Obesity Reviews最新文献

This systematic review and meta-analysis examined the effects of mindful-based interventions (MBIs) on changes in obesogenic eating behaviors. Seven databases (CINAHL, PubMed, PsycINFO, Cochrane, Web of Science Core Collection, Embase, Sociological Abstracts) were searched. Random-effects models were performed to estimate the pooled effects, and mixed-effects models were used to explore potential moderators of MBIs on eating behavioral changes. The significant effects on mindless eating habits included controlled eating (Hedge's g = 0.23, p = 0.005), external eating (g = -0.62, p = 0.001), fullness awareness (g = 0.64, p < 0.001), hunger eating (g = -0.69, p = 0.032), energy intake (g = -0.60, p = 0.003), sweet intake (g = -0.39, p < 0.001), and impulsive food choice (g = -0.43, p = 0.002). However, small and insignificant effects were noted for stress-related eating habits like emotional eating (g = -0.27; p = 0.070) and binge eating (g = -0.35, p = 0.136). The long-term effects were significantly sustained on hunger eating (g = -0.50, p = 0.007) but insignificant on emotional eating (g = -0.22, p = 0.809). MBIs delivered in clinical settings were more effective for decreasing emotional eating compared with those in school settings. Our findings support the effectiveness of MBIs. The pooled effects on improving mindless eating habits were stronger than the modification of stress-related eating habits.

A scoping review was conducted to identify barriers and enablers to effective weight management in healthcare settings for people living with overweight and obesity in English-speaking high-income countries. Peer-reviewed and gray literature were systematically searched in June 2024. Data were analyzed using inductive thematic analysis. Of the 15,684 unique articles identified and screened for relevance, 216 studies were included. Healthcare-related barriers and enablers to weight management were organized under three themes: a) healthcare provider-related factors, b) provision of care, and c) policy/funding. Prominent barriers included healthcare provider knowledge deficits and low prioritization of obesity management, mainly in the primary care setting. Weight management beyond the primary care setting was found to be especially challenging, with poor referral pathways, service fragmentation, lack of multidisciplinary practice, and restricted eligibility criteria, hindering the accessibility of services. Developing consistent policies and guidelines, improving the education of healthcare providers, and increasing funding to provide low-cost comprehensive care, were identified as enablers to access and uptake of weight management services. Considerable overlap in the identified barriers existed across healthcare providers and settings. A whole health system approach to minimize barriers and strengthen enablers to weight management services is needed, to address rising obesity rates.

Obesity is a prominent feature of Bardet-Biedl syndrome (BBS), which represents a major and growing public health problem. More than half of BBS patients carry mutations in one of eight genes that encode subunits of a protein complex known as the BBSome, which has emerged as a key regulator of energy and glucose homeostasis. However, the mechanisms underlying obesity in BBS are complex. Numerous studies have identified a high prevalence of insulin resistance and metabolic syndrome among individuals with BBS. However, the exact mechanisms are not fully understood. This review summarized evidence from experiments using mouse and cell models, focusing on the energy imbalance that leads to obesity in patients with BBS. The studies discussed in this review contribute to understanding the functional role of the BBSome in the obesity associated with BBS, laying the foundation for developing new preventive or therapeutic strategies for obese patients.

Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10-13% of reproductive-aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed-methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed-methods studies were narratively synthesized and all studies were thematically analyzed. Sixty-eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS-specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight-centric care are necessary for long-term sustainable changes and improvements in health outcomes in people with PCOS.

Branched-chain amino acids (BCAAs), including leucine, isoleucine, and valine, are essential for maintaining physiological functions and metabolic homeostasis. However, chronic elevation of BCAAs causes metabolic diseases such as obesity, type 2 diabetes (T2D), and metabolic-associated fatty liver disease (MAFLD). Adipose tissue, skeletal muscle, and the liver are the three major metabolic tissues not only responsible for controlling glucose, lipid, and energy balance but also for maintaining BCAA homeostasis. Under obese and diabetic conditions, different pathogenic factors like pro-inflammatory cytokines, lipotoxicity, and reduction of adiponectin and peroxisome proliferator-activated receptors γ (PPARγ) disrupt BCAA metabolism, leading to excessive accumulation of BCAAs and their downstream metabolites in metabolic tissues and circulation. Mechanistically, BCAAs and/or their downstream metabolites, such as branched-chain ketoacids (BCKAs) and 3-hydroxyisobutyrate (3-HIB), impair insulin signaling, inhibit adipogenesis, induce inflammatory responses, and cause lipotoxicity in the metabolic tissues, resulting in multiple metabolic disorders. In this review, we summarize the latest studies on the metabolic regulation of BCAA homeostasis by the three major metabolic tissues-adipose tissue, skeletal muscle, and liver-and how dysregulated BCAA metabolism affects glucose, lipid, and energy balance in these active metabolic tissues. We also summarize therapeutic approaches to restore normal BCAA metabolism as a treatment for metabolic diseases.

Fathers remain under-represented in early childhood obesity prevention research and interventions, despite growing evidence that paternal biopsychosocial factors and behaviors from pre- and post-conception can influence lifelong offspring health. Informed by a literature review of high-quality evidence, "CO-Parent" (childhood obesity-Parent) is a new conceptual model underpinned by couple interdependence theory and a socioecological framework. Literature was searched for the concepts parental AND weight-related behaviors AND child weight or weight-related behaviors, in databases including MEDLINE, PsycINFO, Global Health, Scopus, and SocINDEX. Prior evidence syntheses were prioritized as source data to inform model development. "CO-Parent" illustrates the interdependent and independent effects of maternal and paternal weight, weight-related behaviors, and well-being, across preconception, pregnancy, postpartum, and the early years on child weight-related behaviors and weight up to age five. The influences of public policy, social, environmental, economic, community, and other complex modifiable mediating factors are included in the model. The "CO-Parent" conceptual model paves the way for a paradigm shift by recognizing fathers as key figures in early childhood obesity prevention initiatives, encouraging them to "share the motherload." It highlights both the independent and interdependent roles fathers play in the epidemiology of obesity starting from preconception. CO-Parent also provides the foundations necessary to guide future theory and research to be more inclusive of fathers to further understanding of the independent and interdependent influences of parents in early childhood obesity prevention.

The lack of standardization in patient-reported outcome measures (PROMs) has made measurement and comparison of quality of life (QoL) outcomes in research focused on obesity treatment challenging. This study reports on the results of the second and third global multidisciplinary Standardizing Quality of life measures in Obesity Treatment (S.Q.O.T.) consensus meetings, where a core set of PROMs to measure nine previously selected patient-reported outcomes (PROs) in obesity treatment research was established. The S.Q.O.T. II online and S.Q.O.T. III face-to-face hybrid consensus meetings were held in October 2021 and May 2022. The meetings were led by an independent moderator specializing in PRO measurement. Nominal group techniques, Delphi exercises, and anonymous voting were used to select the most suitable PROMs by consensus. The meetings were attended by 28 and 27 participants, respectively, including a geographically diverse selection of people living with obesity (PLWO) and experts from various disciplines. Out of 24 PROs and 16 PROMs identified in the first S.Q.O.T. consensus meeting, the following nine PROs and three PROMs were selected via consensus: BODY-Q (physical function, physical symptoms, psychological function, social function, eating behavior, and body image), IWQOL-Lite (self-esteem), and QOLOS (excess skin). No PROM was selected to measure stigma as existing PROMs deemed to be inadequate. A core set of PROMs to measure QoL in research focused on obesity treatment has been selected incorporating patients' and experts' opinions. This core set should serve as a minimum to use in obesity research studies and can be combined with clinical parameters.

Food addiction (FA) could be a potential prognostic factor of weight loss intervention outcomes. This systematic review with meta-analysis aimed to (1) estimate this prognostic effect of FA diagnosis and symptom count in individuals with overweight or obesity and (2) explore potential sources of heterogeneity based on properties of the weight loss intervention, study, and sample (e.g., age, gender, ethnicity). We searched PubMed, PsycINFO, and Web of Science for studies reporting on associations between pre-intervention FA (assessed with the Yale Food Addiction Scale) and weight outcomes after weight loss intervention in individuals with overweight or obesity without a medically diagnosed eating disorder. Twenty-five studies met inclusion criteria, including 4904 individuals (71% women, M_age = 41 years, BMI = 40.82 kg/m²), k = 18 correlations of weight loss with FA symptom count, and k = 21 mean differences between FA diagnosis groups. Pooled estimates of random-effects meta-analyses found limited support for a detrimental effect of FA symptom count and diagnosis on weight loss intervention outcomes. Negative associations with FA increased for behavioral weight loss interventions and among more ethnically diverse samples. More research on the interaction of FA with pre-existing mental health problems and environmental factors is needed.

Although chronic kidney disease (CKD) is associated with obesity, few studies have used visceral adipose tissue (VAT) as an indicator to investigate its causal effect on CKD. Therefore, Mendelian randomization (MR) was employed to study the causal effects of VAT on CKD and its potential mediation by hypertension. Genome-wide association study (GWAS) statistics on VAT exposure were obtained from the UK Biobank, while GWAS datasets of CKD outcomes were obtained from CKDGen and FinnGen (validation study). Furthermore, VAT was considered the exposure, with the estimated glomerular filtration rate based on creatinine (eGFR (crea)), estimated glomerular filtration rate based on cystatin C (eGFR(cys)), and blood urea nitrogen (BUN) employed to assess the causal effect of VAT on kidney test indicators. Lastly, a two-step MR method was used to study the mediating role of hypertension in the pathogenesis of VAT among patients with CKD. VAT exhibited a positive causal association with CKD, irrespective of whether the GWAS datasets from CKDGen (odds ratio [OR] = 1.18, 95% CI: 1.08 to 1.29, P = 1.433140e-04) or FinnGen (1.47, 1.30 to 1.67, p = 2.500000e-09). VAT was not causally associated with eGFR (crea) (1.00, 0.99 to 1.00, p = 0.53), was negatively associated with eGFR (cys) (0.95, 0.93 to 0.97, P = 5.070000e-10), and was positively associated with BUN (1.02,1.01 to 1.02, P = 7.824860e-04). The mediating effect of VAT on CKD via hypertension was 45.8% (95% CI: 26.4 65.1). VAT has a positive causal effect on CKD, with hypertension playing a significant role. However, the effects of VAT on renal function indicators require further investigation.

A footnote in Adolphe Quetelet's classic 1835 Treatise on Man described his algebraic analysis of how body weight ( $W$ ) varies with height ( $H$ ) in adult males and females. Using data on 12 short and 12 tall subjects of each sex, Quetelet established the rule that $W$ is approximately proportional ( $\propto$ ) to H² in adults; that is, $W\propto H^2$ when $W\approx \alpha H^2$ for some constant $\alpha$ . Quetelet's Rule ( $W\propto H^2$ ), transformed and renamed in the twentieth century to body mass index ( $\mathrm{BMI}=W/H^2$ ), is now a globally applied phenotypic descriptor of adiposity at the individual and population level. The journey from footnote to ubiquitous adiposity measure traveled through hundreds of scientific reports and many more lay publications. The recent introduction of highly effective pharmacologic weight loss treatments has heightened scrutiny of BMI's origins and appropriateness as a gateway marker for diagnosing and monitoring people with obesity. This contemporary context prompted the current report that delves into the biological and mathematical paradigms that underlie the simple index $\mathrm{BMI}=W/H^2$ . Students and practitioners can improve or gain new insights into their understanding of BMI's historical origins and quantitative underpinning from the provided overview, facilitating informed use of BMI and related indices in research and clinical settings.