Joe C. Eisenmann, PhD, Lead Researcher
Helen DeVos Children's Hospital Healthy Weight Center

The opening of the new Helen DeVos Children's Hospital Healthy Weight Center is exciting not just for overweight children and their families and doctors in West Michigan, but for myself and my new colleagues at the center. Together, we will provide a dynamic, multi-disciplinary approach. 

Children referred to the center provide an important opportunity for research into the underlying genetic and environmental contributors to childhood obesity, the consequences of childhood obesity, and its assessment and treatment.

When not fulfilling my role as the lead researcher at the Healthy Weight Center, I direct the Biomarkers and Genetics Laboratory (BAGL) at Michigan State University. 

Our primary focus is to better understand the genesis of childhood obesity and the metabolic syndrome during childhood and adolescence. The long-term goal of this research is to elucidate the mechanisms of the metabolic syndrome through the complex interactions of genetics, environmental factors (particularly stress, exercise, diet, and maternal factors), and the neuroendocrine, hormonal, metabolic, hemostatic and inflammatory systems in the growing and maturing obese child. As we know in so many other disease states, you cannot simply assume that the development of a disease in a child tracks identically with its development in an adult.

It is now becoming clearer that addressing the problem of obesity in children is not as simple as just reducing their caloric intake and increasing their physical activity. For instance, we found a significant inverse relationship between the amount of sleep and the incidence of overweight in adolescent boys, although we saw no such association in girls.

We have also found an association between maternal pre-pregnancy weight status and weight gain during pregnancy and offspring obesity.  Most interesting is that we also found that children born to mothers who were obese during pregnancy but currently met physical activity recommendations still had a higher body fat than children born to mothers who were normal weight during pregnancy but currently did not meet physical activity recommendations.  This finding has important implications for interpreting the results of child obesity programs.

We also found an association between a candidate gene that, together with environmental factors, may contribute to the metabolic changes seen in overweight children.

At the Healthy Weight Center, every patient who comes into the center is potentially a research subject. To that end, I helped develop the initial comprehensive screening and clinical protocols. In addition to the obvious-full physical examination, blood pressure, dietary history, etc.we will be assessing patient and family attitudes and belief about diet and physical activity.

We will also measure their habitual physical activity level objectively through the use of the SenseWear armband. This multi-sensor instrument is about the size of an MP3 player. It assesses body acceleration and temperature and uses an algorithm to estimate the child's energy expenditure on a minute-by-minute basis.

Not only will we know how much time a child spends in moderate and intense physical activity and sedentary pursuits, but we will be able to track it by time. So, for instance, inactivity around 3 p.m. (unrelated to homework) tells us we have a target time for activity. We might suggest the child take a walk or play a game with the neighborhood kids rather than playing video games. In addition, we will also be able to better match energy expenditure and energy intake.

In addition, we will collect resting metabolic rate and expired respiratory gases through a physical activity assessment tool to evaluate a child's efficiency of movement and maximal aerobic capacity. This will help in our exercise and nutrition counseling, and in our ability to understand the child's metabolic state at rest and during movement. We will also be using a family nutrition and physical activity screening tool I helped develop that assesses the shared family obesogenic environment.

Most importantly, my job is to evaluate what we're doing (assessment and treatment) see what is and isn't effective, and disseminate these results at national and international conferences and in peer-reviewed journals. Through our work at the center, we hope to further elucidate genetic aspects of child obesity and the response to diet, physical activity and, perhaps, pharmacologic treatment.

Although we have a host of hypotheses to be tested in the upcoming months, I will facilitate the multi-disciplinary team to develop additional hypotheses to test and will update important research findings related to childhood obesity on this blog.

What do you find working with your patients when it comes to managing their weight and other metabolic factors?

Joe C. Eisenmann, Ph.D. is the lead researcher at the Helen DeVos Children's Hospital Healthy Weight Center, and assistant professor in the departments of Kinesiology and Pediatrics and Human Development at Michigan State University in East Lansing. You can view more information on him and his work at http://eisenmann.wiki.educ.msu.edu/ and reach him at jce@msu.edu.