Explaining differences in birth size and adiposity between Pakistani and white babies.

Lead Research Organisation: University of Leeds
Department Name: Healthcare Studies, School of

Abstract

This study will examine differences in birth size between Pakistani and white babies. In the UK there are differences in birth size, body fat proportion and risk of heart disease and diabetes between south Asians and the general population. South Asians are more likely to be born small and develop heart disease and diabetes in later life. The processes of adult disease begin in early life, possibly even before birth. Despite their smaller size south Asian babies may have more body fat than white babies, which leads to their increased risk of disease as adults. I will clarify whether differences in the arrangement of body fat seen in south Asian adults, can be seen at birth. The study will use data and blood samples from the Born in Bradford project, a unique research programme following the lives of 10,000 babies born in the city between 2007 and 2009. In this study I will use data from 5,000 babies.The study will make a major contribution to efforts to tackle the burden of chronic adult disease in both white and south Asian populations.

Technical Summary

Background
Low birth weight is recognised as an important predictor of child and adult health. In the UK there are marked differences in birth size between babies of south Asian origin and white babies. Babies born to south Asian families are generally lighter and it is unclear whether this difference reduces in second and third generations of UK south Asians. As adults south Asians have the highest mortality rate from coronary heart disease with much of the excess risk believed to be due to an increased risk of type 2 diabetes. For a given body mass index they are more centrally obese and are more likely to be insulin resistant. This has led to the suggestion that south Asians have a specific fat-thin insulin resistant phenotype. However relatively little is known about the fat-thin phenotype in south Asians living in the UK.
Aims
This proposal will take advantage of a newly funded bi-ethnic birth cohort study located in Bradford to examine differences in birth size and adiposity between 2500 white babies and 2500 Pakistani babies. Specifically this proposal aims to determine whether differences in birth anthropometry have reduced with subsequent generation immigrants, whether differences in size between white and Pakistani babies are detectable by ultrasound scan in the first, second and third trimester of pregnancy and whether there is evidence for the existence of the ‘fat-thin insulin resistant phenotype‘ at birth among Pakistani babies in comparison to white babies.
Design
Collection and analysis of data from a birth cohort study
Methods
This proposal will collect and analyse data from the Born in Bradford study, a new birth cohort study based at Bradford Teaching Hospitals NHS Trust which has secured funding and is due to begin recruiting participants in November 2006.This proposal will use data from 5000 mothers, fathers and their offspring (2500 white and 2500 Pakistani) who will be recruited in the first 18 months of the project. Data collection will include ultrasound assessment of fetal growth, birth anthropometry, cord blood samples, socio-economic status, lifestyle and country of origin data. Statistical analysis will apply Students t-tests and multivariable linear regression models to make comparisons between Pakistani and white babies. Power calculation: There will be 85-90% (or greater) power, at the 5% alpha level, to test all of the hypotheses proposed.

Publications

10 25 50

 
Description BHF Project Grant
Amount £144,001 (GBP)
Funding ID PG/09/036/27380 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2009 
End 05/2011
 
Description MRC/ESRC (Co-applicant)
Amount £2,849,674 (GBP)
Funding ID MR/N024397/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start  
End 08/2020
 
Description BHF-The intrauterine environment and differences in adiposity and insulin resistance between South Asian and European populations 
Organisation University of Glasgow
Department BHF Glasgow Cardiovascular Research Centre
Country United Kingdom 
Sector Academic/University 
PI Contribution We are collecting and analysing data for this related project
Collaborator Contribution We have collaborated on a proposal for a related study (not my MRC study but as a result of my MRC study) which has now been funded
Impact BHF funding
Start Year 2009
 
Description Born in Bradford 2nd Wave 
Organisation University of Bristol
Department School of Oral & Dental Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution I am a co-applicant for this MRC/ESRC programme grant.
Collaborator Contribution This award is held by the University of York, the University of Bristol contribute to sample storage, analysis and statistical and methodological support
Impact None as yet, data collection commenced in February 2017
Start Year 2016
 
Description Born in Bradford 2nd Wave 
Organisation University of York
Country United Kingdom 
Sector Academic/University 
PI Contribution I am a co-applicant for this MRC/ESRC programme grant.
Collaborator Contribution This award is held by the University of York, the University of Bristol contribute to sample storage, analysis and statistical and methodological support
Impact None as yet, data collection commenced in February 2017
Start Year 2016
 
Description Early life determinants of pre-adolescent differences in cardiometabolic health between South Asian and White British children: The Born in Bradford (BiB) cohort 
Organisation University of Bristol
Department School of Social and Community Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution I am a co-applicant on a British Heart Foundation Clinical Study Grant (no CS/16/4/32482) and will be managing the Born in Bradford's contribution to the grant.
Collaborator Contribution The University of Bristol will hold the award. Co-applicants include Queen Mary University of London and the University of Glasgow.
Impact None so far, this project began Feb 2017
Start Year 2017
 
Description ActEarly City Collaboratory Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact This workshop provided an important opportunity for all the academic, practice, policy and community partners to share ideas and plan projects but also a creative space to support learning and evaluation of our City Collaboratories.

The morning session consisted of cross-cutting theme updates that covered co-production, systems-thinking, modelling, data linkage and outcome measurement. The afternoon session included breakout sessions run by each theme lead to engage all our partners in the programme.

These covered:

1) Selection of interventions - partner-led, natural experiments or simulation studies
2) Design of co-production and evaluation
3) What outcomes are important to measure
Year(s) Of Engagement Activity 2019
 
Description BBC Radio 4 feature on the Born in Bradford Study 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact I was interviewed for BBC Radio 4 as part of a special feature on the BiB project. I talked about the specific role of my work (neonatal anthropometry) including the rationale for and main objectives of my work

The programme was broadcast on Radio 4
Year(s) Of Engagement Activity 2008
 
Description Born in Bradford study conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact The BiB study conference was an opportunity fo rthe study team to feedback to the local community about progress and early findings. Around 100 people attended including local community leaders, local authority and health organisation staff

The attendees had an opprotunity to participate in discussions around the future direction of the study
Year(s) Of Engagement Activity 2010
 
Description Born in Bradford study newsletter for Bradford primary schools 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact A section of this newsletter is dedicated to teh growth and size measurements collected in schools for the BiB study. This is used to provide an update of what has been achieved so far and what measurements are planned for the future. It is also an opportunity to thank schools for their continued support for the study.
Year(s) Of Engagement Activity 2015,2016,2017
 
Description Presentation to national Health Visitors conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Around 60 practicing health visitors attended the national conference. Lots of questions were asked about our work including how they could be involved or contribute to something similar locally.
Year(s) Of Engagement Activity 2017
URL http://www.profbriefings.co.uk/nihrihv2017/
 
Description The Born in Bradford Study: engaging a city in research 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact This was a presentation for undergraduates at the University of Bradford to introduce them to the study and our plans for developing a city of research. Many questions were asked especially how the students could contribute to and get involved with the study.
Year(s) Of Engagement Activity 2016