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19 pages, 4361 KB  
Systematic Review
Do Ketogenic Diets Produce Greater Weight Loss than Higher-Carbohydrate Diets Under Comparable Prescribed Energy Conditions? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Tomasz Żurawski and Anna Bartosiewicz
Nutrients 2026, 18(15), 2525; https://doi.org/10.3390/nu18152525 - 4 Aug 2026
Viewed by 1259
Abstract
Background/Objectives: Whether ketogenic diets provide greater weight-loss benefits than higher-carbohydrate diets when prescribed energy intake or targeted energy deficit are comparable remains uncertain. This systematic review and meta-analysis evaluated their effects on body weight change in adults with overweight or obesity. Methods [...] Read more.
Background/Objectives: Whether ketogenic diets provide greater weight-loss benefits than higher-carbohydrate diets when prescribed energy intake or targeted energy deficit are comparable remains uncertain. This systematic review and meta-analysis evaluated their effects on body weight change in adults with overweight or obesity. Methods: Following PRISMA 2020, PubMed, Scopus, and Web of Science were searched for randomized controlled trials comparing ketogenic diets with higher-carbohydrate diets under matched energy prescriptions. Ketogenic diets were defined as providing ≤50 g carbohydrate/day or ≤10% of total energy from carbohydrate. A random-effects meta-analysis used restricted maximum likelihood estimation and the Hartung–Knapp adjustment. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE, respectively. Results: Eight reports representing seven studies were included in the systematic review; six studies comprising 259 participants contributed to the meta-analysis. Ketogenic diets were associated with slightly greater weight loss than higher-carbohydrate diets (MD = −1.49 kg; 95% CI: −2.41 to −0.58; p = 0.008; I2 = 0%). Estimates remained similar after alternative imputations of change-score standard deviations, exclusion of the trial at high risk of bias, and leave-one-out analyses. In three trials meeting the prescribed protein-matching criterion, the effect remained directionally consistent but was imprecise and compatible with no difference. Certainty of evidence was low because of risk of bias and imprecision. Conclusions: Under comparable prescribed energy conditions, ketogenic diets may produce a small additional reduction in body weight. However, predominantly short-term evidence, uncertainty regarding achieved energy and protein intakes, the absence of a synthesis of body composition, and low certainty of evidence limit confidence in the magnitude, durability, and clinical significance of this advantage. Full article
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16 pages, 1239 KB  
Article
Beyond the Scale: Changes in Pain, Physical Function (WOMAC), and Low-Grade Inflammation Following Semaglutide Treatment in Patients with Knee Osteoarthritis—Results from a Six-Month Real-World Cohort
by Alessandro Conforti, Linda Lucchetti, Francesca Ciampa, Marco Bonifacio, Marco Giuseppe Musorrofiti, Valerio Cipolloni and Filippo Messina
J. Clin. Med. 2026, 15(15), 5876; https://doi.org/10.3390/jcm15155876 - 27 Jul 2026
Viewed by 493
Abstract
Background: Knee osteoarthritis (KOA) in people with overweight or obesity is clinically heterogeneous, reflecting mechanical loading, synovial and systemic inflammation, metabolic dysfunction, structural severity, and pain-related factors. We evaluated multidomain outcomes after semaglutide initiation and characterized clinically relevant response patterns. Methods: [...] Read more.
Background: Knee osteoarthritis (KOA) in people with overweight or obesity is clinically heterogeneous, reflecting mechanical loading, synovial and systemic inflammation, metabolic dysfunction, structural severity, and pain-related factors. We evaluated multidomain outcomes after semaglutide initiation and characterized clinically relevant response patterns. Methods: This retrospective, self-controlled cohort included 93 adults treated in routine rheumatology care; 88 completed a six-month follow-up. There was no untreated concurrent comparator; within-patient changes and exposure–outcome associations were therefore interpreted as non-causal. Changes in pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function, anthropometry, inflammatory markers, glycated hemoglobin (HbA1c), lipids, dose exposure, and safety were evaluated. Joint multivariable models included percentage weight loss and maximum achieved dose. Exploratory K-means phenotyping integrated dose, weight loss, body mass index (BMI) decrease, visual analog scale (VAS) and WOMAC improvement, and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and HbA1c reductions, with candidate solutions and resampling stability examined. Results: At six months, mean weight decreased by 10.88 kg, VAS pain score by 2.47 points, WOMAC total by 22.50 points, CRP by 2.67 mg/L, ESR by 7.62 mm/h, and HbA1c by 0.51 percentage points (all p < 0.001). Weight loss remained independently associated with WOMAC improvement, while achieved dose retained positive adjusted associations with pain, function, inflammatory, and metabolic changes. Exploratory clustering identified five clinically interpretable patterns along a broader response-intensity gradient, including high-burden multidomain response, high-dose concordant response, dose-modified intermediate response, inflammation-preserved response despite moderate weight loss, and dose-limited graded response. These observational coefficients and clusters cannot distinguish treatment-related effects from residual confounding or co-interventions. Conclusions: Substantial within-patient improvements were observed, but the uncontrolled design precludes causal attribution. The exploratory patterns may be compatible with contributions from baseline disease burden, dose exposure, mechanical unloading, and residual inflammatory variation; they do not establish weight-independent pharmacologic effects or validated patient subtypes. Prospective controlled, multicenter validation is required. Full article
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26 pages, 3278 KB  
Systematic Review
GLP-1RA- and Incretin-Based Therapies Within Lifestyle Interventions for Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis
by Alejandro Bruna-Mejias, Juan José Valenzuela-Fuenzalida, Gustavo Oyanedel, Julio Figueroa-Puig, Juan José Cabezas-Salgado, Mathias Orellana-Donoso, Gloria Cifuentes-Suazo and Juan Francisco Loro-Ferrer
Nutrients 2026, 18(11), 1781; https://doi.org/10.3390/nu18111781 - 31 May 2026
Cited by 1 | Viewed by 1301
Abstract
Background/Objectives: Glucagon-like peptide-1 receptor agonist (GLP-1RA)- and incretin-based therapies are now central to obesity management. Their clinical value, however, should be interpreted beyond total weight loss, because changes in fat mass, lean mass, physical function, and cardiometabolic risk may depend on the accompanying [...] Read more.
Background/Objectives: Glucagon-like peptide-1 receptor agonist (GLP-1RA)- and incretin-based therapies are now central to obesity management. Their clinical value, however, should be interpreted beyond total weight loss, because changes in fat mass, lean mass, physical function, and cardiometabolic risk may depend on the accompanying dietary, behavioral, and exercise co-interventions. This systematic review and meta-analysis evaluated GLP-1RA- and incretin-based therapies delivered within lifestyle interventions in adults with overweight or obesity. Methods: The protocol was registered in PROSPERO (CRD420261360837). PubMed/MEDLINE, Web of Science, Scopus, CINAHL, SPORTDiscus, and CENTRAL were searched from inception to the final search dates. Records were deduplicated in Zotero. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects meta-analyses were estimated using restricted maximum likelihood with Hartung–Knapp adjustment when pooling was appropriate. Results: Across all database sources, 1651 records were identified. After removing 113 duplicate records and 212 records with an ineligible publication type before screening, 1326 records were screened. Seventy-seven reports were sought for retrieval, five were not retrieved, 72 were assessed at full text, and 48 reports corresponding to 35 independent parent trials or trial clusters were retained for qualitative synthesis. The primary kilogram-scale meta-analysis included eight independent comparisons and showed greater body-weight reduction with GLP-1RA/incretin-based therapy delivered within a lifestyle background than with placebo/control (mean difference [MD] −10.08 kg, 95% confidence interval [CI] −12.76 to −7.39; 95% prediction interval [PI] −17.86 to −2.29; I2 = 95.6%). Percentage body-weight change was analyzed separately across 11 independent comparisons and also favored GLP-1RA/incretin-based therapy (MD −9.53 percentage points, 95% CI −11.92 to −7.14; 95% PI −17.58 to −1.48; I2 = 95.4%). Conclusions: GLP-1RA- and incretin-based therapies delivered within lifestyle interventions are associated with clinically meaningful reductions in body weight in adults with overweight or obesity. Absolute and relative body-weight change metrics should remain analytically separate. The magnitude of benefit varies across trial contexts, and certainty remains limited by risk-of-bias concerns and considerable heterogeneity. Future trials should standardize the reporting of lifestyle co-interventions, body composition, adherence, physical-function outcomes, and safety monitoring. Full article
(This article belongs to the Special Issue The Role of Nutritional Interventions and Exercise for Weight Loss)
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26 pages, 1451 KB  
Systematic Review
Adipocyte Size, Overweight, and Insulin Resistance in Type 2 Diabetes Mellitus and the Impact of Weight Loss: A Systematic Review
by Kuat P. Oshakbayev, Altay N. Nabiyev, Aigul K. Durmanova, Gani M. Kuttymuratov, Timur S. Suleimenov, Nurzhan A. Bikhanov, Alisher S. Idrissov, Guldana Zh. Bazheneyeva, Kenzhekyz Manekenova, Ainur R. Akilzhanova and Bibazhar A. Dukenbayeva
Nutrients 2026, 18(9), 1382; https://doi.org/10.3390/nu18091382 - 28 Apr 2026
Viewed by 1811
Abstract
Background: The impact of overweight and adipocyte size on the development of type 2 diabetes mellitus (T2DM) remains unclear. Aim: We studied (1) the relationship between the state of adipocytes and/or overweight/obesity, the development of T2DM and its clinical and laboratory features; and [...] Read more.
Background: The impact of overweight and adipocyte size on the development of type 2 diabetes mellitus (T2DM) remains unclear. Aim: We studied (1) the relationship between the state of adipocytes and/or overweight/obesity, the development of T2DM and its clinical and laboratory features; and (2) weight loss effect on glycemic level, endogenous hyperinsulinism (HI), insulin resistance (IR), and T2DM. Methods: We designed a systematic review by searching Web of Science, EBSCO, Scopus/ Science-Direct, Google Scholar, PubMed, Cochrane, and Wolter Kluwer for articles published in 26 years (2000–2026). The study was based on a systematic review of 3853 articles published worldwide. Results: In total, 142 full-text articles were assessed for eligibility. As overweight increases, the size of adipose tissue, adipocytes, and cell radius increase. The increase in cell size overloads intracellular transport and internal organs. The development of IR is a conformational change in cellular receptors caused by an excessive increase in cell size. The increase in cell size with overweight gradually leads to hyperglycemia and HI with the development of IR and T2DM. Any targeted intentional weight loss in patients with T2DM improves metabolic and cardiovascular health, reduces blood pressure and blood sugar, and decreases HI, IR, and T2DM. Conclusions: IR is a protective response of cells that prevents oversaturation and overflow. Overweight is an independent risk factor for the development of HI, IR, and T2DM. Targeted weight loss leads to the cure of HI, IR and T2DM. Full article
(This article belongs to the Section Nutrition and Diabetes)
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11 pages, 1897 KB  
Article
An Analysis of Hip and Knee Joint Movement Characteristics in Overweight Individuals During Sit-to-Stand Transfers—Based on Statistical Parametric Mapping: An Exploratory Study
by Guohui Zhao, Feifei Ma and Lei Li
Life 2026, 16(3), 515; https://doi.org/10.3390/life16030515 - 20 Mar 2026
Viewed by 876
Abstract
Objective: The objective of this study was to explore the motion characteristics and movement strategies of the hip and knee joints in overweight individuals during sit-to-stand (STS) transfers using statistical parametric mapping (SPM). Methods: Twenty subjects were divided into an overweight group ( [...] Read more.
Objective: The objective of this study was to explore the motion characteristics and movement strategies of the hip and knee joints in overweight individuals during sit-to-stand (STS) transfers using statistical parametric mapping (SPM). Methods: Twenty subjects were divided into an overweight group (n = 10) and a normal-weight group (n = 10) based on body mass index (BMI). The Qualisys infrared motion capture system and Kistler three-dimensional force platform were used for motion data collection, and Visual 3D and Matlab were used to calculate the angles and torque indicators of the lower limb hip and knee joints. Results: During the STS process, the maximum hip flexion angle of the overweight group was smaller than that of the control group (Z = −1.83, p = 0.043, r = 0.39), while the maximum abduction and external rotation angles were greater than those of the control group (Z = −2.15, p = 0.022, r = 0.46; Z = −2.02, p = 0.028, r = 0.48). SPM analysis showed that during the 0–52% phase of the hip joint in the frontal plane, the abduction amplitude of the overweight population was greater than that of the normal population (p < 0.05). The minimum external rotation angle of the knee joint was less than that of the control group (F(1,18) = 9.135, p = 0.043). The peak internal adduction and abduction torque of the hip joint in the overweight group was greater than that of the control group (Z = 2.37, p = 0.017, r = 0.54). Conclusions: Compared with the normal-weight population, the overweight population exhibited distinct motion characteristics of the hip and knee joints during the STS, with particularly pronounced differences in the hip joint. To maintain stability during STS, the overweight population adopts a compensatory movement strategy featuring a wider base of support via hip abduction and increased muscular torque to control frontal plane stability, which imposes greater functional loads on the hip joint. BMI-related movement characteristics should be studied in young adults under controlled experimental conditions, and future studies are needed to verify whether similar patterns exist in older adults. Full article
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15 pages, 1402 KB  
Article
The Impact of Body Mass Index and Nutritional Status on Cardiac Electrophysiological Balance Using ICEB and ICEBc: A Cross-Sectional Approach
by Fethullah Kayan, Ömer Faruk Alakuş, Mihriban Elçiçek, Serdar Soner, Cansu Öztürk, Geylani Güleken and Ihsan Solmaz
J. Cardiovasc. Dev. Dis. 2026, 13(3), 109; https://doi.org/10.3390/jcdd13030109 - 26 Feb 2026
Cited by 3 | Viewed by 947
Abstract
Background: The Index of Cardiac Electrophysiological Balance (ICEB) has emerged as a electrocardiographic marker reflecting the equilibrium between ventricular depolarization and repolarization. Although obesity is known to alter cardiac electrophysiology, the combined influence of body mass index (BMI) and objective nutritional status on [...] Read more.
Background: The Index of Cardiac Electrophysiological Balance (ICEB) has emerged as a electrocardiographic marker reflecting the equilibrium between ventricular depolarization and repolarization. Although obesity is known to alter cardiac electrophysiology, the combined influence of body mass index (BMI) and objective nutritional status on ICEB and its heart rate-corrected form (ICEBc) remains insufficiently defined. This study aimed to investigate the associations between BMI categories, nutritional status, and cardiac electrophysiological balance. Methods: This cross-sectional study included 591 adult patients classified as normal-weight, overweight, or obese according to BMI. Electrophysiological assessment of ICEB (QT/QRS) and ICEBc (QTc/QRS) values was calculated from standard 12-lead electrocardiogram recordings. Participants’ nutritional status was analyzed using validated clinical indices such as the Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT), Geriatric Nutritional Risk Index (GNRI) and Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) score. Results: According to the results, both ICEB and ICEBc showed significant differences among BMI categories (p < 0.001). ICEB/ICEBc exhibited a non-linear distribution. The ICEB/ICEBc values were found to be minimum in the normal weight group at 4.22 ± 0.54/4.87 ± 0.66 and maximum in the obese group at 4.27 ± 0.51/4.99 ± 0.59. The ICEB/ICEBc value closest to the optimal physiological limits was found in the overweight group at 4.04 ± 0.53/4.59 ± 0.58. Higher ICEBc quartiles were accompanied by increased GNRI (120.9 ± 13.7, 129 ± 15.1, 130.5 ± 16.3, 131.8 ± 17.6, p < 0.001)and decreased HALP scores (59.7 ± 24.4, 56.1 ± 25.3, 55.2 ± 25.9, 51.1 ± 19.4, p: 0.025). Conclusion: The association between BMI and cardiac electrophysiological balance is non-linear and appears to be modulated by nutritional and inflammatory status. ICEBc may represent a more sensitive marker than ICEB for detecting subtle electrophysiological alterations related to obesity. Full article
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15 pages, 1070 KB  
Article
Physical Activity Determinants Under the Double Burden of Malnutrition: Contrasting Pathways for Underweight and Overweight Chinese Adolescents
by Liying Yao, Shuaishuai Jia, Xiaochang Lv, Yongguan Dai, Yee Cheng Kueh, Jinfu Xu, Jianqiu Cong and Garry Kuan
Nutrients 2026, 18(1), 179; https://doi.org/10.3390/nu18010179 - 5 Jan 2026
Viewed by 1266
Abstract
Background: Chinese adolescents face a dual burden of malnutrition, yet the weight-status-specific mechanisms underlying physical activity (PA) participation remain underexplored. Methods: We conducted a cross-sectional study among 1573 adolescents (aged 9–15 years) in Shangrao City, China. Validated scales measured social-ecological factors (family/peer support, [...] Read more.
Background: Chinese adolescents face a dual burden of malnutrition, yet the weight-status-specific mechanisms underlying physical activity (PA) participation remain underexplored. Methods: We conducted a cross-sectional study among 1573 adolescents (aged 9–15 years) in Shangrao City, China. Validated scales measured social-ecological factors (family/peer support, physical environment), psychological factors (stage of change, self-efficacy, decisional balance), and PA participation. Data preprocessing utilized full information maximum likelihood to handle missing values. Confirmatory factor analysis was performed to validate the measurement model, followed by multi-group structural equation modeling to analyze pathway configurations across underweight (n = 187), normal-weight (n = 1070), and overweight/obese (n = 316) groups. Mediation effects were tested using bootstrapping with 5000 resamples. Results: Clear weight-specific patterns emerged. Normal-weight adolescents presented a fully functional comprehensive model where PA was predicted by the stage of change (β = 0.211, p < 0.001), friend support (β = 0.120, p < 0.001), self-efficacy (β = 0.092, p < 0.05), and perceived benefits (β = 0.095, p < 0.01). Underweight adolescents primarily relied on internal readiness driven by stage of change (β = 0.270, p < 0.001) and self-efficacy (β = 0.164, p < 0.05), with family support only indirectly influencing participation via psychological mediators. In contrast, overweight/obese adolescents showed a “socially dependent” pattern: friend support directly predicted PA levels (β = 0.136, p < 0.05), significantly enhanced self-efficacy (β = 0.370, p < 0.01), and effectively lowered perceived barriers (β = −0.165, p < 0.05). Additionally, the physical environment strongly impacted perceived benefits (β = 0.471, p < 0.01) but did not translate into action. Conclusions: These findings underscore the significant differences in PA determinants across the spectrum of malnutrition, necessitating targeted public health interventions to support the Healthy China 2030 initiative. Full article
(This article belongs to the Section Nutrition and Public Health)
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9 pages, 214 KB  
Brief Report
Body Weight Perception and Eating Attitudes Among Polish Midwives with Overweight and Obesity: A Cross-Sectional Study
by Aleksandra Łopatkiewicz, Olga Barbarska, Iwona Kiersnowska, Beata Guzak and Edyta Krzych-Fałta
Nutrients 2026, 18(1), 144; https://doi.org/10.3390/nu18010144 - 1 Jan 2026
Viewed by 833
Abstract
Background: Midwives, despite their health-promoting role, face factors that may disrupt eating behaviours and weight regulation. Little is known about their body weight perception or disordered eating attitudes (DEAs). This study assessed body weight perception and eating attitudes across BMI categories among Polish [...] Read more.
Background: Midwives, despite their health-promoting role, face factors that may disrupt eating behaviours and weight regulation. Little is known about their body weight perception or disordered eating attitudes (DEAs). This study assessed body weight perception and eating attitudes across BMI categories among Polish midwives. Methods: A cross-sectional survey of 568 midwives was conducted. BMI was calculated from self-reported measures and classified according to WHO criteria. Body weight perception was assessed using discrepancies between actual and ideal body weight and between self-perceived ideal body weight and ideal body weight. Long-term weight variability was additionally evaluated using the difference between maximum and minimum adult body weight. Eating attitudes were examined using the Polish version of the EAT-26. Group differences were analysed with the Kruskal–Wallis and χ2 tests. Results: Among the participants, 62.9% had normal weight, 23.4% were overweight, and 13.7% were obese. Perceived ideal body weight increased with BMI (p < 0.001). Midwives with overweight and obesity demonstrated higher EAT-26 scores than those with normal BMI, with EAT-26 > 20 observed in 8.3% of overweight and 14.1% of obese participants (p = 0.010). Overweight and obese midwives also showed larger discrepancies between actual and ideal body weight and greater lifetime weight variability, and these groups simultaneously presented higher levels of disturbed eating attitudes. Emotional eating, binge-type episodes, and dieting behaviours were more common among overweight and obese participants, while calorie awareness remained consistently high across groups. Conclusions: Midwives with excess body weight often misperceive their body size and show an elevated risk of DEA. Weight perception appears more strongly related to maladaptive eating patterns than BMI alone. These findings highlight the need for targeted, non-stigmatising interventions addressing weight perception, eating attitudes, and occupational stressors, which may support both midwives’ well-being and their professional effectiveness in delivering nutrition and lifestyle counselling. Full article
(This article belongs to the Special Issue Research on Eating Disorders, Physical Activity and Body Image)
17 pages, 486 KB  
Article
The Impact of Maternal BMI on the Efficacy and Safety of Oral Misoprostol for Labor Induction
by Maciej W. Socha, Wojciech Flis, Julia Sowińska, Martyna Stankiewicz and Anita Kazdepka-Ziemińska
Pharmaceuticals 2025, 18(12), 1888; https://doi.org/10.3390/ph18121888 - 14 Dec 2025
Viewed by 1331
Abstract
Background: Maternal obesity may influence the efficacy and course of induction of labor (IoL). Misoprostol, a prostaglandin E1 analogue, is widely used for cervical ripening, but evidence regarding its effectiveness in obese women remains limited. This study aimed to evaluate the efficacy [...] Read more.
Background: Maternal obesity may influence the efficacy and course of induction of labor (IoL). Misoprostol, a prostaglandin E1 analogue, is widely used for cervical ripening, but evidence regarding its effectiveness in obese women remains limited. This study aimed to evaluate the efficacy and safety of oral misoprostol for IoL across different body mass index (BMI) categories. Methods: This prospective study was conducted at a tertiary center. Term singleton pregnancies with medical indications for IoL and an unfavorable cervix (Bishop score < 6) received oral misoprostol 50 μg every 4 h to a maximum of 200 μg. Primary outcomes were vaginal delivery (VD) rates. Secondary outcomes included cesarean section (CS) rate, oxytocin use, labor duration, analgesia, adverse events, and neonatal outcomes. Results: Among 291 participants (43.0% overweight; 40.2% obese), the Bishop score increased from 2.3 to 6.2 (p < 0.0001). VD occurred in 77.3%, and CS in 22.7%. Most women delivered within 48 h (96.6%). Higher BMI correlated with longer time to contractions, pain onset, and delivery, as well as with more misoprostol doses. Neonatal outcomes were uniformly favorable, with median Apgar scores of 10 at 1, 5, and 10 min, and mean umbilical pH values ranging from 7.2 to 7.3. Adverse events were infrequent, with tachysystole observed in 1.7% of cases. Conclusions: Oral misoprostol is an effective and safe IoL method across BMI categories, achieving high vaginal delivery rates and favorable neonatal outcomes. Obesity modestly prolongs induction and increases dose requirements, supporting individualized dosing and close monitoring. Full article
(This article belongs to the Special Issue Advances in Perinatal Pharmacology)
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1699 KB  
Article
Body Mass and Foot Dominance Disparities in the Foot Plantar Pressure Parameters of Older Women
by Min Liu, Yalu Zhang, Ning Kang, Donghui Mei, Erya Wen, Dongmin Wang and Gong Chen
J. Am. Podiatr. Med. Assoc. 2025, 115(6), 23210; https://doi.org/10.7547/23-210 - 1 Nov 2025
Cited by 2 | Viewed by 160
Abstract
Background: We examined the effects of foot dominance and body mass on foot plantar pressures in regular-weight, overweight, and obese older women. Methods: Ninety-six women were divided into the regular-weight group (mean ± SD age, 68.30 ± 4.19 years), overweight group (mean [...] Read more.
Background: We examined the effects of foot dominance and body mass on foot plantar pressures in regular-weight, overweight, and obese older women. Methods: Ninety-six women were divided into the regular-weight group (mean ± SD age, 68.30 ± 4.19 years), overweight group (mean ± SD age, 69.88 ± 3.76 years), and obesity group (mean ± SD age, 68.47 ± 3.67 years) based on their body mass index. The Footscan plantar pressure measurement system was used to assess the dynamic plantar pressures, and parameters were collected from risk analysis, foot axis analysis, single-foot timing analysis, and pressure analysis. Results: Significant within-subject differences were found for local risks of the lateral forefoot and midfoot, minimum and maximum subtalar joint angles, flexibility of the subtalar joint, foot flat phase, as well as the average pressures on toes, metatarsals, midfoot, and lateral heel, with the peak pressures on toes 2 to 5, second metatarsal, fifth metatarsal, midfoot, and lateral heel. The phases of initial contact and foot flat, the average pressures on toes 2 to 5, metatarsals, midfoot, and heels, with the peak pressures on the first to fourth metatarsals, midfoot, and heels, exhibited significant between-subject differences. There was an interaction effect of foot dominance and body mass index on the flexibility of the subtalar joint. Conclusions: The nondominant foot works better for stability, especially when touching on and off the ground. The dominant foot works better for propulsion but is more susceptible to pain, injury, and falls. For obese older women, the forefoot and midfoot are primarily responsible for maintaining stability, but the lateral midfoot and hindfoot are more prone to pain and discomfort. (J Am Podiatr Med Assoc 115(6), 2025; doi:10.7547/23-210) Full article
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14 pages, 924 KB  
Article
Effects of Mulberry Leaf and Corn Silk Extracts Against α-Amylase and α-Glucosidase In Vitro and on Postprandial Glucose in Prediabetic Individuals: A Randomized Crossover Trial
by You Sun, Xiaokang Niu, Yifan Wang, Qi Zhang, Yan Liu, Jingjing He, Lingling Xu, Ran Wang and Jie Guo
Nutrients 2025, 17(21), 3438; https://doi.org/10.3390/nu17213438 - 31 Oct 2025
Cited by 2 | Viewed by 2432
Abstract
Objective: Postprandial hyperglycemia is a major risk factor for type 2 diabetes and cardiovascular disease. Inhibition of α-amylase and α-glucosidase can attenuate postprandial glycemic response (PPGR). This study aimed to investigate the inhibitory effects of mulberry leaf and corn silk on these enzymes [...] Read more.
Objective: Postprandial hyperglycemia is a major risk factor for type 2 diabetes and cardiovascular disease. Inhibition of α-amylase and α-glucosidase can attenuate postprandial glycemic response (PPGR). This study aimed to investigate the inhibitory effects of mulberry leaf and corn silk on these enzymes in vitro and their impact on postprandial glucose (PG) levels in prediabetic individuals using milk-based matrices. Research Design and Methods: In vitro, enzyme inhibition was assessed using the DNS method (α-amylase) and pNPG method (α-glucosidase). A randomized crossover trial was conducted in 11 prediabetic individuals with four interventions: pure milk; lactose-hydrolyzed milk; lactose-hydrolyzed milk with mulberry leaf, corn silk, and resistant dextrin; and GOS milk with mulberry leaf and corn silk. PPGR was assessed by area under the glucose curve, 1 and 2 h PG, maximum PG, and 2 h glucose excursion. Paired Wilcoxon signed-rank tests were used for comparisons. Results: Mulberry leaf and corn silk extracts inhibited both enzymes dose-dependently, with synergistic effects. No significant differences in PPGR indices were observed across interventions in the overall prediabetic individuals. However, in the overweight subgroup, the combination of GOS milk supplemented with mulberry leaf and corn silk significantly reduced 1 h PG (median difference [P25, P75]: −0.84 mmol/L [−1.05, −0.49]), maximum PG (−0.54 mmol/L [−0.75, −0.25]), and glucose excursion (−0.62 mmol/L [−0.75, −0.24]) compared to pure milk. Conclusions: Mulberry leaf and corn silk extracts inhibit α-amylase and α-glucosidase in vitro and may attenuate postprandial glucose excursions in overweight prediabetic individuals when delivered in a GOS milk matrix. Full article
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23 pages, 1178 KB  
Article
A Qualitative Analysis and Discussion of a New Model for Optimizing Obesity and Associated Comorbidities
by Mohamed I. Youssef, Robert M. Maina, Duncan K. Gathungu and Amr Radwan
Symmetry 2025, 17(8), 1216; https://doi.org/10.3390/sym17081216 - 1 Aug 2025
Cited by 2 | Viewed by 1168
Abstract
This paper addresses the problem of optimizing obesity, which has been a challenging issue in the last decade based on recent data revealed in 2024 by the World Health Organization (WHO). The current work introduces a new mathematical model of the dynamics of [...] Read more.
This paper addresses the problem of optimizing obesity, which has been a challenging issue in the last decade based on recent data revealed in 2024 by the World Health Organization (WHO). The current work introduces a new mathematical model of the dynamics of weight over time with embedded control parameters to optimize the number of obese, overweight, and comorbidity populations. The mathematical formulation of the model is developed under certain sufficient conditions that guarantee the positivity and boundedness of solutions over time. The model structure exhibits inherent symmetry in population group transitions, particularly around the equilibrium state, which allows the application of analytical tools such as the Routh–Hurwitz and Metzler criteria. Then, the analysis of local and global stability of the obesity-free equilibrium state is discussed based on these criteria. Based on the Pontryagin maximum principle (PMP), the deviation from the obesity-free equilibrium state is controlled. The model’s effectiveness is demonstrated through simulation using the Forward–Backward Sweeping algorithm with parameters derived from recent research in human health. Incorporating symmetry considerations in the model enhances the understanding of system behavior and supports balanced intervention strategies. Results suggest that the model can effectively inform strategies to mitigate obesity prevalence and associated health risks. Full article
(This article belongs to the Special Issue Mathematical Modeling of the Infectious Diseases and Their Controls)
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22 pages, 3169 KB  
Article
Effects of High-Intensity Intermittent Training Combined with Asparagus officinalis Extract Supplementation on Cardiovascular and Pulmonary Function Parameters in Obese and Overweight Individuals: A Randomized Control Trial
by Tadsawiya Padkao and Piyapong Prasertsri
J. Funct. Morphol. Kinesiol. 2025, 10(2), 202; https://doi.org/10.3390/jfmk10020202 - 1 Jun 2025
Cited by 1 | Viewed by 3231
Abstract
Background: High-intensity intermittent training (HIIT) has been proven to improve cardio-metabolic and respiratory health outcomes. In addition, 20-hydroxyecdysone from plant extracts has been studied for its anabolic effects. However, studies examining these two interventions in individuals who are obese or overweight are limited. [...] Read more.
Background: High-intensity intermittent training (HIIT) has been proven to improve cardio-metabolic and respiratory health outcomes. In addition, 20-hydroxyecdysone from plant extracts has been studied for its anabolic effects. However, studies examining these two interventions in individuals who are obese or overweight are limited. This study, thus, examined the effects of HIIT combined with Asparagus officinalis (A. officinalis) extract supplementation on cardiovascular and pulmonary function parameters in obese and overweight individuals. Methods: Seventy-two obese and overweight participants were randomized into four groups (n = 18 each): the control (CON) group; HIIT group (HIIT for 3 days/week); AOE (A. officinalis extract) group (supplementation with 20E at 1.71 mg/kg/day); and HIIT + AOE group. Pre- and 12-week post-intervention measures included heart rate (HR), HR variability, endothelial function, blood pressure (BP), BP variability, pulmonary function and volume, respiratory muscle strength, chest expansion, and body composition. Results: The HIIT + AOE group showed better HR variability with higher high-frequency power and a lower low-frequency/high-frequency ratio (both p = 0.038) compared to the CON group. The peak blood flow increased in both the HIIT (p = 0.03) and HIIT + AOE (p = 0.028) groups, but only the HIIT group had a shorter vascular recovery time (p = 0.048). The maximum expiratory pressure was increased in both the HIIT and HIIT + AOE groups compared to the CON group (p = 0.029 and p = 0.041). The ratio of forced expiratory volume in one second to forced vital capacity, the percent-predicted FEV1/FVC, and chest wall expansion were higher in the HIIT + AOE group than in the CON group (p = 0.047, p = 0.038, and p = 0.001). The waist-to-hip ratio was lower in the HIIT + AOE group than in the CON group (p = 0.043). There were no significant differences in HR, BP, BP variability, or pulmonary volume parameters among groups. Conclusions: The combination of HIIT with A. officinalis extract supplementation markedly improves HR variability. Moreover, it also greatly improves expiratory muscle strength, chest wall expansion, pulmonary function, and body composition parameters in obese and overweight individuals. Full article
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16 pages, 1559 KB  
Article
Difference Between Walking Parameters During 6 Min Walk Test Before and After Abdominal Surgery in Colorectal Cancer Patients
by Nikolina Santek, Sanja Langer, Iva Kirac, Danko Velemir Vrdoljak, Gordan Tometic, Goran Musteric, Ljiljana Mayer and Maja Cigrovski Berkovic
Cancers 2025, 17(11), 1782; https://doi.org/10.3390/cancers17111782 - 26 May 2025
Cited by 1 | Viewed by 2533
Abstract
Background/Objectives: Colorectal cancer is a significant health problem worldwide. Surgery is the primary curative treatment for most colorectal cancers. Cardiopulmonary exercise testing is now performed widely before surgery, and it is the most objective and precise means of evaluating pre-surgical physical fitness. Also, [...] Read more.
Background/Objectives: Colorectal cancer is a significant health problem worldwide. Surgery is the primary curative treatment for most colorectal cancers. Cardiopulmonary exercise testing is now performed widely before surgery, and it is the most objective and precise means of evaluating pre-surgical physical fitness. Also, we can use the 6 min walk test to measure cardiorespiratory fitness before surgery. Methods: We included colorectal patients who were awaiting open abdominal or laparoscopic surgery. After admission to the hospital, patients who signed informed consent forms fulfilled a short questionnaire about health and physical status, preoperative physical activities, and quality of life questionnaire (EORTC QLQ-C30). Patients performed a 6 min walk test (6MWT) 2 days before surgery and 7 days after surgery. 6MWT is a tool for measuring the functional status of fitness. Also, they fulfilled the quality of recovery questionnaire (QoR 15) 7 days after surgery. Results: In a final analysis, we included 72 patients with a mean age of 62.48. We compared the number of steps, walk distance, average and maximal walk speed, and average and maximal heart rate before and after surgery, overall, and by group. Our findings show a statistically significant difference between men and women in the walk distance (F = 4.99, p = 0.02) The number of steps showed a statistically significant difference according to patients’ ages (F = 2.90, p = 0.02). Also, we detected differences in the average and maximum heart rate during walking when comparing body mass index (average heart rate F = 5.72, p = 0.00, maximum heart rate F = 2.52, p = 0.04). Conclusions: Our study provides evidence that average and maximal heart rate during the 6 min walk test was higher in the postoperative period, especially in overweight and obese participants. Full article
(This article belongs to the Section Clinical Research in Cancer)
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17 pages, 8924 KB  
Article
The Impact of Modified Tabata Training on Segmental Fat Accumulation, Muscle Mass, Muscle Thickness, and Physical and Cardiorespiratory Fitness in Overweight and Obese Participants: A Randomized Control Trial
by Tadsawiya Padkao and Piyapong Prasertsri
Sports 2025, 13(4), 99; https://doi.org/10.3390/sports13040099 - 26 Mar 2025
Cited by 3 | Viewed by 6205
Abstract
The purpose of this study was to examine changes in body fat, muscle mass, muscle thickness, and physical and cardiorespiratory fitness in overweight and obese individuals following progressive Tabata training. Thirty-six participants were randomly assigned to either the Tabata group (four progressive cycles [...] Read more.
The purpose of this study was to examine changes in body fat, muscle mass, muscle thickness, and physical and cardiorespiratory fitness in overweight and obese individuals following progressive Tabata training. Thirty-six participants were randomly assigned to either the Tabata group (four progressive cycles of body-weight high-intensity intermittent training at 75–85% of maximum perceived exertion, 3 days/week for 12 weeks) or the control group. Body composition, muscle thickness, strength and endurance, and peak oxygen uptake (VO2peak) were measured at baseline and after the training period and compared between groups. No changes in body fat percentage and fat mass were found, but the waist-to-hip ratio was lower in the Tabata group (p = 0.043). The muscle mass percentages of the right (p = 0.026) and left legs (p = 0.043) increased, while the muscle thicknesses of the biceps, triceps, rectus femoris, and vastus intermedius were increased in the Tabata group (p < 0.05) to a greater extent than in the control group (p < 0.05). Muscle strength and endurance (p < 0.05), as well as VO2peak (p = 0.006), also increased in the Tabata group. Twelve weeks of modified Tabata training effectively increased muscle mass and thickness and physical and cardiorespiratory fitness, although it did not reduce fat mass in overweight and obese participants. The combination of this training with a dietary intervention may have a more obvious impact. Full article
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