Obesity Reviews最新文献

The food system significantly affects the environment through land use, emissions from livestock, deforestation, and food waste. Diet sustainability considers the environmental effects of food production, distribution, and consumption. Animal products emit more greenhouse gases than plant-based foods, prompting a shift towards plant-focused diets for reduced emissions. Sustainable diets, like the EAT-Lancet model, prioritize plant-based foods, adjusting for regional eating habits. These diets aim to be both environmentally friendly and conducive to human health, addressing concerns like obesity and chronic diseases. Obesity is a major global health challenge, and its complex relationship with food production and consumption patterns calls for sustainable solutions to reduce pressure on ecosystems and promote healthier lifestyles. Tackling obesity requires holistic strategies that address not only individual health but also the broader environmental impacts of food systems. A systematic review examined the link between plant-based diets and obesity focusing on studies assessing Body Mass Index (BMI) and body fat assessment. Despite limited research, evidence suggests that adherence to a plant-based diet, particularly a healthy one, is associated with lower obesity rates. More longitudinal and intervention studies are necessary for a stronger consensus on the matter.

Introduction: Immunotherapy is a crucial treatment for type 1 diabetes (T1D), yet analyses focusing on research priorities and trends in this field are limited. Therefore, this study employs bibliometric methods to systematically explore the current research status of immunotherapy for T1D.

Methods: Based on the Web of Science Core Collection Database, 1573 articles and review articles related to immunotherapy for T1D published from 2004 to 2023 were screened for bibliometric analysis. VOSviewer, CiteSpace, and R software were applied to comprehensively analyze the number of publications, journals, countries, authors, institutions, keywords, and references.

Results: In the past two decades, the global annual publication rate has seen a significant increase of 238.24%. Almost 40% of all publications have appeared in the last 5 years, accounting for over 50% of total citations. Journals such as Diabetes, Journal of Autoimmunity and Frontiers in Immunology have exerted substantial influence. Collaboration across nations has been notably strong, with the United States leading the way. The University of Florida is the most productive institution. Terms like "nivolumab," "ipilimumab," "pembrolizumab," and "immune checkpoint inhibitor(s)" gain considerable traction. The majority of research has clustered around themes such as immunomodulation, autoimmune diseases, immune checkpoint inhibitors, mesenchymal stem cells, and cell therapy. Precision medicine, immune checkpoint inhibitors, and nanotechnology are trending focal points in contemporary research.

Conclusion: The outcomes of the study are instrumental in enabling scholars to comprehend the evolving trajectory of immunotherapeutic approaches for T1D and facilitate the swift recognition of emerging research pathways.

Introduction: Currently, trials are investigating the efficacy of nutrient-stimulated hormone-based therapies (NuSHs) in promoting weight loss in people living with overweight and obesity. However, the extent to which nutritional and functional outcomes are evaluated remains uncertain. Thus, we conducted a systematic mapping to assess the presence of nutritional and functional outcomes in randomized controlled trials (RCTs) investigating NuSHs.

Methods: We conducted a systematic mapping search on the Cochrane Central Register of Controlled Trials (CENTRAL), which includes ClinicalTrials.gov and the International Clinical Trials Registry Platform for interventional trials of NuSHs registered from inception to December 31, 2023. We excluded non- and quasi-randomized trials, phase I trials, trials that did not include body weight as a primary or secondary outcome, trials with an intervention duration of less than 6 months, and trials that did not specify a body mass index threshold in their eligibility criteria. Outcomes included: dietary intake, eating behavior, body composition, physical performance, muscle strength, bone health, and levels of vitamins, trace elements, albumin, prealbumin, and hemoglobin.

Results: The search identified 2284 trials, of which 417 were included in the analysis. The proportion of RCTs that included nutritional assessment other than body weight increased over time. Approximately, 20.4% reported measurements of body composition, 17.3% reported measurements of albumin/prealbumin/hemoglobin, and 17% reported assessment of dietary intake and eating behavior. Evaluations of bone health, physical performance, muscle strength, and measurements of vitamins/trace elements were reported in less than 5% of the total trials each.

Conclusion: The present review has shown the sparse reporting of nutritional and functional outcomes in RCTs evaluating the impact of NuSHs.

Developments in basic stem cell biology have paved the way for technology translation in human medicine. An exciting prospective use of stem cells is the ex vivo generation of hepatic and pancreatic endocrine cells for biomedical applications. This includes creating novel models 'in a dish' and developing therapeutic strategies for complex diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD) and diabetes. In this review, we explore recent advances in the generation of stem cell-derived hepatocyte-like cells and insulin-producing β-like cells. We cover the different differentiation strategies, new discoveries, and the caveats that still exist regarding their routine use. Finally, we discuss the challenges and limitations of stem cell-derived therapies as a clinical strategy to manage metabolic diseases in humans.

IntroductionTraditional obesity measures including body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio have limitations. The primary objective of this study was to identify and review the validity of non-traditional obesity measures, using measures of total body fat as the reference standard, that have been used across multiple life stages. MethodsWe conducted a systematic review and searched MEDLINE, Embase, and PsycINFO. We included observational studies published from 2013 to October 2023 among "the general population" for any life stage that reported the validity of non-traditional obesity measures compared to total body fat reference standards. Separate meta-analyses were performed to pool correlation coefficients and mean differences for non-traditional obesity measures that were evaluated at multiple life stages. ResultsA total of 123 studies were included, and 55 validated non-traditional obesity measures were identified. Of these, 13 were evaluated at multiple life stages. Two-dimensional (2D) digital imaging technologies, three-dimensional (3D) body scanners, relative fat mass (RFM), and mid-upper arm circumference had high or moderate validity (pooled correlation coefficient >0.70). Pooled mean differences were small (<6%) between total body fat percentage from reference standards and from RFM, 2D digital imaging technologies, 3D body scanners, and the body adiposity index. Heterogeneity (I²) was >75% in most meta-analyses. ConclusionNumerous validated non-traditional obesity measures were identified; relatively few were evaluated at multiple life stages and did not consider health risks associated with adiposity. More research is needed to define valid obesity measures across all life stages that assess health and adiposity.

Introduction: Obesity is a potential risk factor for anemia in children. This systematic review (SR) was undertaken to estimate the association of obesity with iron deficiency (ID) and ID anemia (IDA), in children.

Methods: A systematic literature search for observational studies was done in PubMed, EMBASE, Scopus, and the Cochrane library, with additional hand-searching. Two reviewers independently screened the search output, included eligible studies, extracted data, and assessed study quality using the National Institutes of Health tool. The main outcomes were association of obesity with anemia (IDA), and ID. Secondary outcomes were hemoglobin level, serum iron, ferritin, transferrin receptor saturation, and hepcidin. Meta-analysis was done using a random-effects model. Comparisons were expressed through pooled OR with 95% CI.

Results: Forty-two studies comprising one cohort, 29 cross-sectional, and 12 case-control studies comparing 16,633 children living with obesity and 32,573 children without obesity were included. The pooled OR (95% CI) for ID was 1.64 (1.22, 2.21), 16 studies, 20,949 children; and 0.78 (0.43, 1.43), 17 studies, 40,022 children, for IDA. The pooled prevalence of ID was 20.07% (14.98, 25.16) among children living with obesity (16 studies, 3147 children), compared to 16.1% (11.82, 20.38) in children without obesity. Children living with obesity had significantly lower levels of hemoglobin, iron, % transferrin saturation, and higher levels of ferritin and hepcidin than children without obesity.

Conclusion: There is a significant association between iron deficiency and obesity in children.

Background: There is limited evidence and clinical guidelines on the behavior change support required for low-calorie diet programs. This systematic review aimed to establish the behavior change technique(s) (BCT) implemented in weight loss interventions (≤1200 kcal/d) and how these contribute to effectiveness.

Methods: Databases were searched from inception to April 2022. Screening, data extraction, BCT coding, and quality appraisal were conducted in duplicate using the Template for Intervention Description and Replication framework, Behavior Change Technique Taxonomy, and Cochrane Risk of Bias 2 tool. Data were analyzed via narrative synthesis and random effects multi-level meta-analyses.

Results: Thirty-two papers reporting on 27 studies were included. Twenty-four BCTs were identified across studies. Eight BCTs were significantly associated with a larger reduction in weight at the end-of-diet time-point; one BCT was statistically significant at the end of weight maintenance. Physical activity, Type 2 Diabetes, and BMI category moderated intervention effects.

Conclusions and implications: This is the first meta-analysis to examine how specific BCTs contribute to the effectiveness of low-calorie diets. It is recommended that a) these findings are used to develop clinical guidelines specific to behavioral support in low-calorie diet programs, and b) program commissioners stipulate the use of these BCTs in their service specifications.

Purpose: To quantitatively synthesize published evidence on the association between 24-hour movement behavior composition with adiposity in children and adolescents aged 3-18 years.

Methods: Systematic literature searches were conducted in five electronic databases to identify papers published between January 2015 and January 2024. A machine learning-assisted systematic review was conducted to identify studies applying compositional data analysis to examine the association between 24-hour movement behaviors and adiposity in children and youth. Random effect meta-analyses were estimated to examine the relative association between each component of the 24-hour movement behavior composition and body mass index z-score (zBMI), waist circumference, fat mass percentage, and fat mass index (FMI).

Results: A total of 16 studies reporting on 15,230 children and youth were included in the review. Most studies reported on zBMI (k = 14), followed by waist circumference (k = 5), body fat percentage (k = 3), and FMI (k = 2). Spending more time sleeping and engaged in moderate-to-vigorous intensity physical activity (MVPA) relative to other behaviors was associated with lower adiposity, while spending more time sedentary and engaged in light-intensity physical activity was associated with higher adiposity.

Conclusion: These results provide support for most recommendations of the 24-hour movement behavior guidelines, including getting an adequate amount of sleep, limiting sedentary time, and engaging in MVPA, to improve adiposity outcomes.

The increasing prevalence of obesity, complex nature of this chronic disease, and risks of developing obesity-related comorbidities outline the need for sustainable and effective management for people living with obesity. In addition to behavioral interventions, obesity medications (OMs) are increasingly considered an integral part of management of people living with obesity. OM adherence is essential to achieve the health benefits of these medications. Adherence to medications, defined as the process by which patients take their medications as prescribed, is determined by a range of factors and can be broken down into phases: initiation, implementation, and persistence (the persistence phase includes discontinuation/stopping treatment). Obesity-specific challenges exist to optimize OM adherence, which may explain varying OM adherence compared with medication for other chronic diseases (diabetes, hypertension, dyslipidemia, and osteoporosis). However, lessons can be learned from other chronic diseases to improve OM adherence, for example from type 2 diabetes and hypertension. This review aims to provide practical guidance for identifying OM- and obesity-specific determinants of adherence and discusses adherence determinants per adherence phase and obesity management phase (weight gain, weight loss, and weight stabilization/regain). This practical guidance will assist with developing obesity-specific interventions to improve OM adherence. PRACTITIONER POINTS: OMs are increasingly considered as an integral part of obesity management; however, like with all chronic disease medications, low adherence to these medications is often observed, impacting their therapeutic effect. Adherence to obesity medication can be affected at any phase of obesity management (weight gain, weight loss, and weight stabilization/regain) so considering the disease phase can help identify potential reasons for low adherence. Future initiatives to improve adherence to obesity medication should be a key focus of discussions at each opportunity with healthcare professionals, including thorough evaluation and targeted education, all in a supportive and stigma-free manner.