Causal mechanisms behind intergenerational transmission of nutritional choices and their association with metabolic risk indicators
Lead Research Organisation:
King's College London
Department Name: Social Genetic and Dev Psychiatry Centre
Abstract
Low- and middle-income countries (LMICs) globally have undergone rapid urbanisation, and changes in demography and health behaviours. Whilst life expectancy at birth for many LMICs has improved, disease burden from non-communicable diseases, and years lived with disability have risen. In Sri Lanka, the setting for this proposed work, cardio-vascular disease is the leading cause of mortality (one in ten in the population has diabetes), and an exponential increase in hospitalisations is seen for these diseases. High prevalence estimates of cardio-vascular risk factors, including hypertension (18-20%), dysglycaemia (14-20%) and obesity (9-36%) have been reported.
Nutritional and dietary choices are key modifiable risk factors for both cardio-vascular disease and diabetes as well as their risk factors. However, looking at genetically sensitive study data, we know that they are heritable influenced behaviours but also that the genes associated with nutritional/dietary preferences are also correlated with the genes that influence metabolic risk. We also know that dietary choices are transmitted across generations: poor diet in parents causes poor eating behaviours in children which then lead to cardio vascular disease in the next generation. However, it is not clear what the mechanism of this effect might be: is it due to a direct behavioral impact or due to transmitted genetic factors and other family level variable like SES that can cause the association, and can we disentangle these effects?
The main objective of the study is to try to understand the mechanisms by which parental diet impacts child nutritional choices and metabolic risk factors. There are different routes through which transmission may occur. First, the association may be environmental, due to the child growing up in a family who provide nutritional diet (and even earlier taste development, in utero and during breastfeeding). Second, the association may be due to passive gene-environment correlation whereby the child inherits a disposition for a nutritional preference (e.g. a high fat diet) and a disposition for cardio-vascular disease but also the parent's provided unhealthy dietary environment during childhood and adolescence. The 'Children-of-Twins' design estimates the causal effects of parental on offspring traits while control for possible confounding familial effects. Using this design will help us understand the mechanisms underpinning intergenerational transmission of diet on cardio-vascular disease. This is of crucial importance given the increases in poor nutrition and metabolic risk factors in Sri Lanka and other South-Asian populations.
The current proposal will develop an interdisciplinary project which will use advanced structural equation modelling methods of data from twins and their children to help us understand the mechanisms underlying intergenerational transmission of diet and nutrition within families and how these impact on cardio-vascular disease. The project represents a collaborative effort across KCL, UCL, Keele and the Institute for Research Development in Sri Lanka. We seek to build on an existing resource based in Sri Lanka - the Colombo Twin and Singleton Study (CoTaSS), a well-phenotyped, epidemiological sample. This resource will be expanded by following up our current participants and extending the sample to include their children.
We ask for funding to cover a 7-month period between June 2019 and January 2020 to undertake some key activities that would strengthen our application for the full stage: Activity 1: Establish new collaborations and partnerships in Sri Lanka with local experts in eating behaviours, nutrition and diet. Activity 2: Investigate and develop the psychometric properties of the current nutrition questionnaire. Activity 3: Re-contacting participants from the CoTaSS study and ascertaining whether they have had children.
Nutritional and dietary choices are key modifiable risk factors for both cardio-vascular disease and diabetes as well as their risk factors. However, looking at genetically sensitive study data, we know that they are heritable influenced behaviours but also that the genes associated with nutritional/dietary preferences are also correlated with the genes that influence metabolic risk. We also know that dietary choices are transmitted across generations: poor diet in parents causes poor eating behaviours in children which then lead to cardio vascular disease in the next generation. However, it is not clear what the mechanism of this effect might be: is it due to a direct behavioral impact or due to transmitted genetic factors and other family level variable like SES that can cause the association, and can we disentangle these effects?
The main objective of the study is to try to understand the mechanisms by which parental diet impacts child nutritional choices and metabolic risk factors. There are different routes through which transmission may occur. First, the association may be environmental, due to the child growing up in a family who provide nutritional diet (and even earlier taste development, in utero and during breastfeeding). Second, the association may be due to passive gene-environment correlation whereby the child inherits a disposition for a nutritional preference (e.g. a high fat diet) and a disposition for cardio-vascular disease but also the parent's provided unhealthy dietary environment during childhood and adolescence. The 'Children-of-Twins' design estimates the causal effects of parental on offspring traits while control for possible confounding familial effects. Using this design will help us understand the mechanisms underpinning intergenerational transmission of diet on cardio-vascular disease. This is of crucial importance given the increases in poor nutrition and metabolic risk factors in Sri Lanka and other South-Asian populations.
The current proposal will develop an interdisciplinary project which will use advanced structural equation modelling methods of data from twins and their children to help us understand the mechanisms underlying intergenerational transmission of diet and nutrition within families and how these impact on cardio-vascular disease. The project represents a collaborative effort across KCL, UCL, Keele and the Institute for Research Development in Sri Lanka. We seek to build on an existing resource based in Sri Lanka - the Colombo Twin and Singleton Study (CoTaSS), a well-phenotyped, epidemiological sample. This resource will be expanded by following up our current participants and extending the sample to include their children.
We ask for funding to cover a 7-month period between June 2019 and January 2020 to undertake some key activities that would strengthen our application for the full stage: Activity 1: Establish new collaborations and partnerships in Sri Lanka with local experts in eating behaviours, nutrition and diet. Activity 2: Investigate and develop the psychometric properties of the current nutrition questionnaire. Activity 3: Re-contacting participants from the CoTaSS study and ascertaining whether they have had children.
Technical Summary
Low- and middle-income countries (LMICs) globally have undergone rapid urbanisation, and changes in demography and health behaviours. Whilst life expectancy at birth for many LMICs has improved, disease burden from non-communicable diseases, and years lived with disability have risen. In Sri Lanka, the setting for this proposed work, cardio-vascular disease is the leading cause of mortality, and an exponential increase in hospitalisations is seen for these diseases. High prevalence estimates of their risk factors, including hypertension (18-20%), dysglycaemia (14-20%) and obesity (9-36%) have been reported.
Nutritional and dietary choices are key modifiable risk factors for both cardio-vascular disease and diabetes as well as their risk factors. They are not only genetically influenced behaviours but are also genetically correlated with metabolic risk indicators and known to be transmitted across generations. However, whether poor diet in parents leading to cardio vascular disease in the next generation is due to a direct behavioral impact or due to transmitted genetic factors and other family level variable like SES that can cause the association, is less understood.
The main objective of the study is to examine the mechanisms by which parental diet impacts child nutritional choices and metabolic risk factors. The association may be environmental, due to the child growing up in a family who provide nutritional diet. Or the association may be due to passive gene-environment correlation whereby the child inherits a disposition for nutritional preference and for cardio-vascular disease but also the parent's dietary environment. The 'Children-of-Twins' design estimates the causal effects of parental on offspring traits while control for possible confounding familial effects. Using this design will help us understand the mechanisms underpinning intergenerational transmission of diet on cardio-vascular disease.
Nutritional and dietary choices are key modifiable risk factors for both cardio-vascular disease and diabetes as well as their risk factors. They are not only genetically influenced behaviours but are also genetically correlated with metabolic risk indicators and known to be transmitted across generations. However, whether poor diet in parents leading to cardio vascular disease in the next generation is due to a direct behavioral impact or due to transmitted genetic factors and other family level variable like SES that can cause the association, is less understood.
The main objective of the study is to examine the mechanisms by which parental diet impacts child nutritional choices and metabolic risk factors. The association may be environmental, due to the child growing up in a family who provide nutritional diet. Or the association may be due to passive gene-environment correlation whereby the child inherits a disposition for nutritional preference and for cardio-vascular disease but also the parent's dietary environment. The 'Children-of-Twins' design estimates the causal effects of parental on offspring traits while control for possible confounding familial effects. Using this design will help us understand the mechanisms underpinning intergenerational transmission of diet on cardio-vascular disease.
Planned Impact
Cardio-vascular disease and diabetes are common and impairing conditions in LMIC(s), not only associated with high mortality and premature death, but also with high economic costs due to medical care and hospitalisation. Nutrition and diet are key factors known to impact these conditions and are potentially modifiable, but we first need to better understand how the impact of nutritional choice in parents works to lead to increase in cardio-vascular disease in the offspring. Is there a causal effect of the nutritional environment that parents provide for their children up an above the genes they transmit to their offspring that give rise to eating behaviours and other metabolic risk factors?
We believe that the research results from the current proposal will be of interest to a broad range of individuals from academics to policy makers, clinicians and the public. What does it mean if we say that eating behaviour as well as risk to develop cardio-vascular disease is under genetic control? Our Public and Patient Involvement Engagement workshops will bring together relevant stakeholders in SL (patients, local nutritionists, parents, GPs) to guide and inform on diet habits. They will also play an important role in translating the results from this work to establish health-promoting behaviours as well as to help us in communicating genetic results to the public. It is important to communicate results of this research in a way that it is understandable. We will pay special attention to trying to shift away from "genetic/environmental determinism" prevalent in the media today. We will prepare press releases of published research in plain language and will also actively seek out activities that will bring the results of this research to the public's attention with the help of our PPIE work.
We believe that the research results from the current proposal will be of interest to a broad range of individuals from academics to policy makers, clinicians and the public. What does it mean if we say that eating behaviour as well as risk to develop cardio-vascular disease is under genetic control? Our Public and Patient Involvement Engagement workshops will bring together relevant stakeholders in SL (patients, local nutritionists, parents, GPs) to guide and inform on diet habits. They will also play an important role in translating the results from this work to establish health-promoting behaviours as well as to help us in communicating genetic results to the public. It is important to communicate results of this research in a way that it is understandable. We will pay special attention to trying to shift away from "genetic/environmental determinism" prevalent in the media today. We will prepare press releases of published research in plain language and will also actively seek out activities that will bring the results of this research to the public's attention with the help of our PPIE work.
Publications
Dissanayake L
(2024)
The Colombo Twin and Singleton Study (COTASS): Piloting the Feasibility of Collecting Nutritional Data and Extension of the Sample to Include Children of Twins
in Behavior Genetics
Zavos Helena M. S.
(2021)
The Etiology of Nutrition and Cardio-Metabololic Phenotypes in a South Asian Population
in BEHAVIOR GENETICS
Zavos HMS
(2024)
Frequency of Consumption of Food Groups and Cardio-Metabolic Risk Factors: A Genetically Informative Twin Study in Sri Lanka.
in Behavior genetics
| Description | • For our proposed pilot study (i.e., collecting data on dietary intake and nutrition), we have so far collected 303 questionnaires and 221 blood and urine samples from CoTASS-2 and the wider Sri Lankan Twin Registry. • We are in the process of developing a Sri Lankan specific Food Composition Database which currently consists of 243 food items. • We ran a specialist training course on the Structural Equation Model Fitting of Twin Data in 2021. Through this, we upskilled 17 scientific/research professionals from Sri Lanka in using the twin method and children-of-twins design. We continue to support statistical skill development through fortnightly zoom sessions. • We have run six workshops/webinars on Public and Patient Involvement (PPIE) and Engagement in Research since 2021. These events have built capacity among various scientific/research professionals in Sri Lanka to use PPIE in their work. The feedback for each session has been overwhelmingly positive with attendees reporting that they found it useful, were motivated to apply PPIE to their research and were likely to attend future sessions. • In 2022, we conducted a webinar on research ethics and evaluating research proposals to a large group of scientific/research professionals in Sri Lanka to strengthen their knowledge in these areas. • Using the MRC Public Engagement Seed Fund, we ran a focus group with 11 members from the Sri Lankan Twin Registry to discuss our ongoing work of using social media platforms as an engagement method for the registry. |
| Exploitation Route | The Sri Lankan specific Food Composition Database which currently consists of 243 food items can be further extended and utilised by other researchers and policy makers who are seeking to understand more about nutrition within Sri Lanka. Our work to introducing Public and Patient Involvement (PPIE) will lead to future research projects in Sri Lanka to incorporate this component into their research. |
| Sectors | Agriculture, Food and Drink,Education,Healthcare,Other |
| Description | The work proposed for this award has important societal impact. This is described below: • Currently, there is no food composition database available in Sri Lanka. The database we have developed as part of this award will support and advance future nutrition-related research in Sri Lanka as well as contribute to better public health outcomes. This is particularly important given the high incidence of non-communicable diseases in Sri Lanka, which is strongly linked to unhealthy dietary habits and poor nutrition literacy. • We have collected questionnaire data and blood & urine from a sample of twin parents and their adult children. The data collected from this study has provided 'proof of concept' for the feasibility of using biomarker data in children-of-twins studies of dietary intake and nutrition. Additionally, it will provide a strong foundation for future nutrition related grant applications as well as the feasibility of collecting children of twin data in Sri Lanka. This pilot will support work which focuses on understanding the mechanisms behind intergenerational transmission. • Historically, research practices in Sri Lanka have overlooked the importance of Patient and Public Involvement and Engagement (PPIE) in research. Our PPIE training events have equipped research professionals in Sri Lanka with the necessary skills to include PPIE techniques in their work. This capacity building effort will result in research that reflects the needs and priorities of individuals and the wider community. • We have built capacity and upskilled the research team at the IRD in social media content creation and engagement. As a result, ongoing communication, and engagement efforts with the SLTR have been made possible beyond the current grant funding. This has strengthened trust between researchers and society. These newly acquired skills and strategies will be extended to other research projects undertaken at the IRD, thereby increasing its overall impact. In addition, we have created a website for the SLTR that registry members and researchers can use to obtain more information about the registry, facilitating future collaborations which use data from members of this registry. • In 2021, we successfully ran a specialist training course on the 'Structural Equation Model Fitting of Twin Data' for scientific professionals from various research institutions across Sri Lanka. Course participants were upskilled in using the twin method and the children-of-twins design, the latter of which can investigate the causal mechanisms behind the intergenerational transmission of nutrition as well as its association with metabolic risk indicators. This capacity building effort will also enhance the use of existing data from the Colombo Twin and Singleton Study (CoTASS). |
| First Year Of Impact | 2022 |
| Sector | Agriculture, Food and Drink,Education,Healthcare |
| Impact Types | Cultural,Societal,Policy & public services |
| Description | August 2021 PPIE Workshop: General Sir John Kotelawala Defence University |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | Feedback showed that the workshop was successful in meeting its objectives of enhancing attitudes of researchers in Sri Lanka towards using PPIE in their work. Feedback suggested that attendees were motivated to apply PPIE techniques in their research as well as undertake further learning and training on using PPIE within research. This workshop has a social impact and makes an important contribution to inclusivity as it promotes high level changes to the way in which research is conducted in Sri Lanka. Traditionally, research conducted in Sri Lanka does not involve actively engaging with patients and the public to produce research. This workshop helps to encourage researchers in Sri Lanka to include PPIE in their work as well as build PPIE capacity amongst them and create a framework for how research is designed, conducted and disseminated using PPIE techniques. Capacity building in PPIE will have benefits for society as it will lead to better quality research which is relevant and reflects the priorities and diverse needs of individuals. |
| URL | https://www.kdu.ac.lk/14th-international-research-conference/ |
| Description | August 2022 PPIE Workshop: University of Colombo |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | Overall, the workshop received positive feedback, as attendees reported finding it useful for their research and expressed an interest in participating in future workshops. Many also reported that, from the workshop, they gained new knowledge about PPIE or strengthened their existing understanding of PPIE. This workshop has a social impact and makes an important contribution to inclusivity as it promotes high level changes to the way in which research is conducted in Sri Lanka. Traditionally, research conducted in Sri Lanka does not involve actively engaging with patients and the public to produce research. This workshop helps to encourage researchers in Sri Lanka to include PPIE in their work as well as build PPIE capacity amongst them and create a framework for how research is designed, conducted and disseminated using PPIE techniques. Capacity building in PPIE will have benefits for society as it will lead to better quality research which is relevant and reflects the priorities and diverse needs of individuals. |
| Description | December 2022 PPIE Webinar: Gampaha Wickramarachchi University of Indigenous Medicine |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | This webinar has a social impact and makes an important contribution to inclusivity as it promotes high level changes to the way in which research is conducted in Sri Lanka. Traditionally, research conducted in Sri Lanka does not involve actively engaging with patients and the public to produce research. This webinar helps to encourage researchers in Sri Lanka to include PPIE in their work as well as build PPIE capacity amongst them and create a framework for how research is designed, conducted and disseminated using PPIE techniques. Capacity building in PPIE will have benefits for society as it will lead to better quality research which is relevant and reflects the priorities and diverse needs of individuals. |
| Description | January 2023 PPIE Webinar: Rajarata University |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | The webinar received overwhelmingly positive feedback. Of those who provided feedback, many reported that the session was very useful and that they had either gained new knowledge or strengthened their existing understanding. The majority of responses also said that there were enough opportunities to ask questions and that they would likely attend future sessions. This webinar has a social impact and makes an important contribution to inclusivity as it promotes high level changes to the way in which research is conducted in Sri Lanka. Traditionally, research conducted in Sri Lanka does not involve actively engaging with patients and the public to produce research. This webinar helps to encourage researchers in Sri Lanka to include PPIE in their work as well as build PPIE capacity amongst them and create a framework for how research is designed, conducted and disseminated using PPIE techniques. Capacity building in PPIE will have benefits for society as it will lead to better quality research which is relevant and reflects the priorities and diverse needs of individuals. |
| Description | July 2021 PPIE Workshop: The Open University of Sri Lanka |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | Overall, feedback for this workshop was positive, and many participants were interested in attending future workshops. Furthermore, the OUSL expressed an interest in collaborating with the IRD in the future to conduct PPIE work. This workshop has a social impact and makes an important contribution to inclusivity as it promotes high level changes to the way in which research is conducted in Sri Lanka. Traditionally, research conducted in Sri Lanka does not involve actively engaging with patients and the public to produce research. This workshop helps to encourage researchers in Sri Lanka to include PPIE in their work as well as build PPIE capacity amongst them and create a framework for how research is designed, conducted and disseminated using PPIE techniques. Capacity building in PPIE will have benefits for society as it will lead to better quality research which is relevant and reflects the priorities and diverse needs of individuals. Furthermore, developing capacity and skills in nutrition-related research will benefit the health of the population in Sri Lanka. |
| Description | November 2022 PPIE Workshop: Pre-congress workshop |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | Overall, the workshop received positive feedback. Of those who provided feedback, the majority reported that they had either gained new knowledge or strengthened their existing understanding of PPIE. The majority of responses also said that there were enough opportunities to ask questions. Other comments highlighted that the workshop was very useful for researchers and that it should be delivered in postgraduate research courses. This workshop has a social impact and makes an important contribution to inclusivity as it promotes high level changes to the way in which research is conducted in Sri Lanka. Traditionally, research conducted in Sri Lanka does not involve actively engaging with patients and the public to produce research. This workshop helps to encourage researchers in Sri Lanka to include PPIE in their work as well as build PPIE capacity amongst them and create a framework for how research is designed, conducted and disseminated using PPIE techniques. Capacity building in PPIE will have benefits for society as it will lead to better quality research which is relevant and reflects the priorities and diverse needs of individuals. |
| Description | September 2022 Evaluation Webinar: Rajarata University |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | Overall, feedback for the webinar was positive. Of those who provided feedback, many reported that the session was very useful for their research and that they had either gained new knowledge or strengthened their existing understanding. The majority of responses also said that there were enough opportunities to ask questions and that they would likely attend future sessions. This webinar carries an important social impact as it strengthens the knowledge of researchers in Sri Lanka in research ethics as well as the evaluation of research proposals, which can both be applied to practice. |
| Description | Specialist Training in Structural Equation Model Fitting (SEM) of Twin Data |
| Geographic Reach | Asia |
| Policy Influence Type | Influenced training of practitioners or researchers |
| Impact | The Twin Model Fitting Training Course was successfully hosted from April-December 2021. 17 scientific professionals attended from various Sri Lankan research institutions. These include the General Sir John Kotelawala Defence University, Rajarata University of Sri Lanka, University of Jaffna, University of Sri Jayewardenepura, and the Sri Lankan Institute for Research and Development. |
| Title | Children-of-Twins Mental health and nutrition dataset |
| Description | Using the MRC Training Grant, we have proposed a pilot study where we will collect self-reported (questionnaire) measures of nutrition as well as urine and blood samples from 400 children-of-twins quads (50 identical and 50 non-identical female twin pairs each with 1 female adult offspring). The data collected from this pilot study will be used in our training stream of macro- and micro-element analysis in food and biological samples. It will also provide 'proof of concept' for the feasibility of using dietary (biomarker) data within nutrition studies using a children-of-twins design. |
| Type Of Material | Database/Collection of data |
| Year Produced | 2020 |
| Provided To Others? | No |
| Impact | A total of 303 questionnaires and 221 blood and urine samples have been collected from children-of twins quads from CoTASS-2 and the wider twin registry. The pilot study will provide a strong foundation for future nutrition related grant applications and research conducted at the IRD. |
| Title | Children-of-Twins sub-data base |
| Description | One key objective of the development award was to re-contacting participants from the CoTaSS study and ascertaining whether they have had children. The children of the twins to establish whether they would be willing to participate in the proposed study. This was conducted using Local Sri Lankan RAs and admin support, who were funded by the award. We have now established a dataset which contains updated contact details for twin participants and information about their offspring. This research infrastructure will support our work on our MRC training award making it possible to easily identify twins who meet the inclusion criteria and who have had children. The proportion of twins interested in taking part in future research is high - approximately 90% - and there is a ratio of approximately 2 offspring per CoTaSS-2 twin. |
| Type Of Material | Database/Collection of data |
| Year Produced | 2020 |
| Provided To Others? | No |
| Impact | This sub-data base will directly serve as pool to select Children-of-Twin quads (N=400, 50 identical and 50 non-identical female pairs with 1 female adult offspring each) for a pilot study which is part of an MRC Training grant, an extension to this development grant. The pilot study will to collect questionnaire measures of nutrition, urine samples for urinary bioanalysis and blood samples for serum bioanalysis. Data generated in this pilot study will be used in different training objectives (Lab and Statistical) and will provide 'proof of concept' for the feasibility of using dietary (biomarker) data within the Children-of-Twin design in nutrition studies. |
| Title | Food composition database for Sri Lanka |
| Description | As part of this award, we aim to establish a Sri Lankan specific food composition database which contains nutritional information (i.e., energy levels, macronutrient, and micronutrient content) on food items commonly consumed in Sri Lanka. This includes raw, cooked and branded foods as well as cooked and mixed dishes. We have identified common foods and recipes using multiple sources such as PPIE and market-based data (e.g., popular recipe books and results from previous national surveys). We then collected data on their nutritional composition by using values from existing international food composition databases, running calculations or through chemical analysis where appropriate. The data currently consists of 243 food items. |
| Type Of Material | Database/Collection of data |
| Year Produced | 2022 |
| Provided To Others? | Yes |
| Impact | In Sri Lanka, the high disease burden from non-communicable diseases is significantly associated with unhealthy dietary habits as well as poor nutrition literacy. There is also high cultural variation in food preferences and methods of preparation in Sri Lanka. Therefore, it is important to incorporate these variations within dietary advice and daily nutritional recommendations. At present there is no food composition database available in Sri Lanka. As a result, our Sri Lankan specific food composition database will benefit society by facilitating and fostering future nutrition-related research. The database will also be used in the public health domain to improve health outcomes. |
| Description | Nutrition & MRI Experts in Sri Lanka |
| Organisation | University of Colombo |
| Country | Sri Lanka |
| Sector | Academic/University |
| PI Contribution | At the basis of this grant is the long-standing collaboration between King's College London (IoPPN) and the Institute for Research Development in Health & Social Care (IRD) in Colombo, Sri Lanka. This partnership has resulted in a successful two-wave study (The Colombo Twin and Singleton Study, CoTaSS) on mental health and cardio-metabolic risk in the Sri Lankan population. To strengthen the full application on 'Understanding the mechanistic links between nutrition and non-communicable diseases in low and middle-income countries' one of the main aims of this development grant was to establish new collaborations with local Sri Lankan experts in nutrition and diet. |
| Collaborator Contribution | The Institute for Research Development in Health & Social Care (IRD) in Colombo and Professor Athula Sumathipala (Professor of Psychiatry at the Research Institute for Primary Care & Health Sciences, Keele University), have established two excellent new collaborations. The first one is with Dr Ranil Jayawardena (Department of Physiology, Faculty of Medicine, University of Colombo), a leading nutrition practitioner in Sri Lanka with more than 10 years of experience as a specialist in treating patients with obesity, diabetes and other metabolic abnormalities. Jayawardena has ~70 published papers in international peer-reviewed journals around nutrition and diabetes. Dr Jayawardena has provided valuable knowledge of assessment of food consumption using his own Sri Lankan validated Food Frequency Questionnaire and 24-hour dietary recall protocols. The second one is with Dr Ruwini Liyanage, Head of the Nutritional Biochemistry Research Group at a new facility in Sri Lanka, the National Institute of Fundamental Studies (NIFS), (https://www.nifs.ac.lk/about/board-of-governors). Dr Liyanage is an expert in macro/micro element analysis in food and biological samples. Collaborations with Drs Jayawardena and Liyanage will extend to the proposed follow-up study where using objective measures of dietary intake to study nutrition effects on metabolic risk and establishing a Sri-Lankan specific food composition database are central. The benefits that have occurred as the result of activities undertaken to build equity into the research partnership is that Sri Lankan based biochemical lab skills will be developed to aid nutrition research. |
| Impact | Direct outputs and outcomes of the development grant, include: • A grant-writing workshop/meeting in London to prepare for the full application including a panel of independent colleagues and advisors • A site visit to Colombo to undertake public engagement activities with local stakeholders (Professionals such as fitness trainers, Research assistants and associates of the IRD and subjects enrolled on the Twin Registry, including their children) • Discussion with Dr Ranil Jayawardena about the proposed follow-up Full proposal and the use of biological markers of nutrition in addition to 24-hour recall of dietary intake measurements. • Discussion with Dr Ranil Jayawardena about the possibilities of establishing a Sri-Lankan specific food composition database, which will incorporate the diversity in methods of preparation and food additives due to high cultural variation in food preferences. This database will be fundamental for all nutrition research and for use in the public health domain. • Established a sub-data base with Female Twin parents with female offspring for the pilot study of the MRC follow-up Training grant • New collaboration with the Nutritional Biochemistry Research Group at a new facility in Sri Lanka, the National Institute of Fundamental Studies (NIFS) (https://www.nifs.ac.lk/about/board-of-governors). Providing expertise in macro/micro element analysis in food and biological samples. |
| Start Year | 2019 |
| Description | Grant writing Workshop London |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Other audiences |
| Results and Impact | This workshop was set up to discuss objectives and methodology for the proposed bid for GCRF MRC Nutrition call full stage funding call. |
| Year(s) Of Engagement Activity | 2019 |
| Description | March 2022 PPIE workshop |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | Local |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | This activity consisted of a workshop for Research User Group (RUG) members on PPIE in Health Research. 11 members of the Research User Group attended the workshop. Some attendees had participated in previous PPIE workshops by the IRD. This training session was hosted with the intention of establishing a project-specific PPIE group that supports future nutritional research at Rajarata University. Feedback from group members was overwhelmingly positive as many felt keen to undertake further training sessions and create a positive change within a community setting. Furthermore, the participants were most grateful to the organizers for providing this valuable opportunity. All 11 participants provided their thoughts on the workshop through a feedback form. Here, attendees were satisfied with content delivery and compelled to learn more about nutrition. This group viewed engagement with PPIE work as a duty towards society; this can be attributed to village culture, unity, and a passion for making a positive difference in society. The positive feedback suggests that this group may respond positively when asked to form a project-specific PPIE group at Rajarata University. |
| Year(s) Of Engagement Activity | 2022 |
| Description | Public Patient Involvement and Engagement Activity Colombo |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Study participants or study members |
| Results and Impact | In December 2019 we conducted a PPIE workshop with lay members of the public in Sri Lanka. This included individuals who were participants of the existing CoTaSS study; non-participating twins; and offspring of participants of CoTaSS study. The overall aim of the workshop was to engage the potential participants in our proposed research and co-design research aims and objectives to ensure they are maximally relevant to the wider population. Specific research components were discussed to garner feedback on (1) proposed recruitment strategy, (2) data collection methods, for both blood and questionnaire data and (3) acceptability of 24-hour diet recall measures, DEXA scans, skinfold thickness and bioimpedance measures which are new potentially intensive measures which have not been collected as part of the CoTaSS study previously. |
| Year(s) Of Engagement Activity | 2019 |
| Description | Social Media Campaign, Sri Lanka Twin Registry: Twin Focus Group Discussion February 2023 |
| Form Of Engagement Activity | A formal working group, expert panel or dialogue |
| Part Of Official Scheme? | No |
| Geographic Reach | Regional |
| Primary Audience | Study participants or study members |
| Results and Impact | A focus group discussion was conducted by the IRD with 11 twins from the Sri Lankan Twin Registry (SLTR) as part of work funded by the MRC Public Engagement Seed Fund, which aims to pilot the use of social media as a method of engaging with the SLTR. The session also included a presentation by creative partner MUSE Sri Lanka. One twin participated in a previous PPIE group for CoTASS-3. The purpose of this session was to ensure that content proposed for the SLTR social media campaign would be relevant to the target population and stakeholders. Another objective of the session was to explore ways to facilitate two-way engagement between researchers and Twin Registry members using social media. There was fruitful discussion around using social media as a continuous engagement method which will greatly inform and shape the SLTR social media campaign. Ten of the twins provided feedback for the delivery of the focus group session which was overwhelmingly positive. The majority of participants were satisfied with the focus group discussion and reported that they would likely attend similar events in the future. |
| Year(s) Of Engagement Activity | 2023 |