Weight Loss After Bariatric Procedures Mostly Sustained Over Time

MedicalResearch.com Interview with:

Anita P. Courcoulas MD, MPH Professor of Surgery, Chief MIS Bariatric & General Surgery University of Pittsburgh Medical Center

Dr. Courcoulas

Anita P. Courcoulas MD, MPH
Professor of Surgery, Chief MIS Bariatric & General Surgery
University of Pittsburgh Medical Center

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

Response: This study is the main long term outcomes report from The Longitudinal Assessment of Bariatric Surgery (LABS) Study, an NIH-NIDDK ( National Institute of Diabetes and Digestive and Kidney Diseases) funded study at 10 hospitals in 6 clinical centers and a data coordinating center.  It was a multicenter, prospective three phase longitudinal cohort study that began recruitment of participants in 2006 when gastric bypass and laparoscopic adjustable banding were the two most common bariatric procedures performed in the U.S.

The goal of this particular study from LABS was to address the longer-term durability and variability of weight loss and the assess the longer-term impact of bariatric surgery on major health conditions including diabetes, dyslipidemia, and hypertension. Continue reading

No Mortality Benefit From Weight Gain in Rheumatoid Arthritis

MedicalResearch.com Interview with:

Jeffrey A. Sparks, M.D., M.M.Sc. Assistant Professor of Medicine Division of Rheumatology, Immunology and Allergy Department of Medicine Brigham and Women’s Hospital Harvard Medical School

Dr. Sparks

Jeffrey A. Sparks, M.D., M.M.Sc.
Assistant Professor of Medicine
Division of Rheumatology, Immunology and Allergy
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School

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

Response: We compared women diagnosed with rheumatoid arthritis (RA) during follow-up in the Nurses’ Health Study and matched women without RA during the same index time period. Women with RA had higher mortality than women without RA. In both groups, those that had severe weight loss (>30 pounds), had the highest mortality after the early RA/index period. Weight gain in the early RA period was not associated with mortality for either group.

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Liraglutide (SAXENDA) May Lead To Weight Loss By Slowing Stomach Emptying

MedicalResearch.com Interview with:

Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN

Prof. Camilleri

Prof Michael Camilleri, MD
Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER)
Mayo Clinic, Rochester, MN

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

Response: Liraglutide is approved for treatment of obesity; the precise mechanisms for the beneficial weight loss are unclear. We are interested to learn whether it is possible to identify people who are more likely to benefit from this treatment.

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Intermittent Dieting May Result In Greater Weight Loss

MedicalResearch.com Interview with:

Professor Nuala Byrne PhD Head of School | Health Sciences Faculty of Health University of Tasmania

Prof. Byrne

Professor Nuala Byrne PhD
Head of School | Health Sciences
Faculty of Health
University of Tasmania 

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

Response: Calorie restriction (or cutting back on the energy we are eating) triggers powerful compensatory responses by our body’s metabolism – we might think of it as a “Famine Reaction”. Our body weight is regulated by a series of nervous system and hormone networks that act together to make sure we have enough energy to sustain life. When we eat more energy than our body needs to meet our daily metabolic requirements (positive energy balance), we are designed to store that excess energy; and we are very good at storing. We store this energy in the fat cells (adipocytes) as an emergency reserve for when we hit hard-times when food availability is scarce. The problem in today’s society is that most of us have a constant availability of energy-dense food; making it more common to be in energy excess.

When we have less calories being consumed than what we need to fuel all the body’s metabolic processes (negative energy balance), we convert the stored fat into usable energy, and consequently lose weight. While our body does sense the positive energy balance, it is designed to be more sensitive to gauging when we are in a negative energy balance. Our body senses the change in energy intake and the decreasing fat stores, and brings out the artillery to defend our energy stores – this is the Famine Reaction. Our body is constantly changing our physiology in response to challenges to the status quo; the body works constantly to keep the oxygen concentration in the blood at an optimal level, to keep a constant and optimal body temperature, and a constant and optimal amount of sugar in the blood. Our body’s regulatory systems also work hard to defend our energy stores if it senses we are continually in negative energy-balance (i.e., dieting). One major metabolic compensatory as part of the “Famine Reaction” is a decrease in the body’s resting metabolic rate (energy expended while at rest to maintain the basic functioning of our major organs). Given that resting metabolic rate is determined largely by body size and composition, it is expected to decrease with weight loss. However, during dieting, resting metabolic rate has been reported to decrease to a greater extent than that expected from changes in body composition, a phenomenon termed ‘adaptive thermogenesis’. This leads to markedly reduced efficiency of weight loss.

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Vegetarian Diet More Effective For Weight Loss

MedicalResearch.com Interview with:

Hana Kahleova, MD, PhD</strong> Director of Clinical Research at Physicians Committee for Responsible Medicine Physicians Committee for Responsible Medicine Charles University in Prague

Dr. Kahleova

Hana Kahleova, MD, PhD
Director of Clinical Research at Physicians Committee for Responsible Medicine
Physicians Committee for Responsible Medicine
Charles University in Prague

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

Response: The vegetarian diet was found to be almost twice as effective in reducing body weight, resulting in an average loss of 6.2kg compared to 3.2kg for the conventional diet. Using magnetic resonance imaging, we studied adipose tissue in the subjects’ thighs to see how the two different diets had affected subcutaneous, subfascial and intramuscular fat.

We found that both diets caused a similar reduction in subcutaneous fat. However, subfascial fat was only reduced in response to the vegetarian diet, and intramuscular fat was more greatly reduced by the vegetarian diet.

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Re-Operations After Gastric Band Surgery Are Common and Costly

MedicalResearch.com Interview with:

Andrew Ibrahim, M.D., M.Sc</strong> Institute for HealthCare Policy and Innovation University of Michigan

Dr. Ibrahim

Andrew Ibrahim, M.D., M.Sc
Institute for HealthCare Policy and Innovation
University of Michigan

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

Response: The laparoscopic gastric band was approved by the FDA in 2001 and widely adopted for the surgical treatment of morbid obesity. Reported rates of reoperation to revise or remove the device ranged from 4 to 60 percent in small scale studies, but no population estimates in the United States existed.

In a review of Medicare Claims data between 2006 and 2013, we observed that reoperation was common with 18% of patients requiring at least one reoperation. More over, we found that on average, patients who did need a reoperation often underwent an average of 3.8 additional procedures. Taken together, nearly half (47%) of the $470 million paid by Medicare for device related procedures was for reoperations.

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Sustained Contact With Dietician Improves Maintenance of Weight Loss

MedicalResearch.com Interview with:

Corrine I. Voils, PhD Research Career Scientist, William S Middleton Veterans Memorial Hospital Visiting Professor of Surgery, University of Wisconsin-Madison

Dr. Corrine Voils,

Corrine I. Voils, PhD
Research Career Scientist, William S Middleton Veterans Memorial Hospital
Visiting Professor of Surgery, University of Wisconsin-Madison

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

Response: Weight loss interventions can help people lose weight, but most people tend to regain weight after a weight loss period. There is a need to identify effective strategies to help people maintain weight loss. We found that an intervention focused on maintenance behavioral skills that was delivered primarily by telephone reduced weight regain compared to usual care over 56 weeks.

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Losing Some Weight May Reduce Risk of Endometrial Cancer

MedicalResearch.com Interview with:

Juhua Luo, PhD Associate professor of epidemiology and biostatistics Indiana University School of Public Health

Dr. Juhua Luo

Juhua Luo, PhD
Associate professor of epidemiology and biostatistics
Indiana University School of Public Health

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

Response: We already know obesity increases risk of endometrial cancer. However, information on whether weight loss reduces risk of endometrial cancer is limited.

MedicalResearch.com: What are the main findings?

Response: Women losing 5% or more weight reduced risk of getting endometrial cancer by 29%. This was observed for any weight loss but risk was even lower for obese women with intentional weight loss. Obese women intentionally losing their weights by 5% or more reduced risk of getting endometrial cancer by 56%.

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

Response: Among post-menopausal women, intentional weight loss reduces risk of getting endometrial cancer, especially for obese women. Our findings suggest that weight loss in postmenopausal women may not be too late for potential health benefit.

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

Response: Additional research on intentional weight loss in relation to risk for other obesity-related cancer types and for mortality from cancer or other diseases are needed.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Intentional Weight Loss and Endometrial Cancer Risk

Juhua LuoRowan T. ChlebowskiMichael HendryxThomas RohanJean Wactawski-WendeJ, Cynthia A. ThomsonAshley S. FelixChu Chen, …

JCO Jan 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Government Endorsed DASH Diet Voted Best Overall

MedicalResearch.com Interview with:

Janet M. de Jesus, M.S., R.D. Program Officer, Implementation Science Center for Translation Research and Implementation Science (CTRIS) National Heart, Lung, and Blood Institute

Janet de Jesus

Janet M. de Jesus, M.S., R.D.
Program Officer, Implementation Science
Center for Translation Research and Implementation Science (CTRIS)
National Heart, Lung, and Blood Institute

MedicalResearch.com: What is the background for the DASH diet? What are the main components?

Response: The DASH eating plan was created for a clinical trial funded by the National Heart, Lung, and Blood Institute (NHLBI). DASH stands for Dietary Approaches to Stop Hypertension. The goal of the original DASH trial was to test the eating plan compared to a typical American diet (at the time in the 1990s) on the effect of blood pressure.

The DASH eating plan is rich in fruits, vegetables, and whole grains. It includes low-fat dairy products, poultry, fish, legumes, vegetable oils, and nuts; and limits intake of sweets and sugar-sweetened beverages and high-fat meats. The eating plan is a good source of potassium, magnesium, and calcium. The DASH eating plan was shown to reduce blood pressure and improve lipid profiles.

A second DASH trial, “DASH-sodium,” showed that adding sodium reduction to the DASH eating plan reduced blood pressure even more.

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Early Weight Loss Predicts Who Will Successfully Lose Weight With Liraglutide

MedicalResearch.com Interview with:

Ken Fujioka M.D. Director of the Center for Weight Management Scripps Clinical Department of Endocrinology La Jolla CA

Dr. Ken Fujioka

Ken Fujioka M.D.
Director of the Center for Weight Management
Scripps Clinical Department of Endocrinology
La Jolla CA

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

Response: Obesity is an odd disease that has many causes (overeating, underactivity, the patient being placed on a medication that drives up weight and a whole lot of other causes that result in a higher weight) so trying to find the right treatment, in this case a weight loss medication, for a particular patient is not an easy task. If there is a way to find out if you’ve picked the right medication (a weight loss of at least 5%) then this can help you decide whether you should keep the patient on the medication or stop the medication.

There are two huge benefits to this:
1. Is that you find your responders (patients) that will go on to lose weight and do well and 2. When you stop the medication in the non-responders you eliminate any potential adverse events from the weight loss medication.
Thus this study was designed to find out if early weight loss can predict who will go on to lose a significant amount of weight on Liraglutide.

And yes those who lose weight go on to lose weight.

Continue reading

FTO Gene Make Obesity More Likely But Doesn’t Prevent Weight Loss

MedicalResearch.com Interview with:

Prof. John C. Mathers Director, Human Nutrition Research Centre Institute of Cellular Medicine and Newcastle University Institute for Ageing Newcastle University Biomedical Research Building Campus for Ageing and Vitality Newcastle on Tyne

Prof. John C. Mathers

Prof. John C. Mathers
Director, Human Nutrition Research Centre
Institute of Cellular Medicine and
Newcastle University Institute for Ageing
Newcastle University
Biomedical Research Building
Campus for Ageing and Vitality
Newcastle on Tyne

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

Response: More than 90 different genetics variants are associated with body fatness and, of these, the FTO gene has the biggest effect. People who are homozygous for the unusual variant of FTO i.e. carry two copies of the risk allele, are on average 3kg heavier than those not carrying the risk allele. In addition, they have 70% greater risk of being obese. Since the FTO gene is associated with being heavier, we wondered whether it made it more difficult for people to lose weight.

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JAMA Study Looks At Comparable Effectiveness of Four Weight Loss Medications

MedicalResearch.com Interview with:

Siddharth Singh, MD, MS Postdoctoral Fellow, NLM/NIH Clinical Informatics Fellowship Division of Biomedical Informatics Clinical Assistant Professor of Medicine, Division of Gastroenterology, Department of Internal Medicine, University of California San Diego, La Jolla

Dr Siddharth Singh

Siddharth Singh, MD, MS
Postdoctoral Fellow, NLM/NIH Clinical Informatics Fellowship
Division of Biomedical Informatics
Clinical Assistant Professor of Medicine, Division of Gastroenterology, Department of Internal Medicine,
University of California
San Diego, La Jolla

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

Dr. Singh: Over the last 4 years, four new medications have been approved for long-term use for weight loss by the FDA. We sought to evaluate the comparative effectiveness and tolerability of these medications through a systematic review and network meta-analysis. Based on 28 trials in over 29,000 overweight or obese patients, we observed that magnitude of weight loss achieved with these agents is variable, ranging from 2.6kg with orlistat to 8.8kg with phentermine-topiramate. Over 44-75% of patients are estimated to lose at least 5% body weight, and 20-54% may lose more than 10% of body weight; phentermine-topiramate was the most efficacious, whereas lorcaserin was the best tolerated.

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Study Finds High Protein Dairy Products Can Be Included in Healthy Weight Loss Program

MedicalResearch.com Interview with:

Evelyn Parr Research Officer / PhD Candidate | Centre for Exercise and Nutrition Mary MacKillop Institute for Health Research Australian Catholic University

Evelyn Parr

Evelyn Parr
Research Officer / PhD Candidate | Centre for Exercise and Nutrition
Mary MacKillop Institute for Health Research
Australian Catholic University

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

Response: Results from previous investigations suggest that compared to a healthy ‘control’ diet, increased consumption of dairy foods in an energy restricted diet lead to improved body composition (i.e., a loss of fat mass and the maintenance of lean mass).

We investigated the effects of manipulating  the type of dairy foods (i.e., low- or high fat) within high protein, energy restricted diets on body composition and selected health parameters. Eighty-nine middle-aged (35-59 y), male and females who were overweight or obese completed a 16 week intervention comprising 3 d/wk supervised resistance training and 4 d/wk unsupervised aerobic -based exercise (i.e. walking). During this time they consumed a diet that was energy restricted by 250 kcal/d comprising either
1) high protein, moderate carbohydrate (4-5 normal fat dairy product servings),
2) high protein, high carbohydrate (4-5 low-fat, carbohydrate sweetened dairy product servings or
3) a control diet of moderate protein, high carbohydrate diet (1-2 dairy servings).

We found that in the face of energy restriction, when protein intakes were above the recommended daily intakes (>0.8 g/kg body mass) and regular exercise was completed, there was no difference in the loss of fat mass  (~8 kg) when participants consumed 4-5 serves of dairy products in either low- or high-fat. Furthermore, participants maintained  lean (muscle) mass throughout the energy restricted period.

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Higher Protein Intake Plus Exercise Preserves Muscle Mass During Weight Loss

MedicalResearch.com Interview with:

Professor Stuart M. Phillips Ph.D., FACSM, FACN Department of Kinesiology, McMaster University, CANADA Exercise Metabolism Research Group – Protein Metabolism Research Lab Director, Physical Activity Centre for Excellence

Prof. Stuart Phillips

Professor Stuart M. Phillips Ph.D.,
FACSM, FACN

Department of Kinesiology, McMaster University, Canada
Exercise Metabolism Research Group – Protein Metabolism Research Lab
Director, Physical Activity Centre for Excellence

Medical Research: What is the background for this study? What are the main findings?

Prof. Phillips: During weight loss with diet only people lose both muscle and fat and muscle. The long-term health consequences of losing metabolically active muscle versus fat are not likely to be beneficial. In the context of this study we thought perhaps the preservation of muscle would also be important in very active young men. We wanted to see whether when men were in a very large energy deficit (40% less energy than they required) higher protein (2.4 g/kg/d) could preserve muscle mass and still result in increased function (strength) and fitness.

Our results show that during a marked energy deficit that consumption of 2.4 g protein/kg/d was more effective than consumption of a diet containing 1.2 g protein/kg/d in promoting increases in LBM (1.2 vs 0.1kg increase) and losses of fat mass (-4.8kg vs. -3.5kg) when combined with a high volume of resistance and anaerobic exercise.

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Gene Therapy with Leptin Induces Weight Loss

Urszula T. Iwaniec, Ph.D. Associate Professor Skeletal Biology Laboratory School of Biological and Population Health Sciences Oregon State University Corvallis, OR 97331MedicalResearch.com Interview with:
Urszula T. Iwaniec, Ph.D.
Associate Professor
Skeletal Biology Laboratory
School of Biological and Population Health Sciences
Oregon State University
Corvallis, OR 97331

Medical Research: What is the background for this study? What are the main findings?

Dr. Iwaniec: Excessive weight gain in adults is associated with a variety of negative health outcomes. Unfortunately, dieting, exercise, and pharmacological interventions have had limited long-term success in weight control and can result in detrimental side effects, including accelerating age-related bone loss.  Leptin, a hormone produced by fat cells plays an essential role in weight regulation. Delivery of leptin directly into the hypothalamus by gene therapy normalizes body weight. We investigated the efficacy of using hypothalamic leptin gene therapy as an alternative method for reducing weight in skeletally-mature female rats and determined the impact of leptin-induced weight loss on bone. Our findings show that hypothalamic leptin gene therapy reduced body weight with minimal effects on bone mass or microarchitecture.

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Believing In Yourself Important For Weight Loss Maintenance

MedicalResearch.com Interview with:
Linda J Ewing PhD RN
Department of Psychiatry and
Lora E Burke PhD, MPH, RN, FAAN
Department of Health and Community Systems
University of Pittsburgh School of Nursing
Pittsburgh, Pennsylvania

Medical Research: What is the background for this study? What are the main findings?

Response: This study was the product both of work done in Dr. Burke’s lab as well as cumulative findings of other investigators demonstrating that improved self-efficacy is related to positive changes in health behaviors (e.g., physical activity, increased Intake of healthier foods, such as fruits and vegetables).  Given that, we designed a behavioral weight loss study that included an intentional focus on enhancing participant self-efficacy for healthy behaviors related to weight loss maintenance.  No previous study had self-efficacy enhancement as a focus of intervention with the long-term goal of increasing weight loss maintenance.  Thus our study focused on mastery performance of weight loss related behaviors.  Findings supported our hypothesis; participants in both arms of the study (standard behavioral weight loss (SBT) and SBT with self-efficacy enhancement (SBT+SE) achieved clinically significant weight loss.  Participants in the SBT+SE group had greater weight loss maintenance while those in the SBT group had clinically significant weight regain.
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A Pint of Water Before Meals May Speed Weight Loss

Dr Helen Parretti NIHR Clinical Lecturer University of BirminghamMedicalResearch.com Interview with:
Dr Helen Parretti
NIHR Clinical Lecturer
University of Birmingham

Medical Research: What is the background for this study?

Dr Parretti: Drinking water is widely advocated as a useful tool in weight loss and is included in many weight loss programs, yet there is little evidence to support this in practice. Some initial small laboratory studies suggested drinking water before main meals might help with weight loss, but we didn’t know whether it would work in an everyday setting over a sustained period of time.

Medical Research: What are the main findings?

Dr Parretti: We recruited 84 people into the trial. 41 in the “preloading water” group and 43 in the comparator group. The people in the preloading water group were asked to drink 500ml (around 1 pint or 2 glasses) of water 30 minutes before each main meal and lost, on average 1.3kg (2.87lb) more than those in the comparator group over 12 weeks. Those who reported preloading before all three main meals in the day reported a loss of 4.3kg (9.48lbs) over the 12 weeks, whereas those who only preloaded once, or not at all, only lost an average of 0.8kg (1.76lbs).

Medical Research: What should clinicians and patients take away from your report?

Dr Parretti: We believe that drinking 500ml of water before main meals is a simple message that could easily be given by healthcare professionals to patients with obesity when they are giving weight loss advice. When combined with brief instructions on how to increase your amount of physical activity and on a healthy diet, it seems to help people to achieve some extra weight loss – at a moderate and healthy rate.

Just drinking about a pint of water, three times a day, before your main meals may help reduce your weight and it’s something that doesn’t take much work to integrate into our busy everyday lives

Medical Research: What recommendations do you have for future research as a result of this study?

Dr Parretti: We would like to carry out a larger trial with 12 month follow up to allow us to gain more definitive evidence that water preloading is effective and also to investigate the potential mechanisms of action more fully.  We are now looking to gain funding to carry out this research.

Citation:

Helen M. Parretti, Paul Aveyard, Andrew Blannin, Susan J. Clifford, Sarah J. Coleman, Andrea Roalfe, Amanda J. Daley. Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT. Obesity, 2015; DOI: 10.1002/oby.21167

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MedicalResearch.com Interview with:, & Dr Helen Parretti (2015). A Pint of Water Before Meals May Speed Weight Loss 

Dementia Patients on Cholinesterase Inhibitors Risk Substantial Weight Loss

Meera Sheffrin MD Geriatrics Fellow Division of Geriatrics | Department of Medicine San Francisco VA Medical Center University of California, San Francisco MedicalResearch.com Interview with:
Meera Sheffrin MD
Geriatrics Fellow
Division of Geriatrics | Department of Medicine
San Francisco VA Medical Center
University of California, San Francisco

Medical Research: What is the background for this study? What are the main findings?

Dr. Sheffrin: The main drug treatments for dementia are a class of medications called cholinesterase inhibitors. They have only modest effects on cognition and function in most patients, but since they are one of the few available treatments for dementia and thus very commonly prescribed. However,they are known to cause GI side effects (nausea, vomiting, diarrhea, and anorexia) in many patients when first started. It is plausible they could also caust weight loss, espeically considering they cause nausea and anorexia. However, the data on weight loss from randomized controlled trials is very limited and inconclusive, so we did a very large observational study in a real-world of the VA national healthcare system who were newly started on these medications, to see if they were associated with weight loss.

We found that patient with dementia started on cholinesterase inhibitors had a substantially higher risk of clinically significant weight loss over a 12-month period compared to matched controls.

1,188 patients started on cholinesterase inhibitors were matched to 2,189 similar patients who were started on other new chronic medications. The primary outcome was time to a 10-pound weight loss over a 12-month period, as this represents a degree of loss that would be clinically meaningful – not only noticed by a clinician but would perhaps prompt further action in considering the causes of the weight loss and medical work-up.

We found that starting cholinesterase inhibitors was associated with a 24% greater risk of developing weight loss. Overall, 29% of patients started on cholinesterase inhibitors experienced a weight loss of 10 pounds or more, compared with 23% of the control group. This corresponds to a number needed to harm of 21 over 1 year; meaning only 21 patients need to be treated with a cholinesterase inhibitor over the course of a year for one patient to experience a 10 pound weight loss.

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Bariatric Surgery Reduces Urinary Incontinence As Well As Obesity

MedicalResearch.com Interview with:
Leslee L. Subak, MD

University of California, San Francisco
Professor, Departments of Obstetrics, Gynecology & Reproductive Sciences, Urology and Epidemiology & Biostatistics
Chief of Gynecology, SF Veterans Affairs Medical Center
UCSF Women’s Health Clinical Research Center

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

Dr. Subak: Urinary incontinence is very common, affecting an estimated 30 million adults in the U.S., and may account for as much as $60 billion in annual medical costs. Incontinence can cause significant distress, limitations in daily functioning, and reduced quality of life. Obesity is an important risk factor, with each 5-unit increase in body mass index – a ratio of someone’s weight divided by the square of their height – above normal weight associated with far higher rates of incontinence.   The prevalence of incontinence has been reported to be as high as 70 percent among severely obese women, and 24 percent among severely obese men (BMI greater than 40, or more than about 100 pounds greater than ideal body weight).

Since obesity is a risk factor for incontinence, several studies have examined whether weight loss is a treatment for incontinence among obese people with the condition.  Clinical trials have shown the low calorie diets, behavioral weight reduction, and bariatric surgery are associated with improvement in incontinence in obese women and men through one year, but evidence on the durability of this effect is lacking.

We performed this study to examine changes in urinary incontinence and identify factors associated with improvement among women and men in the first 3 years following bariatric surgery.

This study included 1987women and men in the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study performed at 10 hospitals at 6 clinical centers in the U.S. who underwent bariatric surgery between 2005 and 2009.  The study participants ranged in age from 18 to 78 years old – the median age was 47. The analysis controlled for factors such as age, race, smoking status and recent pregnancy.  Nearly 79 percent of the participants in the study were women with 49% reporting at least weekly incontinence, compared with 2% of men reporting incontinence.

Following surgery and large weight loss of 29% for women and 26% for men, substantial improvements in incontinence were observed, with a majority of women and men achieving remission at 3 years post-surgery. The more weight lost, the higher the chances of improvement. While the risk of relapse rose with each gain of about 10 pounds, overall there was substantial improvement for both women and men. People who were older, had severe walking limitations or were recently pregnant showed less improvement.

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TOPS: Take Off Pounds Sensibly Program Enables Sustained Weight Loss

Nia S. Mitchell, MD, MPH Assistant Professor Division of General Internal Medicine Department of Medicine University of Colorado Anschutz Medical CampusMedicalResearch.com Interview with:
Nia S. Mitchell, MD, MPH
Assistant Professor
Division of General Internal Medicine
Department of Medicine
University of Colorado Anschutz Medical Campus

Medical Research: What is the background for this study? What are the main findings?

Dr. Mitchell: Despite decades of obesity research two issues remain elusive in weight management: significant, long-term weight loss and weight loss maintenance and widely accessible programs. There are numerous weight loss programs out there, but there is little evidence of the long-term effectiveness of many programs. Furthermore, these programs may not be accessible to the general population because they are too expensive and may not be geographically available.

I chose to evaluate the Take Off Pounds Sensibly (TOPS) program because I thought it had the potential to address these issues. TOPS is a nationally-available, nonprofit, low-cost, peer-led weight loss program. It costs only $92 per year–$32 is the annual fee plus local chapter dues that average about $5 per month–and any four people can start a TOPS chapter, so it can be implemented and disseminated widely.

The main objective of this study was to determine the weight change for individuals who consecutively renewed their membership in TOPS. We looked at people who joined TOPS from 2005 to 2011, so they could have been followed for up to seven years. We found that people who join TOPS and consecutively renew their annual membership can lose a clinically significant amount of weight and maintain the weight loss for up to seven years. Clinically significant weight loss is defined as weight loss of at least 5% of initial weight, because with a 5% weight loss people with weight-related medical conditions, such as diabetes, can see an improvement in their conditions. Therefore, a diabetic who weighs 200 pounds may see an improvement in her blood sugar control if she loses 10 pounds.

In our study, fifty percent of individuals had clinically significant weight loss in their first year in the program, and 62% of those renewed their annual membership consecutively for seven years had clinically significant weight loss at seven years. This was exciting because many people who lose weight tend to gain it back. I often say that the unfortunate natural history of weight loss tends to be weight re-gain. However, the majority of these individuals maintained a clinically significant weight loss.

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It Really Is Harder For Some People to Lose Weight

MedicalResearch.com Interview with:
Martin Reinhardt, MD
Postdoctoral Fellow
PECRB, NIDDK, NIH
Phoenix, AZ 85016

Medical Research: What is the background for this study? What are the main findings?

Dr. ReinhardtIt can be very difficult for some people with obesity to lose weight despite great efforts. There is an immense deal of individual variability in weight loss success. Beyond differences in diet adherence, it is not clear what causes this variability in weight loss.

Through a study conducted at our facilities at the National Institutes of Health in Phoenix, Arizona, we have now shown that individual differences in biology – more precisely, differences in the amount of energy bodies use during fasting – make it difficult for certain obese people to lose weight.

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Dietary Restriction Provides Benefits Beyond Weight Loss

MedicalResearch.com Interview with:
Edward “Ted” Weiss, Ph.D.
Associate Professor
Department of Nutrition and Dietetics
Saint Louis University Saint Louis MO

Medical Research: What is the background for this study? What are the main findings?

Dr. Weiss:  Results from one of our previous study yielded a surprising result that diet-induced weight loss improved insulin sensitivity (major diabetes risk factor) by the same amount as exercise induced weight loss. We thought that the exercise-induced weight loss would have yielded benefits from the weight loss itself but also from a weight loss-independent benefit that has been reported in other studies. One explanation for dietary restriction providing the same benefit of exercise was that it also provides benefits besides those that are attributable to weight loss. Our recently completed/published study was designed to evaluate this possibility and the finding do suggest what we hypothesized… i.e. that dietary restriction provides benefits above and beyond that which are attributable to weight loss.

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Weight Watchers and Jenny Craig Achieved One Year Weight Loss

Kimberly Gudzune, MD, MPH Assistant Professor; The Johns Hopkins University School of Medicine Core Faculty; Welch Center for Prevention, Epidemiology, and Clinical Research The Johns Hopkins Digestive Weight Loss CenterMedicalResearch.com Interview with:
Kimberly Gudzune, MD, MPH
Assistant Professor; The Johns Hopkins University School of Medicine
Core Faculty; Welch Center for Prevention, Epidemiology, and Clinical Research
The Johns Hopkins Digestive Weight Loss Center

Medical Research: What is the background for this study? What are the main findings?

Dr.Gudzune: Changes in healthcare policy may encourage healthcare providers to screen their patients for obesity, so it is critical to then have a weight management plan if obesity is identified. Recent guidelines recommend that clinicians consider referring patients to high intensity weight loss programs. Commercial weight loss programs may be one of the options available, so providers need to know which programs help people lose weight and keep it off.

We found that only 11 out of 32 programs that we looked at had rigorous studies reporting on weight loss, which means that we do not know whether most programs work. Several well-known commercial programs have been scientifically tested and two programs, Weight Watchers and Jenny Craig, achieved significant weight loss that was sustained 12 months later.

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Successful Long Term Weight Loss May Hinge On Increasing Exercise, Decreasing Alcohol

MedicalResearch.com Interview with:
Sirpa Soini, MHC, researcher
Department of General Practice and Primary Health Care
University of Helsinki

Medical Research: What is the background for this study?
Response: Short-term weight loss is often successful, but he obtained results
are difficult to maintain. Therefore, a study focusing on obese people who successfully lost weight, with special  emphasis upon methods applied and background factors,
is of major importance. Many people are successful in losing weight by
themselves without taking part in any organized group activity. The
knowledge about their success and the methods applied does not usually
reach the health care personnel and is one reason why it is difficult
to get reliable information about those who are successful in losing
weight.

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Why Is It So Hard To Reach Our Behavior Goals?

Margaret C. Campbell, Phd | Professor | Marketing Chair, Doctoral Curriculum Program Committee 437 Leeds School of Business University of Colorado at Boulder Boulder, CO 80309-0419MedicalResearch.com Interview with:
Margaret C. Campbell, Phd | Professor | Marketing

Chair, Doctoral Curriculum Program Committee
437 Leeds School of Business
University of Colorado at Boulder
Boulder, CO 80309-0419
 

Medical Research: What is the background for this study? What are the main findings?

Dr. Campbell: People try to maintain healthy body weights, attain academic and career success, save money for a car, a house, or retirement, and achieve a host of other goals that require repeated, goal-consistent behaviors. Unfortunately, consumers’ efforts often fall short. For example, 68% of Americans are overweight (Weight Control Information Network 2010), 46% who begin college do not graduate within six years (Associated Press 2006), and although 93% say that saving for retirement is important, only about 60% are actually saving (TIAA-CREF 2010) and approximately 50% have accumulated less than $25,000 (Helman, VanDehrei and Copeland 2007). Understanding goal pursuit and consumers’ choices to continue effort toward a goal that requires repeated goal-consistent behaviors is thus important. People need to be able to make progress on important goals that substantially impact their quality of life.

Monitoring the influence of behavior on distance from a focal goal has been identified as important for successful goal pursuit – such as weight loss. In seven experiments, we find that people tend to have a “progress bias” such that they perceive that goal-consistent behaviors (such as avoiding eating a piece of cake) help progress more than equivalent-sized goal-inconsistent behaviors (such as eating a piece of cake) hurt progress. An experiment on exercise and eating shows that the progress bias can lead to poor understanding of progress and thus, premature release of the goal. In this study, the progress bias resulted in people with a goal of expending more calories than they consumed ended up consuming more than they expended.

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Pedometers Motivated Patients To Increase Physical Activity And Weight Loss

MedicalResearch.com Interview with
Christopher C. Imes, PhD, RN
Assistant Professor, Acute and Tertiary Care
University of Pittsburgh, School of Nursing

MedicalResearch: What is the background for this study?

Dr. Imes: Increased physical activity (PA) with reduced energy intake is the key strategy to achieve weight loss. However, in research, there are challenges to obtaining accurate PA data. Many studies rely on self-report, which is easily accessible and inexpensive but is known to have numerous limitations. Pedometers are a relatively inexpensive and accessible method to objectively measure certain aspects of physical activity. The purpose of this analysis was to examine the associations between self-reported physical activity, pedometer step count data and weight loss during the first 6-months of the Self-Efficacy Lifestyle Focus (SELF) trial. All participants in this trial were instructed to reduce their calorie and fat intake, were encouraged to engage in at least 150 minutes of moderately intense PA/week or 7500 steps/day, and to self-monitor their diet and physical activity.

MedicalResearch: What are the main findings?

Dr. Imes: Change in self-reported physical activity from baseline to 6 months was not associated with weight change. However, average daily step count, derived from pedometers given to participants during the same time period, was associated with weight loss. More daily steps results in more weight loss. The participants who averaged over 7500 steps/day lost about 9.5% of their initial body weight; whereas, the participants who averaged less than 5000 steps/day only lost about 5.0%.

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Vegetarian Protein Sufficient For Appetite Control and Weight Loss

dr alex johnstoneMedicalResearch.com Interview with:
Dr. Alex Johnstone PhD

Rowett Institute of Nutrition and Health
Aberdeen

 

Medical Research: What is the background for this study?
Response:

  • Previous work has indicated that high-protein (30% of diet as protein) meat-based weight loss diets are highly satiating, and reduce the free food intake over a four-week period (1,2).
  • There is limited data on assessing the effect of different types of protein on appetite in weight loss studies (3). Previously, a mixed meat source of protein was used in our high protein diets, but this approach has been criticised both from a policy and public health perspective because of potential negative side effects, especially on gut health (4).
  • There is acceptance that vegetable based weight loss diet may offer protection from diseases (5).
  • It may be that alternative vegetable sources of protein could be satiating, and yet maintain a healthy gut during weight loss, and we set up a study to test this, using soya (plant) protein
  1. Westerterp-Plantenga MS, Nieuwenhuizen A, Tomé D, Soenen S, Westerterp KR. Annu Rev Nutr 2009; 29:21-41.
  2. Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Am J Clin Nutr 2008; 87(1):44-55.
  3. Due A, Toubro S, Skov AR, Astrup A.. Int J Obes Rel Metab Disord 2004; 28(10):1283-90.
  4. Russell WR, Gratz SW, Duncan SH, Holtrop G, Ince J, Scobbie L, Duncan G, Johnstone AM, Lobley GE, Wallace RJ, et al.. Am J Clin Nutr 2011; 93(5):1062-1072.
  5. Clifton P. Brit J Nutr 2012; 108:122–129.

Medical Research: What are the main findings?
Response:

  • Over the two weeks, subjects lost similar amounts of weight, on average 2.41 and 2.27 kg on the vegetarian high-protein weight loss and meat based high-protein weight loss diets respectively, with similar reduction in fat-mass and preservation of fat-free mass, due to the high protein component.
  • The vegetarian high-protein weight loss had a similar impact on appetite and motivation to eat as the meat based high-protein weight loss diet.
  • Blood biomarkers improved with weight loss for both high protein diets (plasma cholesterol, low density lipoproteins (LDL), high density lipoproteins (HDL), triglycerides and glucose)
  • There was a greater reduction in total cholesterol with the plant based diet for cholesterol and LDL cholesterol. This finding could be attributed to the composition of vegetarian source of protein (soya), (i.e. fibre, phytochemicals, and other micro and macro nutrients).

Medical Research: What should clinicians and patients take away from your report?

Response: Since appetite control and weight loss was similar in both weight loss diets, vegetarian meals are acceptable to  include in a high-protein moderate carbohydrate weight loss diet. In this context, the diets were 30% protein, 30% fat and 40% carbohydrate from energy. A diet that contains mixed sources of protein is acceptable, to feel fuller for longer during calorie restriction for weight loss.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Alternative plant sources of protein in the context of weight loss is of interest to achieve a healthy body weight but also sustainable sources for the environment. Also the role of dietary protein with carbohydrate in promoting body weight maintenance after weight loss.

Read more here about our research on sustainable protein :  http://www.abdn.ac.uk/rowett/research/strategic-partnership.php

Citation:

Research presented at the Association for the Study of Obesity (ASO) in London, UK

 

MedicalResearch.com Interview with: Dr. Alex Johnstone PhD, Rowett Institute of Nutrition and Health, & Aberdeen (2015). Vegetarian Protein Sufficient For Appetite Control and Weight Loss 

Weight Loss May Be Better For Bone Health in Obese Men

Sue Shapses, PhD Professor, Department of Nutritional Sciences Acting Chair, Department of Exercise Sciences and Sports Studies Rutgers, The State University New Brunswick, NJ 08901-8525MedicalResearch.com Interview with:
Sue Shapses, PhD

Professor, Department of Nutritional Sciences
Acting Chair, Department of Exercise Sciences and Sports Studies Rutgers, The State University
New Brunswick, NJ 08901-8525

MedicalResearch: What is the background for this study?

Dr. Shapses: Improving health outcomes through dieting and weight loss is encouraged for the majority of Americans who are either overweight or obese. However, while most studies show that a moderate reduction in body weight decreases obesity related comorbidities, there may also be loss of bone and muscle in older individuals. Specifically in postmenopausal women, intentional moderate weight loss results in a 1-2.5% bone loss when compared to a weight stable group. Studies in men, designed to address the effect of weight reduction at multiple bone sites, compartments and geometry, are currently lacking. In addition, while a higher body weight is associated with higher bone mass, evidence indicates that bone quality, a predictor of fracture risk, is compromised in the obese. It is possible that frequent dieting or weight cycling in these obese individuals may have deleterious effects on bone. Therefore, understanding whether bone quality changes with weight loss, is important to better predict osteoporosis risk in this population. In this controlled trial, the effect of dietary restriction on bone mineral density (BMD), geometry and strength were examined in middle aged and older obese/overweight men. In addition, we addressed whether endocrine changes associated with weight loss explain bone changes.

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After Weight Loss Surgery, ThighLifts Come With Minor Complications

Jeffrey A. Gusenoff, MD Associate Professor of Plastic Surgery Co-Director, Life After Weight Loss Program Co-Director, BodyChangers Director, Post-Bariatric Body Contouring Fellowship UPMC Department of Plastic SurgeryMedicalResearch.com Interview with:
Jeffrey A. Gusenoff, MD

Associate Professor of Plastic Surgery
Co-Director, Life After Weight Loss Program
Co-Director, BodyChangers
Director, Post-Bariatric Body Contouring Fellowship
UPMC Department of Plastic Surgery

Medical Research: What is the background for this study? What are the main findings?

Dr. Gusenoff: With the rise in massive weight loss patients from bariatric surgery or diet and exercise, more patients are choosing to have a thighplasty to remove excess skin of the inner thigh. Many techniques exist for treating this, but there aren’t many studies that look into the safety of these procedures in massive weight loss patients. What we found is that  many patients have scars that go all the way down the thigh with a fairly high complication rate of almost 70%.
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Daily Weighing May Promote More Weight Loss

Elina Helander, PhD Personal Health Informatics Department of Signal Processing Tampere University of Technology, Tampere, FinlandMedicalResearch.com Interview with:
Elina Helander, PhD
Personal Health Informatics
Department of Signal Processing
Tampere University of Technology, Tampere, Finland

Medical Research: What is the background for this study? What are the main findings?

Dr. Helander: Frequent or at least regular self-weighing is a part of behavioral therapy in many weight programs. However, self-weighing frequency typically varies over time. We analyzed almost 3,000 weight observations from 40 overweight individuals that participated in a 1-year health promotion program. These individuals were instructed to weigh themselves daily but eventually had varying self-weighing frequencies. We examined how different self-weighing frequencies of the same individual were linked with weight changes.

We found that weight loss generally occurred during daily weighing. When there were longer breaks in self-weighing such as one month or more, there was a risk of weight gain.  We also computed a theoretical minimum self-weighing frequency for having no weight gain that was 5.8 days in our study. That corresponds approximately weekly weighing.

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Eating Behaviors Predict Long Term Weight Loss After Bariatric Surgery

MedicalResearch.com Interview with:
Hanna Konttinen, PhD, Docent

Post-doctoral researcher
Department of Social Research
University of Helsinki

Medical Research: What is the background for this study?

Dr. Konttinen: Bariatric surgery yields significant weight reduction for the majority
of severely obese individuals with accompanied improvements in health
status and health-related quality of life. Nonetheless, slow weight
regain over time is frequent and there is a need for a better
understanding on the factors that influence long-term post-surgical
weight outcomes. To our best knowledge, this was the first study to
examine whether psychological aspects of eating behavior predicted
weight changes 10 years after surgical and conventional treatment for
severe obesity.

The participants were from the Swedish Obese Subjects intervention
study: 2010 obese subjects who underwent bariatric surgery and 1916
contemporaneously matched obese controls who received conventional
treatment.
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Internalized Fat Bias Impacts Bariatric Surgery Success

Dr. Michelle Lent PhD Geisinger Health SystemMedicalResearch.com Interview with
Dr. Michelle Lent PhD
Geisinger Health System

Medical Research: What is the background for this study?

Dr. Lent: Previous study findings indicate that weight bias relates to a number of adverse outcomes in overweight and obese populations, including binge eating, psychological disorders and body image issues. In this study, we measured the degree to which people undergoing weight-loss surgery translate “anti-fat” attitudes into negative beliefs about themselves before surgery (known as “internalized weight bias”) and if this influences weight loss outcomes after surgery. Continue reading

Bariatric Surgery Effective For Both Weight Loss and Diabetes Remission

Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center MedicalResearch.com Interview with: 
Anita P. Courcoulas M.D., M.P.H., F.A.C.S
Professor of Surgery
Director, Minimally Invasive Bariatric & General Surgery
University of Pittsburgh Medical Center

Medical Research: What are the main findings of the study?

Dr. Courcoulas: This paper was not a study but a summary of findings from a multidisciplinary workshop (and not a consensus panel) convened in May 2013 by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. The goal of the workshop was to summarize the current state of knowledge of bariatric surgery, review research findings on the long-term outcomes of bariatric surgery, and establish priorities for future research.
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Study Finds Only Small Weight Loss Differences Between Brand Diet Plans

Bradley Johnston, PhD Scientist | Child Health Evaluative Sciences Hospital for Sick Children Research Institute Assistant Professor | Department of Clinical Epidemiology & Biostatistics  McMaster University Toronto, Ontario, Canada, M5G 0A4MedicalResearch.com Interview with:
Bradley Johnston, PhD
Scientist | Child Health Evaluative Sciences
Hospital for Sick Children Research Institute
Assistant Professor | Department of Clinical Epidemiology & Biostatistics
McMaster University Toronto, Ontario, Canada

Medical Research: What are the main findings of the study?
Dr. Johnston:

  • Our findings represent the first meta-analysis using advanced epidemiological methods to summarize popular branded diets for weight loss, trials having been investigated using randomized trial methodology.
  • Among the 48 original RCTs included in our NMA, low to moderate quality evidence showed that both low-carbohydrate and low-fat diets were associated with an approximate 8 kg weight loss at 6 months when compared to no diet. Approximately 1-2 kg of this effect was lost by 12-months.
  • Although statistical differences existed among several of the diet macronutrient classes, the differences were small and unlikely to be important to those seeking to lose weight.
  • Similarly, our results showed that although there are statistically significant differences between some of the brand named diets, these differences are small and not likely patient important.
  • In terms of potential effect modifiers, behavioural support was significant at 6-months (enhancing weight-loss by 3.23 kg) and exercise was significant at 12-months (enhancing weight loss by 2.13 kg)
  • Regarding our sensitivity analyses, Differences in weight loss were not clinically important based on risk of bias, missing data, baseline weight, gender, and those with and without specific health conditions
  • Overall, our findings suggest that patients may choose, among those associated with the largest weight loss, the diet that gives them the least challenges with adherence.

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Crowdsourcing App May Help Dieters Stay On Track

Brie Turner-McGrievy, Ph.D., M.S., R.D. Assistant Professor University of South Carolina Arnold School of Public Health Department of Health Promotion, Education, and Behavior Discovery Columbia, SC 29208MedicalResearch.com Interview with:
Brie Turner-McGrievy, Ph.D., M.S., R.D.
Assistant Professor, University of South Carolina
Arnold School of Public Health
Department of Health Promotion, Education, and Behavior Discovery
Columbia, SC 29208

 Medical Research: What are the main findings of the study?

Dr. Turner-McGrievy: This study assessed how closely crowdsourced ratings of foods and beverages contained in 450 pictures from the Eatery mobile app as rated by peer users using a simple “healthiness” scale were related to the ratings of the same pictures by trained observers. Our trained observers used a rating scale based on the U.S. Dietary Guidelines to assess the healthiness of the foods and beverages in each picture. Crowdsourcing uses the input of several users to provide feedback and information. We found that all three trained raters’ scores was highly correlated with the peer healthiness score for all the photos. In addition, we found that peer ratings were in the expected direction for both foods/beverages the Dietary Guidelines say to increase and ones to limit. Photos with fruit, vegetables, whole grains, and legumes, nuts, and seeds were all associated with higher peer healthiness scores and processed, food from fast food restaurants, refined grains, red meat, cheese, savory snacks, sweets/desserts, and sugar sweetened beverages were associated with lower peer healthiness scores.
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Intermittent vs Continous Dieting: Is One Better for Weight Loss?

Jennifer Keogh PhD, MSc, APD Associate Professor Dietetics and Nutrition Fellow of the South Australian Cardiovascular Research Development Program School of Pharmacy and Medical Sciences University of South AustraliaMedicalResearch.com Interview with:
Jennifer Keogh PhD, MSc, APD
Associate Professor Dietetics and Nutrition
Fellow of the South Australian Cardiovascular Research Development Program
School of Pharmacy and Medical Sciences
University of South Australia

Medical Research: What is the background for this study?

Dr. Keogh: A variety of weight loss strategies are needed to help individuals lose weight and maintain weight loss.  In this study we investigated the effects on weight loss of an intermittent energy restricted diet using a ‘week-on, week-off’ strategy compared to a continuous energy restricted diet after 8 weeks and on maintenance of weight loss at 12 months in healthy overweight and obese women. Using a group setting participants were advised to reduce their energy intake to approximately 5500 kJ per day when restricting their intake. The diet plan used was based on the previously published CSIRO Total Wellbeing Diet.
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Increasing Fruits & Vegetables In Diet May Not Lead To Weight Loss

Kathryn A. Kaiser, Ph.D. Department of Biostatistics Ryals Public Health Bldg, University of Alabama at Birmingham Birmingham, AL 35294MedicalResearch.com Interview with:
Kathryn A. Kaiser, Ph.D.
Department of Biostatistics
Ryals Public Health Bldg,
University of Alabama at Birmingham
Birmingham, AL 35294

MedicalResearch: What are the main findings of the study?

Dr. Kaiser: Recommendations to increase or home delivery of fruits and vegetables to increase intake results in no significant weight loss or gain in adults studied over 8-16 weeks.
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PCOS: Metformin and Weight Loss

Dr. Dorte Glintborg PhD Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University HospitalMedicalResearch.com Interview with:
Dr. Dorte Glintborg PhD
Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University Hospital

MedicalResearch.com: What are the main findings of this study?

Dr. Glintborg: The main finding of the study is that one year’s metformin treatment is associated with a minor but significant weight loss in patients with PCOS irrespective of BMI at study inclusion. Treatment with oral contraceptives improves sex-hormone levels but is associated with at minor weight gain. Based on the study results, clinicians should consider the combined treatment with metformin and oral contraceptives in patients with PCOS.

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Frequent Meals Don’t Promote Weight Loss

Dr. Milan K Piya NIHR Clinical Lecturer in Diabetes and Endocrinology Warwick Medical School, University of Warwick; University Hospitals Coventry and Warwickshire NHS Trust Coventry, UKMedicalResearch.com Interview with:
Dr. Milan K Piya
NIHR Clinical Lecturer in Diabetes and Endocrinology
Warwick Medical School, University of Warwick;
University Hospitals Coventry and Warwickshire NHS Trust
Coventry, UK

MedicalResearch.com: What are the main findings of the study?

Answer: Our studies have identified two main findings:

Firstly that the size or frequency of the meal doesn’t affect the calories we burn in a day, but what matters most for losing weight is counting calories.

Secondly, by carrying more weight, more endotoxin enters the circulation to cause inflammation and eating more often will exacerbate this risk which has been linked to metabolic diseases such as type-2 diabetes.

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Online Access to Dietitian Improved Weight Loss

Beverly B. Green, MD, MPH GroupHealth Research Institute Seattle WAMedicalResearch.com Interview with:
Beverly B. Green, MD, MPH
GroupHealth Research Institute
Seattle WA

 

MedicalResearch.com: What are the main findings of the study?

Dr. Green: We found that Group Health patients who were overweight and had hypertension were more likely to have lost 10 pounds in six months if they had secure online access to a dietitian than if they received only information and usual care. The patients really loved this intervention—and having access to a dietitian to work with them toward a healthier lifestyle. Although blood pressure and heart risk trended lower in the intervention group, the differences weren’t significant—unlike their weight.

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Weight Loss Healthy Living Program for Men

Professor Sally Wyke Deputy Director, Institute of Health and Wellbeing Professor (Institute of Health and Wellbeing Social Sciences) The University of GlasgowMedicalResearch.com Interview with:
Professor Sally Wyke
Deputy Director, Institute of Health and Wellbeing
Professor (Institute of Health and Wellbeing Social Sciences)
The University of Glasgow


MedicalResearch.com: What are the main findings of the study?

Prof. Wyke: The FFIT programme was very effective.  The men who did the programme lost nine times as much weight as the men who did not.  On average, they lost over 5.5kg  (11lbs)and kept it off for the full 12 months.

In addition, we found highly significant differences in favour of the intervention objectively-measured waist, percentage body-fat, systolic and diastolic blood pressure, and self-reported physical activity, diet and indicators of well-being and physical aspects of quality of life.
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Pre-Diabetes: Early Weight Loss Reduces Longer-Term Diabetes Risk

MedicalResearch.com Interview with: Nisa M. Maruthur, MD, MHS
Assistant Professor of Medicine & Epidemiology
The Johns Hopkins University

Early Response to Preventive Strategies in the Diabetes Prevention Program

MedicalResearch.com: What are the main findings of the study?

Dr. Maruther: For patients engaged in a lifestyle intervention to prevent diabetes, weight loss early on (at 6 months) is an extremely strong predictor of whether they will develop diabetes down the road.  Even in the setting of substantial weight loss (>10%) at 6 months, it is still beneficial to lower fasting glucose.  These results are unique in that we previously understood that weight loss over time (years) is important to prevent diabetes, but now we know the impact of early weight loss on longer-term diabetes risk.
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Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends

MedicalResearch.com eInterview with

Manuel Franco MD, PhD Associate Professor Department of Health Sciences, Public Health Unit Universidad de Alcalá mfranco@uah.es http://www.uah.es/pdi/manuel_franco Adjunct Associate Professor Department of Epidemiology Johns Hopkins Bloomberg School of Public Health mfranco@jhsph.eduManuel Franco MD, PhD
Associate Professor
Department of Health Sciences, Public Health Unit
Universidad de Alcalá
Johns Hopkins Bloomberg School of Public Health
Adjunct Associate Professor Dept. of Epidemiology
mfranco@jhsph.edu

MedicalResearch.com: What are the main findings of the study?

Dr. Franco: Population wide weight loss of about 5 kg was related with large decreases in diabetes and cardiovascular mortality. On the contrary, Body weight regain was related with an increase in diabetes prevalence, incidence, and mortality, as well as a deceleration in the previously declining rates of cardiovascular death.
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Scientists create small molecules that alter biological clock and lead to weight loss

The new molecules could lead to unique treatments for obesity, diabetes, high cholesterol, and sleep disorders

JUPITER, FL — Scientists from the Florida campus of The Scripps Research Institute have synthesized a pair of small molecules that dramatically alter the core biological clock in animal models, highlighting the compounds’ potential effectiveness in treating a remarkable range of disorders—including obesity, diabetes, high cholesterol, and serious sleep disorders.

The study was published on March 29, 2012, in an advance, online edition of the journal Nature.

The study showed that when administered in animal models the synthetic small molecules altered circadian rhythm and the pattern of core clock gene expression in the brain’s hypothalamus, the site of the master cellular clock that synchronizes daily rhythms in mammals; circadian rhythms are the physiological processes that respond to a 24-hour cycle of light and dark and are present in most living things.

When given to diet-induced obese mice, these same small molecules decreased obesity by reducing fat mass and markedly improving cholesterol levels and hyperglycemia—chronically high blood sugar levels that frequently lead to diabetes.

“The idea behind this research is that our circadian rhythms are coupled with metabolic processes and that you can modulate them pharmacologically,” said Thomas Burris, a professor at Scripps Florida who led the study. “As it turns out, the effect of that modulation is surprisingly positive—everything has been beneficial so far.”

Burris stressed that these compounds were first generation—the first to hit their targets in vivo with room for improvement as potential treatments. “In terms of therapeutics, this is really the first step,” he said.

In the new study, the team identified and tested a pair of potent synthetic compounds that activate proteins called REV-ERBα and REV-ERBβ, which play an integral role in regulating the expression of core clock proteins that drive biological rhythms in activity and metabolism.

In the study, the scientists observed clear metabolic effects when the synthetic compounds were administered twice a day for 12 days. Animals displayed weight loss due to decreased fat mass with no changes in the amount of food they ate. The animals followed the human model of obesity closely, eating a standard Western diet of high fat, high sugar foods, yet still lost weight when given the compounds.

In one of the study’s more striking findings, both synthetic compounds were shown to reduce cholesterol production. Cholesterol in the blood of treated animal models decreased 47 percent; triglycerides in the blood decreased 12 percent.

The circadian pattern of expression of a number of metabolic genes in the liver, skeletal muscle, and in fat tissue was also altered, resulting in increased energy expenditure, something of a surprise. In the study, the scientists observed a five percent increase in oxygen consumption, suggesting increased energy expenditure during the day and at night. However, these increases were not due to increased activity—the animals displayed an overall 15 percent decrease in movement during those same time periods.

In addition to its impact on metabolism, the two compounds also affected the animals’ activity during periods of light and darkness, suggesting that this class of compound may be useful for the treatment of sleep disorders, including the common problem of jet lag.

The first authors of the study, “Regulation of Circadian Behavior and Metabolism by Synthetic REV‐ERB Agonists,” are Laura A. Solt and Yongjun Wang of Scripps Research. Other authors include Subhashis Banerjee, Travis Hughes, Douglas J. Kojetin, Thomas Lundasen, Youseung Shin, Jin Liu, Michael D. Cameron, Romain Noel, Andrew A. Butler, and Theodore M. Kamenecka of Scripps Research; and Seung Hee Yoo and Joseph S. Takahashi of the Howard Hughes Medical Institute and University of Texas Southwestern Medical Center.