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About the Institute

Profile of Jill Hamilton

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Dr. Jill Hamilton

Dr. Jill Hamilton, MD

  • Senior Associate Scientist, Translational Medicine
  • Staff Endocrinologist, Division of Endocrinology
  • Associate Professor, Department of Paediatrics

1. Where are you from?/Where did you study?
I was born in Canada and moved a lot as a young child, mostly growing up in the Ottawa area. I studied medicine in Ottawa and then came to Toronto for both my paediatric and endocrinology training. I’ve been on staff at SickKids since 2000.

2. What are you researching right now?
I am interested in looking at the determinants of metabolic risk in obesity and trying to understand the differences in the physiology and other factors that may predispose one person who gains weight to develop problems like diabetes or high blood pressure, versus others who don’t.

Obesity is a very complicated and important issue for child health. Part of our research is supported by a team grant from CIHR which is called High Impact Strategies Toward Overweight Reduction in Youth (HISTORY). I’m working with several other investigators, including Dr. Brian McCrindle in Cardiology, Dr. Greg Wells, an exercise physiologist, as well as Dr. Paul Pencharz in Nutrition. We are studying children of different body weights, and performing various investigations to understand their physiology. This includes looking at how their pancreas works, how much insulin they can secrete and how sensitive their body is to insulin. It also includes different metabolism tests including exercise tests to see how different kids burn energy and how their muscles recover from exercise. We use an MRI machine to look at ectopic fat – the fat that accumulates outside typical fat stores, underneath the skin. The way that fat is located in the body influences an individual’s risk for diabetes. If a person’s fat is under the skin and there is not a lot inside the belly, or particularly inside the liver or pancreas, this may mean that they have a really low risk of diabetes. But if a person has ectopic fat, located in these organs, then the organs don’t work well and they will be more likely to get complications related to obesity.

I’m also interested in trajectories of weight gain in children that might be at risk of obesity later on. I’m looking at children born to women who have had gestational diabetes (diabetes while pregnant). These babies have been exposed in utero to a different environment than babies born to a mom who didn’t have diabetes during pregnancy. We know from long-term studies that if mom has diabetes, then the baby is more at risk to have diabetes and is more likely to be obese. However, we don’t really understand how this occurs. We’re studying a group of moms, some with diabetes and some without. Then, when the babies are born, we’re following them as they grow up. I am collaborating with endocrinologists who are following the moms, while we’re following up with the children at birth, three months, and then every year for five years.

I am also interested in a group of children with a type of brain tumour called craniopharyngioma. About half of these kids develop very serious weight gain because the tumours are often located right near the appetite centre of the brain and the site that regulates body weight. It gets disturbed, either by the tumour or by the treatment and then they have a really rapid trajectory of weight gain and it’s very difficult to manage. We’ve been studying how these children differ from others who are overweight who didn’t have this tumour. We look at their risks for heart disease and diabetes among other risks.

On the clinical side, I am director of the SickKids Team Obesity Management Program (STOMP) clinic with my colleague Dr. Catherine Birken in the Department of Paediatrics. As part of the clinic, we are performing bariatric surgery with Dr. Jacob Langer in a small group of kids, and we’re observing them before and after surgery. We’re the only paediatric centre in Canada performing this type of surgery in kids and because it’s a new field, we are studying the teens carefully before and after surgery to evaluate their changes in physiology and also capture changes in psychological function and other parameters of health.

Another issue is the psychology of behaviour as it relates to body weight. With one in four overweight kids, there are obvious steps that need to be taken to change behaviour in our society. Many families know what they’re supposed to do but they need to be able to figure out how to do it in their environment. With psychologist Dr. Beth Dettmer, we’re conducting a randomized control trial in a community obesity program where we’re looking at motivational interviewing versus social support to see if we can teach children to make changes through their own motivation. It’s a technique that has been used quite successfully in smoking cessation and other types of behavioural programs.

3. Who is your all-time favourite scientist, and why?
This may be unoriginal, but the first name that comes to mind is Albert Einstein. He was a great intellect and passionate about science. It’s amazing how he developed his theories of relativity and published ground breaking papers while working at a patent office. Plus, he has some of the best quotes ever!

4. What in your opinion is the single most important scientific breakthrough, and why?
Ok, I’m biased, but I have to support the home team and say the discovery of insulin.  When Banting and Best figured out a way to extract and purify insulin, they changed the course of type 1 diabetes from a fatal disease to one where individuals can live long and healthy lives.

5. What are your major interests outside the lab?
I have two boys aged13 and 11, and have been really involved in what they’re doing. They both play a lot of sports, so we spend a lot of time at soccer fields, football fields and basketball courts cheering them on. I also love to read and attend the theatre.

6. Why science?
I think I’ve always been a curious person. As a kid, I was always asking questions and it was my nature to challenge the status quo. I moved schools a lot and was constantly in a new environment and that gave me the opportunity to view things from different perspectives. 

I knew that I wanted to do academic medicine and paediatrics but I hadn’t thought a lot about a career in research until I became a resident. As a medical student, I spent my summers working in labs. When I became a resident and realized I wanted to do endocrinology because I really loved the physiology, it made me want to do research and look into some of the existing issues in the field. I was lucky to have a lot of support from my mentor, Dr. Denis Daneman. He always encouraged me and supported me in all my endeavors.

When I first came to SickKids, there was no obesity program. At that time, it wasn’t considered a priority issue for a tertiary care facility. Over the years, I’ve been able to convince a few people that there are tertiary care elements to the management of obesity. It is really to nice to be able to provide the care that my patients need but also have the capacity to conduct studies that help us develop better strategies to treat them. Not too long ago, high blood pressure was always treated the same way. Nowadays, the underlying cause for the high blood pressure is determined, and treatment is targeted based on the pathophysiology. I believe we need to take the same approach when addressing obesity.

7. Why SickKids?
Once I decided I wanted to do academic paediatric endocrinology, I knew SickKids was the only place in Canada that would give me the breadth and depth of experience that I was looking for. In Toronto, I have the opportunity to work in collaboration with other investigators within the other University of Toronto and SickKids. In my clinical and research area of interest, obesity issues are important for every subspecialty. In our STOMP clinic we see kids who have chronic illnesses, where increased weight impacts not only their general health but also their underlying chronic illness. They might have congenital heart disease and the obesity is putting an extra strain on their heart or they have a bone problem and the extra weight is impacting their mobility.

8. What is the most controversial question in your field right now?
When we think of obesity and why it develops, the question is: How much of it occurs because of genetic susceptibility versus physiologic differences versus environmental exposures versus lifestyle choices? We need to better understand why some people are more vulnerable or susceptible than others to weight gain.

As a society, obesity remains a prominent source of discrimination or stigma. I think that understanding the science behind why people gain weight will help us to reduce this stigma. Particularly for children, this discrimination can be heartbreaking. I want to try and change the ‘shame and blame’ culture that surrounds the topic of obesity.

9. What are you reading right now?
I’m reading an excellent book called the Disciple of Las Vegas, the second in a series of four novels by Ian Hamilton. It’s an excellent read, although I may be a little biased because he’s my father!  

My dad worked primarily as a businessman, and travelled a lot throughout his life. A few years ago, he required urgent surgery for an aortic aneurysm. While recovering, he made the decision to pursue one of his lifelong goals – to write a mystery novel. He completed his first book, The Water Rat of Wanchai, in just four months. The protagonist is Ava Lee, a young Chinese Canadian forensic accountant who retrieves money for her clients. She is a very strong female lead character. Now, he has a series of four books and his publisher will be releasing one book every six months. He also just received a movie deal. He is really an inspiration to me!

10. If you could give one piece of advice to someone considering a research career, what would it be?
Do something you love. To be fulfilled in your career choice, you have to really care about the questions you are asking.

11. What does the Research & Learning Tower mean to you?
I think it’s a positive opportunity to interact on a new level with other people in science. Blending disciplines and departments will create more opportunities for synergy and collaborative research. We always have something to learn from each other, and my hope is that this environment will facilitate innovation and move science in new directions.

November 2011

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