Obesity Reviews最新文献

Introduction: Interventions in the food system to improve sustainability are emerging research areas reflecting complex relations between consumption, production, and environmental impact. This umbrella review aimed to explore current research on food systems initiatives and their relationship with human health and sustainability outcomes.

Methods: An umbrella review of systematic and scoping reviews describing food system initiatives with cobenefits for health and at least one sustainability outcome was conducted. Five databases were searched, covering 2015-2024.

Results: The systematic search identified 2770 records and 20 articles were included. Most reviews described initiatives on sustainable diets (n = 7), food security (n = 3), urban agriculture (n = 4), food supply chain (n = 3), education (n = 2), and the global syndemic (n = 1). Three reviews (15%) reported on all three sustainability outcomes combined. Economic sustainability was reported only alongside social (n = 4) or environmental (n = 3) outcomes. Social and environmental outcomes were examined in isolation (social [n = 3]; environmental [n = 3]) or in combination (n = 4). No clear trends emerged between intervention topics and outcomes. Included reviews identified the need for further research that took a holistic approach to food system sustainability.

Conclusion: This review supports the crucial need for robust, methodological multidisciplinary systems research to effectively integrate all sustainability dimensions to drive transformative food systems' change.

Adherence to weight management is an essential indicator of weight management success. However, the conceptualization and operationalization of adherence show substantial variability, posing limitations for research, surveillance efforts, policy formulation, and comparisons across studies. This study aimed to identify in the literature of weight management interventions for people with obesity and overweight: (a) adherence definitions, (b) adherence components, (c) adherence metrics and measurement methods, and (d) behavior change techniques used to enhance it. A scoping review was conducted following PRISMA-ScR guidelines. A comprehensive search strategy was used (Web of Science, PubMed/MEDLINE, Scopus, and Cochrane). A total of 182 papers were included. Findings from the data synthesis showed variability in the definition, operationalization, and measurement of adherence across studies. The most frequent components of adherence in the context of weight management included (1) adherence to dietary behaviors, (2) adherence to physical activity, (3) attendance at intervention sessions, (4) self-monitoring of weight, (5) adherence to exercise, (6) adherence to medication, (7) attrition, (8) retention, and (9) dropout. The WHO's definition and framework to operationalize adherence are recommended, with modifications adjusted to the specific weight management context, as well as the use of standardized measurement metrics. Furthermore, behavior change techniques associated with adherence were summarized, with self-monitoring behavior and social support reported as strategies to improve adherence.

Obesity is one of the most prevalent health problems worldwide, and global obesity rates continue to rise. Consequently, rates of obesity in expecting mothers and fathers have also increased. The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that early-life exposure to adverse environmental conditions contributes to the increased risk of noncommunicable disease later in life. In this context, much work has been done to understand how parental obesity can affect the long-term health of offspring. In terms of offspring brain health and function, evidence suggests that elevated maternal body mass index (BMI) is associated with an increased risk of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and anxiety disorders, as well as deficits in learning and memory in offspring. Less well characterized is the impact of paternal obesity on the offspring brain. A limited number of studies have reported an association between paternal obesity and altered offspring neurodevelopment, including a higher risk of the offspring having neurodevelopmental disorders such as ASD and ADHD. Mechanisms proposed to underlie these effects include epigenetic modifications, placental changes, and alterations in neuronal protein expression. Here, we review the body of evidence supporting a neurodevelopmental impact of maternal and paternal obesity and associated biological mechanisms. Understanding how parental obesity influences offspring brain function has important implications for the advice given to people trying to get pregnant and expecting mothers, and provides vital insight into the contribution of parental health toward offspring brain health across the life course.

Body fat distribution is a key indicator of obesity-related disease risk, often assessed through objective anthropometric measurements. However, objective implementation at scale is limited by measurement variability, cost, and anthropometrist skill. Subjective methods, widely applied in body image research, may offer an alternative but are less explored for determining obesity- and disease-related risk. This scoping review aimed to identify the availability and characteristics of subjective body shape assessment tools for assessing regional body fat distribution in adult females. A search across five databases (inception to September 8, 2023), using terms for body shape and assessment tools, limited to females, yielded 13,646 unique records; 177 studies were included, reporting 80 tools (13 were variations of 7 originals). Studies utilized tools for varied purposes: body image/shape attractiveness, satisfaction, or distortion (73.4%); health/disease risk (18.1%); tool development/validation (13.0%); clothing/fashion (5.6%); or other (4.0%). Tools types included: figural (38.8%); photographic (21.3%); silhouette (16.3%); figural/scanned image with shape overlay (6.3%); computer generated image (6.3%); inanimate shape (3.8%); somatograph (1.3%); and unclassified (6.3%). Some tools were culturally adapted (e.g., modifying skin tone, clothing, or shape to the population), but most (17.6% of 51 applicable tools) depicted White ethnicity, limiting inclusivity. Among applicable tools, 56.3% included facial features, and 25.4% nakedness. This review reveals a variety of subjective tools, but limited application for disease-related risk assessment. Further research should refine and culturally adapt subjective tools to ensure conceptual suitability, and validate their use for assessing obesity-related disease risk.

Background: The visceral adipose tissue (VAT) is a crucial marker for assessing the extent of visceral fat accumulation. An increasing number of studies have suggested that the VAT can serve as a screening tool for metabolic syndrome (MetS), given the pivotal role of visceral obesity in MetS. Our aim was to comprehensively evaluate the efficacy of the VAT in predicting MetS through consolidating existing findings.

Methods: The PubMed, Cochrane Library, Web of Science, CNKI, Wanfang Data, and VIP databases were electronically searched to collect eligible studies that investigated the association between VAT and MetS from inception to January 2025. The meta-analysis was divided into two parts on the basis of whether MetS excluded waist circumference (WC). The diagnostic test accuracy (DTA) metrics meta-analyses and odds ratio (OR) meta-analyses were conducted by gender.

Results: A total of 68 articles were included, comprising 43 articles focused on MetS (including WC) and 25 articles on MetS (excluding WC). The DTA meta-analysis results showed that VAT has moderate-to-high accuracy in predicting MetS (including WC), with an area under the summary receiver operating characteristic curve of 0.77 for males and 0.82 for females. For MetS (excluding WC), the accuracy was lower, at 0.72 for males and 0.77 for females. Additionally, increased VAT was linked to higher MetS risk in pooled OR analyses, regardless of whether WC was excluded.

Conclusion: The VAT is an accurate and widely available predictive indicator for MetS and performs significantly better in females than in males.

The prevalence of childhood obesity increases throughout development. Obesity results from a positive energy balance, which suggests different trajectories of energy intake and energy expenditure as children age. Rapid development of reward processes that motivate eating and sedentary over physically active behaviors coupled with slower development of executive functions that allow youth to focus on long-term goals rather than immediate gratification may influence the imbalance in energy intake and expenditure. Children are motivated to engage in activities that have strong reinforcing value in early childhood, including eating palatable foods, and engaging with sedentary activities. Valuing activities that offer long-term rewards, including healthy food consumption and physical activity, increases as children develop more mature executive functions. We present a conceptual overview of how reinforcer pathology theory, or a combination of the high value of immediate reinforcers such as food and high rates of delay discounting, can be used to understand the balance between the motivation to eat and be active or sedentary within a developing executive function system that prioritizes immediate gratification over delayed rewards are related to changes in obesity prevalence through development. We suggest areas for future study and the potential for reinforcer pathology theory for developing prevention and treatment programs.

Objectives: This study investigated the effects of different exercise interventions on intrahepatic lipid content and markers of glucose homeostasis and liver function in adults with and without nonalcoholic fatty liver disease (NAFLD).

Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, and EMBASE using three primary keywords including "exercise training," "liver fat," and "randomization" from inception to August 2025. Eligible studies were those that compared exercise training with either nonexercise groups or other types of exercise training.

Results: Thirty-eight studies comprising 1880 participants were included. Exercise training was more effective for reducing intrahepatic lipids [SMD: -0.33, p = 0.001], confirmed through subgroup analyses based on age, health status, body mass index, intervention duration, specific health status, frequency of weekly exercise sessions, biological sex, steatosis classification, and weight change%. Based on the p-score rankings, the intervention that was likely to be the most effective for lowering intrahepatic lipids was high-intensity interval training (p = 0.95), followed by aerobic training (p = 0.77), combined aerobic and resistance training (p = 0.52), and resistance training (p = 0.10). Secondarily, exercise training reduced fasting blood glucose [WMD: -2.27 mg/dL, p = 0.007], fasting insulin [SMD: -0.16, p = 0.02], glycated hemoglobin [SMD: -0.13, p = 0.03], and liver function enzymes including alanine aminotransferase (ALT) [WMD: -3.72 U/L, p = 0.001] and aspartate aminotransferase (AST) [WMD: -3.51 U/L, p = 0.02] significantly more than nonexercise groups. However, there were no significant differences in insulin resistance.

Conclusions: These results provide evidence of the effects of different exercise interventions as part of a healthy lifestyle for reducing intrahepatic lipids and markers of glucose dysmetabolism. PROSPERO Registration: CRD42025639421.

Background: Colorectal cancer (CRC) has recently been identified as the world's third commonest cause of cancer death, accounting for 900,000 deaths per year. Obesity-related CRC has also been on the rise, with research indicating that increasing body mass index (BMI) is associated with an increased risk of CRC. As a result, there is a need to find safe and effective treatment options for CRC, and one potential complementary therapy might be Chinese medicine (CM), which has gained popularity in recent years.

Scope and approach: This review focuses on the role of CM as a complementary therapy in obesity-associated CRC. The pathophysiological mechanisms of obesity-associated CRC are first reviewed, followed by an overview of several CM methods for managing obesity-associated CRC. Following that, we will discuss current research on the prospects of integrating CM with conventional oncology and conclude with some suggestions for future research.

Key findings and discussion: Complementary CM approaches may be beneficial in the management of obesity-related CRC. The diverse range of pharmacological and nonpharmacological treatments offers several pathways for safe and effective treatment and has the potential to be used in the management of obesity-related CRC and its comorbidities. In addition, combining CM with conventional oncological methods could benefit patients and improve their quality of life during and/or after treatment. Therefore, we hope that these findings may be applied to the long-term therapy of obesity-related CRC and other cancers.

Adipose tissue, beyond its role as a fat storage depot, functions as an endocrine organ, secreting signaling molecules systemically and via paracrine mechanisms (particularly in perivascular and ectopic fat). These diverse functions are crucial for regulating metabolic and cardiovascular health. The circadian clock, an internal ~24-h biological rhythm, orchestrates physiological processes to adapt to environmental cycles (e.g., light, temperature, food). This involves linking gene transcription/translation events to the external environment. Recent studies demonstrate circadian expression patterns in adipose tissue for various genes and metabolic pathways. Disrupted circadian rhythms are implicated in adipose tissue and metabolic dysfunction. Understanding adipose tissue circadian mechanisms may provide strategies to mitigate metabolic and associated cardiovascular disease risk. This review summarizes recent findings on the relationship between circadian rhythms and adipose tissue metabolism, explores how an adipose clock contributes to the pathogenesis of metabolic diseases, and discusses potential therapeutic approaches targeting the adipose tissue clock.

Background: Obesity is a well-documented cardiovascular risk factor. Here, we sought to investigate whether obesity causes subclinical cardiac remodeling and heart failure (HF), and if so, to perform a systematic scan of the plasma protein for novel drug targets.

Methods: We leveraged visceral adipose tissue (VAT), waist circumference (WC), and waist-to-hip ratio (WHR)-all adjusted for body mass index (BMI)-as indicators of obesity. Two-sample Mendelian randomization (MR) analyses were used to estimate the independent, causal effects of obesity on cardiovascular magnetic resonance (CMR)-derived cardiac traits and HF risk. Mediation analyses followed by druggability assessment were conducted to identify promising protein targets for therapeutic translation.

Results: Genetically determined VATadjBMI, WCadjBMI, and WHRadjBMI presented broad causal associations with alterations of distinct cardiac phenotypes, most of which remained significant after controlling for obesity-induced cardiometabolic risk factors, including hypertension, type 2 diabetes, and adverse lipid profiles. By contrast, WHRadjBMI is the only independent causal predictor for HF risk. Of 142 proteins with mediating effects, scavenger receptor class A member 5 (SCARA5), membrane cofactor protein (CD46), and alpha-1-antichymotrypsin (SERPINA3) may contribute to the early-stage adverse cardiovascular effect of obesity, whereas apolipoprotein C-III (APOC3), mitochondrial aldehyde dehydrogenase 2 (ALDH2), and chordin-like protein 2 (CHRDL2) may further promote the development of obesity-driven HF. Medications targeted at these candidate proteins are either approved or under evaluation in clinical trials.

Conclusions: Our MR findings provided genetic evidence for the direct, causal associations of obesity with cardiac remodeling and HF, while also outlining druggable proteins as promising therapeutic targets.