Fida Bacha Lab News and Publications

Launch of the DISCOVERY study!

This large NIH funded study aims to identify risk factors for youth-onset type 2 diabetes to improve prevention and treatment

Description of study:
Type 2 diabetes used to be known as “adult-onset” diabetes and mostly affected people later in life. It is a problem with blood sugar levels being too high, which can lead to health problems down the road. Now more children are being diagnosed with type 2 diabetes. Doctors don’t fully understand why this change is happening, but they believe family history, diet, and the environment may all be part of this.

The DISCOVERY Study will learn a great deal about the risk factors of type 2 diabetes in children and teens. You and your child may be eligible to join the study if your child is between the ages of 9 and 14 years old and if they have a high body mass index (BMI) or they have been diagnosed with prediabetes, which can lead to diabetes.

The study will involve office or clinic visits, questionnaires, blood and urine tests, and wearing a glucose monitor. There are no medications involved in this study. Participants and their parents will receive compensation for their time, parking vouchers (if needed), and small gifts/prizes.

Your help will make a difference for all children and young people who are at risk for type 2 diabetes! By taking part in DISCOVERY, you will join families across the US to help us discover the future of preventing this problem in young people. If your child participates, they will also be followed closely to see if diabetes develops, so if it does develop, it might be identified earlier.

To find out more, please visit: DISCOVERY of Risk Factors For Type 2 Diabetes In Youth | BCM 

Select New Publications:

Puyau M, Shypailo R, Butte NF, Musaad S, Bacha F. Prediction models of basal energy expenditure in children and adolescents across the BMI spectrum based on room calorimetry: a cross-sectional cohort study. Am J Clin Nutr. 2025 Feb;121(2):284-292. doi: 10.1016/j.ajcnut.2024.12.003. Epub 2024 Dec 7. PMID: 39653177.

Abstract:

Background: Existing equations for prediction of basal energy expenditure (BEE) may not be accurate in children with overweight or obesity (OW/OB).

Objectives: We aimed to develop BEE prediction equations applicable to children and adolescents across a wide BMI spectrum using gold standard room calorimetry.

Methods: We measured weight, height, waist and hip circumferences, body composition (DXA), and BEE (whole room calorimetry) in a cross-sectional cohort of 1155 healthy children, 5-19 years of age. 67% of the males and 51% of the females were classified as OW/OB. We applied multiple linear regression analyses to develop BEE prediction models for each sex. Using relevant predictors, we developed models with fat-free mass (FFM); waist and hip circumference; weight and height only; and weight only. A representative sample of participants (83 males, 125 females) served as a validation dataset to test model performance. The models' performance in predicting BEE was compared to existing models in the literature.

Results: Model fits (R2) for the new BEE prediction models were = 0.84 (P < 0.0001). Our BEE prediction models performed equally in children with normal weight and OW/OB, with <1.5% difference between the measured versus predicted BEE in the validation dataset for both sexes. In Bland-Altman analysis, our BEE prediction models were superior to existing prediction models, especially for children with higher BEEs.

Conclusions: New BEE prediction models developed and tested in cohorts representative of children with normal weight and OW/OB had superior performance compared with existing models. The BEE prediction equations based on simple anthropometrics or body composition provided improved accuracy and precision for children with NW or OW/OB, ages 5 to 19. More accurate estimates of BEE should allow for better estimates of energy requirements of children.

Keywords: basal energy expenditure; body composition; childhood obesity; energy metabolism; prediction equations; room calorimetry.

Bacha F, et al. Pathophysiology and Treatment of Prediabetes and Type 2 Diabetes in Youth.

Diabetes Care 2024. PMID: 39250166

Abstract: Youth-onset type 2 diabetes is a heterogeneous disease with increasing prevalence in relation to increased rates of obesity in children. It has genetic, epigenetic, social, and environmental determinants. Youth-onset type 2 diabetes is alarming given a rapidly progressive course compared with the course of adult-onset disease, early-onset vascular complications, and long-term exposure to hyperglycemia and associated complications. It is often preceded by "prediabetes," a disease phase where defects in β-cell function relative to insulin sensitivity emerge. Herein, we review the current understanding of the pathophysiology of prediabetes and type 2 diabetes in youth. We describe the mechanisms underlying insulin resistance, the precipitous decline of β-cell function, and the role of other hormonal abnormalities in the pathogenesis of the disease. We discuss the critical importance of social determinants of health in the predisposition and progression of these conditions and present current management strategies and the advances in therapeutic approaches. These must adapt to meet the unique needs of the individual patient and family. Significant knowledge gaps remain that need to be addressed in future research.

Bacha F, et al. Distinct Amino Acid Profile Characterizes Youth With or at Risk for Type 2 Diabetes.

Diabetes 2024. PMID: 38215171

Abstract: Branched-chain amino acids (BCAA) and aromatic AAs (AAA) are associated with increased risk for type 2 diabetes in adults. Studies in youth show conflicting results. We hypothesized that an AA metabolomic signature can be defined to identify youth at risk for β-cell failure and the development of type 2 diabetes. We performed targeted AA metabolomics analysis on 127 adolescents (65 females, 15.5±1.9 years old, Tanner stage II-V) with normal weight or obesity across the spectrum of glycemia, with assessment of AA concentrations by mass spectrometry, at fasting and steady-state (SS) of a hyperinsulinemic-euglycemic clamp, with determination of insulin sensitivity (ISFFM). We measured insulin secretion during a 2-hour hyperglycemic clamp and calculated the disposition index (DIFFM), a measure of β-cell function. Our results showed that Gly and Gln/Glu were lower, whereas BCAA, Tyr and Lys concentrations were higher in the groups with obesity and dysglycemia compared with those with normal weight. Gly and Gln/Glu were positively related to IS and DIFFM, with opposite relationships observed for BCAA, AAA and Lys. We conclude that a metabolic signature of low Gly, low Gln/Glu and elevated BCAA, AAA and Lys may constitute a biomarker to identify youth at risk for β-cell failure.

From Obesity to Strong Bones: Essential Tips for Healthy Kids
Sept. 12, 2024:

ARS-funded research at the Children's Nutrition Research Center in Houston, Texas, delves into the critical connection between childhood obesity and bone health. The research uncovers how excess weight in Hispanic children can negatively affect bone density and mineral content, potentially increasing the risk of fractures. Researchers emphasize the importance of physical activity as a protective measure against these adverse effects and discuss practical strategies for parents to prevent obesity from the outset.

Video link (USDA YouTube channel)