Obesity - the challenge; the potential for cross-disciplinary studies in Food Science and Medicine

1. Obesity - the challenge;the potential for cross-disciplinary studies in Food Science and Medicine Anthony R Leeds Faculty of Life Sciences, University of Copenhagen, Diabetes Centre, Central Middlesex Hospital, London; Medical Director, Cambridge Weight Plan Food for thought Workshop I University of Copenhagen 29th August 2011 arleeds@cambridgeweightplan.co.uk http://www.cambridgeweightplan.com/healthcare-professionals.asp

2. BBC Website • Global governments must get tough on Obesity • At: http://www.bbc.co.uk/news/health-14669203 • On 26th August 2011

3. Obesity – a global and national crisis • We know some of the causes • We know how to influence some of them • But we don’t have proven long term methods for treatment (except perhaps surgery) • Drug and Surgical treatments are/will be costly • Do we have any food-based solutions?

4. Is there a food-based solution? • Qualitative and Quantitative aspects • Food properties and diet composition can be manipulated • e.g proportion of energy from protein, glycaemic index • Pay attention to the quantitative aspects • Weight loss is related to the energy deficit • Current medical research shows that amounts of weight loss needed are more than can be achieved by usual diets (500 to 600kcal/d deficits)

5. Food development through interdisciplinary studies • A solution for the need for greater energy deficits • Take the dietary intake down to a lower level – either a VLCD (very low-calorie diet <800kcal/d) or a LCD (low-calorie diet 800-1000kcal/d) • To supply all needed micronutrients and sufficient protein - led over 26 years ago to the development of formula diets • In the last few years there has been a renewed interest in this old idea

6. Medical Research ProgrammeObjectives and questions • To demonstrate efficacy • ‘how do I know that the Cambridge Diet does what you say it does’ • To measure the amount of effect • ‘how much weight will I lose and will it be safe?’ • To measure health benefits • ‘how does losing weight benefit me?’ • To determine frequency of adverse or side-effects [and take action to reduce these] • ‘will I lose my hair?, get constipated? feel cold?’ • To demonstrate weight maintenance • ‘how will I avoid re-gaining weight afterwards’

7. Our requirements • The programme must be evidence based • There must be research evidence for translation into primary care or other contexts • Fully defined adverse events profiles must be published • Independent analyses of health economics implications of the treatment must be published

8. Food development through interdisciplinary studies Industrial partner Parker Institute, and LIFE, Copenhagen University Effect of weight loss in Obese people with knee osteoarthritis Reformulation to reduce adverse events Adverse events profiles Evidence of effect

9. Food development through interdisciplinary studies Industrial partner Gentofte Hospital, and LIFE, KU Effect of weight loss in Obese people with psoriasis Development and Reformulation to modify responses Skin flakiness – ? Modify dietary fat profile

10. Food development through interdisciplinary studies Industrial partner Gentofte Hospital, and LIFE, KU Effect of weight loss in Obese people with psoriasis Bispebjerg Hospital, and LIFE, KU Effect of weight loss in Obese people after heart attack Development and Reformulation to modify responses

11. Food development through interdisciplinary studies Industrial partner Gentofte Hospital, and LIFE, KU Effect of weight loss in Obese people with psoriasis Bispebjerg Hospital, and LIFE, KU Effect of weight loss in Obese people after heart attack Development and Reformulation to modify responses Sønderborg Hospital, and Parker Institute Effect of weight loss in Obese people before knee replacement

12. Problems inPrivate-Public partnerships Academic, Healthcare provider partner Industrial partner Who owns the data? Transparency with respect to roles Vested interests of all team members

13. Problems and Solutions inPrivate-Public partnerships Academic, Healthcare provider partner Industrial partner Who owns the data? The research team And there must be full publication of data Transparency with respect to roles Full public description Incl travel grants Vested interests of all team members Full declarations

14. Obesity - the challenge;the potential for cross-disciplinary studies in Food Science and Medicine • Food is produced by private companies • Private-public partnerships in research must • Define the relationship clearly at outset • State data ownership at the start • Fullly publish the data (compare the record of the pharmaceutical industry) including adverse events • Be fully transparent – declaration of interests