Project EAT-III follows up on EAT-I and EAT-II to improve our understanding of what influences eating, physical activity, and weight-related behaviors in teens and young adults. To address the Project EAT-III objectives, there were two major study components.

• Follow-up study with young adults: The EAT survey was revised based on an expanded model, integrating an ecological perspective with Social Cognitive Theory. Previous Project EAT participants were contacted by mail and asked to complete the revised survey, a dietary questionnaire.
• School-based study with teens: A new group of young people are being recruited from middle schools and high schools in Minnesota. This component of the study includes in-school surveys and measurements of student height and weight, as well as measurements of peer, school, and neighborhood environments. Environmental measures are being completed by peers themselves and school personnel. Geographic Information Systems (GIS) is being used to learn about the neighborhood environment.

New Moves is a school-based program designed to promote increased physical activity, healthy eating behaviors, and a positive self-image among sedentary adolescent girls at risk for overweight. It is being offered to high-school girls for credit during school hours as an alternative to the regular physical education program. The program includes physical activity, nutritional guidance, social support, individual counseling, and maintenance components. Social Cognitive Theory is being used to guide the program development, implementation, and evaluation. The intervention focuses on modifying personal, socio-environmental, and behavioral factors.

For more information on New Moves, including the curriculum and surveys, visit the New Moves website.

Several previous studies have shown that obese women whose body fat is greater in the abdomen than in the hips are at increased risk for diabetes, hypertension, and heart disease. This 25-year study is determining whether body fat distribution is also related to risk of breast and endometrial cancer, and total mortality. A sample of 42,000 postmenopausal Iowa women completed a questionnaire and took measurements of their own bodies. The women are being followed for occurrence of cancer, using the Iowa cancer registry. Studies of diet and chronic disease occurrence also have been undertaken. Linkage to medicare records is providing new outcome data.

HCHS/SOL is a comprehensive multi-site cohort study of 16,000 Hispanics living in the US. Adult Hispanics living in San Diego, Chicago, Miami and the Bronx NY are being followed with chief outcomes related to obesity, cardiovascular disease, and diabetes. The University of Minnesota is the Nutrition Reading Center for the study, and develops and oversees the protocols, training, and analysis of dietary intake and other nutrition-related data.

CARDIA is a longitudinal observational study designed to examine secular and age-related trends in risk factors associated with coronary heart disease (CHD). The CARDIA cohort was recruited in 1985 to be balanced on gender, ethnicity, age, and educational attainment among 18 to 30 year-olds in four U.S. communities. These participants have now been followed for 20 years to examine inter-relationships of the major risk factors for CHD in young adulthood as well as emerging risk factors. As the cohort enters middle age, coronary artery calcification will be measured to assess the development of subclinical atherosclerosis and its relationship with antecedent risk factor levels. These trends will help us to better understand the risk factor patterns leading to early disease in an age range when prevention is feasible.

The aim of this study is to examine the effect of nutrition labeling and value size pricing on fast food menu choices.

The CARDIA Study data will be used to evaluate the propensity that television exposure may increase the risk for intentional and unintentional injuries, as well as obesity and chronic diseases through a variety of plausible and interrelated mechanisms. We aim to explore the possibility of an interaction between televesion viewing and the hostility trait in predicting a variatey of important health outcomes over this large 20-year prospective study in Caucasians and African Americans from the four U.S. metrapolitan areas.

This project uses serial growth and maturity data from 650 subjects in the Fels Longitudinal Study who have been followed from birth to adolescence in order to examine the relationship between rapid rate of growth in infancy to later obesity risk, and to test the hypothesis that there are genetic influences on infant growth and obesity in adolescence using genetic linkage analysis and SNP association testing.

This project aims to assess abdominal visceral adipose tissue using multi-image abdominal MRI in 800 related individuals from the Southwest Ohio Family Heart Study in order to localize chromosomal regions influencing level of visceral adipose tissue and related factors in the circulation (adipokines and inflammatory cytokines).

This ongoing randomized controlled trial aims to evaluate the efficacy of twice weekly strength training for physical and psychological improvements for recent breast cancer survivors. Outcomes include body composition, lymphedema changes, estrogen, insulin, and glucose, as well as depression and health related quality of life.

The Iowa Women's Health Study recruited a population-based cohort of 41,837 Iowa women, aged 55-69 years in 1986 to determine whether diet, body fat distribution, and other risk factors were related to cancer incidence

Weight loss maintenance is the most critical challenge for obesity treatment. Extending treatment length can improve maintenance and key behaviors are high physical activity levels, a lower calorie diet, and self-weighing. Treatment studies have incorporated these strategies; however, the most intensive phase occurs during weight loss initiation with the maintenance phase occurring after treatment novelty has faded. Increasing duration improves weight loss, but there is a point of diminishing returns as people eventually stop attending sessions. Recruiting people who have recently lost weight to a maintenance-specific intervention may be a viable strategy. Another key question is optimal intervention timing. One model suggests that maintenance will be enhanced by teaching people about the key behaviors required and assisting them with these behaviors. This model suggests that maintenance programs should be designed like weight loss programs where sessions addressing relevant behaviors occur on a pre-set schedule. Another model recognizes that maintenance inevitably includes periods of weight regain and will be enhanced if individuals pro-actively respond by using behavioral strategies to reverse small gains. This model suggests intervention contact should occur in response to weight trends. The strongest maintenance approach may integrate these models and include core behavioral messages followed by “just in time” intervention delivery in response to small weight gains. This research will evaluate the efficacy of an innovative approach to promoting weight maintenance among recent weight losers. Five hundred adults who have lost at least 5 percent of their weight in the past year will be recruited and randomly assigned to: 1) “usual care” or 2) a “customized” maintenance intervention that includes a core set of phone sessions addressing maintenance behaviors and a second phase with sessions triggered by weight gain. Outcomes will be assessed at 6, 12, 18, and 24 months, with 24-month weight change the primary outcome. The proposed research is innovative because it targets individuals who have recently lost weight and evaluates a novel intervention to enhance weight maintenance. Results will provide important information on the effectiveness of a new weight loss maintenance intervention that could potentially be widely disseminated.

The goal of this project is to examine the relationship between obesity and cancer.

Obesity is a rapidly growing health problem in the US for which neither effective treatment nor preventive measures are currently available. It is now widely accepted that environmental factors that encourage eating and discourage physical activity are important contributors to the problem, and it has been suggested that environmental interventions may be needed to achieve reductions in population obesity. The proposed study will assess the efficacy of a multicomponent environmental intervention in preventing weight gain among working adults. Eight worksites will be randomized to either an intervention or a no-treatment control group. Intervention will be comprised of 1) changing the availability, portion sizes, and prices of foods and beverages sold to employees in their worksites in ways that encourage healthier food choices; 2) increasing the availability of physical activity opportunities at the worksite by implementing walking programs and increasing stairwell access and attractiveness; 3) placing scales in the work environment to encourage body weight monitoring and to enable workers to set goals for their weight; and 4) to provide educational materials to all employees to make them aware of the environmental interventions and of behavioral practices likely to be effective in preventing weight gain. Body weight, eating behavior, and physical activity will be measured at baseline and two years in a cohort of employees from each worksite. Aggregate measures of behavior will also be obtained through direct observation and management records. It is hypothesized that employees in intervention worksites will decrease energy intake, increase energy expenditure, and reduce weight gain compared to those in comparison sites over two years. It is also anticipated that the effects of the intervention on behavior and weight will be related to degree of exposure to intervention activities.

Recent dramatic increases in prevalence have made obesity the number one nutritional problem in the US. Of particular concern is the fact that, although available treatments are effective in producing clinically significant weight loss, their ability to sustain weight loss long term is poor. The present research proposal is based on a conceptual analysis of this problem that argues for greater attention to two issues related to the temporal dynamics of the challenge of long-term weight control. These are: 1) the environment is continually changing and is not supportive of weight control and 2) the intervention methods that are effective in inducing short-term changes in behaviors and weight often lose their potency over time because of habituation. A 30-month randomized trial is proposed to evaluate a maintenance-tailored treatment for obesity that is designed to address these factors. Obese men and women will be randomized to either standard behavior therapy (SBT) or to a maintenance-tailored treatment (MTT) for 18 months, followed by 12 months of no-treatment follow-up. The MTT treatment will differ from SBT because 1) it will deliberately change treatment approaches over time instead of keeping them fixed and 2) it will focus on adaptation to change as the core treatment objective. It is hypothesized that weight losses in the MTT group will be better than those in the SBT group at 30 months. It is also hypothesized that MTT participants will show better compliance to behavioral assignments, express more enjoyment and awareness of the treatment process, and have higher efficacy expectations in regard to handling future challenges to weight control.

The purpose of this center proposal is to conduct transdisciplinary research, training, and outreach on obesity and cancer in youth, family, and young adults. The proposed Center will address questions about the etiology, prevention, and treatment of obesity in youth and families, and explore biological pathways that may link obesity to cancer. The center proposal includes three specific research projects. Project 1 is a multifactorial, cross-sectional, and prospective observational study examining predictors of obesity development in adolescents, including sociocultural factors, family factors, environmental factors, and individual factors. Project 2 is a study evaluating family-base, weight-gain prevention intervention that particularly emphasizes intervention on environmental contributors to weight gain. Project 3 is a study of the effects of physical activity on estrogen metabolism, oxidative stress, and DNA repair mechanisms in young women. The three R01 grants will be supported by two cores, an Administrative Core and a Data Services and Analysis Core. The proposal also includes a career development component, substantial funding for developmental projects, and a dissemination/translation component. The overall goals are to advance transdisciplinary science in the advancement of understanding of obesity, youth, family, and cancer; to support the career development of new investigators in the field; and to disseminate scientific knowledge about the topic to broader audiences.

This is a field center for the Study of Health Outcomes of Weight Loss, which is a multicenter, randomized, clinical trial designed to examine the effects of sustained weight loss on health outcomes in individuals with Type 2 diabetes. The trial has three study groups: 1) community care, 2) lifestyle intervention (comprised of an intensive and sustained program of counseling for diet and exercise behavior change), and 3) lifestyle intervention plus pharmacologic intervention (Orlistat and/or sibutramine). The primary study outcome is carotid intima-media wall thickness. Secondary outcomes include glycemic control, cardiovascular risk factors, cardiovascular and cerebral event rates, cardiovascular disease, and psychosocial well-being. Specific research hypotheses include: 1) that interventions designed to produce sustained weight loss in Type 2 diabetic patients will result in a reduced rate of atherosclerotic progression compared to community care, 2) that individuals receiving weight loss interventions will achieve greater long-term weight reduction and greater improvement in glycemic control and CVD risk factors than those receiving community care, and 3) that aggregated across treatments, a dose-response relationship will be observed between weight change and change in atherosclerotic progression and other study endpoints.

School-based interventions have great potential to reach children from ethnically diverse, low-income backgrounds who are at high risk for obesity. However, parents provide a major source of influence for their children, and empirical findings suggest that family level participation in school-based interventions is typically low. Results from formative work show that a good way to reach out to parents is by inviting them to a performance by their children. The primary aim of this study is to examine the feasibility of an innovative theater program, Ready. Set. ACTION!, that reaches out to children and parents. Intervention messages are based on the children’s own experiences and thus personally and culturally relevant to children and their parents. The after-school program is being run for a 12-week period and reaches out to parents through home food and fitness packs, home challenge activities, healthy eating opportunities, and a play performance. The intensive portion of the program is followed by booster sessions in which children further enhance their skills as agents of change. Results from this study will provide insight into how to engage parents in school-based interventions.

Dietary patterns developed during adolescence may contribute to obesity and eating disorders and may increase risk for several important chronic diseases later in life. Furthermore, the prevalence of overweight has increased significantly, in particular among minority youth and youth from low socio-economic backgrounds. In order to address these growing problems, it is essential to identify which groups of adolescents need to be targeted for intervention and to identify the factors that need to be addressed in interventions. Large gaps exist in our understanding of the factors associated with nutritional intake, physical activity, and weight status among adolescents. This study aims to identify the socio-environmental, personal, and behavioral determinants of nutritional intake and weight status among a large and ethnically diverse adolescent population. Study components included: 1) focus groups with adolescents, 2) school-based surveys and anthropometric measurements with adolescents, and 3) parental telephone interviews, and 4) a five-year longitudinal follow-up of 2,516 adolescents.

You can also visit the Project EAT website for additional information on Project EAT.

This intervention study will develop and evaluate school and community linked approaches to reduce the decline in physical activity in adolescent girls. It is a multicentered trial, being conducted in 36 schools in 6 field centers across the nation.

We believe people’s physiological responses to exercise have an important systematic influence on their psychological response to exercise, which we refer to as ‘exercise tolerance’. We theorize that the composition of the diet may affect exercise tolerance through its known impact on metabolic fuels (i.e. glucose and fatty acid. Specifically, typical high carbohydrate diets may have a deleterious impact on exercise tolerance through effects of postprandial hyperinsulinemia on the partitioning of metabolic fuels from oxidation to storage. Our research has shown that high carbohydrate diets, relative to energy-matched moderate carbohydrate diets, result in reactive hypoglycemia, an augmented drop in resting energy expenditure during weight loss, and greater perceived hunger. We theorize that the proposed interplay between the physiological and the psychological systems may have implications for the maintenance of a physically active lifestyle. To this end, we will use a randomized cross-over design to compare the effects of two dietary patterns – Control (high carbohydrate) v. Experimental (lower in carbohydrate, more slowly digested carbohydrates) -- on obese individuals. A second version of the Experimental diet will be high in protein. Specifically, we will examine the relative effect of the diets on metabolic fuels during standardized exercise testing; perceived exertion, energy, and mood during standardized exercise testing; and free-living day-to-day reported energy levels, mood, and well-being. By addressing these aims, the proposed study will contribute to our understanding of the interplay between the physiological and psychological systems that regulate people’s exercise behavior. Moreover, if the composition of the diet is shown to have a causal influence on exercise physiology and, in turn, on how people think and feel about exercise, it will provide the basis for new directions in the design of interventions to promote physical activity and prevent obesity.

This study is designed to evaluate the effects of eating breakfast and to examine the content of breakfast meals on appetite, mood, and cognitive performance in boys. Many studies have documented high rates of skipping breakfast among youth, but prospective and experimental studies are lacking. We hypothesize that children will be less hungry, less irritable, more energetic, and demonstrate superior memory and analytical skills following a breakfast meal in comparison to skipping breakfast. Due to effects of dietary composition on blood glucose and satiety, we further hypothesize that children may be less hungry and perform better on these parameters following a balanced breakfast meal containing whole grain cereal, fruit, and milk than after a refined carbohydrate breakfast meal including a pastry and fruit juice. The proposed study will include a cross-over experimental design in 15 overweight adolescent boys in good health and between the ages of 11 and 14 (middle school). The study findings may provide insight into the role of breakfast habits in modulating energy regulation, behavior, and academic performance.

This study will evaluate the efficacy of a two-year, multi-component environmental intervention to prevent excess weight gain among 1200 bus operators working in four garages in a major metropolitan area. Four garages will be randomized to the intervention or control group for a two-year period. The environmental interventions are based on a social ecological framework and target four areas: 1) food availability and incentives; 2) physical activity opportunities and incentives; 3) the social environment; 4) media and promotion related to healthy food choices, physical activity and body weight. In addition to the environmental components, social cognitive theory will be used to develop interventions for individual-level behavior change. Body weight, energy intake and physical activity will be measured at baseline and at two years. The effect of the intervention on health claims costs, work absenteeism and worker's compensation claims will be evaluated as a secondary outcome.

This study is aimed at testing the effects of four different breakfast meals, and of a fasting (water only) condition, on postprandial blood concentrations of glucose, insulin, and fatty acids, and on appetite and mood levels. The meals vary in amount and type of carbohdyrate and fat. This pilot study will help us to design protocols needed to test other potential effects of dietary composition, such as effects on physiologic and psychologic states during and after exercise, and ultimately adherence to dietary and physical activity interventions.

Fast food is a premier dietary pattern in the U.S., yet no clinical trial has been conducted to evaluate the effects of eating at fast food restaurants on body weight and related health parameters. This study is a randomized controlled crossover trial to compare the effects of eating fast food on body weight, body composition, and chronic disease risk factors in young overweight and obese adults. Twenty healthy overweight and obese adults will be recruited from the University and surrounding community. Participants will be assigned to receive two months of each treatment – 1) eating at fast food restaurants daily, or 2) eating home prepared meals with little or no restaurant use. Body weight, body composition, risk factors for chronic disease, detailed dietary intake assessment, and physical activity will be measured before during and after each intervention period. The findings will have the potential to contribute significant scientific information to the limited body of evidence regarding the potential impact of eating fast food on health.

This randomized controlled trial will test the efficacy of twice weekly strength training for preventing age associated increases in body fat (total and visceral) in women aged 25-44 and BMI 25-35. Primary outcomes are total percent fat and visceral fat. Secondary outcomes include insulin sensitivity, bone density, blood pressure, blood lipids, and a variety of psychosocial correlates of physical activity.

This study will compare the BMI and body fat % of 4th grade children in 10 Minnesota schools that have the highest minutes of PE programming compared to the 10 schools with the least minutes of PE programming to assess whether there are difference in the prevalence of obesity in these 2 sets of schools.

Collating an international data bank of prospective studies linking abdominal obesity and Type II diabetes.

We will develop a non-invasive or minimally invasive screening tool to identify persons with impaired glucose metabolism. We will test the sensitivity and specificity of this tool in different subgroups, formed for example by sex, age, ethnicity and their combinations, and if needed modify the screening tool in the different subgroups. Our database includes sufficient ethnic variation and sample size to give precise estimates even for those subgroups which are not adequately represented in any individual study. Our large international database includes more than 40 studies and 500, 000 participants.