The Reporter
ssue 492, 29 September 2003
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Diet, exercise, genes, culture or reflexes? – Leeds research into why we're putting on the pounds


Fattening foods  - chipsIt’s been called a ‘global epidemic’ and a ‘health time bomb’, causing nine thousand premature deaths each year in England alone. Rates amongst children in particular are rising fast. The disease in question: obesity. Changing diets and exercise only partly explain the phenomenal increase of obesity over recent years. Research at Leeds is looking at a range of possible causes, bringing together dieticians, psychologists, health professionals, neuroscientists and nutritionists to improve both prevention and treatment.

On the surface, the cause of obesity does seem simple. We eat more and more fat and sugar, yet do less and less physical activity. But not everyone responds in the same way to the same diet. Some claim they need only to look at a cake to pile on the pounds, and others eat what they like, yet stay slim.

These differences are probably biological, according to Clare Lawton and John Blundell from psychology. They are working with EU partners on people who are either resistant or susceptible to obesity, to try and identify the mechanisms responsible and the genes involved. But they acknowledge that finding the genes won’t provide all the answers. Current research calculates obesity is 40% due to inherited factors, with 40% due to the culture we’re brought up in and the rest down to individual behaviour and habits we pick up elsewhere.

John Blundell“Whatever the general statistics, there’s no ‘one rule for all’ with obesity,” said Professor Blundell (pictured right). “Both genes and environment play key roles, and the impact of this interaction varies for each individual. It is important to recognize that genetic susceptibilities to weight gain can be overcome, although the current food environment in Britain is very powerful, with aggressive advertising of high fat food, and accessibility problems for healthy food. The environment currently amplifies susceptibility and we have to reverse this.”

The researchers are part of the Leeds Obesity group of over 70 academics from both universities and NHS professionals who work on collaborative projects and share knowledge.

“The link between academics and clinicians which the group provides is very important,” said Dr Andrew Hill from psychiatry and behavioural sciences. “Leeds is unique in having such a richness and diversity of interest, and the University plays an important role as a hub for the activity in this area.”

David LewisUniversity research includes clinical trials of weight loss drugs or alternative interventions such as support through websites, analysing supermarket till receipts to measure food consumption and fat intake or measuring the success of healthy eating campaigns. Biomedical scientist Dr David Lewis (pictured left) is looking at how our reflexes control how much we eat and why sometimes we eat more than our bodies need.

Leeds is pioneering research and practice in one area of particular concern: the rise of obesity amongst children. The disease is blamed for the growing numbers of children showing type 2 diabetes, a condition previously only found in adults.
In a University/NHS collaboration, consultant paediatrician Dr Mary Rudolf has set up the first community-based weight loss clinics to help overweight children and teenagers tackle their problems. The WATCH IT clinics were recently visited by the House of Commons health select committee. They follow on from an earlier project which tried to promote healthier eating and increased physical activity in schools.

Dr Rudolf’s team measured 700 primary school children over three years and found a marked rise in obesity. By age 11, 30% of children were overweight and 17% obese. This mirrors increases in the general population: levels of obesity in England have tripled over the past two decades.

“Nevertheless, primary schools can provide an excellent setting for preventative strategies, if parents also get involved, and if there are facilities and opportunities for children to be active,” said Dr Rudolf.

Many of those trying to promote healthier eating habits to children find they are competing with other messages, particularly through food advertising. Dr Andrew Hill, who also works with Paul Gately of LMU on the Leeds weight loss camps, found that around half of advertising during prime time children’s TV was for food, particularly cereals, confectionery and fast food.
Dr Hill said: “Health officials may be trying to encourage children to eat fruit and vegetables, but the world these children inhabit tells them the opposite, inviting them to purchase and consume high fat, high sugar foods. Not all kids respond to advertising. Some, often those with a low self-image of their body shape and weight, are more vulnerable.”

Dr Hill has also been studying ‘fat teasing’ in schools, to see how widespread the problem is and monitor the psychological issues involved. His study has found that 14% of 12 year olds and 18% of nine year olds were regularly teased for being ‘fat’, yet around half of these children weren’t medically obese or even overweight.

“All those teased, and some of the teasers showed lower self-esteem, were more likely to diet and more likely to dislike their bodies,” he said. “We need to remember, when dealing with obesity, that psychological factors are very important and eating disorders such as anorexia are the flip side of the coin.”

Dr Hill is one of many in the group who offer expert advice to government departments, feeding into health policy on this issue. “By sharing experience through the Leeds Obesity group, we can ensure that the academic research informs policy and practice and see clearly where work on obesity needs to advance,” he said.



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