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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Who Does Better After Bariatric Surgery?

MedicalResearch.com Interview with:

Alison E. Field, ScD Professor and Chair of Epidemiology Brown University School of Public Heath Providence, RI

Dr. Field

Alison E. Field, ScD
Professor and Chair of Epidemiology
Brown University School of Public Heath
Providence, RI

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

Response: In the United States, approximately 40% of adults are obese. There are a range of treatment options, but relatively few people are able to lose weight and maintain the loss. The most effective treatment is bariatric surgery, but even among patients who have undergone bariatric surgery, there is a range in weight change patterns after surgery. This suggests that not all people with obesity are similar. There may be different causes and optimal treatment plans that vary by obesity subgroup. Our goal was to identify subgroups and to examine if they differed in terms of weight loss after bariatric surgery.

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Antibiotics and Acid Suppressants May Be Risk Factor For Pediatric Obesity

MedicalResearch.com Interview with:
"babies (365-222)" by Robert Couse-Baker is licensed under CC BY 2.0Dr. Christopher M Stark
Department of Pediatrics
William Beaumont Army Medical Center
El Paso, Texas
Department of Pediatrics
Walter Reed National Military Medical Center
Bethesda, Maryland

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

Response: Rates of pediatric obesity have increased over the past decade, which has led researchers to search for modifiable risk factors that may explain this increase. Recent studies have identified an association between native gut bacteria alterations and the development of obesity. Several population-based studies have evaluated whether or not there is an association between antibiotic exposure and the development of obesity, with mixed results.

No studies have previously evaluated if acid suppressing medications are associated with developing obesity.

We found that young children prescribed antibiotics, acid suppressants, and combinations of these medications in the first two years of life are more likely to develop obesity after two years of age.

Our study represents the largest study to evaluate pediatric antibiotic prescriptions and obesity risk, with nearly ten times as many patients as the next largest study.

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Obesity Increases Risk of Death From All Causes

MedicalResearch.com Interview with:

Dr. Kaitlin Wade PhD Research Associate and Early Career Researcher Representative Integrative Epidemiology Unit (IEU) Bristol Medical School (Population Health Sciences) Faculty of Health Sciences University of Bristol 

Dr. Wade

Dr. Kaitlin Wade PhD
Research Associate and Early Career Researcher Representative
Integrative Epidemiology Unit (IEU)
Bristol Medical School (Population Health Sciences)
Faculty of Health Sciences
University of Bristol 

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

Response: Whilst severe obesity increases the risk of death in the population, there are conflicting results in the literature with some papers suggesting a protective effect of being overweight. Many observational studies also report a J-shaped association between body mass index – a measure of weight accounting for a person’s height – and mortality, where individuals who are underweight also have an increased risk of mortality compared to those within the ‘normal’ range. Such controversial findings are not without limitation, as bias by age, ill-health and other lifestyle factors are likely. One method to overcome the limitations of observational studies – Mendelian randomization – uses genetic variation in a person’s DNA to help understand the causal relationships between risk factors and health outcomes to provide a more accurate estimate of relationships by removing confounding factors (such as smoking, income and physical activity) and reverse causation (where people lose weight due to ill-health), which can explain conflicting findings in previous studies.

Until now, no study has used such a genetic-based approach to explore the link between body mass index and mortality.

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Parental Attitudes Linked to Infant Sugar-Sweetened Beverage Consumption

MedicalResearch.com Interview with:
“Soda” by Jannes Pockele is licensed under CC BY 2.0Jennifer Woo Baidal, MD, MPH
Assistant Professor of Pediatrics
Director of Pediatric Weight Management,
Division of Pediatric Gastroenterology, Hepatology, and Nutrition,
Columbia University Medical Center &
New York-Presbyterian Morgan Stanley Children’s Hospital

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

Response: Childhood obesity prevalence is historically high, with most incident obesity among children occurring before age 5 years. Racial/ethnic and socioeconomic disparities in childhood obesity are already apparent by the first years of life. Latino/Hispanic children in low-income families are at-risk for obesity. Thus, understanding potentially effective ways to prevent childhood obesity, particularly in vulnerable populations, should focus on early life.

Sugar-sweetened beverage (SSB) consumption is a modifiable risk factor for obesity and is linked to other adverse health outcomes. Maternal SSB consumption in pregnancy and infant sugar-sweetened beverage consumption in the first year of life are linked to later childhood obesity.

We sought to describe beverage consumption in a modern cross-sectional cohort of 394 low-income, Latino families, and to examine the relationship of parental attitudes toward sugar-sweetened beverages with parental and infant SSB consumption.

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Why Are Children Not Receiving Adequate Treatment For Obesity?

MedicalResearch.com Interview with:
Dr. Janey Pratt, MD Clinical Associate Professor, Surgery Stanford UniversityDr. Janey Pratt, MD
Clinical Associate Professor, Surgery
Stanford University

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

Response: In 2013 obesity became recognized as a disease.  The rate of pediatric obesity continues to rise.  Severe pediatric obesity is rising at a even faster rate than obesity in pediatrics.  Despite this Metabolic and Bariatric Surgery (MBS) remains underutilized in the treatment of severe pediatric obesity.  There is a significant amount of adult data and now pediatric data about effective treatments for severe obesity.  These support the use of MBS as a primary treatment for severe obesity in children. (BMI > 120% of 95th percentile with a comorbidity or BMI > 140% of 95th percentile).

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Higher BMI Linked to Increased Risk of Younger Colon Cancer

MedicalResearch.com Interview with:

Stuart Po-Hong Liu, MD, MPH

Dr. Po-Hong Liu

Stuart Po-Hong Liu, MD, MPH
Clinical and Translational Epidemiology Unit Massachusetts General Hospital and
Harvard Medical School
Boston

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

Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50.

However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda. Continue reading

More Patients With Bariatric Surgery Admitted for Gallstone-Related Biliary Disease

MedicalResearch.com Interview with:

Violeta Popov, MD PhD FACG Assistant Professor of Medicine Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan) Division of Gastroenterology NYU Langone Medical Center 

Dr. Popov

Violeta Popov, MD PhD FACG
Assistant Professor of Medicine
Director of Bariatric Endoscopy, NY VA Harbor Healthcare(Manhattan)
Division of Gastroenterology
NYU Langone Medical Center 

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

Response: Bariatric surgery is the most effective method currently available for durable weight loss. In the first few months after surgery, patients typically experience significant weight loss. Rapid weight reduction though can lead to the development of gallstones and biliary disease, described in up to 40% of post-bariatric patients. To avoid these complications, the gallbladder was removed during open bariatric procedures in the past. However, with the advent of laparoscopic surgery, concomitant cholecystectomy with bariatric surgery is no longer performed for many reasons.  The aim of is study is to assess if biliary diseases such as acute pancreatitis, acute cholecystitis, acute cholangitis, and cholecystectomy have increased with this change in practice. This is a retrospective cohort analysis of the National Inpatient Sample (NIS), the largest publicly available inpatient database in the United States of nonfederal institutions, with approximately 1000 hospitals participating and information on over 7 million inpatient admissions.

We found that from 2006 to 2014 there has been an approximately 10-fold increase in hospital admissions for biliary diseases, as well as similar increase in cholecystectomies, in patients who have a history of bariatric surgery. There was no significant change in admissions in patients without bariatric surgery between 2006 and 2014 admitted for the same biliary diseases.  Continue reading

Obesity Linked to Alarming Risk in Gastric and Colon Cancers in Young Adults

MedicalResearch.com Interview with:

Hisham Hussan, M.D. Assistant Professor of Clinical Medicine Director, Obesity and Bariatric Endoscopy Section Division of Gastroenterology, Hepatology, and Nutrition Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus, OH 43210

Dr. Hussan

Hisham Hussan, M.D.
Assistant Professor of Clinical Medicine
Director, Obesity and Bariatric Endoscopy Section
Division of Gastroenterology, Hepatology, and Nutrition
Department of Internal Medicine
The Ohio State University Wexner Medical Center
Columbus, OH 43210

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

Response: Obesity, a major healthcare burden, is an established risk factor for many gastrointestinal cancers. With obesity being on the rise, we inspected whether obesity related gastrointestinal cancers are increasing in different age groups, and relation to obesity.

MedicalResearch.com: What are the main findings? 

Response: We identify an alarming increase in incidence of gastric and colorectal cancers in young adults (less than 50 years of age) between 2002-2013.

This was paralleled by an uptrend in obese patients undergoing surgeries for these cancers during the same period. 

MedicalResearch.com: What should readers take away from your report?

Response: Our results suggest, for the first time, a contributing role of obesity in the etiology as well as the increasing incidence of gastric and colorectal cancers in young adults. 

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

Response: More studies are needed to investigate the interplay of epigenetics factors such as young-onset obesity and western diet in relation to risk of adults developing colorectal and gastric cancers at an earlier age. Also public policies are needed to counter obesity and the rising incidence of gastric and colorectal cancer in this young high risk group.

MedicalResearch.com: Is there anything else you would like to add?

Response: My main career focus is translational and clinical research at the interface of energy balance, the microbiome and gastrointestinal cancer.

We have no financial disclosers or conflict of interest.

Citation:

 ACG18 abstract:

Rising, Age‐Specific, Trends of Obesity‐Related Gastrointestinal Cancers Correspond With Increasing Cancer Resections in Obese Patients: A 2002‐2013 National Analysis Using the SEER and NIS Databases

Oct 9, 2018 @ 11:58 am

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Most Overweight or Obese Children Will Stay So

MedicalResearch.com Interview with:

Antje Körner, M.D Center for Pediatric Research University Hospital for Children and Adolescents University of Leipzig Germany

Dr. Körner

Antje Körner, M.D
Center for Pediatric Research
University Hospital for Children and Adolescents
University of Leipzig
Germany

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

Response: We were interested to find out, when (at what age) obesity in children emerges, whether there is something such as an critical age.

There are many opinions on that but very few well-powered studies. We tracked weight/BMI development of more than 51,000 children from infancy to adolescence. We see, that it is clearly early childhood – the preschool years when obesity sets in in the children. If a child is obese at one or up to two years of age, chances are about 50:50 to return to normal weight; with 3 years of age, most children with overweight or obesity will stay so, almost 90%.

When we look at it dynamically, we see the strongest increase in excessive weight between 2 and 6 years of age in those adolescents who are obese. Even after that young age there is steady further increase in additional weight gain, hence worsening of obesity. 

MedicalResearch.com: What should readers take away from your report?

Response: Our intention is to raise awareness that obesity sets in at that very young age. Often you hear of “innocent puppy fat” in the very young children, which will grow away. According to our data you cannot rely on returning to normal weight as soon as 3 years of age.

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

Response: Therefore, we have to think more in means of prevention. This early childhood is the age where habits are formed. Hence every day life should be structured in a healthy way and environment should favour a healthy life style. 

Citation:

Acceleration of BMI in Early Childhood and Risk of Sustained Obesity

Mandy Geserick, M.Sc., Mandy Vogel, Ph.D., Ruth Gausche, M.B.A., Tobias Lipek, M.D., Ulrike Spielau, M.Sc., Eberhard Keller, M.D., Roland Pfäffle, M.D., Wieland Kiess, M.D., and Antje Körner, M.D.

October 4, 2018
N Engl J Med 2018; 379:1303-1312
DOI: 10.1056/NEJMoa180352

Oct 5, 2018 @ 12:41 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Functional Imagery Training Improved Weight Loss and Keeping Weight Off

MedicalResearch.com Interview with:

Dr Linda Solbrig PhD University of Plymouth

Dr. Solbrig

Dr Linda Solbrig PhD
University of Plymouth

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

Response: Diets are restrictive; they work in the short-term, but re-gain is common. Individuals trying to manage their weight find that motivation fades over time and that this is the hardest part about maintain a healthy weight. When given choice to self-set goals we are much more likely to stick with them; they are more sustainable and we can succeed long-term. Using multi-sensory mental imagery supports motivation to change in the long run and also the opportunity to test out in our imagination if the actions we decided will lead to personal goal success actually fit with our lives, or whether we need to tweak, or even change them.

Functional Imagery Training (FIT) is based on two decades of research showing that mental imagery is more strongly emotionally charged than other types of thought and that it can directly interfere with unwanted food cravings. It uses multi-sensory mental imagery to strengthen people’s motivation and confidence to achieve their own goals, and teaches people how to do this for themselves, so they can stay motivated even when faced with challenges. It is not about creating a static picture, but encourages the use of all our senses, how a situation may feel, seeing with the mind’s eye and hearing with the mind’s ear and so on, creating a mini movie in our minds where we are the lead actors working on our personal goals, overcoming adversity and succeeding.  Continue reading

Could Household Cleaners Be Making Children Overweight?

MedicalResearch.com Interview with:

Dr. Kozyrskyj

Anita Kozyrskyj PhD
Professor in Pediatrics
Faculty of Medicine & Dentistry
School of Public Health
University of Alberta

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

Response: Data for this study were collected in the Canadian Healthy Infant Longitudinal Development (CHILD) cohort of over 3,500 full-term infants born between 2009 and 2012. When infants were 3-4 months of age, parents provided a sample of their poop. At that time, parents checked-off responses to questions about their home, including type and frequency of cleaning product use. The infant poop was initially frozen, then thawed later to extract DNA from the sample and identify microbes on the basis of their DNA sequence.  Continue reading

USPSTF: Behavior-Based Weight Loss Interventions Associated with Weight Loss and Lower Risk of Diabetes

MedicalResearch.com Interview with:

Chyke Doubeni, M.D., M.P.H.  Harrison McCrea Dickson, M.D. and Clifford C. Baker, M.D. Presidential Professor Associate Professor of Epidemiology  Senior scholar, Center for Clinical Epidemiology and Biostatistics  University of Pennsylvania School of Medicine

Dr. Doubeni

Chyke Doubeni, M.D., M.P.H.
Harrison McCrea Dickson, M.D. and Clifford C. Baker, M.D. Presidential Professor
Associate Professor of Epidemiology
Senior scholar, Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania School of Medicine 

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

Response: Obesity is an important public health issue that affects nearly 4 in 10 American adults. It increases the risk for many chronic health conditions as well as premature death from diabetes, coronary heart disease, various types of cancer, and other conditions. As such, it was important for the U.S. Preventive Services Task Force to review the current evidence and update the recommendation on this topic.

Based on a review of the most recent studies, we found that intensive, multicomponent behavioral interventions are safe and effective. They can help people lose weight, maintain their weight loss, and reduce the risk of obesity-related conditions such as diabetes in people with high blood sugar. Therefore, the Task Force is recommending that clinicians offer or refer adults with a body mass index, or BMI, of 30 kg/m2 or higher to these behavioral interventions.    Continue reading

Mouth Microbiome Linked to Childhood Obesity

MedicalResearch.com Interview with:

Dr. Sarah J.Carnahan Craig PhD

Dr. Carnahan Craig

Dr. Sarah J.Carnahan Craig PhD
Postdoctoral Scholar
Makova Lab
Biology Department
Center for Medical Genomics
Penn State University

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

Response: This study stems from a long standing collaboration with pediatrician, Ian Paul at Penn State Hershey Medical School (and a co-author on this paper). Ian is very interested in understanding and preventing childhood obesity. It also is part of a much larger, collaborative study objective, lead by Ian and Leann Birch (another co-author), to understand social/behavioral contributors to childhood obesity, how a responsive parenting intervention can prevent childhood overweight/obesity, and the biological factors that contribute to the disease. This is an important research area as childhood obesity is a public health problem — one in three children are overweight or obese. A fuller understanding of factors that contribute to childhood obesity, how to identify children who are at risk for developing childhood obesity, and methods to prevent childhood obesity are of critical importance.

MedicalResearch.com: What are the main findings?

Response: The main finding from this paper is that the oral microbiota (the collection of bacteria that live in the mouth) are significantly related to young child growth patterns. The surprising part of this finding was that we observed this result with the oral microbiota and not the gut microbiota. The oral microbiota (in comparison to the gut microbiota, which has been associated with obesity in many previous studies) are largely understudied, especially in young children. The gut microbiome we found to be strongly influenced by diet; when the two are considered together, there is a significant relationship with child growth patterns.

Additionally, our team developed novel statistical methods to use child growth curves as a more comprehensive outcome rather than an outcome of weight at a single time point (i.e. it uses more of the information about how a child is growing). These methods allow us to better detect the relationship between child growth and the microbiota; they increase our power. 

MedicalResearch.com: What should readers take away from your report?

Response: Readers should take away that there are many factors that contribute to obesity and obesity prevention – along with a healthy diet and exercise, biological factors, such as the microbiota for instance, could potentially be an important consideration. Additionally, we’re in the early stages of truly understanding how these microbes influence health. Importantly, we are unable to make any kind of causal conclusions – meaning we don’t know if the microbes are influencing the growth patterns, is health/environment influencing the microbes, or is it both directions.  

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

Response: One of the limitations of this study is that it looks at the microbiota at a single time point, at two years after birth –  this is a dynamic community, so we are really only seeing a snapshot of what is happening. Additionally, the study is retrospective in that the microbiota is sampled at two years and the growth trajectory is made of measurements from birth through two years. Because of this, we might be missing important dynamics happening earlier in life. A more comprehensive study would be to sample the microbiota at all the time points you are sampling growth, health, and other information — this is a study we are currently doing. We hope that by building on this study and examining the microbiota (both oral and gut) longitudinally and in concert with the social, environmental, and health data that we will be closer to a fuller understanding, which could potentially identify children who are most at risk of developing childhood obesity and be prime candidates for obesity intervention programs.  

Citation: 

Sarah J. C. Craig, Daniel Blankenberg, Alice Carla Luisa Parodi, Ian M. Paul, Leann L. Birch, Jennifer S. Savage, Michele E. Marini, Jennifer L. Stokes, Anton Nekrutenko, Matthew Reimherr, Francesca Chiaromonte, Kateryna D. Makova. Child Weight Gain Trajectories Linked To Oral Microbiota Composition. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-31866-9

Sep 19, 2018 @ 9:27 pm

 

 

 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Diabetes: Microvascular Complications Markedly Decreased After Bariatric Surgery

MedicalResearch.com Interview with:

David Arterburn, MD, MPH Kaiser Permanente Washington Health Research Institute Seattle, WA 

Dr. Arterburn

David Arterburn, MD, MPH
Kaiser Permanente Washington Health Research Institute
Seattle, WA

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

Response: More than 9 percent of adult Americans—about 30 million people—are estimated to have type 2 diabetes, according to the American Diabetes Association. The disease tends to worsen over time, with blood sugar levels rising along with the risks of developing large blood vessel (macrovascular) complications like heart attack and stroke, as well as small blood vessel (microvascular) complications affecting the nerves of the feet and hands (neuropathy), kidneys (nephropathy), and eyes (retinopathy).

Among more than 4000 patients who underwent bariatric surgery, the 5-year incidence of microvascular disease — including neuropathy, nephropathy, and retinopathy — was nearly 60% lower than that of 11,000 matched nonsurgical control patients receiving usual diabetes care.  Continue reading

Obesity Links PTSD and Diabetes Risk

MedicalResearch.com Interview with:

Jeff Scherrer, Ph.D. Associate professor; Research director Department of Family and Community Medicine Saint Louis University Center for Health Outcomes Research

Dr. Scherrer

Jeff Scherrer, Ph.D.
Associate professor; Research director
Department of Family and Community Medicine
Saint Louis University Center for Health Outcomes Research 

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

Response: The rationale for this study comes from evidence that patients with PTSD are more likely to be obese than persons without PTSD and have more difficulty losing weight.

Given the obesity epidemic and substantial role of obesity in risk of type 2 diabetes, we sought to determine if obesity accounted for the existing evidence that PTSD is a risk factor for incident type 2 diabetes.  Other studies have adjusted for obesity or BMI in models that control for obesity/BMI and other confounders simultaneously which prohibits measuring the independent role of obesity on the ass Continue reading

Parenting Educational Intervention Can Reduce Childhood Obesity

MedicalResearch.com Interview with:

Ian M. Paul, M.D., M.Sc. Professor of Pediatrics and Public Health Sciences Chief, Division of Academic General Pediatrics Vice Chair of Faculty Affairs, Department of Pediatrics Penn State College of Medicine Hershey, PA 17033-0850

Prof. Paul

Ian M. Paul, M.D., M.Sc.
Professor of Pediatrics and Public Health Sciences
Chief, Division of Academic General Pediatrics
Vice Chair of Faculty Affairs, Department of Pediatrics
Penn State College of Medicine
Hershey, PA 17033-0850

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

Response: 20-25% of 2-5 year old children are overweight or obese in the US, and these children have increased risk of remaining overweight across the lifecourse. To date, research efforts aimed at preventing early life overweight have had very limited success.

In our randomized clinical trial that included 279 mother-child dyads, a responsive parenting intervention that began shortly after birth significantly reduced body mass index z-score compared with controls at age 3 years. Continue reading

Behavioral Intervention for Underserved Preschool-Age Children on Change in BMI

MedicalResearch.com Interview with:

Shari Barkin, MD, MSHS William K. Warren Foundation Endowed Chair Professor of Pediatrics Division Chief of Academic General Pediatrics Director of Pediatric Obesity Research Vanderbilt University Medical Center

Dr. Barkin

Shari Barkin, MD, MSHS
William K. Warren Foundation Endowed Chair
Professor of Pediatrics
Division Chief of Academic General Pediatrics
Director of Pediatric Obesity Research
Vanderbilt University Medical Center

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

Response: Obesity often begins in childhood and disproportionately affects some populations, including underserved children. Given the challenges associated with achieving effective obesity treatment, the focus needs to be on prevention and needs to start early. Barkin et al conducted the longest behavioral intervention obesity prevention trial with 610 underserved parent-preschool child pairs, testing a three-year pragmatic approach that focused on families based in the communities in which they lived, and partnering with both Metro Parks and Recreation and the Nashville Public Library Foundation. Eligible children were high normal weight or overweight but not obese and lived in neighborhoods with access to neighborhood built environments that included parks and recreation and library branches.  Continue reading

So Far, Genes Don’t Explain How Many Calories We Consume

MedicalResearch.com Interview with:
“In-N-Out meal #1” by Chris Makarsky is licensed under CC BY 2.0Dr. Christina Holzapfel PhD
Junior Research Group Leader at
Institute for Nutritional Medicine
Technical University of Munich

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

Response: A lot of articles about genetic factors and nutritional intake have been published in the last years. Findings are inconsistent and it is not clear, whether genetic variants, especially associated with body mass index, are associated with nutritional intake.

Therefore we performed a systematic literature search in order to get an overview about the association between single nucleotide polymorphisms and total energy, carbohydrate and fat intakes. We identified about specific search terms and their combinations more than 10,000 articles. Of these, 39 articles were identified for a relationship between genetic factors and total energy, carbohydrate, or fat consumption.

In all studies, we most frequently encountered the fat mass and obesity (FTO) associated gene as well as the melanocortin 4 receptor gene (MC4R). There are indications of a relationship between these two genes and total energy intake. However, the evaluation of the studies did not provide a uniform picture. There is only limited evidence for the relationship between the FTO gene and low energy intake as well as between the MC4R gene and increased energy intake.

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It Take More Than Obesity To Shorten Lifespan

MedicalResearch.com Interview with:

Jennifer L. Kuk, PhD Associate Professor York University School of Kinesiology and Health Science Toronto, Ontario 

Dr. Kuk

Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Toronto, Ontario

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

Response: Most of the literature on metabolic health obesity has shown that individuals with ‘metabolically healthy obesity’ are still at increased mortality risk.

However, most of these studies have defined healthy as zero or one metabolic risk factor.  This is problematic as hypertension, diabetes or dyslipidemia alone increase your mortality risk and should preclude you from the ‘healthy’ group.

We show that individuals with obesity and no other metabolic risk factors are no more likely to die than normal weight individuals with no metabolic risk factors. 

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Severe Obesity More Common in Rural or Urban Areas in US?

MedicalResearch.com Interview with:

Cynthia L. Ogden, PhD, MRP Chief, NHANES Analysis Branch Epidemiologist, NCHS/CDC Hyattsville, MD 20782

Dr. Ogden

Cynthia L. Ogden, PhD, MRP
Chief, NHANES Analysis Branch
Epidemiologist, NCHS/CDC
Hyattsville, MD 20782

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

Response: 40% of adults and over 18% of youth in the US have obesity. Disparities in obesity have been reported by demographics and urbanization.

We looked at the prevalence of obesity and severe obesity by demographics and by level of urbanization – rural, small/medium metro and large urban. We also looked at trends over time in urban and rural areas.

Obesity and severe obesity rates were higher in rural areas than large urban areas among adults. Among youth, severe obesity rates were higher in rural areas compared to large urban areas.

Differences in age, smoking, education or race/ethnicity between urban and rural areas did not explain the differences we found between urban and rural areas.

Between 2001-2004 and 2013-2016 severe obesity among men in rural areas more than tripled and among women more than doubled. Increases in severe obesity also occurred in urban areas in men and women but they were not nearly as large.

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