Author Interviews, Lancet, Primary Care, Weight Research / 26.10.2016
Short Interventions By Primary Care Physicians Can Help Patients Lose Weight
MedicalResearch.com Interview with:
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Prof. Paul Aveyard[/caption]
Paul Aveyard PhD MRCP FRCGP FFPH
Professor of Behavioural Medicine
Nuffield Department of Primary Care Health Sciences
University of Oxford
Radcliffe Primary Care Building
Radcliffe Observatory Quarter
Oxford
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that opportunistic brief interventions by physicians can be effective, but there is no evidence that they are so for obesity. Physicians worry that broaching this topic will be offensive, time-consuming, and ineffective. We needed a randomised trial to assess whether physicians’ fears were justified, or in fact brief interventions could be as effective for patients who are overweight as they are for smoking or problem drinking and that’s what we did.
Prof. Paul Aveyard[/caption]
Paul Aveyard PhD MRCP FRCGP FFPH
Professor of Behavioural Medicine
Nuffield Department of Primary Care Health Sciences
University of Oxford
Radcliffe Primary Care Building
Radcliffe Observatory Quarter
Oxford
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that opportunistic brief interventions by physicians can be effective, but there is no evidence that they are so for obesity. Physicians worry that broaching this topic will be offensive, time-consuming, and ineffective. We needed a randomised trial to assess whether physicians’ fears were justified, or in fact brief interventions could be as effective for patients who are overweight as they are for smoking or problem drinking and that’s what we did.

















Dr. Annika Rosengren[/caption]
Annika Rosengren MD
Department of Molecular and Clinical Medicine, Institute of Medicine
Sahlgrenska Academy
University of Gothenburg,
Gothenburg, Sweden
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In an earlier study we found that while hospitalizations for heart failure decreased among people aged 55 and older in Sweden 1987-2006, there was a clear increase among those younger than 45 years, particularly in young men. We thought that increasing body weight in the population might be a factor behind this.
We used anonymized data from more than 1.6 million Swedish men from the Swedish conscript registry aged on average 18 and followed them from adolescence onwards. Those who were overweight as teenagers were markedly more likely to develop heart failure in early middle age. The increased risk of heart failure was found already in men who were within the normal body weight range (a body mass index of 18.5 to 25) in adolescence, with an increased risk starting in those with a BMI of 20 and rising steeply to a nearly ten-fold increased risk in those who were very obese, with a BMI of 35 or over.
Among men with a BMI of 20 and over, the risk of heart failure increased by 16% with every BMI unit, after adjustments for factors that could affect the findings, such as age, year of enlistment into the Swedish armed forces, other diseases, parental education, blood pressure, IQ, muscle strength and fitness.
Dr. Mikhail Kolonin[/caption]
Mikhail Kolonin, PhD, Associate Professor
Director, Center for Metabolic and Degenerative Diseases
Harry E. Bovay, Jr. Distinguished University Chair in Metabolic Disease Research
The Brown Foundation Institute of Molecular Medicine
University of Texas Health Science Center at Houston
Houston, TX 77030
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Epidemiology studies have indicated that in obese patients progression of prostate, breast, colorectal, and other cancers is more aggressive. Adipose (fat) tissue, expanding and undergoing inflammation in obesity, directly fuels tumor growth. Adipose tissue is composed by adipocytes and stromal/vascular cells, which secrete tumor-trophic factors. Previous studies by our group have demonstrated that adipose stromal cells, which support blood vessels and serve as adipocyte progenitors, are recruited by tumors and contribute to cancer progression. Mechanisms underlying stromal cell trafficking from fat tissue to tumors have remained obscure. We discovered that in obesity a chemokine CXCL1, expressed by cancer cells, attracts adipose stromal cells to tumors.
Dr. Cynthia Ogden[/caption]
Cynthia L Ogden PhD, MRP
Public Health, Nutrition and Dietetics
CDC Atlanta
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ogden: Monitoring trends in obesity prevalence is important because of the health risks associated with obesity and because obesity often tracks from childhood to adulthood. The most recent data before this point showed no increases overall in youth, men or women over the previous decade.
We used the most recent nationally representative data with measured weights and heights from the National Health and Nutrition Examination Survey to look at trends in obesity prevalence.
Dr-Aurora-Perez-Cornago[/caption]
Aurora Perez-Cornago, PhD
Cancer Epidemiology Unit
Nuffield Department of Population Health
University of Oxford
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Excessive body size and adiposity have been proposed to influence
several metabolic and hormonal mechanisms that can promote cancer development.
We found that men who have greater adiposity have an elevated risk of
high grade prostate cancer, an aggressive form of the disease, and
prostate cancer death.
Dr. Markus Juonala[/caption]
Markus Juonala, MD, PhD
Murdoch Childrens Research Institute, Parkville
Victoria, Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Juonala: This is an epidemiological follow-up study investigating whether childhood infections and socieconomic status are associated with cardiovasular risk factor and early chances in vasculature.
The main finding was that childhood infections were associated with obesity and impaired vascular function in adulthood among those individuals with low socioeconomic status.
