International Journal of Nutrology

Clinical studies on the interrelationship between gut microbiota and oral health for systemic homeostasis: a systematic review

Maria Eduarda Fiurst Colturato Silva — 2026-05-28

Introduction: The oral microbiota has shown important actions in the physical and mental health of human beings. Oral diseases related to oral dysbiosis are studied, as well as systemic degenerative inflammatory diseases. Objective: It was to present and discuss the main considerations and results of clinical studies on the interrelationship between gut microbiota and oral health for systemic homeostasis. Methods: The PRISMA Guidelines were followed. The search was conducted from January to February 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X2=67.5% > 50%. A total of 112 articles were found and submitted for eligibility analysis, with 18 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that there are distinct causal relationships between the microbiota and acute and chronic gingivitis. Oral microbiota dysbiosis not only induces local inflammation and exacerbates inflammation associated with metabolic diseases, but can also trigger systemic inflammation, leading to metabolic and neuropsychiatric disorders. Clinical studies have shown the effectiveness of anti-inflammatory treatments of the gut and oral microbiota in reducing periodontal disease and cognitive decline. The integration of advanced microbiome analysis and neuroimaging techniques may help to elucidate the mechanisms linking gut health, systemic inflammation, and cognitive function.

A systematic review on marine-derived fucoidan as a nutritional therapeutic in periodontal disease

B Bhuvaneswari — 2026-05-09

Introduction: Fucoidan is a naturally occurring sulfated polysaccharide derived from brown seaweeds such as Fucus vesiculosus, Laminaria japonica, and Undaria pinnatifida. As a nutritive agent, fucoidan modulates tsystemic health through its bioactive components that influence metabolic, immune, and cellular functions. Its anti-inflammatory properties have a promising role in mitigating chronic low-grade inflammation, which underlies many systemic and oral diseases. Fucoidan is recently reported to possess significant antibacterial activity and the evidence regarding its use for periodontal diseases is scattered. Objective: Critical evaluation of the efficacy of fucoidan on periodontal pathogens using the existing evidence. Methods: Literature search was done on PubMed, Cochrane, Scopus, etc, according to PRISMA guidelines. Relevant articles were collected and evidence was tabulated. Results: The collected evidence indicated that fucoidan shows multifaceted therapeutic potential regarding periodontal diseases through multiple mechanisms like modulation of microbial virulence, reduction of inflammation, and boosting host–pathogen balance. Conclusion: Fucoidan exhibited promising antimicrobial, antibiofilm, and anti-inflammatory properties against periodontal pathogens.

Micronutrient supplementation and cognitive aging in Brazil: evidence, challenges, and policy directions

Carlos Alberto Nogueira-de-Almeida — 2026-05-06

Introduction: Brazil is undergoing rapid population aging, with individuals aged 60 and above comprising 15.6% of the population in 2023. This demographic shift poses significant publichealth challenges, particularly the rising prevalence of cognitive decline, compounded by widespread micronutrient deficiencies. Objective: To synthesize evidence on the relationship between micronutrient status, supplementation, and cognitive decline in older Brazilian population, and to identify barriers to implementing nutritional strategies into public health and clinical practice. Methods: A narrative review was conducted using data from national surveys, regional studies, clinical trials and reviews. Literature searches were performed in PubMed, MEDLINE, and Embase using Brazil-specific terms related to micronutrients, cognitive health, and aging. Results: Deficiencies in vitamins B-complex, D, E, and minerals such as magnesium, zinc, and selenium are prevalent among older Brazilians, with some inadequacy rates exceeding 60–80%. These deficiencies are mechanistically linked to cognitive decline via oxidative stress, neuroinflammation, and elevated homocysteine levels. Evidence from clinical trials, notably COSMOS, and the 2025 Latin American Consensus Statement supports multivitamin and mineral supplementation (MVMs) as an effective strategy to improve memory and cognition. However, key barriers include lack of age-specific dietary reference values, national supplementation guidelines, and systematic integration of nutrition into geriatric care. Conclusions: Addressing micronutrient deficiencies through targeted supplementation and nutrition policy reforms represents a practical, evidence-based approach to promote cognitive resilience and healthy aging in Brazil.

Functional Molecular Biomarkers in the Identification of Probiotic Strains

Trinh Thi Trang Nhung — 2026-05-28

Identification of novel probiotic strain candidates based on sequence information of currently available probiotic strains and their key biomarkers requires comprehensive functional evaluation to establish their contributions to human health. Potential functional molecular biomarkers play a vital role in facilitating the discovery of new probiotic strains through sequence similarity analyses, remarkably within metagenomic datasets and unexplored microbial “dark matter”. It is critical to evaluate probiotic properties beyond taxonomical identifications by including the most important functional, metabolic, antibacterial and immunological features, as well as by using them as a marker for selection of probiotics. This review highlighted some key molecular biomarkers of probiotics, but also considered challenges like lack of standardization and in vitro and in vivo data, and discussed potential for further use. Probiotic screening by molecular markers in combination with bioinformatic search technology, which might represent future development direction toward the generation of next-generation probiotic strains.

Potential of nutraceutical fucoidan against periodontal pathogens: a novel molecular docking study

B Bhuvaneswari — 2026-05-10

Introduction: Fucoidan from seaweed has gained significant attention due to its diverse therapeutic properties. Its antibacterial potential in periodontitis needs exploration. Objective: This paper aims to explore the suitability of fucoidan to treat periodontitis by molecular docking methods. Methods: Molecular docking of fucoidan was done with targets from Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans. Binding energy, inhibition constant, number of hydrogen bonds, aminoacid residues involved in H-Bond were identified. Control docking was done with chlorhexidine and compared. Results: Docking of Porphyromonas gingivalis enzyme, gingipain K (Kgp) with fucoidan had an inhibition constant of -6.83, ODP from T. denticola with fucoidan had binding energy of -4.52, anti-CRISPR protein AcrIF9 with fucoidan had a binding energy of 4.81 and Tannerella forsythia potempin E with Fucoidan had a binding energy of -3.09 all expresssed as kcal/mol. Respective inhibition constants were 67.3 µM, 485.11µM, 295.72 µM and 5.47 mM. All binding energies ranged from -3 to -6 range suitable for inhibition of their targets. Conclusion: Inhibition constant for targets from T. denticola and A. actinomycetemcomitans had highest values indicating that fucoidan inhibits T. denticola and A. actinomycetemcomitans more significantly than P. gingivalis and T. forsythia.

A prospective clinical study on metabolomic profiling for early detection of response to nutritional interventions in pediatric obesity

Maktuba Mirrakhimova — 2026-04-03

Introduction: Obesity in children is a significant health issue, exposing children to the risk of metabolic and insulin resistance and long-term cardiometabolic complications. It is essential to detect and identify the responses to nutritional interventions at the earliest possible time to provide effective and personalized treatments. The overall evaluation of small-molecule metabolites in biological samples, termed metabolomics profiling, could be applicable in the characterization of real-time biological biochemical responses related to pediatric obesity and nutritional intervention. Objective: This research aimed to determine how metabolomics could serve to detect early biological metabolic changes to scientific dietary interventions in children by exploiting lipid, carbohydrate, and amino acid metabolism biomarkers. Methods: As its look at the use of metabolomic markers in methods that define clinical response measures (e.g., clinical, anthropometric), it also shows that the distinctive molecular responses that are discovered by the metabolomics can forecast individual reactions to dietary interventions, which allow the reaction to occur within effective and precise time frames. Results: It was observed that it is possible to engage in metabolomic-guided nutritional planning at the pediatric level, a transition between evidence-based nutrition and personalized nutrition. It also evaluated the possibility of applying metabolomics in clinical practice to assist the establishment of treatment efficacy, metabolic health optimization, and prevention of the development of obesity-related problems. Conclusion: In general, metabolomic profiling is a new method of pediatric nutrition with practical implications to stimulate early diagnosis, personalized therapy, and better treatment outcomes in childhood obesity.

A randomized controlled trial on the efficacy of intermittent fasting and mediterranean diet on visceral adiposity and gut microbiota in overweight adults

Umida Tashkenbaeva — 2026-04-02

Introduction: Obesity, particularly visceral adiposity, is a considerable risk factor for metabolic diseases, including insulin resistance, dyslipidemia, and chronic inflammation. A growing body of evidence suggests that the gut microbiota is influenced by food and plays a role in energy homeostasis and systemic metabolism, with dysbiosis typically observed in individuals with excess weight. Nutritional strategies of intermittent fasting (IF) and the Mediterranean diet (MD) have each been independently shown to help reduce adiposity and alter gut microbiota composition. However, there remains a dearth of research on the effects of IF and the MD when combined. Objective: The purpose of this study was to assess the effectiveness of a combination of IF and MD intervention for visceral fat loss, and for the dietary intervention to modify gut microbiota. Methods: A total of 60 participants were recruited into a 12-week human intervention study, along with longitudinal assessment of dietary intake and compliance. Visceral adiposity was measured using imaging-based techniques, and gut microbiota profiles were analysed using 16S rRNA sequencing. Results: As a result of the intervention, there were considerable reductions in visceral fat, increased microbial diversity, and enrichment of some beneficial bacterial taxa that are linked to better metabolic health. Conclusion: The data demonstrate that the time-restricted feeding in combination with the Mediterranean diet is an experimental dietary approach resulting in a decrease of visceral fat mass and restoration of the microbiota toward a healthy one. It also provides a required evidence-based structure for therapeutic nutrition in the treatment of metabolic complications induced by obesity.

Major relevances of nutrological therapy and gut microbiota in neurodegenerative diseases: a systematic review

Alexandre Chaves — 2026-03-31

Introduction: Critical patients, both due to brain injury and neurodegenerative diseases, have an increased risk of developing nutritional malnutrition due to complex problems and deleterious effects of diseases on protein and energy metabolism, resulting in metabolic dysregulation, hypercatabolic state and depletion of energy reserves energy. Objective: It was to carry out a systematic review to externalize and discuss the main findings on the effects of enteral nutritional therapy, as well as on the action of the gut microbiota in patients with brain injuries or neurodegenerative diseases. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from March to May 2025 in the Web of Science, Scopus, Embase, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 108 articles were found, and 20 articles were evaluated in full, and 08 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 24 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X²=88.9%>50%. Enteral nutrition supplemented with probiotics effectively decreases the risk of mortality, gastrointestinal complications, and infection, and shortens the length of stay in the intensive care unit, therefore, it should be widely adopted for the management of these patients. Nasal inspiratory pressure during a sniff at baseline is an early indicator of disease progression and therefore the need for enteral nutrition in amyotrophic lateral sclerosis. Furthermore, problems with tolerance, diarrhea, and abdominal distension decreased between the 3 and 6-month visits in patients who received home enteral nutrition.

Metabolic actions of the gut microbiota in obesity: a systematic review

Cristina Moraes Osório Leite — 2026-03-31

Introduction: Obesity is a multifactorial disease that is difficult to manage and causes several comorbidities, such as physiological and mental disorders, diabetes, stroke, and depression. Worldwide, more than 2.3 billion people are overweight or obese. The gut microbiota interacts with several organs, including the brain, and can regulate metabolism, adiposity, homeostasis, energy balance, and central signaling of appetite and food reward. Objective: To explore and describe the metabolic actions of the gut microbiota and probiotics in the management of patients with obesity. Methods: The systematic review guidelines of the PRISMA Platform were followed. The search was conducted from August to November 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Study quality was based on the GRADE instrument, and risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found. A total of 32 articles were fully evaluated, and 21 were included and developed in this systematic review. Using the Cochrane risk of bias tool, the overall assessment resulted in 23 studies with a high risk of bias and 25 studies that did not meet the GRADE and AMSTAR-2 criteria. Most studies presented homogeneous results, with X²=74.8%>50%. It was concluded that bidirectional signaling occurs within the gut-brain axis in the pathophysiology of obesity, mediated by metabolic, endocrine, neural, and immune system mechanisms. Fecal microbiota transplantation and supplementation with probiotics and prebiotics may be potential treatments for obesity. Diet is a determining factor for healthy colonization of the gut microbiota. Studies in obese humans also found a lower proportion of Bacteroidetes compared to those in normal-weight individuals. After weight loss, the proportion of Firmicutes is reduced and becomes more similar to that of lean individuals. Inulin supplementation can significantly promote intestinal bacterial diversity and improve gut microbiota dysbiosis in obese patients. Low-carb diets and time-restricted feeding are effective in weight management and produce profound changes in the gut microbiome and metabolome, in addition to caloric restriction.

Randomized controlled clinical study on proteomic analysis of skeletal muscle adaptations to high-protein nutrition in post-bariatric surgery patients with obesity

Abdigaffor Gadaev — 2026-03-30

Introduction: Bariatric surgery can cause complicated metabolic and physiological changes in some patients, leading to a significant amount of loss of lean mass. The preservation of skeletal muscle mass is important for metabolic health, functional performance, and long-term weight maintenance. Proteomics provides detailed information on muscle tissue molecular responses, but can be best utilized when coupled with intentional nutritional interventions such as high-protein diets. Objective: The intent of the present study was to examine skeletal muscle proteomic responses to bariatric surgery in obese males and females using a high-protein nutrition intervention. Methods: Patients with obesity after bariatric surgery followed a standardized high-protein nutritional intervention (≥ 1.5g protein per kg per day). Muscle biopsies were taken at baseline (pre-treatment) and 12 weeks post-surgery. Muscle biopsies were taken, proteins extracted, digested, and analyzed by LC-MS-MS (label-free quantification). It used bioinformatic applications to perform differential quantitative analysis of protein expression, pathway enrichment, and functional annotation of differentially expressed proteins. Results and Conclusion: High protein nutrition resulted in upregulation of proteins associated with mitochondrial function, oxidative phosphorylation, and translation, while demonstrating downregulation of proteins representing catabolic and inflammatory pathways. Also, many of the proteomic adaptations identified were supportive of improved muscle remodelling (i.e., improved structural contractile proteins and regulators of protein synthesis). High protein nutritional support after bariatric intervention promotes advantageous skeletal muscle proteomic remodelling, which promotes retention of lean mass and recovery of metabolic status. The data also demonstrated that high-protein nutrition, after bariatric surgery, was associated with positive molecular adaptations.

Major clinical approaches to palliative care and nutrology in dentistry: a systematic review

Danielle Cristina Fluxo — 2026-03-26

Introduction: Poor oral health is a common and neglected concern in palliative care (PC), negatively impacting patients' quality of life. There is a significant gap in the knowledge and practices of primary care physicians regarding oral health due to various barriers, with few documented support strategies in this area, as well as an information gap on the nutritional aspects that complement palliative practices in oral care. Objective: It was to carry out a concise systematic review in order to present the main clinical approaches to palliative care in dentistry, as well as showing the associated nutritional importance. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneity in their results, with X²=77.8%>50%. A total of 136 articles were found and submitted for eligibility analysis, with 12 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 33 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that early palliative care intervention can be effective in reducing psychological suffering and improving the quality of life of critically ill dental patients. Dentists can play a key role in linking tertiary and community care to promote patient well-being. Weight loss and impaired oral intake were associated with psychosocial distress affecting patients and caregivers. Future research is needed to explore the experiences of patients, caregivers, and healthcare professionals regarding nutrition and to evaluate the effectiveness of alternative nutritional strategies.

Barriers encountered by nurses while caring of mechanically ventilated adult patients: a cross-sectional study

Younus Khudhur Baeez — 2026-03-25

Introduction: Mechanical ventilation (MV) is a critical and frequently used intervention in intensive care units (ICUs), with up to 70% of ICU patients requiring it. The rates of invasive mechanical ventilation range from 29.1% to nearly 90% in some studies, particularly during the COVID-19 pandemic, with associated mortality rates exceeding 35% to 50%. Providing care for mechanically ventilated adult patients is a complex and high-risk nursing responsibility. Objective: This study aimed to identify the primary barriers encountered by nurses when caring for mechanically ventilated adult patients and to examine how these barriers relate to their demographic and professional characteristics. Methods: A descriptive cross-sectional study was conducted in the Respiratory Care Units (RCUs) of Kirkuk and Azadi Teaching Hospitals to identify barriers encountered by ICU nurses caring for mechanically ventilated adult patients. The study included 93 nurses with at least six months of RCU experience, recruited using a convenience sampling technique. Sample size adequacy was justified using a single-proportion formula at 95% confidence and 5% margin of error. Data were collected via a structured, self-administered questionnaire covering demographics, staffing/ workload, knowledge/training, equipment/ resources, and communication/emotional barriers, measured on a 5-point Likert scale. The questionnaire was validated by experts and piloted (Cronbach’s alpha = 0.87). Ethical approval was obtained, and participants provided informed consent with confidentiality ensured. Data were analyzed using SPSS 26.0, employing descriptive statistics, t-tests, and ANOVA, with p < 0.05 considered statistically significant. Results: The majority of participants were female (62.4%) and aged 30–39 years (43.0%). The most prominent barriers identified were staffing shortages (mean = 4.2), lack of formal ventilator training (mean = 4.1), stress and burnout (mean = 4.1), and equipment shortages (mean = 3.9). Overall mean scores for staffing/workload, knowledge/training, equipment/resources, and communication/ emotional barriers were 3.77, 3.86, 3.71, and 3.82, respectively. No statistically significant relationships were observed between demographic variables and perceived barriers (p > 0.05). Conclusion: ICU nurses face multiple, interconnected barriers when caring for mechanically ventilated adult patients, including inadequate staffing, insufficient knowledge, limited availability of equipment, and work-related psychological stress. Organizational interventions such as improving staffing levels, providing formal training, ensuring resource availability, and supporting nurses’ well-being are essential to enhance the quality of patient care.

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Prevalence of complications for type 2 diabetes mellitus among patients visiting the diabetes clinic at azadi teaching hospital: a cross-sectional study

Rebaz I. Ali — 2026-03-25

Diabetes mellitus, commonly referred to as DM, is a chronic illness that can no longer develop or be transmitted as an epidemic. The research study aims to ascertain the frequency of type 2 diabetes mellitus complications among patients attending the diabetes clinic of Azadi Teaching Hospital. Azadi Teaching Hospital Kirkuk City was conducted the cross-sectional descriptive research. Purposively sampling (non- probability) of 118 samples was done. A strong relationship was found in the current study between the length of diabetes and number of problems. Having a disease for a long period of time is linked with more hypertension, cardiovascular disease, and ischemic heart disease rates, with DM consequences being a particularly important one. More research involving more people will get more accurate results.

Graphical Abstract

Major approaches to parenteral nutrology therapy in the intensive care unit: a systematic review

Pablo Wanglon Richter — 2026-03-23

Introduction: In the context of parenteral nutrition, critically ill patients are associated with a state of catabolic stress and a systemic inflammatory response. Patients admitted to intensive care units (ICU) have a prevalence of malnutrition greater than 35%. Objective: It was to carry out a systematic review to list the main approaches to macro and micronutrients in parenteral therapy in intensive care units. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from June to July 2025 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 115 articles were found. A total of 45 articles were evaluated and 25 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 32 studies that did not meet GRADE. It was concluded that several clinical studies critically analyzed the evolution and changes that marked the development of parenteral nutrition in intensive care units. Standard solutions of crystalline amino acids, although devoid of side effects, remain incomplete about their composition (e.g., glutamine). Lipid emulsions have evolved a lot and are now included in bi- and tri-compartmented feeding bags, allowing true total parenteral nutrition, as long as daily micronutrients are prescribed. The question of exact individual energy, macro and micronutrient needs has not yet been resolved. Many complications attributed to total parenteral nutrition are the consequence of under- or overfeeding. The historical concept of hyperalimentation is the main cause, along with the use of fixed weight-based predictive equations (incorrect in 70% of critically ill patients).

Nutritional aspects and waiting time for surgery in cobb angle worsening in young patients with scoliosis: a systematic review

João Victor Gomes Mota — 2026-03-18

Introduction: The prevalence of scoliosis varies geographically and ethnically, and it is most frequently diagnosed in adolescence, typically between the ages of 10 and 18. The impact of the use of calcium and vitamin D in patients with idiopathic scoliosis appears to be promising, reducing the incidence and prevalence of cases. Studies on the natural progression of scoliosis indicate that untreated patients may experience significant worsening of the condition. Objective: It was to analyze the nutritional aspects and waiting time in Cobb Angle worsening in young patients with scoliosis. Methods: The PRISMA systematic review guidelines were followed. Randomized clinical trials, prospective studies, and retrospective studies were included in the analysis. The literature search was conducted from January to March 2026 and was based on Web of Science, Scopus, Embase, PubMed, Lilacs, Ebsco, Scielo, and Google Scholar, covering scientific articles from various periods to the present. Results and Conclusion: A total of 119 articles were submitted to eligibility analysis, with 18 final studies selected with 3,778 participants selected for this systematic review (scoliosis and nutritional deficiency, n=07, and scoliosis, waiting times, and the progression of Cobb angle, n=11). According to the GRADE instrument, most studies for scoliosis and nutritional deficiency showed homogeneity in their results, with X²=77.1%>50%, and X²=68.4>50% for scoliosis, waiting times, and the progression of Cobb angle. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 22 studies that did not meet the GRADE and AMSTAR-2 criteria. Figures 2 and 3 present the results of the risk of bias of the studies with symmetrical behavior, suggesting a low risk of bias. It was concluded that patients undergoing scoliosis surgery experience prolonged waiting times, which may contribute to the progression of the deformity, including an increase in the Cobb angle. Strategies to reduce this waiting time may lead to improved clinical outcomes and fewer complications. Studies show that individuals on the waiting list for adolescent idiopathic scoliosis surgery experience worsening of the spinal deformity, increased treatment costs, and may negatively impact patients' quality of life. Increased waiting times for surgery negatively impact the quality of life of scoliosis patients. The positive correlation between vitamin D and calcium, together with the negative correlation with the Cobb angle, is further proof that patients with idiopathic scoliosis should be regularly investigated for these pathologies.

Correlation between vitamin D3 level and frequency of vestibular migraine attacks: a prospective cross-sectional study

Dhiaa Mohammed Yaseen — 2026-04-20

Introduction: Vestibular migraine (VM) is considered to be the second most common cause of vertigo and most common cause of spontaneous episodic vertigo. Keeping in mind the global health burden of low vitamin D level and its effect on pain and balance. Objective: This study aiming at determining the effect of vitamin D on VM. Methods: A prospective, cross-sectional study conducted in Basrah hearing and balance center with 37 patients diagnosed with VM. Female to male ratio were 4.3:1. Mean age of 37.622 +/- 14.36 years. Results: It was found a significant relation between the frequency of VM attacks and the level of vitamin D as patients with low or sub optimal level have more frequent attacks than those with normal vitamin D level (p-value = 0.0012). Conclusion: These findings suggest that assessment of vitamin D level may be important in patients suffering from vestibular migraine. Vitamin D supplementation may serve as a simple and cost-effective adjunct in the management of these patients.

Oral administration of Bacillus acidophilus lactic acid bacteria and copper oxide nanoparticles to mice with induced diarrhea- causing serotype of E.coli in Samarra-Saladin -Iraq

Rawya Fadhil Mohammed — 2026-03-09

L. acidophilus bacteria are found in foods and are used in pharmaceuticals to supplement the natural gut flora associated with human digestive health. They also possess excellent therapeutic properties, attributed to their biological activity. These bacteria produce serotypes that inhibit the growth of pathogenic bacteria and adhere to epithelial cells, preventing intestinal pathogens from attaching to them through a process called competitive exclusion. In this study, L. acidophilus strains were isolated and identified from local yogurt, and the efficacy of the isolated strains' metabolites against the diarrheal serotype of Escherichia coli was investigated. Additionally, some L. acidophilus strains were examined for their probiotic properties. The research was conducted in the laboratories of the Department of Biological Sciences and the Central Laboratories at Samarra University from September 1, 2025, to November 1, 2025. In this study, one of the L. acidophilus strains was obtained from lactic acid bacteria. The study results showed that the metabolites of the studied strains exhibited good inhibitory activity against the diarrheal serotype of E. coli. Regarding the probiotic assay, the results confirmed the ability of all strains to adhere to epithelial cells. The group treated with a combination of pathogenic bacteria and copper oxide nanoparticles (G2) showed a significantly higher level of IL-8 (9.78±3.45 pg/mL), which is considerably higher than G1, suggesting that the nanoparticles may have stimulated a level of inflammatory stress or an immune response. The control group (G3: pathogenic bacteria only) recorded the highest mean IL-8 (12.21 ± 3.09 pg/mL). In comparison, the presence of gut microbiota (G1) appeared to have a modulating effect on the IL-8 response to pathogenic infections, resulting in a marked decrease in its mean concentration (4.54±0.99 pg/mL) compared to the control group (G3) (p<0.05). Interestingly, the group treated with pathogenic bacteria and copper oxide nanoparticles (G2) exhibited an exceptionally high mean IL-6 (63.5 ± 22.28 pg/mL), significantly higher than the mean of both the control group (G3: 18.13 ± 9.49 pg/mL) and the gut microbiota group (G1: 9.52 ± 4.11 pg/mL). Copper oxide nanoparticles not only directly and effectively affect bacteria but also influence the host's immune system. The large increase in IL-6 may be due to the recognition of nanoparticles as foreign bodies, causing phagocytic cells to activate and release pro-inflammatory cytokines in an attempt to remove the particles.

Quality of life and psychological aspects for disabled people: an observational cross-sectional study

Zainab Fadhil Kzar — 2026-03-11

Introduction: Disability is used to describe a broad range of disabilities, activity constraints, or participation limitations, disability arises from the combine of health conditions with contextual factors–environmental and personal factors. Objective: This study aimed to assess Quality of life and psychological aspects for disabled people, and Find Out the Relationship between Quality of Life and Psychological Aspects with Demographical Characteristic and Find-Out the Correlation between Psychological Aspects with Quality of Life for disabled People. Methods: A descriptive correlational study was conducted in two Rehabilitation Centers for Disabled and Physiotherapy at Hilla City/Babylon Province (Babylon Specialized center for medical rehabilitation, Babylon Center for Artificial Limbs and Medical Supports) during the period from September, 12, 2024 to April, 20, 2025. The study sample consisted of 155 physical disabled people who were selected according to the non-probability (convenience) sampling method. Data from interviews method were examined through both descriptive and inferential methods. statistics. Results: The research's findings are significant, revealing that 68.7% of participants' quality of life was moderate. with mean with mean 46.25 (Min- Max 23-69), and 56% had moderate psychological aspects (depression, anxiety and stress) with mean=57.56 (Min- Max 21 - 84). These findings underscore the importance of this research. Also, it was found highly significant statistical negative direction correlations between Psychological Aspects with Quality of Life for physical disabled People at p<0.05. Quality of life were also significantly associated with demographic variables such as age, income and type of disability at p˂0.05. Psychological aspects (depression, anxiety and stress) were linked to age, Occupation status and income at p˂0.05. Conclusion: The quality of life for individuals with disabilities was found to be moderate. The Depression Anxiety Stress (Psychological Aspects) with disabilities was found to be moderate. There were statistically significant negative direction relationships between Psychological Aspects with Quality of Life for physical disabled People. Accordingly, the study recommended to improve accessibility and support for individuals with physical disabilities by establish dedicated psychological therapy clinics within healthcare centers, specifically designed to provide mental health services to individuals with disabilities. Efforts should also be made to raise public awareness and foster greater acceptance and social inclusion of individuals with impairments.

Creatine and body composition in individuals with obesity: a brief review

Ana Clara Verônica Pereira — 2026-03-06

Obesity represents a global public health challenge, characterized by excessive body fat accumulation, associated with comorbidities such as type 2 diabetes and sarcopenic obesity. Effective intervention requires body composition modulation, prioritizing fat mass loss and the preservation of Fat-Free Mass (FFM), which is essential for metabolism and insulin sensitivity. In this context, the present study, a Systematic Literature Review, aimed to analyze the impact of creatine (Cr) supplementation, combined with resistance training, on body composition modulation in individuals with obesity. The search was conducted in the PubMed, SciELO, and Google Scholar databases, filtering for high-quality studies (RCTs and Meta-Analyses) from the last ten years. Creatine was identified as a "gold standard" supplement with dual mechanisms of action: (1) energetic, optimizing the ATP-PCr system to increase strength and training intensity, and (2) anabolic, promoting cell volumization and positively influencing protein synthesis pathways (mTOR) to combat catabolism. Literature findings in clinical populations, such as sarcopenic elderly, suggest that creatine is promising in preserving FFM and increasing strength without inducing fat mass gain. It is concluded that creatine supplementation is a safe and effective adjunct strategy to enhance resistance training in individuals with obesity, optimizing body composition and improving metabolic and functional prognosis.

Evaluation of post-stroke complications and prevention measures among patients at kirkuk city hospitals: an observational cross-sectional study

Rebaz I. Ali — 2026-03-05

Stroke is one of the leading causes of mortality and long-term disability worldwide, accounting for millions of new cases annually and representing a major global health burden. Post-stroke complications may significantly impede recovery and increase the risk of death. This study aimed to evaluate post-stroke complications and preventive measures among patients in hospitals in Kirkuk City. A descriptive cross-sectional study was conducted at Azadi Teaching Hospital in Kirkuk City. A total of 155 patients were randomly selected. Data were analyzed to assess differences in post-stroke complication prevention scores according to gender, residence, and educational level. The findings showed that prevention scores varied significantly by gender and area of residence. Male patients demonstrated higher average ranks compared to females. Similarly, urban participants achieved better preventive evaluation scores than rural patients. Educational level was also significantly associated with prevention measures. The study concluded that demographic factors influence post-stroke prevention outcomes. These findings highlight the importance of targeted educational and preventive strategies. Further large-scale cohort studies are recommended.

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Challenges to diabetes self-management among patients with type2 diabetes: a cross-sectional study

Younus Khudhur Baeez — 2026-03-05

Introduction: Type 2 Diabetes Mellitus (T2DM) is a major global public health problem, affecting more than 537 million adults worldwide, with projections reaching 783 million by 2045. Effective self-management is essential to prevent complications; however, patients often face multiple barriers. Objective: To assess the challenges of diabetes self-management among patients with Type 2 Diabetes Mellitus in Kirkuk City, Iraq. Methods: A cross-sectional study was conducted in the outpatient clinics of Kirkuk City, Iraq, to assess challenges in diabetes self-management among adult patients with Type 2 Diabetes Mellitus (T2DM). A total of 336 patients were recruited using a convenience sampling technique, with sample size justified via standard formulas for population proportions at 95% confidence and 5% margin of error. Data were collected through a structured, validated, and reliable questionnaire covering demographics, clinical characteristics, and five domains of self-management (knowledge, medication adherence, diet, physical activity, and psychosocial challenges). Face-to-face interviews were conducted individually, with written informed consent obtained from all participants. Ethical approval was secured from the College of Nursing, Kirkuk University, and confidentiality and anonymity were ensured. Data were analyzed using SPSS 26.0, employing descriptive statistics, independent t-tests, and one-way ANOVA, with p < 0.05 considered statistically significant. Results: The mean age of participants was 51.9 ± 10.1 years, with females slightly predominating (52.4%). Overall knowledge of diabetes self-management was moderate (mean score = 3.46). Patients experienced moderate challenges related to medication adherence (mean = 2.94), dietary management (mean = 3.28), physical activity (mean = 3.15), and psychological and social factors (mean = 3.33). The most prominent barriers included dietary restrictions, lack of motivation for physical activity, medication costs, and psychological stress. Conclusion: Most participants were middle-aged to older adults, predominantly female and married, with moderate knowledge and self-management abilities. Challenges in medication adherence, lifestyle behaviors, and psychosocial aspects were evident and significantly associated with demographic factors, highlighting the need for tailored interventions.

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Randomized controlled trial of omega-3 fatty acid supplementation and probiotic therapy on insulin sensitivity in obesity-related metabolic syndrome

Nargiza Nurillaeva — 2026-03-05

The metabolic syndrome of obesity has well-defined habitat-related mechanisms associated with obesity, insulin resistance, dyslipidemia, and inflammation, which collectively serve as habit-challenging and problematic issues related to obesity and obesity-related metabolic syndrome. Clearly, nutritional approaches signify the most important types of non-pharmacological treatment that can be explored and are extremely relevant. Two approaches of specific interest, perhaps because they have overlapping yet complementary mechanisms, are omega-3 fatty acids and probiotics. The current nutrologic study assessed the effect of Omega-3 fatty acid vs probiotic treatment on insulin sensitivity in an obese population with metabolic syndrome. Omega-3 fatty acids have many systemic effects (i.e., EPA and DHA), specifically with respect to the metabolic processing of the lipid component of an underlying disordered metabolic state, reducing pro-inflammatory cytokines, and improving insulin signalling at the cellular level. Alternatively, probiotics may come from a different basis and also work via a gut–metabolic axis, through the modulation of gut microbiota, re-establishing the functional gut barrier, and increasing short-chain fatty acids, which may affect glucose metabolism. The clinical examination of the results showed that both dietary strategies influenced different indices of insulin sensitivity, whereas Omega-3 fatty acids influenced lipids, and probiotics tended to be more representative of the modulation of gut-related pathways by the varied dietary strategies. So the effects are synthetically presented here, i.e., in summary, mainly because of the comparisons made, but the differences were examined in several contexts in order to demonstrate the complementary dietary gradients in the two interventions. In conclusion, flexibility for both therapies may be realized with a consideration for their combined use under personalized nutrology protocols to generate better metabolic outcomes. This nutrological viewpoint respects the same perceptions of dietary strategies being very nuanced with modifications to address the burden of metabolic syndrome and supports longer duration studies or trials with prolonged exposure to treatment, considering therapies in different populations, as well as exploring possibilities of dose response or synergistic treatment in metering changes.

Epigenetic modifications in adipose tissue following calorie-restricted diets in adults with obesity: a randomized controlled experimental trial

Khalmurad Akhmedov — 2026-03-04

Obesity is a complex disease that is characterized by an unhealthy proportion of body fat and metabolic diseases. It has also been recently shown that epigenetics (e.g., DNA methylation, histone changes, and non-coding RNAs) must be considered in treating obese clients because epigenetics can manipulate adipocytes and energy metabolism. Calorie-restriction (CR) methods have already been known to yield iweight-loss effects. Recent studies have established that epigenetic modification in adipose tissue are central to CR intervention can initiate a more preferable remodelling of epigenetics in adipose tissue, in a way that will enable a change in metabolic state. The article recounts the effects of CR intervention on the adipose tissue epigenetics in obese adults, and as case illustrations of a clinical nutrology perspective. The recent studies gave significant results, such as coordinated alterations in obesity-related locus CR-induced methylation, histone acetylation, and changes in microRNA expression that result in better insulin sensitivity, reduced inflammation, and lipid metabolism. It means that epigenetic markers can be considered as markers of dietary responsiveness that would allow individualized nutrition in the case of differences in responding to CR interventions, including potential confounders. These are just initiations to the incorporation of epigenetics into the nutrition sciences, and It consider CR not only as a calorie-limiting intervention but also as an intervention that can alter gene regulation. This will enable us to advance the nutrition practice in the future with precision nutrology, developing sustainable obesity management, and providing metabolic health in the long term.

Perceptions of individuals on a vegan diet: a questionnaire-based cross-sectional study

Harijith Raghav Senthilkumar — 2026-04-13

Introduction: Vegan diets are gaining attention for their potential ethical, environmental, and health benefits. However, public opinion on veganism is highly diverse. Objective: This study used a questionnaire to explore perceptions, beliefs concerning animal sentience and welfare, and the willingness to adopt a vegan diet among individuals from different age groups, genders, and dietary backgrounds. Methods: An online cross-sectional survey was conducted with 357 participants after excluding responses where consent was not provided. The questionnaire gathered data on demographics, dietary habits, ethical beliefs about animals, and openness to a vegan lifestyle. Data were analyzed using descriptive statistics and chi-square tests in using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY, USA). A p-value < 0.05 was considered statistically significant. All statistical tests were two-tailed. Results: The sample (n=59) was 50.8% female and 45.8% male, with the largest age cohort being 18-26 years (42.4%). Only two participants were existing vegans. However, a considerable 42.4% stated they 'may consider' trying a vegan diet, and another 20.3% were explicitly willing. We identified statistically significant associations between current diet type and willingness (p<0.001), as well as between age group and willingness (p=0.0023). A large number of respondents recognized animal sentience and endorsed stronger animal welfare legislation. Conclusion: An individual's current diet and their age appear to be significant factors in their openness to veganism. While awareness of animal sentience is common, practical and ethical obstacles remain. Initiatives in education and policy could be instrumental in improving public acceptance of plant-based diets.

The importance of breastfeeding in bone development and oral health in children: a systematic review

Lauani Beatriz de Souza — 2026-02-28

Introduction: The World Health Organization (WHO) recommends exclusive breastfeeding until 6 months or continued breastfeeding until 2 years or more. In addition to providing nutritional and immunological benefits, breastfeeding can aid in the development of breathing, swallowing, speech, chewing, and even help reduce early childhood caries. Objective: It was to present the main considerations of the importance of breastfeeding for children's oral health through a concise systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from October to December 2025 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X² = 80.4% > 50%. A total of 87 articles were found and submitted for eligibility analysis, with 12 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that breastfeeding contributes to bone and muscle growth, leading to facial harmony, correct positioning of teeth and tongue, and aiding breathing and speech. The sucking action the baby needs to perform during breastfeeding stimulates the development of the jawbones. The child also develops nasal breathing and tongue positioning. However, current studies show that prolonged breastfeeding, beyond 12 months, may increase the incidence of tooth decay.

The role of some antioxidants in reducing oxidative stress in female hypothyroidism patients with type II diabetes: a randomized controlled clinical trial

Abdulrahman R. Mahmood — 2026-04-21

Background: Hypothyroidism and type 2 diabetes are common conditions worldwide, with hypothyroidism affecting 4–10% of the population and type 2 diabetes affecting approximately 10% of adults globally. The increasing co-occurrence of these two conditions may contribute to increased oxidative stress and associated complications. Low levels of antioxidants are linked to hypothyroidism with type II diabetes because of the growth and production of free radicals, which makes patients more susceptible to oxidative stress. Objective: It was to assess how low antioxidants may exacerbate the pathogenic state of type 2 diabetic hypothyroid patients. Methods: 140 hypothyroid individuals with type 2 diabetes, ages 25 to 60, were assigned to take supplements every day with either intervention group before Eltroxin,( n = 50) (intervention group after Eltroxin, n=50) ( placebo group, n=40) for twelve weeks, take two capsules of vitamin E (268 mg, 400 IU), and one pill of selenium (200 mcg). Serum malondialdehyde (MDA), total antioxidant status (TAS), glycated haemoglobin (HbA1c), and fasting serum glucose (FSG) were measured using laboratory kits. Meanwhile, thyroid hormones were measured using (ELISA) technique. Estimates of selenium) Se) and vitamin E were obtained using atomic absorption spectroscopy and high-performance liquid chromatography (HPLC), respectively. Results: The levels of MDA, TAS, thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), FSG, HbA1c, and oxidative stress index (OSI) did not differ significantly (p>0.05) between the patient group and placebo participants, according to this study. Vit E and Se levels in the placebo group are not markedly distinct from those in the sick team (p>0.05). Increased degrees of MDA, TAS, OSI, and TSH noticeably (p<0.05) were observed in the placebo group. After taking the medicine, the T4 level was lower noticeably (p<0.05 than that of the patients after taking the medicine. Conclusion: Individuals with hypothyroidism with type 2 diabetes may prevent hypothyroidism by consuming dietary supplements containing antioxidants, which reduce oxidative stress and promote overall health.

Graphical Abstract

Relationship between dietary factors and helicobacter pylori infection: a cross-sectional study

Abdalaziz Darwish — 2026-02-23

Introduction: Helicobacter pylori (H. pylori) is a common bacterial infection linked to gastritis, peptic ulcers, and gastric cancer. Dietary habits may influence the acquisition, progression, and symptoms of this infection. In Palestine, the prevalence of H.pylori and dietary patterns raise public health concerns. This study explores the association between dietary factors and H. pylori infection severity in Palestine. Objectives: To assess the relationship between specific dietary practices and the prevalence and severity of H. pylori infection in Palestinian patients, aiming to inform preventive strategies and dietary management protocols. Methods: A cross-sectional study was conducted between 2023 and 2024, involving 269 H. pylori patients. Participants completed an online semi-quantitative food frequency questionnaire (FFQ) shared via social media. The questionnaire collected data on demographics, infection status, dietary intake, lifestyle factors, and medical history. Statistical analyses included t-tests, Mann-Whitney U-tests, χ²-tests, and Fisher’s exact tests, with significance set at p ≤ 0.05. Ethical approval was obtained from the IRB of An-Najah National University, Palestine. Results: Significant associations were found between diet and H. pylori symptoms. Fast food consumption correlated with bloating and heartburn (p < 0.01). Low vegetable intake was linked to upper abdominal pain (p < 0.01). Energy drink consumption was associated with bloating and nausea (p < 0.01), and citrus intake with upper abdominal pain (p < 0.01). Conclusion: Certain dietary behaviors, including high fast food and low vegetable intake, may exacerbate H. pylori symptoms. Integrating dietary modifications into H. pylori treatment plans is recommended, especially in resource-limited settings.

Association between body mass index and hemoglobin levels among university students: a cross-sectional study

Marwa Hussein Kadhim — 2026-03-20

Introduction: Obesity is a major global health challenge it is estimated that by 2035, approximately 1.77 billion adults will be overweight 1.53 billion will be obese. Anemia has long been recognized in relation to underweight and malnutrition. However, recent studies have found a paradoxical relationship between obesity and iron deficiency which is mediated by chronic inflammation. Objective: This study aimed to determine the association between Body Mass Index (BMI) and Hemoglobin (Hb) levels in university students. Method: An analytical cross-sectional study was carried out at Al-Furat Al-Awsat Technical University in Iraq on 413 students using non-probability purposive sampling. Data were collected using a validated self-administered questionnaire for socio-demographic and lifestyle factors, and anthropometric measurements for calculating BMI, and venous blood analysis for hemoglobin estimation using a hematology analyzer. Data analysis was performed using SPSS version 26 software with Chi-square and One-Way ANOVA tests to find associations at a significance level of p<0.05. Results: The result of 413 students (mean age 20.51 ±1.72 years) showed a high prevalence of anemia (40.7%) and malnutrition, with 17.4% of students being underweight and 32.2% being overweight/obese. There was a statistically significant relationship between BMI and hemoglobin concentration (p<0.001); the prevalence of anemia was significantly higher in both underweight and overweight/obese students than in normally weighted students. In addition, hemoglobin concentration was significantly different according to sex, breakfast and dietary habits, sleep duration and physical activity (p<0.05). Conclusion: The study results revealed a double burden of malnutrition among student anemia posed a serious problem for both underweight and overweight individuals. This condition was closely linked to unhealthy eating habits such as skipping breakfast, high caffeine consumption, and lack of exercise. Therefore, the study recommended integrating anemia screening into all BMI categories and raising nutritional awareness to mitigate the negative health effects of university life.

Relationship between relative skeletal muscle index (RSMI) in physically active adults and the use of major sports supplements: a retrospective observational study

Limiro Luiz da Silveira Neto — 2026-02-19

Introduction: The indiscriminate use of supplements poses a problem for overall health, with Brazil being one of the countries that consumes the most dietary supplements in the world. However, when used as indicated and correctly, supplements can positively influence muscle mass gain, performance, and general health. Objective: This study aimed to evaluate whether there is a relationship between physical exercise and the use of supplements related to physical exercise that are most common in clinical practice (whey protein, creatine, hydroxymethylbutyrate, beta- alanine, glutamine, and caffeine) with relative skeletal muscle indices (RSMI). Methods: The present study employed a retrospective observational design, adhering to the STROBE guidelines. A total of 50 adult patients aged between 18 and 65 years who practice physical exercise were evaluated in medical centers in the city of Brasília between May 2023 and May 2024 using whole-body Bioimpedance Imaging or DEXA analysis. Only patients who used one or more supplements and were non-sedentary according to the criteria of the health organization were included in the study. Results: The general clinical data presented a total of 50 participants, the majority of whom were male (58%), with the DEXA group having 44 participants and the BIO group having 06 participants. The overall mean age was 40.60 years (22 to 60). The amount of physical exercises practiced per week was 4.80 (3 to 9) in general. It was also found that the overall RSMI had a mean of 8.56 ±1.76. The general use of supplements (DEXA and BIO) showed that the use of creatine (34%) and creatine with Whey Protein (24%) were the most frequent. The present study observed that there was an important relationship between the male gender and the RSMI, with OR=4.89 and p=0.000. In addition, the nominal logistic regression analysis of the supplement predictors in general (DEXA and BIO) to the RSMI response predictor showed statistical significance to the combinations of supplements creatine, BCAA, Whey, and Whey, creatine, and beta-alanine, p=0.015 and OR=1.62 for both combinations. There was no statistically significant difference between the mean RSMI values of the DEXA and BIO groups, with p=0.307. Conclusion: It was concluded that there was a relationship between physical exercise and the use of supplements most common in clinical practice, such as Whey protein, creatine, hydroxymethylbutyrate, beta-alanine, glutamine, and caffeine with the increase in the relative skeletal muscle mass index (RSMI) in physically active adults. The general use of supplements (DEXA and BIO) showed that the use of creatine (34%) and creatine with Whey Protein (24%) were the most frequent. Furthermore, there was an important relationship between the male gender and the relative skeletal muscle index (RSMI). In the female gender, no increase was observed. Statistical significance was evidenced by the combinations of supplements creatine, branched-chain amino acids (BCAA), Whey, and Whey, creatine, and beta-alanine. There was no statistically significant difference between the mean RSMI values of the DEXA and BIO groups

Comparative clinical outcomes and metabolomic considerations of the use of tirzepatide and retatrutide in the treatment of obesity: a systematic and umbrella review

Flávio Henrique Figueiredo de Macêdo Andrade — 2026-02-10

Introduction: According to the World Obesity Atlas, overweight and obesity could affect approximately 50% of the world's adult population by 2030. Obesity treatment is complex and multidisciplinary. Pharmacological treatment with tirzepatide and retatrutide begins in secondary prevention to stop disease progression. Objective: To highlight the main clinical outcomes of tirzepatide and retatrutide in the treatment of obesity and comorbidities. Methods: The systematic review guidelines of the PRISMA platform were followed. The search was conducted from September to November 2025 in the Scopus, Embase, PubMed, Science Direct, SciELO, and Google Scholar databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 92 articles were found. A total of 29 articles were evaluated, and 14 were included in this systematic review. Considering the Cochrane risk of bias tool, the overall assessment resulted in 18 studies with a high risk of bias and 20 studies that did not meet the GRADE and AMSTAR-2 criteria. Most studies showed homogeneity in their results, with X² = 86.5% > 50%. It was concluded that retatrutide offers superior efficacy in weight loss compared to tirzepatide and other GLP-1 analogs, but with a higher risk of adverse events. Dual agonists offer a favorable balance between efficacy and safety. Selecting personalized treatments based on patient characteristics is recommended. Available randomized clinical trials showed that, regarding weight loss, tirzepatide (15 mg) resulted in up to 17.8% weight loss at 72 weeks, semaglutide (2.4 mg) in up to 13.9% after 68 weeks, liraglutide (3.0 mg) in up to 5.8% after 26 weeks, and retatrutide (12 mg) produced the greatest weight loss, with 22.1% after 48 weeks. The main adverse effects of retatrutide were related to gastrointestinal events compared to tirzepatide.