29/10/2025
Dr. Cristina Piras presents the current status of the project Better4U, a 4-year Horizon Europe funded project (2023-2027) that aims to develop comprehensive research and innovative interventions to address and reverse the widespread increase in and weight gain. https://better4u.eu.
At the 21th International Workshop on Neonatology and Pediatrics, Cagliari, T-Hotel, 22-25 October 2024, Dr. Cristina Piras, researcher at the University of Cagliari (UNICA), presented the role of UNICA's Metabolomics Laboratory in the project, which comprises primarily two main tasks:
I) The study of the Interplay between psychosocial, biological, and behavioural factors, as obesity and weight change are not solely driven by risk (e.g., , ), but are also strongly modulated by and contextual factors. Preliminary evidence, including transcript discussions, suggests that s*x and gender play specific roles in pathways to weight gain and barriers to weight loss. UNICA is already performing a meta-analysis of data from targeted proton nuclear magnetic resonance (^1H-NMR) spectra, using datasets generated employing the Nightingale Health, Metaboneer, and Biocrates platforms from an extensive multi-cohort study. The aims are to (i) evaluate the association between comprehensive metabolic profiles and continuous body mass index ( ) across diverse European cohorts and (ii) assess the influence of geographical clustering on these associations. This work aligns with the broader objective to develop a refined lifestyle risk score that captures not only diet and physical activity but also upstream determinants.
II) A Multicentre clinical trial focused on implementation, monitoring, and evaluation.
This task will design and deliver a multicentre, open-label, parallel-group randomised controlled trial across seven sites. The arms are the control group, which is based on standard counselling by / , and the intervention group, in which personalized counseling will be performed via the BETTER4U platform, integrating AI-based causal models and polygenic risk scores. The primary outcome will be to observe a change in BMI after 6 months. Whereas, the secondary outcome will be a reduction of ≥5% weight loss at 6 months and maintenance at 12 months; changes in biomarkers (metabolomics (UNICA team), lipidomics, adipokines, cardiometabolic and inflammatory markers, gut microbiota); blood pressure; lifestyle parameters; quality of life; psychosocial measures (anxiety, depression, motivation); and BMI changes in offspring/family members. The sample size is approximately 1,022 participants (~146 per site), with balanced recruitment by s*x, and in particular, the UNICA team will oversee biospecimen handling and perform NMR-based metabolomics analyses at two time points (baseline and 6-month follow-up). The team will also contribute to real-time monitoring of participants and processes, and evaluation of effectiveness and adherence/feasibility to inform iterative improvements to the programme.
The Workshop Proceedings will be published, in the "Journal of Pediatric and Neonatal Individualized Medicine - JPNIM (https://jpnim.com)", Publisher Hygeia Press (https://www.hygeiapress.com).
JPNIM is the official journal of the UENPS - Union of European Neonatal & Perinatal Societies, of the UMEMPS, and several other European scientific societies.
JPNIM, indexed in SCOPUS and Web of Science, was recognized by the Italian Ministry of Culture as a "Journal of High Cultural Value" in 2023. The reasons for this recognition are explained in an article published in volume 13(1) of the journal (J Pediatr Neonat Individual Med. 2024;13(1):e130104 - https://jpnim.com/index.php/jpnim/article/view/e130104).
