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6/7/2012

Off the Scale: Supersizing Obesity Research

Writer: Denise Horton

In the past 15 years, the rate of obesity in Georgia has doubled, creating a state where one-third of adults and 14 percent of youth are considered obese. While these dismal numbers have raised warning flags, with government officials and the media heralding the crisis, for faculty members in the College of Family and Consumer Sciences the obesity problem isn’t new. For decades they have not only been studying obesity’s causes but also developing educational programs—for children and adults alike—focused on improved diets and increased levels of exercise. Unfortunately, the ready availability of inexpensive, tasty, high-calorie, low-nutrition food, combined with a steep decline in physical activity, has meant that researchers and educators have been fighting a losing battle.

Now, as part of a new effort, more than two dozen FACS faculty members are joining with colleagues from across the University of Georgia to establish a university-wide initiative to find new ways to fight obesity. The initiative, led by Clifton Baile, a D.W. Brooks Distinguished Professor and Georgia Research Alliance Eminent Scholar who holds a joint appointment in the FACS foods and nutrition department and the College of Agricultural and Environmental Sciences, is allowing researchers to develop collaborations that expand their work and take it in new directions.

Genuine motherhood issues

For example, Alex Anderson (Associate Professor, Foods and Nutrition) is collaborating with colleagues in the Colleges of Veterinary Medicine and Public Health to complement and enhance his research on maternal and infant obesity. Using technology that can safely measure the body composition of babies and children, as well as of expectant and new mothers, Anderson’s research has already demonstrated that mothers who breastfeed their babies lose more weight and body fat than moms who use baby formula. In addition, the breastfed babies have more of the metabolically active “brown fat” that is likelier to transition into lean body mass.

In his research as part of the new initiative, Anderson is looking more closely at the type of weight that expectant mothers gain, its impact on a newborn’s body composition, and how that composition changes over the course of infancy and early childhood. The work will assess, for example, “whether the nature of the mother’s weight gain—lean muscle or fat—affects the newborn’s weight or the mother’s ability to lose weight post-pregnancy,” he says. The new project will also determine the concentration of “adiposity-induced inflammation markers” found in the blood and breast milk of new and expectant mothers. “Obese individuals tend to have higher concentrations of these markers than do non-obese individuals, but we haven’t examined how the markers react to the different types of weight gained during pregnancy and to the infant’s body composition,” Anderson says.

Anderson also is beginning to reassess the body composition of children who were in his earlier studies. “Some of those babies are now 6 years old. We want to see if we can relate infant-feeding practices to what occurs as the baby grows into a young child.”

Obesity and bone health

For more than 20 years, Rick Lewis (UGA Foundation Professor in Family and Consumer Sciences, Foods and Nutrition) has explored connections between bone health and weight, including amassing a vast collection of blood serum, bone scans and in-depth interviews with young people ranging in age from 4 to 18 about their diets and activity levels. “Historically, body fat was viewed as protective of bone health, but we see that children who are overweight have less bone strength than those who are of normal weight,” he says. Reduced bone strength not only puts the child at greater risk of fractures, it may also play a role in adult osteoporosis.

As part of the new obesity initiative, Lewis and university colleagues are exploring a relationship between obesity and bone strength that involves a common virus—adenovirus-36 (AD-36)—also known for causing upper-respiratory infections. Previous research had correlated obesity with AD-36. Now, Lewis wants to explore whether that link involves bone strength as well. In preliminary research, he found that obese university students who tested positive for AD-36 had weaker bones. However, there was no correlation between normal-weight students’ bone strength and AD-36 exposure.

Lewis and his colleagues are now planning a more extensive study using blood samples gathered from tests of more than 80 children, beginning when they were four years old and continuing at intervals of every few years until they were 18. The researchers will test the samples for AD-36 antibodies and then examine the accompanying data on the children’s height, weight and bone strength before and after exposure to the virus. “A strong correlation between AD-36 infections, obesity and bone strength could lead to the development of vaccines or other treatments” for the conditions involved, according to Lewis.

Obesity and older adults

For close to 15 years, Mary Ann Johnson (Flatt Professor of Foods and Nutrition) has received funding from the Georgia Division of Aging Services and the federal Administration on Aging to provide nutrition education and physical-activity programs to adults who attend senior centers in the 13-county Northeast Georgia region. As a result, she and a number of colleagues from across campus have gathered a wealth of information about these older adults, including data regarding obesity, chronic diseases (such as diabetes), physical disabilities and eating habits.

“A number of our studies looked at individuals who eat most of their lunches at a senior center or who receive lunches through the Meals on Wheels program and we know that these meals provide a third of the recommended daily allowance for calories and nutrition,” Johnson says. “But more than half of the people we studied are obese—not just overweight, but obese. That’s significantly higher than the national average for people who are over 60, which is around 40 percent.”

From her research, Johnson has learned that eating habits don’t necessarily improve with age; older adults frequently skip their vegetables and milk just like kids do. Efforts to provide healthy meals at the senior centers also get undermined by the sodas and snacks that are frequently available, not to mention day-old breads and pastries that are donated by local businesses. In addition, many older adults enjoy fast-food meals, despite understanding the risks such food poses to their health. Because obesity can lead to or exacerbate illnesses (including high blood pressure and diabetes), as well as limit the mobility of older adults, Johnson says it’s now seen as a major contributor to increased medical costs.

Johnson’s research on those who attend senior centers will continue and expand as a part of the obesity initiative, but she’s also developing new collaborations such as one at the Shepherd Spinal Center in Atlanta. In that study, Johnson will assess the nutrition and eating habits of those who have experienced spinal injuries. That information will be combined with data on physical activity gathered by colleagues as part of an effort to address obesity in this population. Johnson also is collaborating with colleagues on a project that focuses on exercise, nutrition and obesity in older women.

Combining research and practice

A key aspect of UGA’s new obesity initiative is developing programs that can be implemented in communities throughout the state—a goal that dovetails with the long history of FACS Cooperative Extension programs. “In the case of basic research it may be years before work moves out of the lab, but in other instances the outreach and research components are working hand in glove,” says initiative-leader Baile.

A new five-year childhood-obesity project for Colquitt County provides an example of community-based activities that the UGA obesity initiative will encourage. It was Colquitt citizens who identified childhood obesity as a problem in their county and reached out to UGA for support. The project is led by Marsha Davis (an associate professor in the College of Public Health) and Rebecca Mullis (Professor, Foods and Nutrition), who have worked together for more than 20 years on research designed to improve the diets and physical activities of lower-income urban families. Also playing key roles in the project are Gail Hanula (Coordinator, Expanded Foods and Nutrition Education Program) and Connie Crawley (Senior Public Service Associate, Cooperative Extension Health and Nutrition), who have years of experience in “training the trainers”—that is, teaching FACS Cooperative Extension agents the best ways to present information to participants.

“The goal of this [Colquitt County] project is to focus on 600 third-graders to see if we can create an obesity-reduction program that includes their families, their teachers, school administrators, the employees who work in the cafeteria, and the community at-large,” says Mullis. “Much of our success will be measured at the beginning and end of each school year, when we assess the waist circumference and body mass index of these children—to determine whether they are overweight or obese—as they progress through fourth and fifth grades.”

It’s not only the health of the children themselves that is at stake. “Our previous research has shown that we can empower children to encourage better eating habits and improve physical activity in their families,” Mullis says. “In this project, we also hope these children will become enlightened voices in their larger communities—through the encouragement of healthy options in vending machines or through the creation of walking trails in the county, for example. And if children adopt that sort of focus now it will be far more likely to continue into adulthood.” Should the Colquitt County project prove successful, the researchers hope that because it uses a delivery system that already exists throughout Georgia—Cooperative Extension county agents—it can quickly be expanded statewide.

A widening initiative

To assess their interest in a university-wide obesity initiative, Baile began interviewing department heads and faculty in June 2011. At that time, he expected that the focus would be on research projects, especially because a review of 750 grant proposals submitted in 2010 showed that 125 addressed some aspect of obesity. By December, he had held more than 130 meetings and identified some 80 faculty who were interested in joining the initiative.

“This initiative is now about four times the size of what I thought it would be,” Baile says. FACS researchers make up roughly one-fourth of the participating faculty members, each of whom has joined one of 11 interest groups that meet monthly to discuss ways to further their research on obesity. The subjects of the groups range from the new field of epigenetics, which explores how environmental factors such as diet or prenatal nutrition can turn genes on or off, to public health policies. In-between are groups that, for example, address obesity in the workplace, obesity and exercise, and even communications strategies and obesity. Participants include faculty members in journalism, education, public health, environmental design, public service and outreach, kinesiology, genetics, veterinary medicine, animal science, biochemistry, molecular biology, and psychology, in addition to the FACS-related fields of foods and nutrition, consumer economics, child development, and gerontology. At least 15 grant submissions have grown out of the groups’ work; these are in addition to obesity-related grants that individual faculty members already had in progress.

The initiative also has expanded beyond the University of Georgia, with Baile meeting with representatives of the U.S. Centers for Disease Control and Prevention, the Georgia Department of Health, and Georgia Gov. Nathan Deal, among others. Moreover, Baile has found great interest among chief research officers at universities throughout the Southeastern football conference. A presentation to this group has already led to plans for a workshop this year and for obesity to be the topic of the 2014 SEC Academic Conference. Because all of the southeastern states have high rates of obesity, Baile says, expanding the initiative into a regional effort could finally turn the tide toward establishing proven ways of reducing obesity.

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