Physical activity fluctuations and body fat during adolescence: Dr.Bélanger

Posted on February 8, 2012 by weightcontrol

Physical activity fluctuations and body fat during adolescence

Author Interview: Mathieu Bélanger, PhD

Professor, Department of family medicine, Université de Sherbrooke
Director of research, Centre de formation médicale du Nouveau-Brunswick
Epidemiologist, Vitalité Health Network Research Centre
Moncton, Canada

What are the main findings of the study?

Previous studies had shown that fluctuations in physical activity levels are common during adolescence. In our study, we wanted to see if this “yo-yo” pattern of physical activity was related to changes in body fat. We followed up 756 adolescents, who took part in up to 20 survey cycles over the course of five years. We found that among boys, those with the greatest fluctuation in their physical activity level from one survey to another generally ended with the greatest increase in body fat. Among girls, the association was in the opposite direction. That is, girls with the greatest fluctuations in their physical activity level from one survey to another were the ones who generally ended with the smallest increases in body fat.

Were any of the findings unexpected?

Yes. Previous studies reported sex differences in body fat changes as they relate to changes in physical activity levels during adolescence. We therefore expected to find different magnitudes of association in boys and girls. The surprise came when we found that the associations between physical activity fluctuations and body fat for boys and girls were actually in the opposite direction. Although we have a number of hypotheses, we are not sure why this marked difference was noted.

What should clinicians and patients take away from this study?

If our findings are replicated, recommendations for boys wishing to lose weight could be expanded to incorporate the suggestion that they increase physical activity only progressively, and that they aim for activity levels that are realistically sustainable over the long term.

Consistent with current guidelines, girls aiming at controlling their weight should follow the recommendation to increase physical activity levels. Girls should be sensitized to periods when they are less active so that they can identify strategies to increase physical activity when such periods arise. In general, it seems that girls should be physically active as often as possible without worrying over periods of lower activity.

What recommendations do you have for future research as a result of your study?

Several different factors may underpin the observed differential association by sex. Our results are hypothesis generating but other studies are necessary to confirm that boys and girls respond differently to physical activity variations and to understand why this sex difference may exist.

Reference:

Bélanger, M., O’Loughlin, J., Karp, I., Barnett, T., Sabiston, C. Effect of physical activity fluctuations on body fat during adolescence. Pediatric Obes. doi:10.1111/j.2047-6310.2011.00010.x

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Weight Control Interview: Breakfast consumption & meal frequency interaction with childhood obesity – Dr. Antonogeorgos

Posted on February 6, 2012 by weightcontrol

Weight Control Interview: Breakfast consumption and meal frequency interaction with childhood obesity – Dr. Antonogerogos

George Antonogeorgos, MD, MSc, PhD

What are the main findings of the study ?

Our study examined the association between childhood obesity and the joint effect of two meal patterns: increased meal consumption per day (>3 meals per day, excluding snacking) and daily breakfast consumption per week in a sample of children aged 10-12 years old living in urban environment.

Our findings demonstrated that consuming more than 3 meals per day was associated with a lower likelihood of overweight or obesity if-and-only-if breakfast was not skipped.

Were any of the findings unexpected?

Previous research has documented the protective effect of having breakfast daily against childhood overweight and obesity. However, controversial are the evidence in the literature about the role of frequent meal consumption per day (>3 meals/day), a well-known protective factor against obesity in adults, in childhood obesity. Our study provided evidence for an interaction effect between the two aforementioned meal patterns that could contribute in the prevention of childhood obesity.

What should clinicians and patients take away from this study?

Pediatricians, teachers, health practitioners and other public health workers who work with children should advice children’s parents as well as children themselves to adopt a diet pattern with more than 3 meals per day and not to skip breakfast in a daily basis, in order to be protected from becoming overweight or obese.

Children with the help of their parents should try to follow these two meal patterns in their daily lives, in order to increase the likelihood of maintaining their normal body weight.

What recommendations do you have for future research as a result of your study?

Future research should focus on the best content of each meal per day and its weekly frequency, in order to estimate the more efficient food group combination per day and food group frequency per week that could protect children from becoming overweight or obese.
Moreover, more research should be done in order to elucidate the effect of dietary patterns against childhood obesity and the pathophysiological mechanisms that underlying their effect.

Pediatrician, Biostatistician-Epidemiologist
Research Fellow
Department  of Nutrition and Dietetics,
Harokopio University, Athens, Greece

Reference:

Antonogeorgos, G., Panagiotakos, D. B., Papadimitriou, A., Priftis, K. N., Anthracopoulos, M. and Nicolaidou, P. (2012), Breakfast consumption and meal frequency interaction with childhood obesity. Pediatric Obesity, 7: 65–72. doi: 10.1111/j.2047-6310.2011.00006.x

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Common Variants in the CD36 Gene Are Associated With Oral Fat Perception, Fat Preferences, and Obesity in African Americans: Dr. Keller

Posted on February 4, 2012 by weightcontrol

Common Variants in the CD36 Gene Are Associated With Oral Fat Perception, Fat Preferences, and Obesity in African Americans

Author Interview: Kathleen L. Keller, Ph.D.

Assistant Professor
The Pennsylvania State University
321 Chandlee Lab University Park PA 16802

What are the main findings of the study?

The main findings of this study are that variations in the CD36 gene are related to ratings of the creaminess of salad dressings and preferences for some high-fat foods.
 
Were any of the findings unexpected?

We were expecting to see a relationship between the CD36 gene and the ability to detect differences in the fat content of solutions, but instead, we found that adults who had the AA variant rated salad dressings as creamier, regardless of how much fat was in them. 

This is significant because creaminess is a preferred quality for many high-fat foods, like ice cream, puddings, custards, and salad dressings. 

The perception that they are creamier may contribute to higher preferences for high-fat foods in those who have this gene variant. 

This is exactly what we found–AA individuals gave higher liking ratings to added fats like butter and oils (e.g. cooking oil, olive oil).

What should clinicians and patients take away from this study?

This research is still preliminary. This is only the second study that has found a relationship between CD36 and fat preferences in humans.  However, the takehome message is that some people may have higher preferences for fat that are influenced by their genetics. 

These people may have a more difficult time sticking to lower fat diets, and may benefit from a more moderate fat weight-loss diet.  Of course, our environment plays a very important role in determining our preferences and intake of high-fat foods, so genes always interact with the environment in which we live.

What recommendations do you have for future research as a result of your study?

Future studies should test a range of high-fat foods in the laboratory to better understand why AA individuals seem to like these foods more. 

In addition, studies in children are necessary, because this is when food preferences are learned.

Reference:

Common Variants in the CD36 Gene Are Associated With Oral Fat Perception, Fat Preferences, and Obesity in African Americans.

Obesity (Silver Spring). 2012 Jan 12. doi: 10.1038/oby.2011.374. [Epub ahead of print]

Keller KL, Liang LC, Sakimura J, May D, van Belle C, Breen C, Driggin E,
Tepper BJ, Lanzano PC, Deng L, Chung WK.

Department of Research Medicine, New York Obesity Research Center, St. Luke’s Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, New York, USA.

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Using gene expression to predict differences in the secretome of human omental vs subcutaneous adipose tissue: Author Interview

Posted on February 3, 2012 by weightcontrol

Using gene expression to predict differences in the secretome of human omental vs subcutaneous adipose tissue.

Author Interview :  Dr. Nigel Hoggard

Aberdeen Centre for Energy Regulation and Obesity (ACERO)
Obesity & Metabolic Health Theme
University of Aberdeen Rowett Institute of Nutrition and Health
Greenburn Road, Bucksburn
Aberdeen, Scotland, AB21 9SB  UK.

What are the main findings of the study?

White adipose tissue is no longer considered as a passive reservoir for the efficient storage of fuel as triglycerides, but also as an important endocrine organ that influences a range of physiological functions via the secretion of multiple protein hormones and factors termed adipokines (such as adiponectin, leptin).

In obese individuals (BMI ≥ 30), adipose tissue accounts for 45% or more of total body composition and as such this makes white adipose tissue the largest endocrine organ in the body. The adipokines secreted by white adipose tissue have a range of biological functions which include influencing adipocyte differentiation, lipid uptake and transport, energy metabolism, immune response and inflammation, and remodelling of the extracellular matrix.

White adipose tissue is distributed in both subcutaneous and internal locations with a higher risk of obesity-associated metabolic diseases associated with increased adipose tissue mass in the abdominal region.

There are a number of hypotheses as to why this association occurs, for example the proximity of the tissue to the liver, but one possible contributory factor is that different adipose tissue depots express adipokines at different levels. For example adiponectin is secreted at higher levels in subcutaneous adipose tissue when compared to omental adipose tissue. Adiponectin deficiency associated with obesity is considered an independent risk factor for endothelial dysfunction, hypertension, insulin resistance and other cardiovascular complications.

The list of human adipokines is constantly increasing, which is in part due the use of comprehensive profiling technologies such as transcriptomics and proteomics, but this still remains an incomplete list.

In this study we have used gene expression data coupled with predictive bioinformatic algorithms to identify several genes coding for secreted proteins which are expressed differently in omental adipose tissue compared to subcutaneous adipose tissue.

Were any of the findings unexpected?

Yes, we identified a number of proteins which are expressed differently in omental adipose tissue compared to subcutaneous adipose tissue.

What should clinicians and patients take away from this study?

These studies are still at an early stage and more work will be required to determine how important the changes in the proteins we have identified are.

However a simple take home message to clinicians would be not to underestimate the importance of fat as an endocrine organ.

What recommendations do you have for future research as a result of your study?

Clearly more research is needed to understand the links between adipose tissue and the diseases associated with obesity such as diabetes if we are to break this link.

Reference:

Using gene expression to predict differences in the secretome of human omental vs subcutaneous adipose tissue.

N. Hoggard, M. Cruickshank, K-M. Moar, S. Bashir and C-D. Mayer
Obesity doi:10.1038/oby.2012.14; accepted article preview online January 28, 2012

 

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Relation between sleep duration and BMI varies by age and sex in youth age 8–19: Author Interview

Posted on February 3, 2012 by weightcontrol

Relation between sleep duration and BMI varies by age and sex in youth age 8–19.

Author Interview: Amy Storfer-Isser, M.S., M.A.

Statistical Research Consultants, LLC
The CCI is part of the Division of General Medical Sciences
Case Western Reserve University School of Medicine.

What are the main findings of the study?

Short sleep is associated with a greater BMI among children aged 8-19, and the effect is stronger at younger ages.

The relation of short sleep and BMI is stronger in boys, and this sex difference may be partially explained by differences in sex hormones and leptin (an appetite regulating hormone).

Were any of the findings unexpected?

The association of short sleep and higher BMI was stronger in younger children and in boys compared to girls.  Although our results were consistent with previous studies in this area, the effects were more evident than we expected.

What should clinicians and patients take away from this study?

Short sleep is a risk factor for obesity in children, and getting enough sleep is essential for optimum health.

Children age 8-12 need at least 10-11 hours of sleep, and adolescents need at least 9 hours of sleep.

What recommendations do you have for future research as a result of your study?

It is unclear why short sleep duration had a stronger association with BMI in boys compared to girls.

Further studies of sex differences in sociocultural factors that influence eating and exercise/sedentary behaviors, sleep architecture, and hormones (particularly during and after puberty) are needed to better understand these findings.

Reference:

Storfer-Isser, A., Patel, S. R., Babineau, D. C. and Redline, S. (2012) Relation between sleep duration and BMI varies by age and sex in youth age 8–19. Pediatric Obesity, 7: 53–64. doi: 10.1111/j.2047-6310.2011.00008.x

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Weight Cycling and Mortality in a Large Prospective US Study : Dr. Stevens

Posted on February 3, 2012 by weightcontrol

Weight Cycling and Mortality in a Large Prospective US Study

Author Interview Dr. Victoria L. Stevens PhD

Strategic Director, Laboratory Sciences
National Home Office | American Cancer Society, Inc.
250 Williams Street NW, Atlanta, GA 30303

What are the main findings of the study? 

Weight cycling did not increase the risk of premature death from all causes, cardiovascular diseases or cancer.

These findings apply to both men and women of all body weights.

Were any of the findings unexpected?

Despite the fact that some previous studies had suggested that weight cycling was associated with increased risk of mortality, we were not surprised by our findings.
These early studies did not discriminate between weight cycling initiated by intentional weight loss and that initiated by illness-induced weight loss.

More recent studies in which only intentional weight loss-initiated weight cycling was considered have mostly found that weight cycling is not associated with mortality or some other health consequences.

Our study, which studied weight cycling initiated by intentional weight loss, was the first to include men in an investigation of the association with mortality.

What should clinicians and patients take away from this study? 

Weight loss attempts by overweight and obese individuals can safely be encouraged without concern of increased risk of premature death even though the weight loss may not be maintained long-term.

What recommendations do you have for future research as a result of your study?

We observed that weight cyclers were heavier than non-cyclers and BMIs increased with the number of weight cycles.

With our study design, we cannot tell if people are weight cycling because they are heavier or if they are heavier because they weight cycle.  Additional studies are needed to determine if weight cycling influences overall weight gain and body composition.

Additional research is also needed to determine if weight cycling initiated by intentional weight loss is associated with risk of chronic diseases such as cancers and heart disease independent of the influence of BMI and weight gain on these diseases.

Reference:

Weight Cycling and Mortality in a Large Prospective US Study

Victoria L. Stevens, Eric J. Jacobs, Juzhong Sun, Alpa V. Patel,
Marjorie L. McCullough, Lauren R. Teras, and Susan M. Gapstur
Am. J. Epidemiol.
first published online January 27, 2012 doi:10.1093/aje/kwr378

 


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Overweight status and intrauterine exposure to gestational diabetes are associated with children’s metabolic health: Dr. Chandler-Laney

Posted on February 2, 2012 by weightcontrol

Overweight status and intrauterine exposure to gestational diabetes are associated with children’s metabolic health

 

Author Interview: Paula C. Chandler-Laney, Ph.D.

Assistant Professor
Department of Nutrition Sciences
University of Alabama

What are the main findings of the study? 

Children born to mothers with gestational diabetes during pregnancy had relatively more body fat, higher insulin secretion, and lower HDL-cholesterol (“good” cholesterol) as compared to children of women who were not diabetic during pregnancy.

These differences were independent of the children’s current weight status suggesting that prenatal exposure to gestational diabetes may result in perturbations of metabolic health even for children who remain at normal weight.

Were any of the findings unexpected?

On the whole, the findings were not unexpected given that we hypothesized that prenatal exposure to gestational diabetes would be associated with poorer metabolic health among these children.

It was somewhat surprising however, that even among these young children (5-10 years), those who had the combination of overweight and prenatal exposure to gestational diabetes, had relatively more body fat in the trunk region as compared to the legs, compared to children of non-diabetic mothers.  This suggests that following prenatal exposure to gestational diabetes, when children start to gain excess weight they are more likely to deposit fat in the abdomen, and this is concerning because abdominal fat is associated with poorer metabolic health.

What should clinicians and patients take away from this study?

This study adds to the growing body of literature suggesting that it is useful for clinicians to have information about the prenatal history of patients because this may provide some insight as to their risk for obesity and metabolic disease.  The knowledge that a child was exposed to maternal diabetes in utero, for example, may facilitate greater vigilance of the child’s body weight management and metabolic health.

What recommendations do you have for future research as a result of your study?

More research is needed to understand the mechanisms by which certain pregnancies, such as those complicated by maternal diabetes or obesity, increase the risk for obesity and co-morbid health problems among offspring.

To this end, we are currently conducting prospective studies in which pregnant women are recruited to assess their metabolic health, and we follow-up with the children to examine what aspects of maternal health during pregnancy are related to children’s body composition during infancy and early childhood.

In addition, a number of research groups are conducting important studies to develop interventions during pregnancy and early life that may help to reduce the risk for obesity among children.

Reference:

Overweight status and intrauterine exposure to gestational diabetes are associated with children’s metabolic health

Chandler-Laney, P. C., Bush, N. C., Granger, W. M., Rouse, D. J., Mancuso, M. S. and Gower, B. A. (2012), Pediatric Obesity, 7: 44–52. doi: 10.1111/j.2047-6310.2011.00009.x

Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL

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Baseline Sympathetic Nervous System Activity Predicts Dietary Weight Loss in Obese Metabolic Syndrome Subjects : Dr. Straznicky

Posted on February 1, 2012 by weightcontrol

Baseline Sympathetic Nervous System Activity Predicts Dietary Weight Loss in Obese Metabolic Syndrome Subjects

Author Interview: Nora Straznicky PhD MPH
Senior Research Officer
Human Neurotransmitters Laboratory
Baker IDI Heart & Diabetes Institute
PO Box 6492, St Kilda Rd Central
Melbourne VIC 8008 Australia

Nervous System Activity May Predict Successful Weight Loss

Obesity is caused by a complex combination of lifestyle, environmental and biological factors. Changes in the global food system, which is producing more processed, calorie dense foods, increasingly time-poor lifestyles, and the advent of the computer age has led to an imbalance between food consumption and energy expenditure through physical exercise. Beyond these modifiable factors are others that we can’t control—namely, our biology, which is estimated to contribute at least 40% to our body weight and shape. Our biology includes genetic makeup, hormonal, metabolic, and nervous system factors, and these each play in important role not only in the development of obesity, but also the pursuit to lose weight.

Weight loss: How are nerves involved?

Individuals vary widely in their ability to lose weight during dieting—some shed pounds easily whilst others really struggle. A recent study conducted by researchers from Baker IDI Heart and Diabetes Institute has examined how a person’s nerve activity may influence dietary weight loss.

The sympathetic nervous system is widely distributed throughout the body and subconsciously regulates many important functions including how much energy we burn during sleep and rest, the energy we use to digest and utilize food (known as the ‘thermic effect of food’) and the breakdown of fat during fasting and weight loss. The present study examined the relationship between activity of the sympathetic nervous system and subsequent weight loss, in a group of 42 obese individuals on a 12-week low calorie diet intervention program.

Nerve activity was measured by the technique of microneurography, which involves the insertion of metal microelectrodes, similar to an acupuncture needle, into nerve fascicles (a bundle of nerve fibers) in the lower leg. Electrical activity, representing nervous impulses travelling from the brain to skeletal muscle, is manually counted and expressed as the number of bursts per minute, as illustrated below.

Figure: Microneurographic recordings of sympathetic nerve activity from the peroneal nerve in the lower leg. Top shows raw nerve signals and the bottom integrated nerve signals. Asterisks represent electrical firing from within a single nerve.

Figure: Microneurographic recordings of sympathetic nerve activity from the peroneal nerve in the lower leg. Top shows raw nerve signals and the bottom integrated nerve signals. Asterisks represent electrical firing from within a single nerve.

 

Key findings of the study were that successful weight losers (who lost an average of 9 kg after 12-weeks dieting) had higher resting nerve activity at the start of the program compared to weight loss resistant individuals (who lost an average of 3 kg). Moreover, successful weight losers demonstrated large increases in nerve activity following a carbohydrate test meal, whereas the responses were minimal in weight loss resistant subjects. The study findings, which were published in the February 2012 edition of the Journal of Clinical Endocrinology & Metabolism, highlight the importance of biological determinants in weight loss success and suggest that nerve activity contributes significantly to metabolic efficiency.

What are the implications of this study?

These findings provide two opportunities:  (1) the potential to identify those people who will benefit most from lifestyle weight loss interventions and (2) the development of weight loss treatments which stimulate this specific nervous activity.

Whilst microneurography is a highly specialized technique, limited to the realms of research laboratories, there are other more accessible measures of nerve activity, which may be used on a population level. The main chemical released from sympathetic nerves is ‘noradrenaline’ and blood levels of this hormone in the fasting state and in response to food intake could be used as an index of sympathetic activity.

Over the past decades, much effort has focused on the development of anti-obesity drugs that enhance weight loss, and the sympathetic nervous system has been a logical target. The ideal drug in this regard would be one that selectively stimulates metabolic efficiency (resting metabolic rate, dissipation of calories after food intake and the breakdown of fat tissue) without unwanted side effects. Unfortunately, because of the widespread distribution of the sympathetic nervous system within the body, any drug that stimulates this nerve activity often has effects on multiple organs and body functions. Therefore unwanted side-effects of such drugs may include an increase in heart rate and blood pressure, insomnia, dry mouth and constipation, which limits their long-term use. Currently, several ongoing trials are testing the long-term effectiveness and safety of drug combinations, which include a component acting on the sympathetic nervous system.

What can I do if I fall in the weight loss resistant category?

The good news is that moderate-intensity exercise training has beneficial effects on the thermic effect of food. Therefore, regular brisk walking, swimming or bike-riding may help to facilitate greater weight loss. It is also important to emphasize that even modest weight loss, favorably influences the risk factors associated with obesity (cholesterol profile, blood pressure, blood sugar). The key to success is perseverance, setting realistic body weight goals and recognizing that lifestyle change requires long-term commitment, involving vigilance to both food intake and physical activity.

What recommendations do you have for future research as a result of your study?

It is important to find out why some people have blunted nerve activity response to food intake. The underlying mechanisms need to be fully explored. The role of hormones such as insulin and cortisol as well as genetic factors, merit further investigation.

Conflict of interest: None

Reference:

Baseline Sympathetic Nervous System Activity Predicts Dietary Weight Loss in Obese Metabolic Syndrome Subjects

Nora E. Straznicky, Nina Eikelis, Paul J. Nestel, John B. Dixon, Tye Dawood, Mariee T. Grima,Carolina I. Sari, Markus P. Schlaich, Murray D. Esler, Alan J. Tilbrook,
Gavin W. Lambert,and Elisabeth A. Lambert

JCEM jc.2011-2320; doi:10.1210/jc.2011-2320

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Prospective associations of dietary insulin demand, glycemic index, and glycemic load during puberty with body composition in young adulthood : Author Interview

Posted on February 1, 2012 by weightcontrol

Prospective associations of dietary insulin demand, glycemic index, and glycemic load during puberty with body composition in young adulthood

Dipl. oecotroph. Gesa Joslowski
Forschungsinstitut für Kinderernährung
Research Institute of Child Nutrition
Heinstück 11 44225 Dortmund Germany

What are the main findings of the study?

We observed a prospective adverse relation of dietary insulin index and insulin load during puberty with body fat in young adulthood. These observations were made in a sample of 262 German healthy, free-living participants of the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) Study.

We also found that substitutions of carbohydrate- and protein-rich foods with a higher insulin demand for carbohydrate- and protein-rich foods with a lower insulin demand are particularly relevant for the associations with body fat.

Were any of the findings unexpected?

We did not see a relation between the dietary glycemic index or dietary glycemic load in adolescence and later body fat. Hence, postprandial rises in insulin levels rather than postprandial increases in blood glucose appear to be relevant for an unfavorable development of body composition. That means that foods with little or no carbohydrates and a higher protein and fat content make additional important contributions, since they do entail increases in insulin levels.

What should clinicians and patients take away from this study?

At the moment this observation bases on only one cohort study in relatively healthy adolescents. Therefore, we do presently not suggest to implement the concept of the dietary insulin index in clinical practice.

Our analysis was more a mechanistic approach to disentangle the proposed relevance of postprandial glycemia from that of postprandial insulinemia for body composition. Foods with a high insulin index comprise those with a high glycemic index (e.g. potatoes, FII = 88; white rice, FII = 58; white bread, FII = 73), but also foods with little or no carbohydrates (e.g. non-fat milk, FII = 60; low-fat cottage cheese, FII = 52; white fish, FII = 43; beef steak, FII = 37).

What recommendations do you have for future research as a result of your study?

The new insulin index concept offers a novel approach to estimate the insulinogenic effect of foods. It is known that postprandial rises in blood glucose levels are involved in deteriorating existing insulin resistance.

Thus future studies, both observational and clinical, should elucidate the role of the dietary insulin index in the development of insulin resistance and body composition. In particular, the relevance of the dietary insulin index for body composition in persons with insulin resistance is of interest.

Reference:

Prospective associations of dietary insulin demand, glycemic index, and glycemic load during puberty with body composition in young adulthood

Joslowski G, Goletzke J, Cheng G, Günther AL, Bao J, Brand-Miller JC, Buyken AE
Int J Obes (Lond). 2012 Jan 17. doi: 10.1038/ijo.2011.241

 

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Effects of combining simvastatin with rosiglitazone on inflammation, oxidant stress and ambulatory blood pressure in patients with the metabolic syndrome: Dr. Bakris

Posted on January 29, 2012 by weightcontrol

Effects of combining simvastatin with rosiglitazone on inflammation, oxidant stress and ambulatory blood pressure in patients with the metabolic syndrome: the SIROCO study

Author Interview: George Bakris, MD,F.A.S.H.,F.A.S.N.

Professor of Medicine
Director, Hypertensive Diseases Unit Department of Medicine
University of Chicago-Pritzker School of Medicine, Chicago, IL, USA

What are the main findings of the study?

Patients that have metabolic syndrome manifest greater reductions in markers of vascular inflammation and oxidant stress, 24-h ambulatory BP and increases in adiponectin as well as improved glycemic indices when given a statin plus a low dose thiazolidinedione combination.

Were any of the findings unexpected?

Not really the hypothesis stated that we expected a greater reduction in oxidant stress markers

What should clinicians and patients take away from this study?

In people with metabolic syndrome who do not have diabetes the addition of a low dose agent like pioglitazone further reduces oxidant stress markers seen with metformin.

What recommendations do you have for future research as a result of your study?

Comparing the effects of weight loss and exercise to this medical treatment on the same variables.

Reference:

Effects of combining simvastatin with rosiglitazone on inflammation, oxidant stress and ambulatory blood pressure in patients with the metabolic syndrome: the SIROCO study

Lazich, I., Sarafidis, P., de Guzman, E., Patel, A., Oliva, R. and Bakris, G.
Diabetes, Obesity and Metabolism (2012),14: 181–186.
doi: 10.1111/j.1463-1326.2011.01510.x

 

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