Changes in WIC Program Linked to Decreased Obesity in Children

MedicalResearch.com Interview with:

M. Pia Chaparro, MS, PhDAssistant ProfessorDepartment of Global Community Health and Behavioral SciencesSchool of Public Health and Tropical MedicineTulane UniversityNew Orleans, LA 70112

Dr. Chaparro

M. Pia Chaparro, MS, PhD
Assistant Professor
Department of Global Community Health and Behavioral Sciences
School of Public Health and Tropical Medicine
Tulane University
New Orleans, LA 70112

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

Response: In 2009, the WIC program changed the food packages participants receive to better align them with federal dietary guidelines. These changes included the addition of fruits, vegetables, and whole grains; a reduction in the amount of dairy and juice; and a calibration in formula amounts to match infants’ age and needs.

We found that this change in the food package was associated with a 10-12% lower obesity risk at age 4 years among children who participated in WIC in Los Angeles County continuously from birth until age 4. Continue reading

Overweight and Obese Young Adults at Decreased Risk of Acne

MedicalResearch.com Interview with:
Igor Snast, MD
Department of Dermatology
Rabin Medical Center–Beilinson Hospital
Israel

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

Response: Acne is the most common skin disorder among adolescents. Obesity has been suggested to promote acne, however various studies evaluating the relationship between obesity and acne have yielded contradictory outcomes.

Our population-based study demonstrates that overweight, obese and severely obese youths have decreased odds of having acne (20%, 35% and 50% respectively) compared to normal-weight subjects. Continue reading

Gout Medication Colchicine May Mitigate Inflammatory Effects of Obesity

MedicalResearch.com Interview with:

Jack A. Yanovski, MD, PhDSenior InvestigatorSection on Growth and Obesity, DIR, NICHDNational Institutes of HealthHatfield Clinical Research CenterBethesda, MD 20892‐1103

Dr. Yanovski

Jack A. Yanovski, MD, PhD
Senior Investigator
Section on Growth and Obesity, DIR, NICHD
National Institutes of Health
Hatfield Clinical Research Center
Bethesda, MD 20892‐1103

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

Response: Studies of both mouse models and people suggest that obesity induced inflammation may promote insulin resistance and progression to diabetes. Others have proposed that suppressing this chronic, low level inflammation may slow the onset of diabetes. Nod-like Receptor Family Pyrin Domain Containing 3 (NLRP3) has recently been shown to play a strong role in promoting the inflammatory state in obesity. Colchicine, traditionally used to suppress or prevent inflammation in gout and other disorders is believed to inhibit formation of the NLRP3 inflammasome. Our group hypothesized that colchicine would improve obesity associated inflammation in adults with metabolic syndrome who had not yet developed type 2 diabetes.

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Oxytocin Reduces Activation of Brain Areas Linked to Stimulation by High Calorie Food Images

MedicalResearch.com Interview with:

Liya Kerem, MDFellow, Pediatric Endocrine UnitMassachusetts General Hospital for ChildrenHarvard Medical School

Dr. Kerem

Liya Kerem, MD
Fellow, Pediatric Endocrine Unit
Massachusetts General Hospital for Children
Harvard Medical School

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

Response: The hypothalamic neurohormone Oxytocin (OXT), shown to decrease food intake in animals and humans, is a promising novel treatment for obesity. We previously showed that in men with overweight/obesity, intranasal (IN)OXT reduced the fMRI activation in the ventral tegmental area (VTA), the origin of the mesolimbic dopaminergic reward system, in response to high-calorie food vs non-food visual stimuli.

Here, we employed fMRI functional connectivity analysis, which better characterizes the exchange in information between neural systems in a context-dependent manner. We hypothesized that Oxytocin would reduce the functional connectivity of the VTA with food motivation brain areas in response to high-calorie foods.  Continue reading

Chemicals in Household Dust May Promote Fat-Cell Development

MedicalResearch.com Interview with:

Christopher D. Kassotis, Ph.D.NRSA Postdoctoral Research ScholarStapleton LabDuke UniversityNicholas School of the EnvironmentDurham, NC 27708 

Dr. Kassotis

Christopher D. Kassotis, Ph.D.
NRSA Postdoctoral Research Scholar
Stapleton Lab
Duke University
Nicholas School of the Environment
Durham, NC 27708 

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

  • So this was something that Heather Stapleton had been curious about for years, as she’s been one of several researchers characterizing the hundreds of chemicals that have been measured in indoor house dust. Before I came to Duke, one of her PhD students had measured the ability of many common indoor contaminants to activate the peroxisome proliferator activated receptor gamma (PPARg). The majority of these chemicals did, often quite well, which led to them testing indoor house dust extracts, also finding that the majority of dust extracts were also able to do so at very low levels. As PPARg is often considered the master regulator of fat cell development, the next obvious question was whether these common contaminants (and house dust) could promote fat cell development in cell models. My first work at Duke evaluated a suite of common indoor contaminants, finding that many of these chemicals could promote fat cell development, and that low levels of house dust extracts did as well.
  • We next explored this more systematically in a group of adults involved in a thyroid cancer cohort (this was just recently published in Science of the Total Environment:
    https://www.sciencedirect.com/science/article/pii/S0048969719307715?dgcid=author
  • In this study we evaluated the extent to which house dust extracts could promote fat cell development in a common cell model, and associated this with the metabolic health of adults living in these homes. We found that the greater extent of fat cell development was associated with significantly greater thyroid stimulating hormone concentrations (control residents only, with no evidence of thyroid dysfunction) and lower free triiodothyronine (T3) and thyroxine (T4). We further found a significant and positive association between extent of fat cell development and the body mass index (BMI) of all adults in the study. So this suggested that the indoor environment might play a role in the BMI and metabolic health of residents, and we next wondered if this would be more pronounced in children, who may be exposed to these contaminants during a critical window of development.
  • The next step, for our current work, was to substantiate these effects in a larger group of households, each with children.
  • Our major conclusions thus far have been that ~80% of house dust extracts promote significant fat cell development in a cell model – either via development from precursor cells into mature fat cells, measured via accumulation of lipids into the cells, or via the proliferation of those precursor fat cells. We also reported positive correlations of fat cell development with the concentrations of 70 different contaminants in the dust from these homes, suggesting that mixtures of contaminants are likely all acting weakly to produce these effects in combination. We’ve also begun to assess the other chemicals present in dust – chemistry can be either targeted (measuring concentrations of specific known chemicals in a sample), or non-targeted, where you try and determine the identity of the other chemicals in a sample. This has greater utility for identifying many more chemicals, though you will often not get chemical concentrations from this, nor absolute confirmed identification – just varying degrees of certainty based on evidence.

    Thus far we report approximately 35,000 chemicals in house dust samples across this study, and differential analyses have begun to pick out the few (less than 10 in each case) chemicals most differentially expressed between samples that exhibit high degrees of fat cell development in the lab vs inactive samples, for example, or which are differentially present in the homes of children categorized as obese or overweight. We are now working to confirm identity of these select contaminants that are more likely to be causative factors in the results we have observed.

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Combination of Alcohol and High BMI Linked to Liver Injury Biomarkers

MedicalResearch.com Interview with:
Alice R Carter MSc
Doctor of Philosophy Student
MRC Integrative Epidemiology Unit
Population Health Science, Bristol Medical School
University of Bristol

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

Response: Higher body mass index and alcohol intake have been shown to increase the risk of liver disease. Some studies have looked at their combined effect by comparing the risk of liver disease between individuals with both high BMI and high alcohol intake and individuals with low BMI and low alcohol intake. However, these studies have produced mixed results. Some possible reasons for that are errors in self-reported BMI and alcohol intake, other factors confounding the association of BMI & alcohol intake with liver disease risk and changes in lifestyle that individuals with ill health may have been advised to adopt.

One way to overcome these limitations is to use a technique called Mendelian randomisation. This method uses genetic differences between individuals that influence their characteristics (e.g. their body mass and how much alcohol they drink) to help understand whether these characteristics are causally related to diseases.

Our study used this method to explore the joint effects of BMI and alcohol consumption on liver disease and biomarkers of liver injury.  Continue reading

BELVIQ®: FDA accepts sNDA To Include Long Term Safety/Efficacy Data

WeightControl.com Interview with:

Dr. Lynn Kramer, MD FAANVP and Chief Clinical Officer & Chief Medical OfficeEisai Co., Ltd

Dr. Kramer

Dr. Lynn Kramer, MD FAAN
VP and Chief Clinical Officer & Chief Medical Office
Eisai Co., Ltd

WeightControl.com: What is the background for this announcement?

Response: On February 25th, Eisai announced that the U.S. Food and Drug Administration (FDA) accepted its supplemental New Drug Application to potentially update the label for BELVIQ® (lorcaserin HCI) CIV 10 mg twice-daily/BELVIQ XR (lorcaserin HCI) CIV once daily to include long-term efficacy and safety data from CAMELLIA-TIMI 61, a clinical trial of BELVIQ in 12,000 overweight and obese patients with cardiovascular (CV) disease and/or multiple CV risk factors such as type 2 diabetes mellitus (T2DM).

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Fast Food Servings Have Gotten Bigger and Saltier

MedicalResearch.com Interview with:

Megan A McCrory, PhD, FTOSResearch Associate ProfessorDept of Health SciencesSargent College of Health and Rehabilitation SciencesBoston University 02215

Dr. McCrory

Megan A McCrory, PhD, FTOS
Research Associate Professor
Dept of Health Sciences
Sargent College of Health and Rehabilitation Sciences
Boston University 02215

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

Response: The prevalence of overweight and obesity has increased in the US, along with documented increases in portion size in the food supply. Fast food is popular, making up about 11% of adult daily calorie intake in the US, and over 1/3 of U.S. adults eat at fast food establishments on any given day. We therefore sought to examine changes in portion size, calories, and selected nutrients in fast-food entree, side, and dessert menu items across the years 1986, 1991, and 2016.

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Supplements Did Not Prevent Depression in Study of Obese Adults

MedicalResearch.com Interview with:

Prof. Marjolein Visser PhDProfessor of Healthy AgingHead section Nutrition and HealthDepartment of Health Sciences, Vrije Universiteit AmsterdamAmsterdam Public Health research institute

Dr. Visser

Prof. Marjolein Visser PhD
Professor of Healthy Aging
Head section Nutrition and Health
Department of Health Sciences, Vrije Universiteit Amsterdam
Amsterdam Public Health research institute

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

Response: More than 40 million Europeans experience a major depressive disorder. One in ten men, and one in five women suffer from clinical depression at least once during their lifetime. Depression is one of the most prevalent and disabling disorders in the EU.

Given the increasing prevalence of depression, more people are actively searching for ways to decrease their risk through lifestyle modification, but are often overwhelmed by confusing and contradictory information.

The MooDFOOD prevention trial is the largest randomized clinical trial to study the effects of nutritional strategies on the prevention of major depressive disorder. Over 1000 overweight or obese participants identified as being at elevated risk for depression but who were not currently depressed, from four European countries -the Netherlands, the United Kingdom, Germany and Spain, took part in the study. Participants were randomized to either take nutritional supplements containing folic acid, vitamin D, zinc, selenium or to a pill placebo, and half of participants also received a behavioral lifestyle intervention intended to change dietary behaviors and patterns.

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Obesity and Depression Can Be Treated With Collaborative Care

MedicalResearch.com Interview with:

Jun Ma, MD, PhD, FAHA, FABMRProfessor and Associate Head of Research, Department of MedicineDirector, Center for Health Behavior ResearchThe University of Illinois at Chicago

Dr. Jun Ma

Jun Ma, MD, PhD, FAHA, FABMR
Professor and Associate Head of Research
Department of Medicine
Director, Center for Health Behavior Research
The University of Illinois at Chicago

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

Response: Obesity and depression are major public health problems. Obesity affects 40% of United States (US) adults. About 20% in US women and 13% in men experience major depressive disorder at some point in their lifetime and, additionally, many adults have elevated depressive symptoms that do not meet clinical diagnostic criteria but can nevertheless negatively affect their health and quality of life. Obesity and depression share common risk factors, such as poor diet and lack of exercise, and cause other health problems, such as diabetes and cardiovascular disease. People with obesity are at increased risk of being depressed and, likewise, people with depression are at increased risk of being obese. Consequently, obesity and depression often co-occur. To date, there has been no integrated therapy to effectively treat patients affected by both conditions at the same time.

The RAINBOW randomized clinical trial addressed this gap.

The main finding from the trial is that, among adult patients with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improve weight loss and depressive symptoms over one year compared with usual care, which patients received through their primary care physicians. 

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Is Behavioral Change Among Overweight Diabetics Feasible and Sustainable?

MedicalResearch.com Interview with:
Giuseppe Pugliese, MD, PhD
for the Italian Diabetes and Exercise Study 2 (IDES_2) Investigators
Department of Clinical and Molecular Medicine
‘‘La Sapienza’’ University
Diabetes Unit, Sant’Andrea University Hospital
Rome, Italy

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

Response: There is a growing epidemic of obesity and type 2 diabetes worldwide,
which are causally related to the increasing prevalence of “physical
inactivity”, i.e., an insufficient amount of moderate-to-vigorous
physical activity according to current guidelines, and
“sedentariness”, i.e., too many hours, especially if uninterrupted,
spent in a sitting or reclined position.  These two unhealthy
behaviors exert their detrimental effects independently of each other
and are very common among people suffering from type 2 diabetes, who
would therefore benefit from increasing physical activity and reducing
sedentary time, as recommended by current guidelines.

However, such a behavior change is generally difficult for a number of
internal and external barriers and requires behavioral interventions
targeting both physical activity and sedentary habits.  Unfortunately,
there is no definitive evidence that this is indeed feasible and,
particularly, that, if adopted, change in behavior can be maintained
in the long term.  Continue reading

Genes Help Determine Whether You Are Shaped Like an Apple or Pear

MedicalResearch.com Interview with:

Ruth Loos, PhD The Charles Bronfman Professor in Personalized Medicine Director, Genetics of Obesity and Related Traits Program Co-Director, Charles Bronfman Institute for Personalized Medicine Icahn School of Medicine at Mount Sinai New York, NY

Dr. Loos


Ruth Loos, PhD
The Charles Bronfman Professor in Personalized Medicine
Director, Genetics of Obesity and Related Traits Program
Co-Director, Charles Bronfman Institute for Personalized Medicine
Icahn School of Medicine at Mount Sinai
New York, NY

 

 

MedicalResearch.com: What is the background for this study? Which type of body fat distribution carries greater risk of diabetes or other obesity-related health disorders?

Response: Obesity broadly consists of two component; [1] there is overall body size (assessed using BMI) and [2] there is fat distribution (assessed using WHR). Both are “heritable”, which mean that they are in part determined by our genome (and the other part is determined by our lifestyle).

Over the past 15 years, geneticists have used an approach to screen the whole genome of thousands of people to identify genetic variations that differ between e.g. obese people vs non-obese people.

We have applied this approach to both components of obesity and have found so far that genes for “overall body size” seem to act in the brain, likely controlling hunger, satiety, reward, etc., whereas the genes that determine where in the body the excess fat will be stored when you gain weight (i.e. fat distribution) seem to act more “locally” at the fat cell level itself, determining the storage and release of fat.  Continue reading

Poor Fitness and Obesity in Early Life Linked to Greater Disability as Adult

MedicalResearch.com Interview with:

Pontus Henriksson | PhD and Registered Dietitian Postdoctoral Researcher | SFO-V Fellow Department of Biosciences and Nutrition Karolinska Institutet

Dr. Henriksson

Pontus Henriksson | PhD and Registered Dietitian
Postdoctoral Researcher | SFO-V Fellow
Department of Biosciences and Nutrition
Karolinska Institutet 

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

Response: In many countries, disability pensions are granted to working-aged persons who are likely to never work full-time again because of a chronic disease or injury diagnosed by a physician. In addition to serving as an important indicator of chronic disease, disability pensions are associated with high societal costs.

Hence, we examined whether cardiorespiratory fitness and obesity (two potentially modifiable factors) were associated with disability pension later in life.

Our main findings were that low physical fitness and/or obesity during adolescence, were strongly associated with disability pension later in life due to a wide range of diseases and causes.  Continue reading

Waist to Height Ratio Linked to Cardiovascular Disease Risk in Men

MedicalResearch.com Interview with:

Vitor Engrácia Valenti Professor São Paulo State University Marília

Dr. Valenti

Vitor Engrácia Valenti, PhD
Professor
São Paulo State University Marília

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

Response: Autonomic modulation and cardiorespiratory variables are influenced by numerous factors. Abdominal fat tissue is a relevant variables related to metabolic and cardiovascular disorders, including diabetes mellitus, dyslipidemia and hypertension, which are associated to increased risk of morbidity and mortality.

We evaluated cardiorespiratory variables and autonomic nervous system before and during recovery from exercise in healthy physically active men divided according to with waist-stature ratio (WSR): G1 – between 0.40 and 0.449 (N = 19), and G2 – between 0.45 and 0.49. This metholodigcal procedure is able to provide important information regarding the risk for developing cardiovascular disease in the future.

Our main findings indicated that healthy physically active men with waist-stature ratio values close to the risk limit (between 0.449 and 0.5) presented slower return of autonomic and cardiorespiratory variables to baseline values after moderate exercise. It suggests that this group present an elevated probability of developing cardiovascular disease in the future compared to the groups with lower values of waist-stature ratio.

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Younger Generations at Much Higher Risk of Obesity Related Cancers

MedicalResearch.com Interview with:

Hyuna Sung, PHD Principal Scientist, Surveillance Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303 

Dr. Sung

Hyuna Sung, PHD
Principal Scientist, Surveillance Research
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303 

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

Response: This project was motivated by our previous finding on the rise of colorectal cancer among young adults before age 55. Changes in cancer trends among young age group have significant implications because the newly introduced carcinogenic agents are likely to affect trends among young people before they affect those among older people. Owing to this relationship, cancer trends among young people can be often considered as a bellwether for future disease burden. Given the dramatic increase of the obesity prevalence during 3-4 decades in the US, we wanted to expand the colorectal cancer finding to the more comprehensive list of cancers and explain them in the context of obesity epidemic.

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Risk Factors for Kidney Cancer Identified

MedicalResearch.com Interview with:

Brian R. Lane MD PhD Division of Urology Spectrum Health Grand Rapids, Michigan

Dr. Lane

Brian R. Lane MD PhD
Division of Urology
Spectrum Health
Grand Rapids, Michigan

MedicalResearch.com: Can you explain how you conducted your study, and what the main findings were?

Response:  We used large-scale genome-wide association studies (GWAS) to identify genetic variants associated with obesity measures, blood pressure, lipids, type 2 diabetes, insulin, and glucose. these genetic variants were used as proxies for the above-mentioned risk factors and evaluated in relation to renal cell carcinoma risk (kidney cancer) using GWAS data from 10,000 RCC patients and 20,000 control participants.

–          Based on these genetic data, we found that multiple measures of obesity, as well as diastolic blood pressure (DBP) and fasting insulin, are associated with renal cell carcinoma risk. In contrast, we found little evidence for an association with RCC risk for systolic blood pressure (SBP), circulating lipids, overall diabetes, or fasting glucose.  Continue reading

Men, the Microbiome, and Weight Loss

The obesity rate has climbed steadily for men in the United States, currently rolling in at nearly 38% and still rising. That’s far from good news, and it’s doing nothing to help with the growing cardiovascular and heart disease statistics. Fighting obesity can be incredibly difficult, especially with our increasingly sedentary lifestyles brought on by modern conveniences. With diets popping up every day, it can be hard to pick, but one diet has arisen with a focus on digestive and general body health rather than strict weight loss: fiber-high diets.

What is it?

Fiber-high diets are exactly what they sound like, in that they’re dietary plans based on consuming fiber heavy foods to help promote a healthy digestive system. Our gut is home to massive colonies of helpful bacteria that work to aid us in breaking down our food and keep our body healthy. Fiber-high diets focus on feeding these bacteria the best possible fuel to promote a healthy body system, commonly referred to as the microbiome.

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Obesity in Childhood Adversely Impacts Lung Development

MedicalResearch.com Interview with:

Judith Garcia Aymerich Head of the Non-Communicable Diseases and Environment Programme ISGlobal 

Dr. Garcia-Aymerich

Judith Garcia Aymerich
Head of the Non-Communicable Diseases and Environment Programme
ISGlobal 

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

Response: Several studies have assessed the associations of overweight and obesity with lung function in children and adolescents, but they have found contradictory results. An important limitation of these studies is that most of them considered only overall body weight and did not take into account for the different contribution of lean body mass and fat mass, and their relative proportions that vary by age and sex. Continue reading

New Intestinal Microbiome Changes After Bariatric Surgery

MedicalResearch.com Interview with:

Casey Morrow, Ph.D. Leader of the research team and professor emeritus Department of Cell, Developmental and Integrative Biology University of Alabama at Birmingham

Dr. Morrow

Casey Morrow, Ph.D.
Leader of the research team and professor emeritus
Department of Cell, Developmental and Integrative Biology
University of Alabama at Birmingham

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

Response: The human gastrointestinal tract (GIT) contains several distinct physical environments within the stomach, small intestine (duodenum, jejunum, ileum) and colon that harbor complex microbial communities.

Changes in the fecal microbe composition have been described for Roux-en-Y gastric bypass (RYGB), the most effective and durable treatment for morbid obesity, and sleeve gastrectomy (SG). Continue reading

Cancers Attributable to Obesity Vary by State

MedicalResearch.com Interview with:

Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303

Dr. Islami

Farhad Islami, MD PhD
Scientific Director, Surveillance Research
American Cancer Society, Inc.
Atlanta, GA 30303

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

Response: Despite variations in excess body weight (EBW) prevalence among states in the United States, there was little information on the proportion of incident cancers attributable to EBW (or population attributable fraction, PAF) by state. This information would be useful to help states set priorities for cancer control initiatives.

In this paper, we estimated the PAF and number of incident cancer cases attributable to EBW by sex in all 50 states and the District of Columbia using representative exposure and cancer occurrence data. To provide more accurate estimates, we adjusted state-level data on body mass index (BMI) based on self-reported weight and height from the Behavioral Risk Factor Surveillance System by sex, age group, race/ethnicity, and education level (162 strata) using BMI values from the National Health and Nutrition Examination Survey, a nationally representative survey with objectively-measured height and weight.

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After Menopause, High Body Fat Associated with Doubled Risk of Estrogen+ Breast Cancer

MedicalResearch.com Interview with:

Neil M. Iyengar, MD Breast Medicine Service Department of Medicine Memorial Sloan Kettering Cancer Center Evelyn H. Lauder Breast And Imaging Center New York, NY

Dr. Neil Iyengar

Neil M. Iyengar, MD
Breast Medicine Service
Department of Medicine
Memorial Sloan Kettering Cancer Center
Evelyn H. Lauder Breast And Imaging Center
New York, NY 

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

Response: Obesity is one of the leading modifiable risk factors for the development of hormone receptor positive breast cancer in postmenopausal women.

Traditionally, physicians use a person’s body mass index (weight in kilograms divided by height in squared meters, kg/m2) to estimate body fat levels. A BMI of 30 or greater is considered to be obese, and this level of BMI increases the risk of at least 13 different cancers.

However, BMI is a crude measure of body fat and can be inaccurate. For example, some normal weight individuals (BMI less than 25) have obesity-related problems like diabetes and high blood pressure. Before our study, it was unknown whether high body fat levels in normal weight women contributes to obesity-related cancers such as breast cancer.

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Obesity Threat to Health of Individuals and Populations May Be Underestimated

MedicalResearch.com Interview with:

Ching-Ti Liu, PhD Department of Biostatistics Boston University School of Public Health Boston, Massachusetts

Dr. Liu

Ching-Ti Liu, PhD
Department of Biostatistics
Boston University School of Public Health
Boston, Massachusetts

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

Response: Being overweight and obese are increasing worldwide and this obesity epidemic threatens to reverse the gains in life expectancy achieved over the past century. However, many investigators have observed, paradoxically, that overweight individuals are associated with a lower mortality risk. These results may suffer from a potential confounding due to illness or reverse causality in which preexisting conditions may alter both body weight and the risk of death.  Recently published studies have tried to mitigate this reverse causal bias by implementing sample exclusion and they came to a different conclusion: between BMI and all-cause mortality there is an increased risk of death for the entire range of weights that are in the overweight and obesity ranges.

However, the elimination strategies may lead to the loss of generalizability or precision due to over-adjustment. In addition, the traditional investigations have only utilized a subject’s weight at a single point in time, which makes it difficult to adequately address bias associated with reverse causality.

Currently, the idea incorporating a subject’s weight history has been proposed to deal with the concern of reverse causality, but the existing works had been based on a subject’s recall or self-reported data, which may lead to misclassification and, therefore, result in overestimating the risk of mortality.

To help assess the relevance of being overweight or obese to the risk of death in the general population, we conducted a prospective study, using an individuals’ maximum BMI before the beginning of survival follow-up instead of their weight status at a single point in time, using data from the Framingham Heart Study (FHS).

We observed increasing risk of mortality across various BMI categories (overweight < obese I < obese II) relative to normal weight using maximum BMI over 24 years of weight history.

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Obesity Strongly Related to Coronary Artery Disease and Diabetes

MedicalResearch.com Interview with:
"Obesity runs rampant in Indiana." by Steve Baker is licensed under CC BY-ND 2.0Haris Riaz MD
(Cardiology Fellow
Haitham Ahmed MD, MPH , Preventive Cardiologist,
Cleveland Clinic, Ohio

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

Response: Elevated cholesterol (specially low density lipoprotein) has been causally linked to the development of coronary artery disease whereas the causal relationship between obesity and cardiovascular disease has remained controversial. This is important because of increasing epidemic of obesity and metabolic syndrome. Mendelian randomization studies provide one way of determining a causal association where we can look at the outcomes of individuals stratified by the presence or absence of a particular allele. Since these alleles are randomly distributed in the population of interest, this is “nature’s randomized trial” in that the particular allele is naturally distributed and hence minimal risk of bias.

In other words, lets say that I hypothesize that a particular gene “A” is linked with coronary artery disease. If the given gene is indeed causally linked with coronary artery disease, patients with activation of that gene should have significantly greater risk of developing coronary artery disease.

Based on these principles, we conducted a systematic review and meta-analysis of the available evidence and found that the risk of developing coronary artery disease and diabetes is significantly increased with obesity. Although hypothesis generating, we think that these findings may suggest a causal association between obesity and cardiovascular disease.  Continue reading

Gelesis100 Hydrogel In Development For Weight Loss and Obesity

MedicalResearch.com Interview with:
Gelesis, Inc.H.M. Heshmati, M.D.

Executive Vice President, Endocrinology and Metabolism
Gelesis, Inc.

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

Response: The Gelesis Loss Of Weight (GLOW) clinical study is a pivotal, multicenter, double-blind, placebo-controlled study of our lead investigational product candidate, Gelesis100, which is an oral, non-systemic approach to weight loss. The GLOW study was designed to assess change in body weight in adults with overweight or obesity after six months of treatment with Gelesis100.

Main findings from the GLOW study include the following:

  • 59% of Gelesis100-treated adults achieved weight loss of at least 5% over six months.

o   The new data show that Gelesis100-treated adults fell into two groups: responders, the 6 out of 10 who lost an average of 10% of their total body weight (about 22 pounds) and nearly 4 inches from their waist circumference. Non-responders, the 4 out of 10 who lost an average of 1% of their total body weight (about 2 pounds).

o   The complete Gelesis100 treatment group (including both responders and non-responders) demonstrated superiority compared to placebo (–6.4% vs. –4.4%, P=0.0007)

  • Successful response to Gelesis100 may be predicted by elevated fasting plasma glucose at baseline or weight loss as early as week 8.
  • There was a clear and early separation between responders and non-responders. More specifically, weight loss of at least 3% as early as after eight 8 weeks of treatment predicted clinically meaningful weight loss at six months, with sensitivity and specificity levels exceeding 80%.
  • The study also showed that nearly half of the adults with prediabetes or drug-naive type 2 diabetes were super-responders. These individuals, who typically face greater challenges to lose weight, had six times greater odds of being super-responders, compared to placebo (adjusted OR: 6.1, P=0.0071).
  • Gelesis100 had a highly favorable safety and tolerability profile. 

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OPTIFAST Total Meal Replacement Plan Supported Significant Weight Loss

MedicalResearch.com Interview with:

Dr. Jamy Ard MD Professor of Epidemiology and Prevention Co-director,the Wake Forest Baptist Health Weight Management Center Wake Forest School of Medicine

Dr. Ard

Dr. Jamy Ard MD
Professor of Epidemiology and Prevention
Co-director,the Wake Forest Baptist Health Weight Management Center
Wake Forest School of Medicine

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

Response: Obesity continues to be a growing health challenge, and doctors need as many resources as possible to help their patients achieve success. The OPTIWIN trial shows that a total meal replacement program like OPTIFAST can help with significant and sustained weight loss.

The OPTIFAST Program is a medically monitored weight loss program that combines meal replacement with behavioral counseling and personalized support. In the OPTIWIN study, participants were randomized to either the OPTIFAST Program (OP) or a behavioral intervention using a food-based diet (FB).

At both 26 and 52 weeks, the OP group lost, on average, twice as much of their initial body weight as the FB group:

  • At 26 weeks: 12.4% (SE 0.6) vs 6.0% (SE 0.6) of body weight lost (OP vs FB, respectively; p<0.001)
  • At 52 weeks: 10.5% (SE 0.6) vs 5.5% (SE 0.6) of body weight lost (OP vs FB, respectively; p<0.001)

Additionally, the proportion of participants who achieved clinically meaningful weight loss (≥5%, ≥10%, and ≥15%) was significantly higher in the OP group. For example:

  • At 26 weeks, 55% of the OP group lost at least 10% of their initial body weight vs 23% of the FB group (p<0.001)
  • At 52 weeks, 44% of the OP group lost at least 10% of their initial body weight vs 22% of the FB group (p<0.001)

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