Fetal programming of health and disease; follow-up of children whose mothers took part in a pre-conceptional nutrition trial in Mumbai, India

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

Abstract

The Mumbai Maternal Nutrition Project was a randomised controlled trial which took place in a slum community in the city of Mumbai, India. The participants were women planning to have children. They had diets low in vitamins and minerals (micronutrients) and their newborns were at high risk of low birth weight. The aim of the trial was to test whether improving the micronutrient quality of their diet for a sustained period of time before conception, and throughout pregnancy, increases birth weight and improves the children's long-term health. Women were offered, in addition to their usual diet, a specially designed daily snack made from (treatment group) micronutrient-rich foods including green leafy vegetables, fruit and milk, or (controls) low micronutrient vegetables such as potato and onion. On average the treatment snacks contained 10-23% of the WHO recommended Reference Nutrient Intake for beta-carotene, folate, vitamins B2 and B12, calcium and iron.

The trial was unusual in two ways: (a) in supplementing women before pregnancy and (b) in using local micronutrient-rich foods rather than pharmaceutical micronutrient supplements. The primary outcome was birth weight, but it was powered to enable the study of longer term outcomes in the children. We pre-specified that we planned to test the effect of starting the intervention at least three months before conception, and we expected greater effects on birth weight among thinner women. The first women were recruited in January 2006 and the last baby was born in May 2012. We enrolled 6513 women, of whom 2291 became pregnant, resulting in 1962 singleton live births; 1826 of the 2291 women started the supplement at least three months before becoming pregnant and had 1562 live births.

Among all the women who gave birth, the intervention had a positive but non-significant effect on birth weight (+26 g [95% CI -15, 68 g], p=0.22). There was a greater effect among women who started supplementation at least three months before pregnancy (+48g [95% CI 1, 96 g], p=0.046). In these women, the intervention reduced the rate of low birth weight babies (Treatment: 34%, Controls 41%; OR 0.76 [95% CI 0.59, 0.98], p=0.03). The birth weight effect increased with maternal pre-pregnant body mass index: -8g, +79g and +113g in the lowest, middle and highest thirds of maternal BMI respectively (p for interaction=0.001). An unexpected benefit of the intervention was that it reduced the prevalence of diabetes in the mothers during pregnancy (Treatment: 7%, Controls: 13%, p<0.01).

In the proposed study, we now aim to assess the effect of the intervention on outcomes in the children (N~1800) at the age of 6 years. We will measure a range of growth, functional and health outcomes, including height, body composition, risk markers for later diabetes and heart disease, and brain function.

The study has already started (from Sept 2013) in order assess children in a narrow age window. Ethical approval was obtained from the JJ Hospital, Mumbai. Families are visited by a health worker to explain the study. As close as possible to the child's 6th birthday, the child and both parents are asked to attend a research clinic at the Centre for the Study of Social Change in Bandra, Mumbai, after an overnight fast. Detailed body measurements of the parents and child are performed. A fasting blood sample is taken from the child for glucose, insulin and lipids. Further blood samples are drawn at 30 and 120 minutes after an oral glucose load. Blood pressure and hand grip strength are measured. Cognitive (intelligence) testing is carried out using tests validated for Indian children. The children have fat, lean and bone mass measured using dual X-ray absorptiometry at a local hospital. In parents, a full blood count and fasting glucose are measured. DNA and RNA samples for future genetic and epigenetic analyses are collected from the children and parents and frozen. The study will take 3 years to complete.

Technical Summary

As described above, the Mumbai Maternal Nutrition Project was a randomised controlled trial in Mumbai, India, which aimed to test whether improving the micronutrient quality of a women's diet before conception and throughout pregnancy increases birth weight and improves the long-term health of the child. The intervention reduced the incidence of gestational diabetes, and among women of normal or high BMI, increased birth weight. The aim of the study proposed here is to determine whether it has improved the health and capacity of the children at the age of 6 years.

The study has already started (from Sept 2013) so as not to miss the age window in the earliest-born children. Ethical approval was obtained from JJ Hospital, Mumbai. Families are visited by health workers to explain the study. As close as possible to their 6th birthday, the child and both parents attend a research clinic at the Centre for the Study of Social Change in Bandra, Mumbai, after an overnight fast. Detailed body measurements of the parents and child are performed. A fasting blood sample is taken from the child for glucose, insulin and lipids, and further samples drawn at 30 and 120 minutes after an oral glucose load. Blood pressure and hand grip strength are measured. Fat, lean and bone mass are measured using DXA. Cognitive function is measured using the Kaufman Assessment Battery and other tests validated for Indian children and designed to measure multiple domains. Parents' fasting glucose is measured. DNA and RNA samples for future genetic/epigenetic analyses are collected from children and parents, and frozen.

110 children have been studied so far, and over 3 years we expect to study ~1500 (80%) of the surviving children from the original 1962 births. We will have 80% power to detect a difference of 0.14 SDs in continuous outcomes between treatment and control groups at 5% significance. This equates, for example, to approximately 1.4 mmHg of systolic blood pressure.

Planned Impact

Our findings have enormous public health potential as they offer a primordial prevention strategy to control and prevent the rising burden of non-communicable disease. The research will benefit the public by improving health and reducing chronic disease in the current and future generations. In the longer term, this will enhance human capital in India; translating the findings to other populations will benefit the wider population.

The beneficiaries of our research include colleagues working in the field of DOHaD, other clinicians, nutritionists, epidemiologists, public health practitioners and policy makers; the findings will add to the existing knowledge base on the influence of maternal nutrition on offspring health in young childhood. We know from earlier work in India and elsewhere that the measurements we are planning at the age of 6 years (cardiovascular risk factors, body composition, cognitive function) track into adult life, and our findings will therefore provide evidence of the importance of maternal nutrition for adult health.

Our work has resulted in a network of scientists and researchers who work closely together and share learning and skills. This enables young researchers in both India and the UK to develop transferable research skills and contributes to capacity building. Our work in India has led to the development of research infrastructure, skilled teams and independent researchers.

A better understanding of the relationships between maternal nutrition and chronic disease risk factors in childhood, as well as an improved understanding of optimal childhood growth patterns will have significant impact for other scientists and policy makers. It will help guide the development of further interventions in infancy and early childhood and address translation of evidence into practice. Our work has influenced research strategy in India and the UK with major funders such as the Indian Council of Medical Research, Department of Biotechnology, the Medical Research Council and the Wellcome Trust funding and prioritising early life origins research. The DOHaD work has also influenced policy. Recent evidence of impact includes the adoption by the International Diabetes Federation of a 'life circle' approach to diabetes prevention; the emphasis by international agencies on better nutrition in the 'first 1000 days' (conception to age 2 years); and the World Health Assembly declaration on chronic disease, recognising the importance of early life factors. The Lancet series on maternal and child nutrition in 2008 and 2013 have included the DOHaD concept and highlighted the wider nutrition-sensitive issues in tackling maternal and child undernutrition. This will in turn feed into the high level panel which will consider the next set of Millenium Development Goals and possibly lead to the inclusion of targets for maternal health and child stunting.

Publications

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Bhawra J (2018) Results from India's 2018 Report Card on Physical Activity for Children and Youth. in Journal of physical activity & health

 
Description Systematic review on long-term effects of multiple micronutrients in pregnancy
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in systematic reviews
 
Description Collaborative network for adolescent nutrition and health in sub-Saharan Africa and India
Amount £200,000 (GBP)
Funding ID MC_PC_MR/R018545/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 02/2018 
End 01/2019
 
Description Early-life origins of brain resilience to mental illness and cognitive impairment across the life-course
Amount £0 (GBP)
Funding ID MC_PC_MR/R019541/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 03/2018 
End 02/2019
 
Description Epigenetic mechanisms linking maternal pre-conceptional micronutrient supplementation with offspring health in India and The Gambia.
Amount £923,645 (GBP)
Funding ID MR/N006208/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 05/2015 
End 05/2018
 
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 Senior Fellowship to GV Krishnaveni: Lifecourse programming of stress responses in young adults in India: A multi-faceted approach to explore mediating factors and develop interventions
Amount £575,000 (GBP)
Funding ID IA/CPHS/16/1/502655 
Organisation The Wellcome Trust/DBT India Alliance 
Sector Multiple
Country Global
Start 04/2017 
 
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 CF: EMPHASIS collaboration 
Organisation Council of Scientific and Industrial Research (CSIR)
Department Centre for Cellular and Molecular Biology (CCMB)
Country India 
Sector Academic/University 
PI Contribution Colaboration led by Caroline Fall. Contribution of data from Mumbai Maternal Nutrition Study. Contribution of expertise in epidemiology, nutrition, epigenetics.
Collaborator Contribution Contribution of data from trial in the Gambia. Epigenetics and bioinformatics expertise.
Impact Abstracts at conferences. Multi-disciplinary collaboration (epidemiology, nutrition, epigenetics)
Start Year 2015
 
Description CF: EMPHASIS collaboration 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Department Department of Global Health and Development
Country United Kingdom 
Sector Academic/University 
PI Contribution Colaboration led by Caroline Fall. Contribution of data from Mumbai Maternal Nutrition Study. Contribution of expertise in epidemiology, nutrition, epigenetics.
Collaborator Contribution Contribution of data from trial in the Gambia. Epigenetics and bioinformatics expertise.
Impact Abstracts at conferences. Multi-disciplinary collaboration (epidemiology, nutrition, epigenetics)
Start Year 2015
 
Description CF: EMPHASIS collaboration 
Organisation Medical Research Council (MRC)
Department MRC Unit, The Gambia
Country Gambia 
Sector Public 
PI Contribution Colaboration led by Caroline Fall. Contribution of data from Mumbai Maternal Nutrition Study. Contribution of expertise in epidemiology, nutrition, epigenetics.
Collaborator Contribution Contribution of data from trial in the Gambia. Epigenetics and bioinformatics expertise.
Impact Abstracts at conferences. Multi-disciplinary collaboration (epidemiology, nutrition, epigenetics)
Start Year 2015
 
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 Engagement with University of Aberdeen and other collaborators at Mysore 
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 Our unit hosted a workshop with participants from the University of Aberdeen, Centre for Cellular and Molecular Biology, Hyderabad, Centre for the Study of Social Change, Mumbai and University of Southampton to develop new collaborations and grant applications on areas of mutual interest. Following that workshop, we have obtained joint funding for a pilot study in neuroimaging and for public engagement activities with our existing cohorts.
Year(s) Of Engagement Activity 2017
 
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 21st Annual SNEHA Meeting, Pune 
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 SNEHA (Society for the Natal Effects of Health in Adults) held its 21st annual meeting at Pune. I am the current Secretary of the organisation. We had two days of interactive oral and poster presentations by the members and external speakers. We also had a day where we conducted the 3rd David Barker Memorial Symposium which consisted of invited speakers in the morning followed by a session for the public in the afternoon on reversal of diabetes. The event went well and we received positive feedback on the public session. We plan to incorporate public sessions in future meetings.
Year(s) Of Engagement Activity 2019
 
Description 23. The first 1000 days 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact "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.
Year(s) Of Engagement Activity 2015
 
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 CF: Newspaper article on the Mumbai Trial 
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 An Article entitled "For healthy and intelligent future generation" appeared in the Loksatta, Marathi Daily, Mumbai, India and spoke about the findings of the Mumbai Trial. The CSSC has been working for 40 years to develop a healthy and enabled society in the slum of Mumbai. They started working with MRC LEU in 2005.
Year(s) Of Engagement Activity 2017
 
Description Caroline Fall (organiser), K Kumaran (rapporteur); Steering Committee meeting for EMPHASIS study 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Steering committee meeting for the EMPHASS study (epigenetic changes in children born to mothers who participated in randomised controlled trials of nutritional interventions during pregnancy.
Year(s) Of Engagement Activity 2016
 
Description Caroline Fall, K Kumaran, Sarah Kehoe. Organisers and chairs: 20th Annual Workshop of SNEHA India 2017 
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). The 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 invited speakers
Year(s) Of Engagement Activity 2017
 
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: "So you think you can do a pre-conceptional trial? What we learned from the Mumbai 'samosa' trial". Invited plenary presentation at the 9th World Congress on Developmental Origins of Health and Disease, Capetown, South Africa, 11th 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 "So you think you can do a pre-conceptional trial? What we learned from the Mumbai 'samosa' trial". Invited plenary presentation at the 9th World Congress on Developmental Origins of Health and Disease, Capetown, South Africa, 11th 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: "The role of food-based approaches to improve pre-conceptional nutrition and birth outcomes". Invited presentation in Symposium on 'Do we need preconception nutrition interventions to improve birth outcomes beyond the prevention of neural tube defects? Current knowledge'. Annual meeting of the American Nutrition Society, Boston, March 29th 2015. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Annual meeting of the American Nutrition Society, Boston, March 29th 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: 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: Mothers, babies and the global diabetes epidemic 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Invited speaker to the NEEDLES club annual meeting (medical and lay audience), Southampton 4 June 2016
Year(s) Of Engagement Activity 2016
 
Description DOHaD - what is it and where is it going? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "DOHaD - what is it and where is it going?" Invited lecture, 2nd David Barker Memorial Symposium, Integrated School for Health Affairs, Bharati Vidyapeeth deemed University, Pune, India, 18th February 2017
Year(s) Of Engagement Activity 2017
 
Description DOHaD and diabetes in India 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact DOHaD and diabetes in India. Seminar series. Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), 29th November 2017
Year(s) Of Engagement Activity 2017
 
Description Developmental origins of health and disease 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact "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.
Year(s) Of Engagement Activity 2015
 
Description Dr Sirazul Ameen sahariah Presentation at 19th annual Sneha meeting 
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 protocol of the SARAS KIDS study (follow-up of children born in MMNP) at the 19th annual workshop of Sneha-India, the annual meeting in India of research groups working in the DOHaD field.
Year(s) Of Engagement Activity 2016
 
Description EMPHASIS website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Website created to the EMPHASIS study.
Year(s) Of Engagement Activity 2016
URL http://www.emphasisstudy.org
 
Description Early life programming: a driver of the global diabetes burden? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Overview of DHaD research and diabetes. Invited speaker STENO conference, Copenhagen, 25th-27th May 2016 .
Year(s) Of Engagement Activity 2016
 
Description Engagement with University of Aberdeen and other collaborators at Aberdeen (KK) 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The University of Aberdeen unit hosted a workshop with participants from the University of Aberdeen, Centre for Cellular and Molecular Biology, Hyderabad, Narayana Hospitals, Mysore, CSI Holdsworth Memorial Hospital, Mysore and the MRC LEU, Southampton. The main aims were to 1) share knowledge on brain imaging data analysis and data management and security; and 2) develop a grant application for the MRC Mental Health GCRF. We have submitted a grant application with Alison Murray and Kalyanaraman Kumaran as lead PIs.
Year(s) Of Engagement Activity 2018
 
Description International consultation panel on birth defects, Pune India Mar 2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Discussion around appropriate maternal care before and during pregnancy
Year(s) Of Engagement Activity 2016
 
Description Invited plenary talk: British and Irish Hypertension Society annual meeting, 17 September 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Update on the Barker Hypothesis and hypertension
Year(s) Of Engagement Activity 2019
 
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 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: Annual Workshop 2015. Society for the Natal Effects of Health in Adults. 26-28 February 2016. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Evolution of hyperglycemia in young rural Indians. Presentation to post-grad and PhD students, multi-disciplinary professionals attending Annual Workshop 2015. Society for the Natal Effects of Health in Adults. 26-28 February 2016.
Year(s) Of Engagement Activity 2016
 
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 Longitudinal DOHaD studies in India 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact "Longitudinal DOHaD studies in India". Conference on South Asian Children's Environmental Health (CEH) organised by the Pacific Basin Consortium for Environmental Health, India Habitat Centre, New Delhi, 15th November 2017
Year(s) Of Engagement Activity 2017
 
Description Presentation at 21st Sneha-India workshop on Developmental Origins of Health and Disease, Pune, February 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Presentation of main EMPHASIS study findings to 21st Sneha-India research workshop
Year(s) Of Engagement Activity 2019
 
Description Presentation at 65th annual conference of the Society for Reproductive Investigation, San Diego, USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Invited presentation: Pre-conceptional interventions to improve child health outcomes. Invited talk at the 65th annual conference of the Society for Reproductive Investigation, San Diego, USA 9th March 2018.
Year(s) Of Engagement Activity 2018
 
Description Sarah Kehoe: Diets of Women of Reproductive Age in Mumbai Slums Provide Insufficient Intakes of Multiple Micronutrients (Mumbai Maternal Nutrition Project). Presentation at SNEHA 19th Annual conference, Hyderabad, Feb 2016 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk to developmental origins academics and students:
Diets of Women of Reproductive Age in Mumbai Slums Provide Insufficient Intakes of Multiple Micronutrients (Mumbai Maternal Nutrition Project)
Year(s) Of Engagement Activity 2016
 
Description Sarah Kehoe: Identifying nutrition-sensitive interventions to improve maternal diet quality in rural Indian settings using value chain analysis. Presentation at Leverhulme Centre for Integrated Research on Agriculture and Health 5th Annual Conference, June 2015 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk to inter-disciplinary academics and students: Identifying nutrition-sensitive interventions to improve maternal diet quality in rural Indian settings using value chain analysis
Year(s) Of Engagement Activity 2015
 
Description Sarah Kehoe: Value Chains for Nutrition, CSSC Workshop, May 2015 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Talk to representatives of NGOs, policy makers from Indian government agencies and academics at the Value Chains for Nutrition in Maharashtra Stakeholder Workshop, CSSC, Mumbai
Year(s) Of Engagement Activity 2015
 
Description Sarah Kehoe:Vitamin B12 intake and its association with socio-demographic factors among women living in urban slums of Mumbai. Presentation at Nutrition Society of India Annual Conference, Hyderabad, Oct 2015 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk to nutrition academics and students:
Vitamin B12 intake and its association with socio-demographic factors among women living in urban slums of Mumbai
Year(s) Of Engagement Activity 2015
 
Description So you think you can do a pre-conceptional trial? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact "So you think you can do a pre-conceptional trial? What we learned from the Mumbai 'samosa' trial". Invited plenary presentation at the 9th World Congress on Developmental Origins of Health and Disease, Capetown, South Africa, 11th November 2015.
Year(s) Of Engagement Activity 2015
 
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 The 'thin-fat' Indian and developmental origins of health and disease 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
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 The fetal origins of type 2 diabetes 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact "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.
Year(s) Of Engagement Activity 2015
 
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
 
Description Translating 'developmental origins' to benefit women and babies in low- and middle-income countries 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
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 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
 
Description Workshop at Centre for Cellular and Molecular Biology, Hyderabad (KK) 
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 My colleague Dr Krishnaveni and I were invited to participate in a workshop by Dr Chandak at Hyderabad to discuss future research projects and also for us to train his team and others at their institute (mostly PhD students) on research methods. The teaching was interactive and well received. The discussions with his team resulted in the development of a project to investigate genetic determinants of vitamin D on the Parthenon Cohort in Mysore. The study received intramural funding from the Centre for Cellular and Molecular Biology.
Year(s) Of Engagement Activity 2018