Obese Women Remain at Risk For Heart Disease, Even When Metabolically Healthy

MedicalResearch.com Interview with:
Nathalie Eckel, MSc

German Diabetes Center
Düsseldorf, Germany 

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

 Response: Obesity is associated with metabolic disorders such as diabetes, high blood pressure and hypercholesterolemia, and with a higher risk of cardiovacular disease compared to normal weight. However, there is also the phenomenon of the so-called “metabolically healthy obesity” and “metabolically unhealthy normal-weight”. So far it has been unclear how metabolic risk factors change over time in metabolically healthy people depending on body weight and what cardiovascular disease risk results from this.

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Maternal Gestational Diabetes Increased Risk of Childhood Obesity

MedicalResearch.com Interview with:

Dr. Gang Hu, Associate Professor LSU’s Pennington Biomedical Research Center & Director Chronic Disease Epidemiology Lab

Dr. Gang Hu

Dr. Gang Hu, Associate Professor
LSU’s Pennington Biomedical Research Center & Director
Chronic Disease Epidemiology Lab

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

Response: Some studies have found that maternal gestational diabetes mellitus (GDM) places offspring at increased risk of long-term adverse outcomes, including obesity. However, most of studies are from high income countries, with limited data from low to middle income countries. The present study, conducted at urban and suburban sites in 12 countries, found that the increased risk for children of GDM mothers compared with non-gestational diabetes mellitus mothers was 53% for obesity, 73% for central obesity, and 42% for high body fat.

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MRI Images Demonstrate Why Drinking Water Sometimes Curbs Appetite

MedicalResearch.com Interview with:

Guido Camps, MSc PhD candidate Wageningen University and Research Centre The Netherlands

Guido Camps

Guido Camps, MSc PhD candidate
Wageningen University and Research Centre
The Netherlands

Editor’s note:  The researcher would like readers to be aware that this work is preliminary and has not yet been published in a peer-reviewed journal.

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

Response: The background was that we wanted to study gastric distension with actual food. Because using different foods would also change the caloric content, we added water. We wanted to see if we could measure both the stomach and the brain, and what the added distension would feel like to the subjects and what brain effects we could see.
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Obese Black Patients With Abnormal Sleep Have Greater Stroke Risk Than Whites

MedicalResearch.com Interview with:

Azizi Seixas, Ph.D. Post-Doc Fellow Department of Population Health Center for Healthful Behavior Change NYU School of Medicine

Dr. Azizi Seixas

Azizi Seixas, Ph.D.
Post-Doc Fellow
Department of Population Health
Center for Healthful Behavior Change
NYU School of Medicine

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

Response: Compared with whites, blacks are disproportionately affected by strokes. The overwhelming prevalence of obesity among blacks compared to whites has been suggested as a possible explanation for the disproportionate rates of strokes among blacks compared to whites. Recent findings linking insufficient sleep and stroke as well as the disproportionate burden of insufficient sleep among blacks compared to whites might provide a unique mechanism explaining why blacks have higher rates of stroke. However, it is unclear whether insufficient sleep and obesity contributes to the higher rates of stroke among blacks compared to whites.

To test our hypothesis, we utilized data from the National Health Interview Survey from 2004-2013 with a sample size of 288,888 individuals from the United States. Using Bayesian Belief Network (BBN) analysis, a form of machine learning analysis, we assessed the mediating effects of BMI on the relationship between short sleep duration (≤6 hrs. total sleep duration), long sleep duration (≥9 hrs. total sleep duration), and stroke, and whether race/ethnicity differences in obesity moderated these relationships.

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Late Sleepers Don’t Have Higher BMI

MedicalResearch.com Interview with:

Kelly Glazer Baron, PhD, MPH, C. B.S.M. Diplomate, Academy of Cognitive Therapy Northwestern University Feinberg School of Medicine Chicago, IL 60611

Dr. Kelly Glazer Baron

Kelly Glazer Baron, PhD, MPH, C. B.S.M.
Diplomate, Academy of Cognitive Therapy
Northwestern University
Feinberg School of Medicine
Chicago, IL 60611

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

Response: In contrast to several previous studies, being a late sleeper was not associated with higher BMI (good news for late sleepers!!) but it was associated with less healthy behaviors, more fast food, fewer vegetables, lower dairy. It may be possible that these late sleepers who are able to get enough sleep can compensate for their poor diet by controlling overall calories or it could possibly lead to weight gain over time if their habits continue over time.

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Optimal BMI With Lowest Mortality Has Shifted to Higher Weight

MedicalResearch.com Interview with:
Shoaib Afzal, MD, PhD
Department of Clinical Biochemistry
Copenhagen General Population Study
Herlev and Gentofte Hospital,
Faculty of Health and Medical Sciences
University of Copenhagen, Copenhagen, Denmark

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

Dr. Afzal: Previous findings indicate that while average BMI has increased over time in most countries, the prevalence of cardiovascular risk factors may be decreasing among obese individuals. Thus, the BMI associated with the lowest all-cause mortality may have changed over time. This study included three cohorts from the same general population enrolled at different times: the Copenhagen City Heart Study in 1976-1978 (n = 13,704) and 1991-1994 (n = 9,482) and the Copenhagen General Population Study in 2003-2013 (n = 97,362).

The increased risk for all-cause mortality that was associated with obesity compared to normal weight decreased from 30% in 1976-1978 to 0% in 2003-2013, that is, over a 30-year period. In addition, the optimal BMI for lowest all-cause mortality increased by 3.3 from 23.7 in 1976-1978 through 24.6 in 1991-1994 to 27 in 2003-2013. Another interesting finding in this study is that the optimal BMI in relation to lowest mortality is placed in the overweight category in the most recent 2003-2013 cohort.

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Weight Loss Improves Quality of Life But Not Atrial Fibrillation Ablation Outcomes

MedicalResearch.com Interview with:
Sanghamitra Mohanty, MD MS FHRS

Director, translational research, Texas Cardiac Arrhythmia Institute and Associate Professor (affiliate) Dell Medical School

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

Dr. Mohanty:  In the last few years, several trials from a research group in Australia have generated tremendous interest in life-style modifications to manage AF more effectively. These studies reported significant decrease in arrhythmia burden and symptom severity and improvement in ablation outcome in patients with paroxysmal and persistent atrial fibrillation. We investigated the impact of weight-loss on procedure outcome in terms of arrhythmia burden, quality of life and arrhythmia-free survival in long-standing persistent (LSPAF) patients undergoing catheter ablation.

Our main findings were the following;

  1. In patients with long-standing persistent atrial fibrillation, weight loss improved quality of life but had no impact on symptom burden and long-term ablation outcome
  2. No change in AF type or status was detected after the weight loss
  3. Extensive ablation including pulmonary vein (PV) isolation plus ablation of posterior wall and non-PV triggers resulted in comparable outcome in both groups at 1-year follow-up, irrespective of weight-loss interventions (63.8% vs 59.3%, p=0.68).

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Canadian Children Less Overweight Than Decade Ago

MedicalResearch.com Interview with:

Atul Sharma MD, MSc(Statistics), FRCPC Researcher, Children’s Hospital Research Institute of Manitoba; Assistant Professor, Department of Pediatrics and Child Health, University of Manitoba; Senior Consultant, Biostatistics Group, George and Fay Yee Center for Healthcare Innovation

Dr. Atul Sharma

Atul Sharma MD, MSc(Statistics), FRCPC
Researcher, Children’s Hospital Research Institute of Manitoba; Assistant Professor, Department of Pediatrics and Child Health, University of Manitoba; Senior Consultant, Biostatistics Group, George and Fay Yee Center for Healthcare Innovation

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

Dr. Sharma: Between 1978 and 2004, a previous comparison of directly measured heights and weights demonstrated an alarming increase in the prevalence of overweight or obesity in Canadian children aged 2-17y, from 23.3% (95% CI = 20.5-26.0) to 34.7% (33.0-36.4) based on the new 2007 WHO criteria.

In Canada, the definitions of overweight and obesity changed with the introduction of the new ‘2010 WHO Growth Charts for Canada’, Previous definitions were based on Body Mass Index (BMI) percentiles from the 2000 Centers for Disease Control and Prevention (CDC) growth chart’s. In addition to revising the percentile thresholds for diagnosing overweight or obesity, the WHO charts were based on a very different reference population. As a result, the proportion of Canadian children being classified as overweight or obese increased with the introduction of the new WHO charts.

Our current study applied current Canadian definitions of overweight and obesity to a contemporary sample of Canadian children age 3-19y to assess recent trends in the rates of overweight and obesity. By pooling data from the Canadian Community Health Survey (CCHS, cycle 2.2) and the Canadian Health Measures Survey (CHMS, cycles 2 and 3), we were able to study a representative sample of more than 14000 Canadian children from the period 2004-2013.  The sample was evenly split between boys and girls and approximately 80% white.

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Dieting and Weight Loss Improved Quality of Life in Mildly Overweight Patients

MedicalResearch.com Interview with:

Dr. Corby K. Martin PhD Department/Laboratory: Ingestive Behavior Laboratory Director for Behavioral Sciences and Epidemiology Pennington Biomedical Research Lab Baton Rouge, LA

Dr. Corby Martin

Dr. Corby K. Martin PhD
Department/Laboratory:
Ingestive Behavior Laboratory
Director for Behavioral Sciences and Epidemiology
Pennington Biomedical Research Lab
Baton Rouge, LA 

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

Dr. Martin: We know that calorie restriction extends the lifespan of many species and in humans calorie restriction or dieting might extend our healthspan, which is the length of time that we are free of disease. It is possible that more healthy weight or mildly overweight people might calorie restrict to improve their health, and one concern is the possible negative effects of calorie restriction on the quality of life of these individuals.

This study tested if 2 years of calorie restriction affected a number of quality of life measures compared to a group that did not calorie restrict and ate their usual diet and did not lose weight. People who enrolled in the study were normal weight to mildly overweight. The study found that calorie restriction improved mood, reduced tension and improved general health and sexual drive and relationship (a measure of sexual function) over two years. Further, the more weight that people lost, the greater their improvement in quality of life.

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Inflammation Factors in How Obesity Influences Prostate Cancer Progression

MedicalResearch.com Interview with:

Charnita Zeigler-Johnson, Ph.D., M.P.H. Assistant Professor Division of Population Sciences Department of Medical Oncology Thomas Jefferson University Philadelphia, PA 19107

Dr. Zeigler-Johnson

Charnita Zeigler-Johnson, Ph.D., M.P.H.
Assistant Professor
Division of Population Sciences
Department of Medical Oncology
Thomas Jefferson University
Philadelphia, PA 19107

Medical Research: What is the background for this study?

Dr. Zeigler-Johnson: Obesity has been associated with poor prostate cancer outcomes, included advanced disease at diagnosis, increased risk for cancer recurrence, and risk for mortality. One possible link in the relationship between obesity and prostate cancer progression is inflammation. Obesity produces a state of systemic chronic low-grade inflammation which may contribute to the underlying biology of the tumor microenvironment. The presence of immune cells (T-cells and macrophages) in the tumor microenvironment may indicate aggressive tumors that are likely to metastasize. The goal of this study was to examine prostate cancer tissue to characterize differences in immune cells within the tumor microenvironment by obesity status and cancer severity. We studied tumor samples from 63 non-obese and 36 obese prostate cancer patients.

Medical Research: What are the main findings?

Dr. Zeigler-Johnson: We found that T-cell and macrophage counts in the tumor did not differ by patient obesity status. However, macrophage (CD68) counts were higher among men diagnosed with higher tumor grade (Gleason Score 7-10). We also found that T-cell (CD8) counts were associated with quicker time to prostate cancer recurrence (indicated by detectable prostate specific antigen levels after treatment.)

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