Obesity

Welcome to the Obesity research them. Headed by CNRC Director, Professor Peter SW Davies, studies under this research theme focus purely on obesity and its relationship to nutrition, feeding practices, breastfeeding, growth and obesity.

An investigation of the Relationship between Body Composition, Adipokines and Asthma in Children and Adolescents: Asthma Fit Study
In recent years, we have been witnessed an increase in the incidence of childhood obesity, both in Australia and worldwide. This increase was in pararell with an increase in the number of children with asthma. Therefore, it has raised the question: Are these two common conditions related?

As evidenced by numerous studies on large populations, yes; there is an association between obesity and asthma in children and obesity is a risk factor for asthma. However the linking mechanism  is not clear yet.
Recently, the role played by fat tissue in the development of heart disease, insulin resistance and diabetes has been well understood. Fat tissue is no longer considered only a storage organ. It is an active tissue that produces hormones and cytokines. Products of adipose tissue, known as adipokines, including leptin, resistin, TNF-α, PAI-1 and IL-6, have been found to induce an inflammatory state in the overweight and obese, both systemically and regionally.

The aim of this study is therefore to examine the role of adipokines and insulin resistance in children with persistent asthma, compared with healthy subjects.

Understanding the linking mechanism between obesity, insulin resistance and asthma may significantly enhance current treatment options in the management of asthma, and also possibly lead to the development of new therapies.
 
Research team:
Dr Mandana Arshi - Children’s Nutrition Research Centre, The University of Queensland
Dr John Cardinal - Department of Chemical Pathology, Endocrinology Section, Queensland Health Pathology Services, Royal Brisbane Hospital
Dr Bahram Adeli Kodehi -  Children’s Nutrition Research Centre, The University of Queensland
A/Prof Claire Wainwright, RCH Foundation Respiratory Specialist, Head of CF Services, Queensland Children's Respiratory Centre, Royal Children's Hospital,  Queensland
Dr Rebecca J Hill - Children’s Nutrition Research Centre, The University of Queensland
Prof Peter SW Davies - Children’s Nutrition Research Centre, The University of Queensland 

Dietary Interventions in Obese Young People - The 'Eat Smart' Study
Dietary change is one of the cornerstones of obesity treatment yet there is a lack of good evidence for optimal dietary approaches particularly in children and young people.

Eat Smart is a novel research study in which 2 dietary approaches to treat childhood obesity are being tested. The study is a collaboration between Professor Jenny Batch, Consultant Endocrinologist at the Royal Children’s Hospital and the Children’s Nutrition Research Centre at The University of Queensland, and commenced in January 2007. Families initially undertake a short course in life skills called FRIENDS for Life, which focuses on emotional resilience building and self esteem. Families are then randomly allocated to one of three groups:

• A reduced carbohydrate eating plan
• A structured low fat meal plan system
• A wait listed control group

For those families allocated to one of the dietary groups, this will include 6 months of support with 10 appointments at the Royal Children’s Hospital over that time. For families allocated to the control group, this will involve a 12 week monitoring (waiting) period after which they may undertake the dietary program of their choice. Eat Smart is supported by an experienced weight management dietitians and includes measures of energy expenditure, body composition and biochemical markers of inflammation.

For more information on this research please contact Ms Kim Cojean on 3365 5476 or k.cojean@uq.edu.au

Research Team
Prof Helen Truby – Monash University. Melbourne
Prof Jennifer Batch – Royal Children’s Hospital, Brisbane
Ms Kimberley Cojean - The Children’s Nutrition Research Centre, The University of Queensland
Dr Diane Jensen - The Children’s Nutrition Research Centre, The University of Queensland
Ms Sarah Elliott- The Children’s Nutrition Research Centre, The University of Queensland

Validating the use of the Waist-Height Ratio in Children and Adolescents
The prevalence of obesity is commonly determined using the Body Mass Index. The BMI is widely used in both adults and children, however, there may be other recently described indices that may be more appropriate in determining health risks, such as the waist to height ratio (WHtR).

The use of the WHtR was proposed because it has the ability to identify individuals with higher abdominal adiposity, after adjusting for their height, that are at greater risk of developing obesity related co-morbidities such as diabetes, cardiovascular disease and the metabolic syndrome. This index has been highly correlated with markers of cardiovascular disease and abdominal distribution of body fat. A cut-off of 0.5 has been established for both adult males and females for differentiating high and normal central adiposity, and this cut-off is independent of sex, age and ethnicity. The majority of studies to date have employed the use of this index in adult population studies, although they is growing interest in utilising this index in child and adolescent studies, where the WHtR has shown to be highly correlated with body composition and markers of cardiovascular health as well. The WHtR, however, has yet to be validated as an appropriate index to use among this cohort. For example, does dividing the waist circumference by height remove the influence of height? Is the cut-off of 0.5, which was developed for adult subjects, appropriate for use in children?  The aim of the Thesis is to validate the use of the WHtR in children and adolescents; to study the trends in WHtR in Queensland over the last two decades; to develop appropriate cut-offs to mark increased risk of obesity and related co-morbidities; and to test the WHtR and newly developed cut-offs to find possible associations between WHtR and markers of cardiovascular disease, body composition and common factors that previous research as shown to contribute to overweight and obesity such as the effects breastfeeding and energy intake. The results from these analysis will be compared to results using BMI and the practically of using the WHtR in public health and clinical practice will be assessed. The Healthy Kids Queensland: Physical Activity and Nutrition Survey dataset, 1985 Australian Health and Fitness Survey and Eat Smart Study will be used in the analyses.

Research Team:
Ms Smita Nambiar - Children’s Nutrition Research Centre, The University of Queensland
Supervisors:
Prof Peter SW Davies - Children’s Nutrition Research Centre, The University of Queensland
Prof Helen Truby - Monash University, Melbourne

Validation of reduced dose isotopes in the measurement of total energy expenditure using doubly labelled water
Information on energy expenditure is useful in many clinical and research settings. In some disease states, children may have altered energy requirements and reliable measures of energy expenditure enable better nutritional management of these patients. In a research setting, measurements of energy expenditure can provide useful data on the energy used in physical activity of children, an area of increasing public health concern. This research aims to validate the use of a reduced isotope dose of doubly labelled water in children, and provide an accurate, cost effective way of measuring total energy expenditure.
If using a reduced isotope dose in the DLW technique proves to be reliable and valid it would mean that energy expenditure could be measured in a wider range of clinical and research settings. This would have many potential applications, for example: children with different clinical conditions may require different dietary treatments based on their energy requirements. Treatment strategies could be improved if an accurate and cost effect way of measuring energy expenditure is more widely available. It would also enable dietitians to determine energy requirements, and validate reported food intakes more precisely. It would generate accurate control (normative) data, for use in future comparison studies utilising the doubly labelled water technique in a specific clinical population. 

Research Team:
Ms Sarah Elliott – Children’s Nutrition Research Centre, The University of Queensland
Prof Peter SW Davies – Children’s Nutrition Research Centre, The University of Queensland
Prof Helen Truby – Monash University, Melbourne

Studies of Energy Metabolism in children with Prader-Willi Syndrome
Prader-Willi Syndrome (PWS) affects between 1 in 15,000 and 1 in 20,000 live births, and can lead to morbid obesity.  This study will evaluate aspects of energy metabolism and energy balance in children with this genetic syndrome.  The influence of growth hormone therapy will also be evaluated.

Research Team:
Prof Peter SW Davies - Children’s Nutrition Research Centre, The University of Queensland
Dr Ohn Nyunt – Mater Children’s Hospital, Brisbane
Dr Mark Harris - Mater Children’s Hospital, Brisbane
Prof Andrew Cottrell - Mater Children’s Hospital, Brisbane

 
The “EAT SMART FOR SUCCESS” Study
This study is designed as a follow-on study to the Eat Smart Study.  We aim to show that, medical therapy using metformin, in addition to lifestyle modification;  will enhance the success weight loss maintenance in overweight/obese adolescents.  This trial is a randomised controlled trial of metformin vs placebo for 6 months after completion of the ‘Eat Smart’ program.  During this study, we will investigate appetite and appetite related hormones in young people:  both within and above the healthy weight range.  We will also investigate the effect of metformin on appetite in overweight/obese adolescents.

For further information, please contact Dr Diane Jensen on 0412 027 454 or d.jensen1@uq.edu.au.

Research Team
Dr Diane Jensen – PhD student, Children’s Nutrition Research Centre (CNRC), School of Medicine, The University of Queensland, Queensland Children’s Medical Research Institute (QCMRI), Royal Children’s Hospital, Brisbane
Prof Jennifer Batch – QCMRI, Royal Children’s Hospital, Brisbane
Prof Helen Truby – Monash University, Melbourne
A/Prof Neil King – Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane
Ms Natalie Webster – CNRC, Royal Children’s Hospital, Brisbane
Dr John Cardinal – Queensland Health Pathology Services (QHPS), Royal Brisbane and Women’s Hospital, Brisbane.