Our results suggest, for the first time, a contributing role of obesity in the etiology as well as the increasing...
Obesity Sets In At Very Early Age...
Dr. Solbrig[/caption]
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. 
Dr. Kozyrskyj[/caption]
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. 
Dr. Doubeni[/caption]
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. 
MedicalResearch.com Interview with: [caption id="attachment_44637" align="alignleft" width="128"] Dr. Carnahan Craig[/caption] Dr. Sarah J.Carnahan Craig PhD Postdoctoral Scholar Makova Lab Biology Department Center for Medical Genomics Penn State...
Dr. Arterburn[/caption]
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. 
Dr. Scherrer[/caption]
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
Prof. Paul[/caption]
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.
Dr. Barkin[/caption]
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. 
Dr. 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.
Dr. Kuk[/caption]
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.
Dr. Ogden[/caption]
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.
Rebecca Somerville MB BCh BAO, BMedSci, MRCPI, MPH, PhD
School of Public Health, Physiotherapy and Sports Science
University College Dublin
Dublin, Ireland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Rates of obesity in the Western world have increased dramatically over recent decades. The negative health consequences of obesity are well known and significant amounts of research have been conducted into the causes and possible solutions. While it is clear that there have been massive changes in diet and physical activity at a societal level that are primarily responsible for this 'obesity epidemic', it is less clear the extent to which obesity, once established, or risk factors for same, can be perpetuated down generations. Family studies lend opportunity to explore these questions, however there are few world wide which incorporate 3 generations.
We therefore sought to examine patterns of central adiposity, as measured by waist circumference, between grandparents and their grandchildren, separately in maternal and paternal lines. We were able to utilize prospectively collected data from the Lifeways Cross-Generation Cohort Study. This is a longitudinal birth cohort, established in Ireland in 2001, involving up to 7 members of the same family (mother, father, child and 4 grandparents). In the 589 families where a child had a waist circumference measurement we found that, at the age of both 5 and 9, there was a direct relationship between the waist circumference of the maternal grandmother and her grandchild (both male and female). This remained after adjustment for a wide range of confounding variables including mother's waist circumference. There was no relationship seen with any of the other grandparents.
Dr. Mongraw-Chaffin[/caption]
Morgana Mongraw-Chaffin, PhD MPH
Wake Forest School of Medicine
North Carolina
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: While some large studies and meta-analyses of this topic suggest that metabolically healthy obesity (MHO) is not a benign condition, discrepancies persist in the results of individual studies. Lack of a clear explanation for these differences drives the continuing controversy over whether MHO is a useful tool for risk stratification or an intermediate condition on the pathway to cardiometabolic risk.
In the Multi-Ethnic Study of Atherosclerosis (MESA), we found that 48% of those with metabolically healthy obesity transitioned to unhealthy obesity by the end of follow-up. Those who transitioned had higher odds of developing cardiovascular disease compared to those who maintained normal weight. We further found that earlier transition from MHO to unhealthy obesity was associated with higher odds.
Dr. Chang[/caption]
Eugene B. Chang, MD
Martin Boyer Professor of Medicine
Knapp Center for Biomedical Discovery
University of Chicago
Chicago, IL 60637 and
[caption id="attachment_41147" align="alignleft" width="200"]
Dr. Martinez-Guryn[/caption]
Kristina Martinez-Guryn, Ph.D., R.D.
Dr. Geisler Bjerregaard[/caption]
Lise Geisler Bjerregaard PhD
Postdoc, PhD, M.Sc. Public Health
Center for Klinisk Forskning og Sygdomsforebyggelse/ Center for Clinical Research and Disease Prevention
Sektion for Klinisk Epidemiologi
Frederiksberg Hospital, Frederiksberg
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Being overweight in childhood and early adulthood is associated with an increased risk of developing type 2 diabetes in adulthood. We wanted to know whether or not remission of overweight before early adulthood can reduce the risks of type 2 diabetes later in life.
We studied the associations between different combinations of weight status in childhood, adolescence and early adulthood, and later development of type 2 diabetes.
We found that men who had been overweight at 7 years of age but normalised weight by age 13 years and were normal weight as young men had similar risks of type 2 diabetes as men who were never overweight. Men who normalised weight between age 13 years and early adulthood had increased risks of type 2 diabetes, but lower risks than men who were overweight at all ages. MedicalResearch.com Interview with:
[caption id="attachment_40814" align="alignleft" width="200"]
Trends in calorie availability in Canada and synthetic controls, 1978-2006. Data from the United Nations Food and Agricultural Office (2016). 'Synthetic controls' are constructed from a weighted combination of OECD countries, where weights correspond to the similarity of each country with Canada before CUSFTA.Pepita Barlow, MSc, Department of Sociology University of Oxford, Manor Road Building, Manor Road, Oxford, United Kingdom
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The escalating global prevalence of overweight and obesity, or “globesity,” is often described as a pandemic. Globalization via free trade agreements (FTAs) with the US has been implicated in this pandemic because of its role in spreading high-calorie diets rich in salt, sugar, and fat through the reduction of trade barriers like tariffs in the food and beverage sector.
We used a “natural experiment” design (that mimics a randomized controlled trial as closely as possible) and data from the United Nations Food and Agricultural Office to evaluate the impact of the 1989 Canada-US Free Trade Agreement on caloric availability in Canada (CUSFTA).
We found that CUSFTA was associated with an increase in caloric availability and likely intake of approximately 170 kilocalories per person per day in Canada. Additional models showed that this rise in caloric intake can contribute to weight gain of between 1.8-9.3 kg for men and 2.0-12.2 kg for women aged 40, depending on their physical activity levels and the extent to which availability affects caloric intake.
MedicalResearch.com Interview with: Craig M. Hales, MD Cheryl D. Fryar, MSPH; Margaret D. Carroll, MSPH; David S. Freedman, PhD; Cynthia L. Ogden, PhD National Center for Health Statistics National Center for Chronic Disease Prevention and Health Promotion US...
Dr. Dando[/caption]
Robin Dando, PhD
Assistant Professor
Director, Cornell Sensory Evaluation Facility
Department of Food Science
Cornell University
Ithaca, NY 14853
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: For many years, people have been interested in if gaining weight can change how we perceive foods, thus maybe encouraging less healthy food choices. There is some evidence in previous work that if we become obese, we seem to perceive things as tasting less intense. Now if this were the case, to make up for this we might eat more of whatever food it was we were eating, or conversely we might choose something that tasted more intense, to make up this difference. More intense usually means higher calories, so if we took either of these approaches, we’re at risk for weight gain.
In our study, we examined the taste buds of mice who were fed an unhealthy diet that induces obesity, versus sibling mice fed a more healthy diet that keeps them lean. The mice gaining weight ended up after only 8 weeks with a lot fewer taste buds than the lean mice. This loss of taste buds represents one explanation for foods tasting less intense to the obese.
Dr. Khan[/caption]
Dr. Sadiya S. Khan, MD MS
Division of Cardiology, Department of Medicine
Department of Preventive Medicine
Northwestern University Feinberg School of Medicine
Chicago, Illinois
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In recent years, controversy has grown regarding findings termed the "obesity paradox" whereby individuals with cardiovascular disease who are obese have "better" outcomes. These findings have led to confusion for patients who are obese.
The main findings of our study help clarify the adverse cardiovascular risks for obese individuals with a shorter overall health span and lifespan. Obese participants in our study lived shorter and sicker with more years lived with cardiovascular diseases and greater lifetime risk of developing cardiovascular disease. 
Trine Moholdt, PhD
Research Fellow
Department of Circulation and Medical Imaging | Exercise, Cardiometabolic Health and Reproduction
Norwegian University of Science and Technology
MedicalResearch.com: What is the background for this study?
Response: Although obese individuals have an increased risk of cardiovascular disease, evidence from many observational studies shows that in those who already have cardiovascular disease, being overweight or obese is associated with lower risk of mortality compared to their normal weight counterparts.
This phenomenon is often called the “obesity paradox”. Recently we observed that in individuals who have a high physical activity level, there is no such obesity paradox and body mass index did not associate with survival time in those who with high physical activity (Moholdt et al, American Journal of Medicine, 2017). 
Dr. Gang Liu[/caption]
Gang Liu, PhD
Postdoctoral Research Fellow
Department of Nutrition
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Although many approaches can be used to achieve a short-term weight loss, maintenance of weight loss has become a key challenge for sustaining long-term benefits of weight loss. Accumulating evidence has suggested that certain environmental compounds may play an important role in weight gain and obesity development.
The potential endocrine-disrupting effects of perfluoroalkyl substances (PFASs), which are extensively used in many industrial and consumer products including food packaging, paper and textile coatings, and non-stick cookware, have been demonstrated in animal studies, but whether PFASs may interfere with body weight regulation in humans is largely unknown.
In a 2-year POUNDS Lost randomized clinical trial that examined energy-restricted diets on weight changes, baseline plasma concentrations of major PFASs were measured among 621 overweight and obese participants aged 30-70 years. Body weight was measured at baseline, 6, 12, 18, and 24 months. Resting metabolic rate (RMR) and other metabolic parameters, including glucose, lipids, thyroid hormones, and leptin, were measured at baseline, 6, and 24 months.
We found that higher baseline levels of PFASs were significantly associated with a greater weight regain, primarily in women. On average, women in the highest tertile of PFASs regained 1.7-2.2 kg more body weight than women in the lowest tertile. In addition, higher baseline plasma PFAS concentrations, especially perfluorooctanesulfonic acid (PFOS) and perfluorononanoic acid (PFNA), were significantly associated with greater decline in RMR during the first 6 months and less increase in RMR during weight regain period. 
Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Sherman Health Science Research Centre
Toronto, Ontario
MedicalResearch.com: What is the background for this study? What are the main findings?
- The benefits of fitness are well know, but it was unclear whether the benefits applied to those with severe obesity. This is even more important give that the health risks associated with severe obesity are exponentially higher than in mild obesity. Fitness in this study was defined as the top 80% of a normal population.This means that unfit is the bottom 20%. In the past, research has shown that this threshold of fitness is associated with the biggest health benefits.
- We see that 40% of individuals with mild obesity are fit, while 11% of those with severe obesity are fit. Individuals with high fitness had no differences in health risk, despite the large differences in obesity (~50-100 pounds). Conversely, those within the unfit group did have significantly higher glucose, blood pressure and lipids with higher obesity levels.
In other words, fitness was able to protect individuals with severe obesity from many of the expected negative health consequences. 
Peymané Adab, MD
University of Birmingham in England
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Childhood obesity is an increasing problem worldwide. In the UK, the proportion of children who are very overweight doubles during the primary school years. Furthermore during this period inequalities emerge. At school entry there is little difference in the likelihood of being overweight between groups. However on leaving international primary schools, children from minority ethnic groups and those from more deprived, compared to more affluent backgrounds are more likely to be overweight. Excess weight in children is linked with multiple health, emotional and social problems. As children spend a lot of time at school, it seems intuitive that they are an ideal setting for prevention interventions.
Although a number of studies have investigated the evidence for school obesity prevention programmes, the results have been mixed and methodological weaknesses have prevented recommendations being made. As a result we undertook a major high quality trial to evaluate an intervention that had been developed in consultation with parents, teachers and the relevant community. The 12 month programme had four components. Teachers at participating schools were trained to provide opportunities for regular bursts of physical activity for children, building up to an additional 30 minutes each school day. There was also a workshop each term, where parents came in to cook a healthy meal (breakfast, lunch of dinner) with their children. In conjunction with a local football club, Aston Villa, children participated in a six-week healthy eating and physical activity programme. Finally, parents were provided with information about local family physical activity opportunities.
We involved around 1500 year 1 children (aged 5-6 years) from 54 state run primary schools in the West Midlands. At the start of the study, we measured their height and weight and other measures of body fat, asked the children to complete a questionnaire about their wellbeing, to note everything they ate for 24 hours, and to wear an activity monitor that recorded how active they were. After this, the schools were randomised to either receive the programme or not. We then repeated the measures 15 and 30 months later.
Maria Luger, MSc
SIPCAN
Special Institute for Preventive Cardiology And Nutrition
Spendenbegünstigte Einrichtung gem. FW 1914/19.3.2005
Vorstand: Univ.-Prof. Prim. Dr. Friedrich Hoppichler
Salzburg, Austria
MedicalResearch.com: What is the background for this study?
Response: Worldwide obesity has nearly tripled since 1975. Rising consumption of sugar-sweetened beverages (SSBs) has been a major contributor to the obesity epidemic and it increases the risk of diabetes or cardiovascular disease, as previous evidence has shown. Partly inconsistent findings from previous reviews have fueled discussions on the impact of SSBs on obesity development.
Therefore, the aim of our review was to systematically review the recent evidence in children and adults.
Prof. Hjelmesæth[/caption]
Jøran Hjelmesæth MD, PhD
Professor, Head
Morbid Obesity Centre and Section of Endocrinology
Department of Medicine
Vestfold Hospital Trust
Tønsberg, Norway
Department of Endocrinology, Morbid Obesity and Preventive Medicine
Institute of Clinical Medicine
University of Oslo, Norway
MedicalResearch.com: What is the background for this study? What is known? Some previous studies have shown beneficial long-term effects of bariatric surgery on the remission and incidence of diabetes, hypertension and dyslipidemia, whilst high quality data on the long-term incidence of adverse effects, mental health conditions and complications after bariatric surgery are sparse or lacking. In addition, the control groups in previous studies of the effect of bariatric surgery seldom or never received any specific specialist based non-surgical treatment alternative.
The present pragmatic real world study was performed at a publicly funded single tertiary care obesity center in Norway where patients could choose between bariatric surgery and specialized medical treatment (voluntarily and free of charge). Nearly complete short- and long-term (≤ 10 years) data on beneficial and detrimental outcomes were retrieved from national registries (Norwegian Prescription Database and Norwegian Patient Registry). The results confirm the beneficial long-term effects of bariatric surgery (gastric bypass) on the remission and incidence of diabetes, hypertension and dyslipidemia, as demonstrated in some previous studies.