Author Interviews, JAMA, Pediatrics, Weight Research / 28.07.2022
Huge Number of Children Newly Classified as Obese In Only a Decade
MedicalResearch.com Interview with:
[caption id="attachment_59343" align="alignleft" width="200"] Dr. Staiano[/caption]
Amanda Staiano, PhD
Associate Professor
Director, Pediatric Obesity and Health Behavior Laboratory
Pennington Biomedical Research Center
Baton Rouge, LA
MedicalResearch.com: What are the main findings?
Response: The U.S. government funds the National Health and Nutrition Examination Survey (NHANES), which is an ongoing surveillance study on the health and nutritional status of people living in the U.S. What is special about NHANES is it’s designed to be nationally representative and it uses objective measurements, so we’re more confident that this accurately reflects the health of the country. For this paper, we looked at the most recently released data to see how many children in the U.S. have obesity, meaning they’re above the 95th percentile for height and weight based on their age and sex. We extracted data from 2011 to 2020, which includes nearly 15,000 children and adolescents and is the most recently available data prior to the March 2020 COVID-19 shutdown when NHANES paused.
Dr. Staiano[/caption]
Amanda Staiano, PhD
Associate Professor
Director, Pediatric Obesity and Health Behavior Laboratory
Pennington Biomedical Research Center
Baton Rouge, LA
MedicalResearch.com: What are the main findings?
Response: The U.S. government funds the National Health and Nutrition Examination Survey (NHANES), which is an ongoing surveillance study on the health and nutritional status of people living in the U.S. What is special about NHANES is it’s designed to be nationally representative and it uses objective measurements, so we’re more confident that this accurately reflects the health of the country. For this paper, we looked at the most recently released data to see how many children in the U.S. have obesity, meaning they’re above the 95th percentile for height and weight based on their age and sex. We extracted data from 2011 to 2020, which includes nearly 15,000 children and adolescents and is the most recently available data prior to the March 2020 COVID-19 shutdown when NHANES paused.
Clare Jensen[/caption]
Clare Jensen
O’Haire Research Team
Center for the Human-Animal Bond
Purdue University College of Veterinary Medicine
MedicalResearch.com: What is the background for this study?
Response: Service dogs for PTSD are becoming more common and the evidence shows they can help improve mental health and quality of life for many veterans with PTSD. However, some veterans benefit more than others. Our research goal was to ask for the very first time: Why?
Dr. LeBoff[/caption]
Meryl S. LeBoff, MD
Dr. Manson[/caption]
JoAnn E. Manson, MD, DrPH
Professor, Epidemiology, Harvard T.H. Chan School Of Public Health
Michael and Lee Bell Professor of Women's Health, Medicine, Harvard Medical School
Chief, Preventive Medicine, Brigham And Women's Hospital
Co-Director, Womens Health, Brigham And Women's Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Osteoporosis is a major public health problem. Although supplemental vitamin D has been widely used to reduce the risk of fractures in the general population, studies of the effects of vitamin D on fractures, the most important bone health outcome, have been conflicting.
Randomized controlled trials, the highest quality studies, from around the world have shown benefit, no effect, or even harm of supplemental vitamin D on risk of fractures. Some of the trials used bolus dosing, had small samples sizes or short study duration, and co-administered calcium. No large RCTS of this scale tested whether daily supplemental vitamin D (without co-administration with calcium) prevented fractures in the US population.
To fill these knowledge gaps, we tested the hypothesis in this ancillary study to VITAL, whether daily supplemental vitamin D3 reduced the risk of incident total, non-spine and hip fractures in women and men in the US.
Joanna Jiang, PhD
Agency for Healthcare Research and Quality
Rockville, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the last decade we have seen two trends occurring to rural hospitals – closures and mergers. A hospital in financial distress could likely face closure. But if the hospital affiliates with a multihospital system, it may have access to resources from the system that help shelter the hospital from closure.
That is exactly what we found in this study. System affiliation was associated with a lower risk of closure for financially distressed hospitals. However, among hospitals that were financially stable, system affiliation was associated with a higher risk of closure. This is somewhat puzzling and needs further study to better understand the reason for closure.
Dr. Midya[/caption]
Dania Valvi, MD MPH PhD
Assistant Professor
Department of Environmental Medicine and Public Health
Co-Director, MS in Epidemiology
Icahn School of Medicine at Mount Sinai
Email: dania.valvi@mssm.edu
MedicalResearch.com: What is the background for this study?
Response: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children in the U.S., Europe and other world regions, currently affecting 1 in every 10 children, and 1 in every 3 children with obesity in the U.S. The rate of pediatric NAFLD has more than doubled in recent decades following the epidemic rates also noted for childhood obesity. There is increasing interest in the role that environmental chemical exposures may play in NAFLD etiology, since several animal studies have shown that prenatal exposures to endocrine-disrupting chemicals (EDCs) cause liver injury and damage; but, until now, the potential effects of prenatal EDC mixture exposures in pediatric NAFLD had not been studied.
SooYoung VanDeMar[/caption]
SooYoung VanDeMark, MBS
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Health care providers utilize subscription-based, point-of-care databases such as DynaMed and UpToDate to provide clinical care guidance and remain current on the latest evidence-based findings. Both of these websites maintain this content through a cadre of physician contributors who write and edit articles for these sites. These physician contributors are required to self-report any conflicts of interest (COI) as outlined by the respective policies on each website. However, prior COI research into similarly self-regulated areas, such as medical and pharmacology textbooks, and clinical practice guidelines, has found both appreciable potential COI and inconsistencies between self-reported and industry mandated disclosures (1-3).
This study (4) explored the accuracy of physician contributors to DynaMed and UpToDate by comparing their self-reported disclosure status with the financial remunerations they received from the healthcare industry (e.g., pharmaceutical companies) as reported to the U.S. Centers for Medicare and Medicaid Services’ Open Payments database. Physician contributors who reported “nothing to disclose” on their respective article topic but had an entry on Open Payments for having received money from industry, were classified as discordant and, thus, as having the potential for a COI. Additionally, total remuneration, gender, and payment category were investigated more in depth for each database.
Dr. Soriano[/caption]
Victoria Soriano PhD
Research Assistant/Officer, Population Allergy
University of Melbourne
MedicalResearch.com: What is the background for this study?
Response: Peanut allergy is one of the most common childhood food allergies, and children rarely grow out of it. The only proven way to prevent peanut allergy is to give infants age-appropriate peanut products in the first year of life.
We previously showed there was a dramatic increase in peanut introduction from 2007-11 to 2018-19, following changes to infant feeding guidelines. We wanted to know if earlier peanut introduction would reduce peanut allergy in the general population (in Melbourne, Australia).
Dr. Altan-Bonnet[/caption]
Nihal Altan-Bonnet, Ph.D.
Chief of the Laboratory of Host-Pathogen Dynamics
NHLBI
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Enteric viruses such as norovirus, rotavirus and astrovirus are responsible for nearly 1.5 billion global infections per year resulting in gastrointestinal illnesses and sometimes leading to death in the very young, in the elderly and in the immunocompromised. These viruses have been thought to traditionally infect and replicate only in the intestines, then shed into feces and transmit to others via the oral-fecal route (e.g. through ingestion of fecal contaminated food items).
Our findings reported in Nature, using animal models of norovirus, rotavirus and astrovirus infection, challenge this traditional view and reveal that these viruses can also replicate robustly in salivary glands, be shed into saliva in large quantities and transmit through saliva to other animals.
In particular we also show infected infants can transmit these viruses to their mothers mammary glands via suckling and this leads to both an infection in their mothers mammary glands but also a rapid immune response by the mother resulting in a surge in her milk antibodies. These milk antibodies may play a role in fighting the infection in their infants .
Dr. Barry[/caption]
Michael J. Barry, M.D
Director of the Informed Medical Decisions Program
Health Decision Sciences Center
Massachusetts General Hospital.
Professor of medicine at Harvard Medical School
Dr. Barry was appointed as Vice Chair of USPSTF in March 2021.
He previously served as a member from January 2017 through December 2020.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Task Force looked at the use of vitamin and mineral supplementation specifically for the prevention of heart disease, stroke, and cancer. We found that there is not enough evidence to recommend for or against taking multivitamin supplements, nor the use of single or paired nutrient supplements, to prevent these conditions.
However, we do know that you should not take vitamin E or beta-carotene for this purpose.
Dr. Dryden-Peterson[/caption]
SCOTT DRYDEN-PETERSON, MD
Assistant Professor, Medicine, Harvard Medical School
Research Affiliate, Immunology and Infectious Diseases
Harvard T.H. Chan School Of Public Health
Associate Physician, Medicine, Infectious Diseases
Brigham And Women's Hospital
Research Associate, Botswana Harvard AIDS Institute
MedicalResearch.com: What is the background for this study?
Response: The combination of the antiviral medicine nirmatrelvir and ritonavir (Paxlovid) which boosts antiviral levels was found to reduce the need for hospitalization by nearly 90% among unvaccinated people. Whether nirmatrelvir plus ritonavir can also help vaccinated people was uncertain.
Colleen Jordan[/caption]
Colleen G. Jordan, MBS
Department of Medical Education
Geisinger Commonwealth School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Opioid addiction and misuse remain a prevalent issue in the United States (U.S.). There have been more than one-million drug overdoses in the U.S. since 1999 [1], largely driven by opioids, which exacerbate the strain on resources in hospitals, treatment centers, first responders, patients, and their families. The existing pharmacotherapies for opioid use disorder (OUD) are not working.
Naloxone is a competitive mu opioid receptor antagonist used to reverse respiratory and CNS depression in those experiencing an opioid overdose but requires further dosing to prevent subsequent overdose. Naltrexone is a competitive mu opioid receptor antagonist, and has extended-release formulations intended to reduce relapse and promote adherence, yet patient noncompliance and retention continue to be limiting factors. Methadone is commonly used to treat opioid addiction as a replacement for illicit opiates but is itself an addictive substance which can result in overdoses [2] and can lead to withdrawal if not closely monitored by a licensed professional. Buprenorphine is currently used to treat opioid use disorder (OUD), and while it reduces illicit drug use, it is less effective than methadone for retaining patients in treatment. For these reasons, there is an urgent need for new opioid misuse interventions.
The objectives of this study [3] were to understand the implications of OUD and overdose treatments and determine the strengths and shortcomings of current treatments in comparison with the novel drug candidate methocinnamox (MCAM). These were completed through an extensive literature review into the history of the opioid epidemic in the United States, opioid receptors in the brain, current pharmacological treatments, and the pharmacological properties of MCAM.