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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