Arkansas Children’s Nutrition Center15 Children’s Way, Little Rock Arkansas 72202

Our Children, Our NutritionVolume 24 • A publication of Arkansas Children’s Nutrition Center • Fall 2015

When American author and poet Maya Angelou stated, “Life loves the liver of it,” she was not speaking of the reddish- brown, football-shaped organ located on the right side of your belly. Howev-er, if we are to take Angelou’s words to heart, then we should be mindful that living a full life requires a healthy liver.

Performing over 500 vital func-tions, the liver is the most active part of your body. It supports almost every or-gan and is necessary for survival. Its list of jobs include controlling blood sugar by storing and exporting glucose to the body; regulating the storage and export-ing of dietary fats and vitamins to the bloodstream; synthesizing and secreting proteins such as albumin, blood clotting factors, and some hormones; neutral-izing toxins; metabolizing drugs; and supplying the intestine with bile for di-gestion1. As a result of all this daily multi-tasking, the liver is at high risk for injury. Although there is a built-in safeguard, a process called regeneration, through which the liver can repair itself, this re-generative response may also become damaged and ineffective, thus reducing liver function and increasing disease risk.

In the United States, more than one-third of our pediatric population is over-weight or obese2 and are at risk for devel-oping nonalcoholic fatty liver disease, or NAFLD. Moreover, children diagnosed with NAFLD have a greater risk for devel-oping cardiovascular disease, metabolic syndrome and liver cancer as adults3,4. At the Arkansas Children’s Nutrition Cen-ter (ACNC), Dr. Kelly Mercer, who is an Assistant Professor and the Director of the Metabolomics Core, is tackling the is-sue of pediatric obesity and liver health

through nutrition. “Because obesity is the best predictor of NAFLD in children, most effective treatment strategies have focused on weight loss through calorie restriction and physical activity. How-ever, the optimal diet for treating NAFLD has not been well characterized, and emerging research suggests that diet quality may have a huge impact on the prevention of NAFLD,” says Dr. Mercer. “The liver’s primary role is to filter and process all the food stuffs coming from the digestive tract, therefore it makes sense that by modifying diet, we im-prove liver health, and potentially reduce adverse clinical outcomes in overweight children.” Her research is designed to first see how obesity alters the liver’s nutri-ent metabolism (sugars, fats, proteins) during pediatric development, and sec-ond to see how specific changes in the diet coupled with exercise, may improve weight loss and reduce liver disease risk.

Dr. Mercer also plans to include newly emerging chemistry techniques into her research design. “Metabolo-mics studies the unique chemical signa-tures of small molecules called metabo-lites, which are circulating in our bodies. Some of these metabolites are by-prod-ucts of liver metabolism, and when identified, can be used to monitor the influence of specific dietary components and physical activity on liver function.”

References:1. Taylor, Tim. “Anatomy of the Liver.” InnerBody.com.

HowToMedia, Inc., Oct 2012. Web. 14 Nov 2013. < http://www.innerbody.com/anatomy/respiratory>.

2. Ogden et al. (2014) Prevalence of obesity in the United States. JAMA. 321(2): 189-190.

3. Schwimmer et al. Cardiovascular risk factors and the metabolic syndrome in pediatric nonalcoholic fatty liver disease. Circulation 2008;118:277–283.

4. Berentzen et al. (2014) Body Mass Index in Child-hood and Adult Risk of Primary Liver Cancer. J. Hepatology. 60: 325-330.

Healthy Liver, Healthy Life ACNC HAPPENINGS

Aloha, Retirement! ACNC wishes Jan Washok, former

Administrative Assistant, all the best for a very happy retired life!

We hope she enjoys relaxing after the hard work and dedication she

provided to the Center over the last 10 years.

Head of the Class Bash Andrea Sellew, RN, represented

ACNC at the Back to School Bash at the Clinton Center held on Saturday,

August 15.

Introducing Mrs. ChamblissBreanna, Brain Lab Technician for

clinical studies, was married to Kevin Chambliss at Okaloosa Island

on April 18th.

Dr. Kartik Shankar to Serve on NIH Study Section

Congratulations to Dr. Shankar on accepting an invitation to join the In-tegrative Physiology of Obesity and Diabetes Study Section, NIH Center for Scientific Review. Study section members are selected on the basis of their demonstrated competence and achievement in their scientific disci-pline as evidenced by the quality of research accomplishments, publica-tions in scientific journals, and other significant scientific activities, achieve-ments, and honors. Dr. Shankar’s four-year term to the study section began this summer.

Dr. Jin-Ran Chen Receives 2015 ASBMR Most Outstanding Translational Abstract Award

Congratulations to Dr. Chen who has been awarded a very prestigious honor from the American Society for Bone and Mineral Research (AS-BMR). This award is given to the lead investigator of the highest ranking abstract submitted to a translational category for presentation at the AS-BMR Annual Meeting. Dr. Chen’s abstract reported results relating to how maternal obesity programs senescence signaling and metabolism in fetal osteoblasts.

Volume 24

MEET THE SCIENTIST: KELLY MERCER, PH.D.Dr. Kelly Mercer is an Assistant Professor in Pediatrics at the University of Arkansas for Medical Sciences and is the Director of the Metabolomics Core at Arkansas Children’s Nutrition Center. Dr. Mercer received a Bachelor of Science degree from the University of Dallas in 1997. As a native Arkansan, she returned home to continue her education in graduate school at UAMS and obtained her Ph.D. in 2001 from the Department of Biochemistry and Molecular Biology. Dr. Mercer’s interests lie in understanding the influence of diet on liver metabolism and function during childhood, and to determine how diet modification can prevent adverse clinical outcomes. Her most current project is examining the molecular mechanisms underlying the develop-ment of non-alcoholic fatty liver disease (NAFLD) during pediatric development in rodent offspring, and to test if dietary intervention with soy foods will reduce the risk of adult primary liver cancer associated with pediatric NAFLD. Outside of her time at the Center, Dr. Mercer enjoys running, coaching her son’s basketball team, and spending weekends at one of the many lakes around Little Rock.

ACNC Garners Awards, Publications

IS YOUR CHILD...• 9 -10 years old?• Right handed?

BRAIN FOODSTUDY

Arkansas Children’s Nutrition Center is investigating how nutrition and body composition affect a child’s brain

function and cognition.

Contact us to see if she/he is eligible to participate in the BRAIN FOOD study. Monetary compensation provided

to thank you for your time.

501.364.3309acncstudies@uams.edu

www.arkansaschildrensnutritioncenter.com

IS YOUR CHILD...• 9 -10 years old?• Right handed?

BRAIN FOODSTUDY

Arkansas Children’s Nutrition Center is investigating how nutrition and body composition affect a child’s brain

function and cognition.

Contact us to see if she/he is eligible to participate in the BRAIN FOOD study. Monetary compensation provided

to thank you for your time.

501.364.3309acncstudies@uams.edu

www.arkansaschildrensnutritioncenter.com

IS YOUR CHILD...• 9 -10 years old?• Right handed?

BRAIN FOODSTUDY

Arkansas Children’s Nutrition Center is investigating how nutrition and body composition affect a child’s brain

function and cognition.

Contact us to see if she/he is eligible to participate in the BRAIN FOOD study. Monetary compensation provided

to thank you for your time.

501.364.3309acncstudies@uams.edu

www.arkansaschildrensnutritioncenter.com

Longitudinal Body Composition of Children Born to Motherswith Normal Weight, Overweight, and ObesityAline Andres1,2, Holly R. Hull3, Kartik Shankar1,2, Patrick H. Casey2, Mario A. Cleves1,2, and Thomas M. Badger1,2

Objective: The longitudinal trajectories of body composition of children born to mothers with normal

weight, overweight, and obesity have not been evaluated using precise body composition methods. This

study investigated the relationship between maternal prepregnancy BMI and offspring body composition

trajectories during the first 6 years of life.

Methods: Healthy infants (N5 325) were assessed longitudinally (at ages 0.25, 0.5, 0.75, 1, 2, 3, 4, 5,

and 6 years) using dual-energy X-ray absorptiometry. Mixed-effects regression for repeated measures

was used to model each continuous outcome as a function of maternal BMI and covariates (race, gesta-

tional age, birth weight, and mode of infant feeding).

Results: Maternal obesity differentially impacted body fat, but not bone mineral content or density, of

girls and boys. Boys born to mothers with obesity have higher body fat from ages 2–6 years compared

to boys born to normal-weight and overweight mothers (P<0.05), whereas body composition of girls

born to mothers with obesity was not different across groups during the first 6 years of life (P>0.05).

Conclusions: This clinical observational study demonstrates a sexual dimorphism in offspring body com-

position until age 6 years based on maternal BMI, with a greater effect of maternal adiposity seen in

boys than in girls.

Obesity (2015) 00, 00–00. doi:10.1002/oby.21078

IntroductionWith the current rates of childhood and adult obesity (1), ongoing

research is attempting to understand the antecedents and critical

time periods that predict obesity development. Past focus has been

on the time periods surrounding pregnancy, early infancy, and child-

hood as critical windows that relate to future obesity development.

Key indicators of the maternal in utero environment have been

found to influence offspring fat mass (FM). Maternal prepregnancy

BMI has been reported by several studies to be positively related to

newborn FM (2-4), and offspring born to obese mothers have greater

central FM (5). However, a 2012 study found maternal pre-

pregnancy BMI was not related to infant FM (total or by region) at

1 year (6). Maternal gestational weight gain (GWG) was reported to

be positively related to offspring FM at 1 month and 6 years (7).

Further, excessive GWG on newborn FM has been reported to vary

by maternal prepregnancy BMI (3).

Other reports suggest that the relationship between total FM and

where that FM is located (central versus peripheral) is influenced by

prepregnancy maternal obesity (8). While it appears maternal obesity

influences newborn body composition, longitudinal body composi-

tion data with repeated measures are largely absent from the litera-

ture. It is less clear whether the influence of maternal obesity is

long lasting or what factors may influence the trajectory for the

development of offspring body composition in childhood. Kaar et al.

(9) collected maternal data during pregnancy and performed mag-

netic resonance imaging (MRI) scans when offspring were 10 years

old. They found that offspring born to overweight/obese women had

a greater BMI and greater volumes of subcutaneous and visceral adi-

pose tissue when compared to offspring born to normal-weight

women. This relationship may continue beyond the first decade of

life. As part of the Motherwell Birth Cohort Study, Reynolds et al.

(10) estimated offspring FM using skinfolds. A positive relationship

was found between maternal BMI and adult offspring FM at 30

years old. However, the study was conducted more than 40 years

ago when the average BMI at 17 weeks in pregnancy was 23.3 kg/

m2, and the average GWG was between 9.4 and 10 kg (10). Recent

data report the average maternal BMI before pregnancy is 25.0 kg/

m2, and average GWG is 15.7 kg (11). Therefore, older cohort data

may under-represent the relationships when compared to more

recent cohorts.

1 Arkansas Children’s Nutrition Center, Little Rock, Arkansas, USA. Correspondence: Aline Andres (E-mail: andresaline@uams.edu) 2 Department ofPediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA 3 School of Health Professions, University of Kansas Medical Center,Kansas City, Kansas, USA.

Funding agencies: USDA Agriculture Research Service CRIS 6251–51000-07D.

Disclosure: The authors declare no conflicts of interest.

Author contributions: TMB and PHC designed the study. TMB, PHC, and AA supervised data collection. MAC and AA analyzed the data. All authors were involved in

writing the paper and had final approval of the submitted and published versions.

Received: 30 October 2014; Accepted: 11 February 2015; Published online 00 Month 2015. doi:10.1002/oby.21078

www.obesityjournal.org Obesity | VOLUME 00 | NUMBER 00 | MONTH 2015 1

Original ArticlePEDIATRIC OBESITY

Obesity

Study Results Published in Obesity

Researchers at ACNC recently released findings related to the relationship between maternal pre-pregnancy Body Mass Index (BMI) and offspring body composition trajectories during the first 6 years of life. The clinical observational results, gathered from the Beginnings study, demonstrates a differ-ence in offspring body compo-sition in boys versus girls until age 6 years based on maternal BMI, with a greater effect of maternal adiposity seen in boys than in girls.

MEET THE STAFF: LINDSAY PACK, M.S.

Lindsay Pack has been a Research Associate at ACNC for almost two years. She holds a Bachelor of Science degree in Chemistry from the University of Central Arkansas and a Master of Science in Interdis-ciplinary Biomedical Sciences from the University of Arkansas for Medical Sciences. She currently works as an analytical chemist in the Metabolomics Core under the direction of Dr. Kelly Mercer. Her job duties include preparing and analyzing samples by multiple instruments, most notably the Q-Exactive Hybrid Quadropole-Orbitrap Mass Spectrometer (Thermo Scientific). When asked why she joined the staff of ACNC, Lindsay said, “I’m very proud of the research that is done here at the Center; I also enjoy the atmosphere and the location.”

Metabo-What?Metabolomics is the study of an organism’s metabolome, which is the total collection of small molecules needed for the growth, health, and reproduction of an organism. These small molecules, called metabolites, are things like vitamins and sugars that are found in the cells, tissues, and organs of your body. Looking at these metabolites helps scientists understand the chemical processes, cellular functions, and genetic makeup of an organism. For example, a difference in a person’s metabolomic profile may reflect different risks for disease- as such, metabolomics studies are becoming increas-ingly important in clinical research.

Arkansas Children’s Nutrition Center

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Brain Food Arkansas Children’s Nutrition Center is studying how nutrition and body composition affects learning and retention.

QualificationsBrain Food is a study for right handed 9-10 year olds.

CompensationTo thank you for your participation, monetary compensation will be provided. Contact us to determine eligibilty.

Expecting StudyThis study is designed to determine how the health and physical activity of a mother during pregnancy could affect the growth and development of her child.

QualificationsMoms must be healthy, less than 12-weeks pregnant, over the age of 18, have a BMI ≥ 30, sedentary, and meet other specific entry criteria.

CompensationTo thank you for your partici-pation, diapers and mon-etary compensation will be provided.

Our Children, Our Nutritionis published quarterly by

Arkansas Children’s Nutrition Center

www.arkansaschildrensnutritioncenter.com

Send comments or change of address information to acncstudies@uams.edu

Editor:Amanda Xaysuda, B.S.Contributors:Kelly Mercer, PhDCenter Director:Sean Adams, PhD

Arkansas Children’s Nutrition Center (ACNC) is part of the National Human Nutrition Research Centers Program funded by the U.S. Department of Agriculture’s Agricultural Research Service (USDA-ARS). It is housed on the campus of one of the ten largest children’s hospitals in the United States. ACNC is a partnership between Arkansas Children’s Hospital (ACH) and the USDA-ARS, in collaboration with the ACH Research Institute and the University of Arkansas for Medical Sciences (UAMS)