- Author: Mike Hsu
Nutrition Policy Institute researcher influenced obesity research, SNAP-Ed evaluation
Young people across California and the U.S. enjoy healthier, more nutritious food options at school, thanks to the contributions of Gail Woodward-Lopez, who retired on July 1 as the associate director of research at the Nutrition Policy Institute, a part of University of California Agriculture and Natural Resources.
Woodward-Lopez officially joined UC ANR in 2015, when she and other researchers at the Atkins Center for Weight and Health at UC Berkeley merged with NPI. But her association with UC ANR goes back much further, as her work at CWH was always directed by UC Cooperative Extension academics – including the research that paved the way for California's “junk food ban” in schools.
Two bills, signed in 2005, set nutrition standards in California for “competitive foods”– the items sold in vending machines and from food service a la carte (as opposed to federally subsidized school meals). That legislation – which inspired similar policy changes across the country – was informed by the work of Woodward-Lopez and her colleagues, who had looked at the financial impact of establishing those standards.
“Our study was so pivotal that I literally had people calling me from the floor of the Senate or the Assembly when they were debating that legislation,” recalled Woodward-Lopez.
Changing perceptions of population weight gain
Originally intending to pursue a career in neurobiology, Woodward-Lopez found that lab work didn't suit her temperament. Seeking to work more directly on social issues, she embarked on a public health path, with an emphasis on nutritional aspects that incorporated her interest in biological sciences.
Woodward-Lopez's early work focused on a challenge that was just beginning to catch the attention of researchers: the rapid rise in the Body Mass Index (BMI) among the U.S. population. In tracing the causes of this epidemic, she and her colleagues shifted academic and public attention toward the host of environmental factors that contribute to weight gain – instead of focusing exclusively on an individual's choice to eat healthy and be physically active.
“Two decades ago, Gail led groundbreaking work to identify the determinants of obesity when child obesity was emerging as a public health concern,” said Nutrition Policy Institute Director Lorrene Ritchie. “While we and other researchers across the nation were working on generating more evidence to inform action, she had the vision that we could use a variety of existing data – from trends to trials – to point to the main causes.”
Many of the researchers' conclusions, which were published in the 2006 book “Obesity: Dietary and Developmental Influences,” stand to this day.
Helping to set the identity and agenda of the Center for Weight and Health when it was founded in 2000, Woodward-Lopez moved policy and practice beyond educational approaches and public awareness campaigns. As she noted: “No one thinks sugar-sweetened beverages are good for you.”
“Education alone is not going to work if people do not have access to the healthy foods and opportunities for physical activity, if they're not safe in their neighborhoods, or if they can't afford the healthy options,” she explained.
Given her seminal role in the field, Kaiser Permanente sought out Woodward-Lopez as a “thought partner” on the organization's community-based obesity prevention programs and school health work.
“Gail brought deep rigor and expertise, of course, but also a super-practical, community-focused perspective to our work,” said Loel Solomon, professor of health systems science at the Kaiser Permanente Bernard J. Tyson School of Medicine. “Her integrity and values around health equity were evident in everything we did together, and our communities are so much the better for it.”
Elevating and enhancing CalFresh Healthy Living
At the Nutrition Policy Institute, the focus of Woodward-Lopez's work has been refining the evaluation and delivery of SNAP-Ed, the educational component of the Supplemental Nutrition Assistance Program (commonly referred to as “food stamps”). Known in California as CalFresh Healthy Living, SNAP-Ed represents the largest single source of ongoing funding for nutrition and physical activity promotion in the state – outside of the WIC program which serves women, infants and young children.
“CalFresh Healthy Living can really impact millions of people,” Woodward-Lopez said. “For county health departments, this is one of their main sources of funding and provides the backbone for everything else they do in nutrition and physical activity.”
But given the variety of interventions implemented by health departments in response to local needs, determining the efficacy of those efforts is a daunting task. Woodward-Lopez and her NPI colleagues have been instrumental in devising creative approaches that help pinpoint the most effective public health measures.
For example, NPI researchers found that combining school policy changes with increased opportunities for physical activity during the school day was the best strategy to encourage student fitness. They discovered that reductions in nutrition programs during the COVID-19 pandemic disproportionately affected communities of color. And they also continue to emphasize that interventions need to be tailored to the specific cultural and political conditions within a community.
“I think in all of the work we do, we try to come up with those practical applications – what does this mean for communities? How can we do this differently? How are our findings actionable?” Woodward-Lopez said.
Her contributions toward the evaluation of California Department of Public Health SNAP-Ed have impressed and inspired Lauren Whetstone, chief of CDPH's Research, Evaluation and Strategic Alignment Section, Nutrition Education and Obesity Prevention Branch.
“Gail and her team have elevated the quality of our evaluation work and the evaluation support that we provide to local health department grantees,” said Whetstone, who has worked with Woodward-Lopez for nearly a decade. “Gail contributed substantially to statewide SNAP-Ed evaluation as well, again working collaboratively to ensure high quality evaluation. Our work is all the stronger due to Gail's dedication to excellent SNAP-Ed evaluation.”
To the benefit of the field and community health, Woodward-Lopez said she plans to remain engaged in her life's work.
“I'd really like to get more involved in policy through advocacy and through doing things like writing letters to the editor or social media commentary,” she said. “I already have some ideas for some editorials I want to write.”
And while she looks forward to spending more time with loved ones, traveling, and pursuing her interests in art and music, Woodward-Lopez will remain a guiding voice for advancing public health.
“Gail's leadership in public health nutrition – even after she retires – is a testament to her dedication,” Ritchie said. “She not only has contributed to sustainable changes in California and nationally, she has been a mentor to me and so many others in the field who will strive to continue her legacy.”
People interested in supporting Woodward-Lopez's legacy and the ongoing work in health and nutrition can donate to NPI's Student Fellowship, which provides students from underrepresented groups the opportunity to work on NPI research and be mentored by NPI researchers./h3>/h3>/h3>
- Author: Kathy Keatley Garvey
DAVIS--Newly published research in the Proceedings of the National Academy of Sciences (PNAS) indicates that a drug discovered and developed in the laboratory of Bruce Hammock,UC Davis Department of Entomology and Nematology, may have a major role in preventing and treating llnesses associated with obesity.
More than 43 percent of adults in the United States are obese, according to the Center for Disease Control and Prevention (CDC). Obesity increases the risk of coronary artery disease, stroke, type 2 diabetes, and certain kinds of cancer.
The drug, a soluble epoxide hydrolase (sEH) inhibitor, appears to regulate “obesity-induced intestinal barrier dysfunction and bacterial translocation,” the 12-member team of researchers from UC Davis, University of Massachusetts and University of Michigan discovered. The same non-opioid drug is being investigated in human clinical safety trials in Texas to see if it blocks chronic pain associated with diseases such as spinal cord injury, diabetes and inflammatory bowel disease.
The research, funded by multiple federal grants, is titled “Soluble Epoxide Hydrolase Is an Endogenous Regulator of Obesity-Induced Intestinal Barrier Dysfunction and Bacterial Translocation.”
“Obesity usually causes the loss of tight junctions and leaky gut,” said first author Yuxin Wang, a postdoctoral researcher who joined the Hammock lab in 2019 from the Department of Food Sciences, University of Massachusetts, Amherst. “In normal conditions, the gut mucosal barrier is like a defender to protect us from the ‘dirty things' in the lumen, such as bacteria and endotoxin. For obese individuals, the defender loses some function and leads to more ‘bad things' going into the circulation system, causing systemic or other organ disorders.”
Although intestinal dysfunction and other problems enhancing bacterial translocation underlies many human diseases, “the mechanisms remain largely unknown,” said Wang, who holds a doctorate in biochemistry and molecular biology from the Chinese Academy of Sciences. “What we found is sEH inhibition can repair the defender function (barrier function), decrease the ‘bad things' going into the blood (bacteria translocation), and reduce inflammation of fat.”
“Our research shows that sEH is a novel endogenous regulator of obesity-induced intestinal barrier dysfunction and bacterial translocation,” said corresponding author Guodong Zhang, a former researcher in the Hammock lab and now with the Food Science Department and Molecular and Cellular Biology Graduate Program at the University of Massachusetts. “To date, the underlying mechanisms for obesity-induced intestinal barrier dysfunction remain poorly understood. Therefore, our finding provides a novel conceptual approach to target barrier dysfunction and its resulting disorders with clinical/transitional importance.”
Corresponding author Hammock, a distinguished UC Davis professor who holds a joint appointment with the Department of Entomology and Nematology and the Comprehensive Cancer Center, praised Zhang's “amazing record while he was a postgraduate at UC Davis, and now in Food Science Department at the University of Massachusetts, where he recently received tenure.”
Zhang mentored two co-authors of the paper: Yuxin and Weicang Wang, both formerly of the Department of Food Science, University of Massachusetts and now with the Hammock lab.
“I feel so lucky that Yuxin and Weicang have joined my laboratory,” Hammock said. “The drugs studied in this PNAS paper are now in human clinical trials and on a path to replace opioid analgesics for pain treatment. I hope the continuing work of Guodong, Weicang and Yuxin will evaluate them as treatments for a variety of inflammatory bowel diseases.”
Andreas Baumler, professor and vice chair of research in the UC Davis Department of Medical Microbiology and Immunology, who was not affiliated with the study, said: “Obesity-induced gut leakage and bacterial translocation can be ameliorated by targeting microbes with antibiotics, suggesting that the microbiota contributes to disease. However, the work by Zhang and co-workers suggest that rather than targeting the microbes themselves, obesity-induced gut leakage and bacterial translocation can be normalized by silencing a host enzyme, which identifies host metabolism as an alternative therapeutic target.”
In addition to Hammock, Zhang, Yuxin and her husband Weicang, the other eight co-authors on the team are:
- Jun Yang, Sung Hee Hwang, and Debin Wan of the Hammock lab, UC Davis Department of Entomology and Nematology, and UC Davis Comprehensive Cancer Center
- Kin Sing Stephen Lee, formerly of the Hammock lab, and Maris Cinelli, both of the Department of Pharmacology and Toxicology, Michigan State University, Lansing
- Katherine Sanidad and Hang Xiao, Department of Food Science and the Molecular and Cellular Biology Graduate Program, University of Massachusetts, Amherst
- Daeyoung Kim, Department of Mathematics and Statistics, University of Massachusetts, Amherst
The abstract: “Intestinal barrier dysfunction, which leads to translocation of bacteria or toxic bacterial products from the gut into bloodstream and results in systemic inflammation, is a key pathogenic factor in many human diseases. However, the molecular mechanisms leading to intestinal barrier defects are not well understood, and there are currently no available therapeutic approaches to target intestinal barrier function. Here we show that soluble epoxide hydrolase (sEH) is an endogenous regulator of obesity-induced intestinal barrier dysfunction. We find that sEH is overexpressed in the colons of obese mice. In addition, pharmacologic inhibition or genetic ablation of sEH abolishes obesity-induced gut leakage, translocation of endotoxin lipopolysaccharide or bacteria, and bacterial invasion-induced adipose inflammation. Furthermore, systematic treatment with sEH-produced lipid metabolites, dihydroxyeicosatrienoic acids, induces bacterial translocation and colonic inflammation in mice. The actions of sEH are mediated by gut bacteria-dependent mechanisms, since inhibition or genetic ablation of sEH fails to attenuate obesity-induced gut leakage and adipose inflammation in mice lacking gut bacteria. Overall, these results support that sEH is a potential therapeutic target for obesity-induced intestinal barrier dysfunction, and that sEH inhibitors, which have been evaluated in human clinical trials targeting other human disorders, could be promising agents for prevention and/or treatment.”
The research was funded by grants from the National Institute of Food and Agriculture, U.S. Department of Food and Agriculture (USDA); National Cancer Institute; USDA Hatch Grant; National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program; and a National Science Foundation.
According to the CDC, many of obesity-related conditions that lead to diseases are preventable. In 2008, the estimated annual medical cost of obesity in the United States tallied $147 billion. The medical cost for obese individuals averaged $1,429 higher than those of normal weight.
Contact: Bruce Hammock, email@example.com
- Author: Jeannette E. Warnert
In a new series starting today, UC ANR features a sampling of our academics whose work exemplifies the public value UC ANR brings to California.
UC Cooperative Extension nutrition, family and consumer sciences advisor Deepa Srivastava arrived in the San Joaquin Valley in 2017 to conduct a research and education program that makes children and families healthier in Tulare and Kings counties.
Srivastava joined Cooperative Extension with diverse experience in obesity prevention research and program implementation and evaluation. Her job combines extension, research, university and public service to promote healthy living among families and children in low-income communities.
“I could hardly believe how well this job fit my interests, skills and education,” she said. “I have been involved in research and implementation and evaluation of nutrition education programs in the Department of Nutrition at the University of Nebraska-Lincoln. The UCCE position is ideal.”
Born in India, Srivastava immigrated to the United States after completing undergraduate and graduate degrees in her home state of Allahabad. She also earned a master's degree at North Dakota State University before moving to Nebraska, where she earned a Ph.D. in human sciences, with specialization in child, youth and family studies. After completing her doctorate degree at the University of Nebraska-Lincoln, Srivastava also worked as a project lead for the Ecological Approach to (EAT) Family Style project.
“My educational background and diverse experience prepared me to be a professional in the field of childhood obesity prevention and nutrition education,” Srivastava said.
Srivastava manages two federally funded nutrition programs for low income residents of Tulare and Kings counties. The CalFresh Healthy Living program presents information on food safety, food resource management, gardening, physical activity and youth engagement. Educators reach out to elementary schools to help develop school wellness policies and make lunchroom changes that steer children toward making nutritious food choices.
The second program, the Expanded Food and Nutrition Education Program, presents a series of classes to low-income families at community centers, schools and other service centers. The classes help participants stretch their food dollars, select and prepare healthy foods and take part in physical activity.
To shape her research program in Tulare and Kings counties, Srivastava conducted a needs assessment study to understand nutrition practices in early childhood education settings. Tulare and Kings counties are among the counties in the state with high levels of obesity and food insecurity.
Following her needs assessment, Srivastava concluded a successful pilot focused on preschoolers in Kings County. She and her nutrition team in Kings County, in partnership with the Department of Hospitality Management at West Hills Community College-Lemoore and preschools located at the college campus, implemented a collaborative nutrition education program to help preschoolers learn about healthy eating.
Srivastava is conducting further research to assess program sustainability and community engagement efforts, including how nutrition education offered by UCCE in Tulare and Kings counties motivates children and families to improve their knowledge, attitude, skills and behavior. Her research aims to understand the influences on children's eating and physical activity practices.
Srivastava is actively involved in obesity prevention initiatives within UC ANR and at the local, statewide and national level. Working with local community partners, she and her team have already introduced a number of change initiatives in Tulare and Kings counties to promote healthy lifestyles across lifespan, such as establishing new school gardens, youth engagement projects, healthy youth farmer's market and physical activity such as walking clubs and dance exercise classes.
“Our team is supported by experts from the University of California who are on the cutting-edge of the latest research and curriculum design,” Srivastava said.
Srivastava and her team were recognized at the National Extension Association for Family & Consumer Sciences conference in Hershey, Penn., in October 2019, where they won two SNAP-Ed/EFNEP awards: third-place at the national level and first place for the Western region.
“I am proud of my team's passion and hard work,” she said. “Our nutrition education programs have meaningful private and public values that promote healthy people and communities.”
- Author: Kathy Beerman, Ph.D., School of Biological Sciences, Washington State University
A well-nourished population requires that all members of society have access to sufficient amounts of nutritious food. Unfortunately, food insecurity continues to be a staggering problem throughout the world with negative consequences in terms of health and well-being.
In the United States, millions of households, an estimated 1 in 8 Americans, lack access to enough food. Children growing up in food insecure households face many challenges, such as behavioral problems, lower academic achievement, disrupted social interactions and poor health. The prevailing belief is that children living in a food insecure environment are at greater risk of undernutrition, not obesity. Although this may be true in some cases, food insecurity and childhood obesity also coexist.
Because childhood food insecurity may increase obesity risk later in life, it is important to better understand the relationship between food insecurity and children's obesity, and how it varies by demographic characteristics in the United States.
A recent study published in the September 2019 issue of The Journal of Nutrition assessed the relationship between household food insecurity and child adiposity-related outcomes. This included variables such as body mass index, waist circumference and diet outcomes. The study, conducted by Lauren Au, a researcher at UC Agriculture and Natural Resources' Nutrition Policy Institute, and colleagues examined associations by age, sex, and race/ethnicity. Data collected in 2013-2015 from 5,138 U.S. schoolchildren ages 4-15 years old from 130 communities in the cross-sectional Healthy Communities Study were analyzed.
Household food insecurity was self-reported using a two-item screening instrument and dietary intake was assessed using a food frequency questionnaire. Information on dietary behaviors, physical activity and demographics was collected. To assess adiposity, children's weight, height and waist circumference were measured.
Study results support an association between food-insecure households and measures of adiposity. Children from food-insecure households had high body mass index, waist circumference, greater odds of being classified as overweight or obese, consumed more sugar from sugar-sweetened beverages, and less frequently ate breakfast and dinner with family compared to children from food-secure households. When examined by age groups, significant relationships were observed only for older children, however, results did not differ according to sex or race/ethnicity.
These results suggest that household food insecurity is associated with higher child adiposity-related outcomes and several nutrition behaviors, particularly among older children. Clearly, further research is needed to better understand the complexities of food insecurity, childhood obesity, and future health outcomes.
This research was supported by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
- Author: Jeannette E. Warnert
Real progress has been made in tackling the epidemic of childhood obesity since the first California Childhood Obesity Conference was held 20 years ago, but there is more work to be done.
“Collectively, we have come so far,” UC Nutrition Policy Institute Director Lorrene Ritchie told an audience of 1,025 public health, nutrition education, research, and other professionals at the event in Anaheim in July 2019. NPI was one of six conference hosts.
In the last 20 years:
- Federal school meal standards have been revised so that the food children eat at school is healthier than the lunches they bring from home.
- Sugar-sweetened beverages are no longer available to students during the school day.
- Foods provided by the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) are healthier and give mothers incentive to breast feed their babies.
- The Supplemental Nutrition Assistance Program (SNAP) education component is now linked to policy, systems and environmental changes.
- The Child and Adult Care Food Program now provides healthier meals and snacks to children in childcare centers and homes across the country.
The average quality of the diet of American children has improved, but the rate of childhood obesity in the United States is still too high.
According to the Centers for Disease Control and Prevention, 18.5% of U.S. children and adolescents 2 to 19 years old are obese – about 13.7 million youth in all. The rates trend higher in minority communities, with 25.8% of Latinx youth and 22% of African American youth obese. Obesity is also more prevalent among children in families with low incomes.
Obesity, which is defined in children as a body mass index at or above the 95th percentile of CDC growth charts, is associated with poorer mental health status, reduced quality of life, and increased prevalence of diabetes, heart disease, stroke and some types of cancer.
The vice president of UC Agriculture and Natural Resources, Glenda Humiston, pledged the organization's commitment to community health and wellbeing at the Childhood Obesity Conference. UC ANR is the umbrella organization of the Nutrition Policy Institute, UC CalFresh Healthy Living, UC Cooperative Extension, 4-H Youth Development, the UC Master Gardener Program and the California Naturalist Program, among others.
“Going forward, solutions to the obesity epidemic are multidisciplinary,” Humiston said. “NPI does world class work in conducting research to influence nutrition policy. We need to harness 4-H. Master Gardeners are increasingly focusing on edible gardens. CalNat is getting people out into nature. We are finding synergies in community wellness.”
Humiston has dedicated UC ANR resources to finding and implementing solutions to the obesity crisis.
“I'm looking forward to working with all of you – public and private organizations – to design a way to move forward,” she said.
The opening keynote presentation at the conference featured Patricia Crawford, NPI's Senior Director of Research emeritus, a pioneer in addressing the growing problem of childhood obesity during her long career. Beginning in the 1970s, she recognized that childhood obesity was on the rise and launched several studies to search for the causes and potential solutions.
In one study, Crawford followed a group of 9-year-old African American girls over a period of 10 years to determine why these youth were growing up heavier than other adolescents.
“Finally, we began to get some answers,” Crawford said. “We learned obesity wasn't the children's fault. They were living in environments that made the unhealthy choice cheaper and easier to find. It's so unfair for people who have fewer resources. Health disparities has to be the No. 1 thing we are working on to address chronic disease rates in this country.”
“The solution to obesity is prevention. It's cheaper and more effective than treatment,” Crawford continued. “Healthy food is a taste that is easy to acquire if it is not preempted by junk food.”
Crawford said she honed in on the best strategies for prevention by actively listening to people struggling to make healthy choices
“There is a chasm between research and community,” Crawford said. “We have to get people together from the research level and the policy level with folks on the ground. We need to learn from people.”