Dr. Rob van Dam’s research is focused on nutrition and physical activity in the development of obesity, type 2 diabetes, and cardiovascular diseases. He is interested in extending this research to diverse ethnic groups. The ultimate goal of this research is to inform recommendations and policies for the lifestyle prevention of chronic diseases. He conducts epidemiological studies, trials, and meta-analyses to define more precisely what aspects of dietary and movement patterns affect cardio-metabolic health. For this purpose, he is currently incorporating metabolic and proteomic biomarkers and device-based and digital assessments to gain more insight into patterns of lifestyle behaviors. He has conducted pioneering research on the impact of dietary composition in type 2 diabetes and on diet and cardio-metabolic diseases in Asian populations. In addition, he examines how the cultural and physical environment influence lifestyle behaviors to bridge epidemiological studies and behavioral interventions. In more detail, his research has focused on the following topics:
The role of dietary factors in developing type 2 diabetes: The research by Dr. van Dam and colleagues have provided novel insights into the role of dietary composition in the development of type 2 diabetes. For example, they were the first to report that dietary patterns were associated with diabetes risk independent of adiposity (van Dam RM et al. Ann Intern Med 2002) and that higher coffee intake is associated with lower diabetes risk (van Dam RM and Feskens EJ. Lancet 2002). In addition, their research provided early evidence for a beneficial role of the flavonoid anthocyanin (Wedick NM et al. Am J Clin Nutr 2012) and a detrimental role of processed meat intake (van Dam RM et al. Diabetes Care 2002) in the development of type 2 diabetes. These findings suggest that diet may affect diabetes risk beneficially (phytochemicals) and adversely (components of processed meat) independent of energy balance and macronutrient intakes. Finally, they have extended their research on the impact of coffee consumption to other health outcomes contributing to the evidence that moderate coffee consumption can be part of a healthy lifestyle in non-pregnant individuals (van Dam RM et al. NEJM 2020).
Effects of obesity throughout life and physical activity on chronic disease risk and mortality: Dr. van Dam and colleagues have highlighted the importance of adolescent adiposity for premature mortality, particularly cancer mortality, showing a monotonous association between higher body mass index and a higher risk of chronic diseases and premature mortality (van Dam RM et al. Annals of Internal Medicine 2006; de Mutsert R, et al. Am J Epidemiol 2014). In addition, they identified adiponectin levels as a consistent mediator of the effects of adiposity on diabetes development (Li S et al. JAMA 2009). They also conducted meta-analyses indicating that physical activity can contribute to long-term weight maintenance (Wu T et al. Obesity Reviews 2009), and moderate activity is associated with lower diabetes risk (Jeon CY et al. Diabetes Care 2007). Finally, they estimated that the impact of diet, physical activity, and obesity on premature mortality in US women was similar in magnitude to smoking (van Dam RM, et al. BMJ 2008).
Dietary patterns and risk of cardio-metabolic diseases in Asian populations: Dr. van Dam’s team examined dietary patterns and foods commonly used in Asia in relation to cardio-metabolic conditions. A key result has been that associations between diet quality indices such as the DASH and AHEI-2010 scores and chronic disease risk were remarkably consistent for western and Asian populations supporting dietary recommendations aligned with these dietary patterns (Neelakantan N et al. J Nutr 2018. Chen GC et al. Am J Epidemiol 2018). In addition, their meta-analyses of clinical trials showed that consumption of palm oil (Sun Y et al. J Nutr 2015) and coconut oil (Neelakantan N et al. Circulation 2020) substantially increase LDL-cholesterol levels compared with non-tropical cooking oils. Furthermore, replacing carbohydrates with polyunsaturated fat, but not saturated fat, was associated with a lower risk of cardiovascular diseases in a multi-ethnic Asian cohort (Lim C et al. Am J Clin Nutr 2021). These findings suggest that greater attention to dietary fat quality in Asian populations is warranted. They also facilitated nutrition research by developing and validating a food frequency questionnaire for a multi-ethnic Asian population (Whitton C et al. Nutrients 2017).
Lifestyle, metabolomics and proteomics, and cardio-metabolic diseases: Dr. van Dam and colleagues identified enterolignans, gut microbiota metabolites of dietary lignans, as potential contributors to the beneficial effects of plant foods on diabetes risk (Sun Q et al. Diabetes Care 2014). They also examined dietary and lifestyle determinants of metabolomic, lipidomic, and proteomic profiles. For example, we reported that higher intakes of polyunsaturated fatty acids and protein were associated with more favorable sphingolipid profiles (Seah JY et al. Metabolites 2021). These sphingolipid profiles were, in turn, associated with the risk of cardiovascular diseases (Seah JY et al. Metabolomics 2020), suggesting that sphingolipids may be novel mediators of the effects of diet on cardiovascular diseases. They also conducted research highlighting the consistency of associations between metabolomics profiles and diabetes risk for Asian and European populations (Seah JY et al. J Clin Endocrinol Metab 2022).
Genetic, cultural, and environmental determinants of eating behaviors and obesity
Dr. van Dam and colleagues conducted research highlighting the strong association of ethnicity with obesity independent of socioeconomic status and geographical location in a multi-ethnic Asian setting (Park SH et al. Obesity 2020). They also conducted quantitative and qualitative research on cultural determinants of eating behaviors (Chen LW et al. Public Health Nutr 2014; Reddy G, van Dam RM, Appetite 2020; Lim CG Appetite 2020). This research showed that the social environment and traditional health beliefs play a prominent role in food choice in Asian populations. Furthermore, they have examined the genetic determinants of food choice and identified genetic variants associated with the consumption of coffee, other bitter beverages, and foods, and obesity-related eating styles (Cornelis MC et al. Plos Genet 2011, Obesity 2013, Sci Rep 2021). In addition, their intervention research has provided insights into the role that food labels can play in changing food choices (Seah SS et al. IJBNPA 2018; Finkelstein EA et al. Nutrients 2019). Furthermore, they showed in a cluster-randomized trial how a healthy dining program targeting vendors and consumers could improve food consumption Asian institutes of higher learning (Seah SS et al. Food Policy 2022). Currently, they are conducting the COBRA study with continuous assessment through multiple devices to understand better personal and environmental determinants of diet and physical activity (Edney SM et al. Digit Health 2022).