Accurate Measurements Suggest High Salt Intake Leads To Higher Death Rate

MedicalResearch.com Interview with:
Salt-Sodium
Dr. Feng J He PhD
Wolfson Institute of Preventive Medicine,
Barts and The London School of Medicine & Dentistry,
Queen Mary University of London,
London

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

Response: Studies have shown that there is a strong linear relationship between sodium intake and blood pressure and raised blood pressure is a leading cause of death and disability worldwide.

The current mean population sodium intake among adults in most countries is approximately 4,000 mg/d (10 g/d salt). The World Health Organisation (WHO) has recommended a 30% reduction in sodium intake by 2025 with an eventual target of less than 2,000 mg/d (5 g/d salt) for all countries. Several recent cohort studies have challenged the WHO’s recommendations, as these studies suggested that there was a J or U-shaped relationship between sodium and risk, i.e. lower and higher sodium intake both were associated with an increased risk of cardiovascular events and deaths.

However, these studies have several severe methodological problems, one of which is the use of a biased or unreliable estimate of individual’s usual sodium intake, e.g. a single spot urine with the Kawasaki formula.

Our study, for the first time, has compared the relationship of sodium intake and mortality, based on various methods to assess usual sodium intake, including estimates based on the Kawasaki formula (single and average of multiple days) and a single measured 24-hour urine, with the gold standard method, i.e. the average of multiple non-consecutive measured 24-h urines.

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How Does Alcohol Affect Risk of Cancer or Premature Death?

MedicalResearch.com Interview with:
“Alcohol” by zeevveez is licensed under CC BY 2.0Andrew Kunzmann
Research Fellow
Queen’s Universit
Belfast

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

Response: We decided to conduct this research because the messages about the health effects linked to light-moderate drinking are less consistent. Previous studies suggest that light-moderate drinking is linked to an increased risk of cancer but a lower risk of mortality than never drinking. The international guidelines around what constitutes drinking in moderation also differ, with UK guidelines now recommending intakes below 6 pints of beer or 175ml glasses of wine per week (equivalent to less than 1 per day) but other guidelines recommending intakes of 2 drinks or less per day. We wanted to see what the risk of getting either of these conditions (cancer or mortality) were to give a more comprehensive and less confusing message about the health effects of light-moderate drinking.

This was part of a well-established collaboration between Queen’s University Belfast and the National Cancer Institute in the US. We used data from a cancer screening trial in the US that contained data on over 100,000 people from the US, who were free from cancer at the start of the study and who completed a questionnaire asking how much alcohol they consumed at different periods of their adult life. This was then linked to data over an average of 9 years after they completed the questionnaire to see which individuals developed cancer or died from any cause. We then assessed whether risk of cancer and mortality differed based on lifetime alcohol intakes after accounting for a number of other factors such as age, educational attainment, smoking and dietary intakes.

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Premature Mortality in Rheumatoid Arthritis Reduced With Early Treatment

MedicalResearch.com Interview with:
Maarten Boers, MSc, MD, PhD

Professor of Clinical Epidemiology
Department of Epidemiology and Biostatistics
VU University Medical Center–F wing MedFac
Amsterdam, Netherlands

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

Response: Mortality in rheumatoid arthritis is increased. Recent (short-term) studies suggest the situation is improving, but in studies with long (>10-year) follow up the increased mortality persists.

We have been following a trial cohort of rheumatoid arthritis patients treated right from the beginning of disease (the COBRA trial) for 23 years and now, for the first time, show normal mortality compared to the general population.

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Night Owls Risk Dying Early

MedicalResearch.com Interview with:
“Sleep” by Spencer Smith is licensed under CC BY 2.0Kristen L. Knutson, PhD

Associate Professor
Center for Circadian and Sleep Medicine
Department of Neurology
Northwestern University Feinberg School of Medicine
Chicago, IL  60611​

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

Response: Previous research has shown that “night owls” (people who prefer the evening) have higher rates of diseases such as diabetes or high blood pressure.  We wanted to determine whether mortality risk was also higher in night owls. We used data from the UK Biobank of almost a half million people who were asked whether they were morning or evening types.

We found that the night owls had a 10% increased risk of dying over a 6 ½ year period compared to the morning types, even after taking into account existing health problems.

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2015 Marked First Decline In Life Expectancy in Over 20 Years

MedicalResearch.com Interview with:

Francesco Acciai PhD Postdoctoral Research Associate Food Policy and Environmental Research Group School of Nutrition and Health Promotion University of Arizona

Dr. Acciai

Francesco Acciai PhD
Postdoctoral Research Associate
Food Policy and Environmental Research Group
School of Nutrition and Health Promotion
Arizona State University

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

Response: In 2015 life expectancy at birth (e0) in the United States was lower than it was in 2014. In the previous 30 years, a reduction in life expectancy at the national level had occurred only one time, in 1993, during the HIV/AIDS epidemic. The decrease in life expectancy observed in 2015 is particularly worrisome because it was not generated by an anomalous spike in a specific cause of death (like HIV/AIDS in 1993). Instead, age-adjusted death rates increased for 8 of the 10 leading causes of death—heart disease, chronic lower respiratory diseases, accidents, stroke, Alzheimer’s, diabetes, kidney disease, and suicide, according to the CDC.

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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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Poor Functional Status Predicts Increased Mortality After Dialysis Initiation

MedicalResearch.com Interview with:

Silvi Shah, MD, FACP, FASN Assistant Professor, Division of Nephrology University of Cincinnati Cincinnati, OH

Dr. Shah

Silvi Shah, MD, FACP, FASN|
Assistant Professor
Division of Nephrology
University of Cincinnati
Cincinnati, OH

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

Response: Elderly represent the fastest growing segment of incident dialysis patients in Unites States. The annual mortality in end stage renal disease (ESRD) patients is very high ~ 20%.

Since most of the deaths occur in the first year of dialysis, it is possible that health conditions present prior to initiation of dialysis may impact long-term outcomes. In this study, we determined the impact of poor functional status at the time of dialysis initiation and pre-dialysis health status on type of dialysis modality, type of hemodialysis access and one-year mortality in elderly dialysis patients. We evaluated 49,645 adult incident dialysis patients (1/1/2008 to 12/31/2008) from the United Data Renal Data System (USRDS) with linked Medicare data for at least 2 years prior to dialysis initiation. Mean age of our study population was 72 years. At dialysis initiation, 18.7% reported poor functional status, 88.9% has pre-dialysis hospitalization, and 27.8% did not receive pre-dialysis nephrology care. Patients with poor functional status had higher odds of being initiated on hemodialysis than peritoneal dialysis, lower odds of using arteriovenous access as compared to central venous catheter for dialysis and higher risk of one-year mortality.

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Premature Midlife Deaths Increase in US Whites and Native Americans

Dr. Meredith Shiels

Dr. Meredith Shiels

MedicalResearch.com Interview with:
Dr Meredith S Shiels

Division of Cancer Epidemiology and Genetics
National Cancer Institute
Bethesda, MD

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

Response: In most high-income countries, premature death rates have been declining, due to the overwhelming successes of public health efforts to prevent and treat chronic disease. The US is a major outlier, where death rates overall have plateaued, or even increased, as reported recently by our sister agency, the Centers for Disease Control and Prevention. Of particular concern are recent reports of increasing death rates among Americans during mid-life.

To expand upon prior findings, we focused on premature death, which we defined as death occurring between the ages of 25 and 64. We examined finely detailed death certificate data for the entire U.S. population and described changes in death rates during 1999-2014 by cause of death, sex, race, ethnicity, and geography. To provide context to our findings, we compared trends in death rates in the U.S. to England and Wales and Canada.

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Early Menopause Linked To Increased Risk of Heart Disease and Carotid Atherosclerosis

MedicalResearch.com Interview with:
Taulant Muka, MD, MPH, PhD
Postdoctoral Researcher
Erasmus University, Rotterdam

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

Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis.

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All-Cause Mortality Increased in Women With History of Child Abuse

MedicalResearch.com Interview with:

Edith Chen, Ph.D. Professor Faculty Fellow, Institute for Policy Research Northwestern University Department of Psychology Evanston, IL 60208-2710

Dr. Edith Chen

Edith Chen, Ph.D. Professor
Faculty Fellow, Institute for Policy Research
Northwestern University
Department of Psychology
Evanston, IL 60208-2710

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

Response: Previous research has documented psychiatric consequences of childhood abuse, but less is known about possible physical health consequences.

The main finding is that women who self-reported childhood abuse (in adulthood) were at greater risk for all-cause mortality compared to those who did not report abuse.

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Being Unhappy Doesn’t Shorten Your Life

Dr Bette Liu MD PhD University of New South Wales Sydney, NSW

Dr. Bette Liu

MedicalResearch.com Interview with:
Dr Bette Liu MD PhD
University of New South Wales
Sydney, NSW

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

Dr. Liu: There is a generally held belief that being happier makes you live longer. We wanted to look at this question. We examined over 700,000 women enrolled in the UK Million Women Study. We found that being in poor health was associated with being unhappy but after accounting for an individuals poor health, unhappiness in itself was not associated with an increased risk of death. This finding was true for overall deaths, for deaths from heart disease and from cancer and it was true for stress as well as for unhappiness. 

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US Continues To Make Progress in Mortality Reduction

Jiemin Ma, PhD, MHS Director of Surveillance and Health Services Research American Cancer SocietyMedicalResearch.com Interview with:
Jiemin Ma, PhD, MHS
Director of Surveillance and Health Services Research
American Cancer Society

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

Dr. Ma: This study is an analysis of long-term trends in mortality for all causes combined and for 6 leading causes of death, including heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD), unintentional injuries, and diabetes, in the United States from 1969 through 2013. We found that death rates for all causes and for five of these 6 leading causes (except COPD) decreased during this time period, although the rate of decrease appears to have slowed for heart disease, stroke, and diabetes. COPD death rates doubled during this time period, although the rate began to decrease in men since 1999.

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Improving Diabetes Control Means Decreasing Mortality

Marcus Lind, M.D., Ph.D Department of Medicine, Uddevalla Hospital Uddevalla, Swede

MedicalResearch.com Interview with:
Marcus Lind, M.D., Ph.D
Department of Medicine, Uddevalla Hospital
Uddevalla, Swede


Medical Research: What is the background for this study?

Dr. Lind:  One of the main goals of the diabetes care is to reduce excess mortality in individuals with type 2 diabetes close to that of the general population. We want patients to have a similar life expectancy as individuals in the general population. Earlier studies have shown that targeting good glucose levels, blood lipid and blood pressure levels are beneficial with respect to decrease cardiovascular disease being the main cause for mortality. We wanted to evaluate the prognosis for individuals with type 2 diabetes today in Sweden.

Further, earlier population-based studies have generally assessed mortality rates only on a group level whereas we believe the prognosis differs greatly depending on various factors such as how well risk factor control is obtained in clinical practice. The Swedish Diabetes Registry include more than 90% of all individuals with type 2 diabetes in Sweden and information of e.g. the glycaemic control, measured by a biomarker called A1c exists for most persons. There were 97% who had at least 1 measurement. Also most patients had information of other risk factors, among others renal complications which we believed were of special concern.  Continue reading

Is Lean Always Better? Body Fat and Mortality Not Linked In Older Women

Jennifer W. Bea, PhD Assistant Professor, Medicine Assistant Research Scientist, Nutritional Sciences University of Arizona Cancer Center Tucson, AZ 85724-0524MedicalResearch.com Interview with:
Jennifer W. Bea, PhD
Assistant Professor, Medicine
Assistant Research Scientist, Nutritional Sciences
University of Arizona Cancer Center
Tucson, AZ 85724-0524

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

Dr. Bea: The analysis was based on a subgroup of the largest study of post-menopausal women in the United States, Women’s Health Initiative (WHI), which has been answering important questions about health and wellness among post-menopausal women since the 1990s. In the analysis, body mass index, a proxy for body fat, and actual body composition (i.e. fat and muscle mass) determined by an imaging technique called dual energy X-ray absorptiometry (DXA) were used to predict risk of death. In the younger post-menopausal women,  aged 50–59 years, higher body fat increased risk of death by more than 2 times and the highest muscle mass decreased risk of death by almost 60%. Importantly, the relationships were reversed among the older women, aged 70–79 years (P < 0.05). These results were true in spite of BMIs in these groups spanning nearly the full range of possible BMIs (16.4–69.1kg/m2). These data indicate that BMI does not estimate mortality risk as well as we would hope among post- menopausal women.

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Social Support From Friends and Family Linked To Lower Mortality

MedicalResearch.com Interview with:
Katie Becofsky Ph.D.
Weight Control and Diabetes Research Center
The Miriam Hospital
Providence, RI

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

Dr. Becofsky: Previous research has provided clear evidence of a relationship between social relations (e.g., frequency of social participation, perceived social support) and mortality risk.  We investigated two specific aspects of social relations- source of social support and size of weekly social network- in more detail.  The purpose of our study was to examine the associations between different sources of social support (relative, friend, and partner support), as well as size (and source) of weekly social network, on mortality risk in a large cohort of patients from the Aerobics Center Longitudinal Study. We found that perceived support from one’s spouse/partner and relatives, as well as weekly social interaction with a network of 6-7 friends, was associated with lower long-term mortality risk.  When the sources were reversed, the effects did not stand- perceived social support from friends did not affect mortality risk, nor did the quantity of weekly familial contacts. Continue reading

Study Show Close Link Between Leisure Time Exercise and Mortality

MedicalResearch.com Interview with: Hannah Arem, MHS, PhD Division of Cancer Epidemiology and Genetics National Cancer Institute, Bethesda, MarylandMedicalResearch.com Interview with:
Hannah Arem, MHS, PhD
Division of Cancer Epidemiology and Genetics
National Cancer Institute, Bethesda, Maryland

Medical Research: What is the background for this study?

Dr. Arem: The 2008 Physical Activity Guidelines for Americans recommend a minimum of 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity per week for “substantial” health benefit, and suggest “additional” benefit with more than double the exercise minimum. However, the guidelines note that there is a lack of evidence for an upper limit of health benefit. We set out to define the dose-response relationship between leisure-time physical activity and mortality and to determine the upper limit of benefit associated with higher levels of aerobic exercise.

Medical Research: What are the main findings?

Dr. Arem: We found that study participants who met the recommended minimum level of leisure-time physical activity derived most of the mortality benefit, with a 31% lower risk of death compared to inactive individuals. Study participants who engaged in three to five times the recommended minimum level of leisure-time physical activity had a marginally increased mortality benefit, with a 39% lower risk of death compared to inactive individuals. Three to five times the recommended minimum is equivalent to a weekly minimum of walking 7 hours or running 2 hours 15 minutes.

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‘Leadership Saves Lives’ Program Aims To Reduce Heart Attack Mortality

Dr. Leslie CurryMedicalResearch.com Interview with:
Leslie Curry PhD, MPH
Senior Research Scientist in and Lecturer in Public Health (Health Policy)
Co-Director, Robert Wood Johnson Clinical Scholars Program
Yale School of Public Health

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

Dr. Curry: Quality of care for patients with acute myocardial infarction (AMI) has improved substantially in recent years due to important investments by clinicians and policymakers; however, survival rates across U.S. Hospitals still differ greatly. Evidence suggests links between hospital organizational culture and hospital performance in care of patients with AMI. Yet few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with acute myocardial infarction.  We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL). We have a large team of people with backgrounds in nursing, medicine, health care administration and research working in 10 very diverse hospitals across the country in 10 states. All hospitals are members of the Mayo Clinic Care Network and are fully committed to saving lives of patients with heart attacks. Teams of 10-12 clinicians and administrators are devoting substantial energy, expertise and good will to this project.

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Equation Helps Predict Mortality In Elderly Patients With Chronic Kidney Disease

Nisha Bansal MD MAS Assistant Professor Associate Program Director for Research Kidney Research Institute Division of Nephrology University of WashingtonMedicalResearch.com Interview with:
Nisha Bansal MD MAS
Assistant Professor
Associate Program Director for Research
Kidney Research Institute Division of Nephrology
University of Washington

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

Dr. Bansal: We pursued this study to develop a prediction equation for death among elderly patients with chronic kidney disease (CKD), a high-risk patient population that is often difficult to manage given competing risks of end stage renal disease (ESRD) vs. death. In this paper, we developed and validated a simple prediction equation using variables that are readily available to all clinicians.

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Shorter Hospital Stay For Hip Fracture Linked To Higher Mortality After Discharge

Prof. Peter Nordström Department of Community Medicine and Rehabilitation Geriatrics, Umeå University Umeå, SwedenMedicalResearch.com Interview with:
Prof. Peter Nordström

Department of Community Medicine and Rehabilitation
Geriatrics, Umeå University
Umeå, Sweden

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

Prof. Nordström: The number of elderly people is increasing, while the number of hospital beds is decreasing in Europe, which may be related to economic constraints and a more efficient health care. This may have contributed to a shorter length of stay in hospital after surgery. We found that a length of stay (LOS) of ten days or less was associated with a progressive increased risk of death after discharge from hospital.

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

Prof. Nordström: That a length of stay (LOS) of ten days or less is associated with a progressive increased risk of death after discharge from hospital in patients with a hip fracture.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Prof. Nordström: In addition to evaluation of also other diagnoses than hip fractures, further research should seek to gain a better understanding of the underlying cause of the increased risk of death after discharge in surgical patients, and evaluate whether early discharge to rehabilitation centers or nursing homes is associated with a worse outcome.

Citation:

Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden
Peter Nordström, professor, Yngve Gustafson, professor, Karl Michaëlsson, professor, Anna Nordström, associate professor

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h696 (Published 20 February 2015) Cite this as: BMJ 2015;350:h696

MedicalResearch.com Interview with: Prof. Peter Nordström (2015). Shorter Hospital Stay For Hip Fracture Linked To Higher Mortality After Discharge 

New and Experienced Surgeons Have Similar Patient Mortality Rates

Samuel D. Pimentel Doctoral student Statistics Department Wharton School of the University of PennsylvaniaMedicalResearch.com Interview with:
Samuel D. Pimentel
Doctoral student Statistics Department
Wharton School of the University of Pennsylvania

 

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

Response: Surgical training has undergone major changes in recent years – including a reduction of six to twelve months of training time – and there is controversy about whether these changes have been good or bad for patient outcomes.   Our work partially addresses the issue by asking whether newly-trained surgeons perform better or worse than experienced surgeons.  We compared surgical patients treated by new surgeons to a similar group of patients treated by experienced surgeons using a new statistical technique called large, sparse optimal matching.  Our analysis found no significant differences in mortality rates between the two groups.
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High Fat-Free Mass Linked To Lower Mortality In Men

Dr. med. Laurence Genton, FMH Médecine Interne Médecin adjointe agrégée, chargée de cours Nutrition Clinique Hôpitaux universitaires de Genève GenèveMedicalResearch.com Interview with:
Dr. med. Laurence Genton
, FMH Médecine Interne
Médecin adjointe agrégée, chargée de cours
Nutrition Clinique
Hôpitaux universitaires de Genève
Genève

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

Response: Several studies have shown that body mass index is linked to mortality through a U- or J-curve, i.e. that a low and maybe a high body mass index are related to a higher risk of mortality in elderly people. However, body mass index consists of fat mass and fat-free mass, and the former studies cannot differentiate the impact of these body compartments. However, this differentiation may be important to guide our public health care strategies. For instance, fat and fat-free mass can both be reduced by hypocaloric diet and endurance exercise, while fat-free mass can be increased with adequate calorie and protein intakes, resistance exercise and anabolic treatments. Thus, this study aimed at evaluating the impact of fat mass and fat-free mass on mortality.

We found that body mass index and body composition did not predict mortality in older women. However, a high fat-free mass was associated with a lower risk of mortality in men, even when adjusting for body mass index. Continue reading

Coronary Heart Disease Deaths Fall Due to Population Decreases in Blood Pressure and Cholesterol

MedicalResearch.com Interview with:
Dr. Maria Guzman-Castill
o
Department of Public Health and Policy
University of Liverpool, Liverpool, UK

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

Dr. Guzman-Castillo: The UK has experienced a remarkable 60% reduction in coronary heart disease (CHD) mortality since the 1970s. However CHD remains the leading cause of premature death.

The aim of our study was to analyse the recent falls in coronary heart disease mortality and quantify the relative contributions from preventive medications and from population-wide changes in blood pressure and cholesterol levels, particularly exploring the potential effects on socioeconomic inequalities, an aspect not well explored in the past.

Our study found that, approximately 22,500 fewer deaths were attributable to reductions in blood pressure and cholesterol in the English population between 2000-2007.

The substantial decline in blood pressure was responsible for approximately 13,000 fewer deaths. Approximately 1,800 fewer deaths came from medications and some 11,200 fewer deaths from population-wide changes. Reduction in population blood pressure fewer deaths in the most deprived quintile compared with the most affluent.

Reduction in cholesterol resulted in substantially smaller gains, approximately 7,400 fewer deaths; approximately 5,300 fewer deaths were attributable to statin use and approximately 2,100 DPPs to population-wide changes. Interestingly, statins prevented more deaths in the most affluent quintile compared with the most deprived. Conversely, population-wide changes in cholesterol prevented threefold more deaths in the most deprived quintile compared with the most affluent.

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Sitting Time Linked To Increased Heart Disease and Cancer Mortality

David Alter, MD, PhD FRCPC Senior Scientist Toronto Rehabilitation Institute-University Health Network and Institute for Clinical Evaluative Sciences Research Director, Cardiac Rehabilitation and Secondary Prevention Program Toronto Rehabilitation InstituteMedicalResearch.com Interview with:
David Alter, MD, PhD FRCPC Senior Scientist

Toronto Rehabilitation Institute-University Health Network and Institute for Clinical Evaluative Sciences
Research Director, Cardiac Rehabilitation and Secondary Prevention Program Toronto Rehabilitation Institute

 

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

Dr. Alter: We knew going into the study that exercise was an important lifestyle factor that improved health. We also knew from studies that sedentary time was associated with deleterious health-effects. What we didn’t know was whether the health-outcome effects of sedentary time and exercise were really one and the same (i.e., albeit opposite ends of the same spectrum) or alternatively, whether the health effects of each were independent of one another.  We explored over 9000 published studies to quantify the health-outcome effects associated with sedentary behaviour and extracted only those which took into account both sedentary time and exercise. We found a consistent association between sedentary time and a host of health outcomes independent of exercise. Specifically, after controlling for an individual’s exercising behaviour, sitting-time was associated with a 15-20% higher risk of death, heart-disease, death from heart disease, cancer-incidence, and death from cancer. Sitting time was also independently  associated with a marked (i.e., 90% increase) in the risk for diabetes after controlling for exercise. In short, sedentary times and exercise are each independently associated with health outcomes. We hypothesize that the two may have different mechanism, and may require different therapeutic strategies. But, the health-outcome implications of both are each important in their own right.

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Obesity and Mortality: Association Varies By Age, Gender

Tapan Mehta, Ph.D. Assistant Professor School of Health Professions University of Alabama at BirminghamMedicalResearch.com: Interview with
Tapan Mehta, Ph.D.
Assistant Professor
School of Health Professions
University of Alabama at Birmingham


MedicalResearch: What are the main findings of the study?

Dr. Mehta: Grade 1 obesity’s (body mass index [BMI] 30 to < 35) association with reduced longevity has lessened over calendar time for older white men (age >60) but not for younger middle aged (age ≤60) men. For white women, there is evidence of a decline in the association of obesity, both for Grade 1 obesity and grade 2-3 obesity (BMI ≥35), with reduced longevity across all adult ages.

To the extent that these associations can be taken as indicators of causation, this implies that the harmfulness of obesity-mortality association has declined over calendar time in white women across all ages. However, the decline in the harmfulness of obesity-mortality association is limited to older grade 1 obese white men.
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Diabetes: In-Hospital Mortality Risk Has Decreased Over Time

MedicalResearch.com Interview with:
Neel M. Butala, AB
Medical student at Yale School of Medicine
New Haven, Connecticut

MedicalResearch.com: What are the main findings of the study?

Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010.

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