Life expectancy is rising for many across the globe. At the same time, low and middle income countries are experiencing increasing urbanisation, a changing diet and reduced physical activity.
This is leading to an increase in non-communicable diseases (NCDs), including diabetes and obesity, which pose a growing threat to sustainable development, especially in countries where healthcare resources may be scarce. Around 75% of all deaths from NCDs, and 82% of premature death – that is, before the age of 70 – occur in low and middle income countries.
At the MRC Epidemiology Unit, we are a partner in the Wellcome Trust–Cambridge Centre for Global Health Research. We are developing a portfolio of work aimed at contributing to the prevention and control of non-communicable diseases in low and middle income countries through intervening on the underlying determinants of physical inactivity and unhealthy diets.
Our approach to Global Public Heath Research
Our approach builds on techniques, methods and expertise developed across our research programmes. We have a number of international collaborations in low and middle income countries, including in sub-Saharan Africa, Latin America, the Caribbean, the Middle East, South and South East Asia, and China. In collaboration with partner institutions in these regions, we have four main goals:
Measuring behaviours. We will measure current levels and trends in physical activity and diet using combinations of objective and subjective methods. We will estimate the contribution of these behaviours to NCD illness and mortality, including their contribution relative to smoking and excess alcohol consumption.
Investigating determinants. We will investigate the social, environmental, economic and other factors that influence diet and physical activity behaviours. The evaluation of ‘natural experiments’ will play an important role in identifying determinants of diet and physical activity and in evaluating the impact of policy measures.
Informing and evaluating interventions. We will inform and evaluate interventions and policies designed to modify the determinants of diet and physical activity. We will use public health modelling to estimate the health impact and interaction of different interventions.
Building capacity. We will support researchers in low and middle income countries to undertake research and guide policy. We will establish a research capacity building network with collaborating institutions. Activities will include joint PhD supervision, post-doctoral training, provision of short courses, and staff and student exchanges.
The Global Diet and Activity Research Group
Two of the most important causes of growing levels of NCDs globally are unhealthy diets and a lack of physical activity, both of which are associated with rapid economic development and urbanisation. In fact, although NCDs are often thought of as diseases of affluence, they are more common in low and middle income countries (LMICs) than in high income countries.
The Global Diet and Physical Activity Research Group adopts a transdisciplinary systems approach to co-design and co-produce urban health research for healthy sustainable cities that help to prevent diet and activity-related NCDs.
We are generating evidence on the factors that lead to poor diet and physical inactivity. We are then using this evidence to inform intersectoral policies and the development and evaluation of interventions in built and food environments. The goal is that these can support healthy eating and active living in cities across the globe. Our work involves finding solutions that are affordable and created in partnership with local communities.
GLASST: Global and local health impact assessment of transport
Transport is a major determinant of population health, and adverse health impacts are greatest in lower and middle income cities. GLASST to develop the next generation of transport and health impact models and tools that are academically robust and practically useful. More about GLASST.
Towards an Integrated Global Transport and Health Assessment Tool (TIGTHAT)
This project is laying the scientific foundations of a health impact assessment (HIA) tool that will be readily applied to a wide variety of urban settings in Low or Middle Income Countries (LMICs) to estimate health impacts of transport choices. More about TIGTHAT.
Technology and diabetes risk, Chennai, India
Recent estimates suggest there are 68 million people living with diabetes in India, the majority with type 2 diabetes. A mixture of poor diet and lack of exercise, low birth weight followed by rapid growth, and genetic pre-disposition – Indians tend to develop diabetes at a lower body-mass index (BMI) than Caucasians – means that diabetes is twice as common in India as it is in the UK.
At the MRC Epidemiology Unit, we are collaborating with the India Diabetes Research Foundation in a trial of a mobile phone based intervention design to change people’s behaviour and reduce their diabetes risk. Results so far have found that almost a third fewer men in the high risk group went on to develop diabetes if they received between two and four texts a week giving advice on diet and exercise.
- Read more in University of Cambridge Research Horizons magazine (pdf).