Obesity Reviews最新文献

Background: The prevalence of overweight and obesity among children and adolescents is rising and is a recognized global health problem. This overview of reviews explored the views of children, adolescents, and parents/caregivers regarding behavioral interventions for obesity management.

Methods: Eleven electronic databases were searched to identify reviews of qualitative research regarding the views of children or adolescents with obesity, and their caregivers, concerning behavioral interventions for obesity. Synthesis was performed using a mega-ethnography approach.

Results: Eleven reviews were included. Factors associated with feasibility, acceptability, and equity were identified that influenced decisions to engage with these interventions. Children and adolescents with obesity can be encouraged to engage and participate in behavioral interventions if there is a positive environment, free from stigma; have the necessary resources needed to fully engage in the intervention; are taught holistic, practical skills that allow for long-term lifestyle change, not just short-term weight loss; and are provided with activities likely to be perceived as fun and enjoyable. Interventions are more acceptable to the child/adolescent when parents and families are able to engage with them.

Conclusion: Practitioners can improve engagement with behavioral interventions for obesity management for children/adolescents if they are aware of specific motivating factors.

Background: A chronic inflammatory state characterizes a wide range of diseases for which obesity is a risk factor. Weight loss could reduce levels of circulating inflammatory markers potentially reducing the incidence of associated diseases and improving response to treatment. However, dietary weight loss studies have reported inconsistent effects on serum inflammatory makers and the long-term effects are unknown.

Objective: To systematically review randomized controlled trials and analyze any differences in serum interleukin-6 and tumor necrosis factor-alpha between adults with obesity achieving weight loss through dietary intervention compared to those receiving none or standard care.

Methods: Studies were identified by searching databases from 1966 to November 2024. Randomized controlled trials with at least 12 months' follow-up were included in this systematic review and meta-analysis with an assessment of Cochrane risk of bias version 1.

Results: Twelve eligible studies were included. No trials reported a significant effect of weight loss on circulating tumor necrosis factor-alpha, whilst studies achieving greater than 5% weight loss significantly reduced circulating interleukin-6 in adults with obesity.

Conclusion: Weight loss interventions achieving and maintaining greater than 5% weight loss appear to be required to reduce circulating interleukin-6 levels in adults with obesity.

With the evolving landscape of diseases, heart failure with preserved ejection fraction (HFpEF) now encompasses more than half of all heart failure patients. This condition is clinically diverse, involving multiple organ systems and often occurring alongside the aging process. To deeply investigate the common pathogenesis of HFpEF and to explore new therapeutic approaches is of great significance for the treatment of HFpEF. Epicardial adipose tissue (EAT) is not only a dynamic organ with biological functions but also physically adjacent to the myocardium and coronary arteries, endowing it with unique properties as a visceral fat depot. During pathology, EAT can secrete adipocytokines via paracrine mechanisms, establishing direct communication with the heart and vascular, thereby impacting cardiac function. This review aims to elucidate the intricate relationship between EAT and cardiac function in HFpEF, delineate the roles of adipocytes, macrophages, lymphocytes, and stem cells within EAT in HFpEF, and summarize the progress in research regarding drug therapies targeting EAT for HFpEF treatment.

Background: General adiposity is a well-known risk factor for cardiovascular disease. By contrast, the interconnection between high intra-pancreatic fat deposition and cardiovascular disease has been scantily investigated. This field-wide systematic review aimed to map the available evidence on cardiovascular disease according to the fat content of the pancreas.

Methods: A literature search using two electronic databases (MEDLINE and Embase) was conducted independently by two reviewers. Studies reporting on the association between intra-pancreatic fat deposition and cardiovascular disease in humans were included. Where meta-analysis was possible, data were pooled using a random-effects method.

Results: A total of 16 studies published between 1966 and 2024 were included. The most credible findings across domains of heart diseases, diseases of arteries, arterioles, and capillaries, as well as subclinical atherosclerosis provided supportive evidence of a positive relationship between high intra-pancreatic fat deposition and cardiovascular disease. Meta-analysis showed that high intra-pancreatic fat deposition was significantly associated with increased aortic intima-media thickness (mean difference: 0.19 mm; 95% confidence interval: 0.12-0.26; p < 0.001), increased carotid intima-media thickness (mean difference: 0.06 mm; 95% confidence interval: 0.03-0.08; p < 0.001), and increased vascular stiffness (mean difference: 167 cm/s; 95% confidence interval: 81-254; p < 0.001).

Conclusion: The accumulated evidence from more than 7000 people demonstrates a tangible connection of intra-pancreatic fat deposition with cardiovascular disease (especially, subclinical atherosclerosis). Purposely designed investigations of high intra-pancreatic fat deposition as an additional risk factor (independent of general adiposity) for cardiovascular disease are warranted.

Introduction: All European Union (EU) countries have established national school food policies. However, evaluations of those policies for secondary schools remain limited. This scoping review aims to synthesize the evidence of school food policies in secondary schools on child health, acceptance, and affordability in the EU, UK, Switzerland, Norway, and Iceland.

Methods: The scoping review adheres to the PRISMA-ScR guideline. Searches were conducted in four databases from 2000 to September 2023 without language and methods restrictions following a published protocol. After a two-stage screening process, reviewers extracted data using a standardized and predefined coding scheme.

Results: The search identified 185 records with N = 10 articles meeting the inclusion criteria (n = 7 UK, n = 1 each in Norway, Sweden, and Portugal). Among the included articles, n = 7 addressed school meal acceptance, n = 6 addressed health impacts, and n = 3 addressed affordability. Findings indicate low acceptance rates of school meals. Results of several studies showed that the reformulated menus did not meet nutritional standards and were not accepted because of taste, quality, and pupils' different food preferences. Affordability was reported as a barrier across the three articles addressing this topic.

Conclusion: The existing literature highlights challenges in interpreting the impact of school food policies on health, acceptance, and affordability. Further research is needed to strengthen the methodological approaches and increase the evidence to inform policy development and implementation.

Digital health interventions can support the treatment of overweight and obesity in children and adolescents, yet primary research and systematic reviews leave uncertain evidence. In this umbrella review of reviews and meta-analyses, we methodologically appraise and investigate the effects of digital health interventions used to manage overweight and obesity in children. Systematic searches were conducted in July 2023 in Medline (Ovid), CINAHL (EBSCOhost), Cochrane, EMBASE (Ovid), PsycINFO (Ovid), Epistemonikos and Web of Science (Core Collection). Reports on experiences and/or effectiveness of digital health interventions aimed at treating children with overweight or obesity aged 0 to 19 years and/or their parents were eligible for inclusion. Screening, data extraction, and methodological appraisal were conducted in blinded pairs of researchers. In total, the searches identified 2927 citations, of which 16 reviews and 10 meta-analyses, reporting on 162 distinct primary studies, were included. Effects on anthropometric measures of all digital health interventions were small when analyzing BMI and BMI-z-scores combined. Future research should strive to conduct more homogeneous and solid research, employing robust designs, standardized outcomes, and a longer follow-up time. Designing digital health interventions for the future should to a larger extent include end-users to ensure usability and relevance for the population, adding significance to the interventions that are evaluated.

Introduction: The prevalence of obesity among the Chinese population has increased more than three-fold over the last twenty years. It is crucial to understand Chinese people's perceptions toward obesity to inform effective weight management initiatives. This bilingual systematic review aimed to synthesize the existing literature regarding the perceptions of Chinese adults toward overweight and obesity and provide insight on methodological implications and future research directions.

Method: Six databases were searched from inception to 8th January 2025. Studies were included if they were published in English or Chinese, investigated perceptions toward overweight and obesity, and focused on Chinese adults living in or outside of Mainland China. Thematic synthesis was employed for data analysis.

Results: Fifty-three studies (24 in English, 29 in Chinese) were included, involving 83,688 participants. Three themes were identified; (1) Chinese adults connected obesity with appearance more than with health, (2) Chinese adults lacked practical knowledge to manage obesity, and (3) living with obesity was perceived as a solitary journey.

Conclusion: Most studies were conducted on Chinese people within the healthy weight range, who predominantly focused on appearance-oriented weight perception. There was a strong motivation for weight control, but a lack of practical weight loss strategies among Chinese adults.

Practitioner applications: The lack of practical weight management knowledge and weight loss failures lead to low self-efficacy, which may be mistaken as low motivation for weight management among Chinese adults. However, Chinese adults generally have the motivation to control their weight. It is important to empower Chinese people living with overweight or obesity with practical skills and increase self-efficacy through a multidisciplinary and affordable approach. The psychological burden caused by obesity stigma and the influence of Chinese culture makes the weight management journey lonely and challenging for Chinese adults living with overweight and obesity. Practitioners may need to openly address these issues and help reduce the mental burden toward more effective weight loss interventions.

Introduction: Clusters of health behaviors (e.g. physical activity/sedentary behavior/diet/sleep) can exert synergistic influences on health outcomes, such as obesity. Understanding how clusters of health behaviors change throughout childhood and adolescence is essential for developing interventions aimed at uncoupling unhealthy behaviors. This review synthesizes prospective studies examining changes in clusters of physical activity, sedentary behavior, diet, and sleep through childhood and adolescence.

Methods: Electronic searches (PubMed, Embase, Web of Science, Scopus) identified prospective studies, published in English up to/including January 2024, of children/adolescents (0-19 years) which used data-driven methods to identify clusters of 2/more behaviors (physical activity, sedentary behaviors, diet, sleep) at multiple timepoints. A narrative synthesis was conducted due to methodological heterogeneity.

Results: Eighteen studies reporting data from 26,772 individual participants were included. Eleven studies determined clusters at each timepoint (i.e. identified clusters at T1 and T2, respectively), while seven determined clusters longitudinally using behavioral data across multiple timepoints. Among studies that identified clusters at each timepoint, participants commonly transitioned to similarly characterized clusters between timepoints. Where cluster tracking was examined, 64% of clusters had stable transition probabilities of 60-100%. The most prevalent longitudinal cluster trajectories were characterized by co-occurring healthy behaviors which remained stable. Remaining within unhealthy clusters at multiple timepoints was associated with higher markers of adiposity.

Conclusion: 'Healthy' and 'unhealthy' clusters remained highly stable over time, suggesting behavioral patterns developed early can become entrenched and resistant to change. Interventions focused on instilling healthy behaviors early are required to provide a strong foundation for behavioral stability throughout life.

HIV remains a significant health concern, but the advent of antiretroviral therapy (ART) has transformed it into a manageable chronic condition. However, weight gain and obesity pose a substantial challenge for people living with HIV (PLWH). Moreover, the role of lifestyle has not yet been comprehensively investigated. This review aims to provide an updated perspective on the role of lifestyle factors in weight gain and obesity among PLWH. A systematic search was conducted on Medline, Web of Science, Scopus, and ClinicalTrials.gov according to PRISMA guidelines. Overall, 378 articles were identified, of which 22 studies met the inclusion criteria. No article comprehensively addressed all lifestyle factors, and only 8 (36.4%) evaluated 3 or more factors. Addictions (72.7%), food (34.4%), and physical activity (31.8%) were the most analyzed aspects. An absence of concordance was identified among the articles concerning the timing of assessments, methodologies employed in surveys, and the operational definitions utilized for "weight gain," "overweight," and "obesity." Weight gain in PLWH represents a complex phenomenon necessitating a holistic approach to promote well-being in this vulnerable population.

Background: In the current systematic review and meta-analysis, we evaluated the possible role of weight loss on asthma control, quality of life (QOL), and clinical outcomes among patients with asthma.

Methods: We performed a systematic search of PubMed, CINAHL, and OVID Medline for randomized controlled human trials that examined the effects of weight loss on asthma control, QOL, and spirometry results, from 1 January 2000 to 31 December 2023. Twelve eligible studies (total n = 1052 participants) were included. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were used to evaluate the effect size. Subgroup analyses and meta-regression approaches were performed to reveal possible sources of heterogeneity. Fractional polynomial modeling was performed to assess non-linear associations.

Results: Weight loss reduced ACQ score (WMD -0.67 [95%CIs - 1.20, -0.13], P = 0.02; I² 91.3%, P < 0.001), and improved forced expiratory volume percent predicted (FEV)1_pp (WMD 13.08 [95%CIs 2.42, 23.73], P = 0.02; I² 94.1%, P < 0.001) among patients with asthma. In a dose-response analysis, a significant non-linear association was reported between change in weight and changes in FEV1_pp (P_{non-linearity} = 0.01). The effects of weight loss on QOL (WMD 0.53 [-0.38, 1.44], P = 0.25; I² 95.6%, P < 0.001) and forced vital capacity percent predicted (FVC _pp, WMD 4.90 [-3.22, 13.02], P = 0.24; I² 91.4%, P < 0.001) were not statistically significant.

Conclusion: Weight loss improves asthma control and FEV1_pp among patients with asthma in a two-class meta-analysis. Because of the relatively low number of well-designed clinical trials (n = 12), further trials are needed to better define the beneficial effects of weight loss on asthma control.