Opinion

The incidence of adolescent obesity is increasing, which has serious long-term implications for the affected individuals and wider society. Here, Thomas Reinehr outlines the effects of adolescent obesity and discusses how the epidemic could be addressed.

In this Opinion article, Klose and Feldt-Rasmussen posit that the true risk and disease burden of hypopituitarism after traumatic brain injury might have been overestimated in recent years. Possible reasons for this overestimation are discussed, along with current recommendations for diagnosing and treating the condition.

The emerging field of omics has the potential to advance and strengthen research into endocrine-disrupting chemicals (EDCs). In this Opinion article, Andrea Baccarelli and colleagues discuss the potential of using omics technologies — both established and developing — to characterize present and past EDC exposures and predict risk of developing EDC-related diseases.

The concept of food addiction as an explanation for the rise in obesity has become increasingly popular. In this Opinion article, Graham Finlayson critically evaluates the food addiction hypothesis and highlights several problems with its use.

Monthly or annual bolus doses of vitamin D have been reported to be harmful rather than beneficial, increasing falls and fractures. In this Perspectives, J. Christopher Gallagher proposes that the vitamin D dose recommended by the Institute of Medicine be revised downwards.

In this Perspectives article, Paul Zimmet and colleagues outline how current estimates of the prevalence diabetes mellitus and of related mortality are imprecise. They call for international consensus on uniform standards and criteria for reporting national data on diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cancer. In this Perspectives article, Xilin Yang and colleagues discuss risk factors (subphenotypes) for cancer in Chinese patients with T2DM, which can lead to drug-subphenotype interactions. The authors also propose plausible biological links between T2DM and cancer and underlying the drug-subphenotype interactions.

Successful studies in the nonobese diabetic (NOD) mouse model often do not translate to positive outcomes in human studies. This Perspectives outlines the genetic and immunologic differences that might contribute to these differential outcomes and suggests how the NOD mouse model could be adapted to improve its utility.

Colonization of an infant with their microbiota in early life is important for normal development of host metabolism. In this Perspectives article, Cox and Blaser posit that exposure to antibiotics that disrupt either vertical transmission or colonization and maturation of the microbiota in the infant can lead to adverse consequences such as obesity in adulthood.

Transfer from paediatric to adult health-care services for individuals with a disorder of sex development has specific issues that can impede continuity of care. Here, Crouch and Creighton discuss these barriers, and propose that a long-term plan with psychological support at each stage of transition could ensure successful transfer for these patients.

Hyperinsulinaemic androgen excess leads to hirsutism, acne, seborrhoea and irregular menstrual cycles in young women. In this Perspectives article, Ibáñez and colleagues hypothesize that hyperinsuliaemic androgen excess arises owing to increased lipid load in adipose tissue, outline potential diagnostic criteria, and discuss the advantages and disadvantages of different treatment options for girls with this disorder.

The cellular mechanisms whereby stressful life experiences cause biological damage and increase disease risk remain poorly understood. Here, Picard et al. expand upon the metabolic aspects of this process. They propose that mitochondrial allostatic load could underpin the deleterious structural and functional changes that mitochondria undergo in response to elevated glucose levels and stress-related pathophysiology.

Emerging data suggest a role for autoimmunity in type 2 diabetes mellitus (T2DM). In this Perspectives, the authors discuss the nature of the immune response in diabetes mellitus and the evidence for an autoimmune component in T2DM and obesity.

Fructose is increasingly being used in food supply. In this Perspectives, the authors discuss the links between fructose intake and obesity; in particular, the negative effects of fructose exposure during early development are highlighted.

Vitamin D is the nutrient du jour, yet scant evidence exists for various health claims related to vitamin D. This Perspectives article aims to dispel misconceptions about vitamin D, including discussion of osteoporosis, chronic disease risk, requirements in pregnancy and lactation, and vitamin D deficiency and supplementation.

For >30 years, HDL's association with protection from atherosclerosis has been unquestioned. However, in the past 5 years, powerful new human genetic data together with negative clinical trials have cast doubt on the HDL hypothesis. This Perspectives examines evidence for and against HDL's direct role in atherosclerosis and considers reasons why the HDL hypothesis seems to be 'too big to fail'.

Early life experiences can affect cardiovascular risk and influence the development of metabolic problems later in life. In this Perspectives article, Gerthe Kerkhof and Anita Hokken-Koelega discuss how rapid weight gain in relation to length increase during the first few months of life can lead to an increased risk of obesity, diabetes mellitus and cardiovascular problems in adults.

Developing countries are experiencing huge rises in the incidence of type 2 diabetes mellitus (T2DM). In this Perspectives, Justin Echouffo-Tcheugui and Samuel Dagogo-Jack describe factors that underlie the rising prevalence of (T2DM), strategies to tackle the problem and discuss the difficulties that need to be overcome in order to implement solutions.

Controversy on the optimal target for blood glucose control in patients admitted to the intensive care unit remains. The debate has been fierce, given the universally present risk of hypoglycaemia and its associated adverse outcomes. In this Perspectives article, the author endeavours to reconcile the currently available evidence on stress-induced diabetes mellitus.

This Perspectives re-evaluates the role of radioiodine treatment following surgery in low-risk patients with undetectable serum thyroglobulin levels after TSH stimulation and without evidence of disease. Moreover, the authors discuss the methods used for preparing low-risk patients for the administration of radioiodine after surgery and the activity of radioiodine that should be administered.