Professor of Nutritional Sciences, Pediatrics, and Population Health Sciences
Director, Didactic Program in Dietetics, 2008-2017
B.S. 1987, Taipei Medical College (Taiwan)
Ph.D. 1994, University of Wisconsin – Madison
M.S. 2002, University of Wisconsin – Madison (Biostatistics)
Precision nutrition in cystic fibrosis: clinical and epidemiological studies linking nutrition and disease outcomes.
Cystic fibrosis (CF) is a genetic disease that affects more than 30,000 Americans. Malnutrition and lung disease reduce survival of cystic fibrosis patients; 20% of deaths occur before 20 years of age and half die before mid 30’s. CF is caused by mutations in the cystic fibrosis transmembrane regulator (CFTR) gene, resulting in defective chloride transport and production of viscid secretions of low water content in exocrine glands. Major clinical manisfestions of CF include malnutrition, growth faltering, nutrient deficiencies, airway obstruction and recurrent respiratory infections, leading to pulmonary failure.
Our research group investigates how nutrition affects treatment, quality of life and survival in people with cystic fibrosis (CF), one of the most common genetic diseases in the US. The ultimate goal of this research is to develop personalized nutrition therapy and evidence-based clinical practice guidelines to improve clinical care and health outcomes of CF. Since 2012, we have been conducting a prospective multi-center clinical study referred to as FIRST (Feeding Infants Right… from the STart) in six CF centers located in five states (WI, IL, IN, MA and UT), that follows a birth cohort of 180 children with CF from the neonatal period to 6 years of age (2024). FIRST has expanded to include many ancillary studies such as breast milk composition, gut microbiome with sibling control, probiotic supplementation, chest computed tomography and lung clearance index, and nutrigenomics and pharmacogenomics using whole genome sequencing-derived genotype data. The goals of FIRST are to identify optimal feeding regimens during infancy, to predict non-responders of vitamin D supplementation, to resolve the longstanding controversy of essential fatty acid supplementation, and to advance our understanding of the gut microbiome and its relationship to obesity, malnutrition, diabetes and liver diseases in children with CF.
Lai HJ, FitzSimmons SC, Allen DB, Kosorok MR, Rosenstein BJ, Campbell P and Farrell PM. Persistent growth impairment in children with cystic fibrosis following treatment of alternate-day prednisone. New Engl J Med. 2000;342: 851-859.
Lai HJ, Cheng Y, Cho H, Kosorok MR, Farrell PM. Association between initial disease presentation, lung disease outcomes and survival in patients with cystic fibrosis. Am J Epidemiol 2004;159:537-546.
Shoff SM, Ahn H, Davis LA, Lai HJ. Temporal associations between energy intake, plasma linoleic acid and growth improvement in response to treatment initiation after diagnosis of cystic fibrosis. Pediatrics 2006;117:391-400.
Lai HJ and Shoff SM. Classification of malnutrition in cystic fibrosis: implications on evaluating and benchmarking clinical practices. Am J Clin Nutr 2008;88:161-166.
Lai HJ, Shoff SM, Farrell PM, and the Wisconsin CF Neonatal Screening Group. Recovery of birth weight z-score within two years of diagnosis is positively associated with pulmonary status at age six years in children with cystic fibrosis. Pediatrics 2009;123:714-722.
Yan J, Cheng Y, Fine JP, Lai HJ. Uncovering symptom progression history from disease registry data with application to young cystic fibrosis patients. Biometrics 2010;66:594-602.
Zhang Z, Lai HJ, Roberg KA, Gangnon RE, Evans MD, Anderson EL, Pappas TE, Dasilva DF, Tisler CJ, Salazar LP, Gern JE, Lemanske RF Jr. Early childhood weight status in relation to asthma development in high-risk children. J Allergy Clin Immunol 2010;126;1157-1162.
Jadin, S, Wu GS, Zhang Z, Shoff SM, Tippets BM, Farrell PM, Miller T, Rock MJ, Levy H, Lai HJ. Growth and pulmonary outcomes during the first two years of life of breastfed and formula-fed infants diagnosed through the Wisconsin routine cystic fibrosis newborn screening program. Am J Clin Nutr 2011; 93:1037-1047.
Sun X, Peng L, Huang Y, Lai HJ. Generalizing quantile regression for counting processes with applications to recurrent events. J Am Stat Assoc 2016;111:145-156.
Zhang Z, Lindstrom M, Farrell PM, Lai HJ. Pubertal height velocity and adult height in patients with cystic fibrosis diagnosed through the Wisconsin randomized clinical trial of newborn screening. Pediatrics 2016;137:e20152907.
Sander DB, Zhang Z, Farrell PM, Lai HJ. Early life growth patterns persist for 12 years and impact pulmonary outcomes in cystic fibrosis. J Cyst Fibro 2018;17:528-535.