May 2011 - Clinical, translational, and basic science researchers and clinicians gathered at UMass Medical School on Monday evening, May 16 to launch the new Community of Scholars Symposia. Dr. Gyongyi Szabo, a practicing gastroenterologist/hepatologist and physician scientist at the Medical School kicked off the event with an overview of goals of the symposia: to identify future research and collaboration opportunities for the advancement of health and science. Dr. Julia Johnson, chair and professor of obstetrics and gynecology, introduced the first symposium topic: Predicting, Altering & Optimizing the Cardio-metabolic Health and Weight of Mothers & Children. “Pregnancy as an altered state of health, with increased risks of diabetes, hypertensive disease, weight gain and obesity, offers a window to explore the larger impacts on immediate and long-term maternal and offspring health,” noted Johnson.
Experts from the Medical School and UMass Memorial Medical Center, UMass Amherst and Tufts University offered perspectives from the fields of behavioral and preventive medicine, epidemiology, psychiatry, community health, pediatrics, and obstetrics/gynecology.
Dr. Tiffany A. Moore Simas1, a clinician, researcher, and educator in the department of obstetrics and gynecology reviewed the history of guidelines associated with body mass index (BMI) and gestational weight gain (GWG). She highlighted an evolving optimal standard: a 15-pound weight gain guideline for women during the 1930s; 20-27 pounds in the 1970s; to no single standard through the 1990s. With a growing body of evidence concerning the negative outcomes associated with excessive weight gain during pregnancy for the mother and child, the Institute of Medicine (IOM) revised its guidelines for gestational weight gain in 2009. Moore Simas underscored, “Even with updated guidelines, awareness of them and adherence to them remains low, with only 1/3 of women following them”.
Dr. Olga Hardy4, a pediatric endocrinologist in the department of pediatrics presented data regarding obesity in both adults and children, with particular urgency associated with infant obesity. Calling childhood obesity and epidemic, Hardy demonstrated the strong relationship between gestational weight gain and child obesity with alarming potential for negative health outcomes
Dr. Milagros C. Rosal2, a behavioral psychologist with the division of preventive medicine, called weight loss within six months post-partum critical to the mother’s long-term health, noting that post-partum weight retention after six weeks averages 3-7 kilograms. At ten years, average weight retention is three kilograms per pregnancy. Rosal’s work includes obesity and diabetes prevention and management. In discussing preliminary work conducted by Rosal and colleagues with women enrolled in the Women, Infant and Children (WIC) program to facilitate post-partum weight loss, Rosal noted the challenges of working in real world settings and populations.
Dr. Silvia Corvera3 brought a basic science perspective to the symposium. A professor of molecular medicine, she recently expanded her group’s work to include studies that clarify the factors that control angiogenesis in human adipose tissue, a process crucial for adipose tissue biogenesis, distribution and function. Corvera showcased recent work showing that obesogenic diets induced inactivity in mice. “Though we don’t yet have a way to test this in humans, research with animal models may prove valuable in fighting the increase in human obesity and diabetes, especially since we know that where the weight is deposited [adipose tissue in the abdomen is more risky in humans]," Corvera said.
A postdoctoral research fellow at Tufts University’s Friedman School of Nutrition Science, Dr. Alison Tovar, has studied community-based interventions to prevent obesity in ethnic minority populations. Presently working on a community-based participatory intervention to reduce or moderate weight gain in new immigrant mothers, Tovar stressed the need to move beyond interventions based only in the clinic setting. She uses the social ecological framework for obesity prevention research and agreed with Dr. Moore-Simas that knowledge of weight gain guidelines is low, making adherence more difficult.
Dr. Lisa Chasan-Taber, an associate professor of epidemiology in the School of Public Health and Health Sciences at UMass Amherst, studies reproductive epidemiology and is nationally recognized for her expertise on physical activity during pregnancy. Discussing the impact of physical activity on GWG and gestational diabetes, Chasan-Taber explained, “Walking is an important tool to prevent/reduce the incidence of gestational diabetes during pregnancy,” noting that gestational diabetes is highly associated with type 2 diabetes. Further, “pregnancy is an important teachable moment for many women as they may be more willing to make positive health changes at that time,” said Chasan-Taber.
An attentive audience responded during a highly interactive question and answer panel led by Dr. Mary Lee. Among the intriguing questions posed:
· What is the role of the father in gestational weight gain?
· How do cultural differences in perceptions of weight impact weight gain during pregnancy and weight loss postpartum?
· While much research focuses on the mother as generating their gestational weight gain, is it possible that the baby plays a bigger role? Are some babies more hungry than others, causing their mothers to eat more/gain more weight?
1,2,3 Drs. Moore Simas, Rosal, and Corvera are currently collaborating on a research project: Percent Dietary Saturated Fat Composition in Pregnancy and Post-Partum Weight Loss with pilot funding from the UMass Center for Clinical and Translational Science (UMCCTS). 4Dr. Hardy is the first Clinical Research Scholar at the Medical School, funded in part through the UMCCTS.
The symposium was co-sponsored by the Department of Obstetrics and Gynecology and the UMass Center for Clinical and Translational Science.