$81m for new research projects and programmes

WEDNESDAY 26th JUNE 2019

Finding new way to control blood pressure receives $5m funding boost

Half the New Zealanders being treated for blood pressure don’t have it under control, according to a University of Auckland researcher who has been awarded nearly $5 million from the Health Research Council of New Zealand (HRC) to look at the problem from a completely different angle.

Professor Julian Paton says we urgently need a new way to control high blood pressure – a condition affecting one-third of adult New Zealanders and disproportionately more Māori and Pacific people.

His study is one of five research programmes funded as part of the HRC’s $81 million investment in new research projects and programmes announced today by Minister Megan Woods.

Professor Paton says despite the armoury of medications currently available, treated patients still remain at elevated risk of cardiovascular events such as stroke, heart attacks and blood-clotting.

The poor control rate reflects treatment resistance, drug intolerance and poor patient compliance due to the unpleasant side-effects of some medications. But it’s also due to current medications treating the symptoms, and not what Paton believes is a primary cause of high blood pressure.

“None of the frontline pills affect the activity that’s generated from the brain that goes to the heart and blood vessels” – an area that’s become a focal point for researchers in recent years.

Professor Paton says activity in the nerves to the heart and blood vessels – known as the sympathetic nerves – is substantially increased in people with high blood pressure.

“We know that their activity is raging – much higher than it should be – and we believe this is causing much of the squeezing down on the blood vessels, causing blood pressure to rise.”

Professor Paton’s research team believes controlling sympathetic activity is the key to controlling blood pressure, and the best way to do that could be by targeting a sensory organ that’s the size of a rice grain at the top of the neck, called the carotid body.

Dysfunctional activity in the carotid body has been found to activate the sympathetic nerves which in turn squeezes blood pressure up. But what exactly causes this abnormal activity will be the focus of Professor Paton’s research over the next five years.

Initial testing will be in rats and sheep to first establish the mechanisms involved and to decipher if a new drug candidate could switch off the problematic signals. Patients recruited from specialist clinics will also be tested to see if excessive carotid body activity causes severe levels of blood pressure.

By the end of this programme, researchers will know whether the carotid body is over-active in patients with high blood pressure – a critical first step before testing any new treatment on humans.

The Health Research Council’s acting chief executive, Dr Vernon Choy, says this research programme gives New Zealand a unique opportunity to identify the root cause of a problem affecting a billion people worldwide, and could pave the way for new treatments to be developed.

“High blood pressure is the biggest risk factor for cardiovascular disease – the leading cause of death globally – and it’s clear we don’t yet know everything about controlling it. This is research that could save lives, improve the quality of life in people with high blood pressure, and dramatically reduce hospital admissions.”

See below for the full list of 2019 HRC Programme grant recipients. To read lay summaries of these Programmes, go towww.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Researcher Initiated Proposals’, ‘Programmes’ and ‘2019’.

2019 Programme grants – full list

Professor Jane Harding, The University of Auckland
Assessing the impact of maternal and perinatal interventions on life-long health
60 months, $4,971,164

Professor Janet Hoek, University of Otago
Whakahā o Te Pā Harakeke
60 months, $4,949,736

Professor Helen Moewaka Barnes, Massey University
Tangata Whenua Tangata Ora: Investigating health gain through whenua initiatives
60 months, $4,999,332

Professor Julian Paton, The University of Auckland
Aberrant purinergic afferent signalling in cardiovascular disease
60 months, $4,928,392

Professor Valery Feigin, Auckland University of Technology
Measuring the incidence and outcomes of stroke and TIA in NZ
60 months, $1,200,000 (partial funding)

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Baby food pouches come under the spotlight

They dominate the baby food section in supermarkets, but could baby food pouches be setting our babies up for future problems with obesity and dental cavities?

Squeezable baby food pouches with plastic spouts are described as a mess-free and easy food alternative for babies ‘on-the-go’, and they now have an extraordinary market share in New Zealand – a 2018 audit of one of New Zealand’s largest supermarket chains indicates that these pouches make up 70 per cent of baby foods available. However, despite their apparent widespread use, there has been virtually no published research done either in New Zealand or internationally on the possible impacts of these pouches on babies’ diets or health.

Associate Professor Anne-Louise Heath from the University of Otago has received a Project grant from the Health Research Council of New Zealand (HRC) to explore what babies are eating in New Zealand once they move from an exclusively milk diet to solid food.

This ‘First Foods NZ’ study will observe 625 babies aged between eight and nine months from Auckland and Dunedin, measuring their nutrient intake, particularly iron levels, and assess the impact of baby food pouches on babies’ growth and dental health.

“The food in baby food pouches is similar to that found in baby food jars and cans, but their delivery method has the potential to markedly change infant nutrition,” says Associate Professor Heath.

“Anecdotal reports suggest babies are often consuming the food straight from the pouch, unsupervised. These super smooth foods are very easy for babies to eat. A 120g pouch is the equivalent of about 22 teaspoons of food. It can take a lot of time to spoon-feed a baby that amount, whereas to squeeze out that amount from a pouch is much easier. We want to find out if pouches result in babies overeating because they’re so easy to eat, and if they are displacing more nutrient-rich foods such as breastmilk from the diet.”

The research team will also track the babies to see if the sweet and acidic foods commonly found in baby food pouches – even some vegetable-based varieties – are causing problems for babies’ erupting teeth.

“Manufacturers in New Zealand are generally super cautious about not adding sugar to baby foods, but natural fruit sugar is still sugar. When these baby foods are consumed by sucking on a pouch, the teeth are bathed in fruit sugars, and probably much more so than if they were to eat whole fruit or to be spoon-fed. This could increase the risk of tooth decay.”

A recent small randomised controlled trial1 suggests that even by seven months of age, 12 percent of New Zealand babies may already be consuming more than the World Health Organisation recommendation of less than five percent of energy intake from free sugars, including fruit purees.

“If you’re only giving your baby a pouch every now and again it will probably make no difference to your baby’s health, whereas if it’s a regular thing it may have risks – or it may have benefits, such as upping your baby’s fruit and vegetable intake. We have to keep an open mind with our research as we don’t know which way it will go.”

As part of the First Foods NZ study, Associate Professor Heath and co-principal investigator Professor Rachael Taylor will also assess the nutrition, health and safety impacts of another method of feeding that’s growing in popularity in New Zealand: baby-led weaning. This technique involves giving babies finger foods to feed themselves from about six months on, instead of parents spoon-feeding them pureed food and slowly progressing to more textured food as the Ministry of Health currently recommends.

Proponents of baby-led weaning see it as a healthier, more convenient, and less stressful way of feeding babies, however some health professionals have raised concerns about the potential increased risk of iron deficiency, slower weight gain, and choking.

HRC acting chief executive Dr Vernon Choy says all parents want to know what the safest and best way is to feed their babies.

“There is so little research on baby food pouches or baby-led weaning that the Ministry of Health is currently unable to advise parents on their use. This puts health professionals in a difficult position because they are forced to form an educated opinion based on little-to-no evidence. They then have to decide if they’re going to share that opinion or leave parents to perhaps seek out other sources like social media for advice,” says Dr Choy.

“This research will provide some much-needed evidence to help the Ministry of Health update their advice to Plunket and other Well-Child providers on whether, and how, parents should use these relatively new methods of baby feeding.”

The HRC has awarded $60.3 million in funding for 53 research projects, including Pacific health and Rangahau Maori projects. These grants form part of the HRC’s $81 million investment in new research projects and programmes announced today by Minister Megan Woods.

See below for the full list of 2019 HRC Project and Pacific Project grant recipients. To read lay summaries of these Projects, go towww.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Researcher Initiated Proposals’, ‘Projects’ and ‘2019’.

1 Williams Erickson L, Taylor R, Haszard J, Fleming E, Daniels L, Morison B, Leong C, Fangupo L, Wheeler B, Taylor B, Te Morenga L, McLean R, Heath A. Impact of a modified version of Baby Led Weaning on infant food and nutrient intakes: the BLISS randomized controlled trial. Nutrients 2018;10:740.

2019 Project grants – full list

Dr Philip Adamson, University of Otago
Duration of Dual Antiplatelet Therapy in Acute Coronary Syndrome (DUAL-ACS)
48 months, $1,549,999

Professor Richard Beasley, Medical Research Institute of New Zealand
Two RCTs of salbutamol therapy in exacerbations of asthma in adults
36 months, $578,713

Dr Peter Bergin, Auckland District Health Board
International case-control study of Sudden Unexpected Death in Epilepsy
48 months, $1,190,647

Professor David Bilkey, University of Otago
A novel biomarker for preclinical drug development in schizophrenia
24 months, $489,282

Professor Steven Dakin, The University of Auckland
Measuring visual field loss in glaucoma using involuntary eye movements
36 months, $1,184,344

Professor Nicola Dalbeth, The University of Auckland
Transitions to Gout Research (TIGER) study
36 months, $1,196,151

Dr Martin de Bock, University of Otago
Automated insulin delivery for Type 1 diabetes utilising open source technology
36 months, $1,317,623

Professor Sarah Derrett, University of Otago
Prospective Outcomes of Injury Study: 10 years on (POIS-10)
36 months, $1,188,041

Professor Robert Doughty, The University of Auckland
Biomarker-guided secondary prevention post-acute coronary syndromes: An RCT
36 months, $1,596,636

Professor Jeroen Douwes, Massey University
Biodiversity and microbiota: a novel pathway to allergy and asthma prevention
48 months, $1,199,961

Professor Michelle Glass, University of Otago
Characterisation of synthetic cannabinoid signalling bias and toxicity
36 months, $1,172,581

Associate Professor Simon Hales, University of Otago
Climate change, extreme rainfall events and enteric disease outbreaks
36 months, $1,190,579

Professor Bob Hancox, University of Otago
A Randomised Controlled Trial of beta-blockers in COPD
60 months, $1,439,384

Associate Professor Michael Hay, The University of Auckland
Doubling down on DNA-PK: Radiosensitisers for head & neck cancer
36 months, $1,199,999

Associate Professor Anne-Louise Heath, University of Otago
Novel methods of infant feeding in New Zealand – cause for concern or optimism?
36 months, $1,185,359

Professor Janet Hoek, University of Otago
Developing optimal strategies to support smoking cessation among RYO users
36 months, $1,195,934

Associate Professor Julia Horsfield, University of Otago
A novel genetic mechanism in Acute Myeloid Leukaemia
36 months, $1,177,919

Associate Professor Stephanie Hughes, University of Otago
Dissecting the role of glial lysosome function in neurodegeneration
36 months, $1,199,417

Dr Karl Iremonger, University of Otago
A neural circuit to suppress stress in motherhood
36 months, $1,167,222

Dr Anne-Marie Jackson, University of Otago
Tangaroa Ara Rau: Māori water safety programme for whānau
36 months, $1,192,263

Dr Stephen Jamieson, The University of Auckland
Precision treatment of head and neck cancer with evofosfamide
36 months, $1,199,967

Mrs Bernadette Jones, University of Otago
Te Ao Mārama: Disability perspectives of tāngata whaikaha Māori
36 months, $1,186,338

Professor Andrew Jull, The University of Auckland
Exercise or hypochlorous acid for venous leg ulcer healing: Factorial4VLU trial
36 months, $1,402,941

Professor Kurt Krause, University of Otago
New drugs for the post-antibiotic era by targeting glutamate racemase
36 months, $1,199,914

Professor Beverley Lawton,
Victoria University of Wellington Whānau Manaaki: Methamphetamines- a strength based community approach
36 months, $ 1,187,031

Dr Alex Macmillan, University of Otago
Health and equity impacts of Te Ara Mua Future Streets
30 months, $1,185,793

Associate Professor Sandra Mandic, University of Otago
Built Environment and Active Transport to School: BEATS natural experiment
36 months, $1,197,487

Dr Shay McGuinness, Medical Research Institute of New Zealand
BLING III - Phase III RCT of continuous -lactam infusion in the critically ill
60 months, $1,195,807

Professor Mark McKeage, The University of Auckland
Do concomitant medicines impede safe and effective lung cancer treatment in NZ?
36 months, $1,194,776

Professor Dr Neil McNaughton, University of Otago
Do hippocampus, insula and amygdala contribute to an anxiety syndrome biomarker?
36 months, $ 1,090,630

Dr Kimberley Mellor, The University of Auckland
Glycotoxicity in the diabetic heart – novel treatment targets
36 months, $1,148,222

Professor Tony Merriman, University of Otago
Addressing clinical questions in gout using genetic data
36 months, $1,198,120

Associate Professor Brian Monk, University of Otago
Readying next-generation antifungals for drug development
36 months, $1,199,967

Dr Garry Nixon, University of Otago
A rural-urban classification for NZ health research and policy
30 months, $ 943,443

Professor Gail Pacheco, Auckland University of Technology
Ethnic differences in the uptake of healthcare services: A microanalysis
36 months, $ 1,088,386

Professor Dr Suetonia Palmer, University of Otago
Serum phosphate to improve outcomes for dialysis patients: The PHOSPHATE trial
60 months, $ 1,266,603

Professor Dr Suetonia Palmer, University of Otago
Teaching to improve health outcomes for peritoneal dialysis: The TEACH-PD trial
60 months, $ 1,439,326

Associate Professor Rachael Parke, Medical Research Institute of New Zealand
Targeted therapeutic mild hypercapnia after resuscitated cardiac arrest
48 months, $1,199,994

Professor Emily Parker, Victoria University of Wellington
Tackling antimicrobial resistance
36 months, $1,180,238

Dr Anna Pilbrow, University of Otago
A precision medicine approach to improving heart disease outcomes
36 months, $1,193,680

Professor John Reynolds, University of Otago
Manipulating rewards to treat maladaptive brain disorders: focus on tinnitus
36 months, $1,192,994

Professor Nicola Starkey, University of Waikato
Patterns of recovery from concussion in children and adolescents
36 months, $1,197,414

Professor Rachael Taylor, University of Otago
Does a brief sleep intervention in infancy have long-term health benefits?
36 months, $1,190,308

Dr Martin Than, Canterbury District Health Board
ICare-FASTER Improving care by FAster risk-STratification in the EmeRgency dept.
36 months, $1,152,385

Dr James Ussher, University of Otago
The role of microbial viability in regulating MAIT cell activation
36 months, $1,191,634

Professor Mark Vickers, The University of Auckland
Circulating miRNAs in maternal blood as biomarkers for preterm birth
36 months, $ 1,142,110

Associate Professor Logan Walker, University of Otago
Impact of germline copy number variation on endometrial cancer risk
36 months, $1,145,197

Dr Emma Wyeth, University of Otago
POIS-10 Māori: Outcomes and experiences in the decade following injury
36 months, $1,191,067

Dr Paul Young, Medical Research Institute of New Zealand
Targeted Early Activity and Mobilisation in the ICU (the TEAM study)
48 months, $ 1,011,247

2019 Pacific Project grants – full list

Dr Allamanda Faatoese, University of Otago
Environmental effects on cardiometabolic biomarkers in Pacific peoples
36 months, $ 594,804

Professor Steven Ratuva, University of Canterbury
Enrichment of community health through targeted social protection strategies
36 months, $588,534

Dr Gerhard Sundborn, The University of Auckland
Understanding scabies prevalence to improve the health of Pasifika/Māori kids
36 months, $594,346

Dr Jemaima Tiatia-Seath, The University of Auckland
Climate change and mental wellbeing: The impacts on Pacific peoples
36 months, $589,691

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Supporting the mental health of Pacific ‘climate change migrants’

New Zealand could become a potential relocation destination for many Pacific peoples displaced from their homelands by rising sea levels and other climate-change related natural disasters.

Dr Jemaima Tiatia-Seath, co-head of the School of Māori Studies and Pacific Studies at the University of Auckland, has received a Pacific Project grant from the Health Research Council of New Zealand (HRC) to explore how New Zealand could ready its health system to best support the mental health needs of Pacific ‘climate change migrants’. Her study will involve research sites in New Zealand, Niue and the Cook Islands.

“Very few people in the Pacific region will be unaffected by climate change, particularly as half the population live within 1.5 kilometers of the ocean. Rapid rises in sea level, more severe cyclones and floods, and changes to seasonal weather are all occurring in the Pacific and are attributed to climate change,” says Dr Tiatia-Seath.

“Migration is an indirect impact of climate change. One estimate is that 75 million people from the Asia-Pacific region will be forced to migrate by 2050 because of it. Much of the health research done to date has largely focused on the physical health problems associated with climate change – the mental health impacts have only recently been recognised.”

Dr Tiatia-Seath says Pacific peoples forced to relocate will likely be at higher risk of negative mental health challenges due to the cultural loss and stress of climate-induced migration.

“An understanding of this issue in New Zealand’s mental health sector is vital. Mental health services will need to cater to Pacific climate change migrants in culturally-inclusive ways and recognise the new challenges that migration and forced relocation will bring to the already visible barriers to mental health access for Pacific peoples.”

HRC manager of Pacific research investment, Tolotea Lanumata, says this study is very timely as the New Zealand Government has made looking at the impacts of climate change a priority.
“Climate change is predicted to have a substantial negative effect on global mental health. This study gives New Zealand the chance to get on the front-foot and prepare our health system for the mental health challenges that climate change will likely have on Pacific communities,” says Ms Lanumata.

The HRC has awarded funding for four Pacific project grants worth a combined total of $2.37 million. These grants form part of the HRC’s $81 million investment in new research projects and programmes announced today by Minister Megan Woods.
Pacific Project grants support research that contributes to better health outcomes for Pacific peoples, families and communities. For a full list of the recipients, see below. To view lay summaries of these projects, go to www.hrc.govt.nz/funding-opportunities/recipientsand filter for ‘Researcher initiated proposals’, ‘Projects’, ‘2019’.

2019 Pacific Project grants – full list

Dr Allamanda Faatoese, University of Otago
Environmental effects on cardiometabolic biomarkers in Pacific peoples
36 months, $594,804

Professor Steven Ratuva, University of Canterbury
Enrichment of community health through targeted social protection strategies
36 months, $588,534

Dr Gerhard Sundborn, The University of Auckland
Understanding scabies prevalence to improve the health of Pasifika/Māori kids
36 months, $594,346

Dr Jemaima Tiatia-Seath, The University of Auckland
Climate change and mental wellbeing: The impacts on Pacific peoples
36 months, $589,691

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