Phaeochromocytomas and paragangliomas (PPGL) are rare endocrine tumours that can affect paediatric patients as well as adults. In this first international Consensus Statement on PPGL in paediatric patients, the authors discuss the diagnosis, management and long-term surveillance of these tumours in children and adolescents.

Climate change is causing human populations to be exposed to increasingly higher ambient temperatures and more frequent and extreme heatwaves than previously observed. This Perspective considers the available evidence on the endocrine effects of heat exposure, and maps out a path for future research into this field.

Nutritional imbalances (such as overnutrition in obesity) alter many properties of the neurovascular system, including neurovascular coupling and blood–brain barrier permeability. This Perspective examines how lifestyle interventions targeting weight loss, including intermittent fasting, caloric restriction and physical activity, affect the neurovascular system and neuronal networks.

Thyroid nodules are common; the majority are benign and asymptomatic, and therefore the main aim of the diagnostic process is to determine their clinical significance without leading to overdiagnosis and, consequently, overtreatment, as outlined in this article.

Exploring the glymphatic system across neurological and metabolic diseases might help us to better define the link between obesity and neurological disorders. Recent studies have identified metabolic dysfunction as a risk factor for cognitive decline and neurological disorders through disruption of the glymphatic system.

Pharmacological therapies with incretin-based ‘multi-agonists’ are rapidly advancing the therapeutic landscape for obesity. The loss of skeletal muscle mass with these potent weight-loss agents is emerging as a possible side effect. It is therefore important to determine whether multi-agonists increase the risk of sarcopenia in susceptible patients.

Mechanistic and clinical data indicate that DNA damage contributes to the pathogenesis and progression of diabetic complications. Thus, DNA damage and its signalling are entering the field of diabetology.