Profa. Silveira[/caption]
Profa. Patrícia Pelufo Silveira, MD, PhD
Universidade Federal do Rio Grande do Sul
Brazil
Medical Research: What is the background for this study? What are the main findings?
Response: Previous studies have shown that women who carry a certain gene variant (namely the 7-repeat allele of the dopamine type 4 receptor) have increased risk for obesity, especially if they also suffer from eating disorders. We have also demonstrated that girls who have this gene variant prefer to eat more fat when allowed to choose. However, for some neuropsychiatric conditions, this gene was shown to function as a “plasticity gene”. That is to say that being a carrier makes the individual more or less vulnerable to the disease, depending if the environment in which the person lives is bad (more risk) or good (less risk for the disease). This is called the “differential susceptibility” model.
Therefore, in this paper, we wondered if the above described higher fat intake already reported in 7-repeat girls could be modified by the social environment in which they are raised. We saw that if a girl has the gene variant and is raised in a poorer environment, she is more likely to prefer to eat fat in her diet as we knew. However, if she has the gene variant but is raised in a better socioeconomic environment, she actually eats less fat in her regular diet compared to her counterparts who do not carry the gene variant. This is important because we change the focus from the gene (previously "blamed" for increasing fat preference and obesity as the years pass by) to the environment, as the genetic association will increase or decrease the risk according to the conditions in which the child is raised.
Dr. Rosebud Roberts[/caption]
MedicalResearch.com Interview with:
Rosebud O. Roberts, M.B., Ch.B.
Mayo Clinic
Rochester, Minn.
Medical Research: What is the background for this study?
Dr. Roberts: Decline in weight has been observed 10-20 years prior to onset of dementia. We wanted to study whether this decline also occurs for mild cognitive impairment (an intermediate stage in the progression from normal cognition to dementia).
Medical Research: What are the main findings?
Dr. Roberts: The main finding was that there was indeed a decline in weight (from the maximum weight in midlife to weight assessed in late life) was associated with a increased risk of mild cognitive impairment.
Prof. Stuart Phillips[/caption]
Professor Stuart M. Phillips Ph.D.,
FACSM, FACN
Department of Kinesiology, McMaster University, Canada
Exercise Metabolism Research Group – Protein Metabolism Research Lab
Director, Physical Activity Centre for Excellence
Medical Research: What is the background for this study? What are the main findings?
Prof. Phillips: During weight loss with diet only people lose both muscle and fat and muscle. The long-term health consequences of losing metabolically active muscle versus fat are not likely to be beneficial. In the context of this study we thought perhaps the preservation of muscle would also be important in very active young men. We wanted to see whether when men were in a very large energy deficit (40% less energy than they required) higher protein (2.4 g/kg/d) could preserve muscle mass and still result in increased function (strength) and fitness.
Our results show that during a marked energy deficit that consumption of 2.4 g protein/kg/d was more effective than consumption of a diet containing 1.2 g protein/kg/d in promoting increases in LBM (1.2 vs 0.1kg increase) and losses of fat mass (-4.8kg vs. -3.5kg) when combined with a high volume of resistance and anaerobic exercise.
Dr. Monica Bertoia[/caption]
MedicalResearch.com Interview with:
Monica L. Bertoia, MPH, PhD
Instructor in Medicine, Channing Division of Network Medicine
Brigham and Women’s Hospital & Harvard Medical School
Research Associate, Department of Nutrition
Harvard T. H. Chan School of Public Health
Boston, MA 02115
Medical Research: What is the background for this study? What are the main findings?
Response: Most weight loss studies have focused on one type of flavonoid, the flavan-3-ols found in green tea, and are limited to small numbers of overweight and obese study participants. We examined 7 subclasses of flavonoids and weight change in 124,086 healthy adults who reported their diet and weight repeatedly over up to 24 years.
Dr. Lauren Fiechtner[/caption]
MedicalResearch.com Interview with:
Lauren Fiechtner MD MPH
Director of Nutrition
Division of Pediatric Gastroenterology and Nutrition
Massachusetts General Hospital for Children
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Fiechtner: In previous studies, we investigated if distance to a supermarket was associated with a child’s BMI or weight status. These were cross-sectional studies measuring only one point in time. We wondered if distance to a supermarket modified how much children in a behavioral intervention improved their weight or dietary intake. In particular we examined 498 children participating in the Study of Technology to Accelerate Research, which was a randomized controlled trial to treat childhood obesity in Eastern Massachusetts. The intervention included computerized clinician decision support plus a family self-guided behavior change intervention or a health coach intervention, which included text messages to the family to promote behavior change. We found that children living closer to supermarkets were able to increase their fruit and vegetable intake and decrease their BMI z-score more during the intervention period than children living farther from supermarkets.
Dr. Brian Elbel[/caption]
Brian Elbel, PhD, MPH, Associate Professor, Department of Population Health, NYU Langone Medical Center
Amy Schwartz, PhD, Director, New York University Institute for Education and Social Policy, and the Daniel Patrick Moynihan Chair in Public Affairs, Syracuse University
Michele Leardo, MA, Assistant Director
New York University Institute for Education and Social Policy
Medical Research: What is the background for this study? What are the main findings?
Response: New York City, as well as other school districts, is making tap water available to students during lunch by placing water dispensers, called water jets, in schools. Surprisingly, drinking water was not always readily available in the lunchroom. Water jets are part of a larger effort to combat child obesity.
We find small, but statistically significant, decreases in weight for students in schools with water jets compared to students in schools without water jets. We see a .025 reduction in standardized body mass index for boys and .022 for girls. We also see a .9 percentage point reduction in the likelihood of being overweight for boys and a .6 percentage point reduction for girls. In other words, the intervention is working.
Dr. Fox[/caption]
MedicalResearch.com Interview with:
Dr. Caroline Fox, MD MPH
National Heart, Lung, and Blood Institute
Assistant Clinical Professor of Medicine
Harvard Medical School
Medical Research: What is the background for this study? What are the main findings?
Dr. Fox: There is evidence linking sugar sweetened beverages with obesity and type 2 diabetes. There is also evidence suggesting that specific adipose tissue depots may play a role in the pathogenesis of these diseases. We found that higher levels of sugar sweetened beverage (SSB) intake was associated with more visceral fat (fat in the stomach cavity) over 6 years.
Dr. Aaron Dawes[/caption]
MedicalResearch.com Interview with:
Aaron J. Dawes, MD
Fellow, VA/RWJF Clinical Scholars Program
Division of Health Services Research
University of California Los Angeles
Los Angeles, CA 90024
Medical Research: What is the background for this study? What are the main findings?
Dr. Dawes: We reviewed the published literature to answer three basic questions about bariatric surgery and mental health conditions.
First, how common are mental health conditions among patients being referred for or undergoing bariatric surgery?
Prof. Keast[/caption]
MedicalResearch.com Interview with:
Russell Keast Ph.D., CFS Professor
Centre for Advanced Sensory Science (CASS)
School of Exercise and Nutrition Sciences, Faculty of Health
Deakin University
Melbourne Burwood Campus
Burwood, VIC 3125
Medical Research: What is the background for this study? What are the main findings?
Dr. Keast: Fatty acids are detected at various stages of food consumption and digestion via interactions with nutrient receptors upon the tongue and within the gastrointestinal (GI) tract. This chemoreception initiates functional responses, i.e., taste perception, peptide secretion and alterations in GI motility that play a fundamental role in food consumption, hedonics and satiety. In obesity, both GI and taste detection of fatty acids is attenuated and this may predispose individuals to increased consumption of high-fat foods, or foods containing greater concentrations of fat. In other word overweight and obese people are less sensitive to fat and this is associated with overconsumption of fatty foods leading to weight gain.
Kawther Hashem[/caption]
MedicalResearch.com Interview with:
Kawther Hashem MSc RNutr (Public Health)
Nutritionist and Researcher
Action on Sugar
Wolfson Institute of Preventive Medicine,
Queen Mary, University of London
London UK
Medical Research: What is the background for this study? What are the main findings?
Response: The calculations showed that a 40% reduction in free sugars added to Sugar Sweetened Beverages (SSBs) over five years would lead to an average reduction in energy intake of 38 kcal per day by the end of the fifth year. This would lead to an average reduction in body weight of 1.20kg in adults, resulting in a reduction in overweight and obese adults by approximately half a million and 1 million respectively. This would in turn prevent between 274,000-309,000 obesity-related type 2 diabetes over the next two decades. Policies such as this will reduce cases of overweight and obesity and type 2 diabetes, this will have a major clinical impact and reduce healthcare costs.
Dr. Rebold[/caption]
MedicalResearch.com Interview with:
Michael Rebold, PhD, CSCS
Assistant Professor
Department of Exercise Science
Bloomsburg University
Bloomsburg, PA 17815
Medical Research: What is the background for this study?
Dr. Rebold: The obesity epidemic seen in children. If we can make children at a young age physically active then maybe they will be more likely to be physically active into their adult years. Since parents are the primary role models for younger children we must find ways to get the parents involved in physical activity as well, because children will model their parent's behaviors.
Medical Research: What are the main findings?
Dr. Rebold: The main findings from this study are that when parents are actively participating in activities with their children, their children spend more time in physical activities and less time in sedentary activities. When parents are not present and children are alone, then they spend more time engaging in sedentary activities and less time in physical activities. When parents are actively watching their children, children still engaged in a significant more amount of time in physical activities than sedentary activities when compared to the alone condition but still not as great as with parents participating.
Children also liked and were motivated to engage in additional physical activity time when parents were participating with them.
Prof. Schmid-Schonbein[/caption]
MedicalResearch.com Interview with:
Geert W. Schmid-Schonbein, Ph.D.
Distinguished Professor and Chairman
Department of Bioengineering
Adjunct Professor in Medicine
University of California San Diego
Medical Research: What is the background for this study? What are the main findings?
Dr. Schmid-Schonbein: Most approaches to control/reduce body weight focus on reducing food quantity, improving quality and promoting daily activity. These approaches, effective in the short term, only yield modest weight control. Weight management strategies recommended in the past have not significantly diminished the current trend towards childhood and adolescence obesity.
We developed and tested an alternative approach to control weight gain in healthy individuals to reduce the risk for development of obesity and diabetes complications. The essence is to:
“Eat deliberately slow AND stop eating when you feel no longer hungry”.
The approach avoids any form of special diet, uses no drugs, can be adopted for a lifetime and used in any ethnic environment. Children in a Mexican School in Durango were instructed by a pediatrician to learn to eat deliberately slow and to stop eating when the satiety reflex sets in, i.e. the moment when the feeling of hunger has disappeared.
They were instructed to:
Dr. Martin[/caption]
MedicalResearch.com Interview with:
Dr Anne Martin PhD
Research Associate/Research Fellow
Physical Activity for Health Research Centre (PAHRC)
Institute for Sport, PE & Health Sciences
University of Edinburgh
TeleScot Research Group
Usher Institute for Population Health Sciences and Informatics
Edinburgh
Medical Research: What is the background for this study? What are the main findings?
Dr. Martin: Impairments in cognitive development during childhood can have detrimental effects on health behaviour, educational attainment, and socio-economic status later in life. Epidemiological evidence indicates an association between childhood obesity and cognition and educational attainment. Knowledge of when obesity related deficits in cognition and attainment emerge, and how large the deficits are at various ages, may be useful to support arguments for school-based obesity prevention initiatives and in translating evidence on this topic into policy aimed at preventing obesity.
In this study we explored whether the adverse association between obesity and cognition emerges in early childhood. Measures of cognitive abilities included visuo-spatial skills, expressive language skills and reasoning skills. Our findings indicated that obesity in the pre-school years may be weakly associated with some poorer cognitive outcomes at age 5 years in boys, independently of socioeconomic status.
Stronger relationships between obesity and cognition or educational attainment may emerge later in childhood. Evidence from an English cohort study suggested an adverse association between obesity in teenage girls and lower academic attainment in Mathmatics, Science and English.
Dr. Gersing[/caption]
MedicalResearch.com Interview with:
Alexandra S. Gersing, MD
Department of Radiology and Biomedical Imaging
University of California, San Francisco
Medical Research: What is the background for this study? What are the main findings?
Dr. Gersing: This study is part of a larger NIH-funded project focusing on the effects of weight change in individuals at risk for and with osteoarthritis. Our group has previously shown that weight gain causes substantial worsening of knee joint degeneration in patients with risk factors for osteoarthritis and now we aimed to show that weight loss could protect the knee joint from degeneration and osteoarthritis. Osteoarthritis is one of the major causes of pain and disability worldwide; and cartilage plays a central role in the development of joint degeneration. Since cartilage loss is irreversible, we wanted to assess whether lifestyle interventions, such as weight loss, could make a difference at a very early, potentially reversible stage of cartilage degradation and whether a certain amount of weight loss is more beneficial to prevent cartilage deterioration. To measure these early changes we used a novel Magnetic Resonance Imaging (MRI) technique, called T2 mapping, which allows us to evaluate biochemical cartilage degradation in the patient on a molecular level. The most relevant finding of this study is that patients with more that 10% of weight loss benefited significantly more from losing weight compared to the obese controls that did not lose weight or only lost little weight.
Dr. Ida Donkin[/caption]
MedicalResearch.com Interview with:
Ida Donkin MD, PhD
Postdoc, Medical Doctor, PhD
University of Copenhagen
Faculty Of Health Sciences
Copenhagen, Denmark
Medical Research: What is the background for this study?
Dr. Donkin: We know that children of obese fathers are more prone to develop obesity themselves – regardless of the weight of the mother. We also know that obesity and diabetes are diseases with a very big inheritable components in their aetiology. If your parents are obese, you have a risk of about 75% percent of developing obesity yourself. But we do not know how the disease is inherited from one generation to the next. Despite exhaustive research trying to investigate genes potentially responsible for this, and more than 125 genetic mutations have been discovered to associate to the development of obesity, all the genetic mutations put together cannot explain more than about 10% of the actual inheritance. So how is obesity inherited from parents to children? One explanation could be the transfer of epigenetic information from one generation to the next. Epigenetic information is established in our body’s cells in response to our lifestyle and the environment around us. We discovered that the epigenetic factors of semen cells also responds to changes in our lifestyle, and we speculated whether these might be the key to understand how obesity in dads can lead to obesity in children.
Medical Research: What are the main findings?
Dr. Donkin: In this study we discovered that the information kept in our semen cells responds dynamically to changes in our lifestyle. If you are obese, your semen cells will contain a different epigenetic pattern than if you are lean. Weight loss induced by gastric bypass surgery will dynamically change these epigenetic patterns, meaning that by changing our lifestyle, we can actively change the epigenetic information we pass on to our children. Other research groups have created solid evidence showing us that most these epigenetic marks kept in the sperm cells will be passed on to the embryo at fertilization. The epigenetic information can affect the development of the embryo, and thereby change the health – and the risk of disease – of our children. Our study thus provides a likely explanation for the mechanism of the inheritance of acquired traits and diseases through generations, and gives us a likely explanation as to why children of obese fathers are more prone to develop obesity themselves.
Prof. Cnattingius[/caption]
MedicalResearch.com Interview with:
Professor Sven Cnattingius
Professor in reproductive epidemiology
Clinical Epidemiology Unit, Department of Medicine
Karolinska University Hospital
Karolinska Institutet, Stockholm, Sweden
Medical Research: What is the background for this study?
Prof. Cnattingius: Maternal overweight and obesity are associated with increased risks of stillbirth and infant mortality.
Weight gain between pregnancies increases risks of other obesity-related complications, including preeclampsia, gestational diabetes, and preterm birth. Weight gain appear to increase these risks especially in women who start off with normal weight.
As these complications increases risks of stillbirth and infant mortality, we wanted to study the associations between weight change between successive pregnancies and risks of stillbirth and infant mortality (deaths during the first year of life).
Medical Research: What are the main findings?
Prof. Cnattingius: The main findings include:
Dr. Yang[/caption]
MedicalResearch.com Interview with:
Quanhe Yang, PhD
Division for Heart Disease and Stroke Prevention
Centers for Disease Control and Prevention
Atlanta, GA 30341
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Yang: Body mass index (BMI) is an important risk factor for high blood pressure among adolescents. Despite a recent leveling off in the numbers of overweight and obese youths, weight-associated health outcomes remain a problem in the U.S. Some researchers have suggested that the increased prevalence of high blood pressure among adolescents is associated with the epidemic of overweight and obesity in the U.S.
As a result, we analyzed trends in pre-high blood pressure and high blood pressure among U.S. youth using data from a series of National Health and Nutrition Examination Surveys. Nearly 15,000 adolescents between the ages of 12 and 19 were included in the surveys, which were conducted between 1988 and 2012.
During that 24-year timeframe, the prevalence of high blood pressure actually decreased overall, while pre-high blood pressure remained largely unchanged. However, those rates differed based on body weight category. For example, pre-high blood pressure was consistently higher among overweight/obese adolescents (18 to 22 percent) than those of normal weight (11 to 12 percent). The observed changes in both pre-high blood pressure and high blood pressure prevalence were consistent across age group, sex and race/ethnicity.
Dr. Schlansky[/caption]
MedicalResearch.com Interview with:
Barry Schlansky, M.D., M.P.H
Assistant Professor of Medicine
Oregon Health & Science University
Medical Research: What are the main findings and significance of this study?
Dr. Schlansky: This study examines how obese patients fare before and after liver transplantation. Similar to other researchers, we found that obese patients do just as well as normal weight patients after liver transplantation. We were surprised, however, to find that very obese patients died more often while on the wait list before liver transplant.
Dr. Braun[/caption]
MedicalResearch.com Interview with:
Joseph M. Braun PhD
Assistant Professor
Department of Epidemiology in the Program in Public Health
Brown University
Medical Research: What is the background for this study?
Dr. Braun: Perfluoroalkyl substances are a class of chemicals used to produce stain/water repellent textiles, fire fighting foams, and non-stick coatings. Virtually all people in the US have measurable levels of several different perfluoroalkyl substances in their blood. There is concern that early life exposure to these chemicals can increase the risk of obesity by reducing fetal growth or promoting adipogenesis.
What are the main findings?
Dr. Braun: Pregnant women in our study had perfluorooctanoic acid (PFOA) concentrations in their blood that were over 2-fold higher than pregnant women in the United States (median: 5.3 vs. 2.3 ng/mL) during the same time period (2003-2006).
Children born to women with higher serum PFOA concentrations during pregnancy had a higher body mass index, greater waist circumference, and more body fat at 8 years of age compared to children born to women with lower serum PFOA concentrations. In addition, children born to women with higher serum PFOA concentrations during pregnancy gained more fat mass between 2 and 8 years of age than children born to women with lower PFOA concentrations.
Dr. Wopereis[/caption]
MedicalResearch.com Interview with:
Suzan Wopereis, Ph.D.
TNO, Microbiology and Systems Biology Group
Zeist, The Netherlands
Medical Research: What is the background for this study? What are the main findings?
Dr. Wopereis: For the first time we could demonstrate the very subtle start of negative health effects caused by a high calorie snack diet in healthy men. We already knew about the negative consequences of such diets from so called epidemiologic studies. In such studies, scientists compare large populations (thousands of people) to better understand disease development. For example, by comparing obese populations to a lean population, scientists could define various steps in the disease development related to obesity, like high cholesterol, onset of inflammation, high blood pressure, high glucose, etc. Yet, the early deviations from health were difficult to study because human metabolism (the way we digest and metabolize our meals from a biochemical viewpoint) is very flexible and able to efficiently deal with all kinds of daily stressors, such as a meal or intensive exercise. So, at TNO we decided to exploit this flexibility by giving our healthy volunteers a ‘challenge test’, in the form of a high-fat milkshake. Next, we studied how multiple aspects of their metabolism react to such a challenge test. We showed that a snack diet for 4 weeks reduced many aspects of flexibility of our healthy men, thus indicating very early changes in health. Both the high-fat challenge test and the integral study of many different outcomes form a novel approach of what “healthy” really means.
In the study we used two groups of male volunteers. One group of 10 healthy male volunteers and one group of 9 male volunteers with Metabolic Syndrome, who had a combination of 2 or more risk factors that raises your risk for heart disease and other health problems (unhealthy cholesterol levels, high blood pressure, high blood sugar, high blood lipids, and abdominal fat). In other words, subjects with Metabolic Syndrome have a suboptimal health condition. Both groups received a high-fat milk-shake, and before and up to 8 hours after consumption of this metabolic challenge-test, blood samples were taken. In these blood samples, 61 different biomarkers were measured, such as cholesterol and blood sugar. These 61 biomarkers were used for a thorough health assessment of these 2 groups in response to the challenge test. We noted that biochemical processes related to sugar metabolism, fat metabolism and inflammation function abnormal in subjects with Metabolic Syndrome. The next step was to provide the 10 healthy male volunteers with a snack diet for 4 weeks. On top of their normal diet they had to consume an additional 1300 kcal per day, in the form of sweets and savory products such as candy bars, tarts, peanuts, and crisps. After these 4 weeks the response of the same 61 biomarkers to the challenge test was evaluated. Here, we observed that signaling molecules such as hormones regulating the control of sugar and fat metabolism and inflammation were changed, resembling the very subtle start of negative health effects. Without the use of the challenge test, we would not have been able to observe that even this short period of overfeeding induces changes in the metabolism of healthy people that resemble what happens in people with metabolic syndrome.
Prof. Rogers[/caption]
MedicalResearch.com Interview with:
Prof. Peter J. Rogers PhD
School of Experimental Psychology
University of Bristol, Bristol, UK
Medical Research: What is the background for this study?
Prof. Rogers: In recent years low-calorie sweeteners have been in the headlines because of concern that they may undermine rather than help with healthy weight management. That concern is based on selective reporting of studies and outright speculation. Our aim was to review the totality of evidence on this subject, which included results from human and animal (mouse and rat) studies.
Medical Research: What are the main findings?
Prof. Rogers: We found that randomised, controlled intervention trials in humans showed consistently that low-calorie sweeteners versus sugar consumption reduced energy intake and body weight, with no effect or even reduced body weight compared with consumption of water. These types of studies provide the strongest form of evidence – superior to animal and observational studies. In the animal studies, exposure to low-calorie sweeteners was mostly not representative of how people consume low-calorie sweeteners.
Dr. Han[/caption]
MedicalResearch.com Interview with:
Joan C. Han, MD
Director, Pediatric Obesity Program, Le Bonheur Children’s Hospital
Associate Professor, Division of Pediatric Endocrinology
Department of Pediatrics, University of Tennessee Health Science Center
Memphis, TN 38103
Medical Research: What is the background for this study? What are the main findings?
Dr. Han: Obesity has become a world-wide epidemic. Our research group studies the genetic factors that contribute to the development of obesity. Brain-derived neurotrophic factor (BDNF) is a protein that plays a key role in regulating appetite. We found that a common genetic variant of the BDNF gene is associated with lower expression of this gene in the hypothalamus, a region of the brain that controls energy balance. The mechanism of this reduced gene expression appears to be due to diminished binding of the transcription factor hnRNPD0B. We also observed that this genetic variant is associated with higher body mass index and higher body fat in children and adults. The obesity-predisposing variant of the BDNF gene occurs more commonly in people of African-American or Hispanic backgrounds, which could have important clinical implications given the higher rates of obesity in these populations.
MedicalResearch.com Interview with:
Dr. Marcia C. de Oliveira Otto MD PhD
Assistant professor
Division of Epidemiology, Human Genetics and Environmental Sciences
The University of Texas Health Science Center
School of Public Health, Houston, Texas
Medical Research: What is the background for this study? What are the main findings?
Dr. Otto: Eat a variety of foods, or food diversity, is a long standing public health recommendation because it is thought to ensure adequate intake of essential nutrients, to prevent excessive intakes of less healthy nutrients such as refined sugars and salt, thus promoting good health. However there hasn’t been empiric evidence from populational studies testing this hypothesis. In our study, we characterized three metrics of diet diversity and evaluated their association with metabolic health using data from 6,814 participants in the Multi-Ethnic Study of Atherosclerosis, including whites, blacks, Hispanic-Americans, and Chinese-Americans in the United States, including the total count (number of different foods eaten in a week), evenness (the distribution of calories across different foods consumed), and dissimilarity (the differences in food attributes relevant to metabolic health, such as fiber, sodium or trans-fat content). We then evaluated how diet diversity was associated with change in waist circumference five years after the beginning of the study and with onset of Type 2 diabetes ten years later. We also examined the relationship between diet quality and the same metabolic outcomes. Diet quality was measured using established scores such as the Dietary Approaches to Stop Hypertension (DASH) and the Alterative Healthy Eating (AHEI) score.
When evaluating both food count and evenness, we found no associations with either increase in waist circumference or incidence of diabetes. In other words, more diversity in the diet was not linked to better metabolic outcomes. Participants with greater food dissimilarity actually experienced more central weight gain, with a 120 percent greater increase in waist circumference than participants with lower food dissimilarity. Contrary to what we expected, our results showed that participants with greater diversity in their diets, as measured by dissimilarity, had worse diet quality. They were eating less healthy foods, such as fruits and vegetables, and more unhealthy foods, such as processed meats, desserts and soda.
When evaluating diet quality, we found about a 25 percent lower risk of developing Type 2 diabetes after 10 years of follow up in participants with higher diet quality. There was no association between diet quality scores and change in waist circumference.
Dr. Brian Elbel[/caption]
MedicalResearch.com Interview with:
Brian Elbel, PhD MPH
Associate professor, Department of Population Health
NYU Langone Medical Center and at
NYU’s Wagner Graduate School of Public Service
Medical Research: What is the background for this study? What are the main findings?
Dr. Elbel: Since New York City implemented in 2008 its mandatory calorie counts in all chain restaurants, including in fast-food eateries, public health officials and the general public have wondered what impact it’s having on curbing the obesity epidemic gripping the nation and the city.
An estimated third of adult Americans are obese (with a body mass index of 30 or more), and that number is expected to rise to 42 percent by 2030, among the highest of any country in the developed world.
Our study looks at the effects of so-called calorie counts some six years out from when the law took effect. Between 2013 and 2014, a team of NYU Langone researchers analyzed the receipts of some 7,699 diners at fast-food restaurants in NYC and in nearby NJ cities to see if the menu labels reduced the overall number of calories that consumers of fast food order and presumably eat. Our research team compared calories consumed at fast-food eateries with and without calorie labels.
Researchers found that the average number of calories bought by patrons at each sitting between 2013 and 2014 was statistically the same as those in a similar survey we conducted in 1,068 fast-food diners in 2008, when New York City initially imposed menu labeling. Diners were surveyed at major fast-food chains: McDonald’s, Burger King, KFC, and Wendy’s.
Calorie counts in the 2013-2014 analysis averaged between 804 and 839 per meal at menu-labeled restaurants, and between 802 and 857 per meal at non-labeled eateries; whereas, they averaged 783 per meal for labeled restaurants and 756 per meal for non-labeled restaurants shortly after the policy was introduced.
For the surveys, diners entering the fast-food restaurant were asked to return their itemized receipt to research assistants and answer some follow-up questions in person in exchange for two dollars.
Our study suggests that menu labeling, in particular at fast-food restaurants, will not on its own lead to any lasting reductions in calories consumed.