Author Interviews, Heart Disease, Infections, Pediatrics, Pediatrics, Weight Research / 01.06.2016
Childhood Infections Linked to Later Life Obesity and Impaired Vascular Function
MedicalResearch.com Interview with:
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Dr. Markus Juonala[/caption]
Markus Juonala, MD, PhD
Murdoch Childrens Research Institute, Parkville
Victoria, Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Juonala: This is an epidemiological follow-up study investigating whether childhood infections and socieconomic status are associated with cardiovasular risk factor and early chances in vasculature.
The main finding was that childhood infections were associated with obesity and impaired vascular function in adulthood among those individuals with low socioeconomic status.
Dr. Markus Juonala[/caption]
Markus Juonala, MD, PhD
Murdoch Childrens Research Institute, Parkville
Victoria, Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Juonala: This is an epidemiological follow-up study investigating whether childhood infections and socieconomic status are associated with cardiovasular risk factor and early chances in vasculature.
The main finding was that childhood infections were associated with obesity and impaired vascular function in adulthood among those individuals with low socioeconomic status.
Dr. Jennifer Kuk[/caption]
Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Toronto, Ontario
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Kuk: Artificial sweeteners are used to help individuals manage their weight, however, individuals who consume aspartame (a type of artificial sweeteners) have worse glucose metabolism than individuals with the same body weight but do not consume aspartame. This observation was only true for adults with obesity. Further, saccharin and natural sugars were not associated with differences in health after considering differences in obesity.
Dr. Brian Stansfield[/caption]
Dr. Brian Stansfield MD
Neonatologist
Children's Hospital of Georgia and the Medical College of Georgia
Augusta University
MedicalResearch.com: What is the background for this study?
Dr. Stansfield: Since the mid-20th century, we have experimental evidence in animal models and human data demonstrating the influence of maternal nutrition on the offspring - both in the short term and long term. Low birth weight has been connected with higher incidence of cardiometabolic diseases including insulin resistance, coronary artery disease, and hypertension. Interestingly, low birth weight infants grow up to be relatively thin adults compared to their normal or high birth weight counterparts. Conversely, high birth weight infants tend to become heavier adults and obesity is directly linked with the same adult outcomes. So the association of cardiac and metabolic diseases with low birth weight is not linked to adult obesity in general. Thus, speculation as to why extremes of birth weight lead to adult onset cardiometabolic disease suggests different mechanisms and modifying factors.
MedicalResearch.com: What are the main findings?
Dr. Stansfield: The findings of our study shed considerable light on the relationship between birth weight and risk factors for insulin resistance and visceral adiposity. Using magnetic resonance imaging (MRI) to achieve precise measurements of visceral adipose content and biomarkers for insulin resistance, we show that both low and high birth weight are associated with increased visceral adiposity and insulin resistance in a healthy population of adolescents aged 13-17 years. This association persists when we account for several recognized confounders including age, sex, race, activity level, and socioeconomic status. The most interesting finding of our study is that when you account for each adolescent’s current body mass index, a measure of obesity, the relationship between increased visceral fat and insulin resistance and low birth weight is strengthened suggesting that these adolescents had relatively high visceral adipose content despite obesity rates that were similar to their normal birth weight counterparts. On the other hand, correction for adolescent BMI (obesity) reduced the relationship between these metabolic markers and high birth weight infants. Thus, low birth weight infants may develop insulin resistance and increased visceral fat, both significant risk factors for cardiovascular disease and metabolic disease, despite having a relatively normal body shape in adolescents.
Dr. Annette Schürmann[/caption]
Prof-Dr. Annette Schürmann
Department of Experimental Diabetology
German Institute of Human Nutrition Potsdam-Rehbruecke
Nuthetal, Germany
MedicalResearch.com: What is the background for this study?
Dr. Schürmann: The aim of our study was to clarify why genetically identical mice respond very different to a high fat diet. Some of the mice react with an elevated body weight, others not. We analyzed the expression pattern
of liver at two time points, at the age of 6 weeks, (the earliest time
point to distinguish between those that respond to the diet (responder
mice) and those that did not (non-responders)), and at the age of 20
weeks. One transcript that was significantly reduced in the liver of
responder mice at both time points was Igfbp2. The reason for the
reduced expression was an elevated DNA-methylation at a position that is
conserved in the mouse and human sequence. The elevated DNA-methylation
of this specific site in human was recently described to associate with
elevated fat storage (hepatosteatosis) and NASH. However, as 6 weeks old
mice did not show differences in liver fat content between responder and
non-responder mice we conclude that the alteration of Igfbp2 expression
and DNA methylation occurs before the development of fatty liver.
Our data furthermore showed that the epigenetic inhibition of Igfbp2
expression was associated with elevated blood glucose and insulin
resistance but not with fatty liver.
Dr. Gerda Pot[/caption]
Dr Gerda Pot
Lecturer in Nutritional Sciences
King’s College London | Faculty of Life Sciences & Medicine
Diabetes & Nutritional Sciences Division |
London UK
MedicalResearch.com: What is the background for this study?
Dr. Pot: Previous evidence suggested that the timing of food intake can have a significant impact on circadian rhythms (i.e. the body's internal clock) and therefore on metabolic processes within the body, potentially leading to an increased risk of being overweight or obese. However, the evidence from studies in children is very limited so we set out to establish whether this risk was also associated with the timing of children's evening meals.
MedicalResearch.com: What are the main findings?
Dr. Lori Hoepner[/caption]
Lori A. Hoepner, DrPH
Department of Environmental Health Sciences
Columbia University
New York, NY 10032
MedicalResearch.com: What is the background for this study?
Dr. Hoepner: The Columbia Center for Children’s Environmental Health was funded starting in 1998. Pregnant African American and Dominican mothers residing in Northern Manhattan and the South Bronx were enrolled from 1998 to 2006, and mothers and their children have been followed since this time. We collected urine samples from the pregnant mothers in their third trimester and from the children at ages 3 and 5. At ages 5 and 7 we measured the height and weight of the children, and at age 7 we also measured body fat and waist circumference.
MedicalResearch.com: What are the main findings?
Dr. Hoepner: We found a significant association between increased prenatal exposure to Bisphenol A (BPA) and increases in childhood body fat measures of waist circumference and percent body fat at age 7. Our research builds on earlier findings of an association between prenatal exposure to BPA and body fat in children up to age 4, and this is the first study to report an association at age 7.
Dr. Kapp[/caption]
Julie M. Kapp, MPH, PhD
Associate Professor
2014 Baldrige Executive Fellow
University of Missouri School of Medicine
Department of Health Management and Informatics
Columbia, MO 65212
MedicalResearch.com: What is the background for this study?
Dr. Kapp: For the past several decades the U.S. has had the highest obesity rate compared to high-income peer countries, and for many years people in the U.S. have had a shorter life expectancy. For female life expectancy at birth, the U.S. ranked second to last. At the same time, the U.S. has the third highest rate of mammography screening among peer countries, and the pink ribbon is one of the most widely recognized symbols in the U.S. While the death rate in females for coronary heart disease is significantly higher than that for breast cancer, at 1 in 7.2 deaths compared to 1 in 30, respectively, women have higher levels of worry for getting breast cancer.
Chloe Barrera MPH
ORISE Fellow
Centers for Disease Control and Prevention
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies have been inconsistent in whether introduction of solid foods to babies before 4 months may be associated with later obesity. In our analysis of more than a thousand babies followed through the first year of life and contacted again at 6 years, we did not find this association.
Dr. Meghan Azad[/caption]
Meghan Azad PhD
Assistant Professor, Department of Pediatrics & Child Health and Community Health Sciences
University of Manitoba
Associate Investigator, Canadian Healthy Infant Longitudinal Development (CHILD) Study
MedicalResearch.com: What is the background for this study?
Dr. Azad: It is well known that maternal nutrition plays a key role in “programming” fetal development and infant weight gain, but the impact of artificial sweetener consumption during this critical period has not been extensively studied. Some animal research suggests that consuming artificial sweeteners during pregnancy can predispose offspring to develop obesity, but this has never been studied in humans, until now.
Dr. Anny Xiang[/caption]
Anny H. Xiang, PhD
Kaiser Permanente Southern California Department of Research & Evaluation
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Xiang: Previous studies have identified a link between maternal obesity, diabetes and/or excessive gestational weight gain and long-term obesity risk in children. Our study examined the interplay among all four factors associated with childhood obesity: pre-pregnancy obesity, gestational weight gain, gestational diabetes and breastfeeding. To our knowledge, the interplay among these factors and their independent contributions to childhood obesity with data from a large and multi-ethnic cohort under current standard clinical care had not been previously studied.
The study included 15,710 women who delivered babies at Kaiser Permanente medical facilities in Southern California in 2011. The key findings were:
Dr. Ofir Turel[/caption]
Ofir Turel, Ph.D
Professor, Information Systems and Decision Sciences
California State University, Fullerton
Scholar in Residence, Department of Psychology
University of Southern California
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Turel: The study emerged as a response to the growing societal concern regarding potentially problematic information system use” lifestyles”, including videogame addiction, among adolescents. Much research in this domain has focused on negative psychological (e.g., reduced wellbeing, depression) and social/life functioning (e.g., reduction in normal activities, diminished school performance). Less is known regarding potential physiological outcomes of videogame addiction.
Interestingly, the increase in videogame addiction-like symptoms among adolescents happened in conjunction with an increase in sleep curtailment and obesity in this population. These are too growing concerns in North America and perhaps elsewhere. Medical research implies that these three phenomena may be related. Hence, we hypothesized that videogame addiction will be associated with increased sleep curtailment and increased abdominal adiposity; and consequently, indirectly, with cardio-metabolic deficits.
Our findings suggest that videogame addiction predicts reduced 
Dr. Atul Sharma[/caption]
Atul Sharma MD, MSc(Statistics), FRCPC
Researcher, Children’s Hospital Research Institute of Manitoba; Assistant Professor, Department of Pediatrics and Child Health, University of Manitoba; Senior Consultant, Biostatistics Group, George and Fay Yee Center for Healthcare Innovation
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Sharma: Between 1978 and 2004, a previous comparison of directly measured heights and weights demonstrated an alarming increase in the prevalence of overweight or obesity in Canadian children aged 2-17y, from 23.3% (95% CI = 20.5-26.0) to 34.7% (33.0-36.4) based on the new 2007 WHO criteria.
In Canada, the definitions of overweight and obesity changed with the introduction of the new '2010 WHO Growth Charts for Canada’, Previous definitions were based on Body Mass Index (BMI) percentiles from the 2000 Centers for Disease Control and Prevention (CDC) growth chart’s. In addition to revising the percentile thresholds for diagnosing overweight or obesity, the WHO charts were based on a very different reference population. As a result, the proportion of Canadian children being classified as overweight or obese increased with the introduction of the new WHO charts.
Our current study applied current Canadian definitions of overweight and obesity to a contemporary sample of Canadian children age 3-19y to assess recent trends in the rates of overweight and obesity. By pooling data from the Canadian Community Health Survey (CCHS, cycle 2.2) and the Canadian Health Measures Survey (CHMS, cycles 2 and 3), we were able to study a representative sample of more than 14000 Canadian children from the period 2004-2013. The sample was evenly split between boys and girls and approximately 80% white.
Dagfinn Anne[/caption]
Dagfinn Aune
Department of Epidemiology and Biostatistics
School of Public Health
Imperial College London
St. Mary's Campus
Norfolk Place, Paddington, London
MedicalResearch.com: What is the background for this study?
Response: The prevalence of overweight and obesity has increased rapidly over the past decades in all areas of the world. This has raised serious public health concerns because of the relationship between excess weight and increased risk of many chronic diseases including cardiovascular disease, several types of cancer, type 2 diabetes, gallstones, gout, osteoarthritis, and several other conditions as well as all-cause mortality.
Body mass index (BMI) is an established way of measuring adiposity and is calculated by dividing the weight in kilograms with the height in metres squared. Although overweight (BMI 25-29.9) and obesity (BMI ≥30) has been associated with increased risk of mortality in several previous studies, the largest previous study showed that when compared to normal weight, overweight was associated with reduced mortality, and only grade 2 obesity (BMI ≥35) was associated with increased risk of mortality.
However, there were several limitations in that study, for example, smoking and prevalent or prediagnostic illness were not taken into account, both of which can cause lower body weight and increased mortality and may therefore bias the optimal BMI range upwards. In addition, many large studies which did not use the standard WHO categories of normal weight, overweight and obesity, but had used smaller increments to categorize BMI to provide more detailed assessment of the dose-response relationship between BMI and mortality, had been excluded.
Dr. Albert Roh[/caption]
Albert Roh MD
Radiology Resident
Maricopa Integrated Health System
MedicalResearch.com: What is the background for this study?
Dr. Roh: Obesity is well documented to be associated with many medical conditions. Currently, obesity is defined as body mass index (BMI) over 30 kg/m^2. Although simple to calculate and relatively accurate, BMI has its limitations. BMI does not factor in the subject’s body type or fat distribution pattern. For example, a muscular subject and a fatty subject may both have BMI of 30 and be considered obese, although the muscular subject would not be predisposed to the comorbidities associated with obesity. Similarly, two subjects may have the same BMI but have different fat distribution patterns: “apple” with fat distributed primarily on the chest/abdomen and “pear” with fat distributed on the hips. The “apple” fat distribution correlates better with the comorbidities associated with obesity.
Dr. Jed Friedman[/caption]
Jacob (Jed) E. Friedman, Professor, Ph.D.
Department of Pediatrics, Biochemistry & Molecular Genetics
Director, NIH Center for Human Nutrition Research Metabolism Core Laboratory
University of Colorado Anschutz
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Scientists have long established that children who are breastfed are less likely to be obese as adults, though they have yet to identify precisely how breastfeeding protects children against obesity. One likely reason is that children who are breastfed have different bacteria in their intestines than those who are formula fed.
The study, published Monday in the American Journal of Clinical Nutrition examines the role of human milk hormones in the development of infants’ microbiome, a bacterial ecosystem in the digestive system that contributes to multiple facets of health.
“This is the first study of its kind to suggest that hormones in human milk may play an important role in shaping a healthy infant microbiome,” said Bridget Young, co-first author and assistant professor of pediatric nutrition at CU Anschutz. “We’ve known for a long time that breast milk contributes to infant intestinal maturation and healthy growth. This study suggests that hormones in milk may be partly responsible for this positive impact through interactions with the infant’s developing microbiome.”
Researchers found that levels of insulin and leptin in the breastmilk were positively associated with greater microbial diversity and families of bacteria in the infants’ stool. Insulin and leptin were associated with bacterial functions that help the intestine develop as a barrier against harmful toxins, which help prevent intestinal inflammation. By promoting a stronger intestinal barrier early in life, these hormones also may protect children from chronic low-grade inflammation, which can lead to a host of additional digestive problems and diseases.
In addition, researchers found significant differences in the intestinal microbiome of breastfed infants who are born to mothers with obesity compared to those born to mothers of normal weight. Infants born to mothers with obesity showed a significant reduction in gammaproteobacteria, a pioneer species that aids in normal intestinal development and microbiome maturation.
Gammaproteobacteria have been shown in mice and newborn infants to cause a healthy amount inflammation in their intestines, protecting them from inflammatory and autoimmune disorders later in life. The 2-week-old infants born to obese mothers in this study had a reduced number of gammaproteobacteria in the infant gut microbiome.
Dr. Corby Martin[/caption]
Dr. Corby K. Martin PhD
Department/Laboratory:
Ingestive Behavior Laboratory
Director for Behavioral Sciences and Epidemiology
Pennington Biomedical Research Lab
Baton Rouge, LA
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Martin: We know that calorie restriction extends the lifespan of many species and in humans calorie restriction or dieting might extend our healthspan, which is the length of time that we are free of disease. It is possible that more healthy weight or mildly overweight people might calorie restrict to improve their health, and one concern is the possible negative effects of calorie restriction on the quality of life of these individuals.
This study tested if 2 years of calorie restriction affected a number of quality of life measures compared to a group that did not calorie restrict and ate their usual diet and did not lose weight. People who enrolled in the study were normal weight to mildly overweight. The study found that calorie restriction improved mood, reduced tension and improved general health and sexual drive and relationship (a measure of sexual function) over two years. Further, the more weight that people lost, the greater their improvement in quality of life.
Dr. Ashley Kranjac[/caption]
Ashley Wendell Kranjac, PhD
Department of Sociology and
Kinder Institute for Urban Research
Rice University
Houston, Texas and
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Dr. Robert Wagmiller[/caption]
Robert L. Wagmiller, Jr.
Associate Professor
Department of Sociology
Temple University
Philadelphia, PA 19122
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Center for Disease Control recently reported a decline in child obesity amongst 2-to5-year old children between 2003/4 and 2011/12 (see, Ogden et al. 2014). We aimed to identify the sources of this decline because this change occurred in a relatively short period of time. What we found is that the decline in obesity did not occur due to the things that you might expect like changes in physical activity or dietary practices (although there were some differences in these factors across years). But, rather, what we found is that because there were differences in obesity rates for the youngest and oldest children in this age range in 2003/4, but not in 2011/12, that the decline in obesity exists. In other words, because the oldest children in 2003/4 had significantly higher obesity rates than the youngest children in this time period, but this effect is not observable in 2011/12, we see a decline in obesity.
Evelyn Parr[/caption]
Evelyn Parr
Research Officer / PhD Candidate | Centre for Exercise and Nutrition
Mary MacKillop Institute for Health Research
Australian Catholic University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Results from previous investigations suggest that compared to a healthy 'control' diet, increased consumption of dairy foods in an energy restricted diet lead to improved body composition (i.e., a loss of fat mass and the maintenance of lean mass).
We investigated the effects of manipulating the type of dairy foods (i.e., low- or high fat) within high protein, energy restricted diets on body composition and selected health parameters. Eighty-nine middle-aged (35-59 y), male and females who were overweight or obese completed a 16 week intervention comprising 3 d/wk supervised resistance training and 4 d/wk unsupervised aerobic -based exercise (i.e. walking). During this time they consumed a diet that was energy restricted by 250 kcal/d comprising either
1) high protein, moderate carbohydrate (4-5 normal fat dairy product servings),
2) high protein, high carbohydrate (4-5 low-fat, carbohydrate sweetened dairy product servings or
3) a control diet of moderate protein, high carbohydrate diet (1-2 dairy servings).
We found that in the face of energy restriction, when protein intakes were above the recommended daily intakes (>0.8 g/kg body mass) and regular exercise was completed, there was no difference in the loss of fat mass (~8 kg) when participants consumed 4-5 serves of dairy products in either low- or high-fat. Furthermore, participants maintained lean (muscle) mass throughout the energy restricted period.
