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Sydney Sester, a fifth grade student at Manchester Elementary School in Clay County, Ky., didn't expect to be a scientific researcher at the age of 10. But she's one of more than 100 elementary students in the county who have been working with University of Kentucky researchers to answer questions about weight and body clocks, or circadian rhythms, in children. 

"I'm just glad they picked us to do it, because I never thought I would do this. I'm glad I did, too," she said. 

The project,  "Circadian Rhythm Parameters and Metabolic Syndrome Associated Factors in Young Children", also known as the Clay County Clock Study, is led by co-principal investigators Dr. Jody Clasey, associate professor of kinesiology and health promotion, and Dr. Karyn Esser, professor of physiology. The research team hopes to learn about the relationship between circadian rhythms, eating, and activity behaviors and the incidence of overweight and obesity in children. 

Funded by a pilot grant from the UK Center for Clinical and Translational Science, the project was designed as a community-engaged partnership from the beginning. It draws on the diverse expertise of UK researchers from public health, kinesiology, and physiology in close collaboration with the students and staff of Clay County public schools. Together, the UK and Clay County faculty and staff planned every detail of the project so that it would not only generate the necessary data but also supplement the curriculum of the students and not disrupt their school time. Two Clay County elementary schools, Manchester and Oneida, participated. 

"UK didn’t go down to Clay County and do a study," said Clasey. "We met in the middle and we each have contributions that make the sum of our contributions worth more than independent efforts… It’s not only about promoting the science and discovery but establishing long-term relationships with the community." 

She was particularly encouraged by the response of one student who was asked to share the study devices with a friend who wasn’t participating in the study. 

"I was so pleased to hear that one of the children, when asked to give up part of the device by another child, said, 'I can’t. I am a university of Kentucky researcher,'" recalled Clasey. 

Esser agrees that "the key to all of this was our community connection with Clay County Schools." In fact, the study would have been impossible without the fourth and fifth graders in Clay County, who gained first-hand experience in research and data collection. For one week, the students wore FitBits and a new, noninvasive skin temperature monitoring system, about the size of a watch battery, to gather physiological data. The students also recorded their sleep and eating activities each day.  

For Clay County administrators and teachers, the collaborative project was immediately appealing because it actively engaged students in applied sciences while promoting healthy behaviors. Deann Allen, the instructional supervisor, district assessment coordinator, and district health coordinator for Clay County public schools, saw the project as a unique opportunity for students gain hands-on experience conducting research. 

"With the introduction of the next generation science standards, we're moving away from learning science in a book. But instead, we want kids to learn how to do science, be a part of science, and what better way than to be a researcher in your own science project," she said. "This is a chance for our students to interact with real researchers. And we want to make sure that every child, whether in the city limits or on the banks of the Kentucky River, has the same opportunities." 

Sester, a Clay County fifth grader, says that in addition to learning more about science and helping others by contributing to research, participating in the study showed her the importance of maintaining a healthy weight and eating well. 

"It made me want to be more responsible with food and be patient with what I eat and only eat when I'm hungry," she said. 

Kentucky has elevated rates of childhood obesity and overweight, but the incidence is particularly high in rural Appalachian areas. Previous studies have demonstrated that circadian rhythm disruption is associated with increased risk for metabolic disease in adults, but similar research with children has been limited. 

"What the circadian field has taught us is that there are associations between disruptions and circadian health and development of chronic disease, in particular metabolic disease and cardiovascular disease," said Esser, who brings more than decade of circadian rhythm expertise to the project. "And, in particular, Clay County and many of the counties in Appalachia have a much higher rate of these chronic diseases." 

While we've known that light exposure affects the body clock, recent findings indicate that the time of physical activity and time of eating (even beyond what you eat) contribute to circadian health.  There is reason to believe that these lifestyle factors contribute to metabolic health in children, but very little is known is known to date.  The research team hopes that the study will lead to better understanding of how and when in incorporate meals and physical activity into children's -- and families' -- lives to prevent chronic disease. 

"It could not only influence an individual, but school start times, activity intervention, just so many different areas from personal practice or behavioral choices to public policy, all for the metabolic or physiological good of the individual or collective body," said Clasey. 

Esser similarly sees the need to cultivate individual behaviors and understanding about how and why to keep our body clocks working for optimal health. 

"We would have to be working with the parents and the families to limit late night eating, and [promote] getting out and getting sunlight and physical activity during the day," she said. "There are reasons for trying to get them to think about these things -- that if they're watching the moon rise or set or the sun rise or set, that that’s related in many ways to what’s going on in your body." 

For Allen and the staff of Clay County schools, the research findings could also inform how children spend their time at school. 

"We're hoping that this will give us information to better structure our school day so that it to matches students' circadian rhythms and they can get the most out of their educational experiences," said Allen. 

The project builds upon a partnership that was originally initiated by Dr. Jill Day, a Clay County native turned UK faculty member, who partnered with the Clay County school system to study the relationships between physical activity, body composition, and academic achievement in rural children for her doctor of education (Ed.D) dissertation at UK. Clasey served as Day's dissertation advisor. 

Allen describes Day as a local hero who is inspiring a generation in Clay County. 

"She has a servant's heart and she wants to give back to her community, and what better way than to influence the next generation of scientist," Allen said of Day. 

As a reward for participating in the research project, the Clay County students took a field trip to UK's campus in April, touring the campus, visiting science labs, eating in the dining hall, and even meeting UK President Eli Capilouto.  Day knows that for some of the students, the trip to UK was their first outside of Eastern Kentucky. 

"For some of them, it will be a once-in-a-lifetime opportunity that they've never had -- to come here to UK and see that there's more than that what's in their hometown, and get them excited about science and research and their own health," she said. 

The project has had a personal impact on members of the research team, too. 

"I have to say this project has touched me in all kinds of ways. I love the science -- that is the kind of thing that has driven me my whole career -- but yes, having an impact on the kids at a time that can impact their health for the rest of their life was very humbling to me," said Esser. 

This story is part one of our coverage of the Clay County Clock Study. See the next segment of the story & video here

This story is part of a going series exploring how UK is working with communities in Appalachia. Read more at Rooted in Our Communities: The University of Kentucky

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