Thursday, August 19, 1999
70 years, 1 question: What makes us tick?
Fels study tracks human development
BY TIM BONFIELD
The Cincinnati Enquirer
Will Chatfield, 11, has his lung volume measured in the "Bod Pod."
(Gary Landers photo)
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Twice a year, Kathy Hill drives an hour-and-a-half from Anderson Township to Yellow Springs, Ohio, so her three children can see the doctor.
They spend several hours giving samples of blood and saliva, taking cardiac fitness tests, getting bone density scans, and spending time inside an egg-shaped machine called the “Bod Pod.”
Mrs. Hill's children aren't sick. They are the family's third generation of participants in one of America's longest-running medical studies — the Fels Longitudinal Study.
The project, now celebrating its 70th anniversary, has been tracking several thousand people, most of them Ohio residents, from birth to glean data about human growth and development.
Kathy Hill and children Karli, Ryan and Mallory are in the study because Mrs. Hill's father, far right in photo, was born as a triplet in 1928.
(Yoni Pozner photo)
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“I didn't understand why I was doing it as a kid, but I remember going from the time we were small,” Mrs. Hill said. “I guess we keep doing it out of a sense of loyalty. I tell my kids it's their community service.”
Many parents already know about one of the most significant research results from the Fels study — the curvy growth charts pediatricians use to track the weight and height of infants and toddlers. But they probably never realized the charts — pink for girls and blue for boys — were based on data from children who grew up in and near Yellow Springs.
Doctors nationwide have used the charts for years to spot early signs of malnutrition and other abnormalities. Parents use the information to guess how their children will grow up. The shortest in their class? A potential basketball star? Or more likely, something in between.
“It's kind of neat to see the growth charts and know you had something to do with creating those,” Mrs. Hill said.
Beyond the growth charts, Fels project data have been used in several ways:
Francis Chatfield's skeletal system is diplayed on a computer screen after being scanned.
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• To study obesity, including whether childhood obesity will lead to adult obesity.
• Measuring the links between weight gain and high cholesterol.
• To study whether high body fat causes or aggravates high blood pressure.
• Studying whether differences in the rate of body fat gain can predict the chances of developing health problems.
The Fels study started in 1929 with the goal of defining the stages of physical, psychological and social development.
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THE FELS STUDY
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• What: The Fels Longitudinal Study started in 1929 as a long-range effort to track human growth and development.
• Who: More than 1,400 people serve as core participants, including several dozen Hamilton, Butler and Warren county residents, plus several thousand of their relatives.
• Where: Yellow Springs, Ohio.
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INFOGRAPHIC
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Where participants live
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HIGHLIGHTS
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• More than 1,500 scientific publications have resulted from the study.
• The Fels project set the standards for infant and toddler growth charts still widely used today.
• Many researchers use the Fels method of skeletal assessment, which determines physical maturation by measuring the bones in a child's hand.
• The World Health Organization and the National Center for Health Statistics recommend using Fels measurement methods for assessing whether children and the elderly are getting proper nutrition.
• Fels project data also have been used to study whether childhood obesity will lead to adult obesity; links between weight gain and high cholesterol; body fat and high blood pressure; and whether differences in the rate of body fat gain can predict the chances of developing health problems.
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The concept was to follow 1,000 people from birth to death. Since then, the project has been expanded to include the descendants of the original core participants. Over the years, the Fels study has generated more than 1,500 articles in medical journals and texts.
Today, the research goes on in a low, brick building a few blocks from downtown Yellow Springs — a town best-known for being home to Antioch College, a school with an activist, counterculture history. In coming months, the study headquarters will be moved to Kettering, Ohio.
The Fels study was started by Antioch President Arthur Morgan and campus doctor Lester Sontag. The study got its name from its early sponsor, Samuel Fels, a Philadelphia soap manufacturer and philanthropist who was a longtime associate of Mr. Morgan.
They were responding to a White House conference that had called for more detailed information about the stages of childhood development. Scientists wanted to know: What makes people different from each other?
Several similar studies were started nationwide, including projects in Denver, Boston and Berkeley, Calif. Those studies stopped when the first groups reached 18 years old. The Fels study kept going.
The Fels project never was formally part of Antioch. In fact, the study was private and independent until it became part of Wright State University's Division of Human Biology in 1977.
The study started by enlisting local doctors to recruit healthy babies as soon as they were born. Of the first 1,000 core participants, nearly all were born in or near Yellow Springs, Xenia, Springfield or Dayton.
Now, the only way to be entered in the study is to be a relative of the core group members. The Fels study has gathered at least some data on more than 4,500 people, including some people four generations removed from the first participants.
Of the more than 1,400 current core participants, 953 still live in Ohio, including dozens of residents of Hamilton, Butler and Warren counties. The rest have scattered to 43 other states.
Today, the Fels project involves eight faculty researchers and 20 support staff members. In April, the project won a five-year, $5.5 million grant from the National Institutes of Health to continue its work.
With a healthy budget and 80 percent of its original participants still alive, in many ways, the Fels study is just getting started, said study director Dr. Roger Siervogel.
Children get the most frequent testing, every three months until they reach 18 months, then twice a year until they reach 18. Adults come in every five years.
Last week, Hyde Park resident Anne Chatfield took her sons Will, 10, and Francis, 8, for their Fels exams. Like the Hill family, the Chatfields also have participated across three generations.
“My grandmother, who lived in Yellow Springs, happened to be pregnant when the study started. So my mother was in it,” Mrs. Chatfield said.
“I grew up doing it. It was fun. So it seemed right that my kids should do it,” she said.
Out-of-town participants are reimbursed for travel costs. Participants also receive small payments (up to $50) for their time.
A full visit takes about half a day, during which a person gets the most thorough measurement of body composition science can offer.
Will and Francis took turns lying under an X-ray scanner that measured bone density. They were pinched with calipers and their heads were measured.
They wore electrodes for monitors that measure body fat by tracking variations in how electricity flows through fat and muscle. They were dunked in an over-sized whirlpool tub to measure body mass through water displacement.
Then they sat in the “Bod Pod.”
This egg-shaped device measures body composition via air displacement. The pod is so sensitive, it can pick up changes in air displacement caused by variations in body heat.
All the testing gives researchers a precise knowledge of how much of the body is bone, muscle or fat. That information then gets linked to information from blood pressure checks, blood and saliva samples and other medical data. It also gets linked to age, gender, exercise, dietary habits, family history and so on.
While much of medical research has been devoted to understanding and developing cures for disease, the Fels study has always focused on defining “normal” growth and development, Dr. Siervogel said.
“When I was a freshman in college, I remember the Fels Longitudinal Study being part of Psych I,” Mrs. Chatfield said.
While some of the Fels' psycho-social research of the 1930s and '40s was considered outdated by the 1970s, the study continues to gather data to answer new questions.
Can childhood growth trends predict health problems later in life? What are the roles of diet and physical activity on body composition? How does body composition change during puberty and menopause?
Dr. Siervogel predicts that the best information from the Fels study is yet to come, as the study looks at how disease develops among its older participants.
By comparing body composition, personal habits and other data from generation to generation, the study may help establish models to predict who faces the most risk of developing heart disease, diabetes, osteoporosis and other diseases.
One weakness of the study, however, is a shortage of minority participation, a factor that reflected the demographics of the Miami Valley in the 1930s.
Of more than 1,400 core participants, only 15 are African-American and three are of Asian heritage. The rest are Caucasian.
It's a weakness caused by the way the study was originally designed and where it was. It can't be fixed without fundamentally changing the study, researchers said.
Mrs. Hill got involved in the study through her father, John Kramer, who was part of a set of identical triplets born in Dayton in 1928. The Fels researchers were thrilled to have the Kramer triplets in their study, and even more thrilled to have many of the triplets' children and grandchildren in the study over the years.
“We did it out of tradition. My brothers went as kids. My cousins went as kids. (The Fels team) even came and picked us up sometimes,” Mrs. Hill said.
The family often made an outing of testing days, although Mrs. Hill confesses that her memories of Yellow Springs were limited.
“You know how kids are. A lot of times we didn't like going,” Mrs. Hill said.
Fels researchers aren't surprised that so many families remain loyal to the study. “I think participants recognize the importance of their contribution to humanity,” Dr. Siervogel said.
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