One Health: Nutrition and physical activity interventions created to get public in shape

15 Apr 2024 --- In the last few years, researchers from the University of Illinois, US, have been working on behavioral health intervention programs to improve nutrition and physical activity levels in the US using the One Health approach, which connects human, animal, plant and environmental health. They presented their work before peers in the field during Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) week.

Thus far, more than 3,000 evidence-based nutrition and physical activity interventions have been created and tested nationwide. About 200 of these are available in public repositories, according to a survey conducted by one of the researchers.

“The percentage of US citizens meeting nutritional and physical activity recommendations is still very low. Among children aged six to 11, the percentage is 49% for boys and 35% for girls. But as they grow up, these rates get much worse, dropping to 7% and 4%, respectively, in the 16–19 age group, and stagnating at 3% and 2% from the age of 60 onwards,” says Eduardo Esteban Bustamante, a professor at the University of Illinois and FAPESP panelist. 

“When it comes to diet, the reality isn’t much better. Just over 10% of US adults over 18 routinely eat fruits and vegetables,” says Bustamante. 

A new publication by the Gerontological Society of America evaluates critical nutritional choices that enhance cognition and decrease the risk of cognitive impairment.

Human and ecological connection
About 90% of scientifically tested physical activity intervention programs in the US face barriers to dissemination and implementation that prevent them from impacting public health. A contributing factor is a lack of alignment with people’s expectations and the places it should be implemented.

“I’ve worked with a number of intervention programs, and one of the problems I’ve identified is that we didn’t think about the target audience before we started, and we saw that people weren’t engaged with them. We need to think about how to engage the target audience so that, from the beginning, our interventions fit in and are aligned with their goals,” Bustamante says.

The researchers are now developing and testing new physical activity intervention programs in schools and communities. In collaboration with the University of California Irvine, US, one project has been using physical activity in schools to teach mathematics. The basketball court was redesigned to teach children about fractions and decimals. Another project in the Chicago Park District uses sports and recreation to develop communication, emotional and conflict resolution skills in at-risk youths.University of Illinois researchers run various behavioral intervention projects to improve nutrition and physical activity (Credit: Anna Samoylova).

“We also need to stop thinking of nutrition and physical activity as medicines that can only benefit health. They’re activities that take place in a context and we can use them to achieve the goals we want, whether they’re health-related or not,” Bustamante emphasizes.

Reducing diabetes
According to the researchers, behavioral health interventions are crucial in reigning in the diabetes epidemic in the US, where one in 10 people have the disease. They are trying to better understand the social determinants of health around the disease and intervene early to prevent it.

“The causes of this disease are multifactorial. It’s not just because people aren’t taking insulin and medications for hyperglycemia, but also because their diet is inadequate and they don’t exercise. It’ll take a multifaceted approach to address this problem, such as interventions in schools,” says Marck Rosenblatt, dean of the University of Illinois College of Medicine.

“We’re trying to work with local organizations to improve diet quality and encourage physical activity, while at the same time studying the molecular underpinnings of diabetes itself. Only around 15–20% of a person’s health is related to the solutions we develop in our hospitals and clinics. People’s health is more related to their zip code, which correlates with a number of other factors, such as socioeconomic level, social and community context.”

Environmental risks play a fundamental role in the emergence of degenerative diseases. One of the researchers is working on a project to identify mutational signatures in cancer patients where they look at a cell mutation and try to recapitulate its origin and the agents that caused it.

“We know that the cause of cancer is not only genetic. There are also very strong environmental factors. We can intervene in the genetic risk factors, but we also have to look at the environment,” says Leandro Colli, professor at the Ribeirão Preto Medical School of the University of São Paulo, Brazil.

“We’re following a series of patients to try to better understand the risk factors for mutations that lead to cancer, such as tobacco, exposure to solar radiation and the burning of sugar cane in the Ribeirão Preto region,” Colli explains.

Meanwhile, a comprehensive new report endorsed by several US research institutions has quantified the potential health and economic benefits of Food is Medicine – food-based nutrition interventions used in healthcare to treat or prevent chronic diet-related disease.

By Inga de Jong