China has dedicated significant efforts to preventing obesity, but the rising prevalence of overweight and obesity remains a pressing public health issue. Therefore, unique solutions are required to address this challenge in China. As a research priority, the food environment plays a pivotal role in addressing overweight and obesity. However, research on this topic in China lags behind that in other developed countries, and the conflicting global evidence on the association between the food environment and obesity cannot be directly applied to policymaking and intervention in China. In addition, the rapid advancement of digital technology has introduced complexities and uncertainties in the food environment. To address these challenges, we propose an alternative research framework through (a) dissecting the challenges associated with defining and measuring the food environment, (b) reorganizing the relationship chains between the food environment and human diet/health, and (c) taking into consideration digital platforms as crucial monitoring tools for studying the food environment. Our framework aims to unlock the potential of food environment research in the digital age, ultimately striving to tackle the overweight and obesity issues in China.

Obesity and its comorbidities (e.g. laminitis) are identified as major welfare issues among domestic equids in the United Kingdom (UK) and abroad. Weight-management typically focuses on restricting consumption (e.g. limiting pasture grazing), often facilitated through stabling. This leads to social isolation, prompting other welfare issues. Increased exercise may be a preferable solution for equine obesity, if viable. The aims of this study were to explore horse (Equus caballus) owner perceptions regarding the importance of exercise, and to investigate how exercise provision related to welfare outcomes. Data obtained via an online survey from 804 UK horse owners indicated that most respondents’ horses were managed in obesogenic conditions, and 40% were owner-reported as overweight/obese. Exercise-related variables (e.g. if a horse was ridden) correlated with physical health problems, including decreased reports of laminitis and Equine Metabolic Syndrome. Approximately 90% of respondents reported that barriers outside of their control substantially limited opportunities to provide human-led exercise (e.g. riding, lunging). Analysis of a hypothetical weight-management scenario found owners with horses at livery yards felt significantly less able to increase horses’ self-directed exercise (e.g. free movement in fields/pastures) than owners keeping horses on their own properties. These findings indicate that while increased exercise may improve welfare, owner knowledge is not the only barrier that must be overcome to implement this prospective solution. Both human-led and self-directed exercise appear limited by a lack of opportunities available to horses and humans. These results justify future investigations into alternative management strategies as potentially viable methods of increasing exercise to improve welfare.

Supplemental Nutrition Assistance Program (SNAP) makes an exception to its rules, which allows elderly and/or disabled individuals, their spouses, as well as homeless beneficiaries, to buy hot prepared food from restaurants if they live in a state that participates in the Restaurant Meals Program (RMP). Using the staggered countywide adoption timeline in California, coupled with a stacked difference-in-differences empirical strategy, I examine the intent-to-treat (ITT) nutritional effects of RMP on the elderly population. Overall, I find no evidence that obesity rates for the elderly are any different in counties with RMP versus those without RMP. I can statistically rule out moderate effects. Additional evidence from some of the early-adopting counties suggests that RMP is associated with a reduction in food insecurity among the elderly.

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

As obesity rates rise globally, addressing modifiable lifestyle factors, such as sleep, presents an opportunity for public health interventions. This review explores the growing evidence linking sleep duration, quality and timing with weight management and dietary behaviours throughout the life course. Observational studies associate short or irregular sleep with increased obesity risk, poor diet quality and metabolic disturbances. Plausible mechanisms include decreased physical activity, heightened hedonic and/or emotional eating, dysregulated appetite signals and circadian misalignment of metabolism, which contribute to a positive energy balance. Unravelling the bidirectional relationship between sleep and weight is challenging; poor sleep exacerbates weight gain, while obesity-related comorbidities such as obstructive sleep apnoea further impair sleep. Despite promising evidence from sleep-restriction studies showing increased energy intake, long-term randomised controlled trials (RCTs) examining interventions designed to improve sleep with weight management as an outcome are lacking. A handful of short-term interventions suggest benefits in reducing energy intake or improving dietary quality, but their effects on weight loss remain inconclusive. This review calls for robust, well-powered RCTs that integrate sleep, diet and physical activity interventions to evaluate the potential of sleep as a core component of obesity prevention and treatment strategies. Currently, there is insufficient evidence to support sleep-focused interventions as a mandatory element in clinical weight-management programmes.

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

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

Oral supplementation with probiotics, prebiotics, and synbiotics is a novel potential complementary therapy for addressing overweight and obesity through gut microbiota modulation. This systematic review provides a comprehensive summary of the existing evidence to guide future research. Literature searches were conducted in four databases to identify human trials published until May 2024 that examined the impact of probiotic, prebiotic, or synbiotic interventions on faecal microbiota composition changes in overweight and obese participants from Latin American and Caribbean populations (LACPs). Of the 13,090 identified records, five randomised controlled trials (RCTs) from Brazil, Mexico, and Chile met the inclusion criteria for this review. The included RCTs evaluated different forms of therapies over short-term interventions (6 or 8 weeks), with sample sizes ranging from 21 to 39 participants across the studies. Variations in the reported outcomes were observed due to differences in supplement formulation, dosage, population characteristics, and methodological heterogeneity. The findings indicate that the available data are inadequate to establish definitive conclusions regarding the impact of biotic treatments on gut microbiota profiles in LACP. Further research with larger sample sizes and precise microbiota analysis is required to elucidate the implications of dietary interventions on gut microbiota in obesity and related disorders.

Ozempic and related semaglutide drugs represent a popular new strategy to address obesity in the United States, yet uptake of these medications has sparked opposition highlighting concerns about off-label drug use policies, drug safety, supply shortages and cost. Public attitudes towards off-label prescribing by physicians broadly, and towards Ozempic in particular, in light of this opposition are unclear. To better understand public sentiment on this topic, we analysed data from a representative survey of 3,420 US adults conducted from 13 to 22 June 2023. Public attitudes towards off-label prescribing were split, with 46.3 percent supporting physician discretion to prescribe off-label. Importantly though, 58 percent of respondents were at least somewhat concerned about Ozempic supply shortages caused by off-label use and 63 percent were concerned about Ozempic safety in the context of off-label use. Further analysis from an embedded survey experiment shows that rhetoric highlighting safety (but not supply) concerns surrounding off-label Ozempic prescribing is associated with a significant drop in support for off-label use. These results suggest that the introduction of obesity drugs like Ozempic present a pharmaceutical industry-led path for combatting obesity, but rhetoric opposing these drugs could blunt public support and uptake.

Renal sinus fat (RSF) crucially influences metabolic regulation, inflammation, and vascular function. We investigated the association between RSF accumulation, metabolic disorders, and nutritional status in obese individuals with hypertension. A cross-sectional study involved 51 obese hypertensive patients from Salamat Specialized Community Clinic (February–September 2022). Basic and clinical information were collected through interviews. Data included anthropometrics, blood pressure, number of antihypertensive medications, body composition (bioelectrical impedance analysis), dietary intake (semi-quantitative 147-item food frequency questionnaire), and blood samples. Renal sinus fat was measured via ultrasonography. Statistical analyses included Pearson correlation, binary logistic regression, and linear regression. RSF positively correlated with abdominal visceral adipose tissue (VAT) area (P = 0.016), systolic blood pressure (SBP) (P = 0.004), and diastolic blood pressure (DBP) (P = 0.005). A strong trend toward a positive association was observed between antihypertensive medications and RSF (P = 0.062). In linear regression, RSF was independently associated with abdominal VAT area, SBP, and DBP after adjusting for confounders. After considering other risk factors, RSF volume relates to prescribed antihypertensive medications, hypertension, and central fat accumulation in obese hypertensive subjects. These findings suggest the need for further investigations into whether RSF promotes metabolic disorders.

The aim of this randomised controlled trial was to investigate the effects of breakfast high or low in protein on body composition and cardiometabolic markers in young women with overweight. In total, fifty-six women aged 18–30 years consumed a breakfast containing either high protein (34 g protein, n 26) or low protein (6 g protein, n 30) for 12 weeks. Measurements of body composition by dual-energy X-ray absorptiometry, waist circumference, glucose tolerance, fasting glucose, insulin and lipid profile were performed before and after this period. The primary outcome was fat mass. Satiety and hunger were evaluated by self-reported Visual Analogue Scale (VAS) scores. Dietary intake was estimated by 4-d dietary records, and calcium intake was estimated by FFQ. At baseline, relative daily protein intake was 15·2 ± 2·8 E%, which increased to 19·3 ± 3·4 E% in high protein but was unchanged in low protein (P < 0·001 between groups). High protein reported higher satiety compared with low protein (P = 0·02). Yet, no group differences were observed in changes in energy intake, body composition, blood lipid profile or measures of glucose tolerance (all P > 0·10). However, bone mineral content tended to increase in high protein (P = 0·05) and decrease in low protein (P = 0·07, interaction effect: P = 0·01). Conclusively, a high v. low content of protein in breakfast increased satiety but did not affect body composition or cardiometabolic markers in young women with overweight. This study adds to the sparse evidence on the effects of breakfast with different macronutrient compositions on health parameters in women with overweight. Registered at clinicaltrials.gov: NCT04518605.