Welcome to the spring 2022 issue of epigram, the newsletter from the MRC Epidemiology Unit. Now issued quarterly.
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In this issue
- Food for thought
- Influences shaping our behaviours and health
- Innovative approaches to studying proteins
- Understanding our growth and development
- Responding to COVID-19
- Researcher voices
- Cambridge Festival 2022
- Our latest publications
Food for thought
To offer sound advice and implement policies that support healthy diets, we need a good understanding of how what we eat affects our bodies, and what influences our food choices.
Heart disease risk from saturated fats may depend on where they come from
Heart disease is a major cause of death worldwide, but it is preventable. Health behaviour changes, such as exercising more, quitting smoking and eating healthier, are often recommended. One diet change commonly recommended by experts is to eat fewer saturated fats, such as those found in meat and dairy, and instead consume polyunsaturated fats, which are typically found in nuts, vegetable oils and fish and considered healthier. New research, led by Unit scientists Dr Marinka Steur and Professor Nita Forouhi, suggests that instead of only paying attention to the amount of saturated fat we consume, we should also look at what food sources it is coming from. Read more.
The role of NDNS in folic acid fortification
In September 2021, the UK government and devolved administrations announced the decision to introduce mandatory fortification of UK non-wholemeal flour with folic acid, the synthetic form of the vitamin B9/folate. Inadequate folate is a risk factor for neural tube defects and other poor health outcomes during foetal development, and can also cause a type of anemia in adults and children. By showing that folate concentrations in the blood have decreased since 2008, including in women of child bearing age, data from National Diet and Nutrition Survey Rolling Programme, currently carried out by the MRC Epidemiology Unit and NatCen Social Research, provided strong evidence to support folic acid fortification in the UK. Read more.
Transport for London’s junk food advertising ban linked to reduced purchases of high fat, salt and sugar products
Restricting the outdoor advertising of high fat, salt and sugar (HFSS) foods and drinks across the Transport for London (TfL) network significantly decreased the average amount of calories purchased by households every week from these products. That was the conclusion of an analysis by a research team led by the London School of Hygiene & Tropical Medicine (LSHTM) and including several Unit scientists. The study used data on nearly two million grocery purchases of HFSS foods and drinks to estimate the effect of the policy, which saw restrictions on advertising implemented across the London transport network in February 2019. Read more.
Influences shaping our behaviours and health
Obesity and type 2 diabetes are driven by influences on our behaviour. But how can we know what will encourage and enable healthier behaviours, both for patients and the wider population?
Seeing is believing when it comes to health risk and behaviour change
Changing risky behaviours such as smoking, poor diet, and lack of physical exercise can reduce the risk of diseases such as type 2 diabetes, heart disease or cancer. Researchers are keen to understand whether the growing use of medical imaging technologies could improve the outcome of interventions aiming to change risky behaviours. By analysing the results of 21 clinical trials involving over 9,000 patients, a team from the University of Cambridge, including Unit researcher Professor Simon Griffin, found that combining health information with visual examples of personalized risk information following an imaging procedure such as computed tomography, ultrasound, or radiography, was more effective than providing health information without visual feedback. Read more.
Planning for Action
The University of Cambridge has published a ‘Stories’ article about how our evidence and free online tools are helping planners design exercise into our towns and cities. The article discusses research undertaken by Dr James Woodcock, Dr Jenna Panter and colleagues that has provided evidence of a link between low levels of physical activity and poor health, and demonstrated how changing the built environment can be effective in increasing people’s activity levels. Their findings, and our development of free online tools directly supporting better transport planning, have already influenced transport policy in the UK and globally, promoting active travel as a means of increasing physical activity. Read more.
Young adults at highest risk of weight gain
“Middle-age” spread starts earlier than you might think. Research co-led by Unit scientist Dr Claudia Langenberg has found that young adults aged 18 to 24 are at the highest risk of becoming overweight or developing obesity in the next decade of their life, compared to adults in any other age group, and obesity prevention policies should target this group. By analysing anonymised primary care health records from more than 2 million adults in England between 1998 and 2016 they found that people aged 18 to 24 were four times more likely to become overweight or develop obesity over the next 10 years than those aged 65 to 74. They suggest this weight gain may result from behavioural changes when young people start work, go to university or leave home for the first time. Read more.
Innovative approaches to studying proteins
How our DNA influences our risk of developing obesity and health conditions has been studied intensely for decades, helped by analysis methods that allow fast measurement in many thousands of people. Now new techniques being pioneered by MRC Epidemiology Unit scientists promise to do the same with proteins, allowing researchers worldwide to dive deeply into information on genes, proteins and diseases. The researchers have made their data available to the research community on the Omicscience platform.
Filling the gaps: connecting genes to diseases through proteins
Hundreds of connections between different human diseases have been uncovered through their shared origin in our genome by an international research team led by Unit scientists Dr Maik Pietzner and Dr Eleanor Wheeler. The team generated data on nearly 5,000 circulating proteins in each of 10,000 Fenland Study participants, and combined this with genetic data. Genetic differences affecting the abundance or function of at least one of nearly 4,000 proteins circulating in the blood linked together seemingly diverse as well as related diseases, challenging the categorisation of diseases by organ, symptoms, or clinical speciality. Read more.
Proteomics techniques reveals importance of protein structure to health
In an analysis undertaken in blood samples from more than 10,000 Fenland Study Participants, an international research team led by Unit scientists Dr Claudia Langenberg and Dr Maik Pietzner demonstrated that otherwise hidden links between proteins and human health and disease can be identified by integrating information derived from different technologies used to measure proteins. The researchers also identified examples in which the results of the two proteomic assays for the genetic relationship of a protein with a particular disease differed, and attributed such effects to the differences in the affinity of the two technologies for different versions of the proteins that they called ‘proteoforms’. Read more.
Understanding our growth and development
How our brain uses nutritional state to regulate growth and age at puberty
An international scientific team, co-led by Unit researcher Dr John Perry, has discovered how a receptor in the brain, called MC3R, detects the nutritional state of the body and regulates the timing of puberty and rate of growth in children and increases in lean muscle mass. These findings may explain how humans have been growing taller and reaching sexual maturity earlier over the past century, and identifies the mechanism that links adequate nutritional body stores to reproductive maturity right across the animal kingdom. In addition to its importance to child development and reproductive health, this discovery suggests that drugs that selectively activate MC3R may help reverse the loss of lean muscle mass, and resultant frailty, that is associated with many chronic diseases.
This research included large scale genetic analysis in the half a million volunteers in UK Biobank, follow-up analysis in the Avon Longitudinal Study of Parents and Children, Fenland and EPIC-Norfolk studies, and experiments in cell and animal models. Read more.
Responding to COVID-19
Even as pandemic restrictions ease, our researchers are still studying COVID-19 and its impacts.
28 million extra years of life lost in 31 countries in 2020, study finds
An international team, led by former Unit member Dr Nazrul Islam who is now at the Nuffield Department of Population Health at the University of Oxford, and including Professor Martin White of the MRC Epidemiology Unit, analysed data for 37 countries from the Human Mortality Database for 2005-20.
The researchers found that years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, the number of years lost from premature deaths increased in 2020, with the highest decline in life expectancy in years observed in Russia, the US, and Bulgaria, and overall the excess years of life lost in 2020 were more than five times higher (2,510 per 100,000) than those associated with the seasonal influenza epidemic in 2015. Read more.
Fenland COVID-19 participants webinar
In July 2020 we launched a study in the Fenland Study cohort inviting participants to carry out antibody testing at regular intervals using the novel OneDraw device that enabled them to take their own dried blood sample at home.
The study’s main objective was to determine how many people had evidence in their blood of previous infection with COVID-19, and then to investigate whether it is possible to identify the COVID-19 pre-symptomatic phase using measurements of signs and symptoms collected via the Huma Fenland COVID-19 smartphone App, to help scientists develop better measures of early detection. The Fenland COVID-19 study closed in April 2021 when a large proportion of participants had received COVID-19 vaccines.
On Wednesday 9 March 2022 Fenland COVID-19 study investigators Dr Kirsten Rennie and Professor Nick Wareham joined Huma employees Dr Nikola Dolezalova and Dr Davide Morelli for a webinar for Fenland COVID-19 participants, with a question and answer session hosted by Fenland Study participant panel member Jane Bramwell. The webinar examined the preliminary findings of the study and their implications, as well as future research plans. Watch a recording of the webinar.
The views of Unit researchers are often sought on issues related to their work. Here are a few example from the last few months, and you can find more on our Researcher Voices page
University of Cambridge Mind Over Chatter podcast
Mind Over Chatter is the Cambridge University Podcast, where panels of experts from across different disciplines break down complex issues into simple questions.
On 13 January Unit geographer Dr Thomas Burgoine joined clinician and scientist Professor Sadaf Farooqi andhealth psychologist Professor Dame Theresa Marteau to discuss the role our genes and lived environment play in influencing our body weight and what we like to eat. Listen to the podcast.
On 20 January 2022 Unit behavioural epidemiologist Dr Esther van Sluijs discussed the link between sedentary behaviour, mentally passive activities and mental health, in a conversation with Professor of Child and Adolescent Psychiatry Tamsin Ford and Professor of Health Neuroscience Paul Fletcher. Listen to the podcast.
Why we need better evidence for the long-term health effects of weight loss in type 2 diabetes
In an article on our research blog MRC Postdoctoral Fellow Dr Jean Strelitz discusses the results of a systematic review she led with colleagues at the Unit, which indicated that as some people with type 2 diabetes may be affected differently from others by weight loss, we need better evidence to inform weight loss advice and support for them. Read the blog article.
The past, present, and future of health in Nigeria
Dr Tolullah Oni of our Global Diet and Physical Activity Research Group was part of the Lancet Nigeria Commission that recently published a major report in The Lancet. In a Lancet Voice podcast she joined Professor Ibrahim Abubakar of the UCL Institute for Global Health and Professor Obinna Onwujekwe of the College of Medicine of the University of Nigeria join to discuss how Nigeria’s history affects the modern-day health system, and the challenges and opportunities for Nigeria in the future. Listen to the podcast.
Unit Senior Clinical Research Associate Dr Raghib Ali, a Government expert adviser on COVID-19 and ethnicity who contributed to the quarterly reports on progress to address COVID-19 health inequalities, has written several commentaries on COVID-19 for national newspapers, including two articles in the Guardian in January 2022, ‘Here’s some good news for 2022: this could be the year the pandemic comes to an end‘ and ‘Why it’s the right time to lift plan B restrictions in England’.
Cambridge Festival 2022
Unit members are are delivering three in-person activities at this year’s Cambridge Festival. All these are drop-in events, so if you’re in Cambridge on the weekend of 2/3 April call by and chat to us about our work.
Fortune Telling Molecules
When: Saturday 2 April (10 AM-4 PM), Sunday 3 April (12 PM – 4 PM)
Where: University of Cambridge Admissions Office, New Museums site, CB2 3PT
What are biomarkers? What can they tell us about our future health? Pick a card, spin the wheel, then find out how we learn about nutrition and future disease risk by analysing molecules in our bloodstream. More details.
It takes a town to build a healthier future
When: Saturday 2 April (10 AM-4 PM)
Where: Outdoors Marquee, New Museums site,CB2 3PT
Our towns, communities, schools and families can shape our travel choices in ways we don’t realise. Join MRC Epidemiology Unit scientists to discover what this means for our health and what we can do about it. More details.
Dinner Diaries – Food, Feelings & Futures
When: Saturday 2 April (10 AM-4 PM)
Where: Outdoors Marquee, New Museums site,CB2 3PT
Which foods brings back fond memories from your past? Is there a weeknight meal that fuels your week? What kind of diet would you wish for the next generation?
Our stall will invite participants to address some important overarching questions that are relevant to one of the unit’s major research goals: transforming the UK’s food systems to be healthier, more sustainable, and more equitable. More details.
React 2022 Exhibition
When: Saturday 2 April – Sunday 10 April (times vary)
Where: Cambridge Science Centre, Unit 44, Clifton Road Industrial Estate, CB1 7EP
React 2022 displays the work of local school students from Swavesey Village College and Netherhall School, for and inspired by the themes of the Cambridge festival: Society, Health, Environment, and Discovery!
Dr Kate Ellis, a scientist with our Population Health Interventions programme, was one of four University of Cambridge researchers who worked with the students on this project. More details.
Our latest publications
You can now find all publications from the MRC Epidemiology Unit at our new Publications Database:
You can search by journal, year, study, programme, Unit author, and keywords in the title and abstract.
Since the last issue of epigram, we have published the following papers:
- Health trends, inequalities, and opportunities in South Africa’s provinces, 1990–2019: Findings from the Global Burden of Disease 2019 Study Achoki T et al. J Epidemiol Community Health
- Factors Influencing Satisfaction with Service Delivery Among National Health Insurance Scheme Enrollees in Ibadan, Southwest Nigeria Adewole DA et al. J Patient Exp
- Placental uptake and metabolism of 25(OH)vitamin D determine its activity within the fetoplacental unit Ashley B et al. Elife
- Using Health economic modelling to inform the design and development of an intervention: estimating the justifiable cost of weight loss maintenance in the UK Bates SE et al. BMC Public Health
- Impact of Risk of Generalizability Biases in Adult Obesity Interventions: A meta-epidemiological review and meta-analysis Beets MW et al. Obes Rev
- Diets for weight management in adults with type 2 diabetes: an umbrella review of published meta-analyses and systematic review of trials of diets for diabetes remission Churuangsuk C et al. Diabetologia
- Cross-sectional and prospective associations of sleep duration and bedtimes with adiposity and obesity risk in 15,810 youth from 11 international cohorts Collings PJ et al. Pediatr Obes
- Physical Activity Intensity Profiles Associated with Cardiometabolic Risk in Middle-Aged to Older Men and Women Dempsey P et al. Prev Med
- “Post-GDM support would be really good for mothers”: a qualitative interview study exploring how to support a healthy diet and physical activity after gestational diabetes Dennison R et al. PLoS One
- Perceptions of the South African 24-hour movement guidelines for birth to 5 years: a qualitative study Draper C et al. J Phys Act Health
- Socioeconomic and gendered inequities in travel behaviour in Africa: Mixed-method systematic review and meta-ethnography Foley L et al. Soc Sci Med
- Understanding Marketing Responses to a Tax on Sugary Drinks: a Qualitative Interview Study in the United Kingdom, 2019 Forde H et al. Int J Health Policy Manag
- Epigenome-wide association study of incident type 2 diabetes: a meta-analysis of five prospective European cohorts Fraszczyk E et al. Diabetologia
- Influence of guideline operationalization on youth activity prevalence in the International Children’s Accelerometry Database Gammon C et al. Med Sci Sport Exerc
- Gender differences in travel behaviour in major cities across the world Goel R et al. Transportation
- The power of genetic diversity in genome-wide association studies of lipids Graham SE et al. Nature
- Effects of a group-based weight management programme on anxiety and depression: a randomised controlled trial (RCT) Heath L et al. PLoS One
- Trends in energy and nutrient content of menu items served by large UK chain restaurants from 2018 to 2020: an observational study Huang Y et al. BMJ Open
- Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity Hunter KE et al. BMJ Open
- Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 industrialised countries Islam N et al. BMJ
- A guide to value of information methods for prioritising research in health impact modelling Jackson C et al. Epidemiologic Methods
- Patients’ views and experiences of live supervised tele-exercise classes following bariatric surgery during the COVID-19 pandemic: The BARI-LIFESTYLE qualitative study Jassil FC et al. Clin Obes
- Genetic associations and architecture of asthma-chronic obstructive pulmonary disease overlap John C et al. Chest
- The impact of participant mental health on attendance and engagement in a trial of behavioural weight management programmes: Secondary analysis of the WRAP randomised controlled trial. Jones R et al. Int J Behav Nutr Phys Act
- Behavioural interventions to promote physical activity in a multiethnic population at high risk of diabetes: PROPELS three-arm RCT Khunti K et al. Health Technol Assess
- Levels and correlates of physical activity and capacity among HIV-infected compared to HIV-uninfected individuals Kitilya B et al. PLoS One
- Identification of rare loss of function genetic variation regulating body fat distribution Koprulu M et al. J Clin Endocrinol Metabol
- Trans fatty acid biomarkers and incident type 2 diabetes: pooled analysis of 12 prospective cohort studies in the Fatty Acids and Outcomes Research Consortium (FORCE) Lai H et al. Diabetes Care
- MC3R links nutritional state to childhood growth and the timing of puberty Lam BYH et al. Nature
- Face Validity of Observed Meal Patterns Reported with 7-Day Diet Diaries in a Large Population-Based Cohort Using Diurnal Variation in Concentration Biomarkers of Dietary Intake Lentjes MAH et al. Nutrients
- Associations of serum folate and holotranscobalamin with cardiometabolic risk factors in rural and urban Cameroon Mba CM et al. Nutrients
- Restricting the advertising of high fat, salt and sugar foods on the Transport for London estate: process and implementation study Meiksin R et al. Soc Sci Med
- Concepts of responsibility in the German media debate on sugar taxation: A qualitative framing analysis Moerschel KS et al. Eur J Pub Health
- A Systematic Review Protocol of Opportunities for Noncommunicable Disease Prevention via Public Space Initiatives in African Cities Mogo ERI et al. Int J Environ Res Pub Health
- Association between patient activation, self-management behaviours and clinical outcomes in adults with diabetes or related metabolic disorders: a systematic review and meta-analysis protocol Mueller J et al. BMJ Open
- Associations Between Glycemic Traits and Colorectal Cancer: A Mendelian Randomization Analysis Murphy N et al. J Natl Cancer Inst
- Evaluating the citywide Edinburgh 20mph speed limit intervention effects on traffic speed and volume: A pre-post observational evaluation Nightingale GF et al. PLoS One
- Salicylic Acid and Risk of Colorectal Cancer: A Two-Sample Mendelian Randomization Study Nounu A et al. Nutrients
- ImprintSeq, a novel tool to interrogate DNA methylation at human imprinted regions and diagnose multilocus imprinting disturbance Ochoa E et al. Genet Med
- Cross-Sectional Association of Food Source with Food Insecurity, Dietary Diversity and Body Mass Index in Western Kenya Olatunji E et al. Nutrients
- CHoosing Active Role Models to INspire Girls (CHARMING): protocol for a cluster randomised feasibility trial of a school-based, community-linked programme to increase physical activity levels in 9-10-year-old girls Pell B et al. Pilot Feasibility Stud
- Self-reported physical functional health predicts future bone mineral density in EPIC-Norfolk cohort Perrott S et al. Arch Osteoporos
- Evidence for Shared Genetic Aetiology Between Schizophrenia, Cardiometabolic, and Inflammation-Related Traits: Genetic Correlation and Colocalization Analyses Perry BI et al. Schizophr Bull Open
- Synergistic insights into human health from aptamer- and antibody-based proteomic profiling Pietzner M et al. Nat Comm
- Mapping the serum proteome to neurological diseases using whole genome sequencing Png G et al. Nat Comm
- Development of a web-based, guided self-help, ACT-based intervention for weight loss maintenance: an evidence-, theory- and person-based approach. Richards R et al. JMIR Formative Research
- Protocol for a multi-level policy analysis of non-communciable disease determinants of diet and physical activity: Implications for low- and middle-income countries in Africa and the Caribbean Shung-King M et al. Int J Environ Res Pub Health
- Aerobic fitness mediates the intervention effects of a school-based physical activity intervention on academic performance. The school in Motion study – A cluster randomized controlled trial Solberg RB et al. Prev Med Rep
- Dietary fatty acids, macronutrient substitutions and food sources and incidence of coronary heart disease: findings from the EPIC-CVD case-cohort study across nine European countries Steur M et al. J Am Heart Assoc
- A pan-Canadian dataset of neighbourhood retail food environment measures using Statistics Canada’s Business Register Stevenson AC et al. Health Rep
- Population level physical activity before and during the first national COVID-19 lockdown: A nationally representative repeat cross-sectional study of 5 years of Active Lives data in England Strain T et al. Lancet Regional Health
- Considerations for the use of consumer-grade wearables and smartphones in population surveillance of physical activity Strain T et al. J Meas Phys Behav
- Association between weight change and incidence of cardiovascular disease events and mortality among adults with type 2 diabetes: a systematic review of observational studies and behavioural intervention trials Strelitz J et al. Diabetologia
- Challenges and opportunities in the care of chronic subdural haematoma: perspectives from a multi-disciplinary working group on the need for change Stubbs DJ et al. Br J Neurosurg
- Device-measured physical activity, adiposity and mortality: a harmonised meta-analysis of eight prospective cohort studies Tarp J et al. Br J Sports Med
- Analysis of Cameroon’s Sectoral Policies on Physical Activity for Noncommunicable Disease Prevention Tatah L et al. Int J Environ Res Pub Health
- Progressing the development of a food literacy questionnaire using cognitive interviews Thompson C et al. Public Health Nutr
- Risk models for recurrence and survival after kidney cancer: a systematic review Usher-Smith JA et al. BJU Int
- Four groups of type 2 diabetes contribute to the etiological and clinical heterogeneity in newly diagnosed individuals: An IMI DIRECT study Wesolowska-Andersen A et al. Cell Rep Med
- Changes in household food and drink purchases following restrictions on the advertisement of high fat, salt and sugar products across the Transport for London network: A controlled interrupted time series analysis Yau A et al. PLoS Med
epigram is the newsletter for everyone interested in work happening at the MRC Epidemiology Unit at the University of Cambridge.
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