Research Projects
Observational
A Longitudinal Evaluation of Food Insecurity and the Development of Obesity in Young Adults
Food insecurity is a well-recognized risk factor for obesity among women. However there has been limited longitudinal evaluation of this relationship. The goal of this study is to establish the extent to which food insecurity is related to the incidence of obesity and cardiovascular risk factors in young adults. More details
PI: Hilary Seligman
Funding: Hellman Family Award for Early Career Faculty
Intergenerational transmission of obesity: the role of life stress
The growing racial disparity in obesity has reached a critical juncture, particularly among black and white females. Obesity is now being perpetuated across generations While there is uncertainty about how best to prevent obesity and the related racial disparities, converging lines of evidence support the influence of stress on obesity. We hypothesize that income and race are associated with higher levels of both objective and perceived stress, which in turn are associated with higher rates of nonhomeostatic eating, a behavior posited to result in an increased rate of obesity. More Details
PI: Barbara Laraia
Co-Investigators: Elissa Epel, David Rehkopf
Funding: Robert Wood Johnson
Maternal Depression and Child Weight Gain in a Latino Cohort
We are evaluating the relationship between maternal prenatal and postnatal depressive symptoms and child weight gain in the first couple years of life in a cohort of Latino mother-child pairs. More details
Principal Investigator: Janet Wojcicki
Collaborators: Melvin B. Heyman, Robert Lustig, Elissa Epel, Ricardo Munoz
Funding: Children's Digestive Health and Nutrition Foundation (CDHNF), the Hellman Family Foundation
Maternal Nutrition Knowledge, Pediatric Overweight and Participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
This study will assess the relationship between maternal attitudes towards diet and feeding using new questions added in the NHANES (2005-6) on label reading and use of nutritional knowledge in relationship to participation in the Women, Infant and Children Program in mothers of children 1-5 years of age. More details
Principal Investigator: Janet Wojcicki
Collaborators: Melvin B. Heyman (Pediatrics, UCSF)
Funding: USDA/UC Davis RIDGE
Mediators of Atherosclerosis in South Asians Living in America (MASALA)
The project is a prospective cohort study of a community-based sample of South Asians without clinical cardiovascular disease between the ages of 40 and 79 at two clinical sites, to investigate the relationship of traditional and novel cardiac risk factors with subclinical cardiovascular disease and the progression of disease.
PI: Alka Kanaya
Co-Investigators: Steve Hulley, Namratha Kandula, Kiang Liu, David Herrington, Matthew Budoff
Funding: NIH/NHLBI
Funding Period: 4/1/10 – 3/31/14
Migration and Risk for Obesity in Latino School Children in San Francisco and Mexican School Children in Tijuana
To evaluate the role migration (both international and regional) plays in increasing risk for obesity in a sample of Latino school children in the Bay Area and also among school children in Mexico. More details
Principal Investigator: Janet Wojcicki
Collaborators: Melvin B. Heyman, Norah Schwartz (COLEF, Tijuana), Arturo Jimenez-Cruz (UABC - Tijuana), Montserrat Bacardi-Gascon (UABC-Tijuana).
Funding: UC MEXUS
Neighborhoods and Obesity in Pre-adolescent Girls: Part II
Renewal of a previously funded IDEA grant. The original grant added city planning data and direct observations of neighborhood circumstances to incorporate how neighborhoods are designed and how they appear on the ground to an analysis on girls’ diet, physical activity, body mass index, and pubertal maturation. More details
Principal Investigator: Irene Yen
Other Investigators: Nancy Adler, Robert Hiatt, Barbara Laraia
Funding Source: California Breast Cancer Research Program
Funding Period: 9/2/08-8/31/10
Neighborhood Effects on Weight Change and Diabetes Risk Factors
Diabetes is increasing at an alarming rate. Between 1980 and 2004, as obesity increased, the number of Americans with diabetes more than doubled . Individuals from minority, low-income and low education populations are disproportionately affected by diabetes (and by complication of diabetes), and these socioeconomic disparities may be growing. Health disparities are often attributed to differences in medical care or self-care, but data suggest that these individual level factors explain few of the existing disparities. More Details
PI: Barbara Laraia
Co-Investigators: Nancy Adler, Andy Karter (Kaiser Division of Research), Will Dow (UCB), Maggi Kelly (UCB) and Michael Jerrett (UCB)
OurSpace: Neighborhood Database Initiative
The aim of this initiative is to establish a comprehensive contextual database for use by Kaiser 43200A6089 Division of Research (KP-DOR) and UCSF investigators in conjunction with the Research Program in Genes, Environment and Health (RPGEH) and other Kaiser DOR research initiatives . We will compile identified environmental, geographical, socio-economic, administrative, and contextual data in order to permit sophisticated spatial and multilevel analysis of neighborhood-level effects on health behaviors and outcomes. More Details
PI: Barbara Laraia
Co-Investigators: Bob Hiatt, Neil Risch, Nancy Adler, Irene Yen, David Rehkopf, Julie Deardorff, Stephen Vander Eden (Kaiser DOR), Andy Karter (Kaiser DOR), Carol Sumkin (Kaiser DOR), Kathy Schafer (Kaiser DOR), Elize Brown (Kaiser DOR), Maggi Kelly (UCB)
Link to: Neighborhood Effects on Weight Change and Diabetes Risk Factors
Parental Influences on Obesity among Mexican American Children
The prevalence of overweight among children in the United States has increased markedly during the past several decades. Latino children are at particular risk of overweight. Childhood overweight is partially due to behavioral factors, and parental behaviors are thought to be important influences on children’s obesity. However, most studies have examined a narrow range of parental behaviors, and few have focused on Latino children. More Details
Principal Investigator: Jeanne M. Tschann
Co-Investigators: Lauri Pasch, Elena Flores (USF), Louise Greenspan (Kaiser SF), Nancy Butte (Baylor), Steven Gregorich, Mel Heyman, Julianna Deardorff
Funding Source: NIH/NHLBI
Funding Period: 7/15/07 – 4/30/12
Socioenvironmental Influences on Nutrition and Obesity
Obesity rates are increasing in the US, with no signs of slowing; obesity is increasing in all age groups, races and both sexes. It is higher among women of reproductive age and is growing rapidly among children. In order to curtail this complex, global epidemic, it is critical to identify modifiable environmental risk factors—such as food security status; proximity to supermarkets, fast food restaurants and recreational facilities; transportation; neighborhood safety and crime—that contribute to nutrition, health disparities, and obesity risk in these populations. More Details
PI: Barbara Laraia
The Park as our patient: evaluating child physical activity and neighborhood indicators before and after playlot revitalization in Richmond, CA
Two playgrounds in Richmond will be re-designed and renovated in the spring of 2009. This project will conduct assessments of social capital (through a survey of neighborhood residents), crime activity, observations of who visits the playground and what they do there, and accelerometer measures of children’s activity in the playground before and after the renovation work. More details
Principal Investigator: June Tester (Children’s Hospital Research Institute)
Other Investigators: Irene Yen
Funding Source: Robert Wood Johnson Foundation
Funding Period: 12/1/08-11/30/09
The Role of Street Vendors in the After-School Food Environment
The proposed study would increase knowledge about the role of street vendors in the after-school eating environment among elementary and middle school children in low-income neighborhoods. Our overall aim is to examine whether mobile vendors are a feasible vehicle for the sales of fresh fruits, vegetables and healthy snacks. We propose an initial formative phase consisting of spatial and observational data, followed by interviews to contextualize street vending near selected elementary and middle schools in Oakland, California. More Details
PI: Barbara Laraia
Co-Investigators: Irene Yen , June Tester (CHORI)
School Assignment Policies and Active Transport
Funding from The California Endowment and Cal Trans is being used to gather baseline data on how elementary students in San Francisco Unified School District get to and from school, prior to implementation of school reassignment policy.
Prinicipal Investigators: Kristine Madsen, MD, MPH (California Endowment) and Patrick Fox (Cal Trans)
Funding Source: California Endowment and Cal Trans Fundign Period: October 2010-September 2011
Physical Education Quality and Quantity in San Francisco
To describe the current quantity and quality of physical education in the San Francisco Unified School District, and do a preliminary cost-effectiveness analysis.
Prinicipal Investigator: Kristine Madsen, MD, MPH
Funding Source: Shape Up San Francisco
Funding Period: October 2010-September 2011
Intervention
Keep Fit - A Video Doctor Intervention to Improve Nutrition and Physical Activity in Pregnancy
Dr. Stotland is a co-investigator in this randomized trial of a computer-based interactive patient counseling tool to aid in patient counseling during pregnancy. The study randomized over 300 women to the intervention or a control arm, at multiple prenatal care practices throughout the Bay Area. We found that the intervention improved women’s knowledge as well as diet and physical activity behaviors compared to the control group. Dr. Stotland plans to test a new version of the intervention to prevent excessive weight gain during pregnancy in high-risk women.
PI: Barbara Gerbert
Co-Investigators: Naomi Stotland, Rebecca Jackson, and Aaron Caughey
Funding: NIDA
Novel Interventions to Reduce Stress Induced Non-Homeostatic Eating
This application brings together a strong interdisciplinary team of scientists at the UCSF Center for Obesity Assessment, Study and Treatment (COAST) with researchers at California Pacific Medical Center to test novel interventions based on the physiology by which stress and reward from palatable food influence eating behaviors and abdominal fat deposition. This type of eating is typically non-homeostatic (not meeting caloric deficit). We plan to reduce this type of intake through proof-of-concept and intervention strategies tailored for obese lower income women during pregnancy, a critical period for intervention, which may affect gestational weight gain, postpartum weight retention, and offspring weight. Our translational approach draws from the psychology of eating and behavior change, and neuroscience of stress, appetite and reward, to test whether modulating the reward and stress response systems reduces abdominal obesity and weight. In Phase 1, we will finalize our conceptual model of non-homeostatic eating and develop two distinct interventions that target diet, activity, and stress but with different conceptual bases: (1): Emotional Brain Training (EBT) designed to curb addictions through promoting self-regulation of emotions and eating behavior. (2): Mindfulness and Diet (MIND) aimed to reduce stress and improve awareness of hunger-satiety cues and automatic eating patterns through mindfulness and mindful eating. Preliminary data on each intervention are promising. We will also test an indirect measure of endogenous opioid tone that may provide insight into mechanisms of weight loss. Pilot research has shown that response to a naltrexone “opioid probe” is linked to indices of non-homeostatic eating and predicts weight loss. We will evaluate correlations between the measure of opioid tone and measures of non-homeostatic eating in 60 non-pregnant women for use with our pregnant population in Phases 2 and 3. In Phase 2, we will randomize 40 obese pregnant women to a proof-of-concept trial of EBT and MIND, to compare relative effects on proposed mechanisms (stress, opioid tone), and feasibility. In Phase 3, we will refine EBT and MIND and test their efficacy, randomizing 180 obese pregnant women to EBT, MIND, or active control condition (diet and exercise alone). These efforts will produce promising intervention strategies for curbing obesity in women during their reproductive years. Scientific Advisory panel and Data Safety and Monitoring Board input will inform all phases. Accomplishing the aims of this proposal will expand current understanding of mechanisms that lead to sustained weight reduction, and will inform further study of alternative strategies for obesity intervention.
PI: Elissa Epel, Barbara Laraia, Nancy Adler
Funding Source: NIH/NHLBI
Funding Period: 9/25/09 - 6/30/2014
SHE Study
MAMAS
Physical Activity to Reduce Disparities in Diabetes Risk
The aims of this project are to: 1) adapt CHAMPS to: a) augment its dietary component; b) meet the needs of our target population, and c) be integrated into the infrastructure of a city and county public health department; and 2) evaluate the effectiveness of an adapted 6-month program (and 6 month maintenance phase) with a 1-yr randomized controlled trial (n=330), and 3) describe costs to health departments of program start-up and provision.
PI: Anita Stewart
Co-Investigators: Alka Kanaya
Funding: NIH/NIDDK
Funding Period: 9/30/05-7/31/10
Restorative Yoga for Therapy of the Metabolic Syndrome (RHYTHMS)
This project is a multi-center randomized controlled trial of Restorative Yoga therapy vs. an equal attention control group given to underactive and overweight individuals with the metabolic syndrome. The aims are to examine the effects of yoga on visceral fat and metabolic features after a 6-month intervention and 6-month maintenance period.
PI: Alka Kanaya
Co-Investigators: Deborah Grady, Eric Vittinghoff, Elissa Epel
Funding: NIH/NCCAM
Funding Period: 7/1/09 – 4/30/13
Reducing Pediatric Obesity through After-School Programs
Childhood obesity is of tremendous concern and public health approaches are necessary to address the problem. Existing school-based programs promoting physical activity that have demonstrated appeal for children may provide a cost-effective means of addressing obesity among children of diverse backgrounds. More Details
Principal Investigator : Kristine Madsen, MD, MPH
Other Investigators : Pat Crawford, DrPH, RD (U.C. Berkeley); Charles McCulloch, PhD; Jeanne Tschann, PhD; Elizabeth Ozer, PhD; Hannah Thompson, MPH
Funding Source: NICHD (9/2007-8/2012) & American Heart Association Beginning Grant-in-Aid (7/2008-6/2011)
Metabolic impact of fructose restriction in obese children
This study will examine the effects of isocaloric fructose restriction for 10 days on metabolic co-morbidities in obese children with metabolic syndrome.
PI: Robert Lustig, M.D. and Jean-Marc Schwarz, Ph.D.
Co-Investigators: Kathleen Mulligan, Ph.D., Anjali Jain, M.D., Emily Perito, M.D., Susan Noworolski, Ph.D., Laurie Herraiz, R.D.
Funding Source: NIDDK
Funding Period: July 2010-June 2015
Effect of community schools on health and academic outcomes in low-income youth: A pilot study
To gather preliminary data on the mechanism and effect of the community school model.
Prinicapl Investigator: Kristine Madsen, MD, MPH
Funding Source: UCSF CTSI-Strategic Opportunity Support
Funding Period: July 2010-June 2011
Clinical
Diet Glycemic Load in Pregnancy
Dr. Stotland is a co-investigator in this randomized trial of a low-glycemic diet versus a low-fat diet in overweight and obese pregnant women at San Francisco General Hospital. We are studying the effect of diet on insulin resistance and other metabolic parameters during pregnancy.
PI: Janet King (CHORI)
Co-Investigators: Naomi Stotland and Lisa Murphy
Funding: NICHD
Practicing Restorative Yoga or Stretching for the Metabolic Syndrome
This project is a multi-center randomized controlled trial of Restorative Yoga therapy vs. an equal attention stretching control group given to underactive and overweight individuals with the metabolic syndrome. The aims are to examine the effects of yoga on visceral fat and metabolic features after a 6-month intervention and a 6-month maintenance period."
PI: Alka Kanaya
Co-Investigators: Deborah Grady, Elizabeth Barrett-Connor, Maria Araneta
Funding: NIH/NCCAM
Funding Period: 7/1/09-4/30/13