#	Pagina
attuale pagina	/open-h2020/projects/206926/results.html

Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - CLIP (Comprehensive Lifestyle Intervention Project (CLIP))

Teaser

Summary

Cardiovascular (CV) disease is the leading cause of death in Europe, and its prevalence continues to rise at an alarming rate largely because of behavioral risk factors (smoking, unhealthy diet, physical inactivity, obesity, etc.). CLIP (Comprehensive Lifestyle Intervention Project) is funded by a Marie SkÅ‚odowska-Curie Action from the European Union Horizon 2020 Research and Innovation Program. The Project is tackling novel approaches to health promotion and CV disease prevention. CLIP will help to reduce the huge economic burden to society and healthcare systems associated with CV disease treatment as it will directly contribute to Europeâ€™s aim of fighting the CV disease epidemic.

Treatment of disease once symptoms are present represents a huge economic burden to societies and healthcare systems. This problem is anticipated to be exponentially magnified in the coming years due to the alarming increase in obesity (especially in children) and unhealthy lifestyles. One of the most effective ways to tackle this epidemic would be to implement preventive strategies before the disease appears [Image. Taken from Fernandez-Jimenez et al. J Am Coll Cardiol. 2018;72(25):3310-3319]. These preventive strategies apply to both adults and children. A key remaining problem is that advanced CV disease is recognized too late. Discoveries of genetic risk factors may help early diagnosis and improve outcomes by providing better targets for intervention through application of personalized medicine.

The overall objectives of the project are to perform extensive and multidisciplinary training on innovative strategies for effective lifestyle modification in adults and children (24-month outgoing phase), and to transfer the new methodology to Europe by carrying out a pilot lifestyle-centered program in Spain (12-month incoming phase). The new abilities I will acquire from various areas will enable me to implement new programmes to attain primary CV disease prevention and to become an independent group leader upon my return to Europe at the host institution.

Work performed

CLIP is providing me with innovative skills on new methods to achieve lifestyle changes in adults and children. For this endeavor, I participated in a study focused on CV disease prevention at the Icahn School of Medicine at Mount Sinai (ISMMS) in New York, led by Dr Valentin Fuster (supervisor during the outgoing phase). This study had the necessary infrastructure in place to develop the research and training activities proposed in CLIP. The work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far are as follows:

AIM 1: Training in novel strategies for lifestyle modification and CV disease prevention.
Taking advantage of the unique setting and the interaction with team members in charge of the design, randomization and statistical management of the trial conducted in New York, I was able to accomplish the following tasks: (i) promote the study at schools, and actively recruit and consent participants for the study; (ii) perform baseline and follow-up assessments; (iii) apply original tools to induce positive behavioral changes; (iv) provide counselling to participants to improve their health habits; (v) participate in events at schools sharing my expertise with parents on health topics; (vi) trial database management; (vii) statistical analysis; (viii) presentation of results at international scientific conferences; (ix) draft and submit manuscripts for publication; (x) complete training courses as described in the CLIP proposal.

AIM 2: Generation of a computational network model of the genomic/molecular signature of favorable vs poor responders to lifestyle intervention.
The genomic influences on the outcome of behavioral modifications have not been studied in relation to CV disease. As a major innovation, the trial in New York included RNA-sequencing of lipid-loaded macrophages (foam cells), which are a hallmark of atherosclerosis. These cells were isolated before and after the intervention from a subsample of adults participating in the global lifestyle program outlined above to identify novel genetic markers of subclinical atherosclerotic disease. I was trained in a multidisciplinary environment and learned how to apply computational network models to test the association of genomic and phenotypic data collected at baseline and after intervention. All these activities offer comprehensive training in applied genomics, and will strengthen my multidisciplinary skills and contact networks for successful implementation of this novel methodology on my return to Europe.

Final results

CLIP is expected to have a strong societal impact because it will directly contribute to Europeâ€™s aim of fighting the CV disease epidemic. CLIP also addresses the lack of specialized workforce in Europe to lead innovative CV disease prevention programs. Results arising from CLIP are being published in high-impact journals and discussed at international scientific meetings. This will help to maintain the EU research community at the international forefront of the advances in CV disease prevention. The Spanish National Center for Cardiovascular Research (CNIC) is at the centre of European cardiovascular research and will be a catalyst for transferring the new knowledge to Europe via its numerous partnerships with European institutions involved in cardiovascular research. CNICâ€™s European partners. On a personal level, I will be able to make smooth transition towards an independent research position.

Because of the work performed in years 2017 and 2018, I presented several abstracts at the American College of Cardiology Annual Scientific Sessions 2018 and the American Heart Association Scientific Sessions 2018; and I was invited as lecturer at international conferences such as American Heart Association Scientific Sessions 2017 and XII Mediterranean Diet International Conference 2018, among others. In addition, I had the opportunity to interact with other international projects focused on health promotion and prevention that greatly enriched my training experience and networking. Finally, I published review and original articles as main author in the Journal of the American College of Cardiology and American Heart Journal.

The topic of the CLIP proposal is of great social relevance. Dissemination activities included publications related to the project posted in Twitter (https://twitter.com/JACCJournals/status/1074816548093784066); a promotional video of the project uploaded to Youtube (https://www.youtube.com/watch?v=P0p1l3GQd3U); and the participation in the European Commission Steering Group on Promotion and Prevention-Marketplace workshop on nutrition and physical activity best practices (https://ec.europa.eu/health/non_communicable_diseases/events/ev_20180315_en), where I had the opportunity to share my experience on health promotion programs. Because of the research work performed and career trajectory, I received the Promising Young Investigator Award 2018 and was nominated for the 2018 Blavatnik Regional Awards. In addition. I was selected as participating Young Researcher (Marie SkÅ‚odowska-Curie fellow) by the 68th Lindau Nobel meeting committee and the European Commission for the 68th Lindau Nobel Laureate Meeting dedicated to Physiology and Medicine.