Obesity paradox in patients with community-acquired pneumonia:Have you fully considered the confounding factors?

There exists a notion that there is an obesity paradox in the prognosis of community-acquired pneumonia.In other words,obese individuals with communityacquired pneumonia have a better prognosis.The study by Wang et al supports this claim,but we believe that the obesity paradox should not be proposed hastily as it is influenced by numerous subjective and objective confounding factors.

Gut-brain axis as a bridge in obesity and depression:Mechanistic exploration and therapeutic prospects

A recent study by Wang et al,published in the World Journal of Psychiatry,provided preventative and therapeutic strategies for the comorbidity of obesity and depression.The gut-brain axis,which acts as a two-way communication system between the gastrointestinal tract and the central nervous system,plays a pivotal role in the pathogenesis of these conditions.Evidence suggests that metabolic byproducts,such as short-chain fatty acids,lipopolysaccharide and bile acids,which are generated by the gut microbiota,along with neurotransmitters and inflammatory mediators within the gut-brain axis,modulate the host's metabolic processes,neuronal regulation,and immune responses through diverse mechanisms.The interaction between obesity and depression via the gut-brain axis involves disruptions in the gut microbiota balance,inflammatory immune responses,and alterations in the neuroendocrine system.Modulating the gut-brain axis,for example,through a ketogenic diet,the use of probiotics,and the supplementation of antioxidants,offers new remedial approaches for obesity and depression.Future research that explores the mechanisms of the gut-brain axis is needed to provide more evidence for clinical treatment.

Selenoprotein P1 as a biomarker of insulin resistance in pediatric obesity:Insights and implications

This editorial discusses the findings of Elbarky et al on the role of selenoprotein P1(SEPP1)in pediatric obesity and insulin resistance.Their study uncovered si-gnificantly lower SEPP1 Levels in children who were obese compared with hea-lthy peers,demonstrating a negative correlation between SEPP1 levels and mea-sures of adiposity and insulin resistance.These findings suggest that SEPP1 is a biomarker useful in the early identification of insulin resistance in pediatric populations.This editorial emphasizes the clinical implications of the study and calls for further research to validate and explore the role of SEPP1 in metabolic health.

The collaborative cross mouse for studying the effect of host genetic background on memory impairments due to obesity and diabetes

Background:Over the past few decades,a threefold increase in obesity and type 2 diabetes(T2D)has placed a heavy burden on the health-care system and society.Previous studies have shown correlations between obesity,T2D,and neurodegenera-tive diseases,including dementia.It is imperative to further understand the relation-ship between obesity,T2D,and cognitive deficits.Methods:This investigation tested and evaluated the cognitive impact of obesity and T2D induced by high-fat diet(HFD)and the effect of the host genetic background on the severity of cognitive decline caused by obesity and T2D in collaborative cross(CC)mice.The CC mice are a genetically diverse panel derived from eight inbred strains.Results:Our findings demonstrated significant variations in the recorded phenotypes across different CC lines compared to the reference mouse line,C57BL/6J.CC037 line exhibited a substantial increase in body weight on HFD,whereas line CC005 ex-hibited differing responses based on sex.Glucose tolerance tests revealed significant variations,with some lines like CC005 showing a marked increase in area under the curve(AUC)values on HFD.Organ weights,including brain,spleen,liver,and kidney,varied significantly among the lines and sexes in response to HFD.Behavioral tests using the Morris water maze indicated that cognitive performance was differentially affected by diet and genetic background.Conclusions:Our study establishes a foundation for future quantitative trait loci map-ping using CC lines and identifying genes underlying the comorbidity of Alzheimer's disease(AD),caused by obesity and T2D.The genetic components may offer new tools for early prediction and prevention.

Research Progress of Massage Therapy for Obesity-Induced Insulin Resistance

By searching the relevant literature in recent ten years,this paper summarizes the research progress of massage in the treatment of obesity-induced insulin resistance,in order to provide more basis for massage in the treatment of obesity-induced insulin resistance.

Ultra-processed food,obesity,and colon cancer:A systematic review and meta-analysis

BACKGROUND Recently,there has been a significant increase in the consumption of ultraprocessed foods worldwide.However,the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer remains controversial.AIM To find out the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer.METHODS A comprehensive systematic literature search of PubMed,Scopus,Web of Science,and Google Scholar for grey literature was done for articles published before 8th March 2023.The search was done to retrieve potential peer-reviewed articles that explored the association between the consumption of ultra-processed food,obesity,and the prevalence of colon cancer.RESULTS Of the 246 potential articles assessed,17 met the inclusion criteria.Meta-analysis results demonstrated that high consumption of ultra-processed food is associated with an increased risk of obesity[odds ratio(OR):1.65;95%CI:1.07-2.45;P<0.05].Consequently,there is a positive association between obesity and an increased risk of colon cancer(OR 1.48;95%CI:0.77-2.87;P>0.05).CONCLUSION Consuming ultra-processed foods increases the risk of obesity and colon cancer.

Selenoprotein-p and insulin resistance in children and adolescents with obesity

BACKGROUND Insulin resistance and obesity present significant challenges in pediatric populations.Selenoprotein P1(SEPP1)serves as a biomarker for assessing selenium levels in the body.While its association with metabolic syndrome is established in adults,its relevance in children remains underexplored.AIM To ascertain SEPP1 blood levels in children and adolescents diagnosed with obesity and to assess its correlation with insulin resistance and adiposity indices.METHODS 170 children participated in this study,including 85 diagnosed with obesity and an equal number of healthy counterparts matched for age and sex.Each participant underwent a comprehensive medical evaluation,encompassing a detailed medical history,clinical examination,and anthropometric measurements like waist circumference and waist-to-height ratio.Furthermore,routine blood tests were conducted,including serum SEPP1,visceral adiposity index(VAI),and Homeostatic Model Assessment of Insulin Resistance(HOMA-IR)level.RESULTS Our findings revealed significantly lower serum SEPP1 levels in children with obesity compared to their healthy peers.Moreover,notable negative correlations were observed between serum SEPP1 levels and body mass index,VAI,and HOMA-IR.CONCLUSION The study suggests that SEPP1 could serve as a valuable predictor for insulin resistance among children and adolescents diagnosed with obesity.This highlights the potential utility of SEPP1 in pediatric metabolic health assessment and warrants further investigation.

Combating obesity in Southeast Asia countries:current status and the way forward

Obesity is gaining prominence as a serious public health challenge in the Southeast Asia(SEA)region,with an alarming rate of increase in its prevalence.Countries in the region have shown commitment to curbing the rise of obesity by establishing policies,strategies,and action plans.This paper summarises the current situation and strategies undertaken to combat obesity and related chronic diseases.Although a range of policies and strate-gies have been developed,including national nutrition action plans,community intervention programmes,fiscal measures,nutrition labelling to promote healthier choices,countries in the region are struggling to make signifi-cant progress toward halting the scourge of obesity.It is imperative to strengthen existing health systems with a paradigm shift from a focus on"sick care"to and enhancing nutrition initiatives to support obesity prevention.A comprehensive and coordinated approach is essential,one that emphasises high-level coordination across all lev-els of government and multiple sectors,and a unified plan rather than fragmented initiatives.For strategies to be effective and sustainable,they must address the fundamental environmental determinants of poor dietary choices and nutritional inequalities.A more holistic approach is clearly needed to improve the entire food environment,which in SEA countries must include the multitude of eating places where large segments of the population"eat out"everyday to meet their energy and nutrient needs.There is a recognised need for more comprehensive measures to promote healthy eating among school children and ensure a supportive environment for lifelong healthy habits.This paper calls for a whole-of-government,whole-of-society approach that combines changes to the fundamental food environment and accompanied by systematic monitoring and surveillance systems to achieve long-lasting health outcomes.

Time trends and disparities of obesity and related national policies and programs in Nepal:a systematic review

Objective Overweight and obesity prevalence has increased in low-income countries.This study systematically reviewed the obesity trend,disparities,and prevention and control efforts in Nepal.Methods We searched PubMed and Google Scholar for articles and reports published between January 1,2004 and December 31,2022.Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts.Overweight and obesity were defined using the World Health Organization body mass index cut points.Thirty-two studies and reports were included.Results Overall,overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited.The combined overweight and obesity(OW/OB)and obesity rates in women aged 15-49 years increased from 8.5%to 22.2%and from 0.9%to 5.1%between 2006 and 2016,respectively.OW/OB and obesity rates in men were 17.1%and 2.5%based on data from the 2016 Demographic and Health Survey.OW/OB rate in under-five children increased from 0.6%to 2.8%between 2006 and 2016.Obesity rates for school-age(5-9 years)boys and girls in 2016 were 2.4%and 2.8%,respectively,and were 1.1%and 1.4%for male and female adolescents aged 10-19 years,respectively.OW/OB prevalence was much higher among women,residents in urban areas and central provinces,and in higher socioeconomic status groups.Projected prevalence of OW/OB and obesity for 2030 in adults aged 15-49 was 44.7%and 8.3%,respectively,while it was 2.2%for OW/OB in preschool children.Policies and direct interventions that specifically focused on obesity prevention and control are limited.Conclusions OW/OB prevalence in Nepal has increased during the past 1.8 decades,disproportionately affecting population groups.Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention.In the future,Nepal needs to develop population-based programs for obesity prevention.

Clinical characteristics and treatment compounds of obesity-related kidney injury

Disorders in energy homeostasis can lead to various metabolic diseases,particularly obesity.The obesity epidemic has led to an increased incidence of obesityrelated nephropathy(ORN),a distinct entity characterized by proteinuria,glomerulomegaly,progressive glomerulosclerosis,and renal function decline.Obesity and its associated renal damage are common in clinical practice,and their incidence is increasing and attracting great attention.There is a great need to identify safe and effective therapeutic modalities,and therapeutics using chemical compounds and natural products are receiving increasing attention.However,the summary is lacking about the specific effects and mechanisms of action of compounds in the treatment of ORN.In this review,we summarize the important clinical features and compound treatment strategies for obesity and obesityinduced kidney injury.We also summarize the pathologic and clinical features of ORN as well as its pathogenesis and potential therapeutics targeting renal inflammation,oxidative stress,insulin resistance,fibrosis,kidney lipid accumulation,and dysregulated autophagy.In addition,detailed information on natural and synthetic compounds used for the treatment of obesity-related kidney disease is summarized.The synthesis of detailed information aims to contribute to a deeper understanding of the clinical treatment modalities for obesity-related kidney diseases,fostering the anticipation of novel insights in this domain.

Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity:Implications for prevention and intervention

BACKGROUND Childhood obesity is a growing global concern with far-reaching health implications.This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity.Despite the increasing prevalence of childhood obesity worldwide,this issue remains inadequately addressed in the Moroccan context.AIM To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity.METHODS The research encompasses a comprehensive survey of practicing physicians,revealing significant gaps in awareness and practices related to maternal obesity.RESULTS Notably,a significant portion of doctors do not provide adequate guidance to overweight pregnant women,highlighting the urgency for targeted educational programs.CONCLUSION In conclusion,this research illuminates critical areas for improvement in tackling childhood obesity in Morocco.By addressing these gaps,fostering awareness,and enhancing medical practices,the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.

Management of male obesity-related secondary hypogonadism:A clinical update

The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism(MOSH)with emerging evidence on the role of testosterone therapy.We aim to provide an updated and practical approach towards its management.We did a comprehensive literature search across MEDLINE(via PubMed),Scopus,and Google Scholar databases using the keywords“MOSH”OR“Obesity-related hypogonadism”OR“Testosterone replacement therapy”OR“Selective estrogen receptor modulator”OR“SERM”OR“Guidelines on male hypogonadism”as well as a manual search of references within the articles.A narrative review based on available evidence,recommendations and their practical implications was done.Although weight loss is the ideal therapeutic strategy for patients with MOSH,achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice.Therefore,androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity.However,there is conflicting evidence for the appropriate use of testosterone replacement therapy(TRT),and it can also be associated with complications.This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH.Before starting testosterone replacement in functional hypogonadism of obesity,it would be desirable to initiate lifestyle modification to ensure weight reduction.TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients.Balancing the risks and benefits of TRT should be considered in every patient before and during longterm management.

Microbial phenolic metabolites 3-(3',4'-dihydroxyphenyl)propanoic acid and 3',4'-dihydroxyphenylacetic acid prevent obesity in mice fed high-fat diet

Obesity is associated with numerous metabolic disorders,and dietary polyphenols have been confirmed to have beneficial effects on the metabolism in obesity.However,the effect of 3-(3’,4’-dihydroxyphenyl)propanoic acid(DHPA)and 3’,4’-dihydroxyphenylacetic acid(DHAA),two main metabolites of dietary polyphenols,on obesity remains poorly understood.In this study,DHPA and DHAA were found to alleviate obesity,as well as regulate insulin resistance,lipid metabolism,and oxidative stress response in high-fat diet(HFD)mice.Surprisingly,the 16S rRNA sequencing and UHPLC-Q-TOF/MS demonstrated that DHPA and DHAA only slightly disturbed the intestinal microbiome,but significantly altered the urine metabolome of HFD mice mainly by regulating pentose and glucuronate interconversion,tyrosine metabolism,pentose phosphate and tricarboxylic acid(TCA)cycle as indicated by metabolic pathway analysis based on Kyoto Encyclopedia of Genes and Genomes(KEGG)database.Correlation analysis revealed that the differential metabolites are strongly associated with body weight,blood glucose,insulin level,and superoxide dismutase(SOD)enzyme activity.Our results revealed that DHPA and DHAA exert their anti-obesity effect by regulating important metabolites in the glucose,lipid and tyrosine metabolism pathways.

Association between childhood obesity and gut microbiota:16S rRNA gene sequencing-based cohort study

BACKGROUND This study aimed to identify characteristic gut genera in obese and normal-weight children(8-12 years old)using 16S rDNA sequencing.The research aimed to provide insights for mechanistic studies and prevention strategies for childhood obesity.Thirty normal-weight and thirty age-and sex-matched obese children were included.Questionnaires and body measurements were collected,and fecal samples underwent 16S rDNA sequencing.Significant differences in body mass index(BMI)and body-fat percentage were observed between the groups.Analysis of gut microbiota diversity revealed lowerα-diversity in obese children.Differences in gut microbiota composition were found between the two groups.Prevotella and Firmicutes were more abundant in the obese group,while Bacteroides and Sanguibacteroides were more prevalent in the control group.AIM To identify the characteristic gut genera in obese and normal-weight children(8-12-year-old)using 16S rDNA sequencing,and provide a basis for subsequent mechanistic studies and prevention strategies for childhood obesity.METHODS Thirty each normal-weight,1:1 matched for age and sex,and obese children,with an obese status from 2020 to 2022,were included in the control and obese groups,respectively.Basic information was collected through questionnaires and body measurements were obtained from both obese and normal-weight children.Fecal samples were collected from both groups and subjected to 16S rDNA sequencing using an Illumina MiSeq sequencing platform for gut microbiota diversity analysis.RESULTS Significant differences in BMI and body-fat percentage were observed between the two groups.The Ace and Chao1 indices were significantly lower in the obese group than those in the control group,whereas differences were not significant in the Shannon and Simpson indices.Kruskal-Wallis tests indicated significant differences in unweighted and weighted UniFrac distances between the gut microbiota of normal-weight and obese children(P<0.01),suggesting substantial disparities in both the species and quantity of gut microbiota between the two groups.Prevotella,Firmicutes,Bacteroides,and Sanguibacteroides were more abundant in the obese and control groups,respectively.Heatmap results demonstrated significant differences in the gut microbiota composition between obese and normal-weight children.CONCLUSION Obese children exhibited lowerα-diversity in their gut microbiota than did the normal-weight children.Significant differences were observed in the composition of gut microbiota between obese and normal-weight children.

Akkermansia muciniphila-directed polyphenol chlorogenic acid intervention for obesity in mice

Akkermansia muciniphila play an important in ameliorating obesity but is not allowed for direct consumption in most countries.To date,microbiota-directed foods selectively promote the targeted human gut microbes,providing a strategy for A.muciniphila enhancement.Multiple studies have indicated the potential regulation of the polyphenol on A.muciniphila.Therefore,a polyphenol screening based on A.muciniphila upregulation was performed in mice.Chlorogenic acid(CGA)exhibited a greater response to A.muciniphila upregulation.Furthermore,we found that CGA did not directly promote A.muciniphila growth or mucin secretion.Microbiome and metabolomics revealed that the increased abundance of A.muciniphila resulted from the inhibition of CGA on Desulfovibrio and Alistipes and the influence of docosahexaenoic acid,β-hydroxybutyrate,and N-acetyl-lactosamine.Finally,to confirm the regulation of CGA on A.muciniphila under disease conditions,high-fat diet-fed mice were established.The results showed CGA promoted A.muciniphila growth,and we expectedly found that CGA suppressed the augment in body weight of mice,significantly attenuated adipose tissue abnormality,provided liver protection and improved gut barrier integrity.These results suggest that CGA inhibits the development of obesity.Overall,our results indicate that microbiota-directed food is a promising approach for the treatment of obesity.

Effect of bariatric surgery on metabolism in diabetes and obesity comorbidity:Insight from recent research

Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.There are some models built by researchers to discuss the surgical procedures’effects on me-tabolism in diabetes animal models and diabetes patients.It is high time to conclude all this effects and recommend procedures that can better improve metabolism.

Insights into the interplay between gut microbiota and lipid metabolism in the obesity management of canines and felines

Obesity is a prevalent chronic disease that has significant negative impacts on humans and our companion animals,including dogs and cats.Obesity occurs with multiple comorbidities,such as diabetes,hypertension,heart disease and osteoarthritis in dogs and cats.A direct link between lipid metabolism dysregulation and obesity-associated diseases has been implicated.However,the understanding of such pathophysiology in companion animals is lim-ited.This review aims to address the role of lipid metabolism in various metabolic disorders associated with obesity,emphasizing the involvement of the gut microbiota.Furthermore,we also discuss the management of obesity,including approaches like nutritional interventions,thus providing novel insights into obesity prevention and treatment for canines and felines.

New advances of adiponectin in regulating obesity and related metabolic syndromes

Obesity and related metabolic syndromes have been recognized as important disease risks,in which the role of adipokines cannot be ignored.Adiponectin(ADP)is one of the key adipokines with various beneficial effects,including improving glucose and lipid metabolism,enhancing insulin sensitivity,reducing oxidative stress and inflammation,promoting ceramides degradation,and stimulating adipose tissue vascularity.Based on those,it can serve as a positive regulator in many metabolic syndromes,such as type 2 diabetes(T2D),cardiovascular diseases,non-alcoholic fatty liver disease(NAFLD),sarcopenia,neurodegenerative diseases,and certain cancers.Therefore,a promising therapeutic approach for treating various metabolic diseases may involve elevating ADP levels or activating ADP receptors.The modulation of ADP genes,multimerization,and secretion covers the main processes of ADP generation,providing a comprehensive orientation for the development of more appropriate therapeutic strategies.In order to have a deeper understanding of ADP,this paper will provide an all-encompassing review of ADP.

Carbonic anhydrase 2 mediates anti-obesity effects of black tea as thermogenic activator

Obesity is a metabolic disorder due to over-accumulation of adipose tissue and ultimately becomes a“disease”.Brown adipose tissue(BAT)thermogenesis and white adipose tissue(WAT)browning emerge as a potential strategy of anti-obesity by dissipating energy as heat.However,drugs based on adipose tissue thermogenesis have not been successfully approved yet.In current study,we found that black tea extract(BTE)obtained by patentauthorized manufacturing process prevented body weight gain as novel thermogenic activator with reduction of adiposity,improvement of adipose distribution,and glucose metabolism improvement in diet-induced obesity mice.Mechanismly,anti-obesity effect of BTE depends on promoting BAT thermogenesis and WAT browning with upregulation of uncoupling protein 1(UCP1),especially visceral adipose tissue(VAT)with browning resistance.Specifically,utilizing in silico approach of network pharmacology and molecular docking,we identified carbonic anhydrase 2(CA2)in nitrogen metabolism as anti-obesity target of BTE and further elucidated that protein kinase B(AKT)signaling pathway linked CA2 and UCP1.Meanwhile gut microbiota regulation may prompt the CA2-dependent thermogenesis activation.Our findings demonstrated anti-obesity effect of BTE as thermogenic activator through CA2-mediated BAT thermogenesis and WAT browning via CA2-AKT-UCP1 signaling pathway,which could be developed as promising anti-obesity agent with good safety and efficacy.

Association of Serum Folate and Vitamin B_(12) Concentrations with Obesity in Chinese Children and Adolescents

Objective This study aimed to evaluate the associations of serum folate and/or vitamin B12 concentrations with obesity among Chinese children and adolescents.Methods A cross-sectional study was conducted including 3,079 Chinese children and adolescents,aged 6 to 17 years,from Jiangsu,China.Anthropometric indices,such as,children's body mass index(BMI),BMI z-scores,waist circumference,and waist-to-height ratio were utilized.Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B12 levels with anthropometric indices and odds of obesity.Results We observed that serum vitamin B12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity[odds ratio(OR)=0.68;95%confidence interval(CI)=0.59,0.78]and abdominal obesity(OR=0.68;95%CI=0.60,0.77).When compared to participants with both serum vitamin levels in the two middle quartiles,those with both serum folate and vitamin B12 levels in the highest quartile were less prone to general(OR=0.31,95%CI=0.19,0.50)or abdominal obesity(OR=0.46,95%CI=0.31,0.67).Conversely,participants with vitamin B12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity(OR=2.06,95%CI=1.09,3.91).Conclusion Higher serum vitamin B12 concentrations,but not serum folate concentrations,were associated with lower odds of childhood obesity.Children and adolescents with high levels of vitamin B12 and folate were less likely to be obese.