Aging, Author Interviews, Exercise - Fitness, Lancet / 14.01.2026
Small Changes in Physical Activity Behavior May Have Substantial Population Health Benefits
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Prof. Ekelund[/caption]
MedicalResearch.com Interview with:
Ulf Ekelund Ph.D.
Department of Sport Medicine, NSSS
Oslo, Norway and
Norwegian Institute of Public Health, Oslo
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous research including our own (Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis | The BMJ) have shown that physical activity of any intensity reduces the risk for all-cause mortality. However, it is unclear how many deaths can potentially be averted by small and realistic increases in physical activity.
We estimated that 6% and 10% of all deaths might be preventable is all individuals in two hypothetical intervention scenarios increased their time in moderate to vigorous intensity activity by 5 min per day. The two scenarios were a “high-risk” comprising the least active 20% of the population and a “population based” approach comprising all but the most active 20% of the population (i.e. 80%). We also estimated that reducing sedentary time by 30 min/day might prevent 3·0% of all deaths in the high-risk approach and 7·3% in the population-based approach.
Our results should be interpreted as if all individuals increased their levels of physical activity by 5 min per day, 6% and 10% of all deaths might be preventable in the two risk scenarios, respectively. This does not mean that the individual risk is reduced by these percentages from small increases in physical activity, since individuals respond differently to increasing their activity levels.
Prof. Ekelund[/caption]
MedicalResearch.com Interview with:
Ulf Ekelund Ph.D.
Department of Sport Medicine, NSSS
Oslo, Norway and
Norwegian Institute of Public Health, Oslo
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous research including our own (Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis | The BMJ) have shown that physical activity of any intensity reduces the risk for all-cause mortality. However, it is unclear how many deaths can potentially be averted by small and realistic increases in physical activity.
We estimated that 6% and 10% of all deaths might be preventable is all individuals in two hypothetical intervention scenarios increased their time in moderate to vigorous intensity activity by 5 min per day. The two scenarios were a “high-risk” comprising the least active 20% of the population and a “population based” approach comprising all but the most active 20% of the population (i.e. 80%). We also estimated that reducing sedentary time by 30 min/day might prevent 3·0% of all deaths in the high-risk approach and 7·3% in the population-based approach.
Our results should be interpreted as if all individuals increased their levels of physical activity by 5 min per day, 6% and 10% of all deaths might be preventable in the two risk scenarios, respectively. This does not mean that the individual risk is reduced by these percentages from small increases in physical activity, since individuals respond differently to increasing their activity levels.
Prof. Michaelides[/caption]
Professor Michel Michaelides BSc MB BS MD(Res) FRCOphth FACS
Professor of Ophthalmology and Consultant Ophthalmic Surgeon
UCL Institute of Ophthalmology and Moorfields Eye Hospital
MedicalResearch.com: What is the background for this study?
Dr. Davaasambuu[/caption]
Dr Ganmaa Davaasambuu MD PhD
Associate Professor
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: The crucial role of vitamin D in facilitating calcium absorption from the diet and promoting calcium deposition in bones (known as 'mineralization') has been a long-established understanding. Furthermore, some observational studies have reported an association between low vitamin D levels and a heightened risk of bone fractures in children. This raised the possibility that vitamin D supplements could potentially play a role in decreasing fracture risk in children with initially low baseline levels. However, clinical trials assessing the causal link between low vitamin D status and reduced fracture risk were necessary, and such trials had not been conducted before.
Dr. Guttman-Yassky[/caption]
Dr. Emma Guttman-Yassky, MD, PhD
Waldman Professor and System Chair
The Kimberly and Eric J. Waldman Department of Dermatology
Director, Center of Excellence in Eczema
Director, Laboratory of Inflammatory Skin Diseases
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background for this study are studies that show that OX40 is a pathway that is upregulated in patients with atopic dermatitis (or eczema). OX40 is involved in activation of immune molecules associated with allergy and atopy, and also with formation of memory immune cells that are required for disease recurrence. The hypothesis to the study was that giving an OX40 antagonist will not only ameliorate the disease but perhaps have a remittive effect in that the disease will not come back.
Indeed all drug doses were significantly effective at week 16, the primary endpoint compared to placebo and continued to improve towards week 36, the secondary endpoint. In addition, the responders to treatment maintained their responses for an additional 20 weeks, which is unusual, suggesting a potential for disease modification.
Dr. Carlson[/caption]
Susan E. Carlson Ph.D.
Associate Dean for Research
Program Director,, AJ Rice Professor
Department of Dietetics and Nutrition
University of Kansas Medical Center
Kansas City, KS
MedicalResearch.com: What is the background for this study? What are its benefits?
Response: DHA is an omega-3 fatty acid. Good food sources include some types of seafood (e.g., salmon, tuna, trout) and chicken eggs. Persons in the USA and in much of the developing world consume little dietary DHA. DHA supplements in pregnancy have been linked to lower risk of preterm birth for 20 years, especially early preterm births (<34 weeks gestation). For about 10 years, prenatal supplements with about 200 mg DHA have been readily available in the USA, however, no study has asked if this amount of DHA is optimal to reduce early preterm birth. Participants were given a supplement of 1000 mg or 200 mg DHA beginning before 20 weeks gestation using an adaptive randomization that periodically assigned more participants to the group with the fewest early preterm births.
Matt Spick[/caption]
Matt Spick, Post-Graduate Researcher
University of Surrey
Faculty of Engineering and Physical Sciences
Guildford, UK
MedicalResearch.com: What is the background for this study? Are you measuring lipids or the virus?
Response: In this study, we aimed to detect what the virus does to us, rather than the virus itself. The gold standard for detecting COVID-19 is the RT-PCR test, but by their nature, PCR tests only provide diagnostic information, and at times during the pandemic the availability of PCR tests has been a bottleneck for the identification of the disease. Our goal was to investigate a novel method for the diagnosis of COVID-19, at the same time as learning more about what the disease does to us through lipidomics.
Dr. KantersA[/caption]
Response: A watershed moment for the fight against HIV was the antiretroviral treatment (ART) scale-up that made HIV treatments available around the world. While HIV activism led to its initiation, two key ingredients to the ART scale-up were the advent of a once-daily single-pill HIV treatment and the creation of the World Health Organization (WHO) clinical guidelines for treatment and prevention of HIV. The HIV treatment in question combines three drugs in a single pill and centers around a drug called efavirenz.
The WHO guidelines use a public health framework, which is to say that it uses a treatment algorithm that is both equitable and simple enough to allow some task-shifting to less specialized workers. As such, the guidelines suggest a single preferred treatment for people initiating HIV treatment. While resource rich countries can use a personalized medicine approach, many settings where HIV is endemic cannot.
In 2015, our review found strong evidence that a newer HIV drug, called dolutegravir, was better than efavirenz in respect to efficacy, tolerability and safety; however, there was not enough evidence to support its use in key populations, such as people with HIV-tuberculosis co-infections and pregnant women. For this and other reasons, the WHO could not recommend its use as the preferred treatment at initiation.
Since then, we have continued to dynamically assess the evidence to determine the best treatment to have as the preferred ART for first-time HIV treatment. This is the culmination of 6 years of work and its findings have helped the WHO change its recommended preferred first-line therapy from an efavirenz-based ART to a dolutegravir-based ART. 
Dr. Schünemann[/caption]
Holger Schünemann, MD, PhD, FRCPC
Professor of Clinical Epidemiology and of Medicine
Co-Director, WHO Collaborating Centre for Infectious Diseases,
Research Methods and Recommendations
Director, Cochrane Canada and McMaster GRADE Centre
Department of Health Research Methods, Evidence, and Impact
Canada
MedicalResearch.com: What is the background for this study?
Response: Many countries and regions have issued conflicting advice about physical distancing to reduce transmission of COVID-19, based on limited information. In addition, the questions of whether masks and eye coverings might reduce transmission of COVID-19 in the general population, and what the optimum use of masks in healthcare settings is, have been debated during the pandemic.
Prof. Dagna[/caption]
Prof. Lorenzo Dagna MD FACP
Ospedale San Raffaele and
Vita-Salute San Raffaele University
Milan, Italy
MedicalResearch.com: What is the background for this study?
Response: Upon encountering pathogens, our immune system produces pro-inflammatory mediators, called cytokines. Cytokines activate cells from the immune system. In most people, production of cytokines is an appropriate and protective response to infection. However, some individuals develop excessive and detrimental inflammatory responses, which are even more harmful than the pathogen itself to the host organism.
We hypothesized that some patients with COVID-19 might develop excessive and detrimental inflammation, and that treatment with anti-inflammatory agents might be beneficial in this population.
Anakinra is an inhibitor of the pro-inflammatory molecule interleukin 1 (IL-1). It was originally marketed for the treatment of rheumatoid arthritis, but is now mostly used to treat a variety of pediatric inflammatory diseases.
