The aim of this randomized, controlled trial was to investigate effects of breakfast high or low in protein on body composition and cardiometabolic markers in young women with overweight. In total, 56 women aged 18-30 years consumed a breakfast containing either high-protein (HP, 34 g protein, n= 26) or low-protein (LP, 6 g protein, n=30) for 12 weeks. Measurements of body composition by DXA, waist circumference, glucose tolerance, and fasting glucose, insulin, and lipid profile were performed before and after this period. The primary outcome was fat mass. Satiety and hunger were evaluated by self-reported VAS-scores. Dietary intake was estimated by 4-day dietary records, and calcium intake was estimated by food frequency questionnaires. At baseline, relative daily protein intake was 15.2±2.8 E%, which increased to 19.3±3.4 E% in HP but was unchanged in LP (P<0.001 between groups). HP reported higher satiety compared to LP (P=0.02). Yet, no group differences were observed in changes in energy intake, body composition, blood lipid profile, or measures of glucose tolerance (all P>0.10). However, bone mineral content tended to increase in HP (P=0.05) and decrease in LP (P=0.07, interaction effect: P=0.01). Conclusively, a high versus low content of protein in breakfast increased satiety but did not affect body composition or cardiometabolic markers in young women with overweight. This study adds to the sparse evidence on effects of breakfast with different macro-nutrient compositions on health parameters in women with overweight. Registered at clinicaltrials.gov: NCT04518605.

Obesity is a chronic, complex and multi-factorial condition with an increasing prevalence worldwide. Irregular eating schedules might be a contributing factor to these numbers through the dysregulation of the circadian system. Time-restricted eating (TRE), an approach that limits eating windows, has been studied as a strategy to treat obesity, aligning eating occasions with metabolic circadian rhythms. This review aims to provide an overview of the impact of TRE protocols on metabolic, inflammatory, oxidative stress, and circadian rhythm biomarkers in people with overweight or obesity. Most studies report significant weight loss following TRE protocols. While glucose levels decreased in nearly all TRE interventions, only a few studies demonstrated statistically significant differences when compared to the control groups. The findings for CRP and TNF-α were inconsistent, with limited significant differences. Changes in lipid profile changes were variable and generally did not reach statistical significance. Both 4-hour and 6-hour TRE interventions significantly reduced 8-isoprostane levels. Additionally, TRE significantly altered clock gene expression, as well as that of genes associated with metabolic regulation in subcutaneous adipose tissue. While the evidence is still inconsistent, limiting eating to a consistent daily window of 8 to 12 hours can improve insulin sensitivity, reduce blood glucose, cholesterol and triglyceride levels and promote weight loss. These effects are likely attributable to both direct metabolic impacts and indirect benefits from weight loss and improved dietary habits. However, data on circadian, inflammatory, and specific metabolic biomarkers remain scarce and occasionally contradictory, highlighting the need for further research on these interventions.

It is estimated that more than one-tenth of adults aged ≥60 years are now classified as having sarcopenic obesity (SO), a clinical condition characterized by the concurrent presence of sarcopenia (low muscle mass and weakness) and obesity (excessive fat mass). Independently, sarcopenia and obesity are associated with a high risk of numerous adverse health outcomes including cardiovascular diseases (CVDs) and neurological conditions (e.g. dementia), but SO may confer a greater risk, exceeding either condition alone. This imposes a substantial burden on individuals, healthcare systems and society. In recent years, an increasing number of observational studies have explored the association between SO and the risk of CVDs; however, results are mixed. Moreover, the pathophysiology of SO is governed by a complex interplay of multiple mechanisms including insulin resistance, inflammation, oxidative stress, hormonal shifts and alteration of energy balance, which may also play a role in the occurrence of various CVDs. Yet, the exact mechanisms underlying the pathological connection between these two complex conditions remain largely unexplored. The aim of this review is to examine the association between SO and CVDs. Specifically, we seek to: (1) discuss the definition, epidemiology and diagnosis of SO; (2) reconcile previously inconsistent findings by synthesizing evidence from longitudinal studies on the epidemiological link between SO and CVDs; and (3) discuss critical mechanisms that may elucidate the complex and potentially bidirectional relationships between SO and CVDs.

Chrono-medicine considers circadian biology in disease management, including combined lifestyle and medicine interventions. Exercise and nutritional interventions are well-known for their efficacy in managing Type 2 Diabetes, and metformin remains a widely used pharmacological agent. However, metformin may reduce exercise capacity and interfere with skeletal muscle adaptations, creating barriers to exercise adherence. Research into optimising the timing of exercise has shown promise, particularly for glycaemic management in people with Type 2 Diabetes. Aligning exercise timing with circadian rhythms and nutritional intake may maximise benefits. Nutritional timing also plays a crucial role in glycaemic control. Recent research suggests that not only what we eat but when we eat significantly impacts glycaemic control, with strategies like time-restricted feeding (TRF) showing promise in reducing caloric intake, improving glycaemic regulation, and enhancing overall metabolic health. These findings suggest that meal timing could be an important adjunct to traditional dietary and exercise approaches in managing diabetes and related metabolic disorders. When taking a holistic view of Diabetes management and the diurnal environment, one must also consider the circadian biology of medicines. Metformin has a circadian profile in plasma, and our recent study suggests that morning exercise combined with pre-breakfast metformin intake reduces glycaemia more effectively than post-breakfast intake. In this review, we aim to explore the integration of circadian biology into Type 2 Diabetes management by examining the timing of exercise, nutrition, and medication. In conclusion, chrono-medicine offers a promising, cost-effective strategy for managing Type 2 Diabetes. Integrating precision timing of exercise, nutrition, and medication into treatment plans requires considering the entire diurnal environment, including lifestyle and occupational factors, to develop comprehensive, evidence-based healthcare strategies.

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 three 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 January 1st, 2020 and December 31st, 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 [odds ratio] =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.

Beyond obesity, visceral adipose tissue (VAT) has emerged as an important predictor of chronic disease, but the role of diet quality patterns (DQP) in VAT development is not well defined. Therefore, we conducted a systematic review of how various DQP are associated with VAT via literature searches in PubMed and EMBASE. We included observational investigations in disease-free adults/adolescents that related DQP to VAT assessed by imaging methods. The studies were evaluated separately for a priori and a posteriori DQP and according to design differences. Study quality was assessed using the Risk of Bias in Non-randomised Studies of Interventions tool. Of the 1807 screened articles, thirty-five studies met the inclusion criteria. The majority of a priori indices, for example, the Healthy Eating Index, showed significant inverse associations with VAT, while only a small proportion of a posteriori patterns were related to VAT. Results did not differ substantially by the method of exposure and outcome assessment or between studies with (n 20) or without (n 15) body-size adjustment, but significant findings were more common in younger v. older individuals, USA v. other populations and investigations with moderate v. serious risk of bias. The heterogeneity of the existing literature limited the ability to quantify the magnitude of the associations across studies. These findings suggest that a high-quality diet, as assessed by a priori DQP, is generally inversely associated with VAT, but results for a posteriori DQP are less consistent. As associations persisted after adjusting for body size, diet quality may beneficially influence VAT beyond its association with obesity.

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.

One of the main challenges in weight loss programmes is compliance with diet and achievement of sustainable changes in eating habits and lifestyles. Most clients desire to lose weight quickly, rather than looking at long-term changes. The literature suggests applying telenutrition, owing to its convenience and easy access in combination with both telemonitoring and health coaching, where confounding factors in the diet are tackled. A 6-month randomised controlled trial will be conducted to compare the effectiveness of telenutrition v. telenutrition supported by weekly telemonitoring and monthly health coaching in a weight loss programme. Participants are obese and overweight adults of both sex groups, aged 20–50 years who will be randomised to join a control or an intervention group. A total of three visits will be scheduled for all participants: at baseline, after three months and after six months. This study aims to answer the question of whether participants following a weight loss programme supported by telemonitoring and health coaching will increase their weight loss and compliance to the diet in comparison with the control group. This will be the first trial to assess the impact of integrating telemonitoring and health coaching in weight loss programmes, including the evaluation of associated confounding factors such as general nutrition education, eating behaviour, sensory modalities and hunger, and stress. This trial will support dietary weight loss programmes, contribute to the emerging field of telenutrition and provide advice for clinical dietitians and health coaches to work together to help individuals lose and maintain weight.

Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of reproductive age, associated with increased risks of metabolic disorders, depression and reduced quality of life. This study examined the impact of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on mental health, PCOS-related quality of life (PCOSQ), anthropometric indices, hirsutism, and metabolic/hormonal parameters in women with PCOS. Total of 52 women with PCOS, aged between 18 and 45 years, were randomly assigned to either the low calorie MIND diet group or the control group. Anthropometric data, depression and anxiety scores, serum levels of gonadotropins (luteinizing hormone [LH], follicle-stimulating hormone [FSH]), PCOSQ, and Ferriman-Gallwey score were evaluated before and after the intervention. Outcomes were assessed at baseline and at the end of the 8-week follow-up period. After 8 weeks, the MIND diet significantly reduced depression (β –3·03; 95 % CI: [–5·36, –0·70]; P = 0·011) and anxiety (β –3·54; 95 % CI: [–6·60, –0·49]; P = 0·024) scores compared with the control group. The MIND diet group exhibited significant increases in the emotion (β 0·63; 95 % CI: [0·18, 1·08]; P = 0·007) and body hair (β 0·65; 95 % CI: [0·03, 1·28]; P = 0·04) domains of the PCOSQ compared to the control group. The changes in other parameters did not show significant differences between the two groups. Both the MIND diet and control groups showed improvements in weight and BMI, with a slight advantage for the MIND diet group. These findings suggest that the MIND diet may be beneficial for improving mental health and some aspects of PCOSQ in women with PCOS.

The purpose of this study was to examine the potential for sustained almond consumption to reduce HbA1c concentrations among individuals with elevated values. A 16-week randomised, parallel-arm, controlled trial was conducted. Eighty-one adults with elevated HbA1c concentrations (> 5·7 %) were randomly assigned to incorporate 2 oz of raw almonds (A: n 39) or energy-matched snacks (C: n 42) into their daily diets. Body weight, body composition, plasma lipids, HbA1c, plasma vitamin E, glycaemia (by meal tolerance test and continuous glucose monitoring), dietary intake and hedonic responses to test foods were measured at stipulated time points. Participants consuming almonds ingested 253 kcal/d more than participants in the control group (P = 0·02), but this did not result in a significant difference in body weight. No statistically significant differences were observed in HbA1c concentrations, blood chemistries, body composition or glycaemia over time or between groups. However, Healthy Eating Index scores improved within the almond group as compared with the control group (P < 0·001). Additionally, the hedonic rating of almonds within the almond group did not decline as markedly as the control group’s reduced liking of the pretzel snack. Alpha-tocopherol increased significantly, and gamma tocopherol tended to decrease in the almond group, indicating compliance with the dietary intervention. Overall, daily ingestion of 2 oz of raw almonds in a self-selected diet for 16 weeks did not alter short-term or longer-term glycaemia or HbA1c concentrations in adults with elevated HbA1c concentrations, but they were well-tolerated hedonically and improved diet quality without promoting weight gain.

Recent advancements in sensory research have brought to light the intricate relationship between taste perception and the oral microbiota, prompting investigations into their influence on human health, particularly in the context of dietary preferences and obesity. This review aims to update the current understanding of how oral microbiota influence taste perception and dietary choices, elucidating shared metabolic pathways between food processing and oral bacteria. Further, this review outlines the mechanisms underlying taste perception, emphasising the role of taste receptors and taste buds in shaping sensory experiences influenced by genetic and environmental factors. Notably, we explore the bidirectional relationship between oral microbiota and taste sensitivity, highlighting the potential impact of microbial composition on taste perception thresholds and implications for dietary habits and health outcomes, such as obesity and dental caries. However, significant research gaps remain, particularly in the understanding of the molecular mechanisms linking oral microbiota with taste sensitivity, as well as the long-term effects of microbiota-targeted interventions. Future research should focus on longitudinal studies and experimental interventions to explore these connections more deeply, offering insights into potential strategies for promoting healthier dietary behaviours and managing diet-related non-communicable diseases.

Obesity rates in Colombia are increasing, with variations among racial and ethnic groups. Studies on adult obesity often address socio-economic status, gender, and education but neglect racial-ethnic influences, notably in areas like Quibdó. Therefore, based on the theory of triadic influence, we conducted a qualitative study to identify biobehavioural, social, and cultural phenomena that, from the perspectives of the participants, influence the onset of obesity in Afro-Colombian and indigenous in Quibdó in 2022. The stratification variables were race, ethnicity (Afro-Colombian and Indigenous), and educational level (secondary or higher). Based on a literature review of qualitative studies that commonly explored food culture, nutritional status, and physical activity in analysing obesity within racial and ethnic populations, we incorporated these categories into our research methodology through semi-structured interviews. A framework analysis was used as a qualitative methodology to organise and analyse the collected data. We conducted 21 semi-structured interviews, 13 with the Afro-Colombian population and eight with indigenous inhabitants. The results indicate that cultural beliefs, forced displacement/migration, and alterations in public order have resulted in changes in food security, food culture, and physical activity practices, affecting the onset of obesity. Notably, distinctions in cultural beliefs regarding food culture and health as factors influencing obesity were observed between Afro-Colombians and the Indigenous populations; however, educational differences within the same racial ethnic group were not predominant. Findings indicate obesity is influenced by cultural, social, and biobehavioural factors, especially in regions with racial-ethnic communities facing complex conditions, necessitating targeted racial-ethnic public health policies.

This study verified the accuracy of the international BMI references and the allometric BMI reference to diagnose obesity in children and adolescents from the USA. Data from 17 313 subjects were obtained from the National Health and Nutrition Examination Survey between the years 1999–2006 and 2011–2018. Fat Mass Index, Allometric Fat Mass Index and fat mass/fat-free mass were calculated. Receiver operating characteristic curve, AUC, sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were estimated to evaluate the accuracy of the growth references for diagnosing obesity. The International Obesity Task Force, MULT BMI 17 years, MULT BMI 18 years and allometric BMI 19 years achieved the best sensitivity-specificity trade-off for boys, with sensitivities ranging from 0·92 to 0·96 and specificities of 0·94, with positive likelihood ratio of 15·51, 16·17, 13·46 and 18·01, respectively. The negative likelihood ratios were notably low, ranging from 0·04 to 0·08. In girls, the International Obesity Task Force, MULT BMI 17 years and MULT allometric BMI 17 years also demonstrated high sensitivity (0·95–0·97) and specificity (0·92), with positive likelihood ratio values of 11·54, 11·82 and 11·77, respectively and low negative likelihood ratio values (0·03–0·05). In summary, these international growth references presented satisfactory performance to diagnose obesity. However, the MULT growth reference performed better, and the MULT allometric BMI was the only indicator capable of detecting that girls have a higher proportion of fat mass than boys for the same index values. These findings suggest that the MULT growth reference may be a better tool to assess the nutritional status of children and adolescents internationally.