Exploring the Epidemic: The Obesity Research Group

One third of Scottish adults will be obese by 2010. Many will suffer from chronic illnesses including diabetes, heart disease, hypertension, stroke and cancers and their life expectancy will dramatically decrease. The strain on the NHS will cost the British economy about £3.6 billion a year.

The problem is not confined to adults. More than 20 per cent of Scottish children born in 2001 were overweight before the age of four. 8.5 per cent of these were obese, and more than 4 per cent were severely obese. Type II diabetes, a disease traditionally emerging in adulthood, is now being seen in children.

As well as the physical health problems, overweight children are more likely to suffer from low self esteem and behavioural problems. They are also more likely to become obese adults with the associated morbidity.

This is the stark reality of the obesity epidemic in Scotland today. Already 65 per cent of men and 60 per cent of women are overweight. More than a fifth are obese and the NHS in Scotland will spend about £170 million this year treating obesity and obesity-related diseases.

The Obesity Research Group was launched in the University of Dundee to tackle the problem, in every facet it affects from inside the body to the external environment. Initial funding has been obtained from The Institute for Cardiovascular Research (TICR) underlining the importance of obesity as a risk factor in cardiovascular disease.

Professor Annie Anderson in the Centre for Public Health Nutrition Research is chairing the group.

"Obesity is a complex, multi-faceted problem that needs a multi-faceted response," she said.

"It is not just a genetic problem or a cultural problem or a clinical problem. It is all of these things and that needs to be recognised as we try to deal with this global issue that is posing a major health risk in our society."

The wide range of research streams the group will be involved in include nutrition, physical activity, cultural and environmental factors, psychosocial factors, paediatrics, clinical studies, genetics and neuroscience.

"At Dundee we already have an excellent track record of research in a variety of disciplines relating to obesity but we have yet to fully develop interdisciplinary perspectives," said Professor Anderson.

"By combining these areas of excellence and forming a solid network of research we can expand our unique capacity to tackle obesity."

Already underway is the first ever study to examine how diet and lifestyle affects bowel cancer survivors, funded by a World Cancer Research Fund grant. Previous research has shown a link between the initial development of bowel cancer and diet and lifestyle factors. Being overweight and inactive, for example, can increase the risk.

Involving collaboration between Professor Bob Steele in Surgery, Mary Wells in Nursing and Professor Anderson, the team will pilot a lifestyle programme in Tayside called LiveWell to help those recovering from bowel cancer to make appropriate lifestyle choices and reduce the risk of recurrence.

"We are using a combination of information, behaviour change skills and social support approaches to see if we can encourage positive lifestyle changes that may improve survival and disease recurrence in bowel cancer," Professor Anderson said.

The results of the programme are expected to be available by the end of the year and will inform the development of a future randomised control trial. If it proves successful, the LiveWell intervention could be used to develop clear diet and lifestyle advice for bowel cancer survivors in the future.

Recently awarded funding also includes a study to investigate the activity of brain cells involved in the control of body weight, the balance of energy in the body and the maintenance of blood glucose levels. Abnormal activity in these brain cells has been linked to some metabolic diseases including obesity and diabetes.

This Wellcome Trust funded project will expand on previous research by the team leader, Professor Michael Ashford in the Division of Pathology and Neuroscience. Experiments led by Professor Ashford have found evidence of factors that can contribute to poor regulation by the brain of hormones involved in controlling appetite and metabolism.

In yet another line of enquiry, members of the ORG have asked how a person's genetic make-up can influence the development of obesity. Funded by the Biotechnology and Biological Sciences Research Council, the interdisciplinary study, led by Dr Colin Palmer in the Biomedical Research Centre, involved researchers in Physiology, Cardiovascular Epidemiology, The Centre for Public Health Nutrition Research and Psychology. The team have explored the relationship between a child's genetic profile and behaviour in the maintenance of a balance between their diet and physical activity levels.

As well as investigating different facets of obesity in adulthood, the group are also committed to exploring questions relating to childhood obesity. What role does the perinatal environment have on weight gain in later life? How can the paediatric obesity time bomb be stopped? And what role can schools play in preventing childhood obesity?

A number of other endeavours investigating factors linked to obesity in children are underway or nearing completion.

For example, results of a major project that involved collaboration between researchers across the University and Tayside will soon be available Funded by the Scottish Executive Chief Scientist Office, the 'AllChange' study, led by Professor Jill Belch and Dr Steve Greene has investigated whether a school-based lifestyle intervention package targeting children aged 8-10 could be developed and implemented. The research team also explored whether such an intervention would lead to changes in diet, physical activity, body size, biochemical indicators and physiological indicators of early cardiovascular disease risk. This study was recently completed and the results are expected soon.

Funding for obesity research is one of the major growth areas in Public Health. Recent awards in the National Prevention Research Initiative (including those awarded to the University of Dundee) have highlighted the importance of this much neglected health area. The interdisciplinary nature of the obesity research group in Dundee provides a firm foundation for expanding research into the cause, mechanisms, prevention and management of obesity.

The integrated approach will enable researchers from across the College of Medicine, Dentistry and Nursing to share experience, equipment and resources in their common goal to increase understanding of obesity

The group will host its first network conference on April 4th bringing together established researchers and doctoral students from a range of departments in order to discuss and design a shared research agenda. The initiative is also supported by NHS Tayside who are actively implementing an obesity strategy involving prevention and management approaches.

Staff members from departments outwith the College of Medicine, Dentistry and Nursing are welcome to network with the group and should do so by contacting Dr Angela Craigie (ORG Group co-ordinator) on a.craigie@dundee.ac.uk.

More information is available at www.dundee.ac.uk/medden/groups/group556