Author Interviews, Diabetes, Sleep Disorders, Weight Research / 26.09.2022
Night Owls May Have Increased Risk of Obesity, Diabetes and Heart Disease
MedicalResearch.com Interview with:
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Dr. Malin[/caption]
Steven K. Malin, PhD, FACSM (he/him)
Associate Professor
Department of Kinesiology and Health | School of Arts and Sciences
Division of Endocrinology, Metabolism and Nutrition | Robert Wood Johnson Medical School
Institute of Translational Medicine and Science
New Brunswick, NJ 08901
MedicalResearch.com: What is the background for this study?
Response: Type 2 diabetes is a condition where blood glucose (sugar) is elevated in the blood. This can be problematic as it leads to blood vessel damage and the promotion of cardiovascular disease. Nearly 30 million people in the U.S. have type 2 diabetes, making it a major public health issue. The cause is not entirely clear, but many, including our team view insulin resistance as a central culprit.
Insulin resistance is when the body does not respond well to the hormone insulin. Insulin is vital because it promotes glucose uptake into tissues, like skeletal muscle. Two reasons that are often used to explain the development of insulin resistance include: poor diet (e.g. high sugar and/or high fat coupled with excess calories) and a lack of physical activity. However, more recently, a lack of sleep has been raised as another critical behavioral factor contributing to insulin resistance. Thus, targeting a healthy diet, activity and sleep pattern is thought to prevent the transition from health to insulin resistance and type 2 diabetes.
Dr. Malin[/caption]
Steven K. Malin, PhD, FACSM (he/him)
Associate Professor
Department of Kinesiology and Health | School of Arts and Sciences
Division of Endocrinology, Metabolism and Nutrition | Robert Wood Johnson Medical School
Institute of Translational Medicine and Science
New Brunswick, NJ 08901
MedicalResearch.com: What is the background for this study?
Response: Type 2 diabetes is a condition where blood glucose (sugar) is elevated in the blood. This can be problematic as it leads to blood vessel damage and the promotion of cardiovascular disease. Nearly 30 million people in the U.S. have type 2 diabetes, making it a major public health issue. The cause is not entirely clear, but many, including our team view insulin resistance as a central culprit.
Insulin resistance is when the body does not respond well to the hormone insulin. Insulin is vital because it promotes glucose uptake into tissues, like skeletal muscle. Two reasons that are often used to explain the development of insulin resistance include: poor diet (e.g. high sugar and/or high fat coupled with excess calories) and a lack of physical activity. However, more recently, a lack of sleep has been raised as another critical behavioral factor contributing to insulin resistance. Thus, targeting a healthy diet, activity and sleep pattern is thought to prevent the transition from health to insulin resistance and type 2 diabetes.
Prof. Koehler[/caption]
Prof. Dr. Karsten Koehler
Department of Sport and Health Sciences
Technical University of Munich
MedicalResearch.com: What is the background for this study?
Response: The primary background is the phenomenon that most people fail to loose (meaningful) weight through exercise alone, which is related to what we call compensatory eating – an increase in food intake to compensate for the increased energy expenditure of exercise. This is been described in a number of studies and is considered a key weight loss barrier – yet few have come up with solutions to overcome this problem. Therefore, we wanted to see if the timing of food choices has an impact on how much and what we want to eat in the context of exercise.
Dr. Grant[/caption]
Leilah K. Grant, PhD
Postdoctoral Research Fellow in Medicine
Brigham and Women’s Hospital
Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: The prevalence of obesity increases in women around the age of menopause which increases the risk of diseases like diabetes and heart disease. Changes in hormones, like estrogen, are thought to contribute to weight gain during menopause, but other common symptoms of menopause such as sleep interruption may also play a role. While short sleep is known to adversely affect metabolism, little is known about the metabolic consequences of the type of sleep disruption most common in menopausal women – increased nighttime awakenings (i.e., sleep interruption) caused by hot flashes, but no change in overall sleep duration. We therefore did this study to see how an experimental model menopause-related sleep interruption would affect metabolic outcomes that may contribute to weight gain. 
Dr. Crosbie[/caption]
Eric Crosbie, PhD, MA
Assistant Professor
School of Community Health Sciences
Ozmen Institute for Global Studies
University of Nevada Reno
MedicalResearch.com: What is the background for this study?
Response: My colleague Dr. Laura Schmidt and I established a framework for studying preemption (when a higher level of government limits the authority of lower levels to enact laws) by studying the 
Dr. Aronne[/caption]
Dr. Louis Aronne, MD, FACP
Chief Medical Officer, Intellihealth
Medical Director, Comprehensive Weight Control Center
Weill Cornell Medicine
MedicalResearch.com: What is the background for the study “Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change: A Randomized Clinical Trial”?
Response: More than 70% of U.S. adults have overweight or obesity. Online programs promoting lifestyle change have had some success in helping people achieve and maintain weight loss, but study results have been variable, and these programs have not been widely implemented in primary care. We studied the effectiveness of an online program we have developed (Intellihealth, formerly known as BMIQ) in routine primary care practices, both alone and integrated with population health management (with participants receiving additional support and outreach from nonclinical staff). The study’s objective was to determine whether a combined intervention integrating online weight management with population health management would increase weight loss at 12 months among primary care patients compared with the online program only and usual care.
Dr. Singh[/caption]
Gurmukh Singh, MD, PhD, MBA
Department of Pathology, Section of Clinical Pathology
Walter Shepeard Professor of Pathology
Section Chief, Clinical Pathology.
Associate Medical Director, Clinical Laboratory GRMC and
Children's Hospital of Georgia
MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by the obesity paradox?
Response: Obese people tend to get more diseases, such as hypertension, diabetes, cancer etc. However, when they get seriously ill, e.g., sick enough to require admission to intensive care treatment unit (ICU), obese people tend to have better outcomes than normal weight people.
Dr. Spann[/caption]
Marisa N. Spann, PhD, MPH
Columbia University Irving Medical Center
New York, New York
MedicalResearch.com: What is the background for this study?
Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.
MedicalResearch.com: What are the main findings?
Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain. 
![MedicalResearch.com Interview with: Sarah Messiah, PhD, MPH Professor of epidemiology, human genetics, and environmental sciences UTHealth School of Public Health Dallas MedicalResearch.com: What is the background for this study? Response: Given that obesity is a prevalent, serious, complex, chronic, and relapsing disease, and severe obesity is a deepening crisis, it is important to pay special attention to these challenges during the COVID-19 pandemic. This will avoid placing an even greater burden on individuals, health systems, and society in the post-COVID-19 recovery phase. Thus, it is critically important to document, in real time, how socioecological determinants of health are impacting behaviors among those with obesity. Before our study, how the COVID-19 pandemic is impacting weight management, health behaviors, and psychosocial health in particular among people with obesity was unknown. MedicalResearch.com: What are the main findings? Response: A total of 123 patients (87% female, mean age 51.2 years, mean BMI 40.2, 49.2% Non-Hispanic white, 28.7% Non-Hispanic black, 16.4% Hispanic, 7% other ethnicity, 33.1% completed bariatric surgery were included). -Two patients tested positive for SARS-CoV-2 and 14.6% reported symptoms. -10% lost their job since the beginning of the pandemic -25% reported food insecurity in that they sometimes, or always could not afford to eat balanced meals -72.8% reported increased anxiety and 83.6% increased depression since stay-at-home orders were initiated. -69.6% reported more difficultly in achieving weight loss goals -47.9% reported less exercise time and 55.8% reported less intensity -49.6% reported increased stockpiling of food -61.2% reported stress eating -61.2% reported following healthy diet plans more challenging - Hispanics were less likely to report anxiety versus non-Hispanic whites MedicalResearch.com: What should readers take away from your report? Response: In a relatively short period of time, our results show that there have been substantial perceptions in changes in health behaviors among patients with obesity. Our sample described a decreases in positive health behaviors, increases in deleterious behaviors and associated deterioration in mental health. Even though actual COVID-19 disease burden was low (1.7% tested positive for COVID-19 and another 14.6% reported symptoms), the pandemic is having a significant impact on those without infections. The major strength of this study is that it is the first snapshot into how the COVID-19 pandemic has influenced health behaviors for patients with obesity. Prior to the pandemic, it has been reported that Americans consume 20% of their calories from restaurants and that there are worsening disparities in fast food meal quality by race/ethnicity, education, and income. Due to recent economic challenges, patients may be more likely to select cheaper foods, which are often energy dense and nutrient poor. Therefore, even though we found more patients are cooking at home, the type of foods that are being stockpiled are likely to be processed foods due to their longer shelf life. These are associated with greater intake of fat, carbohydrate, and calories, which facilitate greater weight gain when compared to more balanced diets. It is possible Americans may be trading one pattern of low-quality consumption for another by choosing cheaper processed foods instead of eating out. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: These results have implications for clinical practice and management of patients with obesity as we now move into post-COVID-19 relief efforts. Due to the increase in obesogenic behaviors related to the COVID-19 pandemic that were found here, it is paramount that healthcare access is not disrupted for patients with obesity. Maintaining these vital services will prevent exacerbating the negative health and economic consequences of excess body weight. This includes access to primary care providers, Obesity Medicine specialists and bariatric surgery programs. In addition to asking about diet and exercise patterns, screening for indicators of mental health, loneliness, financial stressors and behaviors that may influence body weight should be implemented by healthcare teams to combat this problem. Disclosures: This work was funded by the National Institutes of Health, National Institute on Minority Health and Health Disparities (Grant #R01MD011686). This work was a joint collaboration among investigators from UTHealth School of Public Health, UT Southwestern Medical Center and Minimally Invasive Surgical Associates. Citation: Almandoz, J.P., Xie, L., Schellinger, J.N., Mathew, M.S., Gazda, C., Ofori, A., Kukreja, S. and Messiah, S.E. (2020), Impact of COVID ‐19 Stay‐at‐Home Orders on Weight‐Related Behaviors Among Patients with Obesity. Clin Obes. Accepted Author Manuscript. doi:10.1111/cob.12386 [subscribe] [last-modified] 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.](https://medicalresearch.com/wp-content/uploads/2020/06/Dr-Sarah-E.-Messiah.jpg)
