0.71) in the non-surgery group. Adjusted mixed-effects modelling showed the annual HbA1c level decreased by 0.13% (95% CI: -0.18, -0.07; p < 0.001) in the surgery group, compared to an increase of 0.11% (95% CI: 0.05, 0.17; p < 0.001) in the non-surgery group. %TWL decreased by 1.31% per year (95% CI: -1.73, -0.88; p < 0.001) in the surgery group, while the non-surgery group experienced an increase of 1.11% (95% CI: 0.66, 1.55; p < 0.001).
Conclusion: Patients eligible for MBS who proceed with surgery achieve superior weight loss and glycaemic control compared to those who decide not to proceed with surgery. Opting out of surgery may have significant health implications, highlighting the need for alternative interventions such as intensive lifestyle modification, pharmacotherapy, and diabetes education programs for those unable or unwilling to undergo MBS.
{"title":"Metabolic bariatric surgery pays off: a longitudinal analysis of weight loss and HbA1c changes in real-world patients data in the West of Scotland.","authors":"Beatrice Leyaro, Lyz Howie, Abdulmajid Ali, Raymond Carragher","doi":"10.1038/s41366-025-01956-6","DOIUrl":"https://doi.org/10.1038/s41366-025-01956-6","url":null,"abstract":"<p><strong>Rationale: </strong>The long-term trajectories of weight loss and glycemic outcomes for patients who undergo bariatric surgery remain underexplored, particularly when comparing individuals who undergo surgery to those who are eligible but do not proceed after referral.</p><p><strong>Methods: </strong>This retrospective cohort study examined 411 patients with type 2 diabetes and obesity who were referred for consideration of metabolic bariatric surgery (MBS) at University Hospital Ayr, Ayrshire & Arran, between January 2009 and December 2020. The primary outcomes were change in percentage total weight loss (%TWL) and Glycosylated Hemoglobin (HbA1c) from baseline to five years.</p><p><strong>Results: </strong>Of the 411 patients included, 225 (54.7%) did not undergo bariatric surgery. There were no significant differences between the surgery and non-surgery groups with respect to age, BMI or sex. 260 (63%) of the patients were female, the mean age of patients was 48.3 years (SD = 8.5), and the mean BMI was 47.4 kg/m² (SD = 7.9). At five years, patients who underwent surgery maintained a 22.0% TWL reduction compared to 8.6% in the non-surgery group (p < 0.001). HbA1c decreased by 1.0% (95% CI: -1.31, -0.70) in the surgery group but increased by 0.4% (95% CI: 0.09, 0.71) in the non-surgery group. Adjusted mixed-effects modelling showed the annual HbA1c level decreased by 0.13% (95% CI: -0.18, -0.07; p < 0.001) in the surgery group, compared to an increase of 0.11% (95% CI: 0.05, 0.17; p < 0.001) in the non-surgery group. %TWL decreased by 1.31% per year (95% CI: -1.73, -0.88; p < 0.001) in the surgery group, while the non-surgery group experienced an increase of 1.11% (95% CI: 0.66, 1.55; p < 0.001).</p><p><strong>Conclusion: </strong>Patients eligible for MBS who proceed with surgery achieve superior weight loss and glycaemic control compared to those who decide not to proceed with surgery. Opting out of surgery may have significant health implications, highlighting the need for alternative interventions such as intensive lifestyle modification, pharmacotherapy, and diabetes education programs for those unable or unwilling to undergo MBS.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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