Student Profile - Dr Alex Hodge

Alex Hodge

Student Profile - Dr Alex Hodge

Like all other health professionals, consultant gastroenterologist Dr Alex Hodge is very concerned about obesity; and not just because of the increased risk of heart disease, diabetes and high blood pressure.

Alex is worried about chronic liver disease, with good reason. As many as 40% of adults in western countries have fatty liver disease, and of those, 5-7% will develop scarring of the liver, known as cirrhosis.

Alex’s PhD, completed in May 2015 at the School of Clinical Sciences, addressed the two foremost concerns in clinical hepatology today: finding a treatment for patients with cirrhosis and treating the emerging epidemic of non-alcoholic fatty liver disease (NAFLD).

With no current successful therapies for end-stage liver disease, Alex investigated the potential of a novel cell-based therapy, the amniotic epithelial cell (hAEC) to restore the liver.

“Using animal models and cell culture, I looked at specific liver cells that drive fibrosis and liver regeneration and how those cells are influenced by the treatment of placental stem cells,” said Alex.

“My research showed this cell-based therapy has the potential to regenerate the liver, and adds to the growing body of evidence for the use of hAEC as a therapy of chronic liver disease.”

The other part of Alex’s Phd examined treatment strategies for NAFLD, now the most common liver disease in the world.

“By 2020, more people will have cirrhosis from NAFLD than all the people with hepatitis B and hepatitis C combined,” said Alex.

The cause?

“Obesity. Fat in the liver—bad fat. The tyre that 40% of Australian adults walk around with,” said Alex.

The only solution is weight loss, or as Alex prefers to call it, ‘waist loss’.  

Given the poor response to advice about diet and exercise, Alex looked at the barriers for people losing weight in the long term.

“I had read about some animal studies a few years ago that examined the effects of time-restricted feeding with striking results, however, there were no human studies to date.”

In a world-first study, Alex carried out a 12-week randomised controlled clinical trial of a novel lifestyle modification (intermittent fasting) compared to calorie restriction and exercise advice.

“Surprisingly, if you look at the literature involving lifestyle intervention and diet, there are almost no randomised controlled trials – even for the popular 5/2 diet,” said Alex.

“My research study compared a group who was given standard advice about diet and exercise and another group who could eat only between 12pm-8pm without restricting their calories.”

While both groups reduced their weight, total body fat mass and body mass index, only intermittent fasting resulted in an improvement in transient elastography, waist circumference, visceral fat volume, blood pressure and insulin resistance.  

“Through this pilot study I showed that counting minutes, not calories is a well-tolerated, safe and cheap method of weight loss.”

“Significantly, in addition to weight and total body fat loss, intermittent fasting appears to target liver and visceral fat in a way that standard diet and exercise advice do not.”  

With his PhD complete, Alex plans to further his research in stem cell-based therapy for potential liver regeneration while continuing his important work in the clinic with patients.  He is he also currently looking at the association of coffee consumption and liver disease.

“I’d really like to set up a Metabolic Clinic at Monash Health, with a focus on obesity and fatty liver.”

“There is huge potential here at Monash Health Translation Precinct to do great research that positively impacts not just our patients but the wider population.”