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

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

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

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

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

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

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More Weight Loss Linked To Greater Decrease in Knee Arthritis Pain

MedicalResearch.com Interview with:

Wake Forest professor of Health and Exercise Science Steve Messier, Friday, June 15, 2018.

Prof. Messier

Professor Steve Messier
Director of the J.B. Snow Biomechanics Laboratory
J.B Snow Biomechanics Laboratory
Wake Forest University

MedicalResearch.com: Why did you undertake this study?

Response: This was a secondary analysis of the Intensive Diet and Exercise for Arthritis (IDEA) clinical trial originally published in JAMA in 2013, Volume 310, Number 12, pages 11263-1273.

We were interested to see if losing 20% of your body weight had any additional benefits compared to a 10% weight loss that we previously have shown to be beneficial.

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Performance Drops Along With Weight on Ketogenic Diets

MedicalResearch.com Interview with:

Edward "Ted" Weiss, Ph.D. Associate Professor Department of Nutrition and Dietetics Saint Louis University Saint Louis MO 63104

Dr. Weiss

Edward “Ted” Weiss, Ph.D.
Professor
Department of Nutrition and Dietetics
Saint Louis University
Saint Louis MO 63104

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

Response: Ketogenic diets are popular. They are very low in carbohydrate, with moderate protein and large amounts of fat. They are popular for weight loss but definitive studies of this are lacking.

We tested the effects of a ketogenic diet on high-intensity exercise performance, such as sprinting. The result showed that the ketogenic diet was harmful to performance, reducing performance by 6 – 7% when compared to a high-carbohydrate diet.

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Obese Children Who Lose Weight Before Adulthood Can Reduce Risk of Diabetes

MedicalResearch.com Interview with:

Lise Geisler Bjerregaard PhD

Dr. Geisler Bjerregaard

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.  Continue reading

Both Vegetarian and Mediterranean Diets Beneficial for Weight Loss and Heart Health

MedicalResearch.com Interview with:
“Vegetarian dan dan noodles” by Andrea Nguyen is licensed under CC BY 2.0Francesco Sofi, MD PhD
Department of Experimental and Clinical Medicine
University of Florence, Florence, Italy; Clinical Nutrition Unit, Careggi University Hospital
Don Carlo Gnocchi Foundation Italy, Onlus IRCCS
Florence, Italy 

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

Response: Mediterranean and Vegetarian diets are two of the most beneficial dietary patterns for prevention of chronic degenerative diseases.

No studies have been conducted in the same group of subjects, by comparing these two dietary profiles.

Main results are that both diets have been found to be beneficial for cardiovascular prevention, in the same group of subjects at low risk of cardiovascular disease.

In particular, vegetarian diet determined a reduction of total and LDL-cholesterol, whereas Mediterranean diet resulted in lower levels of triglycerides and some inflammatory parameters

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Bariatric Surgery Linked To Long Term Mortality Reduction

MedicalResearch.com Interview with:
Oma Reges, PhD
Clalit Research Institute, Clalit Health Services, Tel Aviv, Israel
Department of Health Systems Management, Ariel University, Ariel, Israel

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

Response: Israel, based on the most recently published data (2015), performs more per-capita bariatric surgery than the U.S.A (about 9,000 to 9,500 procedures annually, which is 1.8 times higher rate per capita than the U.S.A, where there are about 200,000 procedures a year).

It is important to evaluate the impact of these procedures on health status, as there is a lack of data of the effectiveness of these procedures over time. We were able to document lower mortality rates, of up to 50%, in the obese patient undergoing surgery as opposed to matched obese patients who continue with usual care.  Continue reading

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.

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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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