(Press-News.org) 1. For Greater Weight Loss, a Group Cash Incentive Trumps Individual Rewards
A group-based financial incentive leads to greater weight loss than an individual incentive for obese employees. An estimated 67 percent of employers use financial incentives to help their employees adopt healthier behaviors, with the goal of decreasing chronic disease and curbing health care costs. Researchers sought to determine the effectiveness of two financial incentive designs – group-based and individual – for obese employees trying to lose weight. One-hundred-and-four employees with a body mass index (BMI) between 30 and 40 kg/m2 were randomly assigned to one of three weight loss groups. In the first group (control, or no financial incentive), participants were given a link to the Weight-control Information Network of the National Institute of Diabetes and Digestive and Kidney Diseases and were scheduled for monthly weigh-ins and reminded by an automated e-mail or text message to attend the weigh-ins. After the weigh-in, an automated message notified participants of whether they met or did not meet their weight-loss goal for the period. In the second group (individual incentive), individuals were given the same information as the first group, but were also told that $100 would be set aside for them at baseline, four weeks, eight weeks, 12 weeks, 16 weeks, and 20 weeks, and that the $100 would be electronically transmitted to them if they at least met their target monthly weight-loss goal. After each weigh-in, an automated message notified the participants of their earnings, or what they would have earned if they had met their target. In the third group (group incentive), participants were divided into groups of five but were not told the identity of their fellow group members. Each group of five was given the same weight-loss information as the other groups, but also was told that they would earn $500 to split among just the members of the group who at least met their target weight-loss goal for the month. Those who didn't meet their goals were not part of the split. If no participant met the weight-loss goal, then no money was distributed. As in the other groups, an automated message notified participants of their earnings or what they would have earned. After 24 weeks, participants receiving the group incentive lost on average of about 7 pounds more than those receiving individual incentive, and an average of almost 10 pounds more than those in the control group. Twelve weeks after the incentive intervention ended, group incentive participants maintained greater weight loss than control group participants, but not greater than individual incentive participants. According to the authors, the group incentive could be more effective because participants had the opportunity to earn a reward larger than $100 for achieving a weight-loss goal. The author of an accompanying editorial writes that due to the high costs of health care and lost productivity associated with obesity, employers should consider financial incentive programs to encourage employee weight loss money well-spent. A link to this article will be live at 5:00 p.m. on Monday, April 1 http://www.annals.org/article.aspx?doi=10.7326/0003-4819-158-7-201304020-00002.
Note: For an embargoed PDF, please contact Megan Hanks or Angela Collom. To speak with the author, please contact Beata Mostafavi at bmostafa@med.umich.edu or 734-764-2220.
2. Higher Blood Levels of Long-chain Omega-3 Polyunsaturated Fatty Acids Protect Against Death
Older patients with higher blood levels of individual and total omega-3 polyunsaturated fatty acids (ω3-PUFAs) have lower mortality than their peers, especially coronary heart disease-related death. Observational studies have shown a benefit from dietary ω3-PUFA levels, but most of those studies relied on self-reported dietary intake and/or looked at cardiovascular risk factors rather than clinical outcomes such as mortality. Researchers studied 2,692 U.S. adults aged 69 – 79 to determine the association between plasma individual and total ω3-PUFA levels on total and cause-specific mortality among healthy adults not receiving fish oil supplements. Phospholipid fatty acid levels and cardiovascular risk factors were measured in 1992. In 2008, plasma individual and total ω3-PUFA levels were assessed against total and cause-specific mortality and incident total (fatal plus nonfatal) CHD and stroke. The researchers found that patients with higher baseline levels of individual and total ω3-PUFAs had decreased total mortality, primarily due to fewer cardiovascular events. A link to this article will be live at 5:00 p.m. on Monday, April 1 http://www.annals.org/article.aspx?doi=10.7326/0003-4819-158-7-201304020-00003.
Note: For an embargoed PDF, please contact Megan Hanks or Angela Collom. To interview the lead author, please contact Marge Dwyer at mhdwyer@hsph.harvard.edu or 617.432.8416.
3. Statins May be More Tolerable than Discontinuation Rates Suggest
Patients may discontinue statin use unnecessarily, jeopardizing health benefits of therapy. Doctors frequently prescribe statins to patients with high cholesterol. In research studies, statins are effective and well-tolerated. Few trial participants experience side effects such as tiredness and muscle aches, and even fewer stop taking their medication because of those side effects. Conversely, in clinical practice, statins are commonly discontinued, and patients fail to experience the cardiovascular benefits of preventive therapy. Researchers studied medical records for patients receiving a statin prescription between January 2000 and December 2008 to investigate the reasons for statin discontinuation and the role of statin-related events (symptoms believed to have been caused by statins) in routine care settings. Over the eight-year study period, more than one half of the patients discontinued their statin, at least temporarily. And approximately one fifth of those patients reported a statin-related event. One half of those patients were challenged to restart a statin, and more than 90 percent of them were taking a statin one year later, making it unlikely that they had true statin intolerance. The author of an accompanying editorial notes that adherence could be an issue because patients are not accustomed to taking a drug every day for the rest of their lives. Regardless, he writes that better strategies are needed to promote statin adherence because statins can greatly reduce population prevalence of atherosclerotic cardiovascular disease. A link to the free summary of this article will be live at 5:00 p.m. on Monday, April 1 http://www.annals.org/article.aspx?doi=10.7326/0003-4819-158-7-201304020-00001.
Note: For an embargoed PDF, please contact Megan Hanks or Angela Collom. To interview the lead author, please contact Jessica Maki at jmaki3@partners.org or 617-534-1603.
###
Annals of Internal Medicine tip sheet for April 2, 2013
2013-04-02
ELSE PRESS RELEASES FROM THIS DATE:
Cash for weight loss? Works better when employees compete for pots of money, study finds
2013-04-02
ANN ARBOR, Mich. — Do cash rewards for healthier habits work? Maybe, says a new study, if you add on one more condition – peer pressure.
A growing number of companies are offering employees an opportunity to boost earning power at work via cash incentives to stay healthy. Under the Affordable Care Act, employers will soon be able to offer even larger financial incentives to prod healthy lifestyle behaviors among their workforce, such as quitting smoking and losing weight.
But people who are offered money for weight loss may be much more successful when awards are ...
Post-ER care for chest pain reduces risk of heart attack, death
2013-04-02
Seeing a doctor within a month of an emergency room visit for chest pain significantly reduced the risk of heart attack or death among high risk patients, according to research published the American Heart Association journal Circulation.
Chest pain is the most common reason people go to the emergency room in developed countries and accounts for more than 5 million ER visits each year in the United States.
The study is the first to demonstrate the importance of follow-up care for chest pain patients after leaving the ER, researchers said. High risk patients in this study ...
Understanding statin discontinuation
2013-04-02
Boston, MA-- Despite their well-documented benefits, statins, drugs used to lower cholesterol, are commonly discontinued in routine care. Statin discontinuation has been linked to increased risk for cardiovascular events and death in patients with coronary artery disease; nevertheless, the reasons for discontinuation are only starting to be explored. In a new study from Brigham and Women's Hospital (BWH), researchers examined the role adverse reactions play in statin discontinuation and found that more than 90 percent of the patients who stopped taking a statin due to an ...
Extreme algal blooms: The new normal?
2013-04-02
Washington, D.C.—A research team, led by Carnegie's Anna Michalak, has determined that the 2011 record-breaking algal bloom in Lake Erie was triggered by long-term agricultural practices coupled with extreme precipitation, followed by weak lake circulation and warm temperatures. The team also predicts that, unless agricultural policies change, the lake will continue to experience extreme blooms. The research is published in the online early edition of the Proceedings of the National Academy of Sciences the week of April 1, 2013.
"The perfect storm of weather events ...
Record-breaking 2011 Lake Erie algae bloom may be sign of things to come
2013-04-02
ANN ARBOR—The largest harmful algae bloom in Lake Erie's recorded history was likely caused by the confluence of changing farming practices and weather conditions that are expected to become more common in the future due to climate change.
Rather than an isolated, one-time occurrence, Lake Erie's monumental 2011 algae bloom was more likely a harbinger of things to come, according to University of Michigan researchers and colleagues from eight other institutions.
The interdisciplinary team explored factors that may have contributed to the event and analyzed the likelihood ...
Body Mass Index and coronary heart disease
2013-04-02
Coronary heart disease (CHD) increases with BMI, as well as with age, finds an article published in BioMed Central's open access journal BMC Medicine. The research from the Million Women Study indicates that increased weight increases risk of CHD equivalent to that caused by getting older.
Researchers from the University of Oxford followed the health of 1.2 million women from England and Scotland for (on average) almost a decade. Analysis of the data showed that the occurrence of CHD increases with BMI so that every 5 unit increase in BMI, calculated as weight/height2, ...
Tests to predict heart problems may be more useful predictor of memory loss than dementia tests
2013-04-02
MINNEAPOLIS – Risk prediction tools that estimate future risk of heart disease and stroke may be more useful predictors of future decline in cognitive abilities, or memory and thinking, than a dementia risk score, according to a new study published in the April 2, 2013, print issue of Neurology®, the medical journal of the American Academy of Neurology.
"This is the first study that compares these risk scores with a dementia risk score to study decline in cognitive abilities 10 years later," said Sara Kaffashian, PhD, with the French National Institute of Health and Medical ...
Eating fish associated with lower risk of dying among older adults
2013-04-02
Boston, MA – Older adults who have higher levels of blood omega-3 levels—fatty acids found almost exclusively in fatty fish and seafood—may be able to lower their overall mortality risk by as much as 27% and their mortality risk from heart disease by about 35%, according to a new study from Harvard School of Public Health (HSPH) and the University of Washington. Researchers found that older adults who had the highest blood levels of the fatty acids found in fish lived, on average, 2.2 years longer than those with lower levels.
"Although eating fish has long been considered ...
The metabolic weathervane of cancer
2013-04-02
Highly expressed in various cancers and known for its cytoprotective properties, TRAP1 protein has been identified as a potential target for antitumor treatments. As a result of the research conducted by Len Neckers, from the National Cancer Institute in Bethesda, USA, and Didier Picard, from the University of Geneva (UNIGE), Switzerland, this outlook is now being called into question. The researchers' findings, published in PNAS, describe how TRAP1 disrupts the metabolism of malignant cells, and shows that the quantity of this protein decreases as they progress to a more ...
Loss of tumor suppressor SPOP releases cancer potential of SRC-3
2013-04-02
HOUSTON - (April 1, 2013) – Mutations in a protein called SPOP (speckle-type POZ protein) disarm it, allowing another protein called steroid receptor coactivator-3 (SRC-3) to encourage the proliferation and spread of prostate cancer cells, said researchers led by those at Baylor College of Medicine in a report that appears online in Proceedings of the National Academy of Sciences.
Normally SPOP acts as a tumor suppressor gene by marking SRC-3 for destruction, said Dr. Nicholas Mitsiades, assistant professor of medicine – hematology/oncology and molecular and cellular ...