Author Interviews, Lancet, Psychological Science / 10.12.2015

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.  (more…)
Author Interviews, Cancer, Cancer Research, JAMA / 29.10.2015

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. (more…)
Author Interviews, Diabetes, NEJM / 28.10.2015

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.  (more…)
Author Interviews, Menopause, Weight Research / 15.09.2015

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. (more…)
Author Interviews, Psychological Science, Weight Research / 10.06.2015

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. (more…)
Author Interviews, Exercise - Fitness, JAMA, NIH / 06.04.2015

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. (more…)
Author Interviews, Heart Disease, Mayo Clinic, Outcomes & Safety / 11.03.2015

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. (more…)
Author Interviews, Geriatrics, Kidney Disease / 28.02.2015

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. (more…)
Author Interviews, Education, Outcomes & Safety, Surgical Research, University of Pennsylvania / 25.02.2015

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. (more…)
Author Interviews, Weight Research / 17.02.2015

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. (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, Heart Disease / 25.01.2015

MedicalResearch.com Interview with: Dr. Maria Guzman-Castillo 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. (more…)
Annals Internal Medicine, Author Interviews, Exercise - Fitness, Lifestyle & Health / 20.01.2015

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. (more…)
Author Interviews, Weight Research / 16.06.2014

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. (more…)
Author Interviews, Diabetes, JAMA, Yale / 24.05.2014

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. (more…)
Author Interviews, CMAJ, Social Issues / 18.09.2013

MedicalResearch.com Interview with: Matthew S. Pantell, MD, MS Department of Pediatrics University of California, San Francisco MedicalResearch.com: What are the main findings of the study? Dr. Pantell: First of all, our study confirms the strong association between social isolation and mortality in a nationally representative sample from the US. Furthermore, it shows that, within the same national sample, social isolation is a similarly strong predictor of mortality as compared to smoking, obesity, high blood pressure, and high cholesterol. Examining individual components of social isolation, our study shows that, among both women and men, not living with a partner and not participating in religious activities frequently are strong individual predictors of mortality. Finally, our work shows that infrequent social contact is associated with mortality among women, and not participating in social clubs/organizations is associated with mortality among men. (more…)
Author Interviews, JAMA, Nutrition, Outcomes & Safety, Vegetarians / 06.06.2013

MedicalResearch.com eInterview with: Michael J. Orlich, M.D. Program Director Preventive Medicine Residency Loma Linda University www.lluprevmedres.org Research Fellow, Adventist Health Studies www.adventisthealthstudy.org MedicalResearch.com: What are the main findings of the study? Dr. Orlich: The main findings were these. Vegetarians, as we defined them, had reduced risk of death during the study period compared to non-vegetarians. This was true also for particular vegetarian diets including for vegans, lacto-ovo-vegetarians, and pesco-vegetarians.  Reduced risk was seen in particular for deaths related to disease of the heart, kidneys, and diabetes. Findings were stronger in men than women. (more…)