Anita Palfi

Objectives: Adolescence is a pivotal stage of development characterized by significant physical, psychological, and social changes. Establishing healthy lifestyle habits during this period is crucial for long-term health and the prevention of chronic diseases. Despite this, global trends show a marked decline in physical activity among adolescents, particularly girls, who are more susceptible to sedentary behaviors. One potential site for intervention to eliminate physical inactivity at the population level is the school educational setting during childhood. Traditional school-based physical exercise programs often adopt a one-size-fits-all approach, which may not address the diverse needs and interests of students, leading to reduced motivation and participation. Personalized physical exercise programs, tailored to individual capabilities and preferences, offer a promising alternative to enhance physical fitness and foster lifelong engagement in physical activity. Methods: A total of 170 Hungarian high school girls (mean age ≈ 15.3 years) were randomly assigned to either a personalized physical exercise group or a control group following the standard curriculum. The intervention spanned two academic years and consisted of five traditional gym classes per week (control group) or three traditional and two individually tailored classes with cardiorespiratory and resistance training per week (intervention group), each lasting 45–60 min. Individual goals were set based on baseline assessments, emphasizing self-referenced progress. Results: The personalized physical exercise group showed significant improvements in body mass index (BMI), body fat percentage, maximum oxygen uptake capacity (VO₂max), muscular strength, and flexibility (p < 0.05), while the control group exhibited minimal or negative changes. Conclusions: The personalized physical exercise program has been shown to be more effective in achieving higher cardiorespiratory performance and favorable body composition among adolescent girls than a traditional school physical education class, highlighting its potential role in school settings.

Objectives: Obesity has become a major health issue, with multifactorial etiologies involving lifestyle, genetic, and neuroendocrine mechanisms. Despite public health campaigns and lifestyle interventions, long-term weight loss is often difficult to achieve or sustain. This literature review aims to summarize current knowledge on the main molecular mechanisms that hinder weight loss and to summarize the newest therapeutic strategies targeting obesity. Methods: The literature review was conducted using PubMed, Scopus, and Web of Science databases, with a preference for peer-reviewed original articles, systematic reviews, and meta-analyses. Eligible studies were required to be published in the English language and within the last ten years (2015–2025), with the exception of historically significant publications. A total of 112 articles were included in our review. Results: Obesity is a complex, chronic, recurrent metabolic condition that requires personalized, multidisciplinary treatment approaches. In this review, we summarize the major molecular mechanisms underlying weight gain and weight maintenance in obesity. In this literature review, we address the metabolic memory and epigenetics that act through DNA and histone modifications and micro interfering RNAs, resulting in an energy imbalance that can be passed on to further generations. The dysfunction of adipose tissue contributes to chronic low-grade inflammation and insulin resistance, leading to more severe obesity. The ratio of white, beige, and brown adipocytes also plays an important role in regulating energy balance. Novel medical interventions offer promising results in attenuating these mechanisms against successful weight loss. Conclusions: Current interventions, including calorie restriction, physical activity, and pharmacological treatment together, may show great promise in combating obesity, but long-term efficacy and safety remain to be established.

Introduction: Obesity has become a major health issue, with multifactorial etiologies, involving lifestyle, genetic, and neuroendocrine mechanisms. Despite public health campaigns and lifestyle interventions, long-term weight loss is often difficult to achieve or sustain. Objectives: This literature review aims to summarize current knowledge on the main molecular mechanisms that hinder weight loss and to summarize the newest therapeutic strategies targeting obesity. Methods: The literature review was conducted using PubMed, Scopus, and Web of Science databases, with a preference for peer-reviewed original articles, systematic reviews and meta-analyses. Eligible studies were required to be published in English language and within the last ten years (2015-2025), with the exception of historically significant publications. A total of 112 articles were included in our review.Results: Obesity is a complex, chronic, recurrent metabolic condition that requires personalized, multidisciplinary treatment approaches. In this review, we summarize the major molecular mechanisms underlying weight gain and weight maintenance in obesity. In this literature review we address the metabolic memory and epigenetics that act through DNA and histone modifications and micro interfering RNAs, resulting in energy disbalance that can be passed on to further generations. The dysfunction of adipose tissue contributes to chronic low-grade inflammation and insulin resistance, leading to more severe obesity. The ratio of white, beige, and brown adipocytes also play an important role in regulating energy balance. Novel medical interventions offer promising results attenuating these mechanisms against successful weight loss. Conclusions: Current interventions, including calorie restriction, physical activity, and pharmacological treatment together may show great promise in combating obesity but long-term efficacy and safety remain to be established.

Background: After an acute COVID-19 infection, many patients suffered from various complaints called as post-COVID syndrome. Methods: Our post-COVID outpatient department was operational for 19 months, where patients (n = 252) underwent a detailed cardiopulmonary examination within a 3-month-long follow-up period. Results: Most patients (69.9%) had mild acute symptoms with a higher hospitalization risk with preexisting hypertension (p < 0.05) and diabetes (p < 0.001). Most common post-COVID symptoms were fatigue (29.4%) and dyspnea (19.1%). Echocardiographic parameters showed no abnormalities and did not change during the follow-up period. Exercise capacity was also generally normal with no change over time; however, 9.9% of patients showed significant desaturation during a 6 min walk test. This finding showed correlation (p < 0.01) with decreased diffusion capacity (DLCO). Generally, DLCO improved slightly but significantly (p < 0.05) by the end of the follow-up period (from 72.4% to 74.1%). Our key finding was a 10× higher prevalence (24.6%) of lupus anticoagulant positivity among post-COVID patients compared to the normal population (estimated at 2–4%). Conclusions: In conclusion, post-COVID syndrome is a common consequence even after a mild infection. Severe infections tend to lead to worse cardiopulmonary outcomes. Higher prevalence of lupus anticoagulant positivity may underline the importance of autoimmunity in the pathomechanism of post-COVID syndrome.

Obesity is a major public health problem worldwide, and it is associated with many diseases and abnormalities, most importantly, type 2 diabetes. The visceral adipose tissue produces an immense variety of adipokines. Leptin is the first identified adipokine which plays a crucial role in the regulation of food intake and metabolism. Sodium glucose co-transport 2 inhibitors are potent antihyperglycemic drugs with various beneficial systemic effects. We aimed to investigate the metabolic state and leptin level among patients with obesity and type 2 diabetes mellitus, and the effect of empagliflozin upon these parameters. We recruited 102 patients into our clinical study, then we performed anthropometric, laboratory, and immunoassay tests. Body mass index, body fat, visceral fat, urea nitrogen, creatinine, and leptin levels were significantly lower in the empagliflozin treated group when compared to obese and diabetic patients receiving conventional antidiabetic treatments. Interestingly, leptin was increased not only among obese patients but in type 2 diabetic patients as well. Body mass index, body fat, and visceral fat percentages were lower, and renal function was preserved in patients receiving empagliflozin treatment. In addition to the known beneficial effects of empagliflozin regarding the cardio-metabolic and renal systems, it may also influence leptin resistance.

Self-esteem, body image and eating attitudes are important characteristics regarding adolescent mental health. In our present work, we aimed to investigate these psychological items in adolescent boys and girls examining gender differences and correlations with the BMI-for-age and cardiorespiratory performance. 374 students (209 girls with an average age of 16.4 ± 1.08 years, and 165 boys with an average age of 16.5 ± 1.03 years) underwent investigation using the Rosenberg self-esteem scale, EAT-26 and BAT questionnaires. The BMI-for-age was calculated with BMI growth charts and the cardiorespiratory performance was measured with the 20 m shuttle run test. Our results showed that adolescent girls scored lower self-esteem and higher values for BAT and each scale of eating behaviors, such as uncontrolled eating, cognitive restraints and emotional eating compared to boys despite the fact, that obesity and overweight were more common among boys. No significant correlation was found between BMI and psychological test results in either boys or girls, however, subjective body shape and gender predicted self-esteem and BAT scores and the cognitive restraints in the eating attitudes. Uncontrolled and emotional eating were primarily influenced by gender, in which BMI played only a weaker role. Cardiorespiratory performance was positively associated with self-esteem and body image among boys, and it had a negative correlation regarding BMI in both genders.

The high prevalence of obesity in childhood and adolescence has major public health consequences, since it is associated with various chronic diseases in the short- and long-term. The goal of our study was to examine the possible association between obesity and overweight and cardiorespiratory and muscle performance during a 4-year follow up period in adolescents. The body mass index (BMI) and physical performance of adolescents (360 girls and 348 boys) between 14–18 years of age was measured twice a year, and the possible correlation between overweight and obesity and cardiorespiratory and muscle performances were investigated. Our results revealed that cardiorespiratory performance increased significantly in boys during the 4 years (p < 0.001), but the aerobic performance of girls only showed seasonal fluctuation. Muscle performance significantly increased both in boys and girls (p < 0.001). Inverse association between obesity and cardiorespiratory and muscle performance was proved. Overweight was also inversely correlated with cardiorespiratory performance, but it demonstrated no correlation with muscle strength. Avoiding increased BMI and decreased physical fitness is essential for adolescents’ health to prevent short- and long-term adverse effects.