Obesity Reviews最新文献

Introduction: With the growing use of GLP-1/GIP receptor agonist medications, their impact on dietary intake and quality remains unclear. This systematic review examined how randomized controlled trials (RCT) prescribing liraglutide, semaglutide, or tirzepatide assessed and reported dietary intake and quality as outcome measures, alongside weight loss and/or glycemic control, and identified gaps in the use and methodological quality of dietary assessment methods.

Methods: Medline, Embase, Cochrane, Scopus, and CINAHL were systematically searched between January 2008-January 2025 (adults) and January 2014-January 2025 (children/adolescents). The review was registered with the Open Science Framework (DOI: 10.17605/OSF.IO/XPNGY).

Results: Forty-three articles from 41 unique RCTs, comprising 50,690 participants (n = 688 children/adolescents, n = 50,002 adults) were included. Except for two studies targeting adults (one published and one unpublished data from an included study), this review found no other studies that assessed or reported dietary intake or changes in diet. Both reported a reduction in the total energy intake and altered macronutrient distribution in the medication plus diet group, although one was not significantly different from medication alone. Quality of assessment methods used was categorized as "poor" and "acceptable," respectively. These results highlight a critical gap in the literature.

Conclusion: Only 2/41 studies (≈5%) reported or assessed dietary intake or evaluated diet changes secondary to GLP-1/GIP RA medication use. This review highlights a major gap in the evidence requiring urgent attention. More high-quality research, using validated dietary assessment methods as outcome measures in RCTs is needed to understand how these medications impact diet and diet quality, nutrient intake, and chronic disease risk.

Aim: This rapid review aims to summarize the evidence of weight loss following Metabolic and Bariatric Surgery (MBS) associated with preoperative comorbidities.

Methods: Electronic databases Medline and EMBASE were searched for relevant articles up to and including September 2023. Studies that reported associations between the presence of comorbidities and weight loss outcomes in adult patients (age ≥ 18 years) after MBS (with ≥ 6 months of follow-up). Standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated and pooled using random effects meta-analysis. Heterogeneity was quantified using the I² statistic and tested for statistical significance using the Q-statistic.

Results: Twenty-three studies published between 2001 and 2023 were reviewed. Mental illness (SMD = -0.33, 95% CI: -0.53, -0.13; I² = 64.72%, Q statistic p = 0.01), type 2 diabetes mellitus (SMD = -0.20, 95% CI: -0.36, -0.03; I² = 56.88%, Q statistic p = 0.04), and sleep apnea (SMD = -0.28, 95% CI: -0.45, -0.12; I² = 27.39%, Q statistic p = 0.24) achieved slightly lower weight loss outcomes compared to those without these comorbidities. There was no significant difference in weight loss after bariatric surgery between individuals with and without preoperative hypertension (SMD = -0.10, 95% CI: -0.22, 0.03), dyslipidemia (SMD = -0.05, 95% CI: -0.20, 0.10), and metabolic syndrome (SMD = -0.19, 95% CI: -0.58, 0.19). While other comorbidities were also linked to reduced weight loss, the statistical significance of these findings was more variable.

Conclusions: Our evidence synthesis reveals an association between the presence of several preoperative comorbidities and less favorable weight loss outcomes following MBS.

Obesity has emerged as a global health crisis and a potent driver of cancer incidence and mortality, yet its mechanistic impact on tumor biology remains underappreciated. Far from being a passive risk factor, obesity acts as a systems-level oncogenic stressor, reshaping hormonal signaling, immunometabolism, and epigenetic stability across the body. This review synthesizes current knowledge on the physiological, cellular, and molecular cascades linking obesity to carcinogenesis, with emphasis on chronic inflammation, metabolic reprogramming, tumor microenvironment remodeling, and microbiome dysbiosis. We also examine how dietary patterns modulate these cancer-associated processes, positioning nutrition not merely as a preventive tool but as a programmable interphase with cancer biology through soft epigenetic reprogramming. Emerging frameworks in precision nutritional oncology, driven by nutrigenomics, metabolomics, and patient-specific molecular profiling, offer promising avenues for personalized cancer prevention and metabolic targeting. By integrating epidemiological trends, mechanistic insights, and translational strategies, we propose a paradigm shift: treating obesity not just as a comorbid risk factor but also as a modifiable oncogenic ecosystem-one that can be reprogrammed through informed, individualized precision dietary interventions.

A potentially powerful strategy for reducing children and adolescents' exposure to unhealthy food marketing is the implementation of mandatory regulatory measures applicable in the digital environment. This study aimed to systematically identify and characterize regulatory measures concerning food marketing directed at children and adolescents within digital spaces. A systematic scoping review was conducted following the PRISMA-ScR reporting guidelines and registered with the Open Science Framework (OSF). The study assessed the alignment of these measures with the recommendations for regulating food marketing set forth by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Inclusion criteria required regulatory measures to be mandatory, specific to food marketing, applicable at the national level, and relevant to the digital context. Draft laws, general regulatory frameworks not specific to food marketing, and self- or co-regulatory initiatives were excluded. The search identified eight regulatory measures proposed by Argentina, Bolivia, Brazil, Chile, South Korea, Kiribati, Peru, and Portugal. Notably, only the measures from Bolivia and South Korea explicitly state restrictions for individuals under 18 years of age. A rights-based approach was identified in the texts from Argentina, Bolivia, Brazil, and Peru. Furthermore, the regulatory measures from Argentina, Bolivia, Chile, Kiribati, and Peru present a broad definition of marketing. All measures employ nutritional criteria to classify targeted foods and impose limitations on marketing power. In conclusion, mandatory regulations for food marketing in the digital environment are limited, concentrated in specific geographic regions, and do not fully align with WHO and UNICEF recommendations.

Introduction: Polycystic ovarian syndrome (PCOS) is commonly associated with obesity and has cardio-metabolic, reproductive, and psychiatric comorbidities. PCOS in adolescents is challenging to diagnose. Appropriate screening for PCOS among adolescents with overweight/obesity is essential for timely diagnosis and management.

Objective: A PRISMA-compliant scoping review of international and national pediatric obesity (n = 32) and adolescent PCOS (n = 6) management guidelines was performed to evaluate recommendations on PCOS screening and management in adolescents.

Methods: Databases searched included PubMed, MEDLINE, Embase, and CINAHL. Data were extracted from guidelines using a predefined extraction template. Guideline quality was appraised using the AGREE-II instrument. Fourteen (of 32) pediatric obesity guidelines included some recommendations for PCOS evaluation, whereas six incorporated management recommendations. A summary of recommendations from reviewing PCOS-specific guidelines is that all adolescent females with overweight/obesity should be evaluated for PCOS, including a comprehensive menstrual history and clinical evaluation for hirsutism and severe acne. Free testosterone is helpful for PCOS diagnosis; ovarian ultrasound is not routinely recommended. Treatment of adolescent PCOS includes weight loss through multicomponent lifestyle or adjunct antiobesity pharmacotherapy, whereas off-label use of combined oral contraceptives and metformin may be indicated for PCOS-specific symptoms. Clear recommendations on PCOS in obesity guidelines are important to improve outcomes for this condition.

Introduction: While obesity is linked to increased Alzheimer's disease (AD) risk via inflammatory and metabolic pathways, conflicting evidence suggests a protective effect "obesity paradox." This meta-analysis investigates the association between various anthropometric measures and AD risk, focusing on age-dependent differences.

Methods: We searched PubMed, Google Scholar, and Embase for studies assessing the association between body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and AD risk. Thirty-eight studies were included, and a random-effects model was used to calculate pooled effect sizes (EF). Subgroup analyses and meta-regressions examined age-specific relationships.

Results: Underweight BMI was associated with borderline increased risk (ES: 1.28, 95% confidence interval [CI]: 1.00-1.64), and obese BMI was associated with decreased risk (ES: 0.78, 95% CI: 0.64-0.95). However, when stratified by age, overweight and obesity were protective on AD among aged ≥ 60 years (ES range: 0.81-0.90), but risk-enhancing for individuals aged < 60 years (ES range: 1.65-2.45). Weight loss increased AD risk, especially in older individuals (ES: 1.31, 95% CI: 1.08-1.58). A dose relationship between BMI and AD risk indicated increased risk at both low and high extremes, while higher BMI was protective in older adults.

Conclusion: This meta-analysis revealed a complex, age-dependent association between obesity and AD, supporting the obesity paradox in older adults. These findings underscore the importance of age-specific considerations along with obesity management strategies for AD prevention and emphasize the need for further research to elucidate underlying mechanisms.

This systematic review examines the applications of artificial intelligence (AI) in preventing obesity, addressing a critical public health issue that affects a substantial portion of the population. With obesity rates rising alarmingly, particularly in the United States, this review synthesizes findings from 46 studies published between 2008 and 2024, highlighting the potential of AI technologies to enhance obesity prevention efforts. The review employs PRISMA guidelines to ensure a rigorous methodology, encompassing a comprehensive search of major biomedical databases. The results indicate a notable increase in research activity since 2018, with a predominant focus on AI-driven methodologies for obesity detection, whereas areas such as prevention, management, and treatment remain underexplored. Various machine learning (ML) and deep learning (DL) algorithms, including support vector machines and long short-term memory networks, were identified, with performance metrics such as accuracy and sensitivity commonly reported. Despite the promising advancements, the review identifies significant gaps in the literature, including a lack of comprehensive frameworks for integrating AI in real-world settings and the need for more targeted research on prevention strategies. This review underscores the transformative potential of AI in combating obesity and calls for further investigation to optimize its applications in public health initiatives.

Obesity has emerged as a serious public health concern, exerting direct and indirect detrimental effects on vascular injury. This review systematically integrates current knowledge regarding the pathological effects, underlying mechanisms, and recent advances in understanding obesity-induced vascular injury. Obesity triggers pathological changes such as adipose tissue abnormalities, systemic metabolic disorders, and chronic inflammation. These alterations subsequently promote vascular wall pathology through multiple interconnected mechanisms, including adipokine imbalance disrupting endothelial homeostasis and vascular smooth muscle cell phenotypic switching, chronic inflammatory responses triggering vascular remodeling, insulin resistance impairing vascular reactivity, and enhanced oxidative stress accelerating vascular senescence. Notably, obesity establishes a complex interorgan crosstalk network involving adipose tissue, vascular systems, immune components, hepatic function, and lymphatic circulation, which collectively exacerbate vascular damage through paracrine and endocrine pathways. Although some progress has been made in this field, several knowledge gaps and research limitations remain to be addressed. This comprehensive review not only synthesizes existing findings on obesity-related vascular injury but also proposes future research directions based on current limitations, thereby providing a theoretical framework for developing novel preventive and therapeutic strategies against obesity-associated vascular pathologies.

Background: The relationship between adiposity and psychological health is complex, with much of the current research focused on adult or adolescent psychopathology. Affect, a facet of psychological well-being observable from infancy, appears to influence energy balance behaviors, but relationships with adiposity are not fully understood. This review examined the association between affect and adiposity across childhood and adolescence to further understand the nature of these relationships.

Methods: Six electronic databases were searched in February 2024. Studies that reported an association between measures of adiposity and affect were included and synthesized narratively. Study quality was assessed using an adapted version of the Newcastle-Ottawa Scale.

Results: One hundred and sixty-seven studies were retrieved from the search. Studies overwhelmingly focused on negative affect (n = 75) rather than positive affect (n = 14) or both (n = 21). Thirty-three studies focused on adiposity and emotional functioning, and 24 on emotional regulation. Negative affect was more consistently associated with adiposity in adolescence. There was little evidence of bidirectionality, whereby higher adiposity generally preceded negative affect. Positive affect was also related to adiposity, although these relationships were mixed, with prospective associations found with higher and lower adiposity across development. Mechanisms of associations were infrequently examined but varied when reported.

Conclusions: Positive and negative affect both appear to be associated with adiposity, and these relationships may be dynamic across development. Longitudinal research to elucidate these associations across development is necessary to confirm whether these trends are a true developmental phenomenon or a function of sample differences in baseline affect.

Phosphodiesterase 4 (PDE4) inhibitors, originally developed for chronic inflammatory diseases, have shown unexpected metabolic benefits, including weight reduction and improved glycemic control in both preclinical and clinical studies. Weight loss typically occurs within the first 6-12 months of treatment and may be sustained over several years. While the underlying mechanisms remain incompletely understood, preclinical findings suggest that PDE4 inhibition may increase circulating levels of glucagon-like peptide 1 (GLP-1), enhance lipolysis and thermogenesis, and promote energy expenditure via stimulation of mitochondrial biogenesis. Additionally, PDE4 inhibitors reduce markers of systemic inflammation and may influence key obesity-related comorbidities, including steatotic liver disease and impaired glucose metabolism. Despite these promising findings, the weight-reducing potential of PDE4 inhibitors has not been systematically evaluated in individuals with obesity, and clinical studies to date have primarily involved individuals with inflammatory conditions. This review summarizes the current evidence on the metabolic effects of PDE4 inhibition, with a particular focus on body weight regulation. PDE4 inhibitors may represent a novel adjunctive pharmacological approach to obesity treatment, with potential to address multiple dimensions of obesity pathophysiology. However, dedicated trials in individuals with obesity are warranted to clarify their therapeutic efficacy and role in metabolic disease management.