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.

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.

The prevalence of overweight and obesity among children and adolescents is continuously rising. As countries have developed several school-based nutrition policies to control overweight and obesity, it is important to examine the effectiveness of nutrition policies.

To evaluate the effect of the centralized distribution of food material system on overweight and obesity rates among children and adolescents aged 6-15 years.

In April 2023, a total of 104 749 BMI data from sixteen schools aged 6 to 15 years (8 schools were included in the unified food distribution system and recorded as the unified distribution group, and 8 schools were not included in the unified food distribution and supply system and recorded as the non-unified distribution group) in Wuxi were retrospectively collected between 2017 and 2021. The data of physical examination was collected from Student Health Monitoring System in Jiangsu Province. The overweight and obesity epidemiologic trends among children and adolescents were analyzed from 2017 to 2021 in Wuxi, and the changes in BMI-Z scores and trends in overweight and obesity rates among children and adolescents were compared before and after the implementation of the centralized distribution of food material system by the Joinpoint regression and grey GM (1, 1) model.

The prevalence of overweight and obesity among in children and adolescents aged 6-15 years was increasing from 2017 to 2021. The results of the Joinpoint regression analysis indicated that the prevalence of overweight (APC 1.8% vs 4.6%) and obesity (APC 6.9% vs 13.3%) among students included in the system exhibited a slower rate of increase than among those not included. The disparity in the increase of BMI-Z scores among students included in the system and those not included changed from -0.055 (95%CI=-0.108--0.002) to -0.195 (95%CI=-0.246--0.145) before and after the implementation of the system. The results of grey GM (1, 1) model showed that the incidence rate of overweight among children and adolescents in Wuxi in 2022, 2023 and 2024 was 22.02%, 22.39% and 22.77% respectively, with the incidence rate of overweight being 17.02%, 18.50% and 20.12% respectively.

The increasing trend in the prevalence of overweight and obesity, as well as the increase in BMI-Z scores among children and adolescents, has slowed down after the implementation of the centralized distribution of food material system. The system may be an effective method of improving the nutritional status of children and adolescents. Therefore, it is recommended that the centralized distribution of food material system still needs to be implemented and the monitoring area needs to be expanded.

The increasing incidence of childhood obesity has emerged as a novel challenge in the realm of global public health. Studies have demonstrated that alterations in the composition of intestinal flora during the early stages of life contribute to the development of obesity by influencing nutrient absorption and metabolism, triggering inflammatory responses, and regulating the communication between the gut and brain. Currently, Bifidobacterium and Akkermansia muciniphila have been found to reduce body fat content, exhibit anti-inflammatory properties, and enhance intestinal barrier function, whereas Prevotella is strongly associated with improvements in individual glucose metabolism induced by dietary fiber. Translational application of specific intestinal flora benefits to body glycolipid metabolism is helpful for the early prevention and therapy of pediatric obesity. This review elucidates the impact of early-life changes in intestinal flora composition on childhood obesity explores the mechanisms by which intestinal flora contributes to obesity pathogenesis, and specifically focuses on recent advances in utilizing short-chain fatty acids for the regulation of intestinal flora and the amelioration of obesity, aiming to provide a theoretical foundation for the intervention of childhood obesity from the perspective of intestinal flora.

Muscle mass loss increases the risk of hyperglycaemia and sarcopenia in patients with type 2 diabetes mellitus (T2DM), and Chinese adults with T2DM are predominantly non-obese, who are more likely to be associated with muscle mass loss than the obese.

To establish an individualized Nomogram prediction model for the risk factors of muscle mass loss in non-obese patients with T2DM.

A retrospective study was conducted to select 905 non-obese patients with T2DM admitted to the Department of Endocrinology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University from January 2018 to September 2023. The patients were divided into a training set (n=633) and a validation set (n=272) using simple random sampling at a ratio of 7∶3, and the general data and clinical indexes of the two groups of patients were collected and compared. Multivariate Logistic regression analysis was performed to determine risk factors for muscle mass loss in the training set and a Nomogram prediction model was constructed. The predictive value and clinical utility of the Nomogram prediction model were evaluated using receiver operating characteristic (ROC) curve, Hosmer-Lemeshow calibration curve, and decision curve analysis (DCA), respectively.

The prevalence of muscle mass loss in non-obese patients with T2DM was 42.3% (383/905). Comparison of the clinical indicators of the patients in the training and validation sets showed no statistically significant differences (P>0.05). Multivariate Logistic regression analysis showed that age (OR=1.039, 95%CI=1.010-1.070, P=0.009), male (OR=3.425, 95%CI=2.133-5.499, P<0.001), BMI<23.5 kg/m² (OR=19.678, 95%CI=11.319-34.210, P<0.001), elevated HbA_1c (OR=1.196, 95%CI=1.081-1.323, P<0.001), increased visceral fat area (OR=1.021, 95%CI=1.010-1.032, P<0.001) were independent risk factors for muscle mass loss in non-obese patients with T2DM. The area under curve (AUC) of the ROC for the Nomogram prediction model to predict the risk of muscle mass loss occurring in patients in the training and validation sets was 0.825 (95%CI=0.793-0.856, P<0.001) and 0.806 (95%CI=0.753-0.859, P<0.001), respectively. The Hosmer-Lemeshow test showed that the model had a good fit (training set: χ²=11.822, P=0.159; validation set: χ²=8.189, P=0.415). Bootstrap method of plotting the calibration of the model showed that the calibration curves fitted well to the standard curves. The DCA curves showed that it was more beneficial to use the Nomogram prediction model to predict the incidence risk of muscle mass loss in patients with T2DM when the threshold probability of the patient was 0.06 to 0.94.

Age, male, BMI<23.5 kg/m², elevated HbA_1c, and increased visceral fat area are independent risk factors for muscle mass loss in non-obese patients with T2DM. The Nomogram prediction model established in this study can individually predict the risk of muscle mass loss in non-obese patients with T2DM, which facilitates the early identification of high-risk groups and the development of individualised interventions.

With the improvement of economic level and changes in lifestyle of residents, the obesity among children and adolescents has become increasingly severe, threatening the healthy growth of children and adolescents. BMI was used as an evaluation index of obesity in most previous studies, which may underestimate the prevalence of central obesity. Therefore, it is urgent to evaluate the waist circumference (WC) and trend of the prevalence of central obesity among children and adolescents in Putuo District, in order to provide scientific basis for targeted proposed intervention.

To analyze WC and the trend in the prevalence of central obesity among children and adolescents aged 7-18 years in Putuo District, Shanghai, from 2018 to 2023.

Data on medical examinations of primary and secondary school students in Putuo District in 2018 and 2020 to 2023 were used to analyze the WC, the prevalence of central obesity and the trends. The 90th percentile (P₉₀) age-specific children and adolescents of different genders was used as the cut-off point of high WC, and WC exceeding the P₉₀ value was defined as central obesity. SPSS 22.0 and SAS 13.1 were used for statistical analysis and Excel 2021 was used for graphic plotting.

A total of 280 648 primary and secondary school students participated in the medical examination in Putuo District, Shanghai, from 2018 to 2023, of which 146 334 (52.1%) were male students and 134 314 (47.9%) were female students, with an median age of 10.5 (8.7, 12.6) years. WC of male and female students from 2018 to 2023 showed fluctuating downward trends with a statistically significant difference (H_male=209.785, H_female=373.076; P<0.001). WC of male students decreased from 65.2 (58.0, 74.0) cm in 2018 to 64.8 (56.9, 74.0) cm in 2023 and female students decreased from 60.5 (55.0, 67.0) cm to 59.8 (53.8, 66.2) cm. Comparison of the prevalence of central obesity among male and female students in each year showed statistically significant differences (χ²_male=264.123, χ²_female=448.289; P<0.001). The results of Cochran-Armitage trend test showed decreasing trends in prevalences of central obesity among male and female groups from 2018 to 2023 (Z_{trend male}=-10.974, Z_{trend female}=-15.218; P_trend<0.001). The prevalence of central obesity among male students decreased from 28.8% (6 714/23 286) to 24.6% (7 935/32 227), while that among female students decreased from 21.9% (4 604/21 062) to 15.5% (4 604/29 695). The WC and prevalence of central obesity among male students were higher than that among female students (U=7 128 257 114.500、χ²=2 928.075, P<0.001). Prevalence of central obesity showed increasing trends with age for both sexes (Z_{trend male}=35.167, Z_{trend female}=6.533; P_trend<0.001) .

This study suggests that WC and the prevalence of central obesity among children and adolescents aged 7-18 in Putuo District are fluctuating and decreasing. WC and the prevalence of central obesity of male students are high than those of female students of the same age. The prevalence of central obesity is increasing with age. Results of this study provide theoretical support for the targeted intervention of central obesity in children and adolescents.

Studies have confirmed that executive function in overweight and obese children is closely related to obesity and may have a bidirectional association. Aerobic exercise, as an effective intervention, can effectively promote their brain development and cognitive function, especially executive function, but the quantitative relationship of the improvement effect still needs to be further explored.

To systematically evaluate the intervention effect of aerobic exercise on executive function-related indexes in overweight and obese children.

Randomized controlled trials of aerobic exercise interventions for executive function in overweight and obese children were searched in CNKI, Wanfang Data, CBM, Cochrane Library, PubMed, Embase, and Web of Science databases, and the timeframe for searching was from the establishment of each database to July 2023. The quality of the included literature was assessed according to the Cochrane Risk of Bias Assessment Tool, and Meta-analysis of outcome indicators was performed using RevMan 5.3 and Stata 15.0 software.

Nine randomized controlled trials, including 940 overweight and obese children, were finally included. The results of Meta-analysis showed that a single session of aerobic exercise intervention was effective in improving the executive function of overweight and obese children (WMD=-6.98, 95%CI=-11.89 to -2.07, P=0.005). Subgroup analyses showed no significant differences in the improvement of any of the executive function subcomponents in overweight and obese children with a single intervention duration of less than 30 minutes of aerobic exercise (WMD=-0.84, 95%CI=-9.37 to 7.68, P=0.85) ; aerobic exercise with a single intervention duration longer than 30 minutes improved inhibitory function in overweight and obese children (WMD=-10.50, 95%CI=-19.15 to -1.85, P=0.02). When a long-term exercise intervention was carried out (the intervention period was 8 weeks), in contrast to the control group, the aerobic exercise improved interference control in overweight and obese children (WMD=-0.16, 95%CI=-0.18 to -0.14, P<0.000 01), on planning (WMD=4.20, 95%CI=-8.34 to 16.73, P=0.51), attention (WMD=0.41, 95%CI=-12.08 to 12.91, P=0.95), synchronization (WMD=3.93, 95%CI=-8.22 to 16.08, P=0.53), and continuity (WMD=2.48, 95%CI=-9.18 to 14.14, P=0.68) were not significantly improved.

Aerobic exercise for a single long period of time had a selective positive effect on executive function subcomponents in overweight and obese children, and aerobic exercise for a long period of time with a fixed frequency and duration improved interference control in overweight and obese children, but did not produce an improvement in planning, attention, synchronization, or continuity.

Pre-pregnancy obesity can have a range of effects on both the mother and the fetus, possibly due to abnormalities in maternal-fetal metabolism. Therefore, exploring the mechanisms is essential to improve fetal prognosis.

To investigate the alterations of factors associated with obesity and glucose metabolism in the placentas of pregnant women with different BMI levels before pregnancy.

A total of 100 singleton pregnant women who delivered in Beijing Shijitan Hospital, Capital Medical University in 2019 were selected as the study subjects. The clinical data were collected based on the electronic medical record system. The subjects were divided into the low/normal body mass group (n=57) and overweight/obese group (n=43) based on their pre-pregnancy body mass. The expression of long non-coding RNA metastasis-associated Lung adenocarcinoma transcript 1 (LncRNA MALAT1), serum amyloid A3 (SAA3), and interleukin 6 (IL-6) mRNA in placental tissue were measured using reverse transcription-polymerase chain reaction.

The age of the subjects ranged from 22 to 43 years, with an average age of (32.7±4.2) years, including 61 primiparas, 21 with gestational diabetes mellitus (GDM), 14 with low body mass, 43 with normal body mass, 26 with overweight, and 17 with obese. The proportion of GDM and neonatal body mass in the overweight/obese group was higher than that in the low/normal body mass group, and the weight gain during pregnancy was lower than that in the low/normal body mass group, with statistically significant differences (P<0.05). The expression of LncRNA MALAT1 mRNA in placental tissue was higher in the overweight/obese group than the low/normal body mass group, with a statistically significant difference (P<0.05). The mRNA expression of LncRNA MALAT1, SAA3, and IL-6 mRNA in the placental tissue of obese pregnant women were higher than those of normal pre-pregnancy body mass, with statistically significant difference (P<0.05) .

Excessive pre-pregnancy BMI has a more significant impact on mother and child during pregnancy, overshadowing the effects of controlling weight gain during pregnancy. In obese pregnant women, LncRNA MALAT1 may regulate glucose and lipid homeostasis through SAA3 and IL-6, involving inflammatory changes and oxidative stress, thereby affecting fetal metabolism, which deserves more in-depth exploration.

With the gradual aging of China's population and the gradual rise of chronic disease co-morbidities, cardiometabolic co-morbidities (CMM) have become one of the most damaging co-morbidities. Current studies on prediction and intervention methods for CMM have focused on individual cardiovascular diseases and lifestyle, while studies on CMM as a whole are lacking.

To explore the association of Continuous Metabolic Syndrome Score (cMetS) and other obesity indicators with CMM, and to further confirm whether these indicators can be used as a simple indicator for screening CMM, as well as to estimate the threshold for prediction of CMM in the middle-aged and elderly population in Anhui Province.

The study included 131 390 participants from the Anhui Province Cardiovascular Disease High-Risk Population Early Screening and Comprehensive Intervention Project from 2017 to 2021, divided into CMM (779 males, 866 females) and non-CMM groups (53 020 males, 76 725 females). General patient information and biochemical markers were collected, and the waist-to-height ratio (WHtR), WHT.5R, body roundness index (BRI), and cMetS were calculated. Differences in CMM prevalence by gender and age group were compared using the Bonferroni method. Multivariate Logistic regression analysis was employed to investigate the factors influencing CMM. Receiver operating characteristic (ROC) curves for predicting CMM using cMetS and obesity indices were plotted, and the area under the ROC curve (AUC) was calculated. The value of different indices in predicting CMM status was assessed using paired sample tests.

In the male cohort, the CMM group showed higher values for age, BMI, waist circumference (WC), mean arterial pressure (MAP), fasting plasma glucose (FPG), triglycerides (TG), diabetes, ischemic heart disease, stroke, WHtR, WHT.5R, BRI, and cMetS than the non-CMM group. Smoking and alcohol consumption, as well as total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C), were higher in the non-CMM group (P<0.05). In females, similar trends were observed, with lower levels of TC and HDL-C in the CMM group (P<0.05). The prevalence of CMM varied across different age groups in both male and female patients (P<0.05). Multivariate Logistic regression analysis indicated that increases in cMetS, WHtR, WHT.5R, BRI, and BMI are risk factors for CMM in both genders (P<0.05). ROC curve analysis showed that in males, the AUC for cMetS was higher than that for WHtR (Z=6.16, P<0.001), BRI (Z=6.16, P<0.001), WHT.5R (Z=7.21, P<0.001), and BMI (Z=9.36, P<0.001). Similar findings were observed for females, with cMetS outperforming the other indices.

In both genders, cMetS and other obesity indices are closely associated with CMM, with cMetS being a superior identifier. cMetS serves as a novel marker for diagnosing CMM, highlighting its significance in the prevention of this condition.

Chronic kidney disease (CKD) is the eleventh leading cause of death globally, and the burden of disease and economic impact caused by it is increasing rapidly. Its disability and mortality rates have exhibited the highest increase among all chronic diseases. Insulin resistance (IR) and obesity are closely associated with the onset and progression, and triglyceride-glucose (TyG) index can serve as a substitute indicator for IR. Nevertheless, the exact relationship between the TyG index and the development of CKD remains to be fully elucidated.

Through a cohort study, we aim to investigate the relationship between triglyceride-glucose (TyG) index and its combination with obesity indices in relation to the occurrence of CKD.

This retrospective cohort study selected 4 921 adult participants who underwent annual physical examinations at the Sichuan Provincial People's Hospital Health Management & Physical Examination from January 2015 to November 2022, according to specific inclusion and exclusion criteria. The study cohort was categorized into four groups based on quartiles of the baseline triglyceride-glucose (TyG) index: Q1 (5.43-6.66) , Q2 (6.67-7.04) , Q3 (7.05-7.43) , and Q4 (7.43-9.97) , with sample sizes of 1 230, 1 231, 1 230 and 1 230, respeciyvely Obesity-related indices including waist circumference (WC) , BMI, and waist-to-hip ratio (WHR) , were combined with the TyG index to form TyG-WC, TyG-BMI, and TyG-WHR indices. Based on the quartiles of the baseline TyG-WC index, the study subjects were divided into 4 groups, Q1 (204.49-523.14) , Q2 (523.15-593.21) , Q3 (593.22-657.16) , and Q4 (657.17-992.75) , with sample sizes of 1 230, 1 232, 1 229 and 1 230, respectively. Based on the quartiles of the baseline TyG-BMI index, the study subjects were divided into 4 groups, Q1 (92.43-149.16) , Q2 (149.17-168.43) , Q3 (168.49-188.92) , and Q4 (88.93-306.64) , with sample sizes of 1 228, 1 231, 1 232 and 1 230, respectively. Based on the quartiles of the baseline TyG-WHR index, the study subjects were divided into 4 groups, Q1 (2.76-5.66) , Q2 (5.67-6.26) , Q3 (6.27-6.83) , and Q4 (6.84-9.67) , with sample sizes of 1 230, 1 230, 1 231 and 1 230, respectively. The relationship between the TyG index and its combination with obesity indices and the incidence risk of CKD was examined by a Cox proportional hazards model, while a restricted cubic spline regression (RCS) was used to assess dose-response relationships.

At the end of follow-up, there were 139 new cases of CKD in the study cohort, with an incidence rate of 2.8%. After accounting for potential confounding factors, the results showed that compared to the TyG index Q1 group, the TyG index Q4 group exhibited a significantly elevated risk of CKD incidence (HR=1.756, 95%CI=1.010-3.054) . Compared to the TyG-WC index Q1 group, the TyG-WC index Q4 group demonstrated a significantly higher risk of CKD incidence (HR=2.532, 95%CI=1.210-5.296) , with P<0.05. There was a non-linear dose-response relationship between the TyG index and the risk of CKD incidence (P_nonlinearity=0.048) , with higher TyG index values (>6.93) associated with a greater risk of CKD incidence. The TyG-WC index had a linear dose-response relationship with the risk of CKD incidence (P_nonlinearity=0.078) , with an increasing trend of CKD incidence risk with increasing TyG-WC index values.

Both TyG and TyG-WC are risk factors for CKD, controlling for TyG and WC can effectively prevent and manage CKD, this finding holds great importance for the prevention and treatment of CKD.

Adolescence is a high-risk period for obesity, and it is crucial and urgent to implement obesity control among adolescents. However, existing interventions commonly face challenges in sustainability and scalability. Asset assessment to identify and leverage existing community assets and strengths is essential to facilitate and maintain the implementation of these programs.

To assess assets for obesity control among middle school students, and to identify the advantages and deficiencies in the current policy, physical, social, and information environments, along with suggestions for improvements.

From 2023 to January 2024, purposive sampling method was adopted, face-to-face one-by-one interviews were conducted with 11 staff members involved in obesity control for middle school students from the Center for Disease Control and Prevention, Education Bureau, and three middle schools in a major city in East China. Additionally, eight parents and their children from each of the three schools were invited to participate in focus group discussions, with 6 groups and 8 participants per group. Thematic analysis was applied to analyze the interview data.

This study found that the advantages in obesity control for middle school students primarily included policies and conditions ensured for obesity surveillance, nutritional school lunch and physical activity, along with media for health communication. The main deficiencies were the lack of specific policies for efficient obesity control, insufficient physical and social assets to support healthy eating and physical activity, and the quality and intensity of information assets supporting to facilitate changes in knowledge, attitude, and behaviors. In response to these challenges, participants suggested the implementation of both rigid regulations and flexible incentives, improvement of asset accessibility, encouragement of multi-stakeholder cooperation, and strengthening of health communication. Integrating existing assets and suggestions for improvement has formed an asset assessment checklist, corresponding to 10 assets from the policy environment, 8 from the physical environment, 20 from the social environment, and 12 from the information environment.

Several assets exist for obesity control among middle school students and identifies areas for improvement. Subsequent efforts in obesity control for middle school students should be made on promoting intervention strategies to better align with the context based on the asset assessment checklist to diagnose the current status of assets, thus enhancing the efficacy and sustainability of the program.

Craniopharyngioma-related hypothalamic obesity (CHO) has become a key issue in postoperative management of craniopharyngioma. Modified low calorie diet and exercise interventions have been found by some studies to be effective in relieving CHO, and suggested to be used as non-pharmacological treatments for weight management of craniopharyngioma patients. However, there are few relevant studies in China. We reviewed the latest developments in prevalence, hazards and risk factors as well as diet and exercise interventions towards CHO, in order to improve the outcomes and quality of life of CHO patients. In addition, we put forward recommendations on comprehensively improving the quality of life of CHO patients, such as making efforts to value CHO clinically, carrying out prospective studies on weight control in CHO, and developing rigorous diet and exercise interventions.

Overweight, obesity, and central obesity have become significant public health issues globally, affecting the well-being of residents. Analyzing the prevalence trends of overweight, obesity, and central obesity among residents in Shanxi Province can provide valuable scientific insights for the prevention and control of related diseases.

To analyze the prevalence and trends of overweight, obesity, and central obesity among adults aged 20 and above in Shanxi Province between 2010 and 2018.

The survey data of adults aged 20 and above in Shanxi Province were collected during four rounds of the China Chronic Disease Surveillance project from August 2010 to November 2018 (in 2010, 2013, 2015, and 2018) to calculate the rates of overweight, obesity, and central obesity among adults aged 20 and above in different years, and analyze the prevalence trends of overweight, obesity and central obesity for different characteristics of the study subjects.

From 2010 to 2018, the overall crude rates and age- and gender-standardized rates of overweight among adults aged 20 and above in Shanxi Province ranged from 37.7% to 40.1% and 36.1% to 39.6%, respectively, with no significant upward trend (Z=0.005, 2.413; P=0.942, 0.120). The overall standardized obesity rate, overall crude rate of central obesity and the standardized rate central of obesity increased from 17.2%, 53.8%, and 52.4% in 2010 to 20.0%, 61.6%, and 60.2% in 2018, respectively (Z=8.100, 10.994, 12.218; P<0.05). From 2010 to 2018, there was no significant trends in the comparison of the overall crude overweight rate and the standardized overweight rate among adults aged 20 years and above by age, gender and region (P>0.05) ; the standardized overweight rate for males was higher than that for females (χ²=4.259, P<0.05), while the standardized obesity rate was lower than that for females (χ²=13.724, P<0.001) in 2013; no statistically significant differences between genders were observed at other time points (P>0.05) ; the overall obesity rate, male obesity rate, and both male and female central obesity rates in the age group of 20-39 years old showed an upward trend during the 8-year period (P<0.05). From 2010 to 2018, the standardized rates of overweight, obesity, and central obesity among urban residents were overall higher than those among rural residents (P<0.05). Specifically, significant differences were observed in the standardized overweight rates in 2013 and 2015, the standardized obesity rates in 2010 and 2015, and the standardized central obesity rates in 2015 and 2018 (P<0.05). The results of the Joinpoint regression analysis revealed that, from 2010 to 2018, the age-standardized overweight rate among females in Shanxi Province exhibited a decreasing trend (APC=-0.57, P<0.05), while the age-standardized obesity rate among males showed an increasing trend (APC=2.72, P<0.05). The standardized rates of overweight, obesity, and central obesity among urban and rural residents remained relatively stable over the 8-year period (P>0.05). There was also no significant difference in the trends of these rates between different genders and regions (P>0.05) .

From 2010 to 2018, the overweight rate among residents aged 20 and above in Shanxi Province remained stable, while the overall trends for obesity and central obesity rates showed an increasing trend. The prevention and control of obesity and central obesity should focus on the population aged 20-39 years to slow down the growth rate. For residents aged 40 and above, as well as urban residents, targeted prevention strategies should be implemented, so as to control the prevalence of overweight, obesity, and central obesity.

At present, there has been a dramatic increase in the number of obese children and adolescents globally, among which the prevalence of obesity in children aged 5 to 19 years has increased by about 8 times, and the prevalence of obesity in children aged 2 to 4 years has increased by about 1 times. Exercise intervention has an important effect on improving obesity and enhancing cardiorespiratory fitness. However, studies on the effects of combined motion intervention on obese female adolescents aged 14-16 years have not been addressed.

To investigate the effects of 12-week combined motion intervention on body composition, cardiovascular risk factors and cardiopulmonary fitness in obese female adolescents.

From May to July 2022, 48 obese female adolescents aged 14 to 16 years old in Qufu City, Shandong Province were selected as research objects, numbered and divided into the experimental group (n=24) and control group (n=24) using random numbers. The experimental group finally included 20 female adolescents based on the inclusion and exclusion criteria, and the whole intervention lasted for 12 weeks, including rope skipping intervention and taekwondo intervention; while the control group did not perform any exercise intervention and other dietary or pharmacological interventions throughout the 12 weeks. The indicators such as height, body mass, body fat rate (BFR) , waist circumference, BMI, blood pressure (BP) , fasting plasma glucose (FPG) , insulin, insulin resistance index (HOMA-IR) and maximal oxygen uptake (VO_2max) were detected before and after the 12-week combined motion intervention and compared between the two groups, as well as before and after the intervention. Pearson correlation analysis was used to explore the correlation of BFR and waist circumference with VO_2max in obese female adolescents.

Before the intervention, there was no significant difference in age, height, body mass, BFR, waist circumference, BMI, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , pulse pressure difference, FPG, insulin, HOMA-IR, maximal number of completions (Laps) , maximal aerobic speed (MAS) , and VO_2max between the two groups (P>0.05) . After 12-week combined motion intervention, BFR, waist circumference, SBP, DBP, FPG, insulin and HOMA-IR in the experimental group were lower than the control group, while Laps, MAS, VO_2max was significantly higher than the control group (P<0.05) . Compared with pre-intervention, the BFR, waist circumference, SBP, DBP, FPG, insulin and HOMA-IR were decreased and Laps, MAS, VO_2max were increased after 12-week combined motion intervention (P<0.05) . The results of correlation analysis showed that body fat percentage and circumference were negatively correlated with VO_2max in obese female adolescents (r=-0.55, P<0.001; r=-0.41, P<0.001) .

The 12-week combined motion intervention can improve body composition and cardiovascular risk factors in obese female adolescents, and also enhance cardiopulmonary fitness by increasing VO_2max.

As the number of obese and elderly population increases worldwide, sarcopenic obesity is becoming associated with a higher risk of adverse events and outcomes in multiple clinical situations, including cancer. However, there is a lack of unified definition and diagnostic criteria for sarcopenic obesity, and the interaction between sarcopenic obesity and cancer needs to be further clarified. This paper systematically and comprehensively summarizes the relevant definitions and diagnostic methods of sarcopenic obesity, discusses its clinical impact on cancer patients in detail, including the impact on patients undergoing surgery and chemotherapy, and briefly describes the main prevention and treatment strategies. This paper reviews literature and concludes that the incidence of sarcopenic obesity is high in cancer patients, but its definition and diagnostic criteria are still controversial. Sarcopenic obesity is an independent predictor of cancer prognosis with important clinical application value.

Earlier studies have investigated the association between overweight/obesity and an elevated risk of breast cancer in women. However, some studies have found that it may not be scientifically accurate to solely analyze the association between overweight/obesity and breast cancer in women for overweight/obesity can be classified into different metabolic phenotypes. The current findings on the association of different metabolic phenotypes with breast cancer remain inconsistent.

To prospectively analyze the associations of different metabolic obesity phenotypes with the risk of breast cancer in women.

In this prospective cohort study, female employees (n=23 406) of Kailuan Group who participated in physical examinations for the first time in Kailuan General Hospital and its 11 affiliated hospitals from 2006 to 2008 were selected as the study subjects and received questionnaire investigation, physical examination and laboratory tests. The study subjects were divided into the four groups based on the types of metabolic syndrome and BMI, including metabolically healthy normal weight (MHNW) group (n=12 739), metabolically unhealthy normal weight (MUNW) group (n=1 060), metabolically healthy overweight/obese (MHO) group (n=6 394), and metabolically unhealthy overweight/obese (MUO) group (n=3 213). The subjects were followed up, with the first physical examination attended as the starting point, and new onset breast cancer, death, or the end of follow-up time (2020-12-31) as the endpoints. Multivariate Cox proportional hazard regression model was used to estimate the association of the four groups with the risk of breast cancer.

During an average follow-up of (13.26±1.85) years, with 353 new cases of breast cancer and an incidence density of 11.38 cases per 10 000 person-years in the total population. The incidence cases in the MHNW, MUNW, MHO, and MUO groups were 154, 21, 113, and 65, respectively, with the incidence density of 9.08, 15.37, 13.27, and 15.49 per 10 000 person-years, and the cumulative incidence of 1.22%, 2.01%, 1.67%, and 1.93%, respectively. Multivariate Cox proportional hazard regression model analysis, after adjusting for confounders, showed that compared with the MHNW group, the risk of breast cancer was increased by 42% (HR=1.42, 95%CI=1.11-1.82) and 59% (HR=1.59, 95%CI=1.17-2.17) in the MHO group and MUO group, respectively. Stratified analysis by menopausal status showed that compared to the MHNW group, the MUO group was associated with a 69% increase in risk of premenopausal breast cancer (HR=1.69, 95%CI=1.01-2.83). The risk of postmenopausal breast cancer was increased by 85% (HR=1.85, 95%CI=1.09-3.14), 50% (HR=1.50, 95%CI=1.06-2.13), and 55% (HR=1.55, 95%CI=1.05-2.28) for the MUNW, MHO, and MUO groups, respectively, compared to the MHNW group.

Overweight/obesity is a risk factor for female breast cancer, and overweight/obesity with metabolic abnormalities further increases the risk of breast cancer. Additionally, normal weight postmenopausal women who are metabolically unhealthy may be at an increased risk of postmenopausal breast cancer.

Since the reform and opening up in China, socio-economic development has developed rapidly, and the basic indicators such as children's height and body mass have risen rapidly. Previous studies have shown that the growth in height of Chinese children has slowed in recent years, while the growth in body mass has accelerated, leading to a high prevalence of overweight and obesity currently. Investigating the current growth and nutritional status of Chinese children is important to prevent and address the negative effects of growth trends.

To analyse the trends of growth and overweight/obesity in Chinese children aged 7 to 12 years from 2014 to 2020, and provide a scientific basis for formulating measures to promote children's physical fitness and prevent obesity.

In this study, height, body mass and BMI data of 10 817 children aged 7 to 12 years from four surveys of the China Family Panel Studies (CFPS) in 2014, 2016, 2018 and 2020 were selected in May 2022. The trends of height, body mass, prevalence of overweight, obesity and overweight/obesity stratified by gender and urban/rural areas. Logistic regression analysis was also used to explore the factors influencing overweight and obesity among children aged 7 to 12 years in China from 2014 to 2020.

Compared with 2014, the height of 7 to 12 years urban female children, rural male children and rural female children in 2020 increased by 3.8 cm (95%CI=1.3-6.2 cm), 6.5 cm (95%CI=4.3-8.5 cm), 6.6 cm (95%CI=4.3-8.8 cm) respectively Compared with 2014, the body mass of 7 to 12 years urban male children, urban female children, rural male children and rural female children in 2020 increased by 2.3 kg (95%CI=0.8-3.9 kg), 2.1 kg (95%CI=0.6-3.7 kg), 3.0 kg (95%CI=1.7-4.2 kg), 3.0 kg (95%CI=1.8-4.2 kg), respectively, the difference was statistically significant (P<0.05). The prevalence of overweight/obesity among boys increased from 26.5% to 29.5%, the prevalence of obesity and overweight/obesity among girls decreased from 12.1% and 21.1% to 7.9% and 17.3%, the prevalence of overweight and overweight/obesity among urban children increased from 11.7% and 21.6% to 14.9% and 26.4%, and the prevalence of obesity and overweight/obesity among rural children decreased from 14.3% and 25.8% to 11.2% and 21.6% from 2014 to 2020, respectively, which were statistically significant (P<0.05). The results of multivariate Logistic regression analysis showed that age and sex were the influencing factors for prevalence of overweight in children (P<0.05) ; urban/rural areas, age, and gender were the influencing factors for prevalence of obesity and overweight in children (P<0.05) ; age was the influencing factor for prevalence of obesity in boys (P<0.05) ; age and year were the influencing factors for prevalence of obesity in boys (P<0.05) ; age was the influencing factor for prevalence of overweight in girls (P<0.05) ; urban/rural areas, age and year were the influencing factors for prevalence of overweight and obesity in girls (P<0.05) .

From 2014 to 2020, the body shape of children aged 7 to 12 years in China increased rapidly, with greater increase in rural areas than urban areas, and the gap between urban and rural areas has been narrowing. Meanwhile, the prevalence of overweight and obesity in boys and urban children continued to increase, while that in girls and rural children decreased. Rural/urban areas, age and gender are factors influencing the prevalence of overweight/obesity in children.

Dietary inflammatory index (DII), as a new index for quantitative evaluation of dietary inflammatory potential, has been widely used in various chronic disease studies, but the correlation between DII and different types of obesity has not been uniformly established.

To systematically evaluate the correlation of DII with overweight, obesity and abdominal obesity to provide reference for the prevention of different types of obesity.

CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Cochrane Library and Web of Science were searched by computer for cross-sectional studies of the association of DII with overweight, obesity and abdominal obesity from inception to January 10, 2023. Risk of Bias Rating Scale of AHRQ was used to evaluate the included studies. Meta-analysis was performed using RevMan 5.4.1 to calculate OR and 95%CI of the pooled data to assess the association of DII with overweight, obesity and abdominal obesity. Subgroup analyses were performed based on differences in gender, study geography, survey method, number of DII components, whether the sample population was healthy, diagnostic criteria, and type of DII grouping.

A total of 20 studies from 9 countries with 214 808 subjects were included. Meta-analysis results showed that high levels of DII may be a possible risk factor for overweight 〔OR=1.12, 95%CI (1.03, 1.22), P=0.005〕, obesity 〔OR=1.56, 95%CI (1.34, 1.82), P<0.000 01〕, abdominal obesity 〔OR=1.42, 95%CI (1.14, 1.78), P=0.002〕. Subgroup analysis for differences in gender, study geography, survey method, number of DII components, whether the sample population was healthy, diagnostic criteria, and type of DII grouping in the original studies showed no significant between-group heterogeneity within each subgroup for the correlation between DII and overweight (P>0.05). Among the subgroups for the correlation between DII and obesity, the male population〔OR=1.79, 95%CI (1.13, 2.85) 〕 had a higher proportion of obesity than the other gender groups, the North American population 〔OR=1.57, 95%CI (1.27, 1.83) 〕 had a higher proportion of obesity compared to populations from other geographic regions, and the results of the 24-h recall 〔OR=1.83, 95%CI (1.39, 2.42) 〕 had a higher proportion of obesity compared to studies with other survey methods. Among the subgroups for the correlation between DII and abdominal obesity, the North American population 〔OR=1.87, 95%CI (1.44, 2.44) 〕 had a higher proportion of abdominal obesity compared to populations from other geographic regions, and no significant heterogeneity was found among other groups. The funnel plot distribution in this study had good symmetry, suggesting no significant publication bias.

DII diets may be a risk factor for overweight, obesity and abdominal obesity, and the association is more obvious in North American populations. The association between a high DII diet and obesity was more significant in men. Increasing the intake of anti-inflammatory dietary components is important for the prevention and treatment of overweight, obesity and abdominal obesity.

The prevalence of overweight and obesity has been increasing yearly and become a global public health problem with a range of consequences causing widespread concern. Weight loss can reduce the incidence of type 2 diabetes, cardiovascular risk, and all-cause mortality. The most common approaches of weight loss are drug therapy, surgery and lifestyle interventions including diet and exercise, however, exercise intervention remains the healthiest and most fundamental approach of weight loss. Exercise can reduce cellulite, increase muscle mass and improve metabolism. The combination of exercise and other weight loss approaches can reduce adverse reactions and produce better results. Continuing exercise after weight loss can also effectively prevent rebound and maintain weight loss effects. This paper reviews the definition, mechanism, effect, and management of "exercise is the foundation of weight loss", and provide a reference for weight loss through exercise in the context of the experience of Zhongda Hospital.

Obesity is an increasingly prevalent and costly public health problem. Many people regard exercise as an effective weight loss strategy, even superior to dieting. However, the effectiveness and safety of exercise for weight loss in obese individuals need to be carefully weighed. This paper briefly discusses the view that "Exercise is not the foundation of weight loss" in the combination of evidence-based medicine, from the aspects of mild effect of exercise on weight loss, poor adherence to long-term high-intensity exercise, safety of high-intensity exercise in obese individuals, and the mechanism of poor weight loss effect of exercise.

Triglyceride-glucose (TyG) index is an index to evaluate insulin resistance (IR) and obesity-related metabolic diseases, which is closely related to the high risk of cardiovascular disease (CVD). However, TyG index may be different from the high risk of CVD in middle-aged obese people of different genders.

To investigate the relationship between TyG index and the high risk of CVD in middle-aged obese people of different genders, and to evaluate its role in the prevention and treatment of CVD.

A total of 30 425 middle-aged obese residents were selected from 10 early screening and comprehensive intervention projects of high-risk CVD population in Anhui Province and investigated by investigators who were trained and qualified, using the preliminary screening questionnaire and basic information registration form designed by the National Cardiovascular Center. The main survey contents included gender, age, hypertension, dyslipidemia, diabetes, smoking and alcohol consumption, etc, and perform a CVD high-risk assessment. The included residents were divided into the male group (n=11 566) and female group (n=18 859). The male group was divided into T₁ (7.417-8.870) (n=2 892), T₂ (8.871-9.204) (n=2 891), T₃ (9.205-9.578) (n=2 892) and T₄ (9.579-11.435) (n=2 891) subgroups, the female group was divided into F₁ (7.579-8.876) (n=4 715), F₂ (8.877-9.183) (n=4 720), F₃ (9.184-9.526) (n=4 710) and F₄ (9.527-11.647) (n=4 714) subgroups according to the quartiles of TyG index. Binary Logistic regression analysis was used to explore the relationship between TyG index and the high risk of CVD, and Z-test was used to compare the differences in effect values among subgroups.

The high risk rate of CVD was 28.4% (3 280/11 566) in the male group and 26.0% (4 909/18 859) in the female group. Binary Logistic regression analysis showed that TyG index T₂ (F₂), T₃ (F₃), T₄ (F₄) in male group (female group) were correlated with the high risk of CVD (P<0.05), and the correlation with the high risk of CVD increased with the gradual increase of TyG index. In the male group, the risk of developing high risk of CVD in the T₄ subgroup compared to T₁ was OR (95%CI) =1.827 (1.622, 2.058) ; In the female group, the risk of developing high risk of CVD in the F₄ subgroup compared to F₁ was OR (95%CI) =1.552 (1.410, 1.708). There were significant differences in the TyG index and risk of developing high risk of CVD between the T₄ and F₄ subgroups in both male and female groups (P<0.05). After further adjustment for total cholesterol and other indicators (model 2), the correlation between T₂ (F₂), T₃ (F₃), T₄ (F₄) and the risk of developing high risk of CVD was attenuated. However, in both male and female groups, T₂ (F₂), T₃ (F₃) and T₄ (F₄) were all correlated with the high risk of CVD (P<0.05), and the correlation increased with the gradual increase of TyG index level. In the male group, the risk of developing high risk of CVD in the T₄ subgroup compared to T₁ subgroup was OR (95%CI) =1.804 (1.584, 2.055), in the female group, the risk of developing high risk of CVD in the F₄ subgroup compared to F₁ subgroup was OR (95%CI) =1.496 (1.345, 1.665) ; There were significant differences in the risk of developing high risk of CVD between the T₄ and F₄ subgroup in both male and female groups (P<0.05) .

Middle-aged obese men with high TyG index are more prone to develop high risk for CVD, and more attention should be paid to the TyG index level of the population.

Previous studies have shown that the risk of acute pancreatitis (AP) is increased in obesity population, while obese patients are often combined with abnormal fasting plasma glucose (FPG). It still remians controversial whether FPG independently increases the risk of AP and the relationship between FPG and the risk of AP in non-obese patients has been rarely reported in China and abroad.

To explore the association between baseline FPG level and the risk of AP in non-obese population.

Using a prospective cohort study method, a total of 102 512 non-obese cases from the Kailuan study cohort who completed physical examination for the first time in KaiLuan General Hospital and its 10 affiliated hospitals from 2006 to 2009 were enrolled as study subjects. Epidemiological data, anthropometric data, laboratory test indicators and other information of the subjects were collected. The study subjects were divided into 4 groups according to the FPG quartile: the first quartile group (group Q1, FPG≤4.66 mmol/L, n=25 929) ; the second quartile group (group Q2, 4.66 mmol/L≤FPG<5.10 mmol/L, n=25 797) ; the third quartile group (group Q3, 5.10 mmol/L≤FPG<5.67 mmol/L, n=25 162) ; the fourth quartile group (group Q4, FPG≥5.67 mmol/L, n=25 624). The Kaplan-Meier method was used to plot the survival curves of new-onset AP in non-obese population. The cumulative incidence of AP in non-obese population in different FPG level groups were calculated and Log-rank method was used for inter-group test. The Cox proportional hazard regression model was used to analyze the influencing factors for the new-onset AP in non-obese population and the correlation between different FPG level groupings and new-onset AP in non-obese population.

The median follow-up time in this study was (12.8±2.4) years with the cumulative incidence of 320 cases and incidence density of 2.44 cases per 10 000 person-years in AP. There were statistically significant differences in the cumulative incidence of AP among the 4 FPG level groups (χ²=13.96, P<0.001). The results of Cox proportional hazard regression analysis showed that advanced age〔HR=1.02, 95%CI (1.01, 1.03), P=0.001〕, high triacylglycerol (TG) level〔HR=1.22, 95%CI (1.13, 1.30), P<0.001〕, history of cholithiasis〔HR=2.79, 95%CI (1.88, 4.13), P<0.001〕were risk factors for new-onset AP in non-obese population. Years of education ≥9 years〔HR=0.65, 95%CI (0.47, 0.90), P<0.001〕was the protective factor for new-onset AP in non-obese population. The HR for new-onset AP in group Q4 was 1.40 〔95%CI (1.02, 1.92), P=0.038〕. After excluding the population applying hypoglycemic drugs, the conclusions were unchanged, the HR for new-onset AP in group Q4 was 1.40 〔95%CI (1.02, 1.92), P=0.036〕.

Advanced age, high TG levels, and history of cholithiasis are risk factors for new-onset AP, years of education ≥9 years is the protective factor for new-onset AP. And the risk of AP increases when FPG ≥5.67 mmol/L in non-obose population.

The trend of prevalence and severity of the overweight problem in young children, reduces the general quality of the future population to a certain extent, inducing a great risk to the sustainable development of health human capital stock in China.

To scientifically understand the spatio-temporal evolutionary patterns and future development trends of overweight rates among children under 5 in China, in order to provide support for controlling overweight in children, improve the efficiency of local governance and support for the implementation of precise interventions.

In April 2022, the 5 km×5 km gridded dataset in 105 middle-and low-income countries provided by the Institute for Health and Evaluation at the University of Washington (IHME) was used as the data source to extract the gridded data of overweight rates among children under 5 in China (excluding Hong Kong Special Administrative Region, Macao Special Administrative Region and Taiwan District) from 2000 to 2019 in this study. The average overweight rate of children under 5 from 2000 to 2019 was calculated pixel-to-pixel, the Theil-Sen estimator, Mann-Kendall test and Hurst index estimation method was used to characterize the spatio-temporal evolutionary patterns and future development trends among children under 5 pixel-to-pixel.

Overweight among children under 5 is more prevalent in most regions of Shandong Province, Hunan Province and local regions of Fujian Province, Guangdong Province, Hainan Province, Beijing Municipality and Tianjin Municipality during the 20-year period from 2000 to 2019, with the average overweight rate of children under 5 in Hunan Province reaching 29.42%. The area of the regions with significant increase in overweight rates among children under 5 accounts for 60.59% of the total area of the regions in the study (excluding regions with missing data) . The area of the central and eastern regions with a significantly increasing trend in the overweight rates among children under 5 accounts for a higher proportion of the total area of central and eastern regions (excluding regions with missing data) than the proportion accounted by the area of the western regions with a significantly increasing trend in the overweight rates among children under 5 of the total area of western regions (excluding regions with missing data) . The area of the regions with no significant change in the evolution trend of overweight rates accounts for 25.33% of the total area of the regions in the study, which is scattered in patches in parts of provinces, such as cities cluster in the middle reaches of the Yangtze River urban agglomeration. The area of the regions with significant change in the evolution trend of overweight rates accounts for 14.08% of the total area of the regions in the study, concentrated in some regions in the Xinjiang Uygur Autonomous Region, Qinghai Province, Sichuan Province and Yunnan Province in the west of China, and local regions of Hebei Province, Liaoning Province and Shandong Province in the east of China. According to the Hurst index, the area of the regions with persistent or trend-enhancing characteristics of the time series of overweight rates of children under 5 accounts for 84.87% of the total area of the regions in the study.

The spatial heterogeneity of overweight rates among children under 5 in China is obvious. There is a synergistic "U"-shaped association between the overweight rates of children under 5 and the overall level of regional development, the association implies a multi-stage, cascading developmental process of "declining stage of stunting" "stabilization stage" "rising stage of overweight with overnutrition". Focusing on social problems derived from the coupling of multidimensional factors of overweight in young children, the results of the study provide scientific support and policy reference for the government to formulate region-specific policies, build a three-level governance network of "government policy regulation - social concept penetration - family health management", and scientifically and precisely solve the overweight problem among children under 5.

With the growing problem of obesity, the demand for bariatric surgery has increased these years. Patients still need to maintain good living habits after surgery to consolidate the weight loss effects. While the behavioral guidelines are relatively mature, patient's behavioral compliance is not ideal, resulting in a high rate of postoperative weight regain. In that case, we can depend on strategies to promote dietary and physical activity behaviors in patients from the cognitive perspective.

To systematically code and merge the dietary and physical activity behavior promotion strategies after bariatric surgery from the cognitive perspective.

In June 2022, the WHITTEMORE and KNAFL's integrative review methodology was used. Studies written in English related to dietary and physical activity behavior promotion strategies after bariatric surgery were searched in databases of PubMed, Web of Science, the Cochrane Library and CINAHL, and those in Chinese were searched in databases of CNKI and Wanfang Data from January 1994 to June 2022. The 2016 version of the Critical Appraisal Skills Program (CASP) was used to evaluate the quality of the literature. Studies meeting the inclusion criteria were included, and the strategies extracted from which were uniformly coded and merged according to the CALO-RE taxonomy.

A total of 25 studies were included, including 17 randomized controlled trials, 4 observational studies, and 4 reviews. After coding, all strategies were covered by CALO-RE taxonomy, involving 25 kinds, mainly including self-monitoring of behavior, social support, goal setting, identifying barriers/problem resolution, etc. A total of 46 strategies were obtained and used to create a strategy set named "promotion strategies of dietary and physical activity behaviors after bariatric surgery".

Through the application of the integrative review methodology and the guidance of CALO-RE taxonomy, this study systematically coded and merge the dietary and physical activity behavior promotion strategies from the cognitive perspective for applicable to patients after bariatric surgery, providing a reservoir of techniques for postoperative behavioural management. After assessing patients' behavioural levels and cognitive factors, bariatric surgery providers can select appropriate strategies to improve patients' behavioural compliance. This strategy set can be further validated and optimised in future empirical studies.

The grazing behavior after bariatric surgery is significantly related to postoperative weight regain, and its incidence will increase with the extension of time after surgery. So it is particularly important to early detect and accurately evaluate the grazing behavior of patients undergoing bariatric surgery. At present, the assessment tools for grazing behavior in these patients in China are still lacking.

To translate the Repetitive Eating Questionnaire〔Rep (eat) -Q) 〕into Chinese and evaluate its reliability and validity among patients undergoing bariatric surgery.

The Brislin's model of translation was adopted for translation. We developed the Chinese version of Rep (eat) -Q following the process of translation of the English version of the Rep (eat) -Q, back translation, expert review and a pilot study. On 2022-08-31, patients undergoing bariatric surgery admitted to the bariatric follow-up clinic of the First Affiliated Hospital with Nanjing Medical University from March to August 2022 were selected for the study using convenience sampling. Then we used the general information questionnaire, Chinese version of Rep (eat) -Q and the 21-item Three-Factor Eating Questionnaire (TFEQ-R21) to conduct a survey among 294 patients undergoing bariatric surgery to test the reliability and validity of the Chinese version of Rep (eat) -Q.

According to the score of the Chinese version of Rep (eat) -Q, these patients were divided into high-score group (n=79) and low-score group (n=78) by the critical ratio. High-score group scored higher in each item of the Chinese version of Rep (eat) -Q compared with the low-score group (P<0.05) . The score of each item in the Chinese version of Rep (eat) -Q was linear positively correlated with the total score (r=0.368-0.782, P<0.05) . The value of Cronbach's α for the scale, repetitive eating subscale and compulsive grazing subscale was 0.943, 0.928 and 0.898, respectively. The value of split-half reliability for the scale, repetitive eating subscale and compulsive grazing subscale was 0.835, 0.938 and 0.891, respectively. And the value of test-retest reliability of the scale, repetitive eating subscale and compulsive grazing subscale was 0.867, 0.800, and 0.836, respectively. The item-level content validity index (CVI) ranged from 0.80 to 1.00. The scale-level CVI /universal agreement and S-CVI/average were 0.92 and 0.98, respectively. Two common factors were obtained after varimax orthogonal rotation by principal component analysis, whose eigenvalues were 7.086, and 1.596, respectively, explaining 72.35% of the total variance. The factor loading values of all items ranged 0.637 to 0.878. The confirmatory factor analysis indicated that the values ofχ²/df, GFI, AGFI, NFI, IFI, CFI and RMSEA were 2.211, 0.905, 0.860, 0.920, 0.955, 0.954, and 0.080, respectively. 294 patients' total score of the Chinese version of Rep (eat) -Q showed a significant correlation with three dimensions of the TFEQ-R21 (P<0.05) .

The Chinese version of Rep (eat) -Q has good reliability and validity, and is simple and easy-to-operate, which can be used to assess the grazing behavior among Chinese patients undergoing bariatric surgery.

The change of food preference after bariatric surgery is an important factor affecting postoperative weight loss. It is particularly important to assess the specific characteristics and predictive factors of food preference changes after the surgery. It is difficult to guide postoperative weight maintenance based on the large variability in results between available studies.

To investigate the characteristics of food preference change and its effect on weight loss outcomes in patients undergoing bariatric surgery, and to analyze the predictive factors of food preference change.

A convenient sampling method was used to select 245 patients undergoing bariatric surgery who were admitted to Outpatient Weight Loss Follow-up Department, the First Affiliated Hospital of Nanjing Medical University from February to August, 2022. The self-developed General Demographic Questionnaire, Weight Loss Outcome Questionnaire and Food Preference Change Features after Bariatric Surgery were used to collect relevant data. Independent samples t-test was used to compare the effects of changes of food preference after bariatric surgery on the weight loss outcome. Univariate analysis and disordered multi-class Logistic regression were performed to analyze the predictive factors of food preference changes after bariatric surgery.

Two hundred and thirty-seven (96.7%) patients who returned responsive questionnaires were finally enrolled, and 97.0% of them had food preference changes after bariatric surgery. Patients with and without changes in food preferences after bariatric surgery had statistically significant differences in postoperative weight, body mass index drop value and total weight loss percentage (P<0.05) . Disordered multi-class Logistic regression analysis showed that postoperative time was the predictor of changes in preferences of patients undergoing bariatric surgery for vegetables and fruits (P<0.05) ; marital status and preoperative comorbidities were predictors of changes in preference of patients undergoing bariatric surgery for high-quality protein foods (P<0.05) ; place of residence (northern or southern China) was the predictor of changes in preference of patients undergoing bariatric surgery for spicy foods (P<0.05) ; gender, place of residence and bariatric surgery methods were predictors of changes in preferences of patients undergoing bariatric surgery for salty snacks (P<0.05) ; gender and bariatric surgery methods were predictors of changes in preferences of patients undergoing bariatric surgery for high-fat meat (P<0.05) ; gender and postoperative time were predictors of changes in preferences of patients undergoing bariatric surgery for sweet food (P<0.05) ; gender and bariatric surgery methods were predictors of changes in preferences of patients undergoing bariatric surgery for sweet drinks (P<0.05) .

The incidence of food preference changes in patients undergoing bariatric surgery is high, showing a decrease in their preference for high calorie foods and an increase in their preference for healthy foods. Gender, marital status, place of residence, preoperative comorbidities, bariatric surgery methods, and postoperative time are predictors of various food preference changes in patients undergoing bariatric surgery. Weight loss professionals should identify the target population at early stage, pay more attention to postoperative dietary education and guidance for patients, in order to improve the postoperative dietary experience and effectively ensure the effect of bariatric surgery.

People with normal weight obesity (NWO) are prone to cardiovascular diseases in their middle and old age. High-intensity interval training (HIIT) has been demonstrated to effectively improve cardiovascular health. However, whether HIIT can decrease the risk of cardiovascular diseases in NWO population is not clear.

To explore the effects of HIIT on the advanced glycation end-products (AGEs) and the risk of cardiovascular disease in NWO female university students.

From November to December 2020, 137 female college students were recruited in Shanghai University of Medicine & Health Sciences, among whom 40 NWO cases were screened out as subjects by the Asian female NWO standard. They were equally and randomly divided into a control group (n=20) and a HIIT intervention group (n=20) to receive no interventions or weekly five-day interventions, for consecutive four weeks after one-week adaptive training. Body weight, body mass index (BMI) , body fat percentage (BF%) , visceral fat level (VFL) , visceral fat area (VFA) , waist circumference, levels of four blood lipids 〔high-density lipoprotein (HDL) , low-density lipoprotein (LDL) , triglyceride (TG) , and total cholesterol (TC) 〕, cardiovascular disease risk (assessed by the China-PAR model) , AGEs, and fasting blood glucose of two groups were observed before and after intervention. The correlation between AGEs and cardiovascular disease risk was analyzed.

Except for 10 dropouts, the remaining 30 cases (13 in the control group and 17 in the HIIT intervention group) were finally included for analysis. After intervention, the average BMI, BF%, VFA, VFL, waist circumference, TC/HDL ratio, LDL/HDL ratio, TG/HDL ratio, AGEs and fasting blood glucose in HIIT intervention group were lower than those in control group (P<0.05) . Nine subjects in the HIIT intervention group were evaluated for the risk of cardiovascular and cerebrovascular diseases as the China-PAR model was applicable to subjects aged 20 years or older. The risk of cardiovascular disease was (11.82±0.47) % and (9.79±0.57) % in control group and HIIT intervention group, respectively, before intervention, and (14.13±0.97) % and (6.93±1.17) % in the two groups, respectively, after intervention. The post-intervention risk of cardiovascular disease in HIIT intervention group was lower than that in control group (P<0.05) . Spearman rank correlation analysis showed that AGEs were not correlated with cardiovascular disease risk (r_s=-0.006, P=0.979) .

The four-week HIIT can effectively reduce the body fat, the levels of AGEs and fasting blood glucose as well as the risk of cardiovascular disease in NWO female university students.

Maladaptive eating behavior after bariatric surgery is an im-portant cause of postoperative weight regain. However, the depth and reliability of its related research has been greatly hindered partially by non-unification of its concept and inappro-priate words used to explain the concept.

To clarify the concept of maladaptive eating behavior after bariatric surgery.

In May 2022, database of CNKI, WanFang Data, SinoMed, PubMed, Web of Science and CINAHL were systematically searched for studies in Chinese or English mainly about maladaptive eating behavior after bariatric surgery from inception to May 10, 2022, involving related concepts, definition attributes, antecedents and consequences. The contents of included literature were analyzed using the Rodgers' process of concept analysis, involving the evolution, attributes, antecedents, consequences, related concepts, typical case, assumptions and enlightenment for further development.

Altogether, 36 studies were included, 33 of which in English, and the other three were in Chinese. The conceptual attributes of maladaptive eating behavior after bariatric surgery were composed of six aspects: uncontrolled eating, grazing, emotional eating, food craving, food addiction and compensatory behaviors. The antecedents include subjective factors (containing self-efficacy, dietary attitude, psychological status, work pressure and so on) , and objective factors (containing age, gender, education level, obesity history and others) . Eating disorders, mental illness, weight-loss outcome, nutritional status and quality of life compose the consequences.

The concept of maladaptive eating behavior after bariatric surgery is still non-unified. Its meanings in China should be discussed according to the national condition, and in-depth research on relevant theories, assessment tools, influencing factors and intervention should be conducted on this foundation, so as to maintain the effect of bariatric surgery and improve the quality of life in these patients.

The prevalence of metabolic-associated fatty liver disease (MAFLD) has increased rapidly. And there is no conclusion on body fat composition, characteristics of metabolic indicators, and their predictive values for MAFLD in non-obese populations.

To identify the risk factors for MAFLD by comparing body fat composition and key metabolic indicators (blood lipids, blood sugar, uric acid) between obese and non-obese MAFLD patients, and to assess their associations with MAFLD as well as their predictive values for MAFLD in non-obese patients.

Physical examinees with and without liver B-ultrasound-detected fatty liver were recruited from Health Management Center, Nanjing Drum Tower Hospital from January 2018 to January 2019 after excluding those with non-MAFLD, and divided into obese group (including 129 cases with MAFLD, and 129 without fatty liver) and non-obese group (including 129 without fatty liver cases, and 129 with MAFLD) by BMI. The body fat composition and metabolic indices in non-obese MAFLD cases were compared with those of the other three subgroups. The correlation of each index with MAFLD in non-obese cases was analyzed. The independent risk factors of MAFLD in non-obese cases were identified by using Logistic regression. The predictive value of each index for MAFLD in non-obese was assessed using the receiver operating characteristic (ROC) curve.

(1) Comparison of body fat composition and metabolic indicators: compared with non-obese without fatty liver cases, non-obese cases with MAFLD had greater average BMI, body fat (BF), body fat ratio (BFR), visceral fat area (VFA), waist circumference (WC), waist-hip-ratio (WHR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), uric acid (UA), alanine transaminase (ALT) and gamma-glutamyl transpeptidase (GGT), and lower high-density lipoprotein cholesterol (HDL-C) (P<0.05). In comparison with obese cases with MAFLD, non-obese cases with MAFLD had lower average BMI, BF, VFA, WC, WHR, fasting plasma glucose (FPG), and glycosylated hemoglobin (HbA_1c) (P<0.05). Non-obese cases with MAFLD had lower average BMI, BF and WC, and higher average TG, UA, ALT and GGT than obese cases without fatty liver (P<0.05). Non-obese female cases with MAFLD had greater average age, BF, BFR and VFA and lower WC, VA, GGT than non-obese male cases with MAFLD (P<0.05). (2) Kendall's rank correlation analysis showed that the risk of MAFLD in non-obese cases increased with the growth of BFR, VFA, WHR, TC, TG, LDL-C, UA, ALT, and GGT (r=0.099, 0.092, 0.136, 0.095, 0.176, 0.092, 0.114, 0.125, 0.142, P<0.05), but decreased with the growth of HDL-C (r=-0.112, P<0.05). (3) Multivariate Logistic regression analysis showed that TG, ALT, UA, BFR and VFA were risk factors of MAFLD in non-obese cases. (4) The results of ROC analysis of the performance of five indicators predicting MAFLD in non-obese cases were as follows: BFR had an AUC of 0.853〔95%CI (0.807, 0.898) 〕, with 0.789 sensitivity, 0.770 specificity when 22.30% was chosen as the optimal cut-off value; VFA had an AUC of 0.938〔95%CI (0.906, 0.970) 〕, with 0.852 sensitivity, 0.904 specificity when 61.45 cm² was chosen as the optimal cut-off value; TG had an AUC of 0.807〔95%CI (0.754, 0.860) 〕, with 0.822 sensitivity, 0.713 specificity when 1.02 mmol/L was chosen as the optimal cut-off value; UA had an AUC of 0.665〔95%CI (0.599, 0.731) 〕, with 0.605 sensitivity, 0.682 specificity when 356.00 μmol/L was chosen as the optimal cut-off value; ALT had an AUC of 0.752〔95%CI (0.692, 0.812) 〕, with 0.814 sensitivity, 0.770 specificity when 18.35 U/L was chosen as the optimal cut-off value.

Compared with non-obese people without fatty liver, non-obese people with MAFLD had increased BF and visceral fat, abnormal lipid metabolism, elevated levels of UA and transaminase. The risk of MAFLD in non-obese people increased with the increase in TG, ALT, UA, BFR and VFA, but decreased with the increase in HDL-C. BFR, VFA, TG, UA and ALT could partially predict and diagnose MAFLD in non-obese people, providing evidence for the delivery of interventions as soon as possible.