Obesity Reviews最新文献

Smartphone application (app)-based interventions to prevent Type 2 diabetes (T2D) are becoming increasingly available. A thorough summary of their effectiveness is lacking. We synthesized evidence on the effectiveness of app-based interventions to prevent T2D targeting individuals with prediabetes. For this systematic review and meta-analysis, we searched Web of Science, Embase, Scopus, PubMed Central, and Medline between January 1, 2013, and January 31, 2024, to identify randomized controlled trials (RCTs) that assessed the effectiveness of app-based interventions to prevent T2D targeting individuals with prediabetes, published in English, without restrictions regarding the effectiveness outcome. We synthesized all outcomes graphically via effect directions and conducted meta-analyses for clinical outcomes, including the Risk of Bias 2 Tool. This study was prospectively registered with PROSPERO (CRD42023491693) and OSF (DOI 10.17605/OSF.IO/B89QP). Of 9703 articles, 18 RCTs were included in the systematic review, and 15 RCTs in the meta-analysis. We found statistically significant reductions in body weight (-1.35 kg, 95% CI: [-2.48; -0.23], N = 13 RCTs), body mass index (-0.53 kg/m², 95% CI: [-0.97; -0.09], N = 11 RCTs), and glycated hemoglobin (-0.08%, 95% CI: [-0.10; -0.05], N = 11 RCTs) and point estimates and/or effect directions predominantly suggesting improvements for additional outcomes. Stratified meta-analyses showed no statistically significant between-group differences and missing evidence for long-term effectiveness and equity-relevant subgroups. Our study shows that app-based interventions can improve outcomes (i.e., motivation, behavior, and clinical parameters) in individuals with prediabetes. The effect on clinical outcomes is small. Evidence on equity impacts, long-term effectiveness, and diabetes incidence is missing and remains to be investigated.

Very few studies exist examining the effects of mild traumatic brain injury (mTBI) in patients with obesity, which is notable given that mTBI represents ~80% of all recorded TBIs. Given that approximately 40% of US adults have an obese body mass index (with predictions that this proportion will continue to increase), it would be prudent to focus efforts on targeted treatments for this growing subpopulation of patients with TBI. Authors have postulated that higher preinjury inflammation, as observed in the patient with obesity, could lead to greater spikes in acute inflammation following traumatic brain injury and higher chances of prolonged inflammation. Evidence to support this hypothesis has emerged recently, but this body of research has limitations such as evaluating TBI outcomes at variable timepoints along with an underappreciation of the heterogeneity of TBI outcomes. Our goal was to identify gaps where future work is needed by synthesizing the state-of-the-science across these clinical variabilities. In this scoping review, we summarize the available literature across different TBI severities and time from injury before providing a brief summary of basic science evidence on the topic and opportunities for future research.

Background: The prevalence of childhood overweight and obesity has been recognized as a global challenge and poses a severe threat to the health and development of children. Mastery of fundamental motor skills is suggested to be closely related to reducing the risk of obesity.

Objective: The objective of this study is to evaluate and provide evidence regarding the correlation between fundamental motor skill proficiency and the development of overweight and obesity during the period from 2013 to 2025.

Methods: Four databases were surveyed based on the PRISMA standards from January 2013 to April 2025. Studies exploring and analyzing the relationships between fundamental motor skills and overweight or obesity in children aged 3-12 were considered for inclusion.

Results: Forty-seven articles were included, and a meta-analysis was done on 19 of these selected papers. The analysis revealed a statistically significant moderate correlation between overall FMS and BMI (r = -0.314, 95% confidence interval -0.330 to -0.298, p < 0.001) and small correlations for both locomotor skills (r = -0.270, 95% confidence interval -0.289 to -0.251, p < 0.001) and object control skill (r = -0.162, 95% confidence interval -0.182 to -0.142, p < 0.001) with BMI.

Conclusions: There is a significant negative correlation between children's fundamental motor skills and weight status, with children of normal weight consistently outperforming children with obesity. Limited longitudinal evidence suggests that lower FMS levels may be associated with a higher risk of obesity. Further longitudinal and intervention research is needed to confirm its predictive value.

Introduction: Individuals with overweight and obesity exhibit elevated cardiometabolic risks. While high-intensity interval training (HIIT) demonstrates potential in improving cardiometabolic health, evidence-based recommendations for optimal HIIT protocols remain uncertain. This study aimed to explore the effects of HIIT on cardiometabolic risk in individuals with overweight and obesity and to characterize dose-response relationships of HIIT programming variables.

Methods: A systematic search of five databases (PubMed, Embase, Cochrane Library, Web of Science, Scopus) identified 19 randomized controlled trials comprising 24 intervention groups. The risk of bias was evaluated using the Cochrane Collaboration Tool. Relevant data were extracted, and a meta-analysis was performed using RevMan5.4 software.

Results: Meta-analysis demonstrated that HIIT significantly improved cardiorespiratory fitness (CRF) (standardized mean difference [SMD] = 1.18) and reduced TG (SMD = -0.40) compared to nonexercising controls. Subgroup analyses revealed greater CRF improvements with interventions ≥ 8 weeks, work/rest intervals ≥ 90 s, and high-volume long-interval protocols. Total cholesterol (TC) reductions were significant under work/rest intervals ≥ 90 s (SMD = -1.67) and high-volume protocols (SMD = -2.15). Maximal triglycerides (TG) benefits occurred with work/rest intervals ≥ 90 s (SMD = -0.64) and high-volume protocols (SMD = -0.72). However, HIIT showed no significant effects on body composition, blood pressure, glucose, or high-density lipoprotein/low-density lipoprotein cholesterol.

Conclusion: HIIT is an effective strategy to reduce cardiometabolic risk (CRF, lipid metabolism) in individuals with overweight and obesity, with a preliminary dose-response relationship observed between training variables and outcomes. Future studies should optimize protocols and confirm sustained benefits.

Objective: This study aimed to compare 12 exercise interventions on body mass index (BMI) and body fat percentage (BF%) in youth with overweight or obesity using a network meta-analysis to inform intervention and weight management strategies.

Methods: We conducted a search of Scopus, Embase, Cochrane Library, PubMed, and Web of Science databases for randomized controlled trials examining exercise interventions on body composition in children and adolescents with overweight or obesity, covering all studies available up to October 24, 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Statistical analysis was performed using R.

Results: Sixty-three randomized controlled trials involving 2724 children and adolescents with overweight or obesity were included in the analysis. Pairwise meta-analysis revealed that 40% of exercise types showed no significant impact on BMI, and 30% showed no significant impact on BF%. The results from the network meta-analysis were largely consistent with those from pairwise meta-analysis when compared to control groups. The top five interventions for reducing BMI were moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), combined aerobic-resistance training (CT), moderate-to-vigorous aerobic exercise (MVAE), and multicomponent exercise (MCE). For BF%, the top five interventions were CT, resistance training (RT), MICT, HIIT, and MVAE.

Conclusion: MICT, CT, and HIIT performed favorably, with outcome-specific advantages. MICT ranked highest for BMI, CT was highest for BF% (SUCRA), and HIIT offered time-efficient benefits across outcomes versus control; results support tailoring modality choice to goals and feasibility to improve adherence.

Introduction: This study systematically synthesized evidence on adverse health outcomes related to gestational diabetes mellitus (GDM) via an umbrella review with integrated meta-analyses.

Methods: The search covered publications from the database (PubMed/MEDLINE, Google Scholar, Embase, and CINAHL) inception to August 12, 2024. Meta-analyses of observational studies examining the impact of GDM on maternal and neonatal health outcomes were included. Two independent researchers screened and extracted data. Associations were reanalyzed and presented as equivalent odds ratios (eORs) with 95% confidence intervals (CI). The quality of meta-analyses was assessed using AMSTAR 2, and the credibility of associations was categorized into five levels: convincing (Class I), highly suggestive (Class II), suggestive (Class III), weak (Class IV), or nonsignificant (NS).

Results: A total of 27 meta-analyses encompassing 85 associations were included. Among 28 significant maternal outcomes, 11 (subclinical atherosclerosis, angina, hypertension, overall cardiovascular diseases, ischemic stroke, overall stroke, combined cardiovascular/cerebrovascular diseases, subclinical left ventricle systolic dysfunction, type 2 diabetes, postpartum metabolic syndrome, and infections) were supported by convincing or highly suggestive evidence. Of 13 significant neonatal outcomes, three (atrial septal defect, congenital heart disease, and ventricular septal defect) were highly suggestive, while four of eight significant delivery outcomes (hypertensive disorders, cesarean delivery, admission to neonatal intensive care unit admission, and preterm birth) reached this level. Notably, no outcomes previously deemed nonsignificant turned significant upon reanalysis.

Conclusions: These findings underscore the need for targeted prevention and management, and further research is needed to clarify causality and refine guidelines.

Study registration: PROSPERO CRD42024590322.

Epidemiological evidence shows that obesity increases the risk of developing metabolic diseases. Nevertheless, the mechanisms behind this connection remain underappreciated. The substantial impact of these disorders on global health has led to extensive research efforts aimed at identifying the pathophysiological links between them. Chronic low-grade inflammation, induced by altered secretion of adipokines and other bioactive molecules, from adipose tissue, is believed to causally link obesity to various metabolic disorders. Multiple studies have indicated that TLR4 regulates inflammation, adipogenesis, thermogenesis, and glucose metabolism through its interaction with endotoxins, particularly in the context of obesity. The increased expression of TLR4 observed in obesity is believed to contribute to the development of type 2 diabetes (T2D), as it disrupts key physiological processes that regulate metabolic inflammation. This review aims to summarize recent research on the pathobiological roles of TLR4-mediated inflammation in obesity and its contribution to the development of metabolic disorders. Overall, current evidence supports a central role for TLR4 as a mediator of obesity-associated metabolic inflammation, highlighting TLR4 and its downstream pathways as promising targets for preventing or treating obesity related metabolic diseases.

Introduction: This narrative review explores the epidemiological evidence and potential underlying pathophysiological defects underlying the disproportionately greater risk of Type 2 diabetes (T2D) and cardiometabolic disease in people of South Asian and African Caribbean ancestry compared with White Europeans. Differences in (i) insulin dynamics, (ii) body composition and liver and pancreas triglyceride accumulation, and (iii) dysregulated fat metabolism likely contribute to this obesity-related susceptibility.

Insulin dynamics: Insulin resistance and hyperinsulinemia are key pathophysiological defects in T2D, although the primary defect is uncertain. Many believe that insulin resistance precedes compensatory hyperinsulinemia; much data suggest that hyperinsulinemia precedes insulin resistance. Hyperinsulinemia, related to reduced hepatic insulin clearance, may represent the primary defect in people of African Caribbean ancestry.

Body composition: Ectopic fat, particularly visceral, liver, and pancreatic fat, is associated with impairments in insulin action/secretion: Higher liver fat is specifically related to hepatic insulin resistance and higher pancreatic fat to impaired beta cell function. People of South Asian ancestry exhibit greater ectopic particularly liver fat, compared with White Europeans, and more severe insulin resistance, driving hyperinsulinemia. People of African Caribbean ancestry have lower visceral and liver fat and greater muscle mass.

Dysregulated fat metabolism: Dysregulated fat metabolism in adipose tissue/liver may increase serum fatty acids and triglyceride concentrations exposing non-adipose tissues to increased lipid. Differential T2D susceptibility likely reflects diverse but ethnic group-specific metabolic phenotypes representing genetic and environmentally mediated pathophysiological traits, consistent with the "palette" model of T2D.

Introduction: Physical activity (PA) is essential for adolescents' healthy development, yet many fall short of PA guidelines. Movement integration (MI)-infusing PA into regular classroom time-is a well-established approach to increasing elementary children's PA at school. However, less is known about MI in secondary school settings. This scoping review maps the breadth of empirical evidence on MI in secondary schools.

Methods: This review adhered to the Joanna Briggs Institute methodology for scoping reviews and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search was conducted across seven electronic databases (PubMed/MEDLINE, ERIC [EBSCOhost], SPORTDiscus, CINAHL, SCOPUS, Web of Science, and PsycINFO) from November 10-15, 2023, and on August 5, 2025. Inclusion criteria centered on studies involving secondary school students and professionals. Exclusions applied to non-typically developing children and unpublished documents.

Results: MI strategies varied, with non-academic movement breaks (31 instances) and academic subject integration (28 instances) being the most common. The review included 44 studies published between 2014 and 2025. The studies originated from 11 countries and involved 59,973 participants. Two theoretical perspectives were prominent: social cognitive theory and the socio-ecological model. Methodological approaches included quantitative (28 studies), qualitative (10 studies), and mixed-methods (six studies) designs. Knowledge claims underscored student-centered benefits, the importance of contextual and institutional alignment, the feasibility and challenges of implementation, the adaptability of content for pedagogical integration, and the fact that no single MI strategy is universally sufficient for success.

Conclusions: MI in secondary schools presents a viable PA promotion strategy for adolescents. Future research on MI in secondary school settings is warranted.

Introduction: Meal delivery apps increase access to unhealthy foods, contributing to an obesogenic environment. Promotions are widely used on these apps to influence consumer choice. This systematic review aimed to synthesize evidence on the healthiness of foods promoted on meal delivery apps.

Methods: A systematic search for studies published from 2010 to November 2024 was conducted using three electronic academic databases and two search engines. Studies were included if they assessed promotion on third-party aggregator meal delivery apps and used an objective measure of healthiness.

Results: The search returned 1449 articles, of which nine articles from four countries met the inclusion criteria. Three studies assessed food outlet menus, two assessed individual menu items on app home pages, and five assessed menu items on outlet pages. All studies found that unhealthy foods featured more prominently than healthy foods through combination deals, volume incentives, and prioritized placement.

Conclusions: Findings from this review indicate that unhealthy menu items offered on meal delivery apps are more likely than healthy menu items to be the subject of promotional strategies. Considerable variation in study methods limited the quantitative integration of findings, highlighting the need for greater methodological consistency in this evolving research field. Building a strong evidence base will facilitate appropriate policy development to support healthier choices on meal delivery apps.