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1. COVID-19 Prevalence in Nations with Normal Body Mass Index (BMI): Implications of Artificial Intelligence (AI) in Healthcare

   Yedjou, CG; Long, R; Eno, V; Liu, L; Smith, SB; Ngnepieba, P; Densu, K; MsCallister, M; Latinwo, L; Tchounwou, PB (April 2025, Open journal of nutrition and food science)

   Introduction: Coronavirus disease 2019 (COVID-19) has had a profound impact globally, causing the death of millions of people and deeply affecting socio-psychological, human health, and economic systems, with some nations bearing a disproportionate burden. Despite obesity having been established as one of the major risk factors of COVID-19 severity and other degenerative diseases, the effects that dietary pattern plays in COVID-19 outcomes remain poorly understood. The goal of this study is to look into the connection between eating habits, the number of non-obese and obese people, and COVID-19 outcomes in countries with populations exhibiting normal Body Mass Index (BMI), which is an indicator of obesity. Methods: The analysis includes data from 170 countries. From the 170 countries, we focused on 53 nations where the average, BMI falls within the normal range (18.5 to 24.9). A subset of 20 nations was selected for a more detailed examination, comprising 10 nations with the lowest BMI values within the normal range (18.5-19.8) and 10 nations with the highest BMI values within the normal range (23.5-24.9). We used Artificial Intelligence (AI) and Machine Learning (ML) applications to evaluate key metrics, including dietary patterns (sugar and vegetable intake), obesity prevalence, incidence rate, mortality rate, and Case Fatality Rate (CFR). Results: The results demonstrate a significant correlation between higher obesity prevalence and increased COVID-19 severity, evidenced by elevated incidence, mortality, and CFRs in countries like North Macedonia and Italy. In contrast, nations such as Iceland and New Zealand with well-established healthcare systems revealed low mortality rates and case fatality rates despite variations in dietary habits. The study also revealed that vegetable consumption appears to provide a slight to significant protective effect, suggesting that dietary patterns alone do not consistently predict COVID-19 Outcomes. Conclusion: Data generated from this study showed the crucial role of healthcare infrastructure along with the testing capacity and data reporting in influencing the success of pandemic responses. It also highlights the need to integrate public health strategies, which focus on obesity management and improvement of healthcare preparedness. In addition, AI-driven predictive modeling offers valuable insights that may guide pandemic response efforts in the future, thereby enhancing global health crisis management and mitigating the impact of future health emergencies. 

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2. Racial Disparities in Methylation of NRF1, FTO, and LEPR Gene in Childhood Obesity

   https://doi.org/10.3390/genes13112030  

   Patel, Priyadarshni; Selvaraju, Vaithinathan; Babu, Jeganathan Ramesh; Wang, Xu; Geetha, Thangiah (November 2022, Genes)

   Childhood obesity has affected the health of millions of children around the world despite vigorous efforts by health experts. The obesity epidemic in the United States has disproportionately afflicted certain racial and ethnic minority groups. African American children are more likely than other children to have obesity-related risk factors such as hyperlipidemia, diabetes, cardiovascular disease, and coronavirus disease (COVID-19). For the reduction in obesity-related health inequalities to be successful, it is essential to identify the variables affecting various groups. A notable advancement in epigenetic biology has been made over the past decade. Epigenetic changes like DNA methylation impact on many genes associated with obesity. Here, we evaluated the DNA methylation levels of the genes NRF1, FTO, and LEPR from the saliva of children using real-time quantitative PCR-based multiplex MethyLight technology. ALU was used as a reference gene, and the Percent of Methylated Reference (PMR) was calculated for each sample. European American children showed a significant increase in PMR of NRF1 and FTO in overweight/obese participants compared to normal weight, but not in African American children. After adjusting for maternal education and annual family income by regression analysis, the PMR of NRF1 and FTO was significantly associated with BMI z-score only in European American children. While for the gene LEPR, African American children had higher methylation in normal weight participants as compared to overweight/obese and no methylation difference in European American children. The PMR of LEPR was significantly negative associated with the obesity measures only in African American children. These findings contribute to a race-specific link between NRF1, FTO, and LEPR gene methylation and childhood obesity. 

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3. Impact of Obesity on Timing of Tracheotomy: A Multi‐institutional Retrospective Study

   https://doi.org/10.1002/lary.31586  

   Yousef, Andrew; Soliman, Shady I; Solomon, Isaac; Panuganti, Bharat A; Francis, David O; Pang, John; Klebaner, Dasha; Asturias, Alicia; Alattar, Ali; Wood, Samuel; et al (November 2024, The Laryngoscope)

   ObjectiveTo examine the impact of increased body mass index (BMI) on (1) tracheotomy timing and (2) short‐term surgical complications requiring a return to the operating room and 30‐day mortality utilizing data from the Multi‐Institutional Study on Tracheotomy (MIST). MethodsA retrospective analysis of patients from the MIST database who underwent surgical or percutaneous tracheotomy between 2013 and 2016 at eight institutions was completed. Unadjusted and adjusted logistic regression analyses were used to assess the impact of obesity on tracheotomy timing and complications. ResultsAmong the 3369 patients who underwent tracheotomy, 41.0% were obese and 21.6% were morbidly obese. BMI was associated with higher rates of prolonged intubation prior to tracheotomy accounting for comorbidities, indication for tracheotomy, institution, and type of tracheostomy (p = 0.001). Morbidly obese patients (BMI ≥35 kg/m²) experienced a longer duration of intubation compared with patients with a normal BMI (median days intubated [IQR 25%–75%]: 11.0 days [7–17 days] versus 9.0 days [5–14 days];p < 0.001) but did not have statistically higher rates of return to the operating room within 30 days (p = 0.12) or mortality (p = 0.90) on multivariable analysis. This same finding of prolonged intubation was not seen in overweight, nonobese patients when compared with normal BMI patients (median days intubated [IQR 25%–75%]: 10.0 days [6–15 days] versus 10.0 days [6–15 days];p = 0.36). ConclusionBMI was associated with increased duration of intubation prior to tracheotomy. Although morbidly obese patients had a longer duration of intubation, there were no differences in return to the operating room or mortality within 30 days. Level of Evidence3Laryngoscope, 134:4674–4681, 2024 

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4. High Variability of Body Mass Index Is Independently Associated With Incident Heart Failure

   https://doi.org/10.1161/JAHA.123.031861  

   Liu, Chang; Chiang, Yiyun; Hui, Qin; Zhou, Jin J; Wilson, Peter_W F; Joseph, Jacob; Sun, Yan V (May 2024, Journal of the American Heart Association)

   BackgroundHeart failure (HF) is a serious condition with increasing prevalence, high morbidity, and increased mortality. Obesity is an established risk factor for HF. Fluctuation in body mass index (BMI) has shown a higher risk of cardiovascular outcomes. We investigated the association between BMI variability and incident HF. Methods and ResultsIn the UK Biobank, we established a prospective cohort after excluding participants with prevalent HF or cancer at enrollment. A total of 99 368 White participants with ≥3 BMI measures during >2 years preceding enrollment were included, with a median follow‐up of 12.5 years. The within‐participant variability of BMI was evaluated using standardized SD and coefficient of variation. The association of BMI variability with incident HF was assessed using Fine and Gray's competing risk model, adjusting for confounding factors and participant‐specific rate of BMI change. Higher BMI variability measured in both SD and coefficient of variation was significantly associated with higher risk in HF incidence (SD: hazard ratio [HR], 1.05 [95% CI, 1.03–1.08],P<0.0001; coefficient of variation: HR, 1.07 [95% CI, 1.04–1.10],P<0.0001). ConclusionsLongitudinal health records capture BMI fluctuation, which independently predicts HF incidence. 

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5. Health Promotion and Racial Disparity in COVID-19 Mortality Among African American Populations

   https://doi.org/10.29011/2690-9480.100168  

   Yedjou, CG; Webster, S; Osborne, D; Liu, J; Balagurunathan, Y; Odewuni, C; Latinwo, L; Ngnepiepa, P; Alo, R; Tchounwou, PB (September 2023, Reports on Global Health Research)

   COVID-19, known as Coronavirus Disease 2019, is a major health issue resulting from novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Its emergence has posed a significant menace to the global medical community and healthcare system across the world. Notably, on December 12, 2020, the Food and Drug Administration (FDA) approved the utilization of the Pfizer and Moderna COVID-19 vaccines. As of July 31, 2022, the United Stated has witnessed over 91.3 million cases of COVID-19 and nearly 1.03 million fatalities. An intriguing observation is the recent reduction in the mortality rate of COVID-19, attributed to an augmented focus on early detection, comprehensive screening, and widespread vaccination. Despite this positive trend in some demographics, it is noteworthy that the overall incidence rates of COVID-19 among African American and Hispanic populations have continued to escalate, even as mortality rates have decreased. Therefore, the objective of this research study is to present an overview of COVID-19, spotlighting the disparities among different racial and ethnic groups. It also delves into the management of COVID-19 within the minority populations. To reach our research objective, we used a publicly available COVID-19 dataset from kaggle: https://www.kaggle.com/datasets/paultimothymooney/covid19-casesand- deaths-by-race. In addition, we obtained COVID-19 datasets from 10 different states with the highest proportion of African American populations. Many considerable strikes have been made in COVID-19. However, success rate of treatment in the African American population remains relatively limited when compared to other ethnic groups. Hence, there arises a pressing need for novel strategies and innovative approaches to not only encourage prevention measures against COVID-19, but also to increase survival rates, diminish mortality rates, and ultimately improve the health outcomes of ethnic and racial minorities. 

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