VOL 1 § 2016 nutrition & your child

CNRC researchers find link between sleep disruption and obesity in mice Disruption to regular sleep cycles may contribute to the dramatic increase in obesity in the United States, but the biological mechanism underlying this has remained a question. In a recent study, researchers at the USDA/ARS Children’s Nutrition Research Center at Baylor College of Medicine have found that Summer camp for disruption of circadian rhythm, or sleep disruption, affects regulation of a hormone called leptin—a key hormone involved in weight regulation. overweight kids shows The study appeared in the journal Cell Metabolism. long-term success “Our findings uncover a mechanism by which circadian disruption Kamp K’aana, a fun-based weight may promote obesity even in people who are eating a healthy diet,” management camp for overweight and said Dr. Loning Fu, assistant professor of pediatrics at the CNRC. obese children ages 10 to 14, is about to “They suggest that avoiding frequent disruption of the sleep cycle celebrate its 10th anniversary, and researchers may be important for avoiding obesity and maintaining a normal at the USDA/ARS Children’s Nutrition body weight.” Research Center at Baylor College of Medicine Researchers found that frequent sleep disruption leads report that it’s having a long-term impact on to changes in how the brain senses leptin—a so-called participants. “neuroendocrine dysfunction.” In particular, it disrupts the Developed by Baylor, Texas Children’s Hospital proper levels of leptin in the blood. Leptin is produced by and Camp Cho Yeh and now managed by the fat tissue, and its levels increase when fat storage increases YMCA, Kamp K’aana is a two-week, sleep away (i.e. in obesity). Additionally, like many other hormones, camp that includes physical activities such as its levels vary over the normal 24-hour circadian cycle. swimming, horseback riding, pedal cars, soccer, Leptin normally interacts with a brain center called the basketball, lake fun, paint ball, ropes courses, a rock arcuate nucleus, where it acts to decrease food intake and wall and zip lining. stimulate energy expenditure. Thus, leptin decreases fat mass, in a normal feedback loop that helps to maintain In addition, for one hour a day, children receive a stable body weight. lesson from health educators using a curriculum designed by a multi-disciplinary team of experts on If the brain loses its sensitivity to leptin, the brake on how to achieve a healthy lifestyle. A healthy meal that fat storage is lost and excess fat accumulates. This is includes a new fruit or vegetable is served each day. called leptin resistance, which is a hallmark of obesity Parents take part in education sessions on the first and in humans. last days of camp. Additionally, families attend two follow- This study showed that frequent disruption of up reunions three and six months after camp to reconnect circadian rhythm in mice inhibits leptin function in and reinforce lessons learned. the arcuate nucleus, even when blood leptin levels “Overweight and obese children are known to have low are very high. This results in an increase in fat self-esteem,” said Dr. William Wong, professor of pediatrics storage and the development of obesity, even in at the CNRC who developed the program and is one of the mice eating a normal healthy diet, Fu said. recent study’s authors. “The summer camp program offers a “Previous reports have described the nurturing environment and activities that promote confidence. phenomenon of leptin resistance in obese We strongly believe that unless children can feel good about humans and mice, and also have found that themselves, they are not going to have any motivation to circadian disruption causes weight gain in both achieve a healthy lifestyle that could last for a lifetime.”

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, Shulman, Dr. Zev Davidovics, Davidovics, Zev Dr. Shulman, , Nutrition Enteral and Disease Center. Center. Disease

DK56338 which funds the Texas Medical Center Digestive Digestive Center Medical Texas the funds which DK56338 Journal of Parenteral Parenteral of Journal the in published study, final the In

Health, the USDA/ARS No. 6250-51000-057-02S, and P30 P30 and 6250-51000-057-02S, No. USDA/ARS the Health,

personalize this treatment,” said Shulman. said treatment,” this personalize

DK083990, and K23 DK101688 from the National Institutes of of Institutes National the from DK101688 K23 and DK083990,

diet and those kids unlikely to respond need not. We could could We not. need respond to unlikely kids those and diet The work was supported in part by R01 NR05337, UH3 UH3 NR05337, R01 by part in supported was work The

respond to the diet so that those kids could be put on the the on put be could kids those that so diet the to respond

pediatrics at the University of Connecticut School of Medicine. of School Connecticut of University the at pediatrics

up the potential to be able to identify which kids would would kids which identify to able be to potential the up

College of Medicine. Dr. Davidovics is an assistant professor of of professor assistant an is Davidovics Dr. Medicine. of College

“The FODMAP diet is not easy to follow so this opened opened this so follow to easy not is diet FODMAP “The

gastroenterology, hepatology and nutrition section of Baylor Baylor of section nutrition and hepatology gastroenterology,

Center and Dr. Chumpitazi is a member of the pediatric pediatric the of member a is Chumpitazi Dr. and Center bacteria that could digest the sugars. sugars. the digest could that bacteria

Dr. Hollister also is a faculty member of the Microbiome Microbiome the of member faculty a is also Hollister Dr.

who did respond to the diet had a higher abundance of of abundance higher a had diet the to respond did who

of Drs. Ruth Ann Luna, Tor Savidge, and Numan Oezguen. Oezguen. Numan and Savidge, Tor Luna, Ann Ruth Drs. of

of bacteria capable of breaking down sugars and those those and sugars down breaking of capable bacteria of

the direction of Dr. James Versalovic with the assistance assistance the with Versalovic James Dr. of direction the

when fed the low FODMAP diet had a lower abundance abundance lower a had diet FODMAP low the fed when

with the Texas Children’s Hospital Microbiome Center under under Center Microbiome Hospital Children’s Texas the with

The study found that those children who did not improve improve not did who children those that found study The

The microbiome studies are being done in collaboration collaboration in done being are studies microbiome The

(Fermentable Oligo-Di-Monosaccharides and Polyols) diet. diet. Polyols) and Oligo-Di-Monosaccharides (Fermentable related to alterations in the gut microbiome composition. composition. microbiome gut the in alterations to related

carbohydrates. This is referred to as the low FODMAP FODMAP low the as to referred is This carbohydrates. They suspect that this low grade inflammation might be be might inflammation grade low this that suspect They

their diet by removing certain types of sugars and and sugars of types certain removing by diet their in children and low grade inflammation in their intestines. intestines. their in inflammation grade low and children in

pain. Recently, one of these has focused on changing changing on focused has these of one Recently, pain. connection between chronic abdominal pain problems problems pain abdominal chronic between connection

employed to try to help children with chronic abdominal abdominal chronic with children help to try to employed The next stage of Shulman’s research is to look at the the at look to is research Shulman’s of stage next The

a number of different treatments that people have have people that treatments different of number a

most associated with health,” said Shulman. Shulman. said health,” with associated most

Bruno Chumpitazi as lead author. There have been been have There author. lead as Chumpitazi Bruno

disease causing as opposed to those bacteria that are are that bacteria those to opposed as causing disease

, with Dr. Dr. with , Therapeutics and Pharmacology Alimentary

promote the growth of bacteria that are potentially potentially are that bacteria of growth the promote

This was the focus of another study, published in in published study, another of focus the was This

“The condition of short bowel syndrome appeared to to appeared syndrome bowel short of condition “The

Shulman.

bacteria that are known to cause disease in people. people. in disease cause to known are that bacteria

affected by the gut microbiome composition,” said said composition,” microbiome gut the by affected

with short bowel syndrome had a higher percentage of of percentage higher a had syndrome bowel short with

“So we wondered whether or not treatment would be be would treatment not or whether wondered we “So

bowel syndrome compared to healthy children. Those Those children. healthy to compared syndrome bowel

of the same age and gender. and age same the of that the gut microbiome differed in children who had short short had who children in differed microbiome gut the that

abdominal pain problems compared with healthy children children healthy with compared problems pain abdominal bacteria are able to leak into the bloodstream. They found found They bloodstream. the into leak to able are bacteria

of the gut microbiome in children who had chronic chronic had who children in microbiome gut the of bowel syndrome to better understand why certain certain why understand better to syndrome bowel

Researchers also found differences in the composition composition the in differences found also Researchers occurred to the gut microbiome in individuals with short short with individuals in microbiome gut the to occurred

This preliminary study showed what kind of changes changes of kind what showed study preliminary This still transitioning into ‘adulthood,’” said Shulman. said ‘adulthood,’” into transitioning still

“This appears to be an age when the gut microbiome is is microbiome gut the when age an be to appears “This their intestine into their bloodstream, causing infections. causing bloodstream, their into intestine their

individuals are susceptible to is having bacteria leak from from leak bacteria having is to susceptible are individuals what was previously thought. previously was what

to maintain their health. One of the problems these these problems the of One health. their maintain to was not the same as the composition in adults, contrary to to contrary adults, in composition the as same the not was

have to receive specialized or intravenous nutrition nutrition intravenous or specialized receive to have 12 years of age, the composition of the gut microbiome microbiome gut the of composition the age, of years 12

the normal functioning of the intestine and many children children many and intestine the of functioning normal the colleagues, showed that even in children between 7 and and 7 between children in even that showed colleagues,

irreversible damage to the intestines. This radically upsets upsets radically This intestines. the to damage irreversible The study, conducted by Shulman, Dr. Dr. Shulman, by conducted study, The y Hollister and and Hollister y mil E

congenital problems or have had diseases that cause cause that diseases had have or problems congenital

healthy children and compared it to adults. adults. to it compared and children healthy

of their intestines removed because they are born with with born are they because removed intestines their of

focused on examining the gut microbiome composition in in composition microbiome gut the examining on focused

syndrome. Some infants have to have a large portion portion large a have to have infants Some syndrome.

, they they , Microbiome in published study, first their In appear.

and colleagues studied children who had short bowel bowel short had who children studied colleagues and

the ages during which chronic abdominal problems first first problems abdominal chronic which during ages the

the gut microbiome of children between 7 and 12 years, years, 12 and 7 between children of microbiome gut the

and the CNRC, and colleagues focused on understanding understanding on focused colleagues and CNRC, the and

Dr. Robert J. Shulman, professor of pediatrics at Baylor Baylor at pediatrics of professor Shulman, J. Robert Dr.

recently published on this topic. topic. this on published recently

abdominal complaints. Three separate studies were were studies separate Three complaints. abdominal

as the gut microbiome, work in children with chronic chronic with children in work microbiome, gut the as

the gut and the DNA within the bacteria, together known known together bacteria, the within DNA the and gut the

are conducting studies to understand how the bacteria in in bacteria the how understand to studies conducting are

Nutrition Research Center at Baylor College of Medicine Medicine of College Baylor at Center Research Nutrition

remain healthy. Researchers at the USDA/ARS Children’s Children’s USDA/ARS the at Researchers healthy. remain

very important in helping our immune system develop and and develop system immune our helping in important very

good bacteria. In particular, good bacteria in the gut are are gut the in bacteria good particular, In bacteria. good

one’s health, but we now know that there is such a thing as as thing a such is there that know now we but health, one’s

For many years, all bacteria were considered to be bad for for bad be to considered were bacteria all years, many For

of chronic abdominal pain in children in pain abdominal chronic of

w s it s compo microbiome ut G ion help ion ith under ith nding nding ta s

sleep disruption and obesity (continued from page 1) species. Our study is one of the first to connect these very different observations by showing that circadian disruption directly causes leptin resistance,” she said. This points to the importance of our body’s internal function in weight control, in addition to external variables like diet and physical activity. “Current diet and exercise programs for overweight individuals, especially for school children, are often inefficient for maintenance of long-term weight loss because the role of endogenous physiology in weight control is not taken into consideration,” Fu said. “Our discovery may lead to the design of more efficient programs for body weight control by decreasing the risk of both external and internal obesity risk factors for all age groups. However, adolescents may benefit most from our discovery because, compared to adults, adolescents experience a higher risk of lacking hormonal stability and often experience sleep disruption.” Others who contributed to this study include Nicole Kettner, Sara Mayo and Jack Hua, all of the CNRC; David Moore of the department of molecular and cellular biology at Baylor College of Medicine; and Choogon Lee of Florida State University. Support for the research came from the National Institutes of Health and the U.S. Department of Agriculture.

Summer camp (continued from page 1)

A recent study on the program, published in the Journal of skills home. And this study shows that this Pediatric Gastroenterology, looked at long-term (11 month) experience was successful.” outcomes of weight and BMI. The program is an important example of a Previous studies had already determined the success of the healthcare-community partnership­—most program in the short and intermediate term. At two weeks of the campers heard about the program postcamp, there was a reduction in weight and body mass from healthcare offices. Also significant is index (BMI) and fat mass among participants, with an that campers in the program to date were increase in lean body mass, indicating that the campers predominantly non-white and at least half were were losing body fat and increasing muscle. They also low-income, a population that can have difficulty had improved self-esteem and quality of life scores. After accessing typical intensive nutrition programs. three months, the new weight status was maintained on average and the self-esteem scores further improved. Kamp K’aana will be held this year The long-term study found that, on average, the reductions in BMI percentile and BMI z-score, which from June 12–25, at the YMCA of are measures of body weight that take into account Greater Houston Camp Cullen. To height and age, remained significantly improved compared with initial measures. Some campers be eligible for this specialty camp, continued to have not just maintenance of BMI children must be in the 95th percentile percentile or z-score but further improvement. of BMI for their gender and age. “We know that a two-week camp is not enough to move from obesity to healthy weight, but Find more information online at our hope has been that it is a jumpstart,” www.kampkaana.org. said Dr. Sarah Barlow, associate professor of pediatrics at Baylor and director of the Center Others who took part in the study include Alicia Farhat, North for Childhood Obesity at Baylor and Texas Texas Food Bank, Dr. Shreela Sharma, University of Texas Children’s Hospital and a study co-author. “The School of Public Health, and Dr. Stephanie Abrams, Children’s campers have a positive experience of healthy Gastroenterology MCSG, Long Beach, Calif. living that motivates them to bring those

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Nutrition & Your Child is published quarterly by Baylor College of Medicine as a research and information update for the general public and Center volunteers and supporters. Send comments or change of address information to Children’s Nutrition Research Center 1100 Bates Street Houston, TX 77030-2600 [email protected] www.kidsnutrition.org Center Director Dennis M. Bier, M.D. Publication Advisors Janice C. Baranowski, M.P.H., R.D. Nancy F. Butte, Ph.D. Marta L. Fiorotto, Ph.D. Karen W. Cullen, Dr.P.H., R.D. Teresia Margareta O’Connor, M.D., M.P.H. Stephanie Sisley, M.D. Janice E. Stuff, Ph.D., R.D. Robert A. Waterland, Ph.D. Editors Dipali Pathak and Dana Benson Office of Communications & Community Outreach Baylor College of Medicine

The Children’s Nutrition Research Center is operated by Baylor College of Medicine, in cooperation with Texas Children’s Hospital, for the Agricultural Research Service of the United States Department of Agriculture.

Join a CNRC volunteers Nutrition Study! Houston-area residents are Adult Volunteers Needed location monitor for 3 hours (one time only). Your child invited to participate in the H-34291 Healthy, overweight will be asked to perform a series of tasks at your home following nutrition research volunteers aged 18 to 65 and and neighborhood with the assistance of a research staff projects designed to help volunteers diagnosed with type 2 member. The child’s parent has to be with him/her at all CNRC scientists learn more diabetes within the last three years, times. Study requirements are healthy children ages 3 to 5 about the nutritional also aged 18 to 65, are needed for a years old, family owns a car with child car seat, parent needs of children. Free metabolic study. These volunteers will has a valid driver’s license. parking is provided. For help researchers determine whether Fatty Liver H-31469 11- to 21-year-old overweight most studies, financial healthy volunteers, type 2 diabetics and adolescents and young adults with and without liver compensation is provided ketosis-prone diabetics make an important disease are needed for a research study investigating and transportation may compound called arginine in different risk for early heart disease in youth. Study involves body be available. amounts. Healthy, overweight volunteers composition, liver scan and blood tests. should have no chronic medical conditions For more and all who reply should consume a diet Newborn Colic H-35001 Do you have a baby with information adequate in calories and protein. Women fussiness? Gas? Spitting up? Tummy pain? Trouble with on any of the must not be pregnant. bowel movements? Researchers at Texas Children’s following Hospital and Baylor College of Medicine are seeking infants CNRC nutrition Baylor Infant Twin Study (BITS) between 14 and 28 days of age for possible participation in studies, H-36097 Do you expect or have twins less a feeding study. You must be able to read and understand contact Marilyn than 4 months of age? We are seeking twin English and have telephone access to be eligible. Navarrete at infants for a research study being conducted SEEDS H-28013 Ayuda a los científicos aprender sobre las 713.798.7002 or on twins from 4 months through 3 years of age experiencias alimenticias de los niños con su participación [email protected]. to learn more about infant and child feeding and en clases educativas y actividades alimenticias con otras behavior. Two visits are required at the Children’s familias. Todas las madres serán recompensadas por su Nutrition Research Center and other visits are tiempo en cada día de pruebas. Las clases se llevaran a cabo conducted by mailed questionnaires. en el código postal 77016, 77022, 77039, 77044, and 77093. Children’s Physical Activity in the Teen Heart Health H-30665 13- to 18-year-old adoles- Neighborhood H-34292 Researchers at Baylor cents and young adults (normal weight and overweight) with College of Medicine want to study how neighborhoods and without type 2 diabetes are needed for a research study influence young children’s physical activity. If you enroll, investigating risk for heart disease in youth. Study involves your child will be asked to wear activity monitors and a body composition, heart scan and blood tests. GC71197