MRC Epidemiology Unit
Welcome to the winter 2022/23 issue of epigram, the quarterly newsletter from the MRC Epidemiology Unit.
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In this issue
- Tax on sugar showing success?
- Finding the fingerprints of health and disease
- Active at all ages
- Getting into the SWiM of things
- Come on, get appy
- Researcher voices
- Our latest publications
Tax on sugar showing success?
Sugary drinks tax may have prevented over 5,000 cases of obesity a year in year six girls alone
The introduction of the soft drinks industry levy – the ‘sugary drinks tax’ – in England was followed by a drop in the number of cases of obesity among older primary school children. Taking into account current trends in obesity, this suggests that around 5,000 cases of obesity per year may have been prevented in year six girls alone.
In April 2018, the UK governments introduced the soft drinks industry levy, targeted at manufacturers of the drinks to incentivise them to reduce the sugar content of soft drinks and the amount of sugar in diets – particularly the diets of young people. MRC Epidemiology Unit researchers tracked changes in the levels of obesity in children in England in reception year and year six between 2014 and 2020. Taking account of previous trends in obesity levels they compared changes in levels of obesity 19 months after the sugar tax came into effect.
The team found that the introduction of the sugar tax was associated with an 8% relative reduction in obesity levels in year six girls, equivalent to preventing 5,234 cases of obesity per year in this group alone. Reductions were greatest in girls whose schools were in deprived areas, where children are known to consume the largest amount of sugary drinks – those living in the most deprived areas saw a 9% reduction. However, the team found no associations between the sugar tax coming into effect and changes in obesity levels in children from reception class. In year 6 boys, there was no overall change in obesity prevalence. Read more.
This research was widely covered by UK and international news outlets, and first author Dr Nina Rogers was interviewed by BBC Newsnight, Times, ITV Anglia, and Der Spiegal. Other newspapers covering it included the Guardian, Daily Mail, Telegraph, New York Post, Evening Standard, Bloomberg and Independent.
Finding the fingerprints of health and disease
A team of researchers from the MRC Epidemiology Unit and Berlin Institute of Health at Charité, led by Professor Claudia Langenberg, has analysed the genes, proteins and metabolites in blood samples from tens of thousands of people to identify particular patterns that are associated with health and disease. Their approach could aid earlier and more accurate diagnosis, and improve the effectiveness and safety of strategies to prevent and treat disease.
Detecting the undetected: measuring levels of three proteins in the blood can aid detection of undiagnosed prediabetes
Medical and behavioural interventions are effective in delaying or preventing type 2 diabetes onset in people with prediabetes (which is when you have a higher than normal blood sugar level.) However, a substantial proportion of people with prediabetes are missed by current clinical screening techniques. Individuals with isolated impaired glucose tolerance (isolated IGT), a common type of prediabetes, can only be identified through oral glucose tolerance testing, which is not routinely performed as part of type 2 diabetes clinical screening.
By analysing the levels of nearly 5,000 different proteins in blood plasma samples from more than 11,000 Fenland Study participants, each of whom underwent an oral glucose tolerance test, scientists identified a three-protein signature in the blood that can improve detection of isolated IGT. Incorporating testing for this signature may substantially reduce the number of individuals who need to undergo oral glucose tolerance testing. This would help to improve the health of affected individuals and to alleviate the burden to healthcare systems caused by delayed diagnosis. Read more.
Revealing the chemical fingerprints of healthy metabolism and disease
Our body continuously processes thousands of small molecules such as fats, proteins and sugars as part of our normal metabolism, with the levels of these metabolites varying from person to person as a chemical fingerprint. Small changes in an individual’s metabolite levels can cause or reflect illness, and potentially provide useful information about their health. Now scientists have discovered more than 300 regions in the genome that contribute to each person’s individual chemical fingerprint.
To identify these regions, scientists measured the amount of more than 900 small molecules in blood samples from over 14,000 participants in two large UK population studies – the INTERVAL study and the EPIC-Norfolk study – whose genetic code had also been analysed. They identified which genes are relevant to the changing amounts of specific molecules in the blood, and which changes in metabolism contribute to the development of individual diseases, such as breast cancer. The scientists hope that in future this information about an individual’s chemical fingerprint and the genomic variations that underpin it could help clinicians to more effectively tailor treatments to individual patients. Read more.
Active at all ages
Mums’ activity levels may depend on number and ages of children
New analysis of data from the Southampton Women’s Survey led by Unit scientists found that less than half of mums meet the recommended levels of moderate-to-vigorous physical activity, and that mothers of younger children manage to do the least.
The research showed that women with school-aged children did on average around 26 mins of moderate-to-vigorous physical activity per day, whereas mothers with only younger children managed around 18 mins per day. The number of children was also a factor, having more than one child meant mothers managed only around 21 mins of moderate-to-vigorous physical activity per day, but mums with multiple children all under five years old did more light intensity activity than those with only children of school-age. Read more.
Fitness levels can be accurately predicted without strenuous exercise using wearable devices
VO2 max is the capacity of the body to carry out aerobic work and a key measurement of overall fitness, and is an important predictor of heart disease and mortality risk. While measurement of VO2 max is considered the “gold standard” of fitness tests, measuring it currently requires expensive equipment like a treadmill or exercise bike, and strenuous exercise that can be risky for some individuals.
Using physical activity data from more than 11,000 participants in the Fenland Study who wore devices that measured their heart rate and movement, scientists from the Unit and University of Cambridge Department of Computer Science and Technology developed a new method that uses machine learning to predict VO2 max during everyday activity. Their method doesn’t need the person whose fitness is being evaluated to undertake strenuous activity, so it is safer and can potentially be used with far larger numbers of people. Read more.
Getting into the SWiM of things
How well did the a weight management programme support health during COVID-19?
- Read more here
- Watch a short video about the findings and download a factsheet below:
Come on, get appy
Lessons from the high levels of participant engagement with Fenland COVID-19 study app
The COVID-19 pandemic accelerated interest in the use of remote health monitoring for patient care and also for research – where it’s often becoming harder to recruit and retain participants. In collaboration with Huma Therapeutics Limited, Unit scientists undertook research with over 2,250 participants in the Fenland COVID-19 study exploring how digital technologies can support population research. The study examined the potential to identify people infected in the pre-symptomatic phase of Covid using information collected remotely, and to measure effects of Covid restrictions on health-related behaviours such as diet, physical activity, wellbeing and mental health.
Their results showed that participants had high, sustained engagement with a smartphone app that collected information including health related measurements. Participants reported a positive experience, finding the app easy to use and quick to report measurements and symptoms. They took part for at least six months, with minimal drop-off in engagement over the study. Interestingly there was a higher engagement rate amongst the participants aged over 65. Out of this experience we’ve developed a checklist for mobile health engagement in population-based studies. Read more.
Researcher Voices
The views of Unit researchers are often sought on issues related to their work. Here are a couple of examples from the last few months, and you can find more on our Researcher Voices page
Weight loss treatments are not a permanent fix – that doesn’t mean they ‘don’t work’
In an article published in The Conversation, Unit scientist Dr Amy Ahern and Professor Giles Yeo of the IMS Metabolic Research Laboratories discuss why is it so difficult to keep the weight off after you’ve lost it. Read more
Breaking the decades-long cycle of failed obesity policy – Max Perutz Science Writing Award 2022
In an article was shortlisted for the 2022 Max Perutz Science Writing Award, Unit PhD student Dolly Theis examines why so many Government obesity policies have failed, how they can more effectively, equitably and rapidly solve major problems like rising obesity rates. Read more.
Our latest publications
You can now find all publications from the MRC Epidemiology Unit at our new Publications Database: https://publications.mrc-epid.cam.ac.uk/ You can search by journal, year, study, programme, Unit author, and keywords in the title and abstract.
Since the last issue of epigram, we have published the following papers:
- Association between depression, happiness, and sleep duration: data from the UAE healthy future pilot study Al Balushi M et al. BMC Psychol
- Associations between serum 25-hydroxyvitamin D, body mass index and body fat composition among Emirati population: Results from the UAE healthy future study AlAnouti F et al. Front Endocrinol (Lausanne)
- Discovery of drug-omics associations in type 2 diabetes with generative deep-learning models Allesøe RL et al. Nat Biotech
- Rationalisation of the UK Nutrient Databank for incorporation in a web-based dietary recall for implementation in the UK National Diet and Nutrition Survey Amoutzopoulos B et al. Nutrients
- Effectiveness of digital and remote provision of the Healthier You: NHS Diabetes Prevention Programme during the COVID-19 pandemic Barron E et al. Diabet Med
- Association between indicators of inequality and weight change following a behavioural weight loss intervention Birch J et al. Obesity Facts
- Proteomic signatures for identification of impaired glucose tolerance Carrasco-Zanini J et al. Nat Med
- Genomic atlas of the plasma metabolome prioritizes metabolites implicated in human diseases Chen Y et al. Nat Genet
- Making better use of natural experimental evaluation in population health Craig P et al. BMJ
- Physical Activity Volume, Intensity and Incident Cardiovascular Disease Dempsey P et al. Eur Heart J
- Variants in CLDN5 cause a syndrome characterized by seizures, microcephaly and brain calcifications Deshwar AR et al. Brain
- Science has no Borders, so Should Scientific Publishing: A Position Statement from the Journal of Physical Activity and Health Ding D et al. J Phys Act Health
- Understanding experts’ Conflicting perspectives on tobacco harm reduction and E-Cigarettes: An interpretive policy analysis Eisenkraft Klein D et al. SSM Qual Res Health
- Damaging missense variants in IGF1R implicate a role for IGF-1 resistance in the aetiology of type 2 diabetes Gardner E et al. Cell Genom
- Mild-to-Moderate Kidney Dysfunction and Cardiovascular Disease: Observational and Mendelian Randomization Analyses Gaziano L et al. Circulation
- Dietary Intake of 91 Individual Polyphenols and 5-Year Body Weight Change in the EPIC-PANACEA Cohort Gil-Lespinard M et al. Antioxidants (Basel)
- UKRI MRC National Musculoskeletal Ageing Network: strategic prioritisation to increase healthy lifespan and minimise physical frailty Harvey NC et al. Arch Osteoporos
- Interventions in Small Island Developing States to improve diet, with a focus on the consumption of local, nutritious foods: a systematic review Haynes E et al. BMJ Nutr Prev Health
- Investigating the impact of a 20 miles per hour speed limit intervention on road traffic collisions, casualties, speed and volume in Belfast, UK: 3 year follow-up outcomes of a natural experiment Hunter RF et al. J Epidemiol Community Health
- Characterization of the degree of food processing in the European Prospective Investigation into Cancer and Nutrition: Application of the Nova classification and validation using selected biomarkers of food processing Huybrechts I et al. Front Nutr
- Long-term impact of a behavioural weight management programme on depression and anxiety symptoms: 5-year follow up of the WRAP trial Jones R et al. Obesity
- Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis Kanoni S et al. Genome Biol
- Impact of Long-Term Air Pollution Exposure on Incidence of Neurodegenerative Diseases: A Protocol for A Systematic Review and Exposure-Response Meta-Analysis Khreis H et al. Environ Int
- Associations between recreational cannabis legalization and cannabis-related emergency department visits by age, gender, and geographic status in Ontario, Canada: An interrupted time series study Kim C et al. PLoS One
- Stepping towards More Intuitive Physical Activity Metrics with Wrist-Worn Accelerometry: Validity of an Open-Source Step-Count Algorithm Maylor BD et al. Sensors (Basel)
- Supporting Weight Management during COVID-19 (SWiM-C): Twelve-month follow-up of a randomised controlled trial of a web-based, ACT-based, guided self-help intervention Mueller J et al. Int J Obes
- In simulated data and health records, latent class analysis was the optimum multimorbidity clustering algorithm Nichols L et al. J Clin Epidemiol
- The Childhood Acute Illness and Nutrition (CHAIN) network nested case-cohort study protocol: a multi-omics approach to understanding mortality among children in sub-Saharan Africa and South Asia Njunge JM et al. Gates Open Res
- Air quality management strategies in Africa: A scoping review of the content, context, co-benefits and unintended consequences Okello G et al. Environ Int
- Associations between breast milk intake volume, macronutrient intake, and infant growth in a longitudinal birth cohort: the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF) Olga L et al. Br J Nutr
- Body Fat Percentage and Long-Term Risk of Fractures. The EPIC-Norfolk Prospective Population Cohort Study Pana TA et al. Maturitas
- Effect of nationwide school policy on device-measured physical activity in Danish children and adolescents: A natural experiment Pedersen NH et al. Lancet Regional Health Europe
- Active travel and paratransit use in African cities: Mixed-method systematic review and meta-ethnography Randall L et al. J Transp Health
- Stepping up with GGIR: Validity of step cadence derived from wrist-worn research-grade accelerometers using the verisense step count algorithm Rowlands AV et al. J Sports Sci
- Creation of a Pilot School Health Research Network in an English Education Infrastructure to Improve Adolescent Health and Well-Being: A Study Protocol Sharp CA et al. Int J Environ Res Public Health
- The association between number and ages of children and the physical activity of mothers: cross-sectional analyses from the Southampton Women’s Survey Simpson R et al. PLoS One
- Physical activity volume and intensity distribution in relation to bone, lean and fat mass in children Skinner AM et al. Scand J Med Sci Sports
- Longitudinal cardio-respiratory fitness prediction through free-living wearable sensors Spathis D et al. npj Digit Med
- Rare and common genetic determinants of metabolic individuality and their effects on human health Surendran P et al. Nature Med
- Imagine this: Visualising a recent meal as bigger reduces subsequent snack intake Szypula J et al. Appetite
- Resilience in maternal and child nutrition outcomes in a refugee-hosting community in Cameroon: A quasi-experimental study Tatah L et al. Heliyon
- Foodscapes, Finance and Faith: multi-sectoral stakeholder perspectives on local population health and wellbeing in an urbanizing area in Kenya Wadende P et al. Front Public Health
- Results from Aotearoa New Zealand’s 2022 Report Card on Physical Activity for Children and Youth: A call to address inequities in health-promoting activities Wilson OWA et al. J Exerc Sci Fit
- Transport and health on the path to a net zero carbon world Woodcock J et al. BMJ
- Shifting towards healthier transport: carrots or sticks? Systematic review and meta-analysis of population level interventions Xiao C et al. Lancet Planet Health
- A saturated map of common genetic variants associated with human height Yengo L et al. Nature
- Bidirectional associations of accelerometer-assessed physical activity and sedentary time with physical function among older English adults: The EPIC-Norfolk cohort study Yerrakalva D et al. Eur J Ageing
About epigram
epigram is the newsletter for everyone interested in work happening at the MRC Epidemiology Unit at the University of Cambridge.
We welcome your views on it. Email us at comms@mrc-epid.cam.ac.uk
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