obesity: state of the science
TRANSCRIPT
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Grifn P. Rodgers, M.D.,M.A.C.P.Director
National Institute o Diabetes andDigestive
and Kidney Diseases
National Institutes o ealt!
The State of Obesity Research
witter: @NIDDKgov
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The National Institutes ofHealth (NIH
• '!e (ission o t!e NI is to see)unda(ental )no*ledge about t!enature and be!avior o livingsyste(s and t!e a++lication o t!at)no*ledge to en!ance !ealt!,lengt!en lie, and reduce illnessand disability.
• '!e NI su++orts (ore t!an$$,$$$ (e(bers o t!e researc!
*or)orce t!roug!out t!e countryand around t!e *orld atuniversities, (edical centers,co(+anies, and at t!e NI itsel.
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& &#!ults
-e!avioral Ris) "actor urveillance yste( /-R"0, %123
No Data
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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No Data
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Obesity Tren!s" #$ong %&S& #!ults-R", %12&
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No Data
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#
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No Data
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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#
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Obesity Tren!s" #$ong %&S& #!ults-R", %122
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No Data
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)*+,*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", %121
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No Data
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)*+,*
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I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
Obesity Tren!s" #$ong %&S& #!ults-R", %11$
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No Data
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)*+,*-*+
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", %11%
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No Data
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)*+,*-*+
.*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", %11#
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No Data
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)*+,*-*+
.*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
Obesity Tren!s" #$ong %&S& #!ults-R", %11
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No Data
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)*+,*-*+
.*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
Obesity Tren!s" #$ong %&S& #!ults-R", %119
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No Data
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)*+,*-*+
.*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
Obesity Tren!s" #$ong %&S& #!ults-R", %113
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No Data
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)*+,*-*+
.*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
Obesity Tren!s" #$ong %&S& #!ults-R", %11&
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No Data
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)*+,*-*+
.*/)*+/,*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", %11;
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No Data
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)*+,*-*+.*/)*+/,*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
Obesity Tren!s" #$ong %&S& #!ults-R", %112
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No Data
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)*+,*-*+.*/)*+/,*
ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
Obesity Tren!s" #$ong %&S& #!ults-R", %111
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No Data
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$$
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No Data
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$#
b i ! ! l
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No Data
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Ob i ! " S ! l
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No Data
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$9
Ob i T ! " # % S #! l
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No Data
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$3
Ob it T ! " # % S #! lt
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No Data
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$&
Ob it T ! " # % S #! lt
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No Data
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$;
Ob it T ! " # % S #! lt
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No Data
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$2
Ob it T ! " # % S #! lt
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No Data
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", #$$1
Ob it T ! " # % S #! lt
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No Data
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", #$%$
Ob it T ! " # % S #! lt
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No Data
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", #$%%
Ob it T ! " # % S #! lt
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ource4 CDC -e!avioral Ris) "actor urveillanceyste(.
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Obesity Tren!s" #$ong %&S& #!ults-R", #$%9
l!hoo! Obesity Tren!s in the %nite! Sta
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l!hoo! Obesity Tren!s in the %nite! Sta(Through /),
$<
#<
9<
&<
2<
%$<
%#<
%9<
%&<
%2<
#$<
2hil!ren34outh#=%1 years o age
4ear
5 e r c e n t
O b e s e
Source: Data from Centers for Disease Control and Prevention
Obesity-relateddiseases once seenonly in adults are
now being seen inchildren.
%&S& Obesity Tren!s" #$ong Racial36thnic
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ource4 CDC7NC National ealt! and Nutrition >?a(inationurvey, #$%%=#$%9.
I 6$ )g7(# or ∼$ +ounds over*eig!t or 389: *o(an
%&S& Obesity Tren!s #$ong Racial36thnic7rou8s
NAN>, #$%%
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NIH Obesity Research
Goals – understand t!e
causes and
conse@uences oobesity
– develo+ and evaluate+revention and
treat(ent strategies – build t!e evidencebase to inor(+olicies
Th 5 bli H lth 5 bl f Ob it
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The 5ublic Health 5roble$ of Obesity:5revalence an! #ssociate! Health 2on!itions
eininBa((ation
Coronary !eartdisease
ung disease
Gall bladder disease
Gout
Diabetes
steoart!ritis
Nonalco!olic atty liverdisease
ig! blood +ressure
>levated at in t!e blood
Cataracts
)in
Pancreatitis
Cancerbreast, uterus, cervi?, +rostate, )idney
colon, eso+!agus, +ancreas, liver
Gynecologic abnor(alities
tro)eIntracranial +ressure
De+ression
9&)* of /+ to .+year+ol! chil!ren3a!olescents an! 1&-* ofa!ults are obese!revalence data from "#$$-$%& NC'S Data (rief& No. "$). National Center for 'ealthStatistics CDC "#$*.
: ,da!ted from image created by Dr. ei Shen and Dr. Steven 'eymseld& New /or0 Obesity 1esearch Center& St. 2u0e3s-1oosevelt 'os!ital& Columbia 4niversi
The NIH Obesity Research Tas;
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The NIH Obesity Research Tas;
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Research an!5otentially
NewsworthyIssues
ultifacete! NIH Obesity Research:
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#88etite3foo! inta;e
5hysical activity=Se!entary behavior
Insulin resistance= in>a$$ationobesity+relate! !iseases
2irca!ian regulation=slee8
#!i8ose (fat tissue!e8ots
• Health Dis8arities
• Interventions for chil!ren=a!ults:+ ?ifestyle(behavior3environ$ent+ e!ical
+ Surgical (bariatric
Rewar! 8athways
Arain control of energy balance
ultifacete! NIH Obesity Research:Basic, Clinical, Translational
• 7enetics
• olecular signaling8athways(fat= $uscle= liver= gut=brain
5regnancy=intrauterineenviron$ent
7ut $icrobio$e(bacteria
: ,da!ted from image created by Dr. ei Shen and Dr. Steven 'eymseld& New /or0 Obesity 1esearch Center& St. 2u0e3s-1oosevelt 'os!ital& Columbia 4niversi
ultifacete! NIH Obesity Research:
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#88etite3foo! inta;e
5hysical activity=Se!entary behavior
Insulin resistance= in>a$$ationobesity+relate! !iseases
2irca!ian regulation=slee8
#!i8ose (fat tissue!e8ots
• Health Dis8arities
• Interventions for chil!ren=a!ults:+ ?ifestyle(behavior3environ$ent+ e!ical
+ Surgical (bariatric
Rewar! 8athways
Arain control of energy balance
ultifacete! NIH Obesity Research:Basic, Clinical, Translational
• 7enetics
• olecular signaling8athways(fat= $uscle= liver= gut=brain
5regnancy=intrauterineenviron$ent
7ut $icrobio$e(bacteria
: ,da!ted from image created by Dr. ei Shen and Dr. Steven 'eymseld& New /or0 Obesity 1esearch Center& St. 2u0e3s-1oosevelt 'os!ital& Columbia 4niversi
Bhite Arown an! Aeige #!i8ose
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Bhite= Arown= an! Aeige #!i8ose(
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Recent NIDDK Initiatives:#!i8ose Tissue
Roles of Arown an! Aeige #!i8ose Tissue inHu$ans 'o investigate t!e biological unctions o bro*n and beigeadi+ose tissue in !u(ans, and to e?+lore t!eir i(+act on
!u(an !ealt!.
Auil!ing a Hu$an #!i8oseDe8ot
'o develo+ a !u(an at c!i+ t!at *ill(i(ic t!e nor(al +!ysiology ounctional at tissue.
Ceteorin+li;e E a hor$one that
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eteorin+li;e E a hor$one thatlin;s eFercise to fat browning
a!ted from 1ao et al. Cell $*7: $"7) "#$%8
Immune cells
(Eosinophils)
Heat Production
Beige Fat Cells
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6Gects of 6Fercise
9ierath 1 et al. Cell ;etabolism ""$8& "*-=#&
olecular Trans!ucers of 5hysical
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olecular Trans!ucers of 5hysical#ctivity in Hu$ans
IH Common Fund launches physical
ctivity research program
rogram aims to identify molecules that contribute to a variety of health benet
% ! t !i DiG A t
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%n!erstan!ing DiGerences Aetween5eo8le
>asy access to !ig!=calorieoods and sedentary
liestyle contribute to
obesity
it!in si(ilarenviron(ents, individual
variability in *eig!t and
res+onse to treat(ent is
considerable
I(+roved understanding o
be!avioral variability *ill
!el+ advance obesity
+revention and treat(ent
N=174
(19.6%)
P e r c e n t a g e
G e i g ! t C o s s
% # 9 4ear
Gained
N=374
(42.2%)
N=152
(17.1%)
N=99
(11.2%)
N=88
(9.9%)L#
$
#
9
&
2
%$
%#
%9
%&
%2
L9
0-5%
5-6.9%
7-10%
≥ 10%
9=ear eig!t oss 'raectories o 22;Intensive iestyle Intervention
Partici+ants !o ad ost 6 %$<Initial eig!t at ear %
Data from 2oo0 ,'5,D clinical trial
Recent Bor;sho8 on Aehavioral
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Recent Bor;sho8 on Aehavioralariability
%8!ate:
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NIH Ao!y Beight 5lanner
%n!erstan!ing the Inta;e Si!e
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• Bhat= an! how $uch= are we eating
• Bhat shoul! we eat
• Bhen shoul! we eat
%n!erstan!ing the Inta;e Si!eof the 6nergy Aalance 6Juation
hat did + eat yesterda
New etho!s To I$8rove 6ating 5lan
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New etho!s To I$8rove 6ating 5lan#ssess$ents
2lic;
2alorie contentNutrientanalysis
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Ti$e to6at
Daily Hours of #ccessto High
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7ut Aacteriaan! Obesity
7ut Aacteriaan! Obesity
7ut icrobial 2o$$unity:
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7ut icrobial 2o$$unity:7enetics an! etabolis$
,da!ted from @oodrich et al. Cell $*): 7A)-
Identical (!) N"n-identical (#!)
$ean indiid&al' ae ie* leel'
"+ il, e*itale acte*ia called
Christensenallaceae
ice *ai'ed e*-+*ee *eceied a i/ "+ &t
acte*ia. en Christensenallaceae a'
added t" te i/ ice ained le'' eit.
Identical (!) N"n-identical (#!)
How 6arly Shoul! Be Intervene
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How 6arly Shoul! Be InterveneTo 5revent or Re!uce 2hil!hoo! Obesity
?ifestyle Interventions in
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yOverweight3Obese 5regnantBo$en
'!e ?ifestyle Interventions
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y8 g y5regnancy Outco$es (H#5O Stu!y
H#5O
tudy o over #,$$$ +regnant *o(en *it!blood glucose /sugar0 levels t!at *ere !ig!/!y+erglyce(ia0Obut belo* t!e t!res!old ordiagnosis o diabetes
"ound t!at serious co(+lications occur att!ese lo*er levels o (aternal !y+erglyce(ia
H#5O
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www&ni!!;&nih&gov3news
NIDDKs #nnual Re8ort
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NIDDKs #nnual Re8ort
Beight+control Infor$ation Networ;
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g(BIN
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www&ni!!;&nih&gov3news3for+
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nidd)(edianidd).ni!.gov
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Twitter: @NIDDKgov