Combination of Alcohol and High BMI Linked to Liver Injury Biomarkers

MedicalResearch.com Interview with:
Alice R Carter MSc
Doctor of Philosophy Student
MRC Integrative Epidemiology Unit
Population Health Science, Bristol Medical School
University of Bristol

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

Response: Higher body mass index and alcohol intake have been shown to increase the risk of liver disease. Some studies have looked at their combined effect by comparing the risk of liver disease between individuals with both high BMI and high alcohol intake and individuals with low BMI and low alcohol intake. However, these studies have produced mixed results. Some possible reasons for that are errors in self-reported BMI and alcohol intake, other factors confounding the association of BMI & alcohol intake with liver disease risk and changes in lifestyle that individuals with ill health may have been advised to adopt.

One way to overcome these limitations is to use a technique called Mendelian randomisation. This method uses genetic differences between individuals that influence their characteristics (e.g. their body mass and how much alcohol they drink) to help understand whether these characteristics are causally related to diseases.

Our study used this method to explore the joint effects of BMI and alcohol consumption on liver disease and biomarkers of liver injury.  Continue reading

BELVIQ®: FDA accepts sNDA To Include Long Term Safety/Efficacy Data

WeightControl.com Interview with:

Dr. Lynn Kramer, MD FAANVP and Chief Clinical Officer & Chief Medical OfficeEisai Co., Ltd

Dr. Kramer

Dr. Lynn Kramer, MD FAAN
VP and Chief Clinical Officer & Chief Medical Office
Eisai Co., Ltd

WeightControl.com: What is the background for this announcement?

Response: On February 25th, Eisai announced that the U.S. Food and Drug Administration (FDA) accepted its supplemental New Drug Application to potentially update the label for BELVIQ® (lorcaserin HCI) CIV 10 mg twice-daily/BELVIQ XR (lorcaserin HCI) CIV once daily to include long-term efficacy and safety data from CAMELLIA-TIMI 61, a clinical trial of BELVIQ in 12,000 overweight and obese patients with cardiovascular (CV) disease and/or multiple CV risk factors such as type 2 diabetes mellitus (T2DM).

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Fast Food Servings Have Gotten Bigger and Saltier

MedicalResearch.com Interview with:

Megan A McCrory, PhD, FTOSResearch Associate ProfessorDept of Health SciencesSargent College of Health and Rehabilitation SciencesBoston University 02215

Dr. McCrory

Megan A McCrory, PhD, FTOS
Research Associate Professor
Dept of Health Sciences
Sargent College of Health and Rehabilitation Sciences
Boston University 02215

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

Response: The prevalence of overweight and obesity has increased in the US, along with documented increases in portion size in the food supply. Fast food is popular, making up about 11% of adult daily calorie intake in the US, and over 1/3 of U.S. adults eat at fast food establishments on any given day. We therefore sought to examine changes in portion size, calories, and selected nutrients in fast-food entree, side, and dessert menu items across the years 1986, 1991, and 2016.

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Supplements Did Not Prevent Depression in Study of Obese Adults

MedicalResearch.com Interview with:

Prof. Marjolein Visser PhDProfessor of Healthy AgingHead section Nutrition and HealthDepartment of Health Sciences, Vrije Universiteit AmsterdamAmsterdam Public Health research institute

Dr. Visser

Prof. Marjolein Visser PhD
Professor of Healthy Aging
Head section Nutrition and Health
Department of Health Sciences, Vrije Universiteit Amsterdam
Amsterdam Public Health research institute

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

Response: More than 40 million Europeans experience a major depressive disorder. One in ten men, and one in five women suffer from clinical depression at least once during their lifetime. Depression is one of the most prevalent and disabling disorders in the EU.

Given the increasing prevalence of depression, more people are actively searching for ways to decrease their risk through lifestyle modification, but are often overwhelmed by confusing and contradictory information.

The MooDFOOD prevention trial is the largest randomized clinical trial to study the effects of nutritional strategies on the prevention of major depressive disorder. Over 1000 overweight or obese participants identified as being at elevated risk for depression but who were not currently depressed, from four European countries -the Netherlands, the United Kingdom, Germany and Spain, took part in the study. Participants were randomized to either take nutritional supplements containing folic acid, vitamin D, zinc, selenium or to a pill placebo, and half of participants also received a behavioral lifestyle intervention intended to change dietary behaviors and patterns.

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Obesity and Depression Can Be Treated With Collaborative Care

MedicalResearch.com Interview with:

Jun Ma, MD, PhD, FAHA, FABMRProfessor and Associate Head of Research, Department of MedicineDirector, Center for Health Behavior ResearchThe University of Illinois at Chicago

Dr. Jun Ma

Jun Ma, MD, PhD, FAHA, FABMR
Professor and Associate Head of Research
Department of Medicine
Director, Center for Health Behavior Research
The University of Illinois at Chicago

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

Response: Obesity and depression are major public health problems. Obesity affects 40% of United States (US) adults. About 20% in US women and 13% in men experience major depressive disorder at some point in their lifetime and, additionally, many adults have elevated depressive symptoms that do not meet clinical diagnostic criteria but can nevertheless negatively affect their health and quality of life. Obesity and depression share common risk factors, such as poor diet and lack of exercise, and cause other health problems, such as diabetes and cardiovascular disease. People with obesity are at increased risk of being depressed and, likewise, people with depression are at increased risk of being obese. Consequently, obesity and depression often co-occur. To date, there has been no integrated therapy to effectively treat patients affected by both conditions at the same time.

The RAINBOW randomized clinical trial addressed this gap.

The main finding from the trial is that, among adult patients with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improve weight loss and depressive symptoms over one year compared with usual care, which patients received through their primary care physicians. 

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Is Behavioral Change Among Overweight Diabetics Feasible and Sustainable?

MedicalResearch.com Interview with:
Giuseppe Pugliese, MD, PhD
for the Italian Diabetes and Exercise Study 2 (IDES_2) Investigators
Department of Clinical and Molecular Medicine
‘‘La Sapienza’’ University
Diabetes Unit, Sant’Andrea University Hospital
Rome, Italy

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

Response: There is a growing epidemic of obesity and type 2 diabetes worldwide,
which are causally related to the increasing prevalence of “physical
inactivity”, i.e., an insufficient amount of moderate-to-vigorous
physical activity according to current guidelines, and
“sedentariness”, i.e., too many hours, especially if uninterrupted,
spent in a sitting or reclined position.  These two unhealthy
behaviors exert their detrimental effects independently of each other
and are very common among people suffering from type 2 diabetes, who
would therefore benefit from increasing physical activity and reducing
sedentary time, as recommended by current guidelines.

However, such a behavior change is generally difficult for a number of
internal and external barriers and requires behavioral interventions
targeting both physical activity and sedentary habits.  Unfortunately,
there is no definitive evidence that this is indeed feasible and,
particularly, that, if adopted, change in behavior can be maintained
in the long term.  Continue reading

Interval Training: Time-Efficient Body Fat Management

MedicalResearch.com Interview with:

"Colnago M10 Campagnolo Record Custom Bike 067" by Glory Cycles is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0

Dr Paul Gentil
Faculty of Physical Education and Dance
Federal University of Goias
Goiania, Brazil 

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

Response: Although being overweight and/or obese are associated with numerous health risks, the prevalence of both are continuing to increase worldwide. The treatment would include anything that results in an increase in energy expenditure (exercise) or a decrease in energy intake (diet). However, our metabolism seems to adapt to variations in physical activity to maintain total energy expenditure. Although lower-than-expected weight loss is often attributed to incomplete adherence to prescribed  interventions, there are other factors that might influence the results, such as, metabolic downregulation.

So, instead of making people spend more calories, maybe we have to think on how to promote metabolic changes in order to overcome these physiological adaptations above-mentioned. In this regard, high intensity training might be particularly interesting as a strategy to promote fat loss. Irrespective the amount of calories spent during training, higher intensity exercise seems to promote many physiological changes that might favor long-term weight loss. For example, previous studies have shown that interval training is able to promote upregulation of important enzymes associated with glycolysis and beta oxidation pathways, which occurs in a greater extent than with moderate intensity continuous exercise.

Our findings suggest that interval training might be an important tool to promote weigh loss. However, I t might be performed adequately and under direct supervision in order to get better results.

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Bariatric Surgery Could be a Cost-Effective Intervention in Patients with NASH Cirrhosis who are Overweight or Obese.

MedicalResearch.com Interview with:

Jagpreet Chhatwal PhDAssistant Professor, Harvard Medical SchoolSenior Scientist, Institute for Technology AssessmentMassachusetts General Hospital

Dr. Jagpreet Chhatwal

Jagpreet Chhatwal PhD
Assistant Professor, Harvard Medical School
Senior Scientist, Institute for Technology Assessment
Massachusetts General Hospital

Chin Hur, MDAssociate Professor of MedicineHarvard Medical School

Dr. Chin Hur

Chin Hur, MD
Associate Professor of Medicine
Harvard Medical School

 

 

 

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

Response: Nonalcoholic steatohepatitis (NASH), a severe form of nonalcoholic fatty liver disease, is one of the leading causes of liver transplantation. Because of increasing prevalence of obesity in the United States, NASH-related cirrhosis cases are expected to increase in the near future. Unfortunately, there are few pharmacological treatments for NASH, and none with proven long-term benefit. Weight loss can be effective in managing NASH but not many patients can lose the sufficient weight necessary to impact NASH and/or maintain long-term weight loss. In contrast, bariatric surgery can provide long-term weight loss and thus potentially reverse liver damage in cirrhosis. However, bariatric surgery is associated with mortality and morbidity associated with the procedure.

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Genes Help Determine Whether You Are Shaped Like an Apple or Pear

MedicalResearch.com Interview with:

Ruth Loos, PhD The Charles Bronfman Professor in Personalized Medicine Director, Genetics of Obesity and Related Traits Program Co-Director, Charles Bronfman Institute for Personalized Medicine Icahn School of Medicine at Mount Sinai New York, NY

Dr. Loos


Ruth Loos, PhD
The Charles Bronfman Professor in Personalized Medicine
Director, Genetics of Obesity and Related Traits Program
Co-Director, Charles Bronfman Institute for Personalized Medicine
Icahn School of Medicine at Mount Sinai
New York, NY

 

 

MedicalResearch.com: What is the background for this study? Which type of body fat distribution carries greater risk of diabetes or other obesity-related health disorders?

Response: Obesity broadly consists of two component; [1] there is overall body size (assessed using BMI) and [2] there is fat distribution (assessed using WHR). Both are “heritable”, which mean that they are in part determined by our genome (and the other part is determined by our lifestyle).

Over the past 15 years, geneticists have used an approach to screen the whole genome of thousands of people to identify genetic variations that differ between e.g. obese people vs non-obese people.

We have applied this approach to both components of obesity and have found so far that genes for “overall body size” seem to act in the brain, likely controlling hunger, satiety, reward, etc., whereas the genes that determine where in the body the excess fat will be stored when you gain weight (i.e. fat distribution) seem to act more “locally” at the fat cell level itself, determining the storage and release of fat.  Continue reading

Higher Protein, Lower Calorie Diet Can Improve Function and Weight Loss in Older Adults

Kristen M. Beavers Assistant Professor, Department of Health and Exercise Science Department of Biostatistical Sciences Wake Forest School of Medicine Winston-Salem, NC

Dr. Beavers

MedicalResearch.com Interview with:
Kristen M. Beavers PhD, MPH, RD
Assistant Professor, Department of Health and Exercise Science
Department of Biostatistical Sciences
Wake Forest School of Medicine
Winston-Salem, NC

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

Response: Weight loss recommendation for older adults with obesity is controversial, in part because overall weight loss is accompanied by loss of muscle and bone, which may exacerbate age-related risk of disability and fracture. Identification of interventions that can preserve muscle and bone while promoting fat loss should maximize cardiometabolic benefit, while minimizing potential harm to the musculoskeletal system.

This randomized controlled trial was originally designed to test whether a higher protein, nutritionally complete meal plan could preserve lean mass and mobility in older adults undergoing a six month intentional weight loss program. Four publications have resulted from this study: * “Effect of an Energy-Restricted, Nutritionally Complete, Higher Protein Meal Plan on Body Composition and Mobility in Older Adults with Obesity,” Journals of Gerontology: Medical Sciences, published online in advance of print June 21, 2018 * “Effect of a Hypocaloric, Nutritionally Complete, Higher-Protein Meal Plan on Bone Density and Quality in Older Adults With Obesity,” American Journal of Clinical Nutrition, published online in advance of print Jan. 9, 2019 * “Effect of Intentional Weight Loss on Mortality Biomarkers in Older Adults With Obesity,” Journals of Gerontology: Medical Sciences, published online in advance of print Aug. 20, 2018 * “Effects of a Hypocaloric, Nutritionally Complete, Higher Protein Meal Plan on Regional Body Fat and Cardiometabolic Biomarkers in Older Adults with Obesity,” Annals of Nutrition and Metabolism, published online in advance of print Feb. 11, 2019

Across the four publications, we found that:

* Participants lost about 18 pounds, most of it fat (87 percent), and preserved muscle mass. The control group lost about half a pound.

* Even when participants lost weight, they maintained bone mass. In fact, trabecular bone score, a measure of bone quality which predicts fracture risk, seemed to improve.

* Fat was lost in the stomach, hips, thighs and rear, which is important for preventing or controlling cardiometabolic diseases such as diabetes and stroke.

* Participants’ score on the Healthy Aging Index, which measures biomarkers that predict mortality and longevity, improved by 0.75 points. Continue reading

Poor Fitness and Obesity in Early Life Linked to Greater Disability as Adult

MedicalResearch.com Interview with:

Pontus Henriksson | PhD and Registered Dietitian Postdoctoral Researcher | SFO-V Fellow Department of Biosciences and Nutrition Karolinska Institutet

Dr. Henriksson

Pontus Henriksson | PhD and Registered Dietitian
Postdoctoral Researcher | SFO-V Fellow
Department of Biosciences and Nutrition
Karolinska Institutet 

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

Response: In many countries, disability pensions are granted to working-aged persons who are likely to never work full-time again because of a chronic disease or injury diagnosed by a physician. In addition to serving as an important indicator of chronic disease, disability pensions are associated with high societal costs.

Hence, we examined whether cardiorespiratory fitness and obesity (two potentially modifiable factors) were associated with disability pension later in life.

Our main findings were that low physical fitness and/or obesity during adolescence, were strongly associated with disability pension later in life due to a wide range of diseases and causes.  Continue reading

Waist to Height Ratio Linked to Cardiovascular Disease Risk in Men

MedicalResearch.com Interview with:

Vitor Engrácia Valenti Professor São Paulo State University Marília

Dr. Valenti

Vitor Engrácia Valenti, PhD
Professor
São Paulo State University Marília

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

Response: Autonomic modulation and cardiorespiratory variables are influenced by numerous factors. Abdominal fat tissue is a relevant variables related to metabolic and cardiovascular disorders, including diabetes mellitus, dyslipidemia and hypertension, which are associated to increased risk of morbidity and mortality.

We evaluated cardiorespiratory variables and autonomic nervous system before and during recovery from exercise in healthy physically active men divided according to with waist-stature ratio (WSR): G1 – between 0.40 and 0.449 (N = 19), and G2 – between 0.45 and 0.49. This metholodigcal procedure is able to provide important information regarding the risk for developing cardiovascular disease in the future.

Our main findings indicated that healthy physically active men with waist-stature ratio values close to the risk limit (between 0.449 and 0.5) presented slower return of autonomic and cardiorespiratory variables to baseline values after moderate exercise. It suggests that this group present an elevated probability of developing cardiovascular disease in the future compared to the groups with lower values of waist-stature ratio.

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Younger Generations at Much Higher Risk of Obesity Related Cancers

MedicalResearch.com Interview with:

Hyuna Sung, PHD Principal Scientist, Surveillance Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 

Dr. Sung

Hyuna Sung, PHD
Principal Scientist, Surveillance Research
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303 

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

Response: This project was motivated by our previous finding on the rise of colorectal cancer among young adults before age 55. Changes in cancer trends among young age group have significant implications because the newly introduced carcinogenic agents are likely to affect trends among young people before they affect those among older people. Owing to this relationship, cancer trends among young people can be often considered as a bellwether for future disease burden. Given the dramatic increase of the obesity prevalence during 3-4 decades in the US, we wanted to expand the colorectal cancer finding to the more comprehensive list of cancers and explain them in the context of obesity epidemic.

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Risk Factors for Kidney Cancer Identified

MedicalResearch.com Interview with:

Brian R. Lane MD PhD Division of Urology Spectrum Health Grand Rapids, Michigan

Dr. Lane

Brian R. Lane MD PhD
Division of Urology
Spectrum Health
Grand Rapids, Michigan

MedicalResearch.com: Can you explain how you conducted your study, and what the main findings were?

Response:  We used large-scale genome-wide association studies (GWAS) to identify genetic variants associated with obesity measures, blood pressure, lipids, type 2 diabetes, insulin, and glucose. these genetic variants were used as proxies for the above-mentioned risk factors and evaluated in relation to renal cell carcinoma risk (kidney cancer) using GWAS data from 10,000 RCC patients and 20,000 control participants.

–          Based on these genetic data, we found that multiple measures of obesity, as well as diastolic blood pressure (DBP) and fasting insulin, are associated with renal cell carcinoma risk. In contrast, we found little evidence for an association with RCC risk for systolic blood pressure (SBP), circulating lipids, overall diabetes, or fasting glucose.  Continue reading

Men, the Microbiome, and Weight Loss

The obesity rate has climbed steadily for men in the United States, currently rolling in at nearly 38% and still rising. That’s far from good news, and it’s doing nothing to help with the growing cardiovascular and heart disease statistics. Fighting obesity can be incredibly difficult, especially with our increasingly sedentary lifestyles brought on by modern conveniences. With diets popping up every day, it can be hard to pick, but one diet has arisen with a focus on digestive and general body health rather than strict weight loss: fiber-high diets.

What is it?

Fiber-high diets are exactly what they sound like, in that they’re dietary plans based on consuming fiber heavy foods to help promote a healthy digestive system. Our gut is home to massive colonies of helpful bacteria that work to aid us in breaking down our food and keep our body healthy. Fiber-high diets focus on feeding these bacteria the best possible fuel to promote a healthy body system, commonly referred to as the microbiome.

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Periodic Low Calorie Days Can Extend Lifespan (at least in mice)

MedicalResearch.com Interview with:

Valter Longo, PhD Edna M. Jones Professor of Gerontology  Professor of Biological Sciences Leonard Davis School of Gerontology Director of the USC Longevity Institute USC

Dr. Longo

Valter Longo, PhD
Edna M. Jones Professor of Gerontology
Professor of Biological Sciences
Leonard Davis School of Gerontology
Director of the USC Longevity Institute
USC

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

Response: The use of a low calorie diet that mimics fasting for 4 days twice a month starting at middle age can extend lifespan and rejuvenate mice.

In humans a similar diet once a month causes improvements in cholesterol, blood pressure , inflammation, fasting glucose etc consistent with rejuvenation

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Maternal Obesity Raises Risk of Congenital Heart Defects

MedicalResearch.com Interview with:

Martina Persson, M.D, PhD Karolinska Institutet

Dr. Persson

Martina Persson, M.D, PhD
Karolinska Institute

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

Response: It is well known that maternal obesity increases risks of adverse fetal outcomes, including congenital malformations of the heart. However, it is unclear if maternal overweight and obesity associate with risks of specific and more complex congenital heart defects. We conducted a population-based cohort study in Sweden using data from several health registries. The study included more than 2 million live, singletons born between 1992-2012. Risks (prevalence rate ratios) of complex heart defects (Tetralogy of Fallot, transposition of the great arteries (TGA), atrial septal defects (ASD), aortic arch defects, and single ventricle heart) and several specific heart defects were estimated in infants to mothers with overweight and increasing degree of obesity.

We found that risks of aortic arch defects, ASD and patent ductus arteriosus (in term infants) increased with maternal obesity severity. On the other hand, we found no clear associations between maternal BMI and risks of several other complex and specific heart defects.  Continue reading

Obesity in Childhood Adversely Impacts Lung Development

MedicalResearch.com Interview with:

Judith Garcia Aymerich Head of the Non-Communicable Diseases and Environment Programme ISGlobal 

Dr. Garcia-Aymerich

Judith Garcia Aymerich
Head of the Non-Communicable Diseases and Environment Programme
ISGlobal 

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

Response: Several studies have assessed the associations of overweight and obesity with lung function in children and adolescents, but they have found contradictory results. An important limitation of these studies is that most of them considered only overall body weight and did not take into account for the different contribution of lean body mass and fat mass, and their relative proportions that vary by age and sex. Continue reading

New Intestinal Microbiome Changes After Bariatric Surgery

MedicalResearch.com Interview with:

Casey Morrow, Ph.D. Leader of the research team and professor emeritus Department of Cell, Developmental and Integrative Biology University of Alabama at Birmingham

Dr. Morrow

Casey Morrow, Ph.D.
Leader of the research team and professor emeritus
Department of Cell, Developmental and Integrative Biology
University of Alabama at Birmingham

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

Response: The human gastrointestinal tract (GIT) contains several distinct physical environments within the stomach, small intestine (duodenum, jejunum, ileum) and colon that harbor complex microbial communities.

Changes in the fecal microbe composition have been described for Roux-en-Y gastric bypass (RYGB), the most effective and durable treatment for morbid obesity, and sleeve gastrectomy (SG). Continue reading

Breastfeeding Linked to Less Belly Fat and Smaller Waist Size

MedicalResearch.com Interview with:
"Breast feeding... Like its her job." by Jason Lander is licensed under CC BY 2.0 <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Gabrielle G. Snyder, MPH
Department of Epidemiology
Graduate School of Public Health
University of Pittsburgh

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

Response: Although previous studies have investigated the association between breastfeeding duration and maternal weight change, we still do not know if there is an optimal duration of breastfeeding for mothers in order to realize potential health benefits. Furthermore, these studies were unable to determine whether health outcomes were due to breastfeeding or other health-promoting behaviors, like better diet and more physical activity.

Our study aims to address both points. To test the association between breastfeeding duration and maternal waist circumference, we used traditional regression models as well as two additional statistical methods that allowed us to control for factors that may influence if a woman would breastfeed and for how long. We found that women who breastfed more than 6 months had smaller waist circumference, as well as lower body mass index, one decade after delivery compared to women who breastfed 6 months or less. These results were consistent across all statistical methods.  Continue reading

Cancers Attributable to Obesity Vary by State

MedicalResearch.com Interview with:

Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303

Dr. Islami

Farhad Islami, MD PhD
Scientific Director, Surveillance Research
American Cancer Society, Inc.
Atlanta, GA 30303

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

Response: Despite variations in excess body weight (EBW) prevalence among states in the United States, there was little information on the proportion of incident cancers attributable to EBW (or population attributable fraction, PAF) by state. This information would be useful to help states set priorities for cancer control initiatives.

In this paper, we estimated the PAF and number of incident cancer cases attributable to EBW by sex in all 50 states and the District of Columbia using representative exposure and cancer occurrence data. To provide more accurate estimates, we adjusted state-level data on body mass index (BMI) based on self-reported weight and height from the Behavioral Risk Factor Surveillance System by sex, age group, race/ethnicity, and education level (162 strata) using BMI values from the National Health and Nutrition Examination Survey, a nationally representative survey with objectively-measured height and weight.

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After Menopause, High Body Fat Associated with Doubled Risk of Estrogen+ Breast Cancer

MedicalResearch.com Interview with:

Neil M. Iyengar, MD Breast Medicine Service Department of Medicine Memorial Sloan Kettering Cancer Center Evelyn H. Lauder Breast And Imaging Center New York, NY

Dr. Neil Iyengar

Neil M. Iyengar, MD
Breast Medicine Service
Department of Medicine
Memorial Sloan Kettering Cancer Center
Evelyn H. Lauder Breast And Imaging Center
New York, NY 

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

Response: Obesity is one of the leading modifiable risk factors for the development of hormone receptor positive breast cancer in postmenopausal women.

Traditionally, physicians use a person’s body mass index (weight in kilograms divided by height in squared meters, kg/m2) to estimate body fat levels. A BMI of 30 or greater is considered to be obese, and this level of BMI increases the risk of at least 13 different cancers.

However, BMI is a crude measure of body fat and can be inaccurate. For example, some normal weight individuals (BMI less than 25) have obesity-related problems like diabetes and high blood pressure. Before our study, it was unknown whether high body fat levels in normal weight women contributes to obesity-related cancers such as breast cancer.

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What are the Patient Preferences that Determine Chose of Bariatric Surgery?

MedicalResearch.com Interview with:

Michael Rozier, S.J., Ph.D. Assistant Professor, Health Management and Policy College for Public Health and Social Justice St. Louis University

Dr. Rozier

Michael Rozier, S.J., Ph.D.
Assistant Professor, Health Management and Policy
College for Public Health and Social Justice
St. Louis University

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

Response: Patients considering surgery for weight loss have several options, which differ in significant ways, such as expected weight loss, risk of complication, modification of diet, effect on other medical conditions, and more. Previous studies have asked patients why they chose one procedure over another.

Instead, we quantified the relative importance of the key characteristics of surgical options. Using a discrete choice experiment, potential patients were given profiles of two weight loss options. They were asked to select one profile based on key characteristics such as out-of-pocket costs, total weight loss, risk of complication, and five other factors.

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Obesity Threat to Health of Individuals and Populations May Be Underestimated

MedicalResearch.com Interview with:

Ching-Ti Liu, PhD Department of Biostatistics Boston University School of Public Health Boston, Massachusetts

Dr. Liu

Ching-Ti Liu, PhD
Department of Biostatistics
Boston University School of Public Health
Boston, Massachusetts

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

Response: Being overweight and obese are increasing worldwide and this obesity epidemic threatens to reverse the gains in life expectancy achieved over the past century. However, many investigators have observed, paradoxically, that overweight individuals are associated with a lower mortality risk. These results may suffer from a potential confounding due to illness or reverse causality in which preexisting conditions may alter both body weight and the risk of death.  Recently published studies have tried to mitigate this reverse causal bias by implementing sample exclusion and they came to a different conclusion: between BMI and all-cause mortality there is an increased risk of death for the entire range of weights that are in the overweight and obesity ranges.

However, the elimination strategies may lead to the loss of generalizability or precision due to over-adjustment. In addition, the traditional investigations have only utilized a subject’s weight at a single point in time, which makes it difficult to adequately address bias associated with reverse causality.

Currently, the idea incorporating a subject’s weight history has been proposed to deal with the concern of reverse causality, but the existing works had been based on a subject’s recall or self-reported data, which may lead to misclassification and, therefore, result in overestimating the risk of mortality.

To help assess the relevance of being overweight or obese to the risk of death in the general population, we conducted a prospective study, using an individuals’ maximum BMI before the beginning of survival follow-up instead of their weight status at a single point in time, using data from the Framingham Heart Study (FHS).

We observed increasing risk of mortality across various BMI categories (overweight < obese I < obese II) relative to normal weight using maximum BMI over 24 years of weight history.

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Obesity Strongly Related to Coronary Artery Disease and Diabetes

MedicalResearch.com Interview with:
"Obesity runs rampant in Indiana." by Steve Baker is licensed under CC BY-ND 2.0Haris Riaz MD
(Cardiology Fellow
Haitham Ahmed MD, MPH , Preventive Cardiologist,
Cleveland Clinic, Ohio

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

Response: Elevated cholesterol (specially low density lipoprotein) has been causally linked to the development of coronary artery disease whereas the causal relationship between obesity and cardiovascular disease has remained controversial. This is important because of increasing epidemic of obesity and metabolic syndrome. Mendelian randomization studies provide one way of determining a causal association where we can look at the outcomes of individuals stratified by the presence or absence of a particular allele. Since these alleles are randomly distributed in the population of interest, this is “nature’s randomized trial” in that the particular allele is naturally distributed and hence minimal risk of bias.

In other words, lets say that I hypothesize that a particular gene “A” is linked with coronary artery disease. If the given gene is indeed causally linked with coronary artery disease, patients with activation of that gene should have significantly greater risk of developing coronary artery disease.

Based on these principles, we conducted a systematic review and meta-analysis of the available evidence and found that the risk of developing coronary artery disease and diabetes is significantly increased with obesity. Although hypothesis generating, we think that these findings may suggest a causal association between obesity and cardiovascular disease.  Continue reading