A population-wide approach to health's biggest questions

Data collected at the checkpoint between childhood and adolescence is helping researchers understand how to set kids up for the healthiest possible life.

Many of the diseases and illnesses affecting Australian adults have their roots in childhood, presenting an opportunity to stamp them out before they take hold.

Paving the way to healthy adulthood requires in-depth knowledge of the links between the physical, environmental and familial factors in childhood.

Research that looks at the relationships between physical, environmental and genetic factors and health outcomes, is known as life course research.

MCRI is at the forefront of this life course approach, with the richness of their Child Health CheckPoint data already helping researchers and policymakers around the world to plan new studies and programs to help children and families grow well.

"The aim of the initiative was to learn more about the health of young people as they pass through the 'checkpoint' between childhood and teenage years, as it is expressed in their developing body and brain," says Child Health CheckPoint study lead Professor Melissa Wake.

"CheckPoint allowed us to collect an amazing wealth of different data spanning all of the body's physical and biological systems."

Like piecing together a puzzle, Child Health CheckPoint collected data to create a snapshot of what child health looks like in Australia, and what adult health could look like. The project was a significant addition to Australia's only large-scale child health and wellbeing study, Growing Up in Australia, which has tracked the development of 10,000 young people and their families since 2004.

With funding from the NHMRC, the Child Health CheckPoint team ran a series of pop-up assessment centres In 2015-2016 across 30 Australian towns and cities. They invited 1800 of the 11 and 12 year-old kids from the Growing Up in Australia cohort, together with a parent, to take part in the three-and-a-half hour sessions.

Through 17 different assessment stations, researchers collected details spanning physical activity and fitness, body composition, bone health, nutrition, sleep, vision, hearing, language, dental, cardiovascular, kidney and respiratory health.  By collecting parent data, the researchers also created a unique cross-generational resource at a moment in time. The rich biological samples collected and measurements taken will also enable future study involving genetics, inflammation, metabolic and micronutrient health, ageing and many other aspects of biologic health.

Prof Wake says the great strength of longitudinal studies is the opportunity they present for measuring a range of factors in many different ways.

"By putting them all together we can reveal rich secrets and answer many different questions."

"We started to see a huge range of differences in children, in areas as simple as blood pressure and cholesterol, and not surprisingly we started to see them resemble their parents in some of these measures," Prof Wake says.

"One of the most surprising results was how strikingly children resemble their parents on bone strength far more than on other characteristics. Hearing was also linked between children and parents and there is early evidence that even in childhood, poorer hearing could be related to factors such as obesity and inflammation." She says this would make it another life course condition, rather than an unavoidable disease of old age.

While most developed countries have some form of longitudinal study of children based on interviews and surveys, the millions of data points gathered in CheckPoint's in-depth health assessments and biological collection is unique.

When this large dataset was made available to researchers worldwide in 2018, they leapt at the chance to mine it for better understanding of how health develops in children and adults. Almost 100 researchers and policymakers have already accessed the data for their own studies.

CheckPoint study project manager Dr Susan Clifford says that by making the information available to other researchers, MCRI is taking the lead in the area of Open Science; a movement that aims for faster and more transparent research, leading to faster evidence-based outcomes.

"Early adolescence is a time when there is a chance to make a real difference for a child's health," Dr Clifford says.

"By sharing the dataset, it means that CheckPoint could one day help to design interventions that can guide kids back on to a healthy path."

The Child Health CheckPoint has also delivered important lessons for the researchers in Prof Wake's team who will soon embark on GenV, which received a $14 million Victorian Government commitment in late 2018 to help progress the project to its next stage.

"Through CheckPoint we found that children and parents really enjoyed the chance to be part of a comprehensive project that was creating knowledge to help future children and their families," Prof Wake says.

"In time, Gen V will become one of the world's largest health studies, following the lives of 160,000 babies born in Victoria in 2020 and 2021. It will fast-track solutions to the complex problems facing today's children and tomorrow's adults."