Monthly Archives

October 2018

Dr. Andrew Mente in the produce aisle of a grocery store

The evolving relationship between diet and health

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By Dr. Andrew Mente
Principal Investigator, Population Health Program, Population Health Research Institute
Associate Professor, Health Research Methods, Evidence and Impact, McMaster University

Understanding how food affects our health is not a new journey, but as our societies change and evolve, so must our explorations.

In the early 1900s, researchers were focused on the role of vitamins and minerals in human health, since common conditions like scurvy were a result of nutritional deficiency. By the 1950s, Western countries saw a major increase in heart disease, so attention shifted to the “heart-healthy diet”. While this concept is still in focus today, it’s being examined through many new and different lenses.

Early Western-led studies on the effects of nutrition on health focused only on Western countries, and it was these studies that provided the evidence that informed global dietary guidelines. Since then, we’ve learned much more about nutrition around the world and we know now that we can’t take a ‘one-size-fits-all’ approach to educating people about nutrition. Increasingly, as researchers, we need to look from a global perspective as we continue to explore the relationship between diet and health. Because health concerns like heart disease are now a global issue, broadening our scope can have a greater impact and help people around the world live healthy lives.

Broadening our scope can help people around the world live healthy lives.

In 2002, myself and a team of researchers at Population Health Research Institute began the challenge of capturing dietary patterns on a global scale. This is ongoing, but we’re analyzing data from over 50 countries on six continents to explore how food intake affects the health of people all over the world from all walks of life.

So far we’ve learned that, contrary to popular belief, a higher intake of fat is actually linked to lower health risks. By contrast, a diet higher in carbohydrates is associated with a higher health risks. This means that a moderate amount of fat and lower intake of carbohydrates is best for our overall health.

As expected, a high intake of salt increases a person’s risk of health problems such as heart disease. However, we also found that a very low intake can be detrimental, too. This means that a moderate intake is salt is the healthiest option – an amount that the majority of people already consume.

Our work is already challenging common nutritional wisdom.

We also believe a strong case can be made for increasing the consumption of potassium-rich foods since we’ve found that it contributes to decreased rates of stroke in people from all countries. Since fruit, vegetables and certain dairy foods are high in potassium and consumption is low worldwide, this may be a good place to start.

These are only a few observations so far. However, our work is already challenging common nutritional wisdom and will hopefully begin to influence public health recommendations.

Since one of the largest research biobank’s in the country is onsite, we’re lucky to continually have access to the samples collected. This means the opportunities are endless on our nutritional explorations. We hope to venture into finding out why we’ve found these results – what the foods or nutrients are doing within our bodies to cause heath issues like heart disease and stroke.

For now, regardless of our dietary guidelines, “everything in moderation” is the key.

Dr. Andrew Mente, explorer

Stelios Georgiades, autism researcher, explorer

Autism research should be based on individual strengths

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By: Dr. Stelios Georgiades
Co-Director, McMaster Autism Research Team (MacART)
Scientist, Offord Centre for Child Studies
Assistant Professor, Psychiatry and Behavioural Neurosciences, McMaster University

Autism is challenging and complex. It impacts different aspects of life in different ways. It changes throughout development and over time. It touches no two people the same.

However, traditional research approaches to autism tend to “lump” children into large groups based on their symptoms and behaviours at any given point in time. These approaches are too simplistic and don’t capture the complexity and diversity we see across the spectrum and the lifespan. Bottom line – much of our research efforts to date have had limited success in advancing autism care.

We hope to inform the development of more individualized and adaptive, family-centred services and supports.

In my opinion, autism is about diverse perspectives and how these are communicated. How do children with autism see the world? How do they see themselves in the world? How does the world see them? These perspectives shape how each child interacts differently with their family, peers, teachers, care providers, and community. If we can better understand these interactions and the perspectives that influence them, we can help support the child along the most appropriate developmental path.

So, my colleagues and I at the McMaster Autism Research Team (MacART) and the Offord Centre for Child Studies are exploring autism using a strengths-based approach to understand how children grow and develop within their surroundings. Ultimately, we hope to inform the development of more individualized and adaptive, family-centred services and supports.

Our new Pediatric Autism Research Collaborative (PARC) project is embedded within the autism clinic at the Ron Joyce Children’s Health Centre of McMaster Children’s Hospital. Our research team is working alongside clinicians to gain a better understanding of which services, or combinations of services, contribute to healthier outcomes for children with autism. Of course, there is no one answer for this, so we’re hoping to find some positive trends that can help parents and care teams navigate the system effectively for each child.

An optimal outcome should be based on each child’s personal characteristics and individual growth over time.

As autism researchers, we’re not striving for a single discovery. Instead, we aim to ensure that every child with autism has an “optimal outcome”. But first, we want to re-define what that means.

In my 15 years as an autism researcher, I have had the opportunity to work with some of the world’s best clinicians and scientists. But, the most valuable lessons I’ve learned are from my interactions with children with autism and their families. Based on this, my team and I believe that an optimal outcome should be based on each child’s personal characteristics and individual growth over time, within a system of care that adapts to their changing needs. That’s the vision we’re working toward.

Katie Porter, Explorer, HHS Research Administration

Exploring a healthier community together

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By: Katie Porter, Director of Research Administration, Hamilton Health Sciences

At Hamilton Health Sciences (HHS), research isn’t something that happens on the outskirts of health care. Health care and research come together to provide the best care for our patients. Our researchers are our health care professionals – doctors, nurses, therapists, even students. The patients and families we serve aren’t just at the heart of the care we provide, they’re at the heart of our research explorations.

Our desire to discover runs deep. Many of us live in the communities we serve. We understand the unique health challenges we face and recognize that we all have a vested interested in discovering alternative treatments and therapies. The vision that together, we can create a healthier future for our families, friends and neighbours inspires us. We are finding ways to change health outcomes in our community from child and youth mental health to mobility in older adults. Here are two examples.

The vision that together, we can create a healthier future for our families, friends and neighbours inspires us.

For the first time our researchers are working with clinical staff and physicians, patients, families and care givers to explore ways to improve the delivery of Autism Spectrum Disorder (ASD) services. We’re trying to gain a better understanding of what contributes to healthier outcomes for patients with ASD by utilizing the data already collected. Determining how best to navigate ASD services leads to improved care and ultimately provides these kids with more opportunities to become active members of our community in the future.

We’re also exploring ways to ensure our older patients stay healthier longer as our population ages. We’re bringing our best minds into their homes to make their lives better from day one. Our researchers are providing one-on-one support on medication management, nutritional coaching, and physical activity as well as moral support. Patients speak highly of the relationships they form with the research team, and the positive impact they’ve had on their daily lives. For one patient, the study helped him return to his love of skating.

Research is not about numbers, it’s about people.

Research is not about numbers, it’s about people. We’re looking for answers to the questions our patients and our communities are asking. Working with our patients to explore a healthier future for all of us is what makes it to rewarding.

Dr. Stacey Marjerrison

Improving care for Indigenous children with cancer

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Written By: Dr. Stacey Marjerrison, pediatric oncologist at McMaster Children’s Hospital and assistant professor at McMaster University.

Treating childhood cancer is an incredible privilege. Most days, I get to meet families facing their worst nightmare, and have the honour of watching them find strength they didn’t know they had. I get to giggle with kids who somehow manage to find joy and humour in the most trying circumstances. I get to say the words: “the cancer is in remission” and see parents’ faces light up with relief. But, that isn’t every day.

One in five children with cancer will not survive. We do not yet have the tools to save every child’s life. We do, however, have the tools to make their cancer journey better. When days get tough, being able to take a step back and think about how I can improve the cancer journey for all of the families that I help care for makes those awful days easier.

We know that for marginalized families, the cancer journey is tougher than average. Families from low-income neighbourhoods and low-income countries face additional hurdles to those of an average family. Among them are Indigenous families living in Canada. Improving care for marginalized families, including Indigenous families, is the major focus of my research.

I noticed early in my career the differences in survival that Indigenous kids with cancer were facing.

I’m a childhood cancer doctor and a researcher, but I am not an expert on Indigenous health. I noticed early in my career the differences in survival that Indigenous kids with cancer were facing across American studies. Working with experts in Indigenous health, I set about trying to answer the question being asked by many of our Indigenous patients: does this difference also exist in Canada? Our analysis in Ontario showed that First Nations, Inuit and Métis kids diagnosed with childhood cancer had about a 15 per cent lower survival rate than the general population. But, we noted that this difference doesn’t seem to be due to factors such as the time it took for a child to be diagnosed, their adherence to treatment, individual characteristics (age, gender, nutritional status), the severity of the disease, or the strength of the treatment. Our findings differed from a study from Manitoba (which showed no worse outcomes for First Nations children), so we’re now working together on a Canadian-wide analysis. We hope this will help us discover if outcomes have been worse for Indigenous kids with cancer, and if so, why this difference exists and how we can close the gap.

Research is an opportunity for us  to learn how we can make the cancer journey easier for our patients and their families.

Beyond survival, we must also improve the health journey for families. We know that Indigenous Canadians often face systemic racism when interacting with the healthcare system, and when participating in healthcare research. Working with Dr. Chelsea Gabel – an expert in Indigenous well-being – my colleagues and I published a review of ways to improve Indigenous health research in Canada. Ensuring meaningful partnership with Indigenous communities and scholars, considering Indigenous methods and methodologies, and making sure that research findings are considered within the context of Colonial history and current inequities are some of the ways forward.

We also need to ensure that healthcare providers are educated to provide culturally safe and informed care to Indigenous patients. As such, I’m helping to develop new curricula for post-graduate students under the umbrella of the McMaster University Faculty of Health Sciences Indigenous Health Initiative. We hope to build on the lessons we’re learning through a qualitative evaluation of the pediatric residency curriculum this past year, applying our findings across the programs at McMaster.

Inside the hospital, we also hope that the recent opening of Mkoonhs Zhongehgii Iako’nikonhrahnira:ton, our Indigenous family room at the McMaster Children’s Hospital, creates a space where all our Indigenous families feel welcome.

Finally, on an international scale, I’m working with global experts to evaluate how to safely integrate Traditional and complementary medicines into childhood cancer care; a priority for many Indigenous Peoples.

Walking with families through their childhood cancer journey is an honour. Research is an opportunity for us – as healthcare providers – to learn how we can make that journey easier for our patients and their families.

researcher and lab technician in the lab

Leading thrombosis care

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Hamilton Health Sciences and McMaster University are the epicenter of thrombosis research in Canada and the world. Through their ground breaking discoveries, our experts have set the global standards for the prevention and treatment of thrombosis, a common threat that causes one in six deaths worldwide.

Setting the standard for treatment

Thrombosis – or the “bad” kind of blood clotting – causes heart attack and stroke. Our scientists lead many important global projects that have set the standard on how and which drugs are most effective in preventing thrombosis-related issues in those at risk.

People with atrial fibrillation (AF), a common heart rhythm disorder, are especially susceptible to blood clotting and often live with the fear of stroke looming over their heads. In the past, a drug called warfarin was used to reduce the risk of blood clots and stroke in people with AF. But, Dr. Stuart Connolly and his colleagues have proven that the new, blood-thinning drugs are safer and far more effective, meaning those with AF can live with a lower risk of stroke and greater peace of mind.

People who have had a heart attack, stroke or arterial disease share the concern of blood clotting and the complications it brings. Dr. Salim Yusuf (pictured, p. 3), Dr. John Eikelboom and their colleagues have led the charge on a series of studies that have proven that combinations of certain drugs with aspirin, commonly used to prevent blood clotting, are more effective in preventing clotting-related issues than aspirin alone. Their findings can change how we treat these patients in Canada as well as in other parts of the world. Ultimately, fewer lives lost to the very real threat of thrombosis-related disease.

Safer treatment, at home

Our scientists have pioneered discoveries that have made thrombosis care safer and more effective. So effective, that many patients can now benefit from receiving treatment from home instead of a hospital bed.

Previously, those with venous thromboembolism (VTE) – a blood clotting disease affecting the veins – required specialized treatment in hospital to help keep potential problems like stroke and heart attack at bay. But, Dr. Jeffrey Weitz and his team have focused on advancing treatment of VTE so that, in most cases, the disease can be safely managed at home using medication. For hospitals, it means more room to care for the patients who really need it, and for those with VTE, it means a better quality of life.

 

This article is featured in the latest Explorers publication.