Search Results (6,115)

Background: Overweight and obesity have emerged as major public health challenges in China, with rising prevalence rates posing substantial burdens on healthcare systems. This study is a secondary analysis of data from the 2019 Chinese National Survey on Students’ Constitution and Health (CNSSCH), aimed to investigate the association of family and individual physical activity (PA) environments with overweight and obesity transition among children and adolescents, and to analyze subgroup differences by sex and urban–rural location as well as potential mechanisms. Methods: This was a one-year longitudinal study based on the 2019–2020 follow-up of 5008 children and adolescents. Family and individual physical activity environments were assessed as main exposures, and transitions to overweight and obesity were defined as outcomes. Multivariate logistic regression was applied to evaluate the association between family and individual PA environments and transitions to overweight and obesity, while also examining their moderating effects on unhealthy lifestyle behaviors. Results: A favorable family and individual PA environment was significantly associated with a reduced risk of obesity transition (OR = 0.78, p = 0.016). Subgroup analyses indicated that males (OR = 0.69, p = 0.009) and rural children and adolescents (OR = 0.70, p = 0.021) were more sensitive to supportive family and individual PA environments. Furthermore, a favorable environment was significantly correlated with a reduction in unhealthy behaviors such as skipping daily breakfast and consuming sugar-sweetened beverages (p < 0.001). Conclusions: A supportive family and individual PA environment was associated with a lower risk of obesity transition in children and adolescents, with more pronounced associations observed among males and those in rural areas. Full article

Objective: This narrative review summarizes current evidence on the associations between ultra-processed food (UPF) consumption, childhood and adolescent obesity, and functional gastrointestinal disorders (FGIDs), and examines the metabolic, inflammatory, microbial, and gut–brain mechanisms underlying these links. Methods: A comprehensive search of PubMed and Scopus identified articles published between January 2010 and September 2025. Eligible studies included human research in individuals aged 0–18 years; adult studies were considered when contributing relevant mechanistic insights. Of 335 records screened, 112 studies met the inclusion criteria and were synthesized narratively according to methodological appropriateness. Results: High UPF intake was consistently associated with increased adiposity, metabolic dysregulation, and greater cardiometabolic risk in youth. Children with overweight or obesity showed a higher prevalence of FGIDs compared with their normal-weight peers. Mechanistic evidence suggests that UPFs, rich in refined carbohydrates, unhealthy fats, and additives, may promote gut microbiota dysbiosis, impair intestinal barrier integrity, alter motility, and induce low-grade inflammation, thereby disrupting gut–brain signaling and contributing to FGID symptoms. Early-life and maternal UPF exposure may further increase susceptibility to metabolic and gastrointestinal disturbances through epigenetic and microbiome-mediated pathways. Conclusions: UPFs emerge as a shared etiological factor for obesity and FGIDs in childhood. This review contributes an integrated synthesis of epidemiological and mechanistic data while highlighting key research gaps, particularly the need for standardized methodologies and pediatric interventional studies to strengthen the evidence base. Full article

Overweight and obesity in young people represent a major public health challenge, not only due to their association with metabolic alterations but also because of their impact on emotional well-being. Background/Objectives: The objective of this study was to determine the structure of the network between metabolic indicators and emotional symptoms Methods: A sample of 78 university students was assessed through biochemical, anthropometric, and psychometric measures. Results: A total of 37.9% showed risk levels associated with excess weight and moderate emotional distress. There exist significant links between central adiposity and lipid alterations, as well as positive correlations between anxiety, depression an emotional exhaustion and inverse with happiness. Conclusions: The results highlight an interaction between metabolic and emotional factors even among individuals with normal weight, underscoring the value of network models for early risk detection. The findings are useful for implementing preventive strategies in university settings to promote improved health and emotional well-being. Full article

Background and Objectives: Previous research shows that stress can alter eating habits. This study analyzed the impact of COVID-19 confinement on eating behaviors and weight in Spanish adults, as well as related factors. Methods: A total of 2834 adults (69.3% women, Mean age: 41.36) completed an online questionnaire assessing eating habits, weight, and sociodemographic variables. Results: Strict lockdown in Spain was linked to a general worsening of eating habits, particularly increased food intake and weight gain. Risk factors for less healthy eating and weight gain included being female (p < 0.001), under 35 years old (p < 0.001), overweight or obese (p < 0.001), caring for minors (p = 0.002), and experiencing nervousness or anxiety (p < 0.001). Conversely, maintaining pre-confinement eating habits and weight was more common among men (p < 0.001), individuals aged 50 years or older (p < 0.001), those with normal or underweight BMI (p < 0.001), those working outside the home (p < 0.013), and those without minors in their care (p = 0.001). Conclusions: Prolonged lockdowns associated with high stress may negatively influence diet and weight. Prevention strategies should therefore promote healthy eating during such periods, particularly targeting groups at higher risk of worsening habits and weight gain. Full article

Background: Autism spectrum disorder (ASD) constitutes a heterogeneous neurodevelopmental condition frequently accompanied by considerable disturbances in feeding behavior and nutritional balance. These difficulties arise from complex and multifactorial mechanisms, exerting a significant impact on physical health, metabolic homeostasis, and psychosocial functioning. The present review aims to provide a critical synthesis of current evidence regarding the underlying biological and behavioral mechanisms of feeding difficulties in ASD and to delineate the spectrum of comorbid eating disorders within this population. Methods: A narrative review of the peer-reviewed scientific literature was undertaken, emphasizing studies investigating the interrelationship between ASD and nutritional functioning in pediatric and adolescent populations. Particular focus was placed on research exploring sensory processing abnormalities, gut microbiota alterations, and the clinical manifestation of eating disorders in individuals with ASD. Results: The analysis revealed that sensory hypersensitivity, behavioral inflexibility, and disturbances within the gut–brain axis constitute principal determinants of atypical eating patterns in ASD. Individuals on the autism spectrum frequently exhibit pronounced food selectivity, neophobia, and symptoms consistent with Avoidant/Restrictive Food Intake Disorder (ARFID). Furthermore, an increased prevalence of anorexia nervosa and orthorexia nervosa has been documented, likely reflecting shared cognitive and behavioral features with ASD. “Emotional eating” tendencies and a marked preference for high-caloric, energy-dense foods—often potentiated by psychopharmacological treatment and reduced physical activity—further contribute to an elevated risk of overweight and obesity. Conclusions: Children and adolescents with ASD display a bimodal distribution of body mass, encompassing both undernutrition and obesity, indicative of a multifaceted interplay among sensory, behavioral, cognitive, and metabolic determinants. A comprehensive understanding of this heterogeneity is crucial for the development of individualized, evidence-based interventions integrating nutritional management with behavioral and psychotherapeutic approaches. Full article

Background: Early childhood obesity is an urgent public health challenge, with long-term health risks. The 12-month fruehstArt intervention aims to improve healthcare for 3 to 6-year-olds with overweight and obesity in Germany through a family-centred approach, including home-based counselling with coaches, paediatric consultations, and a supportive web application for both German- and Turkish-speaking families. This process evaluation will examine the barriers and enabling factors critical for successful implementation, identify necessary adaptations to the intervention, and assess its quality and acceptability among families, coaches, and paediatricians. Methods: This formative evaluation will use a mixed-methods approach including qualitative and quantitative data. Semi-structured interviews will be conducted with parents, coaches, and paediatricians at two different time points. Interviews will be analysed using qualitative content analysis. An Implementation Quality Index assessing the four dimensions of dosage, adherence, quality of delivery, and participant responsiveness will be developed, based on data collected from coaches carrying out the home-based counselling and participating parents of the intervention group. Linear mixed models for repeated measures will be used to analyse the relationship between data of the Implementation Quality Index and the primary and secondary outcomes of the effectiveness evaluation. Conclusions: The formative evaluation of the fruehstArt intervention is expected to identify important determinants of the implementation and provide valuable insights for future strategies to improve implementation. By identifying barriers and facilitators to participation, this study aims to pave the way for an effective dissemination of the intervention and ultimately contribute to improved health outcomes for children. Full article

The prevalence of maternal obesity is rapidly increasing, which represents a major public health concern worldwide. Currently more than 50% of all adult women are overweight or obese, and this trend is reflected in women of child-bearing age. Maternal obesity is characterized by metabolic dysfunction and chronic inflammation, and is associated with health problems in both the mother and the offspring. Intrauterine programming occurs during embryonic and fetal development, a critical period not only for the formation of tissues and organs but also for the etiology of diseases later in life. The principal mechanisms underlying fetal programming in the offspring of obese mothers appear to involve DNA methylation and chromatin remodeling within progenitor cells. Aberrant DNA methylation patterns have been identified in genes involved in insulin signaling, lipid metabolism, and appetite regulation in the placenta and fetal tissues. Histone modifications, such as acetylation and methylation of histone tails, may also play a crucial role in modulating chromatin structure and accessibility of transcriptional machinery to DNA. The persistence of such modifications throughout life, and potentially across generations, can lead to permanent alterations in gene expression, thereby contributing to the intergenerational transmission of metabolic disorders. The aim of this paper is to present an overview of the current knowledge regarding the effects of maternal obesity on fetal development and the occurrence of fetal complications, as well as long-term complications observed in adulthood related to intrauterine exposure to maternal obesity, including hypertension and cardiovascular diseases, impaired insulin secretion and resistance, diabetes mellitus, and metabolic syndrome. The mechanisms underlying fetal programming are also discussed. Full article

Studies have widely indicated that the composition of maternal nutrition and diets might affect offspring health later in life. Studies on paternal contribution to the offspring’s disease are relatively scarce but are an important subject to the field. Recent research has suggested that paternal factors influenced by nutrition have been implicated in the transgenerational heritage of health and diseases through epigenetic mechanisms. This review aims to explore the current state of knowledge on nutrition-based paternal impacts on gynecological disease through epigenetics, focusing on the transmission of cancer and metabolic diseases from father to female offspring. We will explore the various mechanisms by which epigenetic landmarks, such as DNA methylation, histone modifications, and non-coding RNAs, are passed on through sperm and reprogrammed in the embryo, influencing offspring development and health. We will discuss the impacts of preconception paternal nutrition on two common cancer such as breast cancer and ovarian cancer in female offspring. Additionally, paternal overweight or obesity has been associated with increased risk of obesity in the offspring and compromised metabolic health, which may link to reproductive conditions such as infertility. Understanding the molecular mechanisms underlying non-genetic inheritance is crucial for elucidating the nutrition-mediated developmental origins of health and disease. This review highlights the mechanistic correlation between preconception paternal nutrition and female offspring gynecological health. Furthermore, it emphasizes the need for additional research to establish evidence-based paternal nutrition consultation and guidelines aimed at optimizing reproductive health and pregnancy outcomes in couples planning to conceive. Full article

Background/Objectives: Advanced Practice Nurses (APNs) counsel patients regarding diet and exercise behaviors and serve as role models for health promotion and prevention of chronic disease. This study evaluated personal diet and exercise behaviors of APNs and their association with body mass index (BMI) as a biomarker of obesity and disease risk. Methods: APNs (N = 1268) self-reported height and weight, and answered four questions regarding personal diet and exercise. Based on BMI, they were grouped as normal weight (≤24.9 kg/m²) and overweight/obese (≥25.0 kg/m²). Results: The prevalence of overweight/obesity was 55%. The majority of APNs engaged in muscle strengthening exercises (53%) and consumed fruits and vegetables (62%), and protein foods and/or supplements (94%), while less than half engaged in moderate–vigorous physical activity (46%). Exercise behaviors (moderate–vigorous physical activity and muscle strengthening exercises) had a statistically significant impact on BMI. The predicted decrease in BMI due to participation in moderate–vigorous physical activity was 2.06 kg/m² and the predicted decrease due to muscle strengthening exercises was 1.35 kg/m². Diet behaviors (consumption of fruit, vegetables, and protein) were not found to have a significant impact on BMI. Conclusions: The prevalence of overweight/obesity among APNs in the United States is less than what is reported for the general adult population. Exercise behaviors, especially moderate–vigorous physical activity, significantly impact BMI and are associated with clinically meaningful differences. By comparison, healthy diet behaviors, including consumption of fruits, vegetables, and protein, are relatively widespread among advanced practice nurses but do not appear to significantly impact BMI. Full article

Objective: Obesity is characterized by chronic inflammation and gut dysbiosis, yet circulating markers reflecting intestinal immune activation remain limited. Regenerating islet-derived protein 3 alpha (REG3α), an antimicrobial peptide secreted by intestinal Paneth cells, plays a pivotal role in mucosal defense and mirrors microbial–epithelial interactions. In this cross-sectional study, we aimed to examine circulating REG3α levels in infection-free adults with obesity, overweight, and normal weight, and to explore their associations with vitamin D supplementation and biomarkers of inflammation and dysbiosis. Methods: Sixty-nine participants were stratified into control, overweight, and obesity groups. Serum REG3α, interleukin-6 (IL-6), β-defensin-2, high-sensitivity c-reactive protein, ferritin, and presepsin were assessed. Vitamin D status and supplementation history were recorded. Multivariable linear regression, principal component analysis (PCA), and bootstrap mediation models were applied to explore associations and potential indirect effects. Results: REG3α concentrations were higher in overweight and obesity compared to controls (646 ± 217 vs. 521 ± 311 ng/mL); however, the difference was not significant (p = 0.15). Vitamin D supplementation was inversely associated with REG3α (p = 0.06), and this effect appeared weaker in obesity. REG3α correlated positively with IL-6 (ρ = 0.28) and β-defensin-2 (ρ = 0.43). PCA revealed a shared inflammatory–mucosal activation component that predicted REG3α levels. Exploratory mediation suggested a partial indirect effect of vitamin D via reduced inflammatory activity. Conclusions: Circulating REG3α shows associations with indicators of inflammation and vitamin D supplementation in individuals with overweight and obesity. Although differences between groups did not reach statistical significance, the observed trends suggest possible links between mucosal immune activity and metabolic status. These exploratory results warrant validation in larger, longitudinal studies before any biomarker role can be established. Full article

Background: Foundational learning spaces in South Africa, designed to nurture growth and development, continue to grapple with malnutrition, a persistent barrier to the health, cognitive potential, and wellbeing of preschool-aged children, amidst a nutrition transition. Aim: This study assessed dietary diversity, nutritional status, and their associations among children aged 2–5 years attending funded Early Learning Centres (ELCs) in Johannesburg (Region C). Methods: Using systematic random sampling across 33 nutrition-funded ELCs in Region C, we assessed the nutritional status of children aged 2–5 years with WHO Anthro software (z-score cut-offs for undernutrition: stunting, underweight, thinness; overnutrition: overweight, obesity). Dietary diversity scores (DDSs) were derived from a 24 h recall of 16 food groups, classified by primary nutrient contributions (some groups spanning multiple classes), and categorized as low (≤8) or normal (≥9). Associations between DDS and nutritional indicators were analyzed using Poisson regression to estimate adjusted prevalence ratios (aPRs). Results: Despite structured feeding practices, all ELCs reported inadequate nutritional funding, prompting calls for dietitian support. While 27% sourced groceries from wholesalers, most relied on supermarkets and spaza shops; all had cooking infrastructure, but only 12% had food gardens, and 88% expressed interest in establishing them to improve dietary diversity. The mean DDS was 9.47 (±1.07), and 83% of children had a normal DDS (≥9), with common consumption of cereals (100%), vitamin A-rich vegetables (100%), oils (100%), and leafy greens (96%), but limited intake of protein-rich foods like eggs (7%), legumes (19%), and fish (37%). A dual burden of malnutrition was observed: 31% of children were stunted and 30% were overweight or obese. Multivariable analysis showed that boys had significantly lower odds of stunting compared to girls (aPR = 0.38; 95%CI: 0.01–0.74), while younger age (aPR = 0.61; 95%CI: 0.37–0.85) and low DDS (aPR = −0.15; 95%CI: −0.29–−0.06) were independently associated with increased risk of stunting. Age was positively associated with underweight (aPR = 1.27; 95%CI: 0.58–1.96), and thinness was strongly associated with boys (aPR = 17.00; 95%CI: 15.12–18.74), with a marginal association with age. Conclusions: Integrated nutrition strategies are critical to addressing the dual burden of stunting and being overweight in urban ELCs. Strengthening funding, professional dietetic support, and promoting food gardens can enhance dietary diversity and child health outcomes. Full article

Background: Recent studies have indicated that serum calprotectin, a marker of inflammation, is associated with obesity and disorders of glucose and lipid metabolism. The aim of this study was to evaluate the relationship between serum calprotectin and cardiometabolic risk factors in presumably healthy young adults. Methods: The study enrolled 118 (61 females, 57 males) non-obese, normoglycemic, subjects aged 25–40 years, selected from the general population among participants of the diabetes preventive screening program in 2014–2015. Basic anthropometric measurements and the following laboratory tests were performed on all participants: glucose, glycated hemoglobin (HbA1c), lipid profile, insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), high sensitivity C-reactive protein (hs-CRP), calprotectin and adiponectin. Results: The serum calprotectin concentration was significantly higher in men compared to women (p = 0.016), and in overweight subjects (p < 0.001) and those with abdominal obesity (p < 0.001), compared to lean individuals. Serum calprotectin was positively correlated with body mass index (BMI), waist circumference, HbA1c, hs-CRP, insulin, HOMA-IR and triglycerides, and negatively with HDL-cholesterol and adiponectin. In the univariable logistic regression analysis, overweight (OR = 2.529; p = 0.015), abdominal obesity (OR = 3.217; p = 0.006), hs-CRP > 1 mg/L (OR = 5.00; p < 0.001), HOMA-IR > 2.0 (OR = 4.394; p < 0.001), and HbA1c > 32 mmol/mol (OR = 2.166; p = 0.021) were significant predictors of increased calprotectin concentration (≥540.8 ng/mL; ≥median). However, in models adjusted for sex, BMI and hs-CRP, the significant association remained only for increased HbA1c and HOMA-IR values. Conclusions: Association of serum calprotectin with overweight, hs-CRP and laboratory indicators of glucose metabolism and insulin resistance suggest its significance as a laboratory biomarker of initial metabolic impairment. Full article

Background: Postoperative sagittal imbalance, including hyperextension and flexion contracture after total knee arthroplasty (TKA), adversely affects long-term outcomes. Conventional techniques depend on surgeons’ visual estimation, which may vary with patient anatomy. This study compared the accuracy of sagittal alignment assessment between a robot-assisted system and surgeons’ visual evaluation and analyzed the influence of body mass index (BMI) and anatomic factors on concordance. Methods: Sixty unilateral TKAs performed between October 2023 and May 2024 using the MAKO system were retrospectively reviewed. Sagittal mechanical axis angles were obtained from the robotic system (M group) and visually estimated by two blinded orthopedic surgeons from intraoperative lateral photographs (S group) for 9, 10, and 11 mm trial inserts. Final alignment was verified by C-arm radiographs. Inter-observer reliability was analyzed using Cohen’s κ and ICC, and correlations with BMI, thigh circumference, and limb proportions were assessed. Results: In patients with overweight/obesity, the S group significantly underestimated sagittal alignment (p < 0.001), whereas the M group maintained consistent accuracy regardless of BMI. With thinner inserts (9 mm), hyperextension was often overestimated (mismatch 55%, p < 0.0001), and with thicker inserts (11 mm), flexion contracture was underestimated (mismatch 46.7%, p = 0.001). Inter-observer reliability was good (κ = 0.717, ICC = 0.816). Conclusions: Visual assessment may underestimate sagittal alignment, especially in patients with obesity or those with abundant soft tissue. The MAKO robotic system provided consistent, objective alignment evaluation regardless of body habitus. Robotic-assisted quantitative assessment enables more accurate and reproducible sagittal alignment, supporting safer and more reliable TKA outcomes. Full article

Background: Background: Childhood dietary habits are critical determinants of physical growth, cognitive development, and long-term health. In Ecuador, malnutrition remains a major public health concern, with both undernutrition and overweight/obesity affecting children—especially in rural and indigenous populations. Methods: This systematic review followed PRISMA 2020 guidelines (PROSPERO ID: CRD420251080987). Searches were conducted in SciELO, Dialnet, and ScienceDirect (accessed August 2025) using Boolean operators to identify quantitative studies in Spanish or English published between 2018 and 2025 that assessed dietary habits and nutritional status in Ecuadorian children aged 1–11 years. Seventeen studies, including approximately 12,000 children, were included. Results: Prevalence of chronic undernutrition ranged from 15% to 35%, while overweight and obesity reached 20–30%. Undernutrition was higher among rural and indigenous children, whereas overweight predominated in urban and higher-income settings. Common dietary patterns included high consumption of ultra-processed foods and sugar-sweetened beverages, and insufficient intake of fruits, vegetables, and quality proteins. Maternal education, socioeconomic level, and school food environments were key determinants. Conclusions: Both malnutrition and overweight persist among Ecuadorian children, reflecting a nutrition transition influenced by socioeconomic and environmental factors. Context-specific public health actions are urgently needed, including school-based nutrition education, regulation of food marketing, improved access to affordable healthy foods, and community-level engagement to promote sustainable dietary habits. The included studies were mostly cross-sectional and often used non-validated dietary assessment tools, which may influence the reported prevalence estimates. Full article

Background/Objectives: Resistin is an adipokine involved in obesity pathogenesis, but its effects on blood and colostrum immune cells from obese mothers remain unclear. This study evaluated the functional activity of phagocytes modulated by resistin in blood and colostrum from overweight and obese mothers. Methods: An observational study was conducted with 82 postpartum women divided according to pregestational BMI into control, overweight, and obese groups. Blood and colostrum samples were collected to determine resistin levels and assess the functional activity of mononuclear (MN) cells. Results: Plasma resistin levels were higher in overweight mothers, whereas colostrum levels were lower in obese mothers. Resistin treatment enhanced superoxide release in both colostrum and blood phagocytes, independent of maternal weight status. In the presence of enteropathogenic Escherichia coli (EPEC), resistin-treated phagocytes from both colostrum and maternal blood showed increased superoxide production. In blood cells from overweight mothers, resistin reduced superoxide dismutase (SOD) concentration, while in colostrum, the highest SOD levels were observed in cultures of resistin-treated cells from mothers with altered weight, regardless of weight status. Blood and colostrum cells treated with resistin increased phagocytosis rates. In colostrum, resistin-treated cells from eutrophic mothers showed high microbicidal indices, whereas cells from mothers with altered weight showed reduced microbicidal indices. In colostrum cells, adipokine levels were reduced in the obesity group. Conclusions: Resistin modulates oxidative metabolism and the functional activity of blood and colostrum phagocytes across all maternal weight statuses, suggesting a possible role for resistin in the maternal immune response associated with obesity. Full article