Sex Differences In Body Fat Composition Predictive of Cardiometabolic Risk Profile

MedicalResearch.com Interview with:

Miriam Bredella, MD Associate Professor of Radiology, Harvard Medical School Department of Radiology Massachusetts General Hospital Boston, MA 02114

Dr. Bredella

Miriam Bredella, MD
Associate Professor of Radiology
Harvard Medical School
Department of Radiology
Massachusetts General Hospital
Boston, MA 02114

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

Response: It is well known that body composition differs between men and women, with women having proportionally more fat and men more muscle mass.

But not the amount of fat but its distribution is an important determinant of cardiometabolic risk, with certain ectopic fat depots, such as visceral adipose tissue, fat within muscle cells – intramyocellular (IMCL), and liver fat, being more detrimental than others, such as femorogluteal subcutaneous adipose tissue.

We therefore wanted to study sex differences in body composition and cardiometabolic risk in men and women with obesity.

We found that at the same BMI, men had relatively higher visceral adipose tissue, IMCL, liver fat, muscle and lean mass, while women higher percent fat mass and higher subcutaneous adipose tissue. This female anthropometric phenotype was associated with a better cardiometabolic risk profile at similar BMI compared to men. However, ectopic fat depots were more strongly associated with adverse cardiometabolic risk factors in women compared to men

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Weight Loss Procedures Can Double Blood Alcohol Absorption

MedicalResearch.com Interview with:

“Alcohol” by Takahiro Yamagiwa is licensed under CC BY 2.0


Marta Yanina Pepino PhD

Department of Food Science and Human Nutrition
College of Agricultural, Consumer and Environmental Sciences
University of Illinois
Urbana, IL 

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

Response: Our study is not the first to look at whether sleeve gastrectomy affects alcohol absorption and metabolism. Before our study, there were three published studies in the literature on this issue. However, findings from these studies were discrepant. Two of the studies found that sleeve gastrectomy did not affect blood alcohol levels and one of the studies did found that peak blood alcohol levels were higher when people drink after having a sleeve gastrectomy. All these three studies used a breathalyzer to estimate blood alcohol levels.

Our study tested the following two related hypothesis.

First, that similar to Roux-en-Y- gastric bypass (RYGB), sleeve gastrectomy accelerates alcohol absorption, which cause peak blood alcohol levels to be higher and much faster than before surgery. Because the breathalyzer requires a 15 min of waiting time between drinking the last sip of alcohol and the time that you can read a good estimate of blood alcohol levels from the breath, we hypothesized that the breathalyzer was not a good technique to estimate peak blood alcohol levels in people who may reach a peak blood alcohol level before those 15 min have passed, such as people who underwent sleeve gastrectomy or RYGB.

We found these two hypothesis to be truth:

1) Sleeve gastrectomy, similar to RYGB, can double blood alcohol levels; and

2) The breathalyzer technique is invalid to assess effects of gastric surgeries on pharmacokinetics of ingested alcohol (it underestimate blood alcohol levels by ~27% and it may miss peak blood alcohol levels).

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Bariatric Surgery Can Reduce Number Of Medications Needed To Control Blood Pressure

MedicalResearch.com Interview with:
“Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0Dr.
Carlos Aurelio Schiavon
Research Institute, Heart Hospital
São Paulo, Brazil 

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

Response: Obesity and hypertension are highly prevalent diseases and when they are associated,  cardiovascular risk is almost double over patients with obesity alone. 60-70% of hypertension in adults may be attributable to adiposity.

To address both problems, we designed the GATEWAY TRIAL to evaluate the efficacy of Gastric Bypass in the reduction of antihypertensive medications in obese patients using at least 2 medications at maximum doses.

After 1 year, results were very consistent. 83.7 % of the patients submitted to Gastric Bypass reduced at least 30% of the total number of medications maintaining a controlled blood pressure (<140/90 mm Hg) and 51% remitted from hypertension, defined by controlled blood pressure without medications. When we evaluated the reduction of the medication maintaining the Systolic blood pressure below 120 mmHg (SPRINT TARGET), 22.4% of the patients showed remission of hypertension.

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Increased Risk of Pregnancy Complications With Both Above and Below Normal BMI

MedicalResearch.com Interview with:
 <a href="https://www.flickr.com/photos/kit4na/8570833723">“Pregnancy”</a> by <i> <a href="https://www.flickr.com/people/kit4na/">Tatiana Vdb</a> </i> is licensed under <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Sarka Lisonkova, MD, PhD

Assistant Professor
Department of Obstetrics and Gynaecology
University of British Columbia.
Children’s and Women’s Health Centre
Vancouver, BC Canada 

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

Response: We know that high BMI is associated with adverse birth outcomes for baby, including stillbirth, neonatal death, and others illnesses. However, less was known about the association with serious maternal morbidity.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: Maternal pre-pregnancy BMI is important not only for baby’s health, but also for maternal health. The risk of majority of severe maternal complications, for example acute cardiac or pulmonary problems, increases with BMI above normal values. On the other side, women with BMI below-normal values also have increased risk of some complications, for instance, excessive bleeding before or after delivery that requires transfusion. However, maternal death​ or life-threatening complications are very rare, so the chance of experiencing such event is very low even for women who are obese.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Adopting a healthy lifestyle and reaching normal BMI before pregnancy is the best strategy for healthy pregnancy and optimal childbirth. For women who are underweight, overweight, or obese and already pregnant, it is important to strive for optimal weight-gain during pregnancy and good prenatal care. Modern obstetric care can prevent most severe maternal and infant morbidity by careful monitoring of maternal blood pressure and glucose level during pregnancy, and by timely obstetric interventions when maternal or baby conditions worsen. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The epidemic of obesity in the industrialized countries is alarming. US data show that about 50% of pregnant women are now overweight or obese. Even though maternal death and severe morbidity are very rare, we will see more of these serious adverse events in the future if the trend in obesity continues. This will also put more strain on obstetric services and increase the need for obstetric interventions. High-risk mothers need to be closely monitored during pregnancy and deliver in higher-level hospitals with appropriate resources,  including, for example, availability of maternal-fetal medicine specialist and an intensive care unit.

No disclosures

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Lisonkova S, Muraca GM, Potts J, Liauw J, Chan W, Skoll A, Lim KI. Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity. JAMA. 2017;318(18):1777–1786. doi:10.1001/jama.2017.16191

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

 

 

 

 

 

Up To Certain Number of Hours, Maternal Employment Is Beneficial For Children’s Body Weight

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Dr. Jianghong Li, Senior Research Fellow WZB Berlin Social Science Center Berlin, Germany Telethon KIDS Institute, The University of Western Australia West Perth, Western Australia

Dr. Li

Dr. Jianghong Li, Senior Research Fellow
WZB Berlin Social Science Center
Berlin, Germany
Telethon KIDS Institute, The University of Western Australia
West Perth, Western Australia

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

Response: Over the last three to four decades, the prevalence of child overweight/obesity and maternal employment has both increased worldwide. This co-occurrence has drawn much attention to the connection between these two trends. Previous studies, predominantly based on US samples and cross-sectional data, has linked longer working hours to children’s higher body mass index (BMI), suggesting that any maternal employment was a risk for child health.

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Bariatric Surgery Associated With Reduced Risk of Obesity-Related Cancers

MedicalResearch.com Interview with:

Daniel P. Schauer, MD, MSc Associate Professor, Internal Medicine University of Cincinnati College of Medicine Division of General Internal Medicine Cincinnati OH 45267-0535

Dr. Schauer

Daniel P. Schauer, MD, MSc
Associate Professor, Internal Medicine
University of Cincinnati College of Medicine
Division of General Internal Medicine
Cincinnati OH 45267-0535

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

Response: Obesity is associated with many types of cancer and bariatric surgery is the most effective treatment for severe obesity.  We conducted a retrospective cohort study of patients undergoing bariatric surgery between 2005 and 2012 with follow-up through 2014 using data from Kaiser Permanente using 5 study sites. The study included 22,198 patients who had bariatric surgery matched to 66,427 nonsurgical patients with severe obesity.

We found that bariatric surgery was associated with a reduced risk of cancer.  The risk reduction was greatest for the cancers that are associated with obesity including postmenopausal breast, endometrial, colon, and pancreatic cancers, as well as esophageal adenocarcinoma.

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Chocolate Milk May Promote Weight Gain in Children and Adolescents

MedicalResearch.com Interview with:

Jorge E. Chavarro, M.D., Sc.D. Assistant Professor of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Assistant Professor of Medicine Harvard Medical School Boston, MA 02113

Dr. Chavarro

Jorge E. Chavarro, MD, ScD
Associate Professor
Departments of Nutrition and Epidemiology
Harvard T.H. Chan School of Public Health
Channing Division of Network Medicine
Department of Medicine
Brigham and Women’s Hospital and Harvard Medical School
Boston, MA 02115

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

Response: It is well known that sugared sweetened beverages (SSBs) promote excessive weight gain and obesity in children. The excess sugars in chocolate milk and other flavored milks puts them in a category that may be closer to sugared sweetened beverages than to plain milk. However, data on whether flavored milks promote weight gain is scarce.

We followed a cohort of 5,321 children and adolescents over a four year period to evaluate whether intake of chocolate milks was related to weight gain. We found that children who increased their intake of flavored milk gained more weight than children whose intake of flavored milk remained stable over this period. Moreover, among those children who did not drink any chocolate milk at baseline, those who started drinking chocolate milk over the course of the study gained substantially more weight than children who remained non-consumers of chocolate milk.

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Limiting Calories Changes Mitochondria, The Main Hub For Energy Metabolism

MedicalResearch.com Interview with:
Alicia J. Kowaltowski, MD, PhD

Professor of Biochemistry
Departamento de Bioquímica, IQ, Universidade de São Paulo
Cidade Universitária
São Paulo, SP, Brazil

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

Response: We recently found that brain mitochondria from calorically-restricted animals can take up more calcium than mitochondria from animals that eat ad libitum (or “all they can eat”; doi: 10.1111/acel.12527). Calcium is a well-know regulator of energy metabolism, as is caloric intake, but this was the first evidence that limiting caloric intake changed calcium handling by mitochondria, the main hub for energy metabolism. As a result, we decided to investigate if this result was specific for the brain or happened in other tissues, focusing on the liver because of its central importance in metabolic control.

We found that liver mitochondria from calorically-restricted mice take up substantially more calcium than ad libitum fed mice. We also found that this result is related to a change in the amount of ATP within the mitochondria; ATP can complex calcium ions effectively due to its negative charges. Finally, we were able to correlate the increase in calcium uptake by liver mitochondria to a very strong protection of caloric restriction livers against ischemia/reperfusion damage.

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Mouse Study Shows Intermittent Fasting Limits Obesity and Improves Metabolism

MedicalResearch.com Interview with:

Dr. Hoon-Ki Sung MD PhD Scientist at The Hospital for Sick Children (SickKids) and Assistant Professor in Laboratory Medicine & Pathobiology University of TorontoDr. Hoon-Ki Sung MD PhD Scientist at The Hospital for Sick Children (SickKids) and Assistant Professor in Laboratory Medicine & Pathobiology University of Toronto

Dr. Sung

Dr. Hoon-Ki Sung MD PhD
Scientist at The Hospital for Sick Children (SickKids) and
Assistant Professor in Laboratory Medicine & Pathobiology
University of Toronto 

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

Response: Despite extensive research and medical interventions, the prevalence of obesity and associated metabolic disease is increasing. More and more studies show that obesity and its associated metabolic problems are often associated with unhealthy lifestyles and eating habits, including frequent eating (non-stop) throughout the day, resulting in a shorter period of physiological fasting. As such, various dietary approaches, such as calorie restriction and intermittent fasting have gained popularity as therapeutic strategies for obesity treatment. Intermittent-fasting is when one temporarily stops eating for a period of time, returns to normal food consumption, and then temporarily stops again.

In our study we examined the effect of an intermittent-fasting regimen, without restricting caloric intake, in mice. We found that an intermittent fasting regimen not only prevented obesity in mice, but also improved metabolism by changing the quality of fat in the body.

Our findings show that the health of the mice is significantly influenced by daily eating patterns. The addition of a ‘stop eating’ period converted inflammatory fat to brown-like (or beige) fat by anti-inflammatory immune cells, meaning it changed bad fat into good fat.

The results are exciting, because they show that weight loss is not the sole benefit of fasting. Fasting also restores the dual function of fat cells, which is to store energy and to release energy.

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40% of Cancers Associated With Overweight and Obesity

MedicalResearch.com Interview with:
Dr. C. Brooke Steele D.O.

Division of Cancer Prevention and Control
Centers fo Disease Control and Prevention 

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

Response: This report contains new information about cancer risk and people being overweight and obese. Research shows that being overweight or having obesity is associated with at least 13 types of cancer (adenocarcinoma of the esophagus; cancers of the breast [in postmenopausal women], colon and rectum, endometrium, gallbladder, gastric cardia, kidney, liver, ovaries, pancreas, and thyroid; meningioma; and multiple myeloma). We also know that the number of people who weigh more than recommended has increased over the past few decades. Therefore, we looked at the numbers of new cases of cancers associated with overweight and having obesity in the United States, as well as how the rates have changed over a 10-year period. Because screening for colorectal cancer can reduce colorectal cancer incidence through detection and removal of precancerous polyps before they become cancerous, we analyzed trends with and without colorectal cancer.

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Night Shift Work Linked To Increased Risk of Obesity

MedicalResearch.com Interview with:
Sun Miaomiao

Prof. Shelly Tse
JC School of Public Health and Primary Care
The Chinese University of Hong Kong
Sha Tin, Hong Kong

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

Response: Approximately 20% of the overall workforce is involving in a shift work schedule, which is equivalent to nearly 0.7 billion workers. It has been several studies and systematic reviews reported that shift work could contribute a risk to abdominal obesity, that was identified to be associated with increased mortality. However, the previous related studies derived from different industries and companies that held with various occupational settings of night shift work, and the results have been inconsistent or lack of statistical power. We believed that a better understanding of the knowledge gaps on the associations between specific obesity types and different shift work settings has important implications for occupational health practice. Our meta-analysis provided a clearer picture for the association between night shift work and overweight/ obesity with a potential gradient association, especially for the abdominal obesity.

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Liraglutide (SAXENDA) May Lead To Weight Loss By Slowing Stomach Emptying

MedicalResearch.com Interview with:

Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN

Prof. Camilleri

Prof Michael Camilleri, MD
Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER)
Mayo Clinic, Rochester, MN

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

Response: Liraglutide is approved for treatment of obesity; the precise mechanisms for the beneficial weight loss are unclear. We are interested to learn whether it is possible to identify people who are more likely to benefit from this treatment.

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Maternal Blood Pressure Rise During Pregnancy Linked To Increased Risk Of Childhood Obesity

MedicalResearch.com Interview with:

Duo Li, PhD Chief professor of Nutrition Institute of Nutrition and Health Qingdao University, China. 

Dr. Duo Li

Duo Li, PhD
Chief professor of Nutrition
Institute of Nutrition and Health
Qingdao University, China. 

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

Response: Childhood obesity is becoming an emerging public health issue worldwide, owing to its association with a variety of health problems at younger ages in adulthood, including obesity, type 2 diabetes and cardiovascular diseases. Identification of prenatal and early life risk factors is key for curbing the epidemic of the childhood obesity.

Main finding of the present study is that among pregnant women, elevated blood pressure is associated with a greater risk of overweight and obesity for their children.

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Blocking Gherlin May Be Key To Preventing Weight Gain After Dieting

MedicalResearch.com Interview with:

Dr. W. Stephen Brimijoin PhD Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic, Rochester, MN 55905

Dr. Brimijoin

Dr. W. Stephen Brimijoin PhD
Department of Molecular Pharmacology and Experimental Therapeutics
Mayo Clinic, Rochester, MN 55905

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

Response: The background for this study was:

1) Ordinary C57 black mice readily become obese when given unrestricted access to high-fat mouse chow.

2) If the obese mice are put on a forced calorie restricted diet they will regain their previous normal healthy weight.  However, if they are given unrestricted access to their previous “normal” low-fat mouse chow, they will rebound into obesity.  This effect can be seen as a model of human obesity and the difficulties that formerly obese men and women face in maintaining healthy body mass gained after dieting.

3) The literature on obesity provided reason to believe that this self-defeating behavioral cycle involves ghrelin, the so-called “hunger hormone.”

4) We had recently shown that the plasma enzyme called “butyrylcholinesterase” was a key regulator of active ghrelin. Therefore, it seemed plausible that raising enzyme levels would reduce ghrelin and, in turn, would blunt food craving.

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Intermittent Dieting May Result In Greater Weight Loss

MedicalResearch.com Interview with:

Professor Nuala Byrne PhD Head of School | Health Sciences Faculty of Health University of Tasmania

Prof. Byrne

Professor Nuala Byrne PhD
Head of School | Health Sciences
Faculty of Health
University of Tasmania 

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

Response: Calorie restriction (or cutting back on the energy we are eating) triggers powerful compensatory responses by our body’s metabolism – we might think of it as a “Famine Reaction”. Our body weight is regulated by a series of nervous system and hormone networks that act together to make sure we have enough energy to sustain life. When we eat more energy than our body needs to meet our daily metabolic requirements (positive energy balance), we are designed to store that excess energy; and we are very good at storing. We store this energy in the fat cells (adipocytes) as an emergency reserve for when we hit hard-times when food availability is scarce. The problem in today’s society is that most of us have a constant availability of energy-dense food; making it more common to be in energy excess.

When we have less calories being consumed than what we need to fuel all the body’s metabolic processes (negative energy balance), we convert the stored fat into usable energy, and consequently lose weight. While our body does sense the positive energy balance, it is designed to be more sensitive to gauging when we are in a negative energy balance. Our body senses the change in energy intake and the decreasing fat stores, and brings out the artillery to defend our energy stores – this is the Famine Reaction. Our body is constantly changing our physiology in response to challenges to the status quo; the body works constantly to keep the oxygen concentration in the blood at an optimal level, to keep a constant and optimal body temperature, and a constant and optimal amount of sugar in the blood. Our body’s regulatory systems also work hard to defend our energy stores if it senses we are continually in negative energy-balance (i.e., dieting). One major metabolic compensatory as part of the “Famine Reaction” is a decrease in the body’s resting metabolic rate (energy expended while at rest to maintain the basic functioning of our major organs). Given that resting metabolic rate is determined largely by body size and composition, it is expected to decrease with weight loss. However, during dieting, resting metabolic rate has been reported to decrease to a greater extent than that expected from changes in body composition, a phenomenon termed ‘adaptive thermogenesis’. This leads to markedly reduced efficiency of weight loss.

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Gastric Bypass: Half of Diabetic Patients In Remission 12 Years After Surgery

MedicalResearch.com Interview with:
Ted Adams PhD
Adjunct Professor, Internal Medicine
Adjunct Associate Professor, Nutrition & Integrative Physiology
The University of Utah 

MedicalResearch.com: Why did you decide to conduct this study?

Response: The primary aim of the study was to determine the clinical outcomes in patients who underwent gastric bypass surgery.

As NIDDK/NIH continued to fund the study, the aim was extended to determining the durability) long-term outcomes) of gastric bypass surgery when compared to non-surgical, severely obese patients.

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48-Hours of Antibiotics Reduced Infection Rate After C-Section in Obese Women

MedicalResearch.com Interview with:

Dr. Carri R. Warshak, MD Associate Professor of Obstetrics & Gynecology University of  Cincinnati

Dr. Warshak

Dr. Carri R. Warshak, MD
Associate Professor of Obstetrics & Gynecology
University of  Cincinnati

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

Response: Cesarean deliveries are the most common major surgical procedure performed in the United States.  A common complication of cesarean section is wound infections that can include infections in the skin and incision site, or infections in the uterus itself after delivery.  These complications can lead to prolonged hospitalization after delivery for antibiotics and even further surgery in severe infections.  Often these wound complications lead to delayed healing, wound opening which can sometimes take several weeks to heal. Studies have demonstrated as many as 12% of women experience a surgical site infection after delivery.

Obesity is a strong risk factor for increased surgical site infections.  Increasing maternal weight increases the risk of wound complications, with a two to five fold increase in risk, making surgical site infections and common and concerning complication of cesarean delivery in obese women.

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Low-Fat Dairy Products Linked To Decreased Abdominal Fat, Increased Lean Body Mass

MedicalResearch.com Interview with:

Dr Nita Forouhi, MRCP, PhD, FFPHM Programme Leader MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Institute of Metabolic Science Cambridge Biomedical Campus

Dr Nita Forouhi

Dr Nita Forouhi, MRCP, PhD, FFPHM
Programme Lead & Consultant Public Health Physician
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine
Institute of Metabolic Science
Cambridge Biomedical Campus, Cambridge

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

Response: Past research has shown a beneficial link between some dairy products and risk of developing type 2 diabetes, but the mechanisms are not well understood. Body composition (total fat and lean mass) has been suggested as one pathway for the link, but the distribution of body fat and lean mass in relation to dairy consumption is not well studied. Based on this research gap, we aimed to investigate associations between types of dairy consumption and markers of body fat and lean mass distribution including: peripheral fat, the ratio of visceral (fat that surrounds the body organs) to abdominal subcutaneous fat (fat that accumulates under the skin) and appendicular lean mass (i.e., in the limbs).

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Weight Gain Early In Pregnancy Linked To Higher Birthweight Babies

MedicalResearch.com Interview with:

Leanne M. Redman MS, PhD LPFA Endowed Fellowship Associate Professor Pennington Biomedical Research Center Baton Rouge, Louisiana

Dr. Redman

Leanne M. Redman MS, PhD
LPFA Endowed Fellowship
Associate Professor
Pennington Biomedical Research Center
Baton Rouge, Louisiana 

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

Response: Two well-documented risk factors for aberrant weight gain and obesity is whether your mother was obese when she was pregnant and the amount of weight she gained.

Up until now few studies have asked questions about whether the pattern of weight gain in pregnancy affect outcomes in offspring, such as birth weight.

In a cohort of over 16,000 pregnant women and infants, we found that regardless of the obesity status (BMI) of the mother at the time of pregnancy, weight gain that occurs up until week 24, had the strongest effect on infant birth weight. Infants born to mothers who had weight gain in excess of the 2009 IOM guidelines from conception until week 24, had a 2.5 times higher likelihood of being born large for gestational age. The weight gain that occurred after 24 weeks until delivery, did not attenuate this risk.

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Caffeine May Make Other Foods Taste Less Sweet

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Robin Dando, PhD Assistant Professor Director, Cornell Sensory Evaluation Facility Department of Food Science Cornell University Ithaca, NY 14853 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study arose from a previous paper I authored in the Journal of Neuroscience, where we found Adenosine receptors in taste. We managed to prove that they were there to amplify sweet signals. This led us to wonder, what about the foods we consume, that would come into contact with these receptors in taste buds. It just happens that a lot of us habitually consume a powerful blocker of adenosine receptors every morning. Caffeine. So is our coffee impairing sweet signals? It turns out when we gave people sweetened coffee containing caffeine, they judged it as less sweet than the same coffee without the caffeine, sampled on a different day. Interestingly, this persisted, and sweet solutions they tested afterwards were still a little less sweet. Finally, just for kicks, we asked them to rate how much caffeine they thought was in either coffee, and how much more alert it made them feel. Turns out, there was no difference. They couldn’t tell which was deacf, and either coffee gave them just as much of an alertness boost. MedicalResearch.com: What should clinicians and patients take away from your report? Response: Readers should consider that they may be altering how their food tastes when consuming coffee. And perhaps also, they could be drinking decaf, and getting just as good a jolt from it (as long as someone else was preparing it for them, so they didn’t know). MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: We’re interested in how many factors we encounter in our every day lives change our perception, from the foods we’re consuming themselves, to our own bodies. We’re currently looking into how obesity, pregnancy and sleep can change our sense of taste, and the foods we crave. If you’d like to hear more about what we do, you can follow our work on twitter @DandoLab. MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. 1.Citation: Ezen Choo, Benjamin Picket, Robin Dando. Caffeine May Reduce Perceived Sweet Taste in Humans, Supporting Evidence That Adenosine Receptors Modulate Taste. Journal of Food Science, 2017; DOI: 10.1111/1750-3841.13836 Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

Dr. Dando

Robin Dando, PhD
Assistant Professor
Director, Cornell Sensory Evaluation Facility
Department of Food Science
Cornell University
Ithaca, NY 14853 

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

Response: The study arose from a previous paper I authored in the Journal of Neuroscience, where we found Adenosine receptors in taste.  We managed to prove that they were there to amplify sweet signals.  This led us to wonder, what about the foods we consume, that would come into contact with these receptors in taste buds.

It just happens that a lot of us habitually consume a powerful blocker of adenosine receptors every morning.  Caffeine.  So is our coffee impairing sweet signals?  It turns out when we gave people sweetened coffee containing caffeine, they judged it as less sweet than the same coffee without the caffeine, sampled on a different day.  Interestingly, this persisted, and sweet solutions they tested afterwards were still a little less sweet.

Finally, just for kicks, we asked them to rate how much caffeine they thought was in either coffee, and how much more alert it made them feel.  Turns out, there was no difference.  They couldn’t tell which was deacf, and either coffee gave them just as much of an alertness boost.

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Serotonin Receptors Tied To Weight Gain From Atypical Antipsychotic Medications

MedicalResearch.com Interview with:

Chen Liu, Ph.D. Assistant Professor Departments of Internal Medicine and Neuroscience Division of Hypothalamic Research The University of Texas Southwestern Medical Center Dallas, Texas 75390-9077

Dr. Chen Liu

Chen Liu, Ph.D.
Assistant Professor
Departments of Internal Medicine and Neuroscience
Division of Hypothalamic Research
The University of Texas Southwestern Medical Center
Dallas, Texas 75390-9077 

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

Response: Atypical antipsychotics are second-generation antipsychotics (SGAs) that have been increasingly used to treat a variety of neuropsychiatric conditions such as schizophrenia, depression, and autism. Many patients taking these medications, however, are left in an agonizing dilemma.

On one hand, they rely on these drugs’ psychotropic effect for normal functioning in daily life. On the other, many SGAs, including the most widely prescribed olanzapine and clozapine, can cause a metabolic syndrome that is known for excessive weight gain, dyslipidemia, and type-2 diabetes_ENREF_2. Notably, while full-blown type 2 diabetes and morbid obesity typically take years to unfold in the general population, these conditions progress at a much faster pace (within months) following second-generation antipsychotics treatment. Other factors such as ethnicity, age, and sex can also aggravate SGA-induced metabolic syndrome. Together, these peculiar features strongly suggest a distinct etiology underlying SGA-induced metabolic syndrome that has yet been fully elucidated. Currently, there is no medication specifically targeting SGA-induced metabolic syndrome. For many youths and adults taking second-generation antipsychotics, metabolic complications are difficult to manage as lifestyle changes, nutritional consulting, and commonly used anti-diabetic medications only provide limited relief.

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How Much Does Mother’s BMI Influence Children’s Metabolic Health?

MedicalResearch.com Interview with:

Prof. Deborah A Lawlor MSc(Lond), MBChB, PhD(Bristol), MPH(Leeds), MRCGP, MFPHM Professor of Epidemiology MRC Integrative Epidemiology Unit at the University of Bristol NIHR Bristol Biomedical Research Centre Population Health Sciences, Bristol Medical School Oakfield House, Oakfield Grove, Bristol

Prof. Lawlor

Prof. Deborah A Lawlor
MSc(Lond), MBChB, PhD(Bristol), MPH(Leeds), MRCGP, MFPHM
Professor of Epidemiology
MRC Integrative Epidemiology Unit at the University of Bristol
NIHR Bristol Biomedical Research Centre
Population Health Sciences, Bristol Medical School
Oakfield House, Oakfield Grove, Bristol

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

Response: As the obesity epidemic has occurred there has been increasing concern about pregnant women being more adipose (having higher levels of fat) during their pregnancy. One particular concern is that women who are on average fatter will have more extreme changes in pregnancy on their lipid, fatty acid, amino acid and glucose levels. In normal ‘healthy’ pregnancy these metabolites increase during pregnancy as part of the physiological response to pregnancy which ensures that the developing fetus has sufficient fuel (nutrients – fats, proteins, sugars) for healthy growth and development. Women who are more adipose tend to have a more extreme change in these fuels and as a consequence the developing fetus is ‘overfed’. There is a linear relationship between a pregnant woman’s body mass index and her infants birth weight, such that each increment greater adiposity (body mass index) of the mother there is on average and increment greater infant birth weight.

Recently, using a method that uses genetic variants (Mendelian randomization) we have shown that this association is likely to be causal (JAMA 2016). But whether there is a lasting effect on offspring health of being overfed in the uterus is unknown. There are concerns that there will be a lasting effect and that for daughters of more adipose women, this would mean that they go into their pregnancies on average fatter and with higher levels of the metabolites that could then overfeed their developing fetus. If this were the case it would mean the obesity epidemic could be accelerated across generations.

There are associations of mothers body mass index with later offspring body mass index, BUT this might not be anything to do with developmental overfeeding of the feeding in the uterus – it could simply reflect shared lifestyles that offspring adopt from their mother (and father) or shared genetic effects. In this study we tried to separate out whether there was evidence for a long-term offspring effect on their lipids, fatty acids, amino acids, glucose, and an inflammatory marker, of having a mother who was on average fatter during her pregnancy that was due to overfeeding in the uterus, as opposed to shared family lifestyle and genetics. We did this by comparing associations of mothers pre-pregnancy BMI with offspring outcomes to the same associations of fathers pre-pregnancy BMI with the same outcomes.

Our assumption here was that fathers BMI could not directly result in overfeeding of the fetus and so if the associations were similar this would suggest that they were largely driven by family factors.

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Skin-Grafted Stem Cells May Treat Obesity and Diabetes

MedicalResearch.com Interview with:

Dr. Xiaoyang Wu PhD Ben May Department for Cancer Research The University of Chicago, Chicago, IL

Dr. Xiaoyang Wu

Dr. Xiaoyang Wu PhD
Ben May Department for Cancer Research
The University of Chicago, Chicago, IL

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

Response: We have been working on skin somatic stem cells for many years. As one of the most studies adult stem cell systems, skin stem cells have several unique advantages as the novel vehicle for somatic gene therapy (summarized also in the paper). The system is well established. Human skin transplantation using CEA device developed from skin stem cells have been clinically used for decades for burn wound treatment, and been proven to be safe the effective.

In this study, we developed a skin 3D organoid culture model to induce stratification and maturation of mouse epidermal stem cells in vitro, which allows us to efficiently transfer engineered mouse skin to isogenic host animals. In the proof of concept study, we showed that we can achieve systematic release of GLP1 at therapeutic concentration by engineered skin grafts.

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Medical School Curriculum Aims To Overcome Physician Bias Against Obese Patients

MedicalResearch.com Interview with:

Gregory Gayer, PhD Associate Professor Chair of Basic Science Department TUCOM California

Dr. Gayer

Gregory Gayer, PhD
Associate Professor
Chair of Basic Science Department
TUCOM California 

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

Response: The prevalence of obesity in the United States continues to be a growing and remains a major health concern.  Closely associated with obesity is an extensive list of chronic diseases, including hypertension, dyslipidemia, and type 2 diabetes.  Unfortunately, physician bias against obese people may create a self-defeating environment that can produce less effective communication in a manner that could reduce the patient’s willingness to participate in their own health. Our overall goal is to prepare future physicians to appropriately engage the obese patient in order to optimize health care delivery.

This study was initiated in response to the ever increasing demand on the medical profession to properly care for the obese patient. We demonstrated that medical students have the same inherent bias as other health care providers and this bias can be sustainably reduced by education. We hope that this reduction in bias shown in medical school will enable students to be better prepared to address the concerns of their obese patients and ultimately translate into better clinical outcomes for them.

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Dieting and Physical Activity During Pregnancy Linked To Lower C-Section Rate

MedicalResearch.com Interview with:

Shakila Thangaratinam Professor of Maternal and Perinatal Health Joint Director of BARC (Barts Research Centre for Women's Health) Women's Health Research Unit | Multidisciplinary Evidence Synthesis Hub (MESH) Barts and the London School of Medicine and Dentistry  R & D Director for Women's Health Queen Mary University of London 

Prof. Thangaratinam

Shakila Thangaratinam
Professor of Maternal and Perinatal Health
Joint Director of BARC
(Barts Research Centre for Women’s Health)
Women’s Health Research Unit | Multidisciplinary Evidence Synthesis Hub (MESH)
Barts and the London School of Medicine and Dentistry
R & D Director for Women’s Health
Queen Mary University of London 

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

Response: Pregnant women who are overweight or obese, or who gain excess weight gain in pregnancy are at high risk of complications. We wanted to find

  1. If healthy diet and physical activity in pregnancy reduced weight gain, and improved outcomes for the mother and baby
  2. If the effects of the interventions differed according to the characteristics of the mother such as body mass index, parity, ethnicity, and underlying medical condition

We established a network (International Weight Management in Pregnancy i-WIP) of researchers from 16 countries, and 41 institutions to answer the above.

We found that women who followed a healthy diet and moderate physical activity gained less weight in pregnancy than other women; this beneficial effect was observed irrespective of mother’s body mass index, parity, ethnicity, and underlying medical condition.

Diet and physical activity in pregnancy has a beneficial effect on weight gain in pregnancy, and lowers the odds of caesarean section, and gestational diabetes.

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Midlife Weight Gain Raises Risks of Chronic Disease and Premature Death

MedicalResearch.com Interview with:
Yan Zheng Research Fellow, Department of Nutrition Harvard T.H. Chan School of Public HealthYan Zheng
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: Most people gain weight cumulatively during young and middle adulthood. Because the amount of weight gain per year may be relatively small, it may go unnoticed by individuals and their doctors—but the cumulative weight gain during adulthood may eventually lead to obesity over time. Compared to studies of attained body weight or BMI, the investigation of weight change may better capture the effect of excess body fat because it factors in individual differences in frame size and lean mass.

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Obesity Paradox: Overweight and Mildly Obese Stroke Patients Have Better Prognosis

MedicalResearch.com Interview with:

Hugo J. Aparicio, MD, MPH Assistant Professor Vascular Neurology, Department of Neurology Investigator, The Framingham Heart Study www.framinghamheartstudy.org Boston University School of Medicine Boston, MA 02118-2526

Dr. Aparicio

Hugo J. Aparicio, MD, MPH
Assistant Professor
Vascular Neurology, Department of Neurology
Investigator, The Framingham Heart Study
www.framinghamheartstudy.org
Boston University School of Medicine
Boston, MA 02118-2526

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

Response: The association of body weight with survival after stroke has been studied before and is a controversial topic. Results have varied between studies and have often been contradictory. The observational findings that carrying extra weight can be protective after having a disease, like stroke or heart attack, has been called an obesity paradox, since obesity in itself is a risk factor for cardiovascular disease and mortality in the general population. Stroke research has focused on hospitalized stroke patients with weight measured at the time of the stroke. BMI is often missing in this group of patients, especially when a stroke is severe or the patients cannot report their weight. In the FHS we have data regarding weight prior to stroke, obtained during regularly scheduled research exams, with multiple data points on body weight and vascular risk factors over time. All before the stroke occurs. And have also compared survival outcomes with a group of control participants, those without stroke, to see if the so-called ‘obesity paradox’ is a non-specific finding seen in older adults or seen specifically in stroke patients.

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Artificial Sweeteners May Be Bad For Your Waistline and Your Heart

MedicalResearch.com Interview with:

Dr. Azad

Dr. Azad

Meghan Azad PhD
Assistant Professor, Department of Pediatrics & Child Health and Community Health Sciences, University of Manitoba; Associate Investigator, Canadian Healthy Infant Longitudinal Development (CHILD) Study
Research Scientist, Children’s Hospital Research Institute of Manitoba; co-Lead, Population Health Pillar, Developmental Origins of Chronic Diseases in Children Network

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

Response: Consumption of artificial sweeteners, such as aspartame, sucralose and stevia, is widespread and increasing.  Emerging data indicate that artificial, or non-nutritive, sweeteners may have negative effects on metabolism, gut bacteria and appetite, although the evidence is conflicting.

MedicalResearch.com: What are the main findings?

Response: We conducted a systematic review of 37 studies that collectively followed over 400,000 people for an average of 10 years.

Only 7 of these studies were randomized clinical trials (the gold standard in clinical research), involving 1003 people followed for 6 months on average. The trials did not show a consistent effect of artificial sweeteners on weight loss, and the longer observational studies showed a link between consumption of artificial sweeteners and relatively higher risks of weight gain and obesity, high blood pressure, diabetes, heart disease and other health issues.

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Your Dusty House May Be Making You Fat

MedicalResearch.com Interview with:

Heather M. Stapleton PhD Dan and Bunny Gabel Associate Professor of Environmental Ethics and Sustainable Environmental Management EEH Program Chair Nicholas School of the Environment Duke University Durham, North Carolina 27708

Dr. Stapleton

Heather M. Stapleton PhD
Dan and Bunny Gabel Associate Professor of Environmental Ethics and Sustainable Environmental Management
EEH Program Chair
Nicholas School of the Environment
Duke University
Durham, North Carolina 27708

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

Response: Building materials and products common to most homes (e.g. furniture, TVs, carpets, etc) are often treated with synthetic chemicals, which migrate out of the products over time and accumulate in house dust, where residents can be exposed to these chemicals on a daily basis.

This study assessed approximately forty chemicals commonly detected and measured in house dust samples for their ability to stimulate the development of fat cells, using a mouse precursor fat cell model. Approximately two thirds of these chemicals were able to promote lipid accumulation by these cells and/or stimulate the proliferation of the precursor fat cells. We then assessed eleven extracts of indoor house dust samples (containing mixtures of these chemicals) and exposed our cells to these extracts, finding that even low levels of these extracts were sufficient to promote the accumulation of lipids and/or the proliferation of the fat precursor cells.

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Overweight, Tall Men Have Greater Risk of Aggressive Prostate Cancer

MedicalResearch.com Interview with:

Aurora Perez-Cornago, PhD Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford

Dr. Perez-Cornago

Aurora Perez-Cornago, PhD
Cancer Epidemiology Unit
Nuffield Department of Population Health
University of Oxford

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

Response: Greater height and adiposity have been suggested as possible prostate cancer risk factors, but these associations are not clear, probably
because most previous studies have not looked separately at different tumour subtypes.

For this reason, we wanted to look at these associations splitting tumours into subtypes according to tumour stage and histological grade, looking as well at death from prostate cancer.

We found a marked difference in risks looking at low and high risk tumours. Taller men and men with greater adiposity had an elevated of high-grade prostate cancer and prostate cancer death.

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Father’s Involvement In Childrearing Important In Reducing Pediatric Obesity

MedicalResearch.com Interview with:

Michelle S. Wong PhD Department of Health Policy and Management Johns Hopkins School of Public Health Baltimore, Maryland

Dr. Wong

Michelle S. Wong PhD
Department of Health Policy and Management
Johns Hopkins School of Public Health
Baltimore, Maryland
MedicalResearch.com: What is the background for this study?

Response: As background, there haven’t been many studies on how fathers might influence overweight or obesity in their children.

Unsurprisingly most of the research has focused on
the mothers’ influence. Existing studies on fathers have focused on the relationship between their parenting practices (e.g., discipline), as well as feeding and physical activity behaviors, with child overweight or obesity. A few studies found that some father feeding practices were related to higher child BMI, but we don’t know whether fathers’ general caregiving matters.

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USPSTF Recommends Children and Adolescents Be Screened For Obesity

MedicalResearch.com Interview with:

David C. Grossman, M.D., M.P.H. US Preventive Services Task Force Chair Senior Investigator, Kaiser Permanente Washington Health Research Institute Senior Associate Medical Director, Market Strategy & Public Policy Kaiser Permanente Washington Physician, Washington Permanente Medical Group, Pediatrics

Dr. Grossman

David C. Grossman, M.D., M.P.H.
US Preventive Services Task Force Chair
Senior Investigator, Kaiser Permanente Washington Health Research Institute
Senior Associate Medical Director, Market Strategy & Public Policy
Kaiser Permanente Washington
Physician, Washington Permanente Medical Group, Pediatrics

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

Response: Recognizing that obesity is a nation-wide health problem, affecting approximately 17% of 2-to 19-year-old children and adolescents in the U.S., the Task Force finalized its recommendation on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. The Task Force found sufficient evidence to recommend screening for obesity in children and adolescents age 6 years and older and then offering or referring those who are found to be obese comprehensive, intensive behavioral interventions to manage their weight and improve overall health.

MedicalResearch.com: What are the potential benefits and harms of early screening and intervention for obesity in children?

Response: The Task Force found that intensive behavioral interventions for children and adolescents who have obesity can result in benefits of improvement in weight status for up to 12 months’ post-intervention. Additionally, the evidence indicated very little harm from screening and comprehensive, intensive behavioral interventions. This is due to likely minimal harms of using BMI (body mass index), the absence of reported harms of behavioral interventions, and the noninvasive nature of the programs.

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Fewer Refined Grains During Pregnancy May Reduce Obesity Risk In Kids

MedicalResearch.com Interview with:

Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Bethesda, MD 20817 

Dr. Zhang

Cuilin Zhang MD, PhD
Senior Investigator, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Bethesda, MD 20817 

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

Response: Refined grains with a high glycemic index and reduced fiber and nutrient content have been linked to increased adiposity and higher risk of metabolic syndrome among adults. Despite these differences and the growing body of literature on the link between maternal diet/nutrition during pregnancy and subsequent offspring health consequences throughout the lifespan, little is known about the intergenerational impact of refined-grain intake during pregnancy on long-term cardio-metabolic outcomes in the offspring.

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Maternal Obesity Linked To Increased Risk of Congenital Malformations in Offspring

MedicalResearch.com Interview with:
Dr. Martina Persson

Clinical Epidemiology Unit
Department of Medicine Solna
Karolinska University Hospita

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

Response: It is well known that obesity increases risks of several maternal, fetal and neonatal complications including congenital malformations. However, it has not been clear if risks of malformations are increased also in offspring of normal weight mothers or if risks increase with degree of maternal obesity.

In this study, we found progressively increasing risks of major congenital malformations in the offspring with a mother’s overweight and obesity severity.

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

Response: The most sensitive period of fetal organ development is the first eight weeks of gestation and it is during this time a mother´s BMI may influence risks of malformations. Thus, it is important to try to obtain a normal bodyweight before conception.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Our results should be confirmed in other populations and mechanisms behind the increased risks of malformations associated with maternal obesity should be further explored.

MedicalResearch.com: Is there anything else you would like to add?

Response: Obesity is a major health problem in many countries in the world. Preventive measures to halt the obesity epidemic should be implemented at all levels of society.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

 

 

 

Vegetarian Diet More Effective For Weight Loss

MedicalResearch.com Interview with:

Hana Kahleova, MD, PhD</strong> Director of Clinical Research at Physicians Committee for Responsible Medicine Physicians Committee for Responsible Medicine Charles University in Prague

Dr. Kahleova

Hana Kahleova, MD, PhD
Director of Clinical Research at Physicians Committee for Responsible Medicine
Physicians Committee for Responsible Medicine
Charles University in Prague

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

Response: The vegetarian diet was found to be almost twice as effective in reducing body weight, resulting in an average loss of 6.2kg compared to 3.2kg for the conventional diet. Using magnetic resonance imaging, we studied adipose tissue in the subjects’ thighs to see how the two different diets had affected subcutaneous, subfascial and intramuscular fat.

We found that both diets caused a similar reduction in subcutaneous fat. However, subfascial fat was only reduced in response to the vegetarian diet, and intramuscular fat was more greatly reduced by the vegetarian diet.

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Prebiotics May Help Limit Obesity In Childhood

MedicalResearch.com Interview with:

Raylene Reimer, PhD, RD Professor, Faculty of Kinesiology University of Calgary Department of Biochemistry & Molecular Biology Cumming School of Medicine Full Scientist Alberta Children's Hospital Research Institute

Dr. Reimer

Raylene Reimer, PhD, RD
Professor, Faculty of Kinesiology
University of Calgary Department of Biochemistry & Molecular Biology
Cumming School of Medicine Full Scientist
Alberta Children’s Hospital Research Institute

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

Response: The human gut microbiota is a complex and dynamic population of microorganisms that benefit the human host through a variety of microbial activities (e.g. production of vitamins, immune regulation, utilization of dietary fiber). Despite these benefits however, it is now recognized that disruption of the microbiota (dysbiosis) can upset homeostasis and contribute to diseases such as obesity and type 2 diabetes. Manipulation of the gut microbiota to prevent or treat chronic disease is now an area of intense scientific and clinical interest. Dietary prebiotics, such as inulin and oligofructose, are used selectively by host microorganisms to confer a health benefit. Prebiotics have previously been shown to reduce body fat, improve appetite control and reduce blood glucose in adults with overweight or obesity.

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Comparative Effectiveness of Childhood Obesity Interventions

MedicalResearch.com Interview with:

Elsie M. Taveras, MD, MPH Ofer and Shelly Nemirovsky MGH Research Scholar Chief, Division of General Academic Pediatrics, Department of Pediatrics Mass General Hospital for Children Professor of Pediatrics, Harvard Medical School Professor in the Department of Nutrition, Harvard T.H. Chan School of Public Health Boston, MA

Dr. Taveras

Elsie M. Taveras, MD, MPH
Ofer and Shelly Nemirovsky MGH Research Scholar
Chief, Division of General Academic Pediatrics, Department of Pediatrics
Mass General Hospital for Children
Professor of Pediatrics, Harvard Medical School
Professor in the Department of Nutrition, Harvard T.H. Chan School of Public Health Boston, MA

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

Response: We designed this study to test the effectiveness of two interventions that linked clinical and community approaches in improving childhood body mass index (BMI) and obesity prevalence. Another important question we set out to understand was whether there were outcomes aside from BMI and obesity that mattered most to families of children with obesity.

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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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Brain Triggers For Eating Differ in Obese Men vs Women

MedicalResearch.com Interview with:

Arpana Gupta, Ph.D. Assistant Professor G. Oppenheimer Center for Neurobiology of Stress and Resilience Ingestive Behavior and Obesity Program Vatche and Tamar Manoukin Division of Digestive Diseases David Geffen School of Medicine, UCLA

Dr. Gupta

Arpana Gupta, Ph.D.
Assistant Professor
G. Oppenheimer Center for Neurobiology of Stress and Resilience
Ingestive Behavior and Obesity Program
Vatche and Tamar Manoukin Division of Digestive Diseases
David Geffen School of Medicine, UCLA

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

Response: Past studies have demonstrated how an imbalance in the processing of rewarding and salient stimuli results in maladaptive or excessive eating behaviors. However, stress and drug use are known to affect how sex and sex hormones modulate responses of the dopamine system involved in reward, and are thought to underlie sex differences in the pathophysiology of drug addiction and treatment response. These results suggest similar sex effects on the mesolimbic reward system may also be at play in obesity.

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Re-Operations After Gastric Band Surgery Are Common and Costly

MedicalResearch.com Interview with:

Andrew Ibrahim, M.D., M.Sc</strong> Institute for HealthCare Policy and Innovation University of Michigan

Dr. Ibrahim

Andrew Ibrahim, M.D., M.Sc
Institute for HealthCare Policy and Innovation
University of Michigan

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

Response: The laparoscopic gastric band was approved by the FDA in 2001 and widely adopted for the surgical treatment of morbid obesity. Reported rates of reoperation to revise or remove the device ranged from 4 to 60 percent in small scale studies, but no population estimates in the United States existed.

In a review of Medicare Claims data between 2006 and 2013, we observed that reoperation was common with 18% of patients requiring at least one reoperation. More over, we found that on average, patients who did need a reoperation often underwent an average of 3.8 additional procedures. Taken together, nearly half (47%) of the $470 million paid by Medicare for device related procedures was for reoperations.

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Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults?

MedicalResearch.com Interview with:

Dennis T. Villareal, MD Professor of Medicine Division of Endocrinology, Diabetes & Metabolism Baylor College of Medicine Staff Physician, Michael E DeBakey VA Medical Center

Dr. Villareal

Dennis T. Villareal, MD
Professor of Medicine
Division of Endocrinology, Diabetes & Metabolism
Baylor College of Medicine
Staff Physician, Michael E DeBakey VA Medical Center

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

Response: The prevalence of obesity in the elderly is rapidly increasing, given that the baby boomers are becoming senior citizens, but we do not know how best to manage obesity in the elderly population. Weight loss is the cornerstone of management for obesity but weight loss in the elderly is controversial because weight loss could cause not only fat loss but also muscle mass and bone mass losses, that could worsen rather than improve frailty.

We tested the hypothesis that weight loss plus exercise training, especially resistance training, would improve physical function the most compared to other types of exercise (aerobic training or combined aerobic and resistance training added to diet-induced weight loss).

Previous studies especially in younger adults have shown that combining aerobic with resistance exercise could lead to interference to the specific adaptations to each exercise, and thus less gain in strength with combined exercise compared to resistance training alone.

On the other hand, contrary to our hypothesis, we found that there was no interference between aerobic and resistance exercise, and the most effective mode to improve physical function and thus reverse frailty was in fact weight loss plus the combination of aerobic and resistance exercise, which was also associated with some preservation of muscle and bone mass.

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Diet Foods Can Make You Fat By Changing Your Microbiome

MedicalResearch.com Interview with:

Krzysztof Czaja VBDI, D.V.M Associate professor of veterinary biosciences and diagnostic imaging College of Veterinary Medicine University of Georgia

Dr. Krzysztof Czaja

Krzysztof Czaja VBDI, D.V.M
Associate professor of veterinary biosciences and diagnostic imaging
College of Veterinary Medicine
University of Georgia

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

Response: The neural regulation of food intake and satiety in rodents and human are similar. Therefore, rodent model is well established in studying neural regulation in obesity in humans.

MedicalResearch.com: What are the main findings?

Response: We determined that diets rich in sugar, and many “diet products” contain high amount of sugar (sometimes under different names), increase efficiency of accumulation of body and liver fat. We also found that sugar-rich diets change the gut microflora toward overpopulation of enterotoxic bacteria, damaging neural gut-brain communication and disrupting neural regulation of food intake. The implications of our results on human health are very significant because they show that diets rich in sugar changes the brain circuits responsible for food intake and satiety, induces chronic inflammation and symptoms of non-alcoholic liver disease (NALD).

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Brief Nutritional Telephone Calls Help Keep Pounds Off

MedicalResearch.com Interview with:

Corrine I. Voils, PhD Research Career Scientist, William S Middleton Veterans Memorial Hospital Professor of Surgery, University of Wisconsin-Madison

Dr. Corrine Voils

Corrine I. Voils, PhD
Research Career Scientist, William S Middleton Veterans Memorial Hospital
Professor of Surgery, University of Wisconsin-Madison

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

Response: Keeping weight off is hard due to physical and behavioral factors. When people lose weight, their metabolism slows down a bit, making it difficult to keep off the weight. It is also difficult to keep off the weight because people don’t continually engage in behavioral skills such weighing yourself regularly. Our study focused on the behavioral component of weight loss maintenance.

After losing an average of 16 pounds initially, the maintenance group regained less than 2 pounds (net weight loss around 14 pounds), whereas the usual care group regained more than 5 pounds (net weight loss less than 11 pounds).

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Maternal Obesity Linked To Increased Risk of Epilepsy in Offspring

MedicalResearch.com Interview with:
Neda Razaz-Vandyke, PhD, MPH
Postdoctoral Fellow
Reproductive Epidemiology Unit
Karolinska Institutet  

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

Response:   There is a growing concern about long-term neurological effects of prenatal exposure to maternal overweight and obesity.

The etiology of epilepsy is poorly understood and in more than 60% of cases no definitive cause can be determined. We found that maternal overweight and obesity increased the risks of childhood epilepsy in a dose-response pattern.

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Omega-3 Fatty Acid Supplementation Improves Luteal Function in Obese Women

MedicalResearch.com Interview with:

Alex J. Polotsky, MD Associate Professor of Obstetrics and Gynecology University of Colorado Denver Practice homepage

Dr. Polotsky

Alex J. Polotsky, MD
Associate Professor of Obstetrics and Gynecology
University of Colorado Denver
Practice homepage

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

Response: It has been well established that profound dietary changes occurred over the past 100 years. The type and amount of fat consumed has changed quite a bit over the course of 20th century. Intake of omega-3 polyunsaturated fatty acids (PUFAs), previously consumed in large quantities by humans from vegetable and fish sources, has dropped significantly. The typical Western diet (sometimes also called the typical American diet) provides an omega-6 to omega-3 fatty acid ratio of as high as 25:1, which is quite different from what it used to up until about the 19th century (believed to be about 1:1 ratio).

In animal studies, diets enriched with omega-3 PUFA enhance early embryonic development and boost progesterone secretion. Obesity is well known to be associated with decreased progesterone production in women (even if a obese woman ovulates). The reasons for this are not clear. Obesity is also a state of low-grade chronic inflammation. Omega-3 fatty acids are well known to have anti-inflammatory properties.

We sought to test whether dietary supplementation with omega-3 PUFA favorably affects reproductive hormones in women and whether this effect includes normalization of progesterone production in obesity.

All women in the study tolerated supplementation well, and had significantly decreased their omega-6 to omega-3 ratios (they were normalized much closer to a 1:1 ratio). Omega-3 supplementation resulted in a trend for increased progesterone in obese women, thus enhancing ovulatory function. A 16 to 22 percent increase was observed. Additionally, the supplementation resulted in reduced systemic inflammation.

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Earlier Onset of Arthritis in More Recent Generations Linked to Obesity

MedicalResearch.com Interview with:

Elizabeth Badley PhD Professor Emeritus Dalla Lana School of Public Health, University of Toronto Director: The Arthritis Community Research and Evaluation Unit and Head, Division of Health Care and Outcomes Research Krembil Research Institute Toronto Western Hospital Toronto, Ontario

Dr. Elizabeth Badley

Elizabeth Badley PhD Professor Emeritus
Dalla Lana School of Public Health, University of Toronto
Director: The Arthritis Community Research and Evaluation Unit and
Head, Division of Health Care and Outcomes Research
Krembil Research Institute
Toronto Western Hospital
Toronto, Ontario 

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

Response: The aging of the baby boomer population is focusing attention on the health experience of this sector of the population.  Arthritis is one of the most frequent chronic health problems in the population.  Our research question was to investigate whether the prevalence of arthritis differs between generations (also called birth cohorts) and what might be associated with any differences. Using data collected in a longitudinal Canadian population health survey between 1994 and 2011, we looked at 4 generations: the World War II generation born 1935-1944, older baby boomers born 1945-1954, younger baby boomers born 1955-64, and Generation X born 1965-1974.
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How Does Fruit Juice Affect Weight Gain in Children?

MedicalResearch.com Interview with:

Brandon Auerbach, MD, MPH Acting Instructor Division of General Internal Medicine University of Washington

Dr. Auerbach

Brandon Auerbach, MD, MPH
Acting Instructor
Division of General Internal Medicine
University of Washington

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

Response: The question of whether 100% fruit juice causes poor health outcomes in children, such as weight gain, has been a subject of controversy. On one hand, 100% fruit juice contains vitamins and nutrients that many children lack, is often cheaper than whole fruit, and may help kids with limited access to healthy food meet their daily fruit requirements.

On the other hand, leading nutrition experts have expressed concern that fruit juice contains amounts of sugar equal to or greater than those of sugary drinks like regular soda. Guidelines from the American Academy of Pediatrics warn that 100% juice can be a significant source of calories and contribute to obesity if consumed excessively.

Our main finding was that consuming 1 serving/day of 100% fruit juice was not associated with weight gain in children. Children ages 1 to 6 years gained a small amount of weight, but not enough to negatively impact health. Children ages 7 and older gained no weight. We did not study amounts of 100% fruit juice higher than 1 serving/day.

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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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Adiposity Related Cancer Risk May Vary On Fat Locations

MedicalResearch.com Interview with:
Arjun Gupta, MD and

Ian J. Neeland MD, Assistant Professor
Dedman Family Scholar in Clinical Care
Division of Cardiology
UT Southwestern Medical Center

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

Response: Adiposity is traditionally measured using the body mass index, which refers to a persons weight in kilograms divided by their height (in meters) squared. Persons with higher body mas index have been shown to have increased risk of certain cancers, however body mass index by itself is not a completely representative measure of body fat risk, because distinct fat depots such as visceral adipose tissue, abdominal subcutaneous adipose tissue, liver fat and lower body fat have differing metabolic impact.

We aimed to study the relationship between specific fat depots and the risk of incident cancer among relatively young, multiethnic participants in the Dallas Heart Study. Individuals without prevalent cancer underwent quantification of adipose depots using MRI and DEXA scans from 2000-2002, and were followed for the development of cancer for up to 12 years. In multivariable models adjusted for age, sex, race, smoking, alcohol use, family history of malignancy and body mass index, visceral adipose tissue, subcutaneous adipose tissue or liver fat were not associated with risk of cancer but each 1-standard deviation increase in lower body fat was associated with a 31% reduced incidence of cancer.

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Democrats More Likely To Attribute Obesity to Genetics

MedicalResearch.com Interview with:

Professor Don Haider-Markel Chair, Department of Political Science University of Kansas Lawrence, KS 66045

Prof.  Haider-Markel

Professor Don Haider-Markel
Chair, Department of Political Science
University of Kansas
Lawrence, KS 66045

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

Response: We have studied causal attributions for conditions and problems in society for some time. We noticed that public debate over obesity had increased and new policy proposals were being proposed to address what was deemed as a growing public health problem. As the salience of the issue increased so too did partisan views on the topic.

Based on these observations, we wanted to explore individual beliefs about the causes, or attributions for, obesity. Existing research and theory suggested that Republicans following a conservative philosophy would be more likely to attribute obesity to personal choices, such as eating habits and lack of exercise—in short, putting the locus of control on individuals. Meanwhile liberal leaning Democrats, with a known predisposition to suggest conditions or problems are outside of the control of the individual, would be more likely to attribute obesity to either genetic or other biological factors, or the broader context of widely available low-cost high-fat food sources.

Additionally, we know that individuals tend to make attributions that are self-serving. In other words, people tend to make attributions that put themselves in a positive light. Thus, personal weight should factor into obesity attributions. Here we expected that overweight people would be more likely to make attributions that removed personal blame, such as pointing to a genetic cause. People closer to an ideal weight would, on the other hand, be more likely to attribute weight-level to personal choices.

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