India’s nutrition transition has led to an increased burden of overweight/obesity (body mass index of ≥23 kg/m2), driven by lifestyle factors like poor diet, inactivity, and substance use, prompting public health interventions. However, these interventions lack supporting evidence, especially in rural areas, hindering effective strategies for this population. To address this evidence gap, this study used cohort data (baseline: 2018–19, follow-up: 2022–23) from the Birbhum Population Project (West Bengal, India) to analyse lifestyle risk factors and their association with incidence and remission of overweight/obesity among adults aged ≥18 years (sample: 8,974). Modified Poisson regression model was employed to attain the study objective. From 2017–2018 to 2022–2023, the prevalence of overweight/obesity increased from 15.2% (95% CI: 14.1%–16.4%) to 21.0% (95% CI: 19.7%–22.3%) among men and from 24.1% (95% CI: 22.9%–25.2%) to 33.8% (95% CI: 32.5%–35.1%) among women. Overall, 23.0% (95% CI: 21.8%–24.3%) of adults experienced incidence of overweight/obesity, while 13.9% (95% CI: 12.4%–15.6%) experienced remission. Use of motor vehicles among unemployed participants was associated with incident overweight/obesity (relative risk or RR: 1.058; 95% CI: 1.023–1.095; P: 0.001). Vigorous activity at home (including gardening, yard work, and household chores) was linked to higher odds of recovering from overweight/obesity (RR: 1.065; 95% CI: 1.008–1.125; P: 0.025). Frequent tobacco use (often/daily vs. none) was inversely associated with remission of overweight-obesity (RR: 0.689; 95% CI: 0.484–0.980; P: 0.038), as was each 1 ml in alcohol consumption (RR: 0.995; 95% CI: 0.991–0.999; P: 0.022). Discouraging habitual motor vehicle use may help prevent overweight/obesity, while promoting home-based activities may aid remission, particularly for women who are at higher risk for overweight/obesity.

A hospital-based cross-sectional study involving children aged 2–15 years attending the obesity clinic of a tertiary care hospital from January 2016 to March 2018 was carried out to study carotid intima media thickness (cIMT) and its association with cardiometabolic risk factors in children with overweight and obesity. Secondary objective was to compare children with elevated (EcIMT) and normal cIMT (NcIMT). Out of 223 patients enrolled for the study, 102 (45·7 %) had EcIMT. Mean cIMT of the study participants was 0·41 (sd 0·13) mm. Median alanine transaminase levels (27 v. 24, P= 0·006) and proportion of patients with fatty liver (63·7 % v. 48·8 %, P= 0·025) and ≥ 3 risk factors (80·4 % v. 66·1 %, P= 0·003) were higher in the EcIMT group compared with NcIMT group. Proportion of patients with hypercholesterolemia (36·4 % v. 16 %, P= 0·024), elevated LDL-cholesterol (38·6 % v. 16 %, P= 0·013), low HDL-cholesterol (40·9 % v. 20 %, P= 0·027) and dyslipidemia (84·1 % v. 58 %, P= 0·006) was higher in the pubertal EcIMT group and those with fatty liver (63·8 % v. 45·1 %, P= 0·034) was higher in the prepubertal EcIMT group compared with pubertal and prepubertal NcIMT groups, respectively. No significant correlations were observed between cIMT and various cardiometabolic parameters. Our finding of EcIMT in nearly half of the study participants including young children is very concerning as these children are at increased risk of atherosclerotic CVD in adulthood. Interventions starting at a young age are important when trajectories are likely to be more malleable and adverse cardiometabolic phenotypes and subclinical atherosclerosis are reversible.

Substantial changes resulting from the interaction of environmental and dietary factors contribute to an increased risk of obesity, while their specific associations with obesity remain unclear. Identify inflammation-related dietary patterns (DPs) and explore their associations with obesity among urbanized Tibetan adults under significant environmental and dietary changes.Totally, 1826 subjects from the suburbs of Golmud City were enrolled in an open cohort study, of which 514 were followed up. Height, weight, and waist circumference were used to define overweight and obesity. DPs were derived using reduced rank regression with 41 food groups as predictors and hs-CRP and prognostic nutritional index as inflammatory response variables. Altitude was classified as high or ultra-high. Two DPs were extracted. DP-1 was characterized by having high consumptions of sugar-sweetened beverages, savory snacks, and poultry, and a low intake of tsamba. DP-2 had high intakes of poultry, pork, animal offal, and fruits, and a low intake of butter tea. Participants in the highest tertiles (T3) of DPs had increased risks of overweight and obesity (DP-1: OR=1.37, 95% CI: 1.07, 1.77; DP-2: OR=1.48, 95% CI: 1.18, 1.85) than those in the lowest tertiles (T1). Participants in T3 of DP-2 had an increased risk of central obesity (OR=2.25, 95% CI: 1.49, 3.39) than those in T1. The positive association of DP-1 with overweight and obesity was only significant at high altitudes, while no similar effect was observed for DP-2. Inflammation-related DPs were associated with increased risks of overweight and/or obesity.

This study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of 3 months. The study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between 1 January 2020 and 31 December 2023. The primary outcome is the percentage weight loss. Among the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 (49·56 %)), followed by balanced dietary guidance (139 (41·00 %)) and pharmacotherapy (32 (9·44 %)). The total percentage weight loss for patients who were followed up for 1 month, 2 months and 3 months was 4·98 (3·04, 6·29) %, 7·93 (5·42, 7·93) % and 10·71 (7·74, 13·83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥ 3 % and ≥ 5 % at 1 month (OR = 0·461, P < 0·05; OR = 0·349, P < 0·001). The results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy.

This study aimed to explore the combined effects of serum vitamin-D level and tobacco exposure on the risk of overweight and obesity in children. This cross-sectional study analysed the data of 11 636 children aged 2–17 years from the National Health and Nutrition Examination Surveys database between 2007 and 2018. Univariable and multivariate weighted logistic regression models were used to analyse the associations of serum vitamin-D or cotinine levels with overweight and obesity in children as well as the combined effects of serum vitamin-D and cotinine on the risk of overweight and obesity in children. Subgroup analysis was performed in terms of gender, age, race and household smokers. OR with corresponding 95 % CI was presented. The elevated risk of overweight and obesity in children was found in those with serum vitamin-D < 20 ng/ml (OR = 1·44, 95 % CI: 1·29, 1·61). Also, the odds of overweight and obesity in children was 1·14 (OR = 1·14, 95 % CI: 1·01, 1·29) in children with cotinine ≥ 0·05 ng/ml. Relative to participants with serum vitamin-D ≥ 20 ng/ml and cotinine < 0·05 ng/ml, increased risk of overweight and obesity was identified in those with serum vitamin-D < 20 ng/ml and cotinine < 0·05 ng/ml (OR = 1·45, 95 % CI: 1·26, 1·68) and serum vitamin-D < 20 ng/ml and cotinine ≥ 0·05 ng/ml (OR = 1·62, 95 % CI: 1·38, 1·91). Serum vitamin-D and cotinine exposure had combined effects on the risk of overweight and obesity in children.

Few studies investigated the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status, particularly among adolescents. The present study was designed to investigate the association of MIND diet with metabolic health status in Iranian adolescents with overweight/obesity. This cross-sectional study was done among 203 adolescents with overweight/obesity (12–18 years) in Isfahan, Iran. A validated FFQ was applied to collect dietary intakes. Anthropometric indices and blood pressure were also measured by standard procedures. Fasting blood samples were obtained to determine serum insulin, glucose and lipid profile. To categorise participants as being with metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO), two methods including International Diabetes Federation (IDF) criteria and IDF plus Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were applied. Participants had a mean age of 13·98 years and 50·2 % of them were girls. In fully adjusted models, participants with highest MIND diet adherence had lower odds of MUO status based on IDF (OR = 0·20; 95 % CI 0·08, 0·51) and IDF/HOMA-IR (OR = 0·22; 95 % CI 0·08, 0·59) criteria. Stratified analyses revealed that this association was stronger among girls and was only significant among individuals with overweight. An inverse association was also found between MIND diet score and odds of hyperglycaemia and insulin resistance (IR). Higher MIND diet adherence was associated with lower odds MUO in adolescents with overweight/obesity. Inverse associations were also found between MIND diet and odds of hyperglycaemia and IR. Future longitudinal prospective studies are necessary to confirm our results.

This study evaluated the effect of green tea extract and metformin and its interaction on markers of oxidative stress and inflammation in overweight women with insulin resistance. After screening, 120 women were randomly allocated in 4 groups: Placebo (PC): 1g of microcrystalline cellulose/day; Green tea (GT): 1 g (558 mg polyphenols) of standardized dry extract of green tea/day and 1 g of placebo/day; Metformin (MF): 1 g of metformin/day and 1 g of placebo/day; Green Tea and Metformin (GTMF): 1 g (558 mg polyphenols) and 1 g of metformin/day. All groups were followed-up for 12 weeks with assessment of oxidative damage to lipids and proteins, specific activity of antioxidant enzymes and inflammatory cytokine serum levels. The association of green tea with metformin significantly reduced IL-6 (GTMF: –29.7((–62.6)–20.2))(p = 0.004). Green tea and metformin isolated reduced TNF-α (GT: –12.1((–18.0)–(–3.5)); MF: –24.5((–38.60)–(–4.4)) compared to placebo (PB: 13.8 (1.2–29.2))(P < 0.001). Also, isolated metformin reduced TGF-β (MF: –25.1((–64.4)–0.04)) in comparison to placebo (PB: 6.3((–1.0)–16.3))(p = 0.038). However, when combined, their effects were nullified either for TNF-α (GTMF: 6.0((–5.7)–23.9) and for TGF-β (GTMF: –1.8((–32.1)–8.5). This study showed that there is a drug-nutrient interaction between green tea and metformin that is dependent on the cytokine analyzed.

Saccharin is a widely used sugar substitute, but little is known about the long-term health effects of saccharin intake. Our study aimed to examine the association between saccharin intake and mortality in diabetic and pre-diabetic population and overweight population from NHANES 1988–1994. Cox proportional hazard models were used to evaluate the association between saccharin intake and CVD, cancer and all-cause mortality. After multivariable adjustment, increased absolute saccharin intake was associated with the risk of all-cause mortality (hazard ratio (HR): 1·41, 95 % CI: 1·05, 1·90), CVD mortality (HR: 1·93, 95 % CI: 1·15, 3·25) and cancer mortality (HR: 2·26, 95 % CI: 1·10, 4·45) in diabetic and pre-diabetic population. Among overweight population, higher absolute saccharin intake was associated with the risk of cancer mortality (HR: 7·369, 95 % CI: 2·122, 25·592). Replacing absolute saccharin intake with total sugar significantly reduced all-cause mortality by 12·5 % and CVD mortality by 49·7 % in an equivalent substitution analysis in the diabetic and pre-diabetic population. Aspartame substitution reduced all-cause mortality by 29·2 % and cancer mortality by 30·2 %. Notably, the relative daily intake of saccharin also had similar effects as the absolute intake on all-cause, cardiovascular and cancer mortality in all analyses. This was despite the fact that the relative daily intake in our study was below the Food and Drug Administration limit of 15 mg/kg. In conclusion, our study showed a considerable risk of increased saccharin intake on the all-cause, CVD mortality and cancer mortality.

Dicarbonyl compounds are highly reactive precursors of advanced glycation end products (AGE), produced endogenously, present in certain foods and formed during food processing. AGE contribute to the development of adverse metabolic outcomes, but health effects of dietary dicarbonyls are largely unexplored. We investigated associations between three dietary dicarbonyl compounds, methylglyoxal (MGO), glyoxal (GO) and 3-deoxyglucosone (3-DG), and body weight changes in European adults. Dicarbonyl intakes were estimated using food composition database from 263 095 European Prospective Investigation into Cancer and Nutrition–Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating Out of Home in Relation to Anthropometry participants with two body weight assessments (median follow-up time = 5·4 years). Associations between dicarbonyls and 5-year body-weight changes were estimated using mixed linear regression models. Stratified analyses by sex, age and baseline BMI were performed. Risk of becoming overweight/obese was assessed using multivariable-adjusted logistic regression. MGO intake was associated with 5-year body-weight gain of 0·089 kg (per 1-sd increase, 95 % CI 0·072, 0·107). 3-DG was inversely associated with body-weight change (–0·076 kg, −0·094, −0·058). No significant association was observed for GO (0·018 kg, −0·002, 0·037). In stratified analyses, GO was associated with body-weight gain among women and older participants (above median of 52·4 years). MGO was associated with higher body-weight gain among older participants. 3-DG was inversely associated with body-weight gain among younger and normal-weight participants. MGO was associated with a higher risk of becoming overweight/obese, while inverse associations were observed for 3-DG. No associations were observed for GO with overweight/obesity. Dietary dicarbonyls are inconsistently associated with body weight change among European adults. Further research is needed to clarify the role of these food components in overweight and obesity, their underlying mechanisms and potential public health implications.

Considered the epidemic of the 21st century by the WHO, obesity is a global problem that is on the rise and will continue to increase in the coming years. Spain and Andalusia, in particular, are no exception to this pathology, which has tripled since the 1970s, representing a public health challenge. The aim of this study is to analyse the socioeconomic determinants of this pathology, with special emphasis on answering the question of what has a greater influence on overweight, education level, or income. For this purpose, we have used the European Survey of Health in Spain (ESHS-2020), a microdata base, with a total of 22,072 valid individual observations (of which 2,820 belong to the Andalusian population). Results we obtain in our estimations of qualitative response models reveal that, although both income and educational attainment could be effective in the fight against overweight, the social gradient of this health problem is greater with respect to educational attainment. Additionally, there are many other variables and other factors related to the individual’s overweight (mental health, subjective state of health, oral health, among others) which are much less explored and which must be considered in health policies to combat this disease.

Weight abnormalities (underweight, overweight, and obesity) can cause life-threatening ailments. This study investigates disparities in the prevalence of underweight, overweight, and obesity between northern and southern Nigeria and their associated factors. Using the 2018 Nigeria Demographic and Health Survey (NDHS), the study analysed a sample of 12,333 women with complete records of body mass index. The study found that southern women had lower odds of being underweight than women in the north, but the reverse was the case for overweight and obesity. The prevalence of underweight was 11.6%, and it varies from 6.9% in the southern state of Enugu to 31.6% in the northern state of Jigawa. The national prevalence of overweight was 17.9%, ranging from 6.7% in Jigawa State of the northern region to 39.9% in Lagos State of the south. Similarly, the prevalence of obesity in the north was 6.1% compared to 14.4% in the south, with Anambra State of the southern region recording the highest figure of 35.5% compared to 2.1% in the Yobe State of the northern region. In all, the rate of abnormal weight was significantly higher in the south than in the north. However, the type of weight abnormality varies between the two regions. Religion, education, use of contraceptives, and wealth were associated with the three forms of abnormal weights. However, while religion was significantly associated with obesity in the north, the association was not significant in the south. This study found that wealth and education have dissimilar influences on overnutrition. While the odds of being overweight and obese increase with wealth, being educated up to a secondary level significantly reduces the odds in Nigeria and across the two regions.

Obesity is one of the major contributors to the excess mortality seen in people with severe mental illness (SMI) and in low- and middle-income countries people with SMI may be at an even greater risk. In this study, we aimed to determine the prevalence of obesity and overweight in people with SMI and investigate the association of obesity and overweight with sociodemographic variables, other physical comorbidities, and health-risk behaviours. This was a multi-country cross-sectional survey study where data were collected from 3989 adults with SMI from three specialist mental health institutions in Bangladesh, India, and Pakistan. The prevalence of overweight and obesity was estimated using Asian BMI thresholds. Multinomial regression models were then used to explore associations between overweight and obesity with various potential determinants. There was a high prevalence of overweight (17·3 %) and obesity (46·2 %). The relative risk of having obesity (compared to normal weight) was double in women (RRR = 2·04) compared with men. Participants who met the WHO recommendations for fruit and vegetable intake had 2·53 (95 % CI: 1·65–3·88) times greater risk of having obesity compared to those not meeting them. Also, the relative risk of having obesity in people with hypertension is 69 % higher than in people without hypertension (RRR = 1·69). In conclusion, obesity is highly prevalent in SMI and associated with chronic disease. The complex relationship between diet and risk of obesity was also highlighted. People with SMI and obesity could benefit from screening for non-communicable diseases, better nutritional education, and context-appropriate lifestyle interventions.

Later timing of eating has been associated with higher adiposity among adults and children in several studies, but not all. Moreover, studies in younger children are scarce. Hence, this study investigated the associations of the timing of evening eating with BMI Z-score and waist-to-height ratio (WHtR), and whether these associations were moderated by chronotype among 627 preschoolers (3–6-year-olds) from the cross-sectional DAGIS survey in Finland. Food intake was measured with 3-d food records, and sleep was measured with hip-worn actigraphy. Three variables were formed to describe the timing of evening eating: (1) clock time of the last eating occasion (EO); (2) time between the last EO and sleep onset; and (3) percentage of total daily energy intake (%TDEI) consumed 2 h before sleep onset or later. Chronotype was assessed as a sleep debt-corrected midpoint of sleep on the weekend (actigraphy data). The data were analysed with adjusted linear mixed effects models. After adjusting for several confounders, the last EO occurring closer to sleep onset (estimate = −0·006, 95 % CI (−0·010, −0·001)) and higher %TDEI consumed before sleep onset (estimate = 0·0004, 95 % CI (0·00003, 0·0007)) were associated with higher WHtR. No associations with BMI Z-score were found after adjustments. Clock time of the last EO was not significantly associated with the outcomes, and no interactions with chronotype emerged. The results highlight the importance of studying the timing of eating relative to sleep timing instead of only as clock time.

Globally, the prevalence of those living with obesity (≥30 kg/m2) is rising, with this trend expected to continue if firm and decisive policy interventions are not introduced. Across Europe, despite many consecutive policies aiming to reverse rising trends in weight status over recent decades, no country is currently on track to halt and reverse current trends in the coming years. This is evident in Ireland too, whereby the reporting of nationally representative weight status data show that targets have not been achieved since reporting began. The aim of this review is to critically appraise recent evidence relating to the key determinants of obesity including weight status, diet quality and physical activity with an emphasis on socioeconomic inequalities. And to consider these in the context of respective policy measures and propose future-focused recommendations. Furthermore, as with the complex nature of obesity, multifaceted approaches that shift the focus from the individual and place responsibility at a societal level will be reviewed.