Not Clear That Physical Activity Programs Reduce Cognitive Decline

MedicalResearch.com Interview with:
“Exercise” by Diabetes Education Events is licensed under CC BY 2.0
Michelle Brasure, MSPH, PhD, MLIS
Evidence-based Practice Center
School of Public Health
University of Minnesota 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We conducted a large systematic review to assess the evidence relating to interventions to prevent cognitive decline and dementia. We included experimental studies with follow up times of at least six months. This paper analyzes the physical activity interventions; other papers in this issue address other types of interventions.

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More Evidence That Higher Education May Lower Risk of Alzheimer’s Disease

MedicalResearch.com Interview with:

Susanna C. Larsson, PhD Associate Professor, Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden

Dr. Larsson

Susanna C. Larsson, PhD
Associate Professor, Karolinska Institutet,
Institute of Environmental Medicine,
Stockholm, Sweden

MedicalResearch.com: What is the background for this study?

Response: The causes of Alzheimer’s disease are largely unknown and there are currently no medical treatments that can halt or reverse its effects. This has led to growing interest in identifying risk factors for Alzheimer’s that are amenable to modification. Several observational studies have found that education and various lifestyle and vascular risk factors are associated with the risk of Alzheimer’s disease, but whether these factors actually cause Alzheimer’s is unclear.

We used a genetic epidemiologic method known as ‘Mendelian randomization’. This method involves the use of genes with an impact on the modifiable risk factor – for example, genes linked to education or intelligence – and assessing whether these genes are also associated with the disease. If a gene with an impact on the modifiable risk factor is also associated with the disease, then this provides strong evidence that the risk factor is a cause of the disease.

MedicalResearch.com:  What are the main findings?

Response: Our results, based on aggregated genetic data from 17 000 Alzheimer’s disease patients and 37 000 healthy controls, revealed that genetic variants that predict higher education were clearly associated with a reduced risk of Alzheimer’s disease. A possible explanation for this link is ‘cognitive reserve’, which refers to the ability to recruit and use alternative brain networks or structures not normally used to compensate for brain ageing. Previous research has shown that high education increases this reserve.

We found suggestive evidence for possible associations of intelligence, circulating vitamin D, coffee consumption, and smoking with risk of Alzheimer’s disease. There was no evidence for a causal link with other modifiable factors, such as vascular risk factors.

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Lifestyle Modifications Slow Progression To Diabetes As Effectively As Medications

MedicalResearch.com Interview with:
Dr. Karla Galaviz PhD
Hubert Department of Global Health
Rollins School of Public Health
Emory University
Sonya Haw, MD| Assistant Professor
Division of Endocrinology, Metabolism & Lipids
Emory University, School of Medicine
Grady Memorial Hospital
Atlanta, GA

MedicalResearch.com: What is the background for this study? What are the main findings?

  • Diabetes affects 1 in 11 adults worldwide and though there is evidence that lifestyle modification (eating healthier diets and exercising about 150 mins a week) and certain medications can prevent or delay diabetes onset, it is not clear which of these strategies offers long-term benefits.
  • To answer this question, we compiled all available randomized controlled trials of lifestyle programs and medications to prevent diabetes and analyzed the data to see if the diabetes prevention effects persisted in the long-term. We specifically compared studies where the lifestyle or drug interventions were discontinued to see if the effect was long lasting or diminished when the intervention was stopped.

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Wearable Device Study Confirms Moderate-to-Vigorous Physical Activity Linked To Decreased Mortality

MedicalResearch.com Interview with:

I-Min Lee, MD, ScD Professor of Medicine, Harvard Medical School Professor of Epidemiology, Harvard T.H. Chan School of Public Health Brigham and Women's Hospital Boston, MA 02215

Dr. Lee

I-Min Lee, MD, ScD
Professor of Medicine, Harvard Medical School
Professor of Epidemiology, Harvard T.H. Chan School of Public Health
Brigham and Women’s Hospital
Boston, MA 02215

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The fact that physical activity lowers the risk of premature mortality is not a new fact – we have many studies showing this.  However, previous studies have primarily relied on self-reported physical activity, and self-reports tend to be imprecise.  Based on these self-report studies, we know that physical activity is associated with a 20-30% reduction in mortality rates.  And, these self-report studies also have focused on moderate-to-vigorous intensity physical activity, since they are more reliably reported than lighter intensity activity.  We have little information on whether light-intensity activities (e.g., light household chores, very slow walking such as when strolling and window shopping) are associated with lower mortality rates.

We now have “wearables” – devices that can more precisely measure physical activity at low (as well as higher) intensities, and sedentary behavior.  The present study, conducted between 2011 and 2015, investigated a large cohort of older women (n=16,741; mean age, 72 years)  who were asked to wear these devices for a week – thus, providing detailed physical activity and sedentary behavior measures.  During an average follow-up of about two-and-a-half years, 207 women died.  The study confirmed that physical activity is related to lower mortality rates.

What is new and important is how strong this association is when we have more precise measures of physical activity – the most active women had a 60-70% reduction in mortality rates, compared with the least active, during the study.  For context, non-smokers have about a 50% risk reduction, compared to smokers, which is why patients (and doctors) should pay attention to being physically active.

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Inactivity Plus Frailty Predict Mortality

MedicalResearch.com Interview with:

Olga Theou, MSc PhD Assistant Professor, Department of Medicine, Dalhousie University Affiliated Scientist, Geriatric Medicine, Nova Scotia Health Authority Adjunct Senior Lecturer, School of Medicine, University of Adelaide Halifax, Nova Scotia

Dr. Theou

Olga Theou, MSc PhD
Assistant Professor, Department of Medicine, Dalhousie University
Affiliated Scientist, Geriatric Medicine, Nova Scotia Health Authority
Adjunct Senior Lecturer, School of Medicine, University of Adelaide
Halifax, Nova Scotia 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We already know that moderate to vigorous intensity physical activity, such as time accumulated during exercise, is associated with numerous health benefits. More recent studies also have shown that sedentary time, such as time accumulated during prolonged sitting at work, transportation, and leisure, can also increase the risk of adverse outcomes. What was not known was whether prolonged sitting affects people across different levels of frailty similarly. This is what we examined in our study.

We found that there were differences. Low frailty levels (people who are extremely healthy; frailty index score < 0.1) seemed to eliminate the increased risk of mortality associated with prolonged sitting, even among people who did not meet recommended physical activity guidelines. Among people with higher frailty levels, sedentary time was associated with mortality but only among those who did not meet recommended physical activity guidelines

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2017’s Fattest Cities in America

MedicalResearch.com Interview with:

Jill Gonzalez WalletHub Analyst

Jill Gonzalez

Jill Gonzalez
WalletHub Analyst

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We based our research on recent findings that suggest that 70 percent of the adult U.S. population is overweight or obese. With that in mind, we wanted to find which metro areas offer the best environments for a healthy and active lifestyle.

Based on the report’s methodology, we concluded that areas in the south tend to have higher overweight and obese rates, as some fail to offer residents healthy environments and amenities that would facilitate a more active lifestyle. Please find the report’s main findings here: https://wallethub.com/edu/fattest-cities-in-america/10532/#main-findings.

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Health Lifestyle Could Cut Cardiovascular Disease 50% in Chinese

MedicalResearch.com Interview with:

Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112

Dr. Lu Qi

Lu Qi, MD, PhD, FAHA
HCA Regents Distinguished Chair and Professor
Director, Tulane University Obesity Research Center
Department of Epidemiology
Tulane University
School of Public Health and Tropical Medicine
New Orleans, LA 70112 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Adherence to healthy lifestyle (high physical activity, less smoking, moderate alcohol consumption, healthy diet, and low adiposity) has been related to substantially reduced risk of cardiovascular diseases in large cohorts from the US and Europe, however, similar evidence in Asians such as Chinese is lacking.

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Lifestyle Modifications May Improve Health and Prognosis in Breast Cancer Patients

MedicalResearch.com Interview with:
Ellen Warner, MD, FRCPC, FACP, M.Sc.
Affiliate scientist
Sunnybrook Health Sciences Centre
Toronto, ON

MedicalResearch.com: What is the background for this review?

Response: As a medical oncologist who has treated breast cancer patients for over 30 years, I have found that most of the women in my practice are desperately looking for things they can do beyond standard surgery, radiation, chemotherapy, etc. to increase their chance of cure.  Unfortunately, many fall prey to false claims they read over the Internet or hear from well-meaning friends and relatives.  As a result they turn to absurdly restrictive diets (eg. No meat, dairy or sugar) or to ‘supplements’ with unproven effectiveness or even safety. So I thought it would be helpful to review the literature to determine what evidence-based lifestyle changes these women could make that would at least improve their overall health and, ideally, reduce their risk of dying of recurrent breast cancer.  For this review I thought it would be great to team up with Julia Hamer, a pre-med student with a degree in nutrition who just happens to also be an Olympic level athlete!
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Non-Exercise Algorithm Predicts Fitness and Lifestyle-Related Disease

MedicalResearch.com Interview with:
Bjarne M. Nes, PhD
K.G. Jebsen Center for Exercise in
Medicine, Department of Circulation and Medical Imaging
Norwegian University of Science and Technology
Trondheim, Norway.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is well known that cardiorespiratory fitness is an important predictor of future cardiovascular disease risk. Still, fitness levels are rarely measured in clinical practice, likely because of costly and time-consuming procedures that requires quite a lot of training.

Therefore, we wanted to test the ability of a simple estimation of fitness, from a so-called non-exercise algorithm, to identify individuals at high and low risk of cardiovascular mortality. We tested fitness alone and in combination with traditional risk factors such as high blood pressure, cholesterol, smoking and family history of heart disease and diabetes, among 38,480 men and women from the Nord-Trondelag Health Study in Norway. We found that estimated fitness strongly predicts premature deaths from all causes and that traditional clinical risk factors added little above and beyond fitness in terms of predicting risk.

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Pandemic of Global Physical Inactivity Costs Lives and Money

MedicalResearch.com Interview with:

Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney

Dr. Melody Ding

Ding Ding (Melody), Ph.D., MPH
NHMRC Early Career Senior Research Fellow
Sydney University Postdoctoral Research Fellow
Prevention Research Collaboration
Sydney School of Public Health
The University of Sydney

MedicalResearch.com: What is the background for this study?

Response: Understanding the true burden of a pandemic is indispensable for informed decision making. After decades of research, we now have established knowledge about how physical inactivity contributes to pre-mature deaths and chronic diseases, but the economic burden of physical inactivity remains unquantified at the global level. Through estimating the economic burden of physical inactivity for the first time, we hope to create a business case for investing in cost-effective actions to promote physical activity at the global levels.

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Physical Activity During Leisure Time Linked to Cancer Risk

MedicalResearch.com Interview with:

Steven C. Moore PhD, MPH Division of Cancer Epidemiology and Genetics Rockville, MD

Dr. Steven Moore

Steven C. Moore PhD, MPH
Division of Cancer Epidemiology and Genetics
Rockville, MD 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Moore: More than half of Americans fail to meet recommended levels of regular physical activity; physical inactivity has become a major public health concern.

Physical activity during leisure time is known to reduce risks of heart-disease and all-cause mortality, as well as risks of colon, breast, and endometrial cancers. However, less is known about whether physical activity reduces risk of other cancers.

Hundreds of prospective studies have examined associations between physical activity and risk of different cancers. Due to small case numbers, results have been inconclusive for most cancer types.

In this study, we examined how leisure-time physical activity relates to risk of 26 different cancer types in a pooled analysis of 12 prospective cohort studies with 1.44 million participants. Our objectives were to identify cancers associated with leisure-time physical activity, and determine whether associations varied by body size and/or smoking history.

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Lifestyle Factors Can Prevent Up to 50% of US Cancer Deaths

MedicalResearch.com Interview with:
Mingyang Song
Research Fellow
Department of Nutrition
Harvard T.H. Chan School of Public Health 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although substantial data support the importance of lifestyle factors for cancer risk, a study published in Science early last year “led some to conclude that only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions, while most is due to random mutations arising during stem cell divisions, so-called bad luck.” That study “has been widely covered by the press and has created confusion for the public regarding the preventability of cancer.” In response to that study, we conducted this study to estimate how many cancer cases and deaths in the US can be potentially attributed to common lifestyle factors. Our study showed that about 20-30% of cancer incidences and 40-50% of cancer deaths may be avoided if everyone in the US adopted a lifestyle pattern that is characterized by “never or past smoking (pack-years <5), no or moderate alcohol drinking ([1]1 drink/d for women,[1]2 drinks/d for men), BMI of at least 18.5 but lower than 27.5, and weekly aerobic physical activity of at least 75 vigorous-intensity or 150 moderate-intensity minutes”.

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Attendance At Religious Services Linked To Increased Longevity in Women

MedicalResearch.com Interview with:

Dr. Tyler VanderWeele PhD Professor of Epidemiology Department of Epidemiology Department of Biostatistics Harvard T. H. Chan School of Public Health

Dr. Tyler VanderWeele

Dr. Tyler VanderWeele PhD
Professor of Epidemiology
Department of Epidemiology
Department of Biostatistics
Harvard T. H. Chan
School of Public Health 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. VanderWeele: There have been some prior studies on religious service attendance and mortality. Many of these have been criticized for poor methodology including the possibility of reverse causation – that only those who are healthy can attend services, so that attendance isn’t necessarily influencing health. We tried to address some of these criticisms with better methodology. We used repeated measures of attendance and health over time to address this, and a very large sample, and controlled for an extensive range of common causes of religious service attendance and health. This was arguably the strongest study on the topic to date and addressed many of the methodological critiques of prior literature. We found that compared with women who never attended religious services, women who attended more than once per week had 33% lower mortality risk during the study period. Those who attended weekly had 26% lower risk and those who attended less than once a week had 13% lower risk.

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Type 2 Diabetes: “Stand Up, Sit Less, Move More, More Often” For Better Glucose Control

MedicalResearch.com Interview with:

Paddy Dempsey MPhEd, PhD in Medicine (expected June 2016) Physical Physical Activity and Behavioural Epidemiology Laboratory Baker IDI Heart and Diabetes Institute Melbourne VIC

Paddy Dempsey

Paddy Dempsey
MPhEd, PhD in Medicine (expected June 2016)
Physical Physical Activity and Behavioural Epidemiology Laboratory
Baker IDI Heart and Diabetes Institute
Melbourne VIC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In addition to too little physical activity (PA), sedentary behavior – defined as any waking sitting or reclining behavior with low energy expenditure – has emerged as a ubiquitous and significant population-wide influence on cardiometabolic health outcomes, with potentially distinct and modifiable environmental and social determinants. There is now a consistent base of epidemiologic evidence reporting deleterious associations of excessive sedentary behaviors (e.g. TV viewing, car use, and desk work) with mortality and cardiometabolic morbidity, independent of moderate-vigorous PA.

To date, efforts to influence participation in moderate-to-vigorous exercise (i.e. 30 min a day of ‘exercise’ on most days a week for health) at the population level, such as through large-scale campaigns to promote walking, and other initiatives to encourage people to exercise during their leisure time have achieved only modest success. There may, however, be untapped preventive-health and clinical management potential through shifting the high volume of time spent sedentary to light-intensity physical activity interspersed throughout the day. As such, sedentary behavior represents a potentially feasible and therapeutic target, particularly in the promotion of metabolic health.

We posited that people with type 2 diabetes (T2D) were likely to derive the greatest benefits from interrupting their sitting time. However, until now the contributions of prolonged sitting and/or interrupting prolonged sitting with very-brief bouts of light-intensity PA had never been experimentally tested in patients with T2D. Moreover, this study for the first time moved beyond interrupting sitting with standing or ambulatory bouts (although walking bouts were also examined), which may have differing levels of metabolic stimulus (i.e. not physiologically taxing the body enough), practicality, or health efficacy, to examine a potential addition/alternative: simple resistance activities (SRA). A key premise behind these SRA bouts (half-squats, calf raises, gluteal contractions, and knee raises) were that they required no specialized equipment, only small amounts of space, and could be easily performed in a fixed position behind a work desk or at home with minimal disruption to work tasks or leisure pursuits. In addition, they also markedly increase muscle activity, and may also have other longer-term benefits (for example physical function, muscle strength, bone density), however we can only speculate on these aspects at present.

In this study in men and women with type 2 diabetes, plasma glucose, insulin and C-peptide (marker of insulin secretion and pancreatic beta cell function) levels following standardized breakfast and lunch meals were all markedly attenuated when prolonged sitting was regularly interrupted with light walking or resistance activities (3 min every 30 min) over an 8 hour day. Plasma triglyceride levels were also reduced for both types of activity bout; however, the reduction was only significant for the SRAs. Interestingly, the magnitude of glucose reduction for the walking bouts was greater in women for glucose levels.

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Active Commuting Can Lead To Healthier Weight in Mid-Life

MedicalResearch.com Interview with:

Dr Ellen Flint Lecturer in Population Health MRC Strategic Skills Fellow Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine London

Dr. Ellen Flint

Dr Ellen Flint
Lecturer in Population Health
MRC Strategic Skills Fellow
Department of Social & Environmental Health Research
London School of Hygiene & Tropical Medicine
London

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Flint: Globally, physical inactivity is a major cause of obesity, chronic disease and premature mortality. Improving population levels of physical activity is therefore a key public health policy aim, in high and middle income countries. In the past, functional active travel was a key source of physical activity for many people. However, since the mass adoption of private motorised travel in the 20th century, the vast majority (63%) of working adults in the UK commute to by car. Using UK Biobank data from more than 150,000 middle-aged adults, we found that those who commuted to work via cycling or walking had significantly lower body fat percentage and lower body mass index (BMI) compared to adults who commuted by car. The strongest associations were seen for adults who commuted via bicycle. For the average man in the sample (age 53 years; height 176.7cm; weight 85.9kg), cycling to work rather than driving was associated with a weight difference of 5kg or 11lbs (1.71 BMI points). For the average woman in the sample (age 52 years; height 163.6cm; weight 70.6kg), the weight difference was 4.4kg or 9.7lbs (1.65 BMI points). Even people who commuted via public transport also showed significant reductions in BMI and percentage body fat compared with those who commuted only by car. This suggests that even the incidental physical activity involved in public transport journeys may be important. The link between active commuting and obesity reduction was independent of other factors such as income, area deprivation, urban or rural residence, education, alcohol intake, smoking, general physical activity, dietary energy intake and overall health and disability.
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Retirees Report Significant Improvement in Lifestyle

MedicalResearch.com Interview with:

Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney

Dr. Melody Ding

Ding Ding (Melody), Ph.D., MPH
NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow
Prevention Research Collaboration
Sydney School of Public Health
The University of Sydney

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Ding: This study used data from the Sax Institute’s 45 and Up Study, a large Australia based cohort of adults aged 45 or older. We followed around 25,000 participants who were working at baseline (2006-2008) for an average of 3 years (follow-up in 2010). During the follow-up period, around 3,000 participants retired from the workforce. Participants were asked to report their health-related lifestyle behaviors, such as physical activity, smoking, and sleep time at both baseline and follow-up. We found that those who retired overall had significant improvement in their lifestyle as compared with those who did not, including more physical activity, less sitting time, and more sleep. Female smokers who retired were also more likely to have quit smoking.

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We Don’t Need To Assume Diabetes Is a Relentless Process

MedicalResearch.com Interview with:

David Drozek, D.O. Assistant Professor of Surgery Ohio University Heritage College of Osteopathic Medicine Athens, Ohio 45701

Dr. David Drozek

David Drozek, D.O.
Assistant Professor of Surgery
Ohio University Heritage College of Osteopathic Medicine
Athens, Ohio 45701

Medical Research: What is the background for this study?

Response: Half of the U.S. population has diabetes or prediabetes.  The rate is even higher in Appalachia.  As a society, we cannot sustain this level of disease.  It exacts a heavy toll on our productivity and our health care costs. Current approaches to diabetes, primarily with medication, are not sufficient.  More attention needs to be placed on the underlying cause of diabetes, and its traveling partners, overweight / obesity, heart disease and many common cancers.  That cause is our lifestyle. 

Medical Research: What are the main findings?

Response: As has been demonstrated in many other studies of lifestyle modification programs, chronic illnesses, like diabetes, can actually be reversed, and in some cases, even cured, by instituting a plant-based, whole food diet, increased physical activity and stress management techniques.  Our study reinforces that this is possible, even in a rural, poverty stricken region, when people are ready to make healthy changes.  Our study participants, on average, lost weight, and improved their blood sugar, lipid panel and blood pressure, by participating in The Complete Health Improvement Program (CHIP), a lifestyle medicine program.

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Behavioral Risk Factors Cluster and Compound Mortality Risk

Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney

Dr. Melody Ding

MedicalResearch.com Interview with:
Ding Ding (Melody), Ph.D., MPH

NHMRC Early Career Senior Research Fellow
Sydney University Postdoctoral Research Fellow
Prevention Research Collaboration
Sydney School of Public Health
The University of Sydney 

Medical Research: What is the background for this study? What are the main findings?
Response:  The study followed a large sample (around 200,000) of Australian adults aged 45 or older. Participants reported their lifestyle behaviours (smoking, excessive alcohol use, physical inactivity, unhealthy diet, prolonged sitting, short/long sleep duration) at baseline (2006-2009) and were followed up for around 6 years (up to June 2014). Based on linked administrative data (death records), we found a clear relationship between the total number of lifestyle risk behaviours and the risk of mortality—the more risk behaviours, the higher risk for mortality. This pattern of associations was consistent in men and women, participants in different age groups, of different socioeconomic status, and with and without major chronic disease.

Certain behavioural risk factors have synergistic associations with mortality and appear more harmful together than individually. For example, if people only sit for long hours (defined as >7 hours a day), without having other co-occurring risk behaviours, the risk for mortality was only elevated by 15%, and if people are only physically inactive without having other co-occurring risk behaviours, the risk for mortality was elevated by 60%. However when the two risk factors were combined, say if one is not physically active AND sit for long hours, the combined risk has become much larger (increased by 140%, compared with those with zero risk behaviours).  Similarly, the combination of smoking and excessive alcohol use appeared a lot more “deadly” than the two risk factors alone.

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Men More Likely To Develop Diabetes If Spouse Has Gestational Diabetes

Dr. Kaberi Dasgupta MD, MSc, FRCPC Associate Professor, Department of Medicine Divisions of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism Royal Victoria Hospital Quebec, Canada

MedicalResearch.com Interview with:
Dr. Kaberi Dasgupta MD, MSc, FRCPC
Associate Professor, Department of Medicine
Divisions of Internal Medicine, Clinical Epidemiology, and Endocrinology and Metabolism
Royal Victoria Hospital
Quebec, Canada

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Dasgupta: We know that health behaviours can contribute to developing gestational diabetes and type 2 diabetes (e.g., eating out frequently, lack of fruits and vegetables, not walking enough, spending most of the day sitting). We also know that genetic factors are important. Sometimes we focus more on the genetic factors than on health behaviours. By showing that spouses share diabetes risk, we highlight the importance that behaviour and environment play as spouses are not generally related biologically. In a previous meta-analysis, we showed that spouses were concordant for diabetes (if one had it, there was a 24% relative risk increase that the other did too.)

In the study Gestational Diabetes Mellitus in Mothers as a Diabetes Predictor in Fathers: A Retrospective Cohort Analysis, we took it further and compared men whose partners had gestational diabetes and men whose partners did not. Over a 13 year period of follow-up, the men whose partners had gestational diabetes were 33% more likely to develop diabetes. 

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Prolonged Standing Associated With Musculoskeletal Disorders and Health Problems

MedicalResearch.com Interview with:
Maria-Gabriela Garcia Ph.D candidate
Sensory-Motor Systems Lab, ETH Zurich
Zurich, Switzerland and
Dr. B.J. Martin
University of Michigan, Ann Arbor

Medical Research: What is the background for this study? What are the main findings?

Response: Many workers are required to stand for prolong periods of time at their workplace. Several investigations have associated prolonged standing with back pain, and musculoskeletal disorders.  The accumulation of muscle fatigue is assumed to lead to such disorders.  However, the long-lasting effects of fatigue in the lower limbs induced by prolonged standing work have received little attention. Our main findings indicate that 5 hours of standing work including regular seated rest breaks lead to a significant long-term fatigue in the lower leg muscles.  The objective measures showed that the effects persisted at least 30 min after a seated recovery period while they were not subjectively perceived.  Thus, subjective evaluations may not be sensitive to the long-term effects of fatigue.  In addition, fatigue was not observed after 2 hours of standing work.       Continue reading

High Coronary Calcium Score May Encourage Healthier Lifestyle

MedicalResearch.com Interview with:
Ms. Rikke Elmose Mols

Department of Cardiology, Lillebaelt Hospital-Vejle, Vejle, Denmark.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Current ESC guidelines for patients with chest pain and low to intermediate pre-test probability of coronary artery disease (CAD) recommend control and modification of risk factors. However, patients with an elevated cardiovascular risk profile are frequently inadequately motivated for lifestyle changes and medicine adherence from knowledge about risk factors and information about risk reduction alone. Coronary artery calcification (CAC) is a marker of coronary atherosclerosis. The degree of coronary artery calcification may be assessed by the Agatston score (AS) derived by non-enhanced cardiac computed tomography, whereas non-invasive CT imaging of the coronary arteries require contrast-enhancement (coronary computed tomography angiography [CTA]). The presence of CAC is associated with an elevated probability of obstructive coronary artery disease (CAD) and an unfavorable clinical outcome. In symptomatic patients, demonstration of non-obstructive CAD identified by coronary CTA is associated with risk modifying behavior and intensified prophylactic medical treatment in observational studies. Among asymptomatic individuals, those with the highest Agatston score levels seem to be motivated for the adoption of risk modifying behaviour and visualization of CAC may stimulate adherence to lipid-lowering therapy and aspirin and a healthier lifestyle. The aim of the present prospective, randomized controlled study was to test the effect of adding visualization of coronary artery calcification to the standard information about risk and lifestyle modification on cholesterol levels and other risk markers in patients with a new diagnosis of non-obstructive CAD.

Visualization of coronary artery calcification and brief recommendations about risk modification (ESC guidelines) after coronary CTA in symptomatic patients with hyperlipidemia and non-obstructive CAD may have a favorable influence on plasma total-cholesterol concentration, adherence to statin therapy and risk behavior. Further investigations are needed.

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Successful Long Term Weight Loss May Hinge On Increasing Exercise, Decreasing Alcohol

MedicalResearch.com Interview with:
Sirpa Soini, MHC, researcher
Department of General Practice and Primary Health Care
University of Helsinki

Medical Research: What is the background for this study?
Response: Short-term weight loss is often successful, but he obtained results
are difficult to maintain. Therefore, a study focusing on obese people who successfully lost weight, with special  emphasis upon methods applied and background factors,
is of major importance. Many people are successful in losing weight by
themselves without taking part in any organized group activity. The
knowledge about their success and the methods applied does not usually
reach the health care personnel and is one reason why it is difficult
to get reliable information about those who are successful in losing
weight.

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Lifestyle Factors May Limit Cognitive Decline

MedicalResearch.com Interview with:
Miia Kivipelto MD, PhD, Professor
Deputy Head, Senior Geriatrician
Aging Research Center and Alzheimer Disease Research Center
Karolinska Institutet Clinical Trials Unit, Memory Clinic
Karolinska University Hospital Stockholm, Sweden

Medical Research: What is the background for this study? What are the main findings?

Dr. Kivipelto: Epidemiological studies have linked several modifiable risk factors to cognitive impairment and dementia but evidence from randomized controlled trials (RCT) has been lacking showing the efficacy of the interventions. Because cognitive impairment, dementia and Alzheimer’s disease are complex, multi-factorial disorders, multidomain interventions targeting several risk factors and disease mechanisms simultaneously could be needed for optimum preventive effect. The FINGER study is the first large, long-term RCT indicating that multi-domain intervention can improve and maintain cognitive functioning in at risk elderly people from the general population. We observed a significant intervention effects on the primary outcome (overall cognition), main secondary outcomes (executive functioning and processing speed) as well as on complex memory tasks and risk of cognitive decline. The multidomain lifestyle intervention was feasible and safe.

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Too Much Time Spent Sitting, TV Viewing May Increase Sleep Problems

Matthew Buman PhD Asst Professor SNHP Exercise & Wellness Arizona State UniversityMedicalResearch.com Interview with:
Matthew Buman PhD Asst Professor
SNHP Exercise & Wellness
Arizona State University

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Buman: A lack of physical activity is a known risk factor for insomnia, poor sleep, and obstructive sleep apnea. In addition to physical activity, sedentary behavior has emerged as an important behavior. Sedentary behavior is not just the lack of physical activity, but actually refers to the time someone spend sitting. This behavior has been shown to, independent of physical activity, be related to many poor health outcomes including cardiovascular disease, diabetes, and even premature death. This is the first study to examine whether there is a relationship between excess sitting and insomnia, poor sleep, and risk for obstructive sleep apnea.

We found, after adjusting for physical activity and body weight (among other confounding factors), that total daily sitting was associated with poor sleep quality but not other sleep metrics or OSA risk. However, we also examined sitting while watching television and found a significant relationship between this type of sitting and a host of sleep quality metrics as well as risk for OSA. In a subsequent analysis we found that despite the independent relationship between sitting while watching television with OSA risk, those that were physically active were protected from this negative impact.

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MOVE! VA Lifestyle Program Linked To Lower Diabetes Incidence

Dr Sandra L Jackson PhD  Atlanta VA Medical Center, Decatur, GA, Nutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences Emory University, Atlanta, GA, USAMedicalResearch.com Interview with:
Dr Sandra L Jackson PhD 
Atlanta VA Medical Center, Decatur, GA, Nutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences Emory University, Atlanta, GA, USA

Medical Research: What is the background for this study? What are the main findings?

Dr. Jackson: Lifestyle change programs are aimed to improve health, yet little is known about their impact once translated into clinical settings. The Veterans Health Administration (VA) MOVE! program is the largest lifestyle change program in the U.S. Participation is a key challenge of the program, as only 13% of the eligible population participated. However, among patients who did not have diabetes at baseline, we found that MOVE! participation was associated with lower diabetes incidence.

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Healthy Lifestyle In Women Markedly Reduces Cardiovascular Risk

Andrea Kaye Chomistek ScD Assistant Professor Epidemiology and Biostatistics Indiana University BloomingtonMedicalResearch.com Interview with:
Andrea Kaye Chomistek ScD
Assistant Professor Epidemiology and Biostatistics
Indiana University Bloomington

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Chomistek:  Although mortality rates from coronary heart disease in the U.S. have been in steady decline for the last four decades, women aged 35-44 have not experienced the same reduction. This disparity may be explained by unhealthy lifestyle choices. Thus, the purpose of our study was to determine what proportion of heart disease cases and cardiovascular risk factors (diabetes, hypertension, and high cholesterol) could be attributed to unhealthy habits.

We defined healthy habits as not smoking, a normal body mass index, physical activity of at least 2.5 hours per week, watching seven or fewer hours of television a week, consumption of a maximum of one alcoholic drink per day on average, and a diet in the top 40 percent of a measure of diet quality based on the Alternative Healthy Eating Index.

We found that women who adhered to all six healthy lifestyle practices had a 92 percent lower risk of heart attack and a 66 percent lower risk of developing a risk factor for heart disease. This lower risk would mean three quarters of heart attacks and nearly half of all risk factors in younger women may have been prevented if all of the women had adhered to all six healthy lifestyle factors. Continue reading

Healthy Lifestyle, Not Supplements, Linked to Longevity

Annlia Paganini Hill PhD Project Scientist Biostatistician and Epidemiologist Department of Neurology, School of Medicine University of California, Irvine, Irvine, CaliforniaMedicalResearch.com Interview with:
Annlia Paganini Hill PhD
Project Scientist Biostatistician and Epidemiologist
Department of Neurology, School of Medicine
University of California, Irvine, Irvine, California

Medical Research: What is the background for this study? What are the main findings?

Response: Free radicals are formed when one exercises and when the body converts food to energy. Environmental sources (e.g. smoke, air pollution, sunlight) also expose the body to free radicals. Free radicals can cause “oxidative stress” and damage cells. Oxidative stress is thought to play a role in a variety of diseases: cancer, cardiovascular disease, diabetes, Alzheimer’s disease, Parkinson’s disease, cataracts, and age-related macular degeneration.

Antioxidants are man-made or natural substances that may prevent or delay some types of cell damage. Antioxidants are found in many foods and are also available as dietary supplements. Vegetables and fruits are rich sources of antioxidants. There is good scientific evidence that eating a diet with lots of vegetables and fruits is healthful and lowers risks of certain diseases. However, it is unclear whether this is because of the antioxidants, something else in these foods, other foods in people’s diet, or other lifestyle choices.

While antioxidants have been shown to counteract oxidative stress in cells and animal studies, whether consuming large amounts of antioxidant supplements benefits human health is debated. Given the continued use of vitamin supplements by a large proportion of the population and the presumed safety of antioxidant supplementation, we assessed the relationship between antioxidant vitamin intake and all-cause mortality in older adults.

We examined these associations using data from the Leisure World Cohort Study, a study of nearly 14,000 residents of a California retirement community. In the early 1980s, participants (median age, 74 years) reported details on use of vitamin supplements and dietary intake of foods containing vitamins A and C. During followup (1981-2013), over 93% of participants had died (median age at death, 88 years).

Medical Research: What are the main findings?

Response: Previously, we had found that a number of factors were associated with lower risk of death in our cohort — not smoking, physical activity, moderate alcohol consumption, caffeine intake, ideal body mass index (neither too fat nor too thin), and no history of high blood pressure, angina, heart attack, stroke, diabetes, rheumatoid arthritis, or cancer .

Neither dietary nor supplemental intake of vitamins A, C or E were significantly associated with reduced mortality in this study once these other lifestyle behaviors and disease conditions were taken into account.

In Leisure World Cohort and in the general population, health-promoting habits often cluster; e.g. those who take vitamin supplements often exercise, do not smoke, and are not obese. Thus, these factors explain the observed association between longevity and vitamin supplements in our and previous studies.

Medical Research: What should clinicians and patients take away from your report?

Response: Antioxidant supplements should not be used to replace a nutritionally adequate diet. A healthful diet characterized by high amounts of fruits and vegetables, whole grains, and fish should be recommended to avoid nutritional deficiencies and to prevent chronic disease.

Additionally, other studies have shown that high-dose antioxidant supplements may even be harmful (increased risks of prostate cancer, hemorrhagic stroke, and lung cancer in smokers). And because antioxidant supplement may interact with other medications, use of supplements should be discussed with a health care provider.

Citation:

Antioxidant Vitamin Intake and Mortality: The Leisure World Cohort Study.

Paganini-Hill A, Kawas CH, Corrada MM.
Am J Epidemiol. 2014 Dec 29. pii: kwu294. [Epub ahead of print]

 

 

 

Lifestyle Practices May Prevent Most Heart Attacks in Men

Agneta Åkesson Associate professor, senior lecturer  Photo by Anna Persson                                                                   Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedMedicalResearch.com Interview with
Agneta Åkesson
Associate professor, senior lecturer                                                  Nutritional Epidemiology
IMM Institute of Environmental Medicine
Karolinska Institutet Stockholm, Sweden

Medical Research: What are the main findings of the study?

Dr. Åkesson: Our study indicates that a healthy diet together with low-risk lifestyle practices such as being physically active, not smoking and having a moderate alcohol consumption, and with the absence of abdominal adiposity may prevent the vast majority of myocardial infarctions in men.
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Diabetic Lifestyle Interventions Reduced Hospitalizations, Medications and Costs

Mark A. EspelandMedicalResearch.com Interview with:
Mark A. Espeland PhD Professor
Department of Biostatistics
Sticht Center on Aging Center for Diabetes Research
WFU Primate Center Center for Integrative Medicine
Translational Science Institute
Wake Forest School of Medicine, Winston-Salem, NC

Medical Research: What are the main findings of the study?

Dr. Espeland : Over 10 years, overweight and obese adults with type 2 diabetes who were provided a lifestyle intervention targeting sustained weight loss and increased physical activity, lowered their rates of hospitalizations and medication use and reduced the costs of their health care by over $5,000.
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