Gillings uses a precision health approach through the Obesity Hub to investigate why different individuals have varying weight gain patterns when consuming the same diets.
Obesity has become one of the nation’s top health challenges, and there is no shortage of trendy diets and exercise routines promising successful results. But most research indicates that putting two people on the same diet often yields dramatically different results: One will lose weight, while the other may not lose weight at all — in fact, sometimes they even gain a few pounds.
By Penny Gordon-Larsen, PhD
Associate Dean for Research and Professor of Nutrition
Using Big Data to Solve Big Public Health Problems: Gillings faculty thrive on tackling complex public health issues. We’re Gillings. We’re on it! Powerful technologies and innovative methods fuel their work, while UNC’s uniquely collaborative environment empowers them to reach across disciplines for answers to some of the most pressing public health challenges of our time.
So why does the same nutrition plan work for some people and not for others? A transdisciplinary team of researchers at the UNC Gillings School of Global Public Health is working together to find out using a precision health approach. The Obesity Hub, an innovative team-based approach in the Gillings School involving more than two dozen faculty members from all parts of UNC campus, is using big data to study animals, people and populations to understand why different people can consume the same diets and have different weight gain patterns — and using data-driven strategies to transform behavioral weight loss.
Hub leader Penny Gordon-Larsen, PhD, associate dean for research and professor of nutrition, says most weight studies look at the average effects of weight interventions. Focusing instead on the tails (those most likely to gain or lose, for example) of the distribution rather than averages can highlight the most (and least) successful weight loss in individuals and answer key questions about weight loss.
“If you take the full data in any kind of weight intervention — for example, low fat, low carb, surgery — and look at the population, you see a normal curve where some people on that therapy actually gain weight and for some people it works beautifully, but most people are in the middle with very little weight loss,” she says. “You want to figure out what it is about the person who is very successful on a particular treatment — whether it’s their biology, their behavior, or other factors — and what it is about that intervention that produces a really good result for a specific person or type of person. If you can match the right therapy with the right person, then you will have good results.”
Using several different study designs and analyzing thousands of data points, Hub researchers aim to delve into that variability to find out what factors predict success. A central hypothesis is that a genetic defect could lead to metabolic inefficiency, disrupting a person’s ability to process energy from food and leading that person to gain weight instead of lose it.
“We do a series of experiments in the first few weeks to hone the right prescription, and then we follow that tailored prescription, adjusting as needed, to see if we can maximize successful weight loss.”
Deborah Tate, PhD
Professor of Health Behavior and Nutrition
Analyzing genetic, bacterial and molecular information from 10,000 individuals followed over 30 years, these same markers found in animal models, and behavioral data from people who volunteered for a weight-loss treatment, the researchers’ goal is to find molecular and genetic signals that will help doctors personalize and tailor more effective therapies to people. Stephen Hursting, PhD, a professor of nutrition who is part of the team studying animals, says, “The exciting work is really in the translation of findings from animal to human.”
In the clinic, mobile monitoring devices and behavioral strategies are being integrated to personalize interventions for people who want to lose weight. Initially, 40 patients will try out different dietary compositions and intervention strategies, while researchers glean real-time glucose, exercise, and sleep data and other information so they can adjust recommendations for each person as an individual.
“We do a series of experiments in the first few weeks to hone the right prescription, and then we follow that tailored prescription, adjusting as needed, to see if we can maximize successful weight loss,” says Deborah Tate, PhD, professor of health behavior and nutrition. “Our goal is to get away from the one-size-fits-all approach that we’ve done historically — using identical diet and activity prescriptions and behavioral strategies across the board, even though it may not be the right approach for everyone.”
The Obesity Hub Leadership Team
The Obesity Hub is an exciting collaboration of 32 scientists working to develop weight-loss treatment and prevention approaches that go far beyond the common “one-size-fits-all” approach. The team won a Creativity Hub award from the University last year to spur the kind of novel, collaborative science that helps keep UNC at the forefront of research and discovery. The hub has published two position papers, has nine grants in progress, three spin-off grants, and a grant from the NIH valued at more than $6 million.
- Nutrition: Penny Gordon-Larsen, PhD (Associate Dean for Research and Professor of Nutrition)
- Computer Science: Stan Ahalt, PhD (Professor of Computer Science and Director of the Renaissance Computing Institute)
- Biology: Vicki Bautch, PhD (Beverly Long Chapin Distinguished Professor of Biology)
- Endocrinology: Sriram Machineni, MD (Assistant Professor of Endocrinology and Metabolism and Director of UNC Medical Weight Clinic)
- Epidemiology: Kari North, PhD (Professor of Epidemiology)
- Nutrition/NRI: Steve Zeisel, MD, PhD (Professor of Nutrition and Director of UNC Nutrition Research Institute)
- Health Behavior: Deborah Tate, PhD (Professor of Health Behavior and Nutrition)
