Background: Overweight and obesity among adults are a growing global public health threat and an essential risk factor for various noncommunicable diseases. Although intermittent fasting is a generally new dietary approach to weight management that has been increasingly practiced worldwide, the effectiveness of 2 days per week dry fasting remains unclear. Objective: The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study aims to determine the cardiometabolic, anthropometric, dietary intake, and quality of life changes among civil servants with overweight and obesity, following combined intermittent fasting and healthy plate (IFHP) and healthy plate (HP) and explore the participants’ experiences. Methods: We designed a mixed methods quasi-experimental study to evaluate the effectiveness of the IFHP and HP methods among adults with overweight and obesity. A total of 177 participants were recruited for this study, of which 91 (51.4%) were allocated to the IFHP group and 86 (48.6%) to the HP group. The intervention comprised 2 phases: supervised (12 weeks) and unsupervised (12 weeks). Data collection was conducted at baseline, after the supervised phase (week 12), and after the unsupervised phase (week 24). Serum and whole blood samples were collected from each participant for analysis. Data on sociodemographic factors, quality of life, physical activity, and dietary intake were also obtained using questionnaires during data collection. Results: Most of the participants were female (147/177, 83.1%) and Malay (141/177, 79.7%). The expected outcomes of this study are changes in body weight, body composition, quality of life, physical activity, dietary intake, and cardiometabolic parameters such as fasting blood glucose, 2-hour postprandial blood glucose, hemoglobin A1c, fasting insulin, and lipid profile. Conclusions: The Cardiometabolic and Anthropometric Outcomes of Intermittent Fasting study is a mixed methods study to evaluate the effectiveness of combined IFHP and HP interventions on cardiometabolic and anthropometric parameters and explore participants’ experiences throughout the study. Trial Registration: ClinicalTrials.gov NCT05034653; https://clinicaltrials.gov/ct2/show/NCT05034653 International Registered Report Identifier (IRRID): RR1-10.2196/33801

Background: Adult obesity and overweight pose a substantial risk to global public health and are associated with various noncommunicable diseases. Although intermittent fasting (IF) is increasingly used as a relatively new dietary strategy for weight loss, the effectiveness of 2 days per week of dry fasting remains unknown. Objective: This study aims to evaluate the effectiveness of a combined dry IF and healthy plate (IFHP) and healthy plate (HP) intervention in improving anthropometric outcomes and body composition. Methods: This nonrandomized controlled trial involved 177 adults who were overweight and obese. Among them, 91 (51.4%) were allocated to the IFHP group and 86 (48.6%) were allocated to the HP group. The overall study duration was 6 months (October 2020 to March 2021). The intervention was divided into 2 phases: supervised (3 months) and unsupervised (3 months). The data were collected at baseline, after the supervised phase (month 3), and after the unsupervised phase (month 6). Anthropometric (weight, height, waist circumference, and hip circumference) and body composition (body fat percentage, body fat mass, skeletal muscle mass, and visceral fat area) data were measured at all 3 data collection points. Sociodemographic data were obtained using a questionnaire at baseline. Results: Most participants were female (147/177, 83.1%) and Malay (141/177, 79.7%). After 3 months, there were significant reductions in weight (difference −1.68; P<.001), BMI (difference −0.62; P<.001), body fat percentage (difference −0.921; P<.001), body fat mass (difference −1.28; P<.001), and visceral fat area (difference −4.227; P=.008) in the IFHP group, whereas no significant changes were observed in the HP group. Compared to baseline, participants in the IFHP group showed a significant decrease in weight (difference −1.428; P=.003), BMI (difference −0.522; P=.005), body fat percentage (difference −1.591; P<.001), body fat mass (difference −1.501; P<.001), visceral fat area (difference −7.130; P<.001), waist circumference (difference −2.304; P=.001), and hip circumference (difference −1.908; P=.002) at month 6. During the unsupervised phase, waist (IFHP difference −3.206; P<.001, HP difference −2.675; P=.004) and hip (IFHP difference −2.443; P<.001; HP difference −2.896; P<.001) circumferences were significantly reduced in both groups (P<.01), whereas skeletal muscle mass (difference 0.208; P=.04) and visceral fat area (difference −2.903; P=.003) were significantly improved in the IFHP group only. No significant difference in the between-group comparison was detected throughout the intervention (all P>.05). Conclusions: A combined IFHP intervention was effective in improving anthropometric outcomes and body composition in adults with overweight and obesity. International Registered Report Identifier (IRRID): RR2-10.2196/33801.

Obesity is a complex, diverse, and multifactorial disease that has become a significant public health concern. It is a modifiable risk factor for developing type 2 diabetes (T2D). The current classification systems rely on anthropometric measurements, such as body mass index (BMI), which cannot capture the physiopathological diversity of this disease. This study aimed to analyze the metabolic signatures of obesity and diabetes using ¹H-nuclear magnetic resonance (NMR). Obese patients with BMI ≥ 25 kg/m² (according to the Asian cut-off value) with different diabetes status scheduled to undergo metabolic-bariatric surgery at three hospitals were prospectively recruited for this study. Plasma samples of 111 obese patients and 26 healthy controls were analyzed by ¹H-NMR. When compared among groups with different diabetes statuses, four clusters with no differences in BMI but different metabolomics profiles were obtained. These clusters highlight intricate metabolic relationships associated with obesity and diabetes. This study demonstrated the benefits of using precision techniques like ¹H-NMR to better early detection, substantially decreasing the risk of developing T2D and its related complications. This study is the first to report on metabolic markers and altered metabolic profiles of T2D and prediabetes among obese Malaysians with a BMI cut-off value for the Asian population.

Metabolic surgery is an essential option in the treatment of obese patients with type 2 diabetes (T2D). Despite its known advantages, this surgery still needs to be introduced in Malaysia. In this prospective study, the pathophysiological mechanisms at the molecular level will be studied and the metabolomics pathways of diabetes remission will be explored. The present study aims to evaluate the changes in the anthropometric measurements, body composition, phase angle, diet intake, biochemistry parameters, adipokines, microRNA, and metabolomics, both pre- and post-surgery, among obese diabetic patients in Malaysia. This is a multicenter prospective cohort study that will involve obese patients (n = 102) with a body mass index (BMI) of ≥25 kg/m² (Asian BMI categories: WHO/IASO/IOTF, 2000) who will undergo metabolic surgery. They will be categorized into three groups: non-diabetes, prediabetes, and diabetes. Their body composition will be measured using a bioimpedance analyzer (BIA). The phase angle (PhA) data will be analyzed. Venous blood will be collected from each patient for glycated hemoglobin (HbA1c), lipids, liver, renal profile, hormones, adipokines, and molecular and metabolomics analyses. The serum microRNA will be measured. A gene expression study of the adipose tissue of different groups will be conducted to compare the groups. The relationship between the 1HNMR-metabolic fingerprint and the patients’ lifestyles and dietary practices will be determined. The factors responsible for the excellent remission of T2D will be explored in this study.

Background: Obesity presents a growing challenge to public health, and its intricate association with genetics continues to be a compelling field of study. In countries such as Malaysia, where diverse genetic backgrounds converge, exploring the molecular genetics of obesity is even more imperative. Objective: This scoping review aimed to explore the literature on molecular genetics of obesity in Malaysia. Specifically, we sought to characterize existing studies, identify the genetic determinants of obesity, and assess their association with obesity predisposition in the population. Methods: This scoping review followed the methodology of the Joanna Briggs Institute and used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist as its guiding framework. Searches were conducted using electronic databases such as PubMed, ScienceDirect, and Scopus, filtering for human studies published until March 2024. Eligible studies included peer-reviewed articles on the Malaysian population irrespective of age or sex. This review excluded review articles, book chapters, non–peer-reviewed conference proceedings, gray literature, and preclinical studies, and the reference lists of the retrieved studies were manually examined to ensure thorough inclusion. The articles were subjected to a 2-stage screening process (title/abstract and full text) conducted by 2 reviewers to assess eligibility. Eligible articles were then extracted following a data extraction framework and organized into a charting table. Only studies investigating the genetics of obesity in Malaysian populations were included. Results: As of March 2024, our extensive search strategy has yielded 572 records. After removing 153 duplicates, 419 records were screened by title and abstract, resulting in 47 selected for full-text review. Of these, 34 were chosen for data extraction and detailed analysis. These studies predominantly involved participants from major ethnic groups (Malay, Chinese, and Indian) recruited from local health centers and university communities. The articles primarily explored the relationship between specific gene variants and obesity or obesity-related health parameters. This ongoing research is expected to be completed with a comprehensive scoping review by April 2025. Conclusions: This review provides valuable insights into the genetic determinants of obesity in Malaysia, despite limitations such as no quality appraisal being conducted for the included studies and the search strategy being restricted to selected databases, potentially omitting relevant studies. However, this review ensured reliability and reproducibility by adhering to the Joanna Briggs Institute and PRISMA-ScR guidelines. Ultimately, this study advances the understanding of local research and sets the foundation for future molecular genetic studies to improve obesity risk prediction and management in Malaysia’s multiethnic population. International Registered Report Identifier (IRRID): DERR1-10.2196/60838

Background: Obesity is a pressing public health issue in Malaysia, involving not only excess weight but also complex metabolic and physiological changes. Addressing these complexities requires comprehensive strategies, including understanding the population-level differences in obesity susceptibility. This review aims to compile the genetic variants studied among Malaysians and emphasize their implications for obesity risk. Methods: Relevant articles published up to March 2024 were extracted from the Scopus, PubMed, and ScienceDirect databases. The review process was conducted in accordance with the PRISMA-ScR guidelines. From an initial pool of 579 articles, 35 of these were selected for the final review. Results: The identified gene variants, including LEPR (K656N), LEP (G2548A—Indian only), ADIPOQ (rs17366568), UCP2 (45bp-I/D), ADRB3 (rs4994), MC3R (rs3827103), PPARγ (pro12Ala—Malay only), IL1RA (intron 2 VNTR), NFKB1 (rs28362491), and FADS1 (rs174547—Indian only), showed significant associations with obesity as measured by the respective studies. Conclusions: Overall, more intensive genetic research is needed, starting with population-based profiling of genetic data on obesity, including among children. Sociocultural contexts and environmental factors influence variations in genetic elements, highlighting the need for targeted interventions to mitigate the impacts of obesity in the population.