MedicalResearch.com Interview with: Rhonda Stewart
Senior Communications
Institute for Health Metrics and Evaluation
Seattle, WA 98121, USA
MedicalResearch: What are the main findings of the study?Answer: Globally, obesity has become a public health epidemic. Obesity is affecting not just developed countries, but developing countries as well. Almost one-third of the world’s population, over 2 billion people, are considered to be overweight or obese. Of this group, nearly two-thirds (62%) are in developing countries. If current trends continue, this number will continue to rise. Between 1980 and 2013, the prevalence of overweight or obesity for children and adolescents increased by nearly 50%. This study is the first analysis of global trends on obesity and covers more than 30 years and 188 countries.
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MedicalResearch.com Interview with: John Wilding DM FRCP
Professor of Medicine & Honorary Consultant Physician
Head of Department of Obesity and Endocrinology
Institute of Ageing & Chronic Disease
Clinical Sciences Centre
University Hospital Aintree
Liverpool United Kingdom
MedicalResearch: What are the main findings of the study?Dr. Wilding:This trial studied over 3700 obese people who were trying to lose weight. The main findings were that liraglutide (an injectable medication already approved for diabetes treatment at lower dose of 1.8mg) can help reduce body weight in people with obesity when used at a higher dose than is usually used in diabetes (3mg). Trial participants experienced a weight loss of 8 % from baseline compared to 2.6 % with placebo (diet and exercise alone).
Some risk factors for diabetes and heart disease such as blood sugar, blood pressure and cholesterol also improved with liraglutide treatment to a greater extent than with placebo. The main side effects seen were nausea which in most cases resolved after a few weeks treatment; there were also more cases of gallstones (which could be due to weight loss) and a few more cases of acute pancreatitis in people treated with liraglutide.
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MedicalResearch.com Interview
Anna Peeters
Associate Professor, BSc(Hons) PhD
Head Obesity & Population Health | Baker IDI Heart and Diabetes Institute
President Australian & New Zealand Obesity Society
MedicalResearch: What are the main findings of the study?Professor Peeters: The context for this study is that ‘point of sale menu labelling’ policies in fast food restaurants have some evidence of generally decreasing how many calories are consumed by people who go there. They may also lead the companies to reformulate their food to become slightly healthier. The key finding of our study is that those from more disadvantaged/ poorer backgrounds are unlikely to have a direct benefit from ‘point of sale menu labelling’ policies in fast food restaurants through a decreased number of calories consumed.
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MedicalResearch Interview with: Dr Gianluca Tognon
University of Gothenburg
Gothenburg, Sweden
MedicalResearch: What are the main findings of the study?Dr. Tognon: We found that eating a pattern rich in vegetables, fruit, nuts, cereal grains and fish, that we call a Mediterranean-like diet was not only inversely associated to being overweight or obese, but also protective against an increase in body mass index and waist circumference at a 2-year follow up.
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MedicalResearch.com Interview with:Dr. Farid Saad
Global Medical Affairs Men’s Healthcare, Bayer Pharma, Berlin, Germany;
Gulf Medical University School of Medicine
Ajman, United Arab Emirates
MedicalResearch: What are the main findings of the study?Dr. Saad: There are two ongoing registry studies in men with testosterone deficiency (hypogonadism, defined by two separate measures of low serum testosterone and the presence of symptoms which are typical for testosterone deficiency). The studies are being conducted by office urologists. The total number of men who have been treated for a maximum duration of six years is 561, mean age just under 60 years. All men received three-monthly intra-muscular injections of a long-acting testosterone depot preparation.
The main findings were that at baseline only five per cent of these men had normal weight, some 25 per cent were overweight and the majority obese. Both overweight and obese men showed reductions in weight and waist circumference. The more obese men were, the more they lost. Men in the highest obesity category grade III (BMI ≥ 40 kg/m2), had a mean weight loss of 26 kg and a reduction of waist size by 12 cm.
In parallel, all components of the metabolic syndrome improved in a clinically meaningful magnitude, i.e., blood pressure, lipid profile, and glycemic control. When we analyzed a subgroup of 156 men with type 2 diabetes, we found marked improvements in their diabetes as a result of adding testosterone to the standard diabetes treatment men are receiving by their famaily physicians.
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MedicalResearch.com Interview with: Hana Kahleova, MD, PhD
Diabetes Centre, Institute for Clinical and Experimental Medicine
140 21 Prague
Czech Republic
MedicalResearch: What was the aim of your study?Dr. Kahleova: The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function.
MedicalResearch: What are the main findings of the study?Dr. Kahleova: Comparison of the effect of six vs. two meals (breakfast and lunch) with the same daily caloric restriction (-500 kcal/day) and macronutrient content, each regimen lasting 12 weeks, demonstrated a superior effect of breakfast and lunch on body weight, hepatic fat content, fasting plasma glucose, C-peptide, glucagon and insulin sensitivity.
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MedicalResearch.com Interview with: Maria E.C. Sandberg, MSc PhD
Institutet för Miljömedicin / Institute of Environmental Medicine
Karolinska Institutet
Stockholm, Sweden
MedicalResearch: What are the main findings of the study?Dr. Sandberg: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of rheumatoid arthritis (RA).
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MedicalResearch Interview with:
Arya Mani, M.D.
Department of Internal Medicine and Genetics
Yale Cardiovascular Research Center
Yale, New Haven CTMedicalResearch: What are the main findings of the study?Dr. Mani: Our group has identified a gene that when mutated it causes a form of truncal (central) obesity that is associated with a cluster of coronary artery disease risk factors, including high blood pressure, insulin resistance and possibly elevated blood lipids. These associated risk factors are collectively known as the metabolic syndrome, which may lead to development of diseases such as diabetes and coronary artery disease, both of which were very prevalent in the populations we studied. All identified mutations by our group have been so far gain of function mutations, which means they increased the activity of the gene in pathways related to adipogenesis and gluconeogenesis.
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MedicalResearch Interview with: Alicia J. Kowaltowski, MD, PhD
Professor of Biochemistry Departamento de Bioquímica, IQ,
Universidade de São Paulo
São Paulo, SP, Brazil
MedicalResearch: What are the main findings of the study?Dr. Kowaltowski: Intermittent fasting (24 hour cycles of all-you-can-eat followed by 24 fasting) is often used as a way to control excessive weight gain in laboratory animals, despite the fact that these animals overeat on the days they get food, and end up ingesting total quantities of food very similar to animals that eat every day. We show here that although lower weight gain occurs with intermittent fasting and there are some health benefits in adopting this diet, there are also some undesirable consequences. One such consequence is that this diet changes the control of hunger in the hypothalamus within the brain, making the rats hungry all the time, even when they are eating.
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MedicalResearch.com Interview with: Judy C. Boughey, MD
Chair, Division of Surgery Research
Mayo Clinic, Rochester, Minn.
MedicalResearch.com: What are the main findings of the study?Dr. Boughey: Rates of bilateral mastectomy are higher in hospitals with immediate breast reconstruction available. Bilateral mastectomy rates were highest in hospitals with high volumes of immediate breast reconstruction. Large, teaching, urban, and Northeastern hospitals were more likely to have higher immediate breast reconstruction volumes.
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MedicalResearch.com Interview with:Mireille Serlie, MD PhD
Academic Medical Center
University of Amsterdam
Department of Endocrinology and Metabolism
Amsterdam, The Netherlands
MedicalResearch What are the main findings of the study?Dr. Serlie: We studied the effects of hypercaloric high sugar or high fat/high sugar drinks consumed with the 3 main meals (representing an increase in meal size) or in between the 3 main meals (representing an increase in meal frequency or snacking). All subjects gained a similar amount of body weight but only the ones that snacked showed an increase in liver and abdominal fat. This suggests that besides caloric content and diet composition, eating pattern independently contributes to liver and abdominal fat accumulation. We also observed a trend for a decrease in hepatic insulin sensitivity in the high fat/high sugar frequency group only.
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MedicalResearch.com Interview with: Tina Hieken, M.D.
Associate Professor of Surgery
Mayo Clinic,Rochester, Minn
MedicalResearch.com: What are the main findings of the study?Dr. Hieken: Among more than 1,300 newly diagnosed invasive breast cancer patients, 36 percent of whom were obese (BMI ≥ 30), preoperative axillary ultrasound with fine needle aspiration biopsy of suspicious lymph nodes identified metastasis to the lymph nodes in 36 percent of patients found to be node-positive at operation. For all BMI categories (normal, overweight, obese) axillary ultrasound was predictive of pathologic nodal status (p<0.0001). The sensitivity of axillary ultrasound did not differ across BMI categories while specificity and accuracy were better for overweight and obese patients, respectively, than for normal weight patients. Furthermore, patients across all BMI categories who had suspicious axillary lymph nodes on ultrasound and had a positive fine needle aspiration biopsy had significantly more positive lymph nodes at operation, an average of five metastatic nodes, and an overall higher nodal disease burden at operation.
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MedicalResearch.com Interview with:Mr. David Bowrey, MD FRCS (Gen Surg) MMedEd FHEA
Consultant General / Oesophagogastric Surgeon & Honorary Senior Lecturer, Dept Cancer Studies,
Training Programme Director for Core Surgery, East Midlands South
University Hospitals of Leicester NHS Trust,
Leicester Royal Infirmary
MedicalResearch.com: What are the main findings of this study?Dr. Bowrey: Of 103 patients who had undergone Roux en Y gastric bypass surgery, changes in appetite, taste and smell were noted in 97%, 73% and 42% respectively. Seventy-three percent of patients developed aversions to certain types of foods, most frequently meat, starch and dairy produce. The change in taste sensation for the three common modalities of "sweet", "salt" and "sour" was decreased in some patients and increased in other patients. Patients who experienced food aversions typically experienced more weight loss than patients not developing aversions.
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MedicalResearch.com Interview with:Takehiro Sugiyama, MD, MSHS, PhD
Project Director, Diabetes Policy Planning Office
Management and Planning Bureau
Fellow, Department of Diabetes, Endocrinology and Metabolism
National Center for Global Health and Medicine
Shinjuku-ku, Tokyo Japan
MedicalResearch.com: What are the main findings of the study?Dr. Sugiyama:In the US nationally representative sample from the National Health and Nutrition Examination Survey 1999-2010, we found that statin users in 2009-2010 eat 9.6% more calories and 14.4% more fat than statin users in 1999-2000. These increases were not observed in statin non-users; the trends of caloric and fat intake were statistically different between statin users and non-users. In 1999-2000, caloric and fat intake was significantly less for statin users compared with non-users, but the difference between the groups because smaller as time went by and there was no statistical difference in 2009-2010. Body mass index increased more rapidly for statin users compared to non-users.
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MedicalResearch.com Interview with:
Tomás Ahern MB, BCh, BAO
St Columcille's Hospital and St Vincent's University Hospital
Dublin, Ireland
MedicalResearch.com: What are the main findings...
MedicalResearch.com Interview with:Sneha Sridhar, MPH
Kaiser Permanente, Division of Research
2000 Broadway, 3rd Floor
Oakland, CA 94612
MedicalResearch.com: What are the main findings of the study? Answer:We found that women whose weight gain during pregnancy exceeded the current Institute of Medicine (IOM) recommendations were 46% more likely to have an overweight or obese child at ages 2-5, compared to women who met the recommendations. The association was stronger among women who were of normal weight before pregnancy. These normal weight women were more likely to have an overweight or obese child if they gained either below or above the IOM recommendations.
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MedicalResearch.com Interview with: Jeffrey R. Parker
Assistant Professor of Marketing
Robinson College of Business - Georgia State UniversityMedicalResearch.com: What are the main findings of the study?Mr. Parker: Recently, there has been quite a bit of debate about the effectiveness of providing dish-specific calorie information (a practice called “calorie posting”) on restaurant menus in terms of the healthiness of consumers’ food choices. Some results suggest that such labels lead to lower-calorie choices, while other research shows that there is no effect. We examined one factor that might impact the effectiveness of calorie posting: the practice of grouping low-calorie options on a menu and labeling this category accordingly (i.e., incorporating a low-calorie menu/category in the menu)—which we call “calorie organizing”—as opposed to simply allowing them to appear in their natural categories with the caloric content appearing in the dish descriptions (e.g., Sandwiches, Salads, Pastas, etc.).
On the surface it seems obvious that making low-calorie options easier to find—by giving them their own labeled category on the menu—would bolster the positive effects of calorie posting. However, we found the opposite: additionally calorie organizing an already calorie-posted menu regularly eliminates the benefits that calorie posting can have.
We argued and found evidence indicating that the underlying cause of this effect stems from how consumers make decisions. Restaurant menus are often too large for a consumer to seriously consider all of the dishes. Some consumers typically eliminate large portions of the menu on the basis of simple criteria (e.g., “I don’t like seafood.”, “It’s too early to eat pasta.”, etc. ). Since consumers generally make negative inferences about low-calorie dishes (e.g., “They don’t taste good.”, “They are small dishes.”, etc.) they are likely to summarily dismiss all of the low-calorie options early in the decision process when the menu is calorie-organized (i.e., has grouped the low-calorie dished and labeled the new category accordingly). Thus, they are likely to choose as poorly as they would were they given no calorie information. In contrast, when the menu is just calorie-posted, and the low-calorie dishes appear in their natural categories, these dishes are unlikely to be dismissed in the early choice-simplification stages. Thus, low-calorie dishes are likely to be seriously considered in the final decision process, during which the pros and cons of dishes can be more comprehensively traded off, and are therefore more likely to be chosen.
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MedicalResearch.com Interview with: Dagfinn AuneMS
Department of Epidemiology and Biostatistics
School of Public Health
Imperial College London
St. Mary's Campus
Norfolk Place, Paddington, London W2 1PG, UK
MedicalResearch.com: What are the main findings of the study?Answer: We conducted a systematic review and meta-analysis of studies examining the association between maternal body mass index (BMI) and risk of fetal death, stillbirth, neonatal, perinatal and infant death. We found that the risk of all these outcomes increased with greater BMI in a dose-response fashion. For example even within the high end of what is considered the normal BMI range (BMI of 24-25) there was a 10-20% increase in the relative risk, but the strongest relations were seen for those who were obese and morbidly obese with 30-60% and 2-3 fold increases in the relative risk respectively (depending on the outcome examined).
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MedicalResearch.com Interview witih: Dr. Constance Tom Noguchi, Ph.D.
Molecular Medicine Branch
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892 and
Dr. Mawadda Al-Naeeli
Department of Biological Sciences, Ohio University
MedicalResearch.com: What are the main findings of the study?Answer: The main findings of our study are:
1) EPO treatment has an anti-inflammatory effect on white adipose tissue macrophage population during diet-induced obesity in addition to its associated metabolic improvements on glucose tolerance and insulin sensitivity in vivo.
2) In this model of obesity, EPO treatment was found to reduce M1-like [pro-inflammatory] and increased M2-like [anti-inflammatory] macrophages in visceral white adipose tissue depot.
3) In addition, EPO decreased circulating inflammatory monocytes.
4) These anti-inflammatory effects of EPO were found to be driven, at least in part, by direct EPO-R response in macrophages via Stat3 activation, where EPO effects on M2 but not M1 macrophages required interleukin-4 receptor/Stat6 axis.
5) The anti-inflammatory effects of EPO are not restricted to treatment with exogenous high dose EPO (1000U/kg), but also include endogenous physiological EPO levels as demonstrated by the series of studies conducted using ΔEpoR mice with EPO-R restricted to erythroid cells.
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MedicalResearch.com Interview withUlla Räisänen
Senior Researcher
HERG Health Experiences Research Group
Department of Primary Care Health Sciences
University of Oxford Oxford OX1 2ET
MedicalResearch.com : What are the main findings of the study?Answer: We conducted a qualitative interview study exploring how young men (aged 16-25) recognise eating disorder symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care in the UK.
Our data suggest that the widespread perception of eating disorders as uniquely or predominantly a female problem led to an initial failure by young men to recognise their behaviours as symptoms of an eating disorder. Many presented late in their illness trajectory when eating disorder behaviours and symptoms were entrenched, and some felt that opportunities to recognise their illness had been missed because of others’ lack of awareness of eating disorders in men. In addition, the men discussed the lack of gender-appropriate information and resources for men with eating disorders as an additional impediment to making sense of their experiences, and some felt that health and other professionals had been slow to recognise their symptoms because they were men. (more…)
MedicalResearch.com Interview with:
Shanthi Srinivasan, M.D. Associate Professor of Medicine
Division of Digestive Diseases Department of Medicine
Emory University Atlanta, GA 30322MedicalResearch.com: What are the main findings of the study?Dr. Srinivasan:The main findings of this study are that the neurotrophic factor GDNF is was able to protect against the weight gain induced by mice on a high fat diet. The mice that had overexpression of GDNF showed less weight gain while eating the same high fat diet as the control mice. GDNF seems to have effects on the genes regulating fat metabolism and energy expenditure and this could be the mechanism of prevention of weight gain.
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MedicalResearch.com Interview with:Dr. Milan K Piya
NIHR Clinical Lecturer in Diabetes and Endocrinology
Warwick Medical School, University of Warwick;
University Hospitals Coventry and Warwickshire NHS Trust
Coventry, UK
MedicalResearch.com: What are the main findings of the study?Answer: Our studies have identified two main findings:
Firstly that the size or frequency of the meal doesn’t affect the calories we burn in a day, but what matters most for losing weight is counting calories.
Secondly, by carrying more weight, more endotoxin enters the circulation to cause inflammation and eating more often will exacerbate this risk which has been linked to metabolic diseases such as type-2 diabetes.
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MedicalResearch.com Interview with:Professor Rodney Sinclair
University of Melbourne and Epworth Hospital
Melbourne, VIC, Australia
MedicalResearch.com: What are the main findings of the study?Answer: Activation of Wnt signalling promoted hair growth and fat growth. Inhibition of Wnt signalling reduces fat growth and hair growth. We looked at the fat layer on the scalp. It was reduced by 50% over the bald areas of alopecia areata. The patch of alopecia areata we looked at was new- only appeared a few days earlier and so the changes in fat thickness are rapid.
What is interesting is that the fat layer is dynamic, and significant fluctuations can occur in a rapid period of time in sync with the hair cycle. It is also interesting that ligands for BMP6 and IGF2 are pro-adipogenic.
There are a couple of bigger questions that earlier media reports did not focus on- namely upstream factors regulating the hair cycle clock and the beauty of synchronization of fat and hair growth for seasonal thermal insulation.
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MedicalResearch.com Interview with:Barbara J. Rolls, PhD
Department of Nutritional Sciences
The Pennsylvania State University, 226 Henderson Building
University Park, PA 16802-6501
MedicalResearch.com: What are the main findings of the study?Dr. Rolls: We found that as we reduced the flake size of a breakfast cereal so that it filled a smaller volume, individuals ate a greater weight and more calories of the cereal. On four occasions, we served a popular wheat flake cereal, or the same weight of cereal crushed to 80%, 60%, or 40% of its volume, to 41 adults for breakfast. As the flake size was reduced, people made reductions in the volume of cereal they poured, but they still took a greater amount of weight and calories. They ended up eating 72 more calories at breakfast when they ate the cereal with the smallest flake size, an increase of 34%. These findings show that variations in food volume due to the size of individual food pieces affect the portion of food that people take, which in turn affects how much they eat.
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MedicalResearch.com Interview with:
Prof. Dr. Bernd Schultes
Endocrinology and Diabetes Internal Medicine
eSwiss Medical & Surgical Center
Brauerstrasse 97
9016 St. Gallen Schweiz
MedicalResearch.com: What...
MedicalResearch.com Interview with:Dr. Kristy Ward
Department of Reproductive Medicine
UCSD School of Medicine
MedicalResearch.com: What are the main findings of this study?Dr. Ward: As the second leading cause of preventable death, obesity is one of the nation’s most serious public health problems. Over two-thirds of the US population is currently overweight or obese and the prevalence continues to increase. A number of studies have linked obesity with an overall elevated risk of cancer and with many individual cancer types. Among obesity related cancers in women, endometrial cancer is most strongly associated with increasing body mass, with 39% of cases in the US attributable to obesity.
In patients with clinically severe obesity (BMI ≥ 40 kg/m2), bariatric surgery results in rapid weight loss and has greater long-term success when compared to non-surgical weight loss methods. Surgical weight loss procedures have been found to reduce obesity-related comorbidites and improve outcomes in clinically severe obese populations. In addition to improved cardiovascular risk factors and mitigation of physical symptoms, there is increasing evidence that cancer risk is reduced after bariatric surgery.
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MedicalResearch.com Interview with:Christos S. Mantzoros, MD, DSc, PhD
Beth Israel Deaconess Medical Center and the VA Boston Healthcare
Cynthia R. Davis PhD
Judge Baker Children’s Center in Boston, MA.
MedicalResearch.com: What are the main findings of this study?Answer: These results highlight that chronic stressors in childhood, like child abuse and family violence, parental substance abuse, divorce and separation from a parental figure, can potentially have a long standing impact on brain structures and functioning, such as the hypothalamic-pituitary-adrenal axis. Our work supports the notion of allostatic load, and is the first of its kind to demonstrate links between childhood adversity and central obesity later in life which leads to increased cardio metabolic risk.
This study describes the role of these novel molecules in mediating metabolic dysregulation highlighting them as a novel mechanism linking childhood adversity to obesity.
We have also used more sensitive assessments of childhood adversity, not typically employed in biomedical research, that incorporate the severity of adversities and their chronicity across childhood. Assessments of this nature are better able to detect severe and chronic adversity, and are critical in the measurement of stress, its role in allostatic load and its impact on the brain. Furthermore, the current study and others from our lab show that severe and chronic adversity in childhood is associated with metabolic dysregulation and obesity in adulthood, regardless of lifestyle factors such as diet and exercise and psychosocial factors like depression and social support.
Clinicians and patients need to be aware of the fact that subjects exposed to early life adversity are at increase risk for central obesity and cardio metabolic risk.
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MedicalResearch.com Interview with:Prof. Lu Qi,
Assistant Professor, Department of Nutrition
Harvard School of Public Health and Channing Division of Network Medicine
Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
MedicalResearch.com: What are the main findings of the study?Dr. Lu Qi: In this study, we for the first time provide reproducible evidence from three large cohort studies to show that the association between regular consumption of fried foods and higher BMI was particularly pronounced among people with a greater genetic predisposition to obesity. On the other hand, the adverse genetic effects on BMI were also amplified by consuming more fried foods, the effects among those who ate fried foods more than four times a week was about twice as large compared with those who ate them less than once a week.
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MedicalResearch.com Interview Invitation with: Dr. Eliana M. Perrin, MD, MPH
Associate Vice Chancellor for Research, and Director, Office of Research Development
University of North Carolina at Chapel Hill and
Associate Professor
Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine University of North Carolina at Chapel Hill, School of Medicine
Chapel Hill, NC 27599-7225
MedicalResearch.com: What are the main findings of the study?Dr. Perrin: The study included a large, diverse sample of 863 low-income parents of two-month-olds participating in Greenlight, an obesity prevention trial taking place at four medical centers: UNC, New York University, Vanderbilt University and the University of Miami. Among all of the parents, behaviors that are thought to be related to later obesity were highly prevalent. Exclusive formula feeding was more than twice as common (45 percent) as exclusive breastfeeding (19 percent). Twelve percent had already introduced solid food, 43 percent put infants to bed with bottles, 23 percent propped bottles instead of holding the bottle by hand (which can result in overfeeding), 20 percent always fed when the infant cried, and 38 percent always tried to get their children to finish their milk. In addition, 90 percent of the infants were exposed to television and 50 percent actively watched TV (meaning parents put their children in front of the television in order to watch). There were differences in these behaviors by race and ethnicity, and study results show that culturally-tailored counseling should be offered to parents of different backgrounds who may feed and play with their children differently.
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MedicalResearch.com Interview with: Beverly B. Green, MD, MPH
GroupHealth Research Institute
Seattle WA
MedicalResearch.com: What are the main findings of the study?Dr. Green: We found that Group Health patients who were overweight and had hypertension were more likely to have lost 10 pounds in six months if they had secure online access to a dietitian than if they received only information and usual care. The patients really loved this intervention—and having access to a dietitian to work with them toward a healthier lifestyle. Although blood pressure and heart risk trended lower in the intervention group, the differences weren’t significant—unlike their weight.
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