Search Results (9,155)

Background: This study aims to investigate the potential modifying effects of lifestyle behavior on the association between drinking water micronutrients and body mass index (BMI) in a large population of children and adolescents. Methods: Data of the present analysis came from a comprehensive regional large-scale surveillance study in 2022, involving 172,880 children and adolescents (50.71% boys vs. 49.29% girls) aged seven to seventeen. A restricted cubic spline (RCS) analysis was utilized to examine the exposure-response association of regular drinking water indices (including fluoride, nitrate nitrogen, pH, chloride, sulfates, and total dissolved solids (TDS), total hardness (TH), and chemical oxygen demand (COD)) with BMI. Generalized linear model and logistic regression were conducted to relate BMI and quartiles of drinking water micronutrients. Results: Our findings reveal a nonlinear association between nitrate nitrogen (P for nonlinear < 0.001) and pH (P for nonlinear < 0.001) with BMI. High TH and COD levels significantly increase BMI. Notably, fluoride and chloride were associated with BMI Z-scores but not with overweight and obesity (OB). The BMI Z-score showed a more pronounced association with low and high pH levels in girls. For urban participants, increased TH levels were associated with a higher risk of OB. This study also found that adopting healthy lifestyles could mitigate the negative effects of fluoride, chloride, and sulfate on BMI Z-scores. Conclusions: This large surveillance study provides new insights into the complex interplay between drinking water micronutrients and BMI in children and adolescents. The association of various drinking water parameters on BMI varies, necessitating ongoing focus on their effects, particularly among girls and urban individuals. Healthy lifestyle behavior could mitigate the effects of fluoride, chloride, and sulfate on BMI Z-score. Full article

Type 2 diabetes mellitus (T2DM) is a multifactorial disease, influenced by dietary and environmental factors that can modify the intestinal microbiota. The aim of this study was to evaluate changes in the composition and diversity of the intestinal microbiota associated with carbohydrate (CHO) consumption in T2DM patients. Forty patients participated, with and without T2DM. Fecal samples were collected for the characterization of microbial diversity from the massive sequencing of the 16S rRNA gene. Carbohydrate consumption was quantified using the Frequency Consumption Foods questionnaire (FCF), the groups were categorized according to Body Mass Index (BMI) and BMI + CHO consumption. The group without T2DM showed normal biochemical and anthropometric parameters, although they had a high carbohydrate consumption compared to the group with T2DM. At the phylum level, there were differences in relative abundance; the control overweight group (CL–OW > CHO) and T2DM-Normal Weight > CHO patients had increased Bacteroides and decreased Firmicutes. In contrast, the CL–OW > CHO and T2DM-OW < CHO patients, showed reduced Bacteroidetes and an elevated amount of Firmicutes. At the genus level, the differences were in the relative abundance of Roseburia, Clostridium_IV, Prevotella, and Sporobacter, associated with the consumption of carbohydrates. The groups that consumed high amounts of carbohydrates, regardless of whether they had diabetes mellitus or were overweight, had a significantly reduced proportion of Faecalibacterium, an altered proportion of Bacteroides. The high consumption of carbohydrates showed considerable modifications in the composition and diversity of the bacterial communities. Full article

Bioelectrical impedance analysis (BIA) is a widely used method for estimating body composition, and its accuracy may be influenced by various factors, including bladder filling. This study aims to investigate the impact of bladder filling on the accuracy of BIA measurements. An experimental crossover study was conducted with sedentary young adults. The influence of bladder filling on total body water (TBW), fat mass (FM), fat-free mass (FFM), and basal metabolic rate (BMR) was assessed. Participant in underwear followed an overnight fast. They were instructed to abstain from vigorous physical activity and alcohol for at least 24 h prior to the session. The results obtained from single-frequency and multi-frequency BIA devices were compared. The findings suggest that bladder filling does not affect measured impedance; however, changes in weight following bladder voiding influenced derived BIA results. Specifically, TBW, FM, and BMR values significantly reduced after voiding (p < 0.05). Furthermore, the study found poor agreement between single-frequency and multi-frequency BIA devices, indicating that they are not interchangeable. Bladder filling does affect BIA measurements, not clinically meaningful. Further research is needed to explore the implications of these findings for clinical practice and research protocols. Full article

Background and Objectives: We analyzed the changes in obesity, glucose metabolism, and body composition over a 3-year period in Japanese patients with obesity following laparoscopic sleeve gastrectomy (LSG). Methods: Body weight, parameters related to diabetes such as glycated hemoglobin (HbA1c), and electrical impedance analysis were used to assess body composition in forty-eight Japanese patients with obesity before surgery and 6 months, 1 year, 2 years, and 3 years after LSG. Results: At 6 months, 1, 2, and 3 years post-LSG, there were significant reductions in body weight, body mass index, blood pressure, fasting plasma glucose, triglyceride, and HbA1c levels. Six months after LSG, fat mass (FM), muscle mass (MM), and %FM all showed a decrease compared to pre-treatment values (all p < 0.05). FM and %FM remained in a decreased state until 3 years had passed. In contrast, %MM increased at 6 months post-LSG and was maintained up to 3 years post-LSG (all p < 0.05). Furthermore, changes in FM and %FM were associated with changes in body weight and A1C. In contrast, change in %MM exhibited a negative correlation with body weight and A1C following LSG. Finally, multivariate regression analyses demonstrated that alterations in FM were independent factors affecting body weight in patients with obesity 3 years after LSG. Conclusions: We observed improvements in FM, fasting plasma glucose, and HbA1c levels over a 3-year period in Japanese patients after LSG. The reduction in FM and maintenance of %MM after LSG were suggested as possible links between the effects of LSG on obesity and diabetes over 3 years. Full article

Background/Objectives: One of the main culprits of the obesity epidemic is the obesogenic food environment, which promotes the consumption of ultra-processed foods (UPFs) that are highly palatable, have low nutritional quality and a high caloric impact and are economical and ready to use. This monocentric retrospective study explored the association between UPFs, obesity and adiposity measurements among adults living with obesity in Southern Italy. Methods: According to their Body Mass Index (BMI) values, 175 participants (63M) were recruited and stratified into three groups. To evaluate their usual eating habits, PREDIMED and the Nova Food Frequency Questionnaire (NFFQ) were administered to investigate Mediterranean diet (MD) adherence and UPF consumption. Anthropometric and biochemical measurements, body composition, as well as visceral obesity indices were collected. Results: The data showed an increase in UPF consumption as the BMI increased, with a concomitant decrease in MD adherence. Soft drinks were the most representative UPF in all groups, and we observed a significant increase in such consumption as the BMI increased. In addition, in the highest tertile of UPF consumption, there was an increase in adiposity indices. Conclusions: Our data suggest that high UPF consumption correlates with an increased BMI and visceral adiposity, and it is a predictive risk factor for the occurrence of non-communicable diseases. Full article

Obesity, a prevalent metabolic disorder in youth, leads to complications and economic strain. Gut dysbiosis significantly contributes to obesity and metabolic issues. Bifidobacterium breve, a probiotic strain, may help regulate gut dysbiosis and benefit obese individuals. However, more research is needed on its effect on serum metabolism. A total of 75 overweight or obese young adults (aged 19–45) participated in the current study, and were randomly divided into probiotic and placebo groups using a random number table. Both groups received dietary guidance and underwent twelve weeks of intervention with either oral Bifidobacterium breve BBr60 (BBr60) or a placebo. After the intervention, collection and analysis of fasting serum samples were conducted using mass spectrometry coupled with liquid chromatography. Analyses of associations were conducted in order to determine the correlations between key serum metabolites and clinical obesity indicators, aiming to understand the influence of BBr60. Due to 10 participants dropping out for personal reasons, the study included 32 and 33 participants in the placebo and the BBr60 groups, respectively. The BBr60 intervention significantly regulated 134 serum metabolites and influenced crucial metabolic pathways in obesity management (p < 0.05), including ascorbate and aldarate metabolism for oxidative stress reduction, cholesterol metabolism for lipid regulation, parathyroid hormone synthesis, secretion and action for the endocrine system, oxidative phosphorylation for enhanced energy efficiency, and glycolysis/gluconeogenesis for glucose metabolism. Analysis showed a positive relationship between fasting blood glucose (FBG), aspartate aminotransferase (AST), total protein (TP), and the content of 5-Methyl DL-glutamate (p < 0.05). Similarly, body mass index (BMI), weight, and body fat percentage (BFP) were positively linked to serum metabolites (1-Hydroxycyclohexyl) acetic acid, and 5-Oxooctanoic acid (p < 0.05). Significant associations of AST levels with key serum metabolites in cholesterol metabolism pathways further suggest BBr60’s potential to improve liver function and overall metabolic health in overweight or obese individuals. These findings support BBr60’s effectiveness in modulating serum metabolic profiles and suggest it may improve liver function and BMI in overweight or obese individuals by regulating key serum metabolites. Full article

Background and Objectives: Obesity-related chronic inflammation may lead to neuroinflammation and neurodegeneration. This study aimed to evaluate the neurometabolic profile of obese patients using cerebral multivoxel magnetic resonance spectroscopy (mvMRS) and assess correlations between brain metabolites and obesity markers, including body mass index (BMI), waist circumference, waist-hip ratio, body fat percentage, and indicators of metabolic syndrome (e.g., triglycerides, HDL cholesterol, fasting blood glucose, insulin, and insulin resistance index (HOMA-IR)). Materials and Methods: This prospective study involved 100 participants, stratified into two groups: 50 obese individuals (BMI ≥ 30 kg/m²) and 50 controls (18.5 ≤ BMI < 25 kg/m²). Anthropometric measurements, body fat percentage, and biochemical markers were evaluated. All subjects underwent long- and short-echo mvMRS analysis of the frontal and parietal supracallosal subcortical and deep white matter, as well as the cingulate gyrus, analyzing NAA/Cr, Cho/Cr, and mI/Cr ratios, along with absolute concentrations of NAA and Cho. Results: Obese participants exhibited significantly decreased NAA/Cr and Cho/Cr ratios in the deep white matter of the right cerebral hemisphere (p < 0.001), while absolute concentrations of NAA and Cho did not differ significantly between groups (p > 0.05). NAA levels showed negative correlations with more reliable obesity parameters (waist circumference and waist-to-hip ratio) but not with BMI, particularly in the deep frontal white matter and dorsal anterior cingulate gyrus of the left cerebral hemisphere. Notably, insulin demonstrated a significant negative impact on NAA (ρ = −0.409 and ρ = −0.410; p < 0.01) and Cho levels (ρ = −0.403 and ρ = −0.392; p < 0.01) at these locations in obese individuals. Conclusions: Central obesity and hyperinsulinemia negatively affect specific brain regions associated with cognitive and emotional processing, while BMI is not a reliable parameter for assessing brain metabolism. Full article

Background: Individuals observe Ramadan fasting for ~11 h per day for 28–30 days, which can negatively affect lean mass. Resistance training or increased protein intake can potentially preserve lean mass in these individuals. Methods: Twenty-three young and healthy adult Muslim men were divided into three groups: Ramadan fasting (RAM), Ramadan fasting combined with resistance training (RAM + RT), and Ramadan fasting combined with 30 g of daily whey protein (RAM + WH). Participants’ body mass, body mass index (BMI), body fat percentage, fat mass, and lean mass were measured the week prior to and during the last week of Ramadan via a stadiometer and dual-energy X-ray absorptiometry (DXA). Results: Body mass (kg) was decreased for all three groups (RAM = −1%, RAM + RT = −1%, RAM + WH = −1.3%; p = 0.033), though there were no differences between groups. Lean mass (kg) was decreased for all three groups (RAM = −1%, RAM + RT = −1%, RAM + WH = −2%; p = 0.013), though there were no differences between groups. No differences were observed for body weight, BMI, or body fat percentage. Conclusions: These results indicate resistance training or whey protein did not provide any advantage for preserving lean mass in individuals participating in Ramadan fasting. Full article

Background/Objectives: Multiple-drug-resistant (MDR) bacteria are pathogens resistant to three or more antibiotic classes, and infection with these bacteria is associated with increased mortality, morbidity, and hospital management costs. Given the rise in antibiotic resistance, selecting appropriate antimicrobial drugs and avoiding the unnecessary use of new antibiotics are crucial. Due to their nosocomial nature, monitoring and preventing MDR infections are essential. Methods: This study enrolled patients who underwent cardiac surgery from January 2020 to May 2022. The patients included were those 18 years or older who tested positive for MDR intestinal colonization before surgery. Excluded were patients who tested positive after surgery, or were younger than 18, pregnant, or lactating. For each positive patient, the National Surgical Quality Improvement Program (NSQIP) score was calculated. The data collected included age, gender, body mass index (BMI), the type of surgery, the intensive care unit (ICU) length of stay, ICU readmission, mortality, and other infections (pneumonia, bacteremia, or surgical site infection) to establish a control group and postoperative outcome measures. Results: No statistically significant differences were found between the groups regarding the ICU length of stay, new ICU admissions, or mortality. Additionally, there were no differences in the infection rates, such as bacteremia, wound infections, and pneumonia. Conclusions: Preoperative rectal colonization by MDR bacteria does not appear to worsen postoperative outcomes for cardiac surgery patients. These findings suggest that patients with a preoperative MDR-positive rectal sample might undergo cardiac surgery without significantly increased risk. Besides the limitations of this study, pre-surgical antibiotic prophylaxis may not need to be adjusted for patients with preoperative MDR positivity. Full article

Scope: The main purpose of our study was to collect computed tomography (CT) measurements of fat parameters that are significantly related to body mass index (BMI) and evaluate the associations of these measurements and sarcopenia with early and long-term complications after transcatheter aortic valve implantation (TAVI) in order to investigate the existence of the so-called ‘obesity paradox’ and the role of sarcopenia in this phenomenon. Materials and Methods: We analyzed the significance of fat CT measurements in 85 patients undergoing the TAVI procedure and compared these with each other, as well as with quantified CT BMI and fat density measurements. Secondly, we evaluated the associations of BMI, CT measurements of fat, and CT evaluations of skeletal muscle mass with early and long-term complications after 24 months of post-TAVI follow-up. Results: We found positive and significant relationships between fat CT measurements with each other and with BMI and a negative and significant relation between fat density and fat quantity. By comparing the CT measurements of fat and skeletal muscle mass with early and long-term complications after TAVI, we confirmed the existence of the ‘obesity paradox’ and the poor effect of sarcopenia after the TAVI procedure. Conclusions: We confirm that overweight and obesity are good prognostic factors, and sarcopenia is a poor prognostic factor for outcomes following the TAVI procedure. We focused on the scientific validation of an easy and fast way to measure fat and skeletal muscle mass using CT to better predict the outcomes of patients undergoing TAVI. Full article

Borderline personality disorder (BPD) is a complex psychiatric disorder characterized by an unstable sense of self and identity, emotional dysregulation, impulsivity, and disturbed interpersonal relationships. This narrative review examines the interplay between dysregulation of the autonomic nervous system, metabolic changes, and cardiovascular risk in BPD. Altered heart rate variability (HRV), reflecting the dysregulation of the autonomic nervous system, is associated with some BPD core symptoms, such as emotional instability and impulsivity. Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, often stemming from early trauma, contributes to chronic inflammation and elevated allostatic load, which further increases cardiovascular risk. Metabolic dysfunctions in BPD, such as elevated body mass index (BMI), high blood pressure, and inflammatory markers like C-reactive protein (CRP), exacerbate these risks. Speckle-tracking echocardiography, particularly global longitudinal strain (GLS) and biomarkers such as homocysteine and epicardial fat, could be considered early predictors of cardiovascular events in individuals with BPD. Chronic stress, inflammation, and maladaptive stress responses further heighten cardiovascular vulnerability, potentially accelerating biological aging and cognitive decline. A literature search covering the period from 2014 to 2024 on PubMed identified 189 studies on this topic, of which 37 articles were deemed eligible for this review. These included cross-sectional, longitudinal, case–control, randomised controlled trials (RCTs), reviews, and meta-analysis designs, with sample sizes ranging from 14 to 5969 participants. The main limitations were that only one database was searched, the time of publications was limited, non-English manuscripts were excluded, and the quality of each paper was not commented on. This narrative review aims to provide an overview of recent evidence obtained on this topic, pointing out a direction for future research. Full article

Background: Providing early nutritional support through Ying Yang Bao (YYB) can assist children in achieving their full developmental potential. We aimed to examine the lasting impact of YYB and how growth affects neurodevelopment in preschool children. Methods: 1104 children aged 1 year were divided into a YYB control group (YYB-CG) and a YYB intervention group (YYB-IG). Information on basic characteristics, anthropometric measurements, dietary status, YYB consumption, and neurodevelopment for these children was taken annually from 2018 to 2022 until they reached 5 years old. Confounders were well balanced using propensity score matching (PSM), and then 474 pairs of children were included in subsequent analyses. The comparison between groups was performed using t-tests or chi-square analyses. Linear regressions were used to examine the independent associations between children’s dimensions (Z-score for weight relative to age [WAZ], Z-score for height relative to age [HAZ], Z-score for body mass index by age [BAZ], and conditional measures of height- and weight-based growth) and neurodevelopment. Results: Children in the YYB-IG had higher scores in the mental index (MI), the developmental quotient (DQ), height, and BAZ (p < 0.05) and had a lower risk of stunting. Accelerated weight gain from ages 1 to 5 (β (95% confidence interval [CI]): 0.26 (0.08–0.45)) and increased height gain during this period (β (95% CI): 0.68 (0.14–1.23)) were associated with greater MI. A higher WAZ was linked to increased MI at 1 year (β (95% CI): 0.89 (0.09–1.68)), 2 years (β (95% CI): 0.99 (0.20–1.78)), 3 years (β (95% CI): 0.92 (0.15–1.69)), 4 years (β (95% CI): 0.88 (0.09–1.68)), and 5 years of age (β (95% CI): 1.01 (0.28–1.74)). An increased HAZ corresponded with a higher MI score at ages 1 year (β (95% CI): 1.47 (0.75–2.20)), 2 years (β (95% CI): 1.25 (0.49–2.02)), 3 years (β (95% CI): 1.11 (0.31–1.90)), 4 years (β (95% CI): 0.93 (0.12–1.74)), and 5 years old (β (95% CI): 1.17 (0.43–1.90)); higher DQ levels were also recorded at 1 year (β (95% CI): 0.82 (0.10–1.55)) and 5 years of age (β (95% CI): 0.79 (0.06–1.51)). Conclusions: YYB can improve specific areas of neurodevelopment and growth in preschool children. Additionally, children’s linear growth is positively linked to neurodevelopment in those of preschool age. Full article

Background/Objectives: This study aims to evaluate the potential of the SarQoL questionnaire as a screening tool for sarcopenic obesity by comparing its effectiveness in Spanish and Belgian community-dwelling older people. This research seeks to address the primary question of whether the SarQoL can reliably differentiate quality of life impacts between these groups. Methods: A cross-sectional study was conducted involving community-dwelling older adults from Valencia (Spain) and Liège (Belgium). Participants were assessed using the SarQoL questionnaire, which measures health-related quality of life specifically for sarcopenia, and a sarcopenic obesity diagnostic method based on a combination of the EWGSOP2 criteria for sarcopenia and of body mass index for obesity. The sample included diverse demographic and clinical characteristics to ensure comprehensive analysis. Statistical methods were employed to compare the outcomes between the two populations. Results: The study highlighted a significant relationship between quality-of-life scores and the prevalence of sarcopenic obesity in the Spanish and Belgian populations. The SarQoL questionnaire effectively identified lower quality of life in individuals with sarcopenic obesity, demonstrating its potential as a reliable screening tool across different populations. In conclusion, the SarQoL questionnaire proved to be an effective tool for evaluating quality of life and for screening individuals with sarcopenic obesity. Conclusions: Future research should prioritize longitudinal studies to determine the SarQoL questionnaire’s predictive value and investigate interventions to alleviate the adverse effects of sarcopenic obesity. Our results highlight the critical need to include quality of life assessments in managing sarcopenic obesity, advocating for a comprehensive approach to patient care. Full article

Objectives: Observational research shows associations of the gut microbiota and its metabolites with autoimmune thyroid disease (AITD), but the causality is undetermined. Methods: Two-sample Mendelian randomization (MR) was employed to analyze the association of the gut microbiota and its metabolites with AITD. A total of 119 gut microbiotas and nine fecal/circulating metabolites were the exposures. AITD, Graves’ disease (GD), and Hashimoto’s thyroiditis (HT) were the outcomes. Inverse-variance weighting (IVW) was primarily used to assess causality; Cochran’s Q was used to assess heterogeneity. Sensitivity analyses (weighted median, MRPRESSO regression, MRPRESSO intercept, MRPRESSO global, Steiger filtering, leave-one-out) were conducted to assess causal estimate robustness. Multivariable MR (MVMR) was used to estimate the effects of body mass index (BMI) and alcohol consumption frequency on causality. Results: The outcomes were potentially causally associated with 22 gut microbiotas and three metabolites. After multiple-test correction, 3-indoleglyoxylic acid retained significant causality with AITD (IVW: odds ratio [OR] = 1.09, 95% confidence interval [CI] = 1.05–1.14, p = 2.43 × 10⁻⁵, FDR = 0.009). The sensitivity analyses were confirmatory (weighted median: OR = 1.06, 95% CI = 1.01–1.12, p = 0.025; MRPRESSO: OR = 1.09, 95% CI = 1.15–1.14, p = 0.001). MVMR revealed no confounding effects on this association (BMI: OR = 1.21, 95% CI =1.08–1.35, p = 0.001; drinks/week: OR = 1.22, 95% CI = 1.04–1.43, p = 0.014). Conclusions: MR revealed no significant causal effects of the gut microbiota on the outcomes. However, MR revealed the causal effects of 3-indoleglyoxylic acid on the risk of AITD. Full article

Background and Objectives: Diabetic patients are more likely to develop infections compared to the general population, especially urinary tract infections (UTIs). The aim of this study was to assess the prevalence of UTIs in a population of patients with diabetes (DM) from Romania, to identify the most common uropathogens and their antimicrobial resistance (AMR) patterns, as well as to determine the correlations between resistance behavior and particularities of patients with UTIs according to DM type. Materials and Methods: The hospital records of 1282 type 1 (T1D) and type 2 DM (T2D) adult inpatients who were ordered urine cultures during hospitalization were reviewed, and all 241 patients who presented a positive urine culture were included in the present study analysis. Results: The prevalence of UTIs in diabetic patients was 18.8% and higher in patients with T2D vs. T1D. Patients with UTIs and T2D had a significantly older age, longer duration of DM, higher waist circumference and body mass index, lower levels of estimated glomerular filtration rate, and more frequent chronic complications of DM than patients with T1D. E. coli was the most frequently isolated uropathogen (56.4%), with a significantly higher incidence for T2D, followed by K. pneumoniae (12.9%) and Enterococcus spp. (9.5%). Although the acquired resistance phenotypes were more frequently isolated in T2D patients (over 90% of the multidrug-resistant and extended-spectrum beta-lactamase-producing isolates, respectively, and 75% of the total carbapenem-resistant organisms), no statistically significant correlation was found regarding the distribution of AMR patterns in the two types of DM. Conclusions: The present study brings new data regarding the prevalence of UTIs in diabetic patients from Western Romania. By identifying the spectrum of uropathogens and their AMR pattern, this paper may contribute to improving UTI management in diabetic patients, thus reducing antibiotic overuse and preventing recurrent UTIs. Full article