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Ohri-Vachaspati P, Acciai F, Melnick EM, Lloyd K, Martinelli S, DeWeese RS, DiSantis KI, Tulloch D, DeLia D, Yedidia MJ. Food Environments Within and Outside of Schools Play a Critical Role in Curtailing the Rise in Obesity among School-Aged Children over Time. J Nutr 2023; 153:3565-3575. [PMID: 37844841 PMCID: PMC10739773 DOI: 10.1016/j.tjnut.2023.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/28/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Sound evidence for effective community-based strategies is needed to curtail upward trends in childhood obesity in the United States (US). OBJECTIVES The aim of the study was to assess the association between school and community food environments and the prevalence of obesity over time. METHODS Data were collected from K-12 schools in 4 low-income New Jersey cities in the US. School-level obesity prevalence, calculated from nurse-measured heights and weights at 4 time points, was used as the outcome variable. Data on the school food environment (SFE) measured the healthfulness of school lunch and competitive food offerings annually. The community food environment (CFE), i.e., the number of different types of food outlets within 400 m of schools, was also captured annually. The count and presence of food outlets likely to be frequented by students were calculated. Exposure to composite environment profiles both within schools and in communities around schools was assessed using latent class analysis. Data from 106 schools were analyzed using multilevel linear regression. RESULTS The prevalence of obesity increased from 25% to 29% over the course of the study. Obesity rates were higher in schools that had nearby access to a greater number of limited-service restaurants and lower in schools with access to small grocery stores and upgraded convenience stores participating in initiatives to improve healthful offerings. Interaction analysis showed that schools that offered unhealthier, competitive foods experienced a faster increase in obesity rates over time. Examining composite food environment exposures, schools with unhealthy SFEs and high-density CFEs experienced a steeper time trend (β = 0.018, P < 0.001) in obesity prevalence compared to schools exposed to healthy SFE and low-density CFEs. CONCLUSIONS Food environments within and outside of schools are associated with differential obesity trajectories over time and can play an important role in curtailing the rising trends in childhood obesity.
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Affiliation(s)
| | - Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Emily M Melnick
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Kristen Lloyd
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, United States
| | - Sarah Martinelli
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Robin S DeWeese
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | | | - David Tulloch
- Department of Landscape Architecture, Rutgers University, New Brunswick, NJ, United States
| | - Derek DeLia
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, United States
| | - Michael J Yedidia
- Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, United States
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Baker JL, Bjerregaard LG. Advancing precision public health for obesity in children. Rev Endocr Metab Disord 2023; 24:1003-1010. [PMID: 37055611 PMCID: PMC10101815 DOI: 10.1007/s11154-023-09802-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 04/15/2023]
Abstract
Worldwide, far too many children and adolescents are living with the disease of obesity. Despite decades of public health initiatives, rates are still rising in many countries. This raises the question of whether precision public health may be a more successful approach to preventing obesity in youth. In this review, the objective was to review the literature on precision public health in the context of childhood obesity prevention and to discuss how precision public health may advance the field of childhood obesity prevention. As precision public health is a concept that is still evolving and not fully identifiable in the literature, a lack of published studies precluded a formal review. Therefore, the approach of using a broad interpretation of precision public health was used and recent advances in childhood obesity research in the areas of surveillance and risk factor identification as well as intervention, evaluation and implementation using selected studies were summarized. Encouragingly, big data from a multitude of designed and organic sources are being used in new and innovative ways to provide more granular surveillance and risk factor identification in obesity in children. Challenges were identified in terms of data access, completeness, and integration, ensuring inclusion of all members of society, ethics, and translation to policy. As precision public health advances, it may yield novel insights that can contribute to strong policies acting in concert that ultimately lead to the prevention of obesity in children.
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Affiliation(s)
- Jennifer L Baker
- Center for Clinical Research and Prevention, Copenhagen University Hospital- Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
| | - Lise G Bjerregaard
- Center for Clinical Research and Prevention, Copenhagen University Hospital- Bispebjerg and Frederiksberg, Frederiksberg, Denmark
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Li J, Wu K, Zhong Y, Kuang J, Huang N, Guo X, Du H, Guo C, Li R, Zhu X, Zhang T, Gong L, Sheng L, Sun R. Si-Ni-SAN ameliorates obesity through AKT/AMPK/HSL pathway-mediated lipolysis: Network pharmacology and experimental validation. JOURNAL OF ETHNOPHARMACOLOGY 2023; 302:115892. [PMID: 36334816 DOI: 10.1016/j.jep.2022.115892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Si-Ni-San (SNS) is a famous Chinese herbal formula used in China for thousands of years. It has clinical effects on a variety of lipid metabolism disorders, but the ameliorating effects of SNS on obesity and underlying mechanisms remained poorly elucidated. AIM OF THE STUDY This study aims to explore the therapeutic effect and mechanism of SNS on obesity from multiple perspectives in vitro and in vivo. MATERIALS AND METHODS The high-fat diet (HFD)-induced obesity mouse model was established to evaluate the effect of SNS. Then network pharmacologic methods were performed to predict underlying mechanisms, and the core pathways were verified in animal and cell studies. RESULTS Our results demonstrated that SNS significantly reduced body weight, body fat content, white adipose tissue (WAT) expansion in obese mice, and lipid accumulation in primary mouse embryonic fibroblasts (MEFs) cells. Network pharmacologic analysis identified 66 potential therapeutic targets, and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of these genes revealed that the most important signaling pathway includes AMP-activated protein kinase (AMPK) signaling pathway, regulation of lipolysis in adipocytes, lipid and atherosclerosis. Western blot assay confirmed that SNS activated hormone-sensitive triglyceride lipase (HSL) and adipose triglyceride lipase (ATGL) activity and promoted lipolysis through AMPK signaling pathway. CONCLUSION The results confirmed that SNS improves lipid accumulation through AKT/AMPK/HSL axis mediated lipolysis, which opens a new option for clinical treatment of obesity and associated complications.
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Affiliation(s)
- Jianchao Li
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China; Shandong University of Traditional Chinese Medicine, 4655 Daxue Road, Jinan, Shandong, 250355, China.
| | - Kaiyi Wu
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China; Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, Tianjin, 301617, China.
| | - Ying Zhong
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Jiangying Kuang
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Nana Huang
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Xin Guo
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China; Tianjin University of Traditional Chinese Medicine, 10 Poyanghu Road, Tianjin, 301617, China.
| | - Hang Du
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Chong Guo
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Rongrong Li
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China; Shandong University of Traditional Chinese Medicine, 4655 Daxue Road, Jinan, Shandong, 250355, China.
| | - Xiaomin Zhu
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Tianyu Zhang
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China; Shandong University of Traditional Chinese Medicine, 4655 Daxue Road, Jinan, Shandong, 250355, China.
| | - Liping Gong
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Lisong Sheng
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China.
| | - Rong Sun
- The Second Hospital of Shandong University, 247 Beiyuan Ave, Jinan, Shandong, 250033, China; Advanced Medical Research Institute, Shandong University, 44 Wenhua Xi Road, Jinan, Shandong, 250012, China.
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