The Prevalence of Overweight/Obesity and Related Comorbidities among HIV-Positive and HIV-Negative Patients Attending the Same Clinics in Gaborone, Botswana

Context: Antiretroviral therapy (ART) helps restore the health status of people living with HIV (PLHIV). Likewise, it increases the risk of overweight/obesity and related comorbidities among the recipients. In countries like Botswana where ±84% of PLHIV is on ART, the paucity of data comparing overweight/obesity between HIV-positive on ART and HIV-negative patients may impede clinical and policy decision-making. This study sought to estimate and compare: i) the prevalence of overweight/obesity between HIV-positive on ART and HIV-negative patients;ii) the prevalence of hypertension (HTN), diabetes mellitus (DM)/coronary heart disease (CHD) between HIV-positive patients on ART and HIV-negative patients attending same outpatient departments of general clinics in Gaborone, Botswana. Patients and Methods: Five hundred eighty-one (581) outpatients were recruited in four major clinics of Gaborone, Botswana, between June and July 2019;294 or 51% of them were HIV-negative and 287 or 49% were HIV-positive on ART. The prevalence of overweight/obesity and of HTN and DM/CHD were calculated and examined using stratified analysis. Subgroups were compared using Chi-square analysis with Yates correction or Fisher exact test and t-student test for continuous data. Results: Major findings after stratification of the study population by HIV status were: i) the prevalence of all categories of (BMI), including overweight/obesity, were comparable between HIV-negative-patients and HIV-positive. In fact, there were 24 (8.0%) cases of underweight among HIV-negative-Patients and 15(5%) cases among HIV-positive patients, p = 0.2;145 (49%) HIV-negative-patients and 128 (45%) HIV-positive, p = 0.07 cases of normal weight;72 (25%) HIV-negative-patients and 87 (30%) HIV-positive, p = 0.08, were overweight;53 (18%) HIV-negative-patients and 57 (20%) HIV-positive, p = 0.12, were obese;125 (43%) HIV-negative patients and 144 (50%) HIV-positive, p=0.06 were overweight/obese;ii) the prevalence of HTN and DM/CHD among HIV-positive-patients were significantly lower (p < 0.05) compared to HIV-negative patients: There were 32 (10.9%) cases of HTN among HIV-negative patients compared to 18 (6.3%) cases of HTN among HIV-positive patients, p = 0.001;32 (11%) cases of DM/CHD HIV-negative patients compared to 4 (1.4%) cases of DM/CHD among HIV-positive patients, p = 0.001. Conclusion: the prevalence of overweight/obesity observed between HIV-negative and HIV-positive patients may suggest that the two groups shared the same exposure factors. That HTN and DM/CHD prevalence was lower among HIV-positive compared to HIV-negative patients, is possibly due to interplay factors of ART, HIV or the host population. Further studies are, however, recommended for clarifications.

Overweight/Obesity in University Students from Mexico: Comparison Using Different Indices

The goal was to compare body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), and relative fat mas (RFM), to identify the best predictor of overweight and obesity in university students from Mexico. This is a cross-sectional survey with 697 university students from northern and central Mexico (448 women, and 249 men aged 18 - 19 years). Data was collected during 2018. Overweight and obesity were calculated from those indices and for both, female and male students, the order of correlation between a pair of indices were WHtR vs. RFM > WHtR vs. WC > RFM vs. WC > WHtR vs. BMI > BMI vs. WC > RFM vs. BMI. It is concluded to use the WHtR and the RFM to better predict overweight and obesity in young Mexican university students.

Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring

BACKGROUND Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes,metabolic syndrome,and cardiovascular diseases in adulthood.It is very important to identify relevant risk factors and intervene as early as possible.At present,the relationship between maternal and offspring metabolic factors is conflicting.AIM To estimate the association of maternal obesity and gestational diabetes mellitus(GDM)with overweight/obesity and fatty liver risk in offspring at 8 years of age.METHODS The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age.Offspring birth weight,sex,height,weight,and body mass index(BMI)were measured and calculated.FibroScan-502 examination with an M probe(Echosens,Paris,France)was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.RESULTS A total of 430 mother-child pairs were included in the analysis.A total of 62(14.2%)mothers were classified as obese,and 48(11.1%)were classified as having GDM.The mean age of the offspring at follow-up was 8 years old.Thirty-seven(8.6%)offspring were overweight,14(3.3%)had obesity,and 60(14.0%)had fatty liver.The prevalence of overweight,obesity and fatty liver in offspring increased significantly across maternal BMI quartiles(all P<0.05).Among offspring of mothers with GDM,12(25.0%)were overweight,4(8.3%)were obese,and 12(25.0%)had fatty liver vs.25(6.5%),10(2.6%)and 48(12.6%),respectively,for offspring of mothers without GDM(all P<0.05).In multiple logistic regression,after adjustment for variables,the OR for fatty liver in offspring was 8.26(95%CI:2.38-28.75)for maternal obesity and GDM.CONCLUSION This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring,and GDM status also increases the odds of overweight/obesity in offspring.Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.

Relationship between circulating irisin levels and overweight/obesity: A meta-analysis

BACKGROUND Currently, the findings about irisin as a novel myokine related to obesity are inconsistent in overweight/obese people. To our knowledge, no systematic analysis has been conducted to evaluate the relationship between irisin levels and overweight/obesity. AIM To evaluate the association between circulating irisin levels and overweight/obesity. METHODS The Cochrane Library, MEDLINE, SCOPUS, and the ISI Web of Science were searched to retrieve all of the studies associated with circulating irisin levels and overweight/obesity. Standard mean difference values and 95% confidence intervals (CI) were estimated and pooled using meta-analysis methodology. RESULTS A total of 18 studies were included in our meta-analysis containing 1005 cases and 1242 controls. Our analysis showed that the circulating irisin level in overweight/obese people was higher than that in overall healthy controls (random effects MD = 0.63;95%CI: 0.22-1.05;P = 0.003). In the subgroup analysis by ethnicity, the irisin level was higher in overweight/obesity people than that in controls in Africa (random effects MD = 3.41;95%CI: 1.23-5.59;P < 0.05) but not in European, Asian, or American populations. In addition, in a subgroup analysis by age, the results showed that obese children exhibited a higher irisin level than controls (random effects MD = 0.86;95%CI: 0.28-1.43;P < 0.05). CONCLUSION This meta-analysis provides evidence that circulating irisin is higher in obese individuals compared to healthy controls and it is important to identify the relationship between circulating irisin levels and overweight/obesity in predicting overweight/obesity.

The prevalence of hypertension overweight/obesity and its relation with cardiovascular disease among middle-aged Chinese population

Objective To investigate the prevalence of hypertension overweight/obesity and the combined effect on the incidence of cardiovascular disease(CVD).Methods The study population(aged from 35 to 64)were selected from 9 regions of China by cluster sampling method.The baseline was conducted in 2010,and the follow-up survey was done in 2017.Participants with 24≤BMI28 kg/m^2 was defined as overweight,BMI≥28 kg/m^2 was defined as obesity.

Association between sleep duration and overweight/obesity among Chinese children and adolescents:a longitudinal study

Background:To determine the associations between sleep duration and overweight/obesity in Chinese children and adolescents.Methods:This longitudinal study analyzed 3,126 children and adolescents aged 7 to 18 years who had participated in the China Health and Nutrition Survey during 2004-2011.Sleep duration was classified into<9 h,9-10 h,and>10 h for children aged 7-12 years,and<8 h,8-9 h,and>9 h for adolescents aged 13-18 years.Results:After adjusting for confounder,short sleep duration was associated with overweight/obesity for girls aged 7-12 years(β=4.32,95%confidence interval=1.27 to 7.37,P=0.006)and boys aged 13-18 years(β=3.38,95%confidence interval=2.01 to 4.74,P<0.001).No statistically significant association was found among the other 2 groups.Meanwhile,long sleep duration was not statistically significant at any age.Conclusion:The association between short sleep duration and overweight/obesity to be dependent on both age and gender.

Proteomic analysis of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention

Objective:To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.Methods:Seventy-one subjects were enrolled in the study.We assessed blood glucose,blood lipids,body mass index(BMI),and phlegm-dampness pattern,which was confirmed by a traditional Chinese medicine clinician.Of the participants,we included healthy participants with normal weight(NW,n=23),overweight/obese participants with normal metabolism(ONM,n=19),overweight/obese participants with pre-diabetes(OPD,n=12),and overweight/obese participants with marginally-elevated blood lipids(OML,n=17).Among them,the ONM,OPD,and OML groups were diagnosed with phlegmdampness pattern.The data-independent acquisition(DIA)method was first used to analyze the plasma protein expression of each group,and the relevant differential proteins of each group were screened.The co-expressed proteins were evaluated by Venn analysis.The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis(IPA)software.Parallel reaction monitoring(PRM)was used to verify the differential and common proteins in each group.Results:After comparing ONM,OPD,and OML groups with NW group,we identified the differentially expressed proteins(DEPs).Next,we determined the DEPs among OPD,OML,and ONM groups.Using Venn analysis of the DEPs in each group,24 co-expressed proteins were screened.Two co-expressed proteins were verified by PRM.IPA analysis showed that pathways including LXR/RXR activation,acute phase response signaling,and FXR/RXR activation were common to all three groups of phlegmdamp overweight/obesity participants.However,the activation or inhibition of these pathways was different among the three groups.Conclusion:Participants with overweight/obesity have similar proteomic characteristics,though each type shows specific proteomic characteristics.Two co-expressed proteins,VTN and ORM1,are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegmdampness retention.

Parental perceptions and childhood overweight/obesity: A population-based study among school children in Japan

The lifestyle of children is primarily controlled by their parents, and that childhood obesity is related to family variables. The aim of this study was to investigate the relationship between parental perceptions on childhood obesity and their child’s overweight/obesity in Japan. The study subjects were 3168 school children (aged 9 or 10 years) and their parents in the town of Ina, Saitama Prefecture, Japan, between 2002 and 2009. Information regarding parental perceptions about childhood obesity and the lifestyle factors of their children was collected using self-administered questionnaires completed by the participants and their parents. Childhood over-weight was defined according to the International Obesity Task Force cutoffs. Parental perceptions on childhood obesity were significantly associated with their child’s overweight status. Specifically, low perceptions regarding childhood obesity significantly increased the odds ratio (OR) for the child’s overweight status (OR: 1.86, 95% CI: 1.32 - 2.62). However, when the analysis was limited to children with both parents being overweight, there was no statistically significant difference between levels of parental perceptions and the overweight status of their children. Accordingly, the present study suggests that, when both parents are obese, not only is raising parental awareness important, but also encouraging parents to prevent themselves from becoming overweight, leads to improvements in the lifestyle habits of children, which may contribute to the prevention of childhood overweight.

Effects of Food Habits and Lifestyle on Prevalence of Overweight/Obesity among Schoolchildren in Taif Area, KSA

Background/Objectives: The Saudi population has experienced significant transformations in their lifestyle which could be attributed to several factors. Aims: This work sought to determine effects of food habits and lifestyle on prevalence of overweight (OW)/obesity (OB) among schoolchildren in Taif City, KSA. Materials and Methods: A cross-sectional study was carried out using well-designed questionnaire. Pretested questionnaire was randomly distributed among schoolchildren in Taif city. Body mass index and waist circumference were used as tools for assessing nutritional status of schoolchildren. Results: A total of 2027 students filled the questionnaire with a mean age of 15.83 ± 2.18 years. The prevalence of OW and OB was 14.6% and 12.9%, respectively, while the combined one was 27.5%. The combined prevalence of OW and OB was significantly higher among boys than girls (31.9 vs. 21.9). Schoolchildren from high income families had high rate of OW and OB. Smoking, stress, TV viewing, daylight and night sleep had no effects on BMI, while only smoking of a family member and stress had considerable relationship with W_C. Unfortunately, 52.2% of students admitted that they were physically inactive but this effect was insignificant for both indicators. Students skipped breakfasts constitute 18.8% of subjects included but link with BMI and W_C was statistically insignificant. Regular soft or diet drinks had significant effects on BMI. Results showed considerable link between consumption of fruits/vegetables, grains and W_C. Conclusions: The prevalence of combined OW/OB among schoolchildren was 27.5%. Family income, participant’s gender, intake of regular soft or diet drinks had significant effects on BMI. While, stress, smoking of a family member, and uptake of fruits and vegetables showed considerable relationship with W_C.

Physical Activity, Screen Time, and Prevalence of Overweight/Obesity among Adolescents in a Creative, Problem-Solving Program

Certain dietary, physical activity, and sedentary behaviors have been studied extensively and consistently have been found to be associated with childhood overweight and obesity Productive sedentary-to-light activity pursuits may enhance the relationship among positive health behaviors. The purpose of this study was to identify the prevalence of overweight and obesity in a population of adolescents participating in a creative, problem-solving afterschool program and to identify the physical activity, sedentary, and dietary behaviors related to overweight and obesity in this group. This study describes health behaviors thought to be related to weight status for 1679 adolescents in grades 6 12 participating in a competitive, creative, team-oriented, problem-solving afterschool program. Self-reported dietary, physical activity, and sedentary behavior data were collected in this convenience sample based on the 2007 Youth Risk Behavior Survey. Measured height and weight data were collected to calculate BMI percentile. Using multinomial regression, models were constructed to predict the likelihood of being classified as overweight/obese. The prevalence of overweight in the study population was 15.6%, obese was 11.4%. Fruit/vegetable intake, milk consumption, moderate-to-vigorous physical activity, television time, and total screen time were all independently associated with weight status. After controlling for all covariates, male gender, minority racial/ethnic status, and high screen time while not meeting the physical activity recommendation significantly increased the likelihood of overweight/obesity. The participants in the current study are leaner and engage in healthier behaviors compared to national data for adolescents. The interactive variable combining both sedentary and PA measures is a relatively new technique used to provide a better understanding of the relationship between sedentary and physical activity behaviors as they relate to weight status. Even among healthy eating, physically active, low-risk adolescents, the interactive variable of physical activity and screen time strongly was associated with weight status.

Gut Microbiota Diversity and Overweight/Obesity in Infancy:Results from a Nested Case-control Study

Objective:Childhood obesity is a major health concern worldwide.Previous studies have explored the relationship between obesity and gut microbiota.However,the results from such studies remain contradictory.Methods:In the present nested case-control study,based on a twin birth cohort study,the relationship between gut microbiota diversity and overweight/obesity in 1-and 6-month-old infants was explored.

Epidemiological Aspects of Obesity, Overweight and Cardiovascular Risk Factors at Associes in Semi-Urban Areas (Case of Sébikotane)

Introduction: Obesity and overweight are a public health problem. The general objective was to determine the epidemiological aspects of obesity, overweight and associated risk factors in a semi-urban environment. Patients and Methods: This was a cross-sectional, descriptive study conducted on November 28 and 29, 2023 in Sébikotane. It focused on volunteers for screening for chronic non-communicable diseases. Epidemiological and clinical data were evaluated. Results: One hundred and twenty-nine cases of obesity were recorded (28%). Two hundred and eighty-two cases were overweight or obese (61.3%). The mean age was 49.55 years, with a standard deviation of 12.41 years. The age group [40 - 49 years] was the most representative, with 85 cases (30.1%), and the majority were female, with 264 cases (93.6%). Primary education was the most common, with 75 cases (46.3%). Grade 1 obesity concerned ninety-seven cases (75.2%), and diabetes was present in thirty cases (23%). Hypertension was present in ninety-five cases (33.7%). Obesity was more marked in the age group [40 - 49 years] with 45 cases (36%). Conclusion: Obesity and overweight are a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

Prevalence and Factors Associated with Overweight and Obesity among Public Secondary School Teachers in Parakou, Benin, in 2021

Introduction: Overweight and obesity represent a public health problem in Africa due to the epidemiological transition. The objectives of this work were to determine the prevalence of overweight and obesity and to identify associated factors among public secondary school teachers in Parakou, Benin in 2021. Methods: We conducted a descriptive and analytical cross-sectional study. Teachers working in public secondary schools in Parakou during the 2020-2021 academic year, present at work and who gave their written informed consent, were included. A two-stage random sampling was carried out. Data were collected during an individual interview using a questionnaire followed by the measurement of anthropometric parameters and blood pressure. Overweight and obesity were defined by a body mass index ≥ 25 kg/m2. Multivariable logistic regression was performed to identify associated factors. Results: A sample of 325 teachers, including 88.6% of men, was recruited with an average age of 36.2 ± 6.8 years. The prevalence of overweight and obesity was 43.7% (95% CI [38.1%-44.8%]). It increased significantly with income (p Conclusion: The results show a high prevalence of overweight and obesity. Actions are necessary to prevent overweight and obesity among secondary school teachers in Parakou, in Benin.

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.

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.

Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography

AIM:To evaluate the relationship of overweight and obesity with retinal and choroidal thickness in adults without ocular symptoms by swept-source optical coherence tomography(SS-OCT).METHODS:According to the body mass index(BMI)results,the adults enrolled in the cross-sectional study were divided into the normal group(18.50≤BMI<25.00 kg/m^(2)),the overweight group(25.00≤BMI<30.00 kg/m^(2)),and the obesity group(BMI≥30.00 kg/m^(2)).The one-way ANOVA and the Chi-square test were used for comparisons.Pearson’s correlation analysis was used to evaluate the relationships between the measured variables.RESULTS:This research covered the left eyes of 3 groups of 434 age-and sex-matched subjects each:normal,overweight,and obesity.The mean BMI was 22.20±1.67,26.82±1.38,and 32.21±2.35 kg/m^(2) in normal,overweight and obesity groups,respectively.The choroid was significantly thinner in both the overweight and obesity groups compared to the normal group(P<0.05 for all),while the retinal thickness of the three groups did not differ significantly.Pearson’s correlation analysis showed that BMI was significantly negatively correlated with choroidal thickness,but no significant correlation was observed between BMI and retinal thickness.CONCLUSION:Choroidal thickness is decreased in people with overweight or obesity.Research on changes in choroidal thickness contributes to the understanding of the mechanisms of certain ocular disorders in overweight and obese adults.

Drawing lines in the sand: The growing threat of obesity in type 1 diabetes

In this editorial,we comment on the article by Zeng et al published in the recent issue of the World Journal of Diabetes in 2024.We focus on the epidemiological,pathophysiological,and clinical interplay between obesity and type 1 diabetes mellitus(T1DM).Overweight and obesity represent a growing threat for modern societies and people with T1DM could not be an exception to this rule.Chronic exogenous insulin administration,genetic and epigenetic factors,and psy-chosocial and behavioral parameters,along with the modern way of life that incorporates unhealthy eating patterns and physical inactivity,set the stage for the increasing obesity rates in T1DM.As our knowledge of the underlying mechanisms that lead to the development of obesity and hyperglycemia expands,it becomes clear that there are overlap zones in the pathophysiology of the two main types of diabetes.Stereotypes regarding strict dividing lines between“autoimmune”and“metabolic”phenotypes increase the risk of trapping physicians into ineffective therapeutic approaches,instead of individualized diabetes care.In this context,the use of adjuncts to insulin therapy that have the potential to alleviate cardiorenal risk and decrease body weight can reduce the burden of obesity in patients with T1DM.

Global research trends and hotspots in overweight/obese comorbid with depression among children and adolescents: A bibliometric analysis

BACKGROUND Overweight/obesity combined with depression among children and adolescents(ODCA)is a global concern.The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity.Childhood and adolescence represent critical periods for physical and psychological development,during which the comorbidity of overweight/obesity and depression may increase the risk of adverse health outcomes.AIM To evaluate the relationship between ODCA,we conduct a bibliometric analysis to aid in formulating prevention and treatment strategies.METHODS From 2004 to 2023,articles related to ODCA were selected using the Science Citation Index Expanded from the Web of Science Core Collection.Bibliometric analysis of relevant publications,including countries/regions,institutions,authors,journals,references,and keywords,was conducted using the online bibliometric analysis platforms,CiteSpace,VOSviewer,and bibliometrix.RESULTS Between 2004 and 2023,a total of 1573 articles were published on ODCA.The United States has made leading contributions in this field,with Harvard University emerging as the leading contributor in terms of research output,and Tanofsky being the most prolific author.The J Adolescent Health has shown significant activity in this domain.Based on the results of the keyword and reference analyses,inequality,adverse childhood experiences,and comorbidities have become hot topics in ODCA.Moreover,the impact of balancedrelated behavior and exploration of the biological mechanisms,including the potential role of key adipocytokines and lipokines,as well as inflammation in ODCA,have emerged as frontier topics.CONCLUSION The trend of a significant increase in ODCA publications is expected to continue.The research findings will contribute to elucidating the pathogenic mechanisms of ODCA and its prevention and treatment.

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.