Obesity and related cardiometabolic diseases are more common among the Pacific Islander population group than any other population in the world. As a member of the Obesity, Lifestyle, and Genetic Adaptations (OLaGA, meaning "life" in Samoan) Study Group, I work with an interdisciplinary team to uncover the origins of these diseases among Pacific Islanders (Samoans) from Samoa and American Samoa and explore interventions that can help address them. My mission as a nurse scientist is to understand how genetic, social, and environmental factors influence early childhood growth and metabolism so that we can ultimately intervene to improve health.
To advance this mission, my colleague, Dr. Tapa Fidow—a physician in Samoa and expert in childhood health and wellness—and I were awarded the Dr. Patricia E. Thompson Global Nursing Research Grant from Sigma. This funding has allowed us to investigate the metabolomic foundations of body composition among Pacific Islander infants in Samoa during their first two years of life. We conducted this research alongside a team of experts—including Dr. Nicola Hawley, Dr. Daniel Weeks, Dr. Stacy Gelhaus, and several dedicated clinicians and community health advocates who are part of OLaGA.
Our research inspiration
Our team studies a unique genetic variant (rs373863828) in the CREBRF (CREB3 Regulatory Factor) gene. This variant has a minor allele (A) that is uniquely common among Pacific Islanders—especially Samoans, where about 45% of the population carries at least one copy. What makes this variant so intriguing is its paradoxical effects: it is associated with larger body size (both weight and height) but lower fasting glucose. Unlike most genetic variants, which have only a small impact and are often overshadowed by lifestyle and environmental factors, the CREBRF variant is different. It has a big effect and is linked to multiple traits in this population. In fact, it has one of the largest effects on body size out of any common genetic variant ever discovered. Most studies have focused on its effects in adults, but we wanted to understand how it shapes metabolism from birth through early childhood.
To that end, with support from the Dr. Patricia E. Thompson Global Nursing Research Grant, we conducted an untargeted metabolomic association study to explore how this genetic variant influences infant metabolism over time. Our findings suggest that, while the clinical obesity-related phenotypes of the CREBRF variant are not present at birth, its biological effects are already at play, which is evidenced by distinct metabolic profiles across genotype groups. This early metabolic differentiation highlights the potential for CREBRF to shape metabolic health trajectories from infancy, reinforcing the need for early-life research to inform future interventions.
Why this research matters to nursing
Because we are at the forefront of maternal and child health, nurses are essential to reducing and managing childhood obesity. The long-term goal of our research is to identify screening tools or early intervention targets that can help nurses, physicians, and public health teams implement tailored strategies to promote healthy growth in the Samoan setting. By understanding how metabolism develops in infancy, we can create culturally appropriate, community-based interventions that support families from the very beginning.
This work also highlights the importance of conducting research among Pacific Islanders, who face disproportionately high rates of obesity and diabetes yet remain underrepresented in maternal and child health research, especially in genetics. Our team is committed to addressing these gaps by working with communities (not just researching them) and ensuring our findings are meaningful and applicable. While research progress can feel frustratingly slow, we are dedicated to making sure the knowledge gained from this work is shared with and directly benefits the communities we serve.
The impact of the Dr. Patricia E. Thompson Global Nursing Research Grant for our team
Receiving this grant provided the resources needed to collect and analyze untargeted metabolomic data, allowing us to explore how genetic and environmental factors shape early metabolism among Samoan infants. Beyond funding though, this grant carried deeper significance. It validated the essential role of nursing in cutting-edge biomedical research and reinforced that nurses bring a unique, holistic perspective to scientific discovery—one that integrates biological insights with a community-centered, long-term vision for health. Given that many of us on the team are early-stage investigators, this grant also served as a crucial springboard for additional funding opportunities. For example, alongside my Pathway to Independence Award (K99/R00) from the National Institutes of Health (NIH), it provided essential pilot data for my first R01 submission, which is currently under review. Without Sigma’s support, we would not have been able to generate the foundational data that made these next steps possible.
Continuing the work
This research has set the stage for future studies. Our team is now expanding our focus to explore how maternal factors, such as glucose levels during pregnancy, interact with the CREBRF variant to shape infant metabolism. Ultimately, our goal is to bridge the gap between genetics and practical nursing interventions to ensure that our discoveries translate into meaningful changes in clinical practice and public health.
But this is just the beginning. We envision a future where precision health strategies—guided by genetic and metabolic insights—help reduce obesity from the earliest stages of life. Through continued collaboration with nurses, physicians, geneticists, and public health experts, we aim to turn research into action while building capacity for research in the Samoan setting. Our work isn’t just about understanding metabolism; it’s about making a lasting impact on health, equity, and the future of nursing science.
To learn more about the contributions that made this grant possible, visit Sigma Foundation for Nursing.
About the research team:- The OLaGA Study Group is a cross-institutional and international team that uses a life course approach to understand the origins of obesity-related diseases among Samoans and other Pacific Islanders while developing and testing interventions to address them.
- Lacey W. Heinsberg, PhD, RN, is an Assistant Professor of Nursing and Human Genetics at the University of Pittsburgh and a member of Sigma’s Eta Chapter.
- Ulai Tapa Fidow, MD, is a medical doctor at the Samoa Ministry of Health.
- Nicola L. Hawley, PhD, is an Associate Professor of Epidemiology (Chronic Diseases) at Yale University.
- Daniel E. Weeks, PhD, is a Professor of Human Genetics and of Biostatistics and Health Data Science at the University of Pittsburgh.
- Stacy L. Gelhaus, PhD, is an Associate Professor of Pharmacology and Chemical Biology at the University of Pittsburgh.
Declaration of generative AI and AI-assisted technologies: ChatGPT 4o was utilized to provide feedback on this article, aiming to enhance readability, language, and flow. After using this tool, the author carefully reviewed and edited the output, and she takes full responsibility for the content.