Maternal nutrition, fetal and childhood growth, and programming of cardiovascular disease and diabetes in South Asians

Lead Research Organisation: University of Southampton
Department Name: Development Origin of Health and Disease

Abstract

South Asians have a higher risk of developing coronary heart disease (CHD), type 2 diabetes and the insulin resistance syndrome than white caucasians. This is related to a characteristic South Asian body type: low muscle mass, high body fat and central (abdominal) obesity. Recent research in the UK and Europe has shown that smaller size at birth, lower weight during infancy, and rapid weight gain in childhood, predict higher rates of adult CHD and diabetes. This has given rise to the theory that environmental factors influencing early growth can permanently alter (?programme?) the body?s structure and metabolism, leading to later disease. Early-life programming may explain the high rates of CHD and diabetes in South Asians, who are typically light and thin at birth and in infancy. The applicant has established a research programme in India, collaborating with colleagues in four centres, to study the relationship of fetal, infant and childhood growth, to CHD and diabetes in South Asians. Work so far has confirmed that low birthweight and rapid weight gain in childhood are associated with higher CHD risk factors and increased adult CHD and diabetes. Lower birthweight and infant weight predict lower adult muscle mass, while rapid weight gain in childhood predicts greater adult body fat. Studies in pregnancy showed that the ?low-muscle high-fat? body type is present in Indian newborn babies. Neonatal fat is related to maternal body fat and maternal diabetes. Mothers with lower intakes of micronutrient-rich foods (green leafy vegetables, fruit and milk) had babies that were smaller in all body measurements. In the next 5 years we will study the relationship of maternal nutrition and maternal diabetes to her children?s body composition and CHD risk factor profile. In a study designed to directly test the programming hypothesis, a randomised controlled trial of improved diet quality in undernourished mothers will be undertaken, with the aim of improving fetal growth and later outcomes. The premise of this research is that adult disease may be preventable by measures that optimise fetal, infant and childhood nutrition. Our objectives are to determine the validity of this premise and to develop such interventions.

Technical Summary

South Asians have a higher risk of developing coronary heart disease (CHD), type 2 diabetes and the insulin resistance syndrome than white caucasians of comparable age and body mass index. This is related to a characteristic South Asian body phenotype: low muscle mass, high percentage body fat and central adiposity. Recent research in white European populations has shown that smaller size at birth, lower weight during infancy, and accelerated weight gain in childhood, predict higher rates of adult CHD and diabetes, giving rise to the hypothesis that environmental factors influencing early growth can permanently alter (?programme?) the body?s structure and metabolism, leading to later disease. Early-life programming may explain the high rates of CHD and diabetes in South Asians, who are typically light and thin at birth and in infancy. The applicant has established a research programme in India, collaborating with colleagues in four centres, to study the relationship of fetal, infant and childhood growth, to CHD and diabetes in South Asians. Work so far has confirmed that low birthweight and rapid weight gain in childhood are associated with higher CHD risk factors and increased adult CHD and diabetes. Based on anthropometric measurements of adult body composition, lower birthweight and infant weight predict lower adult lean body mass, while accelerated BMI gain in childhood predicts greater adult adiposity. Prospective studies in pregnancy showed that the ?muscle-thin but adipose? phenotype is present in Indian newborns. Neonatal adiposity is related to maternal adiposity and plasma glucose concentrations, and is most marked in babies of diabetic mothers. Mothers with lower intakes of micronutrient-rich foods (green leafy vegetables, fruit and milk) and lower micronutrient status, had babies that were smaller in all measurements. In the next 5 years we will investigate the relationship of growth in early life to better measurements of adult body composition, and also to adult endothelial function. We will determine the relationship of maternal diet, nutritional status and glucose tolerance to the children?s body composition and CHD risk factor profile. In a study designed to directly test the programming hypothesis, a randomised controlled trial of improved diet quality in undernourished mothers will be undertaken, with the aim of improving fetal growth and later outcomes. The premise of this research is that adult disease may be preventable by measures that optimise fetal, infant and childhood nutrition. Our objectives are to determine the validity of this premise and to develop such interventions.

Organisations

Publications

10 25 50

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Addo OY (2013) Maternal height and child growth patterns. in The Journal of pediatrics

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Addo OY (2015) Parental childhood growth and offspring birthweight: pooled analyses from four birth cohorts in low and middle income countries. in American journal of human biology : the official journal of the Human Biology Council

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Agnihotri B (2008) Trends in human birth weight across two successive generations. in Indian journal of pediatrics

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Antonisamy B (2009) Cohort Profile: the 1969-73 Vellore birth cohort study in South India. in International journal of epidemiology

 
Description Findings that have supported interventions in the first 1000 days
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in other policy documents
Impact Caroline Fall and Clive Osmond are members of the COHORTS collaboration, which has carried out research that supports the targeting of nutritional interventions for the prevention of undernutrition in pregnancy and infancy.
 
Description Member of advisory group commissioned by WHO/Unicef/SCN to review data from multiple micronutrient trials in pregnancy in developing countries.
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in advisory committee
Impact The findings will guide the policy of the international health agencies regarding maternal micronutrient supplementation. ; The findings will guide the policy of the international health agencies regarding maternal micronutrient supplementation.
 
Description Genomic and lifestyle predictors of foetal outcome relevant to diabetes and obesity and their relevance to prevention strategies in South Asian peoples (GIFTS).
Amount £98,000 (GBP)
Funding ID 278917 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 12/2011 
End 11/2014
 
Description Mumbai Maternal Nutrition Study
Amount £551,753 (GBP)
Organisation Parthenon Trust 
Sector Charity/Non Profit
Country Guernsey
Start 03/2005 
 
Description Programme Grant: Randomised controlled trial of of micronutrient-dense food before and during pregnancy to prevent low birthweight; the Mumbai Maternal Nutrition Study
Amount £785,523 (GBP)
Funding ID 074048/Z/05/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start  
 
Description Wellcome Trust Project Grant (Early-life antecedents of type 2 diabetes and polycystic ovary syndrome in young Indian adults)
Amount £472,000 (GBP)
Funding ID 083460/Z/07/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2008 
End 06/2011
 
Description Wellcome Trust Project Grant COHORTS 2
Amount £177,000 (GBP)
Funding ID 082554/Z/07/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2007 
End 06/2009
 
Description Wellcome Trust Project Grant Pune Mysore
Amount £391,000 (GBP)
Funding ID 079877/Z/06/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2006 
End 06/2008
 
Title Collection of stored samples for bio-markers and DNA 
Description All the collaborating cohorts in India have stored samples for measurement of bio-markers, DNA and epigenetic studies 
Type Of Material Biological samples 
Year Produced 2006 
Provided To Others? Yes  
Impact New discoveries in our and other research groups. Extensive international collaborations. 
 
Title Improved research infra-structure in India 
Description Extension of research units and laboratory equipment in 3 Indian research centres 
Type Of Material Improvements to research infrastructure 
Year Produced 2006 
Provided To Others? Yes  
Impact Increase in quantity and quality of research output, and training of young investigators 
 
Title Maternal Vitamin B12 deficiency as a risk factor for diabetes in next generation 
Description Birth cohort studies have linked maternal vitamin B12 deficiency in pregnancy to insulin resistance in the children. 
Type Of Material Model of mechanisms or symptoms - human 
Provided To Others? No  
Impact Several publications, and stimulated replicative studies by other groups. This work has led directly to funding of intervention studies. 
 
Title Multiple cohort studies 
Description Data (including birth data, longitudinal growth data, and outcomes data including cardiovascular and metabolic health, bone health, cognitive function) from a number of birth cohorts in the UK and India 
Type Of Material Biological samples 
Year Produced 2006 
Provided To Others? Yes  
Impact Strong evidence of the importance of early life nutrition and growth on a wide variety of adult health outcomes. 
 
Title Use of stress response measurements in children 
Description Use of the Trier Social Stress Test in Indian children to measure cortisol and autonomic responses to streeful situations 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2014 
Provided To Others? Yes  
Impact Too early 
 
Title Databases from 8 Indian birth cohorts 
Description Lifecourse data from 8 Indian birth cohorts. 
Type Of Material Database/Collection of data 
Provided To Others? Yes  
Impact Widening of research usage 
 
Description COHORTS collaboration 
Organisation Federal University of Pelotas (UFPel)
Department 1982 Pelotas Birth Cohort
Country Brazil 
Sector Academic/University 
PI Contribution Contributions to study design, fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise; Cohort-specific knowledge.
Collaborator Contribution Contribution to study design, data management, analysis and interpretation. Cohort data. Epidemiological, statistical, social science, economic expertise.
Impact 19297457, 19856426, 20007336, 21224276, 21325148, 22100968, 22121058, 23477997, 23541370, 23977075, 24064150, 21511113, 22100968, 25008854, 25186666, 25999096, 27765286. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary partnership (epidemiology, paediatrics, statistics, social science, nutrition).
Start Year 2007
 
Description COHORTS collaboration 
Organisation Institute of Nutrition of Central America and Panama (INCAP)
Country Guatemala 
Sector Public 
PI Contribution Contributions to study design, fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise; Cohort-specific knowledge.
Collaborator Contribution Contribution to study design, data management, analysis and interpretation. Cohort data. Epidemiological, statistical, social science, economic expertise.
Impact 19297457, 19856426, 20007336, 21224276, 21325148, 22100968, 22121058, 23477997, 23541370, 23977075, 24064150, 21511113, 22100968, 25008854, 25186666, 25999096, 27765286. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary partnership (epidemiology, paediatrics, statistics, social science, nutrition).
Start Year 2007
 
Description COHORTS collaboration 
Organisation The New Delhi Birth Cohort Study
Country India 
Sector Academic/University 
PI Contribution Contributions to study design, fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise; Cohort-specific knowledge.
Collaborator Contribution Contribution to study design, data management, analysis and interpretation. Cohort data. Epidemiological, statistical, social science, economic expertise.
Impact 19297457, 19856426, 20007336, 21224276, 21325148, 22100968, 22121058, 23477997, 23541370, 23977075, 24064150, 21511113, 22100968, 25008854, 25186666, 25999096, 27765286. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary partnership (epidemiology, paediatrics, statistics, social science, nutrition).
Start Year 2007
 
Description COHORTS collaboration 
Organisation University of North Carolina at Chapel Hill
Department Cebu Longitudinal Health and Nutrition Survey
Country United States 
Sector Academic/University 
PI Contribution Contributions to study design, fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise; Cohort-specific knowledge.
Collaborator Contribution Contribution to study design, data management, analysis and interpretation. Cohort data. Epidemiological, statistical, social science, economic expertise.
Impact 19297457, 19856426, 20007336, 21224276, 21325148, 22100968, 22121058, 23477997, 23541370, 23977075, 24064150, 21511113, 22100968, 25008854, 25186666, 25999096, 27765286. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary partnership (epidemiology, paediatrics, statistics, social science, nutrition).
Start Year 2007
 
Description COHORTS collaboration 
Organisation University of the Witwatersrand
Department Birth to Twenty
Country South Africa 
Sector Academic/University 
PI Contribution Contributions to study design, fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise; Cohort-specific knowledge.
Collaborator Contribution Contribution to study design, data management, analysis and interpretation. Cohort data. Epidemiological, statistical, social science, economic expertise.
Impact 19297457, 19856426, 20007336, 21224276, 21325148, 22100968, 22121058, 23477997, 23541370, 23977075, 24064150, 21511113, 22100968, 25008854, 25186666, 25999096, 27765286. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary partnership (epidemiology, paediatrics, statistics, social science, nutrition).
Start Year 2007
 
Description Earlyread Collaboration 
Organisation Academic Medical Center
Country Netherlands 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation George Institute for Global Health
Country Australia 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation Harvard University
Department Harvard Medical School
Country United States 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation Karolinska Institute
Department Department of Medical Epidemiology and Biostatistics
Country Sweden 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation Kuopio University Hospital
Country Finland 
Sector Hospitals 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Country United Kingdom 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation Saiseikai Central Hospital, Tokyo
Department Department of Internal Medicine
Country Japan 
Sector Hospitals 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation St George's University of London
Department Community Health Sciences Division
Country United Kingdom 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation Sunder Lal Jain Hospital
Department Department of Paediatrics
Country India 
Sector Hospitals 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation Thomas Jefferson University
Department School of Medicine Thomas Jefferson
Country United States 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation Trondheim University Hospital
Department Department of Internal Medicine
Country Norway 
Sector Hospitals 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation University College London
Department MRC Centre for Epidemiology for Child Health
Country United Kingdom 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation University of Bristol
Department MRC Centre for Causal Analyses in Translational Epidemiology
Country United Kingdom 
Sector Public 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation University of California, San Diego (UCSD)
Department Department of Family and Preventive Medicine
Country United States 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation University of Helsinki
Department Diabetes and Obesity Research Program
Country Finland 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation University of Iceland
Department Faculty of Food Science and Nutrition
Country Iceland 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Earlyread Collaboration 
Organisation University of Saskatchewan
Country Canada 
Sector Academic/University 
PI Contribution Contributed data, participated in interpretation of results
Collaborator Contribution Shared data for meta-analyses
Impact Publications: 19109117, 18689365, 22558399
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation Aga Khan University
Department Maternal Micronutrient Supplementation Study Group
Country Pakistan 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation Emory University
Department Nutrition and Health Sciences
Country United States 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation Institute of Tropical Medicine Antwerp
Country Belgium 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
Country Bangladesh 
Sector Charity/Non Profit 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation Johns Hopkins University
Department Department of International Health
Country United States 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Country United Kingdom 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation MURAZ Center
Country Burkina Faso 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation Mother and Infant Research Activities (MIRA)
Country Nepal 
Sector Charity/Non Profit 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation UNICEF
Department Nutrition Section UNICEF
Country United States 
Sector Charity/Non Profit 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation University College London
Department Institute of Child Health
Country United Kingdom 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation University of Copenhagen
Department Centre for Epidemiology and Screening
Country Denmark 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation University of Copenhagen
Department Department of Human Nutrition, Exercise and Sports
Country Denmark 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation University of Indonesia
Department Center for Health Research
Country Indonesia 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation University of Southampton
Department Institute of Human Nutrition
Country United Kingdom 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation World Health Organization (WHO)
Country Global 
Sector Public 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Maternal Micronutrient Supplementation Study Group 
Organisation Xi'an Jiaotong University
Department Department of Public Health
Country China 
Sector Academic/University 
PI Contribution Data management, analysis and interpretation, report writing.
Collaborator Contribution Provision of data, contribution to data analysis and interpretation.
Impact Publications: 20120796, 20120794, 20120793, 20120795 Multidosciplinary collaboration: epidemiology, statistics, nutrition, public health, policy
Start Year 2006
 
Description Mumbai Maternal Nutrition Project 
Organisation Centre for the Study of Social Change
Country India 
Sector Public 
PI Contribution Study design, research governance, epidemiological and statistical expertise. Epidemiological, statistical and nutritional expertise. Research governance.
Collaborator Contribution Expertise in community-based research, including interventions, in low income settings in a developing country. Fieldwork and data management.
Impact Publications 19292744, and Chopra H et al 2012. 25332324, 25677713, 27281802, 28251804 PhD studentships. Medical student and Masters research projects. Presentations at national and international conferences.
Start Year 2006
 
Description Mysore Parthenon Cohort Study 
Organisation Holdsworth Memorial Hospital, Mysore
Department Epidemiology Research Centre
Country India 
Sector Academic/University 
PI Contribution Epidemiological and statistical expertise, study design, training of field team, mentorship, interpretation of data.
Collaborator Contribution Day-to-day liaison with cohort, fieldwork, data management, and analysis and interpretation. Publications. Fellowship for Dr GV Krishnaveni
Impact Publications and conference presentations 16929411, 16929412, 17143606, 17640759, 1773682, 18285809, 19236724, 19430084, 19690580, 19707742, 19918007, 19946010, 20032815, 20090113, 20335637, 20614102, 20852257, 21166711, 21228264, 21682572, 21731039, 21924491, 21978208, 22318657, 22558399, 22751963, 22829248, 22895107, 23297873, 23819872, 23920141, 24098836, 24146284, 24162586, 24609067, 24866058, 24986282, 25052622, 25478935, 26575994, 27520466. Multi-disciplinary (Epidemiology, Nutrition, Psychiatry, Endocrinology, Paediatrics). PhD Dr GV Krishnaveni 2005; Wellcome Trust Intermediate fellowship Dr GV Krishnaveni 2011; PhD studentship Dr SR Veena 2011.
Start Year 2006
 
Description New Delhi Birth Cohort Study 
Organisation All India Institute of Medical Sciences
Country India 
Sector Academic/University 
PI Contribution Contributions to study design,fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise.
Collaborator Contribution Day-to-day liaison with cohort subjects, fieldwork management, data management, analysis and interpretation. Publications. Membership of COHORTS collaboration. Membership of Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group,
Impact 18835958, 19015213, 20090113, 20660641, 21511113, 21682572, 22237812, 22537976, 23798637, 25008854, 25186666, 25999096, 26109024, 26831418, 27061677, 27115820, 27458798, 27484448, 27765286, 27863813. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary study: epidemiology, statistics, diabetes, cardiology, paediatrics, genetics
Start Year 2006
 
Description New Delhi Birth Cohort Study 
Organisation Centre for Chronic Disease Control (CCDC)
Country India 
Sector Hospitals 
PI Contribution Contributions to study design,fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise.
Collaborator Contribution Day-to-day liaison with cohort subjects, fieldwork management, data management, analysis and interpretation. Publications. Membership of COHORTS collaboration. Membership of Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group,
Impact 18835958, 19015213, 20090113, 20660641, 21511113, 21682572, 22237812, 22537976, 23798637, 25008854, 25186666, 25999096, 26109024, 26831418, 27061677, 27115820, 27458798, 27484448, 27765286, 27863813. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary study: epidemiology, statistics, diabetes, cardiology, paediatrics, genetics
Start Year 2006
 
Description New Delhi Birth Cohort Study 
Organisation Sitaram Bhartia Institute of Science and Research
Country India 
Sector Hospitals 
PI Contribution Contributions to study design,fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise.
Collaborator Contribution Day-to-day liaison with cohort subjects, fieldwork management, data management, analysis and interpretation. Publications. Membership of COHORTS collaboration. Membership of Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group,
Impact 18835958, 19015213, 20090113, 20660641, 21511113, 21682572, 22237812, 22537976, 23798637, 25008854, 25186666, 25999096, 26109024, 26831418, 27061677, 27115820, 27458798, 27484448, 27765286, 27863813. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary study: epidemiology, statistics, diabetes, cardiology, paediatrics, genetics
Start Year 2006
 
Description New Delhi Birth Cohort Study 
Organisation Sunder Lal Jain Hospital
Country India 
Sector Hospitals 
PI Contribution Contributions to study design,fieldwork training and quality control, data management, analysis and interpretation. Epidemiological and statistical expertise.
Collaborator Contribution Day-to-day liaison with cohort subjects, fieldwork management, data management, analysis and interpretation. Publications. Membership of COHORTS collaboration. Membership of Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group,
Impact 18835958, 19015213, 20090113, 20660641, 21511113, 21682572, 22237812, 22537976, 23798637, 25008854, 25186666, 25999096, 26109024, 26831418, 27061677, 27115820, 27458798, 27484448, 27765286, 27863813. Abstracts presented at a major international meetings and published in peer-reviewed international journals. Multi-disciplinary study: epidemiology, statistics, diabetes, cardiology, paediatrics, genetics
Start Year 2006
 
Description Pune Children's Study 
Organisation KEM Hospital, Pune
Department Department of Paediatrics
Country India 
Sector Hospitals 
PI Contribution Contributions to study design, fieldwork training and quality control, data management, analysis and interpretation. Epidemiological, statistical and nutritional expertise.
Collaborator Contribution Expertise in long-term follow-up of birth cohorts, clinical and laboratory expertise. Day-to-day liaison with cohort members, fieldwork/data collection, data management, analysis and interpretation.
Impact Publications: 24874906, 25940643 and several abstracts presented at a major international meetings and published in peer-reviewed international journals.
Start Year 2006
 
Description Pune Maternal Nutrition Study 
Organisation KEM Hospital Research Centre
Department Department of Diabetes
Country India 
Sector Hospitals 
PI Contribution Contributions to study design, fieldwork training and quality control, data management, analysis and interpretation.Epidemiological, statistical and nutritional expertise.
Collaborator Contribution Expertise in community-based research, including interventions, in rural and urban settings in a developing country. Day-to-day liaison with cohort subjects, fieldwork management, data management, analysis and interpretation.
Impact 16480528, 16735496, 17032446, 17116720, 17620450, 17653070, 17851649, 19005641, 19498084, 19636321, 19776185, 20090113, 20103791, 20216560, 20675085, 21682572, 21731039, 22109280, 22323413, 22829248, 22941936, 22941936, 22941936, 22323413, 23349157, 23757425, 23920141, 24162586, 24459167, 25052622, 26902699 Abstracts presented at major international meetings and published in peer-reviewed international journals. Multi-disciplinary study: diabetes, paediatrics, obstetrics, radiology, nutrition, epidemiology, statistics
Start Year 2006
 
Description Vellore Birth Cohort Study 
Organisation Christian Medical College, Vellore
Department Department of Biostatistics
Country India 
Sector Academic/University 
PI Contribution Epidemiological and statistical expertise
Collaborator Contribution Expertise in community-based follow-up of birth cohorts, laboratory expertise, statistical expertise. Study design, fieldwork, data analysis and interpretation.
Impact Publications (17229484, 18334789, 18684785, 20115937, 21712988, 22366083, 22421923, 23963770, 27823768) and presentations at national and international conferences.
 
Title Food based micronutrient supplements 
Description Development of a micronutrient-rich food supplement for poorly nourished pre-pregnant and pregnant women living in urban slums in India. Made from vegetables, fruit and milk. 
Type Preventative Intervention - Nutrition and Chemoprevention
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2006
Development Status Under active development/distribution
Clinical Trial? Yes
UKCRN/ISCTN Identifier ISRCTN62811278
Impact Intervention associated with increased birth weight and reduction in gestational diabetes. 25332324. 
URL http://www.controlled-trials.com/ISRCTN62811278
 
Title Vitamin B12 
Description Physiological doses of vitamin B12 for women and men before conception and (women) during pregnancy, to prevent adverse fetal programming 
Type Preventative Intervention - Nutrition and Chemoprevention
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2010
Development Status Under active development/distribution
Clinical Trial? Yes
Impact Trial ongoing. 
URL http://www.controlled-trials.com/ISRCTN32921044
 
Description Caroline Fall, Sarah Kehoe: Organised conference on Body composition and physical activity in children. 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Workshop Facilitator
Geographic Reach International
Primary Audience Health professionals
Results and Impact Organised conference on Body composition and physical activity in children; applying global knowledge to the South Asian scenario. Calicut, India, 5th-6th November 2008. Sponsored by DOHaD and RCUK.

Conference led to a move to form all-India network of birth cohort studies to pool data, standardise methods, and write joint grant applications.
Year(s) Of Engagement Activity 2008
 
Description Caroline Fall: Film on the Mumbai Maternal Nutrition Project 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Used as a teaching aid for research workers, nutrition and epidemiology students, and for presentation to grant donors.

Too early.
Year(s) Of Engagement Activity 2011,2012
 
Description Caroline Fall: Interviews with journalists at FIGO conference, Rome 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Wide public dissemination. The presentation reaced a large number of international obstetricians at their major annual conference. Presentation has been posted on the website of C3 for Health, for longer term dissemination to everyone interested in global health issues.

Requests to give further talks!
Year(s) Of Engagement Activity 2012
 
Description Caroline Fall: MRC Life Magazine article (Jun 2014) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact An article advertising the David Barker Commemorative meeting, "The Future of the Science David Barker Inspired", organised by MRC Lifecourse Epidemiology Unit and University of Southampton

Highlighting the commemorative event and work of the unit
Year(s) Of Engagement Activity
 
Description Caroline Fall: Press launch for Lancet series on maternal and child undernutrition 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Press conference.

Major impact on the policy of international health agencies
Year(s) Of Engagement Activity 2008
 
Description Caroline Fall: Television documentary BBC Horizon Aug 2011 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Multiple e-mails from lay public and scientists around the world; requests for copies for teaching purposes
Year(s) Of Engagement Activity 2011,2012
 
Description Caroline Fall: The 'Barker hypothesis' - why is it relevant to India? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact The 'Barker hypothesis' - why is it relevant to India? Invited speaker. Fetal and developmental origins of disease; counting the cost. New Delhi, India, November 8th-10th 2006.

This meeting led to a new collaborative network to study economic costs of early life malnutrition.
Year(s) Of Engagement Activity 2006
 
Description Clive Osmond: Inaugural lecture (May 2014) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Clive Osmond gate his inaugural lecture on 29 May 2014. It was entitled "Painting with numbers: exploring life's wonders"

Increased awareness of the work of the MRC LEU
Year(s) Of Engagement Activity
 
Description Engagement with Research Participants from the Mysore Birth Records Cohort, Mysore (KK) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact We held an engagement with members of the Mysore Birth Records Cohort (who are now 60-80 years of age) and their carers in Mysore. The main aims were to seek their views on: 1) the information provided to them about the research for consent; 2) how they would like feedback from the results of the study; and 3) their interest in continued participation in the results. Our team presented the summary of the research followed by an interactive session. The response from the participants was very positive and they expressed satisfaction with the information provided and that they would like to continue to participate in the research.
Year(s) Of Engagement Activity 2018
 
Description Engagement with Research Participants from the Parthenon Cohort, Mysore (KK) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Study participants or study members
Results and Impact We held an engagement with members of the Parthenon Cohort and their parents/carers in Mysore. The main aims were to seek their views on: 1) the information provided to them about the research for consent; 2) how they would like feedback from the results of the study; and 3) their interest in continued participation in the results. Our team presented the summary of the research followed by an interactive session. The response from the participants was very positive and they expressed satisfaction with the information provided and that they would like to continue to participate in the research.
Year(s) Of Engagement Activity 2018
 
Description Invited presentation at the 2nd annual PRIDE meeting, University of Warwick. Prof Caroline Fall "The Mumbai Maternal Nutrition Project" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited presentation at the 2nd annual PRIDE meeting, University of Warwick. November 2014
Year(s) Of Engagement Activity 2014
 
Description Invited presentation at the annual review meeting of the GIFTS consortium. Prof Caroline Fall "The Mumbai Maternal Nutrition Project" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited presentation at the annual review meeting of the GIFTS consortium, London, April 2014
Year(s) Of Engagement Activity 2014
 
Description Launch of Southampton India Centre 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact A day of presentations of research in Southampton related to India; presentations from all departments of the university. Attended by Indian High Commissioner and his team, major grant donors, media, staff and students from all faculties, general public. Official launch of University of Southampton India Centre for Sustainable Growth and Innovation.
Year(s) Of Engagement Activity 2019
 
Description Press interviews with local and national radio, and major newspapers 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact More than 20 interviews.

Greater public awareness.
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010
 
Description Prof Caroline Fall: Disentangling the effects of weight and height gain in early life on chronic disease risk and human capital; data from 5 cohorts in low- and middle-income countries; the COHORTS collaboration 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation of the work of the COHORTS collaboration at the 17th Annual meeting of Sneha-India, Mysore, India, 2013
Year(s) Of Engagement Activity 2013
 
Description The catch-up dilemma in low and middle-income countries; data from the COHORTS collaboration, MRC Unit seminar with Prof Clive Osmond 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact Seminar to colleagues in MRC Unit 11th December 2012 with Prof Clive Osmond
Year(s) Of Engagement Activity 2012