Search Results (44)

Background: Chronic diseases such as type 2 diabetes mellitus and cardiovascular disease and their cardiometabolic risk factors require management, which includes lifestyle interventions. Rural and remote residents are disproportionately affected by these conditions compared to their urban counterparts. Studies have examined barriers to chronic disease and cardiometabolic risk factor management in urban environments, but rural perspectives remain underexplored, especially in Western Australia (WA) with its vast geography. This study examined rural general practitioners’ (GPs) views on barriers and facilitators to chronic disease and cardiometabolic care in rural WA through lifestyle management. Methods: This qualitative study used semi-structured interviews with 15 rural WA GPs recruited via rural networks using convenience and snowball sampling. Braun and Clarke’s reflexive thematic analysis was used to identify patterns and themes within the qualitative data that addressed the study questions. Results: According to rural general practitioners, major barriers to chronic disease and cardiometabolic risk care included geographic isolation, socioeconomic disadvantage and an obesogenic food environment in rural areas, as well as severe time and financial constraints for GPs and workforce shortages with a high turnover and lack of accessible allied health professionals. Facilitators included co-located multidisciplinary teams, case management/health coaching, better remuneration for complex consultations involving preventive care and upstream policy measures, such as improving healthy food affordability and availability. Conclusion: Rural patients face systemic, geographic and socioeconomic barriers that are substantially greater than those in urban settings; these barriers impact GPs caring for their patients with chronic disease and cardiometabolic risk factors. Targeted solutions to these barriers such as attention to workforce issues, investment in lifestyle coaching approaches and having dedicated case managers, could reduce rural–urban inequities in chronic disease outcomes. Full article

Background/Objectives: Insufficient dietary fiber intake contributes to gut microbiota dysbiosis, systemic inflammation, and the onset of obesity-related metabolic disorders. Agro-industrial by-products have emerged as sustainable sources to restore microbial and metabolic balance. This study aimed to evaluate the effects of a mango bagasse- and peel-based confectionery (MC) on gut microbiota composition, short-chain fatty acids (SCFAs), and hepatic gene expression in Wistar rats fed either a standard diet (STD) or a high-fat diet (HFD). Methods: Twenty-four rats were randomly assigned to four groups (STD, MC-STD, HFD, MC-HFD) and treated for 11 weeks. Eating behavior, body composition, microbiota composition, SCFAs, and hepatic transcriptomics were evaluated. Results: MC supplementation did not significantly alter weight gain or SCFA levels but shifted clustering patterns in principal component analysis, indicating a distinct dietary response. Microbiota analysis revealed a trend toward lower relative abundances of obesogenic species such as Phascolarctobacterium faecium and Ruminococcus torques, while Intestimonas butyriciproducens and Anaerostipes hadrus were modulated according to diet type. Transcriptomic profiling demonstrated consistent downregulation of lipid metabolism–related genes (Cyp4a14, Hmgcs1, Cyp51, Fads1), linked to PPAR signaling pathways. Conclusions: MC supplementation may beneficially modulate the gut–liver axis and highlights the nutritional potential of fruit by-products as functional ingredients to promote metabolic health under high-fat dietary conditions. Full article

Background: Obesity is a risk factor for several non-communicable diseases and premature death. The Western-type diet, rich in calories and diverse in tastes, smells, and textures, promotes the onset and progression of obesity. We compared the effects of two Western-style palatable obesogenic diets—the cafeteria (CAF) diet, which allows for self-selection of calorie-dense food items consumed by humans, and the fast-food diet (FFD)—composed of a fixed combination of cheeseburgers and fries—on the manifestation of obesity-related complications. Methods: 3-month-old female rats consumed either the control (CTRL), FFD, or CAF diet for 12 months. Body weight was monitored weekly. At the end of the experiment, rats underwent metabolic and behavioral testing. Cardiometabolic markers and those characterizing glycoxidative and carbonyl stress, inflammatory status, and tryptophan metabolism were determined. Results: The CAF rats gain most weight (CTRL: +111 ± 40 g; FFD: +211 ± 77 g; CAF: 316 ± 87 g). CAF feeding produced a classical metabolic syndrome–like profile with severe obesity, insulin resistance, dyslipidemia, and liver steatosis, whereas the FFD model led to moderate obesity with preserved insulin sensitivity but elevated blood pressure and hepatic cholesterol accumulation. Thus, the CAF group developed a severe metabolic syndrome-like pathology assessed as continuous metabolic syndrome z-core (CTRL: −2.3 ± 1.0; FFD: −0.4 ± 1.9; CAF: 3.0 ± 2.4). Despite these differences, both diets promoted neuroinflammation and social deficits, likely mediated through gut microbiota–derived metabolites such as 5-HIAA and indoxyl sulfate. Conclusions: In female rats, self-selected CAF diet drives more severe and distinct pattern of metabolic syndrome-like pathology than a fixed FFD. Full article

Background/Objectives: There is clear evidence that maternal micronutrient deficiencies result in adverse maternal and fetal health outcomes. Therefore, corrective supplementation should be considered when dietary intake is insufficient, particularly for vitamin D (VD), omega-3 fatty acids (O3), folic acid (FA), or prenatal multiple micronutrient products (PMM). Despite its significance, intake patterns in Hungary remain largely unexplored, and evaluating adherence to recommended intake levels would be of even greater importance. This is the first Hungarian study to provide a comprehensive overview of the frequency and adherence patterns of micronutrient supplementation among pregnant women, while also analyzing their association with predictors and outcomes. Methods: This cross-sectional study involved 300 pregnant women who delivered in a university hospital. Data were collected using a self-reported questionnaire and clinical maternal and neonatal records. Results: The prevalence of FA, VD, O3, and PMM intake among the participants was 89.0%, 76.4%, 58.7%, and 67.6%, respectively. However, adherence to recommendations was notably lower: 41.1% for VD, 37.5% for O3, 36% for PMM, and 31% for FA. Higher adherence was associated with older maternal age, higher educational level, county town residence, planned pregnancy, primiparity, previous spontaneous abortion, and early initiation of antenatal care. Our findings refute concerns about the obesogenic effect of supplementation for both mothers and newborns. FA intake correlated with a lower likelihood of cesarean section, while O3 use was associated with improved uterine contractility and reduced risk of gestational diabetes mellitus. Conclusions: Our study underscores the need for individualized counselling on micronutrient supplementation, with particular emphasis on appropriate timing, dosage, and potential benefits. Full article

Obesity, a global health concern of increasing significance, is characterized by chronic low-grade inflammation (LGCI) that significantly contributes to metabolic dysfunction. This narrative review explores the intricate pathophysiological mechanisms driving LGCI in obesity, emphasizing the role of adipose tissue, immune cell activation, and inflammatory signaling pathways. Hypertrophic adipocytes and infiltrating immune cells, particularly macrophages, release a cascade of pro-inflammatory cytokines, including TNF-α, IL-6, and IL-1β, creating a self-perpetuating cycle of inflammation. These mediators disrupt insulin signaling through JNK and NF-κB pathway activation, leading to systemic insulin resistance, cardiovascular complications, gut dysbiosis and other metabolic disorders. The review further discusses therapeutic strategies to mitigate obesity-related LGCI, focusing on lifestyle interventions, nutritional approaches, and pharmacological agents. Physical activity, specific nutrients, and dietary patterns can modulate inflammatory responses, while anti-obesogenic medicines and bariatric procedures offer additional avenues for intervention. By understanding and addressing the root causes of inflammation in obesity, healthcare professionals can develop targeted strategies to improve metabolic health and overall well-being of individuals with obesity and, ultimately, prevent and manage the wide-ranging complications associated with this condition. Full article

A body of evidence indicates an association between ultraprocessed foods (UPFs) and health outcomes. Most of it has been obtained through preclinical studies, although a number of observational studies substantiate how a high intake of these products increases the risk of neuropsychiatric disorders, and an increasing amount of dietary intervention studies confirm these findings. The aim of this narrative review is to describe some of the putative mechanisms involved in the deleterious effects of a high intake of UPFs on neuropsychiatric outcomes. A myriad of unhealthy actions may be associated with the consumption of UPFs, and some mechanisms are being discussed. They include UPFs’ high caloric density; their high sugar, sodium, and additives content and low amounts of fiber; and a high palatability that induces overconsumption, acting as obesogens. Moreover, thermal treatment of these foods generates oxidative products such as glycotoxins, lipotoxins, and acrolein, all of which affect the brain. The chemical products act, directly or indirectly, on the gut microbiome and affect the gut–brain axis, causing neuroinflammation, oxidative stress, and neurodegeneration. UPFs also exert various epigenetic effects that affect mental health and might explain the intergenerational inheritance of neuropsychiatric disorders. A diet containing a high proportion of these foods has a low nutritional density, including bioactive protective agents such as antioxidant and anti-inflammatory compounds that promote eubiosis. The evidence shows that UPFs intake affects neuropsychiatric outcomes such as neurodegeneration, cognitive decline, dementia, and mood disorders and reinforces the need to promote a healthy dietary pattern throughout all life stages, thus interfering with the current commercial determinants of health. Full article

In an obesogenic environment, such as the one we have been experiencing in recent decades, epigenetics provides answers to the relationship between hereditary and environmentally acquired patterns that have significantly contributed to the global rise in obesity prevalence. MicroRNA (miRNA) constitutes a diminutive non-coding small RNA molecule, 20 to 24 nucleotides in length, that functions as a regulator of gene regulation at the post-translational level. Circulating miRNAs (c-miRNAs) have been detected in multiple body fluids, including blood, plasma, serum, saliva, milk from breastfeeding mothers, and urine. These molecules hold significant therapeutic value and serve as extracellular biomarkers in metabolic diseases. They aid in the diagnosis and tracking of therapy responses, as well as dietary and physical habit modifications. Researchers have studied c-miRNAs as potential biomarkers for diagnosing and characterizing systemic diseases in people of all ages and backgrounds since then. These conditions encompass dyslipidemia, type 2 diabetes mellitus (T2DM), cardiovascular risk, metabolic syndrome, cardiovascular diseases, and obesity. This review therefore analyzes the usefulness of c-miRNAs as therapeutic markers over the past decades. It also provides an update on c-miRNAs associated with general obesity and overweight, as well as with the most prevalent pathologies in the adult population. It also examines the effect of different nutritional approaches and physical activity regarding the activity of miRNAs in circulation in adults with overweight or general obesity. All of this is done with the aim of evaluating their potential use as biomarkers in various research contexts related to overweight and obesity in adults. Full article

Dietary exposure to the plasticiser bisphenol A (BPA), an obesogenic and endocrine disruptor from plastic and epoxy resin industries, remains prevalent despite regulatory restriction and food safety efforts. BPA can be accumulated in humans and animals, potentially exerting differential health effects based on individual metabolic capacity. This pilot study examines the impact of direct ex vivo BPA exposure on the gut microbiota of obese and normal-weight children, using 16S rRNA amplicon sequencing and anaerobic culturing combined methods. Results showed that direct xenobiotic exposure induced modifications in microbial taxa relative abundance, community structure, and diversity. Specifically, BPA reduced the abundance of bacteria belonging to the phylum Bacteroidota, while taxa from the phylum Actinomycetota were promoted. Consistently, Bacteroides species were classified as sensitive to BPA, whereas bacteria belonging to the class Clostridia were identified as resistant to BPA in our culturomics analysis. Some of the altered bacterial abundance patterns were common for both the BPA-exposed groups and the obese non-exposed group in our pilot study. These findings were also corroborated in a larger cohort of children. Future research will be essential to evaluate these microbial taxa as potential biomarkers for biomonitoring the effect of BPA and its role as an obesogenic substance in children. Full article

The environmental impact of unhealthy diets and the obese population is becoming clearer. However, little is known about the impact of ‘healthy’ diets related to ‘fitness’ lifestyles, such as diets directed to gain muscle mass and lose body fat, or the diets of the physically active population. This paper aims to evaluate the Dietary Water Footprint (DWF) of a representative sample of the Guadalajara Metropolitan Area, Mexico, identifying differences according to body composition (levels of fat and muscle) and physical activity (type and intensity), with a focus on contrasting active, healthy lifestyles (i.e., fitness) with sedentary and obesogenic patterns and examining protein consumption. A validated and adapted Food Frequency Questionnaire (FFQ) was applied to 400 adults (18–74 years) from the Guadalajara Metropolitan Area. The participants were grouped according to their body fat and muscle mass levels and physical activity type and intensity. DWF, food and nutrient intake, and adequacy were calculated. The DWF of the sample with a low body fat, a high muscle mass, moderate to intense exercise, and anaerobic exercise (i.e., ‘fitness’ lifestyle) was up to 800 L per person per day (L/p/d) higher than the sedentary/obese populations. Risks of a high DWF were found as protein intake increases (OR = 6; p < 0.0001). Although unhealthy diets linked to obesity are a major environmental problem, ‘fitness’ lifestyles can have serious environmental implications. Full article

The aim of the present study is to identify obesogenic environment profiles to find the obesogenic environment pattern for Belo Horizonte City. The current research followed the ecological approach and was substantiated by data from food shops, public sports venues, crime rates (homicides and robberies) and the rate of accidents with pedestrians. Descriptive analyses and principal component analysis (PCA) were conducted in Stata software, version 14.0. Georeferencing and map plotting were carried out in Qgis software, version 2.10. All neighborhoods in Belo Horizonte City (n = 486) were included in the study. The obesogenic pattern comprised the highest mean number of shops selling ultra-processed food, crime rates, and accidents with pedestrians. The generated latent variable was divided into tertiles, and the second and third tertiles represented the most obesogenic environments. Neighborhoods accounting for the highest obesogenic profile also recorded the largest number of shops selling all food types. Furthermore, neighborhoods in the third tertile recorded the highest mean income (BRL 2352.00) (p = 0.001) and the lowest Health Vulnerability Index (HVI = 54.2; p = 0.001). These findings point towards the need for developing actions, policies and programs to improve these environments, such as tax incentives to open healthy food retailers and public sports venues to promote healthier lifestyles and to prevent diseases in the middle and long term. Full article

Background/Objectives: The incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), a condition linked to the ongoing obesity pandemic, is rapidly increasing worldwide. In turn, its multifactorial etiology is consistently associated with low dietary quality. Changing dietary macronutrient and phytochemical quality via incorporating cooked common bean into an obesogenic diet formulation has measurable health benefits on the occurrence of both obesity and hepatic steatosis in C57BL/6 mice. Methods: A cohort of C57BL/6 mice were randomized into experimental diets containing multiple dietary concentrations of common bean. The primary endpoint of this study was comparing metabolomic analyses from liver and plasma of different treatment groups. Additionally, RNA sequencing and protein expression analysis via nanocapillary immunoelectrophoresis were used to elucidate signaling mediators involved. Results: Herein, global metabolomic profiling of liver and plasma identified sphingolipids as a lipid subcategory on which bean consumption exerted significant effects. Of note, C16 and C18 ceramides were significantly decreased in bean-fed animals. Hepatic RNAseq data revealed patterns of transcript expression of genes involved in sphingolipid metabolism that were consistent with metabolite profiles. Conclusions: Bean incorporation into an otherwise obesogenic diet induces effects on synthesis, biotransformation, and degradation of sphingolipids that inhibit the accumulation of ceramide species that exert pathological activity. These effects are consistent with a mechanistic role for altered sphingolipid metabolism in explaining how bean inhibits the development of MASLD. Full article

Background: Non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. A main cause is the obesogenic, so-called Western lifestyle. NAFLD follows a long, unperceived course, and ends potentially fatally. Early diagnosis of aggressive subtypes saves lives. So far, non-invasive means of detection are limited. A better understanding of the pathogenic interplay among insulin resistance, immune inflammation, microbiome, and genetic background is important. Metabolomics may give insight into these interlaced processes. Methods: In this study, we measured bile acids (BA) in the plasma of adult NAFLD and alcohol-associated liver disease (ALD) patients and healthy controls with targeted mass spectrometry. We focused on gender-related bile acid production pathology in NAFLD and ALD. Results: Compared to healthy controls, women with NAFLD had significantly higher concentrations of total BA, total primary BA, total cholic (CA), total chenodeoxycholic (CDCA), total glycine-conjugated, and total non-12-a-OH BA. Concerning subtypes, glycocholic (GCA) and glycochenodeoxycholic (GCDCA), BA were elevated in women with NAFLD. In contrast, men with NAFLD had no significantly altered total BA fractions. However, the subtypes GCA, glycodeoxycholic (GDCA), glycolithocholic (GLCA), lithocholic (LCA), taurolithocholic (TLCA), and tauroursodeoxycholic acid (TUDCA) were elevated, while CA was significantly decreased. In NAFLD, except ursodeoxycholic acid (UDC), all total BA correlated significantly positively in both sexes with the ELF score, while in ALD, only males showed significant correlations exceptive for total UDC BA. In NAFLD, total BA, total primary BA, total secondary BA, total free secondary BA, total CA, total CDCA, total taurine conjugated, total glycine conjugated, total 12-a-OH, and total non-12-a-OH were significantly higher in cases of a high enhanced liver fibrosis (ELF) score above 9.8. In ALD, total UDC was additionally elevated. Between NAFLD with and without NASH, we found no significant differences. Conclusion: Our data show gender-specific bile acid profiles in NAFLD and markedly different BA patterns in ALD. Women with NAFLD had more severe cholestasis. Men may better compensate fat storage-driven bile acid dynamics, indicated by higher levels of taurine-conjugated BA, which associate with beneficial metabolic functions. Full article

Obesity is a multifactorial disorder that is remarkably heterogeneous. It presents itself in a variety of phenotypes that can be metabolically unhealthy or healthy, associate with no or multiple metabolic risk factors, gain extreme body weight (super-responders), as well as resist obesity despite the obesogenic environment (non-responders). Progression to obesity is ultimately linked to the overall net energy balance and activity of different metabolic fluxes. This is particularly evident from variations in fatty acids oxidation, metabolic fluxes through the pyruvate-phosphoenolpyruvate-oxaloacetate node, and extracellular accumulation of Krebs cycle metabolites, such as citrate. Patterns of fat accumulation with a focus on visceral and ectopic adipose tissue, microbiome composition, and the immune status of the gastrointestinal tract have emerged as the most promising targets that allow personalization of obesity and warrant further investigations into the critical issue of a wider and long-term weight control. Advances in understanding the biochemistry mechanisms underlying the heterogenous obesity phenotypes are critical to the development of targeted strategies to maintain healthy weight. Full article

We investigated whether a high-fat/high-sugar (HF/HS) diet alters the lipidomic profile of the oviductal epithelium (OE) and studied the patterns of these changes over time. Female outbred Swiss mice were fed either a control (10% fat) or HF/HS (60% fat, 20% fructose) diet. Mice (n = 3 per treatment per time point) were sacrificed and oviducts were collected at 3 days and 1, 4, 8, 12 and 16 weeks on the diet. Lipids in the OE were imaged using matrix-assisted laser desorption ionisation mass spectrometry imaging. Discriminative m/z values and differentially regulated lipids were determined in the HF/HS versus control OEs at each time point. Feeding the obesogenic diet resulted in acute changes in the lipid profile in the OE already after 3 days, and thus even before the development of an obese phenotype. The changes in the lipid profile of the OE progressively increased and became more persistent after long-term HF/HS diet feeding. Functional annotation revealed a differential abundance of phospholipids, sphingomyelins and lysophospholipids in particular. These alterations appear to be not only caused by the direct accumulation of the excess circulating dietary fat but also a reduction in the de novo synthesis of several lipid classes, due to oxidative stress and endoplasmic reticulum dysfunction. The described diet-induced lipidomic changes suggest alterations in the OE functions and the oviductal microenvironment which may impact crucial reproductive events that take place in the oviduct, such as fertilization and early embryo development. Full article

Obesity prevention is stated as a simple objective in the public health guidelines of most countries: avoid adult weight gain. However, the success of the global population in accomplishing this goal is limited as reflected in the persisting pandemic of overweight and obesity. While many intervention strategies have been proposed, most are directed at mitigating the consequences of obesity. Efforts intended to prevent unintentional weight gain and associated adiposity are termed anti-obesogenic. Herein, evidence is presented that a neglected category of foods, pulses, i.e., grain legumes, have anti-obesogenic activity. Using a preclinical mouse model of obesity, a dose–response study design in animals of both biological sexes, and cooked, freeze-dried, and milled common bean as a representative pulse, data are presented showing that the rate of body weight gain is slowed, and fat accumulation is suppressed when 70% of the dietary protein is provided from common bean. These anti-obesogenic effects are reduced at lower amounts of common bean (17.5% or 35%). The anti-obesogenic responsiveness is greater in female than in male mice. RNA sequence analysis indicates that the sex-related differences extend to gene expression patterns, particularly those related to immune regulation within adipose tissue. In addition, our findings indicate the potential value of a precision nutrition approach for human intervention studies that identify “pulse anti-obesogenic responders”. A precision approach may reduce the concentration of pulses required in the diet for benefits, but candidate biomarkers of responsivity to pulse consumption remain to be determined. Full article