Obesities

The study examines the link between dietary diversity and BMI using data from Kenyan women aged 15–49. By exploring how dietary diversity affects BMI across various BMI categories, the study examines the demand for diet diversity and its impact on BMI. The results reveal a positive relationship between food diversity and BMI at all quantiles, suggesting that a more varied diet is associated with increased BMI levels among underweight, overweight, and obese individuals. This indicates that the correlation between dietary diversity and health outcomes in higher BMI categories may be ‘unfavourable’, with increased food diversity linked to a higher risk of ‘unfavourable’ BMI categories, i.e., overweight and obesity. This may be attributed to higher caloric intake and/or higher consumption of saturated fats and cholesterol from a more diverse diet, which can contribute to increased BMI. These findings highlight the need to consider moderation and balance in energy intake and the overall nutritional quality of diets when considering and evaluating diets and dietary diversity and in formulating and shaping food policies. Full article

Obesity is a multifaceted health issue linked to conditions like type 2 diabetes, hypertension, and cardiovascular disease. Bariatric surgery is a well-established method for significant weight loss and health improvement, but maintaining weight loss and recovering post-surgery can be challenging. Probiotics, beneficial live microorganisms, are suggested as potential aids in managing obesity and its complications, but research on their effectiveness in this context is limited and diverse. This study aimed to evaluate the impact of probiotics on obesity in individuals post-bariatric surgery. A meta-umbrella review was conducted, analyzing systematic reviews and meta-analyses of probiotics’ effects. The review included studies from PubMed, Scopus, EMBASE, and Cochrane Library, focusing on weight loss, body composition, and metabolic parameters. Four systematic reviews met the criteria. The findings indicate that probiotics may significantly reduce waist circumference and body weight, and improve lipid and liver markers. However, their effects on glycemic parameters, quality of life, and adverse events were less clear. Overall, probiotics might offer modest benefits in managing weight and improving certain metabolic parameters after bariatric surgery. However, their overall efficacy, especially regarding glycemic control and quality of life, remains uncertain. Further high-quality research is needed to confirm these findings and elucidate the mechanisms involved. Full article

Sociodemographic factors affect how metabolic syndrome (MetS) manifests and progresses. This study aimed to investigate the prevalence between MetS and sociodemographic factors among adult participants in the Dikgale HDSS. This was a comprehensive retrospective study where the records of 575 participants were meticulously evaluated. MetS was defined using a joint interim statement (JIS). The data were analyzed using the Statistical Package for SPSS, version 25. A chi-square test was used to compare proportions between groups, with Cramer’s V used to assess the strength of association. Logistic regression was used to determine the association between MetS and sociodemographic profiles. A p-value of less than 0.05 was considered statistically significant. The prevalence of MetS was 28.2% (females 33.3% vs. males 15.6%, p ≤ 0.001). In addition, logistic regression showed males to have lower odds of MetS as compared to females (OR = 0.36, 95% CI: 0.2–0.6, and AOR = 0.4, 95% CI: 0.2–0.6). The 55–60 age group had the highest proportion of affected individuals, and MetS was also more common among individuals with low educational attainment. In addition, on regression, the same association was observed. This study found sociodemographic disparities in MetS among rural adults, especially females, who had an increased risk of MetS, and participants with low educational attainment. Full article

(1) Background: The literature has demonstrated several pathways that link obesity with stress. Thus, new approaches to weight management programs must also integrate health coaching and telemonitoring for overall health and wellbeing. This study aimed to measure stress, anxiety, and depression scales (DASS-21) in overweight and obese participants who joined a pilot randomized controlled trial (RCT) and the association between changes in DASS-21 scores and changes in anthropometric measures. (2) Methods: Fifty participants were enrolled in a randomized controlled trial and divided into two groups: the intervention group, which received a hypocaloric diet remotely, weekly telemonitoring, and monthly telehealth coaching, and the control group, which only followed a hypocaloric diet without any support. The Arabic version of the Depression Anxiety Stress Scales (DASS-21) was used. (3) Results: The data reveal that participants from the intervention group exhibited a significant decrease in the anxiety scale after 3 months compared with the control group. In addition, the correlations between depression, anxiety, stress, and all anthropometric measures in the intervention group showed a moderately significant positive correlation between changes in waist circumference and depression. (4) Conclusions: The findings confirm that integrating health coaching and telemonitoring can improve wellbeing and weight loss. Full article

Rapid weight loss strategies and weight cycling (losing and gaining weight repeatedly) are acknowledged problems in sports with weight categories, including judo. Extreme fasting, especially if combined with dehydration and intense physical exercise, may harm health and development, particularly those of children and teenagers engaging in judo competitions. However, there is substantial evidence for positive health effects of other forms of fasting. Here, we aim to provide an updated overview of the potential health risks associated with extreme dietary strategies in judo and contrast them with health-promoting fasting approaches. We conclude that the literature on the long-term health consequences of fasting in judo is scarce. This applies specifically to its potential association with eating disorders. Although many reports have highlighted the short-term risks of rapid weight loss, vulnerability and protection factors remain poorly understood. Rigorous scientific studies are needed to disentangle the factors that render fasting in judo healthy or unhealthy, considering both physical and mental health. We argue that a better understanding of weight management in judo is crucial to preventing health risks and designing healthy weight loss strategies, especially for young athletes. Full article

(1) Background: The administration of subcutaneous (SC) injectables is among the most frequent procedures a nurse performs in daily practice. The needle for the injection must pass through the skin barrier to reach the SC space, where the drug will be deposited. This procedure can cause pain to the patient and local lesions. Local fat measurement can be performed by measuring the skin fold. Previous studies have found higher levels of pain in people with obesity receiving SC insulin, and this study thus aimed to measure pain levels during and after an SC injection of low-molecular-weight heparin (LMWH) and identify how age, gender, and obesity may modulate the level of pain during and after the procedure. (2) Methods: This was a cross-sectional study, and the variables included age, gender, body mass index (BMI), BMI quartile, abdominal skin folds (ASFs), ASF quartile, and pain level during and after injection. A caliper was used to measure ASFs, height and weight were used to calculate BMI, and the Visual Analog Scale (VAS) was used to measure pain. (3) Results: The sample amounted to 202 participants, which was not considered representative of the study population. The average age was 64.3 years, and females predominated (62.40%). Of these participants, 42.5% were obese, and 29.1% were overweight. The average pain levels were low during (1.4) and after injection (1.9), highlighting the absence of pain during injection in 29.7% and after injection in 34.2%. (4) Conclusions: Obesity was associated with increased pain, but when adjusted for age, the pain was no longer significant. Females and young participants showed a significant relationship with pain during injection. Age, gender, and obesity had a statistically significant relationship with pain level. Participants with obesity (according to BMI and ASF) showed the highest levels of pain during and after injection. After injection, there was an increase in pain in most cases, possibly due to the discomfort caused by the drug itself, an aspect considered in the drug’s technical data sheet as a frequent adverse effect (>1/10 to <1/100). However, the drug volume does not seem to be related to pain in this study. Full article

Background: Research suggests that commercial weight management services are efficacious in helping people manage their body mass, but they typically only include education and advice on physical activity. The objective of this analysis was to assess 3- and 12-month body mass after attendance at a community-based weight management programme delivered by a commercial slimming group, which included the provision of tailored physical activity sessions by a local leisure trust between January 2009 and November 2014. Methods: After institutional ethical approval and participants giving informed consent, a retrospective analysis of a 12-week multi-component intervention, tier 2 community weight management service for adults in Wigan, North West England, United Kingdom, was undertaken. Participants’ (n = 8514) mean ± SD age was 47.4 ± 14.3 years and starting body mass was 86.7 ± 14.3 kg. The main outcome measure was body mass (kg) at 0 months (baseline), 3 months (immediately post intervention) and 12 months. Significant differences in body mass were ascertained if p < 0.05 using repeated measures ANOVA with Bonferroni post hoc test, with effect sizes calculated using partial eta squared. To confirm and account for missing data, the Last Observation Carried Forward (LOCF) approach was used. Results: Repeated measures ANOVA showed a significant effect of time (p < 0.01, ${\eta }_p^2$ = 0.36). Post hoc tests revealed there was a significant reduction in body mass from baseline to 3 months (86.7 ± 14.3 kg vs. 81.2 ± 13.6 kg) and baseline to 12 months (79.7 ± 14.0 kg). The difference between 3 months and 12 months was also significant. LOCF confirmed a significant effect of time (p < 0.01, ${\eta }_p^2$ = 0.42), with all previously highlighted significant differences remaining. Conclusions: Significant reductions in body mass were reported at 3 and 12 months, providing evidence for the efficacy of the community weight management programme that included tailored physical activity opportunities for participants. Whilst comparisons to a resting control group cannot be made, partnerships between commercial slimming groups and local leisure providers should be encouraged and explored nationally. Full article

Background: There are still discrepancies in the literature as to whether COVID-19 infection could impact biochemical, anthropometric, and cardiovascular markers. The purpose of this study was firstly to observe the effects of COVID-19 infection over 12 months on Type 2 diabetes (T2D) and obesity. Secondarily, we analyzed the individual influence of COVID-19 infection on changes in biochemical, anthropometric, and cardiovascular markers. Methods: This study is part of a secondary analysis of a recently published article. The research involved 84 participants with T2D, divided into two groups: the control group (40 participants) received only medical care, while the intervention group (44 participants) received both medical care and nutritional assessment. Consultations were held quarterly over 12 months, with a follow-up after 3 months. Data Analysis: For influence analysis, non-normal variables were compared using the Mann–Whitney test, and normal variables were compared using unpaired t-tests. For all cases, α = 0.05 and p < 0.05 were considered significant. Results: The analysis revealed a high percentage of patients in both groups who had a COVID-19 infection (70% control and 72.7% intervention) over 12 months. Regarding the influence analysis, participants in the intervention group who were infected with COVID-19 showed smaller reductions in glycated hemoglobin (HbA1c) (p = 0.0120) and systolic blood pressure (SBP) (p = 0.0460). For the other biochemical, anthropometric, and cardiovascular markers, in both groups, no significant differences were found (p > 0.05). Conclusion: COVID-19 possibly influenced SBP and HbA1c levels over 12 months in people with T2D and obesity. However, caution should be exercised in generalizing these results due to the limitations of this study. Additionally, influence analysis does not establish a causal relationship, and more clinical trials in different populations are needed to fully analyze this topic. Full article

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were originally developed in the late 1980s as a class of antidiabetic medication. However, research over the past decade has found them to be a safe and effective weight-loss agent, which has led to the approval of GLP-1 RAs such as Semaglutide as a supplement to lifestyle obesity interventions in multiple countries. When Semaglutide has become commercially unavailable, digital weight-loss services (DWLSs) have prescribed a compounded form of the medication—a practice in which health professionals formulate a replica of the commercial medication to serve ongoing patient needs. Although compounding has been relatively common over the past century, prominent medical bodies have argued that compounding a relatively novel medication such as Semaglutide represents a major safety risk. This study retrospectively compared the weight and side effect outcomes of patients from a large Australian DWLS whose lifestyle coaching was supplemented with either compounded or pure Semaglutide (both groups following the same titration schedule). All data were extracted from the service’s central data repository. To be included in the weight loss analysis, patients needed to have received a minimum of four monthly medication orders between June 2023 and May 2024 and have submitted weight data between 90 and 150 days after the arrival of their first order. All patients who received at least one medication order within the same period were included in the side effect analysis. The mean four-month weight loss percentage was statistically lower in the compounded Semaglutide group (N = 923, M = 9.11, SD = ±5.76) compared to those in the pure Semaglutide group (n = 1858, M = 9.87, SD = ±6.46), t (2032) = −3.15, p = 0.0017. A statistically lower proportion of patients in the compounded Semaglutide group (71.61%) reported at least one side effect than patients in the pure Semaglutide group (77.40%) during the study period, X² (1, N = 7683) = 32.32, p < 0.001. When side effects were disaggregated into severity categories, a statistical difference was only observed in mild side effects, X² (1, N = 7683) = 59.16, p < 0.001. A significantly higher rate of patients from the pure Semaglutide group achieved the ten (50.54% vs. 44.64%), X² (1, N = 7683) = 10.34, p < 0.001, and fifteen (21.42% vs. 12.78%), X² (1, N = 7683) = 30.43, p < 0.001, percent weight loss thresholds than patients from the compounded Semaglutide group. The findings indicate that compounded Semaglutide can be used as a component of tightly controlled DWLSs with slightly less effectiveness and but with slightly lower side effect incidence when compared to pure Semaglutide. Full article

Obesity, a complex social issue with profound health implications, intersects with various facets of society, from cultural norms to economic structures. This paper explores the sociology of obesity through multiple lenses, examining its social construction, the evaluation of societal perceptions, and the stigmatisation of obese individuals. It scrutinises the medicalisation of obesity and its consequences, urging caution in policy interventions and the interpretation of scientific evidence. Furthermore, it advocates for a nuanced approach to obesity prevention, emphasising the importance of public health policies grounded in evidence-based practices and a shared responsibility across diverse sectors. By delving into the intricate interplay between science, society. and culture, this research underscores the legitimate conditions of public health actions in fighting against the development of the obesity epidemic. Full article

Obesity is a growing epidemic that threatens to deplete healthcare resources by increasing the prevalence of diabetes, heart disease, high blood pressure, cancer, and chronic kidney disease. The prevalence of general and central obesity among the rural Black population in Limpopo Province is high; however, few studies have evaluated the association between obesity and its comorbidities among the rural Black population, and, hence, this study aims to determine the relationship between obesity and associated comorbidities. This study was cross-sectional and retrospective in design, using secondary data from the Africa Wits-INDEPTH Partnership for Genomic (AWI-Gen) research phase 1 study. A sample size of 791 participants was collected conveniently. Data were analysed using the Statistical Package for Social Sciences version 27 (SPSS). A chi-square, unpaired Student’s t-test, bivariate and partial correlation, and multivariate regression analysis were used for analysis. General obesity correlated positively and significantly with LDL-C/HDL-C ratio and hypertension, while central obesity correlated positively and significantly with diabetes, hypertension, chronic kidney disease, LDL-C/HDL-C ratio, and TC/HDL-C ratio. In the present study, obese participants were more likely to be hypertensive, and have an increased LDL-C/HDL-C ratio. Centrally obese participants were more likely to be diabetic, hypertensive, have dyslipidaemia, and exhibit reduced kidney function. Full article

This study analyzed changes in ultra-processed food consumption patterns during weekends in patients in the post-metabolic and bariatric surgery periods. It is a cross-sectional study, which recruited and collected data via social media from adults who underwent metabolic and bariatric surgery. The Brazil Food and Nutritional Surveillance System markers of dietary consumption and the NOVA Ultra-Processed Food Screening tools were applied to evaluate dietary patterns and ultra-processed food consumption from the previous day. A total of 1525 participants were included, with a mean age of 38 ± 8 years and a mean body mass index of 29.9 ± 5.8 kg/m². From these, 766 (50.3%) individuals answered the questionnaire referring to a weekend day. After adjusting for confounders, ultra-processed food consumption was higher on weekends compared to weekdays (NOVA Score 3.07 vs. 2.42; p < 0.01). The consumption of fruits and vegetables was lower on weekends, whereas the consumption of hamburgers/sausages, sugar-sweetened beverages, boxed/canned juice, and frozen pizza increased on weekends. Instant noodles and sandwich cookies did not show differences between weekdays and weekend days. This pattern suggests the need to monitor eating habits on weekends in individuals after metabolic and bariatric surgery. Full article

(1) Background: We aimed to associate the degree of food processing with blood pressure levels in adult women. (2) Methods: A cross-sectional study was carried out on 85 adult women. The participants were subdivided into three groups: normal weight (NW: 27.05%), overweight (OW: 34.1%) and obesity (OB: 38.8%). Their anthropometric parameters, food consumption and blood pressure (BP) were evaluated. The groups were compared using one-way ANOVA or the Kruskal–Wallis test, and correlations were established using Spearman’s correlation, partial correlations (adjusted for age, medications and pathologies) and simple linear regression. Significance was set at p < 0.05. (3) Results: Women with obesity had higher systolic and diastolic blood pressure (SBP = NW: 106.5 ± 11.6; OW: 111.60 ± 11.8; OB: 123.63 ± 14.0; p < 0.001 and DBP = NW: 66.5 ± 9.9; OW: 70.2 ± 8.7; OB: 80.6 ± 11.0; p < 0.001) and a lower consumption of unprocessed or minimally processed food (MPF) (NW: 0.25 ± 0.1; OW: 0.27 ± 0.09; OB: 0.21 ± 0.07; p = 0.027). Moreover, we found an inverse association among the consumption of MPF and diastolic blood pressure that remained after adjustments for covariates (r: −0.27; p = 0.01), suggesting that lower consumption of MPF is related to higher levels of DBP. (4) Conclusions: Our data suggest that women with obesity seem to have a lower consumption of MPF. In addition, MPF is negatively correlated with BP, suggesting an association with obesity and cardiovascular health. Full article

The aim of this study is to assess the effectiveness of swimming training in reducing body mass index (BMI) and body fat percentage among individuals with Down syndrome (DS), utilizing a meta-analysis approach. We conducted a systematic search for studies examining the clinical impact of swimming training on individuals with DS. Inclusion criteria encompassed studies involving DS patients who underwent swimming training for a minimum duration of 4 weeks. The primary focus was to compare changes in BMI and body fat percentage from baseline to post-training. Our analysis incorporated four studies comprising a total of 48 participants. The results demonstrated that swimming training lasting from 8 to 36 weeks did not significantly decrease BMI among DS patients, with a weighted mean difference (WMD) post-training of −0.428 (95% confidence interval (CI): −1.721–0.865) and an I² of 0%. Subgroup analysis based on age or duration (≥33 weeks or 8 weeks) also showed no notable decrease in BMI. Conversely, the analysis of body fat percentage demonstrated a significant decrease, with a WMD of −2.946 (95% CI: −5.056–−0.837). Subgroup analysis indicated a consistent reduction in body fat percentage across all duration groups. Swimming training does not lead to a significant reduction in BMI among individuals with DS. This outcome may be attributed to concurrent muscle gain alongside decreased body fat, resulting in a notable decrease in body fat percentage. Full article

Weight stigma is described as prejudice and discrimination concerning body weight. People stigmatized by their body weight report worse physical and mental health and, consequently, poor psychosocial functioning. Research has shown a high prevalence of weight stigma among health professionals. However, less is known about weight stigma among healthcare undergraduate students. In this vignette study, we assessed weight stigma in 217 healthcare students, who filled sociodemographic and weight stigma measures, and read one of three vignettes at random, each one with a hypothetical patient which differs only in terms of body weight (underweight, healthy weight, and overweight). Then, participants answered ten questions/statements about patient characteristics described in the vignette to assess the influence of body weight on stigmatizing beliefs. Weight stigma was found in 39.44% of healthcare students. Moreover, weight stigma was higher among men, healthy weight people, and Physical Therapy students. This experimental study showed more negative attitudes in participants exposed to the patient with overweight and underweight vignettes compared to those exposed to the healthy weight patient vignette. Due to the known impacts of weight stigma, efforts are needed to address this issue during the training of healthcare undergraduate students. Full article

(1) Background: Few studies focus on the development of obesity as a chronic disease as opposed to an acute condition. The “general purpose” C3H/HeJ (C3H) mouse strain is an alternative model for obesity development with regards to sex disparities and non-predisposed populations over time. (2) Methods: In this study, 64 female and 64 male C3H mice were separated into two groups (n = 32) and maintained on a control or high-fat diet (HFD) for up to 18 months. At 6-month intervals, a cross-sectional cohort (n = ~8) was censored for evaluation. The mice were monitored for change in total, lean and fat mass, survivability, and tumor incidence. (3) Results: Both sexes in the C3H mouse strain developed diet-induced obesity (DIO). An increase in total mass consistent with a HF diet was observed in both female and male C3H mice. Survivorship at 18 months was the highest in the HF-diet-fed males (~62%) and lowest in the males fed the control diet (~19%). Females showed survivability at ~40%, regardless of diet. Cancer development increased more notably in the males with the HF diet and showed sex bias for liver cancer (males) and ovarian cancer (females) incidence with age. (4) Conclusions: This study establishes a baseline for future use of C3H mice as a strong model for studying obesity as a chronic disease, in both sexes, and as long-term model for age-related diet-induced obesity and cancer development. Full article

Silybum marianum (L.) Gaertn, commonly known as milk thistle, is an herbal medicine rich in silymarin, a bioflavonoid complex. Historically, silymarin was used for treating liver diseases, but recent studies highlight silymarin’s potential for obesity management. This narrative review aims to provide an in-depth examination of the existing knowledge of Silybum marianum (L.) and its secondary compounds concerning obesity and associated comorbidities, summarizing data from in vitro, preclinical, and clinical studies. Obesity is a significant public health issue, exacerbated during the COVID-19 pandemic, as a major risk factor for mortality. It contributes to metabolic dysfunction, including oxidative stress, metainflammation, cardiovascular diseases, and type 2 diabetes development. Silymarin has demonstrated benefits on insulin signaling and lipid metabolism, as well as antioxidant and anti-inflammatory properties at the molecular level. Innovative studies also suggest silymarin’s potential as a prebiotic, positively influencing gut microbiota composition, a key factor affected by obesity. These promising findings support the potential anti-obesity action of silymarin in clinical practice. Looking forward, using silymarin as an innovative complementary therapy could offer substantial benefits for natural health promotion and obesity management. Nevertheless, further research into optimal doses and cellular mechanisms is still needed. Full article

Introduction: Over the past 40 years, there has been a significant increase in the global prevalence of childhood obesity, which is associated with an increased risk of heart problems and the earlier onset of heart diseases. Objective: The aim of this research is to assess the prevalence of obesity and its risk factors in children and adolescents among students from the second and third cycle and secondary education of a school grouping in the interior of Portugal. Materials and Methods: The sample was collected from a school grouping in Alcains, among attending students from the fifth to the twelfth grade. The sample consisted of a total of 156 students aged between 10 and 18 years. A questionnaire was proposed, and blood pressure measurement and lipid profile evaluation were performed for each individual. The collection and statistical treatment of data for this study required a submission and authorization request to the Ethics Committee of the Polytechnic Institute of Castelo Branco, followed by authorization from the school group’s administration. Results: The percentage of elevated BMI was 30.8%, and was higher in males. A higher prevalence of hypertension (37.8%), elevated triglyceride levels in students who did not exercise outside of school, and in individuals who consumed larger amounts of meat, who also showed a higher prevalence of lower-than-expected high-density lipoprotein (HDL) cholesterol levels, were observed. Discussion: A high percentage of elevated BMI, high blood pressure levels, and changes in lipid profile were observed among high school students in this school in the interior of Portugal, as has been observed in other studies. Conclusions: It is essential to conduct more studies, screenings, and investigations that can identify these cases early, in order to mitigate risk factors. Full article

Start Strong, a 4-week culinary nutrition education and obesity prevention program designed for rural family care providers in low-income areas of Minnesota, was initially an in-person training program and was recently adapted into a virtual version. Using a quasi-experimental design, this study examined within-group and between-group (in-person versus virtual) changes in culinary skill confidence and familiarity with food assistance programs after Start Strong participation. Additionally, we examined post-program participant experiences. The in-person program (n = 12, mean age of 45 years, September 2019) took place at community locations. The virtual program (n = 27, mean age of 41 years, Fall 2021–Winter 2022) used online learning and videoconferencing. Following data collection pre- and post-program, we used t-tests to examine within-group changes after Start Strong participation, repeated measures analysis of variance tests to compare outcomes between the in-person and virtual implementations, and Fisher’s exact test to compare post-survey outcomes. The in-person and virtual programs demonstrated similar improvements in cooking skill confidence and familiarity with food assistance programs. Compared to the virtual program, in-person participants reported significantly greater connection with other providers. This evaluation is relevant to addressing disparities in obesity prevention and provides an initial model for public health and community partnerships with ECE providers. Full article