Primer Grants

Methods to reduce the burden of obesity and type 2 diabetes in Aotearoa are desperately needed, with obesity one of the greatest predisposing factors for type 2 diabetes as well as heart disease, and certain cancers. One promising intervention is a structured programme of a period of rapid weight loss, followed by supported weight-loss maintenance called DiRECT.

DiRECT has been successfully applied in the UK, where its broader uptake is now being phased in throughout the country. The trial will determine if the DiRECT approach is accepted and useful in Aotearoa. The trial is conducted from Te Kāika Health, a Māori Health Provider and medical practice of 5200 Māori, Pacific, refugee, and low-income clientele in South Dunedin. Acceptability outcomes in this pilot trial will enable us to tweak the international intervention to be relevant to Pacific and Māori.

Cardiovascular disease (CVD) risk for Māori people with diabetes is 30% higher than other ethnic groups, and Māori and Pacific people have a disproportionately higher CVD burden. Investing in early and more accurate means to identify people at high CVD risk, so that targeted and timely interventions can be administered, will benefit the community, and reduce the medical, economic and social burden.

The carotid-femoral pulse wave velocity (cf-PWV), a global measure of arterial stiffness, is well established as an additional, independent predictor of CVD events. A preliminary study estimated the normative PWV values in the NZ population. However, Māori and Pacific participants, who have the highest rate of CVD and poorest outcomes, were under-represented. This feasibility study aims to address the past limitations, by focusing on co-design of the research with Māori and Pacific communities and by conducting a pilot study to assess the recruitment rate and other practical aspects of data collection.

It is well over a hundred years since the invention of the electrocardiogram (ECG), yet shortcomings in the diagnosis and monitoring of heart disease incorporating this technology have not been satisfactorily addressed, until now. We will develop a novel ECG system that utilises our innovative AI software platform and a portable ECG patch to monitor heart rate for up to 96 hours continuously. This platform can detect heart abnormalities and disease more efficiently than conventional ECG and prevent errors by eliminating the need for manual reading and interpretation. We will be able to provide cardiovascular disease (CVD) patients with convenient and remote real-time diagnosis and monitoring that they can access regardless of their location in New Zealand.

With this funding we will recruit 100 Māori and Pacific Peoples from the south Auckland community for our study to ensure that the technology we are developing works for them. The participants will have been referred for chest pain, palpitations, breathlessness, or high-risk factors of Atrial Fibrillation/stroke.

Hypertension disproportionally impacts Māori and this funding is enabling us to work in partnership with Māori healthcare providers, iwi, patients and whānau to ensure our approach to using heat therapy is accessible and culturally-appropriate

The aim of this project is threefold:

1. to determine the optimal dosage of heat therapy (bathing duration and water temperature) for lowering blood pressure 
2. to further investigate the physiological mechanisms driving this change 
3. to examine how heat therapy might improve non-physical aspects of hauora

“We are looking forward to examining the role of heat therapy (spa bathing) in lowering blood pressure and investigating the physiological mechanisms driving this effect, alongside examining the potential of heat therapy to improve non-physical aspects of hauora.”

This project was completed in August 2022. The focus of the project was to investigate a DNA variant in a gene that is found at a high frequency in Māori and Pacific people and has been linked to lower blood pressure but increased risk of kidney failure in the setting of type 2 diabetes.

The researchers generated a rat with the equivalent gene variant and found that it shows lower systolic blood pressure, as expected from the human studies. Unexpectedly, they also found that the rats drink and urinate much more than the control rats. Based on these new findings, the researchers suspect that the Vasopressin hormone system is perturbed (which is involved in regulating water balance in the body) and this is now under further investigation.

Since being awarded this project, the team were successful in getting a Health Research Council project grant and Maurice Wilkins Centre funding to continue this work. A research partnership has been established with Ngāti Porou Oranga and knowledge is disseminated locally by Ngāti Porou Oranga newsletters and their public-facing website. 

This primer grant facilitated a collaboration with Dr Nikki Earle see if there was an association between the rs1800795-C gene and acute coronary syndrome outcomes in Māori and Pacific peoples. The project also helped facilitate bidirectional knowledge transfer between the research team and Tangaroa College staff and students. Tangaroa College is low decile South Auckland high school that has predominantly Māori and Pacific students. Through this grant the research team engaged with Tangaroa through several programmes including delivering a metabolic disease-related module to a senior science class, hosting Tangaroa College students for a day at the University of Auckland and running a scientific study design workshop.