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.
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.
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).
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.
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.
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%.
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.
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.
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.
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.
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.
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.
Aging, Memory, NYU/NYMC, 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.
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.
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.
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.
OBGYNE, Pediatrics, Weight Research / 16.11.2014

MedicalResearch.com Interview with: Ian R. Macumber MD Pediatric Nephrology, Seattle Children's Hospital Seattle, Washington Medical Research: What are the main findings of the study? Dr. Macumber: The main finding is that there is a strong association between maternal obesity and odds of congenital anomalies of the kidney and urinary tract (CAKUT) in offspring.  This relationship remains strong when looking at offspring with renal malformation (excluding non-renal congenital anomalies of the kidney and urinary tract), or in offspring with isolated congenital anomalies of the kidney and urinary tract (no congenital anomalies elsewhere in the body).  There is a dose-response relationship to this association, with the offspring of extremely obese mothers have even higher odds of having congenital anomalies of the kidney and urinary tract.
AHA Journals, Author Interviews, Diabetes, Heart Disease, Metabolic Syndrome, Weight Research / 12.11.2014

Gang Hu, MD, MPH, PhD, FAHA Assistant professor & Director, Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health, LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, LouisianaMedicalResearch.com Interview with: Gang Hu, MD, MPH, PhD, FAHA Assistant professor & Director Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, Louisiana Medical Research: What is the background for this study? What are the main findings? Dr. Hu: Many previous studies had small samples, and thus lacked adequate statistical power when the analysis was focused on those who are extremely obese (BMI ≥40 kg/m2). In addition, most epidemiological studies only use a single measurement of BMI at baseline to predict risk of all-cause mortality, which may produce potential bias. The current study indicated a U-shaped association of BMI with all-cause mortality risk among African American and white patients with type 2 diabetes. A significantly increased risk of all-cause mortality was observed among African Americans with BMI<30 kg/m2 and BMI ≥35 kg/m2, and among whites with BMI<25 kg/m2 and BMI ≥40 kg/m2 compared with patients with BMI 30-34.9 kg/m2.
Author Interviews, JAMA, Metabolic Syndrome, Weight Research / 07.11.2014

MedicalResearch.com Interview with: Venkatesh L. Murthy, MD, PhD Department of Medicine (Cardiovascular Medicine Division) and Department of Radiology (Nuclear Medicine and Cardiothoracic Imaging Divisions), University of Michigan, Ann Arbor, Michigan and Dr. Ravi Shah MD Cardiology Division, Department of Medicine Massachusetts General Hospital, Boston, Massachusetts Medical Research: What is the background for this study? What are the main findings? Response: Prior studies in Framingham, MESA and other cohorts have demonstrated that obesity is an important risk factor for the metabolic syndrome. However, the observations that many non-obese individuals develop metabolic syndrome and diabetes and, conversely, that not all obese individuals develop these complications has motivated the search for better markers of risk than BMI. More recently, it has been shown that the location of adipose tissue is an important factor. The amount of visceral fat, which is thought to be more harmful from a metabolic perspective, can be accurately quantified with CT imaging. In many prior studies, waist circumference has been used as an approximate measure of visceral adiposity. For this study, we analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA). We found that the amount of visceral fat (as quantified by CT) was an important predictor of metabolic syndrome, even after adjusting for weight, waist circumference, gender, race, smoking, exercise, serum lipids and glucose. Each additional 100 cm2/m of height of visceral fat was associated with a 29% increase in the risk of developing metabolic syndrome. In contrast, subcutaneous fat burden (also quantified by CT) was a much weaker predictor. One of the very novel findings of our study arises from an analysis of subjects who had multiple CTs longitudinally in MESA. Using these data, we found that change in visceral fat burden was associated with a corresponding 5% increase in the risk of metabolic syndrome. In part, this is because very small changes in weight could result in very large changes in visceral fat.
Author Interviews, JAMA, Pediatrics, Weight Research / 05.11.2014

MedicalResearch.com Interview with: Angela Alberga, PhD Eyes High Postdoctoral Fellow Werklund School of Education University of Calgary Ronald J. Sigal, MD, MPH, FRCPC Professor of Medicine, Kinesiology, Cardiac Sciences and Community Health Sciences Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary Health Senior Scholar, Alberta Innovates-Health Solutions Member, O'Brien Institute of Public Health, Libin Cardiovascular Institute and Julia McFarlane Diabetes Research Centre Medical Research: What are the main findings of the study? Response: The Healthy Eating, Aerobic and Resistance Training in Youth study examined the effects of exercise on body composition and cardiometabolic risk markers in adolescents with obesity. A total of 304 overweight or obese adolescents were randomized to four groups. The first group performed resistance training involving weight machines and some free weights; the second performed only aerobic exercise on treadmills, elliptical machines and stationary bikes; the third underwent combined aerobic and resistance training; and the last group did no exercise training. All four groups received nutritional counseling. In analyses involving all participants regardless of adherence, each exercise program reduced percent body fat, waist circumference and body mass index to a similar extent, while the diet-only control group had no changes in these variables. In participants who exercised at least 2.8 times per week, we found that combined aerobic and resistance training produced greater decreases in percentage body fat, waist circumference, and body mass index than aerobic training alone. Waist circumference decreased close to seven centimeters in adherent participants randomized to combined aerobic plus resistance exercise, versus about four centimeters in those randomized to do just one type of exercise, with no change in those randomized to diet alone.
Author Interviews, JAMA, Pediatrics, Weight Research / 23.10.2014

Dr Ken Ong, Programme Leader & Paediatric Endocrinologist MRC Epidemiology Unit, University of Cambridge Box 285 Institute of Metabolic Science Cambridge Biomedical Campus, Cambridge MedicalResearch.com Interview Invitation Dr Ken Ong, Programme Leader & Paediatric Endocrinologist MRC Epidemiology Unit, University of Cambridge Box 285 Institute of Metabolic Science Cambridge Biomedical Campus, Cambridge Medical Research: What are the main findings of this report? Dr. Ong: We found that genetic factors that predict adult obesity were associated with faster weight gain and growth during infancy – the findings indicate that the biological mechanisms that predispose to later obesity are already active from birth.
Author Interviews, Psychological Science, Weight Research / 23.10.2014

Dr. Michelle Lent PhD Geisinger Health SystemMedicalResearch.com Interview with Dr. Michelle Lent PhD Geisinger Health System Medical Research: What is the background for this study? Dr. Lent: Previous study findings indicate that weight bias relates to a number of adverse outcomes in overweight and obese populations, including binge eating, psychological disorders and body image issues. In this study, we measured the degree to which people undergoing weight-loss surgery translate “anti-fat” attitudes into negative beliefs about themselves before surgery (known as “internalized weight bias”) and if this influences weight loss outcomes after surgery.
Author Interviews, Mediterranean Diet, Metabolic Syndrome, Weight Research / 17.10.2014

Deborah Clegg, PhD Research Scientist, Diabetes and Obesity Research Institute Associate Professor, Department of Biomedical Science Cedars-Sinai Medical Center Los Angeles, CA 90048MedicalResearch.com Interview with: Deborah Clegg, PhD Research Scientist, Diabetes and Obesity Research Institute Associate Professor, Department of Biomedical Science Cedars-Sinai Medical Center Los Angeles, CA 90048 Medical Research: What are the main findings of the study? Dr. Clegg: The main findings are that males and females differ with respect to how they process and respond to diets high in fat!!!!  Males following consumption of a diet that is 42% of the calories coming from saturated fat (it would be analogous to eating a big mac and having a coke), gained the same amount of weight as did the females BUT the males had increased markers of inflammation in their brains and the females did not.  With the elevated markers of inflammation, the males had dysregulation in glucose homeostasis and alteration in cardiovascular function – yet the females did not!!
Surgical Research, Weight Research / 15.10.2014

MedicalResearch.com Interview with: Donna Tepper, M.D. Henry Ford Hospital Medical Research: What are the main findings of the study? Dr. Tepper: We looked at 94 patients who underwent bariatric surgery at Henry Ford from 2003 through 2013. Of those, 47 subsequently had body recontouring procedures, such as body lift, abdominoplasty (tummy tuck), arm lift, thigh lift, face lift.  We recorded the patients’ body mass index prior to bariatric surgery, and then again at 6 months, 1, 2.5, 4, and 5 years.  Of the patients who underwent contouring surgery, the average decrease in BMI was 18.24 at 2.5 years, compared to a statistically significant 12.45 at 2.5 years for those who did not have further surgery.  This is statistically significant.  This 3 point change in BMI is an 18-21 pound difference depending on patient height.  Furthermore, the BMI in the body contouring group continues to be lower at 4 and 5 years from bariatric surgery compared to the bariatric surgery alone group.
Author Interviews, JAMA, Surgical Research, University of Pittsburgh, Weight Research / 03.10.2014

Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center MedicalResearch.com Interview with:  Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center Medical Research: What are the main findings of the study? Dr. Courcoulas: This paper was not a study but a summary of findings from a multidisciplinary workshop (and not a consensus panel) convened in May 2013 by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. The goal of the workshop was to summarize the current state of knowledge of bariatric surgery, review research findings on the long-term outcomes of bariatric surgery, and establish priorities for future research.
Author Interviews, BMJ, Breast Cancer, Weight Research / 29.09.2014

MedicalResearch.com Interview with: Professor Usha Menon,  Evangelia-Ourania Fourkala PhD and Matthew Burrell PhD Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, University College London, UK Medical Research: What are the main findings of the study? Response: Our study has shown that skirt size is a good proxy for central obesity. Each unit increase in UK skirt size every ten years between the age of 20 and 60 was associated with a 33% increase in postmenopausal breast cancer in our cohort.
Author Interviews, JAMA, Mental Health Research, Weight Research / 27.09.2014

Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of MedicineMedicalResearch.com Interview with: Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of Medicine MedicalResearch: What was the study about? Dr. Agras: Family-based treatment (FBT) has been shown to be more effective than individual psychotherapy for the treatment of adolescent anorexia nervosa. This treatment focuses on helping the family to re-feed their child. The question posed in this study was whether Family-based treatment would have any advantages over Systemic family therapy (SyFT) focusing on family interactions that may affect the maintenance of the disorder. The participants were 164 adolescents with anorexia nervosa and their families – one of the largest studies of its type.
Author Interviews, Exercise - Fitness, General Medicine, Metabolic Syndrome, Weight Research / 26.09.2014

MedicalResearch.com Interview with: Tuomo Tompuri, MD Clinical Physiology and Nuclear Medicine Kuopio University Hospital, Finland Medical Research: What are the main findings of the study? Dr. Tompuri: Measures of the cardiorespiratory fitness should be scaled by lean mass instead of body weight, while aiming to enable comparison between the subjects. Our result is physiologically logical and confirms earlier observations of the topic. Scaling by body weight has been criticized, because body fat, per se, does not increase metabolism during exercise. We did observe that scaling by body weight introduces confounding by adiposity.
Weight Research / 26.09.2014

EDJ_3065.NEFMedicalResearch.com Interview with: Dr. Holly R. Wyatt, MD Endocrine Society spokeswoman Associate Professor, University of Colorado Denver Medical Director, Anschutz Health and Wellness Center Medical Director, ABC’s TV series “Extreme Weight Loss”. MedicalResearch.com Editor’s note: Dr. Wyatt is a nationally known expert on obesity and weight control. Dr. Wyatt is co-founder of ‘The State of Slim’ behavioral weight management program and has been the National Program Director for the Centers for Obesity Research and Education (C.O.R.E.) since 1999. Dr. Wyatt publishes extensively in the obesity and metabolism literature including publications in the NEJM, Obesity, Annals of Internal Medicine, Journal of Clinical Endocrinology & Metabolism and American Journal of Clinical Nutrition among others. Dr. Wyatt kindly answered questions regarding weight loss and maintenance for the MedicalResearch.com audience. Medical Research: How did you become interested in weight control? Dr. Wyatt: Basically, because I struggled with my weight all my life. I was always planning on going to medical school and had been interested in learning more about the science of weight gain and metabolism, but at the time the subject was not well studied. When I came to the University of Colorado for my medical residency, I met researchers who were investigating the growing problem of obesity and were passionate about finding effective strategies for weight management. I have been active in clinical practice and obesity research since that time. Medical Research: Why does weight loss or even weight maintenance become so much harder as we age? Dr. Wyatt: We don’t know all the reasons for certain, but the problem is most likely multifactorial.
  • First, as we age we lose muscle mass. To a large degree, muscle mass determines our metabolic rate so even if our body weight stays stable, our metabolic engine slows down as we lose muscle and it becomes harder to maintain that weight.
  • Secondly, there is some role with for hormonal changes, but this role is incompletely understood. With menopause we tend to store weight centrally in our bodies, which may be a hormonal effect.
  • Perhaps most importantly, life changes as we get older and our lifestyle and environment evolves. We may not realize how much these changes affect the amount of energy we burn as our environment become more sedentary and obesogenic.
I should also point out that it is harder for everyone in our society to avoid gaining weight, even for children. Increasing numbers of children and adolescents are overweight and fighting obesity.
Author Interviews, JAMA, Weight Research / 17.09.2014

Aner Tal, PhD Food and Brand Lab Department of Applied Economics and Management Cornell University, Ithaca, New YorkMedicalResearch.com Interview with: Aner Tal, PhD Food and Brand Lab Department of Applied Economics and Management Cornell University, Ithaca, New York Medical Research: What are the main findings of the study? Dr. Tal: Some TV programs might lead people to eat twice as much as other programs. “We find that if you’re watching an action movie while snacking your mouth will see more action too!” says Aner Tal, Ph.D. lead author on the new article just published in the Journal of the American Medical Association: Internal Medicine. “In other words, the more distracting the program is the more you will eat.” In the study 94 undergraduates snacked on M&Ms, cookies, carrots and grapes while watching 20 minutes of television programming. A third of the participants watched a segment of the action movie The Island, a third watched a segment from the talk show, the Charlie Rose Show, and a third watched the same segment from The Island without sound. “People who were watching The Island ate almost twice as many snacks – 98% more than those watching the talk show!” says co-author Brian Wansink, author of Slim by Design (forthcoming) and Professor and Director of the Cornell Food and Brand Lab. “Even those watching “The Island” without sound ate 36% more.” People watching the more distracting content also consumed more calories, with 354 calories consumed by those watching The Island (314 calories with no sound) compared to 215 calories consumed by those watching the Charlie Rose Show. “More stimulating programs that are fast paced, include many camera cuts, really draw you in and distract you from what you are eating. They can make you eat more because you're paying less attention to how much you are putting in your mouth,” explains Tal. Because of this, programs that engage viewers more might wind up being worse for their diets.