While Colorado may be the skinniest state, reports indicate that our state’s residents, both adults and children, are growing more and more obese each year, while both type 1 and type 2 diabetes have increased exponentially in our nation’s youth over the last decade. Researchers are now honing in on human developmental periods (in utero, neonatal, and early childhood) and environmental factors as possible culprits. 

To further investigate and understand the complex interplay of developmental exposure(s), genetic and epigenetic processes, and critical developmental periods in life, the Colorado School of Public Health and other collaborators on the University of Colorado Anschutz Medical Campus have created the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) center, where scientists will help understand the causes and identify population approaches to preventing obesity and diabetes.

Dana Dabelea, MD, PhD, the Conrad M. Riley Endowed Professor in epidemiology at the Colorado School of Public Health has been named the LEAD center’s director, bringing with her seven new and existing grants totaling more than $16.5 million under the new center’s umbrella. 

Dabelea is principal investigator (PI) or co-PI on three new National Institutes of Health (NIH) grants totaling more than $7 million over the next three to five years that focus on: 

• epigenetic markers of in utero exposure to diabetes;
• fetal exposure to endocrine-disrupting chemicals in utero that are known to be associated with the development of obesity-related outcomes in offspring (the ECCHO study); and
• ongoing data collection from pregnant mothers and their babies through the Healthy Start Study to understand how metabolic and behavioral factors during pregnancy and early life can contribute to the development of obesity and related health problems in children.

Additional existing grants totaling more than $9.5 million that Dr. Dabelea is PI for include:

• the landmark SEARCH for Diabetes in Youth, a national multi-center population-based study aimed at understanding the burden of diabetes and its complications among youth and young adults nationally; 
• the Tribal Turning Point, a study exploring a culturally-appropriate behavioral intervention to prevent type 2 diabetes in American Indian youth; 
• Exploring Perinatal Outcomes among Children (EPOCH), a longitudinal study of adolescents and their long-term health outcomes related to whether they were exposed to maternal gestational diabetes; and 
• the Diabetes Prevention Program Outcomes Study (DPPOS), a landmark trial to show that lifestyle changes or the metformin drug can effectively delay diabetes in overweight or obese American adults.

“During critical phases of development, the environment we live in is continually reprogramming our genomes through epigenetic processes to respond to a variety of environmental stressors such as the foods we eat or our exposure to environmental pollutants,” explained Dr. Dabelea. “As a result of this, as well as many other processes we are just beginning to understand, we are seeing higher rates of obesity and earlier onset of diabetes at younger and younger ages globally. A collaborative center like LEAD will help us not only understand why this is happening, but will also develop programs and make recommendations on how to prevent it from happening in the future.”

The LEAD center is a collaboration between the Colorado School of Public Health, the CU School of Medicine’s Department of Pediatrics and Children’s Hospital Colorado with additional support from the CU Anschutz Medical Campus Chancellor Don Elliman, CU Denver | Anschutz Provost Roderick Nairn and the Anschutz Health and Wellness Center. Collective support from all LEAD partners totals more than $1.6 million to launch and develop the center over its first five years, as well as provide for three new faculty positions within the Colorado School of Public Health and CU School of Medicine. 

“This center brings together obesity and diabetes experts in epidemiology, public health, and basic and clinical science in a way that hasn’t yet been done in this region of the U.S.,” said Colorado School of Public Health’s Dean Emeritus David Goff. “The LEAD center will help us understand why diabetes and obesity develop so we can identify effective population-based prevention strategies.”