Search Results (27,921)

Background: Overweight and obesity remain major public health challenges in Puerto Rico, affecting over 70% of adults and contributing to cardiovascular, metabolic, and mental health disorders. This study explores the psychosocial and behavioral factors influencing obesity within low-income Puerto Rican communities, emphasizing both biological sex differences and socially defined sex-role influences, along with their respective mental health dimensions. Method: Using a qualitative approach, Community-Based Participatory Research (CBPR), ten focus groups were conducted with 71 participants (37 women and 34 men) from two municipalities in southern Puerto Rico. Discussions were analyzed thematically with the Socioecological and Health Belief Models to identify key determinants. Results: The data collected revealed that women expressed greater emotional vulnerability, frequently citing anxiety, depression, body image concerns, and stress-related eating as contributors to obesity. Men, meanwhile, reported frustration with diet adherence, economic limitations, and healthcare inaccessibility. Across participants, economic hardship, cultural norms, and limited health education emerged as major obstacles. Conclusions: Findings underscore the need for holistic, sex-informed and socially responsive interventions that integrate mental health support with nutritional and physical health strategies. Addressing self-esteem, emotional regulation, and stress management alongside behavioral modification can promote sustainable, culturally tailored obesity prevention in Puerto Rico. Full article

Obesity is recognized as a risk factor for breast cancer development and progression. Adipocytes exert their oncogenic effects through complex and interconnected biological mechanisms that encompass metabolic dysfunction, chronic low-grade inflammation, and systemic endocrine alterations. Herein, we reviewed the current evidence explaining how obesity induces a state that reprograms adipose tissue and remodels the breast cancer tumor microenvironment (TME). We first discuss the systemic and local mechanisms linking obesity to inflammation and how these alterations reshape the functional organization of the mammary gland. Then, we discuss how the chronic exposure to tumor-derived signals, together with the altered metabolic state of obese adipose tissue, induces a functional reprogramming of adipocytes, giving rise to so-called cancer-associated adipocytes (CAAs), which actively contribute to tumor progression. Also, the strengths and limitations of biological models to study the crosstalk between adipocytes and tumor cells, including two-dimensional (2D) monolayers and three-dimensional (3D) cell cultures, as well as animal models, are discussed. Special emphasis is placed on 3D co-culture models, which more accurately reproduce spatial organization, direct cell–cell contact, and diffusion dynamics, providing a more physiologically relevant environment for studying how obesity and inflammation reshape the TME in breast cancer. Finally, we highlight the limitations of conventional experimental models and review recent advances in 3D-based platforms, emphasizing their mechanistic insights and translational potential. Full article

Background: Artificial intelligence (AI) is increasingly incorporated into nutrition research and practice; however, the extent of its clinical integration and impact on health outcomes remains unclear. This systematic review evaluated how AI-based systems have been implemented in human nutritional interventions and summarized reported outcomes. Methods: PubMed, Scopus, Google Scholar, SpringerLink, JMIR, and MDPI were searched from January 2020 to March 2025 (search completed in March 2025). Randomized controlled trials and prospective or retrospective cohort studies published in English or Spanish were included if they evaluated AI-driven nutritional interventions in human populations and reported health-related outcomes. Risk of bias was assessed using RoB 2 and ROBINS-I. A qualitative synthesis was performed. Results: Sixteen studies involving 10,863 participants were included. Most were randomized controlled trials targeting metabolic disorders, particularly type 2 diabetes and obesity. Eleven studies evaluated metabolic outcomes, including HbA1c, body weight, fat mass, lipid levels, and insulin resistance indices. Six studies assessed gastrointestinal symptom severity scores, and two examined quality-of-life or patient-reported outcomes. Several trials reported short-term improvements favoring AI-supported interventions in glycemic control, weight reduction, and symptom severity. However, effects were heterogeneous and often observed within multimodal programs, limiting attribution of outcomes solely to the AI component. Conclusions: AI integration in nutrition remains in an early phase of clinical implementation. Although preliminary findings suggest potential benefits, interpretation should be cautious given methodological heterogeneity and moderate-to-high risk of bias across studies. Larger, rigorously designed investigations are required to determine sustained clinical effectiveness. Full article

Background: Metabolic syndrome (MetS) is a cluster of pathologies (obesity, dyslipidemia, insulin resistance, hypertension) that affects over one quarter of old adults. MetS is a condition that markedly increases the susceptibility of various organs to dysfunctionality and is associated with the development of oxidative stress. The existing guidelines point out that exercise is highly advantageous for patients with MetS. However, there is a need for specific guidance and clinical evidence. Objective: This study aimed to investigate the effects of a moderate aerobic exercise program on older women without and with MetS. Methods: A total of 120 women aged 60–70 years old were recruited and divided into two groups: healthy old women (HOW, N = 60) and old women with MetS (OW-MetS, N = 60). Anthropometric values, biochemical parameters and markers of oxidative damage were evaluated before and after moderate aerobic exercise. Exercise was performed five days per week for three months (64 sessions). Each exercise session consisted of 40 min and included the following: (a) five minutes of warm-up exercise; (b) ten minutes of flexibility exercise with resistance using own weight and coordination; (c) twenty minutes of moderate-intensity aerobic exercise (heart rate max between 60% and 70%); and (d) five minutes to cool down/stretching with respiratory techniques. Results: A significant decrease in anthropometric variables was generated by the exercise program [waist circumference 4.35 cm (p < 0.05) in OW-MetS, body fat −1.55, −1.39% (p < 0.05) and muscle mass 0.8, 1.1% (p < 0.05) in HOW and OW-MetS, respectively]. The exercise program resulted in beneficial changes in all biochemical parameters in both groups. Importantly, HOMA values showed a significant decline of −0.85 and −6.17 in HOW and OW-MetS, respectively. Furthermore, oxidative stress was present in the OW-MetS group, which was reduced by the exercise program, resulting in a decrease in protein damage [formazan 45% and 42% in HOW and OW-MetS respectively] and an increase in antioxidant defenses (thiol groups 36%, 99% and GPx 55%, 20% in HOW and OW-MetS, respectively). Conclusions: The data of this study show that moderate aerobic exercise may be potentially useful in treating and preventing MetS in older patients. Full article

Pancreatic lipase (PL) inhibition is a promising dietary strategy for obesity management. In this study, the inhibitory mechanisms and structural basis of polyphenols extracted from different sugarcane fractions were investigated using in vitro enzyme assays, spectroscopy, and molecular docking analyses. PL inhibitory activity was evaluated using p-nitrophenyl laurate (pNPL) as the substrate, with all assays performed in triplicate and results statistically analyzed. Among the extracts, sugarcane peel polyphenols (SP) exhibited the strongest inhibition, with a half-maximal inhibitory concentration (IC₅₀) of 31.56 mg/mL, significantly lower than that of sugarcane juice polyphenols (SJ, 55.86 mg/mL) and sugarcane bagasse polyphenols (SB, 65.31 mg/mL). Enzyme kinetic analyses revealed a reversible mixed-type inhibition mechanism. In contrast to crude extracts, individual phenolic monomers showed substantially lower IC₅₀ values (0.13–1.33 mg/mL), highlighting the intrinsic dilution. Compositional analysis identified ferulic acid, gallic acid, chlorogenic acid, and schaftoside as key contributors to PL inhibition. Fourier transform infrared (FTIR) and fluorescence spectroscopy demonstrated that polyphenols altered PL secondary structure by modulating α-helix and β-sheet contents and perturbed the microenvironment of tryptophan (Trp) and tyrosine (Tyr) residues. Molecular docking further indicated that these compounds bind within or near the substrate-binding channel via hydrogen bonding and hydrophobic interactions, engaging critical residues including Ser152, His263, and Phe77, and potentially influencing conformational elements involved in active-site accessibility. Collectively, these results suggest that sugarcane, particularly its peel, represents a valuable natural source of PL inhibitors. Despite the relatively high IC₅₀ values of crude extracts, their inhibitory activity arises from multicomponent contributions and supports their potential application as dietary modulators of fat digestion rather than as pharmaceutical lipase inhibitors. Full article

Zinc-α2-glycoprotein (ZAG) is a novel adipokine with a plethora of functions meaningful for the regulation of adipose tissue and insulin sensitivity. Despite research, the role of ZAG in the course of childhood obesity is not fully understood. The aim of this study is to investigate whether the levels of ZAG can be used as a predictive or monitoring biomarker of adolescent obesity. Secondly, to determine the cut-off value of ZAG in blood serum in adolescents with obesity. The study included a group of 77 adolescent patients, including 59 obese patients, and 18 without obesity as healthy control subjects. All study participants had their biochemical parameters assessed by a certified medical laboratory. The recommendations of the Polish Society of Hypertensions were used to assess the blood pressure measurements in each group. ELISA enzyme immunoassays (R&D Systems, Minneapolis, MN, USA) were used to detect serum levels of ZAG. Our study showed that obese children and adolescents have significantly higher body mass, cholesterol, LDL-cholesterol, triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP), but lower serum ZAG levels compared to the healthy control subjects. Furthermore, in our study, we found that median ZAG values were comparable between females and males within the same obesity category (median female ZAG level: 2.84, median male ZAG level: 2.89) and healthy control participants (median female ZAG level: 5.20, median male ZAG level: 4.99). Serum ZAG concentrations were significantly lower in obese participants (2.86 ± 0.40 mg/L) than in the control group (5.10 ± 0.74 mg/L; p < 0.001). The multivariable Firth’s logistic regression model, incorporating the selected factors, revealed a significant association between obesity and ZAG. ROC curve analysis indicated strong discriminatory ability of ZAG for identifying obesity, with a proposed cut-off value of 3.62 mg/L. Circulating ZAG level is significantly reduced in children and adolescents with obesity. An important finding of our study is the detection of a cutoff value for serum ZAG levels. Furthermore, the use of the Least Absolute Shrinkage and Selection Operator (LASSO) model can be considered a valuable contribution to defining ZAG as an independent factor associated with obesity. Full article

Ambient temperature is a continuous environmental input that affects energy homeostasis through integrated physiological programs. In mammals, thermal cues detected by cutaneous and visceral sensors are conveyed through spinal, vagal, and sympathetic pathways. They are complemented by circulating mediators from the gut, liver, and adipose tissue. These signals converge on brainstem–hypothalamic networks, including the preoptic area and arcuate nucleus, to coordinate feeding behavior, thermogenesis, vasomotor tone, and endocrine outputs. Recent circuit-mapping and single-cell approaches have refined the cellular logic governing the distinct architectures of cold- and heat-defense programs. This review synthesizes these advances to illustrate how a plastic effector network maintains systemic energy homeostasis. Finally, we highlight the translational implications of these thermosensory mechanisms for treating obesity and type 2 diabetes. Full article

Background: Post-bariatric hypoglycemia (PBH) is a clinically significant complication of bariatric surgery, characterized by inappropriate postprandial hyperinsulinemia and recurrent hypoglycemia. Episodes are often frequent, severe, and medically refractory, substantially impacting quality of life and potentially causing compensatory carbohydrate intake that leads to weight regain. Methods: A 50-year-old male underwent Roux-en-Y gastric bypass (RYGB) in 2009. Symptomatic postprandial hypoglycemia emerged in the second postoperative year and progressively worsened to multiple severe daily episodes. The patient developed compensatory carbohydrate intake with subsequent weight regain. Following the failure of dietary interventions and pharmacologic therapy, he underwent conversion to single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) in September 2022. Results: Following surgical conversion, the patient reported no clinically significant hypoglycemia during the follow-up period. Weight and obesity-related comorbidities improved. Gastrointestinal symptoms remained manageable, and micronutrient status was closely monitored. Conclusions: In selected patients with severe, medically refractory PBH following RYGB, conversion to an ileal-based procedure may be considered a viable therapeutic strategy. Prospective studies are needed to better define this hypothesis. Full article

Background: Assessing food and nutrient intake is an important yet challenging component of nutrition research, particularly in populations at higher risk for dietary underreporting. Objective: To evaluate the feasibility, acceptability, and preliminary measurement characteristics of augmenting interviewer-administered 24 h dietary recalls with a photo-based mobile food record application (mCC: my Circadian Clock). Design: This was a randomized cross-over feasibility study in which each participant completed two sets of three 24 h dietary recalls. One set consisted of standard interviewer-administered recalls, while the other incorporated dietary intake captured via the mCC app during the 24 h preceding the recall to guide the interview. Participants: Participants (n = 10) were adults aged 18–65 years with obesity (BMI > 30 kg/m²) and less than a college-level education, recruited from a general community setting. Main Outcome Measures: Primary feasibility outcomes included recall adherence, protocol completion, participant burden, and usability of the mobile application. Secondary and exploratory outcomes included average energy intake (kcal/day), number of food items and eating occasions reported, Healthy Eating Index (HEI)-2015 scores, and recall duration. Statistical Analyses: Descriptive statistics and paired t-tests were used to explore differences between methods; analyses were considered exploratory and hypothesis-generating. Results: All enrolled participants completed every scheduled recall, resulting in 100% adherence and protocol completion. Most participants (70%) rated the mCC app as easy or very easy to use, although 60% reported greater burden with the Augmented Recalls. Average energy intake was 274 kcal/day lower with the augmented method compared with Standard Recalls (95% CI: −597, 50; p = 0.09), with no clear differences observed in reported food items, eating occasions, HEI-2015 scores, or recall duration. Conclusions: Augmenting interviewer-administered 24 h dietary recalls with a photo-based mobile food record is feasible and acceptable in adults with obesity, though it did not demonstrate clear improvements in dietary intake capture in this small feasibility sample. These findings provide practical guidance for refining technology-assisted recall protocols and informing the design of future, adequately powered studies. Full article

Background: Migration from low- and middle-income to high-income settings is often accompanied by dietary and lifestyle changes that may increase long-term risk of non-communicable diseases. African migrants represent a growing but under-studied population in Australia, with limited evidence on post-migration nutrition transitions and associated chronic disease risk. This study examined changes in diet and lifestyle among Nigerian-born adults before and after migration to Australia and explored any association with chronic diseases. Methods: A pilot cross-sectional study was conducted among adults who migrated from Nigeria to New South Wales, Australia, between 1992 and 2019. Data were collected via a culturally adapted, self-administered online questionnaire assessing socio-demographic characteristics, dietary intake, lifestyle behaviours, and self-reported chronic conditions in the 12 months immediately before and after migration. Descriptive statistics (frequencies and proportions) and inferential analyses (Chi-square tests, McNemar test, and the Bowker test) were used to compare pre- and post-migration behaviours and examine associations with chronic disease outcomes. Results: Ninety-three participants completed the survey (mean age 37.0 ± 7.2 years; 50.5% male). Post-migration, regular breakfast consumption declined (−24.3%), while irregular eating (low and moderate) patterns increased (+7.6% and +16.7%). Regular vegetable intake improved (+5.4%), whereas fruit intake remained low (13.0%). Regular consumption of Nigerian local foods decreased markedly (−53.7%), while regular intake of meat (+18.5%), dairy foods, fats (+14.3%), and non-alcoholic beverages increased (+22.8%). Salt use shifted away from the highest-risk category (−22.2%), and smoking and alcohol consumption remained low and stable. Self-reported chronic conditions were uncommon; hypertension (6.5%) and obesity (5.4%) were the most frequently reported. Conclusions: Nigerian migrants in Australia experience substantial post-migration dietary and lifestyle transitions that may elevate long-term chronic disease risk despite a currently low reported disease burden. Early, culturally responsive nutrition and lifestyle interventions are needed to support healthy adaptation and prevent the progression of cardiometabolic conditions in this growing migrant population. Full article

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for the management of obesity and type 2 diabetes, particularly among women of reproductive age. Emerging evidence suggests potential effects on ovulation, fertility, and pregnancy outcomes. This narrative review aims to synthesize current evidence on the reproductive safety of GLP-1RAs, with a focus on their implications for conception, unintended pregnancy, and maternal–fetal outcomes. Methods: A narrative literature review was conducted using PubMed and relevant bibliographic sources to identify studies published between 2020 and 2025. The search included clinical trials, observational studies, registry data, case reports, and selected preclinical evidence. Studies addressing reproductive outcomes, including ovulation, fertility, pregnancy exposure, and fetal safety, were included. Evidence was synthesized descriptively in accordance with recommended approaches for narrative reviews. Results: Available evidence indicates that GLP-1RAs may improve ovulatory function and menstrual regularity, particularly in women with obesity or polycystic ovary syndrome, potentially increasing the likelihood of conception. However, human data on pregnancy exposure remain limited. While current evidence does not consistently demonstrate a strong teratogenic signal, findings are based on small samples and heterogeneous study designs. Concerns persist regarding unintended pregnancies due to improved fertility and the absence of robust safety data during early gestation. Conclusions: GLP-1RAs present a complex clinical scenario in women of reproductive age, with potential benefits for metabolic and reproductive health but uncertain safety during pregnancy. Clinicians should exercise caution, provide appropriate contraceptive counseling, and carefully weigh the risks and benefits when prescribing these agents. Further large-scale, prospective studies are needed to clarify reproductive safety and inform evidence-based clinical guidelines. Full article

Background: Obesity represents a major public health challenge worldwide and contributes substantially to the burden of type 2 diabetes and hypertension. While body mass index (BMI) is widely used in clinical practice, indices reflecting central adiposity may provide additional prognostic value. This study aimed to assess the prevalence of general and central obesity in an adult population across different age groups from Stara Zagora, Bulgaria, and to examine their associations with cardiometabolic outcomes and lifestyle factors. Methods: A quasi-representative cross-sectional study was conducted among 3512 adults (mean age 53.7 ± 14.9 years). Anthropometric indices, including BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio were measured. Cardiometabolic outcomes included diabetes, hypertension, and their combined presence. Multicollinearity was assessed using the Variance Inflation Factor (VIF), and the discriminatory ability of indices was evaluated using Receiver Operating Characteristic (ROC) analysis and DeLong’s test. Results: The prevalence of overweight/obesity (BMI ≥25) was 68.4%, while central obesity (WHtR ≥0.5) affected 66.9% of participants. BMI demonstrated the highest discriminatory ability in this dataset for hypertension (AUC = 0.852) and diabetes (AUC = 0.796), significantly outperforming WC and WHR (p < 0.05). However, 24.4% of individuals with normal BMI exhibited high-risk central adiposity. Significant sex-specific differences were observed: short sleep duration (<6 h) was a strong predictor of obesity in women (aOR = 2.98), whereas smoking showed stronger associations in men. Age-stratified analyses revealed that while BMI stabilizes in the oldest age group (75–89 years), WHtR continues to increase, reflecting age-related redistribution of visceral fat. A strong protective effect of physical activity was observed, supported by quasi-complete separation in active subgroups. Conclusions: General and central obesity represent a substantial health burden in this urban population. While BMI remains a robust screening tool, the integration of WHtR enhances the identification of “hidden” cardiometabolic risk particularly in older adults and individuals with normal BMI. Given the quasi-representative nature of the sample, these findings are primarily generalizable to similar urban populations and may inform targeted regional public health strategies. Full article

Background: Osteocalcin is a bone-derived protein traditionally regarded as a marker of bone formation, but experimental and clinical studies have suggested potential endocrine effects on energy and glucose metabolism. In pediatric populations, particularly in the context of obesity, the relationships between circulating osteocalcin, adiposity, and metabolic health remain inconsistent and poorly defined. Objective: To investigate associations between serum total osteocalcin and anthropometric, metabolic, biochemical, and body composition parameters in children and adolescents with obesity, with particular emphasis on adiposity and mineral metabolism. Methods: This retrospective cross-sectional study included 155 children and adolescents aged 4–18 years with obesity. Anthropometric measurements, laboratory parameters, and body composition assessed by dual-energy X-ray absorptiometry were extracted from medical records. Associations between osteocalcin z-scores and clinical variables were evaluated using linear regression models. Multivariable and extended regression models were applied to assess independent associations. Results: Osteocalcin was positively associated with markers of mineral metabolism, including serum 25-hydroxyvitamin D₃ (β = 0.19, p = 0.012), serum calcium (β = 0.19, p = 0.015), and free triiodothyronine (β = 0.32, p < 0.001) in multivariable analyses. No independent associations were observed between osteocalcin and measures of adiposity, including body mass index, visceral adipose tissue index, leptin, or markers of glucose and lipid metabolism. Conclusions: In children and adolescents with obesity, circulating osteocalcin is primarily associated with mineral metabolism rather than adiposity or metabolic health. These findings support the interpretation of total osteocalcin as a clinically accessible marker of bone turnover and mineral homeostasis rather than a robust surrogate of metabolic dysfunction in pediatric obesity. Full article

Psoriatic arthritis (PsA) is a chronic inflammatory disorder affecting both the joints and skin. Beyond musculoskeletal manifestations, patients with PsA frequently exhibit alterations in lipid metabolism, contributing to an increased risk of cardiovascular disease. Dyslipidemia in PsA arises from multiple mechanisms, including systemic inflammation, insulin resistance, and imbalances in adipokines such as leptin, adiponectin, and resistin. A structured literature search was conducted in PubMed, Scopus, and Web of Science to identify relevant studies on lipid metabolism in psoriatic arthritis, and the evidence was synthesized narratively. PsA is also commonly associated with obesity and metabolic syndrome, further exacerbating dyslipidemia and cardiovascular risk. Interventions including weight loss, lifestyle modification, and anti-inflammatory treatments have been shown to improve lipid profiles and clinical outcomes. This review provides a comprehensive overview of current knowledge on altered lipid metabolism in PsA, highlighting underlying mechanisms, clinical implications, and therapeutic strategies to reduce cardiovascular risk. Full article

Background/Objectives: Understanding the genetic basis of food consumption is a key step toward precision nutrition, viewed as a long-term future perspective. This study aimed to investigate genetic variants associated with grapefruit (Citrus paradisi) intake and to evaluate their potential relationship with obesity risk. Methods: A genome-wide association study (GWAS) was conducted on 19,653 European-ancestry participants from two prospective cohorts, the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS). We employed a functional annotation strategy to select a suggestive locus for follow-up analysis, and computationally derived molecular docking simulations explored a plausible functional link between grapefruit’s bioactive compounds and the candidate gene product. Results: Although falling short of the conventional threshold for genome-wide significance, a suggestive locus was prioritized on chromosome 14, with the lead single nucleotide polymorphism (SNP), rs2124 (p < 5 × 10⁻⁶), located within the metabolic gene ADCK1 (aarF domain containing kinase 1). Molecular docking simulations supported a plausible mechanistic hypothesis, indicating that key bioactive compounds in grapefruit could bind with high affinity to the ADCK1 protein. Consistent with the GWAS finding, individuals with the CC genotype reported lower mean grapefruit intake. This genotype was also associated with other lifestyle factors, notably, lower physical activity in women. In age- and multivariate-adjusted models, the CC genotype was associated with a modestly increased risk of incident obesity in females, but not in males. Conclusions: Our exploratory findings suggest a prioritized candidate locus associated with grapefruit intake, and its link to obesity risk may be mediated by the metabolic gene ADCK1. However, given the lack of genome-wide significance and independent replication, these findings should be considered preliminary and exploratory. These hypothesis-generating results support the integration of genetics and dietary habits, warranting further mechanistic validation. Full article