Summer 2015

Top 10 Research Priorities in the Fight Against Obesity

Friedman School Dean Dariush Mozaffarian and HNRCA Director Simin Meydani compile the list

1. What’s the interplay of our diets and our gut microbiome? 

Growing evidence suggests that the bacteria and other microbes in our intestines influence how our bodies process and respond to foods, while the foods we eat influence the types and function of these organisms. Understanding these interactions will be crucial to discovering why different foods may have different effects on weight, metabolic health and healthy aging.

2. How important is sleep? 

Both adults and children who get too little sleep tend to gain more weight than people who get the right amount. Determining why and how short-changing sleep, and altering our circadian clocks, hurts our weight is a ripe area for research.

3. What keeps weight off in the long run?

The body naturally tries to keep weight stable over time, a tendency called homeostasis. New studies hint that, rather than focusing on calories, eating specific foods (such as yogurt and nuts, or refined starches and sugars) might help or hinder these natural regulatory processes, leading to less or greater weight gain. Understanding the impact of different foods on a person’s ability to maintain a healthy weight, and the underlying mechanisms, is essential for developing effective strategies against the epidemic of obesity.

4. What drives and changes our cravings?

Specific unconscious areas in our brains react positively or negatively to different foods. A better understanding of what drives these brain craving/reward centers, and how these responses can be changed, will be crucial to help people break unhealthy habits and shift to healthier foods.

5. Why are some people obese but healthy?

While most obese people experience metabolic problems like high blood pressure and diabetes, a small number do not. Figuring out how and why they are protected, including reasons related to their genes and influences in their environment, could suggest new treatments for obesity-related diseases.

6. What happens in the earliest days of life? 

Growing evidence suggests that the risk of obesity and metabolic dysfunction in adulthood may be altered by our parents’  behaviors during (or even before) pregnancy.  Understanding how early life influences lead to generational effects, where risks (or protection against risks) are passed from one generation to the next, will give us new tools to reverse obesity and associated diseases.

7. What metabolic messages do fat, liver and immune cells send?

These cell types are very active, sending numerous signals to other parts of the body. We need to know more about how nutrition influences this communication and leads to or protects against central fat storage, inflammation, insulin resistance.

8. Can modern technology make a difference?

There is an explosion of new mobile diet and exercise apps, personal activity monitors, fitness video games and bonding over these on social networks. These technologies are exciting, and we now need to see how they can best promote long-term behavior change.

9. What works in the community? 

Historically, nutrition efforts often focus on the individual. Some of the most promising new strategies are policy changes, such as programs in schools, worksites and communities; changing food prices; quality standards for marketing; and improving neighborhood environments like supermarkets and walkable streets. We need to test the effects and cost-effectiveness of these strategies, including their special benefits for at-risk and disadvantaged populations.

10. How do we bring folks together to achieve real change?
The food environment is complex, with numerous actors including the public, media, scientists, farmers, food manufacturers, retailers, restaurants and policy makers. We need to develop and test new ways to bring these groups together, design and implement new policies, evaluate the results, and then scale up the effective policies.

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