Obesities

Objectives: The purpose of this study is to evaluate the trend of anthropometric and cardiometabolic risk (CMRs) changes among health professionals over a three-year period at a medical center in Taiwan. Study Design: A 3-year follow-up cohort study design. Methods: This cohort study was conducted from 2019 to 2022 in a single healthcare center. The participants underwent annual physical check-ups for three consecutive years. CMRs were measured using standard methods and weight status change was measured using BMI. We used McNemar test and Wilcoxon Sign Rank test to evaluate the differences within and between subgroups. We used logistic regression to examine the risk of increased CMRs among subgroups of different weight status changes. Results: A total of 2217 participants (1641 females and 576 males) were included in this study, with a mean age of 40.2 ± 10.2 years. During this period, 72 (4.4%) female participants’ weight status changed from normal weight to overweight or obese and 530 (32.3%) remained overweight or obese. Among males, the proportion was 6.8% and 61.1%, respectively (p < 0.01). Participants who remained overweight or obese have more adverse CMRs. Compared to remained normal weight male subjects, the mean systolic blood pressure (131.0 ± 18.1 mmHg) and fasting blood glucose (94.4 ± 13.5 mg/dL) were higher in remained overweight or obese subjects (p < 0.001). Among females, those who remained overweight or obese have 4.01 (95% CI 2.92–5.51) times higher risk for abnormal diastolic blood pressure and 2.98 (95% CI 2.05–4.32) times higher risk for abnormal blood glucose compared to those with remained normal weight. Conclusions: Participants who remained overweight or became obese had more adverse CMRs such as high blood pressure, hyperglycemia, and dyslipidemia during the 3-year follow-up period.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are highly effective in the management of obesity; however, their efficacy and tolerability may be further optimized through complementary nutritional strategies. Such interventions may address key challenges associated with GLP-1RA therapy, including gastrointestinal adverse effects, lean mass loss, and reduced long-term adherence leading to weight regain. Evidence from preclinical and clinical studies indicates that omega-3 polyunsaturated fatty acids may enhance the metabolic benefits of GLP-1RAs and attenuate lean mass loss, primarily via anti-inflammatory pathways and modulation of protein synthesis. Synergistic effects have also been reported with other bioactive compounds—such as flavonoids and anthocyanins, which improve metabolic outcomes; probiotics and prebiotics, which may alleviate gastrointestinal intolerance; and high-quality protein sources, which support body composition preservation. Collectively, these findings suggest that nutritional adjuncts may complement GLP-1RA therapies through convergent physiological mechanisms, including the regulation of inflammation, gut microbiome composition, and cellular metabolism. While current data highlight the promise of integrated pharmaco-nutritional strategies as adjuncts to GLP-1-based obesity therapy, further randomized controlled trials are needed to establish the most effective interventions and protocols.

Background/Objectives: Obesity is a major risk factor for cardiovascular disease (CVD), but traditional risk calculators such as Systematic COronary Risk Evaluation (SCORE2) may not fully capture the elevated risks in individuals with obesity, especially when metabolic health is considered. This study aimed to evaluate the effectiveness of QRESEARCH risk estimator version 3 (QRISK3) in estimating 10-year cardiovascular risk in individuals with varying obesity phenotypes compared to SCORE2. Methods: A total of 88 participants (25 men, 63 women; mean age 37.4 ± 11.8 years) were categorized into four obesity phenotypes according to metabolic and anthropometric criteria. The 10-year CVD risk was calculated using SCORE2 and QRISK3 algorithms. Functional cardiovascular assessment included blood pressure (BP) measurement and electrocardiogram (ECG) interpretation for conduction abnormalities and left ventricular hypertrophy (LVH). Biochemical analysis included carbohydrate metabolism (fasting glucose, postprandial glucose, HbA1c) and lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides, atherogenic index). Results: SCORE2 underestimated CVD risk (3–8%), whereas QRISK3 predicted higher values (6–16%), particularly in metabolically unhealthy phenotypes. LVH occurred in 26–45% of participants, with elevated BP and early subclinical ECG changes even in metabolically healthy obesity individuals. Carbohydrate metabolism disturbances were observed in metabolically unhealthy participants with normal or elevated BMI, while lipid abnormalities—including elevated total cholesterol, LDL-C, triglycerides, and atherogenic index—were prominent in these metabolically unhealthy phenotypes. Insulin resistance, assessed via the triglyceride–glucose index, exceeded reference ranges in all obesity phenotypes, with the highest values seen in metabolically unhealthy individuals. Conclusions: QRISK3 provides a more precise and thorough assessment of 10-year cardiovascular risk in individuals with obesity than SCORE2. These findings highlight the importance of incorporating anthropometric and metabolic data into cardiovascular risk assessments and support the clinical use of QRISK3 for more personalized risk stratification, especially in populations with obesity and metabolic disturbances. Early identification of high-risk individuals using QRISK3 could lead to more timely and targeted preventive interventions, improving long-term cardiovascular outcomes.