Strategic Initiative Announcement

The CIHR Institute of Nutrition, Metabolism and Diabetes is pleased to announce a strategic initiative in

Excellence, Innovation and Advancement in the
Study of Obesity and Healthy Body Weight

Introduction

In September 2001, the Institute of Nutrition, Metabolism and Diabetes initiated an environmental scan of its stakeholders and potential partners. Through this scan, INMD sought input into the strategic directions to be undertaken by the Institute. Obesity was identified as a high priority research theme by a large number of respondents across a diverse range of organizations, researchers and policymakers. The Institute Advisory Board of the INMD subsequently affirmed "Obesity Research: Towards Healthy Body Weights for Canadians" as the Institute's primary strategic research focus.

This announcement represents the first in a series of program announcements with a focus on obesity and healthy body weight. The breadth of programs offered under this announcement signal's the INMD's intent to build capacity and strengthen Canadian health research in this broad area. To help facilitate the building of capacity, this announcement includes requests for applications (RFAs) for New Emerging Teams, Training Program Grants, and Expertise and Skills Development Awards. In addition, INMD is offering Establishment Grants under this strategic initiative in an effort to assist eligible institutions to recruit outstanding scientists from outside of Canada. Pilot Project Grants will also help build capacity, by helping researchers with novel ideas or observations build the evidence base needed to determine if a full-scale effort is warranted. INMD also recognizes that there are already many outstanding researchers working on the problem of obesity. To strengthen Canadian research in the area of obesity and healthy body weight, INMD will use funds for this strategic initiative to support highly ranked operating grants that fall below the cutoff in the September and March CIHR Operating Grant competitions.

The World Health Organization has identified obesity as one of today's most blatantly visible, yet most neglected, public health problems. Close to half of adult Canadians are overweight and 1 in 6 is obese. Obesity is a risk factor for many major causes of morbidity and mortality such as cardiovascular disease, stroke, type 2 diabetes and cancer. Obesity has been estimated to cost the health care system in Canada close to $2 billion annually. Research that will help us understand the problem of obesity and will provide new knowledge to help improve the health of Canadians is expected to be in areas from across CIHR's research themes: 1) biomedical, 2) clinical, 3) health systems and services, and 4) the health of populations, the societal and cultural dimensions of health and environmental influences on health.

Timeline: Application and funding dates vary. Check details for each specific RFA.

Funds Available: At present, the maximum funds available per annum for all programs under this strategic initiative are $3.0 million. However, we anticipate that through the development of partnerships, we will be able to expand both programs and funds available for research on obesity and healthy body weight.

Table of Contents

Background
INMD Strategic Plan, Mandate and Vision [ PDF (210 KB) | Help ]
Objectives of the Strategic Initiative
Eligible Research Areas
Mechanisms of Support: Requests for Applications (including: Objectives of the Request for Applications, Eligibility Criteria, Allowable Costs, Funding, Evaluation Criteria for Peer Review, Specific Conditions of Funding, How to Apply, RFA Performance Outcomes and Measures, Contacts for Further Information)

• New Emerging Teams

• Training Programs

• Expertise and Skills Development Awards (training for established investigators)

• Establishment Grants (Institutional recruitment)

• Pilot Project Grants

• Operating Grants

• Randomized Controlled Trials

Peer Review Process
Contacts For Further Information
References

Background

The prevalence of obesity is increasing worldwide and reaching epidemic proportions in industrialized countries1. According to the Canadian Heart Health Surveys, close to half of adult Canadians are overweight and 1 in 6 is obese2. Recent evidence also suggests that Canadian children are becoming progressively overweight and obese3. Although genetic factors are believed to contribute substantially to the predisposition towards obesity, pronounced changes in the human environment, and in human behaviour and lifestyle have also resulted in its escalation.

In order to effectively address the problem of obesity, a thorough understanding of its pathophysiology is needed. Despite significant recent advancements made towards unraveling the complexity of obesity, there still remain a large number of unanswered questions. The available data suggest that multiple systems regulate energy homeostasis4-6. Familial clustering and the high concordance of body weight among monozygotic twins provide strong evidence for a genetic component to human obesity7 and a number of genes associated with human obesity have been identified8. 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.

Overweight and obesity are related to an increased risk of type 2 diabetes, hypertension, hyperlipidemia and cardiovascular disease (CVD)9,10. Furthermore, obesity is an independent risk factor for increased mortality11,12. There is a growing consensus that a 5-10% decrease in body weight can effectively decrease the risk factors associated with diabetes and cardiovascular disease in adults13. Blood pressure, lipid profile and glycemia improve significantly and reliance on medication declines with this degree of weight loss14. Despite the numerous benefits of achieving and maintaining healthy body weights, clinical and environmental interventions have yet to slow the rise in obesity in North America. The first choice for inducing weight loss in the treatment of obesity is negative energy balance, which is best achieved by reducing calorie intake and increasing physical activity. While this appears to be a simple principle of physics, successful achievement and maintenance of a degree of weight loss that is significant to health is rare. Research that illuminates how physiological and behavioural factors affect the determinants of energy balance will be critical for the development and implementation of effective prevention and treatment programs.

Environmental factors and social forces undoubtedly play a role in the development of obesity, especially among certain sub-groups of the population. Those that raise energy intake include targeted advertisements for, and low price of high-energy density foods; marketing of larger portion sizes; and the consumption of more fast-foods and convenience foods, with fewer meals being eaten in the home15. The technological evolution of the physical environment has perpetuated the decline of physical activity and energy expenditure16-18. The effect of health services and public policy on food and physical activity-related behaviour needs to be understood.

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 just beginning to unravel the mysteries of this complex disorder. 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.

INMD Strategic Plan, Mandate and Vision

The Strategic Plan of the CIHR Institute of Nutrition, Metabolism and Diabetes (May 2002) 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.

Objectives of the Strategic Initiative

The objectives of this strategic initiative Excellence, Innovation and Advancement in the Study of Obesity and Healthy Body Weight are to:

• Place obesity on the national health research agenda

• Build capacity to undertake obesity/healthy body weight research

• Fund excellent research aimed at understanding the problem of obesity and maintenance of healthy body weight

In subsequent announcements we hope to provide additional programs that reflect increased funding, partnership activity, and the range of programs necessary to meet the needs of the research community.

Eligible Research Areas

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. People with expertise in diverse areas such as genetics, telehealth/medicine, epidemiology, integrative physiology, health promotion, public policy, clinical trials and environmental psychology, among others, will likely be necessary to tackle the growing problem of obesity.

Examples of research relevant to this strategic initiative include (but are not limited to) studies on the:

• Public health implications and costs of implementing preventive interventions;

• Effects of genetic mutations and polymorphisms in animal models of obesity;

• Influence of environments on physical inactivity and nutritional factors that promote obesity;

• Effects of targeted stimulation or inhibition of obesity-related genes;

• Impact of obesity/maintenance of healthy body weight on causes, prevention or treatment of obesity-related chronic diseases, e.g. diabetes, heart disease and/or cancer;

• Role of sex and gender differences in response to environmental interventions to prevent obesity;

• Utilization of health care resources by obese Canadians;

• Characterization of signaling molecules or genes related to obesity;

• Efficacy of nutritional/pharmacological/complementary and alternative therapies in humans;

• Effectiveness of obesity prevention and treatment;

• Characterization of populations at high-risk for developing obesity;

• Metabolic factors related to fat storage;

• Impact of changes in food advertising, food promotion, or packaging to encourage more healthful food choices;

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 training or 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 should 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.

Mechanisms of Support

For instructions on how to apply to the strategic initiative Excellence, Innovation and Advancement in the Study of Obesity and Healthy Body Weight, please refer to the specific Request for Applications:

Additional Opportunities

In addition to the six RFA's listed above, the INMD would like to point to other opportunities, relevant to our focus on obesity/health body weight, currently being announced in collaboration with our partners:

Peer Review Process

Applicants should refer to the specific RFAs of interest for details on the criteria for peer review.

Applications (except Establishment and Operating Grants) will be evaluated by a special ad hoc, multidisciplinary, peer-review committee with expertise in areas relevant to the strategic initiative Excellence, Innovation and Advancement in the Study of Obesity and Healthy Body Weight. Names of the peer review committee members will be posted on the CIHR website.

On completion of the peer review, the Institute will consider the ranking lists and merit scores (ratings) of the applications submitted. INMD will fund top-ranked applications under each RFA. Applications receiving a score of less than 3.5 will not be considered for funding.

Contacts for Further Information

For general questions about the strategic initiative Excellence, Innovation and Advancement in the Study of Obesity and Healthy Body Weight, please do not hesitate to contact:

Dr. Susan Crawford
Assistant Director,
Institute of Nutrition Metabolism and Diabetes
Simon Fraser University
Burnaby, BC V5A 1S6


Telephone: (604) 268-6706
Email: susan_crawford@sfu.ca

For questions regarding application forms and submission requirements contact:

Linda McKenzie
Program Officer
Canadian Institutes of Health Research
410 Laurier Avenue W., 9th Floor
Address Locator 4209A
Ottawa, ON K1A 0W9

Telephone: (613) 954-6242
Email: lmckenzie@cihr.ca

References

1. Seidell JC. Obesity, insulin resistance and diabetes - a worldwide epidemic. Br J Nutr 2000;83(suppl1):S5-8

2. Macdonald SM, Reeder BA, Chen Y, Despres J-P, and the Canadian Heart Health Surveys Research Group. Obesity in Canada: A descriptive analysis. CMAJ 1997;157(1Suppl):S3-9

3. Tremblay MS, Douglas WJ. Secular trends in the body mass index of Canadian children. CMAJ 2000;163(11):1429-33

4. Giridharan NV. Animal models of obesity and their usefulness in molecular approach to obesity. Indian J Med Res 1998;108:225-42

5. Montague CT, Farooqi IS, Whitehead JP et al. Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature 1997;387:903-8

6. Krysiak R, Okopien B, Belowski D, Madej A, Herman ZS. Recent insughts into body weight control: From physiology to pathology. J Peptide Sci 2001;7:571-8

7. Allison DB, Faith MS, Nathan JS. Risch's lambda values for human obesity. Int J Obes Relat Metab Disord 1996;20:990-9

8. Froguel P, Boutin P. Genetics of pathways regulating body weight in the development of obesity in humans. Exp Biol Med 2001;226:991-6

9. Vega GL. Obesity, metabolic syndrome, and cardiovascular disease. Am Heart J 2001;142(6):1108-16

10. Serrano Rios M. Epidemiology of cardiovascular disease in type 2 diabetes. Int J Clin Pract Suppl 2001;121:4-7

11. Wilcosky T, Hyde J, Anderson JJB, Bangdiwala S, Duncan B. Obesity and mortality in the Lipid Research Clinics Program Follow-Up Study. J Clin Epidemiol 1990;43:743-52

12. Manson JE, Willett WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE, Hennekens CH, Speizer FE. Body weight and mortality among women. N Engl J Med 1995;333:677-85

13. 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

14. 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

15. French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Annu Rev Public Health 2001;22:309-35

16. 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

17. 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

18. Dietz WH. The obesity epidemic in young children. Reduce television viewing and promote playing. BMJ 2001;322:313-4