The problem of overweight and obesity has become increasingly prominent in recent years and has become a major global public health problem. China has also launched the "Weight Management Year" campaign, hoping to prevent and control chronic diseases related to overweight and obesity from the source. However, due to differences in economic and geographical conditions, the prevalence of overweight and obesity varies in different regions. What is the trend of overweight and obesity prevalence in Hebei Province in recent years, and where are the key points for prevention and control? This problem urgently needs to be solved.

To grasp the trend and change of overweight and obesity prevalence among residents aged 18-44 in Hebei Province between 2013 (from May to September) and 2020 (from April to December). Dynamically analyse the influencing factors and provide an objective basis for prevention and treatment strategies and measures for healthy Hebei and weight management.

We collected data from the 2013 Hebei Provincial Cardiovascular Disease Epidemiological Survey and the 2020 Hebei Provincial Residents' Cardiovascular Disease and Risk Factor Surveillance Project cross-sectional survey, and used different obesity indicators to comprehensively measure the prevalence of overweight and obesity among residents aged 18-44 years. The influencing factors and the interaction between each factor of overweight and obesity were explored by using the multifactorial Logistic regression model, and the changing situation was analyzed.

In 2020, the detection rates of standardised overweight, obesity, body fat percentage obesity, abdominal obesity and high waist-to-height ratio (WHtR) of Hebei residents aged 18-44 years will be higher than those in 2013 (the number of individuals detected with overweight, obesity, high body fat percentage, abdominal obesity and high waist-to-height ratio after standardization based on the 2010 national census population / the standard population count of individuals aged 18-44 from the 2010 national census), which were 32.24%, 11.49%, 24.86%, 27.03% and 45.01%, respectively; and in 2020, 32.85%, 25.75%, 57.93%, 40.77% and 59.73%, respectively. Multivariate Logistic regression analyses of the factors affecting different types of obesity in the adult population of China showed that men, older age groups (compared with the 18-20 groups), married and hypertensive individuals had a higher risk of various types of obesity. In addition to the above factors, insufficient physical activity, educational level of junior high school and below, occupation as self-employed and agricultural workers, high-fat diet, intake of fish and eggs >1 000 g/week, and sleep <6 h/d also increased the risk of different types of obesity. The results of the multiplicative interaction analysis showed that the risk of obesity, body fat percentage obesity, and high waist-to-hip ratio in married hypertensive patients was 1.551 (95%CI=1.400-1.758, P<0.05), 1.418 (95%CI=1.170-1.720, P<0.05), and 1.652 (95%CI=1.454-1.935, P<0.05) times that of the reference group, respectively; the risk of abdominal obesity was higher in people with short sleep duration and a high-fat diet (OR=1.428, 95%CI=1.075-1.897, P<0.05); the risk of high waist-to-hip ratio in self-employed or agricultural workers with hypertension was 3.248 (95%CI=1.418-7.44, P<0.05) and 3.100 (95%CI=1.606-5.984, P<0.05) times that of the reference group, respectively. Compared to 2013, in 2020, among the common influencing factors of various obesity types, the proportion of males in the overweight and body fat percentage obesity groups slightly decreased, while in other obesity types, the proportion increased; the proportion of people in different obesity types in the age groups of 31-35 and 36-40 reached over 20%; the proportion of married individuals in the two types of generalized obesity groups slightly decreased, while in the two types of central obesity groups, the proportion slightly increased; the proportion of hypertensive patients in various obesity types significantly increased, more than doubling compared to 2013.

In 2020, the detection rate of all types of obesity among residents aged 18-44 years in Hebei Province will be significantly higher than that in 2013, and attention should be paid to the dynamic trends of risk factors related to overweight/obesity in young and middle-aged populations in Hebei Province, so as to take targeted preventive measures, enhance the health awareness of the residents, and do a good job of weight management.

Obesity is a major global public health challenge. Although intensive lifestyle intervention can induce weight loss, its effectiveness is often constrained by eating behaviors. Existing behavior-focused interventions show limited efficacy. New approaches that can improve eating behaviors are needed to enhance the weight-loss efficacy of intensive lifestyle intervention.

To evaluate the effects of Xiere Xingpi Yin on eating behaviors and weight-related outcomes in adults with obesity.

A total of 108 adults with obesity seen at the Endocrinology Department of Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, from March 2022 to March 2024 were randomized (1∶1) to an experimental group (n=54) and a control group (n=54) using simple randomization. Both groups received a 12-week intensive lifestyle intervention; in addition, the experimental group was given Xiere Xingpi Yin granules and the control group received placebo granules. At 12 weeks, between-group comparisons were made for eating behaviors—cognitive restraint, uncontrolled eating, and emotional eating; weight-related outcomes—change in body weight and BMI, and the proportions achieving≥5% and≥10% body-weight loss; body fat distribution; inflammatory markers; and glycemic and lipid indices. Adverse events were monitored throughout. Data analysis used the full analysis set (FAS) as the primary analysis set, following the intention-to-treat (ITT) principle. Sensitivity analyses for dietary behaviors and weight loss efficacy were conducted using the per-protocol set (PPS).

A total of 93 patients completed the trial, with 42 in the control group and 51 in the experimental group. There were no statistically significant differences in baseline characteristics, including body weight, BMI, prior weight-loss history, and psychological status (P>0.05). At 12 weeks, the experimental group showed better eating-behavior outcomes, with lower endpoint scores for cognitive restraint [(12.9±3.2) points vs (14.3±3.8) points] and uncontrolled eating [(16.5±4.9) points vs (18.9±6.2) points] than the control group (P<0.05). The proportion of patients with ≥5% body-weight loss in the trial group [90.7% (49/54) vs 50.0%(27/54) ] and the proportion with ≥10% body-weight loss [(35.2%(19/54) vs 9.3%(5/54) ] were higher than in the control group (P<0.05), and reductions in body weight [(8.7±3.6) kg vs (5.1±3.0) kg] and BMI [(3.1±1.2) kg/m² vs (1.8±1.0) kg/m²] were greater (P<0.05). The sensitivity analyses showed that the results from the PPS were consistent with those from the FAS for all the aforementioned endpoints. In addition, improvements in body fat distribution, inflammatory markers, glycemic and lipid indices, and TCM syndrome-factor scores were greater in the experimental group (P<0.05). The incidence of adverse events did not differ between the two groups [11.1% (6/54) vs 9.3% (5/54), χ²=0.091, P>0.05].

Xiere Xingpi Yin improved eating behaviors, and thereby enhanced the weight-loss efficacy of intensive lifestyle intervention. It also produced coordinated benefits in body fat distribution, inflammation, and glycemic and lipid indices, with a favorable safety profile. Xiere Xingpi Yin may serve as an adjunctive TCM option to improve eating behaviors and strengthen body-weight management.

Hypertension is an important risk factor for cardiovascular disease (CVD). Traditional body mass index (BMI) has limitations in identifying high-risk patients, and the predictive value of new obesity indicators in the hypertensive population remains to be clarified.

To explore the relationship between novel obesity indicators, such as the Chinese visceral adiposity index (CVAI), body roundness index (BRI), relative fat mass index (RFM), weight-adjusted waist index (WWI), triglyceride-glucose index (TyG), and its related indices TyG-BMI, TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR) and the risk of CVD in patients with hypertension, and to compare their predictive performance, thereby providing a basis for the prevention and management of cardiovascular disease in the hypertensive population.

A retrospective cohort study design was adopted, including 69 627 hypertensive individuals in the public health surveillance database in Urumqi, Xinjiang Uygur Autonomous Region from 2016 to 2022 as the study population. Patient baseline characteristics, general physical examination indicators and laboratory test indicators were collected, and CVAI, BRI, RFM, WWI, TyG, TyG-BMI, TyG-WC, and TyG-WHtR were calculated accordingly.The follow-up endpoint was defined as the first diagnosis of CVD in patients or the end of the study period. Cox proportional hazards regression models and restricted cubic spline models were constructed to assess the risk of cardiovascular disease associated with different indicators. Time-dependent C indices and the area under the ROC curve (AUC) were used to compare the predictive performance of different indicators.

A total of 2 466 (3.54%) individuals developed CVD by the end of follow-up. Multivariate Cox regression analysis showed that after adjusting for confounding factors, the following indicators were associated with an increased risk of cardiovascular disease: CVAI (HR=1.122, 95%CI=1.072-1.175), BRI (HR=1.104, 95%CI=1.061-1.149), RFM (HR=1.236, 95%CI=1.141-1.338), WWI (HR=1.073, 95%CI=1.029-1.118), TyG-BMI (HR=1.099, 95%CI=1.054-1.146), TyG-WC (HR=1.105, 95%CI=1.058-1.154), TyG-WHtR (HR=1.113, 95%CI=1.066-1.161)(P<0.05). Restricted cubic spline analysis indicated a significant nonlinear dose-response relationship between RFM and CVD risk (P_nonlinear<0.05). Time-dependent C-index analysis showed that the discriminative ability of each indicator remained generally stable over the follow-up period. ROC curve analysis showed that the AUCs of TyG, CVAI, BRI, WWI, TyG-BMI, TyG-WC and TyG-WHtR in predicting the risk of CVD were 0.512, 0.568, 0.558, 0.566, 0.518, 0.531 and 0.553, respectively. Subgroup analysis showed that BRI, RFM, WWI and TyG-WHtR showed obvious sex interaction (P_interaction<0.05).

Among hypertensive patients, novel obesity indices such as CVAI, BRI and WWI were associated with the risk of incident CVD and had certain reference value for CVD risk assessment, but their independent predictive performance was limited.

In 2025, obesity diagnosis and management entered a new stage characterized by disease stratification and long-term care. Focusing on six key topics: obesity classification, clinical guidelines, novel pharmacotherapies, comorbidity management, weight management clinics, and nutrition labeling, this paper summarizes the major advances in obesity research and practice worldwide in 2025. The Lancet Diabetes and Endocrinology Commission proposed a new framework distinguishing pre-clinical obesity and clinical obesity. American Association of Clinical Endocrinology (AACE), European Association for the Study of Obesity (EASO), and WHO further emphasized that treatment should be determined by obesity-related complications and functional impairment. Tirzepatide, mazdutide, oral GLP-1 receptor agonists, and multi-target agents have propelled anti-obesity medications into an era of high efficacy and diversification. The management of obesity-related comorbidities and diseases, including type 2 diabetes, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatohepatitis, osteoarthritis, and obstructive sleep apnea, has become a clinical priority. China is concurrently advancing the establishment of standardized weight management clinics and the implementation of digital labeling for pre-packaged foods, marking a strategic shift in obesity management from purely clinical treatment toward integrated prevention and care. This paper aims to provide an annual reference for clinical research, specialty development, and practice in the field of obesity for the year 2026.

Obesity is a major risk factor for cardiovascular disease, but evidence regarding the impact of metabolic obesity phenotypes on the prognosis of acute coronary syndrome (ACS) remains insufficient.

Exploring the impact of diverse metabolic obesity phenotypes on the pognosis of prcutaneous coronary intervention (PCI) in ACS patients.

This study employed a prospective cohort design, consecutively enrolling patients who presented with chest pain at the First Affiliated Hospital of Xinjiang Medical University between June 2012 and June 2023, were diagnosed with ACS, and underwent PCI within 12 hours of symptom onset. Baseline data collected included general demographic characteristics, anthropometric measurements, laboratory test results, imaging findings, and procedural details. Participants were categorized into four groups based on the presence of obesity and metabolic syndrome: metabolically healthy normal weight (MHNW), metabolically healthy obesity (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obesity (MUO). All patients underwent follow-up via telephone and/or outpatient visits every 12 months post-procedure to record major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, non-fatal myocardial infarction, stroke, rehospitalization for unstable angina, and heart failure recurrence. Kaplan-Meier survival curves were used to analyze MACCE incidence across the four groups, with log-rank tests for comparisons. Multivariate Cox proportional hazards regression models were employed to assess the association between metabolic obesity phenotypes and MACCE risk.

A total of 1 913 ACS patients were included in this study, with an average age of (58.8±12.1) years. Among them, there were 1 588 males (83.0%) and 325 females (17.0%).There were 612 cases in the MHNW group, 878 cases in the MUNW group, 105 cases in the MHO group, and 318 cases in the MUO group. There were statistically significant differences in the comparison of age, gender, BMI, the prevalence of hypertension diabetes, and proportion of smoking, admission systolic blood pressure (SBP) and diastolic blood pressure (DBP), blood glucose, hemoglobin concentration, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine, urea, uric acid, and direct bilirubin levels among the 4 groups (P<0.05). Median follow-up time was 4.77 (2.26, 7.16) years, with 136 patients (7.1%) lost to follow-up. A total of 656 cases (34.3%) of MACCE occurred. There were statistically significant differences in the incidence of MACCE and the incidence of readmission for unstable angina pectoris between the 4 groups (P<0.05). Kaplan-Meier survival curve analysis showed that the difference in Cumulative risk probability of MACCE among the four groups was statistically significant (χ²=26.23, P<0.001). Multivariate Cox regression analysis showed that after adjustment for age, sex, smoking, SBP, DBP, TG, HDL-C, LDL-C, urea, and uric acid, the risks of MACCE in the MHO, MUNW, and MUO groups were 1.56, 1.28, and 1.94 times that of the MHNW group, respectively (P<0.05). The results of the sensitivity analysis demonstrated the stability of the association between metabolically obese phenotypes and the risk of developing MACCE in the prognosis.

Obesity significantly increases the risk of long-term adverse outcomes in patients with ACS undergoing PCI regardless of metabolic status, and the risk is even higher in those with concurrent metabolic abnormalities. Clinical management should emphasize the long-term adverse effects of obesity, and stratified evaluation and individualized intervention should be performed in combination with metabolic status.

With global population ageing, sarcopenic obesity has become a common and serious condition in older adults. Exercise guidelines issued by the American College of Sports Medicine (ACSM) are authoritative in exercise science. For older adults with sarcopenic obesity, these guidelines provide multidimensional recommendations on exercise dose, including intensity, frequency, and duration for aerobic and resistance training.

To compare the effects of exercise doses with high adherence to ACSM recommendations versus those with low or uncertain adherence on body composition [body fat percentage, BMI, body weight, appendicular skeletal muscle mass (ASM) ] and physical function (grip strength and walking speed) in older adults with sarcopenic obesity.

Relevant studies on exercise interventions for older adults with sarcopenic obesity were systematically searched in PubMed, Embase, Web of Science, Cochrane Library, Ovid, and China National Knowledge Infrastructure (CNKI). The search period was from database inception to 2023-12-26 for the first four databases, and from database inception to 2024-01-14 for Ovid and CNKI. Two investigators independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Study quality was evaluated using the risk-of-bias tool for randomized controlled trials, and Meta-analysis was performed using RevMan 5.4. Based on whether the intervention group's exercise dose adhered to ACSM recommendations, studies were classified as high adherence or low/uncertain adherence. The effects of these two exercise-dose categories on body fat percentage, BMI, body weight, ASM, grip strength, and walking speed were analyzed. Higgins I² was used to assess heterogeneity among studies, and sensitivity analysis was performed by omitting one study at a time.

A total of 15 studies involving 810 participants were included, of which 7 studies had high adherence to ACSM recommendations and 8 had low or uncertain adherence. Eleven studies reported body fat percentage as an outcome. Compared with the control group, the high-adherence intervention group showed a greater reduction in body fat percentage (MD=-3.54, 95%CI= -5.65 to -1.44, P<0.05), whereas the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=-0.94, 95%CI=-2.54 to 0.67, P>0.05). Five studies reported BMI as an outcome. Compared with the control group, the high-adherence intervention group showed a greater reduction in BMI (MD=-1.98, 95%CI=-3.02 to -0.93, P<0.05). The low/uncertain-adherence intervention group also showed a reduction in BMI, but the difference was not statistically significant (MD=-1.72, 95%CI=-3.42 to -0.03, P=0.05). Five studies reported body weight as an outcome. Compared with the control group, the high-adherence intervention group showed a greater reduction in body weight (MD=-4.85, 95%CI=-7.84 to -1.86, P<0.05), while the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=-1.56, 95%CI=-5.94 to 2.81, P>0.05). Four studies reported ASM as an outcome. For both high-adherence and low/uncertain-adherence exercise doses, no statistically significant differences were observed in ASM compared with the control group (MD=-0.18, 95%CI=-1.03 to 0.67; MD=-0.05, 95%CI=-0.85 to 0.76, P>0.05). Eight studies reported grip strength as an outcome. Compared with the control group, the high-adherence intervention group showed a greater increase in grip strength (MD=2.86, 95%CI=0.76 to 4.97, P<0.05), whereas the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=3.04, 95%CI=-0.26 to 6.34, P>0.05). Seven studies reported walking speed as an outcome. The high-adherence intervention group improved walking speed more than the control group (MD=0.32, 95%CI=0.23 to 0.41, P<0.05), while the low/uncertain-adherence intervention group showed no statistically significant difference versus the control group (MD=0.05, 95%CI=-0.01 to 0.11, P>0.05).

High-adherence exercise interventions had significant effects on improving body fat percentage, BMI, body weight, grip strength, and walking speed in patients with sarcopenic obesity. However, exercise intervention had no effect on ASM. Further studies are needed to verify these findings.

Obesity is a chronic disease characterized by abnormal or excessive fat accumulation, that significantly increases the risk of multiple health complications. Weight loss among individuls with obesity can reduce disease risk and improve both physical and social functioning. Behavior and lifestyle interventions (BLIs) constitute the cornerstone of weight management and should adhere to the principles of effectiveness, gradual progression, comprehensiveness, and individualization. BLIs implementation strategies incorporate established behavior change theories, behavioral change techniques (BCTs), and cognitive behavioral therapy (CBT). Dietary behavioral intervention strategies encompass controlling total energy intake, adjusting dietary patterns, and scientifically managing eating time, manner, location, and emotional factors. Exercise intervention strategies include providing psychological and behavioral support and prescribing individualized exercise regimens. Psychological interventions should integrate BCTs with cognitive restructuring to modify values and beliefs regarding diet and physical activity. Sleep interventions should emphasize education and self-management, CBT, relaxation training, regular exercise, light therapy, and circadian rhythm regulation. The BLIs process comprises pre-intervention assessment, priority determination, intervention objectives, content, settings, delivery methods, intensity, duration, and outcome evaluation, while emphasizing the implementation of a multidisciplinary team (MDT) collaborative care model. Childhood and adolescent obesity interventions should adopt family-based, school-based, community-based, clinical, multi-sector, and full developmental life-cycle strategies. Digital technologies should focus on enhancing precision diagnosis, personalized interventions, and full-cycle monitoring. BLIs effectiveness evaluation includes formative evaluation, process evaluation, and outcome evaluation, integrated with comprehensive judgment based on high-quality research evidence. Other critical considerations include improving practical effectiveness, preventing weight regain, enhancing cultural adaptability, and ensuring rational application and standardized referral for pharmacotherapy and bariatric surgery.

Obesity and aging have emerged as significant global public health concerns. Notably, the issue of aging is especially pronounced in China. However, there is relatively little research evidence regarding the disease burden of obesity in the elderly population, which needs to be addressed urgently.

To analyze the disease burden of elderly obesity population globally and in China from 1990 to 2021, and to predict future trends aiming to provide scientific evidence for the formulation of relevant public health prevention and control policies and healthcare decision-making.

Data on "high body-mass index" related to mortality and disability-adjusted life years (DALYs) for populations aged ≥60 in the global, China, and five sociodemographic index (SDI) regions were obtained from the Global Burden of Disease 2021 database. Joinpoint regression analysis was conducted to evaluate the trends of age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) over time, and results were reported as average annual percent change (AAPC) and corresponding 95%CI. A three-factor decomposition analysis was used to evaluate the relative impact of aging, population growth, and epidemiological changes on the disease burden. Additionally, a Bayesian age-period-cohort (BAPC) model was utilized to forecast mortality and DALYs trends from 2022 to 2035.

In 2021, the number of obesity-related deaths among elderly populations was 2 880 400 globally and 467 000 cases in China, representing increases of 161.26% and 359.19%, respectively, compared to 1990. Corresponding DALYs number reached 71 193 400 person-years globally and 11 763 600 person-years in China, with increases of 171.50% and 344.80%. Globally, the ASMR for obesity in the total elderly population and elderly males showed an overall upward trend from 1990 to 2021, with AAPC of 0.22% (95%CI=0.08%-0.36%, P=0.002) and 0.43% (95%CI=0.31%-0.55%, P<0.001), respectively. In China, the ASMR for obesity in the total elderly population, elderly females, and elderly males also showed an overall upward trend from 1990 to 2021, with AAPC of 1.19% (95%CI=0.97%-1.40%, P<0.001), 1.01% (95%CI=0.80%-1.23%, P<0.001), and 1.47% (95%CI=1.16%-1.77%, P<0.001), respectively. From 1990 to 2021, the global ASDR for obesity in the total elderly population, elderly females, and elderly males showed an overall upward trend, with AAPC of 0.53% (95%CI=0.44%-0.62%, P<0.001), 0.43% (95%CI=0.33%-0.54%, P<0.001), and 0.69% (95%CI=0.60%-0.79%, P<0.001), respectively. In China, the ASDR for obesity in the total elderly population, elderly females, and elderly males also showed an overall upward trend from 1990 to 2021, with AAPC of 1.45% (95%CI=1.32%-1.58%, P<0.001), 1.34% (95%CI=1.21%-1.47%, P<0.001), and 1.60% (95%CI=1.41%-1.79%, P<0.001), respectively. Furthermore, in 2021, the numbers of obesity-related mortality and DALYs among the elderly in the five SDI regions also rose to varying degrees compared to 1990. The 60-64 years age group accounted for the highest DALYs burden globally (16 500 500 person-years, 23.18%), while in China, the highest DALYs burden was observed in the 65-69 age group (2 930 200 person-years, 24.91%). Decomposition analysis identified population growth as the primary driver of the increased obesity-related disease burden across all regions. Forecasting models suggested that by 2035, the numbers of obesity-related deaths and DALYs among the global elderly population will increase by 66.33% and 71.93%, respectively, while in China, they are projected to rise by 151.17% and 135.03%.

The disease burden of obesity among the elderly remains substantial both globally and in China, and is expected to escalate in the future. Targeted efforts to enhance public health awareness, promote healthy aging and lifestyles, and appropriately utilize medical and surgical interventions can be necessary to mitigate the growing burden of obesity in elderly population.

Obesity has become an increasingly serious public health challenge in China, with a steadily rising prevalence. Studies have shown that 24-hour movement behaviors are closely associated with obesity. However, most current guidelines only provide separate time recommendations for individual behaviors without fully considering their interdependence and combined effects within a 24-hour framework.

To explore the associations between 24-hour movement behaviors and obesity-related outcomes among Chinese university students using the compositional data analysis approach, and to develop an optimal time-use composition for obesity prevention.

A total of 108 university students from Hangzhou were recruited. 24-hour movement behaviors were monitored using accelerometers. Anthropometric indicators including height, weight, and waist circumference (WC) were measured following standardized protocols, and BMI, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were calculated. Body fat percentage (BFP) and visceral fat area (VFA) were assessed using the InBody 720 bioelectrical impedance analyzer. A compositional multiple regression model was constructed to estimate optimal time allocations and prediction intervals for different movement behaviors.

The composition of 24-hour movement behaviors was significantly associated with obesity-related indicators among college students, including BMI (F=8.25, P<0.01), BFP (F=27.58, P<0.01), WC (F=13.90, P<0.01), WHR (F=13.10, P<0.01), WHtR (F=14.09, P<0.01), and VFA (F=7.04, P<0.01). The optimal 24-hour time-use composition for obesity prevention was identified as: 131 minutes of moderate-to-vigorous physical activity (MVPA)(110-140 min), 208 minutes of light physical activity (LPA) (160-230 min), 663 minutes of sedentary behavior(SB)(620-730 min), and 438 minutes of sleep (360-520 min).

The composition of 24-hour movement behaviors is closely associated with obesity-related indicators among college students. The optimal time-use composition developed in this study aligns with current guidelines for MVPA and sleep, while also providing recommendations for SB and LPA. These findings offer scientific evidence for the optimized allocation of daily activity time and the prevention of obesity in college populations.

Weight management serves as a critical component in the prevention and control of chronic diseases. In 2024, the National Health Commission of China launched a three-year "Weight Management Year" action plan (2025-2027), aiming to enhance public awareness of weight management and promote scientific control methods. Weight management not only focuses on body weight values but also emphasizes comprehensive interventions in diet, physical activity, and lifestyle to prevent chronic diseases and improve quality of life. Generative artificial intelligence demonstrates significant potential in the field of weight management by providing users with personalized dietary advice, exercise plans, and behavioral interventions, thereby improving management outcomes and adherence. This article systematically explores the application pathways and effectiveness of generative artificial intelligence in weight management, highlighting its advantages in achieving dynamic personalization of dietary plans and increasing physical activity levels, while also addressing multiple challenges such as content authenticity, data privacy, algorithmic biases, and long-term adherence. This study provides valuable insights for the optimization of weight management models in China and the further application of generative artificial intelligence in the health domain.

As the global obesity issue becomes increasingly severe, weight loss has become a key task for improving public health and reducing the burden of chronic diseases. Grassroots medical health institutions can effectively advance the prevention and control of obesity, offering clear advantages such as proximity to community needs and strong accessibility of health services. This paper, based on policy background and practical needs, elaborates on the necessity and existing issues in the construction of weight loss clinics in grassroots medical and health institutions, and systematically explores their functional positioning, service models, and the development of both software and hardware capabilities. Furthermore, taking the Weight Loss Clinic at Huichengmen Community Health Service Station in Haidian District, Beijing, as a typical case, this paper analyzes its practical experiences, including relying on academic support from tertiary hospitals, establishing a two-way referral mechanism, and building an intelligent management system. The construction of grassroots weight loss clinics is an important initiative to promote the transformation of grassroots medical services from a "disease-centered" to a "health-centered" approach. Currently, the construction of grassroots weight loss clinics nationwide is still in its early stages, and this paper can provide references and insights for their standardized development.

Obesity is a chronic and relapsing disease resulting from interactions between genetic and environmental factors. Its global prevalence continues to rise, making it a major public health challenge. Traditional weight management strategies often yield suboptimal outcomes. In recent years, peptide-based therapies targeting the glucagon-like peptide-1 receptor (GLP-1R), glucose-dependent insulinotropic polypeptide receptor (GIPR), and glucagon receptor (GCGR) have advanced rapidly, with multi-target agonists emerging as a promising new therapeutic trend. This review systematically summarizes the mechanisms and clinical progress of these agents: GLP-1R single-target agonists demonstrate significant efficacy in weight reduction, glycemic control, and multi-organ protection, though interindividual variability and gastrointestinal side effects remain limitations. Dual agonists targeting GLP-1R/GIPR and GLP-1R/GCGR (e.g., Tirzepatide, Mazdutide) further improve metabolic parameters, reduce liver fat, and mitigate cardiovascular risks through synergistic regulation of appetite, energy expenditure, and lipid metabolism. Meanwhile, the triple agonist Retatrutide (targeting GLP-1R/GIPR/GCGR) shows robust potential for weight loss and body composition improvement, while also modulating key lipid metabolic regulators such as ANGPTL3/8, thereby broadening the therapeutic horizon for metabolic diseases. Looking forward, the development of multi-target agents-combined with long-acting formulation technologies, precise subtyping, and individualized treatment strategies-is expected to significantly enhance the efficacy and safety of obesity treatments and alleviate the public health burden.

Overweight and obesity represent a major global public health challenge, with significant variations in preventive strategies across national guidelines. This article introduces the core recommendations on weight problem screening and prevention from the tenth edition of the RACGP Guidelines for Preventive Activities in General Practice in Australia, analyzing its characteristics of opportunistic screening model based on WHO screening principles, anti-stigmatization ethical framework, and structured non-drug intervention tools. It also reviews the development status of China's obesity prevention and control system, and compares the differences between China and Australia in screening concepts, ethical considerations, and practical support from the perspective of general practice. This article proposes that China's future obesity prevention should focus on integrating ethical principles into screening and intervention processes, developing localized tools suitable for primary care, and suggests organically integrating weight management into chronic disease management pathways to empower general practitioners in achieving the transition from disease treatment to health management.

In recent years, the prevalence of overweight and obesity has increasingly shifted toward younger ages, posing substantial risks to both the immediate and long-term health of children. In line with China's "Weight Management Year" initiative, the Macao SAR Government has incorporated obesity prevention into the Healthy Macao 2030 Blueprint, promoting a shift from passive treatment to proactive prevention. Therefore, developing a localized and scientifically sound BMI assessment tool for preschool children in Macao is of great significance.

To establish age- and sex-specific BMI percentile reference curves for preschool children in Macao, and to examine age and secular trends in thinness, overweight, and obesity, thereby providing evidence to support the improvement of growth and developmental health among Macao preschoolers.

Data were obtained from four rounds of Macao SAR Government physical fitness surveillance conducted in 2005, 2010, 2015, and 2020 with technical support from the China Institute of Sport Science. Preschool children were included, with sample sizes of 1 044, 1 065, 1 072, and 1 113 in the four respective years. Height and weight were collected and stratified by sex and age. BMI percentile curves were generated using the GAMLSS model to determine cut-offs for thinness, overweight, and obesity.

A total of 4 294 children [2 612 boys (60.8%) and 1 682 girls (39.2%); mean age (4.2±1.0) years; mean BMI (15.4±1.6) kg/m²] were included. Using the GAMLSS approach, we developed BMI percentile reference curves, a percentile-based scoring system, and cut-offs for thinness, normal weight, overweight, and obesity, forming a multidimensional BMI assessment framework integrating individualized precision evaluation, percentile scoring, and categorical classifications. The BMI curves declined and then rose with age, with nadirs at approximately 5 years for boys and 5.5 years for girls. Trend analyses showed slight increases in overweight and obesity rates from 2005 to 2020, but no statistically significant trends (P>0.05).

This study providing an individualized and accurate BMI evaluation tool for Macao preschool children, the BMI curves of Macao preschool children declined and then rose with age, with nadirs at approximately 5 years for boys and 5.5 years for girls. It is recommended that Macao increase opportunities for outdoor physical activity and sleep while reducing screen time to curb the early onset of childhood obesity.

With the aging of the population and the increasing prevalence of multimorbidity in China, the high-risk characteristics of cardio-metabolic multimorbidity (CMM) have become an important research field. The exact nature of the relationship between the Chinese visceral adiposity index (CVAI) and CMM remains to be elucidated.

This study aims to investigate the relationship between the CVAI and the high risk of CMM, and to evaluate the potential role of CVAI in the prevention and treatment of CMM in the elderly in China.

This study was based on the data of 60 029 subjects from the Early Screening and Comprehensive Intervention of High-risk Populations of Cardiovascular Disease in Anhui Province from 2017 to 2021. The demographic information, cardiovascular health status, physical examination and biochemical indicators were analyzed, and the CVAI index was calculated. The subjects were grouped according to the quartile of CVAI (male: T1-T4 group, female: F1-F4 group), and the differences in baseline characteristics were compared. Multtivariate Logistic regression analysis was used to explore the relationship between CVAI and the high risk of CMM. The nonlinear relationship between CVAI and CMM between different genders was assessed by restricted cubic spline (RCS) curves, and a threshold of OR=1 was determined.

There were 60 029 subjects, including 27 203 males (45.32%) and 32 826 females (54.68%). There were statistically significant differences in age, smoking, drinking, rural area, high school education, BMI, mean arterial pressure (MAP), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), fasting plasma glucose (FPG), diabetes, stroke, hypertension, and ischemic heart disease in CVAI quartiles between different genders (P<0.05). There was no significant difference in the history of hypertension medication among males. In women, the difference in medication history of hypertension was statistically significant multivariate. Multtivariate Logistic regression analysis showed that compared with T1 (F1) group, the risk of CMM was significantly increased in T2 toT4 (F2 to F4 ) group. After fully adjusting for confounding factors, the T4 (F4) group showed the highest risk of CMM in both sexes, male (OR=2.335, 95%CI=1.741-3.180, P<0.001), and female (OR=2.735, 95%CI=1.778-2.686, P<0.001). There was no significant difference in the odds ratio between different genders. There was no significant difference in the risk of CMM between males in T4 group and females in F4 group (P>0.05). After controlling for different confounding factors, RCS curve suggested that there was a nonlinear relationship between CVAI index and CMM risk in men, and the threshold of OR=1 was 94.75. There was a linear relationship between CVAI index and CMM risk in women, and the threshold of OR=1 was 114.87.

High level of CVAI may be closely related to the risk of CMM, and the predictive power is consistent in different genders. Special attention should be paid to men with CVAI over 94.75 and women with CVAI over 114.87 to reduce the risk of CMM.

Frailty was an age-related geriatric syndrome, with its prevalence among Chinese older adults being notably high and demonstrating a rising trend over time. Obesity was closely associated with the development of numerous diseases, but its relationship with frailty remained controversial. This uncertainty was potentially attributable to limitations of conventional obesity indicators in characterizing adipose tissue distribution. Therefore, investigating the associations between multiple adiposity metrics and frailty was important for to advance the understanding of frailty pathogenesis and developing preventive interventions.

This study investigates the relationship between various obesity indicators and frailty, providing a scientific basis for the early prevention and control of frailty in older adults.

In this study, a total of 1 429 elderly people aged 60 years and above were surveyed in six rural villages in Jingyuan County, Gansu Province, from March to May 2023. After further exclusions, a final sample of 1 153 participants was included in the analysis. The FRAIL scale was utilized to assess the frailty status of the elderly. Based on Chinese obesity criteria, waist circumference and BMI were categorized, and waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), and Chinese visceral adiposity index (CVAI) were grouped by quartiles. Multivariate Logistic regression, restricted cubic splines, and receiver operating characteristic (ROC) curve analysis were employed to explore the relationship between different obesity indicators and frailty.

This study included 1 153 elderly participants aged≥60 years, comprising 474 males (41.11%) and 679 females (58.89%), with a mean age of 70.86±4.76 years. Based on FRAIL scale assessments, 226 participants were identified as frail and 927 as non-frail, resulting in a frailty prevalence of 19.60%. The adjusted multivariate Logistic regression analysis revealed that central obesity, moderate to severe obesity (reference: normal BMI), Q3 and Q4 (reference: Q1) levels of WHR, and Q4 (reference: Q1) levels of WHtR, BRI, and CVAI were significant risk factors for frailty in the elderly population (P<0.05), with progressively increasing risks of frailty associated with elevated levels of waist circumference, BMI, WHR, WHtR, BRI, and CVAI (P_trend<0.05). The restricted cubic spline (RCS) curve indicated that waist circumference, BMI, WHtR, BRI, and CVAI were linearly and positively correlated with the risk of frailty in the elderly (P_linear<0.05). The ROC curve analysis demonstrated that that the predictive capacity for frailty in the elderly was possessed by waist circumference, BMI, WHR, WHtR, BRI, and CVAI, with area under the curve (AUC) of 0.557 (95%CI=0.515-0.598), 0.570 (95%CI=0.528-0.612), 0.558 (95%CI=0.515-0.600), 0.610 (95%CI=0.568-0.652), 0.610 (95%CI=0.568-0.652), and 0.586 (95%CI=0.546-0.626), respectively (P<0.05). Additionally, WHtR, BRI, and CVAI demonstrated better predictive ability compared to waist circumference (Z=-5.443, P<0.001; Z=-5.443, P<0.001; Z=-2.595, P=0.009), and both WHtR and BRI showed better predictive ability compared to BMI (Z=-2.885, P=0.004; Z=-2.884, P=0.004).

In rural regions, among the elderly population aged 60 and above, obesity indicators such as waist circumference, BMI, WHR, WHtR, BRI, and CVAI were positively correlated with the risk of frailty in the elderly. Among these indicators, WHtR and BRI showed better predictive ability for frailty.

Adolescent obesity can lead to various diseases such as type 2 diabetes, fatty liver, and dyslipidemia, while increasing the risk of chronic diseases in adulthood. The development of obesity is influenced not only by food types and intake quantity but also by eating behaviors, including eating speed, meal timing, breakfast frequency, and nighttime eating. However, the association between dietary behaviors and obesity among Chinese adolescents remains unvalidated.

To explore the association between dietary behaviors and adolescent obesity, and to provide scientific evidence for effective obesity prevention strategies.

A multistage sampling approach was employed: simple random sampling selected 7 provinces nationwide; convenience sampling identified 16 universities within these provinces; cluster sampling included all first-year students aged 16-19 years from the selected universities. Data on current height, weight, and dietary behaviors were collected via self-administered electronic questionnaires. Statistical analyses (chi-square tests and Logistic regression) were performed using SPSS 26.0 and R 4.3.3.

A total of 16 445 freshmen were surveyed, including 6 710 males (40.80%) and 9 735 females (59.20%), with an average age of (18.04±0.75) years. The highest proportions were in the 18 years (9 618 cases, 58.49%) and 19 years (4 169 cases, 25.35%) age groups, and 5 375 (32.68%) were only children. The overall obesity rate among adolescents was 10.48% (1 723/16 445). The obesity rates of adolescents with much faster, slightly faster, and much slower eating speeds were 15.02% (587/3 908), 9.41% (1 029/10 930), and 6.66% (107/1 607), respectively, and the obesity rate increased with the acceleration of eating speed (P<0.05). The obesity rate of adolescents whose parents were both obese was higher than that of those whose parents were both non-obese [18.89% (17/90) vs 10.10% (1 544/15 293), P<0.05]. There was no significant difference in the obesity rate between males and females whose parents were both obese [16.22% (6/37) vs 20.75% (11/53), P=0.79]; the obesity rate of males whose parents were both non-obese was higher than that of females [12.79% (796/6 225) vs 8.25% (748/9 068), P<0.05]. The obesity rate of adolescents whose fathers were obese but mothers were non-obese was 16.06% (88/548), and the obesity rate of males was lower than that of females [14.29% (38/266) vs 17.73% (50/282), P<0.05]. The obesity rate of adolescents whose mothers were obese but fathers were non-obese was 16.15% (26/161), and the obesity rate of males was higher than that of females [22.03% (13/59) vs 12.75% (13/102), P<0.05]. The results of multivariate Logistic regression analysis showed that males [OR (95%CI)=1.46 (1.31-1.62)], younger age [compared with 19 years old, OR (95%CI) of 16 years old was 1.37 (1.08-1.73), and OR (95%CI) of 17 years old was 1.27 (1.06-1.51)], much faster [OR (95%CI)=2.19 (1.76-2.74)] and slightly faster eating speeds [OR (95%CI)=1.42 (1.15-1.75)], and having breakfast and dinner at home and lunch at school [with an OR (95%CI)=0.86 (0.75-0.98) compared to those who eat at school] were more likely to be obese.

Key risk factors for adolescent obesity in China include male gender, younger age, parental obesity, fast eating speed, and eating location patterns (e.g., school lunches with home breakfast/dinner). Additionally, a potential X-chromosome dominant cross-inheritance pattern of obesity was observed, though further validation is required.

Recent studies show that dietary interventions can induce remission of type 2 diabetes mellitus (T2DM) in individuals with overweight or obesity, but related evidence from China remains limited.

To evaluate the clinical efficacy of a short-term dietary intervention in obese patients with abnormal glucose metabolism and to examine its impact on hepatopancreatic fat content and pancreatic β-cell function.

From March 2020 to August 2022, 60 obese adults with abnormal glucose metabolism attending the Obesity Clinic of the Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, were randomized to a low-calorie balanced diet (LCBD; n=30) or a meal-replacement diet (MRD; n=30) for 3 months. At baseline and post-intervention, group differences in changes in body composition, laboratory indices, and imaging examination were compared.

Groups were comparable at baseline in sex distribution, body composition, laboratory variables, and imaging measures (all P>0.05). After intervention, both groups exhibited significant reductions from baseline in body weight (BW), body mass index (BMI), WC, body fat percentage (BFP), visceral fat area (VFA), subcutaneous fat area (SFA), fasting plasma glucose (FPG), 2-hour plasma glucose during oral glucose tolerance test (OGTT 2 hPG), hemoglobin A_1c (HbA_1c), HOMA-β, HOMA-IR, liver FF, pancreatic FF, and lipid measures (P<0.01). Across both groups, most glycemic indices, lipid parameters, uric acid (UA), alanine aminotransferase (ALT), and insulin resistance indices improved significantly (P<0.05), whereas HDL-C did not change significantly. Compared with the LCBD group, the MRD group achieved greater reductions in absolute and percentage BW, BMI, FPG, and VFA (P<0.05). ΔFPG was positively correlated with reductions in BW, WC, VFA, HOMA-IR, and liver FF (P<0.05). The change in HOMA-IR correlated positively with the change in liver FF (r=0.432, P=0.001).

The 3-month dietary intervention effectively reduced BW, BMI, WC, hepatic fat content, and insulin resistance in obese adults with abnormal glucose metabolism, leading to significant improvements in abnormal glucose metabolism.

Excess body weight and adiposity are closely related to the pathogenesis of various chronic diseases. To address this health crisis, the American College of Sports Medicine released the Consensus Statement on Adult Physical Activity and Excess Body Weight and Adiposity in 2024. This consensus supports the inclusion of physical activity in the medical treatment of excess body weight and adiposity (drug therapy, metabolic and bariatric surgery) when medically deemed appropriate. And put forward insights on the application of physical activity in these treatments. This consensus particularly points out: (1) For weight loss and the prevention of weight gain, the effect may be most significant when engaging in at least 150 minutes of moderate-intensity physical activity per week. (2) High-intensity interval training is not superior to the physical activity effect of moderate to high-intensity continuous training in terms of weight regulation. (3) Low-intensity physical activities can be used as an alternative under the premise of ensuring energy consumption. (4) Various forms of exercise are equivalent in weight management. To achieve overall health benefits beyond weight control and fat loss, it is recommended to adopt multiple modes of physical activity. This consensus emphasizes the importance of physical activity in the prevention, treatment and management of overweight and obesity. This guideline interpretation aims to conduct an in-depth analysis of the core points of this consensus statement, provide new suggestions for the prevention and treatment of overweight/obesity through physical activity in our country, and help primary care doctors manage overweight/obesity patients more effectively.

Overweight and obesity have become serious public health problems in China, threatening people's health. However, the weight management models currently available require further research and analysis.

To analyze the effect of an energy-limiting intermittent fasting mode combined with online intervention on weight management in overweight and obese people.

The overweight and obese people who underwent weight management in the Nutrition Department of Wuqing People's Hospital from January to October 2024 were selected as the research object, and divided into intervention (100 cases) and control (96 cases) groups by stratified random method. The control group adopted a conventional energy-limiting intermittent fasting diet model for weight management, while the intervention group used energy-limiting intermittent fasting diet model combined with online intervention for weight management. Changes in weight, metabolic rate, circumferences, muscle mass and before and BMI were assessed before the intervention, 2 months after intervention and 4 months after intervention.

Interactions between group and time were observed for weight, waist circumference and BMI (P_interaction<0.05). Main effects of group were significant for weight, waist circumference and BMI (P_group<0.05), and main effects of time were significant for these variables as well (P_time<0.05). Before the intervention, there were no significant differences between the two groups in terms of weight, waist circumference, BMI, muscle mass, metabolic rate, upper arm muscle circumference, calf circumference or body fat percentage (P>0.05). Four months after the intervention, the intervention group showed significant reductions in weight, waist circumference, BMI and body fat rate, and increased metabolic rate and upper brachial muscle circumference compared to the control group (P<0.05). There was no significant difference in calf circumference between the groups (P>0.05). The weight loss efficiency rate (WLER) was significantly higher in the intervention group (66.0%, 66/100) compared to the control group (20.8%, 20/96)(χ²=10.20, P=0.006). Group and time interactions were observed for exercise, eating behavior, emotional control and total score (P_interaction<0.05). The group had significant main effects on exercise, eating behavior, emotional control and total score respectively (P_group<0.05), and time also had significant main effects on these variables (P_time<0.05). Before the intervention, there were no significant differences in these scores between the groups (P>0.05). After 2 or 4 months of intervention, the above scores of the intervention group were significantly higher than those of the control group (P<0.05).

The energy-limiting intermittent fasting model combined with online intervention significantly improved the weight, metabolic rate, circumference and muscle mass in overweight and obese individuals, compared to the conventional energy-limiting intermittent fasting diet modelIt also enhanced self-management abilities of patients.

Obesity-related hypertension (ORH) , as a long-term persistent chronic disease, is growing in prevalence in China. Exercise is an important means of prevention and treatment for ORH, but due to the limitations of space, distance and cost in exercise rehabilitation, exercise completion and compliance are mostly difficult to ensure, and the health benefits of exercise are greatly reduced. Therefore, it is important to explore appropriate exercise prescription and management models.

To evaluate the clinical efficacy and safety of five-body balance exercise based on the "hospital-gym-community" model for patients with ORH.

This was a prospective randomised controlled study. 84 ORH patients recruited at Guang'anmen Hospital, China Academy of Traditional Chinese Medicine from June 2022 to December 2023 were selected and randomly divided into the experimental group (n=42) and the control group (n=42) by using the SPSS 26.0 online random number generator. Subjects in both groups received the same lifestyle intervention. The control group was provided with moderate-intensity aerobic exercise, and the experimental group was provided with the five-body balance exercise training based on the "hospital-gym-community" rehabilitation model for a period of 6 months. Systolic blood pressure (SBP) , diastolic blood pressure (DBP) , mean arterial pressure (MAP) , waist circumference (WC) , body weight (BW) , BMI, hip circumference (HC) , waist-to-hip ratio (WHR) , waist-to-height ratio (WHtR) , fasting blood glucose (GLU) , total cholesterol (TC) , low-density lipoprotein cholesterol (LDL-C) , very low-density lipoprotein cholesterol (VLDL-C) , triglycerides (TG) , serum ceramides (Cer) , Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) , Short-form Health Survey-36 (SF-36) , and Pittsburgh Sleep Quality Index (PSQI) were observed before and after the intervention in the two groups of subjects. The major adverse cardiovascular events (MACE) and exercise injuries that occurred during the intervention were also recorded.

Eventually 37 subjects in the experimental group and 36 subjects in the control group completed the trial. After 6 months of rehabilitation, SBP, DBP, MAP, WC, BW, BMI, HC, WHR, WHtR, LDL-C, Cer, SAS, SDS, and PSQI in the experimental group were lower than those in the control group (P<0.05) , SF-36 was higher than that in the control group (P<0.05) , and there was no statistically significant difference between GLU, TC, VLDL-C, TG in the experimental group and the control group (P>0.05) . After intervention, SBP, DBP, MAP, WC, BW, BMI, HC, WHR, WHtR, GLU, LDL-C, VLDL-C, TG, Cer, SAS, SDS, and PSQI were lower than before the intervention in the experimental group (P<0.05) , SF-36 was higher compared to the pre-intervention in the experimental group (P<0.05) , and the difference in TC before and after the intervention was not statistically significant (P>0.05) . There were no MACE or exercise injuries in both groups.

The five-body balance exercise based on the "hospital-gym-community" rehabilitation model can promote the blood pressure and morphological indexes of patients with ORH, improve the quality of life, and its efficacy is better than the conventional aerobic exercise, with good safety. It also reduces serum Cer levels, reflecting to some extent the potentially beneficial effects of the exercise programme in reducing cardiovascular risk.

With the aging of the population, the incidence and impact of geriatric syndromes have received widespread attention, and sarcopenic obesity (SO), as one of these syndromes, has become a hot topic in recent studies. Studies have shown that lipid levels may be an important factor influencing SO, but studies on the correlation between lipid composition and SO have not yet reached consistent conclusions.

To explore the relationship between blood lipid levels and the risk of SO in Chinese middle-aged and elderly people.

Based on the 2011-2015 data of the China Health and Retirement Longitudinal Survey (CHARLS), the cohort study included middle-aged and elderly people with no SO at baseline in 2011. The study included middle-aged and elderly people without SO at baseline in 2011. Exposure factors were baseline total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in the study population, and the outcome event was the occurrence of SO in 2013 or 2015. SO was defined by combining the dual criteria of sarcopenia and obesity. Appendicular skeletal muscle mass adjusted by weight (ASM/W) was used to determine sarcopenia, and obesity was defined as a BMI ≥25 kg/m². COX proportional risk regression models were constructed to analyse the relationship between baseline TC, TG, HDL-C, LDL-C and the risk of SO, and possible non-linear associations were examined using a restricted cubic spline model.

A total of 5 268 study subjects were included, with a median age of 58 (52, 64) years and a cumulative follow-up of 20 592 person-years. There were 382 new cases of SO, with a cumulative incidence rate of 7.25%, of which the incidence rate of SO was 5.22% (128/2 451) in men and 9.02% (254/2 817) in women. The results of the fully adjusted proportional risk regression models for COX showed that, compared with the lowest quartile Q1 group of TC, the risk of SO was significantly higher in middle-aged and elderly people in the Q4 (HR=1.35, 95%CI=1.00 to 1.82) group (P<0.05) ; compared with the Q1 group of TG, the risk of SO was significantly higher in the Q2 (HR=1.55, 95%CI=1.08 to 2.21), Q3 (HR=2.07, 95%CI=1.48 to 2.90), and Q4 (HR=2.53, 95%CI=1.82 to 3.52) groups (P<0.05) ; compared with the Q1 group of LDL-C, the risk of SO was also significantly higher in the Q2 (HR=1.38, 95%CI=1.02 to 1.88), and Q4 (HR=1.44, 95%CI=1.07 to 1.95) groups; while the risk of SO was significantly lower in the Q2 (HR=0.75, 95%CI=0.58 to 0.96), Q3 (HR=0.54, 95%CI=0.41 to 0.71), and Q4 (HR=0.43, 95%CI=0.31 to 0.58) groups (P<0.05), as compared with the Q1 group of HDL-C. Restricted cubic spline model showed an inverse "L" -shaped association between TG level and the risk of SO (P_nonliner<0.001), while TC (P_nonliner=0.731), HDL-C (P_nonliner=0.600), and LDL-C (P_nonliner=0.400) were linearly associated with the risk of SO.

TG, TC and LDL-C were the risk factors for SO in Chinese middle-aged and elderly people, while HDL-C had a protective effect, among which TG level had an inverted "L" type association with SO. Therefore, lipid management may be important for the prevention and treatment of SO in Chinese middle-aged and elderly people.

Obesity is frequently accompanied by metabolism-related diseases, serving as a critical etiological factor or risk factor and being associated with adverse clinical outcomes. Effective weight reduction has been demonstrated to ameliorate or even alleviate these comorbidities. However, lifestyle interventions alone often yield suboptimal efficacy, and behavioral resistance is often observed. In China, there are currently no specific guidelines targeting patients with behavioral resistance. In 2024, the Italian Association of Clinical Endocrinologists released the Guidelines for the Management of Adult Individuals with Overweight and Obesity and Metabolic Comorbidities that are Resistant to Behavioral Treatment, grounded in the latest evidence-based research. The guidelines primarily focus on pharmacological and surgical interventions in this patient population. This paper, in conjunction with Chinese guidelines, delves into the obesity evaluation and treatment strategies from the Italian guidelines, aiming to offer a reference for managing Chinese overweight or obese patients with behavioral resistance.

Obesity and type 2 diabetes, both associated with chronic metabolic dysfunction, are characterized by insulin resistance and heightened cardiovascular risk. Concurrent training emerges as an effective intervention to improve physical health in these patients, though the specific impacts warrant further exploration.

This study systematically evaluates the impact of concurrent training on body composition and other health metrics in obese type 2 diabetic patients.

We reviewed randomized controlled trials from databases like PubMed, Web of Science, Ebsco, CNKI, VIP, Wanfang Data, and SinoMed focusing on trials conducted between January 2001 and March 2024. These trials measured the effects of concurrent training on various health outcomes. Quality assessments were performed using the Cochrane risk of bias tool, and data were analyzed using Stata 16.0.

Twelve randomized controled trials involving 967 participants showed that concurrent training significantly improves body composition [BMI: WMD=-0.46, P<0.001; body fat percentage (BF%) : WMD=-3.49, P<0.001; fat-free mass (FFM%) : WMD=3.26, P<0.001; waist circumference (WC) : WMD=-2.73, P<0.001; hip circumference (HC) : WMD=-2.78, P<0.001], cardiorespiratory fitness [maximal oxygen uptake (VO_2max) : WMD=5.13, P<0.001) ], and metabolic profiles [Triglycerides (TG) : SMD=-1.48, P=0.007; total cholesterol (TC) : SMD=-1.66, P=0.002; high-density lipoprotein cholesterol (HDL-C) : SMD=1.10, P=0.011; low-density lipoprotein cholesterol (LDL-C) : SMD=-1.26, P=0.018; glycated hemoglobin percentage (HbA_1c) : WMD=-0.86, P<0.001; homeostasis model assessment of insulin resistance (HOMA-IR) : SMD=-0.97, P=0.004; Glucose: SMD=-1.32, P=0.014], and inflammation markersα (TNF-α) : SMD=-1.98, P<0.001.

Concurrent training markedly improves key health outcomes in obese type 2 diabetes patients. The outcomes vary based on the volume and order of training sessions.

Overweight or obese children and adolescents have been shown to exhibit executive function deficits when compared to healthy populations with normal body mass. These deficits may serve to exacerbate existing overweight or obesity and, in some cases, may serve to predispose the individual to the development of other diseases. A growing body of research has demonstrated that exercise can positively impact executive function; however, the specific benefits and drawbacks of different exercise modalities require further investigation.

To explore the most effective exercise methods for improving executive function in overweight or obese children and adolescents.

A comprehensive search of the CNKI, Wanfang Data, Cochrane Library, PubMed, Embase, and Web of Science databases was conducted to identify randomized controlled trials of exercise interventions for executive function in adolescents and young adults with overweight or obesity. This search was conducted from database construction to October 2024. The literature was screened and the data was extracted by two independent researchers. A network meta-analysis was performed using RevMan 5.4 and Stata 18.0 software to compare the differences between exercise modalities as well as to calculate and rank cumulative probability ranked area under the curve (SUCRA) values. The standardized mean difference (SMD) and its 95% confidence interval (CI) were used as an effect indicator. The Cochrane risk of bias assessment tool was used for risk of bias assessment, and Egger's test was used for publication bias analysis.

A total of 10 papers in English and Chinese were included, encompassing 675 overweight or obese children and adolescents, aged 8 to 15 years old, with outcome indicators of inhibitory control, working memory, and cognitive flexibility. A total of four movement style groups (sports games, ball games, martial arts practice, and physical training) were included with the no-exercise group. With respect to the enhancement of inhibitory control, sports games (SMD=-1.75, 95%CI=-2.83 to -0.68, P<0.05), ball games (SMD=-1.93, 95%CI=-3.87 to -0.10, P<0.05), and physical training (SMD=-1.20, 95%CI=-2.40 to -0.05, P<0.05) all significantly increased the level of inhibitory control in overweight or obese children and adolescents, with ball sports having the largest SUCRA value (82.8) and being ranked first. In terms of enhancing working memory, ball sports demonstrated superiority over physical training (SMD=-1.02, 95%CI=-1.68 to -0.36, P<0.05). Similarly, in the context of promoting cognitive flexibility, ball sports exhibited greater efficacy in comparison to physical training (SMD=-1.22, 95%CI=-1.90 to -0.54, P<0.05) .

A comparison of ball games with other exercise modalities has demonstrated that the former is superior in improving executive function in overweight or obese children and adolescents. A comprehensive consideration of the synergistic integration of ball games with intensity, periodization, frequency, and volume is imperative during practice interventions. Further evidence is necessary to develop more accurate and efficient exercise prescriptions for overweight or obese children and adolescents.

Patients with obesity exhibit a higher risk of atherosclerotic cardiovascular diseases (ASCVD). The effects of short-term medical weight loss interventions on the risk level of ASCVD of patients with obesity at multidisciplinary outpatient department need to be elucidated.

To explore the impact of short-term medical weight loss on ASCVD risk in patients with obesity.

A retrospective analysis was conducted involving 172 patients with obesity who completed a 3-month weight loss treatment at the obesity multidisciplinary outpatient department in Nanjing Drum Tower Hospital from July 2019 to May 2024. Demographics, clinical indicators, and cardiovascular disease risk of patient were documented using the Chinese adult ASCVD overall risk assessment flowchart. Based on baseline cardiovascular risk ratings, patients were categorized into a moderate-high risk group (n=58) and a low-risk group (n=114). Moderate-high risk patients were further divided into the risk decreased subgroup (n=36) and the risk stable subgroup (n=22) based on whether their ASCVD risk decreased after treatment, and comparisons were made between the two subgroups regarding demographic and clinical data. Differences in clinical indicators and cardiovascular disease risk at baseline and post-treatment were analyzed, and multifactorial logistic regression analysis was conducted to identify factors related to reduction of the risk level of ASCVD in patients with moderate-high risk obesity. ASCVD risk and weight loss indicators among different medication groups and patients stratified by BMI, gender, and age after 3 months of treatment were analysised.

Among the 172 patients, there were 73 males and 99 females, with an average age of 32 (28, 38) years, an average body weight of 89.8 (82.0, 101.2) kg, and an average BMI of 31.6 (30.0, 33.9) kg/m². After 3 months of treatment, the total weight loss was 8.8% (5.6%, 13.6%), and the BMI decreased to 28.8 (27.0, 30.7) kg/m². Measurements of waist circumference, waist-to-height ratio, body fat, body fat percentage, fat mass index (FMI), appendicular skeletal muscle mass index (ASMI), total muscle mass, visceral fat area (VFA), systolic blood pressure, diastolic blood pressure, and metabolic indicators [fasting glucose, postprandial blood glucose at 2 hours, fasting insulin, postprandial insulin at 2 hours, homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides, cholesterol, low-density lipoprotein cholesterol, uric acid, alanine aminotransferase, and aspartate aminotransferase] all showed significant reductions compared to pre-treatment levels (P<0.05). Before treatment, 114 patients were classified as the ASCVD low-risk group, while 58 patients were classified as the moderate-to-high-risk group. Compared with the moderate-high risk group, the low-risk group showed a decrease in fasting glucose, postprandial blood glucose at 2 hours, postprandial insulin at 2 hours, HOMA-IR, triglycerides, cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, and aspartate aminotransferase, while high-density lipoprotein cholesterol increased before treatment (P<0.05). Among the 58 patients with moderate-to-high ASCVD risk before treatment, 36 patients transitioned to low risk after 3 months of treatment (risk decreased subgroup), while 22 patients remained in the moderate-to-high-risk category (risk stable subgroup). After 3 months of treatment, the body weight, BMI, waist circumference, waist-to-height ratio, body fat, body fat percentage, FMI, VFA, fasting insulin, postprandial insulin at 2 hours, insulin resistance index, triglycerides, alanine aminotransferase, and aspartate aminotransferase all decreased compared to pre-treatment levels in both subgroups. The risk decreased subgroup also showed decreases in systolic blood pressure, diastolic blood pressure, fasting blood glucose, cholesterol, and low-density lipoprotein cholesterol (P<0.05). The reductions in BMI, body fat, body fat percentage, FMI, and VFA in the reduction subgroup were significantly greater than those in the risk stable subgroup (P<0.05). Multivariate Logistic regression analysis indicated that BMI (OR=1.257, 95%CI=1.034-1.528, P=0.022) was an independent risk factor influencing the reduction of risk factors in obese patients with moderate-to-high ASCVD risk. For every 1 unit decrease in BMI, the ASCVD risk decreased by 25.7%. After 3 months of treatment, the proportion of patients at moderate-to-high ASCVD risk decreased than before in the liraglutide group (n=51), metformin group (n=61), and untreated group (n=60) (P<0.05), with no significant differences in ASCVD risk levels or weight loss indicators among the three groups (P>0.05). In the group with 28.0 kg/m²≤BMI<32.5 kg/m² and the group with BMI≥32.5 kg/m², the proportion of patients at moderate-to-high ASCVD risk decreased after 3 months of treatment, with the 28.0 kg/m²≤BMI<32.5 kg/m² group showing a greater reduction in the proportion of patients at moderate-to-high ASCVD risk compared to the BMI≥32.5 kg/m² group (P<0.05). Both the female and male groups showed a decrease in the proportion of patients at moderate-to-high ASCVD risk after 3 months of treatment (P<0.05), with no significant differences in ASCVD risk levels between the two groups (P>0.05). Comparisons between the 18-30 years group and the ≥30 years group also showed no significant differences in ASCVD risk levels (P>0.05) .

Short-term medical weight loss in patients with obesity was benefit for effective weight loss and fat reduction, and improvement in ASCVD risk factors. However, for patients with a BMI ≥32.5 kg/m² and with moderate-high cardiovascular risk level, such weight loss measures are not sufficient to reduce the risk level of ASCVD in the short term, and stronger and durable weight loss measures are the treatment of choice for these patients in the future.

Obesity is the primary risk factor for essential hypertension, and patients with obesity-related hypertension exhibit higher rates of cardiovascular morbidity and mortality. Exercise-induced weight loss has become an effective therapeutic approach for these patients. However, cardiopulmonary function and blood pressure dynamics during different exercise phases in this population remain unclear.

To investigate the characteristics of cardiopulmonary function in obesity-related hypertensive patients across different BMI categories during various exercise stages, and to explore the relationship between cardiopulmonary exercise parameters and conventional left ventricular structural indices.

A total of 625 patients diagnosed with essential hypertension at the General Medicine Department/Hypertension Center/Cardiac Rehabilitation Center of Yan'an Hospital Affiliated to Kunming Medical University from January 2020 to July 2023 were retrospectively recruited. Participants were stratified into three groups based on the BMI: control group (n=209, 18.5 kg/m²< BMI <24.0 kg/m²), overweight hypertension group (n=210, 24.0 kg/m²≤ BMI <28.0 kg/m²), and obesity-related hypertension group (n=206, BMI≥28.0 kg/m²). Systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen uptake (VO₂), percentage of predicted VO₂ (VO₂%), VO₂ per kilogram (VO₂/kg), oxygen pulse (O₂ pulse), heart rate (HR) during cardiopulmonary exercise testing, and echocardiographic indices such as interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDd), left ventricular mass (LVM), and left ventricular mass index (LVMI) at different exercise phases were recorded.

Peak-exercise SBP was significantly higher in the obesity-related hypertension and overweight hypertension groups compared to the control group (P<0.05). Peak-exercise O₂ pulse, VO₂, and anaerobic threshold VO₂ were significantly higher in the obesity-related hypertension group than those of the overweight hypertension and control groups (P<0.05). Conversely, peak-exercise VO₂/kg, VO₂%, and anaerobic threshold VO₂/kg, VO₂% were significantly lower in the obesity-related hypertension group than those of the overweight and control groups (P<0.05). Peak-exercise O₂ pulse was positively correlated with LVMI and BMI (r=0.098, 0.283; P<0.05). Peak-exercise VO₂/kg and VO₂% were negatively correlated with BMI (r=-0.372, -0.291; P<0.05). Peak-exercise SBP was positively correlated with BMI, LVM, and LVMI (r=0.069, 0.221, 0.151; P<0.05) .

Obesity-related hypertension patients exhibit reduced exercise cardiac function and exercise tolerance compared to normal-weight individuals. Higher BMI is associated with elevated peak-exercise SBP, O₂ pulse, LVM, and LVMI, suggesting abnormal increases in cardiac preload and afterload post-exercise. These physiological changes may contribute significantly to LVMI progression. Integrating cardiopulmonary exercise testing parameters with LVMI provides more precise cardiac function assessment for obesity-related hypertension.

Obesity can influence the occurrence and progression of diabetic retinopathy (DR) through various pathways, however there are limited studies on the mediation of DR by obesity through non-lipid metabolic pathways.

To investigate the mediating role of non-lipid metabolites in the relationship between obesity and DR.

In August 2023, we utilized genome-wide association study (GWAS) data and conducted Mendelian randomization (MR) analysis to explore the mediating role of non-lipid metabolites in the association between obesity and DR.

BMI (OR=1.78, P=5.3E-12) and waist-to-hip ratio (WHR) (OR=1.91, P=1.3E-10) was associated with increased risk of DR, respectively. Lower levels of isoleucine (OR=0.62, P=0.039) , pyruvate (OR=0.60, P=0.039) , albumin (OR=0.65, P=0.002) , glycoprotein (OR=0.92, P=0.002) , and decreased ratio of dienes to double bonds (OR=0.93, P=0.048) was associated with increased risk of DR, respectively. Positive causal associations were observed between BMI and isoleucine (OR=1.21, P=1.0E-08) , glycoprotein (OR=1.33, P=3.2E-14) , pyruvate (OR=1.08, P=0.03) , and negative causal associations with albumin (OR=0.93, P=0.04) and the ratio of dienes to double bonds (OR=0.82, P=2.8E-05) . Positive causal associations were also found between WHR and isoleucine (OR=1.34, P=3.4E-08) and glycoprotein (OR=1.26, P=1.2E-04) . Isoleucine (β=-0.16, P=0.019) , glycoprotein (β=-0.05, P=0.029) , pyruvate (β=-0.07, P=0.027) , and the ratio of dienes to double bonds (β=0.02, P=0.036) mediated the causal association between BMI and DR, while isoleucine (β=-0.21, P=7.2E-04) and glycoprotein (β=-0.03, P=0.031) mediated the causal association between WHR and DR.

Obesity has a positive causal association with DR, with BMI's association with DR mediated by isoleucine, glycoprotein, pyruvate, and the ratio of dienes to double bonds, and WHR's association with DR mediated by isoleucine and glycoprotein. Non-lipid metabolic products play a mediating role between obesity and DR.

Type 2 diabetes mellitus (T2DM) combined with obesity is an increasingly concerned severe global public health issue. Patients typically experience insulin resistance, metabolic abnormalities, chronic inflammation, and impaired cardiopulmonary function. Bariatric surgery can reduce the BMI, and alleviate diabetic and hypertensive symptoms. However, postoperative cardiopulmonary function decline negatively influences the motor function and quality of life. Postoperative intervention of rehabilitation is an established way to improve the cardiopulmonary function, although the effect of postoperative aerobic and resistance training on the cardiopulmonary function of T2DM patients combined with obesity remains unclear.

To explore the effects of exercise training after bariatric surgery on cardiopulmonary function in T2DM patients combined with obesity.

Sixty T2DM patients combined with obesity admitted at the Nanjing Drum Tower Hospital in 2022, who were treated with an elective bariatric surgery were selected as study subjects. They were randomly divided into the exercise group (n=30) and control group (n=30) using a random number table method. A recovery period was defined as the first 4 weeks postoperatively, during which patients were encouraged to engage in physical activities at a moderate intensity. After 4 weeks, cardiopulmonary exercise tests were conducted in both the exercise group and the control group to assess cardiopulmonary function and tailor exercise prescriptions. The control group was instructed to perform daily activities that met general physical activity recommendations, while the exercise group was additionally given to moderate-intensity aerobic and resistance training at 80% of the anaerobic threshold. Both groups were intervened for 12 weeks. After 12 weeks of training, the morphological parameters, cardiopulmonary function indicators, and blood biochemical markers of the two groups were assessed.

One patient in the control group was unable to continue with the study due to personal reasons. In the exercise group, 4 subjects were unable to complete the study, with 3 failing to meet the required exercise volume and 1 withdrew for personal reasons. Ultimately, 55 patients completed the trial, including 26 in the exercise group and 29 in the control group. The mixed ANOVA showed an interaction between group and time for abdominal circumference and cholesterol (P_intercation<0.05) . The main effects of the group were significant for abdominal circumference, postprandial 2-hour blood glucose, and cholesterol (P_group<0.05) . There was a significant interaction between group and time in the peak oxygen uptake, peak oxygen uptake in kg, peak METs (among of energy used during any activity) , peak work rate, anaerobic threshold (AT) power (power@AT) , peak work rate in kg, peak ventilatory equivalent (VE) , anaerobic threshold oxygen uptake (VO₂) , VO₂@AT/peakVO₂, peak O₂ pulse, and resting systolic blood pressure (SBP) (P_intercation<0.05) . In the exercise group, there were significant differences in the peak respiratory exchange ratio (RER) , peak watts, power@AT, peak VE, VE/VCO₂ slope, and anaerobic threshold oxygen uptake before and 4 weeks after surgery (P<0.05) . In the control group, there were significant differences in peak oxygen uptake, peak METs, power@AT, peak VE, VE/VCO₂ slope, and anaerobic threshold oxygen uptake before and 4 weeks after surgery (P<0.05) . After 12 weeks of training, there were significant differences in abdominal circumference, fasting blood glucose, postprandial 2-hour blood glucose, hemoglobin A_1C (HbA_1c) , cholesterol, peak oxygen uptake, power@AT, peak work rate, peak VE, anaerobic threshold oxygen uptake, anaerobic threshold oxygen uptake in kg and VO₂@AT/peakVO₂ between groups (P<0.05) .

Cardiopulmonary function decreases in T2DM patients combined with obesity at four weeks after bariatric surgery. Twelve weeks of exercise training post-surgery can reduce waist circumference, improve blood glucose and lipid levels, and enhance cardiopulmonary function.

Metabolic Syndrome (MetS) is an important risk factor for cardiovascular complications and kidney damage. Obesity and lipid-related markers are closely associated with MetS, and the predictive ability of different markers for MetS is still controversial.

The aim of this study was to evaluate the effect of 12 obesity and lipid-related indices, including lipid accumulation products, body mass index, visceral adiposity index, Chinese visceral adiposity index (CAVI) , abdominal volume index (AVI) , body fat index, BMI, body size index (ABSI) , triacylglycerol-glucose index (TyG) and its combined index TyG-BMI, TyG-waist circumference (TyG-WC) , and TyG-waist-height ratio (TyG-WHtR) , on the optimal cutoff values for MetS screening and prediction and to identify the most appropriate predictors.

The health checkup data of a state-owned enterprise in Anhui Province in 2023 were selected, and the correlation between 12 obesity and lipid-related indexes and MetS was analyzed by binary logistic regression. The work characteristics (ROC) curves of subjects with different obesity and lipid-related indexes assessing MetS were plotted, and the area under the ROC curve (AUC) was calculated and compared with its predictive value.

A total of 4 028 employees of a state-owned enterprise were included in this study, and the overall prevalence of MetS in the study population was 23.43% (944/4 028) , with a prevalence of MetS of 26.53% (816/3 075) in males and 13.43% (128/953) in females.The results of the logistic model showed that the TyG-WHtR was associated with an OR (95%CI) of the total population =7.170 (5.411-9.500) , gender subgroup [male OR (95%CI) =16.277 (11.554-22.930) ; female OR (95%CI) =13.422 (5.388-33.435) ] , age subgroup of males >50 years old OR (95%CI) =31.411 (18.868-52.292) and 36~50 years old women OR (95%CI) =95.154 (22.610-400.465) had the strongest association with the odds of developing MetS. The predictive ability of CVAI for MetS showed the best predictive effect in the total population, males and age subgroups of males ≤35 years old group and 36~50 years old group, with AUCs of 0.926 (95%CI=0.917-0.936, P<0.001) , 0.941 (95%CI=0.933-0.949, P<0.001) , 0.931 (95%CI=0.917-0.946, P<0.001) , 0.947 (95%CI=0.934-0.961, P<0.001) ; the predictive ability of AVI for MetS was higher in women and the age subgroups of women ≤35 and >50 years old, and in the group of men >50 years old, with a higher discrimination ability, with AUCs of 0.951 (95%CI=0.938~0.963, P<0.001) , 0.961 [95%CI=0.943-0.978, P<0.001) , 0.909 (95%CI=0.857-0.961, P<0.001) , 0.962 (95%CI=0.951-0.974, P<0.001) ; TyG-WC in the age subgroup female 36-50 years group performed better in predicting MetS with an AUC of 0.949 (95%CI=0.925~0.972, P<0.001) .

TyG-WHtR had the strongest association with MetS. Except for ABSI, which had poor predictive ability for MetS, CVAI showed better predictive ability for MetS in the total population, males and age subgroups males ≤35 years old group and 36~50 years old group, AVI had higher discriminatory ability for MetS in females and age subgroups females ≤35 years old and >50 years old, and males >50 years old group, and TyG-WC showed better predictive ability for MetS in the age subgroup females 36-50 years old group. MetS predictive ability performed better.

Cardiometabolic multimorbidity (CMM) is one of the most common patterns of co-morbidity aggregated in middle-aged and older adults. It greatly increases the risk of disability and death in our country. Insulin resistance and obesity are closely related to the occurrence and development of cardiometabolic diseases (CMD). The correlation between obesity and various types of CMD has been previously confirmed. The risk of CMM in residents with varying types of obesity and gender may be different and still unclear.

To identify the correlation of the type of obesity and CMM in male and female middle-aged residents in Anhui Province.

The subjects of this study were derived from the Early Screening and Comprehensive Intervention Program for People at High Risk of Cardiovascular Disease carried out in Anhui Province from 2017 to 2021, with a total of 10 project sites involving community residents in 12 counties and cities. Finally, 70 812 permanent middle-aged residents (45-<65 years) were included. Surveying of the subjects was performed by pre-trained investigators, including the general information (age, gender, smoking, alcohol consumption, remarriage education level of high school and above, farmers), disease history (hypertension, heart disease, diabetes, stroke, dyslipidemia), physical examination (height, body mass index, waist circumference), and laboratory tests (blood glucose, blood lipids). Subjects were divided into male and female, and sub-divided into non-obese, peripheral obesity, central obesity, and compound obesity. Logistic regression analysis was conducted to explore the correlation of CMM with gender and type of obesity. The effect value in male and female groups with different types of obesity was compared by the Z-test in R package.

A total of 26 726 male and 44 086 female residents were included. The prevalence of CMM in the total population, male and female groups was 14.6% (10 361/70 812), 16.6% (4 445/26 726), and 13.4% (5 916/44 086), respectively. The prevalence of hypertension, diabetes mellitus, heart disease, stroke, and dyslipidemia among middle-aged residents of Anhui Province was 27.0%, 7.8%, 0.5%, 2.5%, and 29.5%, respectively. Logistic regression analysis showed that, after adjusting for age, smoking, alcohol consumption, remarriage, education level of high school and above, and occupation of farmers, the risk of CMD significantly increased in the peripheral obesity (OR=1.665, 95% CI=1.599-1.734), central obesity (OR=1.788, 95% CI=1.656-1.930), and compound obesity subgroups (OR=3.020, 95% CI=2.913-3.131) than the non-obesity subgroup (P<0.05). In either the male or female group, the risk of CMM increased sequentially in the peripheral obesity, central obesity, and compound obesity subgroups. In the male group, the OR (95%CI) of an increased risk of CMM in peripheral obesity, central obesity, and compound obesity subgroups compared to the non-obese subgroups was 2.008 (1.822-2.213), 2.281 (1.875-2.774), and 4.137 (3.799-4.504), respectively; while in the female group, it was 1.574 (1.443-1.717), 1.727 (1.509-1.976), and 2.916 (2.721-3.126), respectively (P<0.05). The Z-test results showed a significant difference among the peripheral obesity, central obesity, and compound obesity subgroups in male and female residents (P<0.05). After adjusting for the blood lipids and other related indexes, the risk of CMM in the peripheral obesity, central obesity, and compound obesity subgroups in male and female residents increased sequentially with a significant difference (P<0.05). Z-test showed a significant difference in the risk of CMM in the compound obesity subgroup of male and female residents (Z=2.258, P<0.05) .

The risk of CMM varies in middle-aged residents of Anhui Province with different types of obesity, showing the highest risk in those with compound obesity, followed by central obesity. Male middle-aged residents with compound obesity have a higher risk of CMM than females, serving as a highly concerned population.

Currently, the number of obese adolescents in China is increasing dramatically, and adolescent obesity is not only closely related to metabolic diseases, but also a risk factor for coronary heart disease mortality in adulthood. Lipid metabolic flexibility is regarded as an important indicator of the metabolic health of an organism. Studies confirm that cardiorespiratory fitness is associated with lipid metabolic flexibility, but are lacking in obese adolescents with different metabolic phenotypes.

To investigate the association of cardiorespiratory fitness with lipid metabolic flexibility in metabolically unhealthy obesity (MUO) adolescents and metabolically healthy obesity (MHO) adolescents.

Ninety-one obese adolescents were selected to participate in the Shenzhen Weight Loss Camp (2022-2023), and were divided into 35 in the MUO group and 56 in the MHO group in accordance with the "Expert Consensus on the Definition and Screening of Metabolically Healthy Obesity in Chinese Children". The gas metabolism data from the resting metabolic test, incremental load treadmill test and heart rate data were collected using a gas metabolism analyzer and a heart rate meter; the maximum oxygen uptake (VO_2max) was estimated based on the heart rate-oxygen uptake relationship; and the third-order polynomial fitting curve was used to obtain the maximal fat oxidation rate (MFO) or the corresponding maximal fat oxidation intensity (FAT_max) to reflect the flexibility of lipid metabolism. The linear regression analysis was used to explore the correlation between VO_2max and MFO and FAT_max.

The overall MFO and FAT_max of the two groups were (5.54±1.37) mg·min^-1·kg^-1 and (4.19±0.87) MET. The BMI, systolic blood pressure, diastolic blood pressure, and triacylglycerol levels in the MUO group were higher than those in the MHO group, and the level of high-density lipoprotein cholesterol was lower than that in the MHO group (P<0.05). Before adjustment, the MFO in the MUO group was lower than that in the MHO group (P<0.05) ; after adjustment for VO_2max, the difference in MFO between the two groups of obese adolescents was not statistically significant (P>0.05) ; before adjustment and after adjusting VO_2max, there was no statistically significant difference between the two groups of obese adolescents when comparing FAT_max (P>0.05). VO_2max was positively correlated with MFO in obese adolescents in the overall (B=0.077, 95%CI=0.011-0.144, P=0.023) and MHO groups (B=0.105, 95%CI=0.027-0.182, P=0.009) ; VO_2max was positively correlated with FAT_max in obese adolescents in the MHO group (B=0.057, 95%CI=0.003-0.111, P=0.041) ; VO_2max was not linearly related to MFO and FAT_max in obese adolescents in the MUO group (P>0.05) .

MUO adolescents have lower MFO than MHO adolescents; during running exercise, obese adolescents with different metabolic phenotypes could reach MFO at (4.19±0.87) MET intensity. Cardiorespiratory fitness is a key factor influencing lipid metabolic flexibility in MHO adolescents, and MUO adolescents may need to be transformed into MHO adolescents to promote lipid metabolic flexibility.

With the prevalence of obesity, the incidence of non-alcoholic fatty liver disease (NAFLD) is increasing, the risk of liver fibrosis and liver cancer is also increasing. Screening for early fibrosis is of great significance. International guidelines recommend fibrosis-4 (FIB-4) index as an indicator for screening hepatic fibrosis. However, it is unclear whether FIB-4 index screening is affected by type 2 diabetes and BMI in screening for early fibrosis.

To evaluate whether the effectiveness of FIB-4 index in primary care screening is affected by type 2 diabetes and BMI.

A total of 110 patients diagnosed with NAFLD by liver biopsy in the Affiliated Hospital of Hangzhou Normal University from 2013 to 2023 were selected as the study objects. They were divided into type 2 diabete (T2DM) group and non-T2DM group according to T2DM. According to BMI, they were divided into normal weight group, overweight group and obesity group. According to the liver biopsy results, they were divided into F0-F1 group and F2-F4 group. FIB-4 index was calculated and the differences among each group were compared. Spearson correlation was used to analyze the correlation between FIB-4 index and various indexes. The accuracy of FIB-4 index was evaluated via receiver operating characteristics (ROC) curves. The area under ROC curve (AUC) was calculated and Delong test was used to compare AUC differences between groups.

The comparison results of FIB-4 index showed that the T2DM group was higher than non-T2DM group, and F0-F1 group was lower than F2-F4 group with statistical significance (P<0.05). There was no significant difference in FIB-4 index among normal weight group, overweight group and obesity group (P>0.05). Correlation analysis showed that FIB-4 index was positively correlated with age, aspartate aminotransferase, fasting glucose and fibrosis (P<0.05), and negatively correlated with platelet count (P<0.05). The AUC of FIB-4 index in the diagnosis of NAFLD was 0.77 (95%CI=0.68-0.86, P<0.001) and the AUC of FIB-4 index in the diagnosis of NAFLD with T2DM was 0.85 (95%CI=0.72-0.98, P<0.001). The AUC of FIB-4 index in the diagnosis of NAFLD without T2DM was 0.71 (95%CI=0.58-0.84, P=0.006). Delong test results showed that there was no significant difference in AUC between the T2DM group and the non-T2DM group (Z=1.509, P=0.131). The AUC of FIB-4 index in the diagnosis of NAFLD was 0.91 (95%CI=0.76-1.00, P=0.029) in the normal group, 0.65 (95%CI=0.46-0.83, P=0.125) in the overweight group, and 0.82 (95%CI=0.70-0.94, P<0.001) in the obese group. The AUC of the normal group was higher than that of the overweight group, and the difference was statistically significane (Z=2.037, P=0.042). There was no significant difference in AUC between the obese group and the normal group or the overweight group (Z=0.876, P=0.381; Z=1.452, P=0.146) .

FIB-4 is not affected by T2DM in the assessment of early fibrosis in NAFLD patients, but has a certain relationship with BMI.

In the context of rising obesity rates, metabolically healthy obesity (MHO) can achieve favorable outcomes through early intervention. However, grazing behavior in this population poses a significant barrier to weight management. Understanding the factors influencing grazing behavior is essential to improve dietary compliance in obesity management. Currently, there is a lack of qualitative research on this topic.

To explore the influencing factors of grazing behavior in metabolically healthy obese individuals.

Based on the capacity opportunity motivation-behavior (COM-B) model and the theoretical domains framework (TDF), the interview guide was developed. 17 cases of metabolically healthy obese were selected from the Department of Endocrinology, Northern Jiangsu People's Hospital for semi-structured interviews via purpose sampling method. The interview data were coded using the COM-B and TDF frameworks and analyzed through both inductive thematic analysis and deductive framework methods.

Six core themes were identified, including lack of dietary management knowledge, insufficient cognitive resources, perceptual and practical influences, maladaptive coping strategies, absence of reflection/self-motivation, environmental and social influences.

Grazing behavior in individuals with MHO are shaped by a multifaceted interplay of personal, healthcare-related and societal factors. Appropriate intervention measures should be taken according to the multidimensional needs of patients and help them establish healthy eating habits and behaviors.

Obesity and metabolic abnormalities are associated with atherosclerosis, and different metabolic phenotypes of obesity have different risks of AS. The relationship between serum uric acid (SUA) levels and AS is unclear.

Using brachial-ankle pulse wave velocity (baPWV) as an early predictor of AS, we investigated the correlation between different metabolic phenotypes of obesity and the risk of AS, with a focus on metabolically healthy obese populations, and further explored whether uric acid serves as a potential influencing factor.

A total of 622 young medical check-ups at a street community health center from December 2021 to January 2022 were selected for questionnaire survey, physical examination, and laboratory tests. The study subjects were categorized into four groups based on BMI and metabolic status, metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO). Pearson's correlation was used to analyse the correlation between SUA and baPWV and various clinical indicators. Multiple linear regression models were used to analyze the correlation between SUA and baPWV and various clinical indicators, and scatter plots were drawn. Multifactorial Logistic regression models were used to analyze the correlation between different obesity metabolic phenotypes and high baPWV and hyperuricemia.

After grouping according to different obesity metabolic phenotypes, the prevalence of high baPWV levels in the MHNO, MHO, MUNO and MUO groups gradually increased to 3.9%, 9.8%, 14.5% and 29.4%, respectively, with a statistically significant difference (χ² _trend=60.722, P<0.001); and the prevalence of hyperuricemia in the MHNO, MHO, MUNO and MUO groups. The prevalence rates were 3.6%, 8.9%, 10.1% and 26.9%, respectively, and the difference was statistically significant (χ² _trend=56.444, P<0.001). The results of multivariate linear regression analysis correcting for confounders showed SUA was an independent risk factor for atherosclerosis. The results of multifactorial Logistic regression modeling showed that after correcting for gender, age, current smoking, current alcohol consumption, and literacy, the risk of high baPWV was significantly higher in the four groups of MHNO, MHO, MUNO, and MUO in that order, and the risk of hyperuricemia was also significantly higher in that order.

In the young population, there is a significant correlation between different obesity metabolic phenotypes and atherosclerosis, and uric acid may be a potential influencing factor. In addition, we should pay attention to the young MHO population for early lifestyle intervention and health management.

The incidence of frailty among the elderly in China increases with age, investigating the mechanisms by which central obesity and vitamin D levels contribute to the development of frailty is essential for effective management strategies.

A cross-lagged model was employed to investigate the longitudinal mediating role of vitamin D levels in the relationship between central obesity and frailty among the elderly, thereby offering a theoretical framework for the management of frailty in this population.

The study subjects were 1 364 elderly individuals selected from the Chinese Longitudinal Healthy Longevity Study (CLHLS) in 2011-2012 (T1) and 2014 (T2). The vitamin D levels of the study subjects were measured, and abdominal obesity was assessed using the weight-adjusted-waist index (WWI), while frailty was measured using the frailty index (FI). A cross-lagged model was implemented to analyze the causal temporal relationship and underlying mechanisms between central obesity, vitamin D levels, and frailty among the elderly.

The detection rate of frailty in the elderly was 21.8% (298/1 364) at T1 and 31.2% (425/1 364) at T2. At two time points, WWI was negatively correlated with vitamin D levels (P<0.05) and positively correlated with FI (P<0.05) ; vitamin D levels were negatively correlated with FI (P<0.05). Cross-lagged model results showed that WWI at T1 could predict FI at T2 (β=1.124, P<0.05), and FI at T1 could predict WWI at T2 (β=0.125, P<0.05). Longitudinal mediation effect analysis showed that T1 WWI could not only directly predict T2 FI (β=0.040, P<0.05), but also predict T2 FI through the mediating effect of T2 vitamin D level (β=-0.131, P<0.05) .

Abdominal obesity can not only directly predict frailty in the elderly, but also indirectly affect frailty in the elderly through the longitudinal mediating effect of vitamin D levels. Elderly people should regularly monitor abdominal obesity and vitamin D levels, to prevent or delay the onset of debilitation.

Healthcare workers have played a crucial role in preventing and controlling the COVID-19 pandemic. However, the heightened risk of infection and intense work schedules have not only induced occupational burnout among them but also significantly impacted their mental health and lifestyles. A large number of foreign studies have shown that the COVID-19 pandemic has led to unreasonable diet, reduced exercise, irregular work and rest, and decreased sleep quality among HCWs, increasing the risk of overweight and obesity. Despite this, research on weight and lifestyle changes among Chinese healthcare workers during the pandemic is limited, and the key lifestyle factors contributing to these weight changes remain unclear.

To analyze the predictors of overweight and obesity in Chinese healthcare workers by constructing a Bayesian network model, and to provide a scientific basis for the prevention and control of overweight and obesity.

In August 2022, Chinese healthcare workers in 100 medical institutions from five provinces/autonomous regions/municipalities were randomly sampled, and the questionnaire (Cronbach's α=0.820, AVCR=63.55%) was prepared by the researchers to collect data. All respondents were required to scan QR code generated by the "Wenjuanxing" to answer the e-questionnaire and submit. The "bnlearn" package of R 4.3.0 software was used to construct a Bayesian network model, and Netica 6.09 software was used for Bayesian network risk prediction.

The study surveyed a total of 20 261 healthcare workers, of whom females accounted for 67.57% (13 690/20 261) ; The average age was (40.2±9.2) years old; 73.28% (14 848/20 261) had a college or undergraduate education level. In 2019 and 2022, the overweight/obesity rates were 43.06% (8 726/20 261) and 45.71% (9 262/20 261), respectively. From 2019 to 2022, 12.64% (1 458/11 535) of survey respondents' BMI changed from underweight/normal to overweight/obese. The Bayesian network model included a total of 15 nodes, and the amount of consumption of vegetables and fruits, breakfast frequency, alcohol drinking, and appetite were the parent nodes of BMI changing from underweight/normal to overweight/obesity, and when there were "a reduction" in the consumption of vegetables and fruits, "no change" in frequency of eating breakfast, alcohol drinking consumption "no change", and "a great increase" in the appetite the risk of BMI changing from underweight/normal to overweight/obese was the highest (75.00%). And when there were "a great increase" in consumption of vegetables and fruits, "an increase" in the frequency of eating breakfast, "never or rarely" in alcohol drinking and "a reduction" in appetite, the risk of becoming overweight/obese was the lowest (2.04%) .

Consumption of vegetables and fruits, eating breakfast frequently, drinking alcohol and appetite are the direct predictors of overweight/obesity of Chinese healthcare workers. During the epidemic of major infectious diseases such as the COVID-19, on the premise of ensuring the normal operation of medical and health institutions, a reasonable rotation system is implemented to provide psychological support and lifestyle behavior intervention services, which is conducive to the prevention and control of obesity of healthcare workers.

The 6-minute walk test (6MWT) is extensively used to assess the exercise capacity of obese populations and offers a reference for devising intervention measures. While reference equations for the 6MWT distance for various populations have been proposed internationally, there is a scarcity of studies on reference equations for the 6MWT distance among Chinese obese subjects aged 17 to 45 years with a BMI ≥ 30 kg/m².

To develop reference equations for the 6MWT distance for outpatient obese subjects aged 17 to 45 years and to assess its influencing factors.

Following the American Thoracic Society guidelines, from June 2022 to September 2023, 143 adults aged 17 to 45 years with a BMI ≥30 kg/m² (71 males and 72 females) who visitied the Department of Endocrinology, Northern Jiangsu People's Hospital, were prospectively selected for anthropometric measurements and the 6MWT. A stepwise multiple regression model was employed to establish reference equations for the 6MWT distance, and the newly developed equations were compared with existing prediction equations.

The average 6MWT distance for the 143 subjects was (506.1±49.8) m, with males averaging (515.7±50.14) m, which was greater than the females' average of (496.6±47.9) m (P<0.05). Across age groups 17-23, 24-30, 31-37, and 38-45 years, differences in 6MWT distances between males and females were statistically significant (P<0.05). In males, weight, BMI, HR_max, resting heart rate difference (ΔHR), waist circumference, diastolic blood pressure difference (ΔDBP), and Borg scale score difference (ΔBorg) were related to 6MWT distance (P<0.05), whereas in females, weight, BMI, and waist circumference were related to 6MWT distance (P<0.05). Incorporating potential influencing factors into a stepwise multiple linear regression equation, the final reference formulas were established as follows: for males, y=494.463+1.414×ΔHR-3.903×BMI+0.874×HR_max, R²=0.429; for females, y=670.448+0.299×ΔHR-4.342×BMI-0.195×HR_max, R²=0.312.

In outpatient obese patients aged 17 to 45 years, males had a longer average 6MWT distance than females, with significant differences across different age groups. Factors such as weight, BMI, HR_max, ΔHR, wait cirumference ΔDBP, and ΔBorg were associated with 6MWT distance in males, while weight, BMI, waist cirumference and ΔSBP were related to 6MWT distance in females. Through multiple linear regression analysis, reference equations predicting 6MWT distance were established for males and females, providing valuable references for assessing individual physical fitness levels.

Research has linked the physical constitution of overweight/obese individuals to obesity, with a potential bidirectional association. Although FATmax exercise can boost their fitness, the exact magnitude of this benefit needs further study.

Systematic evaluation is needed to assess the impact of FATmax exercise on physical fitness indicators among overweight or obese populations.

Retrieve RCTs from PubMed, Web of Science, EBSCO, CNKI, VIP, Wanfang Data (January 2001 to January 2024) on FATmax exercise effects on body composition, cardiovascular endurance, lipid metabolism in overweight/obese patients. Evaluate quality with Cochrane tool, Meta-analysis with RevMan 5.4.

A total of 16 randomized controlled trials were included, including 568 overweight or obese patients. The Meta-analysis results showed that compared with the control group, the FATmax exercise intervention group significantly improved body composition (BMI: WMD=-1.82, P<0.01; BFR: WMD=-2.86, P<0.01; WHR: WMD=-0.04, P<0.01), cardiovascular endurance (VO_2max: WMD=3.34, P<0.01), and lipid metabolism except for TC (TG: WMD=-0.24, P<0.01; HDL-C: WMD=0.14, P<0.01; LDL-C: WMD=-0.27, P<0.01). Optimal results vary: ≥12 weeks, 3-5 times/week, 60-minute running for body composition; ≥12 weeks, 5 times/week, <60 minutes combined for VO_2max; ≥12 weeks, 3 times/week, 60-minute running for TG; <12 weeks, 4 times/week, 60-minute combined for HDL-C; <12 weeks, 4 times/week, >60-minute combined for LDL-C.

FATmax exercise benefits body composition, cardiovascular endurance, and lipid metabolism (except TC) in overweight/obese patients.

Obesity and hypertension are global public health problems that place a huge burden on individual health and social economy. There is a close correlation between obesity and hypertension, both are major risk factors for cardiovascular diseases. In 2023, the Obesity Medicine Association (OMA) conducted a deep investigation into the mechanisms of obesity-related hypertension and published the Clinical Practice Statement on Obesity and Hypertension in the Obesity Pillars. This statement presents new recommendations for the prevention and treatment of obesity and hypertension. It also identifies ten important considerations for managing these disorders. The goal of this article's interpretation of the OMA statement is to help primary care physicians treat patients with obesity and hypertension more effectively by furthering the updating of China's clinical guidelines for these illnesses.