NIHRDataInsights/HRCSData huggingface dataset:
Title: Nudge150: Combining small changes to foods to achieve a sustained decrease in energy intake
Funder: Medical Research Council

Abstract: Achieving sustained decreases in energy intake is key to maintaining healthy weight. This project combines two principles to meet this challenge. The first is that there is not tight physiological control of energy balance. While this underlies vulnerability to overeating, it can also be exploited to assist in reducing energy intake. The second is that the (biological) reward value of food is derived from its nutrient content, and not the extent to which it causes fullness. Thus reducing portion size or energy density will devalue food. We will investigate ways to compensate for this devaluation, including increasing taste intensity and food variety, and modifying food texture. In consultation with consumers and food industry experts we will prioritise five 'manipulations' and test their effectiveness in increasing eating enjoyment (and other measures of food reward) and meal satisfaction and in decreasing short-term energy intake. We will also measure eating topography and memory for the food eaten as possible mediators of the effects of increasing eating enjoyment. Successful manipulations will be blended for testing in an RCT. Another potential problem with a portion size intervention is that the consumer may choose supplementary items or two portions instead of one. To address this we will develop and apply psychophysical methods to identify and quantify 'breakpoints' in consumer behaviour and decisions around portion size. In the RCT we will test the hypothesis that reducing portion size by 150 kcal at lunch will reduce 24-hour energy intake (nudge group), and that addition of 'nudges' designed to maintain meal satisfaction will reduce energy intake still further (nudge+). We will also investigate the effects of repeated exposure to these nudges. The focus on portion size is consistent with public health initiatives and proposes an avenue whereby industry can help by providing products that are lower in energy and accepted over the long term.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Physical Activity and the Regeneration of Connswater (the PARC Study)
Funder: Medical Research Council

Abstract: The Connswater Community Greenway (CCG) is one of three 2008 Big Lottery Living Landmarks awards and is a major environmental improvement project in East Belfast, which will connect 379 acres of public open space, building 43 bridges and 19kms of cycle and walkways. Around 40,000 people, most from inner city deprived neighbourhoods and living adjacent to CCG, will, by 2013, benefit from a better living environment, opportunities for leisure, exercise, recreation and support for healthier lifestyles. We will use the opportunity afforded by this ?natural experiment? to design a systems-based approach to the promotion of physical activity (PA) and thereby determine the ability of individual, community and organizational networks and of the characteristics of the local environment to change behaviours. The cost effectiveness of this socio-ecological approach will also be assessed. Using a PRECEDE-PROCEDE framework, a multi-stakeholder team will first engage with the targeted communities and devise a logic model for a suite of PA promotion interventions involving statutory and voluntary bodies in the CCG area. A baseline survey will be conducted of a random sample of households in the electoral wards of the CCG area before the urban regeneration project begins. This will assess attitudes to and levels of habitual physical activity, perceptions of the characteristics of the environment associated with active travel and physical activity, individual and social networks and their potential influence on their behaviour. A contemporaneous survey by SportNI of PA behaviours across Northern Ireland will generate a number of ?comparator? communities with which CCG will be compared. Process measures to judge the ?dose?, fidelity and costs of implementing interventions will include an assessment of the changes in ?walkability?, awareness and take-up of PA promoting interventions, the trends and patterns of activity of novel PA ?loyalty? scheme users, and the use made of new environmental amenities or different types of transport. These will be enriched by a qualitative and quantitative study of the voluntary and statutory stakeholder partnerships during the implementation period (2009-2013). A repeat survey of CCG households, more than six months after the completion of the Connswater Greenway construction will be timed to coincide with a further province wide survey of physical activity behaviours conducted by SportNI. Primary endpoints will be the change in the proportion of residents in the CCG area who achieve recommended levels of PA (150mins per week), over the period 2009-2013, compared to other parts of Belfast and Northern Ireland.


Research activity codes: 1.1 NORMAL BIOLOGICAL DEVELOPMENT AND FUNCTIONING;3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Nutritional epidemiology
Funder: Medical Research Council

Abstract: The aim of the nutritional epidemiology programme is to understand the aetiological associations between dietary and nutritional factors and the risk of type 2 diabetes, obesity and related metabolic disorders in order to inform preventive action. The contribution of dietary factors to the risk for diabetes and obesity is acknowledged to be important but major uncertainties exist about the nature of the relationship. This has often been the result of limitations in methods used to assess dietary intake, and has led to mixed, and often confusing messages about the role of dietary factors in promoting disease risk. Our objectives are to study the association of food intake and nutritional content with the risk for diabetes and related endpoints using dietary assessment instruments with greater precision as well as using biomarkers of dietary intake. Our methods include detailed dietary assessment by the self-reported semi-quantitative food frequency questionnaire as well as by the more precise 7-day prospective food diary. From these we derive key nutritional factors. To overcome issues of measurement error and reporting bias we have also measured candidate biomarkers of nutritional status such as plasma vitamin C, serum ferritin (body iron stores), and also serum vitamin D (a hormone, partly derived from the diet). We also await completion of measurement of serum fatty acids in the large EPIC-InterAct Study in European populations, which should provide invaluable information on the association between different types of dietary fat intake, which is particularly difficult to quantify from self-report because of the “invisible” fat in the diet. We use large-scale observational epidemiological studies including EPIC-Norfolk Study, the Fenland Study and InterAct, a case-cohort study of 12,403 incident cases of type 2 diabetes nested within the EPIC-Europe cohort. We also address the critical problems of confounding by using genetic variants as instrumental variables to assess the causal nature of the relationship between nutritional biomarkers and outcomes including diabetes, obesity and quantitative metabolic traits. We have also initiated a randomised double blind placebo controlled trial of the supplementation of vitamin D among people at high risk of diabetes, to assess whether vitamin D might be causally related to diabetes risk. In order to translate the findings of this programme into preventive action, we will also work as part of the Centre of Excellence in Diet and Activity Research (CEDAR) to develop collaborative work on understanding the determinants of dietary behaviour, and the development and evaluation of individual and collective dietary interventions.


Research activity codes: 2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT;2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;6.1 PHARMACEUTICALS
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Will moving into social and affordable housing in the Athletes' Village increase family physical activity levels? Evaluation of a natural experiment
Funder: Medical Research Council

Abstract: We propose to examine whether people moving into the Athletes' Village increase their physical activity levels to a greater extent than people who do not. To observe the impact of this natural experiment, a two-year longitudinal (cohort) study will be carried out, examining changes in physical activity levels in 600 families which move into the Village (intervention) with 600 families which do not. Participants (who apply to live in social and affordable homes in the Village) will be studied initially in their current place of residence and then either in the Villlage (intervention) or the same place of residence (controls). Changes in physical activity (measured objectively using Actigraph monitors) and body build (including bio-electrical impedance) occurring in families living in the Village will be compared with changes occurring in those living in surrounding boroughs. Research objectives will examine:- (i) whether families living in social and affordable housing in the Village show a sustained change in their physical activity levels, compared to their levels before moving into the Village, and by comparison with physical activity changes in families outside the Village. (ii) whether any increase in physical activity in children and adults living in the Village is directly attributable to use of their local built environment, and if so, which facilities. (iii) whether changes in physical activity patterns in families living in the Village are modified by other factors including age, gender, ethnicity, proximity to facilities, perceived social cohesion and safety, social class / employment status. (iv) we will examine (i) in relation to adiposity as well as physical activity levels. The study will provide proof of principle that the built environment can increase physical activity levels. Results will inform evidence-based urban planning that will happen in the future, and the way in which environmental changes impact on health inequalities.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Centre for Diet and Activity Research (CEDAR)
Funder: Medical Research Council

Abstract: Our overall goal is to provide the evidence-base to inform interventions aimed at shifting population-level distributions of dietary and physical activity behaviour. We will achieve our aims through interconnected research themes which each employ a range of methods and experimental designs including analysis of quantitative and qualitative data from observational, interventional and natural experiment studies, modelling and evidence synthesis. We will study environmental and policy approaches to population physical activity change, specifically aiming to quantify the overall and distributional effects of interventions and understand related patterns and mechanisms of behaviour change. In our health geography programme, we will develop and apply methods to understand the dynamic use of the environment and its role as a determinant of physical activity and dietary behaviours. We will study the pattern, correlates and determinants of change in physical activity levels through childhood and use the results to develop and evaluate population-level interventions. Our dietary public health research will identify and measure socioeconomic determinants of dietary behaviour and the mechanisms giving rise to social and spatial patterning of diet quality. This programme is closely linked to our work on public health economics, focused on investigating the correlates, determinants and consequences of diet, physical activity and obesity and the cost-effectiveness of interventions that may promote healthy behaviours. In the second quinquennium of CEDAR we will develop two themes. Dietary public health research will be expanded to include policy, environmental and intervention development approaches to obesity prevention, particularly in infants and young children. Public health modelling will be further developed to better estimate the population impact of interventions and explore agent based modelling of behaviour change to inform intervention development and data collection.


Research activity codes: 2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS;3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;3.5 RESOURCES AND INFRASTRUCTURE (PREVENTION);8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: MICA: Partnership for Improvement and Innovation in Dietary Assessment Technology (PIIDAT)
Funder: Medical Research Council

Abstract: Objective 1: Establish new collection, analysis & reporting standards An Expert Group (co-apps) will develop requirements for researchers undertaking & reporting dietary studies. Guidance for choice of tool will be established; reporting requirements will be published as a reference paper following CONSORT/STROBE. The group will be informed by a systematic literature review of validation studies assessing dietary intake &/or meal pattern. This will identify potential dietary assessment methods for inclusion in the Dietary Assessment Tool-eLibrary. Objective 2: Creation of website hosting dietary assessment tools (DAT-eLibrary) An open access web-based library of valid dietary assessment tools will be created. The website will include guidance for tool selection; the tools; online data entry; food/nutrient analysis & reporting. The number of tools included will depend on Expert Group selection, but ~10-20 tools will initally be available. The website will include an e-algorithm for users to aid decisions regarding selection of the best tool. Objective 3: Expansion of existing UK food composition tables Existing national food tables will be linked to food industry branded data. This will expand the tables to ~70,000 foods from 7,000. Date stamping will allow for future reformulation of products. We will use & validate back of pack nutrient information to expand the food tables. These tables will be linked to the tools in the DAT-eLibrary. Objective 4: Creation of on-line interface between the dietary assessment tools and the food composition tables This interface will enable users to access the tools, code dietary data and generate nutrient/food intake results. Providers of tools will be supported to prepare datasets of foods & nutrients along with associated analysis algorithms. These will be linked to the expanded food tables & a front-end web-based data entry system. The website will contain sections for both researchers and respondents.


Research activity codes: 1.4 METHODOLOGIES AND MEASUREMENTS;1.5 RESOURCES AND INFRASTRUCTURE (UNDERPINNING)
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Investigation of the physiological role of hypothalamic glucocorticoids in the regulation of energy homeostasis
Funder: Medical Research Council

Abstract: Glucocorticoids have a wide variety of functions and are classically thought of as part of the stress response. They are known to pharmacologically powerfully regulate both food intake and energy expenditure. There is extensive evidence for a role for glucocorticoids in the pathogenesis of obesity and the metabolic syndrome. However, the role of locally produced glucocorticoids in the hypothalamus and their physiological role in appetite regulation is yet to be established. A contributing factor to this is the difficulty in manipulating glucocorticoid levels long-term in specific hypothalamic nuclei. To overcome this difficulty I will use rAAV to express a glucocorticoid regulating enzyme, 11betaHSD1 (rAAVHSD1) which acts to increase glucocorticoid levels. I will target expression in the arcuate nucleus of adult rats. My pilot data confirms that injection of rAAVHSD1 into the arcuate nucleus results in an increase in corticosterone levels which is localised within the arcuate and does not affect the corticosterone levels in neighbouring hypothalamic nuclei. Further injection of rAAVHSD1 into the arcuate results identified a powerful hypothalamic effect of glucocorticoids in the regulation of energy homeostasis. This project will investigate the physiological role of glucocorticoids in the arcuate nucleus of the hypothalamus in the regulation of food intake and energy expenditure. This will establish the importance of glucocorticoids in the day to day regulation of food intake and will improve understanding of how modulation of glucocorticoid activity by inhibitors of 11betaHSD1 may be working in the hypothalamus to act as potential anti-obesity therapies.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Mediation analysis in life course epidemiology: methodological innovation and application to studies of obesity and cardiometabolic health
Funder: Medical Research Council

Abstract: Mediation analysis is a key focus in life course epidemiology and can offer insight into mechanisms and likely effects of interventions, but measurement error and confounding can cause bias. Current available methods do not easily extend to complex life course questions. Thus methods development is needed. This fellowship combines methods development with applied research on obesity and cardiometabolic health: 1) whether fetal and infant growth affect cardiometabolic health independently of final attained adiposity, 2) the role of blood pressure (BP), lipids, glucose, insulin and DNA methylation in the association between adiposity and cardiometabolic health, 3) the role of behaviours, BP, lipids, glucose, insulin and DNA methylation in socioeconomic inequalities in cardiometabolic health. Through addressing these questions in 7 cohorts and using simulation studies I will develop mediation methods that minimise bias due to measurement and confounding: 1. Longitudinal mediation analysis (exposure, mediator and/or outcome defined by repeated measures) helps overcome measurement error since a trajectory is likely to better represent true levels than a single measure, and can assess more nuanced questions than using single measures. I will compare longitudinal mediation methods (counterfactual methods, structural equation models, multilevel models, structured life course approach) 2. In network Mendelian Randomization (MR) genetic variants are used as instrumental variables (IVs) for both the exposure and mediator to estimate mediation. The genetic IVs alleviate bias due to measurement error and confounding 3. I will extend network MR to enable it to address more complex life course questions by using genetic variants with age-specific gene expression as age-specific IVs In summary, I will identify potential intervention targets, quantify likely effects of interventions to improve cardiometabolic health, and contribute to advances mediation analysis methods


Research activity codes: 2.5 RESEARCH DESIGN AND METHODOLOGIES (AETIOLOGY)
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Intermittent Fasting: Acceptability, adherence and participant retention
Funder: Medical Research Council

Abstract: Intermittent fasting (IF) is a weight management approach with a strong theoretical rationale and some evidence of positive outcomes in dieters who adhere to it. A version of IF called 5:2 (participants limit their calorie intake on two days per week) has become popular in the UK, with a number of people claiming that it helped them lose weight and maintain weight loss. The approach seems to have a substantial popular appeal, which means that it holds a promise for extensive dissemination. However, its safety and efficacy are not known. The simplicity of 5:2 is attractive, but it also presents possible downsides if healthy eating and exercise are neglected. We previously proposed a pivotal 5:2 trial to the NIHR Public Health Research Programme. The proposal received good referee feedback and was shortlisted, but the board ultimately decided that more primary research is needed. We agree that before launching a main study, there is a need to establish recruitment and retention parameters; optimal protocols; suitable comparators; acceptability of the approach and participants' adherence to it; and basic outcome data to inform sample size and power calculations. We propose an early phase study to provide this information. We would randomise 300 participants into 5:2 delivered in a self-help format; 5:2 delivered with group support; and advice on healthy eating and exercise accompanied by standard self-help materials. To inform the main study, two recruitment strategies would be used, GP referrals and local newspaper adverts. These would be evaluated for recruitment rates and profiles of clients recruited. Treatment attractiveness and acceptability would be evaluated via participants' ratings of the interventions; treatment adherence and participant retention would be monitored throughout the follow-up period; and weight loss, waist circumference, health behaviours and blood pressure would be measured at 1 and 3 months.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE
Title: Health through Faith: can faith-based organisations support weight management and reduce the risk of NCDs in South Africa?
Funder: Medical Research Council

Abstract: Background: Increasing levels of obesity and rises in prevalence of non-communicable diseases (NCDs) bring high costs for the already over-burdened South African health system and people and families affected by them. Low-income, adult, South Africans do not have access to effective support for weight management. We will use our experience of developing effective weight management and healthy living programmes that reach, and engage, low income groups to develop a weight management and healthy living programme for obese adults delivered through churches in a rural and an urban setting in South Africa. Objectives: to establish: i) what adaptations to existing evidence-based programmes are necessary; ii) the target group for the programme; iii) the feasibility of delivery of the programme; iv) its acceptability and feasibility of collecting data in a future trial. Methods: First we will adapt existing, evidence-based, group weight management programmes to the SA setting. We will lead 3, experiential, co-development workshops with end-users in a rural and urban setting (6 workshops in total). We will investigate: recruitment; programme leadership; inclusion criteria; adaptation of programme components; how programmes should be delivered; and best ways to train programme leaders. The programme will be adapted iteratively between each workshop. Second we try to deliver the programme in 4 churches in a formative evaluation. We will triangulate data from observations, focus group discussions, interviews and baseline and post programme measurements to assess the feasibility and likely success of future programmes within a larger scale, formal, pilot trial.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS;CARDIOVASCULAR;METABOLIC AND ENDOCRINE;ORAL AND GASTROINTESTINAL;STROKE