Nutritional and Health-Related Environmental Studies (NAHRES)

Nuclear techniques to assess body composition in children and adolescents as a risk factor in the development of chronic diseases.

Background

The increasing prevalence of obesity in childhood and adolescence is a major public health problem (1-3) because increased body fat is related to an elevated risk of the major 'lifestyle diseases' in adulthood, type 2 diabetes and cardiovascular disease (4-7). There is also evidence that the impact of these lifestyle diseases will be particularly problematic in the developing world in coming years (8). The main causes of obesity and increased metabolic health risk, physical inactivity and a poor diet, often commence from a young age (9-12) and impose a significant health burden on individuals across the socioeconomic gradient (13, 14). There is also increasing evidence that in some populations, including South Asians, health risks occur at a lower level of body fat (12). India leads the world with an estimated 40 million cases of diabetes. Another 30 million Indians are at high risk of developing diabetes with the number of cases projected to increase to approximately 80 million by 2030 (15). The current epidemic of obesity, type 2 diabetes and related cardiovascular disease might be better addressed by identifying and treating any early markers of metabolic dysfunction before they progress to a disease state. The 'metabolic syndrome' is a cluster of disorders including obesity, high blood pressure, unhealthy blood lipid levels and impaired glucose tolerance (a precursor to type 2 diabetes). Individuals with type 2 diabetes also commonly display endothelial dysfunction, an early step in the development of cardiovascular disease. A useful starting point would be a better understanding of the associations between body composition (particularly body fat) and physical activity level on markers of type 2 diabetes and cardiovascular disease risk in children and adolescents. Generation of this information would enable the development of intervention strategies to curb the growing problem of obesity and related conditions. In population health studies, a simple anthropometric index rather than body composition assessment technique is commonly used to assess overweight and obesity. The body mass index (BMI) is defined as body weight in kilograms divided by the square of height in metres (kg/m2), and the risk of type 2 diabetes and cardiovascular disease increases progressively across the BMI range in all populations. A major shortcoming of the BMI is that it cannot distinguish body fat from other tissues, nor characterize fat distribution at the individual level (11, 16). Further, there is a relatively poor understanding of the relationship between the BMI and objectively measured body fat using body composition approaches such as the deuterium dilution technique, during the growing years. A better understanding of body composition and metabolic health relationships in children and adolescents would help inform the development of intervention strategies. Improved understanding of the relationship between body fat and its distribution in children and adolescents, and initiation of long-term studies of cohorts of children from different geographical regions to define the natural history and effectiveness of interventions related to lifestyle are key recommendations of the International Diabetes Federation (17). Stable isotope techniques are the reference methods for assessing body composition and total daily energy expenditure in the community (18). Standardization of anthropometric and stable isotope techniques to assess body composition and energy expenditure is necessary the validity of international comparisons (19-21). This CRP will use standardized procedures as described in recent IAEA publications (18, 22, 23) In summary childhood and adolescent obesity is a major risk factor for obesity and related conditions in adulthood. A high level of body fat consistent with obesity has been linked to components of the metabolic syndrome and the development of type 2 diabetes and cardiovascular disease. Due to the potential long-term adverse health effects, WHO has identified the prevention and management of childhood and adolescent obesity and improved diet and physical activity as a global public health priority (24). To date, there are significant gaps in our knowledge and understanding of the relationships between body fat, physical activity level, metabolic and cardiovascular risk in children and adolescents in different settings.

Objective
Overall objective
  • To contribute new information regarding the body composition, energy expenditure and metabolic health of children and adolescents from different settings.
Specific objectives
  • To assess body composition and energy expenditure by stable isotope techniques in children and adolescents assessed in an earlier CRP and TC regional projects. Follow-up measures on previously evaluated individuals will enable a tracking of variables in a representative group of normal-weight, overweight and obese individuals (originally defined according to the WHO criteria (27)). Recruitment of additional obese individuals in different settings will provide the opportunity to add to the smaller numbers in this category of the current dataset.
  • To assess the associations between anthropometry, body composition, physical activity level and metabolic health in normal-weight, overweight and obese children and adolescents using stable isotope techniques and establish improved predictors of future health risk.
Expected research outputs
  • New data, including longitudinal data on body composition, energy expenditure, and metabolic health in overweight and obese children and adolescents from different geographical regions.
  • New data on the associations between variables of interest and the generation of new predictive models of future health risk in overweight and obese children and adolescents.
  • Publications in the form of scientific reports and peer reviewed papers.
Expected Research Outcomes
  • To contribute to improved prevention and management of obesity and related health risks in obese children and adolescents from different settings.
Proposal submission forms

Research institutions in Member States interested in participating in this CRP are invited to submit proposals directly to the Research Contracts Administration Section (NACA) of the International Atomic Energy Agency: Official.Mail@iaea.org or to Ms Christine Slater: C.Slater@iaea.org. The forms can be downloaded from http://www-crp.iaea.org/html/forms.html. For more information about research contracts and research agreements, please visit our web-site: http://www-crp.iaea.org/html/faqs.html.

Deadline for submission of proposals

Proposals must be received no later than 6 August 2010.
Transmission via Email is acceptable if all required signatures are scanned.

For additional information, please contact:
Christine Slater, Nutrition Specialist
Nutritional and Health-Related Environmental Studies Section
Division of Human Health
International Atomic Energy Agency (IAEA)
Wagramer Strasse 5
A-1400 Vienna, Austria
Phone: +43-1-2600-26059 or 21681
Fax: +43-1-2600-7
C.Slater@iaea.org

References
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  2. LOBSTEIN, T., BAUR, L., UAUY, R., Obesity in children and young people: a crisis in public health, Obes. Rev. 5 (Suppl. 1) (2004) 4e104.
  3. WANG, Y., LOBSTEIN, T., Worldwide trends in childhood overweight and obesity. Int. J. Pediatr. Obes. 1 (2006) 11–25.
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