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A Problem of Patterns Experts Blame Poor Choices for Obesity Epidemic Obesity Studies Among 113 Projects PENNINGTON BIOMEDICAL CENTER RESEARCH

Posted on: Monday, 22 August 2005, 18:00 CDT

Clinical Studies

Pounds Lost, a weight-loss study, is under the direction of Dr. George Bray. The two-year program will use lifestyle and behavioral changes to help participants lose weight. The dietary intervention study is looking at the effectiveness of diets of differing protein and fat content.

Volunteers must commit to a 6 1/2-month weight-loss period, with one-hour weekly dietary counseling, followed by a 1 1/2-year weight maintenance period that includes one-hour group sessions twice a month.

To qualify, volunteers must be 30 to 70 years old and be overweight with a Body Mass Index of 25 to 40. (To check BMI, visit http://www.pbrc.edu and see the Quick Links to find a BMI calculator.) Volunteers cannot be vegetarians or taking medications for diabetes. Women can't be pregnant, planning to become pregnant or breastfeeding.

Weight Loss Maintenance, a three-year, multi-site trial nearing completion, explores the problem of keeping lost weight off. The study is designed to test the effectiveness of counseling on behavior and lifestyle changes. Researchers are comparing an Internet-based program and brief telephone counseling. They also are looking at the effect long-term weight loss has on blood pressure. In addition to Pennington, trials are being conducted at Duke University, Kaiser Permanente Center for Health Research in Portland, Ore., and The John Hopkins Medical Institutions in Baltimore, Md. Phil Brantley is the investigator at Pennington.

CALERIE, or Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy, combines strict calorie control with exercise to determine the effects of a dramatic reduction in caloric intake by itself or combined with exercise.

Eric Ravussin, the principal investigator, also is the investigator in three other projects: Healthy Aging, biological and environmental predictors of obesity, and the relationship between obesity and diabetes.

ADAPT aims to understand how people differ in their ability to burn dietary fat. The study measures fuel oxidation, insulin sensitivity and body composition, along with genetic analyses of muscle and fat tissue and lab cultures of skeletal muscle cells from those same individuals. Investigators are Dr. Steven Smith and Dr. Barbara Ukropcova.

Dr. Smith also is involved in five other clinical projects: GLITZ, Healthy Transitions, PECOS, LIFE and ECO.

GLITZ is designed to test how a drug used to treat diabetes affects fat cells and metabolism.

Healthy Transitions is a long-term study focused on understanding why women gain abdominal fat during perimenopause, which occurs "around the time of menopause (usually three to six years) when a woman transitions from having a menstrual cycle every month to stopping having cycles at all," Smith said.

PECOS tests a pharmacotherapy combination for treating obesity. Its focus is to turn white fat, or fat storing, into brown fat, or fat burning.

LIFE, a 10-year study, is looking at behavior, diet, physiology, genetics and metabolism to understand the factors that influence health and weight gain in young adults.

ECO seeks to understand "how obese subjects differ so researchers may develop diagnostic criteria for obesity" that will help them predict which patients will respond to weight-loss treatments. The researchers will do this by measuring the activity of more than 18,000 genes in fat and muscle tissue to subtype obese patients.

Committed to Kids uses the trademarked "Trim Kids" system developed by Melinda Sothern, who is now an adjunct Pennington faculty member and full-time LSU School of Public Health professor, and others at the LSU Health Sciences Center School of Medicine, New Orleans, Department of Pediatrics. Dr. Stuart Gordon, a pediatrician who directs the program at Pennington, described it as a fee-for- service, multidisciplinary treatment of childhood overweight or obesity.

Gordon, along with a child psychologist, a registered dietitian and an exercise physiologist, meet with the participants, ages 7 to 17, and their families for two hours weekly for six months to change lifelong eating and lifestyle patterns. The program, which combines exercise, diet education and other activity, "has a research component to it, in that we collect blood work on the children and compare two diets," he said.

Dr. Frank Greenway, chief of the Outpatient Unit, is the investigator in four projects: PAR 4, MICRO, OIB and RADIX.

PAR 4 studies the effects of a drug in weight loss. MICRO looks at the effects of a drug on eating behavior. OIB tests the results on volunteers of a gastrointestinal balloon, which creates a feeling of fullness during eating. RADIX examines the effects of a naturally occurring herb on the appetite.

Wise Mind, with Donald A. Williamson as the lead investigator, is "a school-based test of an environmental approach for the prevention of weight gain and prevention of tobacco, alcohol and drug abuse." It's trying to determine if an environment of healthful messages and practices at school and home will lead to healthier adult behaviors.

Eating Rates tests if a slower rate of eating reduces food intake and thus promotes weight loss. The investigator is Corby K. Martin.

Chronic Pain and Obesity investigator Geralyn Datz noted that "chronic pain is often ignored in research with obese and overweight people." The study looks at how bodily pain may affect obesity interventions, such as reducing compliance, and how pain and obesity contribute to disability and psychological impairment.

Olibra, with Dr. Steve Smith as lead investigator, is recruiting volunteers for a 14-week weight loss study. It seeks to learn if Olibra, a mixture of two natural oils found in food, decreases food intake by suppressing the appetite, resulting in weight loss. Participants will be required to eat breakfast, lunch and dinner at the Pennington Center on three separate days and make seven clinic visits. They must be 18-60, nonsmokers, overweight with a BMI range of 25-40, not taking any medications other than birth control or hormones. Women can't be pregnant or have had a baby within the past six months. Volunteers will receive $300 at the end of the study.

Arena II (A2), a 17-week weight-loss medication study headed by Dr. Frank Greenway, is recruiting volunteers. The study looks at a medication thought to reduce appetite. Participants have a 1 in 4 chance of receiving a placebo and must agree to two screening visits and 11 clinic visits. To qualify, volunteers must be 18-65, nonsmokers, overweight with a BMI of 30-45, have no chronic illnesses, and women can't be pregnant or breast feeding. Use of some medications (birth control, hormone replacement therapy, some blood pressure and cholesterol medications, aspirin and Tylenol) during the study is permitted. Participants will get $250 at study completion. Basic Science

Pennington on April 7 announced it won an almost $8 million grant from the National Institutes of Health to establish the national Center of Excellence in Botanicals and Metabolic Syndrome to study the effects of plant extracts on human health and diseases. Dr. William Cefalu will head a team of more than 20 scientific investigators.

Obesity-like Metabolic Changes Following Trauma studies why long- term patients with spinal cord injury are at higher risk of developing type 2 diabetes and other syndromes commonly seen in obese patients despite the fact that SCI patients often have body mass indexes that are equal to or lower than what is considered normal or healthy. These changes contribute significantly to SCI individuals' shortened life spans, researchers say. Gregory M. Holmes is chief investigator for the study.

A study of mice with a genetic mutation that causes them to avoid eating fat and to prefer eating carbohydrates seeks to improve understanding of the biological control of appetite, according to investigator Brenda K. Smith Richards.

Whether advertisement of food products during children's television programming contributes to childhood obesity, possibly by influencing poor eating habits, is the subject of a study headed by Marlene Most. The project is examining the selling points within Saturday morning television advertising since 1976.

Early Obesity Tendency seeks to determine how a tendency toward obesity and its consequences, including type 2 diabetes and cardiovascular disease, may be developed prenatally as a consequence of the mother's environment, such as her diet. Investigators are Kenneth J. Eilertsen and Dr. Jeffrey Gimble.

Daily Rhythm studies whether the time of day one eats affects the metabolism in fat tissues, the liver and other organs in ways that might create an increased obesity risk. Eilertsen and Gimble also are the investigators of this study.

Another study is examining the mechanisms for fat accumulation within skeletal muscle of obese humans. Because skeletal muscle in the obese prefers to store fat within the muscle cell instead of burning it for energy, this leads to insulin resistance and is a risk factor for developing type 2 diabetes. Matthew W. Hulver is the investigator.

Investigator Abba Kastin is studying how two peptides/ polypeptides (urocortin and leptin) interact at the blood-brain barrier to enter the brain from the circulation to suppress appetite.

Molecular Mechanism of Type 2 Diabetes in Obesity seeks to understand at the molecular level why obesity causes type 2 diabetes. Dr. Jianping Ye is the main researcher.

Prevention and Obesity with Herbal Medicine seeks to understand how herbal medicine acts in prevention of obesity and type 2 diabetes. Dr. Ye also is the investigator for this project.

Nutrient Signals and Sensing is a project headed by Roy J. Martin. "This project is to identify the common signaling mechanisms by which carbohydrates, fatty acids and amino acids are sensed by neurons to regulate neuropeptides involved in feeding behavior," Martin said.

Diet/Genetic Relationships, investigated by Maren Hegsted, Mike Keenan, June Zhou and Roy J. Martin, is studying how resistant starch diets reduce body fat by altering the expression of genes in the cells of the large intestine. These genes encode for powerful peptide signals of satiety or fullness.

Characteristics of Genetically Obese Mice is a study of how the brain interacts with peripheral tissues such as liver, fat tissue and muscle to cause insulin resistance and diabetes. Andrew Butler is lead researcher.

Nutrient Sensing is a study of how sensing systems in the body respond to changes in the amount and type of fat in the diet. The investigator is Thomas W. Gettys.

The genetics of obesity is a project headed by Aamir R. Zuberi. "Humans differ in their individual responses to weight gain on high- fat diets. By taking advantage of the genetic variation within mouse strains, we have identified genes that appear to participate in the overall regulation of susceptibility to dietary-induced obesity. Our studies are focused on the functional characterization of these genes."

Source: Advocate; Baton Rouge, La.

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