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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Research Project #436384

Research Project: Body Weight and Health Consequences

Location: Children's Nutrition Research Center

2020 Annual Report


Objectives
Objective 1: Investigate the effect of adiposity, adipokine dysregulation (the balance of circulating anti-inflammatory vs. proinflammatory factors), insulin resistance and vitamin D concentrations on bone microarchitecture (cortical porosity, trabecular thickness), bone biomarkers and endothelial function in youth with and without abnormalities in glucose metabolism. Objective 2: Evaluate the effect of high dose vitamin D therapy in a 6-month randomized controlled trial design on change in bone microarchitecture, restoration of bone biomarkers balance and endothelial function in youth. Objective 3: In two groups of 5-year old boys and girls who are either habitual consumers or non-consumers of milk and dairy (M&D) foods, we will determine anthropometry and body composition, total dietary energy intake, total energy expenditure, energy balance, biomarkers of cardiovascular health and early risk factors for Type 2 diabetes. Repeat these measurements every year for 4 years until the children are 10 years old.


Approach
The long-term objective of this project is to provide an enhanced understanding of how altered bone metabolism in the childhood years contributes to long-term skeletal health and may play a role in glucose metabolism and cardiovascular health in obese children by examining the evolution of risk factors and biomarkers of bone health early in the course of obesity and type 2 diabetes (T2DM). Specifically, we will investigate the effect of adiposity, adipokine dysregulation, insulin resistance and vitamin D concentrations on bone microarchitecture, bone biomarkers and vascular health in youth with and without abnormalities in glucose metabolism. Given the importance of vitamin D to bone mineralization and a host of metabolic functions, we will also examine whether restoration of vitamin D sufficiency, in a randomized placebo controlled study design, has a positive effect on bone microarchitecture, bone biomarkers and endothelial function. Finally, milk and dairy (M&D) products made from milk, except butter foods are the most important food groups for young children’s growth and development, and bone health. Yet, their use as a healthy food for children has been questioned because of the belief that their high fat content may contribute to excessive weight gain. Another objective of this project aims to investigate the effect of habitual M&D foods’ consumption on energy balance and whether they also have a protective effect against early cardiovascular and metabolic diseases. Overall this project will provide an enhanced understanding of how altered bone metabolism may contribute to long-term skeletal health and play a role in glucose metabolism and cardiovascular health in obese children. It will also provide evidence that habitually consuming M&D foods protect children against obesity and cardiometabolic disease.


Progress Report
For Objective 1, we obtained final Institutional Review Board (IRB) approval for the study on December 9, 2019. We had a critical vacancy in the metabolic research unit as our nurse left the institution. We recruited and trained a new research nurse to start performing the research procedures. We obtained permission to utilize the high resolution peripheral quantitative Computed Tomography (HRpQCT) from the company to perform the radius and tibia bone scans as planned. We prescreened participants for enrollment and started study evaluations. Studies were interrupted as we halted research activity in March due to the COVID 19 pandemic per institutional and national guidelines. We resumed research activities at 25% capacity in June; however, study participation is contingent on the pandemic conditions in Houston, Texas, per local regulations. In Objective 2, we submitted the project for IRB approval for the longitudinal component of this study. The start was hampered by delays related to the investigational pharmacy timeline. Recruitment of participants in the longitudinal arm of the study was not possible because of the difficulty in enrollment under Objective 1 (as detailed above). For Objective 3, ethical permission was received from the IRB to start the study on 9/30/2019. Since permission to perform the study was received after the summer school break, we were unable to start recruitment of subjects into the study last year. This summer we cannot start because of the COVID-19 pandemic thus our project is delayed due to these factors.


Accomplishments
1. Blood sugar pattern can inform risk for diabetes in children. It is important to identify children who are at risk for diabetes as early as possible, as some children do not receive a diagnosis until their symptoms are severe. A means to determine diabetes risk is to measure one's blood sugar (glucose) after consuming a sugary drink, and how quickly the blood sugar level rises. Researchers in Houston, Texas, along with collaborators from the University of Pittsburgh investigated whether the time for glucose to reach a peak after a sugary drink is associated with levels of insulin, a hormone that is important to keep the blood sugars normal. Individuals with a "late-peak" in blood sugar levels had lower insulin production and were less responsive to insulin. These findings indicate that examining how quickly the sugar rises after a sugary drink can inform pediatricians about a child's risk for diabetes and provide for an early intervention.