Lifestyle Modifications Slow Progression To Diabetes As Effectively As Medications

MedicalResearch.com Interview with:
Dr. Karla Galaviz PhD
Hubert Department of Global Health
Rollins School of Public Health
Emory University
Sonya Haw, MD| Assistant Professor
Division of Endocrinology, Metabolism & Lipids
Emory University, School of Medicine
Grady Memorial Hospital
Atlanta, GA

MedicalResearch.com: What is the background for this study? What are the main findings?

  • Diabetes affects 1 in 11 adults worldwide and though there is evidence that lifestyle modification (eating healthier diets and exercising about 150 mins a week) and certain medications can prevent or delay diabetes onset, it is not clear which of these strategies offers long-term benefits.
  • To answer this question, we compiled all available randomized controlled trials of lifestyle programs and medications to prevent diabetes and analyzed the data to see if the diabetes prevention effects persisted in the long-term. We specifically compared studies where the lifestyle or drug interventions were discontinued to see if the effect was long lasting or diminished when the intervention was stopped.

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Wearable Device Study Confirms Moderate-to-Vigorous Physical Activity Linked To Decreased Mortality

MedicalResearch.com Interview with:

I-Min Lee, MD, ScD Professor of Medicine, Harvard Medical School Professor of Epidemiology, Harvard T.H. Chan School of Public Health Brigham and Women's Hospital Boston, MA 02215

Dr. Lee

I-Min Lee, MD, ScD
Professor of Medicine, Harvard Medical School
Professor of Epidemiology, Harvard T.H. Chan School of Public Health
Brigham and Women’s Hospital
Boston, MA 02215

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The fact that physical activity lowers the risk of premature mortality is not a new fact – we have many studies showing this.  However, previous studies have primarily relied on self-reported physical activity, and self-reports tend to be imprecise.  Based on these self-report studies, we know that physical activity is associated with a 20-30% reduction in mortality rates.  And, these self-report studies also have focused on moderate-to-vigorous intensity physical activity, since they are more reliably reported than lighter intensity activity.  We have little information on whether light-intensity activities (e.g., light household chores, very slow walking such as when strolling and window shopping) are associated with lower mortality rates.

We now have “wearables” – devices that can more precisely measure physical activity at low (as well as higher) intensities, and sedentary behavior.  The present study, conducted between 2011 and 2015, investigated a large cohort of older women (n=16,741; mean age, 72 years)  who were asked to wear these devices for a week – thus, providing detailed physical activity and sedentary behavior measures.  During an average follow-up of about two-and-a-half years, 207 women died.  The study confirmed that physical activity is related to lower mortality rates.

What is new and important is how strong this association is when we have more precise measures of physical activity – the most active women had a 60-70% reduction in mortality rates, compared with the least active, during the study.  For context, non-smokers have about a 50% risk reduction, compared to smokers, which is why patients (and doctors) should pay attention to being physically active.

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Inactivity Plus Frailty Predict Mortality

MedicalResearch.com Interview with:

Olga Theou, MSc PhD Assistant Professor, Department of Medicine, Dalhousie University Affiliated Scientist, Geriatric Medicine, Nova Scotia Health Authority Adjunct Senior Lecturer, School of Medicine, University of Adelaide Halifax, Nova Scotia

Dr. Theou

Olga Theou, MSc PhD
Assistant Professor, Department of Medicine, Dalhousie University
Affiliated Scientist, Geriatric Medicine, Nova Scotia Health Authority
Adjunct Senior Lecturer, School of Medicine, University of Adelaide
Halifax, Nova Scotia 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We already know that moderate to vigorous intensity physical activity, such as time accumulated during exercise, is associated with numerous health benefits. More recent studies also have shown that sedentary time, such as time accumulated during prolonged sitting at work, transportation, and leisure, can also increase the risk of adverse outcomes. What was not known was whether prolonged sitting affects people across different levels of frailty similarly. This is what we examined in our study.

We found that there were differences. Low frailty levels (people who are extremely healthy; frailty index score < 0.1) seemed to eliminate the increased risk of mortality associated with prolonged sitting, even among people who did not meet recommended physical activity guidelines. Among people with higher frailty levels, sedentary time was associated with mortality but only among those who did not meet recommended physical activity guidelines

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USPSTF: Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Risk Factors

MedicalResearch.com Interview with:

Carol M. Mangione, MD, MSPH, FACP Barbara A. Levey, MD, and Gerald S. Levey, MD Endowed chair in medicine David Geffen School of Medicine University of California, Los Angeles Professor of public health at the UCLA Fielding School of Public Health

Dr. Mangione

Carol M. Mangione, MD, MSPH, FACP
Barbara A. Levey, MD, and Gerald S. Levey, MD
Endowed chair in medicine
David Geffen School of Medicine
University of California, Los Angeles
Professor of public health at the UCLA Fielding School of Public Health

MedicalResearch.com: What is the background for this study?

Response: Americans can experience several health benefits from consuming healthy foods and engaging in physical activity. The Task Force recommends that primary care professionals work together with their patients when making the decision to offer or refer adults who are not obese and do not have hypertension, high cholesterol, high blood sugar, or diabetes to behavior counseling to promote healthful diet and physical activity. Our focus was on the impact of a healthful diet and physical activity on cardiovascular risk because this condition is the leading cause of premature morbidity and mortality. The Task Force evaluates what the science tells us surrounding the potential benefits and harms of a particular preventive service. In this case, the Task Force found high quality evidence focusing on the impact a healthful diet and physical activity can have on a patient’s risk of cardiovascular disease. Relying on this evidence, the Task Force was able to conclude that there is a positive but small benefit of behavioral counseling to prevent cardiovascular disease.

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Daily Crossword Puzzles May Help Sustain Brain Function As We Age

MedicalResearch.com Interview with:

Professor Keith A. Wesnes BSc PhD FSS CPsychol FBPsS Head Honcho, Wesnes Cognition Ltd Professor of Cognitive Neuroscience, Medical School, University of Exeter, UK Visiting Professor, Department of Psychology, Northumbria University, Newcastle, UK Adjunct Professor, Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia Visiting Professor, Medicinal Plant Research Group, Newcastle University, UK Wesnes Cognition Ltd, Little Paddock, Streatley Hill, Streatley on Thames UK

Prof. Wesnes

Professor Keith A. Wesnes
BSc PhD FSS CPsychol FBPsS
Head Honcho, Wesnes Cognition Ltd
Professor of Cognitive Neuroscience, Medical School, University of Exeter, UK
Visiting Professor, Department of Psychology
Northumbria University, Newcastle, UK
Adjunct Professor, Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
Visiting Professor, Medicinal Plant Research Group
Newcastle University, UK
Wesnes Cognition Ltd, Little Paddock, Streatley Hill, Streatley on Thames UK 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This data we reported were taken from the PROTECT study, a 10-year research programme being conducted jointly by Kings College London and the University of Exeter Medical School. It started in November 2015 and over 20,000 individuals aged 50 to 96 years have enrolled.

A highly novel feature of the study is that it is run entirely remotely, the participants logging on via the internet at home and providing demographic and life style information, and also performing online cognitive tasks of key aspects of cognitive function. The tasks are from two well-validated systems, CogTrack and the PROTECT test system, and assess major aspects of cognitive function including focused and sustained attention, information processing, reasoning and a range of aspects of memory.

One of the lifestyle questions was ‘How frequently do you engage in word puzzles, e.g. crosswords?’ and the 6 possible answers were: never; occasionally; monthly; weekly; daily; more than once per day. We analysed the cognitive data from 17,677 individuals who had answered the question, and found that the more often the participants reported engaging in such puzzles, the better their cognitive function on each of the 9 cognitive tasks they performed. The group who never performed such puzzles were poorest on all measures, and the improvements were mostly incremental as the frequency of use increased. The findings were highly statistically reliable, and we controlled for factors including age, gender and education. To evaluate the magnitudes of these benefits, we calculated the average decline over the age-range on the various tasks in the study population. The average difference between those who ‘never’ did puzzles to those who did so ‘more than once a day’ was equivalent to 11 years of ageing; and between those who never did puzzles and all those who did was 8 years.

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Healthy Diet Translates Into Longer Life

MedicalResearch.com Interview with:

Mercedes Sotos Prieto PhD Research Fellow Department of Nutrition Harvard T. H. Chan School of Public Health 

Dr. Sotos-Prieto

Mercedes Sotos Prieto PhD
Research Fellow
Department of Nutrition
Harvard T. H. Chan School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research have found that adherence to the 2010 Alternate Heathy Eating Index, the Mediterranean Diet pattern, and DASH pattern is associated with health benefits, but none of those studies have examined dynamic changes in diet quality over time and subsequent risk of mortality.

This is the first study to demonstrate that improvement in these three diet scores over time is associated with reduced risk of total and cardiovascular mortality. In contrast, worsening diet quality over 12-years was associated with 6%-12% increased mortality.

In addition, not only improvement in diet quality but maintaining a high adherence to any of the three dietary patterns over 12 years was significantly associated with 9%-14% lower total mortality.
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Mind–Body Interventions Reduce Inflammatory Activity of Genes

MedicalResearch.com Interview with:

Ivana Buric Brain, Belief, and Behaviour Lab Centre for Psychology, Behaviour, and Achievement, Faculty of Health and Life Sciences Coventry University, Coventry, United Kingdom Donders Institute for Brain, Cognition and Behaviour Radboud University, Nijmegen, Netherlands

Ivana Buric

Ivana Buric
Brain, Belief, and Behaviour Lab
Centre for Psychology, Behaviour, and Achievement, Faculty of Health and Life Sciences
Coventry University, Coventry, United Kingdom
Donders Institute for Brain, Cognition and Behaviour
Radboud University, Nijmegen, Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  Genes that we inherited can change their activity – the​y can be active and produce proteins, but they can also stop producing proteins and remain silent. We are now beginning to understand what aspects of our environment affect the activity of which genes.

In this study, we analysed all the existing studies that examined the effects of mind-body interventions on the expression of our genes and found that mind-body techniques reduce the activity of genes that produce inflammatory proteins.

This pattern was found in all studies despite the fact that they vary in the amount of physical activity: Tai Chi, yoga, breathing techniques and different types of meditation. We believe that this effect is observed due to reduced stress.

When we experience something stressful, the brain regions associated with pain get activated and send that signal further to sypmathetic nervous system that produces epinephrine and norepinefrine, and activates nuclear factor kappa B – a molecule that travels to and activated the genes that produce inflammatory proteins. When we do yoga or meditation, we learn to perceive situations differently and consequently experience less stress, which then prevents the production of inflammatory proteins.

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Unhealthy Weight Gain in Pregnancy Is Now the Norm

MedicalResearch.com Interview with:

 

Professor Helena Teede MBBS, FRACP, PhD Executive Director Monash Partners Academic Health Research Translation Centre Director Monash Centre for Health Research and Implementation Monash University

Prof. Teede

Professor Helena Teede MBBS, FRACP, PhD
Executive Director Monash Partners Academic Health Research Translation Centre
Director Monash Centre for Health Research and Implementation
Monash University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Reproductive aged women are gaining weight rapidly both before and during pregnancy. Here in 1.3 million pregnancies internationally we show that almost 3 in 4 have unhealthy weight gain (half with excess weight gain and one quarter with inadequate gain)

MedicalResearch.com: What should readers take away from your report?

Response: For women establish your healthy weight for your height and try to stay within this for better fertility, pregnancy and for your and your child’s health. Regardless of your starting weigh,  aim to gain within targets in pregnancy. Seek help to do so.

For health professionals: unhealthy weight gain in pregnancy is now the norm, we must monitor women in pregnancy wand support them to gain healthy weight for better health outcomes. Weighing is not enough with health professionals needing skills in healthy conversations and support strategies for women.

For governments and policy makers this life stage around pregnancy is an optimal time to tackle obesity prevention and is targeted by WHO.

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Some Retirees Begin Risky Alcohol Consumption

MedicalResearch.com Interview with:
Jaana Halonen, Docent and Senior Researcher

Finnish Institute of Occupational Health

MedicalResearch.com: What is the background for this study?

Response: Retirement is a significant life transition when substantial changes in daily life are experienced as retirees adapt to life without work. After retirement people have more leisure time and more opportunities for different activities, and less stress. These changes are positive, but retirement can also lead to reduced social control and loss of social contacts and therefore be perceived as a stressful life transition. Both the positive and negative aspects related to changes in leisure time, stress, and social networks around retirement may affect drinking behaviours. However, little is known about how risky alcohol consumption changes around the retirement transition.

Thus, in our study we wanted to examine how and for whom risky drinking changes around the time of retirement. To do that we followed up public sector workers with questionnaires before and after their old-age retirement.

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2017’s Fattest Cities in America

MedicalResearch.com Interview with:

Jill Gonzalez WalletHub Analyst

Jill Gonzalez

Jill Gonzalez
WalletHub Analyst

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We based our research on recent findings that suggest that 70 percent of the adult U.S. population is overweight or obese. With that in mind, we wanted to find which metro areas offer the best environments for a healthy and active lifestyle.

Based on the report’s methodology, we concluded that areas in the south tend to have higher overweight and obese rates, as some fail to offer residents healthy environments and amenities that would facilitate a more active lifestyle. Please find the report’s main findings here: https://wallethub.com/edu/fattest-cities-in-america/10532/#main-findings.

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Association Between Cardiovascular Risk Factors and Aortic Stenosis

MedicalResearch.com Interview with:
Andrew T. Yan, MD
Terrence Donnelly Heart Centre
St Michael’s Hospital
University of Toronto
Toronto, Ontario, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The pathogenesis of aortic stenosis is complex and incompletely understood. Previous experimental data and epidemiologic studies (mostly cross-sectional) have demonstrated an association between conventional cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia, and aortic sclerosis or stenosis. However, there is a paucity of longitudinal data from large population studies. Therefore, we sought to examine the relationship between conventional cardiovascular risk factors and incident severe aortic stenosis during extended follow-up in a large unselected elderly population in Ontario, Canada.

In over 1 million individuals older than 65 who were followed for a median of 13 years, hypertension, diabetes and dyslipidemia were all significantly and independently associated with development of severe aortic stenosis requiring hospitalization or intervention. Furthermore, we observed a positive dose-response relationship between the number and duration of cardiac risk factors, and the risk of aortic stenosis. Together, these risk factors accounted for approximately one third of the incidence of severe aortic stenosis at a population level.

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Health Lifestyle Could Cut Cardiovascular Disease 50% in Chinese

MedicalResearch.com Interview with:

Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112

Dr. Lu Qi

Lu Qi, MD, PhD, FAHA
HCA Regents Distinguished Chair and Professor
Director, Tulane University Obesity Research Center
Department of Epidemiology
Tulane University
School of Public Health and Tropical Medicine
New Orleans, LA 70112 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Adherence to healthy lifestyle (high physical activity, less smoking, moderate alcohol consumption, healthy diet, and low adiposity) has been related to substantially reduced risk of cardiovascular diseases in large cohorts from the US and Europe, however, similar evidence in Asians such as Chinese is lacking.

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Lifestyle Modifications May Improve Health and Prognosis in Breast Cancer Patients

MedicalResearch.com Interview with:
Ellen Warner, MD, FRCPC, FACP, M.Sc.
Affiliate scientist
Sunnybrook Health Sciences Centre
Toronto, ON

MedicalResearch.com: What is the background for this review?

Response: As a medical oncologist who has treated breast cancer patients for over 30 years, I have found that most of the women in my practice are desperately looking for things they can do beyond standard surgery, radiation, chemotherapy, etc. to increase their chance of cure.  Unfortunately, many fall prey to false claims they read over the Internet or hear from well-meaning friends and relatives.  As a result they turn to absurdly restrictive diets (eg. No meat, dairy or sugar) or to ‘supplements’ with unproven effectiveness or even safety. So I thought it would be helpful to review the literature to determine what evidence-based lifestyle changes these women could make that would at least improve their overall health and, ideally, reduce their risk of dying of recurrent breast cancer.  For this review I thought it would be great to team up with Julia Hamer, a pre-med student with a degree in nutrition who just happens to also be an Olympic level athlete!
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Physical Activity and Abnormal Blood Glucose Among Healthy Weight Adults

MedicalResearch.com Interview with:

Arch G. Mainous III, PhD  HSRMP Department Chair Florida Blue Endowed Professor of Health Administration University of Florida Health

Dr. Arch G. Mainous III

Arch G. Mainous III, PhD
HSRMP Department Chair
Florida Blue Endowed Professor of Health Administration
University of Florida Health

MedicalResearch.com: What is the background for this study?

Response: As our post-industrial society becomes more and more sedentary, there is a concern that a lack of activity is associated with poor health outcomes like diabetes. At the same time, the medical community has a strong focus on determining whether patients are overweight or obese as a way to classify them as  being at higher risk for poor health outcomes. However, individuals at a “healthy weight” in general, are considered to be at low risk. Some recent studies have shown that many individuals at “healthy weight” are not metabolically healthy. How then might we predict who at “healthy weight” would be unhealthy? We hypothesized that individuals at “healthy weight” who had a sedentary lifestyle would be more likely to have prediabetes or undiagnosed diabetes.

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Light-Intensity Activities Can Improve Glycemic Control in Diabetics

MedicalResearch.com Interview with:

Bernard M Duvivier  Department of Human Biology and Movement Science NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre Maastricht, the Netherlands

Dr. Bernard M Duvivier

Bernard M Duvivier 
Department of Human Biology and Movement Science
NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre
Maastricht, the Netherlands

MedicalResearch.com: What is the background for this study?  What are the main findings?

Response: The health benefits of exercise have been well established but sitting is a risk factor for health, independent of exercise.

As many people with type 2 diabetes don’t like to exercise we investigated whether replacing sitting time with light-intensity activities (standing and light walking) is equally effective to exercise when energy expenditure is comparable. Our results suggest that for people with type 2 diabetes, light-intensity activities (light walking and standing) can be an alternative to exercise to improve glucose regulation.

In addition we showed that too much sitting has negative effects on insulin sensitivity which could not be fully compensated by 1 hour of exercise per day.

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Risk Factors For Adult Acne Identified

MedicalResearch.com Interview with:
Luigi Naldi, MD
Director Centro Studi GISED
Department of Dermatology
Azienda Ospedaliera papa Giovanni XXIII
Bergamo Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study was the natural continuation of a previous case-control study focusing on risk factors for moderate to severe acne in adolescents. In that study, we documented the role of a westernized diet to influence acne severity, with a low weekly intake of fruits or vegetables, a low consumption of fresh fish and a high consumption of milk especially skim milk, being risk factors for moderate to severe acne. Not surprisingly, also a family history of acne was associated with acne severity.

After completion of our study in adolescents, we realized that very little was known about acne in adults. Hence, we started a new case-control study focusing on risk factors for adult female acne. Besides the role of a family history, we documented that lifestyle factors could play an important role in adult acne. More specifically, being an office worker, and having a high level of reported psychological stress were associated with acne in adult women. In addition, similarly to acne in adolescents, low weekly intake of fruits or vegetables and a low consumption of fresh fish were documented as risk factors.

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The Health ABC Study: Simple Exercise Test Predicts Heart Failure

MedicalResearch.com Interview with:

Vasiliki Georgiopoulou MD MPH PhD Assistant Professor of Medicine (Cardiology) Emory University School of Medicine

Dr. Vasiliki Georgiopoulou

Vasiliki Georgiopoulou MD MPH PhD
Assistant Professor of Medicine (Cardiology)
Emory University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although existing evidence suggests that more exercise capacity is associated with lower risk of CV disease and death, we don’t know whether more exercise capacity would lead to lower risk for heart failure also. This would be especially important for older adults, who are the group with the highest risk to develop heart failure. We used the data of a cohort study to test this association.

The exercise capacity was evaluated by a walking test that is easy to perform – the long-distance corridor walk test. We observed that older adults who were able to complete the test had the lowest risk to develop heart failure and the lowest mortality rates, when compared with those who were not able to complete the test and those who could not do the test for medical reasons. We also observed that changes in exercise capacity 4 years later did not predict subsequent heart failure or mortality – perhaps because less fit older patients had already developed heart failure or had died.

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High Fitness Level Can Reduce Cardiovascular Risk of Prolonged Daily Sitting

MedicalResearch.com Interview with:

Ulrik Wisløff, PhD Professor, Head of K.G. Jebsen Center for Exercise in Medicine Department of Circulation and Medical Imaging Norwegian University of Science and Technology Norway

Dr. Ulrik Wisløff

Ulrik Wisløff, PhD
Professor, Head of K.G. Jebsen Center for Exercise in Medicine
Department of Circulation and Medical Imaging
Norwegian University of Science and Technology
Norway

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Prolonged time spent sedentary on a daily basis is detrimental for general health and is associated with increased risk of developing and dying from lifestyle related diseases such as cardiovascular disease – even in those following todays advice for physical activity given by health authorities worldwide. Number of hours spent inactive tend to increase with increased age. A person’s fitness level is regarded the best predictor of future health. We tested, in older adults (aged 70-77 years old) whether meeting physical activity recommendations and/or having high age-specific fitness level attenuated the adverse effect of prolonged sedentary time on cardiovascular risk factor clustering.

Main finding was that high age-specific fitness level fully attenuated the adverse effect of prolonged sedentary time on clustering of cardiovascular risk factors, independent of meeting the physical activity recommendation in older adults.

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Sedentary Lifestyle Linked To Increased Risk of Diabetic Retinopathy

MedicalResearch.com Interview with:

Paul Dinneen Loprinzi, PhD Health, Exercise Science and Recreation Management University of Mississippi

Dr. Paul Loprinzi

Paul Dinneen Loprinzi, PhD
Health, Exercise Science and Recreation Management
University of Mississippi

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research demonstrates that adults who have higher daily sedentary behavior tend to have worse cardiometabolic health profiles. The extent to which sedentary behavior is associated with diabetic retinopathy has yet to be evaluated in the literature before our study. Our findings provided some suggestive evidence that more sedentary behavior was associated with a higher odds of having diabetic retinopathy.

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Relatively Brief Physical Activity Can Offset Adverse Effects of Prolonged Sitting

MedicalResearch.com Interview with:

Ulf Ekelund, PhD FACSM Professor Department of Sports Medicine Norwegian School of Sport Sciences

Prof. Ulf Ekelund

Ulf Ekelund, PhD FACSM
Professor
Department of Sports Medicine
Norwegian School of Sport Sciences 

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is known that long sitting hours may be detrimental to health and previous studies have suggested associations between sitting time and all-cause mortality.However, it is not known whether physical activity can eliminate the increased risk of death associated with long sitting time.

We found that at least one hour of physical activity every day appear to offset the increased risk associated with more than eight hours of sitting. We also found that those who were physically inactive and sat for less than 4 hours every day were at greater risk compared with those who were physically active and sat for more than 8 hours providing further evidence on the benefits of physical activity.

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Pandemic of Global Physical Inactivity Costs Lives and Money

MedicalResearch.com Interview with:

Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney

Dr. Melody Ding

Ding Ding (Melody), Ph.D., MPH
NHMRC Early Career Senior Research Fellow
Sydney University Postdoctoral Research Fellow
Prevention Research Collaboration
Sydney School of Public Health
The University of Sydney

MedicalResearch.com: What is the background for this study?

Response: Understanding the true burden of a pandemic is indispensable for informed decision making. After decades of research, we now have established knowledge about how physical inactivity contributes to pre-mature deaths and chronic diseases, but the economic burden of physical inactivity remains unquantified at the global level. Through estimating the economic burden of physical inactivity for the first time, we hope to create a business case for investing in cost-effective actions to promote physical activity at the global levels.

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Poor Cardiovascular Health Linked to Increased Diabetes Risk Especially African Americans and Hispanics

MedicalResearch.com Interview with:
Joshua J. Joseph, MD
Christopher D. Saudek M.D. Fellow in Diabetes Research
Division of Endocrinology, Diabetes and Metabolism
Johns Hopkins University School of Medicine

MedicalResearch.com: What does your study explore?

Response: Our study explores two basic questions:

(a) Are multi-ethnic people with higher levels of cardiovascular health less likely to develop diabetes based on the AHA ideal cardiovascular health metric?

(b) Do these associations vary by race/ethnicity (non-Hispanic white, Chinese American, African American, and Hispanic American)?

MedicalResearch.com: Why did you choose this topic to explore?

Response: The literature has shown a strong association between lifestyle factors and elevated risk of diabetes in majority non-Hispanic white studies. One study of American Indians showed that meeting a greater number of ideal cardiovascular health goals was associated with a reduced risk of diabetes. We aimed to assess the association of baseline ideal cardiovascular health with incident diabetes within a multi-ethnic population, due to variation of ideal cardiovascular health by race/ethnicity.

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Shift Work May Increase Risk of Stroke

MedicalResearch.com Interview with:

David Earnest, Ph.D. Professor in the Department of Neuroscience and Experimental Therapeutics Texas A&M Health Science Center College of Medicine

Dr. David Earnest

David Earnest, Ph.D.
Professor in the Department of Neuroscience and Experimental Therapeutics
Texas A&M Health Science Center College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Earnest: When body clocks are disrupted, as they are when people engage in shift work or go to bed and get up at radically different times every few days, more severe ischemic strokes can result.

MedicalResearch.com: What should readers take away from your report?

Dr. Earnest:  Whenever possible, go to bed and get up at the same time each day and keep regular mealtimes. If you do need to keep an irregular schedule, it is especially important to be mindful of stroke risk and try especially hard to eliminate other risk factors, such as hypertension and obesity.

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Physical Activity During Leisure Time Linked to Cancer Risk

MedicalResearch.com Interview with:

Steven C. Moore PhD, MPH Division of Cancer Epidemiology and Genetics Rockville, MD

Dr. Steven Moore

Steven C. Moore PhD, MPH
Division of Cancer Epidemiology and Genetics
Rockville, MD 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Moore: More than half of Americans fail to meet recommended levels of regular physical activity; physical inactivity has become a major public health concern.

Physical activity during leisure time is known to reduce risks of heart-disease and all-cause mortality, as well as risks of colon, breast, and endometrial cancers. However, less is known about whether physical activity reduces risk of other cancers.

Hundreds of prospective studies have examined associations between physical activity and risk of different cancers. Due to small case numbers, results have been inconclusive for most cancer types.

In this study, we examined how leisure-time physical activity relates to risk of 26 different cancer types in a pooled analysis of 12 prospective cohort studies with 1.44 million participants. Our objectives were to identify cancers associated with leisure-time physical activity, and determine whether associations varied by body size and/or smoking history.

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Lifestyle Factors Can Prevent Up to 50% of US Cancer Deaths

MedicalResearch.com Interview with:
Mingyang Song
Research Fellow
Department of Nutrition
Harvard T.H. Chan School of Public Health 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although substantial data support the importance of lifestyle factors for cancer risk, a study published in Science early last year “led some to conclude that only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions, while most is due to random mutations arising during stem cell divisions, so-called bad luck.” That study “has been widely covered by the press and has created confusion for the public regarding the preventability of cancer.” In response to that study, we conducted this study to estimate how many cancer cases and deaths in the US can be potentially attributed to common lifestyle factors. Our study showed that about 20-30% of cancer incidences and 40-50% of cancer deaths may be avoided if everyone in the US adopted a lifestyle pattern that is characterized by “never or past smoking (pack-years <5), no or moderate alcohol drinking ([1]1 drink/d for women,[1]2 drinks/d for men), BMI of at least 18.5 but lower than 27.5, and weekly aerobic physical activity of at least 75 vigorous-intensity or 150 moderate-intensity minutes”.

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Shift Work Linked To Cognitive Impairment in Middle Aged and Older Adults

MedicalResearch.com Interview with:

Christian Benedict Ph.D Dept. of Neuroscience Uppsala University, Swedenphotographer: Magnus Bergström

Dr. Christian Benedict

Christian Benedict Ph.D
Dept. of Neuroscience
Uppsala University, Sweden

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Benedict: A considerably large proportion of today’s workforce performs shift work. Both epidemiological and experimental studies have demonstrated that shift workers are at an increased risk for multiple diseases, such as cardiovascular diseases. However, knowledge regarding short- and long-term effects of shift work on parameters of brain health is still fragmentary.

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Attendance At Religious Services Linked To Increased Longevity in Women

MedicalResearch.com Interview with:

Dr. Tyler VanderWeele PhD Professor of Epidemiology Department of Epidemiology Department of Biostatistics Harvard T. H. Chan School of Public Health

Dr. Tyler VanderWeele

Dr. Tyler VanderWeele PhD
Professor of Epidemiology
Department of Epidemiology
Department of Biostatistics
Harvard T. H. Chan
School of Public Health 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. VanderWeele: There have been some prior studies on religious service attendance and mortality. Many of these have been criticized for poor methodology including the possibility of reverse causation – that only those who are healthy can attend services, so that attendance isn’t necessarily influencing health. We tried to address some of these criticisms with better methodology. We used repeated measures of attendance and health over time to address this, and a very large sample, and controlled for an extensive range of common causes of religious service attendance and health. This was arguably the strongest study on the topic to date and addressed many of the methodological critiques of prior literature. We found that compared with women who never attended religious services, women who attended more than once per week had 33% lower mortality risk during the study period. Those who attended weekly had 26% lower risk and those who attended less than once a week had 13% lower risk.

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Daytime Naps May Raise Your Blood Pressure

MedicalResearch.com Interview with:

Wisit Cheungpasitporn, MD, Nephrology Fellow Project mentor: Stephen B. Erickson, MD Departments of Nephrology and Hypertension Mayo Clinic, Rochester, MN

Dr. Wisit Cheungpasitporn

Wisit Cheungpasitporn, MD, Nephrology Fellow
Project mentor: Stephen B. Erickson, MD
Departments of Nephrology and Hypertension
Mayo Clinic, Rochester, MN

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Cheungpasitporn: The prevention and management of hypertension continue to be major public health challenges. Studies have shown the benefits of napping, including reduction of fatigue and improvement of alertness, mood and work performance. However, there have also been increasing reported associations between napping and cardiovascular disease, diabetes mellitus, strokes, and higher mortality from all causes. The risk of hypertension in adults who regularly take a nap is controversial.

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Dieting and Weight Loss Improved Quality of Life in Mildly Overweight Patients

MedicalResearch.com Interview with:

Dr. Corby K. Martin PhD Department/Laboratory: Ingestive Behavior Laboratory Director for Behavioral Sciences and Epidemiology Pennington Biomedical Research Lab Baton Rouge, LA

Dr. Corby Martin

Dr. Corby K. Martin PhD
Department/Laboratory:
Ingestive Behavior Laboratory
Director for Behavioral Sciences and Epidemiology
Pennington Biomedical Research Lab
Baton Rouge, LA 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Martin: We know that calorie restriction extends the lifespan of many species and in humans calorie restriction or dieting might extend our healthspan, which is the length of time that we are free of disease. It is possible that more healthy weight or mildly overweight people might calorie restrict to improve their health, and one concern is the possible negative effects of calorie restriction on the quality of life of these individuals.

This study tested if 2 years of calorie restriction affected a number of quality of life measures compared to a group that did not calorie restrict and ate their usual diet and did not lose weight. People who enrolled in the study were normal weight to mildly overweight. The study found that calorie restriction improved mood, reduced tension and improved general health and sexual drive and relationship (a measure of sexual function) over two years. Further, the more weight that people lost, the greater their improvement in quality of life.

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Rotating Night Shift Work Linked to Increased Coronary Heart Disease Risk

MedicalResearch.com Interview with:

Dr. Céline Vetter Dr.Phil. Instructor in Medicine Harvard Medical School Associate Epidemiologist Channing Division of Network Medicine Brigham and Women's Hospital Boston, MA, 02115

Dr. Céline Vetter

Dr. Céline Vetter,  Dr.Phil.
Instructor in Medicine
Harvard Medical School
Associate Epidemiologist
Channing Division of Network Medicine
Brigham and Women’s Hospital
Boston, MA, 02115

MedicalResearch.com: What is the background for this study?

Response: Heart Disease is still the leading cause of death in the US, with 1 in every 4 deaths being attributed to heart disease. On the other hand, it is estimated that approximately 15 millions Americans work evening shifts, night shift, rotating shifts or any other kind of irregular schedule that is arranged by the employer. The link between shift work and coronary heart disease has been studied for decades now, but because shift work can take so many forms, results have not been consistent. Another contributing factor to this inconsistency might be that few studies could actually track individuals over long periods of time, so that some studies might have missed when participants did actually develop coronary heart disease.

Our study was based on the Nurses’ Health Studies I and II, where women about 189,000 registered female nurses completed every two years mailed questionnaires that comprise items about their health status, medical history, and known or suspected risk factors for cancer and heart disease. They also reported their lifetime history of rotating night shift work in 1988 and 1989, respectively. Across the 24 years of the study periods, we observed more than 10,000 cases of coronary heart disease (i.e. myocardial infarction, CHD death, angiogram-confirmed angina pectoris, and procedures related to coronary heart disease, i.e. angioplasty, coronary artery bypass graft surgery or stents). Continue reading

Type 2 Diabetes: “Stand Up, Sit Less, Move More, More Often” For Better Glucose Control

MedicalResearch.com Interview with:

Paddy Dempsey MPhEd, PhD in Medicine (expected June 2016) Physical Physical Activity and Behavioural Epidemiology Laboratory Baker IDI Heart and Diabetes Institute Melbourne VIC

Paddy Dempsey

Paddy Dempsey
MPhEd, PhD in Medicine (expected June 2016)
Physical Physical Activity and Behavioural Epidemiology Laboratory
Baker IDI Heart and Diabetes Institute
Melbourne VIC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In addition to too little physical activity (PA), sedentary behavior – defined as any waking sitting or reclining behavior with low energy expenditure – has emerged as a ubiquitous and significant population-wide influence on cardiometabolic health outcomes, with potentially distinct and modifiable environmental and social determinants. There is now a consistent base of epidemiologic evidence reporting deleterious associations of excessive sedentary behaviors (e.g. TV viewing, car use, and desk work) with mortality and cardiometabolic morbidity, independent of moderate-vigorous PA.

To date, efforts to influence participation in moderate-to-vigorous exercise (i.e. 30 min a day of ‘exercise’ on most days a week for health) at the population level, such as through large-scale campaigns to promote walking, and other initiatives to encourage people to exercise during their leisure time have achieved only modest success. There may, however, be untapped preventive-health and clinical management potential through shifting the high volume of time spent sedentary to light-intensity physical activity interspersed throughout the day. As such, sedentary behavior represents a potentially feasible and therapeutic target, particularly in the promotion of metabolic health.

We posited that people with type 2 diabetes (T2D) were likely to derive the greatest benefits from interrupting their sitting time. However, until now the contributions of prolonged sitting and/or interrupting prolonged sitting with very-brief bouts of light-intensity PA had never been experimentally tested in patients with T2D. Moreover, this study for the first time moved beyond interrupting sitting with standing or ambulatory bouts (although walking bouts were also examined), which may have differing levels of metabolic stimulus (i.e. not physiologically taxing the body enough), practicality, or health efficacy, to examine a potential addition/alternative: simple resistance activities (SRA). A key premise behind these SRA bouts (half-squats, calf raises, gluteal contractions, and knee raises) were that they required no specialized equipment, only small amounts of space, and could be easily performed in a fixed position behind a work desk or at home with minimal disruption to work tasks or leisure pursuits. In addition, they also markedly increase muscle activity, and may also have other longer-term benefits (for example physical function, muscle strength, bone density), however we can only speculate on these aspects at present.

In this study in men and women with type 2 diabetes, plasma glucose, insulin and C-peptide (marker of insulin secretion and pancreatic beta cell function) levels following standardized breakfast and lunch meals were all markedly attenuated when prolonged sitting was regularly interrupted with light walking or resistance activities (3 min every 30 min) over an 8 hour day. Plasma triglyceride levels were also reduced for both types of activity bout; however, the reduction was only significant for the SRAs. Interestingly, the magnitude of glucose reduction for the walking bouts was greater in women for glucose levels.

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“Sitting Disease” Raises Coronary Artery Calcium

MedicalResearch.com Interview with:

Jacquelyn Kulinski, MD Assistant Professor Division of Cardiovascular Medicine Medical College of Wisconsin Milwaukee, WI 53226

Dr. Jacquelyn Kulinski

Jacquelyn Kulinski, MD
Assistant Professor
Division of Cardiovascular Medicine
Medical College of Wisconsin
Milwaukee, WI 53226

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Kulinski: Sedentary behavior, or “sitting disease”, is increasingly recognized as a risk factor for cardiovascular disease, diabetes, cancer and early death.  Many of these associations appear to be independent of exercise activity. The mechanisms through which sedentary behavior influences cardiovascular risk are largely unknown.  Therefore, we investigated the association between accelerometer measured sedentary behavior and coronary artery calcium (CAC), a marker of subclinical heart disease, in over 2,000 participants using data from the Dallas Heart Study (DHS) population.

We found a significant association between increasing sitting time and CAC in a population without prior history of cardiovascular disease.  This association was independent of measured exercise activity, traditional risk factors, and even socioeconomic factors.  Each hour of sedentary time was associated with a 16% increase in CAC burden.  Interestingly, the association between exercise and CAC was not significant in the fully-adjusted model. 

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Miscarriage Risk Reduced by Daily Multivitamins Before and After Conception

MedicalResearch.com Interview with:

Germaine M. Buck Louis, Ph.D., M.S. Office of the Director, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, Maryland 20852.

Dr-Germaine M. Buck-Louis

Germaine M. Buck Louis, Ph.D., M.S.
Office of the Director
Division of Intramural Population Health Research
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Rockville, Maryland 20852.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: To understand the association between couples’ lifestyles and risk of pregnancy loss.  Couples were recruited upon discontinuing contraception to try for pregnancy and followed daily for up to one year of trying or until pregnancy.  Pregnant women were followed daily for 7 weeks following conception then monthly.

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Active Commuting Can Lead To Healthier Weight in Mid-Life

MedicalResearch.com Interview with:

Dr Ellen Flint Lecturer in Population Health MRC Strategic Skills Fellow Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine London

Dr. Ellen Flint

Dr Ellen Flint
Lecturer in Population Health
MRC Strategic Skills Fellow
Department of Social & Environmental Health Research
London School of Hygiene & Tropical Medicine
London

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Flint: Globally, physical inactivity is a major cause of obesity, chronic disease and premature mortality. Improving population levels of physical activity is therefore a key public health policy aim, in high and middle income countries. In the past, functional active travel was a key source of physical activity for many people. However, since the mass adoption of private motorised travel in the 20th century, the vast majority (63%) of working adults in the UK commute to by car. Using UK Biobank data from more than 150,000 middle-aged adults, we found that those who commuted to work via cycling or walking had significantly lower body fat percentage and lower body mass index (BMI) compared to adults who commuted by car. The strongest associations were seen for adults who commuted via bicycle. For the average man in the sample (age 53 years; height 176.7cm; weight 85.9kg), cycling to work rather than driving was associated with a weight difference of 5kg or 11lbs (1.71 BMI points). For the average woman in the sample (age 52 years; height 163.6cm; weight 70.6kg), the weight difference was 4.4kg or 9.7lbs (1.65 BMI points). Even people who commuted via public transport also showed significant reductions in BMI and percentage body fat compared with those who commuted only by car. This suggests that even the incidental physical activity involved in public transport journeys may be important. The link between active commuting and obesity reduction was independent of other factors such as income, area deprivation, urban or rural residence, education, alcohol intake, smoking, general physical activity, dietary energy intake and overall health and disability.
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Cochrane Study Reviews Workplace Interventions For Reducing Sitting at Work

MedicalResearch.com Interview with:

Dr Nipun Shrestha MBBS, MPH Health Research and Social Development Forum Thapathali, Kathmandu, Nepal

Dr. Nipun Shrestha

Dr Nipun Shrestha MBBS, MPH
Health Research and Social Development Forum
Thapathali, Kathmandu, Nepal

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: These days our work in the offices isn’t the same as it used to be. Almost everybody is working with a computer nowadays and that makes you sit still all day. We do not need to move from our chair to do most of the things. This is not just the case in developed countries but for developing countries as well.

One would argue though we are sitting in the office hours but we are regularly doing lots of exercises. However researchers have found that sedentary behavior is an independent risk factor for many chronic diseases like diabetes, cardiovascular diseases and cancer. So breaking up time that we spend sitting is important.

There are many commercial innovations available in the market which are being advertised heavily by the manufacturers. The evidence on effectiveness of such innovation is however not available.

We found that there is limited evidence on effectiveness of interventions that aim to reduce sitting at work. There is some evidence that sit-stand desk may reduce sitting at work between 30 minutes to 2 hours without any adverse effects.

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Retirees Report Significant Improvement in Lifestyle

MedicalResearch.com Interview with:

Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney

Dr. Melody Ding

Ding Ding (Melody), Ph.D., MPH
NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow
Prevention Research Collaboration
Sydney School of Public Health
The University of Sydney

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Ding: This study used data from the Sax Institute’s 45 and Up Study, a large Australia based cohort of adults aged 45 or older. We followed around 25,000 participants who were working at baseline (2006-2008) for an average of 3 years (follow-up in 2010). During the follow-up period, around 3,000 participants retired from the workforce. Participants were asked to report their health-related lifestyle behaviors, such as physical activity, smoking, and sleep time at both baseline and follow-up. We found that those who retired overall had significant improvement in their lifestyle as compared with those who did not, including more physical activity, less sitting time, and more sleep. Female smokers who retired were also more likely to have quit smoking.

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Leisure Physical Activities Linked To Increase in Brain Gray Matter

MedicalResearch.com Interview with:

Cyrus A. Raji, MD, PhD Resident in Diagnostic Radiology UCLA Health System

Dr. Cyrus Raji

Cyrus A. Raji, MD, PhD
Resident in Diagnostic Radiology
UCLA Health System 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Raji: The purpose of this study was to investigate the relationship between caloric expenditure from leisure physical activities (15 different ones were assessed from walking to gardening to dancing to swimming etc.).

Increased caloric expenditure from these physical activities were related to larger gray matter volumes in key brain areas for memory and learning (hippocampus, precuneus) that are also affected by Alzheimer’s. These findings were demonstrated in 876 persons who had MRI scans and caloric expenditure assessed. Five years after the scan a subset of 326 persons from the larger group of 876 were followed cognitively and it was found that those with larger gray matter volumes associated with physical activity in the orbital frontal cortex and precuneus had a 2 fold reduction in the risk for cognitive decline to mild cognitive impairment and Alzheimer’s dementia

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Kids Who Watch A Lot of TV Still Do So As Adults, Adding to Obesity Risk

MedicalResearch.com Interview with:

Dr. Chance York PhD School of Journalism and Mass Communication Kent State University

Dr. Chance York

Dr. Chance York PhD
School of Journalism and Mass Communication
Kent State University

MedicalResearch.com: What is the background for this study? What are the main findings? 

Dr. York: A number of studies have examined the effects of heavy television viewing during childhood on childhood levels of Body Mass Index (BMI), but my study added a new element to this literature: it explores the long-term effects of TV viewing on adult-era BMI.

The major takeaway is that heavy television viewing during childhood results in an individual propensity to watch TV much later in life, and this propensity to watch television results in increased BMI. In other words, kids who watch a lot of television tend to remain heavy TV users as adults, and the fact that they’re heavy TV viewers as adults has a separate, unique effect on their adult BMI.
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Too Much Screen time Raises Risk of Pre-Diabetes in Children

MedicalResearch.com Interview with:

Mélanie Henderson, MD, FRCPC, PhD

Mélanie Henderson

Mélanie Henderson, MD, FRCPC, PhD
Pediatric Endocrinologist and Assistant Clinical Professor
Division of Endocrinology and Diabetes
University of Montreal/Centre Hospitalier Universitaire Ste-Justine
Montréal, Québec

Medical Research: What is the background for this study? What are the main findings?

Dr. Henderson: Dysregulation in insulin sensitivity and insulin secretion are the basic elements in the pathophysiology of type 2 diabetes. There is extensive data suggesting that better lifestyle habits are associated with the prevention or the delay in onset of type 2 diabetes in adults, with improved lifestyle habits having been more effective than pharmacologic agents at diabetes prevention in one study. Little work however has been done to determine whether this holds true in children. Cross-sectional studies in youth have found conflicting results and no study has considered the combined effect of physical activity, fitness and sedentary behavior on insulin dynamics in children.

Understanding the impact of lifestyle habits on insulin dynamics in childhood has become paramount, given that less than 7% of Canadian children are currently meeting physical activity guidelines and that 1/3 of school-aged Canadian children and 2/3 of Canadian teenagers are exceeding the current guidelines in terms of screen time, which advocate for a maximum of 2 hours daily.

Our study shows that adiposity is the central predictor of insulin dynamics in children, and that physical activity and screen time play an important role, in part through their effect on adiposity. Thus, establishing and maintaining a highly physically active lifestyle early on in life, while minimizing sedentary behaviour (specifically screen time) appear to be important strategies to consider to prevent type 2 diabetes in youth.

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Sitting Time Raises Risk of Type II Diabetes

MedicalResearch.com Interview with:
Julianne van der Berg  PhD candidate
Social Medicine
Universiteitssingel Maastricht
The Netherlands 

Medical Research: What is the background for this study? What are the main findings?

Response: The study investigated in data from The Maastricht Study, a large study in the Netherlands, associations of total duration and patterns of sedentary behavior with type 2 diabetes.
We show that participants with type 2 diabetes spent the most time of day sedentary, 26 min more than participants without diabetes.
Each additional hour of sedentary time was associated with a 22% increased risk of type 2 diabetes.
Important is that these results were independent of high-intensity physical activity.

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We Don’t Need To Assume Diabetes Is a Relentless Process

MedicalResearch.com Interview with:

David Drozek, D.O. Assistant Professor of Surgery Ohio University Heritage College of Osteopathic Medicine Athens, Ohio 45701

Dr. David Drozek

David Drozek, D.O.
Assistant Professor of Surgery
Ohio University Heritage College of Osteopathic Medicine
Athens, Ohio 45701

Medical Research: What is the background for this study?

Response: Half of the U.S. population has diabetes or prediabetes.  The rate is even higher in Appalachia.  As a society, we cannot sustain this level of disease.  It exacts a heavy toll on our productivity and our health care costs. Current approaches to diabetes, primarily with medication, are not sufficient.  More attention needs to be placed on the underlying cause of diabetes, and its traveling partners, overweight / obesity, heart disease and many common cancers.  That cause is our lifestyle. 

Medical Research: What are the main findings?

Response: As has been demonstrated in many other studies of lifestyle modification programs, chronic illnesses, like diabetes, can actually be reversed, and in some cases, even cured, by instituting a plant-based, whole food diet, increased physical activity and stress management techniques.  Our study reinforces that this is possible, even in a rural, poverty stricken region, when people are ready to make healthy changes.  Our study participants, on average, lost weight, and improved their blood sugar, lipid panel and blood pressure, by participating in The Complete Health Improvement Program (CHIP), a lifestyle medicine program.

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High Fitness Level May Reduce Mortality After First Heart Attack

MedicalResearch.com Interview with:
Gabriel E. Shaya MS

University of Miami Miller School of Medicine
MD/MPH Candidate 2016

Medical Research: What is the background for this study?

Response: High exercise capacity has been established as an important protective factor against a wide array of poor health indicators and outcomes including cardiovascular morbidity and mortality. Most of the studies assessing the association of exercise capacity and cardiovascular outcomes have done so over an extended period of followup, however, whether high exercise capacity may influence the risk of early mortality following a first myocardial infarction has not been investigated. This is the question that we sought to answer in our study.

Medical Research: What are the main findings?

Response: Our study found that high exercise capacity was associated with statistically significant and clinically meaningful risk reductions in mortality in the short-term following a first myocardial infarction. Achieving the highest category of fitness in our cohort was associated with as much as a 60% mortality risk reduction relative to those in the least fit category, and similar magnitudes of benefit were observed to persist up to 1 year after a myocardial infarction. Importantly, the greatest risk reductions were observed when comparing the least fit patients to those with moderate fitness, suggesting that those with relatively low fitness may stand to benefit most from even just modest fitness improvements.

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Many Hospitalized Oncology Patients Would Like Complementary Health Treatments

Maria T. Chao, DrPH, MPA Assistant Professor of Medicine Osher Center for Integrative Medicine & Division of General Internal Medicine - SFGH UCSF San Francisco, CA 94143-1726

Dr. Chao

MedicalResearch.com Interview with:
Maria T. Chao, DrPH, MPA

Assistant Professor of Medicine
Osher Center for Integrative Medicine
& Division of General Internal Medicine – SFGH
UCSF
San Francisco, CA 94143-1726

Medical Research: What is the background for this study? What are the main findings?

Dr. Chao: Many Americans use complementary and integrative health (CIH) approaches to help them manage the symptoms of chronic diseases. To date, most of these treatments are only available in outpatient clinics. In this study, we asked oncology inpatients which of 12 different CIH approaches they currently use or have tried in the past, and also which approaches they would like to be available in the hospital. We found that 95% of patients had tried at least one  complementary and integrative health approach in the past, and that a similarly high number were interested in accessing these services as an inpatient. More than three quarters of our sample expressed interest in receiving nutritional counseling and massage during their hospital stay, and approximately half were interested in acupuncture, biofeedback, and mindfulness meditation.

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Behavioral Risk Factors Cluster and Compound Mortality Risk

Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney

Dr. Melody Ding

MedicalResearch.com Interview with:
Ding Ding (Melody), Ph.D., MPH

NHMRC Early Career Senior Research Fellow
Sydney University Postdoctoral Research Fellow
Prevention Research Collaboration
Sydney School of Public Health
The University of Sydney 

Medical Research: What is the background for this study? What are the main findings?
Response:  The study followed a large sample (around 200,000) of Australian adults aged 45 or older. Participants reported their lifestyle behaviours (smoking, excessive alcohol use, physical inactivity, unhealthy diet, prolonged sitting, short/long sleep duration) at baseline (2006-2009) and were followed up for around 6 years (up to June 2014). Based on linked administrative data (death records), we found a clear relationship between the total number of lifestyle risk behaviours and the risk of mortality—the more risk behaviours, the higher risk for mortality. This pattern of associations was consistent in men and women, participants in different age groups, of different socioeconomic status, and with and without major chronic disease.

Certain behavioural risk factors have synergistic associations with mortality and appear more harmful together than individually. For example, if people only sit for long hours (defined as >7 hours a day), without having other co-occurring risk behaviours, the risk for mortality was only elevated by 15%, and if people are only physically inactive without having other co-occurring risk behaviours, the risk for mortality was elevated by 60%. However when the two risk factors were combined, say if one is not physically active AND sit for long hours, the combined risk has become much larger (increased by 140%, compared with those with zero risk behaviours).  Similarly, the combination of smoking and excessive alcohol use appeared a lot more “deadly” than the two risk factors alone.

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Physical Activity Important For Brain Health At Any Age

MedicalResearch.com Interview with:
Tina Hoang MSPH
Staff Research Associate
Northern California Institute for Research and Education,
Veterans Affairs Medical Center
Dr. Kristine Yaffe MD
Professor of Psychiatry, Neurology, and Epidemiology
University of California
San Francisco, CA  94121

Medical Research: What is the background for this study? What are the main findings?

Response: We assessed physical activity and TV watching in young adults over 25 years to see if there was an association with cognitive function in middle age.  Most previous studies have only considered this association in older adults. We found that both low physical activity and high TV watching over time were associated with worse cognitive function.

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Increased Time Watching TV Linked To Greater Mortality Risk

Sarah K. Keadle, PhD, MPH Cancer Prevention Fellow Nutritional Epidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute

Dr. Keadle

MedicalResearch.com Interview with:
Sarah K. Keadle, PhD, MPH
Cancer Prevention Fellow
Nutritional Epidemiology Branch
Division of Cancer Epidemiology and Genetics
National Cancer Institute

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Keadle: Television viewing is extremely prevalent in the U.S. Ninety-two percent of Americans have a television at home and watching TV consumes more than half of their available leisure time, potentially displacing more physical activities. Previous studies have reported a relationship between TV viewing and increased risk of death from the two most common causes of death in the U.S., cancer and heart disease.

In our study, we followed more than 221,000 healthy Americans aged 50-71 years old for 14 years to look at this relationship. We confirmed the association with increased risk of death from cancer and heart disease. In addition, we found that TV viewing was associated with an increased risk of six other causes of death, including diabetes, influenza/pneumonia, Parkinson’s disease, and liver disease.

Also, compared to individuals who watched less than one hour per day, those who watched 3-4 hours of TV per day were 15% more likely to die from any cause, and individuals who watched seven or more hours of TV per day were 47% more likely to die over the study period.

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Don’t Just Sit There…Fidget!

Dr Gareth Hagger-Johnson PhD Senior Research associate Epidemiology & Public Health, Div of Population Health University College, LondonMedicalResearch.com Interview with:
Dr Gareth Hagger-Johnson PhD
Senior Research associate
Epidemiology & Public Health, Div of Population Health
University College, London

 

Medical Research: What is the background for this study? What are the main findings?

Response: Even among adults who meet recommended physical activity levels and who sleep for eight hours per night, it is possible to spend the vast majority of the day (up to 15 hours) sitting down. We were concerned about possible harm resulting from sitting for long periods combined with not moving.

Breaks in sitting time have previously been shown to improve markers of good health, such as body mass index and your body’s glucose and insulin responses. But until now, no study has ever examined whether fidgeting might modify an association between sitting time and mortality.

We noticed that The UK Women’s Cohort Study collected data (from 1999 to 2002) on health behavious, chronic disease, physical activity levels, sitting time – and fidgeting (a self-report scale ranging from 0 to 10, where 10 means ‘constantly’). More than 12,000 responses were received. We looked at the data to see who had died over the next 12 years.

Among women with low levels of fidgeting who also sat for 7 or more hours per day (compared to less than 5 hours), there was around a 30% increase in the risk of mortality over 12 years follow-up. Among women with medium or high levels of fidgeting, we did not see this harmful effect of sitting time, even after adjusting for other lifestyle factors including physical activity level.

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Poor Lifestyle Linked to Acute Coronary Syndrome, Even After Event

MedicalResearch.com Interview with:
Sylvie S.L. Leung Yinko, MSc, RD

Division of Clinical Epidemiology
Research Institute of McGill University Health Centre (RI MUHC)
Montreal (QC) and
Louise Pilote, MD, MPH, PhD
Professor of Medicine McGill University and
Director of the Division of General Internal Medicine
McGill University Health Centre

Medical Research: What is the background for this study? What are the main findings?

Response: Patients with premature acute coronary syndrome (ACS) are a vulnerable population of young or middle-aged adults at risk for future cardiovascular events. However, while health behaviors such as diet, physical activity, smoking, alcohol consumption and recreational drug use are important lifestyle factors that can influence cardiovascular risk, there is limited information about health behaviors in this population group. Additionally, there is indication in the literature regarding sex and age differences in health behaviors, but whether such differences exist in patients with premature acute coronary syndrome remained to be explored.

Using data from GENESIS-PRAXY (GENdEr and Sex determInantS of Cardiovascular Disease from bench to beyond in PRemature Acute Coronary Syndrome), a large-scale prospective cohort study across Canada, US and Switzerland, we explored the health behavior profile of patients with premature ACS. As well, we examined whether there is a change in health behaviors 1 year post-ACS and assessed sex differences.

Our results showed that the health behavior profile of men and women with premature Acute Coronary Syndrome are worse than that of the general population. We found a high prevalence of poor health behaviors in a young population with only modest changes after Acute Coronary Syndrome. Health behaviors remained suboptimal and worse than the general population, especially with regards to diet, smoking and recreational drug use. Sex differences existed in the prevalence of these behaviors at baseline and 1 year post-ACS but not in the magnitude of change after the ACS event.

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Sugar Sweetened Beverages Linked To Overall Unhealthy Diet

Louise Brunkwall Nutritionist, MPH and Phd-student Diabetes and Cardiovascular Disease, Genetic Epidemiology Lund University, Clinical Sciences Malmö, Sweden

MedicalResearch.com Interview with:
Louise Brunkwall
Nutritionist, MPH and Phd-student
Diabetes and Cardiovascular Disease, Genetic Epidemiology
Lund University, Clinical Sciences
Malmö, Sweden

 Medical Research: What is the background for this study? What are the main findings?

Response: There has been a huge interest for sugar sweetened beverages (SSB) the last years and SSB has been associated with various diseases like type 2 diabetes and obesity, while juice for example which have approximately the same amount of energy have not. We find this very interesting and wanted to know more about who the people were that consumed a lot of these different beverages. We started of by looking at diet and found that the different beverages were associated with different dietary patterns. Sugar sweetened beverages were associated with a more unhealthy diet while juice was associated with a more healthy diet. We see the same for tea which is a beverage previously associated with a lower risk of several diseases, that it is associated with an overall very healthy diet. Therefore we draw the conclusions that beverages are a part of the overall diet which might contribute to the previous findings of associations with different diseases. This also tells us that it is of great importance to know more about the overall diet than just consumption of a single product when investigating beverages-dieases association studies.

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Men More Likely To Develop Diabetes If Spouse Has Gestational Diabetes

Dr. Kaberi Dasgupta MD, MSc, FRCPC Associate Professor, Department of Medicine Divisions of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism Royal Victoria Hospital Quebec, Canada

MedicalResearch.com Interview with:
Dr. Kaberi Dasgupta MD, MSc, FRCPC
Associate Professor, Department of Medicine
Divisions of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism
Royal Victoria Hospital
Quebec, Canada

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Dasgupta: We know that health behaviours can contribute to developing gestational diabetes and type 2 diabetes (e.g., eating out frequently, lack of fruits and vegetables, not walking enough, spending most of the day sitting). We also know that genetic factors are important. Sometimes we focus more on the genetic factors than on health behaviours. By showing that spouses share diabetes risk, we highlight the importance that behaviour and environment play as spouses are not generally related biologically. In a previous meta-analysis, we showed that spouses were concordant for diabetes (if one had it, there was a 24% relative risk increase that the other did too.)

In the study Gestational Diabetes Mellitus in Mothers as a Diabetes Predictor in Fathers: A Retrospective Cohort Analysis, we took it further and compared men whose partners had gestational diabetes and men whose partners did not. Over a 13 year period of follow-up, the men whose partners had gestational diabetes were 33% more likely to develop diabetes. 

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