Search Results (365)

Smoking and central obesity have both been linked to periodontitis, but their combined relationship with periodontal disease may be influenced by demographic and behavioral factors. This cross-sectional study analyzed records of 420 adult dental patients attending the College of Dentistry at the University of Baghdad. Data included demographic characteristics, smoking status, periodontal clinical findings, body mass index (BMI), and waist-to-height ratio (WHtR). Periodontitis was defined according to the 2018 classification framework, and logistic regression models were used to examine the associations of smoking and obesity-related indicators with periodontitis. The overall prevalence of periodontitis was 36.4%. Participants with periodontitis were significantly older than those without periodontitis (46.0 vs. 28.9 years; p < 0.0001). In the fully adjusted model, age remained the strongest factor associated with periodontitis (OR = 1.15 per year; 95% CI: 1.11–1.18; p < 0.001). The apparent association between smoking and periodontitis was substantially influenced by age, as current smoking was more common among younger participants in this sample. The association between smoking status and periodontitis appeared to differ according to WHtR category (interaction term p = 0.016); however, this finding should be interpreted cautiously because of the cross-sectional design and age imbalance across exposure groups. Overall, the findings suggest that age was the dominant factor associated with periodontitis in this dental patient sample, while the relationship between smoking, central obesity, and periodontitis requires further investigation in longitudinal studies with detailed smoking and metabolic data. Full article

Disordered eating has been identified as a concern among individuals with type 1 diabetes mellitus (T1DM) and is associated with poorer glycaemic control, which may result in vascular complications and increased morbidity and mortality. Despite this, there is a paucity of research examining disordered eating behaviour (DEB) among individuals with T1DM in Ireland. This study aimed to examine the prevalence of DEB among adults with T1DM attending an Irish hospital outpatient clinic. This cross-sectional study recruited 95 adults with T1DM attending an outpatient diabetes clinic at Sligo University Hospital. Screening for DEB was conducted using self-reported measures, including the Diabetes Eating Problem Survey–Revised (DEPS-R) and the Eating Disorder Examination Questionnaire (EDE-Q 6.0). DEB was identified in 16.3% (n = 15) of the participants using the DEPS-R and in 3.2% (n = 3) using the EDE-Q 6.0. Higher levels of DEB were observed among the female participants; however, a notable prevalence was also identified among the male participants. DEB demonstrated a weak positive correlation with body mass index (BMI) and a negative correlation with age and height. No association was found between DEB and glycated haemoglobin (HbA1c). The substantial prevalence of DEB among adults with T1DM, with nearly one in six participants affected, highlights the presence of clinically relevant disordered eating symptoms in this population. The findings suggest potential differences in case identification between diabetes-specific and generic screening tools. These results support further evaluation of diabetes-specific screening instruments such as the DEPS-R in adult T1DM populations within larger studies before routine clinical implementation. Full article

Background: Early childhood nutrition is strongly associated with neurodevelopmental outcomes, particularly in socially vulnerable settings. Limited evidence is available describing the relationship between nutritional status, food security, and neurodevelopment among preschool children in low-income urban areas of Colombia. This study aimed to evaluate nutritional status, household food insecurity, and neurodevelopmental outcomes in children attending early childhood centers in El Codito, Bogotá, and to explore the association between anthropometric indicators and neurodevelopmental performance. Methods: A cross-sectional study was conducted in children enrolled in community childcare centers. Nutritional status was assessed using anthropometric indicators according to World Health Organization growth standards, including weight for age, height for age, and body mass index for age. Neurodevelopment was evaluated using the Escala Abreviada de Desarrollo (EAD). Household food insecurity was measured through a validated questionnaire. Descriptive statistics were performed, and associations between variables were analyzed using correlation tests and group comparisons according to data distribution. Results: Most participants presented adequate nutritional status; however, a proportion of children showed risk of stunting or excess weight. Neurodevelopmental scores were generally within expected ranges, although variability was observed across developmental domains. Significant associations were identified between certain anthropometric indicators and neurodevelopmental outcomes. Moderate to severe household food insecurity was identified in 21.4% of participating households. Conclusions: Nutritional status and household food insecurity represent important contextual factors for child health in vulnerable urban populations. These findings highlight the importance of integrated nutritional and developmental monitoring strategies within early childhood programs. Further longitudinal studies are required to clarify causal pathways and to guide targeted public health interventions in similar contexts. Full article

Background/Objectives: Despite growing recognition of sex as a biological variable that may influence responses to dietary interventions, many studies still pool data from women and men. Moreover, sex-stratified changes in eating behaviors and mental health following dietary interventions remain underexplored. This study aimed to describe sex-stratified changes in adiposity, eating behaviors, and mental health outcomes in men and women following a hypocaloric Mediterranean-style diet. Methods: A 12-week exploratory prospective longitudinal study was conducted in nineteen women and nine men with overweight or obesity. Participants attended two clinical visits (baseline and week 12), where adiposity parameters (body mass index [BMI], body fat, waist and hip circumference), diet quality, eating behaviors, mental health parameters (well-being, perceived stress, flourishing, anxiety and depression) and biochemical parameters were assessed. Analyses were stratified by sex to evaluate changes from baseline to week 12, and repeated-measures correlations were used to explore within-individual associations between concurrent changes in outcomes. Results: Women and men improved significantly in adiposity and diet quality. Uncontrolled eating decreased and cognitive restraint increased in both sexes (p < 0.05). In men, emotional eating decreased (p = 0.011), and mental health improved, with higher well-being (p = 0.043) and flourishing (p = 0.027), and lower stress (p = 0.021), anxiety (p = 0.017), and depression (p = 0.027). Also, in men, anxiety was positively correlated with body fat percentage (p = 0.012) and BMI (p = 0.002) and inversely correlated with diet quality (p = 0.013). Uncontrolled eating was positively associated with BMI in men (p = 0.022) and women (p = 0.006), and cognitive restraint was positively associated with diet quality (both p = 0.003). Conclusions: Women and men achieved similar improvements in adiposity, whereas improvements in mental health variables and emotional eating were observed only in men. These preliminary findings suggest that dietary interventions may benefit from considering sex-sensitive and multidisciplinary approaches, especially psychological support and stress-management components, may be required for women. However, these observations should be confirmed in adequately powered studies. Full article

Background: Infertility is a major public health concern worldwide. While excess body weight is a well-established risk factor for impaired fertility, increasing evidence indicates that elevated body fat content may also occur in women with normal body mass index, a phenotype described as normal-weight obesity. This study aimed to assess associations between diet quality, intake of selected nutrients, and body fat content among women attending an infertility clinic with body mass index (BMI) within the normal range. Methods: This cross-sectional study included 45 women with infertility and normal BMI (18.5–24.99 kg/m²). Dietary intake was assessed using 3-day food diaries and a food frequency questionnaire. Diet quality was evaluated using the pro-healthy diet index, non-healthy diet index, and diet quality index. Body composition was measured by bioelectrical impedance analysis. Participants were divided according to median body fat percentage, <24.9% vs. ≥24.9%. Results: Participants’ body fat percentage ranged from 12.2% to 34.3%, and in the case of 6 women, the body fat percentage (>30%) indicated normal weight obesity. No differences were observed in pHDI, nHDI, or DQI scores between groups after correction for multiple comparisons. Inadequate iron intake was reported in all women. Conclusions: Among women with infertility and normal BMI, body fat percentage varied widely. No associations were observed between dietary variables and body composition parameters. Full article

Background/objective: Hypertension and type 2 diabetes are major causes of morbidity in older adults. Although pharmacological treatments remain the cornerstone of management, structured physical activity has been shown to provide additional benefits, yet evidence from institutionalized populations in Latin America is limited. This study evaluated the impact of a 12-month supervised exercise program on blood pressure (BP), glycated hemoglobin (HbA1c), and body composition in elderly people attending welfare homes in Mexico. Methods: A community-based intervention trial was conducted (February 2018–January 2019) with 260 adults (aged > 60 years) with hypertension and/or diabetes. Participants were allocated based on shelter site to either a control group (n = 129; pharmacological treatment only) or an intervention group (n = 131; pharmacological treatment plus five one-hour supervised recreational physical activity sessions per week). Monthly anthropometric, clinical, and biochemical measurements were analyzed using parametric/non-parametric tests and estimation of effect size (Cohen’s d). Results: Median age was 70 years (86% female). After 12 months, systolic BP decreased from 148.4 to 129.7 mmHg in the intervention group vs. 147.7 to 131.3 mmHg in controls. Diastolic BP showed greater reduction in the intervention group (−25%; 93.1 to 68.9 mmHg) than in controls (−13.5%; 88.1 to 76.2 mmHg). HbA1c reductions were also superior in the intervention group (–2.28% vs. –1.86%). Both groups lost fat mass, but lean mass preservation was limited. Conclusions: Structured community-based physical activity significantly improves BP, glycemic control, and body composition, supporting its integration into routine institutional care with limited resources. Full article

Background and Objectives: Pregnancy causes various physiological and hormonal changes that disrupt sleep architecture and modify respiratory patterns, increasing the risk of sleep-related breathing disorders (SBDs) such as obstructive sleep apnea (OSA) and potentially exacerbating pre-existing conditions. These disorders have been linked to adverse maternal and fetal outcomes. However, current screening tools remain inadequate, and data, including from Portugal, remain limited. This study aimed to assess the prevalence of SBD symptoms suggestive of sleep-disordered breathing during pregnancy, characterize the population, and explore associations with demographic and anthropometric parameters. Materials and Methods: A prospective observational study was conducted from July to December 2024 at Hospital da Luz Lisboa, involving pregnant women ≥ 18 years attending routine consultations. Participants completed a structured questionnaire that assessed demographic and anthropometric data, comorbidities, ten SBD symptoms, and the Epworth Sleepiness Scale (ESS). Results: The cohort included 289 participants, with a mean age of 34.4 years and pre-pregnancy body mass index (BMI) of 23.6 kg/m². On average, women reported 3.1 SBD symptoms, with fatigue (65.4%), memory/concentration impairment (52.2%), and non-restorative sleep (50.5%) being the most common. Excessive daytime sleepiness (ESS >10) was present in 22.8% of the population. Snoring was significantly associated with older age and higher BMI (p = 0.0009 and p < 0.0001, respectively). Both the number of symptoms and ESS scores tended to increase with gestational age, particularly in the third trimester. Women with diabetes had higher odds of reporting snoring, nocturnal dyspnea, and witnessed apneas, with odds ratios of 4.65, 8.77, and 11.38, respectively. Conclusions: SBD symptoms and daytime sleepiness are highly prevalent in pregnancy and typically increase with advancing gestation. These findings emphasize the need for improved clinical strategies to enable early identification and management of SBD in pregnant women, thereby reducing maternal-fetal complications. Full article

Background/Objectives: Pediatric obesity is a public health epidemic in the United States and in many countries worldwide. Due to the interrelatedness of obesity and toxic stress, mindfulness is a promising practice to support healthful eating behaviors and combat stress in the management of this condition. In this pilot study we evaluated the acceptability and feasibility of implementing a brief mindfulness-based program for pediatric patients seeking treatment for overweight and obesity, with an assessment of exploratory outcomes. Methods: Nineteen children (ages 8–17 with body mass indices (BMIs) ≥ the 85th percentile) and caregiver dyads (n = 19) were recruited from a multidisciplinary pediatric weight management clinic. Four thirty-minute psychoeducational mindfulness-based sessions were provided via telehealth. Qualitative feedback was sought during and after program completion. Child and caregiver mindful eating and general mindfulness measures were collected from participant dyads at baseline, and one month and three months after program completion. Results: Qualitative program feedback from participants was generally positive. Session attendance rates were high (89%), with most participants highly engaged during sessions and the follow-up clinic visits. An analysis of exploratory measures data revealed no significant changes in child or caregiver dyad mindful eating or general mindfulness scores at one month (n = 9) or three months (n = 7) post-program completion compared to baseline (n = 10). Conclusions: This pilot, mindfulness-based program was feasible and acceptable to implement as a scalable behavioral intervention in long-term pediatric obesity treatment. Study of a larger, controlled sample is needed to determine the impact of program participation on mindful eating and general mindfulness, along with clinical obesity-related outcomes, in the management of pediatric obesity. Full article

Background: Obesity remains a major public health challenge, with central and visceral fat distribution conferring particularly high cardiometabolic risk. Lifestyle factors, including diet, physical activity, and sleep quality, have been implicated in adiposity, yet their combined and interactive effects in working populations remain insufficiently characterized. Methods: We conducted a cross-sectional study in 88,343 Spanish employees (53,122 men, 35,221 women) attending occupational health examinations between 2021 and 2024. Obesity was assessed using four complementary indices: body mass index (BMI), waist-to-height ratio (WHtR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Lifestyle factors included sleep quality (Pittsburgh Sleep Quality Index), Mediterranean diet adherence (MEDAS), and physical activity (IPAQ). Multivariable logistic regression models were adjusted for sociodemographic and lifestyle variables, with interaction, stratified, joint exposure, and dose–response analyses. Results: Obesity prevalence varied widely by index, ranging from 18.9% (BMI) to 55.6% (CUN-BAE). Poor sleep quality was independently associated with higher odds of obesity across all indices, particularly central obesity (WHtR OR 1.58, 95% CI 1.48–1.69), with stronger associations observed in women. Physical inactivity and non-adherence to the Mediterranean diet were robust predictors, with inactivity showing the largest effect sizes (METS-VF OR 9.92, 95% CI 8.70–11.15). Interaction analyses indicated that both Mediterranean diet adherence and regular physical activity attenuated the adverse association between poor sleep and obesity outcomes. Restricted cubic spline models revealed a progressive dose–response relationship between increasing PSQI score and central obesity. Joint exposure analyses showed nearly five-fold higher odds of central obesity among workers with concurrent poor sleep, physical inactivity, and low Mediterranean diet adherence. A graded inverse association was observed between a composite healthy lifestyle score (0–3) and obesity, with a score of 3 associated with 72–75% lower odds of BMI-obesity and WHtR-high. Conclusions: In this large occupational cohort, poor sleep quality, physical inactivity, and low Mediterranean diet adherence emerged as independent and combined determinants of general, central, and visceral obesity. Integrated workplace strategies promoting sleep hygiene, physical activity, and dietary quality—particularly among women and lower socioeconomic groups—may represent an effective approach to reducing obesity risk in working populations. Full article

Background: Aging is associated with increased adiposity, sarcopenia risk, and metabolic vulnerability. Digital tools may enhance adherence to nutritional strategies, but their impact on detailed body composition remains insufficiently explored. Methods: This 6-month prospective controlled longitudinal intervention study included 60 middle-aged and older adults. All participants received a smart watch and smart scale for self-monitoring. The control group attended evaluations only at baseline and study completion, while the intervention group received monthly follow-up and remote feedback. Body composition was assessed using multi-frequency BIA. Statistical analyses included paired tests, effect sizes, correlations, and linear mixed-effects models. Results: Significant reductions were observed in BMI (p < 0.001), fat mass (p = 0.003), and visceral fat (p = 0.003; Cohen’s d = 0.41). The sarcopenic index improved (p = 0.001), while skeletal muscle mass remained stable. ECW increased significantly (p = 0.010). Age was inversely associated with the magnitude of improvement. Mixed-effects modeling confirmed a time-dependent reduction in visceral fat independent of age and sex. Conclusions: A 6-month digitally assisted nutritional monitoring program was associated with favorable changes in adiposity, muscle quality, and hydration status. Multi-frequency BIA provides valuable integrative markers for monitoring nutritional interventions in aging populations. Full article

Background/Objectives: With increasing requirements for health assessments, the working environment offers an effective setting to engage individuals at risk of disease. This study aimed to investigate the current health status of university employees through individual workplace health screening and explore the perceived feasibility, relevance, demand and impact. Methods: A total of 156 individuals attended a one-off health assessment (September 2024 and July 2025). Sociodemographic characteristics, body composition (height, weight, body mass index, waist-to-hip ratio, waist-to-height ratio), cardiovascular health (heart rate, blood pressure, electrocardiogram) and fasted capillary blood samples (total cholesterol (TC), high-density lipid cholesterol (HDL-C), glucose) were collected. Individuals were then invited to complete an online questionnaire reviewing their experiences, with 71 (67 qualitative) responses collected. Results: Females displayed a higher waist-to-hip (p < 0.001, Rank biserial correlation (RBC) = 0.65), waist-to-height (p = 0.02, RBC = 0.24) ratio, lower systolic blood pressure (p = 0.010, Cohen’s d = 0.44) and QRISK^®3 relative risk (p < 0.001, RBC = 0.41). Fasted capillary blood samples noted significantly lower glucose (p = 0.020, RBC = 0.25) and TC/HDL-C ratio (p < 0.001, RBC = 0.48), with significantly higher HDL-C (p < 0.001, Cohen’s d = 0.93) in females compared to males. A total of three overarching themes were identified from the qualitative responses in the impact assessment, undertaken 2–10 months following screening: ‘Positive experiences of health screening’, ‘The impact of health screening’ and ‘The future of health screening’.Conclusions: This mixed-methods cross-sectional study with post-intervention survey provides an important discussion of the perceived benefits of workplace health screening. Underpinned by both the quantitative and qualitative outcomes, health screening provided a feasible and well-received approach to support the understanding of health in university staff. Full article

Background: Locomotive syndrome (LS) is a major cause of mobility impairment and loss of independence in older adults. Abdominal morphology and patterns of body fat distribution are thought to affect physical function; however, their relationships with the severity of LS in women with osteoporosis remain insufficiently characterized. Standing sacral–abdominal wall distance (SAD) is considered an indicator of compromised trunk support mechanisms, whereas the android/gynoid fat ratio (A/G ratio) primarily reflects body fat distribution patterns. Methods: This retrospective cross-sectional study included 221 women aged 65 years or older attending an osteoporosis outpatient clinic. LS was assessed using the stand-up test, the two-step test, and the Locomo 25 questionnaire according to official criteria. The most severe stage among the three tests was defined as the overall LS stage, and participants were classified into LS stage 0–1 and LS stage ≥ 2 groups. Associations of SAD and the A/G ratio with LS were examined using multivariable logistic regression analysis adjusted for age, skeletal muscle mass index (SMI), femoral neck T-score, and the Controlling Nutritional Status (CONUT) score. Results: Among the participants, 93 (42.1%) were classified as having LS stage ≥ 2. The LS stage ≥ 2 group had a significantly greater SAD than the LS stage 0–1 group (median, 167.3 mm vs. 154.6 mm; p < 0.001), whereas no significant difference was observed in the A/G ratio (p = 0.054). In multivariable analyses (n = 208), SAD was independently associated with LS stage ≥ 2 (odds ratio per 1 mm increase, 1.035; 95% confidence interval, 1.016–1.054; p < 0.001), corresponding to an odds ratio of 1.41 per 10 mm increase. The A/G ratio also showed an independent association, while no significant interaction between SAD and the A/G ratio was observed. Conclusions: In women with osteoporosis, SAD was independently associated with LS severity, reflecting mobility impairment from a perspective distinct from body fat distribution. SAD may serve as a simple and clinically useful indicator for assessing the risk of severe LS. Full article

Background/Objective: Health is a multidimensional construct shaped not only by clinical conditions but also by psychological, social, environmental and cultural factors. In low- and middle-income countries undergoing rapid epidemiological transition, understanding health requires integrated and culturally informed approaches. However, quality of life, perceived health status and lifestyle behaviors are often investigated separately, limiting the interpretation of well-being in specific local contexts. This study aimed to provide an integrated assessment of quality of life, perceived health status and lifestyle behaviours among adults attending a peri-urban public hospital in Kenya, using internationally validated instruments applied within a specific local cultural context. Methods: A cross-sectional observational study was conducted at Tigoni Level 4 Hospital, Kiambu County, Kenya. Adult outpatients (N = 40) were consecutively recruited. Quality of life was assessed using the WHOQOL-BREF, perceived health status using the EQ-5D-5L and EQ-VAS, and lifestyle behaviours using selected modules of the WHO STEPS instrument. Descriptive statistics were performed, and exploratory associations were examined using Spearman’s rank correlation coefficient. Results: Participants had a mean age of 35.9 ± 11.4 years, with a balanced gender distribution. Lifestyle risk factors were prevalent, including insufficient physical activity (40%) and overweight or obesity (>50%). WHOQOL-BREF scores revealed a heterogeneous profile, with relatively preserved social relationships and lower scores in the psychological and environmental domains. Pain/discomfort and anxiety/depression were the most frequently reported EQ-5D-5L problems. The mean EQ-VAS score was 68.2 ± 15.7. Perceived health was positively associated with physical and psychological quality of life, while higher body mass index was associated with lower physical quality of life. Mental health emerged as a cross-cutting factor across instruments. Conclusions: The findings highlight the multidimensional nature of health in a peri-urban Kenyan context and suggest the importance of considering local social and cultural influences when interpreting standardized health measures. Mental health and environmental conditions play a central role in shaping quality of life and perceived health, while lifestyle risk factors are already prevalent in a relatively young outpatient population. Integrating standardized health measures within a cross-cultural framework may support more holistic and person-centred approaches in primary care and public health in similar settings. Full article

Purpose: Anemia remains a major public health concern among vulnerable rural adolescent girls in many countries, including India. This study aimed to assess the prevalence of anemia, nutritional status, and anemia-related knowledge, attitudes, and practices (KAP) among school-going rural adolescent girls, along with predictors of KAP score, complemented by stakeholder perspectives. Methods: A mixed-methods cross-sectional study was conducted among 553 school-going adolescent girls aged 14–19, selected through a multi-stage stratified random sampling technique from three rural districts of Andhra Pradesh, India. Quantitative data were collected using a structured questionnaire assessing KAP, anthropometric measurements to collect Body Mass Index (BMI) and middle upper arm circumference (MUAC), dietary assessments using a dietary diversity score, and hemoglobin estimation using standardized procedures. Qualitative insights were obtained through focus group discussions (FGDs) with teachers, parents, frontline health workers, and community leaders and analyzed thematically. Logistic regression analysis was performed to identify predictors of KAP. Results: The prevalence of anemia among the participants was 55.3%, and 30.7% were underweight. Although over half of the girls demonstrated adequate knowledge of anemia, only 39.6% reported good anemia-preventive practices, indicating a significant gap between knowledge and practice. Dietary scores indicated micronutrient-deficient diet consumption by participants (36.2%), which might be contributing to anemia. Multivariable analysis revealed that maternal education, hemoglobin status, diet patterns, and type of school attended were significantly associated with KAP scores. Qualitative findings highlighted challenges related to health-seeking behavior, cultural misconceptions, gaps in awareness and implementation of existing adolescent health programs. Conclusions: Anemia remains highly prevalent among rural school-going adolescent girls in Andhra Pradesh, with suboptimal anemia-preventive practices despite moderate levels of knowledge. Strengthening school-based nutritional education, improving dietary diversity, and enhancing the reach and effectiveness of adolescent health programs through community engagement may help combat anemia. Full article

Background: Misperception of body weight has been found to negatively impact both diet and physical activity levels, particularly in youth with overweight and obesity. Objectives: This study assessed consistency between actual and perceived weight status and lifestyle factors in a sample of 455 children and adolescents (55% males, 8–13 years) attending a summer camp in Northern Italy. Methods: Weight status was defined applying Body Mass Index (BMI) cut-offs. Adherence to the Mediterranean Diet (MD), physical activity level, sleep duration, and sleep quality were assessed through validated questionnaires. Self-perception was evaluated through 5-point Likert scales, with graphical representations. Results: Comparison between self-perceived and assessed parameters revealed a poor concordance across all types of variables. Approximately half of participants (43–55%) correctly rated their weight status (κ = 0.12; 95% CI: 0.05–0.19), diet quality (κ = 0.09; 95% CI: 0.02–0.15), physical activity level (κ = 0.18; 95% CI: 0.11–0.26), sleep time (κ = 0.10; 95% CI: 0.03–0.17), and sleep quality (κ = 0.18; 95% CI: 0.12–0.24). Participants 12–13 years old were more likely to have a greater weight status perception compared to younger subjects (OR = 2.13; 95% CI: 1.08–4.21). Being in a condition of overweight or obesity significantly decreased the odds of correct weight perception (OR = 0.13; 95% CI: 0.08–0.21). Similarly, subjects with higher adherence to the MD, adequate sleep time, and low sleep quality were more conscious about their diet and sleep patterns. Conclusions: Overall, these findings highlight a certain degree of misclassification, especially in subjects who need to improve their lifestyles, highlighting the potential relevance of fostering accurate self-perception during developmental age. Full article