Genome instability in childhood obesity: A conceptual framework for an assessment, intervention and monitoring programme of inflammation and DNA damage in paediatric obesity

Purpose: Recent studies have raised concerns that obese children may present an increased pre-disposition towards age–related disorders such as cancer. Initial evidence would suggest that the increased risk of developing cancer later in life might be linked to the reported presence of chronic low–grade inflammation in childhood obesity and the sustained accumulation of Reactive Oxygen Species (ROS) capable of inflicting DNA damage, a well–known promoter and driver of carcinogenesis. This conceptual framework outlines the clinical and laboratory investigations required for the combined assessment and monitoring of systemic inflammation, micro–nutritional deficiencies and acquired genome damage in childhood obesity. Approach: A case–control study is proposed in a cohort of obese and healthy weight 11–15 year olds. This study combines assessments of blood, together with minimally invasive investigations of saliva and urine samples to obtain an overview of inflammation and DNA damage status in obesity. Furthermore, we present a nutrition sensitive intervention programme to investigate the reversibility of these pathological states. Findings: It is hypothesised that chronic inflammation in childhood obesity can establish a harmful microenvironment that inflicts damage to DNA. It is postulated that a nutrition sensitive intervention may reverse implications of inflammation and DNA damage in obese children. Value: An evaluation of the role of genomic instability and cumulative DNA damage early in life as a possible causative link between childhood obesity and the ncreased risk of developing cancer in adulthood. The conceptual framework proposes a personalised approach to disease diagnosis and monitoring of ‘genome health’ that can inform the prioritisation and severity of intervention measures in the clinical setting