Author Interviews, Gastrointestinal Disease, mBio, Weight Research / 06.02.2015

Senior Principal Investigator - Systems Biology Singapore Institute for Clinical Sciences Brenner Centre for Molecular Medicine SingaporeMedicalResearch.com Interview with: Joanna Holbrook PhD Senior Principal Investigator - Systems Biology Singapore Institute for Clinical Sciences Brenner Centre for Molecular Medicine Singapore Medical Research: What is the background for this study? Dr. Holbrook: Bacteria in the human gut may influence many aspects of our health; however, it is not fully known what determines the composition of the gut microbiota. Rapid bacterial colonisation of the infant gut could be influenced by the environment of the baby before birth, and microbiota content has been associated with the development of obesity and insulin resistance. Medical Research: What are the main findings? Dr. Holbrook: The rate of bacterial colonisation of the gut is influenced by external factors such as the method of delivery and duration of gestation. Also, infants with a mature gut bacteria profile at an early age gained normal levels of body fat, while infants with less mature gut bacteria profiles displayed a tendency to gain lower levels of body fat at the age of 18 months, indicating that gut bacteria could be related to normal development and healthy weight gain. (more…)
Author Interviews, Exercise - Fitness, Weight Research / 31.01.2015

Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208MedicalResearch.com Interview with: Xuemei Sui, MD, MPH, PhD Assistant Professor Department of Exercise Science Graduate Director Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208 Medical Research: What is the background for this study? Dr. Sui: Previous studies have established that low levels of cardiorespiratory fitness (CRF), an indicator of regular physical activity, and body compositions with higher fat mass serve as risk factors for cardiovascular disease and predictors of deaths related to cardiovascular disease. These studies have examined long-term trends of fatness (i.e., body fat) and cardiorespiratory fitness in children, adolescents and men, but few have looked at these factors in female populations. Therefore, the aim of this study was to investigate secular change of cardiorespiratory fitness and body composition during 35 years in a large sample of women enrolled in the Aerobics Center Longitudinal Study. 13 037  women aged 20 to 64 were enrolled in our study from January first, 1970, through December 31st, 2004. We divided our participants into 2 age groups, and divided 35 years into 7 time groups. Cardiorespiratory fitness was assessed by maximal treadmill testing using a modified Balke protocol, and the percentage of body fat was assessed by hydrostatic weighing or the sum of 7 skinfold measures, following standardized protocols. According to percent body fat, we divided body composition into fat mass and fat free mass. Medical Research: What are the main findings? Dr. Sui: The data showed that body mass index (BMI) increased over the 35-year period even though cardiorespiratory fitness levels rose as well. By looking at the body composition of the participants along with their BMIs, the researchers were able to observe that their body fat did not increase. This finding suggests that the weight gains that led to higher BMIs over time were not necessarily comprised of body fat. Participants may have been putting on muscle mass due to their increased physical activity, as indicated by their higher cardiorespiratory fitness. Another interesting finding was that when leisure-time physical activity (LTPA) reaches 668.5 MET min/wk, cardiorespiratory fitness stays at a higher level. So in order to improve cardiorespiratory fitness for physically inactive women, we should encourage them to meet this level. The drift downward in cardiorespiratory fitness among women indicates the need for continuing efforts to promote their physical activity and fitness. (more…)
Author Interviews, BMJ, Pediatrics, Weight Research / 30.01.2015

Dr Cornelia HM van Jaarsveld and Prof Martin C Gulliford, Department of Primary Care and Public Health Sciences King’s College London, London, UKMedicalResearch.com Interview with: Dr Cornelia HM van Jaarsveld and Prof Martin C Gulliford Department of Primary Care and Public Health Sciences King’s College London, London, UK Medical Research: What is the background for this study? What are the main findings? Response: Overweight and obesity in children have increased dramatically since the 1960s with important clinical and economic impacts, especially among those who become obese adults. Consequently, understanding trends in obesity is of increasing importance for monitoring population health and informing policy initiatives. Current trends suggest that a majority of the world’s population will be either overweight or obese by 2030. However, recent reports suggest that the increasing trend in overweight and obesity in children may have leveled off since 2000. But, in many countries data are based on a limited number of time points and relatively small surveys, limiting definitive conclusions and not allowing examining trends in subgroups by sex and age. Moreover, only a few countries have data on younger children (aged under 6 years). Our study aimed to use primary care electronic health records to examine prevalence of overweight and obesity in 2 to 15 year old children in England and to compare trends over two decades, from 1994 to 2003 and from 2004 to 2013. Medical Research: What are the main findings? Response: We found that currently about a third of children in the UK are overweight or obese. We also found that overweight and obesity prevalence increased during decade 1 (1994-2003) but stabilized in decade 2 (2004-2013). This was observed in both sexes and the in younger age groups (2-5 year and 6-10 year). However, rates continued to increase in older children (11-15 year), albeit at a slower speed than in decade 1 (1994-2003). (more…)
Author Interviews, Weight Research / 17.01.2015

Sue Shapses, PhD Professor, Department of Nutritional Sciences Acting Chair, Department of Exercise Sciences and Sports Studies Rutgers, The State University New Brunswick, NJ 08901-8525MedicalResearch.com Interview with: Sue Shapses, PhD Professor, Department of Nutritional Sciences Acting Chair, Department of Exercise Sciences and Sports Studies Rutgers, The State University New Brunswick, NJ 08901-8525 MedicalResearch: What is the background for this study? Dr. Shapses: Improving health outcomes through dieting and weight loss is encouraged for the majority of Americans who are either overweight or obese. However, while most studies show that a moderate reduction in body weight decreases obesity related comorbidities, there may also be loss of bone and muscle in older individuals. Specifically in postmenopausal women, intentional moderate weight loss results in a 1-2.5% bone loss when compared to a weight stable group. Studies in men, designed to address the effect of weight reduction at multiple bone sites, compartments and geometry, are currently lacking. In addition, while a higher body weight is associated with higher bone mass, evidence indicates that bone quality, a predictor of fracture risk, is compromised in the obese. It is possible that frequent dieting or weight cycling in these obese individuals may have deleterious effects on bone. Therefore, understanding whether bone quality changes with weight loss, is important to better predict osteoporosis risk in this population. In this controlled trial, the effect of dietary restriction on bone mineral density (BMD), geometry and strength were examined in middle aged and older obese/overweight men. In addition, we addressed whether endocrine changes associated with weight loss explain bone changes. (more…)
Author Interviews, Endocrinology, Weight Research / 16.01.2015

Caroline M. Apovian, MD Chair of the Endocrine Society task force that developed “Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline” Boston University School of Medicine Boston Medical CenterMedicalResearch.com interview with: Caroline M. Apovian, MD Chair of the Endocrine Society task force that developed “Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline” Boston University School of Medicine Boston Medical Center MedicalResearch: What is the background for this report? Dr. Apovian: The Food and Drug Administration has approved four new anti-obesity drugs – lorcaserin, phentermine/topiramate, naltrexone/bupropion and liraglutide – in the past two years. To help clinicians navigate this changing landscape, the Endocrine Society developed its Clinical Practice Guideline to provide strategies for prescribing drugs to manage obesity and promote weight loss. MedicalResearch: What are the main findings? Dr. Apovian: In the Clinical Practice Guideline, the Endocrine Society recommends that diet, exercise and behavioral modifications be part of all obesity management approaches. Other tools such as weight loss medications and bariatric surgery can be combined with behavioral changes to reduce food intake and increase physical activity, in appropriate patients. Patients who have been unable to successfully lose weight and maintain a goal weight may be candidates for prescription medication if they meet the criteria on the drug’s label as well as BMI criteria (BMI greater than or equal to 30 or greater than or equal to 27 with at least one comorbidity). Other recommendations from the CPG include:
  • If a patient responds well to a weight loss medication and loses 5 percent or more of their body weight after three months, the medication can be continued. If the medication is ineffective or the patient experiences side effects, the prescription should be stopped and an alternative medication or approach considered.
  • Since some diabetes medications are associated with weight gain, people with diabetes who are obese or overweight should be given medications that promote weight loss or have no effect on weight as first- and second-line treatments. Doctors should discuss medications’ potential effects on weight with patients.
  • Certain types of medication – angiotensin converting enzyme inhibitors, angiotensin receptor blockers and calcium channel blockers – should be used as a first-line treatment for high blood pressure in obese people. These are effective blood pressure treatments that are less likely to contribute to weight gain than an alternative medication, beta-adrenergic blockers.
  • When patients need medications that can have an impact on weight such as antidepressants, antipsychotic drugs and medications for treating epilepsy, they should be fully informed and provided with estimates of each option’s anticipated effect on weight. Doctors and patients should engage in a shared-decision making process to evaluate the options.
  • In patients with uncontrolled high blood pressure or a history of heart disease, the medications phentermine and diethylpropion should not be used.
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Author Interviews, JACC, Weight Research / 06.01.2015

MedicalResearch.com Interview with: Dr. Joshua Bell PhD Candidate Epidemiology & Public Health University College London, UK Medical Research: What is the background for this study? What are the main findings? Dr. Bell: When viewed at single points in time, about one-third of obese adults show normal metabolic profiles, that is, they have normal blood pressure, cholesterol and blood sugar levels. These adults have been labeled as 'healthy', but until now we have lacked evidence on the long-term stability of this state over time. By viewing theDr. Joshua Bell PhD Candidate Epidemiology & Public Health University College London, UK natural course of healthy obesity over two decades we found that about half of healthy obese adults become unhealthy obese after 20 years, with a clear trend for increasing progression to ill-health over time. Healthy obese adults are also much more likely to become unhealthy obese than healthy or unhealthy non-obese adults, indicating that healthy obesity is often just a phase. (more…)
Author Interviews, JAMA, Surgical Research, Weight Research / 06.01.2015

David Arterburn, MD, MPH, FACP Associate Investigator Group Health Research Institute Seattle, WA 9810MedicalResearch.com Interview with: David Arterburn, MD, MPH, FACP Associate Investigator Group Health Research Institute Seattle, WA 98101   and David L. Maciejewski PhD Center for Health Services Research in Primary Care Durham VA Medical Center, Durham, North CarolinaDavid L. Maciejewski PhD Center for Health Services Research in Primary Care Durham VA Medical Center, Durham, North Carolina MedicalResearch.com: Why was this study needed? Response: There were several reasons to conduct this study.  First, although complications and death during and soon after bariatric surgery have progressively declined over the past several decades, there is simply very little long-term evidence on the survival benefits of bariatric surgery in Americans having surgical procedures that are being used today in routine practice. Second, we felt that it was important to look at the impact of bariatric surgery among veterans because they represent an older male cohort often with multiple medical comorbidities, which is different from the typical bariatric patient in the United States, who is often younger and female. MedicalResearch.com: How was your study conducted? Response: We conducted a retrospective observational study using high-quality data from national Department of Veterans Affairs electronic databases and the VA Surgical Quality Improvement Program. We identified veterans who underwent bariatric surgery in VA medical centers from 2000 to 2011. Three quarters of them were men. We matched them to control patients using an algorithm that included age, sex, VA geographic region, body mass index (BMI), diabetes, and Diagnostic Cost Group. We then compared survival across bariatric patients and matched controls using Kaplan-Meier estimators and stratified, adjusted Cox proportional hazards analyses MedicalResearch.com: What were the main findings of your study? Response: This study had three important results: 1)      Our analysis showed no significant association between bariatric surgery and death from all causes in the first year of follow-up. In other words, having bariatric surgery was not significantly related to a veteran’s chance of dying in the first year compared to not having surgery. 2)      We had an average follow-up of 6.9 years in the surgical group and 6.6 years in the matched control group. After one to five years, adjusted analyses showed significantly lower mortality in the patients who had surgery: 55% lower, with a hazard ratio of 0.45. The finding was similar at 5 or more years, with a hazard ratio of 0.47. This means that bariatric surgery was associated with lower long-term mortality – that is, better long-term survival among veterans, which is consistent with limited non-VA research that has addressed this same question. 3)      Finally, we also found that the relationship between surgery and survival were similar comparing men and women, patients with and without diagnosed diabetes, and patients who had bariatric surgery before versus after year 2006. (more…)
Author Interviews, JAMA, Surgical Research, Weight Research / 31.12.2014

Jeffrey A. Gusenoff, MD Associate Professor of Plastic Surgery Co-Director, Life After Weight Loss Program Co-Director, BodyChangers Director, Post-Bariatric Body Contouring Fellowship UPMC Department of Plastic SurgeryMedicalResearch.com Interview with: Jeffrey A. Gusenoff, MD Associate Professor of Plastic Surgery Co-Director, Life After Weight Loss Program Co-Director, BodyChangers Director, Post-Bariatric Body Contouring Fellowship UPMC Department of Plastic Surgery Medical Research: What is the background for this study? What are the main findings? Dr. Gusenoff: With the rise in massive weight loss patients from bariatric surgery or diet and exercise, more patients are choosing to have a thighplasty to remove excess skin of the inner thigh. Many techniques exist for treating this, but there aren't many studies that look into the safety of these procedures in massive weight loss patients. What we found is that  many patients have scars that go all the way down the thigh with a fairly high complication rate of almost 70%. (more…)
Author Interviews, Surgical Research, University Texas, Weight Research / 27.12.2014

Taylor S. Riall, MD, PhD Professor, John Sealy Distinguished Chair in Clinical Research Department of Surgery, University of Texas Medical Branch, Galveston, TXMedicalResearch.com Interview with: Taylor S. Riall, MD, PhD Professor, John Sealy Distinguished Chair in Clinical Research Department of Surgery, University of Texas Medical Branch, Galveston, TX Medical Research: What is the background for this study? What are the main findings? Dr. Riall: In patients who have symptoms related their gallstones – most commonly sharp right upper quadrant abdominal pain (often associated with fatty meals), nausea, and vomiting - the current recommendation is to remove the gallbladder (perform cholecystectomy). However, in older patients there are multiple factors that make this decision difficult. Older patients have more associated medical problems (like diabetes, heart disease, etc.) making elective surgery higher risk. On the flip side, older patients are at higher risk of developing complications from their gallstones, and once they do, their mortality (death from gallbladder disease) and complications increase substantially. In recent study of Medicare beneficiaries with symptomatic gallstones, we found that fewer than 25% underwent elective removal of the gallbladder after an initial episode of pain or symptoms related to their gallbladder. We then developed a model that predicted the likelihood of these same patients requiring emergent gallstone-related complications if they did not have their gallbladder removed electively. This information prompted the current study. We sought to determine if the patients getting their gallbladders removed were the ones at highest risk for complications. Similar to the previous study, we found that only 22% of Medicare beneficiaries in this study (a different population) underwent elective gallbladder removal. We divided patients into three groups based on our risk prediction model – those with <30% risk, 30-60% risk, and >60% risk of requiring acute gallstone-related hospitalization. Please note that while we call the <30% risk group “low” risk, a 17% chance of hospitalization is actually a significant risk – much higher than seen in other medical conditions for which surgery or other interventions may be considered.
  • First, our model worked well – the ACTUAL hospitalization rate was 17%, 45%, and 69% in the two years after the first symptoms.
  • Second, whether patients had their gallbladder removed seemed unrelated to risk. 22% of patients in the lowest risk group, 21% in the middle risk group, and 23% in highest risk group had their gallbladder removed. Even more striking, in the healthiest patients – those with no medical problems and no reason not to perform elective surgery - cholecystectomy rates actually decreased with increasing risk of emergent admission. Cholecystectomy was performed in 34% of patients in the low risk group, 25% of patients in the moderate risk group, and 26% of patients in the highest risk group.
  • In addition, fewer than 10% of patients who didn’t have their gallbladder removed were ever seen by a surgeon, suggesting that this decision is being made at the level of the primary care or emergency physician and not necessarily patient choice.
(more…)
Author Interviews, Dermatology, Smoking, Weight Research / 26.12.2014

MedicalResearch.com Interview with: Seong Jin Jo, MD, PhD Department of Dermatology Seoul National University College of Medicine Seoul Korea. Medical Research: What is the background for this study? What are the main findings? Response: Hair graying is a natural aging process, but some people develop hair graying in their youth. In this study of young Korean males, we found that obesity, smoking, and family history were significantly associated with premature hair graying. (more…)
Author Interviews, Blood Pressure - Hypertension, Case Western, Dermatology, JAMA, Weight Research / 26.12.2014

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, IllinoisMedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology, Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois Medical Research: What is the background for this study? Dr. Silverberg: Previous studies found associations between obesity and atopic dermatitis (AD). However, little was known about the association between AD and metabolic risk factors, such as central obesity and high blood pressure. (more…)
Author Interviews, Depression, Weight Research / 26.12.2014

MedicalResearch.com Interview with: Xiaoling Xiang School of Social Work, University of Illinois at Urbana-Champaign Urbana, IL 61801 Medical Research: What is the background for this study? What are the main findings? Response: The adverse health consequences of obesity have been well documented, but the psychological risks of obesity are less clear. The study examined the long-term impact of obesity on the onset of depression in a sample of middle-aged and older adults who were initially free of clinically relevant depressive symptoms. We found that being overweight or obese significantly predicted onset of clinically relevant depressive symptoms during the 16 years of follow-up. Unhealthy weight appeared to have a stronger, adverse impact on depressive symptoms among females and non-Hispanic whites compared with their male and ethnic minority counterparts. (more…)
Author Interviews, Brigham & Women's - Harvard, Exercise - Fitness, Weight Research / 26.12.2014

Rania Mekary, MS, Ph.D. Harvard School of Public Health Nutrition Department Boston, Ma 02115MedicalResearch.com Interview with: Rania Mekary, MS, Ph.D. Harvard School of Public Health Nutrition Department Boston, Ma 02115   Medical Research: What is the background for this study? What are the main findings? Dr. Mekar: Findings on weight training and waist circumference (WC) change have been controversial.  Moreover, a lot of people focus on aerobic and only aerobic workout... They are not to be blamed because aerobic workout (e.g. jogging) relies mostly on fat as a source of energy while anaerobic workout (e.g. resistance) relies mostly on carbohydrates. Our study, however, showed that resistance training over the long-term was the most inversely associated with waistline change (aka abdominal fat), even more than aerobic exercise. We also justified physiologically why it is the case... It has to do with the greater Excess Post-exercise Oxygen Consumption (EPOC) as compared with aerobic training and also to the muscle adaptation and its increase in mitochondria which leads to more lipid oxidation upon engaging in anaerobic workout over the long-term. (more…)
Author Interviews, PLoS, Weight Research / 22.12.2014

Elina Helander, PhD Personal Health Informatics Department of Signal Processing Tampere University of Technology, Tampere, FinlandMedicalResearch.com Interview with: Elina Helander, PhD Personal Health Informatics Department of Signal Processing Tampere University of Technology, Tampere, Finland Medical Research: What is the background for this study? What are the main findings? Dr. Helander: Frequent or at least regular self-weighing is a part of behavioral therapy in many weight programs. However, self-weighing frequency typically varies over time. We analyzed almost 3,000 weight observations from 40 overweight individuals that participated in a 1-year health promotion program. These individuals were instructed to weigh themselves daily but eventually had varying self-weighing frequencies. We examined how different self-weighing frequencies of the same individual were linked with weight changes. We found that weight loss generally occurred during daily weighing. When there were longer breaks in self-weighing such as one month or more, there was a risk of weight gain.  We also computed a theoretical minimum self-weighing frequency for having no weight gain that was 5.8 days in our study. That corresponds approximately weekly weighing. (more…)
Author Interviews, Blood Pressure - Hypertension, Weight Research / 18.12.2014

Mohammed Elfaramawi , MD PhD MPH MSc Assistant Professor Epidemiology Department College of Public Health University of Arkansas for Medical Sciences Little rock, AR 72205 MedicalResearch.com Interview with: Mohammed Elfaramawi , MD PhD MPH MSc Assistant Professor Epidemiology Department College of Public Health University of Arkansas for Medical Sciences Little rock, AR 72205 Medical Research: What is the background for this study? What are the main findings? Dr. Elfaramawi: A substantial increase in prevalence of obesity has been documented globally. In the USA, overweight and obesity are the second leading cause of preventable death in the USA, affecting ∼97 million adults. Evidence has accumulated showing that visit-to-visit blood pressure variability is associated with adverse cardiovascular outcomes. This study is one of few studies which explored the relationship between obesity and visit-to-visit blood pressure variability. (more…)
Author Interviews, FASEB, Weight Research / 15.12.2014

Dr. Richard Phipps PhD Department of Environmental Medicine and Flaum Eye Institute, School of Medicine and Dentistry, University of Rochester, Rochester, New YorkMedicalResearch.com Interview with: Dr. Richard Phipps PhD Department of Environmental Medicine and Flaum Eye Institute, School of Medicine and Dentistry, University of Rochester, Rochester, New York Medical Research: What is the background for this study? What are the main findings? Response: Obesity has risen dramatically over the past 30 years in the United States and throughout the world. Obesity increases morbidity and mortality by increasing health problems such as Type 2 diabetes, cardiovascular disease and cancer. Thus, obesity is one of our greatest challenges worldwide. Our laboratory has been studying a protein called Thy-1 for several decades. Until now its’ true function was unknown. The main finding from our research is that when cells express this protein on their surface, they are inhibited from becoming fat cells. We show in a mouse model system that mice, which lack Thy-1, and given a high fat diet, increase weight much faster than mice that express Thy-1. These mice that lack Thy-1, also have increased levels of many proinflammatory mediators in their blood. In human cells, those that express high levels of Thy-1 are blocked in their ability to become fat cells, unlike the human cells from different tissues that do not express Thy-1. Thus, the main finding is that learning how to manipulate Thy-1 expression could lead to reduced fat cells and reduced fat production. Not only is this an important finding for obesity, but there are many human diseases that are caused by excess fat production in organs, such as, the orbit of the eye, the liver, and the bone marrow. (more…)
Author Interviews, Weight Research / 15.12.2014

Susanne Mandrup Professor, Department of Biochemistry and Molecular Biology Odense M · DenmarkMedicalResearch.com Interview with: Susanne Mandrup Professor, Department of Biochemistry and Molecular Biology Odense M · Denmark Medical Research: What is the background for this study? What are the main findings? Prof. Mandrup: Obesity affects more than 1 billion adults globally and represents one of the greatest current threats to human health. Paradoxially, the fat tissues in the human body that stores excess calories might hold the key for a future obesity treatment. Most human fat depots are white fat tissues that store energy as fat; however, humans also have small amounts of brown fat, which primarily acts as an effective fat burner for the production of heat. Recent studies have shown that it is possible to “brown” white fat tissues (e.g. by prolonged cold-exposure) leading to an increase in the energy consumption of the body. The challenge is to understand how energy storing white fat cells are reprogrammed into so-called "brite" (brown-in-white) fat cells in the white adipose tissue and thus make adipose tissue burn off excess energy as heat instead of storing it. In this study we have for the first time investigated how the genome of white fat cells is reprogrammed during browning. We stimulated browning in human white adipocytes by a drug used to treat type II diabetes and compared white and "brite" fat cells. This showed that "brite" fat cells have distinct gene programs which, when active, make these cells particularly energy-consuming. Furthermore, we identified an important factor in the browning process - the gene regulatory protein KLF11 (Kruppel Like Factor-11). (more…)
Author Interviews, Imperial College, Sugar, Weight Research / 13.12.2014

MedicalResearch.com Interview with: Dr James Gardiner Reader in Molecular Physiology Imperial College Hammersmith Campus London 0NN Medical Research: What is the background for this study? What are the main findings? Response: It is well known that glucose is a preferred food and is consumed in preference to other nutrients. Food intake is controlled by the brain in part this it is regulated by part of the brain called the hypothalamus.   Glucokinase is an important component of glucose sensing and is expressed in the hypothalamus and specifically in the arcuate nucleus. A hypothalamic mechanism regulating glucose intake has not previously been identified. Using a rodent model we demonstrated that increasing glucokinase activity in the arcuate nucleus increased food intake and body weight. If glucose was available as separately then glucose intake is increased but not weight. Decreasing glucokinase activity in the arcuate nucleus had the opposite effect, reducing glucose intake when it was available.   Our results suggest that glucokinase controls glucose appetite and hence the amount of glucose consumed. This is the first time a mechanism controlling the intake of a specific nutrient has been described. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition, Sugar, Weight Research / 13.12.2014

Dr James J DiNicolantonio PharmD Ithaca, New YorkMedicalResearch.com Interview with: James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart Institute Medical Research: What is the background for this study? What are the main findings? Dr. DiNicolantonio: Cardiovascular disease is the leading cause of premature mortality in the developed world, and hypertension is its most important risk factor. Controlling hypertension is a major focus of public health initiatives, and dietary approaches have historically focused on sodium. A reduction in the intake of added sugars, particularly fructose, and specifically in the quantities and context of industrially-manufactured consumables, would help not only curb hypertension rates, but would also help address broader problems related to cardiometabolic disease. (more…)
Author Interviews, Ophthalmology, Weight Research / 13.12.2014

MedicalResearch.com Interview with: Rui Azevedo Guerreiro Centro Hospitalar de Lisboa Central Portugal Medical Research: What is the background for this study? What are the main findings? Response: This article aims to summarise the current state of understanding on the possible ophthalmic complications that can occur after a bariatric surgery. The main finding of this review article is that ophthalmic complications after bariatric surgeries are more frequent that we could thought initially, especially in patients not adherent to their vitamin supplements. In one study, the percentage of patients with vitamin A deficiency 4 years after the surgery reached up to 69%. (more…)
Author Interviews, Diabetes, Nature, Weight Research / 12.12.2014

MedicalResearch.com Interview with: Prof. Dr. Patrice D. Cani PhD, Research Associate FRS-FNRS Louvain Drug Research Instiute, Metabolism and Nutrition WELBIO, Walloon Excellence in Life sciences and BIOtechnology NeuroMicrobiota lab, European Associated Laboratory (INSERM/UCL) and Dr Amandine Everard Université Catholique de Louvain, Louvain Drug Research Institute, WELBIO (Walloon Excellence in Life sciences and BIOtechnology), Metabolism and Nutrition Research Group, Brussels, Belgium Medical Research: What is the background for this study? What are the main findings? Response: Our intestine harbors more than 100 trillions of bacteria. This huge number of bacteria permanently interacts with our own human cells. Among the systems involved in this crosstalk, the immune system plays a key role in these interactions. We previously showed that specific gut bacteria are able to control energy metabolism, harmful inflammation associated with obesity, body weight gain and type-2 diabetes. However mechanisms involved these effects of gut bacteria on the host during obesity and type-2 diabetes were poorly understood. We identify the essential role of the intestinal immune system in the onset of obesity and type-2 diabetes both induced by a high dose of fat in the diet. This discovery highlights an unexpected mechanism for the control of energy metabolism during obesity and type-2 diabetes. We demonstrate for the first time that the inactivation of a part of the intestine immune system (more specifically the protein MyD88), which is overstimulated by a diet rich in fat, allows to induce weight-loss and to reduce type-2 diabetes associated with obesity. When we tune the immune system by disabling the protein MyD88 specifically in cells covering the intestine, we are able to limit the adipose tissue development induced by the diet rich in fat, to slow down diabetes, to reduce harmful inflammation associated with obesity, to reinforce gut barrier function assumed by our intestine to avoid the inappropriate translocations of bacteria compounds from our intestine in our body. We reveal various mechanisms explaining the partial protection against obesity induced by the inactivation of this protein of the immune system. Among them, we point out that mice that do not have this protein of the immune system (i.e. MyD88) in their intestine are partially protected against obesity because they spend more energy than other obese mice. Moreover, our study shows that this protein of the immune system is able to shape the composition of the gut microbiota residing in our intestine under a high-fat diet. These changes observed in mice deleted for this protein also explain their protection against obesity because when we transfer intestinal bacteria of these mice into other mice that are axenic (without flora), these latest mice are also partially protected against obesity. In conclusions, our studies published in the scientific journal Nature Communications, demonstrated that during consumption of fat food, the intestinal immune system plays an important role in fat storage regulation in the body and is capable to modify the composition of intestinal bacteria (including some which are still unidentified), confirm the implication of intestinal bacteria in the onset of obesity. (more…)
Author Interviews, PLoS, Weight Research / 11.12.2014

MedicalResearch.com Interview with: Peter Würtz, PhD, Docent Head of Molecular Epidemiology, Computational Medicine, Institute of Health Sciences, University of Oulu, Finland

Medical Research: What is the background for this study? What are the main findings? Dr. Würtz: Obesity is linked with unfavorable cholesterol and blood sugar levels, but the fine-grained metabolic consequences of excess body weight remain unclear. We used a novel profiling technology developed in our research group to examine the metabolic consequences of excess body weight. We profiled over 12,000 healthy young volunteers from the general population to determine the detailed metabolic effects of having higher BMI (body mass index). We found that higher BMI is causing adverse metabolic changes in the blood levels of many amino acids and lipids, as well as an altered balance of omega-fatty acids and sex hormones. These measures have been linked with higher risk for developing heart disease and type 2 diabetes. Importantly, the metabolic deviations were not limited to obese individuals, but were observed in a continuous manner including for those who are lean or overweight. In other words, the metabolic profile becomes more adverse for any increase in BMI, with no threshold below which an increase in BMI would not affect the cardiometabolic risk profile. Genetic information was used to demonstrate that the metabolic effects are actually caused by having higher BMI. On the positive side, even a modest weight loss helped to diminish the adverse metabolic influences of excess body fat. (more…)
Author Interviews, PLoS, Smoking, Weight Research / 05.12.2014

Marcus Munafò PhD Professor of Biological Psychology MRC Integrative Epidemiology Unit UK Centre for Tobacco and Alcohol Studies School of Experimental Psychology University of Bristol United KingdomMedicalResearch.com Interview with: Marcus Munafò PhD Professor of Biological Psychology MRC Integrative Epidemiology Unit UK Centre for Tobacco and Alcohol Studies School of Experimental Psychology University of Bristol United Kingdom Medical Research: What is the background for this study? What are the main findings? Dr. Munafo: We were conducting an analysis of data on smoking behaviour and body mass index (BMI), in order to better understand the potential causal effects of smoking on different measures of adiposity. Mendelian randomisation uses genetic variants associated with the exposure of interest (in this case smoking) as proxies for the exposure, in order to reduce the risk of spurious associations arising from confounding or reverse causality. As expected, we found that, among current smokers, a genetic variant associated with heavier smoking was associated with lower BMI, providing good evidence that smoking reduces BMI. However, we also unexpectedly found that the same variant was associated with higher BMI in never smokers. This suggests that this variant might be influencing BMI via pathways other than smoking. (more…)
Author Interviews, BMJ, OBGYNE, Weight Research / 03.12.2014

Stefan Johansson, MD PhD consultant neonatologist Stockholm, SwedenMedicalResearch.com Interview with: Stefan Johansson, MD PhD consultant neonatologist Stockholm, Sweden Medical Research: What is the background for this study? Dr. Johansson: Maternal obesity (BMI ≥ 30) has previously been linked to increased infant mortality. However, research has not produced consistent results. For example, there are disagreements whether infants to overweight mothers (BMI 25-29) are at increased risk, and research on BMI-related specific causes of death is scarce. (more…)
Author Interviews, Cognitive Issues, Weight Research / 26.11.2014

Nicolas Cherbuin PhD ARC Future Fellow - Director of the NeuroImaging and Brain Lab Centre for Research on Ageing, Health and Wellbeing Research School of Population Health - College of Medicine Biology and Environment Australian National UniversityMedicalResearch.com Interview with: Nicolas Cherbuin PhD ARC Future Fellow - Director of the NeuroImaging and Brain Lab Centre for Research on Ageing, Health and Wellbeing Research School of Population Health - College of Medicine Biology and Environment Australian National University Medical Research: What is the background for this study? What are the main findings? Dr. Cherbuin: A number of modifiable risk factors for cognitive aging dementia and Alzheimer’s disease have been identified with a high level of confidence by combining evidence from animal research and systematic reviews of the literature in humans that summarise the available findings without focusing on extreme findings that come about from time to time in research. One such risk factor is obesity for which we have previously conducted a systematic review (Anstey et al. 2011). This showed that obesity is associated with a two-fold increased risk of dementia and a 60% increased risk of Alzheimer’s disease. What was surprising is that this effect was only detectable for obesity in middle age but not old age. This might suggest that the obesity only has an adverse effects on brain health earlier in life and that this effect fades at older ages. This is unlikely because a number of animal studies have shown that the biological mechanisms linking obesity with brain pathology do not disappear with older age but in fact appear to increase. Moreover, human studies show that thinking abilities decline faster in obese individuals. An alternative explanation is that human epidemiological studies investigating this question in older individuals include participants who do not have clinical dementia but in whom the disease is developing. Since dementia and Alzheimer’s disease pathology is associated with weight loss it is possible that estimated effects in humans have been confounded by this issue. Another possible confounder is that older people tend to lose muscle mass (sarcopenia) this may lead to the paradoxical condition in aging where a person has a normal weight but has excessive fat mass. Since it is fat tissue that is linked to risk to cerebral health it may have led to the apparently contradictory findings that obesity may not be a risk in older age. It is therefore of great interest to clarify whether obesity in early old age in individuals free of dementia is associated with poorer cerebral health. The hippocampus is one of the structures most sensitive stressors. Because obesity is known to lead to a state of chronic inflammation which is deleterious to the hippocampus, it was a logical structure to investigate. Moreover, the hippocampus is needed for memory function and mood regulation and is directly implicated in the dementia disease process. This study investigated 420 participants in their early 60s taking part in a larger longitudinal study of aging taking place in Canberra, Australia and who underwent up to three brain scans over an 8-year follow-up. These individuals were free of dementia and other neurological disorders. Associations between obesity and shrinkage of the hippocampus were investigated with longitudinal analyses which controlled for major confounders. The main findings were that overweight and obese participants had smaller volume of the hippocampus at the start of the study. In addition, the hippocampus shrunk more in these individuals over the follow-up period. (more…)
Author Interviews, Nutrition, Weight Research / 25.11.2014

James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart InstituteMedicalResearch.com Interview with: James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart Institute Medical Research: What is the background for this study? What are the main findings? Dr. DiNicolantonio: Focusing on calories misdirects eating away from healthy foods (that are higher in calories - such as nuts, salmon, and avocados) and towards harmful foods (e.g. rapidly absorbable carbohydrates - including added sugars such as table sugar and high fructose corn syrup). Treating obesity should not focus on decreasing caloric intake, rather, it should focus on eating quality foods.  Lower calorie foods - that are high in rapidly absorbable carbohydrates - drive increased hunger throughout the day, whereas higher calorie foods (such as full-fat milk and eggs) leads to satiety.  Consuming rapidly absorbable carbohydrates leads to increased total caloric intake throughout the day (driven by insulin resistance and leptin resistance).  These metabolic consequences derived from overconsuming these types of foods leads us to eat more and exercise less.  In essence, eating more and exercising less doesn't cause obesity, overconsuming rapidly absorbable carbohydrates causes us to eat more and exercise less, which then causes obesity - a subtle but important distinction. (more…)
Aging, Memory, NYU, Weight Research / 24.11.2014

Stephen D. Ginsberg, Ph.D., Associate Professor Departments of Psychiatry and Physiology & Neuroscience New York University Langone Medical Center Center for Dementia Research Nathan Kline Institute Orangeburg, NY  10962MedicalResearch.com Interview with: Stephen D. Ginsberg, Ph.D., Associate Professor Departments of Psychiatry and Physiology & Neuroscience New York University Langone Medical Center Center for Dementia Research Nathan Kline Institute Orangeburg, NY  10962 Medical Research: What is the background for this study? What are the main findings? Dr. Ginsberg: We tested the hypothesis that long-term calorie restriction positively alters gene expression within the hippocampus, a critical learning and memory area vulnerable in aging and Alzheimer’s disease. To test this hypothesis, we conducted experiments on female mice that were given food pellets 30% lower in calories than what was fed to the control group. The mice ate fewer calories derived from carbohydrates. Analyses were performed on mice in middle and old age to assess any differences in gene expression over time. Our data analysis revealed that the mice that were fed a lower calorie diet had fewer changes in approximately 900 genes that are linked to aging and memory. (more…)
Addiction, Author Interviews, Mental Health Research, University of Pittsburgh, Weight Research / 23.11.2014

Michele D. Levine Ph.D. Associate Professor of Psychiatry and Psychology Western Psychiatric Institute and Clinic Department of Statistics, University of Pittsburgh, Pittsburgh PAMedicalResearch.com Interview with: Michele D. Levine Ph.D. Associate Professor of Psychiatry and Psychology Western Psychiatric Institute and Clinic Department of Statistics, University of Pittsburgh, Pittsburgh PA Medical Research: What is the background for this study? What are the main findings? Dr. Levine: Many women quit smoking as a result of pregnancy.  However, psychiatric disorders, which are prevalent among smokers can contribute to weight gain.  Thus, we sought to examine the relationship between maternal psychiatric disorders and gestational weight gain in a sample of pregnant former smokers. Results from the present study demonstrate that the rates of psychiatric disorders were high among pregnant former smokers and that more than half of women gained more weight than recommended by the IOM.  Although a history of having had any psychiatric disorder was not associated with gestational weight gain, a history of alcohol use disorder specifically was positively related to gestational weight gain. (more…)
Author Interviews, Psychological Science, Weight Research / 19.11.2014

MedicalResearch.com Interview with: Hanna Konttinen, PhD, Docent Post-doctoral researcher Department of Social Research University of Helsinki Medical Research: What is the background for this study? Dr. Konttinen: Bariatric surgery yields significant weight reduction for the majority of severely obese individuals with accompanied improvements in health status and health-related quality of life. Nonetheless, slow weight regain over time is frequent and there is a need for a better understanding on the factors that influence long-term post-surgical weight outcomes. To our best knowledge, this was the first study to examine whether psychological aspects of eating behavior predicted weight changes 10 years after surgical and conventional treatment for severe obesity. The participants were from the Swedish Obese Subjects intervention study: 2010 obese subjects who underwent bariatric surgery and 1916 contemporaneously matched obese controls who received conventional treatment. (more…)
Author Interviews, Nutrition, University of Michigan, Weight Research / 19.11.2014

MedicalResearch.com Interview with: Yvonne M. Terry-McElrath, MSA Research Associate, Survey Research Center, Institute of Social Research University of Michigan Tobacco Research Center Medical Research: What is the background for this study? What are the main findings? Dr. Terry-McElrath: The United States Department of Agriculture (USDA) recently improved nutrition standards for federally-reimbursable school lunch and breakfast programs. Most lunch standards were implemented at the beginning of the 2012-13 school year and changes in breakfast began with the 2013-14 school year. Beginning in 2014, schools participating in federally-reimbursable meal programs were also required to improve nutrition standards for foods and beverages sold in vending machines, stores/snack bars/carts, and à la carte cafeteria lines. The new standards limit fats, sodium, sugar, and calories; and will eventually remove candy; regular-fat salty snacks/sugary treats; higher-fat milks; high-fat, high-calorie savory foods; and sugar-sweetened beverages, like regular soda, fruit drinks and high calorie sports drinks. They were developed in response to rising overweight/obesity among US children and adolescents. This study uses five years of data from nationally-representative samples of middle and high school students—and their school administrators—to examine three research questions: What percentage of US secondary students attended schools in 2008-2012 where foods and beverages met at least some of the USDA standards that were to begin phased implementation starting in 2012-13? Is there evidence that those standards were associated with student overweight/obesity? Is there evidence of the effect of those standards on racial/ethnic minorities and students from lower income families? Using data from schools even before the new USDA standards went into effect can indicate potential effect of the standards once they have been in effect for several years. The research was conducted through two studies: The Monitoring the Future study, supported by a grant from the National Institute on Drug Abuse, and the Youth, Education and Society study, part of a larger research initiative funded by the Robert Wood Johnson Foundation, titled “Bridging the Gap: Research Informing Policy and Practice for Healthy Youth Behavior.” Study findings show that from 2008-2012, few middle or high school students attended schools where food and beverage standards would be judged to meet at least some of the USDA school nutrition standards that began to be implemented in 2012-13. Significant increases in the number of standards over time were seen for middle but not high school students. Among high school students, having fruits and vegetables available wherever foods were sold, the absence of higher-fat milks, and increasing the number of positive nutrition standards were associated with significantly lower odds of overweight/obesity. Not having sugar-sweetened beverages was associated with lower overweight/obesity for middle and high school minority students. (more…)