The menace of obesity to depression and anxiety prevalence

Associations between triglyceride glucose index-related obesity indices and anxiety: Insights from the National Health and Nutrition Examination Survey 2007-2012

BACKGROUND

The triglyceride glucose index (TyG), along with its associated obesity indices, including TyG-body mass index (TyG-BMI), TyG-waist-to-height ratio (TyG-WHtR), TyG-waist circumference (TyG-WC), and TyG-weight-adjusted-waist index (TyG-WWI), have become valuable tools for evaluating insulin resistance in metabolic diseases. Few researches explored their links with anxiety.

METHODS

This observational study leveraged data from the National Health and Nutrition Examination Survey (2007-2012), analyzing 6726 participants to investigate the correlations between TyG-related indices and anxiety using multivariable logistic regression, subgroup analysis, and curve fitting.

RESULTS

After adjusting for confounders, significant positive correlations were identified between TyG, TyG-WWI, and anxious days [0.792 (0.262, 1.322); 0.033 (0.003, 0.063)]. These findings were reinforced when TyG-related indices were categorized into quartiles. Positive associations were further observed between TyG and anxiety state [1.243 (1.076, 1.437)], which was consistent across quartile groupings. Subgroup analyses revealed that racial stratification significantly influenced the relationship between TyG, TyG-BMI, TyG-WHtR, TyG-WC, TyG-WWI and anxious days. Gender stratification significantly influenced the relationship between TyG and anxiety state. Linear associations were established between TyG and anxious days, anxiety state with regression coefficients of 0.873 and 1.254 respectively. Non-linear relationships and threshold effects were detected, with inflection points at 187.731, 3.040, 725.288, and 104.011 (for TyG-BMI, TyG-WHtR, TyG-WC, TyG-WWI with anxious days) and 188.677, 3.059, 730.251, and 103.869 (for TyG-BMI, TyG-WHtR, TyG-WC, TyG-WWI with anxiety state).

CONCLUSIONS

These results enhance our understanding of relationships between TyG-related indices and anxiety, providing valuable insights for the prevention and management of obesity and anxiety.

Recent advances in biomimetic nanodelivery systems for the treatment of depression

Depression and cognitive disorders remain major challenges in healthcare, with conventional treatments often facing limitations such as slow onset, side effects, and poor drug delivery to the brain. Biomimetic nanodelivery systems, including nanozymes, cell membrane-based systems, and exosomes, have emerged as promising solutions to these issues. These systems leverage natural biological processes to enhance drug targeting, improve bioavailability, and regulate complex biological pathways. Nanoenzymes, with their catalytic properties, offer antioxidant and anti-inflammatory benefits, while cell membranes and exosomes provide efficient targeting and immune evasion. However, challenges remain, including the immaturity of large-scale production techniques, stability concerns, and incomplete understanding of their mechanisms of action. Moreover, the long-term safety, pharmacokinetics, and toxicity of these systems require further investigation. Despite these obstacles, the potential of biomimetic nanodelivery systems to revolutionize depression treatment is significant. Future research should focus on optimizing their preparation, improving drug targeting and release, and ensuring clinical safety. Multidisciplinary collaboration will be essential for advancing these systems from the laboratory to clinical practice, offering new therapeutic avenues for depression and other neurological disorders.

Association between conicity index and frailty in older Americans: the NHANES cross-sectional study, 2007-2018

This study utilized NHANES data from 2007 to 2018 to investigate the correlation between frailty and the Conicity Index (CI) in individuals aged 60 and above in the United States. The study used NHANES data from 2007 to 2018.CI was calculated as CI = wc / [0.109 × sqrt(bw / Height)]. Frailty was assessed by the frailty index (≥ 0.25). Weighted multivariate logistic regression analysis, subgroup analyses, and interaction tests were used to investigate the connection between CI and the prevalence of frailty. Generalized additive modeling (GAM) was employed to address any non-linear patterns, and the predictive capability of CI for frailty was evaluated by receiver operating characteristic (ROC) analysis. With a 69% rise in the prevalence of frailty for every 0.1 unit increase in the fully adjusted model, the results demonstrated a strong and positive relationship between CI and frailty prevalence (OR: 1.69, 95% CI: 1.53,1.86; P < 0.001). When CI was categorized, the group with the highest CI had a significantly higher prevalence of frailty than the group with the lowest CI (OR = 2.79, 95% CI: 2.22,3.51; P < 0.001). The association between CI and prevalence of frailty was significant in all subgroups. In addition, statistically significant interactions were present in most subgroups. When the CI > reached 1.35, the GAM model demonstrated a threshold effect and a significant nonlinear connection, with a 105% rise in the prevalence of frailty for every 0.1 unit increase in CI. In the male group, CI was a significantly greater indicator of the prevalence of frailty than both BMI and WC. According to this study, frailty in older persons is substantially correlated with a higher CI. Although greater confirmation in large-scale prospective research is required, this study indicates that increased CI is a more reliable predictor of the prevalence of frailty in older men and is significantly linked with its occurrence.

Associations of the body roundness index with cognitive function in US older adults and the mediating role of depression: a cross-sectional study from the NHANES 2011-2014

The body roundness index (BRI) accurately assesses body composition and visceral fat distribution, but its independent associations with cognitive function and cognitive impairment remain unclear. This study, which is based on data from the 2011-2014 U.S. National Health and Nutrition Examination Survey (NHANES), explores the associations between the BRI and cognitive function as well as cognitive impairment in older adults. Weighted linear regression and weighted logistic regression models were used for data analysis. Restricted cubic spline (RCS) models, subgroup analysis, and mediation analysis were conducted to explore effect modification, nonlinear associations, and the mediating role of depression. The BRI score was negatively correlated with the cognitive function score (DSST score β = -0.63, P = 0.037; Sum Score β = -0.83, P = 0.042) and was not significantly associated with cognitive impairment. As the BRI score increases, both the DSST score (trend P = 0.013) and the Sum Score (trend P = 0.023) show a linear decrease. The mediation effect analysis revealed that depression mediated 39.4% of the association between the BRI score and cognitive function, suggesting that the effect may be indirectly mediated through mental health pathways. Subgroup analysis and RCS models did not reveal significant interaction effects or nonlinear associations.

Commentary: The association between uric acid to high-density cholesterol ratio and depression: A population-based cross-sectional study

This commentary examines the recent findings by Wang et al. (2025) on the association between the uric acid to high-density lipoprotein cholesterol ratio (UHR) and depression in a U.S. population. While the study demonstrates a significant correlation using cross-sectional data and advanced statistical methods, several methodological limitations warrant discussion. Key concerns include the study's inability to establish causality, unaddressed confounders (e.g., lifestyle factors, medications), and limited generalizability due to its U.S.-centric sample. The self-reported depression measures and lack of longitudinal data further constrain the clinical interpretation. To advance this research, we recommend prospective designs, causal inference methods, and broader population inclusion. These improvements would strengthen UHR's utility as a potential biomarker for depression risk stratification and prevention strategies.

Impact of the Dinner Tonight Healthy Cooking School on Participants' Nutrition Knowledge and Cooking Confidence

Background/Objectives: Nearly three-quarters of American adults are overweight or obese, leading to serious health challenges. Poor nutrition is a major contributor, highlighting the need for effective nutrition education and cooking interventions. This study evaluated the impact of the Dinner Tonight Healthy Cooking School (DTHCS) on improving nutrition knowledge and cooking confidence among participants. Methods: A secondary data analysis was conducted on self-reported retrospective surveys collected from 7932 individuals across 64 Texas counties between September 2017 and March 2024. The surveys assessed changes in participants' understanding of key nutrition concepts (rated using a four-point scale from poor to excellent) and their confidence in cooking healthy meals (rated using a four-point scale from none to high) before and after attending the program. Results: The findings showed significant improvements in both nutrition knowledge (from fair to good p < 0.001) and cooking confidence (from low to moderate p < 0.001) following program participation. Conclusions: These results highlight the vital role of nutrition and culinary education in addressing the growing obesity epidemic and reducing the risk of diet-related chronic conditions. Given the positive program outcomes, DTHCS has the potential to inform future studies and guide successful planning and implementation of community-based cooking programs for adults to promote healthier eating behaviors.

Mindful Eating and Its Relationship with Obesity, Eating Habits, and Emotional Distress in Mexican College Students

Mindful eating (ME) has gained recognition in multidisciplinary weight management intervention and prevention programs for dysfunctional eating behaviors. This study aimed to evaluate the associations of mindful eating with body mass index, fat percentage, unhealthy food consumption, and emotional distress in Mexican college students. A cross-sectional study was performed. Anthropometry and body composition were evaluated. A self-reported Mindful Eating Questionnaire developed for the Mexican population, Food Frequency Questionnaire (frequency and serving size), and Depression, Anxiety and Stress Scale (DASS-21) were applied. Two separate analyses were conducted: the first used the whole Mexican Mindful Eating Questionnaire with 11 questions (ME-11), and the second excluded the emotional eating items (ME-8). A total of 224 students were included in the analysis. Lower levels of mindful eating were associated with higher body mass index (BMI) (p < 0.001), waist circumference (p < 0.001), and body fat percentage (p < 0.001), using ME-11 or ME-8. Significant associations were identified between lower levels of mindful eating (ME-11) and consumption of fried foods (p = 0.005), sweets and desserts (p = 0.003), and fast food (p = 0.003). Similar associations were observed using the ME-8 score. In both versions of the questionnaire, depression, anxiety, and stress scores were significantly associated with lower levels of mindful eating. Mindful eating was associated with BMI, body fat, eating habits, and emotional distress. Mindful eating could be used in multidisciplinary educational and intervention programs to promote a healthy lifestyle.

Multitrait Genetic Analysis Identifies Novel Pleiotropic Loci for Depression and Schizophrenia in East Asians

BACKGROUND AND HYPOTHESIS

While genetic correlations, pleiotropic loci, and shared genetic mechanisms of psychiatric disorders have been extensively studied in European populations, the investigation of these factors in East Asian populations has been relatively limited.

STUDY DESIGN

To identify novel pleiotropic risk loci for depression and schizophrenia (SCZ) in East Asians. We utilized the most comprehensive dataset available for East Asians and quantified the genetic overlap between depression, SCZ, and their related traits via a multitrait genome-wide association study. Global and local genetic correlations were estimated by LDSC and ρ-HESS. Pleiotropic loci were identified by the multitrait analysis of GWAS (MTAG).

STUDY RESULTS

Besides the significant correlation between depression and SCZ, our analysis revealed genetic correlations between depression and obesity-related traits, such as weight, BMI, T2D, and HDL. In SCZ, significant correlations were detected with HDL, heart diseases and use of various medications. Conventional meta-analysis of depression and SCZ identified a novel locus at 1q25.2 in East Asians. Further multitrait analysis of depression, SCZ and related traits identified ten novel pleiotropic loci for depression, and four for SCZ.

CONCLUSIONS

Our findings demonstrate shared genetic underpinnings between depression and SCZ in East Asians, as well as their associated traits, providing novel candidate genes for the identification and prioritization of therapeutic targets specific to this population.

Investigating the shared genetic architecture between obesity and depression: a large-scale genomewide cross-trait analysis

Introduction

Increasing evidence suggests that individuals with obesity are at a higher risk of developing depression, and conversely, depression can contribute to the onset of obesity, creating a detrimental cycle. This study aims to investigate the potential shared biological pathways between obesity and depression by examining genetic correlations, identifying common polymorphisms, and conducting cross-trait genetic analyses.

Methods

We assessed the genetic correlation between obesity and depression using linkage disequilibrium score regression and high-density lipoprotein levels. We combined two different sources of obesity data using METAL and employed bidirectional Mendelian randomization to determine the causal relationship between obesity and depression. Additionally, we conducted multivariate trait analysis using the MTAG method to improve statistical robustness and identify novel genetic associations. Furthermore, we performed a thorough investigation of independent risk loci using GCTA-COJO, PLACO, MAGMA, POPS, and SMR, integrating different QTL information and methods to further identify risk genes and proteins.

Results

Our analysis revealed genetic correlations and bidirectional positive causal relationships between obesity and depression, highlighting shared risk SNP (rs10789340). We identified RPL31P12, NEGR1, and DCC as common risk genes for obesity and depression. Using the BLISS method, we identified SCG3 and FLRT2 as potential drug targets.

Limitation

Most of our data sources are from Europe, which may limit the generalization of our findings to other ethnic populations.

Conclusion

This study demonstrates the genetic causal relationship and common risk SNPs, genes, proteins, and pathways between obesity and depression. These findings contribute to a deeper understanding of their pathogenesis and the identification of potential therapeutic targets.

Systemic inflammation as a mediator in the link between obesity and depression: Evidence from a nationwide cohort study

BACKGROUND

Obesity and depression are major public health issues with a complex, bidirectional relationship potentially involving systemic inflammation.

METHODS

Using a diverse sample from the National Health and Nutrition Examination Survey (NHANES) (n = 11,324; weighted population = 456,457,366), we examined the associations between obesity, systemic inflammation, and depression. Obesity was classified by Body Mass Index (BMI), depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), and systemic inflammation was measured using markers like Neutrophil-to-Lymphocyte Ratio (NLR), Systemic Inflammation Response Index (SIRI), and Systemic Immune-Inflammation Index (SII). Weighted logistic regression models were used to assess relationships between obesity, inflammation, and depression. Linear regression evaluated BMI's association with inflammation markers, and Restricted Cubic Spline (RCS) analysis explored their interrelationships. Subgroup analyses and interaction tests were conducted, and mediation analysis examined the role of inflammation markers in mediating the obesity-depression association.

RESULTS

Class III obesity was associated with higher inflammatory marker levels and increased depression risk. Mediation analysis showed NLR, SIRI, and SII mediated 5.2%, 5.9%, and 6.1% of the obesity-depression relationship.

CONCLUSIONS

Systemic inflammation partially mediates the relationship between obesity and depression.

The role of child development and socioeconomic factors in child obesity in Pakistan

This study intricately explores obesity's nexus with socio-emotional, physical development, and socioeconomic status, vital for global public health. It delves into psychological dimensions by scrutinizing attitudes toward obesity and their link with physical development. Additionally, it highlights obesity's physical implications, impacting overall health, chronic conditions, and healthcare systems. Using the Multiple Indicator Cluster Survey (MICS) dataset among 39,168 children aged 30 to 59 months in Pakistan, it examines socioeconomic factors like access to healthy food and parental education. Through logistic regression on diverse demographic samples, this research unveils significant associations between physical development, socio-emotional well-being, demographics, socioeconomic status, and overweight/obesity prevalence. Understanding these connections is crucial for tailored interventions to address escalating obesity rates, requiring nuanced strategies in diverse demographics and socioeconomic contexts.

The Interplay of Chronic Stress and Cancer: Pathophysiology and Implications for Integrated Care

BACKGROUND

Cancer-associated depression is a multifaceted condition that arises from the interplay of biological, psychological, and social factors in individuals diagnosed with cancer. Understanding this condition involves exploring how cancer and its treatments can precipitate depressive symptoms and the mechanisms behind this association. Chronic stress, inflammation, and immunological responses play a crucial role in the development of both cancer and depression. The objective of this review is to describe and synthesize information on the complex interactions between chronic stress, inflammation, immunological responses, and cancer development. Additionally, it aims to review existing evidence regarding mechanisms such as neurotransmitter imbalances, structural brain changes, and genetic predispositions as key contributors to depression in cancer patients.

RECENT FINDINGS

A comprehensive literature search on Cancer-associated Depression was conducted in electronic databases, including APA PsycINFO, Medline, Google Scholar, Embase, PubMed, Scopus, and Web of Science. The research focused on understanding the potential relationship between stress-induced depression and cancer by examining neurochemical, anatomical, immunological, genetic, and psychological changes. The findings revealed a compilation of both quantitative and qualitative studies on depression in cancer patients. Evidence suggested a potential link between cancer-induced stress and depression, with increased levels of proinflammatory cytokines (such as IL-6) and dysregulation of neurotransmitters, including serotonin, contributing to the onset of depression. Furthermore, studies indicated that antidepressants, along with psychological interventions, were effective in managing depression among cancer patients.

CONCLUSION

This narrative review provides insights into the importance of integrating oncology and mental health services to address the psychosocial needs of cancer patients. Future research should focus on the bidirectional interactions between stress and cancer, aiming to improve cancer care by incorporating mental health support. Addressing the mental health aspects of cancer treatment can significantly enhance patient outcomes and overall quality of life.

GDF15 links adipose tissue lipolysis with anxiety

Psychological stress changes both behaviour and metabolism to protect organisms. Adrenaline is an important driver of this response. Anxiety correlates with circulating free fatty acid levels and can be alleviated by a peripherally restricted β-blocker, suggesting a peripheral signal linking metabolism with behaviour. Here we show that adrenaline, the β3 agonist CL316,243 and acute restraint stress induce growth differentiation factor 15 (GDF15) secretion in white adipose tissue of mice. Genetic inhibition of adipose triglyceride lipase or genetic deletion of β-adrenergic receptors blocks β-adrenergic-induced increases in GDF15. Increases in circulating GDF15 require lipolysis-induced free fatty acid stimulation of M2-like macrophages within white adipose tissue. Anxiety-like behaviour elicited by adrenaline or restraint stress is eliminated in mice lacking the GDF15 receptor GFRAL. These data provide molecular insights into the mechanisms linking metabolism and behaviour and suggest that inhibition of GDF15-GFRAL signalling might reduce acute anxiety.

Visceral adipose tissue-derived extracellular vesicles promote stress susceptibility in obese mice via miR-140-5p

Obesity increases the risk of depression. Evidence shows that peripheral inflammation, glycemic dysregulation, and hyperactivity within the hypothalamic-pituitary-adrenal axis are implicated in both obesity and depression. In this study we investigated the impact of visceral adipose tissue (VAT), a crucial characteristic of obesity, on stress susceptibility in obese mice. Age-matched mice were fed with chow diet (CD) or high-fat diet (HFD), respectively, for 12 weeks. CD mice were deprived of VAT and received transplantation of VAT from HFD mice (TransHFD) or CD mice (TransCD). Extracellular vesicles (EVs) were prepared from VAT of CD or HFD mice, and intravenously injected (100 μg, 4 times in 2 weeks) in naïve mice or injected into hippocampus (5 μg, 4 times in 2 weeks) through implanted bilateral cannula. Depression-like behaviors were assessed 14 days after transplantation. We showed that HFD mice exhibited significantly higher body weight gain and impaired insulin and glucose tolerance, accompanied by increased stress susceptibility. Transplantation of VAT or VAT-derived EVs from HFD mice caused synaptic damage and promoted stress susceptibility in recipient mice. Through inhibiting miRNA biogenesis in the VAT and miRNA sequencing analysis, we demonstrated that miR-140-5p was significantly upregulated in both VAT-EVs and hippocampus of HFD mice. Overexpression of hippocampal miR-140-5p in naïve mice not only facilitated acute stress-induced depression-like behaviors, but also decreased hippocampal CREB-BDNF signaling cascade and synaptic plasticity. Conversely, knockdown of miR-140-5p in the VAT, VAT-EVs or hippocampus of HFD mice protected against acute stress, reducing stress susceptibility that were mediated via CREB-BDNF pathway. In summary, VAT-EVs or the cargo miRNAs in obese mice promote synaptic damage and stress susceptibility, providing potential therapeutic targets for metabolism-related affective disorders.

Risk of Major Depression Associated with Excessive Daytime Sleepiness in Apneic Individuals

Considering the frequent co-occurrence of major depressive disorder and excessive daytime sleepiness in apneic individuals, this study aimed to explore the relationship between excessive daytime sleepiness and the risk of developing major depressive disorder in this specific subpopulation. Demographic and polysomnographic data were retrospectively extracted from the clinical database of 1849 apneic individuals at the Sleep Unit. Excessive daytime sleepiness was considered present when the Epworth Sleepiness Scale score was >10 and major depressive episodes were diagnosed according to DSM criteria. Logistic regression analyses were performed to assess the risk of major depressive disorder associated with excessive daytime sleepiness in apneic individuals. The prevalence of major depressive disorder was 26.3% in apneic individuals. After controlling for major confounding variables, multivariate logistic regression analyses revealed that apneic individuals with complaints of excessive daytime sleepiness had a higher likelihood of developing major depressive disorder compared to those without complaint of excessive daytime sleepiness. This study highlights the strong association between excessive daytime sleepiness and major depressive disorder in apneic individuals, underlining the importance of systematically assessing and adequately treating excessive daytime sleepiness to better manage depressive symptoms and improve overall treatment outcomes in this specific subpopulation.

Safety analysis of compounded GLP-1 receptor agonists: a pharmacovigilance study using the FDA adverse event reporting system

BACKGROUND

This study evaluated the safety of compounded glucagon-like peptide-1 receptor agonists (GLP-1 RAs) compared to non-compounded formulations using the U.S. FDA Adverse Event Reporting System (FAERS).

RESEARCH DESIGN AND METHODS

A retrospective analysis of FAERS from 2018 to 2024 examined adverse events (AEs), medication errors, and product quality issues for liraglutide, semaglutide, and tirzepatide. Reporting odds ratios (RORs) with 95% confidence intervals were calculated with adjustment using logistic regression.

RESULTS

Of the 81,078 GLP-1 RA reports in the FAERS database, 707 involved compounded products. Compounded formulations demonstrated higher RORs for abdominal pain (2.84 [2.29, 3.49]), diarrhea (1.59 [1.25, 1.99]), nausea (1.27 [1.05, 1.52]), suicidality (6.34, [4.32, 8.99]), and cholecystitis (3.39, [1.61, 6.31]). Compounded products showed higher RORs of preparation errors (48.92 [12.63, 189.6]), prescribing errors (4.46, [2.49, 7.98]), contamination (19.00, [4.24, 85.03]), and compounding/manufacturing issues (8.51, [5.17, 14.0]), while lower odds of administration (0.29 [0.16, 0.53]) and dosing errors (0.24, [0.17, 0.32]). The hospitalization odds were higher for compounded products (2.35 [1.94, 2.83]).

CONCLUSIONS

Compounded GLP-1 RAs may be associated with a higher odds of AEs, safety concerns, and product quality issues compared to non-compounded products. These findings underscore the importance of cautious prescribing, rigorous quality standards, and enhanced patient monitoring.

The Role of Nutraceuticals and Probiotics in Addition to Lifestyle Intervention in the Management of Childhood Obesity-Part 2: Comorbidities

Pediatric obesity is associated with a wide range of comorbidities beyond metabolic changes, affecting cardiovascular, endocrine, reproductive, musculoskeletal systems, and also mental health. Hypertension, commonly observed in children with obesity, increases the risk of long-term cardiovascular disease. Polycystic ovary syndrome (PCOS) presents another significant endo-reproductive challenge that often develops during adolescence in females, leading to further comorbidities in adulthood. Additionally, excess adiposity can negatively impact bone health by modifying bone metabolism and increasing fracture risk. Obesity is also strongly linked to mental health disorders, including depression, anxiety, and low self-esteem, which can further exacerbate unhealthy lifestyle behaviors and disorders. Given the limitations and poor adherence of traditional treatment strategies, nutraceuticals have emerged as potential complementary therapies due to their bioactive properties. Various compounds have demonstrated antihypertensive, insulin-sensitizing, and anti-inflammatory effects, while others support bone metabolism and promote mental well-being. Herewith, we discuss the role of nutraceuticals in managing hypertension, PCOS, bone health, and mental health issues in individuals with obesity, evaluating their mechanisms of action and clinical relevance. Integrating nutraceutical compounds with dietary and lifestyle interventions may improve treatment outcomes and prevent obesity-related comorbidities. Further, we emphasize the need for further large-scale clinical studies, especially in pediatric patients.

Obesity: pathophysiology and therapeutic interventions

Over the past few decades, obesity has transitioned from a localized health concern to a pressing global public health crisis affecting over 650 million adults globally, as documented by WHO epidemiological surveys. As a chronic metabolic disorder characterized by pathological adipose tissue expansion, chronic inflammation, and neuroendocrine dysregulation that disrupts systemic homeostasis and impairs physiological functions, obesity is rarely an isolated condition; rather, it is frequently complicated by severe comorbidities that collectively elevate mortality risks. Despite advances in nutritional science and public health initiatives, sustained weight management success rates and prevention in obesity remain limited, underscoring its recognition as a multifactorial disease influenced by genetic, environmental, and behavioral determinants. Notably, the escalating prevalence of obesity and its earlier onset in younger populations have intensified the urgency to develop novel therapeutic agents that simultaneously ensure efficacy and safety. This review aims to elucidate the pathophysiological mechanisms underlying obesity, analyze its major complications-including type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), non-alcoholic fatty liver disease (NAFLD), obesity-related respiratory disorders, obesity-related nephropathy (ORN), musculoskeletal impairments, malignancies, and psychological comorbidities-and critically evaluate current anti-obesity strategies. Particular emphasis is placed on emerging pharmacological interventions, exemplified by plant-derived natural compounds such as berberine (BBR), with a focus on their molecular mechanisms, clinical efficacy, and therapeutic advantages. By integrating mechanistic insights with clinical evidence, this review seeks to provide innovative perspectives for developing safe, accessible, and effective obesity treatments.

Epigenetic Mechanisms of Obesity: Insights from Transgenic Animal Models

Obesity is a chronic disease with prevalence rates that have risen dramatically over the past four decades. This increase is not due to changes in the human genome but rather to environmental factors that promote maladaptive physiological responses. Emerging evidence suggests that external influences, such as high-fat diets, modify the epigenome-the interface between genes and the environment-leading to persistent alterations in energy homeostasis. This review explores the role of epigenetic mechanisms in obesity, emphasizing insights from transgenic animal models and clinical studies. Additionally, we discuss the evolution of obesity research from homeostatic to allostatic frameworks, highlighting key neuroendocrine regulators of energy balance.

Obesity and psychology: a bibliometric analysis of half a century

Background

The interaction mechanisms between obesity and psychological factors are intricate and bidirectional. Psychological issues can prompt unhealthy eating behaviors, impede weight management efforts, and elevate the risk of obesity. This study employs bibliometric approaches to conduct a comprehensive analysis of the knowledge structure, research hotspots, and development trends in the field of obesity and psychology, offering valuable references for future research in this area.

Methods

This study draws on the Web of Science Core Collection (WoSCC) database, with "obesity" and "psychology" serving as the primary search terms. Leveraging CiteSpace (version 6.3.R1) and VOSviewer (version 1.6.20) software, bibliometric analyses were conducted on various indicators, including the number of publications, publication volume, authors, journals, references, countries, institutions, and keywords. Through co-citation analysis and keyword co-occurrence analysis, the research hotspots and developmental trajectories in this field were revealed.

Results

Based on the inclusion and exclusion criteria, a total of 2,753 relevant articles were ultimately included in this study. The results indicate that since the 21st century, there has been a significant surge in the number of publications in the field of obesity and psychology. Developed countries like the United States, Canada, the United Kingdom, and Australia are at the forefront of this field. Leading research institutions include Yale University, University College London, and the University of Pennsylvania. Among the authors, GRILO CM has the highest publication output. Research hotspot keywords primarily include "depression," "stress," "emotional eating," "bariatric surgery," "intervention," "weight stigma," and "self-regulation." Current research trends reveal a marked regional imbalance in international collaboration in the field of obesity and psychology. In particular, there exists a notable absence of substantive cooperation between developed and developing countries. Research hotspots mainly center around the following aspects: Firstly, it focuses on the prevalence of common psychological distress symptoms, including depression, anxiety, and stress, within the obese population and the implications these symptoms have for health. Secondly, mental health issues like binge eating and emotional eating play a pivotal role in the onset and maintenance of obesity. Thirdly, psychosocial factors like health-related quality of life and weight stigma are at the core of obesity intervention and have potential impacts on behavioral change. Meanwhile, researchers are increasingly concentrating on the individualized mental health requirements of obese populations, emphasizing the importance of evidence-based psychological interventions in the management of obesity. These research hotspots not only enhance our understanding of the complex relationship between obesity and mental health but also provide crucial theoretical foundations and practical insights for future research directions.

Conclusion

This study employs bibliometric approaches to conduct a comprehensive and in-depth analysis of research trends and developments in the field of obesity and psychology. The research reveals the current status and characteristics of this field from multiple perspectives, offering scientific backing for researchers to identify potential collaborators, pinpoint hotspot issues, and keep abreast of the latest developments. Looking forward to the future, related research can further expand data sources, diversify research viewpoints, and delve more profoundly into the complex relationship between obesity and mental health.

Cortisol, cardiovascular risk, and anxiety in full-time workers in Cartagena, Colombia, 2023

Background

Considering the general trend toward an increased occurrence of cardiovascular and mental health diseases, we studied the relationship between the presence of trait and state anxiety and the alteration of serum cortisol, lipid, and glycemia levels.

Material and methods

The study assessed 90 full-time workers waist circumferences, as well as their cortisol levels at 8 AM and 4 PM, and their fasting serum glucose and lipid profiles. The construct of trait and state anxiety was assessed by means of the Inventory of Trait-State Anxiety (IDARE Spanish version).

Results

The state anxiety scale showed high reliability (ω = 0.94, α = 0.939). Moderate to high state anxiety was observed in 61.1% of participants, while 71.1% had moderate to high trait anxiety. Most participants (94.4%) had AM and PM cortisol levels within normal ranges. PM cortisol levels were lower than AM cortisol levels in 95.6% of participants (86/90). Dyslipidemia was present in 60.4% of participants. No significant sex differences were found in AM and PM cortisol or anxiety levels, except for triglycerides, which were higher in men (p = 0.013). State anxiety was positively correlated with PM cortisol levels (r = 0.232, p = 0.028), no significant associations were found with AM cortisol or age. A significant association was observed between waist circumference and fasting glycemia, with 68.9% of participants exceeding the recommended waist circumference threshold. Obesity was significantly associated with hyperglycemia (p = 0.010). An ANOVA revealed a significant effect of state anxiety on evening cortisol levels (F(2, 87) = 7.336, p = 0.001), with the high state anxiety group exhibiting the highest PM cortisol levels. Additionally, a t-test found a significant difference in triglyceride levels between the presence and absence of state anxiety t (87.999) = -2.244, p = 0.027.

Conclusions

The presence of state anxiety proved to be the type of anxiety most associated with increased evening cortisol levels and triglyceride levels. Understanding the relationships between mental states and biochemical physical conditions will be essential in the future for maximizing the benefits of technological developments applied to the diagnosis, prognosis, and monitoring of patients' overall health.

Doctor-patient communication in obesity disease - the perspective of Polish primary care physicians

BACKGROUND

Obesity is a chronic disease that is affecting an increasing number of patients. The prevalence of obesity, the age of patients affected, and the range of associated comorbidities suggest that general practitioners will engage with this patient group extensively throughout their professional careers. It is regrettable that numerous obstacles impede the efficacious treatment of obesity by primary care physicians. These include inadequate training in obesity management and communication with patients, as well as a pervasive and problematic bias in the approach to the treatment of patients with obesity.

METHODS

The objective of the study was to examine the knowledge, self-assessment, experiences and perceptions of primary care doctors in Poland with regard to the communication and management of obesity. The data were collected via computer-assisted telephone interviewing (CATI). The sample was deliberately random selected from the available database of numbers. The inclusion criteria were aged 24 or over and active working as a primary care doctor in Poland. The research sample comprised 150 primary care doctors with various medical specialties, including the following: family medicine, internal medicine, pediatrics, endocrinology, diabetology, and others. An even distribution of participants was not ensured with respect to the parameters considered.

RESULTS

The findings of our study indicate that primary care physicians mostly disagreed with the view that patients living with obesity are less hardworking or more demanding but just over half disagreed that these patients are lazier than others. Doctors reported rarely using fear-based language or blaming excessive food consumption for obesity. Instead, many emphasized that obesity is a disease and considered the patient's perspective. Doctors who rated their communication skills and medical knowledge needed for conversations with patients living with obesity more highly were more likely to address this topic during a visit for an unrelated medical condition. Those who avoided the topic often felt they lacked the skills or knowledge to engage patients effectively. Almost half of the surveyed physicians had not received any training in communicating with patients living with obesity and only 11% had the issue addressed in a course for specialization.

CONCLUSIONS AND IMPLICATIONS

The study indicates a necessity for changes in the curricula of both pre- and postgraduate education, including an enhancement of the knowledge and abilities of primary care providers in the domain of communication during visits with patients with obesity, the encouragement of lifestyle modifications and the implementation of efficacious treatments for obesity, as well as activities designed to modify the negative attitudes of primary care physicians towards patients living with obesity which should not appear in healthcare at all.

Multi-omic analyses of the development of obesity-related depression linked to the gut microbe Anaerotruncus colihominis and its metabolite glutamate

Emerging evidence implicates gut microbiota in the pathogenesis of obesity-related depression (OD); however, the underlying molecular mechanisms remain inadequately explored. This study compared the microbial and transcriptional profiles between patients with OD and healthy individuals. The results revealed an enrichment of Anaerotruncus colihominis (A. colihominis) and glutamate metabolism-related genes in the OD group. Fecal microbiota transplantation (FMT) from patients with OD induced weight gain, compromised barrier function, and intensified depression-like behaviors in high-fat diet (HFD) mice. Microbial analysis in the mice feces corroborated the clinical findings. Single-cell RNA sequencing highlighted the pivotal role of the Efnb2-Ephb2 interaction in cell communication among colon epithelial and hippocampal neuron subtypes in OD mice. Notably, A. colihominis correlated with glutamate levels in the OD mice and patients. It produced glutamate through a glutamic acid metabolism-related DNA sequence, verified in an engineered Escherichia coli MG1655 strain. Both A. colihominis and glutamate reduced barrier proteins in colon epithelial cells and modulated cognitive proteins in neurons. Finally, A. colihominis treatment induced the Efnb2-Ephb2 interaction, exacerbating depression-like behaviors in germ-free HFD mice. Collectively, these findings reveal that A. colihominis and glutamate are potential intervention targets for OD treatment.

Fam172a Mediates the Stimulation of Hypothalamic Oxytocin Neurons to Suppress Obesity-Induced Anxiety

Anxiety disorder is the most common mental disorder worldwide. Although human studies have demonstrated a positive association between obesity and anxiety disorder, the exact mechanism linking these conditions is unclear. Interestingly, oxytocin (Oxt) neurons, predominantly expressed in the hypothalamic paraventricular nucleus (PVN), play a crucial role in both obesity and anxiety. In this study, obesity can induce anxiety-like behavior in mice, which can be ameliorated by the activation of PVN Oxt neurons. Conversely, inhibiting PVN Oxt neurons accelerate the progression of anxiety. Moreover, the family with sequence similarity 172, member A (Fam172a), an anxiety susceptibility gene, is highly expressed in the hypothalamic PVN Oxt neuron but reduce in the PVN Oxt neuron of mice in the high-fat diet and acute restraint stress conditions. Significantly, overexpression of Fam172a in PVN Oxt neurons improve obesity-anxiety-like behavior in mice. In contrast, disruption of Fam172a in PVN Oxt neurons exacerbate obesity-anxiety-like behavior. Furthermore, this study demonstrates that Fam172a is involved in mRNA degradation in Oxt neurons by regulating the intranuclear transport of Argonaute 2, thereby influencing Oxt secretion and ultimately impacting obesity-anxiety-like behavior. These findings suggest that Fam172a serves as a key target of PVN Oxt neurons in the regulation of obesity-induced anxiety.

Treating obesity in patients with depression: a narrative review and treatment recommendation

The high morbidity of obesity and depression pose significant public health concerns, with the prevalence of obesity doubling in the US between 1990 and 2022 and patients frequently presenting with both. Untreated obesity and depression can greatly impact patient health and well-being, as both obesity and depression are associated with a number of comorbidities including sleep apnea, type 2 diabetes mellitus, metabolic syndrome, metabolic dysfunction-associated steatotic liver disease, and cardiovascular disease. This narrative review aims to provide a comprehensive and current overview of the overlapping etiologies between obesity and depression as well as the available treatment options that may be recommended by primary care professionals to treat these patients with concomitant obesity and depression. With the considerable overlap in the population of patients with obesity and depression, as well as the overlap in the neurobiological, hormonal, and inflammatory pathways underlying both diseases, primary care professionals should consider screening patients presenting with obesity for depression. Holistic treatment options, including lifestyle and behavioral modifications, and pharmacotherapy for both depression and obesity and bariatric surgery for obesity are critical to manage both conditions simultaneously. Therefore, due to the overlapping neurobiological pathways and mechanisms responsible for the incidence and progression of both obesity and depression, a holistic treatment plan including strategies with efficacy for both conditions and any additional comorbidities may improve the clinical approach for patients with concomitant obesity and depression.

Obesity is associated with progressive brain structural changes

OBJECTIVE

The aim of this study was to investigate the relationship between obesity (OB) progression and brain structural changes.

METHODS

T1-weighted magnetic resonance images were acquired from 258 participants with overweight (OW) or OB and 74 participants with normal weight. Participants with OW or OB were divided into four groups according to BMI grades. Two-sample t tests compared disparities between the four subgroups and the participants with normal weight. We used causal structural covariance networks to examine the progressive impact of OB on brain structure.

RESULTS

With increasing BMI values, reductions in gray matter volume originated in the left caudate nucleus, medial orbitofrontal cortex, and left insula and expanded to the right hippocampus and left lateral orbitofrontal cortex and then to the right parahippocampal gyrus, left precuneus, and left dorsolateral prefrontal cortex (p < 0.05, false discovery rate corrected). The left caudate nucleus and medial orbitofrontal cortex are the primary hubs of the directional network, exhibiting positive causality to the right hippocampus and left dorsolateral prefrontal cortex. Moreover, the right hippocampus is identified as an important transition hub.

CONCLUSIONS

These findings suggest that changes in gray matter volume in individuals with OB may originate from reward/motivation processing regions, subsequently progressing to inhibitory control/learning memory regions, providing a new reference direction for clinical intervention and treatment of OB.

Obesity paradox in patients with community-acquired pneumonia: Have you fully considered the confounding factors?

There exists a notion that there is an obesity paradox in the prognosis of community-acquired pneumonia. In other words, obese individuals with community-acquired pneumonia have a better prognosis. The study by Wang et al supports this claim, but we believe that the obesity paradox should not be proposed hastily as it is influenced by numerous subjective and objective confounding factors.

The association between metabolically healthy obesity and risk of depression: a systematic review and meta-analysis

This review aimed to explore the association between metabolically healthy obesity (MHO) and the risk of depression. Databases (EMBASE, PubMed, Web of Science, Cochrane Library) were searched up to 20 June 2024. Observational studies were included if they compared groups with MHO, metabolically unhealthy nonobesity, and metabolically unhealthy obesity to groups with metabolically healthy nonobesity for the risk of depression. The random-effect model was used to calculate the pooled odds ratios (ORs). Subgroup analyses and meta-regressions were conducted according to age, study design, definition of MHO, BMI cut-off value, depression assessment method, geographic location, ethnicity, development status, and gender to explore the sources of heterogeneity. Three cohorts and 9 cross-sectional studies (N = 1,277,267 participants) were included in this review. Individuals with MHO (OR 1.08 [95% CI 1.04, 1.12], I² = 88.3%), metabolically unhealthy nonobesity (OR 1.15 [95% CI 1.04, 1.28], I² = 99.6%), and metabolically unhealthy obesity (OR 1.30 [95% CI 1.12, 1.51], I² = 99.8%) had an increased risk of depression than individuals with metabolically healthy nonobesity. The association between MHO and risk of depression was stronger in women (OR = 1.14; 95% CI: 1.08-1.20) and populations from North America (OR = 1.26; 95% CI: 1.01-1.58) and Europe (OR = 1.23; 95% CI: 1.07-1.41). Inconsistencies in MHO definitions and BMI cutoff values across studies were important sources of heterogeneity (subgroup analysis: PQ = 29.87, p = 0.001; meta-regression: p = 0.015, R² = 100%). MHO was associated with an increased risk of depression, particularly among women and populations from North America and Europe. These high-risk groups need personalized interventions. Standardizing definition for MHO could enhance comparability across studies. Future prospective cohort studies are needed to validate our findings by including populations from developing nations and employing rigorous definitions.

Relationship between weight-to-waist index and post-stroke depression

BACKGROUND

The weight-to-waist index (WWI) serves as an innovative metric specifically designed to assess central obesity. However, the relationship between WWI and the prevalence of post-stroke depression (PSD) remains inadequately explored in the literature.

AIM

To elucidate the relationship between WWI and PSD.

METHODS

Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed. Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD, with adjustments for potential confounders. The restricted cubic spline statistical method was applied to explore non-linear associations.

RESULTS

Participants with elevated WWI values had a significantly greater risk of developing PSD. Specifically, individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values (odds ratio = 2.21, 95% confidence interval: 1.84-2.66, P < 0.0001). After propensity score matching, the risk of PSD remained significantly elevated (odds ratio = 1.43, 95%confidence interval: 1.09-1.88, P = 0.01). Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile. Restricted cubic spline analysis further revealed a non-linear association, with the risk of PSD plateauing at higher WWI values.

CONCLUSION

There is a significant association between elevated WWI and increased risk of PSD. Thus, regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.

Association between body roundness index and frailty in older Americans: a cross-sectional study of NHANES 2007-2018

This study used NHANES data from 2007 to 2018 to examine the relationship between frailty and the Body Roundness Index (BRI) in U.S. people 60 years of age and older. BRI = 364.2-365.5 × sqrt [1-(wc/2π)2/(Height/2)2]. The degree of frailty was assessed by the frailty index (≥ 0.25). The relationship between frailty and BRI was examined using weighted multivariate logistic regression. To account for potential non-linear patterns, generalized additive modeling (GAM) was utilized, and the ability of BRI to predict frailty was assessed using receiver operating characteristic (ROC) analysis. Results showed that BRI was significantly and positively associated with prevalence of frailty, with a 34% increase in prevalence of frailty per unit increase in a fully adjusted model (OR: 1.34, 95% CI: 1.28, 1.40; p < 0.0001). The GAM model showed a significant nonlinear relationship and threshold effect. This study indicates that a higher BRI is closely linked to the onset of frailty in older adults, although additional confirmation through large-scale prospective studies is required.

Advances in energy balance & metabolism circuitry

Advancements in informatics, genetics, and neuroscience have greatly expanded our understanding of how the central nervous system (CNS) regulates energy balance and metabolism. This chapter explores the key neural circuits within the hypothalamus and brainstem that integrate behavioral and physiological processes to maintain metabolic homeostasis. It also examines the dynamic interplay between the CNS and peripheral organs, mediated through hormonal and neuronal signals, which fine-tune appetite, energy expenditure, and body weight. Furthermore, we highlight groundbreaking research that unveils molecular and cellular pathways governing energy regulation, representing a new frontier in addressing obesity and metabolic disorders. Innovative approaches, such as neurogenetic and neuromodulation techniques, are explored as promising strategies for improving weight management and metabolic health. By providing a comprehensive perspective on the mechanisms underlying energy balance, this chapter underscores the transformative potential of emerging therapeutic innovations.

Factors influencing mental health outcomes among university students: a cross-sectional study in Bangladesh

INTRODUCTION

Mental health issues, particularly anxiety and depression, are on the rise among university students globally, including in Bangladesh. However, comprehensive data on the factors influencing mental health outcomes in this group remain limited, hindering the development of effective programmes and interventions.

OBJECTIVES

This study aims to assess the mental health status of university students in Bangladesh and examine the key factors influencing mental health outcomes.

DESIGN

A cross-sectional online survey was conducted in Bangladesh from December 2022 to March 2023.

SETTING

Universities in Bangladesh.

PARTICIPANTS

University students aged 18 and older.

OUTCOME MEASURES

Data were collected through a structured survey that assessed depression and anxiety using the Patient Health Questionnaire and the Generalized Anxiety Disorder scale, as well as dietary diversity through the Individual Dietary Diversity Score.

RESULTS

The results showed that while female students exhibited greater dietary diversity, they also had higher obesity rates, whereas male students reported more physical activity. Mental health assessments revealed that 36.1% of participants experienced mild anxiety, 11.5% severe anxiety, 39.8% mild depression and 8.3% severe depression. Binary logistic regression analysis identified significant predictors of anxiety and depression, including gender, personal income, body mass index and screen time. Females were less likely to experience anxiety (crude odds ratios (COR): 0.531, p =0.034) and depression (COR: 0.591, p =0.023) compared with males. Furthermore, low intake of wheat, rice (COR: 2.123, p=0.050) and pulses (COR: 1.519, p=0.050), as well as high consumption of fats, oils (COR: 2.231, p=0.024) and sugary foods (COR: 2.277, p=0.001), were associated with anxiety, while inadequate intake of vitamin A- and C-rich fruits (COR: 1.435, p =0.018) was linked to depression. Overweight students were found to be more susceptible to depression.

CONCLUSION

The findings of the study emphasise the necessity for targeted interventions that promote healthier lifestyles to enhance mental health outcomes among university students in Bangladesh.

Adherence to the Mediterranean diet and risk of anxiety and depression in people with obesity: a cross-sectional analysis

BACKGROUND/OBJECTIVES

Anxiety and depression are common mental disorders worldwide, in particular in people with obesity. Adherence to the Mediterranean diet has been found beneficial for the prevention of anxiety and depression in the general population. We aimed to evaluate this association in a large cohort of people with obesity.

SUBJECTS/METHODS

A cross-sectional study of 4957 patients with obesity (63.1% women, median age 49 years, IQR 40-58 years and BMI 33.6 kg/m2, IQR 31.6-36.9 kg/m2) was carried out. Clinical history, anthropometric measurements and lifestyle-related information were investigated. A 14-item MEDAS questionnaire was used to assess adherence to the Mediterranean diet. The 20-item STAI2 questionnaire and the 24-item QD questionnaire were used to assess the presence of anxious and depressive symptoms, respectively. Clinical cases of anxiety and depression were identified among patients with a physician-made diagnosis of anxiety and depression or with STAI2 and QD score ≥95th percentiles of reference population.

RESULTS

Overall, 11.9% of participants were positive for anxiety and 11% for depression. Multivariate linear regression models showed a decrease in STAI2 and QD scores of 0.18 points (95%CI: -0.33, -0.03) and 0.10 points (95%CI: -0.16, -0.03), respectively, for each 1-point increase in MEDAS score. The multivariate logistic regression model showed a 7% reduction in the odds of anxiety and depression for each 1-point MEDAS increase (OR = 0.93, 95%CI: 0.89, 0.99; OR = 0.93, 95%CI: 0.88, 0.98).

CONCLUSIONS

Mediterranean diet is associated with a lower risk of anxiety and depression in people with obesity. Longitudinal studies are needed to determine causality.

Assessing the Role of Dark Sweet Cherry (Prunus avium L.) Consumption on Cognitive Function, Neuropeptides, and Circadian Rhythm in Obesity: Results from a Randomized Controlled Trial

Background/Objectives: Obesity is linked to a higher risk of cognitive impairment. The objective of this single blind randomized trial was to evaluate the impact of dark sweet cherry (DSC) intake on cognitive function in obese adults. Methods: Participants (body mass index (BMI): 30-40 kg/m2, >18 years, without chronic diseases and/or antibiotic use) consumed 200 mL of DSC drink with 3 g of cherry powder (n = 19) or an isocaloric placebo drink (n = 21) twice daily for 30 days. Cognitive function was assessed at Day 1 (D1) and Day 30 (D30) using standardized cognitive tests and the NeuroTracker (NT) 3D training program. Blood biomarkers related to cognitive health (neurotensin, substance p, and oxytocin) and circadian rhythm (melatonin and cortisol) were assessed at D1 and D30 using a Luminex multiplex bead-based immunoassay. Results: DSC supplementation significantly improved working memory and concentration, as indicated by higher scores in the digit span forward (DSF, p = 0.006) and backward (DSB, p = 0.01) tests. However, processing speed, sustained attention, and visual spatial skills, assessed through the trail making (TMT) and digit symbol substitution (DSST) tests, as well as visual cognitive performance (VCP) evaluated by the NT program, showed no significant differences between groups. Neurotensin, associated with cognitive deficits, increased in both cherry and placebo groups but was significant only in the placebo group (p = 0.007). Similarly, melatonin increased in both groups, reaching significance only in the placebo group (p = 0.02), and it correlated positively with IFNγ, suggesting a compensatory response to inflammation. Conclusions: These findings suggest DSC supplementation may enhance specific cognitive functions in obese adults. Further clinical trials are needed to confirm these results.

Eating to Feel Better: The Role of Comfort Eating in Chronic Pain

Research has identified that individuals with chronic pain comfort eat in response to their pain, however, little is known about the function that comfort eating serves for chronic pain patients. Given the synergistic relationship between higher body weight and chronic pain, it is important to further understand the role and impact of eating behaviours, such as comfort eating, for individuals with chronic pain. This study aimed to investigate the perceived function of pain-induced comfort eating for chronic pain sufferers. Adult participants (N = 141) with chronic pain were recruited through online advertisements. Participants completed self-report questions on an online survey platform. Over two-thirds of the sample identified with engaging in comfort eating in response to chronic pain flare-ups. Results revealed that the most endorsed function of pain-induced comfort eating was 'to have a pleasant experience' (51.8%), followed by 'distraction' (49.6%) and 'to reduce emotions' (39%). This study provides further evidence that comfort eating is common amongst individuals with chronic pain and sheds light on the perceived function of comfort eating for those who are managing chronic pain. Given the potential impact on outcomes for chronic pain patients, future studies should further investigate the relationship between comfort eating and chronic pain.

Psychosocial risks in metabolic dysfunction-associated steatotic liver disease

INTRODUCTION

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly becoming more prevalent in the general population. MASLD is more common in persons with low socioeconomic status (SES), yet little is known about the psychosocial challenges associated with this disease, and clinical recommendations on how to approach psychosocial challenges are lacking.

AREAS COVERED

A PubMed search using the search terms MASLD, psychosocial risks, stigmatization, psychiatric comorbidities (i.e. depression, bipolar disorder, psychosis, attention deficit hyperactivity disorder, and substance abuse), SES, quality of life (QoL), over the past 20 years (2004-2024) was performed.

EXPERT OPINION

Persons with MASLD often experience psychosocial adversities that may be expressed as lower SES, high prevalence of depression, and reduced QoL. Knowledge gaps remain regarding the association between severe mental disorders (e.g. psychosis and bipolar disorders). Timely detection and treatment of MASLD in persons with psychosocial risks may require attention and cross-field collaboration. Studies on QoL in persons with MASLD differ in methodology which makes formal comparisons difficult. Psychosocial adversity may be a barrier to lifestyle modifications, which remain the cornerstone of MASLD management. Guidelines on how to address psychosocial adversities in a clinical setting are warranted to improve outcomes and decrease further multimorbidity.

Body Fat and Visceral Fat Values in Spanish Healthcare Workers: Associated Variables

BACKGROUND/OBJECTIVES

Excessive body adiposity is a significant public health challenge on a global scale. This study aimed to investigate the association between various sociodemographic factors and healthy lifestyle habits and the presence or absence of elevated body adiposity levels.

METHODOLOGY

Two studies were conducted, a retrospective longitudinal study and a cross-sectional descriptive study. The analysis included 44,939 healthcare workers, categorised into four professional groups, to explore the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet and body adiposity, assessed as elevated body fat (BF) and visceral fat (VF) levels. Descriptive statistics encompassed categorical and quantitative variables, analysed using frequencies, Student's t-tests, chi-square tests, and multinomial logistic regression models. Associations, concordances, and correlations were further examined using logistic regression and Cohen's and Pearson's kappa coefficients.

RESULTS

Age, sex, and physical activity were the factors most strongly associated with elevated BF and VF levels. Odds ratios (ORs) indicated the following significant associations: individuals aged 60 years and older exhibited ORs of 6.71 (95% CI: 5.68-7.74) for BF and 12.18 (95% CI: 10.01-14.26) for VF; male sex was associated with ORs of 2.21 (95% CI: 2.06-2.36) for BF and 12.51 (95% CI: 11.29-13.74) for VF. Sedentary behaviour was linked to ORs of 3.69 (95% CI: 3.41-3.97) for BF and 4.20 (95% CI: 3.78-4.63) for VF. Among healthcare professionals, nursing assistants and orderlies demonstrated the highest levels of adipose tissue accumulation.

CONCLUSIONS

Elevated BF and VF levels among healthcare personnel are significantly associated by lifestyle factors, sex, and age, with the most pronounced risk observed in nursing assistants and orderlies. Further research focusing on the causal relationships between lifestyle behaviours and adiposity in this population will provide valuable insights and support the design of targeted preventive strategies to mitigate its prevalence.

Machine learning and confirmatory factor analysis show that buprenorphine alters motor and anxiety-like behaviors in male, female, and obese C57BL/6J mice

Buprenorphine is an opioid approved for medication-assisted treatment of opioid use disorder. Used off-label, buprenorphine has been reported to contribute to the clinical management of anxiety. Although human anxiety is a highly prevalent disorder, anxiety is a latent construct that cannot be directly measured. The present study combined machine learning techniques and artificial intelligence with confirmatory factor analysis to evaluate the hypothesis that buprenorphine alters motor and anxiety-like behavior in C57BL/6J (B6) mice (n = 30) as a function of dose, sex, and body mass. After administration of saline (control) or buprenorphine, mice were placed on an elevated zero maze (EZM) for 5 min. Digital video of mouse behavior was uploaded to the cloud, and mouse position on the maze was tracked and analyzed with supervised machine learning and artificial intelligence. ANOVA and post hoc test showed that buprenorphine significantly altered five motor behaviors. Confirmatory factor analysis revealed that the latent construct of anxiety-like behavior accounted for a statistically significant amount of variance in all five motor behaviors.NEW & NOTEWORTHY Machine learning and pose estimation using a convolutional neural network accurately detected and objectively scored buprenorphine-induced changes in locomotor behaviors of mice on an elevated zero maze (EZM). Confirmatory factor analysis supports the interpretation that the anxiety-like construct accounted for the buprenorphine-induced changes in motor behavior. The results have noteworthy implications for the relationship between Darwin's story model of mammalian emotions and computational models of anxiety-like behavior in mice.

High-fat diet and neuroinflammation: The role of mitochondria

In recent years, increasing evidence has supported that high-fat diet (HFD) can induce the chronic, low-grade neuroinflammation in the brain, which is closely associated with the impairment of cognitive function. As the key organelles responsible for energy metabolism in the cell, mitochondria are believed to involved in the pathogenesis of a variety of neurological disorders. This review summarizes the current progress in the field of the relationship between HFD exposure and neurodegenerative diseases, and outline the major routines of HFD induced neuroinflammation and its pathological significance in the pathogenesis of neurodegenerative diseases. Furthermore, the article highlights the pivotal role of mitochondrial dysfunction in driving the neuroinflammation in the setting of HFD. Danger-associated molecular patterns (DAMPs) from damaged mitochondria can activate innate immune signaling pathways, while mitochondrial dysfunction itself can lead to metabolic remodeling of inflammatory cells, thus inducing neuroinflammation. More importantly, mitochondrial damage, neuroinflammation, and insulin resistance caused by HFD form a mutually reinforcing vicious cycle, ultimately leading to the death of neurons and promoting the progression of neurodegenerative diseases. Thus, in-depth elucidation of the role and underlying mechanisms of mitochondrial dysfunction in HFD-induced metabolic disorders may not only expand our understanding of the mechanistic linkages between HFD and etiology of neurodegenerative diseases, but also help develop the specific strategies for the prevention and treatment of neurodegenerative diseases.

Glucose metabolism impairment in major depressive disorder

Major depressive disorder (MDD) is a common mental disorder with chronic tendencies that seriously affect regular work, life, and study. However, its exact pathogenesis remains unclear. Patients with MDD experience systemic and localized impairments in glucose metabolism throughout the disease course, disrupting various processes such as glucose uptake, glycoprotein transport, glycolysis, the tricarboxylic acid cycle (TCA), and oxidative phosphorylation (OXPHOS). These impairments may result from mechanisms including insulin resistance, hyperglycemia-induced damage, oxidative stress, astrocyte abnormalities, and mitochondrial dysfunction, leading to insufficient energy supply, altered synaptic plasticity, neuronal cell death, and functional and structural damage to reward networks. These mechanical changes contribute to the pathogenesis of MDD and severely interfere with the prognosis. Herein, we summarized the impairment of glucose metabolism and its pathophysiological mechanisms in patients with MDD. In addition, we briefly discussed potential pharmacological interventions for glucose metabolism to alleviate MDD, including glucagon-like peptide-1 receptor agonists, metformin, topical insulin, liraglutide, and pioglitazone, to encourage the development of new therapeutics.

Association between adolescent obesity and early adulthood healthcare utilization-a two-cohort prospective study

BACKGROUND

Pediatric obesity is a growing global health challenge, with long-term implications for individuals and healthcare systems. Existing studies on the association between pediatric obesity and healthcare use in adulthood are limited and often rely on mathematical simulation models. This study aims to provide real-world data on the impact of adolescent obesity on specialized healthcare utilization and costs in early adulthood.

METHODS

This study analyzed data from two longitudinal cohorts: a population-based cohort from Norway (Young-HUNT) and a clinical cohort from Sweden (BORIS), the latter with matched general population comparators. Individuals included were born between 1987 and 1994, with BMI measurements at ages 13-19, and follow-up data from ages 20 to 30 years. Healthcare utilization and costs were assessed using national patient registries.

RESULTS

A total of 7592 individuals from Norway (5.7% with adolescent obesity) and 1543 individuals from Sweden with adolescent obesity, accompanied with 7330 matched general population comparators, were included. Among females, adolescent obesity was associated with significantly higher specialized healthcare utilization and costs in young adulthood, e.g., in Sweden, females with adolescent obesity had a 57% probability of annual specialized healthcare visits at ages 25-29, compared to 49% among the general population, p < 0.0001. In Norway, a similar pattern was observed. Among males, the association between obesity and healthcare utilization/annual specialized visits was less prominent. Annual excess costs for females with a history of adolescent obesity ranged from €578 to €835, while males showed minimal or no annual excess costs.

CONCLUSIONS

Analyses of real-world data cohorts from Norway and Sweden reveal that adolescent obesity is associated with increased healthcare utilization and costs in young adulthood, exceeding previous estimates. A distinct sex difference was evident, with females incurring higher costs compared to males.

Associations between intestinal fatty-acid binding protein and clinical and metabolic characteristics of depression

INTRODUCTION

The topic of increased intestinal permeability is associated with disruption of the intestinal barrier, leading to the "leaky gut" syndrome. Depressive disorders often coexist with abdominal obesity, metabolic syndrome, or its components and complications. Intestinal permeability has been proven to relate to all of the above.

METHODS

In this cross-sectional study, we aimed to assess the "leaky gut" blood biomarker - intestinal fatty acid-binding protein (I-FABP) - in 114 adult patients diagnosed with depressive disorders depending on abdominal obesity comorbidity, depression, anxiety, and stress level, or antidepressant use. The corrected p-value was set at 0.02. We analyzed patients' mental state, diet, anthropometric parameters, metabolic laboratory markers and I-FABP.

RESULTS

There was no difference in circulating I-FABP levels between obese and non-obese patients with depressive disorders (p = 0.648). Similarly, I-FABP levels were not different in patients with different emotional symptoms severity (p = 0.829 for self-assessed depression, p = 0.164 for anxiety, and p = 0.543 for stress). But, I-FABP levels differed significantly between patients treated and not treated with antidepressants (p = 0.011). In general linear model analysis treatment with antidepressants, anxiety severity level, their interaction, along with smoking status, drinks intake, and using dietary supplements were shown to significantly explain I-FABP variance (p < 0.001, R2adj = 0.261).

CONCLUSIONS

Comorbid obesity did not increase intestinal permeability circulating marker, I-FABP, in the population of patients with depressive disorders. Treatment with antidepressants may be connected to higher I-FABP levels. Using dietary supplements, drinks intake, smoking status, or anxiety level may serve as explanatory factors.

Obesity phenotype and gut microbiota alterations are not associated with anxiety-like behaviour in high-fat diet-fed mice

Anxiety is a common co-morbidity with obesity and metabolic disease, and can lead to a significant impact on quality of life. The vast differences in the gut microbiota between obese and control individuals provide a potential avenue for therapeutic intervention. A high-fat diet (HFD) in rodent models have been shown to induce anxiety-like behaviour and has been tested through an array of distinct behavioural tests such as the elevated plus maze test, light-dark test and open field test. Despite differences in testing and assessment parameters, the behavioural outcomes have previously yielded similar results. Recent evidence suggests that HFD has an anxiolytic effect on mice, complicating the model. Here, we aimed to confirm whether HFD-fed mice are more susceptible to presenting anxiety-like behaviours. Our findings showed no significant differences in behaviour, plasma corticosterone and inflammation markers between HFD and control diet (CTD) mice, despite considerable differences in adiposity and faecal microbial communities. Additionally, daily oral gavage is one of the most common methods for testing bacterial probiotics in rodent models, but this handling could potentially also cause stress to the mice. Thus, we investigated if daily oral gavage could mask differences in HFD and CTD mice. We found no significant differences in weight, fat mass or anxiety-like behaviour in CTD-fed mice with or without daily oral gavage.

Depression and obesity: Focus on factors and mechanistic links

Major depressive disorder (MDD) is defined as mood disorder causing a persistent loss of interest and despair for two weeks or greater, with related symptoms. Depression can interfere with daily life and can cause those affected to not work, study, eat, sleep, and enjoy previously enjoyed hobbies and life events as they did previously. If untreated, it can become a serious health condition. Depression is multifactorial with a variety of factors influencing the condition. These factors include: (1) poor diet and exercise, (2) socioeconomic status, (3) gender, (4) biological clocks, (5) genetics and epigenetics, and (6) personal stressors. Treatment of depressive disorders is thus also multifactorial and utilizes the following therapies: (1) diet and exercise, (2) bright light therapy, (3) cognitive behavioral therapy, and (4) pharmaceutical therapy. Obesity is defined as body mass index over 30 and above, is believed to be causally linked to MDD through both psychological and molecular means. Atypical depression, a common form of MDD, is most strongly correlated with a high proclivity for obesity. Obesity and depression have a bidirectional relationship, a patient experiencing either condition singularly is more likely to develop the other due to the neural links between the two, including emotional lability, physical health of the brain, hormones, cytokine secretion, appetite, diet and feeding habits, inflammatory state. In individuals consuming a high fat diet (HFD) commonly ingested by those with obesity, the gut-microbiome is altered leading to systemic inflammation and the dysregulation of mood and the HPA axis impacting their neural health. The purpose of this paper is to examine the interplay of potential molecular, psychological, societal, and environmental causal factors of depressive disorders and how obesity perpetuates depression. A secondary aim of this paper is to examine current interventions that may help improve those affected by both conditions.

The impact of the Mediterranean diet on alleviating depressive symptoms in adults: a systematic review and meta-analysis of randomized controlled trials

CONTEXT

High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain.

OBJECTIVE

This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression.

DATA SOURCES

PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms.

DATA EXTRACTION

Two authors extracted the data independently. The Sidik-Jonkman estimator, the I2 metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration's Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively.

DATA ANALYSIS

In total, 1507 participants (mean age range: 22.0 years-53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: -0.53; 95% confidence interval: -0.90 to -0.16; I2 = 87.1%). The prediction interval ranged from -1.86 to 0.81. The overall risk of bias was within the range of "some concerns" to "high," while the certainty of evidence was low.

CONCLUSION

MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42022341895.

Chemogenetic targeting TRPV1 in obesity-induced depression: Unveiling therapeutic potential of eicosapentaenoic acid and acupuncture

The comorbidity of obesity and depression has major public health impacts, highlighting the need to understand their shared mechanisms. This study explored the connection between obesity and depression through the transient receptor potential V1 (TRPV1) signaling pathway, using obese/depressed murine models and clinical data. Mice fed a high-fat diet showed altered TRPV1 pathway expression in brain regions of the mice: downregulated in the medial prefrontal cortex (mPFC) and hippocampus, and upregulated in the hypothalamus and amygdala, influencing depression-like behaviors and inflammation. Treatments like eicosapentaenoic acid (EPA) and acupoint catgut embedding (ACE) reversed these effects, similar to observations in Trpv1-/- mice. Furthermore, chemogenetic activation in the ventral mPFC also alleviated depression via TRPV1. In our clinical validation, single nucleotide polymorphisms (SNPs) in TRPV1-related genes (PIK3C2A and PRKCA) were linked to interferon-induced depression. These findings underscore the potential of targeting TRPV1 as a therapeutic approach for obesity-related depression.

Depression Symptoms Linked to Multiple Oral Health Outcomes in US Adults

BACKGROUND

Individuals with mental illness have poor oral health compared to those without mental health conditions. However, the literature is still lacking regarding the specifics of this relationship.

OBJECTIVE

This study aims at examining the relationship between depression and oral health problems such as oral conditions, access to dental care, and oral hygiene measures.

METHODS

A cross-sectional study using a secondary data analysis of 9,693 participants from the 2017 to March 2020 prepandemic National Health and Nutrition Examination Survey (NHANES). The independent variable was severity of depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9). Proportional odds and binary logistic regression were used to calculate crude and adjusted odds ratios (AORs) between depression and 8 oral health outcomes and oral hygiene-related behaviors.

RESULTS

After adjusting for sociodemographics, health conditions, and behaviors, individuals with depression were significantly more likely to have dental aches in the past year (AOR = 1.70; 95% confidence interval [CI], 1.13-2.56), difficulty getting dental care when needed (AOR = 1.93; 95% CI, 1.45-2.58), and difficulty at their jobs due to a problem in their mouth (AOR = 1.63; 95% CI, 1.07-2.49) compared to individuals without depression.

CONCLUSION

Individuals with depressive symptoms often neglect oral hygiene and self-care practices and are less likely to seek medical care for oral health problems, making them at increased risk of poor oral health outcomes. These findings can be applied by dentists, psychologists, and therapists to increase awareness of links between depression and oral health and to encourage patients with depression to seek oral hygiene preventative care.

KNOWLEDGE TRANSFER STATEMENT

Health care professionals can be on the frontline in creating awareness in the general public about the links between depression and oral health and hygiene. Applying the findings from this study can help communicate about the relationship between depression and poor oral health and relieve some burden on the American health care sector, which often struggles to provide medical care to patients with depression and oral health issues.

ABHD6 loss-of-function in mesoaccumbens postsynaptic but not presynaptic neurons prevents diet-induced obesity in male mice

α/β-hydrolase domain 6 (ABHD6) is a lipase linked to physiological functions affecting energy metabolism. Brain ABHD6 degrades 2-arachidonoylglycerol and thereby modifies cannabinoid receptor signalling. However, its functional role within mesoaccumbens circuitry critical for motivated behaviour and considerably modulated by endocannabinoids was unknown. Using three viral approaches, we show that control of the nucleus accumbens by neuronal ABHD6 is a key determinant of body weight and reward-directed behaviour in male mice. Contrary to expected outcomes associated with increasing endocannabinoid tone, loss of ABHD6 in nucleus accumbens, but not ventral tegmental area, neurons completely prevents diet-induced obesity, reduces food- and drug-seeking and enhances physical activity without affecting anxiodepressive behaviour. These effects are explained by attenuated inhibitory synaptic transmission onto medium spiny neurons. ABHD6 deletion in nucleus accumbens neurons and dopamine ventral tegmental area neurons produces contrasting effects on effortful responding for food. Intraventricular infusions of an ABHD6 inhibitor also restrain appetite and promote weight loss. Together, these results reveal functional specificity of pre- and post-synaptic mesoaccumbens neuronal ABHD6 to differentially control energy balance and propose ABHD6 inhibition as a potential anti-obesity tool.

Obesity alters circadian and behavioral responses to constant light in male mice

Exposure to artificial light during the night is known to promote disruption to the biological clock, which can lead to impaired mood and metabolism. Metabolic hormone secretion is modulated by the circadian pacemaker and recent research has shown that hormones such as insulin and leptin can also directly affect behavioral outcomes and the circadian clock. In turn, obesity itself is known to modulate the circadian rhythm and alter emotionality. This study investigated the behavioral and metabolic effects of constant light exposure in two models of obesity - a leptin null mutant (OB) and diet-induced obesity via high-fat diet. For both experiments, mice were placed into either a standard Light:Dark cycle (LD) or constant light (LL) and their circadian locomotor rhythms were continuously monitored. After 10 weeks of exposure to their respective lighting conditions, all mice were subjected to an open field assay to assess their explorative behaviors. Their metabolic hormone levels and inflammation levels were also measured. Behaviorally, exposure to constant light led to increased period lengthening and open field activity in the lean mice compared to both obesity models. Metabolically, LL led to increased cytokine levels and poorer metabolic outcomes in both lean and obese mice, sometimes exacerbating the metabolic issues in the obese mice, independent of weight gain. This study illustrates that LL can produce altered behavioral and physiological outcomes, even in lean mice. These results also indicate that obesity induced by different reasons can lead to shortened circadian rhythmicity and exploratory activity when exposed to chronic light.

Association between Weight-Adjusted Waist Index and Depression in NAFLD: the modulating roles of sex and BMI

BACKGROUND

The Weight-Adjusted Waist Index (WWI) is a novel indicator of obesity that accurately reflects body composition. However, the association between WWI and depression in patients with non-alcoholic fatty liver disease (NAFLD) remains unclear. This study aims to explore this relationship through a nationally representative cross-sectional analysis.

METHODS

This study included adult participants diagnosed with NAFLD from NHANES 2017-2020. WWI was calculated as the waist circumference (cm) divided by the square root of body weight (kg). NAFLD diagnosis relied on vibration-controlled transient elastography (VCTE) with a controlled attenuation parameter (CAP) exceeding 248 dB/m to indicate hepatic steatosis. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥ 10 indicating the presence of major depression.

RESULTS

After adjusting for all covariates, a significant positive association was found between WWI and depression in NAFLD (OR = 1.725, 95% CI: 1.442-2.063, p < 0.00001), with a dose-response relationship indicated by restricted cubic spline analysis. The association was stronger in men and lean/normal weight NAFLD patients. Adjusting further for BMI did not alter these findings (OR = 1.643, 95% CI: 1.357-1.989, p < 0.00001). BMI's association with depression was negated after adjusting for WWI.

CONCLUSIONS

WWI had a positive association with depression in NAFLD, independent of BMI. This association was more pronounced in men and lean/normal weight NAFLD. These findings suggest that WWI may be a novel indicator of depression in NAFLD and potentially valuable in depression prevention.