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17 pages, 996 KiB  
Article
The Profiles of Diet- or Exercise-Related Self-Efficacy and Social Support Associated with Insufficient Fruit/Vegetable Intake and Exercise in Women with Abdominal Obesity
by Yanjing Zeng, Qing Long, Yan Jiang, Jieqian Li, Zhenzhen Rao, Jie Zhong and Jia Guo
Nutrients 2025, 17(15), 2478; https://doi.org/10.3390/nu17152478 - 29 Jul 2025
Viewed by 218
Abstract
Background/Objectives: Prioritizing diet- or exercise-related self-efficacy and social support with their interactions may improve the effectiveness of interventions aimed at increasing daily fruit/vegetable intake and exercise, thereby reducing the risk of metabolic disorders in abdominally obese women. This study aimed to identify the [...] Read more.
Background/Objectives: Prioritizing diet- or exercise-related self-efficacy and social support with their interactions may improve the effectiveness of interventions aimed at increasing daily fruit/vegetable intake and exercise, thereby reducing the risk of metabolic disorders in abdominally obese women. This study aimed to identify the profiles of diet- or exercise-related self-efficacy and social support among women with abdominal obesity, examine profiles related to insufficient fruit/vegetable intake and exercise, and explore associating factors of these profiles. Methods: A cross-sectional investigation in central south mainland China collected sociodemographic, anthropometric, and health-related variables, diet-related self-efficacy (Diet-SE) and social support (Diet-SS), exercise-related self-efficacy (Exercise-SE) and social support (Exercise-SS), and daily fruit/vegetable intake and exercise. We used latent profile analysis to identify distinct profiles, and binary logistic regression to examine the profiles’ behaviors and associating factors. Results: A total of 327 abdominally obese women were categorized into four profiles of Diet-SE and Diet-SS, and five profiles of Exercise-SE and Exercise-SS. Women in the Diet Dual-Low Group were associated with insufficient daily fruits/vegetables intake. Women in the Exercise Dual-Low Group or Exercise-SS Medium–Low Group were more likely to engage in insufficient daily exercise. Conclusions: Our findings align with previous evidence that women with low diet- or exercise-related self-efficacy and social support are at increased risk for insufficient daily fruit/vegetable intake or exercise. Additionally, medium Exercise-SS is associated with insufficient exercise behaviors, suggesting that interventions targeting healthy exercise should be initiated earlier among women with medium Exercise-SS, rather than waiting for it to decline to low level. Full article
(This article belongs to the Section Nutrition in Women)
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17 pages, 522 KiB  
Systematic Review
Heterogeneity in Heart Failure with Preserved Ejection Fraction: A Systematic Review of Phenotypic Classifications and Clinical Implications
by Francisco Epelde
J. Clin. Med. 2025, 14(14), 4820; https://doi.org/10.3390/jcm14144820 - 8 Jul 2025
Viewed by 537
Abstract
Background/Objectives: Heart failure with preserved ejection fraction (HFpEF) has emerged as one of the most challenging syndromes in modern cardiology due to its complex pathophysiology, diagnostic ambiguity, and lack of effective targeted therapies. Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF encompasses [...] Read more.
Background/Objectives: Heart failure with preserved ejection fraction (HFpEF) has emerged as one of the most challenging syndromes in modern cardiology due to its complex pathophysiology, diagnostic ambiguity, and lack of effective targeted therapies. Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF encompasses a highly heterogeneous patient population unified only by a preserved left ventricular ejection fraction (LVEF) ≥ 50%. This broad definition overlooks important biological and clinical differences, leading to inconclusive results in large-scale therapeutic trials and suboptimal patient outcomes. In recent years, advances in data-driven methodologies—such as unsupervised machine learning, cluster analysis, and latent class modeling—have enabled the identification of distinct HFpEF phenotypes. These phenotypes, often defined by demographic, clinical, hemodynamic, and biomarker profiles, exhibit differential prognoses and treatment responses. Methods: This systematic review synthesizes findings from 20 studies published between 2010 and 2025, examining phenotypic classification strategies and their clinical implications. Results: Despite methodological variation, several recurring phenotypes emerge, including metabolic–obese, frail–elderly, atrial-fibrillation-dominant, cardiorenal, and pulmonary hypertension/right-heart phenotypes. Each presents a distinct pathophysiological mechanism and risk profile, highlighting the inadequacy of current one-size-fits-all treatment approaches. The review also explores the prognostic value of phenotypes, the impact of phenotypic variation on treatment efficacy, and the methodological challenges that hinder translation into clinical practice—such as inconsistent input variables, lack of external validation, and limited integration with real-world data. Conclusions: Ultimately, the findings underscore the need for a paradigm shift from ejection fraction-based classification to phenotype-guided management in HFpEF. Embracing a precision medicine framework could enable personalized treatment strategies, improve clinical trial design, and enhance outcomes for this diverse patient population. The review concludes by outlining future directions, including the development of standardized phenotyping algorithms, integration of multi-omic and digital health data, and the implementation of pragmatic, phenotype-stratified clinical trials. Full article
(This article belongs to the Section Cardiology)
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15 pages, 249 KiB  
Article
Chrononutrition Patterns in People Who Attempted Weight Loss in the Past Year: A Descriptive Analysis of the National Health and Nutrition Examination Survey (NHANES) 2017–2020 Pre-Pandemic
by Namhyun Kim, Hajin Jang and Marquis Hawkins
Dietetics 2025, 4(2), 24; https://doi.org/10.3390/dietetics4020024 - 3 Jun 2025
Viewed by 522
Abstract
Introduction: Obesity is associated with cardiometabolic diseases, and chrononutrition has become a novel weight loss strategy. However, few have characterized chrononutrition patterns among people attempting weight loss. This study characterizes chrononutrition patterns in a nationally representative sample of U.S. adults who attempted weight [...] Read more.
Introduction: Obesity is associated with cardiometabolic diseases, and chrononutrition has become a novel weight loss strategy. However, few have characterized chrononutrition patterns among people attempting weight loss. This study characterizes chrononutrition patterns in a nationally representative sample of U.S. adults who attempted weight loss in the past year through dietary modifications by weight change and adiposity. Methods: This cross-sectional analysis utilizes NHANES 2017–2020 data. Chrononutrition patterns were assessed using 24 h dietary recalls. Participants self-reported weight loss attempts in the past year and if they tried using diet modification. Weight change (loss, maintenance, and gain) was defined based on differences in current weight and weight one year prior. We used latent profile analysis and descriptive statistics. Results: The sample included 2107 participants who attempted weight loss in the past year through diet modification (median age 47; 58% women and 62% white). Individuals who gained weight (vs. loss) had longer hours between waketime and the first eating (1.78 vs. 1.62 h, p = 0.024), consumed a lower proportion of calories later in the day (43% vs. 52%, p < 0.001), and ate less frequently (5.20 vs. 5.43 episodes, p = 0.008). Participants with obesity had the shortest eating window (11.77 vs. 12.22 h, p = 0.02) despite a longer delay between waketime and the first eating (1.80 vs. 1.29 h, p < 0.001) and lower eating frequency (5.16 vs. 5.97, p < 0.001). Conclusions: Variations in eating timing, eating episodes, and caloric distribution suggest that chrononutrition may play a role in personalized weight management strategies. Full article
40 pages, 1789 KiB  
Article
Bayesian Inference on the Impact of Serious Life Events on Insomnia and Obesity
by David Gunawan
Mathematics 2025, 13(11), 1840; https://doi.org/10.3390/math13111840 - 31 May 2025
Viewed by 302
Abstract
We investigate the impact of significant life events on two critical health outcomes: insomnia and obesity. Using data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, we focus on significant life events experienced in the preceding 12 months. To model [...] Read more.
We investigate the impact of significant life events on two critical health outcomes: insomnia and obesity. Using data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, we focus on significant life events experienced in the preceding 12 months. To model these health outcomes jointly, we employ a bivariate random effects probit panel data model and a longitudinal random effects panel data model whose outcomes can be a combination of discrete/categorical and continuous variables. Estimating these random effects panel data models is challenging because the likelihood is an integral over the latent individual random effects. In addition, the models often have a large number of predictors. In this paper, Bayesian inference is carried out using a particle Metropolis within a Gibbs sampler, which is particularly well suited for statistical models with latent variables. Additionally, within this inference framework, we integrate a Hamiltonian Monte Carlo (HMC) step to sample the high-dimensional vector of regression coefficients efficiently. The HMC step enables faster convergence and improved mixing of the Markov chain. Our article contributes to a better understanding of how stress-related life events shape health outcomes and demonstrates the advantages of combining particle Metropolis within Gibbs and HMC in the estimation of complex panel data models. Full article
(This article belongs to the Section D1: Probability and Statistics)
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14 pages, 280 KiB  
Article
Latent Class Analysis of Cancer Risk Behaviors Among College Students on Guam: A Pacific Islands Cohort of College Students Study (PICCS)
by Aurienne Cruz, Cabrini Aguon, Michael Cajigal, Elaine C. de Leon, Reina Faye P. Evangelista, Su Bin Jin, Ella Macatugal, Gian M. Paras, Lauren Nicole G. Villanueva, Grazyna Badowski and Yvette C. Paulino
Int. J. Environ. Res. Public Health 2025, 22(5), 755; https://doi.org/10.3390/ijerph22050755 - 12 May 2025
Viewed by 549
Abstract
This study aims to explore how cancer-related risk factors cluster among college students in Guam. Using the 2021–2022 Pacific Islands Cohort of College Students data, we conducted a latent class analysis (LCA) to organize the sample into classes based on clustering cancer risk [...] Read more.
This study aims to explore how cancer-related risk factors cluster among college students in Guam. Using the 2021–2022 Pacific Islands Cohort of College Students data, we conducted a latent class analysis (LCA) to organize the sample into classes based on clustering cancer risk factors, including tobacco use, binge drinking, low fruit/vegetable intake, physical inactivity, betel nut use, overweight/obesity, depression, and anxiety. Among the 577 college students surveyed, results show a high prevalence of low fruit/vegetable intake, overweight/obesity, depression, and anxiety. The LCA identified three classes, each defined by different clustering cancer risk behaviors. All classes showed high prevalence of low fruit/vegetable intake. Class 1 had the highest rates of tobacco use, betel nut use, and binge drinking. Class 2 had the highest rates of physical inactivity, depression, and anxiety. Class 3 had the lowest rates of betel nut use, overweight/obese, depression, and anxiety when compared with Classes 1 and 2. The clustering of risk behaviors highlights the need for targeted interventions and prevention strategies among Guam’s youth, aiming to address these behaviors and potentially reduce cancer risk in the region. Full article
8 pages, 588 KiB  
Article
The Impact of Maternal Obesity on the Duration of Labor Stages in Dinoprostone-Induced Vaginal Delivery
by Neslihan Bezirganoglu Altuntas and Yesim Bayoglu Tekin
J. Clin. Med. 2025, 14(9), 3209; https://doi.org/10.3390/jcm14093209 - 6 May 2025
Viewed by 457
Abstract
Objective: Dinoprostone vaginal inserts are widely used as one of the primary pharmacological methods for labor induction. In this study, we aimed to investigate whether BMI affects the duration of the different phases of labor in pregnant women undergoing vaginal delivery induced with [...] Read more.
Objective: Dinoprostone vaginal inserts are widely used as one of the primary pharmacological methods for labor induction. In this study, we aimed to investigate whether BMI affects the duration of the different phases of labor in pregnant women undergoing vaginal delivery induced with slow-release dinoprostone. Methods: A prospective study was conducted on pregnant women at a tertiary maternity hospital between August 2021 and February 2023. Patients were categorized into three groups according to BMI: normal-weight, overweight, and obese. The duration of total labor and each phase of induced labor was recorded. Multivariate analysis was used to determine the association between maternal obesity and the duration of each phase of the labor process. Results: The final analysis included 205 women who received slow-release dinoprostone for labor induction. The mean maternal age was significantly lower in the normal-weight group (p < 0.01). The obese group showed a higher need for oxytocin augmentation and had a higher median infant birth weight compared to the normal and overweight groups. After adjusting for confounders, multivariate linear regression analysis showed that the duration of the latent phase of labor did not differ between the groups. However, the duration of the active phase of labor and total induced labor were significantly longer in the obese group. Conclusions: An increased BMI in pregnant women is associated with a longer active phase and overall labor duration during dinoprostone-induced delivery. Full article
(This article belongs to the Special Issue Clinical Updates on Maternal Fetal Medicine)
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50 pages, 2540 KiB  
Review
Unveiling the Therapeutic Potential of the Second-Generation Incretin Analogs Semaglutide and Tirzepatide in Type 1 Diabetes and Latent Autoimmune Diabetes in Adults
by Marco Infante, Francesca Silvestri, Nathalia Padilla, Francesca Pacifici, Donatella Pastore, Marcelo Maia Pinheiro, Massimiliano Caprio, Manfredi Tesauro, Andrea Fabbri, Giuseppe Novelli, Rodolfo Alejandro, Antonino De Lorenzo, Camillo Ricordi and David Della-Morte
J. Clin. Med. 2025, 14(4), 1303; https://doi.org/10.3390/jcm14041303 - 15 Feb 2025
Viewed by 4388
Abstract
Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic beta cells, resulting in the lifelong need for exogenous insulin. Over the last few years, overweight and obesity have recently emerged as growing health issues [...] Read more.
Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic beta cells, resulting in the lifelong need for exogenous insulin. Over the last few years, overweight and obesity have recently emerged as growing health issues also afflicting patients with T1D. In this context, the term “double diabetes” has been coined to indicate patients with T1D who have a family history of type 2 diabetes mellitus (T2D) and/or patients with T1D who are affected by insulin resistance and/or overweight/obesity and/or metabolic syndrome. At the same time, the use of second-generation incretin analogs semaglutide and tirzepatide has substantially increased on a global scale over the last few years, given the remarkable clinical benefits of these drugs (in terms of glucose control and weight loss) in patients with T2D and/or overweight/obesity. Although the glucagon-like peptide-1 (GLP-1) receptor agonists and the novel dual GIP (glucose-dependent insulinotropic polypeptide)/GLP-1 receptor agonist tirzepatide are currently not approved for the treatment of T1D, a growing body of evidence over the last few years has shown that these medications may serve as valid add-on treatments to insulin with substantial efficacy in improving glucose control, promoting weight loss, preserving residual beta-cell function and providing other beneficial metabolic effects in patients with T1D, double diabetes and latent autoimmune diabetes in adults (LADA). This manuscript aims to comprehensively review the currently available literature (mostly consisting of real-world studies) regarding the safety and therapeutic use (for different purposes) of semaglutide and tirzepatide in patients with T1D (at different stages of the disease), double diabetes and LADA. Full article
(This article belongs to the Special Issue Clinical Management of Type 1 Diabetes)
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18 pages, 1185 KiB  
Article
The Association Between Egg and Egg-Derived Cholesterol Consumption, and Their Change Trajectories, with Obesity Among Chinese Adults: Results from the China Health and Nutrition Survey
by Tianhui Tang, Binghua Chen, Jiahao Hu, Hangzhao Fan, Zilan Zhang, Tianyang Zhai, Chunxiao Li, Duolao Wang, Wanli Xue, Leilei Pei, Fangyao Chen, Baibing Mi and Yaling Zhao
Nutrients 2025, 17(2), 333; https://doi.org/10.3390/nu17020333 - 17 Jan 2025
Viewed by 1917
Abstract
Background/Objectives: As a widely consumed, nutritious, and affordable food, eggs and their derivatives’ impacts on obesity remain inconclusive. In this study, we aimed to determine the association between egg and egg-derived cholesterol consumption, and their change trajectories, with obesity among Chinese adults. Methods [...] Read more.
Background/Objectives: As a widely consumed, nutritious, and affordable food, eggs and their derivatives’ impacts on obesity remain inconclusive. In this study, we aimed to determine the association between egg and egg-derived cholesterol consumption, and their change trajectories, with obesity among Chinese adults. Methods: Longitudinal data collected by the China Health and Nutrition Survey from 1997 to 2015 were analyzed. The latent growth mixture model was used to identify eggs and egg-derived cholesterol consumption trajectories. Cox proportional hazard models with shared frailty were used to analyze the association between egg and egg-derived cholesterol consumption, and their change trajectories, with obesity. Results: Data from 10,971 and 9483 participants aged ≥18 years old were used for the analyses of general obesity and central obesity, respectively. Compared to participants with an average egg intake of 0.1–50.0 g/d during the follow-up period, adults who never consumed eggs or those with an average egg intake of 50.1–100.0 g/d and >100.0 g/d had a higher risk of general obesity, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.31 (1.08, 1.58), 1.30 (1.07, 1.60), and 1.98 (1.17, 3.35), respectively, and had a higher risk of central obesity, with HRs (95% CIs) of 1.17 (1.04, 1.31), 1.31 (1.14, 1.50), and 1.64 (1.15, 2.36), respectively. Participants with a “Baseline Low-Significant Rising Pattern” or a “Baseline High-Rising then Falling Pattern” of egg consumption trajectories during the follow-up period had a higher risk of general obesity, with HRs (95% CIs) of 1.56 (1.25, 1.93) and 1.38 (1.13, 1.69), respectively, and central obesity, with HRs (95% CIs) of 1.47 (1.29, 1.68) and 1.52 (1.34, 1.72), respectively. Compared to the second quartile (Q2) group of the average egg-derived cholesterol intake during the follow-up period, Q1, Q3, and Q4 groups had a higher risk of general obesity, with HRs (95% CIs) of 1.28 (1.06,1.54), 1.21 (1.02, 1.44), and 1.43 (1.19, 1.71), respectively, and a higher risk of central obesity, with HRs (95% CIs) of 1.20 (1.08, 1.33), 1.11 (1.01, 1.23), and 1.32 (1.19, 1.46), respectively. Participants with a “Baseline Low-Significant Rising Pattern” or with a “Baseline High-Rising then Falling Pattern” of egg-derived cholesterol consumption during the follow-up period had a higher risk of general obesity, with HRs (95% CIs) of 1.54 (1.25, 1.92) and 1.37 (1.15, 1.64), respectively, and a higher risk of central obesity, with HRs (95% CIs) of 1.46 (1.28, 1.68) and 1.47 (1.32, 1.64), respectively. Conclusions: Both the insufficient and excessive intake of eggs and egg-derived cholesterol tended to be associated with a higher risk of general and central obesity. Suddenly increasing or consistently high levels of egg and egg-derived cholesterol intake seemed to be associated with a higher risk of obesity. To prevent obesity, people should consume a moderate amount of eggs and egg-derived cholesterol. Full article
(This article belongs to the Section Nutrition and Obesity)
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10 pages, 414 KiB  
Article
Do Patients with Rheumatoid Arthritis Have an (In)Adequate Level of Physical Activity? A Latent Class Analysis Approach
by Sretko Lukovic, Marko Baralic, Nina Tomonjic, Jovana Mihailovic, Aleksandra Neskovic, Marina Vujovic Sestakov, Ivana Pavlovic, Branko Barac, Tatjana Zivanovic Radnic and Predrag Ostojic
Life 2024, 14(12), 1600; https://doi.org/10.3390/life14121600 - 4 Dec 2024
Cited by 1 | Viewed by 1526
Abstract
Introduction: Regular physical activity (PA) has a beneficial effect on joint pain, stiffness, strength, flexibility, and aerobic capacity in patients with rheumatoid arthritis (RA). Objective: The aim of this study was to assess the level of PA in patients with rheumatoid arthritis and [...] Read more.
Introduction: Regular physical activity (PA) has a beneficial effect on joint pain, stiffness, strength, flexibility, and aerobic capacity in patients with rheumatoid arthritis (RA). Objective: The aim of this study was to assess the level of PA in patients with rheumatoid arthritis and to identify potential barriers to this activity. Material and Methods: The study involved 132 patients with RA. Participants completed the International Physical Activity Questionnaire (IPAQ), the Functional Assessment of Chronic Illness Therapy—Fatigue Scale (FACIT-F), the Tampa Scale for kinesiophobia (TSK), Strength, Ambulation, Rising from a chair, Stair climbing and history of Falling questionnaire (SARC-F) for sarcopenia assessment, and the Patient Health Questionnaire-9 (PHQ-9) for depression. Basic socio-epidemiological data, disease activity score in 28 joints (DAS28), duration of disease, and therapy information were retrieved from electronic patient records. Latent class analysis (LCA) was used to identify subpopulations of patients. Results: The study included 109 women (82.6%) and 23 men (17.4%). Low levels of PA were observed in 16 patients (12%), moderate levels in 70 patients (53%), and high levels in 42 patients (35%). Symptoms of pronounced fatigue were significantly associated with low PA (28.5 ± 11.3 vs. 37 ± 7 vs. 37 ± 10; p = 0.002). The risk of sarcopenia was significantly higher in RA patients with low PA (p = 0.05). Kinesiophobia was present in all three groups (65.2%). LCA identified two classes. In the first class, patients were more likely to be non-exercisers compared to the second class. Patients in the first class were characterized by a higher probability of being female, obese, with lower education levels. Patients in the first class had pronounced fatigue, kinesiophobia and more frequent symptoms of depression. The second class (65% of the total population) included patients who exercised moderately to frequently (93%) and were middle-aged. They were less obese, highly educated, employed, and majority of them achieved low disease activity or remission. In addition, they had lower risks for sarcopenia, depression, fatigue, and kinesiophobia. Conclusions: This study showed that RA patients with moderate and high levels of PA have better disease control, fewer symptoms of fatigue and depression, and a lower risk of sarcopenia. However, kinesiophobia was significantly present in all three groups, indicating a need for further promotion of this non-pharmacological treatment. Full article
(This article belongs to the Section Epidemiology)
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16 pages, 414 KiB  
Article
Prevalence and Predictors of the Use of Low-Calorie Sweeteners Among Non-Pregnant, Non-Lactating Women of Reproductive Age in Australia
by Mumtaz Begum, Shao-Jia Zhou, Saima Shaukat Ali and Zohra S. Lassi
Nutrients 2024, 16(22), 3963; https://doi.org/10.3390/nu16223963 - 20 Nov 2024
Cited by 1 | Viewed by 1195
Abstract
Objective: There is concern about the potential health implications of low-calorie sweetener (LCS) consumption. This study aimed to determine the prevalence and patterns of LCS use among women of reproductive age (WRA) in Australia. Methods: This cross-sectional study involved a two-stage analysis. First, [...] Read more.
Objective: There is concern about the potential health implications of low-calorie sweetener (LCS) consumption. This study aimed to determine the prevalence and patterns of LCS use among women of reproductive age (WRA) in Australia. Methods: This cross-sectional study involved a two-stage analysis. First, latent class analyses (LCA) were employed to identify patterns of LCS use. Subsequently, regression analyses were conducted to assess the association between sociodemographic and lifestyle characteristics and the two outcomes: (1) self-reported LCS use, and (2) the identified LCS consumption patterns/classes. Results: A total of 405 WRA completed the survey (mean age 32.0 ± 8.6 years, mean BMI 28.71 ± 11.1 kg/m2), with 44.7% reporting LCS consumption. LCA analysis identified three distinct LCS consumption patterns: light users (45.9%), moderate users (26.0%) and heavy users (28.6%). A high proportion of participants did not meet the Australian dietary guidelines for recommended servings of vegetables (57.8%), dairy (44.2%), meat (48.2%) and grains (74.8%). Compared to Caucasian women, those from South Asian backgrounds (OR 4.16; 95% CI 1.71–10.1) and Aboriginal and Torres Strait Islander women (OR 1.40; 95% CI 0.42–4.63) were more likely to use LCS. Women who participated in the weight loss programs, with overweight/obesity, and those using LCS for weight loss purposes were more likely to be moderate or heavy LCS users than light users. Additionally, socioeconomically disadvantaged women were less likely to be moderate or heavy LCS users. Conclusions: This study highlights the widespread use of LCS among WRA in Australia, with distinct consumption patterns influenced by cultural, health-related, and socioeconomic factors. These findings underscore the need for targeted interventions to promote healthy eating practices within this population. Full article
(This article belongs to the Section Nutrition in Women)
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12 pages, 481 KiB  
Article
Improvements in Insulin Resistance and Glucose Metabolism Related to Breastfeeding Are Not Mediated by Subclinical Inflammation
by Julia Martins de Oliveira, Patrícia Médici Dualib, Alexandre Archanjo Ferraro, Rosiane Mattar, Sérgio Atala Dib and Bianca de Almeida-Pititto
Metabolites 2024, 14(11), 608; https://doi.org/10.3390/metabo14110608 - 9 Nov 2024
Viewed by 1746
Abstract
Background: Lactation is known to improve insulin resistance, but this phenomenon remains poorly understood. Our goal was to evaluate whether subclinical inflammation could mediate the association between breastfeeding (BF) and improvement in glucose metabolism and markers of insulin resistance (MIRs) in the postpartum. [...] Read more.
Background: Lactation is known to improve insulin resistance, but this phenomenon remains poorly understood. Our goal was to evaluate whether subclinical inflammation could mediate the association between breastfeeding (BF) and improvement in glucose metabolism and markers of insulin resistance (MIRs) in the postpartum. Methods: A total of 95 adult women (≥18 years) with a BMI ≥ 25 kg/m2 from the outpatient clinic of the Federal University of São Paulo were followed from early pregnancy until 60 to 180 days postpartum. The patients were divided based on their BF status: BF and non-BF groups. A latent variable termed SubInf was created incorporating inflammation-related biomarkers: adiponectin, E-selectin, branched-chain amino acids, zonulin, copeptin, and lipopolysaccharides. The association of BR with MIRs in the postpartum was evaluated through linear regression analysis, and mediation analysis was performed to evaluate the role of SubInf in this association. Results: The groups were similar regarding gestational diabetes mellitus (GDM) prevalence, pre-gestational BMI, caloric intake, physical activity, and postpartum weight loss. The BF group presented lower levels of triglycerides (TGs), fasting glucose, fasting insulin, TG/HDLcholesterol ratio (TG/HDL), TyG index, and HOMA-IR compared to the non-BF group. A linear regression analysis adjusted for scholarity, parity, pre-gestational BMI, GDM, weight gain during pregnancy, and mode of delivery revealed an inverse association between BF and fasting glucose [−6.30 (−10.71 to −1.89), p = 0.005), HOMA-IR [−0.28 (−0.50 to −0.05), p = 0.017], TyG index [−0.04 (−0.06 to −0.01), p = 0.002], and TG/HDL ratio [−0.23 (−0.46 to −0.01), p = 0.001]. In the mediation analysis, SubInf did not mediate the indirect effect of BF on MIRs. Conclusions: In overweight and obese women, an association between BF and improvement in MIRs in the postpartum was seen, corroborating that BF should be stimulated, especially in these cardiometabolic high-risk women. Subclinical inflammation did not seem to mediate this association. Full article
(This article belongs to the Special Issue Glucose Metabolism in Pregnancy)
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11 pages, 871 KiB  
Article
Phenome-Wide Association Study of Latent Autoimmune Diabetes from a Southern Mexican Population Implicates rs7305229 with Plasmatic Anti-Glutamic Acid Decarboxylase Autoantibody (GADA) Levels
by Germán Alberto Nolasco-Rosales, José Jaime Martínez-Magaña, Isela Esther Juárez-Rojop, Ester Rodríguez-Sánchez, David Ruiz-Ramos, Jorge Ameth Villatoro-Velázquez, Marycarmen Bustos-Gamiño, Maria Elena Medina-Mora, Carlos Alfonso Tovilla-Zárate, Juan Daniel Cruz-Castillo, Humberto Nicolini and Alma Delia Genis-Mendoza
Int. J. Mol. Sci. 2024, 25(18), 10154; https://doi.org/10.3390/ijms251810154 - 21 Sep 2024
Cited by 1 | Viewed by 1475
Abstract
Latent autoimmune diabetes in adults (LADA) is characterized by the presence of glutamate decarboxylase autoantibodies (GADA). LADA has intermediate features between type 1 diabetes and type 2 diabetes. In addition, genetic risk factors for both types of diabetes are present in LADA. Nonetheless, [...] Read more.
Latent autoimmune diabetes in adults (LADA) is characterized by the presence of glutamate decarboxylase autoantibodies (GADA). LADA has intermediate features between type 1 diabetes and type 2 diabetes. In addition, genetic risk factors for both types of diabetes are present in LADA. Nonetheless, evidence about the genetics of LADA in non-European populations is scarce. This study aims to perform a genome-wide association study with a phenome-wide association study of LADA in a southeastern Mexican population. We included 59 patients diagnosed with LADA from a previous study and 3121 individuals without diabetes from the MxGDAR/ENCODAT database. We utilized the GENESIS package in R to perform the genome-wide association study (GWAS) of LADA and PLINK for the phenome-wide association study (PheWAS) of LADA features. Nine polymorphisms reach the nominal association level (1 × 10−5) in the GWAS. The PheWAS showed that rs7305229 is genome-wide and associated with serum GADA levels in our sample (p = 1.84 × 10−8). rs7305229 is located downstream of the FAIM2 gene; previous reports associate FAIM2 variants with childhood obesity, body mass index, body adiposity measures, lymphocyte CD8+ activity, and anti-thyroid peroxidase antibodies. Our findings reveal that rs7305229 affects the GADA levels in patients with LADA from southeastern Mexico. More studies are needed to determine if this risk genotype exists in other populations with LADA. Full article
(This article belongs to the Special Issue Molecular Research on Diabetes)
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12 pages, 926 KiB  
Article
Human Herpesvirus 6—A Rare Aetiologic Agent for CNS Infections in Immunocompetent Individuals or an Underestimation?
by Oana Alexandra Ganea, Cătălin Tilișcan, Anca Streinu-Cercel, Daniela Pițigoi, Anca Cristina Drăgănescu, Mihai Lazar, Nicoleta Mihai, Dragoș Florea, Sorin Ștefan Aramă and Victoria Aramă
J. Clin. Med. 2024, 13(16), 4660; https://doi.org/10.3390/jcm13164660 - 8 Aug 2024
Cited by 2 | Viewed by 1464
Abstract
Background: Human herpesvirus 6 (HHV-6) is considered a ubiquitous virus, with many countries reporting a seroprevalence of more than 80–90% among the general population. However, this virus is unique among herpesviruses in its ability to integrate into the genetic material of the [...] Read more.
Background: Human herpesvirus 6 (HHV-6) is considered a ubiquitous virus, with many countries reporting a seroprevalence of more than 80–90% among the general population. However, this virus is unique among herpesviruses in its ability to integrate into the genetic material of the host’s cells. Thus, there are three ways by which HHV-6 can cause an active infection–primary infection, reactivation of a latent acquired infection, or activation of iciHHV-6 (inherited chromosomally integrated HHV-6). Whole blood quantitative polymerase chain reaction (qPCR) is very useful in distinguishing between iciHHV-6 and primary infection/reactivation. Our aim is to assess the role of HHV-6 in the aetiology of central nervous system (CNS) infections in adults and children, to describe all HHV-6-positive cases in an attempt to determine the susceptible population and to identify potential risk factors that can be linked to HHV-6 meningoencephalitis. Methods: We performed a retrospective study involving patients that were admitted to Prof. Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania, with a diagnosis of meningitis or encephalitis. We only selected the clinical records of patients that had a multiplex PCR Biofire® FilmArray® meningitis/encephalitis panel. Results: We report a 5% HHV-6 positivity in the cerebrospinal fluid (CSF) of patients with CNS infections tested with a commercial multiplex PCR M/E (meningitis/encephalitis) panel. Additionally, 2% to 4% of the total study population (n = 100) had active HHV-6 infections, which denotes 40 to 80% of the HHV-6-positive samples. We did not observe any statistically significant correlation between HHV-6 positivity in the CSF and variables such as age, sex, or comorbidities, including obesity, diabetes, hypertension, immunosuppression, or oncologic disease. Therefore, no risk factors could be linked with HHV-6 positivity in the CSF. Conclusions: although multiplex qualitative PCR is highly useful for providing rapid results and identifying nearly every pathogen that can cause meningitis/encephalitis, we have to be aware of this type of test’s limitations. All patients with HHV-6 detectable in their CSF via a multiplex PCR test should also undergo qPCR testing from both CSF and blood to prevent over-diagnosing HHV-6 CNS infections, to avoid unnecessary antiviral treatments, and ensure the accurate identification of the true diagnosis. Full article
(This article belongs to the Section Infectious Diseases)
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14 pages, 3743 KiB  
Article
Trajectory Patterns of Macronutrient Intake and Their Associations with Obesity, Diabetes, and All-Cause Mortality: A Longitudinal Analysis over 25 Years
by Jingxian Huang, Rong Rong, Zheng Feei Ma and Ying Chen
Nutrients 2024, 16(15), 2567; https://doi.org/10.3390/nu16152567 - 5 Aug 2024
Viewed by 2472
Abstract
Over the past decades, China has been undergoing rapid economic growth, which may have significantly influenced the dietary patterns and health status of the Chinese population. Our study aimed to assess the associations of potential macronutrient trajectory patterns with chronic diseases and all-cause [...] Read more.
Over the past decades, China has been undergoing rapid economic growth, which may have significantly influenced the dietary patterns and health status of the Chinese population. Our study aimed to assess the associations of potential macronutrient trajectory patterns with chronic diseases and all-cause mortality using the latent class trajectory model (LCTM) and the longitudinal data of the China Health and Nutrition Survey obtained between 1991 and 2015. A 24-hour diet recall was used to assess the dietary intake. The Poisson regression model was employed to investigate the correlations between trajectory patterns and chronic diseases and all-cause mortality. A total of 8115 participants were included in the final analysis. We explored four and three trajectory patterns for male and female populations, respectively. We found that a decreasing very high-carbohydrate trajectory together with a U-shape protein trajectory was associated with a higher risk of diabetes in the male population (odds ratio (OR): 2.23; 95% confidence interval (CI): 1.31–3.77). A similar pattern for moderate protein intake was also associated with the risk of diabetes in the female population (OR: 1.82; 95% CI: 1.18–2.79). In addition, we show that a decreasing low-carbohydrate trajectory and an increasing high-fat trajectory were associated with a lower risk of all-cause mortality (OR: 0.76; 95% CI: 0.60–0.96) and a higher risk of obesity (OR: 1.24; 95% CI: 1.05–1.47) in males. Our results shed light on some salient nutritional problems in China, particularly the dual challenges of undernutrition and overnutrition. Full article
(This article belongs to the Section Nutritional Epidemiology)
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11 pages, 970 KiB  
Article
Mediation Effect of Obesity on the Association of Socioeconomic Status with Blood Pressure in the Elderly Hypertensive Population
by Saiyi Wang, Yudong Miao, Yifei Feng, Lipei Zhao, Xiaoman Wu, Shiyu Jia, Weijia Zhao, Clifford Silver Tarimo, Yibo Zuo, Xinghong Guo, Mingze Ma and Jian Wu
Nutrients 2024, 16(15), 2401; https://doi.org/10.3390/nu16152401 - 24 Jul 2024
Cited by 1 | Viewed by 1854
Abstract
Background: Socioeconomic status (SES) plays a crucial role in blood pressure (BP) control. SES may influence BP control through obesity indices, such as body mass index (BMI) and waist circumference (WC). This study aimed to understand the relationships between SES and BP control [...] Read more.
Background: Socioeconomic status (SES) plays a crucial role in blood pressure (BP) control. SES may influence BP control through obesity indices, such as body mass index (BMI) and waist circumference (WC). This study aimed to understand the relationships between SES and BP control in the elderly hypertensive population, and to determine whether BMI and WC mediate the relationship between SES and BP control. Methods: The study was conducted in Jia County, Henan Province, China, from 1 July to 31 August 2023. The 18,963 hypertensive people over 65 years old who were included in the National Basic Public Health Service Program were investigated. The study utilized questionnaire surveys to collect data on participants’ demographic characteristics, disease history, lifestyle behaviors, antihypertensive medication, and measured height, weight, and blood pressure. SES was indexed by participants’ self-reported educational level, family income, and occupation, and categorized into low, medium, and high groups by using latent category analysis (LCA). Logistic regression models were used to analyze the associations between SES and BP control. Obesity indicators, represented by BMI and WC, were included in mediation models to examine the indirect effects of BMI/WC on the association between SES and BP control. Results: The mean age of 17,234 participants was 73.4 years and 9888 (57.4%) of the participants were female. The LCA results indicated the number of participants in low SES, middle SES, and high SES groups were 7760, 8347, and 1127, respectively. Compared with the low SES group, the odds ratios (ORs) and 95% confidence intervals (CIs) for the association of BP control with middle SES and high SES were 1.101 (1.031, 1.175), and 1.492 (1.312, 1.696). This association was similarly found in the subsequent subgroup analyses (p < 0.05). Compared with low SES, our findings further suggested that BMI (indirect effects: 95% CIs: −0.004–−0.001; p < 0.001) and WC (indirect effects: 95% CIs: −0.003–−0.001; p = 0.020) play a suppressing role in the association between high SES and BP control. Conclusions: Our study indicated that the elderly hypertensive population with high SES may have a better result for BP control. However, we found that BMI/WC plays a suppressing role in this association. This indicated that despite the better BP control observed in elderly hypertensive populations with high SES, BMI and WC might undermine this beneficial relationship. Therefore, implementing strategies for obesity prevention is an efficient way to maintain this beneficial association between high SES and BP control. Full article
(This article belongs to the Section Nutrition and Obesity)
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