Pub Date : 2025-07-01DOI: 10.1016/j.orcp.2025.07.002
Xinyu Lei , Liu Wang , Ruilin He, Zongbin Jiang
Objective
To examine the association between waist-to-height ratio (WHtR), a marker of central adiposity, and the odds of frequent or severe headaches, including migraines, in U.S. children and adolescents.
Methods
We analyzed 8915 participants aged 8–19 years in the 1999–2004 National Health and Nutrition Examination Survey (NHANES). WHtR was calculated as waist circumference divided by height and scaled by 10 to reflect the effect of a 0.1-unit increase. We applied survey-weighted logistic regression models to estimate associations between WHtR and self-reported headache status, adjusting for demographic, metabolic, and behavioral covariates. Additional interaction and sensitivity analyses were conducted to assess effect modification and robustness.
Results
Each 0.1-unit increase in WHtR was associated with a 26 % higher odds of reporting headaches (OR = 1.26, 95 % CI: 1.15, 1.38; p < 0.001). Compared to the lowest quartile (Q1), participants in the highest quartile (Q4) had 34 % greater odds (OR = 1.34, 95 % CI: 1.06, 1.70). Restricted cubic spline models demonstrated a linear dose–response association (p for nonlinearity = 0.96). The association remained robust across multiple sensitivity analyses.
Conclusion
WHtR was linearly associated with the odds of frequent or severe headaches in U.S. youth. Although the cross-sectional design limits causal inference, WHtR may serve as a simple and developmentally stable marker for identifying obesity-related neurological symptoms, warranting further longitudinal investigation.
{"title":"Association between waist-to-height ratio and headache symptoms in U.S. youth: A nationwide cross-sectional study","authors":"Xinyu Lei , Liu Wang , Ruilin He, Zongbin Jiang","doi":"10.1016/j.orcp.2025.07.002","DOIUrl":"10.1016/j.orcp.2025.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between waist-to-height ratio (WHtR), a marker of central adiposity, and the odds of frequent or severe headaches, including migraines, in U.S. children and adolescents.</div></div><div><h3>Methods</h3><div>We analyzed 8915 participants aged 8–19 years in the 1999–2004 National Health and Nutrition Examination Survey (NHANES). WHtR was calculated as waist circumference divided by height and scaled by 10 to reflect the effect of a 0.1-unit increase. We applied survey-weighted logistic regression models to estimate associations between WHtR and self-reported headache status, adjusting for demographic, metabolic, and behavioral covariates. Additional interaction and sensitivity analyses were conducted to assess effect modification and robustness.</div></div><div><h3>Results</h3><div>Each 0.1-unit increase in WHtR was associated with a 26 % higher odds of reporting headaches (OR = 1.26, 95 % CI: 1.15, 1.38; <em>p</em> < 0.001). Compared to the lowest quartile (Q1), participants in the highest quartile (Q4) had 34 % greater odds (OR = 1.34, 95 % CI: 1.06, 1.70). Restricted cubic spline models demonstrated a linear dose–response association (<em>p</em> for nonlinearity = 0.96). The association remained robust across multiple sensitivity analyses.</div></div><div><h3>Conclusion</h3><div>WHtR was linearly associated with the odds of frequent or severe headaches in U.S. youth. Although the cross-sectional design limits causal inference, WHtR may serve as a simple and developmentally stable marker for identifying obesity-related neurological symptoms, warranting further longitudinal investigation.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 4","pages":"Pages 303-309"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.orcp.2025.06.004
Diego Montano
Introduction:
The familial environment is one of the major determinants of children’s development of body weight during infancy and adolescence, in particular the socioeconomic status and anthropometric characteristics of the primary care giver. Thus, the aim of the present study is to utilise information on the familial environment of children and adolescents to identify an optimal prediction algorithm for estimating their expected body-mass-index (BMI) in the course of their development.
Methods:
Data from Cohort ’08 and Cohort ’98 of the National Longitudinal Study of Children in Ireland are used (N = 37,960 and 27,499, respectively). The optimal prediction algorithm of children’s BMI was identified by means of deep neural network models, with socioeconomic status and anthropometric characteristics of the primary care giver as predictors. Training and validation of the optimal model was performed with 80% and 20% of the total sample, respectively.
Results:
The optimal deep neural network model yielded substantial improvements in prediction accuracy of children’s BMI. The Pearson correlation between observed and predicted values obtained with the deep neural network was , representing an improvement of about 50% in comparison to a simple linear model.
Conclusion:
The predicted values of deep neural network models offer acceptable accuracy to be used as a communication tool in educational prevention programmes targeting families with children at higher risk of overweight and obesity in paediatric settings.
{"title":"Primary care giver and children’s body-mass-index: A deep neural network model for use in primary paediatric care","authors":"Diego Montano","doi":"10.1016/j.orcp.2025.06.004","DOIUrl":"10.1016/j.orcp.2025.06.004","url":null,"abstract":"<div><h3>Introduction:</h3><div>The familial environment is one of the major determinants of children’s development of body weight during infancy and adolescence, in particular the socioeconomic status and anthropometric characteristics of the primary care giver. Thus, the aim of the present study is to utilise information on the familial environment of children and adolescents to identify an optimal prediction algorithm for estimating their expected body-mass-index (BMI) in the course of their development.</div></div><div><h3>Methods:</h3><div>Data from Cohort ’08 and Cohort ’98 of the National Longitudinal Study of Children in Ireland are used (N = 37,960 and 27,499, respectively). The optimal prediction algorithm of children’s BMI was identified by means of deep neural network models, with socioeconomic status and anthropometric characteristics of the primary care giver as predictors. Training and validation of the optimal model was performed with 80% and 20% of the total sample, respectively.</div></div><div><h3>Results:</h3><div>The optimal deep neural network model yielded substantial improvements in prediction accuracy of children’s BMI. The Pearson correlation between observed and predicted values obtained with the deep neural network was <span><math><mrow><mi>r</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>69</mn></mrow></math></span>, representing an improvement of about 50% in comparison to a simple linear model.</div></div><div><h3>Conclusion:</h3><div>The predicted values of deep neural network models offer acceptable accuracy to be used as a communication tool in educational prevention programmes targeting families with children at higher risk of overweight and obesity in paediatric settings.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 4","pages":"Pages 356-363"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.orcp.2025.07.001
Yu Zhu , Yong Huang , Fandong Zeng , Lei Ding , Yali Liang , Weiwei Chang , Yuelong Jin , Yingshui Yao
Background
This study aimed to investigate the relationship between various folate metabolites and regional body fat composition in children and adolescents, considering the complexity of folate metabolism.
Methods
We performed a cross-sectional study using data from the U.S. National Health and Nutrition Examination Survey (2011–2018). Red blood cell (RBC) and serum folate levels were measured, and body fat distribution was assessed through dual-energy X-ray absorptiometry. Percentage changes were calculated using linear regression models.
Results
Among 2138 children and adolescents, 51.50 % was boys. Higher RBC folate levels (highest versus lowest quintile) were associated with increased fat mass across multiple regions: android (16.73 %, 95 % CI: 6.89–27.47), gynoid (9.35 %, 95 % CI: 2.87–16.25), subcutaneous (16.29 %, 95 % CI: 5.82–27.79), and visceral fat (13.09 %, 95 % CI: 5.62–21.08). Conversely, higher serum folate levels were associated with decreased fat mass in these regions: android (−17.98 %, 95 % CI: −24.94 to −10.37), gynoid (−11.21 %, 95 % CI: −16.51 to −5.57), subcutaneous (−19.45 %, 95 % CI: −26.74 to −11.43), and visceral fat (−11.28 %, 95 % CI: −17.20 to −4.94). Additionally, MeFox showed a positive association with fat deposition, while 5-MTHF was inversely associated with fat accumulation.
Conclusions
Higher RBC folate and MeFox levels were positively linked to fat accumulation, whereas serum folate and 5-MTHF were negatively associated with fat mass. These findings provide preliminary insights into the complex relationship between folate metabolism and fat distribution.
What's New
RBC folate was positively associated with increased body fat, particularly in the android region. However, serum folate was inversely related to fat deposition, showing a more pronounced negative association with android fat compared to gynoid fat.
{"title":"Investigating the link between folate metabolic profiles and body fat distribution among U.S. children and adolescents","authors":"Yu Zhu , Yong Huang , Fandong Zeng , Lei Ding , Yali Liang , Weiwei Chang , Yuelong Jin , Yingshui Yao","doi":"10.1016/j.orcp.2025.07.001","DOIUrl":"10.1016/j.orcp.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the relationship between various folate metabolites and regional body fat composition in children and adolescents, considering the complexity of folate metabolism.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional study using data from the U.S. National Health and Nutrition Examination Survey (2011–2018). Red blood cell (RBC) and serum folate levels were measured, and body fat distribution was assessed through dual-energy X-ray absorptiometry. Percentage changes were calculated using linear regression models.</div></div><div><h3>Results</h3><div>Among 2138 children and adolescents, 51.50 % was boys. Higher RBC folate levels (highest versus lowest quintile) were associated with increased fat mass across multiple regions: android (16.73 %, 95 % CI: 6.89–27.47), gynoid (9.35 %, 95 % CI: 2.87–16.25), subcutaneous (16.29 %, 95 % CI: 5.82–27.79), and visceral fat (13.09 %, 95 % CI: 5.62–21.08). Conversely, higher serum folate levels were associated with decreased fat mass in these regions: android (−17.98 %, 95 % CI: −24.94 to −10.37), gynoid (−11.21 %, 95 % CI: −16.51 to −5.57), subcutaneous (−19.45 %, 95 % CI: −26.74 to −11.43), and visceral fat (−11.28 %, 95 % CI: −17.20 to −4.94). Additionally, MeFox showed a positive association with fat deposition, while 5-MTHF was inversely associated with fat accumulation.</div></div><div><h3>Conclusions</h3><div>Higher RBC folate and MeFox levels were positively linked to fat accumulation, whereas serum folate and 5-MTHF were negatively associated with fat mass. These findings provide preliminary insights into the complex relationship between folate metabolism and fat distribution.</div></div><div><h3>What's New</h3><div>RBC folate was positively associated with increased body fat, particularly in the android region. However, serum folate was inversely related to fat deposition, showing a more pronounced negative association with android fat compared to gynoid fat.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 4","pages":"Pages 289-296"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.orcp.2025.06.001
Katherine Rowell , Lisa Cant, Catherine M. Brignell, Katy Sivyer
Purpose
Although metabolic and bariatric surgery (MBS) is an effective weight loss treatment, patients can find it difficult to adjust to changes post-surgery. To-date, there has been limited research into patients’ and partners’ experiences of managing this journey. This qualitative study explored couples’ expectations and experiences of change, where one individual within the couple had undergone MBS.
Materials and methods
Potential participants were identified by staff within a National Health Service (NHS) Bariatric Service. Sixteen semi-structured joint interviews were conducted, with patients and partners interviewed together (N = 32). Interviews were transcribed verbatim and analysed using inductive thematic analysis.
Results
Five themes were identified around; (1) ‘the patients’ decision to have MBS’, including being determined despite others’ concerns; (2) ‘the importance of feeling supported’, which highlighted that partners felt overlooked; (3) ‘learning to eat again’, encompassing patients and partners adjusting to physical changes following surgery; (4) ‘Improved health and quality of life’ and acknowledging the importance of maintaining changes and avoiding complacency; (5) changes to ‘confidence and body image’, including managing unforeseen disappointments following initial expectations of surgery.
Conclusion
Couples discussed how pre-surgery goals often required reappraising after surgery and that partners played a key role in supporting patients in adjusting to necessary physical, social and psychological changes before, during, and after surgery. This suggests that more holistic support is needed to reduce the risk of expectations being misaligned with the changes experienced after MBS, including providing support to important others who can help enhance patient adjustment.
{"title":"A qualitative exploration of couples’ expectations and experiences of adjusting to changes following metabolic and bariatric surgery","authors":"Katherine Rowell , Lisa Cant, Catherine M. Brignell, Katy Sivyer","doi":"10.1016/j.orcp.2025.06.001","DOIUrl":"10.1016/j.orcp.2025.06.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Although metabolic and bariatric surgery (MBS) is an effective weight loss treatment, patients can find it difficult to adjust to changes post-surgery. To-date, there has been limited research into patients’ and partners’ experiences of managing this journey. This qualitative study explored couples’ expectations and experiences of change, where one individual within the couple had undergone MBS.</div></div><div><h3>Materials and methods</h3><div>Potential participants were identified by staff within a National Health Service (NHS) Bariatric Service. Sixteen semi-structured joint interviews were conducted, with patients and partners interviewed together (N = 32). Interviews were transcribed verbatim and analysed using inductive thematic analysis.</div></div><div><h3>Results</h3><div>Five themes were identified around; (1) ‘the patients’ decision to have MBS’, including being determined despite others’ concerns; (2) ‘the importance of feeling supported’, which highlighted that partners felt overlooked; (3) ‘learning to eat again’, encompassing patients and partners adjusting to physical changes following surgery; (4) ‘Improved health and quality of life’ and acknowledging the importance of maintaining changes and avoiding complacency; (5) changes to ‘confidence and body image’, including managing unforeseen disappointments following initial expectations of surgery.</div></div><div><h3>Conclusion</h3><div>Couples discussed how pre-surgery goals often required reappraising after surgery and that partners played a key role in supporting patients in adjusting to necessary physical, social and psychological changes before, during, and after surgery. This suggests that more holistic support is needed to reduce the risk of expectations being misaligned with the changes experienced after MBS, including providing support to important others who can help enhance patient adjustment.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 4","pages":"Pages 326-333"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.orcp.2025.06.002
Victoria Vought , Rita Vought , Lyndon Zhu , Christopher Diaz , Aziz M. Merchant
Objective
Bariatric surgery is utilized to treat morbid obesity in the United States. The study objective was to identify and analyze topics of interest on a popular social media platform used by bariatric surgery patients.
Methods
Online posts were obtained from the “r/BariatricSurgery” subreddit on Reddit.com. Posts were categorized by topic (Care Acquisition, Surgery-Related, Quality of Life Treatment Anxiety/Seeking validation for feelings) and author type. The sentiment analysis package Valence Aware Dictionary for Sentimental Reasoning (VADER) was then used to generate a compound score of the sentiment of each post. Posts with strongly positive sentiment (≥ 0.75) underwent word-frequency analysis.
Results
In total, 486 posts were evaluated, mainly authored by patients (96.7 %). Most posts discussed Surgery-related topics (77 %), particularly post-operative content, followed by Quality of Life (64.8 %) topics. VADER sentiment analysis found an overall average score of 0.19, with 58.2 % of posts classified as Positive. The lowest sentiment was observed among posts discussing Co-management with Comorbidities (-0.16), while posts with the highest scores discussed Recreation/Occupation (0.88). Of note, Procedure Consideration (0.72) posts also had high sentiment. Frequently utilized words in positive reviews included “surgery” (p < 0.01), “weight” (p < 0.01), “week” (p < 0.01), “month” (p = 0.03), “diet” (p < 0.01), and “help” (p = 0.04).
Conclusion
We found an overall positive sentiment, particularly among Quality of Life improvements for bariatric surgery patients. This may suggest an evolving perspective on bariatric surgery, as well as decreased stigma for those considering the procedure. Evaluations of patient perspectives online tangibly identifies areas of strength and room for improvement in bariatric surgery care.
{"title":"Analysis of patient perspectives on bariatric surgery using an anonymous online forum","authors":"Victoria Vought , Rita Vought , Lyndon Zhu , Christopher Diaz , Aziz M. Merchant","doi":"10.1016/j.orcp.2025.06.002","DOIUrl":"10.1016/j.orcp.2025.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>Bariatric surgery<span> is utilized to treat morbid obesity in the United States. The study objective was to identify and analyze topics of interest on a popular social media platform used by bariatric surgery patients.</span></div></div><div><h3>Methods</h3><div>Online posts were obtained from the “r/BariatricSurgery” subreddit on Reddit.com. Posts were categorized by topic (Care Acquisition, Surgery-Related, Quality of Life Treatment Anxiety/Seeking validation for feelings) and author type. The sentiment analysis package Valence Aware Dictionary for Sentimental Reasoning (VADER) was then used to generate a compound score of the sentiment of each post. Posts with strongly positive sentiment (≥ 0.75) underwent word-frequency analysis.</div></div><div><h3>Results</h3><div>In total, 486 posts were evaluated, mainly authored by patients (96.7 %). Most posts discussed Surgery-related topics (77 %), particularly post-operative content, followed by Quality of Life (64.8 %) topics. VADER sentiment analysis found an overall average score of 0.19, with 58.2 % of posts classified as Positive. The lowest sentiment was observed among posts discussing Co-management with Comorbidities (-0.16), while posts with the highest scores discussed Recreation/Occupation (0.88). Of note, Procedure Consideration (0.72) posts also had high sentiment. Frequently utilized words in positive reviews included “surgery” (p < 0.01), “weight” (p < 0.01), “week” (p < 0.01), “month” (p = 0.03), “diet” (p < 0.01), and “help” (p = 0.04).</div></div><div><h3>Conclusion</h3><div>We found an overall positive sentiment, particularly among Quality of Life improvements for bariatric surgery patients. This may suggest an evolving perspective on bariatric surgery, as well as decreased stigma for those considering the procedure. Evaluations of patient perspectives online tangibly identifies areas of strength and room for improvement in bariatric surgery care.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 4","pages":"Pages 334-338"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
More research is required to determine the joint associations of physical activity and sedentary time with body mass index (BMI) in Latin America. Therefore, the objective of the present study was to investigate said associations in eight countries in the region.
Methods
Physical activity and sedentary time were measured using accelerometers in 2404 participants aged 39.30 ± 12.93 years who took part in the Latin American Study of Nutrition and Health. Linear regression was used to investigate associations with BMI and logistic regression was used to investigate associations with obesity.
Results
The average BMI was 27.51 ± 5.35 kg/m2. Physical activity was inversely associated with BMI, such that every 30 min/day was associated with a BMI 3.75 kg/m2 lower. Compared to the group with high physical activity and low sedentary time, the odds ratio for obesity was no greater in the group with high physical activity and high sedentary time [0.70 (0.45,1.09)]. The risk was greater in the group with low physical activity and low sedentary time, although the confidence interval was relatively wide and included the value of 1.00 [1.36 (0.92,1.80)]. The risk was greater in the group with low physical activity and high sedentary time [1.71 (1.21,2.41)].
Conclusions
Weight loss is incredibly difficult at the population level and primary prevention may be more effective in countries where obesity is still emerging as a major health issue. This study suggests that physical activity may have a more important role than sedentary time in the primary prevention of obesity in Latin America.
Trial registration
ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.
{"title":"Joint associations of accelerometer-measured physical activity and sedentary time with body mass index: Cross-sectional evidence from the Latin American Study of Nutrition and Health","authors":"Eduardo Rossato de Victo , Georgina Gómez , Mauro Fisberg , Irina Kovalskys , Paloma Ferrero-Hernandez , Claudio Farias-Valenzuela , Tatiane K.F. Figueiredo , Gerson Ferrari","doi":"10.1016/j.orcp.2025.08.004","DOIUrl":"10.1016/j.orcp.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>More research is required to determine the joint associations of physical activity and sedentary time with body mass index (BMI) in Latin America. Therefore, the objective of the present study was to investigate said associations in eight countries in the region.</div></div><div><h3>Methods</h3><div>Physical activity and sedentary time were measured using accelerometers in 2404 participants aged 39.30 ± 12.93 years who took part in the Latin American Study of Nutrition and Health. Linear regression was used to investigate associations with BMI and logistic regression was used to investigate associations with obesity.</div></div><div><h3>Results</h3><div>The average BMI was 27.51 ± 5.35 kg/m<sup>2</sup>. Physical activity was inversely associated with BMI, such that every 30 min/day was associated with a BMI 3.75 kg/m<sup>2</sup> lower. Compared to the group with high physical activity and low sedentary time, the odds ratio for obesity was no greater in the group with high physical activity and high sedentary time [0.70 (0.45,1.09)]. The risk was greater in the group with low physical activity and low sedentary time, although the confidence interval was relatively wide and included the value of 1.00 [1.36 (0.92,1.80)]. The risk was greater in the group with low physical activity and high sedentary time [1.71 (1.21,2.41)].</div></div><div><h3>Conclusions</h3><div>Weight loss is incredibly difficult at the population level and primary prevention may be more effective in countries where obesity is still emerging as a major health issue. This study suggests that physical activity may have a more important role than sedentary time in the primary prevention of obesity in Latin America.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 4","pages":"Pages 297-302"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.orcp.2025.04.012
Eve T. House , Hamna Ghouri , Louise A. Baur , Clare E. Collins , Megan L. Gow , Helen Truby , Hiba Jebeile , Natalie B. Lister , on behalf of the Fast Track to Health study team
Aims
Behavioural weight management interventions facilitate short to medium-term weight and cardiometabolic improvements in adolescent obesity. However, recruiting adolescents to trials of such interventions is challenging. This study describes strategies used to recruit adolescents with obesity into the Fast Track to Health (Fast Track) trial, conducted at two tertiary paediatric centres in Australia.
Methods
Fast Track (HREC/17/SCHN/164) was a randomised controlled trial that recruited 13–17-year-olds with obesity and ≥ 1 cardiometabolic complication, from December 2017 to March 2022. Families underwent phone screening, followed by in-person screening appointments. Recruitment strategies were grouped and enrolment yield by strategy was calculated.
Results
Of 308 inquiries received, 141 (45.8 %) adolescents were recruited. The most successful strategy was referral from specialists at participating centres (21.2 % enrolment yield), followed by referrals from family/friends (6.5 %), other doctors/general practitioners (3.6 %), and social media (3.6 %). Social media was used for 11 months only (enrolment yield - 8.5 %). Recruitment strategies with low yield were study flyers/posters (1.6 %), digital/print media (1.3 %), and the study website (1.0 %). Of 137 adolescents excluded at phone screening, most were due to disinterest in participation or inability to make contact (60.6 %). Of 171 adolescents attending in-person screening, 30 did not meet inclusion criteria (n = 7 of those excluded had no metabolic complications, n = 7 were outside the BMI range).
Conclusion
Connecting with medical specialists may be important to support the engagement of treatment-seeking adolescents with obesity in clinical trials. Further research is needed to identify methods of enhancing clinical trial recruitment in primary care, community settings, and online.
{"title":"The recruitment of adolescents with obesity to a randomised controlled trial: A Fast Track to Health sub-study","authors":"Eve T. House , Hamna Ghouri , Louise A. Baur , Clare E. Collins , Megan L. Gow , Helen Truby , Hiba Jebeile , Natalie B. Lister , on behalf of the Fast Track to Health study team","doi":"10.1016/j.orcp.2025.04.012","DOIUrl":"10.1016/j.orcp.2025.04.012","url":null,"abstract":"<div><h3>Aims</h3><div>Behavioural weight management interventions facilitate short to medium-term weight and cardiometabolic improvements in adolescent obesity. However, recruiting adolescents to trials of such interventions is challenging. This study describes strategies used to recruit adolescents with obesity into the Fast Track to Health (Fast Track) trial, conducted at two tertiary paediatric centres in Australia.</div></div><div><h3>Methods</h3><div>Fast Track (HREC/17/SCHN/164) was a randomised controlled trial that recruited 13–17-year-olds with obesity and ≥ 1 cardiometabolic complication, from December 2017 to March 2022. Families underwent phone screening, followed by in-person screening appointments. Recruitment strategies were grouped and enrolment yield by strategy was calculated.</div></div><div><h3>Results</h3><div>Of 308 inquiries received, 141 (45.8 %) adolescents were recruited. The most successful strategy was referral from specialists at participating centres (21.2 % enrolment yield), followed by referrals from family/friends (6.5 %), other doctors/general practitioners (3.6 %), and social media (3.6 %). Social media was used for 11 months only (enrolment yield - 8.5 %). Recruitment strategies with low yield were study flyers/posters (1.6 %), digital/print media (1.3 %), and the study website (1.0 %). Of 137 adolescents excluded at phone screening, most were due to disinterest in participation or inability to make contact (60.6 %). Of 171 adolescents attending in-person screening, 30 did not meet inclusion criteria (n = 7 of those excluded had no metabolic complications, n = 7 were outside the BMI range).</div></div><div><h3>Conclusion</h3><div>Connecting with medical specialists may be important to support the engagement of treatment-seeking adolescents with obesity in clinical trials. Further research is needed to identify methods of enhancing clinical trial recruitment in primary care, community settings, and online.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 3","pages":"Pages 214-222"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.orcp.2025.05.002
Jiahao Zhang , Shuqiang Huang , Chuxian Hu , Cailing Liao , Zhicheng Tang , Nanxi Li , Yuxin Qian , Hongcheng Luo , Fucai Tang , Zhaohui He
Background
The specific relationship among depression, obesity, and wet-overactive bladder (wet-OAB) lacked comprehensiveness.
Methods
This cross-sectional study included 23,154 participants from the 2005–2020 National Health and Nutrition Examination Survey (NHANES). The study outcome was wet-OAB risk. depression levels were the primary exposure and graded to none (0–4), low (5–9), moderate (10–14), and severe (≥ 15) using the Patient Health Questionnaire-9. General and abdominal obesity were assessed based on body mass index (BMI) and waist circumference (WC), respectively. The logistic regression and restricted cubic spline (RCS) analysis were applied to probe their association based on complex multistage sampling designs. Mediation effect analysis was constructed to address the mediating role of obesity.
Results
In fully adjusted models, a positive association was suggested between wet-OAB and depression levels with OR(95 %CI) of 2.34(1.98–2.75) in mild, 2.66(2.13–3.31) in moderate, and 3.14(2.34–4.20) in severe depression. General and abdominal obesity were significantly associated with increasing depression levels and wet-OAB risk (P for trend < 0.001). RCS analyses showed Log-shaped non-linear associations between depression levels and wet-OAB, especially in overweight, obesity subgroups, and abdominal obesity. General obesity with BMI and abdominal obesity with WC performed respectively a partially mediated proportion of 5.16 % and 4.25 % between depression levels and wet-OAB (P for indirect effect < 0.001).
Conclusions
Individuals with elevated depression levels tend to have a higher risk of wet-OAB, especially in obesity. General and abdominal obesity are important partial mediators in the effects of depression levels on wet-OAB. Patients with wet-OAB need to pay attention to mental health interventions and weight control.
{"title":"Obesity mediate associations between depression and wet overactive bladder: Results from 2005 to 2020 NHANES","authors":"Jiahao Zhang , Shuqiang Huang , Chuxian Hu , Cailing Liao , Zhicheng Tang , Nanxi Li , Yuxin Qian , Hongcheng Luo , Fucai Tang , Zhaohui He","doi":"10.1016/j.orcp.2025.05.002","DOIUrl":"10.1016/j.orcp.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>The specific relationship among depression, obesity, and wet-overactive bladder (wet-OAB) lacked comprehensiveness.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 23,154 participants from the 2005–2020 National Health and Nutrition Examination Survey (NHANES). The study outcome was wet-OAB risk. depression levels were the primary exposure and graded to none (0–4), low (5–9), moderate (10–14), and severe (≥ 15) using the Patient Health Questionnaire-9. General and abdominal obesity were assessed based on body mass index (BMI) and waist circumference (WC), respectively. The logistic regression and restricted cubic spline (RCS) analysis were applied to probe their association based on complex multistage sampling designs. Mediation effect analysis was constructed to address the mediating role of obesity.</div></div><div><h3>Results</h3><div>In fully adjusted models, a positive association was suggested between wet-OAB and depression levels with OR(95 %CI) of 2.34(1.98–2.75) in mild, 2.66(2.13–3.31) in moderate, and 3.14(2.34–4.20) in severe depression. General and abdominal obesity were significantly associated with increasing depression levels and wet-OAB risk (<em>P</em> for trend < 0.001). RCS analyses showed Log-shaped non-linear associations between depression levels and wet-OAB, especially in overweight, obesity subgroups, and abdominal obesity. General obesity with BMI and abdominal obesity with WC performed respectively a partially mediated proportion of 5.16 % and 4.25 % between depression levels and wet-OAB (<em>P</em> for indirect effect < 0.001).</div></div><div><h3>Conclusions</h3><div>Individuals with elevated depression levels tend to have a higher risk of wet-OAB, especially in obesity. General and abdominal obesity are important partial mediators in the effects of depression levels on wet-OAB. Patients with wet-OAB need to pay attention to mental health interventions and weight control.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 3","pages":"Pages 239-246"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.orcp.2025.04.010
Rafael Llombart-Blanco , Gonzalo Mariscal , Carlos Barrios , Jose Enrique de la Rubia Ortí , Rafael Llombart-Ais
This meta-analysis aimed to determine the impact of obesity on function, pain, complication and patient-reported outcome measure following rotator cuff repair. This meta-analysis compares patients with obesity and without obesity undergoing rotator cuff repair surgery in terms of effectiveness, safety, and patient-reported measures. Four major databases were searched. Odds ratios, mean differences, and standard mean differences with 95 % confidence intervals (CIs) were calculated. The meta-analysis was performed using Review Manager version 5.4. Sixteen studies (n = 139,638 patients) were included. At the final follow-up, patients with obesity had significantly higher visual analogue scale (VAS) pain (SMD 0.16, 95 % CI 0.03–0.29). Patients with obesity had lower American Shoulder and Elbow Surgeons Shoulder Score (ASES) scores (MD −4.70, 95 % CI −7.57 to −1.82). No differences were observed in range of motion (ROM). Patients with obesity had a higher overall complication risk (OR 1.64, 95 % CI 1.38–1.95; I2 = 19 %) driven by obesity (OR 1.66, 95 % CI 1.29–2.13) and severely subgroups with obesity (OR 1.84, 95 %CI 1.43–2.37). Patients with obesity had significantly higher risks of thrombosis, myocardial infarction, cardiac arrest and renal complications. They also showed significantly higher reoperation (OR 1.31, 95 % CI 1.21–1.43) and readmission rates (OR 1.37, 95 % CI 1.31–1.44). Obesity is associated with worse pain and function and higher complication rates after rotator cuff repair. These findings have implications for perioperative counseling and management in this population.
本荟萃分析旨在确定肥胖对肩袖修复后功能、疼痛、并发症和患者报告的结果测量的影响。本荟萃分析比较了接受肩袖修复手术的肥胖和非肥胖患者的有效性、安全性和患者报告的措施。检索了四个主要数据库。计算比值比、平均差异和标准平均差异，95% %置信区间（ci）。meta分析使用Review Manager版本5.4进行。纳入16项研究（n = 139,638例患者）。在最后随访时，肥胖患者的视觉模拟评分（VAS）疼痛明显更高（SMD 0.16, 95 % CI 0.03-0.29）。肥胖患者的American Shoulder and Elbow Surgeons Shoulder Score （ASES）评分较低（MD -4.70, 95 % CI -7.57 ~ -1.82）。在活动范围（ROM）方面没有观察到差异。肥胖患者的总并发症风险更高(OR 1.64, 95 % CI 1.38-1.95；I2 = 19 %)由肥胖驱动（OR 1.66, 95 %CI 1.29-2.13）和严重肥胖亚组（OR 1.84, 95 %CI 1.43-2.37）。肥胖患者血栓形成、心肌梗死、心脏骤停和肾脏并发症的风险明显增加。再手术率（OR 1.31, 95 % CI 1.21-1.43）和再入院率（OR 1.37, 95 % CI 1.31-1.44）均显著高于对照组。肥胖与肩袖修复术后更严重的疼痛和功能以及更高的并发症发生率有关。这些发现对该人群的围手术期咨询和管理具有启示意义。
{"title":"Effects of obesity on function, pain, and complications after rotator cuff repair: An updated systematic review and meta-analysis","authors":"Rafael Llombart-Blanco , Gonzalo Mariscal , Carlos Barrios , Jose Enrique de la Rubia Ortí , Rafael Llombart-Ais","doi":"10.1016/j.orcp.2025.04.010","DOIUrl":"10.1016/j.orcp.2025.04.010","url":null,"abstract":"<div><div>This meta-analysis aimed to determine the impact of obesity on function, pain, complication and patient-reported outcome measure following rotator cuff repair. This meta-analysis compares patients with obesity and without obesity undergoing rotator cuff repair surgery in terms of effectiveness, safety, and patient-reported measures. Four major databases were searched. Odds ratios, mean differences, and standard mean differences with 95 % confidence intervals (CIs) were calculated. The meta-analysis was performed using Review Manager version 5.4. Sixteen studies (n = 139,638 patients) were included. At the final follow-up, patients with obesity had significantly higher visual analogue scale (VAS) pain (SMD 0.16, 95 % CI 0.03–0.29). Patients with obesity had lower American Shoulder and Elbow Surgeons Shoulder Score (ASES) scores (MD −4.70, 95 % CI −7.57 to −1.82). No differences were observed in range of motion (ROM). Patients with obesity had a higher overall complication risk (OR 1.64, 95 % CI 1.38–1.95; I2 = 19 %) driven by obesity (OR 1.66, 95 % CI 1.29–2.13) and severely subgroups with obesity (OR 1.84, 95 %CI 1.43–2.37). Patients with obesity had significantly higher risks of thrombosis, myocardial infarction, cardiac arrest and renal complications. They also showed significantly higher reoperation (OR 1.31, 95 % CI 1.21–1.43) and readmission rates (OR 1.37, 95 % CI 1.31–1.44). Obesity is associated with worse pain and function and higher complication rates after rotator cuff repair. These findings have implications for perioperative counseling and management in this population.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 3","pages":"Pages 193-201"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-01DOI: 10.1016/j.orcp.2025.04.011
Paraskevi Massara , Charles D.G. Keown-Stoneman , Jonathon L. Maguire , Robert Bandsma , Elena M. Comelli , Catherine S. Birken
Background
Obesity remains a persistent global health issue across generations. Targeting family-level factors may help improve child and adolescent body mass index (BMI) outcomes. While associations between parental and offspring BMI are well-documented, the temporal patterns and risk factors driving these relationships remain unclear. This study aimed to identify longitudinal family-level BMI patterns incorporating child, maternal, and paternal BMI and apply interpretable machine learning (ML) methods to uncover key predictors.
Methods
This longitudinal study included 6092 children and their parents from the TARGet Kids! cohort, with BMI measurements collected from birth to 150 months. Group-based multi-trajectory modeling identified joint trajectories of child BMI-for-age Z-scores (zBMI) and parental BMI. Five ML classifiers predicted group membership using 78 predictors spanning sociodemographic, dietary, parental health, and child lifestyle variables. To explore the modifying effect of parental overweight/obesity (OW/OB) on the relationship between child age and BMI, Bayesian generalized additive mixed models (GAMMs) with smoothed term interactions were applied.
Results
Five distinct joint trajectory groups were identified. Children in the highest BMI trajectory group typically had both parents following similar high BMI trajectories. Parental OW/OB status emerged as the strongest predictor of child OW/OB (37 % classification probability), followed by breastfeeding duration (17 %) and child physical activity (15 %). The influence of parental OW/OB was particularly pronounced in early childhood (0–60 months). Bayesian GAMMs confirmed the robust, longitudinal association between child and parental BMI trajectories.
Conclusions
Parental BMI patterns strongly influence child BMI development, with age-dependent effects. These findings highlight the importance of early family-based interventions.
{"title":"Understanding the association of longitudinal body mass index patterns in children and their parents: A data-driven study from the TARGet Kids! cohort","authors":"Paraskevi Massara , Charles D.G. Keown-Stoneman , Jonathon L. Maguire , Robert Bandsma , Elena M. Comelli , Catherine S. Birken","doi":"10.1016/j.orcp.2025.04.011","DOIUrl":"10.1016/j.orcp.2025.04.011","url":null,"abstract":"<div><h3>Background</h3><div>Obesity remains a persistent global health issue across generations. Targeting family-level factors may help improve child and adolescent body mass index (BMI) outcomes. While associations between parental and offspring BMI are well-documented, the temporal patterns and risk factors driving these relationships remain unclear. This study aimed to identify longitudinal family-level BMI patterns incorporating child, maternal, and paternal BMI and apply interpretable machine learning (ML) methods to uncover key predictors.</div></div><div><h3>Methods</h3><div>This longitudinal study included 6092 children and their parents from the TARGet Kids! cohort, with BMI measurements collected from birth to 150 months. Group-based multi-trajectory modeling identified joint trajectories of child BMI-for-age Z-scores (zBMI) and parental BMI. Five ML classifiers predicted group membership using 78 predictors spanning sociodemographic, dietary, parental health, and child lifestyle variables. To explore the modifying effect of parental overweight/obesity (OW/OB) on the relationship between child age and BMI, Bayesian generalized additive mixed models (GAMMs) with smoothed term interactions were applied.</div></div><div><h3>Results</h3><div>Five distinct joint trajectory groups were identified. Children in the highest BMI trajectory group typically had both parents following similar high BMI trajectories. Parental OW/OB status emerged as the strongest predictor of child OW/OB (37 % classification probability), followed by breastfeeding duration (17 %) and child physical activity (15 %). The influence of parental OW/OB was particularly pronounced in early childhood (0–60 months). Bayesian GAMMs confirmed the robust, longitudinal association between child and parental BMI trajectories.</div></div><div><h3>Conclusions</h3><div>Parental BMI patterns strongly influence child BMI development, with age-dependent effects. These findings highlight the importance of early family-based interventions.</div></div>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":"19 3","pages":"Pages 223-231"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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