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The prevalence of obesity has increased at an alarming rate over the past two decades to the extent that it is now a pandemic, affecting millions globally1. The Canadian experience has been no different than that of many other developed countries. Recent analyses have indicated that between 1981 and 1996, the prevalence of overweight and obesity increased from 48 to 57% among men and from 30 to 35% among women2. Similar dramatic trends have been reported for Canadian children2,3. In all, over one quarter of Canadian children and close to one half of adults are overweight, that is, their body fatness is associated with a decreased life expectancy, poor health and decreased quality of life.
Overweight and obesity, and in particular, high levels of abdominal adiposity, are related to an increased risk for type 2 diabetes, hypertension, hyperlipidemia, cardiovascular disease, and cancer 4,5. Recent analyses of U.S. population data have shown that obesity and overweight in adulthood are associated with large decreases in life expectancy with increases in early mortality similar to those seen with smoking6. The total direct and indirect cost of obesity in Canada were estimated to be $4.3 billion in 2017. Strong evidence indicates that loss of body weight by as little as a 5-10% reduces many of the health risks associated with adult obesity8-10. However, more must be learned about the basic science of obesity, and about human behaviour, clinical intervention, and a host of environmental factors before the epidemic of obesity and its associated health problems can be turned around.
A thorough understanding of the pathophysiology of obesity is essential in order to fully understand the condition and its ramifications. The available data suggest that multiple systems regulate energy homeostasis11-13. Familial clustering and the high concordance of body weight among monozygotic twins provide strong evidence for a genetic component to human obesity and a number of genes associated with human obesity have been identified14. Research must advance knowledge within and across these domains in order to understand the interactions of known homeostatic mechanisms, recognize new ones, and place these into the context of the human-environment interface.
Environmental factors and social forces play a significant role in the development of obesity, especially among certain sub-groups of the population15. Those that raise energy intake include inexpensive and widely available high energy-density foods; large portion sizes; and greater energy consumption outside the home in the form of snacks, fast-foods and convenience foods16. The technological evolution of the physical environment has perpetuated the decline of physical activity and the rise of sedentarism15,17-19. There is an urgent need for a clear understanding of the effects of environmental interventions and public policy on food and physical activity-related behaviour in order to provide directions for stemming the epidemic at a population level.
While the root cause of obesity is a mismatch of energy intake and energy expenditure, there is considerable new knowledge that needs to be generated before the epidemic can be effectively managed. Researchers are only beginning to unravel the mysteries of this complex condition. Through this strategic initiative, we hope to challenge scientists working across a host of disciplines to help develop an understanding of the mechanisms (ranging from gene regulation to population behaviour), that will inform the activities of health professionals, policy makers, and the Canadian public in the prevention and treatment of obesity and the maintenance of healthy body weight.
The Strategic Plan of the CIHR Institute of Nutrition, Metabolism and Diabetes (May 2004) identifies specific goals designed to address INMD's overriding objective of generating and translating new knowledge about obesity, such that the health of Canadians is improved and the health care system of Canada is strengthened. More information on the mandate, vision, specific strategies, actions, outcomes and timelines for each goal are described in INMD's Strategic Plan.
Research within and across CIHR's research themes, and within and across disciplines will be required to achieve the ultimate goal of improving the health of Canadians.
It is anticipated that individuals working in a wide variety of disciplines such as nutrition and dietetics, metabolism, pharmacology, exercise physiology, physical sciences, public health, pediatrics, and many others may be interested in this initiative. Investigators with expertise in diverse areas such as genetics, integrative physiology, epidemiology, sociology, health services, health promotion, environmental psychology, public policy, economics, and political science, among others, will likely be necessary to tackle the growing problem of obesity.
Applicants submitting proposals under the strategic initiative Excellence, Innovation and Advancement in the Study of Obesity and Healthy Body Weight can come from any discipline or expertise, and can propose research in any number of areas. Applicants must justify how their work meets the INMD's goal of increasing our understanding of the measures, causes, prevention, treatment and consequences of obesity and maintenance of body weight.
Applicants must also explain how their research will generate and translate new knowledge about obesity/healthy body weight, leading to improvements in the health of Canadians and strengthening of the health care system of Canada.
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2. Tremblay MS, Katzmarzyk PT, Willms JD Temporal trends in overweight and obesity in Canada, 1981-1996 Int J Ob 2002, 26:538-543.
3. Tremblay MS, Douglas WJ. Secular trends in the body mass index of Canadian children. CMAJ 2000;163:1429-33
4. Vega GL. Obesity, metabolic syndrome, and cardiovascular disease. Am Heart J 2001, 142:1108-16
5. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. NEJM 2003, 348:1625-1638.
6. Peters A, Barendgret JJ, Wiiekens F, Mackenbach JP, et al. Obesity in adulthood and its consequences for life expectancy: A life table analysis. Ann Int Med 2003, 138:24-32.
7. Katzmarzyk PT, Janssen I. The Economic Costs Associated With Physical Inactivity and Obesity in Canada: An Update. Can J Appl Physiol 2004, 29:90-115.
8. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, Erdman JW, Kris-Etherton P, Goldberg IJ, Kotchen TA, Lichtenstein AH, Mitch WE, Mullis R, Robinson K, Wylie-Rosett J, St. Jeor S, Suttie J, Tribble DL, Bazzarre TL. AHA dietary guidelines. Revision 2000: A statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation 2000;102:2284-2299
9. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393-403
10. Khan MA, St Peter JV, Breen GA, Hartley GA, Vessey JT. Diabetes disease stage predicts weight loss outcomes with long-term appetite suppressants. Obes Res 2000;8(1):43-48
11. Marx J. Cellular warriors in the battle of the bulge. Science 2003 299:846-849.
12. Krysiak R, Okopien B, Belowski D, Madej A, Herman ZS. Recent insights into body weight control: From physiology to pathology. J Peptide Sci 2001;7:571-8
13. Schwartz MW, Woods SC, Seeley RJ, Barsh GS, Baskin DG, Leibel RL. Is the energy homeostasis system inherently biased toward weight gain? Diabetes 2003 52:232-238.
14. Froguel P, Boutin P. Genetics of pathways regulating body weight in the development of obesity in humans. Exp Biol Med 2001;226:991-6
15. Hill JO, Wyatt HR, Reed GW, Peters JC. Obesity and the environment. Where do we go from here? Science 2003 299: 853-855.
16. French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Ann Rev Public Health 2001;22:309-35
17. Dowda M, Ainsowrth BE, Addy CL, Saunders R, Riner W. Environmental influences, physical activity and weight status in 8- to 16-year-olds. Arch Pediatr Adolesc Med 2001;155:711-7
18. Crespo CJ, Smit E, Troiano RP, Bartlett SJ, Macera CA, Andersen RE. Television watching, energy intake, and obesity in US children: Results from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2001;155:360-5
19. Dietz WH. The obesity epidemic in young children. Reduce television viewing and promote playing. BMJ 2001;322:313-4
