TARGetting kids for a healthier future

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Imagine being able to predict – and prevent – whether a 2-year-old will be at risk of developing high cholesterol and suffering from a heart attack at the age of 45? A collaborative initiative called TARGet Kids! is attempting to do just that.

“We’re linking nutrition during early life to chronic diseases and health problems in later life,” said Dr. Jonathon Maguire, one of the lead investigators of TARGet Kids! and a pediatrician and scientist at St. Michael’s Hospital. “What happens to us as a child has lasting impacts over the course of our lives. Studying nutritional health in the early years may lead to  tremendous benefits in preventing health problems that affect us later on.”

Three years ago, researchers and children’s health care providers (family physicians and pediatricians) from St. Michael’s Hospital and the Hospital for Sick Children came together to form TARGet Kids! – which stands for The Applied Research Group for Kids! – the only primary care research network for children in Canada. The network is a registry that enrols healthy children, from birth through five years of age, with the aim of linking early nutrition with later health issues, such as obesity, cardiovascular disease and developmental problems and developing interventions to prevent them.

The example above is an ongoing TARGet Kids! study of childhood obesity, led by Dr. Catherine Birken, a SickKids pediatrician. Researchers are studying whether early nutrition and growth patterns are related to the development of high cholesterol.

“If we can figure out at the age of two if that child is likely to develop cardiovascular disease later in life,  we can help prevent that by developing early interventions; for example, by working with the child’s family to develop healthy lifestyle habits before lifestyle habits are set,” said Dr. Nav Persaud, a physician and scientist at St. Michael’s Hospital who is working with Dr. Birken on the obesity study.

Dr. Julia Morinis, a pediatrician and Centre for Research in Inner City Health Achieve postdoctoral fellow at St. Michael’s Hospital and member of TARGet Kids!, uses TARGet Kids! data to better understand the social determinants of childhood obesity.

“TARGet Kids! looks at all aspects of a child’s life to better understand what it is that we can do to make a difference in their health over time.  It makes available a broad range of children’s health information, including information on sedentary and physical activity, nutrition, health and development.”

Parents are keen to know the answers to common health questions (for example, “how can I help my child from becoming obese?”) and are highly motivated to do the right thing for their children. Not only does TARGet Kids! data help arm primary care physicians and parents with the right information, the platform also allows new interventions aimed at preventing chronic disease to be tested.

What initially began as a proof of priniciple now has 5,500 Greater Toronto Area children enrolled in the registry and is set to expand to include Montreal and Winnipeg with plans to roll out across Canada.

“The doctors, allied health professionals and parents involved really get the idea of prevention and believe that by working together, we can make this a huge success,” said Dr. Maguire. “Imagine what we could do with a national collaboration and registry of 20,000 children across Canada. We could tackle some of the greatest health challenges of our time.”

Where is all this information kept?

TARGet Kids! is based on the concept of embedding research within primary care practice, providing a large, heterogeneous sample and providing an opportunity for children from diverse socioeconomic and cultural backgrounds to participate in health research. The result is a massive volume of data, which is where St. Michael’s Hospital’s Applied Health Research Centre comes in. It serves as the data co-ordinating centre. When a research assistant embedded in the primary care practice inputs the systematic data he or she has collected about the children, it goes into a centralized database through a highly secure web portal.  Laboratory data is also fed into this portal creating a rich database that researchers use to tease apart the causes of common health problems. The AHRC provides all data and analytic services for TARGet Kids!.

For more information, visit www.targetkids.ca