Collaborative network for adolescent nutrition and health in sub-Saharan Africa and India

Lead Research Organisation: University of Southampton

Abstract

Our proposed project will focus on the nutrition and health of adolescent boys and girls. Adolescence is the stage of life, from 10 to 19 years of age, when children transition into adults. It is characterized by rapid growth, sexual maturation, widespread 're-wiring' and re-organisation of the brain, and an increase in the scope and complexity of social interactions.
We currently have the largest generation of 10 to 19 year olds in human history, more than 1 billion worldwide, and half of these grow up in countries characterised by high levels of poor quality nutrition and rising rates of non-communicable disease (NCDs: obesity, heart disease and diabetes). In sub-Saharan Africa and South Asia, adolescents form 20-35% of
the population.
It has recently become clear that adolescence is a critical phase in life for achieving human potential, and during which the physical, psychological, behavioural, social and economic foundations of adult health are consolidated. The recent Lancet commission on adolescent health points out that investment in this stage of the lifecourse has the potential to produce a
'triple dividend' benefiting adolescents now, into their future adult life, and into the lives of their children. Half of the inequality in the value of lifetime earnings is due to factors determined before the end of adolescence.
Despite its significance, adolescence has been largely neglected in health and social policy terms; a phenomenon recognised by the recent UN Global strategy for women's, children's and adolescents' health. Adolescent nutrition has, in particular, been under-researched, leading to large knowledge gaps. There have been no comprehensive studies of
nutritional status and physical activity across different populations and settings. Little is known about how nutrition and physical activity change through adolescence, what determines these changes, and how they influence growth, current health, future disease risk, and the health of the next generation. We do not understand the drivers of dietary and activity
behaviours among adolescents, and how these could be changed to benefit health.
Our application brings together a multi-disciplinary network of researchers interested in adolescent health from the UK, India and different regions of sub-Saharan Africa, with the collective expertise to carry out large-scale nutrition research.
Our long-term vision is to 1) conduct in-depth studies of the dietary behaviour, nutritional status, body composition and physical activity of adolescents in vulnerable populations in these countries, and how these change through adolescence; 2) to understand, through qualitative research, the factors which determine their diet and activity behaviour at each stage of adolescence; and 3) develop and test context-specific interventions to improve adolescent health through nutrition.
In preparation for this ambitious future work, the current pump-priming application is to 1) consolidate the new network by holding two workshops, one in India, one in Africa; 2) conduct training in qualitative research methods and carry out pilot qualitative data collection to explore influences on dietary and activity behaviour in adolescents across multiple settings; 3) carry out literature reviews of existing data on the nutritional status of adolescents and existing policies for adolescent nutrition in the countries represented; 4) carry out secondary analyses using data from existing cohorts within the group, to examine how nutrition in young adolescence relates to adolescent growth and adult NCD risk markers; and 5) work together to develop the design of the future project, and prepare a larger grant application in 2018. A major objective of both the pump-priming work and the future larger study is to build capacity among early-and mid-career researchers in these countries for rigorous and cutting-edge nutrition research.

Technical Summary

Adolescence (10-19 years of age) is a critical stage for physical, cognitive, psychological, social and economic
development. Of 1 billion adolescents worldwide, half are in LMICs characterised by poor quality nutrition and rising rates of non-communicable disease (NCDs). Investment in adolescent nutrition has the potential to benefit adolescents themselves, their adult health, and the health of their children.

Despite its importance, research into adolescent nutrition has been relatively neglected. There are large knowledge gaps about the nutritional status and nutritional behaviour of adolescents, how these change during adolescence, and how they influence growth, neuro-development, later disease risk and the health of the next generation. The drivers of adolescent
diet and activity, and how these could be modified to benefit health, are poorly understood.

We have formed a network of researchers in the UK, India and different regions of sub-Saharan Africa with the expertise to carry out large-scale nutrition research among adolescents. Its long-term vision is to 1) conduct in-depth studies of diet, nutritional status, body composition and physical activity among adolescents and how these change through adolescence;
2) understand the factors that determine diet and activity behaviour; and 3) develop and test context-specific interventions to improve adolescent nutrition.
In preparation for this work, the pump-priming application is to 1) consolidate the network by holding two workshops; 2) train early-career researchers in qualitative research methods and collect pilot data on diet and activity behaviour in adolescents; 3) review existing data on adolescent nutritional status and policies for adolescent nutrition in the countries represented; 4) conduct secondary analyses using data from existing cohorts to examine how nutrition relates to adolescent growth and NCD risk markers; and 5) design the future project and submit a major grant application in 2018.
 
Description Contribution to GAIN/WHO consultation on adolescent nutrition
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
 
Description TALENT work highlighted in SPOTLIGHT in the Global Nutrition Report 2018
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a national consultation
 
Description Global Challenges Research Fund Strategic development Award
Amount £46,874 (GBP)
Organisation University of Southampton 
Sector Academic/University
Country United Kingdom
Start 02/2018 
End 01/2020
 
Description MRC Confidence in Global Nutrition and Health Research: Institutional pump-priming award to Kings College London. (PI Sophie Moore). Co-Investigator Caroline Fall
Amount £0 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start  
 
Description NIHR Global Health Research Grant: Southampton 1000 DaysPlus Global Nutrition Research Group (PI Marie-Louise Newell). Co-investigator Caroline Fall
Amount £0 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start  
 
Description DPRU Witwatersrand University, South Africa 
Organisation African Population and Health Research Center
Country Kenya 
Sector Academic/University 
PI Contribution My research teams leads this partnership. We have organised three training workshops for early career researchers from the partner centres. We have led the planning and co-ordination of data collection, analysis and write-up.
Collaborator Contribution The partners have collected qualitative data from groups of adolescents in their research settings, and processed the data. They have undertaken literature reviews, secondary data analyses and policy maker/stakeholder meetings.
Impact Training workshops (x3), data collection and analysis, manuscripts in preparation. Multi-disciplinary partnership (paediatrics, qualitative research, psychology, social science, nutrition)
Start Year 2017
 
Description DPRU Witwatersrand University, South Africa 
Organisation Centre for the Study of Social Change
Country India 
Sector Public 
PI Contribution My research teams leads this partnership. We have organised three training workshops for early career researchers from the partner centres. We have led the planning and co-ordination of data collection, analysis and write-up.
Collaborator Contribution The partners have collected qualitative data from groups of adolescents in their research settings, and processed the data. They have undertaken literature reviews, secondary data analyses and policy maker/stakeholder meetings.
Impact Training workshops (x3), data collection and analysis, manuscripts in preparation. Multi-disciplinary partnership (paediatrics, qualitative research, psychology, social science, nutrition)
Start Year 2017
 
Description DPRU Witwatersrand University, South Africa 
Organisation KEM Hospital Research Centre
Country India 
Sector Hospitals 
PI Contribution My research teams leads this partnership. We have organised three training workshops for early career researchers from the partner centres. We have led the planning and co-ordination of data collection, analysis and write-up.
Collaborator Contribution The partners have collected qualitative data from groups of adolescents in their research settings, and processed the data. They have undertaken literature reviews, secondary data analyses and policy maker/stakeholder meetings.
Impact Training workshops (x3), data collection and analysis, manuscripts in preparation. Multi-disciplinary partnership (paediatrics, qualitative research, psychology, social science, nutrition)
Start Year 2017
 
Description DPRU Witwatersrand University, South Africa 
Organisation Medical Research Council (MRC)
Department MRC Unit, The Gambia
Country Gambia 
Sector Public 
PI Contribution My research teams leads this partnership. We have organised three training workshops for early career researchers from the partner centres. We have led the planning and co-ordination of data collection, analysis and write-up.
Collaborator Contribution The partners have collected qualitative data from groups of adolescents in their research settings, and processed the data. They have undertaken literature reviews, secondary data analyses and policy maker/stakeholder meetings.
Impact Training workshops (x3), data collection and analysis, manuscripts in preparation. Multi-disciplinary partnership (paediatrics, qualitative research, psychology, social science, nutrition)
Start Year 2017
 
Description DPRU Witwatersrand University, South Africa 
Organisation University of Jimma
Department Medicine
Country Ethiopia 
Sector Academic/University 
PI Contribution My research teams leads this partnership. We have organised three training workshops for early career researchers from the partner centres. We have led the planning and co-ordination of data collection, analysis and write-up.
Collaborator Contribution The partners have collected qualitative data from groups of adolescents in their research settings, and processed the data. They have undertaken literature reviews, secondary data analyses and policy maker/stakeholder meetings.
Impact Training workshops (x3), data collection and analysis, manuscripts in preparation. Multi-disciplinary partnership (paediatrics, qualitative research, psychology, social science, nutrition)
Start Year 2017
 
Description DPRU Witwatersrand University, South Africa 
Organisation University of the Witwatersrand
Department School of Public Health
PI Contribution My research teams leads this partnership. We have organised three training workshops for early career researchers from the partner centres. We have led the planning and co-ordination of data collection, analysis and write-up.
Collaborator Contribution The partners have collected qualitative data from groups of adolescents in their research settings, and processed the data. They have undertaken literature reviews, secondary data analyses and policy maker/stakeholder meetings.
Impact Training workshops (x3), data collection and analysis, manuscripts in preparation. Multi-disciplinary partnership (paediatrics, qualitative research, psychology, social science, nutrition)
Start Year 2017
 
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 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 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 Newspaper article: Studies in Developing and Transitional Populations - Workshop on adolescent nutrition in India 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Two articles appeared in Indian newspapers following the workshop on adolescent nutrition run by Caroline Fall and her team
Year(s) Of Engagement Activity 2018
 
Description Training workshop on qualitative research methods (data analysis) for early career researchers from India and sub-Saharan Africa 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Second of three training workshops held under this award. Held in Johannesburg, South Africa. Topic: analysis of qualitative data.
Year(s) Of Engagement Activity 2018
 
Description Training workshop on qualitative research methods (data collection) for early career researchers from India and sub-Saharan Africa 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact First of three training workshops held under this award. Venue: BKL Walawalkar Hospital and Rural Medical College, Derwan, India. Topic: Qualitative research methods.
Year(s) Of Engagement Activity 2018
 
Description Training workshop on qualitative research methods (writing up) for early career researchers from India and sub-Saharan Africa 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Third of three training workshops held under this award. Location: MRC LEU Southampton. Topic: writing up of qualitative research data.
Year(s) Of Engagement Activity 2019