Obesities, Volume 5, Issue 1 (March 2025) – 18 articles

Background: Complete heart block (CHB) is a cardiac conduction disorder that can be fatal if not treated promptly. Malnutrition has been shown to have a significant impact on various cardiac conditions. Aim: The objective was to determine if the nutritional status influences the outcomes in patients with CHB. Methods: A retrospective study was conducted using the United States Inpatient Sample database on patients admitted with complete heart block. Outcomes were compared between the patients with and without concomitant malnutrition. Results: The study included 37,480 patients with complete heart block, of whom 603 (1.61%) had malnutrition. Compared to patients without malnutrition, patients with malnutrition had higher adjusted in-hospital mortality rates (aOR 2.61; 95% CI 1.46–3.48), longer length of stay (LOS) (mean increase 2.23 days; p < 0.01), and higher hospital charges (mean increase USD 76,907.32; p < 0.01). The malnourished group also had significantly higher rates of cardiogenic shock (aOR 2.80; 95% CI 1.56–5.03; p < 0.01) and acute respiratory failure (aOR 2.65; 95% CI 1.67–4.22; p < 0.01). Patients with malnutrition had significantly lower rates of permanent pacemaker (aOR 0.57; 95% CI 0.38–0.86; p < 0.01) and longer delay to permanent pacemaker intervention (mean increase 1.38 days; p = 0.014). The impact on outcomes was worse in patients with severe malnutrition compared to those with mild to moderate malnutrition. Conclusions: Malnutrition is associated with significantly worse outcomes in CHB admissions, including higher mortality, resource utilization, complications, and lower and delayed pacemaker intervention. Individualized and timely nutritional interventions might potentially play a key role in improving outcomes in these patients. Full article

Childhood and adolescent obesity and its associated morbidities are increasing in part due to the ingestion of diets high in fat (HFD). Changes in the gastrointestinal microbiome have been associated with these morbidities, including insulin resistance, cardiovascular disease, and inflammatory states. The use of dietary probiotics may mitigate these microbiome-associated morbidities and improve health during maturation. Using our established model of obesity in rats consuming an HFD from weaning, we examined the gut microbiome with a single-strain probiotic in the drinking water [Lactiplantibacillus plantarum 299v (Lp299v, LP299V^®)] of adolescent and adult rats. Our main finding was a differential effect of HFD and probiotic on the gut microbiome that was associated with maturation (adolescence vs. adulthood). Specifically, probiotic treatment of adolescent rats on an HFD led to alterations in the enrichment of the gut microbiome, which were associated with the morbidities of obesity, while adult rats under the same conditions exhibited minimal changes, demonstrating differences in plasticity associated with maturation. Of particular relevance in this regard is the fact that Oscillospiraceae and Lachnospiraceae, associated with beneficial short-chain fatty acid production, were enriched in adolescent rats on an HFD and treated with Lp299v. Our data suggest that the use of probiotics in childhood and adolescence may improve health in adulthood by potentially affecting the developing gastrointestinal microbiome. Full article

Objective: To investigate the association between coffee consumption and visceral obesity (VO). Methods: We conducted a retrospective, cross-sectional, observational study using data from 45,630 participants who underwent a general health check-up program at a medical center in Japan between 2015 and 2018. After excluding participants with missing data or duplicated visits, 19,253 subjects were included in the final analysis. Visceral fat area (VFA) was measured using computed tomography (CT), and data on metabolic disorders, history of lifestyle-related diseases, coffee consumption, and other lifestyle factors were collected via a self-administered questionnaire. Results: The mean ± SD VFA was 74.0 ± 49.7 cm², and the mean ± SD age was 53.3 ± 9.8 years. The prevalence of VO (VFA ≥ 100 cm²) was 25.5%. The mean coffee consumption was 1.7 ± 1.3 cups per day. In multivariate logistic regression analysis, coffee consumption was significantly inversely associated with VO. Compared to non-coffee drinkers, the odds ratios (ORs) for VO were as follows: 1 or 2 cups/day (OR: 0.75, 95% confidence interval [CI]: 0.68–0.83), 3 or 4 cups/day (OR: 0.67, 95% CI: 0.59–0.75), and ≥5 cups/day (OR: 0.65, 95% CI: 0.53–0.80). In multiple linear regression analysis, coffee consumption was significantly associated with lower VFA (Model 3: β = −1.86, SE = 0.230, p < 0.05). Conclusions: Coffee consumption was significantly associated with lower VO. Full article

Background: Equations for estimating energy expenditure are developed for specific populations and contexts, including clinical settings, body composition variations, and age groups, to enhance precision in nutritional planning and health promotion. Objective: To compare the estimated daily energy requirements using the equations from the 2005 and 2023 Dietary Reference Intakes for Energy in sedentary adults and elderly individuals. Methods: A cross-sectional, retrospective study analyzed data from records at a university outpatient clinic using convenience sampling. Participants included sedentary individuals aged 20 years or older of both sexes. The comparison was conducted using repeated measures Analysis of Variance (rmANOVA). Results: Data from 431 individuals (80% female, mean age 43.57 ± 17.30 years) were analyzed. The 2023 equations provided higher energy estimates compared to the 2005 equations. The rmANOVA revealed a significant difference between the energy estimates (F(1, 429) = 1567.24, p < 0.001, η² = 0.02), with the 2023 equations consistently yielding higher values. Conclusions: The results indicate that the estimated energy requirements significantly increased in the 2023 equations compared with those of 2005, highlighting their relevance to clinical practice. Full article

Background: The mechanisms of diabetes remission following bariatric surgery independent of calorie restriction and weight loss remain unclear. Objectives: To undertake a systematic review and meta-analysis to investigate mechanisms underpinning diabetes remission. Methods: We included individuals with type 2 diabetes who have undergone RYGB, SG, and a very low-calorie diet (VLCD). In total, 234 studies were identified (N = 52 for qualitative; N = 40 for quantitative synthesis). Review Manager v5.4 and IBM SPSS for Windows (v28.0.1.1) were used for analysis. Results: Crude annualised diabetes relapse rates for RYGB and SG are as follows: −6.98 ± 16.19 (p = 0.046) and −2.75 ± 4.94 (p = 0.08); crude remission rates for RYGB and SG, respectively, are as follows: 39.59 ± 45.93 (p = 0.000) and 33.36 ± 33.87 SG (p = 0.006). Differences in other metabolic outcomes (standardised mean difference and 95% confidence intervals (CIs)) are BMI: ([RYGB: −2.73, 95%CI: −3.14 to −2.32, p < 0.000001) (SG: −2.82, 95%CI: −5.04 to −0.60, p = 0.01)]; HbA1c: [(RYGB: −1.58, 95%CI: −2.16 to −1.00, p < 0.00001) (SG: −1.42, 95%CI: −1.69 to −1.15, p < 0.00001)]; insulin: [(RYGB: 0.16, 95%CI: −0.19 to −0.50, p = 0.37) (SG: −3.00, 95%CI: −3.17 to −2.82, p = 0.75)]; and fat mass [(RYGB: −2.56, 95%CI: −4.49 to −0.64, p = 0.009) (SG: −1.69, 95%CI: −4.58 to 1.21, p = 0.25)]. RYGB and SG produced a significant improvement in HOMA-B measurements. Adiponectin and the Matsuda index were significantly increased with RYGB. No difference was observed for other metabolic markers (RYGB: GLP-1, GIP, leptin, ghrelin, PYY) (SG: GLP-1 and FGF19) (VLCD: leptin, GLP-1, GIP, and ghrelin). Conclusions: Diabetes remission following RYGB and SG was primarily driven by improvement in beta-cell function, with improvement in insulin resistance markers also observed for RYGB, driven by reductions in fat mass. No other metabolic mechanism explaining diabetes remission was observed based on clinical studies. Full article

Introduction: Polycystic Ovary Syndrome (PCOS) affects up to 10% of women and is associated with weight gain, insulin resistance, and potential negative body image. In some cases, PCOS can lead to eating disorders, such as anorexia nervosa, due to the psychological impact of the condition’s physical symptoms. Early identification and intervention are crucial to preventing long-term health consequences. Detailed Case Description: A 25-year-old female diagnosed with PCOS at age 15 began restricting food intake to avoid weight gain, developing anorexia nervosa. By age 17, her body mass index (BMI) had dropped to 16.65, indicating moderate thinness. At that point, she started cognitive behavioral therapy (CBT) with strong social support. Over time, her eating behaviors normalized, and ten years later, her BMI was 21.16. She also scored 4.3/5 on the Body Appreciation Scale-2 (BAS-2), indicating a healthy body image. Conclusions: Early detection and intervention are crucial for women with PCOS at risk of eating disorders and body image issues. CBT plays a key role in addressing cognitive distortions, while a supportive social network strengthens recovery. Ongoing monitoring of physical and psychological health, including BMI and BAS-2, ensures effective treatment and improved long-term outcomes for these patients. Full article

According to WHO (World Health Organization), in 2022, 43% of adults worldwide were overweight and 16% suffered from obesity. Overweight and obesity is a condition in which the body, due to the excess of consumed calories, accumulates it in the form of adipose tissue. However, this tissue is not only an energy store but also secretes numerous adipokines, mainly with pro-inflammatory effects. The mobilization of the immune system due to the accumulation of adipose tissue is called low-grade inflammation (LGI) and is a mediating factor between excess body weight and diseases such as cardiovascular disease, insulin resistance, type 2 diabetes, neurodegenerative diseases, sleep apnea, and even cancer. The aim of the review is to update reports related to dietary factors influencing the severity or alleviation of low-grade inflammation in obese people. The review used studies from PubMed and Google Scholar from the last 10 years. The results indicate that the Western diet, rich in processed foods, high levels of saturated fatty acids, simple sugars, salt, and low fiber and nutrient content (vitamins and minerals), leads to increased low-grade inflammation. On the other hand, calorie restrictions and an appropriate balance of macronutrients, fatty acids, and antioxidant or anti-inflammatory nutrients (e.g., polyphenols, vitamins A, C, and E, and selenium) may reduce the severity of LGI, reducing the risk of obesity-related diseases. Full article

The aim of this work was to analyze the trend of overweight, obesity, and body fat distribution of children and adolescents in Catamarca, northwest Argentina, in the last four decades. A data series obtained between 1982 and 2019 in the province of Catamarca was analyzed. The sample of 5596 individuals (46.41% female), between 5 and 14 years old, was grouped into four decades: 1980, 1990, 2000, and 2010. The categories of overweight and obesity, based on body mass index (BMI), were defined from the international reference IOTF. The fat distribution was defined according to the subscapular tricipital index (STI). Between 1980 and 2010, BMI increased by 2.35 kg/m², overweight varied between 13.9% and 21.0%, and obesity varied between 3.4% and 19.2%. The centralized fat distribution varied from 3.9% in 1990 to 27.3% in 2010. In the cohort analysis, and after forty years, an increase in excess weight and body fat centralization was observed in children and adolescents in Catamarca. This trend was inversely proportional to the indicators of unsatisfied basic needs (UBN). It can be concluded that improvements in economic, educational, and housing conditions were not reflected in a better nutritional status. Full article

Time-restricted eating (TRE) has gained attention as an effective approach for weight management and overall well-being by focusing on limiting the eating window, rather than reducing calories. This study explores the biopsychosocial impacts of TRE in free-living individuals using a qualitative design. Twenty-one adults (aged 27–60 years) from Western Australia who had practised TRE for at least three months were purposively recruited, and semi-structured interviews were conducted. The data were analysed using a thematic analysis to identify key themes. The participants reported a range of benefits, including weight loss, reduced joint pain, better digestion, improved mental clarity, increased energy, and a more positive body image. Socially, TRE facilitated simplified daily routines but also introduced challenges, such as disruptions to social interactions and family meal dynamics. Some mixed and negative impacts were reported, including changes in sleep and exercise patterns. These findings highlight TRE’s potential as a holistic dietary intervention. Further research, particularly well-controlled, randomised controlled trials and longitudinal studies, is needed to confirm these insights and guide their appropriate application in clinical and public health settings. Full article

Introduction: Good eating habits are essential for proper growth and development. The aim of this study was to assess the correlates of eating habits and factors associated with poor food habits (i.e., Food Habits Score <50%) among in-school adolescents. Method: A cross-sectional study was conducted among 423 adolescents enrolled from 10 high schools in Harare, Zimbabwe. A questionnaire was used to collect sociodemographic data, food habits, nutrition knowledge, and physical activity. WHO AnthroPlus was used to calculate weight-for-height z-scores for body mass index values. Pearson’s Chi-square and multinomial logistic regression were used to test for associations and explore factors associated with poor food habits (p < 0.05). Results: There were more girls (n = 225, 53.2%) than boys. Poor food habits were more prevalent than healthy eating habits for both sexes (51.1% and 53.5%, p = 0.619) and in the 14–16-year-old group (59.1%, p = 0.004). Overall, poor food habits were observed across the nutrition status spectrum with a higher percentage among underweight adolescents (58.5%, p = 0.693). Significant associations were found between age groups (14–16-year-olds vs. 17–19-year-olds) and high fat consumption, especially among 14–16-year-olds (54.8%, p = 0.036). Overall, sugar consumption was high among girls and 14–16-year-olds (52.6%, p = 0.278 and 55.1%, p = 0.666), and skipping meals, especially breakfast, was also common among the same sex and age groups (53.1%, p = 0.931 and 55.2%, p = 0.882). Poor food habits were significantly associated with the age group of 14–16 years [OR= 1.582 (1.026–2.440), p= 0.038]; places of residence in particularly high-density areas [OR= 1.816 (1.344–2.454), p = 0.001]; inadequate physical activity [OR = 0.479 (0.311–0.738), p = 0.001]; and inadequate nutrition knowledge [OR = 4.321 (2.242–8.330), p = 0.001]. Conclusions: Food habits were poor across the nutrition status spectrum. Poor food habits were more common among girls and 14–16-year-olds. Age, place of residence, nutrition knowledge, and inadequate physical activity were factors significantly associated with poor food habits. Full article

It is widely known that obesity leads to various social or health problems. For example, obesity is known to not only lead to various diseases but also to reduce the performance of workers. However, there is no consensus on how to deal with obesity. Therefore, in this review paper, we narratively reviewed previous research on obesity and discrimination in the workplace and presented a perspective that supports the rationality of supporting obese people to break out of the vicious cycle, not only for the obese people themselves but also for society. Specifically, we discussed how the decline in performance due to obesity leads to worsening working conditions which further reduce performance, and how once people fall into this vicious cycle, it is difficult to break out of it because it is reinforced by stigma and there is a certain rationality in employment discrimination at the organizational level, and therefore it is possible that these people can be saved by local governments and countries taking the lead in forming a consensus on the social acceptance of obese people. Full article

Poor sleep quality is associated with unhealthy dietary choices and worse body composition among night-shift workers and women during the climacteric period. This study aimed to evaluate the effect of exogenous melatonin administration on the dietary intake and body composition in healthcare workers exposed to fixed-shift work during the climacteric period. A phase II randomized, double-blind, placebo-controlled clinical trial of climacteric women working fixed morning, afternoon, or night shifts was conducted. Baseline data collection included sociodemographic information, sleep parameters, dietary intake, and body composition using bioelectrical impedance. Participants received either 0.3 mg of melatonin or a placebo for three months. Baseline total caloric and carbohydrate intake was higher among night-shift workers than afternoon-shift workers, though afternoon-shift workers a had higher body weight and fat percentage. Post-intervention, caloric intake differences dissipated due to reduced intake among night-shift workers and increased intake among afternoon-shift workers, independent of melatonin or placebo administration. However, differences in body composition persisted. Postmenopausal participants showed reduced fat mass, while premenopausal participants experienced an increase, regardless of intervention. The results suggest that physiological nighttime melatonin doses, administered on non-consecutive nights for three months, were ineffective for changing dietary intake or body composition. Full article

Obesity has become the most consequential threat to the health of Mississippians, as it is known to be associated with major chronic diseases such as type II diabetes, heart disease, and strokes. Obesity prevalence among Mississippi adolescents has been among the highest in the nation. In this study, data from Mississippi Youth Risk Behavior Surveillance System (YRBSS) 2001–2021 were obtained from the Centers for Disease Control and Prevention (CDC). YRBSS is a survey using a self-administered questionnaire to track the risk behaviors of students in grades 9 to 12. The survey packages in R were utilized for summary statistics to account for the YRBSS complex sampling design that includes stratification, clustering, and unequal probabilities of selection. Logistic regression models and Joinpoint software 5.3.0 were used for trend analysis. Obesity prevalence in Mississippi high-school students demonstrated a significant increasing trend from 2001 to 2021, as a whole or stratified by gender or race. Furthermore, Mississippi obesity prevalence among high-school students has been increasing at a greater pace compared to that of the United States. The increasing trend in obesity prevalence among Mississippi high-school students warrants urgent attention at the government, community, school, family, and personal levels. Concerted efforts must be made to fight and eventually reverse this epidemic. Full article

Objectives: Since obesity and overweight are strongly associated with cardiovascular diseases, we investigated cardiovascular events risk in individuals who lost weight through bariatric surgery. Methods: Serum levels of glucose, insulin, triacylglycerol, HDL cholesterol, non-HDLDL cholesterol, and lipoprotein ratios were assessed in patients with obesity before and after bariatric surgery, including a 6-month follow-up period. Results: Bariatric surgery significantly improved BMI, triglyceride levels, glucose, and insulin sensitivity. However, HDL cholesterol levels dropped sharply in the first month (p < 0.0001), coinciding with elevated atherogenic indices, indicating a transient increase in cardiovascular risk. By 6 months, indices improved significantly, HDL recovered, and LDL particle size increased, suggesting reduced atherogenic potential. Conclusions: Individuals undergoing bariatric surgery have a higher cardiovascular events risk in the immediate postoperative period. Health professionals should be aware of and monitor these patients closely. Full article

COVID-19, caused by the SARS-CoV-2 coronavirus, has significantly impacted global health, particularly among patients with obesity. This study evaluates the prevalence and effects of overweight and obesity on the clinical profiles and complications of COVID-19 patients admitted to a hospital in Northern Mato Grosso. We conducted a retrospective cohort study analyzing medical records of COVID-19 patients hospitalized from March 2020 to March 2021. Patients were classified into normal body weight, overweight, and obesity groups. Data were statistically analyzed using Kruskal–Wallis’s test and Dunn’s post-test (continuous variables) or by the chi-square test (χ²) (categorical variables). Among 145 ward records, 24.1% were normal body weight, 46.2% were overweight, and 29.7% were obese. In the intensive care unit, data from 243 patients indicated that 17.3% were normal body weight, 37.9% were overweight, and 44.9% were obese, highlighting a concerning prevalence of overweight/obesity. Chest computed tomography revealed that moderate pulmonary involvement (25–50%) was most frequent in the overweight group, while severe involvement (>50%) was predominant in the obesity group. The obesity group experienced more complications, including increased use of mechanical ventilation. Notably, in both settings, mortality rates were higher among patients with overweight and obesity. This study concludes that overweight and obesity significantly worsen COVID-19 outcomes. Full article

The COVID-19 pandemic was a risky period for childhood obesity, due to the increase in unhealthy behaviors. Online interventions could prevent this problem. The aim of this study was to evaluate the feasibility and explore the effect of an online program on the BMI z-score of Mexican schoolchildren at 4 months during the pandemic. A pilot randomized controlled trial was conducted with 54 children. The intervention included three online sessions per week of nutrition and physical activity, as well as nutrition information for parents during 4 months. The control group received one nutrition digital brochure. Of the schoolchildren enrolled, 87% completed the study, and the intervention group attended 46% of the classes. At the end of the intervention, no significant difference between groups in the BMI z-score was observed (−0.02, 95% CI −0.19 to 0.15). However, the intervention group improved their quality of life and daily fruit consumption. This online intervention implemented during the COVID-19 pandemic was feasible, and the exploratory analysis showed positive trends in quality of life and daily fruit consumption but not in the BMI z-score and other secondary variables of Mexican schoolchildren. Additional strategies may be needed to improve attendance in online interventions and their impact on BMI in this age group. Full article

The COVID-19 pandemic profoundly affected the physical activity (PA) patterns of various social groups, including medical students. This study aims to compare the levels of PA, expressed in metabolic equivalent of task minutes per week (MET-m/w), among overweight and obese medical students, during and after the pandemic. The pandemic period was defined as spanning from 2020 to 16 May 2022, while the post-pandemic period covered the second half of 2022 through the end of 2023. PA levels were assessed using the International Physical Activity Questionnaire (IPAQ), and Body Mass Index (BMI) was calculated based on self-reported weight and height. Only individuals with a BMI ≥ 25 kg/m² were included. In total, 233 medical students from Wroclaw Medical University were assessed during the pandemic, and 217 post-pandemic. PA was categorized into walking, moderate, and vigorous with total MET-m/w calculated. During the pandemic, no significant gender differences were observed in walking, moderate, vigorous, or total PA. Post-pandemic, males demonstrated significantly higher levels of vigorous PA (p < 0.001) and total MET-m/w (p < 0.0001) compared to females. These findings underscore the necessity for targeted interventions promoting PA among overweight and obese medical students, especially among females. Full article

Background: Nutritional status can interfere with postoperative morbidity and mortality, but few studies have analyzed patients in the late postoperative period. Objective: To assess the relationship between nutritional status and mortality, complications and length of stay after cardiac surgery. Methods: A prospective longitudinal study, involving patients that had undergone elective cardiac surgery, who were followed up for 180 days. Results: A total of 100 participants, with a mean age of 63.3 years, were included, 61% of whom were men, and 89% of whom were sedentary. A mortality rate of 9% in 30 days and 13% in 180 days were found. Death was not related to physical activity, food, smoking, alcohol consumption and comorbidities. Patients who died had a higher Tuman score. After 6 months, it was observed that the risk of death was 2.17 times higher in those who were obese. Mortality was related to the type of surgery: myocardial revascularization (p < 0.05), complications during surgery (p < 0.001), postoperative complications (p < 0.000) and obesity (p < 0.05). Conclusions: Postoperative mortality is related to obesity, such as surgical complications and the type of surgery performed. Full article