Author Interviews, Breast Cancer, JACC, Weight Research / 18.05.2022
Breast Cancer Survivors: Time Restricted Eating Reduced Body Fat and Cardiovascular Risk
MedicalResearch.com Interview with:
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Dr. Kirkham[/caption]
Dr. Amy Kirkham, PhD
Assistant Professor of Clinical Cardiovascular Health
Faculty of Kinesiology & Physical Education
University of Toronto
Affiliate Scientist at Toronto Rehabilitation Institute
MedicalResearch.com: What is the background for this study?
Response: Women who have had a breast cancer diagnosis are at least two-fold and often higher risk of cardiovascular or heart disease compared to women without a history of breast cancer. Older age, higher body mass index, and receipt of chemotherapy treatment that can injure the heart are risk factors for cardiovascular death after a breast cancer diagnosis.
Time-restricted eating is a type of intermittent fasting that appears to be easy to follow and to improve some measures of metabolic health but has not been studied in populations with a cancer history. Time-restricted eating simply involves consuming all calorie intake within a specific time window, commonly 8 hours, like between 12 and 8 pm, and then only consuming water or black coffee outside of those hours.
We enrolled breast cancer survivors who were aged 60 or older, had an overweight or obese mass index, and were finished chemotherapy treatment in a single-arm trial of time-restricted eating for 8 weeks. We asked participants to restrict their calorie intake between 12 and 8 pm from Monday to Friday with no restrictions on weekend and no further instructions on what to eat.
Dr. Kirkham[/caption]
Dr. Amy Kirkham, PhD
Assistant Professor of Clinical Cardiovascular Health
Faculty of Kinesiology & Physical Education
University of Toronto
Affiliate Scientist at Toronto Rehabilitation Institute
MedicalResearch.com: What is the background for this study?
Response: Women who have had a breast cancer diagnosis are at least two-fold and often higher risk of cardiovascular or heart disease compared to women without a history of breast cancer. Older age, higher body mass index, and receipt of chemotherapy treatment that can injure the heart are risk factors for cardiovascular death after a breast cancer diagnosis.
Time-restricted eating is a type of intermittent fasting that appears to be easy to follow and to improve some measures of metabolic health but has not been studied in populations with a cancer history. Time-restricted eating simply involves consuming all calorie intake within a specific time window, commonly 8 hours, like between 12 and 8 pm, and then only consuming water or black coffee outside of those hours.
We enrolled breast cancer survivors who were aged 60 or older, had an overweight or obese mass index, and were finished chemotherapy treatment in a single-arm trial of time-restricted eating for 8 weeks. We asked participants to restrict their calorie intake between 12 and 8 pm from Monday to Friday with no restrictions on weekend and no further instructions on what to eat.

Dr. Chien-Wen Tseng[/caption]
Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
The Hawaii Medical Service Association Endowed Chair
Health Services and Quality Research
Professor, and Associate Research Director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Gaining weight during pregnancy is natural but gaining too little or too much weight can be harmful for pregnant people and their babies. For the first time, the Task Force reviewed the evidence and found that counseling pregnant people on healthy weight gain during pregnancy can lower their risk for diabetes during pregnancy, emergency cesarean deliveries, and babies born with a birth weight that is too high. Pregnant people may not know what amount of weight gain is healthy during pregnancy, or how weight gain can affect their pregnancy and baby.
We recommend that clinicians offer all pregnant people counseling on healthy weight gain throughout their pregnancy for healthier, safer pregnancies.
Prof. Koehler[/caption]
Prof. Dr. Karsten Koehler
Department of Sport and Health Sciences
Technical University of Munich
MedicalResearch.com: What is the background for this study?
Response: The primary background is the phenomenon that most people fail to loose (meaningful) weight through exercise alone, which is related to what we call compensatory eating – an increase in food intake to compensate for the increased energy expenditure of exercise. This is been described in a number of studies and is considered a key weight loss barrier – yet few have come up with solutions to overcome this problem. Therefore, we wanted to see if the timing of food choices has an impact on how much and what we want to eat in the context of exercise.
Dr. Grant[/caption]
Leilah K. Grant, PhD
Postdoctoral Research Fellow in Medicine
Brigham and Women’s Hospital
Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: The prevalence of obesity increases in women around the age of menopause which increases the risk of diseases like diabetes and heart disease. Changes in hormones, like estrogen, are thought to contribute to weight gain during menopause, but other common symptoms of menopause such as sleep interruption may also play a role. While short sleep is known to adversely affect metabolism, little is known about the metabolic consequences of the type of sleep disruption most common in menopausal women – increased nighttime awakenings (i.e., sleep interruption) caused by hot flashes, but no change in overall sleep duration. We therefore did this study to see how an experimental model menopause-related sleep interruption would affect metabolic outcomes that may contribute to weight gain.
Dr. El Khoudary[/caption]
Samar El Khoudary, PhD, MPH, BPharm, FAHA
Associate Professor of Epidemiology
University of Pittsburgh Graduate School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Research increasingly shows that it isn’t so important how much fat a woman is carrying, which doctors typically measure using weight and BMI, as it is where she is carrying that fat. To investigate this, we looked at 25 years of data on 362 women from Pittsburgh and Chicago who participated in the
Dr. Crosbie[/caption]
Eric Crosbie, PhD, MA
Assistant Professor
School of Community Health Sciences
Ozmen Institute for Global Studies
University of Nevada Reno
MedicalResearch.com: What is the background for this study?
Response: My colleague Dr. Laura Schmidt and I established a framework for studying preemption (when a higher level of government limits the authority of lower levels to enact laws) by studying the
Dr. Aronne[/caption]
Dr. Louis Aronne, MD, FACP
Chief Medical Officer, Intellihealth
Medical Director, Comprehensive Weight Control Center
Weill Cornell Medicine
MedicalResearch.com: What is the background for the study “Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change: A Randomized Clinical Trial”?
Response: More than 70% of U.S. adults have overweight or obesity. Online programs promoting lifestyle change have had some success in helping people achieve and maintain weight loss, but study results have been variable, and these programs have not been widely implemented in primary care. We studied the effectiveness of an online program we have developed (Intellihealth, formerly known as BMIQ) in routine primary care practices, both alone and integrated with population health management (with participants receiving additional support and outreach from nonclinical staff). The study’s objective was to determine whether a combined intervention integrating online weight management with population health management would increase weight loss at 12 months among primary care patients compared with the online program only and usual care.
Dr. Singh[/caption]
Gurmukh Singh, MD, PhD, MBA
Department of Pathology, Section of Clinical Pathology
Walter Shepeard Professor of Pathology
Section Chief, Clinical Pathology.
Associate Medical Director, Clinical Laboratory GRMC and
Children's Hospital of Georgia
MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by the obesity paradox?
Response: Obese people tend to get more diseases, such as hypertension, diabetes, cancer etc. However, when they get seriously ill, e.g., sick enough to require admission to intensive care treatment unit (ICU), obese people tend to have better outcomes than normal weight people.
Dr. Spann[/caption]
Marisa N. Spann, PhD, MPH
Columbia University Irving Medical Center
New York, New York
MedicalResearch.com: What is the background for this study?
Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.
MedicalResearch.com: What are the main findings?
Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain.