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26 pages, 647 KB  
Review
Extracellular Vesicles in Obesity: From Pathophysiological Mediators to Therapeutic Tools
by Nikola Pavlović, Petar Todorović, Mirko Maglica, Andrea Kopilaš, Roko Šantić, Marko Kumrić, Marino Lukenda and Joško Božić
Int. J. Mol. Sci. 2026, 27(7), 3137; https://doi.org/10.3390/ijms27073137 - 30 Mar 2026
Abstract
Obesity is increasingly recognized as a disease of dysregulated intercellular communication rather than merely an energy imbalance. Extracellular vesicles (EVs), membrane-bound nanoparticles (30–1000 nm) released by nearly all cell types, act as central mediators of this pathological crosstalk. In obesity, hypertrophic adipocytes, pro-inflammatory [...] Read more.
Obesity is increasingly recognized as a disease of dysregulated intercellular communication rather than merely an energy imbalance. Extracellular vesicles (EVs), membrane-bound nanoparticles (30–1000 nm) released by nearly all cell types, act as central mediators of this pathological crosstalk. In obesity, hypertrophic adipocytes, pro-inflammatory macrophages, and dysfunctional endothelial cells secrete EVs carrying altered cargo, including pro-inflammatory miRNAs (e.g., miR-34a, miR-155), bioactive lipids, and stress proteins, which propagate systemic metabolic dysfunction. Adipose tissue-derived EVs impair hepatic fatty acid oxidation, promote steatohepatitis, suppress pancreatic beta-cell insulin secretion, induce skeletal muscle insulin resistance via PPARγ repression, and contribute to endothelial dysfunction and atherosclerosis. EV-mediated adipocyte–macrophage crosstalk reinforces chronic adipose inflammation. Circulating EVs also provide biomarkers: subpopulation ratios, miRNA signatures, and tissue factor-positive EVs reflect disease severity, predict cardiovascular risk, and monitor therapeutic responses, with machine learning enhancing diagnostic precision. Therapeutically, EVs from mesenchymal stem cells, Wharton’s jelly MSCs, adipose progenitors, and M2 macrophages reverse insulin resistance, hepatic steatosis, and adipose inflammation in preclinical models. Engineering strategies improve EV potency and tissue targeting, and Phase I trials confirm safety, though manufacturing and cost remain barriers. Preclinical and early clinical studies of MSC-EVs confirm a favorable safety profile, though manufacturing scalability and cost remain barriers to widespread clinical adoption. Overall, EVs represent both diagnostic tools and therapeutic vehicles in precision obesity medicine, offering a pathway from symptom management toward true disease remission. Full article
23 pages, 7092 KB  
Article
Weizmannia coagulans BC99 Ameliorates Obesity and Associated Inflammation by Remodeling the Gut Microbiota and Regulating Lysophosphatidylcholine and Conjugated Bile Acid Metabolism
by Yujia Pan, Jinghui Wu, Shanshan Tie, Xuan Li, Li Cao, Yao Dong, Jianguo Zhu, Shuguang Fang, Ying Wu and Shaobin Gu
Metabolites 2026, 16(4), 228; https://doi.org/10.3390/metabo16040228 - 30 Mar 2026
Abstract
Background: Obesity is closely related to dysbiosis. Probiotics may improve metabolism and alleviate inflammation by regulating microbial–host interaction. Methods: Obesity was induced in rats by feeding a high-fat diet, followed by gavage administration of varying doses of BC99 as an intervention. [...] Read more.
Background: Obesity is closely related to dysbiosis. Probiotics may improve metabolism and alleviate inflammation by regulating microbial–host interaction. Methods: Obesity was induced in rats by feeding a high-fat diet, followed by gavage administration of varying doses of BC99 as an intervention. Results: BC99 significantly reduced body weight gain, improved lipid profiles, alleviated systemic inflammation, and enhanced gut barrier integrity. 16S rRNA sequencing revealed that BC99 increased the abundance of beneficial bacteria, including Bacillota, Akkermansia, and Roseburia. Untargeted metabolomics showed that BC99 upregulated anti-inflammatory lysophosphatidylcholines (LysoPCs) and modulated conjugated bile acids (GUDCA, GDCA), which were correlated with enriched bile salt hydrolase (BSH)-active bacteria (e.g., Lachnoclostridium). Conclusions: The results indicate that W. coagulans BC99 effectively reduces weight gain in rats made obese by a high-fat diet and improves metabolic disorders. These effects are associated with remodeling of the gut microbiota and modulation of key metabolites, supporting a potential ‘microbiota–metabolite–host’ axis in rats that warrants further causal validation. Full article
(This article belongs to the Special Issue Microbial Regulation of Host Metabolism)
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16 pages, 872 KB  
Article
Nutritional Knowledge, Dietary Habits, and Nutritional Status of Patients with Chronic Kidney Disease According to Disease Stage
by Filip Siódmiak and Sylwia Małgorzewicz
Nutrients 2026, 18(7), 1109; https://doi.org/10.3390/nu18071109 - 30 Mar 2026
Abstract
Background/Objectives: Appropriate nutritional management constitutes one of the key elements of conservative treatment and renal replacement therapy in patients with chronic kidney disease (CKD). The level of patients’ nutritional knowledge may significantly influence adherence to dietary recommendations, the rate of disease progression, [...] Read more.
Background/Objectives: Appropriate nutritional management constitutes one of the key elements of conservative treatment and renal replacement therapy in patients with chronic kidney disease (CKD). The level of patients’ nutritional knowledge may significantly influence adherence to dietary recommendations, the rate of disease progression, and the frequency of complications. The aim of this study was to assess the level of nutritional knowledge, dietary habits, adherence to dietary recommendations, and nutritional status of patients with CKD according to disease stage. Methods: This cross-sectional study was conducted among 98 adult patients diagnosed with CKD. A questionnaire assessing nutritional knowledge and dietary behaviors was administered. An overall nutritional knowledge score was calculated based on eight questionnaire items assessing nutritional knowledge. Nutritional status was evaluated using the Subjective Global Assessment (SGA) and the Simplified Nutritional Appetite Questionnaire (SNAQ). Anthropometric, clinical, and biochemical data were collected. Statistical analysis was performed using tests appropriate to the data distribution. Results: The level of nutritional knowledge varied and was dependent on CKD stage. Patients in more advanced stages of the disease demonstrated significantly higher awareness of dietary recommendations compared with those in earlier stages. The median nutritional knowledge score was 6 points, with 46.9% of participants demonstrating insufficient knowledge (<6 points) and 53.1% achieving adequate knowledge (≥6 points). The greatest knowledge deficits concerned the control of phosphorus, potassium, sodium, and fluid intake. Discrepancies were also observed between declared knowledge and actual dietary behaviors. Good nutritional status (SGA A) was identified in 73 patients, risk of malnutrition or moderate malnutrition (SGA B) in 22 individuals, and severe malnutrition (SGA C) in 3 patients. SNAQ indicated good appetite in the study population, with an average consumption of three meals per day, and identified a risk of weight loss in 6% of patients. Overweight and obesity were present in more than half of the study population, while underweight was observed in 4%. Conclusions: Nutritional knowledge among patients with CKD remains insufficient, particularly in the early stages of the disease. The findings highlight the necessity of early and systematic implementation of individualized nutritional education as an integral component of slowing disease progression. Full article
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15 pages, 382 KB  
Article
Changes in Segmental Body Composition in Children Practicing Martial Arts, Swimming and Team Sports
by Anna Sojka, Bartosz Sojka and Agnieszka Chwałczyńska
Children 2026, 13(4), 482; https://doi.org/10.3390/children13040482 - 30 Mar 2026
Abstract
Background: In the year 2022 more than 390 million kids and teenagers aged between 5 and 19 years old were overweight, including 160 million individuals who were suffering from obesity. It is commonly known that, in order to have a possitive change in [...] Read more.
Background: In the year 2022 more than 390 million kids and teenagers aged between 5 and 19 years old were overweight, including 160 million individuals who were suffering from obesity. It is commonly known that, in order to have a possitive change in physical and mental health, physical activity is needed. The aim of this study was to determine whether the type of physical activity undertaken influenced changes in body mass and physical fitness scores in children aged 7–10 years who practice taekwondo, swimming, and team sports, using tag rugby as an example. Material and Methods: A total of 200 children were eligible to participate in the research project and the analysis was conducted on 150 subjects (49% girls and 51% boys). Group IA (n = 20) trained in taekwondo, group IB (n = 42) trained in swimming, and group IC (n = 20) trained in rugby tag. Group II control subjects (n = 68) did not participate in any additional sports activities. Children’s body height was determined with a SECA 213 heightometer and body mass and body composition using Tanita’s MC-780 eight-electrode body composition analyser. Selected Eurofit tests were used to assess physical fitness. Results: A peripheral distribution of fat mass was found in all subjects, with the highest levels determined in the upper limbs. The highest values, apart from arm muscle strength, were found in the swimming group. Significant changes were observed in the subjects training in taekwondo. Conclusions: Results suggest that physical activity targeting the development of different motor skills should be part of preventive health care for children. Full article
(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)
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40 pages, 3162 KB  
Review
Ubiquitin-Specific Protease 2 (USP2) as a Modulator of Energy Metabolism: A Review of Studies Using Animal and Cellular Models
by Hiroshi Kitamura, Jun Okabe, Himeka Hayashi and Tomohito Iwasaki
Biomedicines 2026, 14(4), 783; https://doi.org/10.3390/biomedicines14040783 - 30 Mar 2026
Abstract
Ubiquitin-specific protease 2 (USP2) is a deubiquitinase that controls various cellular events, including cell cycle progression and tumorigenesis. Along with cell culture models, mouse models induced using chemical blockers and gene engineering have substantially contributed to our knowledge of the crucial roles of [...] Read more.
Ubiquitin-specific protease 2 (USP2) is a deubiquitinase that controls various cellular events, including cell cycle progression and tumorigenesis. Along with cell culture models, mouse models induced using chemical blockers and gene engineering have substantially contributed to our knowledge of the crucial roles of USP2 in energy metabolism and metabolic disorders. This review summarizes the evidence of the role of USP2 in regulating energy metabolism in mice and cells under physiological and pathological conditions. In hepatocytes, a short isoform of USP2, USP2b, aggravates type 2 diabetes and metabolic dysfunction-associated steatotic liver disease. Meanwhile, a long isoform of USP2 in adipose tissue macrophages, USP2a, attenuates the onset of diabetes. USP2a mitigates insulin resistance and subsequent muscle atrophy. In ventromedial hypothalamic neurons, USP2b inhibits an increase in blood glucose by repressing hepatic glycogenolysis. In addition to regulating diabetes, USP2 isoforms potentially regulate the progression of atherosclerosis by modulating macrophages and hepatocytes. In brown adipose tissue, USP2a regulates thermogenesis, thus influencing systemic energy control. Meanwhile, in testicular macrophages, USP2 protects the mitochondrial respiration of sperm and consequently contributes to maintaining the quality of frozen sperm for use in the treatment of male infertility. As USP2 is distributed to multiple cellular components, it mediates the polyubiquitination of various molecules. For instance, USP2 modulates the stability of various transcription regulators, including C/EBP-α, PPARγ, EBF2, and PGC1α. The accumulating evidence indicates that USP2 functions as a modulatory molecule for energy metabolism across organs. Full article
(This article belongs to the Special Issue Animal Models for the Study of Human Diseases)
17 pages, 736 KB  
Article
The Mediating Role of Adiposity in the Association Between Respiratory Muscle Strength and Exercise Energy Expenditure in Adult Women: A Cross-Sectional Study
by Monira I. Aldhahi, Daad Alhumaid, Dalia Binshaye, Fatimah Almohsen, Rand Alotaibi and Leen Bahathiq
J. Clin. Med. 2026, 15(7), 2629; https://doi.org/10.3390/jcm15072629 (registering DOI) - 30 Mar 2026
Abstract
Background and Objectives: Obesity affects over 1.9 billion adults globally, with a disproportionately higher prevalence in Saudi Arabia among women. While excessive adiposity is known to impair respiratory mechanics and lung function, its relationship with respiratory muscle strength and exercise energy expenditure remains [...] Read more.
Background and Objectives: Obesity affects over 1.9 billion adults globally, with a disproportionately higher prevalence in Saudi Arabia among women. While excessive adiposity is known to impair respiratory mechanics and lung function, its relationship with respiratory muscle strength and exercise energy expenditure remains inadequately elucidated. This study examined differences in respiratory muscle strength, metabolic equivalents (METs) of physical activity, and energy expenditure during exercise between adults with normal and high body fat percentage (BF%) and explored the statistical role of body fat as a potential mediator in the cross-sectional association between respiratory muscle strength and energy expenditure. Methods: In this cross-sectional study, 126 Saudi women aged 18–45 years (mean age: 21.7 ± 4.2 years) were stratified into normal (n = 63) and high (n = 63) BF% groups. Body composition was assessed via bioelectrical impedance analysis, and respiratory muscle strength (MIP and MEP) was measured using a MicroRPM device. Peak oxygen consumption (VO2peak) and energy expenditure were obtained through the Bruce Submaximal Treadmill Protocol, and physical activity was self-reported via the IPAQ. Hierarchical regression and structural equation modeling were used to examine variable associations and explore statistical mediation patterns. Results: Participants with high body fat demonstrated significantly low MIP (−26%) and MEP (−31%), low VO2peak (−13%), and approximately 26% high energy expenditure during exercise compared to the normal-BF group (all p < 0.001), despite comparable self-reported physical activity levels. Body fat percentage was the most strongly associated with energy expenditure (β = 0.078, R2 = 0.329), with maximal inspiratory pressure contributing an additional 7.3% of explained variance in hierarchical regression (total R2 = 0.414). Mediation analyses revealed that body fat percentage was statistically consistent with a partial mediation model in the relationship between MIP and energy expenditure (indirect association = −0.016, p = 0.033), accounting for 27% of the total association, and between MEP and energy expenditure (indirect association = −0.013, p = 0.035), accounting for 38% of the total association. Conclusions: High BF% is independently associated with low respiratory muscle strength and high exercise metabolic cost. Body fat is statistically associated with (and consistent with a mediating role in) an inverse relationship between respiratory muscle strength and energy expenditure. Alternative directional relationships and shared underlying factors may explain these observations. Full article
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26 pages, 795 KB  
Review
Obesity and Heart Failure: Introducing the Theme
by Francesco Monitillo, Paolo Basile and Giuseppe Lisco
J. Cardiovasc. Dev. Dis. 2026, 13(4), 153; https://doi.org/10.3390/jcdd13040153 (registering DOI) - 30 Mar 2026
Abstract
Obesity is a chronic, highly prevalent disease affecting nearly one-third of the global population and represents a major independent risk factor for heart failure (HF), particularly heart failure with preserved ejection fraction (HFpEF). Excess adiposity—especially visceral and epicardial adipose tissue (EAT)—acts as an [...] Read more.
Obesity is a chronic, highly prevalent disease affecting nearly one-third of the global population and represents a major independent risk factor for heart failure (HF), particularly heart failure with preserved ejection fraction (HFpEF). Excess adiposity—especially visceral and epicardial adipose tissue (EAT)—acts as an active endocrine and immune organ, promoting chronic low-grade inflammation, oxidative stress, endothelial dysfunction, and adverse myocardial remodeling. Expanded EAT exerts both paracrine inflammatory effects and mechanical constraint on the myocardium, contributing to diastolic dysfunction, microvascular impairment, atrial arrhythmogenesis, and elevated filling pressures despite preserved systolic function. Evidence demonstrates a dose–response relationship between increasing body mass index and incident HF. Clinically, obesity-related HFpEF is characterized by concentric left ventricular hypertrophy, impaired relaxation, increased plasma volume, reduced exercise tolerance, and relatively low natriuretic peptide levels, complicating diagnosis. HF management includes traditional treatment with diuretics, renin-angiotensin system inhibitors, β-blockers, mineralocorticoid receptor antagonists, and angiotensin receptor-neprilysin inhibitors. These agents widely remain foundational as they primarily target hemodynamic and neurohormonal pathways in HF. In contrast, sodium–glucose cotransporter 2 inhibitors consistently reduce HF hospitalizations across the ejection fraction spectrum, while glucagon-like peptide-1 receptor agonists and dual incretin therapies (e.g., tirzepatide) promote substantial weight loss, improve symptoms, and demonstrate promising anti-remodeling effects in obesity-related HFpEF. Recognizing obesity-driven HF as a distinct cardiometabolic entity supports an integrated therapeutic strategy combining structured weight reduction with guideline-directed HF polypharmacotherapy to address both hemodynamic burden and upstream adiposity-related mechanisms. Full article
(This article belongs to the Special Issue Obesity and Heart Failure)
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24 pages, 670 KB  
Review
FAM3 Cytokine-like Proteins, Their Putative Receptors and Signaling Pathways in Metabolic Diseases and Cancers
by José E. Belizário, Izabela D. S. Caldeira, Bruna Moreira, João Marcelo Occhiucci, Brant Burkhardt and Humberto M. Garay-Malpartida
Receptors 2026, 5(2), 11; https://doi.org/10.3390/receptors5020011 - 30 Mar 2026
Abstract
FAM3A, FAM3B, FAM3C and FAM3D are members of the “family with sequence similarity 3” (FAM3) gene family, an emerging class of cytokine-like proteins with a unique structural globular β-β-α fold and distinct biological functions. With widespread expression in tissue, organs and in many [...] Read more.
FAM3A, FAM3B, FAM3C and FAM3D are members of the “family with sequence similarity 3” (FAM3) gene family, an emerging class of cytokine-like proteins with a unique structural globular β-β-α fold and distinct biological functions. With widespread expression in tissue, organs and in many cell types, their specific roles in human diseases have been the focus of much research. FAM3A acts as a positive regulator of metabolic health, typically activating canonical pro-survival and metabolic pathways. FAM3B, also called PANDER (PANcreatic DERived Factor), exerts critical physiological functions in the regulation of glycemic levels via promotion of hepatic glucose production and pancreatic β-cell insulin secretion. FAM3C, also named ILEI (Interleukin-like EMT inducer), is involved as an inducer of epithelial–mesenchymal transition (EMT) and cancer metastasis, as well as osteoblast differentiation and bone mineralization. FAM3D is a gut-secreted protein and potential regulator of gastrointestinal homeostasis and microbiota-induced inflammation. Here we provide an overview of previous studies supporting that FAM3 proteins act through putative membrane receptors and co-partners, including fibroblast growth factor receptor (FGFR), leukemia inhibitory factor receptor (LIFR), formyl peptide receptor (FPR1/2), to activate diverse downstream signaling pathways on different cellular contexts. Basic and clinical studies suggest that the FAM3 family influences both obesity, diabetes, and other metabolic disorders; thus, its expression may have diagnostic potential. The differential and often cancer-specific expression patterns make members of the FAM3 family promising candidates for biomarkers and therapeutic targets of some types of neoplasia. Full article
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30 pages, 11072 KB  
Article
Pepper Leaf Extracts Alleviate HFD-Induced Metabolic Disorders via Microbiota-Driven Intestinal Barrier Repair and Bile Acid Reprogramming
by Ning Xu, Suxia Shen, Zhaotian Yang, Lin Zeng, Haifeng Zhang, Xiaojun Liao and Yan Zhang
Nutrients 2026, 18(7), 1105; https://doi.org/10.3390/nu18071105 - 30 Mar 2026
Abstract
Background: Obesity and its related metabolic complications, including non-alcoholic fatty liver disease (NAFLD) and insulin resistance, constitute an escalating global public health challenge, with high-fat diet (HFD) exposure recognized as a primary etiological driver. This study aimed to systematically evaluate the therapeutic [...] Read more.
Background: Obesity and its related metabolic complications, including non-alcoholic fatty liver disease (NAFLD) and insulin resistance, constitute an escalating global public health challenge, with high-fat diet (HFD) exposure recognized as a primary etiological driver. This study aimed to systematically evaluate the therapeutic effects of pepper leaf extracts (PLE), spinach extracts (SE), and obeticholic acid (OCA) on HFD-induced metabolic dysfunction in mice. Methods: Integrated phenotypic, histopathological, gut microbial, bile acid, and metabolomic analyses were applied to evaluate the intervention effects. Results: Our results demonstrated that 16-week dietary intervention with PLE, SE, or OCA all effectively mitigated HFD-induced obesity, pathological adipose remodeling, hepatic steatosis, systemic insulin resistance, and intestinal barrier dysfunction. Mechanistically, PLE effectively restored intestinal barrier integrity and reshaped the dysbiotic gut microbiota, with a marked enrichment of beneficial bacterial taxa closely linked to intestinal barrier maintenance, and normalized the disrupted cecal bile acid profile in HFD-fed mice. Furthermore, untargeted metabolomic analysis revealed that PLE reprogrammed disordered systemic metabolism, with significant modulation of key pathways involved in bile acid homeostasis, amino acid metabolism, and energy metabolism. Conclusions: In summary, this study provides evidence that PLE effectively attenuates HFD-induced metabolic disorders through modulation of the gut microbiota–bile acid–metabolome axis and restoration of intestinal barrier integrity. The superior therapeutic efficacy of PLE compared with SE and OCA, coupled with its favorable safety profile, positions PLE as a promising novel natural candidate for the prevention and treatment of obesity and its associated metabolic complications. Full article
(This article belongs to the Section Phytochemicals and Human Health)
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19 pages, 742 KB  
Review
Management of Obese Patients with Cardiovascular Disease with Emerging Weight-Lowering Drugs: A Narrative Review
by Alessandro Ciarloni, Gianmaria Salvio, Monia Bordoni, Gilberta Giacchetti and Giancarlo Balercia
Biomedicines 2026, 14(4), 778; https://doi.org/10.3390/biomedicines14040778 - 30 Mar 2026
Abstract
Background/Objectives: Obesity has a huge impact on global healthcare and economy. Consequently, the pharmaceutical industry has recently introduced novel anti-obesity drugs such as semaglutide and tirzepatide, which can yield remarkable weight reduction in patients, while also having significant cardiovascular benefits. Methods: [...] Read more.
Background/Objectives: Obesity has a huge impact on global healthcare and economy. Consequently, the pharmaceutical industry has recently introduced novel anti-obesity drugs such as semaglutide and tirzepatide, which can yield remarkable weight reduction in patients, while also having significant cardiovascular benefits. Methods: Other weight-lowering medications are currently under investigation, and this narrative review provides an overview of the main novel drugs that are being tested. Results: These novel agents have different mechanisms of action, e.g., calorie intake reduction, increase in basal metabolism, and increase in muscle mass. Conclusions: In the future, obesity treatment is likely to become increasingly personalized, and further cardiovascular benefits could be expected. The combined use of different molecules could minimize their side effects, for instance, by minimizing muscle wasting observed during glucagon-like peptide 1 receptor agonists (GLP1-RAs) therapy. In our opinion, these highly effective drugs could represent a valuable addition to healthy lifestyle, as the evidence linking increases in muscle mass and basal metabolic rate to improved cardiovascular health is strongest when these changes are achieved through diet and regular physical activity. Full article
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15 pages, 247 KB  
Article
Acceptability and Satisfaction of Eat My ABCs: A Mindful Eating Program for Preschoolers in Low-Income Families
by Hannah Lalonde, Esra’a Sawalmeh, Reese Buhlman, Sophia Tadavich, Yingcen Xie and Jiying Ling
Nutrients 2026, 18(7), 1103; https://doi.org/10.3390/nu18071103 - 30 Mar 2026
Abstract
Background: Mindful eating strategies have shown promise in addressing obesity and food insecurity among children. However, limited research has examined the acceptability of mindful eating programs among low-socioeconomic families in rural areas. This study evaluated caregivers’ and teachers’ acceptability and satisfaction with a [...] Read more.
Background: Mindful eating strategies have shown promise in addressing obesity and food insecurity among children. However, limited research has examined the acceptability of mindful eating programs among low-socioeconomic families in rural areas. This study evaluated caregivers’ and teachers’ acceptability and satisfaction with a 14-week, school-based mindful eating program for preschoolers to inform future implementation. The program effectively improved home eating environment, household food insecurity, and child body mass index. Methods: A convergent parallel mixed methods study design was used to evaluate the 14-week mindful eating intervention among 200 preschoolers from 26 Head Start classrooms in rural Michigan, United States. After intervention completion, acceptability and satisfaction data were collected and assessed from 192 caregivers and 23 classroom teachers via (1) quantitative online survey data analyzed using descriptive statistics, and (2) qualitative data from individual interviews completed with a subset of parents and teachers that were analyzed with thematic analysis. Results: Both quantitative and qualitative data showed high acceptability and satisfaction. Caregivers (survey: 88.9%, interview: 94.1%) and teachers (survey: 87.0%, interview: 100%) were satisfied with the program. Teachers (survey: 82.6%, interview: 87.5%) agreed the program improved children’s eating behaviors. Most surveyed caregivers (81.0%) agreed the completion of child letters sent home after the program session helped caregiver–child communication. Several barriers and suggestions for implementation were also identified by interviewed teachers and caregivers, including the limited availability of specific fruits and vegetables in local areas, concerns about preschoolers’ comprehension of curriculum, and recommendations on improving recruitment strategies. Conclusions: This study highlighted the high acceptability and satisfaction of a mindful eating program among caregivers and classroom teachers. The findings offered implications for future interventions to integrate mindful eating programs into early childcare organizations to help address child obesity and food insecurity. Future research exploring nutrition-related policies to sustain implementation of mindful eating programs is needed. Clinical Trial Registration: The clinical trial was registered at ClinicalTrials.gov (NCT05780008) on 27 February 2023. Full article
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18 pages, 593 KB  
Review
Evaluated Childhood Obesity Prevention and Management Programs in Europe, 2015–2024: A Structured Narrative Review of Behavioral and Anthropometric Outcomes
by Małgorzata Wójcik, Agnieszka Kozioł-Kozakowska, Anna Iwańska, Ewelina Cichocka-Mroczek, Edyta Łuszczki, Justyna Wyszyńska, Ewa Baran, Laura González-Ramos, Isa Hartgring, Lola Martínez, Justė Parnarauskienė, Fernando Fernandez-Aranda, Augustina Jankauskienė, Dorota Drożdż, Artur Mazur and Julio Alvarez-Pitti
Nutrients 2026, 18(7), 1100; https://doi.org/10.3390/nu18071100 - 30 Mar 2026
Abstract
Background: This structured narrative review summarizes and critically appraises evaluated childhood obesity prevention programs implemented in European countries and published between 2015 and 2024. Methods: Systematic searches for PubMed, EBSCOhost, and Google Scholar, complemented by research registries, were conducted year-by-year and independently screened [...] Read more.
Background: This structured narrative review summarizes and critically appraises evaluated childhood obesity prevention programs implemented in European countries and published between 2015 and 2024. Methods: Systematic searches for PubMed, EBSCOhost, and Google Scholar, complemented by research registries, were conducted year-by-year and independently screened by two reviewers. Results: Five multinational/international programs were identified alongside multiple national initiatives delivered in family, school, community, healthcare, and digital settings. Overall, interventions consistently improved intermediate outcomes—such as selected dietary behaviors, physical activity participation, knowledge, and parental self-efficacy—more than anthropometric endpoints. Effects on BMI/BMI z-score or overweight/obesity prevalence were heterogeneous and frequently small or non-significant, especially for short-duration, single-setting educational interventions. More favorable anthropometric outcomes were commonly reported in long-term, population-scaled physical activity or community-based programs as well as in multidisciplinary healthcare-supported approaches; however, these strategies were typically resource-intensive and sometimes showed differential effectiveness across socioeconomic or cultural groups. Conclusions: The evidence indicates that single-setting or short-term interventions may improve selected behavioral outcomes but are generally insufficient to produce sustained effects on anthropometric measures without integration into broader, multi-level strategies. It is needed to integrate families, schools, communities, and health services with explicit attention to sustainability and equity. Technology-supported tools may strengthen reach and continuity when embedded within comprehensive prevention frameworks. Full article
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17 pages, 1032 KB  
Article
Current Body Mass Index Is Associated with Reported Weight Gain as a Reason for Discontinuing Oral Contraceptive Pill Use
by Adnin Zaman, Myla Strawderman, Susan W. Groth, Barbara Lohse, Wendy Vitek, Roland J. Thorpe and Elizabeth Heitman
Obesities 2026, 6(2), 20; https://doi.org/10.3390/obesities6020020 - 29 Mar 2026
Abstract
Concerns about weight gain are commonly cited with combined oral contraceptive pill (COCP) use, yet it remains unclear whether perceived weight gain as a reason for discontinuation differs by body mass index (BMI). We analyzed data from the 2017–2019 National Survey of Family [...] Read more.
Concerns about weight gain are commonly cited with combined oral contraceptive pill (COCP) use, yet it remains unclear whether perceived weight gain as a reason for discontinuation differs by body mass index (BMI). We analyzed data from the 2017–2019 National Survey of Family Growth (NSFG), including 3709 non-pregnant women aged 20–49 years who had ever used COCPs and had BMI calculated from self-reported height and weight. Trained NSFG staff interviewed participants on reasons for discontinuation and coded them into predefined categories, including weight gain. Discontinuation was examined by BMI category (underweight, normal weight, overweight, obesity) using survey-weighted logistic regression adjusted for demographic and socioeconomic covariates. Overall, 35.2% (95% CI 32.3–38.1%) of women reported discontinuing COCPs due to dissatisfaction, with 20.2% (95% CI 18.1–22.3%) citing side effects. Weight gain was reported by 7.0% (95% CI 5.6–8.4%) of ever-users, with higher prevalence among women with overweight (8.4%) and obesity (7.7%) compared with normal-weight women (5.5%). In adjusted analyses, women with overweight (aOR 1.76, p = 0.048) and obesity (aOR 1.68, p = 0.033) had higher odds of COCP discontinuation due to self-reported weight gain. These findings highlight the importance of addressing weight-related concerns during contraceptive counseling, particularly for women with higher BMI. Full article
11 pages, 373 KB  
Review
Endothelial Cells as Active Lipid Gatekeepers: Vascular Control of Lipid Handling and Metabolic Homeostasis
by Takeshi Kanda and Hidonori Urai
Nutrients 2026, 18(7), 1095; https://doi.org/10.3390/nu18071095 - 29 Mar 2026
Abstract
Endothelial cells have emerged as critical peripheral nutrient sensors that actively regulate systemic lipid metabolism rather than serving as passive conduits. Endothelial peroxisome proliferator-activated receptor γ maintains redox balance, supports nitric oxide-dependent perfusion, and preserves insulin sensitivity during high-fat feeding, while ghrelin signaling [...] Read more.
Endothelial cells have emerged as critical peripheral nutrient sensors that actively regulate systemic lipid metabolism rather than serving as passive conduits. Endothelial peroxisome proliferator-activated receptor γ maintains redox balance, supports nitric oxide-dependent perfusion, and preserves insulin sensitivity during high-fat feeding, while ghrelin signaling through endothelial GHS-R promotes triglyceride clearance and lipid uptake into white adipose tissue through an endothelial peroxisome proliferator-activated receptor γ-dependent program. These pathways reveal that the endothelium integrates hormonal and metabolic cues to tune lipid trafficking, vectorial fatty acid delivery, and depot-specific energy storage. The concept that the endothelial phenotype, rather than circulating lipid levels alone, determines organ-level lipid exposure reframes endothelial lipid sensing as a key regulator of whole-body metabolic homeostasis. Understanding how endocrine and transcriptional pathways shape endothelial lipid handling may reveal new therapeutic targets for the treatment of obesity, dyslipidemia, and related metabolic diseases. Full article
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24 pages, 1740 KB  
Review
A Narrative Review on Pseudocereals and Cardiometabolic Health: Biological Mechanisms and Evidence from Human Studies
by Yesim Oztekin and Zehra Buyuktuncer
Nutrients 2026, 18(7), 1093; https://doi.org/10.3390/nu18071093 - 29 Mar 2026
Abstract
Background/Objectives: Demand for functional foods is growing due to the desire to prevent cardiometabolic disorders. Pseudocereals, particularly quinoa, buckwheat, and amaranth, stand out for their functional properties related to cardiometabolic health. The dietary fiber, plant proteins, vitamins, minerals, and phytochemicals in pseudocereals [...] Read more.
Background/Objectives: Demand for functional foods is growing due to the desire to prevent cardiometabolic disorders. Pseudocereals, particularly quinoa, buckwheat, and amaranth, stand out for their functional properties related to cardiometabolic health. The dietary fiber, plant proteins, vitamins, minerals, and phytochemicals in pseudocereals primarily help to regulate glycemic response and lipid profile, as well as blood pressure. The aim of this review is to briefly explain the role of pseudocereals in biological mechanisms underlying cardiometabolic effects and evaluate the findings of human studies. Methods: The biological mechanisms that emphasize potential cardiometabolic effects of pseudocereals were summarized based on preclinical studies. Human studies were searched on Web of Science, PubMed, and ScienceDirect between June and December 2025. Findings of human studies on potential cardiometabolic health benefits of pseudocereals, including their anti-hyperlipidemic, anti-hyperglycemic, anti-obesity, and anti-hypertensive effects, are discussed. Results: The revealed mechanisms in preclinical studies and current outcomes of thirty-three human studies included in this review indicated that pseudocereals, especially quinoa and buckwheat, might be a part of healthy nutrition to assist the prevention and management of cardiometabolic disorders. In human studies, the most notable improvements were reported in plasma triglyceride and total cholesterol levels. Nevertheless, the number of human studies is limited, and existing studies have methodological variations to state cumulative and evidence-based consumption recommendations. Conclusions: Despite the potential protective effects of pseudocereals on cardiometabolic health, well-designed, controlled human studies are needed to elucidate the outcomes and provide clear evidence of the role of pseudocereals in relation to cardiometabolic effects. Full article
(This article belongs to the Special Issue Featured Papers on Dietary Carbohydrates and Human Health)
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