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Thursday, January 12, 2006
Statement on NIH Research on Obesity and Type 2 Diabetes by Allen M. Spiegel, M.D., Director, NIDDK and Elizabeth G. Nabel, M.D., Director, NHLBI
Obesity and type 2 diabetes have become major public health problems in this country. Less than half of American adults are at a healthy weight. Approximately one-third of American adults are obese and an additional one-third are overweight and at risk for becoming obese. Alarmingly, approximately 16 percent of children and teens ages six to 19 are also overweight. Overweight and obesity increase the risk of developing numerous serious health problems, including heart disease and type 2 diabetes. The prevalence of type 2 diabetes has increased with the national increase in overweight and obesity. Approximately 20.8 million people — 7 percent of the United States population — have diabetes. In this month’s Nature Medicine special feature on the metabolic syndrome, we discuss the NIH research portfolio on obesity and type 2 diabetes.*
The National Institutes of Health (NIH) is committed to the continued support of innovative and collaborative research on obesity and its concomitant health problems. Recognizing the urgent need for increased action to counter the problem of obesity in this country, Elias A. Zerhouni, M.D., Director of the NIH, established the NIH Obesity Research Task Force in April 2003. In 2004, the Task Force, co-led by NIDDK and NHLBI, developed and published the Strategic Plan for NIH Obesity Research, with critical input from external scientists and the public. The Strategic Plan is a guide for coordinating obesity research across the NIH and for enhancing research in areas of greatest scientific opportunity.**
The discovery of the appetite-controlling hormone leptin in 1994 led to an explosion of research discoveries elucidating the metabolic and neurobiological mechanisms that regulate appetite, energy expenditure, and energy storage. Today, the NIH continues to support an expansive basic research portfolio on obesity and type 2 diabetes. Among this research are animal and human genetic and developmental studies, and research on nuclear receptors (one of which is already a target for diabetes treatment). In addition, NIH is pursuing research into how the intrauterine environment of a mother who is obese or has type 2 diabetes impacts the later development of obesity, type 2 diabetes, and cardiovascular disease in her children.
The NIH also supports clinical research — from small pilot studies to large clinical trials. NIH-supported scientists are investigating many approaches to obesity and type 2 diabetes intervention, including trials to test medications and lifestyle interventions for prevention and treatment. They are testing therapies and interventions in children and adults, and in different racial and ethnic groups.
Other epidemiological and long-term observational studies, such as the Framingham Heart Study, give insights into the risk factors for and other aspects of obesity, type 2 diabetes, and cardiovascular disease. The information gleaned from this research will help inform future clinical endeavors and, along with the results of clinical studies, provide a scientific evidence base for public policy decisions.
In addition, the NIH supports several national education campaigns to encourage those at risk to take steps to prevent these conditions. For example, in June 2005 NIH launched We Can! (Ways to Enhance Children’s Activity & Nutrition!), a national public education program targeting parents and caregivers of children ages 8 to 13. The program was developed by NHLBI and is promoted in collaboration with several other NIH institutes, national health and youth organizations, and community-based groups. We Can! provides resources to encourage healthy eating, increase physical activity, and reduce sedentary time. More information on We Can! is available at http://wecan.nhlbi.nih.gov.
To achieve the results necessary to bring about changes, the NIH encourages interdisciplinary research and collaboration among basic and clinical investigators. Current efforts focus on bridging the disciplines of biologic and behavioral research and fostering partnerships among basic and clinical scientists. Through this expansive and comprehensive research portfolio, the NIH is working to improve public health.
* Spiegel, Allen M., and Elizabeth G. Nabel. “NIH research on obesity and type 2 diabetes: providing the scientific evidence base for actions to improve health.” Nature Medicine; vol. 12(1); January 2006; pp 67-69.
** “Strategic Plan for NIH Obesity Research.” National Institutes of Health, U.S. Department of Health and Human Services. NIH publication No. 04-5493. August 2004.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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