Epidemics are not what they used to be. Certainly, communicable diseases from Ebola to tuberculosis still flourish. But the biggest global threats to health these days are NCDs – non-communicable diseases. Just because they’re not immediately life threatening doesn’t mean that they pose any less danger in the long term: NCDs are currently the world’s top killers. In short, lifestyle-related diseases – such as diabetes, heart and lung disease, cancers and obesity – are prevalent in the cities that are increasingly home to the majority of the world’s population.
Enter Sarphati Amsterdam, a new research initiative, initially devoted to all things obesity-related, to be launched this year. By pooling together the best minds in scientific research, the government and the private sector, Sarphati Amsterdam – named after the 19th-century Amsterdam doctor and city planner Samuel Sarphati – aims to promote healthy lifestyles and find out where we’ve gone so wrong in the past. Amsterdam is no stranger to cutting-edge research: its GGD (Gemeentelijke Gezondheidsdienst), the municipal health service that oversees the well-being of all children until the age of 18, is world renowned for its work. Sarphati Amsterdam will make use of the GGD’s built-in study group of all of the city’s children, and will work with research institutions including the University of Amsterdam (UvA), the Academic Medical Center (AMC), the Vrije University and its Medical Center (VUmc) and the Amsterdam University of Applied Sciences (HvA). With this collaborative effort to study obesity, Sarphati Amsterdam clearly has high ambitions.
You changed the name from Sarphati Institute to Sarphati Amsterdam in the run up to the launch. Why?
Arnoud: We realised that the word ‘institute’ implies a big distance from people on the street. We would like to contribute to the health of Amsterdam’s population for the sake of its citizens: they have a stake in this project too. The Sarphati community will be interactive, enabling people to communicate with each other and with professionals.
So what is Sarphati Amsterdam all about?
Arnoud: We will focus on new epidemics, one of which is obesity, at the local level. Although research is being done on these epidemics, it is not integrated. We will do innovative research within a network of disciplines.
Jaap: Amsterdam provides a unique structure for our research. Children are followed by the GGD, with the help of their schools, from birth until they are 18 years old. Additionally, Amsterdam has a longterm goal to promote healthy lifestyles. So we have the policy, the infrastructure and the expertise to bring it all together.
Is this what you mean by the ‘Triple Helix’ model?
Jaap: Yes: researchers, government and private partners will be working together. We’re lining up all types of collaborators. To promote healthier lifestyles for children, we need to create partnerships with caterers, retailers and IT partners who can, for example, make apps for smartphones.
I recently attended a UNICEF meeting in New York. The growth of healthy children is a major global issue. Although no one has found a solution yet, we know it must be multi-dimensional. We need an integrated approach, given the current changes in the areas of food and the environment. Amsterdam has the ambition to excel in science and public health, and can provide this integration. And not only Amsterdammers will benefit, but global citizens as well.
The indigenous Dutch are notoriously tall and svelte, but there are many different ethnic groups in the city. How does that factor into your research?
Arnoud: Diversity is the nature of Amsterdam, which makes the group we study very unique.
Jaap: The problem differs in different ethnic groups. Children from Turkish or Surinamese backgrounds are more often overweight. So we are looking into why: is it culture, class, the neighbourhood? Different communities also have different body perceptions and ideals. We’re looking into this from different disciplines.
Tell me more about these so-called ‘new’ epidemics.
Jaap: Global non-communicable diseases are all lifestyle-related, and linked to social and economic differences. 80% of the population in low- and middle-income countries suffers from these diseases. They also threaten economies. Although [UN Secretary General] Ban Ki-moon has developed a prevention plan, no one has found a solution yet. It’s a global challenge: half of the world’s population currently resides in urban areas. In the coming years, that number will reach 75%. Our question is how cities, stakeholders and citizens can contribute to solving the problem. We are not starting from scratch: the city, universities and the GGD have been working together for a long time. A grant from the city has now made it possible to create the infrastructure to cement it all together.
Are there similar models in other parts of the world?
Leeds in England has a similar program. In Amsterdam, 10,000 babies are born annually and they are all included in the study. Our research includes 150,000-160,000 children and young adults, which makes it dynamic and enables intervention studies [to test hypotheses about the determinants of the diseases].
What can we expect in 2017?
Jaap: Our first research meeting in March on the promotion of healthy growth and lifestyles brought together more than 30 researchers from different disciplines – ethnographers, pediatricians, anthropologists and microbiologists. Our initial research is into microbiomes: the correlation of certain bacteria in the body with obesity and weight loss, and ethnography. For example, we want to learn more about how parents and care providers from different cultural backgrounds raise their children with respect to food. There are many overweight children with a high BMI (body mass index). We are focusing on lifestyle and the creation of a healthy environment, which is good for both mental and physical growth.