UC Irvine’s Ninh Nguyen co-leads study of surgery center performance.
Ninh Nguyen, UC Irvine
Patients who underwent weight loss operations in recent years, when most bariatric surgical centers were accredited, had fewer postoperative complications and were 2.3 times less likely to die in the hospital than patients who had bariatric procedures performed before a national movement toward facility accreditation occurred, according to a study published in the September issue of the Journal of the American College of Surgeons.
Study authors said the findings suggest that accreditation of bariatric surgery centers contributes to improved safety for patients who undergo weight loss operations and saves lives. “The patient’s most important concern is, am I going to survive this operation?” said study co-investigator Ninh T. Nguyen, M.D., professor of surgery and chief of gastrointestinal Surgery, at UC Irvine Medical Center in Orange. “We found that death is very uncommon when the operation takes place at an accredited facility, meaning it has met rigorous standards for high-quality surgical care.”
A surgical approach is now widely considered a very effective treatment for severe obesity. Potential benefits of bariatric operations include substantial long-term weight loss, an improvement or reversal of Type 2 diabetes, and improved risk factors for heart disease, according to the American Society for Metabolic and Bariatric Surgery (ASMBS). Common bariatric procedures include the Roux-en-Y gastric bypass, gastric banding, and sleeve gastrectomy.
UC San Diego findings could have impacts on obesity, organ transplantation.
Non-alcoholic fatty liver disease (NAFLD) is a common affliction, affecting almost 30 percent of Americans, with a significant number suffering from its most severe form, called non-alcoholic steatohepatitis or NASH, which can lead to cirrhosis and liver cancer. In recent years, NASH has become the leading cause of liver transplantation.
Development of effective new therapies for preventing or treating NASH has been stymied by limited small animal models for the disease. In a paper published online in Cancer Cell, scientists at the UC San Diego School of Medicine describe a novel mouse model that closely resembles human NASH and use it to demonstrate that interference with a key inflammatory protein inhibits both the development of NASH and its progression to liver cancer.
“These findings strongly call for clinical testing of relevant drugs in human NASH and its complications,” said senior author Michael Karin, Ph.D., Distinguished Professor of Pharmacology in UC San Diego’s Laboratory of Gene Regulation and Signal Transduction. “Our research has shown that, at least in this mouse model, chemical compounds that include already clinically approved drugs that inhibit protein aggregation can also be used to prevent NASH caused by a high-fat diet.”
The increasing prevalence of NAFLD is linked to the nation’s ongoing obesity epidemic. In the past decade, the rate of obesity has doubled in adults and tripled in children, in large part due to a common diet rich in simple carbohydrates and saturated fats. NASH is characterized by inflammation and fibrosis, which damage the liver and can lead to cirrhosis, hepatocellular carcinoma (HCC), the major form of liver cancer, and loss of function. Often, the only remedy is organ transplantation.
Biosensor may help doctors determine which patients should be fed following surgery.
AbStats, developed by a team at UCLA, is a non-invasive acoustic gastrointestinal surveillance biosensor that monitors gut sounds.
A disposable plastic listening device that attaches to the abdomen may help doctors definitively determine which post-operative patients should be fed and which should not, an invention that may improve outcomes, decrease health care costs and shorten hospital stays, according to a UCLA study.
Some patients who undergo surgery develop a condition called post-operative ileus, a malfunction of the intestines. The condition causes patients to become ill if they eat too soon, which can lengthen an affected patient’s hospital stay by two to three days. Until now, there was no way to monitor for post-operative ileus other than listening to the belly for short periods with a stethoscope, said study first author Dr. Brennan Spiegel, a professor of medicine at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health.
If proven successful, the device, a non-invasive acoustic gastrointestinal surveillance biosensor called AbStats, could also be used to help diagnose irritable bowel syndrome and inflammatory bowel disease as well as helping obese people learn by the sounds from their gut when they should or shouldn’t eat, which could help them lose weight.
Spiegel and his team worked with researchers at the UCLA Wireless Health Institute at the Henry Samueli School of Engineering and Applied Science to develop the sensor, which resembles a small plastic cap and has a tiny microphone inside to monitor digestion.
“We think what we’ve invented is a way to monitor a new vital sign, one to go along with heart rate, blood pressure and respiration. This new vital sign, intestinal rate, could prove to be important in diagnosing and treating patients,” Spiegel said. “The role of wearable sensors in healthcare has reached mainstream consciousness and has the capacity to transform how we monitor and deliver care.
“Yet, there are very few biosensors that are supported by any peer-reviewed evidence,” Spiegel continued. “This study represents peer-reviewed evidence supporting use of a biosensor, a device born and bred out of UCLA multidisciplinary research.”
The study appears in the early online edition of the peer-reviewed Journal of Gastrointestinal Surgery.
Study shows developmental exposure to DDT can affect female offspring.
Exposure of pregnant mice to the pesticide DDT is linked to an increased risk of obesity, diabetes, high cholesterol and related conditions in female offspring later in life, according to a study led by the University of California, Davis.
The study, published online today (July 30) in the journal PLOS ONE, is the first to show that developmental exposure to DDT increases the risk of females later developing metabolic syndrome — a cluster of conditions that include increased body fat, blood glucose and cholesterol.
DDT was banned in the United States in the 1970s but continues to be used for malaria control in countries including India and South Africa.
Scientists gave mice doses of DDT comparable to exposures of people living in malaria-infested regions where it is regularly sprayed, as well as of pregnant mothers of U.S. adults who are now in their 50s.
“The women and men this study is most applicable to in the United States are currently at the age when they’re more likely to develop metabolic syndrome, because these are diseases of middle- to late adulthood,” said lead author Michele La Merrill, assistant professor of environmental toxicology at UC Davis.
The scientists found that exposure to DDT before birth slowed the metabolism of female mice and lowered their tolerance of cold temperature. This increased their likelihood of developing metabolic syndrome and its host of related conditions.
“As mammals, we have to regulate our body temperature in order to live,” La Merrill said. “We found that DDT reduced female mice’s ability to generate heat. If you’re not generating as much heat as the next guy, instead of burning calories, you’re storing them.”
Parents indicate greater interest in helping their child eat healthy than encouraging exercise.
A UC San Diego School of Medicine-led study suggests that parents of obese children often do not recognize the potentially serious health consequences of childhood weight gain or the importance of daily physical activity in helping their child reach a healthy weight.
The study is published online in the Journal of the Academy of Nutrition and Dietetics.
“Parents have a hard time changing their child’s dietary and physical activity behaviors,” said lead author Kyung Rhee, M.D., and an assistant adjunct professor in the Department of Pediatrics. “Our study tells us what factors may be associated with a parent’s motivation to help their child become more healthy.”
UC system united in effort to help put world on path to sustainably, nutritiously feed itself.
UC President Janet Napolitano plants oregano with Matt Orke in the student-run community garden at UCLA. (Photo by Reed Hutchinson, UCLA)
By Alec Rosenberg
University of California President Janet Napolitano and chancellors from all 10 campuses are joining forces on an audacious and far-reaching goal: harnessing the collective power of UC to help put the world on a path to sustainably and nutritiously feed itself.
President Napolitano unveiled the UC Global Food Initiative today (July 1) over the course of three events, starting at the Edible Schoolyard in Berkeley, followed by a presentation to the California State Board of Food and Agriculture in Sacramento, and finally at the UCLA community garden in the Sunset Canyon Recreation Center.
The initiative brings together the university’s research, outreach and campus operations in an effort to develop and export solutions throughout California, the United States and the world for food security, health and sustainability, Napolitano said during the morning briefing.
“It is a commitment to apply a laser focus on what UC can do as a public research university — in one of the most robust agricultural regions in the world — to take on one of the world’s most pressing issues,” Napolitano said.
The Edible Schoolyard is a 1-acre garden and kitchen classroom at the Martin Luther King Jr. Middle School, founded by Chez Panisse chef and owner Alice Waters. It has become a model for teaching children how to grow and eat a healthy, sustainable diet. It features vegetables, herbs, vines, berries, flowers, fruit trees and chickens.
UC President Janet Napolitano (right) tours the Edible Schoolyard at Berkeley’s Martin Luther King Jr. Middle School with founder and restaurateur Alice Waters. (Photo by Robert Durell)
Waters gave Napolitano a tour of the garden and then at a press conference gave her a basket of eggs from the garden’s chickens, quipping that she was “putting all her eggs” in Napolitano’s basket.
“I’m extremely excited and very hopeful because I know that she believes as I do that public education is the best way to solve the problems of the world,” said Waters, a UC Berkeley alumna.
Vision and leadership
Napolitano received an equally warm reception from state agricultural leaders.
“There is no better time to launch this initiative than today,” said board President Craig McNamara. “Count on us at the State Board of Food and Agriculture. We are your partners.”
The initiative will harness UC’s leadership in the fields of agriculture, medicine, nutrition, climate science, public policy, social science, biological science, humanities, arts and law, among others.
It comes at a crucial time, Napolitano said. A billion people — most of them in the developing world — suffer from chronic hunger or serious nutritional deficiencies. More than half a billion — primarily in the industrialized nations of the world — are obese. Against this backdrop, climate change and population growth fuel additional uncertainty and urgency about how to sustainably feed the world.
“This initiative shows great vision and leadership from President Napolitano and the University of California,” said Karen Ross, secretary of the California Department of Food and Agriculture. “Climate change and population growth will greatly strain our ability to provide healthy food to people here and around the world.
“President Napolitano’s proposal to leverage the strategic assets of the entire UC organization makes it a valuable partner in addressing the significant challenges and opportunities for our production agriculture and food system.”
Napolitano said that she and campus chancellors decided to launch the Global Food Initiative after recognizing that the university system is uniquely positioned to play a leading role in addressing the related challenges of nutrition and sustainability.
Playing to strengths
Henry Brady, dean of UC Berkeley’s Goldman School of Public Policy, was among a half dozen UC leaders and members of the university’s Food Initiative Working Group to join Napolitano at the Edible Schoolyard. Also in attendance were UC Santa Cruz professor Daniel Press, executive director of the Center for Agroecology & Sustainable Food Systems at that campus, and Ann Thrupp, executive director of the Berkeley Food Institute at UC Berkeley.
Brady said that the initiative’s strength comes from the depth of work and research across the 10-campus system. Each location brings its own area of expertise, he noted.
“We at the Berkeley Food Institute are trying to see how we can transform the food system to be more sustainable and we want to do it through good science, good policy, good thinking,” Brady said.
Press echoed Napolitano’s sentiment that UC’s involvement comes at a crucial moment.
He said that UC Santa Cruz had long been the “mothership” of organic agriculture in California and the U.S.
“We feel a lot of what people are talking about with sustainable agriculture and justice in the food system — these are things we’ve been working on for 40 years,” Press said. “Now the world is much more receptive.”
Helene Dillard, dean of the College of Agriculture and Environmental Sciences at UC Davis, talks with reporters in Sacramento. (Photo by Robert Durell)
Helene Dillard, dean of the College of Agricultural and Environmental Sciences at UC Davis, who joined Napolitano at the meeting with the state board, said that people at UC Davis are particularly excited about the initiative because it aligns so well with work already under way at the campus.
UC Davis last year launched the World Food Center to focus on transformative research at the intersection of food, agriculture, health and public policy.
“We’re already the No.1 agricultural school in the nation and the world,” Dillard said. “Having the UC system focusing on this really plays to our strengths.”
At UCLA, Napolitano was joined by UCLA Executive Vice Chancellor and Provost Scott Waugh; Wendy Slusser, associate vice provost for the UCLA Healthy Campus Initiative; students who manage the garden; and Los Angeles and Riverside school district officials.
UCLA’s initiative is an integrated effort aimed at making the campus the healthiest university in the country, promoting health and wellness of students, faculty and staff, and helping other communities achieve the same objectives. The Healthy Campus Initiative was envisioned and supported by philanthropists Jane and Terry Semel. Jane Semel was present for the announcement.
Napolitano toured the garden with members of the student group DigUCLA. She also planted an oregano plant and learned about gardening basics from the students.
Slusser said that she was excited to learn that the Healthy Campus Initiative served as a starting point for what has grown into a larger and stronger UC-wide effort. “On a personal note, the initiative is bringing me back to my roots since food has been the driving force in my medical and academic career, and also my father is a fourth-generation California rancher. So thank you, President Napolitano, and thank you to all our UCLA and community partners for working so hard in making us stronger together to promote health, wellness and happiness through food.”
UC is California’s land-grant university and has played a key part in helping California become the nation’s leading agricultural state. UC’s Division of Agriculture and Natural Resources has experts in every county in California, helping farmers, ranchers and others cope with tough issues like drought.
But UC’s leadership goes beyond agriculture. Students, faculty and staff have turned UC’s campuses into living laboratories for sustainable food practices. UC also is on the frontlines of addressing issues of food inequality and health, from developing flood- and drought-resistant crops to developing a highly efficient cookstove that addresses food security issues posed by displaced persons in Darfur.
Napolitano noted that the Berkeley Food Institute is studying the relationship between pest control, conservation and food safety on Central Coast farms; the World Food Center at UC Davis stands with 26 other centers dedicated to food and agriculture on that campus; students and faculty at UC Santa Cruz are transforming the field of agroecology; and the cutting-edge Healthy Campus initiative at UCLA taps all members of the campus community.
“We do much,” Napolitano said, “but, together, we can do more.”
Examples of projects that will be undertaken in the first phase of the UC Global Food Initiative include:
Expanding experiential learning, including demonstration gardens;
Creating a course catalogue of all food-related courses available on UC campuses;
Leveraging food purchasing power to encourage sustainable farming practices to serve nutritious fare in dining halls and cafeterias;
Data mining of existing information to help develop insights and action plans for agriculture and responses to climate change;
Organizing food pantries, so that food reaches hungry mouths instead of going to waste; and
Developing policies to better enable small growers to become suppliers.
Supporting student involvement
To support student engagement, Napolitano also announced the creation of the President’s Global Food Initiative Student Fellowship Program. The Office of the President will provide $7,500 to each UC campus to be used for three fellowships of $2,500 each. At the campuses’ discretion, these fellowships will go to undergraduates or graduate students, to fund student-generated research, related projects or internships that focus on food issues.
Keith Gilless, dean of UC Berkeley’s College of Natural Resources, said he was excited to see the system collaborate on such an important goal.
“I’ve been working my whole career to see how does the UC system as a whole come together so the sum is greater than its parts,” Gilless said. “The time is right to mobilize the university’s resources both to advance science and practices and to raise public consciousness about food issues broadly.”
UCSF study results raise hopes for alternative way to lose weight.
Ajay Chawla, UC San Francisco
The calorie-burning triggered by cold temperatures can be achieved biochemically – without the chill – raising hopes for a weight-loss strategy focused on the immune system rather than the brain, according to a new study by UC San Francisco researchers.
The team determined that two signaling molecules secreted by cells of the immune system trigger the conversion of fat-storing white fat cells to fat-burning beige fat cells. Ajay Chawla, M.D., Ph.D., an associate professor of medicine at the UCSF Cardiovascular Research Institute, led the study, published online today (June 5) in the journal Cell.
Working with mice, Chawla’s team discovered that the signaling molecules, called interleukin 4 and interleukin 13, activate cells known as macrophages, which in turn drive the fat conversion. In one experiment the researchers gave interleukin 4 to fat mice, which increased beige fat mass, leading to weight loss.
The finding builds on previous work by Chawla’s team, which reported in 2011 in Nature that cold activates part of the immune system, and specifically activates interleukin 4 in fat. In the new study, Chawla’s team determined that both interleukin 4 and interleukin 13 recruit macrophages to fat and that the production of molecules called catecholamines by the macrophages causes the browning of white fat.
When the researchers inhibited interleukin 4 signaling in white fat, they found that the mice made less beige fat, burned less energy, and could no longer maintain normal body temperature in the cold.
The study results are likely to further fuel the quest to identify new ways to pharmaceutically tame obesity by targeting how much energy we burn, not just how many calories we ingest, according to Chawla.
“If you could increase energy expenditure by even a few percent, over a period of a year or two year you would make a big difference,” he said.
A lack of oxygen in fat cells triggers inflammation and insulin resistance in obesity.
Researchers at the UC San Diego School of Medicine have, for the first time, described the sequence of early cellular responses to a high-fat diet, one that can result in obesity-induced insulin resistance and diabetes. The findings, published in today’s (June 5) issue of Cell, also suggest potential molecular targets for preventing or reversing the process.
“We’ve described the etiology of obesity-related diabetes. We’ve pinpointed the steps, the way the whole thing happens,” said Jerrold M. Olefsky, M.D., associate dean for scientific affairs and Distinguished Professor of Medicine at UC San Diego. “The research is in mice, but the evidence suggests that the processes are comparable in humans, and these findings are important to not just understanding how diabetes begins, but how better to treat and prevent it.”
More than 25 million Americans have diabetes – 8.3 percent of the population – with another 79 million Americans estimated to be pre-diabetic, according to the American Diabetes Association. Diabetes is characterized by high blood sugar levels poorly regulated by either inadequate insulin production or because cells to not respond properly to the regulating hormone. Diabetes is the seventh-leading cause of death in the United States and a major risk factor for other life-threatening conditions, including heart disease and stroke.
Past research by Olefsky and others has shown that obesity is characterized by low-grade inflammation in adipose or fat tissues and that this inflammatory state can become chronic and result in systemic insulin resistance and diabetes. In today’s Cell paper, the scientists describe the earliest stages of the process, which begins even before obesity becomes manifest.
Early complaints often precursors to significant decline in later life, UCLA/Gallup study says.
Gary Small, UCLA
If you’re depressed, don’t get enough exercise or have high blood pressure, you may find yourself complaining more about memory problems, even if you’re a young adult, according to a new UCLA study.
UCLA researchers and the Gallup organization polled more than 18,000 people about their memory and a variety of lifestyle and health factors previously shown to increase the risk of Alzheimer’s disease and dementia. They found that many of these risk factors increased the likelihood of self-perceived memory complaints across all adult age groups.
The findings, published in today’s (June 4) edition of the journal PLOS ONE, may help scientists better identify how early lifestyle and health choices impact memory later in life. Examining these potential relationships, researchers say, could also help to pinpoint interventions aimed at lowering the risk of memory issues.
The 18,552 individuals polled ranged in age from 18 to 99. The known risk factors the researchers focused on included depression, lower education levels, physical inactivity, high blood pressure, diabetes, obesity and smoking. They were surprised by the prevalence of memory issues among younger adults, said the study’s senior author, Dr. Gary Small, UCLA’s Parlow–Solomon Professor on Aging and director of the UCLA Longevity Center.
“In this study, for the first time, we determined these risk factors may also be indicative of early memory complaints, which are often precursors to more significant memory decline later in life,” said Small, who is also a professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA.
Blocking pain receptor may improve lifespan, metabolic health.
Blocking a pain receptor in mice not only extends their lifespan, it also gives them a more youthful metabolism, including an improved insulin response that allows them to deal better with high blood sugar.
“We think that blocking this pain receptor and pathway could be very, very useful not only for relieving pain, but for improving lifespan and metabolic health, and in particular for treating diabetes and obesity in humans,” said Andrew Dillin, a professor of molecular and cell biology at the University of California, Berkeley, and senior author of a new paper describing these results. “As humans age they report a higher incidence of pain, suggesting that pain might drive the aging process.”
The “hot” compound in chili peppers, capsaicin, is already known to activate this pain receptor, called TRPV1 (transient receptor potential cation channel subfamily V member 1). In fact, TRPV1 is often called the capsaicin receptor. Constant activation of the receptor on a nerve cell results in death of the neuron, mimicking loss of TRPV1, which could explain why diets rich in capsaicin have been linked to a lower incidence of diabetes and metabolic problems in humans.
More relevant therapeutically, however, is an anti-migraine drug already on the market that inhibits a protein called CGRP that is triggered by TRPV1, producing an effect similar to that caused by blocking TRPV1. Dillin showed that giving this drug to older mice restored their metabolic health to that of younger mice.
“Our findings suggest that pharmacological manipulation of TRPV1 and CGRP may improve metabolic health and longevity,” said Dillin, who is a Howard Hughes Medical Institute investigator and the Thomas and Stacey Siebel Distinguished Chair in Stem Cell Research. “Alternatively, chronic ingestion of compounds that affect TRPV1 might help prevent metabolic decline with age and lead to increased longevity in humans.”
Dillin and his colleagues at UC Berkeley and The Salk Institute for Biological Studies in La Jolla will publish their results in the May 22 issue of the journal Cell.
A new, collaborative study aimed at designing and evaluating worksite-based health programs to lower the risk of obesity and diabetes among immigrant Latino farmworkers has been launched under the leadership of UC Davis.
The new five-year study, to be carried out through a partnership between UC Davis; Reiter Affiliated Companies, a large California berry grower; and the Health Initiative of the Americas at UC Berkeley; was recently funded with more than $3 million in grant funds from the National Institute of Diabetes, Digestive and Kidney Diseases.
“Latino farmworkers harvest much of our fruit and vegetables, yet they face obesity and diabetes rates much higher than the general population,” said lead investigator Marc Schenker, director of the UC Migration and Health Research Center and the Western Center for Agricultural Health and Safety, and a distinguished professor in UC Davis’ Department of Public Health Sciences.
He noted that the prevalence of obesity and diabetes has rapidly increased during the past decade in the United States. Among Latinos, the prevalence of overweight and obesity is now an alarming 78 percent, markedly higher than in the general population. Furthermore, the prevalence of diabetes among Latinos in the U.S. is almost twice that of non-Latino whites.
“To address that problem, we have created and are evaluating an obesity and diabetes prevention program that can be delivered to workers in the field,” Schenker said.
The study will include food and nutrition educational programs at the participants’ on-farm worksites, as well as exercise activities such as Zumba classes. All programs are led by community health workers or “promotoras.”
The study focuses on ranches in Salinas and Watsonville, but the ultimate goal is to disseminate the intervention program to farms throughout the state and country.
The program is designed to improve health outcomes among the farmworkers participating in the study and to evaluate those outcomes, as well as the economic impact for the employer.
“We hope that the economic benefits — which we anticipate will be demonstrated and quantified through this study — will help convince other companies in the agricultural industry to adopt similar programs,” Schenker said.
He added that Reiter Affiliated Cos. is a model industry partner for this study because it is already invested in the health of its workers.
Co-investigators on the study include Daniel Sumner, a professor of agricultural and resource economics at UC Davis and director of the UC Agricultural Issues Center; Nancy Keim, an adjunct professor in the UC Davis Department of Nutrition; Heejung Bang, a professor of biostatistics at UC Davis; and Xochitl Castaneda, director of the Health Initiative of the Americas at UC Berkeley.
Findings may provide insight into how to protect humans from ill effects of a high-fat diet.
A comparison of the genomes of polar bears and brown bears reveals that the polar bear is a much younger species than previously believed, having diverged from brown bears less than 500,000 years ago.
The analysis also uncovered several genes that may be involved in the polar bears’ extreme adaptations to life in the high Arctic. The species lives much of its life on sea ice, where it subsists on a blubber-rich diet of primarily marine mammals.
The genes pinpointed by the study are related to fatty acid metabolism and cardiovascular function, and may explain the bear’s ability to cope with a high-fat diet while avoiding fatty plaques in their arteries and the cardiovascular diseases that afflict humans with diets rich in fat. These genes may provide insight into how to protect humans from the ill effects of a high-fat diet.
The study was a collaboration between Danish researchers, led by Eske Willerslev and including Rune Dietz, Christian Sonne and Erik W. Born, who provided polar bear blood and tissue samples; and researchers at BGI in China, including Shiping Liu, Guojie Zhang and Jun Wang, who sequenced the genomes and analyzed the data together with a team of UC Berkeley researchers, including Eline Lorenzen, Matteo Fumagalli and Rasmus Nielsen. Nielsen is a UC Berkeley professor of integrative biology and of statistics.
“For polar bears, profound obesity is a benign state,” said Lorenzen, one of the lead authors and a UC Berkeley postdoctoral fellow. “We wanted to understand how they are able to cope with that.”
“The promise of comparative genomics is that we learn how other organisms deal with conditions that we also are exposed to,” said Nielsen, a member of UC Berkeley’s Center for Theoretical Evolutionary Genomics. “For example, polar bears have adapted genetically to a high fat diet that many people now impose on themselves. If we learn a bit about the genes that allows them to deal with that, perhaps that will give us tools to modulate human physiology down the line.”
The findings accompany the publication of the first assembled genome of the polar bear as the cover story in today’s issue of the journal Cell.