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Dr. Jon McGavock of the Manitoba Institute for Child Health recently visited Ireland on his Dobbin Scholarship. He kindly wrote a report for our readers:

Childhood obesity is one of the most significant pediatric public health issues in western cultures. In most OECD countries one of every four children are overweight or obese. The public health implications of this trend are staggering.

Rates of several obesity-related chronic diseases, like type 2 diabetes and hypertension, which were unheard of in children 20 years ago, now affect up to 30% of adolescents. In the search for a culprit for this epidemic, researchers and the lay media tend to focus on factors that directly influence energy balance, like exercise and sugar sweetened beverages. Less attention is paid to hidden factors that regulate a child’s behaviour, rendering them more susceptible to poor dietary habits or sedentary lifestyle.

One of obesity’s hidden factors that is receiving a lot of attention lately is adverse childhood experiences. Large scale studies (http://acestudy.org/) have clearly demonstrated that adults who experienced adversity during their childhood, such as loss of a parent, divorce or living in a foster home, are more likely to experience diseases like heart disease, liver disease and lung diseases (http://www.cdc.gov/ace/findings.htm). The majority of the scientific literature on this topic is focused on adults and factors in childhood that could explain these trends remains unclear.

In fact, very few scientists have examined the influence of being exposed to adversity on health outcomes in children, particularly obesity. The purpose of my research experience at the Economic and Social Research Institute in Dublin was to study the link between adversity and childhood obesity in children in Ireland.

Professor James Williams, at ESRI is the principal investigator for a very unique cohort study in Ireland, called the Growing Up in Ireland Study. The study, (the largest study of its kind ever undertaken in Ireland) is designed to understand the social, economic and cultural factors that influence child development. Professor Williams and his team have enrolled 8,500 9 year olds and 11,500 at 9 month olds who they plan to follow for a period 9 years.

This cohort is the largest of its kind in Ireland and is intended to gather information that is critical for developing policies for improving child health outcomes in Ireland. I had the privilege of working with Professor Williams on this cohort and the purpose of my visit to the ESRI was to use the data from this cohort to understand the role of adversity on childhood obesity. Specifically, we compared rates of obesity among children exposed to different degrees of adversity before 9 years of age.

In addition to this experience, I had the pleasure of meeting with one of the co-investigators on the Growing Up in Ireland study, Professor Tom O’Dowd from the Department of Public Health and Primary Care at Trinity College Dublin. Together with the researchers at ESRI we developed a secondary research project aimed at understanding how children succeed in the face of adversity. To date, most researchers have focused on the negative aspects of childhood adversity.

However, there are many children who are resilient in the face of adversity (See: “Slum Dog Millionaire”). Within my own research program at the Manitoba Institute of Child Health in Winnipeg, Manitoba Canada, we have witnessed first-hand, children that thrive despite significant childhood adversity. A very common question among researchers and physicians alike when exposed to such children is: “How did they become successful in life, when so many of their peers did not?”

With Dr. O’Dowd and Richard Layte from ESRI, we decided to try and address this question. Capitalizing on the world class data from the Growing Up in Ireland Cohort, we tried to uncover the factors that lead to successful academic, social and behavioral development, despite being exposed to adversity early in childhood. The information gained from these analyses may help us design policies to support children exposed to adverse experiences to ensure they have an equal opportunity for a healthy successful fulfilling future.

I am extremely grateful for the Ireland Canada University Foundation for this extraordinary opportunity to work with the Growing Up in Ireland research team and the staff at Tallaght Hospital. The funding provided through the Dobbin Scholarship provided me with the resources and protected time to address these novel and relevant research questions.

I have recently recruited a number of pediatric residents to work on the Growing Up in Ireland cohort data to explore additional research questions related to child health. I recently presented the results of our analyses to the registrar training program at Tallaght Hospital. Together with the staff at Tallaght and ESRI we plan to develop an exchange program to support high quality research for physicians in training within Canada and Ireland.

The funding provided allowed us to plant a seed that will blossom into a lifelong collaboration between our two institutions and lead to a lifetime of discoveries aimed at improving the health of children in both countries.

Jon McGavock, March 2013