Search

Pregnancy is a 40 week-long journey for both mom and baby. This time of growth and development can have impacts on current and future health including a person’s risk of diabetes. Specifically for women who are obese, research has shown this group is at higher risk of adverse pregnancy outcomes like gestational diabetes. What do these concerns mean for both mom and baby, and how can an individual help improve outcomes?

Not only do one third of obese pregnant women develop gestational diabetes, they are also more likely to deliver babies with neonatal adiposity – a term to describe an increased amount of fat. These babies are more likely to be obese in childhood which increases their risk of developing type 2 diabetes. 

In a new analysis from a multi-centre randomized clinical trial, researchers found that counselling obese expectant mothers on both healthy eating and physical activity during pregnancy reduced the risk of neonatal adiposity. In particular, less time spent sitting was associated with improved outcomes. This is the first study to show that a lifestyle change during a mother’s pregnancy can influence the amount of fat present in a baby at birth. 

The DALI Lifestyle Study included expectant mothers classified as obese from nine European countries and a total of 334 babies. The expectant mothers were randomized to receive lifestyle counselling on physical activity, healthy eating or a combination of the two during pregnancy, and were compared to a control group of women who received no counselling. 

The study found that mothers who receive combined counselling on healthy eating and physical activity gain less weight during pregnancy, increase their physical activity, improve their eating habits and reduce their time spent sitting. But, most importantly, their babies have less fat at birth when compared to babies from women who did not receive lifestyle advice.

Since weight alone is not an accurate marker, the amount of fat for each baby was determined through a number of measures including skinfold thickness and estimated fat percentage. 

“We wanted to take a closer look at what specific lifestyle change was related to this reduction in fat. Through further analysis, we found that it was the amount of time spent simply sitting,” says Dr. David Hill, Lawson Scientist and collaborator on this study. “As part of recommendations on healthy eating and physical activity, pregnant women who are obese should be counselled on ways to reduce the time they spend sitting.” 

Less time spent sitting was also associated with reduced levels of leptin, a hormone produced by fat tissue and the placenta. When levels become too high during pregnancy, this hormone can inhibit insulin production and increase the risk of gestational diabetes. Reducing levels of this hormone during pregnancy may help lower risk of gestational diabetes and prevent transfer of excess nutrients to the fetus, which is then stored as fat. 

“Treating pregnant women with medication to control gestational diabetes risks unwanted effects on the fetus,” explains Dr. Hill, also a Professor at the Schulich School of Medicine & Dentistry, Western University. “Identifying effective lifestyle modifications would be the safest, most affordable method of preventing short-term and long-term disease for both the mother and baby.” 

Dr. Hill’s research focuses on understanding gestational diabetes. His team is testing novel drug interventions with the potential to prevent the disease. This includes exploring new molecules identified through the DALI study.

The study, “A reduction in sedentary behaviour in obese women during pregnancy reduces neonatal adiposity: The DALI randomized controlled trial,” is published in Diabetologia. Lawson researchers designed the research database used for the DALI study, and archived and supervised use of the research data. 

Image

Above: Dr. David Hill

St. Joseph’s Health Care London and Lawson Health Research Institute have announced plans to move forward with clinical trials testing a drug that could potentially be used to prevent and treat COVID-19. St. Joseph’s Health Care Foundation will accelerate the creation of the studies by providing seed funding to get the research started through donor support. Based on the immediate need, The St. Joseph’s Health Crisis Fund has been created by St. Joseph’s Health Care Foundation to enable these and other research studies currently in development through Lawson, the research arm of St. Joseph’s. 

While supporting urgent COVID-19 clinical trials will be an immediate focus, The St. Joseph’s Health Crisis Fund will also support critical patient care equipment and care and comfort items for healthcare staff and volunteers working on the frontlines of the pandemic across St. Joseph’s.

Led locally by Dr. Michael Silverman, Medical Director of St. Joseph’s Infectious Diseases Care Program, one trial will assess the safety and efficacy of using hydroxychloroquine (HCQ) to prevent COVID-19 in health care workers recently exposed to the virus. This trial will also assess the drug as a treatment for non-hospitalized patients with mild cases of the illness. St. Joseph’s will be one of many participating sites in the trial, which is being led by the Research Institute of the McGill University Health Centre.

“There is much debate surrounding the drug hydroxychloroquine. We do not yet know whether it’s safe or effective, and it should not be routinely recommended until we do,” says Dr. Silverman, also a Lawson Associate Scientist and city-wide Chair/Chief of Infectious Diseases. “We plan to carefully study the drug through a randomized controlled trial and assess whether it can help combat COVID-19.”

Dr. Silverman is also partnering with Dr. Michael Borrie, Geriatrician at St. Joseph’s and Lawson Scientist, on a prevention trial to test the safety and efficacy of the drug for patients and residents at Parkwood Institute who have been exposed to COVID-19. They are at a higher risk of infection, as well as serious complications and potential admission to acute care.

“There are two critical goals with this prophylactic trial,” explains Dr. Borrie. “First, we want to see if the drug, taken for five days, is safe for the participants in the study. We will then look to see whether it is effective to prevent illness or lessen symptoms and complications.” 

They are testing whether HCQ may inhibit the coronavirus similar to how the antiviral drug Tamiflu is used to prevent influenza after exposure. The research team will recruit patients and residents who have been accidentally exposed to the virus by a confirmed or presumed case of COVID-19, but who aren’t yet experiencing symptoms. In addition to cardiograms and blood tests for safety, they are collaborating with Dr. Saman Maleki, Lawson Scientist and Immunologist, to analyze the blood for a variety of indicators including the presence of antibodies and immune response. They will collect clinical data and information on common health conditions to gain insights into why some vulnerable individuals get the disease and others don’t.

“We are aware of two small studies that were published rapidly last week, one in France and the other in China, testing the use of chloroquine for potentially treating COVID-19. Further studies are greatly needed,” adds Dr. Borrie. “This study at Parkwood Institute is a good start and we hope to have other Canadian sites join us in recruiting participants so that we can offer statistically significant results as soon as possible.”  

Those interested in donating to St. Joseph’s Health Crisis Fund are asked to visit St. Joseph’s Health Care Foundation’s website to learn more at sjhcfoundation.org. Donations can be made online, through direct mail submissions or by calling the Foundation directly at 519-646-6085. 

“The Sisters of St. Joseph, who founded our organization, faced contagious diseases and other pandemics at different times in our 150+ year history,” says Michelle Campbell. “Today, it’s a different time, and a new disease. Now, more than ever, we ask our community to help us address the crisis facing us all.” 

In the news:

• Global News - London, Ont., researchers to study hydroxychloroquine’s potential to prevent, treat coronavirus
• CTV - London researchers testing drug to prevent COVID-19 spread in long-term care homes
• The London Free Press - New fund set up to help bankroll London research into COVID-19 drug

During a virtual event for Londoners hosted by Lawson Health Research Institute and the City of London, a multi-sectoral research team announced two projects representing a collaborative approach to preventing homelessness from within hospital walls. 

Built on the unique and successful No Fixed Address (NFA) strategy, these projects are being tested as a potential best practice for preventing hospital discharge to homelessness. 

Led by Dr. Cheryl Forchuk, Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, and Assistant Scientific Director at Lawson, NFA seeks to stop the cycle between hospital admissions and homelessness by providing timely and accessible supports to patients who would otherwise be discharged into homelessness. It brings housing and financial supports into the health-care system, starting as soon as upon admission, to assist in finding appropriate housing and supports or avoiding a potential eviction. 

Several departments at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London collaborate with staff from the City of London, Canadian Mental Health Association (CMHA) Elgin-Middlesex, Youth Opportunities Unlimited (YOU), Salvation Army’s Housing Stability Bank and Ontario Works in the City of London to provide direct, on-site (or virtual) support for patients at risk of homelessness.

Patients discharged from hospital to homelessness in Canada face many challenges that make recovery more difficult. They often experience higher readmission rates and emergency department visits. This is particularly concerning for youth, who have been found to be the fastest growing segment of the homeless population.

NFA was initially tested with strong success for mental health patients across the city and the second version of the project was extended to medical units at LHSC’s University and Victoria Hospitals.

PROJECT 1: Collaboration to Address Homelessness - Health, Housing and Income (H2I) 

This research study will evaluate the City of London’s Coordinated Access Outreach program at hospital sites. A Coordinated Access Outreach worker will support individuals at risk of homelessness to maintain or obtain housing. Ontario Works will assist with the provision of income and employment supports and the Salvation Army Housing Stability Bank may be accessed for needed financial resources to secure or maintain housing.  

Over two years, 106 participants will be interviewed in hospital and again six months post-discharge. Focus groups with participants, health care providers and community partners will provide further insight into the effectiveness of NFA. This project is funded by the Canada Mortgage and Housing Corporation (CMHC)’s National Housing Strategy. 

PROJECT 2: Preventing discharge to No Fixed Address – Youth (NFA-Y) 

This research study will customize, implement and evaluate the NFA strategy for vulnerable youth agSwitch to plain text editores 16-24. The unique health and housing needs of youth at-risk will be explored by streamlining housing and financial support into a coordinated system of care, with additional support provided by Youth Opportunities Unlimited and Children’s Aid Society London and Middlesex. 

Over 3-4 years, data to be collected from 93 youth at three time points. Focus groups with youth participants, health care providers, and community agency partners will help enhance the NFA strategy to meet the unique needs of youth. This project is funded by the National Centres of Excellence (NCE) Making the Shift (MtS) Youth Social Innovation Lab. 

Media Coverage 

• Could this project keep discharged hospital patients from homelessness? - London Free Press 
• London, Ont., expands work to prevent homelessness after hospital stays - Global News
• London expands strategy to curb homelessness after hospital stays - Blackburn News 
• What happens to people who are discharged from hospital if they have nowhere to go? - CBC London

Learn more about No Fixed Address 

• Expanded No Fixed Address strategy houses half of those in danger of homelessness   
• Funding for unique strategy to prevent homelessness after hospital discharge

Over 400 learners, faculty and researchers from across London Health Sciences Centre (LHSC), St. Joseph’s Health Care London (St. Joseph’s) and Western University gathered for London Health Research Day (LHRD) on May 7, 2024. 

LHRD is one of southwestern Ontario’s largest cross-disciplinary health research conferences, and is presented in partnership by Lawson Health Research Institute (the research institute of LHSC and St. Joseph’s) and Western’s Schulich School of Medicine & Dentistry and Faculty of Health Sciences. It is an opportunity for students to share innovative research on a wide variety of health topics, practice science communication, network, and learn from an insightful keynote presentation and informative workshops.

“There is an amazing diversity of health research being conducted in London, Ontario right now, all represented at this event,” says Dr. David Hill, Interim Research Executive and Scientific Director for London Health Sciences Centre (LHSC). “Looking at all these presentations, the future of health research is bright.”

More than 420 guests, 340 poster presenters, 50 volunteer judges and 24 symposia speakers registered to attend the event held at Western University. 

“An event like this, focused on health research by learners, provides an outstanding opportunity for our trainees to showcase their research and network with peers and leaders in the field,” says Susanne Schmid, Vice Dean of Basic Medical Sciences at Schulich Medicine & Dentistry. “As one of the largest health research gatherings in our city, London Health Research Day not only highlights the amazing work being done at Western, LHSC and St. Joseph’s, but also underscores the powerful collaborations that drive our success.” 

Dr. Lisa Porter, Vice President, Research and Scientific Director at St. Joseph’s, was also on-hand to speak with presenters and learn more about ongoing research.

“I am so proud of the great research happening in London,” says Dr. Porter. “This event is a wonderful opportunity to explore the fabulous research and see what the future holds for health care.”

The event was preceded on May 6 with a public lecture by Dr. Mark Daley, Chief AI Officer at Western University, who addressed how artificial intelligence (AI) has the potential to change the future of health research and the lives of Canadians. The potential of AI to address ongoing challenges in health care, was echoed by keynote speaker Dr. Laura Rosella, Canada Research Chair in Population Health Analytics at the University of Toronto.

The impact of technology on health research was already visible in many of the projects presented by learners, highlighting the rapid advancement of health research in London, Ontario.