Search Results (3,269)

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder associated with substantial long-term morbidity and mortality. Routinely collected anthropometric, biochemical, and hematological variables may contain useful discriminatory information for data-driven classification. This study aimed to compare the apparent classification performance of multiple machine learning algorithms for distinguishing individuals with and without T2DM using routinely obtained clinical parameters in a single-center dataset. Methods: This single-center observational study included 160 adults (95 females, 65 males) evaluated at the Endocrinology Outpatient Clinic of Gaziantep Islam Science and Technology University, Faculty of Medicine, Ersin Arslan Training and Research Hospital. The dataset comprised anthropometric measurements, biochemical markers, and complete blood count parameters. SMOTE was applied only within the training folds to address class imbalance and to avoid information leakage. Following fold-internal data preprocessing, which included imputing missing values and feature standardization where appropriate, the dataset was evaluated using stratified 5-fold cross-validation. SHAP analysis was performed to interpret the model predictions. A calibration curve was used to assess the model’s reliability. Eight supervised machine learning models were evaluated with and without HbA1c: Logistic Regression, Linear Discriminant Analysis, Quadratic Discriminant Analysis, Decision Tree, Random Forest, Extra Trees, Gaussian Naive Bayes, and k-Nearest Neighbors. Model performance was evaluated using accuracy, sensitivity, specificity, and F1 score, and ROC curves were used as a diagnostic tool. Results: The models were evaluated in two different ways: with and without HbA1c. Random Forest demonstrated the best classification performance in the cross-validated evaluation; without HbA1c, it achieved 92.2% accuracy, 93.9% sensitivity, 97.9% specificity, and a 95.9% F1 score. When HbA1c was included, it achieved 98.0% accuracy, 97.9% sensitivity, 98.8% specificity, and a 99.0% F1 score. Decision Tree and Extra Trees demonstrated strong performance with accuracy rates of 87.6% and 92.8%, respectively, without HbA1c, and 90% and 93.5% when HbA1c was included; in contrast, KNN yielded the lowest accuracy rate (70.6%). Overall, tree-based models performed better than linear classifiers on this dataset. Conclusions: Machine learning models based on routine clinical and anthropometric variables demonstrated promising performance for T2DM classification in this single-center dataset; tree-based approaches yielded the most promising results. Including HbA1c improved the models’ ability to classify individuals with and without T2DM. However, since HbA1c was included both as a predictor and as part of the operational definition of the diabetes group, the findings should be interpreted with caution due to the risk of target leakage. Therefore, these results should be considered exploratory rather than evidence of clinically applicable predictive performance, and an independent external validation study should be conducted prior to clinical application. Full article

Background/Objectives: Pediatric obesity is closely associated with metabolic syndrome (MetS), a condition linked to increased cardiometabolic risk. Early identification of high-risk individuals remains challenging. This study aimed to evaluate the diagnostic performance of selected anthropometric, metabolic dysfunction and insulin resistance indexes for identifying MetS in children and adolescents with obesity. Methods: In this retrospective, cross-sectional, single-center study, 758 children and adolescents with obesity (mean age 14.8 ± 2.1 years; 59.9% females) hospitalized for a body weight-reduction program were included. MetS was defined according to International Diabetes Federation criteria, in which central obesity is a mandatory diagnostic component. The triglyceride–glucose (TyG), TyG–waist circumference (TyG-WC), body adiposity index (BAI), fasting glucose-to-insulin ratio (FGIR), and quantitative insulin sensitivity check index (QUICKI) were calculated. Receiver operating characteristic curve analysis was used to assess their discriminative ability. Results: The prevalence of MetS was 27.8% and was significantly higher in males than females (34.9% vs. 23.1%, p < 0.0001). TyG and TyG-WC showed the best discriminative performance (AUC 0.75 and 0.76, respectively), although with only moderate sensitivity and specificity. FGIR and QUICKI demonstrated lower accuracy (AUC 0.64 and 0.63), whereas BAI showed no discriminative ability (AUC 0.48). These findings were consistent across sexes, although sex-specific differences in both MetS prevalence and optimal cut-off values were observed. Correlation analyses confirmed moderate associations between TyG-based indexes and MetS, whereas other indexes showed weaker relationships. Conclusions: In the present cohort of children and adolescents with obesity, TyG and TyG-WC showed the best performance in identifying MetS compared with the other evaluated indexes. However, their performance remained moderate, and the proposed cut-off values require validation in independent populations. These indexes may represent simple supportive screening and risk-stratification tools but should be used alongside comprehensive clinical assessment and established diagnostic criteria rather than as stand-alone diagnostic measures. Full article

Background: Post-COVID syndrome represents a significant medical and public health challenge, particularly among older adults and individuals with type 2 diabetes mellitus (T2DM), in whom disturbances in immune and metabolic homeostasis may contribute to the development and persistence of symptoms following SARS-CoV-2 infection. Objective: To investigate the clinical, immunological, and metabolic characteristics of post-COVID syndrome in older adults with T2DM. Methods: A cross-sectional comparative study was conducted involving 141 patients aged ≥ 60 years who were evaluated more than one year after SARS-CoV-2 infection. Clinical data, anthropometric measurements, complete blood count parameters, biochemical markers, glycated hemoglobin (HbA1c), and SARS-CoV-2-specific IgG antibodies were assessed. Statistical analyses were performed using nonparametric methods, while Pearson’s χ² test was applied for categorical variables. A p-value < 0.05 was considered statistically significant. Results: Symptoms consistent with post-COVID syndrome one year after SARS-CoV-2 infection were identified in 53.2% of participants. No significant differences in anthropometric characteristics, hematological parameters, or most biochemical markers were observed between patients with and without post-COVID syndrome. Patients with T2DM exhibited higher fasting glucose, HbA1c, and SARS-CoV-2–specific IgG antibody levels, reflecting underlying metabolic characteristics and differences in humoral immune responses during the late post-COVID period. Conclusions: Post-COVID syndrome symptoms were frequently observed among older adults at the time of assessment, more than one year after SARS-CoV-2 infection, despite normalization of most laboratory parameters. In patients with T2DM, higher glucose, HbA1c, and antibody levels likely reflect underlying metabolic characteristics rather than a direct effect of post-COVID syndrome. Further longitudinal studies are warranted to clarify the long-term clinical significance of the observed metabolic and immunological findings. Full article

Background: Childhood obesity remains a major public health challenge worldwide, with increasing prevalence across Europe. Schools represent an important setting for promoting healthy lifestyles through physical activity and nutrition-related interventions. This systematic review aimed to evaluate the effectiveness of school-based interventions promoting physical activity and healthy eating behaviours among children and adolescents aged 6–18 years in European countries. Methods: A systematic literature review was conducted using PubMed and Scopus. Studies were eligible if they were conducted in school settings, targeted children and adolescents aged 6–18 years, were implemented in European countries, had a minimum duration of nine months, and assessed anthropometric and/or behavioural outcomes related to obesity prevention. Methodological quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Results: Sixteen studies conducted across nine European countries met the inclusion criteria. Intervention duration ranged from nine months to five years, and most studies employed multicomponent approaches combining physical activity promotion, nutrition education, environmental modifications, and parental involvement. Seven studies were rated as strong quality, six as moderate quality, and three as weak quality. Among the fourteen studies assessing BMI or other anthropometric outcomes, eleven (78.6%) reported statistically significant improvements in at least one obesity-related measure, including BMI, BMI z-score, waist circumference, waist-to-height ratio, body fat percentage, or overweight/obesity prevalence. Evidence regarding physical activity and nutrition-related outcomes was more heterogeneous, although several studies reported improvements in dietary behaviours, nutrition knowledge, sedentary behaviour, and physical activity levels. Positive anthropometric effects were more commonly observed in interventions lasting at least one academic year and in multicomponent programmes. Some studies also reported differential effects according to sex and parental educational background. Conclusions: The findings of this review suggest that long-term, multicomponent school-based interventions can contribute to improving obesity-related anthropometric outcomes among children and adolescents in European countries. However, evidence regarding sustained changes in physical activity and dietary behaviours remains less consistent. Future research should focus on identifying the most effective intervention components and strategies for achieving long-term behavioural change across diverse populations and educational contexts. Full article

Background/Objectives: Obesity is a major public health concern, and accurate diagnosis is essential for effective treatment and prevention strategies. Obesity screening utilizes anthropometric indices, among which body mass index (BMI) has been most widely used; however the comparative performance of alternative indices still needs to be evaluated. Methods: This cross-sectional study included 1042 participants. Anthropometric indices including BMI, waist circumference (WC), waist-to-height ratio (WHtR), waist–hip circumference ratio (WHR), neck circumference (NC), and hip circumference (HC) were measured among Saudi adults. Body fat percentage was measured using bioelectrical impedance analysis and used to define obesity. Correlation analysis was used to assess associations with BF%, and receiver operating characteristic curve analysis was used to compare discriminatory performance and determine optimal obesity-screening cutoffs using the Youden index. Results: The study included 1042 Saudi adults, predominantly women (61.9%), with a mean age of 31.8 ± 12 years. BMI showed the strongest overall correlation with body fat percentage (r = 0.707), followed by hip circumference and waist-to-height ratio. ROC curve analysis revealed excellent discriminatory performance for BMI in the total cohort (AUC = 0.924, 95% CI: 0.908–0.939), followed by HC (AUC = 0.887) and WHtR (AUC = 0.861); the least discriminatory performance was for WHR (AUC = 0.667). Further sex-stratified analysis showed that BMI had the strongest correlation with BF%, in both men (r = 0.837), and women (r = 0.821). On the other hand, ROC analysis showed that WHtR was the best in men (AUC = 0.932), with performance comparable to BMI, whereas BMI remained the strongest discriminator in women (AUC = 0.930). Conclusions: BMI demonstrated the highest discriminatory performance for identifying BF-defined obesity in this cohort, supporting its value as a practical and reliable screening index. Although waist circumference and waist-to-height ratio reflected differences in body fat distribution, they did not outperform BMI. These findings support the continued use of BMI as the primary obesity screening measure, while highlighting the importance of using sex-specific interpretation of complementary anthropometric indices. Full article

Background/Objectives: Anthropometric measurements provide essential normative datasets that form the foundation for clinical practice and forensic identification. The human ear is a highly informative structure due to its complex morphology and individual specificity, making it a valuable tool for biometric systems. This study aimed to estimate biological sex based on auricular morphometric measurements, develop a logistic regression model for this purpose, and validate its performance using ROC analysis. Materials and Methods: This cross-sectional study included 120 adult participants (60 males, 60 females). Standardized digital photographs were analyzed in ImageJ to record 22 linear and 6 angular measurements using established anatomical landmarks. LASSO logistic regression was employed for variable selection and model shrinkage. The final model’s discriminative performance was assessed using the area under the receiver operating characteristic (ROC) curve (AUC), the Hosmer–Lemeshow test, and the Brier score. Results: A comparative analysis revealed that most linear and angular measurements showed significant sexual dimorphism. Almost all linear dimensions (A1–A22) were significantly larger in males (p < 0.001). Auricular width (A2) and width at the level of the tragus (A3) emerged as the most robust indicators, demonstrating “very large” effect sizes. Conversely, the angle between the preauricular line and the vertical plane (A28) was significantly greater in females, providing a unique inverse relationship for sex estimation. A parsimonious 5-predictor model (incorporating A2, A3, A5, A10, and A28) achieved exceptional discriminative performance with an AUC of 0.980. Conclusions: Auricular morphometry is a highly effective tool for sex estimation. The findings confirm significant sexual dimorphism in the external ear, particularly in linear dimensions. The developed model may serve as a preliminary morphometric reference for future automated biometric recognition studies, although no artificial intelligence-based classification model was developed in the present study. Full article

Background/Objectives: Obesity is an increasing challenge among people living with HIV (PLWH). This study aimed to assess the prevalence of general and abdominal obesity and its association with lifestyle in adult Romanian PLWH, providing the first national data. Methods: A single-center, cross-sectional study involved 106 adult PLWH. Eating behavior was assessed using the Rapid Eating Assessment for Participants—Short Version (REAP-S) and physical activity with the General Practice Physical Activity Questionnaire (GPPAQ), both standardized and validated. Anthropometric, clinical, and virological data were collected from medical records and direct measurement. Results: Median age was 36 years [IQR 33–42], 83.3% were male, and 73.6% lived in urban areas. Median time since HIV diagnosis was 11 years, and 60.4% had AIDS-defining illness. General obesity (BMI ≥ 30 kg/m²) occurred in 17.9%, overweight in 29.2%, and high-risk abdominal obesity in 22.6%. Physical inactivity was reported by 20.8%. Multivariable analysis showed that being moderately or physically active was the only independent predictor of abdominal obesity (OR 0.19; 95% CI, 0.07–0.51; p = 0.001). Conclusions: In this young Romanian cohort of PLWH, physical activity reduces the risk of abdominal obesity, underscoring the need to integrate such interventions into the standard of care to reduce metabolic risk associated with HIV. Full article

Background/Objectives: Consumption of ultra-processed foods (UPF) has been linked to poorer diet quality and adverse health outcomes. Although Chile ranks among the highest consumers of UPFs in Latin America, studies using primary dietary data, especially among older adults, are scarce. This study aimed to describe the food intake of Chilean older adults according to the degree of food processing, and to explore the association between UPF intake and sociodemographic, economic and health factors. Methods: A cross-sectional study of 434 non-institutionalized older adults (≥60 years) living in the Metropolitan Region of Chile was conducted. Dietary intake was assessed using interviewer-administered 24h recall, with a second assessment 8–15 days later in a random subsample (n = 60). Foods were classified according to the NOVA system into minimally processed foods (MPFs), culinary ingredients, processed foods (PF), or UPF. Usual energy intake was estimated using the MSM. Sociodemographic (sex, age, area), economic (income, education, health system), and health-related variables (chronic conditions, sedentary lifestyle, tobacco use) were collected through home-visit questionnaires. Anthropometric and functional measurements were taken by trained nutritionists. The association between UPF intake and studied variables was evaluated using multivariate fractional probit regression, with mean marginal effects presented. Results: Most of the participants were women (86.2%), aged 70–79 years (47.9%), and residents of urban areas (76.3%). Most of their calories came from MPF (45.7%), followed by PF (25.5%) and UPF (16.6%). Higher UPF intake was associated with living in an urban area (+3.8%; 95% CI 1.2–6.3%), higher education (+3.5%; 95% CI 1.1–6.0%), and being affiliated with the private health system (+9.1%; 95% CI 4.1–14.0%). Conclusions: In this community-based sample of Chilean older adults, UPF intake was associated with socioeconomic factors but not health status. Full article

Background: Women remain the primary caregivers globally, especially in rural, low-resource settings plagued by poverty, unemployment, low education and poor infrastructure. These factors limit caregiving capacity, heighten vulnerability and increase the risk of food insecurity in female-headed households. Objective: To establish a baseline profile of caregivers of primary school children. Methods: Phase 1 (baseline) of the study was conducted using a quantitative, exploratory cross-sectional survey design among 75 female caregivers of children aged 7–13 years in Qwa-Qwa, Free State Province. Participants were recruited using convenience sampling. Data were collected with a structured, pre-validated questionnaire on socio-demographics, alongside anthropometric measurements. Data were analysed using descriptive statistics. Results: Most participants were unemployed (73.3%) and had low educational attainment, with 86.7% having completed primary school or less. A substantial proportion of households (80.0%) reported a monthly income below R1000. Food insecurity was common, with 69.3% of caregivers reporting experiences of food shortages. Household infrastructure was limited, particularly in refuse removal services (96.0% without access). Despite these socio-economic constraints, a high prevalence of overweight and obesity (72.5%) was observed amongst the participants. Conclusions: Caregivers experience severe, overlapping socio-economic and environmental vulnerabilities alongside a high prevalence of overweight and obesity. The study highlights the need for multi-sectoral interventions focused on poverty reduction, rural infrastructure development, improved service delivery, women’s empowerment and strengthened livelihood opportunities to improve household nutrition and resilience. Full article

Background: High-heeled footwear is widely used by women, yet its systemic influence on spatiotemporal gait parameters, pelvic kinematics, and propulsion across a range of heel heights remains incompletely characterised. This study aimed to quantify gait changes across four footwear conditions and assess the contribution of anthropometric characteristics to observed gait variability. Methods: A within-subject repeated-measures study was conducted with 75 healthy young adult women (mean age 24.3 years, BMI 21.3 kg/m²) assessed barefoot, in ballerina flats, 8 cm heels, and 12 cm heels using the G-WALK inertial measurement system (BTS Bioengineering). Thirty gait parameters were analysed using the Friedman test with Bonferroni-corrected Wilcoxon post hoc comparisons (α_adj = 0.0083), Spearman rank correlations, multiple linear regression, and Kruskal–Wallis tertile analysis. Results: Footwear significantly affected 22 of 30 parameters. Walking speed was higher in all shod conditions than barefoot (up to +9.2%), driven entirely by stride elongation with cadence unchanged, indicating a general effect of footwear rather than heel elevation specifically. Stride length peaked at 8 cm heel (+8.9% vs. barefoot) and declined at 12 cm. Gait symmetry decreased progressively with heel height. Ballerina shoes produced a distinctively dynamic temporal profile—shortest stance duration, lowest double support, and highest single support time—significantly different from both barefoot and heeled conditions. The propulsion index increased height-dependently with heel height, rising 23.3% from barefoot (8.20) to 12 cm heel (10.11; p < 0.001). Pelvic obliquity symmetry was disrupted at 12 cm heel, while tilt symmetry was unaffected. Anthropometric analysis identified 110/600 significant Spearman correlations (23 surviving Benjamini–Hochberg FDR correction) and 29/120 significant regression models (14 surviving FDR); age, body weight, and shoe size were the most consistent predictors, most reliably in the barefoot condition. Conclusions: Heel height exerts condition-specific effects on gait biomechanics. Ballerina shoes produce a gait pattern distinct from both barefoot and heeled walking. Propulsion demand increases height dependently with heel elevation. Because participants walked in their own footwear, the observed effects reflect the combined characteristics of each shoe type rather than heel elevation in isolation. Anthropometric characteristics—particularly age, body weight, and shoe size—are modestly associated with footwear–gait responses and may inform future biomechanical research, although clinical application requires confirmation in standardised-footwear studies and clinical populations. Full article

Background: Nutritional therapy is central in the management of chronic kidney disease (CKD) and cancer, yet these conditions impose partially conflicting requirements. The 2024 KDIGO guideline recommends a controlled protein intake (~0.8 g/kg/day) to reduce metabolic burden in non-dialysis CKD patients, whereas the ESPEN (European Society for Clinical Nutrition and Metabolism) guidelines support higher protein intake (≥1.0–1.5 g/kg/day) to prevent cancer-related malnutrition. Evidence guiding patients affected by both conditions is limited. We evaluated the effects of a Mediterranean-like controlled protein diet in onconephrological patients compared with CKD controls. Methods: In this retrospective study, 358 CKD patients (183 onconephrological, 175 controls) were followed at a tertiary center (2017–2024). Patients received a protein-controlled diet (0.6–1.0 g/kg/day) tailored to comorbidities and nutritional status. Nutritional assessment included bioelectrical impedance analysis and anthropometry. Renal function was evaluated using creatinine and cystatin C, and measured GFR by iohexol clearance at baseline and 12 months. Results: Baseline body composition was comparable between groups. After intervention, serum urea significantly decreased in both groups, without a decline in measured or estimated GFR. Fat mass and central adiposity indices were reduced, while lean mass and phase angle remained stable. No evidence of protein–energy wasting or catabolic activation emerged. Longitudinal analyses showed no significant time × cancer interaction for renal function or most bioimpedance-derived body composition parameters. However, at extended follow-up, arm circumference and tricipital skinfold thickness showed significant time × cancer interactions, suggesting different longer-term peripheral anthropometric trajectories according to cancer status. Conclusions: In this retrospective real-world cohort, structured nephro-nutritional management with an individualized Mediterranean-like controlled protein prescription was associated with preserved renal function and no evidence of overt nutritional deterioration in onconephrological patients. These findings support the feasibility and apparent safety of this approach in selected patients, while highlighting the need for prospective studies with objective dietary adherence assessment and longer-term evaluation of cancer-related anthropometric trajectories. Full article

Despite increasing efforts to improve cardiovascular disease (CVD) risk evaluation and management, it remains a leading cause of mortality and morbidity worldwide. This has driven interest in high-density lipoprotein (HDL)-related biomarkers as indicators of oxidative stress and atherogenic processes not fully captured by traditional lipid measurements. In this study, we examined specific paraoxonase 1 (PON1) activity and its relationship with anthropometric, blood pressure, and lipid metabolism measures in 100 middle-aged Lithuanian individuals at high cardiovascular risk. HDL fractions were isolated using iodixanol-based density gradient centrifugation. PON1 concentration and arylesterase activity were measured, and specific activity was defined as arylesterase activity normalized to PON1 concentration. No significant associations were observed between specific PON1 activity and age, body mass index, waist circumference, blood pressure, smoking status, or statin use. Specific PON1 activity was independently associated with lower risk-weighted apolipoprotein B and lower low-density lipoprotein cholesterol levels. These exploratory findings suggest that higher specific PON1 activity may reflect a less atherogenic lipid profile in individuals at high cardiovascular risk, as indicated by its association with LDL-C and with risk-weighted apolipoprotein B. Because direct oxidative stress and inflammatory markers were not measured, interpretations regarding oxidative burden should be considered indirect and hypothesis-generating. Given the cross-sectional nature of the study and the relatively small sample size, these results should be interpreted as exploratory and hypothesis-generating. Further longitudinal studies in larger populations are needed to confirm these observations. Full article

Background: Dietary behaviours in young athletes are shaped by multiple behavioural, social, and environmental influences, which may contribute to the coexistence of healthy and unhealthy eating patterns. This study aimed to explore factors associated with fast-food consumption frequency and adherence to the Mediterranean diet (MD) among young football athletes. Methods: A cross-sectional study was conducted among 94 male football players aged 10–16 years from a Portuguese football club. Adherence to the MD was assessed using the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) index. Fast-food consumption patterns and food-choice motivations were evaluated through a structured questionnaire. Anthropometric measurements were obtained using standardised procedures. Correlation, linear regression, and ordinal regression analyses were performed. Results: Most participants demonstrated high adherence to the MD (96.8%), with a median KIDMED score of 12.0 (IQR: 10.0–13.0). Although 88.3% of participants reported consuming fast food, intake frequency was generally low, with 67.0% reporting consumption never or only once per month. Higher fast-food consumption frequency was associated with lower fruit and vegetable intake and higher consumption of sweets and pastries. No significant associations were observed between fast-food consumption frequency and overall MD adherence, Body Mass Index z-score, or fat mass percentage. Higher health-related motivation scores were associated with lower odds of more frequent fast-food consumption (OR = 0.248; p = 0.021), whereas greater decision autonomy regarding restaurant choice was associated with higher consumption frequency (OR = 4.036; p = 0.010). Conclusions: Young football athletes showed high adherence to the Mediterranean diet despite the presence of fast-food consumption, suggesting that healthy and unhealthy dietary behaviours may coexist within the same population. Behavioural factors, particularly health motivations and food-choice autonomy, appear to influence fast-food consumption independently of overall diet quality and anthropometric status. Full article

Background: Childhood obesity is a complex public health issue in which parental perceptions and family dietary behaviors are pivotal. This study assessed the feasibility of the Smart Family lifestyle counseling intervention in Greek primary care. It explored changes in children’s dietary behaviors relative to parental weight perception and Mediterranean diet adherence. Methods: A single-arm pretest–posttest pilot study was conducted in Patras, Greece, from Health4EUKids Joint Action. The intervention consisted of four monthly face-to-face counseling sessions using the Smart Family methodology. In total, 49 parent–child dyads (aged 2–12 years) completed the program. Data collection included child anthropometric measurements, validated food frequency questionnaires, parental perception of child weight status, and parental Mediterranean diet adherence. Results: Parents who underestimated their child’s weight status had significantly higher Mediterranean diet scores than those who overestimated (p = 0.032); those with low adherence tended to overestimate and those with moderate adherence to underestimate. The largest reduction was observed for sweets and desserts (median −2.35 servings/week), with significant reductions in sugar-sweetened beverages, grains and cereals, whole wheat products, and dairy. Fish and vegetable intake increased significantly, but fruit intake did not change. Changes in fast food and red meat differed significantly across Mediterranean diet score tertiles, with larger decreases in the lower tertiles. Conclusions: Smart Family counseling was feasible to deliver through trained healthcare professionals in Greek primary care over four months, with reductions in selected discretionary foods observed alongside the intervention. Parental weight perception and Mediterranean diet adherence emerged as potential barriers to change although the findings are exploratory and require confirmation in a future controlled trial. Full article

Background/Objectives: Obesity is a multifactorial chronic condition characterized by the accumulation of excess adiposity and complex interplay between intrinsic and extrinsic factors. It is an increasingly common condition, closely implicated with the incidence and progression of cardiovascular disease and its risk factors. This narrative review synthesizes and summarizes recent evidence on obesity, with a focus on the diagnosis of obesity, an exploration of both visceral and subcutaneous adipose tissue, available interventions for obesity ranging from dietary modifications to novel anti-obesity medications, and key associations with obesity and cardiovascular diseases. This review is distinct in its integrated focus on obesity definition and diagnosis, imaging modalities, the latest non-pharmacologic and pharmacologic interventions, and also the interplay between obesity and certain cardiovascular conditions as well as their risk factors. Results: The diagnosis of obesity has been evolving with the incorporation of anthropometric measurements and imaging modalities rather than simply the body mass index. There is a wide array of contributors to obesity including genetic factors, behavior, hormonal regulators, the brain–gut axis, and psychosocial stressors. Anti-obesity medications have been evolving rapidly, with current emphasis on glucagon-like peptide 1 receptor agonists. Obesity is closely implicated in cardiovascular conditions such as atherosclerotic disease, heart failure, atrial fibrillation, and hypertension as well as related risk factors such as diabetes mellitus, chronic kidney disease and sleep apnea. Conclusions: Obesity is a widely prevalent, chronic, and complex disease. The use of a variety of anthropometric measurements can help risk-stratify individuals. Imaging techniques are also helpful in evaluating body fat. Evaluating individuals from a holistic perspective is imperative to appreciate the various contributors to obesity. There are a variety of interventions available for obesity management including lifestyle interventions, bariatric surgery, and pharmacologic therapy. Notably, obesity is closely tied with cardiovascular diseases and recent pharmacologic anti-obesity agents may mitigate cardiovascular risk. Full article