Welcome to the summer 2022 issue of epigram, the quarterly newsletter from the MRC Epidemiology Unit.

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In this issue

• Briskly does it: being active improves health
• But sitting might be risky
• Hidden risk of extra sex chromosomes
• Minimising side effects of steroid use in asthma
• News from our studies
• Researcher voices
• Gongs and Green Impact
• Our latest publications

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Briskly does it: being active improves health

Physical Activity is associated with a reduced risk of depression

Dr Matthew Pearce and Dr Soren Brage of our Physical Activity Epidemiology programme and Dr James Woodcock of our Public Health Modelling programme led a systematic review of 15 prospective studies including more than 2 million person-years which has found that relatively small doses of physical activity are associated with substantially lower risks of depression.

The paper published in JAMA Psychiatry found that compared with adults not reporting any activity, those accumulating half the recommended amount of physical activity had 18% lower risk of depression, while those accumulating recommended volume had 25% lower risk. However, levels of physical activity beyond the recommend level were not associated with additional reduction in depression. The authors recommend that health practitioners should therefore encourage any increase in physical activity to improve mental health. Read more in the Times article ‘How a bit of brisk walking can give depression the boot’ (£)

Brisk walking may slow biological ageing process

An analysis of genetic data from more than 400,000 adults in UK Biobank has revealed a clear link between walking pace and a genetic marker of biological age. The research led by Unit scientist Dr Paddy Dempsey and researchers at the University of Leicester found a causal link between walking pace and leucocyte telomere length, an indicator of biological age. The researchers estimate that a lifetime of brisk walking could lead to the equivalent of 16 years younger biological age by midlife, and that habitually slower walking speed may be a simple way of identifying people at a greater risk of chronic disease. Read more.

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But sitting might be risky

Reducing TV viewing to less than one hour a day could help prevent coronary heart disease

An analysis of data from more than 370,000 UK Biobank participants led by Unit scientist Dr Katrien Wijndaele and Dr Youngwon Kim of the University of Hong Kong (a former Unit research fellow) found that watching too much TV is associated with increased risk of coronary heart disease regardless of an individual’s genetic makeup. Their results did indicate that up to 11% of cases of coronary heart disease might be prevented if people watched less than an hour of TV each day. In contrast, leisure time spent using a computer did not appear to influence CHD risk, which may be because individuals using their computer may be more likely to break up their activity or to snack less, or be related to the time of day when they use the computer. Read more.

New Evidence Brief – Are you sitting actively?

Excessive sedentary behaviour has been linked with poor mental health, including depression. But while much of the research on this area treats all sedentary behaviours as one activity, it may be that the importance of what we do when we sit has been overlooked. A new Evidence Brief examines mentally active and passive sedentary behaviour and their differing impacts on mental health. Read the Evidence Brief.

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Hidden risks of extra sex chromosomes

One in 500 men carry extra sex chromosome, putting them at higher risk of several common diseases

A new analysis of UK Biobank data led by researchers at the MRC Epidemiology Unit and University of Exeter has found that the great majority of the one in 500 men with an extra X or Y sex chromosome are unaware of it, despite the increased risk of diseases such as type 2 diabetes, atherosclerosis and thrombosis. Men typically have one X and one Y chromosome, while women have two Xs. Fewer than one in four men with XXY and only one of the 143 men they identified with XYY had a known diagnosis.

By linking genetic data to routine health records, the team found that men with XXY had significantly lower blood concentrations of testosterone and much higher chances of reproductive problems including delayed puberty, whereas men with XYY appeared to have a normal reproductive function. However, both men with XXY and those with XYY had higher risks of several other health conditions, for example they were three times more likely to have type 2 diabetes and four times more likely to suffer from chronic obstructive pulmonary disease (COPD). Read more.

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Minimising side effects of steroid use in asthma

Metabolomic study links inhaled cortical steroid treatment for asthma to adrenal suppression

Inhaled cortical steroids (ICS) can help patients manage asthma symptoms, but concerns persist that ICS may reduce production of the steroid hormone cortisol in the body leading to adrenal suppression. While initial adrenal suppression symptoms are subtle, continued progression can lead to fatigue, headache, abdominal pain, vomiting and psychiatric symptoms. By analysing the blood plasma of 14,000 individuals from four independent study cohorts, an international research team co-led by Dr Claudia Langenberg identified 17 steroid metabolites that were reduced in individuals with asthma.

They found that, even among patients taking low-dose ICS treatment, its usage was associated with reduced cortisol levels. The researchers also found significant associations between adrenal insufficiency symptoms, including fatigue and anemia, in asthma patients taking ICS treatment compared to those who were not. They suggest that simple measures, such as regular cortisol monitoring and prescription of the lowest effective ICS dose, may help to mitigate the side effects of ICS use. Read more. Image credit: Alan Levine. Image cropped.

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News from our studies

Our study teams are now welcoming participants back to our facilities, after testing involving direct contact with volunteers was suspended in March 2020 due to the Covid-19 pandemic. But our research never stopped, and we’re grateful to all the volunteers who have participated in our studies, particularly those who joined our innovative studies during the pandemic.

Lockdown learning: Fenland COVID-19 Study demonstrates potential for at home blood sample collection

At the height of the COVID-19 pandemic, our researchers wanted to measure blood samples from participants in the Fenland Study cohort for antibodies to assess previous COVID-19 infection. With home visits not being possible, the only option for the Fenland Covid-19 study was for people to take their own blood sample. Many people find the usual finger prick method painful, and it’s not always reliable due to contamination or insufficient blood being collected, so we used a new OneDraw Blood Collection Device from Drawbridge Health.

The results were very encouraging, with dried blood spot samples from the OneDraw device producing results comparable with those of standard blood samples taken by a trained healthcare worker. Remote blood collection is becoming a standard tool in epidemiological research, so we plan to continue to develop and integrate this technology into our research studies. Read more.

SWiM-C: a guided self-help programme to support weight management during the pandemic

In an interview with the European Association for the Study of Obesity blog, Unit scientists Dr Julia Mueller and Dr Rebecca Richards discussed the SWiM-C study, which was launched during the pandemic. SWiM-c evaluated whether or not a new online 12 week self-help programme is better than standard advice at helping people to prevent weight gain and supporting good physical and mental health. Read the EASO interview.

No-car zones at Cambridgeshire primary schools

Dr Jenna Panter was interviewed by ITV Anglia News on a no-car zone outside St Matthew’s Primary school in Cambridge, part of a pilot scheme that her team is evaluating for the local councils. Watch the ITV report.

Birmingham’s Food System Revolution

Professor Martin White was interviewed by BBC Radio 4 for the Food Programme. In the interview he discussed how the Mandala Consortium he leads aims to transform Birmingham’s food system and its relationship with the West Midlands regional economy. Listen to The Food Programme: Birmingham’s Food Revolution.

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Researchers Voices

The views of Unit researchers are often sought on issues related to their work. Here are a few example from the last few months, and you can find more on our Researcher Voices page

England’s new food strategy: a missed opportunity

Recent Government announcements about their obesity and food strategies for England prompted strong responses from two Unit experts in the evaluation of policy and population health interventions. In a comment article Britain deserves better than 689 failed obesity policies in the Evening Standard on 17 May Dr Dolly Theis responded to news that the UK Government will delay implementation – and possibly abandon – key elements of its flagship obesity reduction policy. In June Professor Martin White published the BMJ Editorial ‘Half hearted and half baked: the government’s new food strategy’ in response to the launch of the Government’s new food strategy for England.

Social media can be a force for good in a crisis: Lessons from Lagos

In an article for the Conversation Africa, Unit researcher Dr Tolullah Oni and Dr Camaren Peter of the University of Cape Town discuss their new research on the role that social media played in driving public engagement with COVID19 health measures in Lagos, Nigeria, and lessons for responses to future crises. Read the Conversation article.

Inequalities and behavioural weight management

Unit PhD student Jack Birch was interviewed by Dr Claudia Hunot for the Alimentos Y Emociones podcast on his research examining inequalities and behavioural weight management. Listen to the podcast.

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Gongs and Green Impact

Unit members across several of our programmes and teams have been given awards that recognise their work.

Dr Raghib Ali receives OBE for Services to NHS

Dr Raghib Ali, Senior Clinical Research Associate at the Unit has been awarded an OBE in the Queen’s Birthday Honours for his services to the NHS and the COVID-19 pandemic response. During the pandemic Dr Ali combined his research with working as a volunteer in NHS hospitals, and contributed to the quarterly reports on progress to address COVID-19 health inequalities as an expert advisor on COVID-19 and ethnicity. Read more.

Successful Excellence Award for Green Impact Group

Following the successful completion of the Platinum award last year our Green Impact Group submitted an entry into the Excellence category in 2022. The award is a seven-month project which enables University teams to focus on a single topic, and the group showcased the work the Unit has achieved through the development of the new sample storage site at Waterbeach. Some key environmental benefits have been achieved by:

• Reducing energy consumption of the current ultra-low temperature (ULT) storage system
• Upgrading to the Nordic ULT compression system which will significantly improve the environmental impact of our sample storage procedures.
• Reducing the environmental impact of travelling to the former storage site in Bishop Stortford.

Read more about the awards here. Image credit: Tobia Nava.

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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:

• Tax awareness and perceived cost of sugar-sweetened beverages in four countries between 2017 and 2019: findings from the International Food Policy Study Acton RB et al. Int J Behav Nutr Phys Act
• Rebalancing the marketing of healthier versus less healthy food products Adams J. PLoS Med
• Peripheral Arterial Disease Prevalence in a Population-Based Sample of People with Diabetes on the Caribbean Island of Barbados Adams OP et al. Vasc Health Risk Manag
• Acceptability and feasibility of an acceptance and commitment therapy-based guided self-help intervention for weight loss maintenance in adults who have previously completed a behavioural weight loss programme: the SWiM feasibility study protocol. Ahern A et al. BMJ Open
• dsSynthetic: Synthetic data generation for the DataSHIELD federated analysis system Banerjee S et al. BMC Res Notes
• dsSurvival: Privacy preserving survival models for federated individual patient meta-analysis in DataSHIELD Banerjee S et al. BMC Res Notes
• Whole-exome sequencing identifies rare genetic variants associated with human plasma metabolites Bomba L et al. Am J Hum Genet
• Using group model building to frame the commercial determinants of dietary behaviour in adolescence – proposed methods for online system mapping workshops Chavez-Ugalde Y et al. BMC Med Res Methodol
• Adverse effects of early puberty timing in girls and potential solutions. Cheng TS et al. J Pediatr Adolesc Gynecol
• Trends towards earlier puberty timing in girls and its likely mechanisms Cheng TS et al. J Pediatr Adolesc Gynecol
• Perceived availability of healthy and unhealthy foods in the community, work, and higher education settings across five countries: Findings from the International Food Policy Study 2018. Contreras-Manzano J et al. J Nutr
• Adolescents’ media usage and self-reported exposure to advertising across six countries: implications for less healthy food and beverage marketing Demers-Potvin É et al. BMJ Open
• Association of Accelerometer-Measured Sedentary Accumulation Patterns With Incident Cardiovascular Disease, Cancer, and All-Cause Mortality Dempsey PC et al. J Am Heart Assoc
• A community jury study exploring the public acceptability of using risk stratification to determine eligibility for cancer screening Dennison RA et al. Health Expect
• Exploring the potential impact of the proposed UK TV and online food advertising regulations: a concept mapping study Forde H et al. BMJ Open
• Physical activity attenuates but does not eliminate coronary heart disease risk amongst adults with risk factors: EPIC-CVD case-cohort study Fortuin-de Smidt MC et al. Eur J Prev Cardiol
• Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model Guariguata L et al. PLoS Glob Pub Health
• Perspectives on strengthening local food systems in Small Island Developing States Guell C et al. Food Secur
• Dietary quality of school meals and packed lunches: a national study of primary and secondary school children in the UK Haney E et al. Pub Health Nutr
• The current state of genetic risk models for the development of kidney cancer: a review and validation Harrison H et al. BJU Int
• Evaluation of routinely collected records for dementia outcomes in UK: a prospective cohort study Hayat S et al. BMJ Open
• Movement behaviours and adherence to guidelines: perceptions of a sample of UK parents with children 0-18 months Hesketh K et al. Int J Behav Nutr Phys Act
• Differences in Energy and Nutrient Content of Menu Items Served by Large Chain Restaurants in the US and the UK Huang Y et al. Pub Health Nutr
• Cross-sectional and longitudinal associations of active travel, organised sport and physical education with accelerometer-assessed moderate-to-vigorous physical activity in young people: The International Children’s Accelerometry Database Ikeda E et al. Int J Behav Nutr Phys Act
• Associations between exploratory dietary patterns and incident type 2 diabetes: a federated meta-analysis of individual participant data from 25 cohort studies Jannasch F et al. Eur J Nutr
• Participant characteristics associated with changes in mental health in a trial of behavioural weight management programmes: Secondary analysis of the WRAP trial Jones R et al. Obes Facts
• High prevalence of multimorbidity and non-communicable disease risk factors in South African adolescents and youth living with HIV: Implications for integrated prevention Kamkuemah M et al. S Afr Med J
• New calorie labelling regulations in England Kaur A et al. BMJ
• Genetic susceptibility, screen-based sedentary activities and incidence of coronary heart disease Kim Y et al. BMC Med
• Impacts of changes in environmental exposures and health behaviours due to the COVID-19 pandemic on cardiovascular and mental health: A comparison of Barcelona, Vienna, and Stockholm Koch S et al. Environ Pollut
• The development, validation and application of remote blood sample collection in telehealth programmes. Koulman A et al. Telemed Telecare
• School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review Kuzik N et al. Int J Behav Nutr Phys Act
• Development and validation of a metabolite score for red meat intake: an observational cohort study and randomized controlled dietary intervention Li C et al. Am J Clin Nutr
• Genome-wide studies reveal factors associated with circulating uromodulin and its relations with complex diseases Li Y et al. JCI Insight
• Revisiting The Concept of Incretin and Enteroendocrine L-cells as Type 2 Diabetes Mellitus Treatment Lok KH et al. Pharmacol Res
• Physical activity measured by accelerometry in paediatric and young adult patients with inflammatory bowel disease Lund K et al. BMC Gastroenterol
• Multi-ancestry genetic study of type 2 diabetes highlights the power of diverse populations for discovery and translation Mahajan A et al. Nat Genet
• Descriptive epidemiology of the prevalence of adolescent active travel to school in Asia: a cross-sectional study from 31 countries Maulida R, Ikeda E, Oni T, Van Sluijs E et al. BMJ Open
• Physical activity behaviours of a middle-aged South African cohort as determined by integrated hip and thigh accelerometry Micklesfield LK et al. Med Sci Sport Exerc
• A protocol for a systematic review on intersectoral interventions to reduce non-communicable disease risk factors in African cities Mogo ERI et al. Public Health in Practice
• The Other Pandemic: Social Media Engagement Around Non-Communicable Disease Preventive Behaviours During Nigeria’s COVID-19 Lockdowns Mogo ERI et al. Cities Health
• Children’s experiences of the journey between home and school: A qualitative synthesis using meta-ethnography Morris S et al. Health Place
• Supporting Weight Management during COVID-19 (SWiM-C): A randomised controlled trial of a web-based, ACT-based, guided self-help intervention Mueller J et al. Obes Facts
• The relationships between socioeconomic status, dietary knowledge and patterns, and physical activity with adiposity in urban South African women Mukoma G et al. South African Journal of Clinical Nutrition
• Assessing adolescent diet and physical activity behaviour, knowledge and awareness in low- and middle-income countries: A systematised review of quantitative epidemiological tools Muzenda T et al. BMC Public Health
• Mapping food and physical activity environments in low- and middle-income countries: A systematised review Muzenda T et al. Health Place
• The impact of the Universal Infant Free School Meal policy on dietary quality in English and Scottish primary school children: evaluation of a natural experiment Parnham J et al. Nutrients
• Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis Pearce M et al. JAMA Psych
• Associations between socio-economic position and young people’s physical activity and sedentary behaviour in the United Kingdom: A scoping review Pearson N et al. BMJ Open
• Effects of Limiting Recreational Screen Media Use on Physical Activity and Sleep in Families with Children Pedersen J et al. JAMA Ped
• Detecting sleep outside the clinic using wearable heart rate devices Perez-Pozuelo I et al. Sci Rep
• Increased Basal Insulin Sensitivity in Late Pregnancy in Women Carrying a Male Fetus: a Cohort Study Petry C et al. Biol Sex Differ
• Associations between maternal iron supplementation in pregnancy and offspring growth and cardiometabolic risk outcomes in infancy and childhood Petry CJ et al. PLoS One
• Using genetic variation to disentangle the complex relationship between food intake and health outcomes Pirastu N et al. PLoS Genet
• How to embed qualitative research in trials: insights from the feasibility study of the SAFER trial programme Powell A et al. Trials
• Associations between abdominal adiposity, body size and accelerometer measured daily patterns of movement in infants from Soweto, South Africa Prioreschi A et al. Matern Child Health J
• A Combined Theory of Change-Group Model Building Approach to Evaluating “Farm to Fork” Models for School Feeding in the Caribbean Saint Ville A et al. Front Sustain Food Syst
• International school-related sedentary behaviour recommendations for children and youth Saunders TJ et al. Int J Behav Nutr Phys Act
• What research evidence exists about physical activity in parents? A systematic scoping review Simpson R et al. BMJ Open
• Maternal Paracetamol Intake During Pregnancy-Impacts on Offspring Reproductive Development Tadokoro-Cuccaro R et al. Front Toxicol
• Physical activity behaviour and comparison of GPAQ and travel diary transport-related physical activity in Accra, Ghana Tatah L, Pearce M, Goel R, Brage S, Woodcock J, Dake F et al. Int J Environ Res Pub Health
• Device-measured sleep onset and duration in the development of depressive symptoms in adolescence Thorburn-Winsor EA et al. J Affect Disord
• Associations between reductions in routine care delivery and non-COVID-19-related mortality in people with diabetes in England during the COVID-19 pandemic: a population-based parallel cohort study Valabhji J et al. Lancet Diabetes Endocrinol
• Distinct infant feeding type-specific plasma metabolites at age 3 months associate with body composition at 2 years. van Beijsterveldt I et al. Clin Nutr
• The politics and fantasy of the gambling education discourse: An analysis of gambling industry-funded youth education programmes in the United Kingdom van Schalkwyk M et al. SSM – Pop Health
• Update of the fracture risk prediction tool FRAX: a systematic review of potential cohorts and analysis plan Vandenput L et al. Osteoporos Int
• Meat-reduced dietary practices and efforts in five countries: analysis of cross-sectional surveys in 2018 and 2019 Vanderlee L et al. J Nutr
• Data Resource Profile: United Kingdom National Diet and Nutrition Survey Rolling Programme (2008-2019) Venables MC et al. Int J Epidemiol
• Relationship of Sodium Intake With Granulocytes, Renal and Cardiovascular Outcomes in the Prospective EPIC-Norfolk Cohort Wenstedt EFE et al. J Am Heart Assoc
• Comparison of household socioeconomic status classification methods and effects on risk estimation: Lessons from a natural experimental study, Kisumu, Western Kenya Were V et al. Int J Equity Health
• Half-hearted and half-baked: the government’s new food strategy White M. BMJ
• DNA methylation signature of chronic low-grade inflammation and its role in cardio-respiratory diseases Wielscher M et al. Nat Commun
• Genetic Landscape of the ACE2 Coronavirus Receptor Yang Z et al. Circulation
• Detection and characterisation of male sex chromosome abnormalities in the UK Biobank study Zhao Y et al. Genet Med

About epigram

epigram is the newsletter for everyone interested in work happening at the MRC Epidemiology Unit at the University of Cambridge.

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