Maternal vitamin B12, folic acid and homocysteine as determinants of gestational diabetes, fetal growth and intergenerational programming of diabesity

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

Abstract

There is a rapidly escalating epidemic of obesity and type 2 diabetes across the world, with the fastest rise occurring in low- and middle-income countries. India not only has one of the highest rates in the world, but the disease starts at a younger age and lower levels of body weight than in UK white caucasians. Among city-dwelling Indians, approximately 8% of people aged 30-40 years already have diabetes. This is creating a heavy burden of disease and disability, and an intolerable economic burden through medical costs and lost earnings. Until now, efforts to prevent diabetes have mainly focussed on modifying the diet, lifestyle and activity of at-risk adults (for example those who are overweight, have a family history of diabetes or already have high blood sugar). However, recent research has indicated that factors acting in early life (during development in the womb) place an individual at risk of later diabetes. These include maternal malnutrition and low birthweight, and diabetes in the mother during pregnancy. Our research has shown that Indian mothers often have low vitamin B12 levels, which in turn causes high blood levels of a harmful metabolite (homocysteine). We have shown that these mothers get more diabetes in pregnancy. Their children are more likely to born with a low birth weight, and develop more body fat and higher plasma insulin levels during childhood, which are signs of higher diabetes risk in later life. The risk is increased further if the mother has normal or high status for another B vitamin, folate. Thus, we have shown, for the first time a link between a specific nutritional deficiency in the mother and diabetes risk in the next generation. One possible mechanism for the effect of maternal nutrition on risk of diabetes in her children is through epigenetic effects, whereby the nutritional environment during early development affects the switches that control gene expression. Since these switches are passed on via either parent, we think it is possible that paternal vitamin B12 status could also be important.

Our proposed programme comprises 3 related projects in India and the UK:

1) A randomised controlled trial of vitamin B12 supplementation in a cohort of 700 rural Indian adolescents (Pune Maternal Nutrition Study) with the aim of improving their vitamin B12 status prior to marriage, conception and pregnancy.

The objectives are to determine

a) whether vitamin B12 supplementation of young Indian women improves the vitamin B12 status of their newborns.

b) whether vitamin B12 supplementation of young Indian women and men improves birth weight, neonatal body composition, and (beyond the time span of this grant) body composition and insulin sensitivity in the children.

2) A case-control study of mothers with gestational diabetes (N=700) and controls (N=1400) in a UK population with a high proportion of S Asians (Coventry, Nuneaton and Leicester).

The objective is to determine:

c) whether Indian and white caucasian women who develop GDM were more likely to have low vitamin B12 status, or an imbalance between B12 and folate (low B12, normal/high folate) in early pregnancy.

3) Measurement of vitamin B12, folate and homocysteine in stored maternal plasma samples from 3000 pregnancies in a UK birth cohort (Southampton Women's Survey) which has subsequently collected data on body composition in the newborns and children.

The objectives will be to determine:

d) whether lower maternal B12 status and higher homocysteine concentrations are associated with lower birthweight in a UK population.

e) whether B12-folate imbalance (low maternal B12 and normal/high folate status) are associated with a more adipose body composition at birth and during childhood.

We expect this unique research to have a major impact on future strategies to prevent diabetes.

Technical Summary

There is an escalating global epidemic of type 2 diabetes, with developing countries experiencing the most rapid increase. Current strategies for preventing the disease rely mainly on altering adult lifestyles. Recent research suggests that factors acting during early development, including fetal growth restriction, and exposure to gestational diabetes (GDM) in the mother, increase diabetes and obesity risk in later life. Our research in India has shown that maternal vitamin B12 deficiency and hyper-homocysteinaemia, in combination with normal/high folate status, is associated with an increased risk of GDM in the mother, growth restriction in her fetus, and adiposity and insulin resistance in her children. These effects could act through epigenetic mechanisms and occur in paternal as well as maternal B12 deficiency. Improving the B12 status of women and men preparing for pregnancy could be a scalable and affordable intervention to prevent diabetes in future generations. Our proposed programme includes an RCT of B12 supplementation in rural Indian adolescents who will marry and conceive within the next 4 years, aiming to improve newborn B12 status and body composition and reduce diabetes risk in their children. We will also carry out 2 observational studies in the UK, to replicate the earlier Indian findings and study their wider relevance. We will measure B12, folate and homocysteine in stored maternal samples from a UK birth cohort which has measured body composition in the children, and carry out a case-control study of mothers with and without GDM in a UK population at high risk and with a high S Asian population (W Midlands) to determine whether UK women who develop GDM have low B12 status, or B12/folate imbalance, in early pregnancy. Samples taken in all studies will be used for genetic studies, and future epigenetic research, relevant to our objectives. We expect this unique research to have a major impact on future strategies to prevent type 2 diabetes.

Planned Impact

This comprehensive programme will assess the impact of 2 B vitamins (B12 and folic acid) on metabolic risk of pregnant mothers, fetal growth and inter-generational programming of common chronic metabolic disorders (obesity and diabetes). We will assess impact in India, as well as in white Caucasians and South Asians living in the UK. We expect the work to have an influence on future strategies to prevent these disorders. This is important given the high burden of disease potentially caused by vitamin B12 deficiency and the scalable and affordable nature of widespread B12 supplementation. It is anticipated 15-20% of all pregnant mothers will develop GDM in the UK if the new International Association of Diabetes and Pregnancy Study Group (IADPSG) guidelines are adopted. Despite best efforts, childhood obesity is increasing along with the epidemic of metabolic disorders in adult life.

Apart from patients who develop GDM, the beneficiaries from this research will be: pregnant mothers of all ethnicities living in India, UK and elsewhere; diabetologists in the NHS and world-wide (if B12 deficiency predicts the risk of GDM); public health experts (involved in strategies to reduce childhood obesity); and policy makers (huge potential to reduce the burden of obesity and metabolic diseases of the next generation).

Publications

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Adaikalakoteswari A (2016) Simultaneous detection of five one-carbon metabolites in plasma using stable isotope dilution liquid chromatography tandem mass spectrometry. in Journal of chromatography. B, Analytical technologies in the biomedical and life sciences

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Curtis EM (2017) Perinatal DNA Methylation at CDKN2A Is Associated With Offspring Bone Mass: Findings From the Southampton Women's Survey. in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

 
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 Chancellor's scholarship
Amount £88,260 (GBP)
Organisation University of Warwick 
Sector Academic/University
Country United Kingdom
Start 10/2017 
End 09/2019
 
Description Department of Biotechnology, Government of India, Centre of Excellence Grant to Diabetes Research Unit, Pune, India (co-applicant K Kumaran)
Amount रू 70,000,000 (INR)
Organisation Ministry of Science and Technology India 
Department Department of Biotechnology, India
Sector Public
Country India
Start 12/2013 
End 11/2018
 
Description Research Fellows Training Scheme
Amount £226,500 (GBP)
Funding ID Fellows 
Organisation George Eliot Hospital NHS Trust 
Sector Public
Country United Kingdom
Start 03/2012 
End 10/2015
 
Description WCPRS - University of Warwick and Industry collaborative scholarships (With BHR Pharmaceuticals)
Amount £96,549 (GBP)
Organisation University of Warwick 
Sector Academic/University
Country United Kingdom
Start 01/2018 
End 07/2021
 
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 Maternal vitamin B12, folic acid and homocysteine as determinants of gestational diabetes, fetal growth and inter-generational programming of diabesity 
Organisation Council of Scientific and Industrial Research (CSIR)
Department Centre for Cellular and Molecular Biology (CCMB)
Country India 
Sector Academic/University 
PI Contribution Epidemiological and statistical expertise, study design, training of field and scientific staff, data interprtetation.
Collaborator Contribution Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry)
Impact 27076577. Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry). Abstracts presented at conferences. Study protocol paper for the Pune B12 interventio study ("PRIYA") published in BMC Nutrition 2017.
Start Year 2010
 
Description Maternal vitamin B12, folic acid and homocysteine as determinants of gestational diabetes, fetal growth and inter-generational programming of diabesity 
Organisation KEM Hospital Research Centre
Department Department of Diabetes
Country India 
Sector Academic/University 
PI Contribution Epidemiological and statistical expertise, study design, training of field and scientific staff, data interprtetation.
Collaborator Contribution Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry)
Impact 27076577. Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry). Abstracts presented at conferences. Study protocol paper for the Pune B12 interventio study ("PRIYA") published in BMC Nutrition 2017.
Start Year 2010
 
Description Maternal vitamin B12, folic acid and homocysteine as determinants of gestational diabetes, fetal growth and inter-generational programming of diabesity 
Organisation University of Oxford
Department Department of Pharmacology
Country United Kingdom 
Sector Academic/University 
PI Contribution Epidemiological and statistical expertise, study design, training of field and scientific staff, data interprtetation.
Collaborator Contribution Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry)
Impact 27076577. Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry). Abstracts presented at conferences. Study protocol paper for the Pune B12 interventio study ("PRIYA") published in BMC Nutrition 2017.
Start Year 2010
 
Description Maternal vitamin B12, folic acid and homocysteine as determinants of gestational diabetes, fetal growth and inter-generational programming of diabesity 
Organisation University of Warwick
Department Warwick Medical School
Country United Kingdom 
Sector Academic/University 
PI Contribution Epidemiological and statistical expertise, study design, training of field and scientific staff, data interprtetation.
Collaborator Contribution Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry)
Impact 27076577. Multi-disciplinary collaboration (paediatrics, obstetrics, diabetes, epidemiology, statistics, nutrition, genetics, biochemistry). Abstracts presented at conferences. Study protocol paper for the Pune B12 interventio study ("PRIYA") published in BMC Nutrition 2017.
Start Year 2010
 
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 Academic/University 
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
 
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 20th Annual Sneha Workshop, Feb 2017 (K Kumaran) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Indian meeting on DOHaD research attended by over 600 delegates and over 200 for the 2nd David Barker Memorial conference
Year(s) Of Engagement Activity 2017
 
Description Address to a school audience, Mysore, India March 3016 (K Kumaran) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Chief guest: address to a school audience (students, teachers and parents) on the importance of early life nuturing to improve child development and later health. The school has subsequently asked Dr Kumaran to run regular sessions on adolescent health for the high school students
Year(s) Of Engagement Activity 2016
 
Description Annual European Congress of Rheumatology EULAR, Madrid, June 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof Cooper shared his expertise and knowledge by lecturing on "Case 1 discussant: Imminent fracture risk: assessment and does it help clinical management" with a particular session on "Predicting short-term fracture risk: can we foresee the (close) future?"
Year(s) Of Engagement Activity 2019
 
Description Annual Sneha conference, Lonavala, India, 2014 (K Kumaran) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Part of the organising team; attended by over 60 delegates for the main workshop and approx 150 for the David Barker Memorial Conference
Year(s) Of Engagement Activity 2014
 
Description Article attracted great deal of media attention 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact Hill WD, Marioni RE, Maghzian O, Ritchie SJ, Hagenaars SP, McIntosh AM, Gale CR, Davies GA combined analysis of genetically correlated traits identifies 187 loci and a role for neurogenesis and myelination in intelligence. Molecular psychiatry 2018/01/11 doi 10.1038/s41380-017-0001-5.
This article attracted a great deal of media attention - as well as appearing in a number of newspapers it was tweeted by 467 people, was on 7 facebook pages, mentioned in 3 Google+ posts, picked up by 14 news outlets, 4 Reddit and 2 videos, plus 54 readers on Mendeley.
Year(s) Of Engagement Activity 2018
 
Description Biostatistics and Epidemiology for Clinical and Public Health Research, Vellore, India, March 2016 and June 2016 (K Kumaran) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Faculty on a course for multi-disciplinary professionals run by Christian Medical College, Vellore in March and again in June 2016
Year(s) Of Engagement Activity 2016
 
Description Bisphosphonates 50th Anniversary Meeting, July 2019 
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 Professor Cooper gave a talk entitled 'the treatment gap' at the Bisphosphonates 50th Anniversary Meeting, Sheffield, July 2019
Year(s) Of Engagement Activity 2019
 
Description Caroline Fall, K Kumaran, Sarah Kehoe; Organisers and chairs; 19th Annual Workshop of SNEHA India 2016 
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 Annual workshop in India on developmental origins of health and disease, under the aegis of SNEHA-INDIA (Society for natal effects on health in adults). This workshop brings senior researchers, multi-disciplinary research teams, under- and post-graduate students working on cohorts studies and trials from all over India together, along with international collaborators and invite speakers.
Year(s) Of Engagement Activity 2016
 
Description Caroline Fall: "Developmental origins of health and disease". Invited speaker to a lay audience; Nutrition of Girls and Women in Oregon, Moore Institute for Nutrition and Wellness, Portland, Oregon, USA, 14th May 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Invited speaker to a lay audience; Nutrition of Girls and Women in Oregon, Moore Institute for Nutrition and Wellness, Portland, Oregon, USA, 14th May 2015.
Year(s) Of Engagement Activity 2015
 
Description Caroline Fall: "How is the memory of early life events retained, and how may it cause disease?" Invited plenary presentation at the 9th World Congress on Developmental Origins of Health and Disease, Capetown, South Africa, 8th November 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "How is the memory of early life events retained, and how may it cause disease?" Invited plenary presentation at the 9th World Congress on Developmental Origins of Health and Disease, Capetown, South Africa, 8th November 2015.
Year(s) Of Engagement Activity 2015
 
Description Caroline Fall: "The 'thin-fat' Indian and developmental origins of health and disease". Invited Keynote speaker, Wessex Paediatric Winter Meeting (organised by the Paediatric Innovation, Education and Research Network), Southampton General Hospital, 11th December 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact "The 'thin-fat' Indian and developmental origins of health and disease". Invited Keynote speaker, Wessex Paediatric Winter Meeting (organised by the Paediatric Innovation, Education and Research Network), Southampton General Hospital, 11th December 2015.
Year(s) Of Engagement Activity 2015
 
Description Caroline Fall: "The environmental and developmental origins of health and disease (WHO CEH module)" and "Birth cohorts in India: An overview". Invited plenary speaker, PHFI-CHEP Workshop on Children's Environmental Health, Gurgaon, India, 23rd November 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "The environmental and developmental origins of health and disease (WHO CEH module)" and "Birth cohorts in India: An overview". Invited plenary speaker, PHFI-CHEP Workshop on Children's Environmental Health, Gurgaon, India, 23rd November 2015.
Year(s) Of Engagement Activity 2015
 
Description Caroline Fall: "The fetal origins of type 2 diabetes". Invited guest speaker to a lay audience, Center for Women's Health, Circle of Giving annual meeting, Portland, Oregon, USA,13th May 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Invited guest speaker to a lay audience, Center for Women's Health, Circle of Giving annual meeting, Portland, Oregon, USA,13th May 2015.
Year(s) Of Engagement Activity 2015
 
Description Caroline Fall: "The first 1000 days". Invited plenary speaker, International Summit on the Nutrition of Adolescent Girls and Young Women, Moore Institute for Nutrition and Wellness, Portland, Oregon, USA, 16th May 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited plenary speaker, International Summit on the Nutrition of Adolescent Girls and Young Women, Moore Institute for Nutrition and Wellness, Portland, Oregon, USA, 16th May 2015.
Year(s) Of Engagement Activity 2015
 
Description Caroline Fall: "Translating 'developmental origins' to benefit women and babies in low- and middle-income countries". Invited plenary speaker, 3rd Annual Harvard Catalyst Child Health Symposium, Boston, 7th October 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "Translating 'developmental origins' to benefit women and babies in low- and middle-income countries". Invited plenary speaker, 3rd Annual Harvard Catalyst Child Health Symposium, Boston, 7th October 2015.
Year(s) Of Engagement Activity 2015
 
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: Invited presentation at NERC workshop on 'Early life developmental effects: unifying evolutionary and biomedical perspectives', Falmouth, 9th to 12th September 2015. 
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 NERC workshop on 'Early life developmental effects: unifying evolutionary and biomedical perspectives', Falmouth, 9th to 12th September 2015.
Year(s) Of Engagement Activity 2015
 
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 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 activity with Coventry and Warwickshire CCG 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Arden wide Annual CCG event - More than 200 people of varying sectors attended. Subsequent to this highly rated activity, a smaller CCG action group was formed and met in Feb 2019 to put action plan as a part of the next year's STP
Year(s) Of Engagement Activity 2018
 
Description Epidemiology for Clinicians course, Southampton, Jan 2017 (K Kumaran) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact On the Faculty of Epidemiology for Clinicians course hosted by University of Southampton, aimed at delegates with both clinical and non-clinical backgrounds who are interested in a career in epidemiological research
Year(s) Of Engagement Activity 2017
 
Description Fake Food Event Feedback 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Sian Robinson was one of the six panellists at the Fake Food event which took place at Lecture Theatre 1, SAB, Southampton General Hospital. The panel were asked questions by groups of local sixth formers who had been invited to the event.
Year(s) Of Engagement Activity 2018
 
Description Hertfordshire Public Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Study participants or study members
Results and Impact Approximately 300 HLS participants and their families attended an open day, which led to discussion, questions and interest in future research studies.
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 Invited talk - Dissemination of preliminary results of PRiDE and STRiDE studies 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Nearly 200 people attended, with several national and international speakers
Year(s) Of Engagement Activity 2019
 
Description Invited talk at British Nutrition Foundation, 27 February 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Prof Caroline Fall met the Princess Royal at launch of a new book "Emerging risk factors for Cardiovascular Disease". The meeting heard findings of the new Task Force report from the BNG entitled Cardiovascular Disease: Diet, Nutrition and Emerging Risk Factors; 2nd Edition. The Princess Royal attended this event in her capacity as BNF Patron. Prof Fall, one of the experts involved in the Task Force, gave a talk entitled "Early life nutrition: the origins of cardiovascular disease".
Year(s) Of Engagement Activity 2019
 
Description Invited talk: Biennial conference of the International DOHaD Society 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited talk: The TALENT Study (Transforming Adolescent Lives through Nutrition) at the DOHaD Society world congress
Year(s) Of Engagement Activity 2019
 
Description Invited talk: Endocrine, nutrition, metabolism and cardiovascular seminar, Institute of Developmental Sciences, 26 March 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presentation "Early life origins of cardiometabolic disease: what have we learned in 25 years?
Year(s) Of Engagement Activity 2019
 
Description K Kumaran: 9th World Congress on Developmental Origins of Health and Disease, Cape Town, South Africa. 8-11 November 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Four presentations to multi-disciplinary audience at 9th World Congress on Developmental Origins of Health and Disease, Cape Town, South Africa. 8-11 November 2015.
- Components of height and the intergenerational change in height as predictors of body composition and CVD risk in young Indian adults.
- Does change in components of childhood height influence cardiovascular risk and cognitive function in Indian adolescents?
- Stunting at 18 years is predicted by femur length in utero.
- Lifecourse evolution of diabetes related phenotypes.
Year(s) Of Engagement Activity 2015
 
Description Launch of Southampton India Centre, March 2019 
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 LifeLab Meet the Scientist - HMI, Pl, JB, 2019 - HMI 2020 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Members of this programme regularly talk to students from local schools at LifeLab Meet the Scientist at the University of Southampton facilities. They speak to the students about the work they carry out as scientists and answer the questions put to them by the students.
Year(s) Of Engagement Activity 2019
URL https://www.southampton.ac.uk/lifelab/teaching_program/for_researchers.page
 
Description Locomotor Lecture, 31 Jan 2020 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact "Introduction to osteoporosis" lectured by Professor Cyrus Cooper in Jan 2020 to Southampton Medical School Undergraduate students.
Year(s) Of Engagement Activity 2020
 
Description MRC Festival of Medical Research 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact On 23rd June 2018 a number of MRC LEU staff (Prof Cyrus Cooper, Prof Hazel Inskip, Prof Elaine Dennison, Prof Sian Robinson, Gregorio Bevilcqua, Leo Westbury, Barbara Fariborz, Martin Stevens, Tina Horsfall, Holly Syddall, Kate Ward, Shirley Simmonds, Millie Parsons, Michael Clines, Vanessa Cox, Clare Harris, Harnish Patel and Ilsa Bloom) travelled to Hertfordshire for the MRC Festival of Medical Research where they held the Hertfordshire Cohort Study Open Day at Harpenden Public Halls. There were two sessions, one in the morning and the other in the afternoon. Many of the participants of the Hertfordshire study, their children and grandchildren attended the event which included a talk by Cyrus Cooper and hands on activities - refreshments were provided. An article appeared in MRC Life and another article about the open day was sent to Charlotte Campbell at UCL to be included in the CLOSER newsletter.
Year(s) Of Engagement Activity 2018
 
Description MRC Festival of Science - Southampton Parkrun 15th June 2019 - HMI 2020 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Around 20 members of staff and one PPI member volunteered on 15th June to help at the Southampton Parkrun#364. They set up their stall, took grip strengths of some of the 1045 runners and 72 volunteers, which were recorded on a graph indicating grip strength, sex and age. This resulted in some healthy competition between those taking part. They also asked people what aspects of health they would like more research to go into and which were important to them. As an incentive to help the MRC we gave away hundrends of bananas, slap wrist bands, water bottles and mesh running vests. It was a very successful event and we plan to do it again. Sarah received an email of thanks from Head Office which was followed up by a certificate to the MRC LEU for taking part.
Year(s) Of Engagement Activity 2019
URL https://www.parkrun.org.uk/southampton/news/2019/06/20/southampton-parkrun-364-15th-june-2019/
 
Description MRC Grant for £134K 
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 Professional Practitioners
Results and Impact Cyrus Cooper and Nick Harvey were successful in securing an MRC Grant to the value of £134k which will fund a new dual energy x-ray absorptiometry (DXA) instrument and Mechanograph technology.
Year(s) Of Engagement Activity 2018
 
Description Meet the Scientist LifeLab 2017 - HMI 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact The sessions were with groups of up to 8 teenagers and Hazel carried out six sessions. Two on 3rd March 2017; 2 on 9th June 2017 and 2 on 20th November 2017. The idea was to engage the students with the excitement of working in science.
Year(s) Of Engagement Activity 2017
URL http://www.southampton.ac.uk/lifelab/
 
Description Member Expert Panel to review MSC Nutrition and Dietetics at Symbiosis School of Biomedical Sciences, Pune (K Kumaran) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Contributed to curriculum review and modification of MSC course at Symbiosis International University
Year(s) Of Engagement Activity 2016
 
Description National Diabetes in Pregnancy (DiP) Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This was organised by Prof P Saravanan, in collaboration with Diabetes UK and national DiP interest group. More than 350 professional participants attended. Highlighted the research Gaps in Gestational Diabetes and presented the preliminary results. Discussions and debate on key issue of how to manage GDM. Several positive feedback, including feedback on that it will change their practice
Year(s) Of Engagement Activity 2018
 
Description Newspaper and Magazine articles 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Wide dissemination to a lay readership

Raised public awareness
Year(s) Of Engagement Activity 2010,2011,2012
 
Description Osteoporosis Review Editorial 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Entry for PURE: Editorial work: Elaine wrote an editorial for Osteoporosis Review. The Journal of the National Osteoporosis Society.
Year(s) Of Engagement Activity 2018
 
Description PPI and stakeholder meeting - University of Warwick 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 47 people (researchers, GPs, PPI representatives) attended the meeting which was help at University of Warwick. Emerging data from the UK GDM cohort was discussed alongside with the STRiDE study's rationale, plan and implementation and proposed rationale and plan for MAGIC in Malaysia
Year(s) Of Engagement Activity 2016
 
Description Paget's Information Event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Third sector organisations
Results and Impact Approximately 50 patients attended for an information afternoon, with Professor Elaine Dennison, which sparked questions and discussion with patients reporting better knowledge of their condition.
Year(s) Of Engagement Activity 2018
 
Description Participation in an open day or visit at my research institution/facility 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Elaine Dennison gave a live interview on BBC Radio 4, Inside Health about Sarcopenia in Jan 2019. Elaine's interview started at 22.50 minutes into the programme and continued until the end of the programme. Elaine was contacted with a follow up email after the show by the show's editor requesting more information due to listener demand.
Year(s) Of Engagement Activity 2019
URL https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.bbc.co.uk%2Fprogrammes%2Fm0002...
 
Description Pregnancy Masterclass 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact As a part of South Asian Health Foundation (SAHF) annual Diabetes conference, an workshop on Pregnancy Masterclass was conducted. 60-70 GPs, Hospital practitioners and postgraduate students attended with several positive feedback on how their views will change re: Diabetes in Pregnancy
Year(s) Of Engagement Activity 2018
 
Description Presentations at St Swithans School 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Approximately 10 sixth form students attended a talk about academic medicine which resulted in questions and discussion with follow up email correspondence, hosted by Professor Elaine Dennison on 3rd May 2018.
Year(s) Of Engagement Activity 2018
 
Description Press Release leading to Media attention of publication of JAMA. 2019 May 7;321(17):1702-1715. doi: 10.1001/jama.2019.3820. - HMI 2020 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact This paper received a lot of international media coverage with Altmetric showiing 20 news outlets, 3 blogs, 101 tweeters, 3 Facebook pages. It also was in the top 5% of all research outputs scored by Altmetric
Year(s) Of Engagement Activity 2019
URL https://www.ncbi.nlm.nih.gov/pubmed/31063572
 
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 Public Health Platform Technical Advisory Group meeting, Pune, Mar 2016 (K Kumaran) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Part of a public health platform in India aimed at capacity building in public health
Year(s) Of Engagement Activity 2016
 
Description Pune Public Health Conference 2014, School of Health Sciences, University of Pune and Joint State Conference of IPHA-IAPSM (K Kumaran) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation to public health conference and IPHA-IAPSM on maternal health and pre-conceptional health
Year(s) Of Engagement Activity 2014
 
Description Science and Engineering Day University of Southampton 16.03.19 - HMI 2020 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact We had two activities at the Science and Engineering Day on 16th March 2019, one, the grip strength measurements, which is a tried and tested activity which we've used a number of times before and a new activity "The 9-Hole Peg Test". This idea of this new activity was initiated by Lisa Newington, people have to remove the pegs from the board and then replace them. They then do the activity again wearing a glove which represents a hand which may have had surgery, or has arthritis etc. The activities were very popular attracting over 500 members of the public from the 7000 people who attended the whole event. We also had a large number of MRC LEU staff volunteer to help with the event, including Hazel Inskip, Janis Baird, Clare Harris, Cathy Linaker, Nick Harvey, Mary Barker, Shirley Simmonds, Lisa Newington, Sofia Strommer, Philip Marshall-Cox, Tina Horsfall, Julia Hammond, Sarah Standfield, Gregoria Bevilacqua, Leo Westbury, Kelly Montague, Eleanour Marshall-Cox and Sue Curtis
Year(s) Of Engagement Activity 2019
URL https://www.southampton.ac.uk/per/university/festival/science-and-engineering-day.page
 
Description Social media: Lifelab Meet the Scientist 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Schools
Results and Impact Using Twitter to disseminate information about the work at the MRC LEU both from the MRC LEU account and my account SHKehoe

Lifelab Meet the Scientists - regular presentations to school children about work as a scientist
Year(s) Of Engagement Activity 2016,2017,2018,2019
 
Description Spanish Bone Research Conference (SEIOMM) 2019 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Professor Cyrus Cooper attended the SEIOMM Conference in Girona from 16-18th October 2019. The aim of Prof Cooper's talk was to update the audience on up-to-date findings from research in the field of osteoporosis. to include the SCOOP data which had not spread well in the Spanish bone community.
Year(s) Of Engagement Activity 2019
 
Description What is DOHaD and where is it going? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact 2nd David Barker Memorial Symposium in India on Developmental Origins of Health and Disease, held at the Integrated Research School for Health Affairs, Bharati Vidyapeeth University, Pune, India. A lecture for clinicians on what DOHaD is all about, and its relevance for cinical care.
Year(s) Of Engagement Activity 2017