Obesities

Obesity is a significant global health challenge, with prevalence rising steadily worldwide. Effective management often involves bariatric surgery, such as sleeve gastrectomy (SG), which has proven effective in reducing weight and improving comorbid conditions. This study aimed to evaluate nutritional status and protein source awareness and its impact on muscle mass among patients post SG surgery in Saudi Arabia. A cross-sectional study was conducted among 98 adults (aged 18–51 years) who underwent SG at the Department of Metabolic and Bariatric Surgery (Badana Clinic)/Mouwasat Hospital in Dammam from December 2023 to February 2024. Data were collected using an electronic questionnaire that covered demographics, dietary habits, physical activity, protein knowledge (from food and supplements), and a 24 h dietary recall. Body composition, including muscle mass, was assessed using the InBody270 Body Composition Analyzer. The results revealed that participants exhibited a high level of awareness regarding the importance of protein sources. However, muscle mass decreased by an average of 4.11 kg after surgery. This decline was attributed to insufficient protein intake, which ranged between 30 and 60 g per day, below recommended levels. Taste aversion and dietary limitations post-surgery contributed to this inadequate protein consumption. In conclusion, while participants understood the significance of protein for muscle maintenance, practical challenges in achieving adequate protein sources led to muscle mass loss. These findings underscore the importance of tailored nutritional strategies and education to optimize recovery and long-term health outcomes for SG surgery patients.

Background: Hypertriglyceridemia is a lipid disorder characterized by elevated plasma triglyceride levels, and its prevalence increases with aging. This condition contributes substantially to morbidity and mortality in older adults. In settings with limited access to laboratory testing, especially in developing countries such as Brazil, identifying low-cost and easily applicable screening tools is essential. Objective: To investigate the discriminatory capacity of anthropometric indicators of obesity for screening hypertriglyceridemia in older adults. Methods: A population-based cross-sectional study was conducted with 223 community-dwelling older adults (57% women). Independent variables included body mass index (BMI), waist circumference (WC), abdominal circumference (AC), triceps skinfold thickness (TSF), body adiposity index (BAI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and conicity index (CI). Hypertriglyceridemia was defined as triglyceride levels ≥ 150 mg/dL. Discriminatory performance was assessed using receiver operating characteristic (ROC) curves, and associations were examined using Poisson regression with robust variance. Results: The prevalence of hypertriglyceridemia was 35%. Among older men, AC and CI showed the highest sensitivities (88.90% and 77.40%), while WHR and BMI demonstrated the highest specificities (83.10% and 76.90%). In older women, AC and BMI had the highest sensitivities (95.70% and 87.20%), whereas CI and WHtR exhibited the highest specificities (72.50% and 68.80%). All anthropometric indicators were positively associated with hypertriglyceridemia after adjustment for confounders. Conclusions: AC and CI demonstrated the strongest discriminatory capacity for screening older men with a higher probability of presenting hypertriglyceridemia, while AC and BMI showed the greatest discriminatory capacity among older women. In contrast, WHR and BMI had the highest ability to rule out the condition in older men, whereas CI and WHtR performed this role more effectively in older women. These findings show that low-cost anthropometric indicators can be used in a complementary manner, combining the most sensitive and the most specific measures to support an optimized triage process for hypertriglyceridemia in older adults, particularly in resource-limited settings.

The ketogenic diet (KD) is a metabolic intervention characterized by high fat and very low carbohydrate intake, showing significant metabolic, neuroprotective, and therapeutic effects. However, its efficacy varies widely due to individual genetic and epigenetic factors. This review synthesizes current knowledge of genes most strongly associated with KD response, including polymorphisms in FTO, APOA2, PPAR, SCN1A, KCNQ2, STXBP1, CDKL5, the MODY gene group, and SLC2A1, which shape outcomes across lipid metabolism, energy expenditure, inflammation, and neurotransmission. Epigenomic modifications induced by a KD, such as changes in DNA methylation and histone acetylation involving BDNF, SLC12A5, KLF14, and others, modulate functional metabolic and neurological effects. Sex and age further modulate KD effects through distinct patterns of gene activation and hormonal interactions. These variables together impact metabolic and neurological outcomes and are critical for developing personalized nutrition and disease management strategies. Based on the reviewed evidence, genetic and epigenetic profiling can help identify patients who are likely to benefit from a KD (e.g., GLUT1DS, PDH deficiency) and those in whom a KD may be ineffective or harmful (e.g., SCOT or SLC2A1-independent defects). The review concludes that genetic and epigenetic profiling is recommended for personalized dietary interventions.