Author Interviews, Lifestyle & Health, NYU / 19.06.2015

MedicalResearch.com Interview with: Stella Yi, PhD, MPH New York University Langone School of Medicine, Department of Population Health New York, NY 10016 MedicalResearch: What is the background for this study? What are the main findings? Dr. Yi: Sedentary behaviors, such as sitting time, are an emerging risk factor in the field of physical activity epidemiology. Recent studies have demonstrated the negative health consequences associated with extended sitting time, including metabolic disturbances and decreased life expectancy independent of the effects of regular exercise. We also assessed mean values of self-reported sitting time to characterize these behaviors in a diverse, urban sample of adults. The average New York City resident sits more than seven hours a day—greatly exceeding the three hours or more per day that is associated with decreased life expectancy. Among the findings:
  • At the lower economic end, individuals spent 6.3 hours per day sitting, while those with higher incomes spent 8.2 hours per day sitting
  • College graduates spent 8.2 hours per day sitting, compared with 5.5 hours per day for those with less than a high school education
  • Whites spent on average 7.8 hours per day sitting, African Americans spent 7.4 hours sitting, Hispanics spent 5.4 hours sitting, and Asian Americans spent 7.9 hours per day sitting
  • Sitting time was highest in Manhattan, compared to other boroughs.
In the current analysis, we also assessed the validity of a two-question survey method of sitting time during waking hours using accelerometers to measure sedentary time in a subsample of our study participants. The correlation between sitting time reported in the survey and accelerometer-measured sedentary time was modest (r=0.32, p<0.01) with wide limits of agreement. We interpreted this to mean that while self-reported sitting might be useful at the population-level to provide rankings and subgroups, it may be limited in assessing an individual’s actual behavior. (more…)
Author Interviews, Education, Heart Disease, Lifestyle & Health, Radiology / 16.06.2015

MedicalResearch.com Interview with: Ms. Rikke Elmose Mols Department of Cardiology, Lillebaelt Hospital-Vejle, Vejle, Denmark. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Current ESC guidelines for patients with chest pain and low to intermediate pre-test probability of coronary artery disease (CAD) recommend control and modification of risk factors. However, patients with an elevated cardiovascular risk profile are frequently inadequately motivated for lifestyle changes and medicine adherence from knowledge about risk factors and information about risk reduction alone. Coronary artery calcification (CAC) is a marker of coronary atherosclerosis. The degree of coronary artery calcification may be assessed by the Agatston score (AS) derived by non-enhanced cardiac computed tomography, whereas non-invasive CT imaging of the coronary arteries require contrast-enhancement (coronary computed tomography angiography [CTA]). The presence of CAC is associated with an elevated probability of obstructive coronary artery disease (CAD) and an unfavorable clinical outcome. In symptomatic patients, demonstration of non-obstructive CAD identified by coronary CTA is associated with risk modifying behavior and intensified prophylactic medical treatment in observational studies. Among asymptomatic individuals, those with the highest Agatston score levels seem to be motivated for the adoption of risk modifying behaviour and visualization of CAC may stimulate adherence to lipid-lowering therapy and aspirin and a healthier lifestyle. The aim of the present prospective, randomized controlled study was to test the effect of adding visualization of coronary artery calcification to the standard information about risk and lifestyle modification on cholesterol levels and other risk markers in patients with a new diagnosis of non-obstructive CAD. Visualization of coronary artery calcification and brief recommendations about risk modification (ESC guidelines) after coronary CTA in symptomatic patients with hyperlipidemia and non-obstructive CAD may have a favorable influence on plasma total-cholesterol concentration, adherence to statin therapy and risk behavior. Further investigations are needed. (more…)
Author Interviews, Lifestyle & Health, Menopause / 22.05.2015

MedicalResearch.com Interview with: Jasmine Lee, M.Sc. and Chris I. Ardern, Ph.D. School of Kinesiology and Health Science York University Toronto, ON, Canada Medical Research: What is the background for this study? Response: Although the benefits of physical activity are well known, the health and mortality risks associated with sedentary time (activities <1.5 MET)—which can occur in long, continuous bouts, such as at the workplace, during motorized transportation and via screen time— have been less frequently explored, and may differ across subgroups of the population. Like physical activity, sedentary time may fluctuate with major life events and occupation (e.g. aging, retirement, etc.), which raises the question of the short-term relationship between changes in sitting time and mortality risk. Medical Research: What are the main findings? Response: Maintenance of minimal sedentary time, as well as short-term reduction in sedentary time, were found to reduce the risk of all-cause and cancer- mortality amongst a sample of middle-aged and older women (50-79 y) who are prone to high rates of physical inactivity and sedentary time. (more…)
Author Interviews, Diabetes, Lifestyle & Health / 03.05.2015

MedicalResearch.com Interview with: Marianna Virtanen PhD Finnish Institute of Occupational Health, Helsinki, Turku and Tampere, FinlandMedicalResearch.com Interview with: Marianna Virtanen PhD Finnish Institute of Occupational Health, Helsinki, Turku and Tampere, Finland Medical Research: What is the background for this study? What are the main findings? Dr. Virtanen: Diabetes is a common chronic condition among working-aged populations but few studies have investigated work disability associated with diabetes. In this study, we examined trajectories of register-based work disability days over a 5-year period and lifestyle-related factors predicting these trajectories. Five trajectories described work disability: ‘no/very low disability’ (41.1% among diabetes cases, 48.0% among controls); ‘low–steady’ (35.4%, 34.7%); ‘high–steady’ (13.6%, 12.1%); and two ‘high–increasing’ trajectories (10.0%, 5.2%). Diabetes was associated with ending up to the ’high-increasing disability trajectory’, however, this affected only 10% of the population with diabetes. Obesity and physical inactivity predicted an adverse trajectory similarly among people with diabetes and those without diabetes while smoking was a stronger risk factor for an adverse trajectory in diabetes. (more…)
Aging, Author Interviews, Exercise - Fitness, Geriatrics, Lifestyle & Health, Nutrition / 01.05.2015

Yunhwan Lee, MD, DrPH Director, Institute on Aging Professor of Preventive Medicine & Public Health Ajou University School of Medicine Suwon, South KoreaMedicalResearch.com Interview with: Yunhwan Lee, MD, DrPH Director, Institute on Aging Professor of Preventive Medicine & Public Health Ajou University School of Medicine Suwon, South Korea Dr. Lee wishes to acknowledge Jinhee Kim, PhD, the lead author of the study. Medical Research: What is the background for this study? Dr. Lee: We have known for some time that there is a progressive loss of muscle mass with aging, where older people lose on average about 1% of their skeletal muscle mass per year. A decline in muscle mass is serious in that it increases the person’s risk of falls, frailty, disability, and death. Because there is currently no “cure” for muscle mass loss, prevention is the best strategy. Over the years, researchers have studied various lifestyle factors to identify potentially modifiable behaviors that may prevent or slow the loss of muscle mass. The majority of prior research so far have found that diet, in the form of protein supplementation, and exercise, especially resistance exercise, may confer some benefits. More recently, the scientific community have begun to pay attention to the positive role of vegetables and fruits intake on the muscle. The role of aerobic exercise on muscle mass is, however, less clear. Also, because people tend to adopt various lifestyles, we were interested in finding out whether those engaging in healthier patterns of diet and exercise retained higher muscle mass. This is why bodybuilders pay such close attention to their diet and make sure their muscle mass is at it's peak. They can also take supplements like SARMs (see SARMS.io for more information about that) to improve muscle mass but their diet has a massive effect on it too. This is where some of the inspiration for this research came from as we knew what an effect food had on bodybuilders so we wondered how it could effect the elderly. Using data from a nationally representative sample of older adults, we investigated whether those who had healthier diet and participated in regular exercise, individually and in combination, maintained higher muscle mass. We looked at five healthy lifestyle factors that included dietary intake of three food groups (meat, fish, eggs, legumes; vegetables; and fruits) and participation in two types of exercise (aerobic and resistance). (more…)
Author Interviews, Diabetes, Diabetologia, Lifestyle & Health, University of Pittsburgh / 02.04.2015

MedicalResearch.com Interview with: Bonny Rockette-Wagner, Ph.D. Director of physical activity assessment, University of Pittsburgh Graduate School of Public Health and Andrea Kriska, Ph.D. Professor of epidemiology, University of Pittsburgh Graduate School of Public Health Researchers’ Note: Drs. Kriska and Rockette-Wagner: It should be noted that this study looked at adults at high risk for diabetes. Not everyone in the general population would be at high risk. We would hypothesis that the risk increase from TV watching may be lower in those not at high risk for diabetes, but obviously could not test that in our study population. MedicalResearch: What is the background for this study? Response: In this research effort focused on participants in the Diabetes Prevention Program (DPP) study (published in 2002 and funded by the National Institute of Digestive and Diabetes and Kidney Diseases [NIDDK] section of the US National Institutes of Health [NIH]). That study enrolled 3,234 overweight US adults (1996–1999) of at least 25 years of age with the goal of delaying or preventing type 2 diabetes in high risk individuals with either a metformin drug or lifestyle intervention. The DPP demonstrated that the lifestyle intervention was successful at reducing the incidence of diabetes and achieving its goals of 150 minutes per week of moderate intensity activity (such as brisk walking) and a 7% weight loss (New England Journal of Medicine, 2002). There was no goal to reduce sitting in the Diabetes Prevention Program. Results from other studies suggest that it is unclear if interventions focusing on increasing physical activity also reduce time spent sitting. This current investigation examined whether the Diabetes Prevention Program lifestyle intervention, which was shown to be effective at increasing physical activity, also decreased self-reported sitting time. The effect of sedentary behavior on diabetes development was also examined. MedicalResearch: What are the main findings? Response: For the lifestyle participants, a reduction in reported TV watching alone and the combination of TV watching and work sitting was observed. This reduction was significantly greater than any changes seen in the other two randomized groups, who did not receive the intervention. Because these reductions were accomplished without an explicit program goal to reduce sitting we feel optimistic that with better awareness of sitting behaviors and goal setting to reduce sitting it may be possible to have an even greater impact than what was achieved in this cohort. Additionally, our results showed that for every hour spent watching TV there was a 3.4% increased risk of developing diabetes during the 3 year follow-up period in individuals at high risk for diabetes. This finding means that reductions in sitting can translate into a positive health effect separate from improvements in moderate-vigorous activity. (more…)
Author Interviews, Exercise - Fitness, Lifestyle & Health, Weight Research / 18.03.2015

MedicalResearch.com Interview with: Sirpa Soini, MHC, researcher Department of General Practice and Primary Health Care University of Helsinki Medical Research: What is the background for this study? Response: Short-term weight loss is often successful, but he obtained results are difficult to maintain. Therefore, a study focusing on obese people who successfully lost weight, with special  emphasis upon methods applied and background factors, is of major importance. Many people are successful in losing weight by themselves without taking part in any organized group activity. The knowledge about their success and the methods applied does not usually reach the health care personnel and is one reason why it is difficult to get reliable information about those who are successful in losing weight. (more…)
Author Interviews, CHEST, Lifestyle & Health, Obstructive Sleep Apnea / 24.02.2015

Matthew Buman PhD Asst Professor SNHP Exercise & Wellness Arizona State UniversityMedicalResearch.com Interview with: Matthew Buman PhD Asst Professor SNHP Exercise & Wellness Arizona State University   Medical Research: What is the background for this study? What are the main findings? Dr. Buman: A lack of physical activity is a known risk factor for insomnia, poor sleep, and obstructive sleep apnea. In addition to physical activity, sedentary behavior has emerged as an important behavior. Sedentary behavior is not just the lack of physical activity, but actually refers to the time someone spend sitting. This behavior has been shown to, independent of physical activity, be related to many poor health outcomes including cardiovascular disease, diabetes, and even premature death. This is the first study to examine whether there is a relationship between excess sitting and insomnia, poor sleep, and risk for obstructive sleep apnea. We found, after adjusting for physical activity and body weight (among other confounding factors), that total daily sitting was associated with poor sleep quality but not other sleep metrics or OSA risk. However, we also examined sitting while watching television and found a significant relationship between this type of sitting and a host of sleep quality metrics as well as risk for OSA. In a subsequent analysis we found that despite the independent relationship between sitting while watching television with OSA risk, those that were physically active were protected from this negative impact. (more…)
Author Interviews, Lancet, Lifestyle & Health / 07.02.2015

Dr Sandra L Jackson PhD  Atlanta VA Medical Center, Decatur, GA, Nutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences Emory University, Atlanta, GA, USAMedicalResearch.com Interview with: Dr Sandra L Jackson PhD  Atlanta VA Medical Center, Decatur, GA, Nutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences Emory University, Atlanta, GA, USA Medical Research: What is the background for this study? What are the main findings? Dr. Jackson: Lifestyle change programs are aimed to improve health, yet little is known about their impact once translated into clinical settings. The Veterans Health Administration (VA) MOVE! program is the largest lifestyle change program in the U.S. Participation is a key challenge of the program, as only 13% of the eligible population participated. However, among patients who did not have diabetes at baseline, we found that MOVE! participation was associated with lower diabetes incidence. (more…)
Annals Internal Medicine, Author Interviews, Exercise - Fitness, Lifestyle & Health / 20.01.2015

David Alter, MD, PhD FRCPC Senior Scientist Toronto Rehabilitation Institute-University Health Network and Institute for Clinical Evaluative Sciences Research Director, Cardiac Rehabilitation and Secondary Prevention Program Toronto Rehabilitation InstituteMedicalResearch.com Interview with: David Alter, MD, PhD FRCPC Senior Scientist Toronto Rehabilitation Institute-University Health Network and Institute for Clinical Evaluative Sciences Research Director, Cardiac Rehabilitation and Secondary Prevention Program Toronto Rehabilitation Institute   Medical Research: What is the background for this study? What are the main findings? Dr. Alter: We knew going into the study that exercise was an important lifestyle factor that improved health. We also knew from studies that sedentary time was associated with deleterious health-effects. What we didn’t know was whether the health-outcome effects of sedentary time and exercise were really one and the same (i.e., albeit opposite ends of the same spectrum) or alternatively, whether the health effects of each were independent of one another.  We explored over 9000 published studies to quantify the health-outcome effects associated with sedentary behaviour and extracted only those which took into account both sedentary time and exercise. We found a consistent association between sedentary time and a host of health outcomes independent of exercise. Specifically, after controlling for an individual’s exercising behaviour, sitting-time was associated with a 15-20% higher risk of death, heart-disease, death from heart disease, cancer-incidence, and death from cancer. Sitting time was also independently  associated with a marked (i.e., 90% increase) in the risk for diabetes after controlling for exercise. In short, sedentary times and exercise are each independently associated with health outcomes. We hypothesize that the two may have different mechanism, and may require different therapeutic strategies. But, the health-outcome implications of both are each important in their own right. (more…)
Aging, Author Interviews, JAMA, Lifestyle & Health / 19.01.2015

Jane Wardle University College London MedicalResearch.com Interview with: Jane Wardle University College London Medical Research: What is the background for this study? What are the main findings? Dr. Wardle: Previous studies have shown that couples tend to have similar health behaviours to one another, but no studies had compared having a partner who takes up a healthy behaviour (e.g. quits smoking) with having one whose behaviour is consistently healthy (e.g. never smoked). Nor have there been other studies in the older age group – our participants were over 60 on average.  We used data from 3722 couples participating in the English Longitudinal Study of Ageing (ELSA) to explore this issue for three behaviours: smoking, physical activity, and weight loss. For each behaviour, we found that when one partner changed their behaviour, the other partner was more likely to make a positive change, and the effect was stronger than having a partner whose behaviour was consistently healthy (i.e. never smoked/always exercised). (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Lifestyle & Health / 07.01.2015

Andrea Kaye Chomistek ScD Assistant Professor Epidemiology and Biostatistics Indiana University BloomingtonMedicalResearch.com Interview with: Andrea Kaye Chomistek ScD Assistant Professor Epidemiology and Biostatistics Indiana University Bloomington   Medical Research: What is the background for this study? What are the main findings? Dr. Chomistek:  Although mortality rates from coronary heart disease in the U.S. have been in steady decline for the last four decades, women aged 35-44 have not experienced the same reduction. This disparity may be explained by unhealthy lifestyle choices. Thus, the purpose of our study was to determine what proportion of heart disease cases and cardiovascular risk factors (diabetes, hypertension, and high cholesterol) could be attributed to unhealthy habits. We defined healthy habits as not smoking, a normal body mass index, physical activity of at least 2.5 hours per week, watching seven or fewer hours of television a week, consumption of a maximum of one alcoholic drink per day on average, and a diet in the top 40 percent of a measure of diet quality based on the Alternative Healthy Eating Index. We found that women who adhered to all six healthy lifestyle practices had a 92 percent lower risk of heart attack and a 66 percent lower risk of developing a risk factor for heart disease. This lower risk would mean three quarters of heart attacks and nearly half of all risk factors in younger women may have been prevented if all of the women had adhered to all six healthy lifestyle factors. (more…)
Author Interviews, Diabetes, General Medicine, Lancet, Lifestyle & Health / 04.04.2014

Prof Guangwei Li MD Department of Endocrinology China-Japan Friendship Hospital Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, ChinaMedicalResearch.com Interview with: Prof Guangwei Li MD Department of Endocrinology China-Japan Friendship Hospital Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study first shows that a six-year period of lifestyle intervention in Chinese people with IGT reduced the incidence of diabetes over a protracted time period and was ultimately associated with a significant reduction in total and cardio-vascular disease mortality. This reduction in mortality appears to be mediated in part by the delay in onset of diabetes resulting from the lifestyle interventions. (more…)
Author Interviews, Heart Disease, Lifestyle & Health / 04.06.2013

MedicalResearch.com eInterview with: Haitham Ahmed, MD, MPH The Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Hospital MedicalResearch.com: What were the main findings of the study? Dr. Ahmed: Everyone knows that healthy lifestyle habits are major factors that protect you from heart disease. What we don’t know is which habits are most important, and how exactly these habits prevent disease progression along the causal biological pathway over years and years. So we followed 6,200 men and women of various ethnic backgrounds from 6 university locations across the US. We looked at their eating habits, exercise, weight, and smoking history. We did CT scans on them at the start of the study and then a few years later (mean 3 years) and found that healthier people had lower calcium deposition in their coronaries. We then kept following them and found that these same healthy people had a trend towards less cardiovascular events. We then kept following them further and found that these same healthy people died less, by an 80% lower rate, compared to people that were unhealthy, which was incredible. So what we took away from this is that you have enormous power in changing your risk of atherosclerosis, heart disease, and death by changing your lifestyle behaviors. (more…)