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    Item type:Publication,
    Impact of obesity on postoperative complications in colorectal cancer surgery: A systematic review and meta-analysis
    (Elsevier BV, 2025-08)
    Sarno, Gerardo
    ;
    SIMANCAS RACINES, DANIEL ALEJANDRO  
    ;
    Gargiulo, Antonio
    ;
    Anna Tedesco
    ;
    Iacone, Biancamaria
    Background Obesity has been increasingly recognized as a factor that influences postoperative outcomes in colorectal cancer surgery. However, its impact on surgical complications, mortality, and oncological outcomes remains controversial. This systematic review and meta-analysis aimed to evaluate the association between obesity and postoperative complications in colorectal cancer surgery. Methods A comprehensive search was conducted in MEDLINE/PubMed, Scopus, and Embase, including studies evaluating body mass index (BMI) in relation to postoperative complications such as infections, anastomotic leakage, postoperative ileus, bleeding, reoperation, and mortality. Data synthesis involved a qualitative analysis of all eligible studies and a meta-analysis when applicable. The quality of the studies included was assessed using the Newcastle-Ottawa Scale, while the certainty of evidence was evaluated through the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Twenty-nine studies were included in the qualitative analysis and 17 were eligible for the meta-analysis. Compared to BMI < 30 kg/m², patients with BMI ≥ 30 kg/m² showed significantly higher risk of any type of surgical site infection (OR=1.49; 95 % CI: 1.37–1.70; low certainty). No significant differences were found in mortality (OR=1.23; 95 % CI: 0.72–2.11; very low certainty), hemorrhage (OR=1.05; 95 % CI: 0.97–1.14; very low certainty), or gastrointestinal complications (OR=1.10; 95 % CI: 0.96–1.26; very low certainty). Conclusion Obesity significantly increases the risk of surgical site infections in colorectal cancer surgery. Although its impact on mortality and gastrointestinal complications remains unclear, implementing preoperative optimization protocols specifically aimed at obesity management could mitigate these surgical risks. The certainty of evidence ranges from low to very low, highlighting the need for high-quality prospective studies with standardized BMI criteria and surgical protocols.
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    Harnessing nutrition to combat MASLD: a comprehensive guide to food-based therapeutic strategies
    (Informa UK Limited, 2025-05-06)
    Reytor-gonzález Claudia  
    ;
    Simancas-racines Daniel  
    ;
    Campuzano Donoso Martín
    ;
    Castano Jimenez Janeth C.
    ;
    Román-galeano Náthaly Mercedes
    Metabolic dysfunction-associated steatotic liver disease is a growing global health issue linked to obesity, insulin resistance, and metabolic syndrome. Diet plays a key role in its progression and management. This narrative review highlights evidence-based nutritional strategies, including the Mediterranean diet, low-carbohydrate and ketogenic diets, and high-fiber intake, which improve insulin sensitivity, reduce hepatic fat, and lower inflammation. Nutritional deficiencies, such as low vitamin D, choline, and omega-3 levels, exacerbate metabolic dysfunction-associated steatotic liver disease, emphasizing the need for targeted supplementation. Emerging approaches, including gut microbiota modulation, precision nutrition, and nutraceuticals like resveratrol and curcumin, offer promising therapeutic potential. A multidisciplinary approach integrating dietary and lifestyle modifications is essential for effective metabolic dysfunction-associated steatotic liver disease management.