UCLA researchers implement, evaluate effectiveness of pilot health-promotion program.

Wendy Slusser, UCLA

FINDINGS:
Research has shown that children from low-income neighborhoods are at higher risk of being obese and overweight than children from affluent neighborhoods; in fact, one-third of low-income children enter kindergarten either overweight or obese.

In an effort to address this issue, UCLA researchers implemented and evaluated the effectiveness of a pilot after-school health-promotion program that focused on increasing students’ opportunities for physical activity and healthy snacks — and boosting their knowledge about physical activity and nutrition — at four low-income, diverse elementary schools in Los Angeles County (four additional school sites were used as comparisons). The study involved students in grades 3 through 5.

After-school staff members were trained by UCLA researchers to implement the evidence-based, sequential nutrition and physical activity curriculum. Data were collected by researchers on students’ nutrition and physical activity knowledge and behavior, and their height and weight measurements, at the beginning and end of the academic year.

Results showed that the proportion of children who were obese or overweight in the intervention group decreased by 3.1 percent by the end of the school year, compared with a 2.0 percent reduction among children in the comparison group. The study found mixed results regarding diet and physical activity knowledge and behavior.

The authors conclude that enhancing after-school physical activity opportunities through evidence-based programs can potentially benefit low-income children who are overweight or obese.

IMPACT:
Findings from this study indicate that after-school programs have the potential to provide opportunities for enhanced physical activity and the development of healthy habits in children from socioeconomically disadvantaged families who may have limited access to nutritious foods and environments conducive to physical activity outside of school.

In addition, as approximately 60 percent of the students in the study were Asian American, the study helps address the dearth of published research on childhood obesity among Asian Americans. This is an important public health concern, given that Asian Americans are the fastest growing racial group in the U.S., and the literature suggests that current definitions of obesity underestimate the disease risk among this subgroup, the study authors said.

AUTHORS:
Study authors included Dr. Wendy M. Slusser, Michael L. Prelip, Mienah Z. Sharif and Janni J. Kinsler of UCLA; Jennifer Toller Erausquin of the North Carolina Division of Public Health; and Daniel Collin of California State University, Long Beach.

JOURNAL:
The article, “Improving Overweight Among At-Risk Minority Youth: Results of a Pilot Intervention in After-School Programs,” is published in a supplement to the current edition of  the Journal of Health Care for the Poor and Underserved.

FUNDING:
The study was supported by funds from the California Vitamin Settlement Fund (#20063972).

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Originally developed from sun anemone venom, ShK-186 boosts metabolism, UC Irvine scientists find.

George Chandy, UC Irvine

Scientists at UC Irvine have discovered that a synthetic compound originally derived from a sun anemone toxin enhances metabolic activity and shows potential as a treatment for obesity and insulin resistance.

The findings, published online this week in Proceedings of the National Academy of Sciences, present the first evidence that the drug candidate – which in March got positive results in a phase-one safety clinical trial – may work in an anti-obesity capacity.

UC Irvine licensed ShK-186 to Kineta Inc., a Seattle-based biotechnology company, in 2009; it’s the company’s lead drug candidate. Kineta is developing the compound to treat autoimmune diseases, such as multiple sclerosis, psoriatic arthritis and lupus. It has also licensed ShK-186 for the treatment of metabolic syndrome and obesity.

Potassium channels regulate cell membrane activities and control a variety of other cellular processes. ShK-186 selectively blocks the activity of a protein that promotes inflammation through the Kv1.3 potassium channel. Earlier research using mice without a Kv1.3 potassium channel gene suggested that Kv1.3 may regulate body weight and the basal metabolic rate.

In the current study, Dr. George Chandy and colleagues evaluated ShK-186 in tests on obese mice that ate a high-fat, high-sugar diet. They found that the therapy reduced weight, white fat deposits, liver fat, blood cholesterol and blood sugar by activating calorie-burning brown fat, suppressing inflammation of white fat and augmenting liver function. The compound had no effect on mice that ate standard chow.

“This is a new twist in a sustained journey of discovery made over 30 years that charts the course for expeditious translation to humans who suffer from potentially lethal consequences of metabolic syndrome and autoimmune diseases,” said Chandy, a UC Irvine professor of physiology & biophysics and a Kineta scientific adviser.

“Knowing that ShK-186’s unique mechanism of action may have broad applications across multiple therapeutic disciplines, such as autoimmune diseases and now obesity, further adds to the potential of this compound. This study also shows how medical progress can be made through academic and private-sector partnerships,” added Charles Magness, president and CEO of Kineta.

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UCSF’s bariatric surgery program offers care for obese patients.

Unless you weigh more than 400 pounds, it’s difficult to imagine walking a mile in James Dials’ shoes. In fact, for most of his life, he couldn’t do that either.

The gregarious 62-year-old limousine driver made friends easily, escorting musicians and athletes all over town. Sometimes they would shower him with choice tickets to concerts and sporting events.

Stanley Rogers (left) and James Dials

But Dials always had to turn them down.

Not because of a company policy or because he didn’t enjoy public events. Not too long ago, Dials weighed 434 pounds, and he couldn’t walk 10 feet without having to stop and catch his breath. The walk from the parking lot to the venue would have been a Herculean task for him to accomplish.

“I could only take about 20 steps and stop and catch my breath,” Dials said. “Then, 20 more steps and then stop.”

He says low self-esteem and his love of his native Southern down home cooking contributed to his gradual weight gain. Before he knew it, Dials passed the 400-pound mark.

“My life was very uncomfortable,” Dials said. “I was a diabetic and I injected insulin. I had high blood pressure, sleep apnea, and high cholesterol. I was on all kinds of medications.”

That’s when he discovered the UCSF Bariatric Surgery Center, a Level 1 accredited center for weight-loss surgery by the Bariatric Surgery Center Network of the American College of Surgeons, which means they provide complete bariatric surgical care. It is a nationally certified “center of excellence,” which offers a multidisciplinary approach to weight loss.

“James had relatively advanced obesity,” says Stanley Rogers, M.D., chief of minimally invasive surgery and director of the Bariatric Surgery Center and Liver Tumor Ablation Program at UCSF Medical Center. “And we know that weight loss either with or without surgery can significantly impact those medical problems, and can make these medical problems called co-morbidities go away as weight loss occurs.”

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They consume nearly as many calories at Subway as at McDonald’s, UCLA study finds.

Lennard Lesser

Subway may promote itself as the “healthy” fast food restaurant, but it might not be a much healthier alternative than McDonald’s for adolescents, according to new UCLA research.

In a study published May 6 in the Journal of Adolescent Health, the researchers found that adolescents who purchased Subway meals consumed nearly as many calories as they did at McDonald’s. Meals from both restaurants are likely to contribute toward overeating and obesity, according to the researchers.

“Every day, millions of people eat at McDonald’s and Subway, the two largest fast food chains in the world,” said Dr. Lenard Lesser, who led the research while a Robert Wood Johnson Foundation Clinical Scholar in the department of family medicine at the David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health. “With childhood obesity at record levels, we need to know the health impact of kids’ choices at restaurants.”

The researchers recruited 97 adolescents ages 12 to 21 to purchase meals at McDonald’s and Subway restaurants at a shopping mall in Carson. The participants went to each restaurant on different weekdays between 3 p.m. and 5 p.m., and paid for the meals with their own money. Researchers used the participants’ cash register receipts to record what each customer ate and estimated calorie counts from information on the chains’ websites.

The researchers found that the participants bought meals containing an average of 1,038 calories at McDonald’s and an average of 955 calories at Subway.

“We found that there was no statistically significant difference between the two restaurants, and that participants ate too many calories at both,” said Lesser, who is now a researcher at the Palo Alto Medical Foundation Research Institute.

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UC convenes discussion on how to sustainably feed 8 billion people by 2025.

Michael Specter moderates a panel discussion on feeding a world of 8 billion people. (Click image for larger view.)

By Alec Rosenberg

The University of California, through its Division of Agriculture and Natural Resources, hosted a wide-ranging, provocative discussion Tuesday (April 9) on how to sustainably feed 8 billion people by 2025.

Several themes emerged from the UC Global Food Systems Forum: Take a bottom-up approach. Focus on solutions. Pursue low-hanging fruit. Decrease food waste. Be practical. Be innovative. Involve education. But opinions differed on how to balance small- and large-scale farming, the role of genetically modified organisms, and what should be the most important area of focus.

More than 475 people attended the food forum in Ontario, Calif., which also reached a worldwide virtual audience. A live webcast received 1,500 unique viewers from 34 countries, while a steady stream of tweets at #Food2025 made the conversation a trending topic on Twitter. With more than 1 billion people going hungry every day and 1 billion people overweight, the conversation was timely.

“We must act now to improve the food and nutrition supply of people in poor countries and communities throughout the world,” said keynote speaker Mary Robinson, former president of Ireland and president of the Mary Robinson Foundation – Climate Justice.

Mary Robinson and Barbara Allen-Diaz at the UC Global Food Systems Forum. (Click image for larger view.)

Myriad challenges

The daylong forum, part of ANR’s statewide conference, addressed the challenges faced by food producers, suppliers and consumers in a world of growing population, strains on natural systems, climate change, shifting geopolitics and other converging forces. The event convened some of the world’s leading experts — farmers, researchers, policymakers, economists, environmentalists and others — with the New Yorker’s Michael Specter moderating a global panel and author and journalist Mark Arax moderating a California panel. The speakers offered thoughtful insights and solutions.

“This is fundamental to our mission as a land-grant university,” said UC ANR Vice President Barbara Allen-Diaz. “Our goal is to take these brilliant ideas and turn them into brilliant plans of action.”

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Related links:

• California farmers face global pressures
  
• View Global Food Systems Forum webcast
• Video: UC Cooperative Extension turns 100

Approach may be viable alternative to clinic-based weight control programs.

It is known that family-based treatment that combines nutrition and exercise education, along with behavior modification, is a good approach to help children lose weight.  But clinic-based weight-control programs for childhood obesity are not accessible to many families, due to issues such as cost or time commitment.

Initial studies at the UC San Diego School of Medicine indicate that a self-help treatment program for overweight children and their parents, guided by clinical experts, may be an effective solution.  The study, led by Kerri Boutelle, Ph.D., associate professor of pediatrics and psychiatry at UC San Diego School of Medicine – the first to demonstrate the effectiveness of such a program – will be published in the journal Pediatrics on April 1.

Boutelle and colleagues enrolled 50 overweight or obese children between the ages of 8 and 12 and their family members in a low-intensity, 5-month long treatment for childhood obesity, measuring the effects on a child’s weight (measured as body mass index or BMI) immediately post-treatment and six months later.  The researchers also evaluated whether the intervention promoted improvements in eating behavior and physical activity among children and parents. The results of the guided, self-help intervention program showed a significant decrease in BMI immediately after completing the 5-month treatment, losses that were maintained six months later.

According to the UCSD researchers, such a program may be an improvement over current methods, especially because the program is designed to fit a busy family’s schedule.

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San Diego Supercomputer Center to host infrastructure.

Researchers at UC San Diego have been awarded a new National Institutes of Health (NIH) grant to expand and enhance a cyberinfrastructure designed to provide scientists with easily accessible, Web-based resources to help fight diabetes and metabolic diseases.

The grant, awarded through the university’s Center for Research in Biological Systems (CRBS), will focus on establishing, coordinating, and making available large pools of datasets to researchers as part of a project to further develop the National Institute of Diabetes and Digestive and Kidney Diseases’ (NIDDK) Interconnectivity Network community and infrastructure.

About 25.8 million children and adults in the United States, or 8.3 percent of the population, have diabetes, according to the American Diabetes Association. Obesity has been cited as a contributing factor to approximately 100,000 to 400,000 deaths in the U.S. each year.

Established in 2010, a prototype of the current system called dkCOIN was initially created to explore requirements for information sharing between four NIDDK-supported consortia, including the Nuclear Receptor Signaling Atlas (NURSA), the Beta Cell Biology Consortium (BCBC), the Mouse Metabolic Phenotyping Centers (MMPC), and the Diabetic Complications Consortium (DCC).

The new NIH grant will allow UC San Diego researchers to expand the data federation and develop and enhance a user-friendly Web portal that will seamlessly integrate information, resources, and data held by NIDDK-related research groups, with the goal of providing a valuable resource for NIDDK investigators.

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UCLA research results not encouraging.

Past studies have suggested a relationship between neighborhood characteristics and obesity, as well as a connection between obesity and advertisements on television and in magazines.

Now, new research from UCLA has identified a possible link between outdoor food ads and a tendency to pack on pounds. The findings, researchers say, are not encouraging.

In a study published online in the peer-reviewed journal BMC Public Health, Dr. Lenard Lesser and his colleagues suggest that the more outdoor advertisements promoting fast food and soft drinks there are in a given census tract, the higher the likelihood that the area’s residents are overweight.

“Obesity is a significant health problem, so we need to know the factors that contribute to the overeating of processed food,” said Lesser, who conducted the research while a Robert Wood Johnson Foundation Clinical Scholar at the UCLA Department of Family Medicine and UCLA’s Fielding School of Public Health.

“Previous research has found that fast food ads are more prevalent in low-income, minority areas, and laboratory studies have shown that marketing gets people to eat more,” said Lesser, now a research physician at the Palo Alto Medical Foundation Research Institute in California. “This is one of the first studies to suggest an association between outdoor advertising and obesity.”

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UC Irvine study identifies transgenerational effects of TBT compound.

Bruce Blumberg, UC Irvine

Exposing pregnant mice to low doses of the chemical tributyltin – which is used in marine hull paint and PVC plastic – can lead to obesity for multiple generations without subsequent exposure, a UC Irvine study has found.

After exposing pregnant mice to TBT in concentrations similar to those found in the environment, researchers saw increased body fat, liver fat and fat-specific gene expression in their “children,” “grandchildren” and “great-grandchildren” – none of which had been exposed to the chemical.

These findings suggest that early-life exposure to endocrine-disrupting compounds such as TBT can have permanent effects of fat accumulation without further exposure, said study leader Bruce Blumberg, UC Irvine professor of pharmaceutical sciences and developmental & cell biology. These effects appear to be inherited without DNA mutations occurring.

The study appears online today in Environmental Health Perspectives, a publication of the National Institute for Environmental Health Sciences.

Human exposure to TBT can occur through PVC plastic particles in dust and via leaching of the chemical and other related organotin compounds from PVC pipes and containers.

Significant levels of TBT have been reported in house dust – which is particularly relevant for young children who may spend significant time on floors and carpets. Some people are exposed by ingesting seafood contaminated with TBT, which has been used in marine hull paint and is pervasive in the environment.

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UCLA study shows links to more immediate health problems than previously thought.

Neal Halfon, UCLA

While a great deal of research on childhood obesity has spotlighted the long-term health problems that emerge in adulthood, a new UCLA study focuses on the condition’s immediate consequences and shows that obese youngsters are at far greater risk than had been supposed.

Compared to kids who are not overweight, obese children are at nearly twice the risk of having three or more reported medical, mental or developmental conditions, the UCLA researchers found. Overweight children had a 1.3 times higher risk.

“This study paints a comprehensive picture of childhood obesity, and we were surprised to see just how many conditions were associated with childhood obesity,” said lead author Dr. Neal Halfon, a professor of pediatrics, public health and public policy at UCLA, where he directs the Center for Healthier Children, Families and Communities. “The findings should serve as a wake-up call to physicians, parents and teachers, who should be better informed of the risk for other health conditions associated with childhood obesity so that they can target interventions that can result in better health outcomes.”

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New research condemning fructose consumption no surprise to UCSF’s Robert Lustig.

Robert Lustig, UC San Francisco

Fructose, a sugar much maligned in recent years, recently took another hit when a preliminary study by Yale University found that it might stimulate appetite more than other sugar types. The results came as no surprise to Robert Lustig, M.D., a pediatric endocrinologist at the UC San Francisco Benioff Children’s Hospital who’s made headlines for years with his public health crusade against excess sugar consumption.

In the Jan. 2 study published in the Journal of the American Medical Association (JAMA), researchers used magnetic resonance imaging (MRI) techniques to demonstrate that ingested fructose affects blood flow differently than glucose in the brainregions associated with feeding behavior, including the hippocampus and the striatum. The Yale researchers concluded that fructose consumption might be more likely to stimulate rather than curb appetite, similar to what was found in earlier animal research.

In fact, on average, the 20 normal-weight, young adults who participated in the study reported that hunger was sated by glucose, but not by fructose, although the study does not demonstrate that fructose causes obesity.

At UCSF, where many researchers and physicians are trying to understand obesity and its causes, Lustig stands out for his concern over the physiological effects of sugar consumption. He’s also a strong advocate of policy changes that would lessen what he believes are sugar’s contribution to the obesity epidemic in the United States.

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UC Davis study deflates that notion.

People who are “apple-shaped” — with fat more concentrated around the abdomen — have long been considered more at risk for conditions such as heart disease and diabetes than those who are “pear-shaped” and carry weight more in the buttocks, hips and thighs.

But new research conducted at UC Davis Health System published in The Journal of Clinical Endocrinology and Metabolism provides further evidence that the protective benefits of having a pear-body shape may be more myth than reality. The journal article posted online today (Jan. 10) and will appear in the March print edition.

The UC Davis study found that fat stored in the buttock area — also known as gluteal adipose tissue — secretes abnormal levels of chemerin and omentin-1, proteins that can lead to inflammation and a prediabetic condition know as insulin resistance in individuals with early metabolic syndrome.

Metabolic syndrome refers to a group of risk factors that occur together, doubling the risk for heart disease and increasing the risk for diabetes at least five-fold. Risk factors include having a large waistline, low levels of high-density lipoproteins (HDL), or “good” cholesterol, high blood pressure as well as high fasting blood sugar ( insulin resistance) and high triglyceride levels. According to the Centers for Disease Control and Prevention, metabolic syndrome affects 35 percent of American adults over age 20.

“Fat in the abdomen has long been considered the most detrimental to health, and gluteal fat was thought to protect against diabetes, heart disease and metabolic syndrome,” said Ishwarlal Jialal, lead author of the study and a professor of pathology and laboratory medicine and of internal medicine at UC Davis. ”But our research helps to dispel the myth that gluteal fat is ‘innocent.’ It also suggests that abnormal protein levels may be an early indicator to identify those at risk for developing metabolic syndrome.”

The UC Davis team found that in individuals with early metabolic syndrome, gluteal fat secreted elevated levels of chemerin and low levels of omentin-1 — proteins that correlate with other factors known to increase the risk for heart disease and diabetes.  High chemerin levels, for example, correlated with high blood pressure, elevated levels of C-reactive protein (a sign of inflammation) and triglycerides, insulin resistance, and low levels of HDL cholesterol. Low omentin-1 levels correlated with high levels of triglycerides and blood glucose levels and low levels of HDL cholesterol.

“High chemerin levels correlated with four of the five characteristics of metabolic syndrome and may be a promising biomarker for metabolic syndrome,” said Jialal. “As it’s also an indicator of inflammation and insulin resistance, it could also emerge as part of a biomarker panel to define high-risk obesity states. The good news is that with weight loss, you can reduce chemerin levels along with the risk for metabolic syndrome.”

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