TAG: "Obesity"

Childhood obesity drops with new school nutrition program, study shows


The program could be adopted nationally at little cost to schools, researchers say.

Principal Paul Hauder (left) and student Cody Tufts of Carroll Elementary School in Elk Grove Unified School District have fun at a 2013 Sharing Healthy Choices program developed at UC Davis. (Photo by Kelley Brian, UC Davis)

The percentage of overweight or obese children in test schools dropped from 56 percent to 38 percent over the course of a single school year, thanks to a new nutrition program  developed and tested in the classroom by nutrition researchers at UC Davis.

The new program fits into the new Common Core educational standards.

“The education component of this program is intended to help children develop nutrition-related problem solving skills,” said co-author Jessica Linnell, a senior doctoral candidate in the UC Davis Department of Nutrition. “We think that these skills, combined with knowledge about foods, may be critical in order for children to make healthy choices.”

Researchers say the program could be adopted nationally at little cost to schools. The program was pilot-tested for this study in schools located in Sacramento and Stanislaus counties. Study findings were reported recently during the Experimental Biology 2014 meeting.

“When we designed the study, we anticipated short-term outcomes such as kids having more knowledge of nutrition or being able to identify more vegetables,” said Rachel Scherr, assistant project scientist in the UC Davis Department of Nutrition and one of the study’s lead investigators.  “We always had a long-term goal of decreasing body mass index, but we didn’t anticipate that it would happen in such a short timeframe, so we are thrilled.”

In a randomized control study, the researchers found that fourth-graders who participated in the nutrition program ate substantially more vegetables and lowered their body mass index during the school year that the nutrition program was implemented.

Senior author Sheri Zidenberg-Cherr, a Cooperative Extension nutrition specialist and co-director of the UC Davis Center for Nutrition in Schools, said that the project could not have been possible without the work of a highly interdisciplinary team, including collaborators from University of California Agriculture and Natural Resources; the UC Davis departments of Nutrition, Human Ecology, Population Health and Reproduction, and Plant Sciences; the UC Davis Health System, Betty Irene Moore School of Nursing, Foods for Health Institute and Agricultural Sustainability Institute; and the University of Utah Department of Physics and Astronomy.

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Being called ‘fat’ makes young girls more likely to become obese


Trying to be thin is like trying to be tall, say UCLA psychologists.

A. Janet Tomiyama, UCLA

Girls who are told by a parent, sibling, friend, classmate or teacher that they are too fat at age 10 are more likely to be obese at age 19, a new study by UCLA psychologists shows.

The study looked at 1,213 African-American girls and 1,166 white girls living in Northern California, Cincinnati and Washington, D.C., 58 percent of whom had been told they were too fat at age 10. All the girls had their height and weight measured at the beginning of the study and again after nine years.

Overall, the girls labeled fat were 1.66 times more likely than the other girls to be obese at 19, the researchers found. They also found that as the number of people who told a girl she was fat increased, so did the likelihood that she would be obese nine years later. The findings appear in the June 2014 print issue of the journal JAMA Pediatrics and are published online April 28.

“Simply being labeled as too fat has a measurable effect almost a decade later. We nearly fell off our chairs when we discovered this,” said A. Janet Tomiyama, an assistant professor of psychology in the UCLA College of Letters and Science and the study’s senior author. “Even after we statistically removed the effects of their actual weight, their income, their race and when they reached puberty, the effect remained.

“That means it’s not just that heavier girls are called too fat and are still heavy years later; being labeled as too fat is creating an additional likelihood of being obese.”

Co-author Jeffrey Hunger, a graduate student at UC Santa Barbara, said that simply being called fat may lead to behaviors that later result in obesity.

“Being labeled as too fat may lead people to worry about personally experiencing the stigma and discrimination faced by overweight individuals, and recent research suggests that experiencing or anticipating weight stigma increases stress and can lead to overeating,” he said.

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Community-based weight loss program aids diabetes management


Majority of participants in trial lost weight and reduced medication use.

Cheryl Rock, UC San Diego

Weight loss and control of blood sugar can reduce the risk of complications in patients with diabetes, but this is difficult for many to achieve. A UC San Diego School of Medicine randomized controlled trial of obese adults with type 2 diabetes suggests that participants enrolled in a community-based structured weight loss program are able to shed more pounds, improve blood sugar control and reduce or eliminate insulin use and other medications compared to a control group.

“Support and a tailored lifestyle intervention have been shown to reduce cardiovascular disease risk factors and adverse outcomes in people with diabetes,” said Cheryl L. Rock, Ph.D., R.D., professor of family and preventive medicine and principal investigator of the study. “However, most overweight individuals with type 2 diabetes do not receive this degree of support for changes in diet and physical activity to promote weight loss in their clinical care, due in part to constraints of time and training for most health care providers and clinicians.”

The results of the study, published in today’s (April 23) online issue of Diabetes Care, found that 72 percent of participants on the weight loss program that included portion-controlled foods and personalized counseling were able to change their insulin use compared with 8 percent of the control group. Similarly, other diabetes, cholesterol and blood pressure drugs were decreased or discontinued more often among the weight loss program enrollees.

According to the Centers for Disease Control and Prevention, 35 percent of adults in the United States are obese and 8 percent of adults are affected by diabetes.

“Weight loss is a primary strategy for successful management of type 2 diabetes due to its impact on glycemic control and improvements in cardiovascular disease risk factors,” said Rock. “These study results suggest that patients not only lose weight on structured commercial weight loss programs that include behavioral modification and individual support, but that this weight loss translates to significant improvements in diabetes control and cardio-metabolic parameters.”

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Does a junk food diet make you lazy?


UCLA psychology study offers answer.

Aaron Blaisdell, UCLA

A new UCLA psychology study provides evidence that being overweight makes people tired and sedentary — not the other way around.

Life scientists led by UCLA’s Aaron Blaisdell placed 32 female rats on one of two diets for six months. The first, a standard rat’s diet, consisted of relatively unprocessed foods like ground corn and fish meal. The ingredients in the second were highly processed, of lower quality and included substantially more sugar — a proxy for a junk food diet.

After just three months, the researchers observed a significant difference in the amount of weight the rats had gained, with the 16 on the junk food diet having become noticeably fatter.

“One diet led to obesity, the other didn’t,” said Blaisdell, a professor of psychology in the UCLA College of Letters and Science and a member of UCLA’s Brain Research Institute.

The experiments the researchers performed, Blaisdell said, also suggest that fatigue may result from a junk food diet.

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Bariatric surgery decreases risk of uterine cancer


Findings indicate obesity may be a modifiable risk factor for endometrial cancer.

Researchers at the UC San Diego School of Medicine and Moores Cancer Center report that bariatric surgery resulting in dramatic weight loss in formerly severely obese women reduces the risk of endometrial (uterine) cancer by 71 percent and as much as 81 percent if normal weight is maintained after surgery.

Published in the April issue of Gynecologic Oncology, the official publication of the Society of Gynecologic Oncology, the findings indicate obesity may be a modifiable risk factor for endometrial cancer, and bariatric surgery a viable option for eligible patients. They are based on a retrospective cohort study of 7,431,858 patients in the University HealthSystem Consortium database, which contains information from contributing academic medical centers in the United States and affiliated hospitals. Of this total, 103,797 patients had a history of bariatric surgery and 44,345 had a diagnosis of uterine malignancy.

Obesity is a widespread public health problem in the United States, with an estimated two-thirds of the U.S. adult population considered to be overweight or obese. The condition is strongly linked to a host of health risks, among them heart disease, diabetes and cancer, in particular endometrial cancer.

“Estimating from various studies that looked at increasing BMI and endometrial cancer risk, a woman with a body mass index (BMI) of 40 would have approximately eight times greater risk of endometrial cancer than someone with a BMI of 25,” said first author Kristy Ward, M.D., the senior gynecologic oncology fellow in the Department of Reproductive Medicine at UC San Diego School of Medicine. “This risk likely continues to go up as BMI goes up.”

Bariatric surgery is often the last resort for obese patients after all other non-surgical weight loss efforts have failed. To qualify, patients must be an acceptable surgical risk and be defined as either severely obese with a BMI of 40 or greater or have a BMI of 35 or greater with at least one related condition: diabetes, obstructive sleep apnea, obesity-related cardiomyopathy or heart muscle disease or severe joint disease.

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Child obesity: cues and don’ts


Study suggests training kids to pay less attention to food might help them eat less.

Kerri Boutelle, UC San Diego

Among the multiple factors that can cause obesity is an abnormal neurocognitive or behavioral response to food cues. The brain becomes wired to seek – and expect – greater rewards from food, which leads to unhealthful overeating.

Attention modification programs, which train a person to ignore or disregard specific, problematic cues or triggers, have been used effectively to treat cases of anxiety and substance abuse. In a novel study published this week in the journal Appetite, Kerri Boutelle, Ph.D., professor of pediatrics and psychiatry at the UC San Diego School of Medicine, and colleagues report using a single session of attention modification to decrease overeating in obese children.

“Attentional bias is a long-studied psychological phenomenon,” said Boutelle. “Attentional bias to food means that food grabs a person’s attention. If two people were in a room with potato chips on the table, the person with attentional bias would be paying attention to, maybe looking at, the chips and the person without the bias would not really notice or pay attention to them.

“We believe that there is a group of people who are inherently sensitive to food cues and, over time, eating in response to paying attention to food makes them pay even more attention.  It’s based on Pavlovian conditioning.”

Obesity in the United States is a well-documented problem, with more than a third of American adults considered to be obese. Child obesity is equally alarming, with an estimated one-third of American children overweight or obese. These children are at greater risk for cardiovascular disease, cancer, orthopedic and endocrine conditions and more likely to die earlier.

Boutelle and colleagues investigated whether attention modification training might be another way to treat problematic eating and obesity in children. In a novel pilot study, they recruited 24 overweight and obese children between the ages of 8 and 12 and split them into two groups.

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Geographic variation of human gut microbes tied to obesity


Changes in latitude may influence more than attitude.

The researchers looked at data from more than 1,000 people from around the world. The blue represents the proportion of obesity-related bacteria in the gut, while red is the proportion of bacteria associated with slimness.

People living in cold, northern latitudes have bacteria in their guts that may predispose them to obesity, according to a new study by researchers at the University of California, Berkeley, and the University of Arizona, Tucson.

The researchers’ analysis of the gut microbes of more than a thousand people from around the world showed that those living in northern latitudes had more gut bacteria that have been linked to obesity than did people living farther south.

The meta-analysis of six earlier studies was published this month in the online journal Biology Letters by UC Berkeley graduate student Taichi Suzuki and evolutionary biology professor Michael Worobey of the University of Arizona.

“People think obesity is a bad thing, but maybe in the past getting more fat and more energy from the diet might have been important to survival in cold places. Our gut microbes today might be influenced by our ancestors,” said Suzuki, noting that one theory is that obesity-linked bacteria are better at extracting energy from food. “This suggests that what we call ‘healthy microbiota’ may differ in different geographic regions.”

“This observation is pretty cool, but it is not clear why we are seeing the relationship we do with latitude,” Worobey said. “There is something amazing and weird going on with microbiomes.”

To Worobey, the results are fascinating from an evolutionary biology perspective. “Maybe changes to your gut community of bacteria are important for allowing populations to adapt to different environmental conditions in lots of animals, including humans,” he said.

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Tighter economic regulation needed to reverse obesity epidemic


Study suggests government action to control food industries can help prevent obesity.

Roberto De Vogli, UC Davis

Roberto De Vogli, UC Davis

Governments could slow — and even reverse — the growing epidemic of obesity by taking measures to counter fast food consumption, according to a study published today (Feb. 2) in the Bulletin of the World Health Organization.

Led by Roberto De Vogli of UC Davis, the study showed that fast food purchases were independent predictors of increases in the average body mass index (BMI) in the U.S. and 24 other wealthy nations from 1999 to 2008. Nations with stronger government regulations — such as producer protection, price controls, and stronger intervention on competition and taxes — experienced slower increases in fast food purchases and average BMIs.

De Vogli’s research is the first to look at the effects of deregulation in the economy, including the agricultural and food sectors, and the resulting increase in fast food transactions and BMIs over time. It suggests that if governments take action to control food industries, they can help prevent overweight and obesity and its serious health consequences, including cardiovascular disease, diabetes, stroke and diet-related cancers.

“Unless governments take steps to regulate their economies, the ‘invisible hand of the market’ will continue to promote obesity worldwide with disastrous consequences for future public health and economic productivity,” said De Vogli, associate professor in the UC Davis Department of Public Health Sciences.

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New insights into controlling pediatric obesity


Electronic health records can be a useful tool to help clinicians educate kids and families.

Ulfat Shaikh, UC Davis

Ulfat Shaikh, UC Davis

Childhood obesity is a growing epidemic. Almost one-third of children in this country are overweight or obese, but how can we stem the tide? One idea is to use electronic health records (EHRs) to help clinicians intervene more aggressively. Programmed alerts could spur caregivers to order key tests and educate patients and families. But how does this approach work in the real world?

n a study published earlier this month in the American Journal of Medical Quality, researchers at UC Davis found mixed results. While EHR alerts definitely changed physician behavior when treating overweight and obese children, they are no magic bullet. The authors believe EHRs must be incorporated into a more comprehensive strategy to help patients overcome their weight issues.

“The alerts led to significant but not dramatic improvements,” said Ulfat Shaikh, lead researcher, pediatrician and director of Healthcare Quality at the UC Davis School of Medicine. “We believe any electronic record intervention must be combined with other approaches.”

To measure whether EHRs enhance practice, the researchers added obesity-related alerts to health records at the UC Davis Health System’s outpatient clinic, which cares for about 12,000 children each year. The alert — highlighted in bright yellow on the screen — warned physicians when a patient’s weight hit the 85th percentile, which is considered “overweight.”

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Related link:
Innovation Profile: Ulfat Shaikh

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Resetting the metabolic clock


Insight into mammalian circadian rhythms could lead to therapies for obesity, diabetes.

Circadian rhythms are affected by things like travel over time zones, diet and light exposure. (Illustration by Peter Allen)

Circadian rhythms are affected by things like travel over time zones, diet and light exposure.

We’ve all heard about circadian rhythm, the roughly 24-hour oscillations of biological processes that occur in many living organisms. Yet for all its influence in many aspects of our lives — from sleep to immunity and, particularly, metabolism — relatively little is understood about the mammalian circadian rhythm and the interlocking processes that comprise this complex biological clock.

Through intensive analysis and computer modeling, researchers at UC Santa Barbara have gained insight into factors that affect these oscillations, with results that could lend themselves to circadian regulation and pharmacological control. Their work appears in the early edition of the Proceedings of the National Academy of Sciences.

“Our group has been fascinated with circadian rhythms for over 10 years now, as they represent a marvelous example of robust control at the molecular scale in nature,” said Frank Doyle, chair of UCSB’s Department of Chemical Engineering and the principal investigator for the UCSB team. “We are constantly amazed by the mechanisms that nature uses to control these clocks, and we seek to unravel their principles for engineering applications as well as shed light on the underlying cellular mechanisms for medical purposes.”

“Focus is often given to metabolism, cell division and other generic cell processes, but circadian oscillations are just as central to how life is organized,” said Peter St. John, a researcher in the Department of Chemical Engineering and lead author of the study.

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Men don’t seek obesity surgery as soon as they should


Obese women more likely to seek weight-loss surgery.

Mohamed Ali, UC Davis

Mohamed Ali, UC Davis

Even though obesity affects women and men equally, a UC Davis study shows that obese women are four times more likely than obese men to seek weight-loss surgery. When they do see a bariatric surgeon, male patients tend to be older, more obese and sicker than women.

“It is important for men to realize that obesity poses a serious threat to their health and lifespans,” said Mohamed Ali, senior author of the study and chief of bariatric surgery at UC Davis. “A patient who is 100 pounds or more above his ideal body weight poses a therapeutic dilemma and should be referred to a surgeon.”

For the study, published in the December issue of Surgical Endoscopy, Ali and his colleagues collected information from 1,368 patients who were evaluated for bariatric surgery at UC Davis between 2002 and 2006.

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Pediatric obesity patients like telehealth services, pilot study finds


Approximately 80 percent satisfied with their telehealth appointment.

Fit for Healthy Weight telehealth station

Fit for Healthy Weight telehealth station

For youth dealing with obesity who need extra help losing weight, experts suggest a multidisciplinary approach in which care is provided by several health specialists. However, the logistics of traveling to multiple appointments, even if just across town, can be a barrier to receiving care, especially for low-income families.

UCLA researchers who work with this patient population set up a pilot program using telehealth technology — a secure system that allowed patients to see and speak with their health care providers at UCLA over a computer from their local health clinic — to evaluate if such a system could be an effective strategy to help overcome these issues.

Their study of the program found that the great majority of pediatric patients — approximately 80 percent — were satisfied with their telehealth appointment, saying it was just as good as talking to the doctor in person, that it was easier to go to the local clinic than to the UCLA campus in Westwood, that they felt comfortable and that their privacy was protected.

In addition, 80 percent said they would participate in a telehealth appointment again. Responses from the health care providers were similarly positive.

The results of the project were presented at the Southern California Public Health Association Conference on Dec. 9.

“One surprise was how natural it was to talk with each other through the telehelath system, even though we never met the patients in person,” said lead author Dr. Wendy Slusser, medical director of the Fit for Healthy Weight program at Mattel Children’s Hospital UCLA and director of pediatric wellness programs at the Venice Family Clinic. “The interaction was very much like being in the same room together. Some kids even thought it was fun to see themselves on the screen.”

To conduct the study, researchers with the Fit for Healthy Weight program worked with UCLA colleagues, the Venice Family Clinic and the Los Angeles Unified School District to implement a telehealth system that met a high standard of encryption and was compliant with national regulations to ensure patient privacy.

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