After studying medicine at the University of Southampton , I undertook specialist clinical training in dermatology and joined the MRC Environmental Epidemiology Unit in 1990. As MRC Clinical Scientist & Honorary Consultant in Southampton University Hospitals NHS Trust, I developed the MRC Environmental Epidemiology Unit Maternal Nutrition programme with the aim of improving the health of women and their offspring. In 2003, I was appointed Deputy Director of the University of Southampton Centre for the Developmental Origins of Health and Disease, followed by appointment as Professor of Epidemiology and Human Development at the University of Southampton in 2005.
Our work has established that people who were small at birth and had poor growth in infancy have an increased risk of adult coronary heart disease and type 2 diabetes, particularly if this is followed by increased childhood weight gain. Impaired early growth is also linked with later osteoporosis and obstructive airways disease including asthma. The relations between smaller infant size and ill-health in adulthood extend across the normal range of infant size in a graded manner. The associations do not simply reflect genetic influences, rather our findings show that interactions between the early life environment and genetic influences determine disease susceptibility.
The observations have led to the hypothesis that cardiovascular disease, type 2 diabetes, osteoporosis and obstructive airways disease originate through developmental plastic responses made by the fetus and infant as part of a prediction of the subsequent environment to which it anticipates that it will be exposed. Critical periods in development result in irreversible changes; if the environment in childhood and adult life differs from that predicted during fetal life and infancy, the developmental responses may increase the risk of adult disease. Evolutionary considerations and experimental findings strongly support the existence of major developmental effects on health and disease in adulthood.
Our research has linked raised adult blood pressure and altered glucose-insulin metabolism and stress responsiveness to specific maternal influences, notably i) the mothers own birthweight, ii) maternal body composition, including fat and lean mass, iii) dietary macro- and micronutrient balance, iv) maternal endocrine status. Mechanisms through which these maternal influences alter fetal development include a) a mis-match between fetal nutrient demands and the materno-placental capacity to meet this demand, b) alterations in the fetal endocrine milieu, c) changes in placental vascular impedance, which impact on fetal cardiovascular loading, and d) epigenetic processes, including altered DNA methylation, which change gene expression.
There is evidence that the consequences of developmental plastic responses can be modified during infancy, and that their effects can be amplified by high childhood weight gain and perhaps by low levels of habitual physical activity, increasing vulnerability to adverse lifestyle influences during adulthood. Within the MRC Epidemiology Resource Centre, my ongoing research in the Southampton Women’s Survey (SWS) is characterising these effects and integrating this understanding with parent/offspring genetic information, including epigenetic modification of fetal and placental genes. In the SWS, 12,500 women aged 20 to 34 years have been characterised before pregnancy and detailed pre- and postnatal measurements have been made on the 3,050 women who subsequently become pregnant and delivered in Southampton.
The SWS is the only population-based study in the developed world of a large and representative group of women who were characterised before pregnancy and had longitudinal measurements of fetal growth rates during pregnancy. Support for assessments of the offspring’s nutrition and body composition from birth to age 4 has come from the Arthritis Research Campaign, MRC and the Food Standards Agency. The Food Standards Agency and British Lung Foundation have funded respiratory assessment at age 6, and a programme grant from the British Heart Foundation is funding detailed measurement of cardiovascular structure and function at age 8. Epidemiological observations are combined with detailed clinical studies of mechanisms through research with the Centre for the Developmental Origins of Health and Disease in Southampton. Our epigenetic studies are supported through Epigen, a consortium founded in 2006 between MRC Technology, the University of Southampton, the University of Auckland, and AgResearch New Zealand.
The SWS shows that women with few educational qualifications eat a poor quality diet, affecting their health and their offspring’s development. We have formed an alliance of researchers to explore barriers to healthy eating in women with lower levels of educational attainment, and to define a complex nutritional intervention to improve the health of young women and their offspring. This alliance, the Southampton Initiative for Health, bridges public health nutrition, clinical epidemiology, psychology and public health medicine. The work forms part of the Southampton Nutrition Biomedical Research Unit, funded in 2008 by the National Institute for Health Research, and will enable us to define preventive measures to optimise early growth and minimise the long-term consequences of impaired early development on later health.
Julia qualified as a Registered General Nurse in 1984 and as a Midwife in1987. In September 1991 she joined the MRC EEU working primarily on two maternal nutrition studies.
Since 1998 Julia has been working as the senior research nurse on the Southampton Women’s Survey (SWS). She has been supervising a team of research nurses, who were initially responsible for carrying out home visits on the 12,500 women in the survey, gathering information on their diet, lifestyle and body composition. Subsequently those who become pregnant (to date over 3000) are being followed up and their offspring seen at 1, 2, 3, 4, and now 6 years of age. She is currently one of eleven nurses employed on various components of the SWS.
Julia is also currently completing a dissertation for an MSc Research Methods in Health, looking at women’s experiences of premenstrual symptoms in the workplace.
Polly is a Trainee Health Psychologist and PhD candidate in Health Psychology Research and Professional Practice at the University of Southampton. She is a Research Fellow at the MRC Lifecourse Epidemiology Unit. Polly’s PhD research investigated the impact of menstrual-related pelvic pain on the health-related quality of life of adolescent girls living in the UK. Before working at the MRC, Polly’s previous roles have included being a senior research assistant at LifeLab, a Brilliant Club tutor, a consultant for the Wessex Interstitial Lung Disease (WILD) support group, a POWeR behaviour change coach, and a mentor to secondary school students across Hampshire and the Isle of White. Polly has co-lead the MSc Diabetes Best Practice module ‘Psychological Aspects of Diabetes’ at the University of Southampton since 2016. Since February 2018, her main role at the MRC LEU has been as a research fellow for the Transforming Adolescent Lives through Nutrition (TALENT) project. TALENT aims to investigate adolescent diet and physical activity across sub-Saharan Africa and India. Polly is interested in using both qualitative and quantitative methodologies to explore and improve the health behaviours of adolescents across the world.
Nicholas Harvey, MA MB BChir PhD FRCP FAOP FASBMR, trained in medicine at the Universities of Oxford and Cambridge. He is Professor of Rheumatology and Clinical Epidemiology at the University of Southampton and Director of the University’s MRC Lifecourse Epidemiology Centre, where he leads an MRC programme, using a lifecourse approach to the epidemiology, determinants and prevention of osteoporotic fractures. He is Chair of the International Osteoporosis Foundation Committee of Scientific Advisors; a member of the ESCEO Board; a former Trustee of the UK Royal Osteoporosis Society (ROS) and was inaugural Vice-Chair of the ROS Osteoporosis and Bone Research Academy. He is a Fellow of the Association of Physicians of Great Britain and Northern Ireland and of the American Society for Bone and Mineral Research (ASBMR). He has won many national/international prizes, most recently the International Osteoporosis Foundation Olof Johnell Science Award. He is an investigator on >£50m grant funding, has published >400 articles and is a member of many national/ international committees, including as Musculoskeletal Lead for the UK Biobank Imaging Study, a member of the UK National Osteoporosis Guideline Group Advisory Committee, as a past member of the ASBMR Professional Practice Committee, and as clinical co-chair of the 2021 ASBMR Annual Meeting.
Tina joined the Southampton Women’s Survey in February 1998. Prior to that her roles were mostly administrative in local or national government, before taking a career break to bring up her family.
Her role in the SWS is to recruit study participants and co-ordinate the data that has been collected. The information is then checked for viability before being passed on to statisticians and senior scientists for analysis. Recently she has taken over the role of collating information regarding the publicity of some of the cohorts within the LEU.
Hazel Inskip is Professor of Statistical Epidemiology and Deputy Director of the MRC Lifecourse Epidemiology Unit within Medicine at the University of Southampton.
Hazel graduated from the University of Edinburgh with a first class degree in Mathematics and Statistics then did an MSc and PhD at the London School of Hygiene and Tropical Medicine where she worked for six years. She subsequently worked for the International Agency for Research in Cancer (WHO) at the MRC Laboratories in The Gambia on the Gambia Hepatitis Intervention Study, a trial of Hepatitis B vaccine in 124,000 infants. She moved to Southampton in 1991 to work at the MRC Unit.
Since 1998, she has been running the Southampton Women’s Survey (SWS) (https://www.mrc.soton.ac.uk/sws/) and contributing to and coordinating some of the resulting intervention studies that are now on-going. The SWS is an internationally-renowned cohort study, which, uniquely in the western world, recruited young women who were not pregnant and characterised them in detail before following up those who subsequently became pregnant. Some 12,583 women were recruited, of whom 3,158 went on to deliver a live-born infant. The children have been followed up regularly. The 11-13 year follow-up of the children started in August 2013 and the 17-19 year follow-up is being piloted.
Findings from the SWS have led to intervention studies assessing measures to improve public health. Notably, (1) we conducted a trial (MAVIDOS) of maternal vitamin D supplementation and showed that it improved bone health of the baby if it was born in the winter months. The children are continuing to be followed-up (2) the observation that maternal health behaviours have a profound influence on the diets and health of the children has led to developing a ‘Healthy Conversation Skills’ training for staff in Southampton Sure Start Children’s Centres, and an initiative for teenagers in schools known as LifeLab, based at Southampton General Hospital. LifeLab has been extended in EACH-B which she co-leads with Professor Mary Barker (https://www.southampton.ac.uk/lifelab/research/each-b.page) to including Healthy Conversation Skills for teachers and a digital app for the school students to use to encourage them to improve their health behaviours. The effects of vitamin D supplementation and/or Healthy Conversation Skills are being assessed in the SPRING trial, a factorial trial in pregnant women in Southampton.
Background
Qualifications
Appointments held
RESEARCH
My research interests focus on the influence of health and health behaviours before and during pregnancy on the development of the offspring. I run a large cohort study, the Southampton Women’s Survey (SWS), which recruited women when not pregnant and we are following up their children (now aged 12 to 20 years). We have developed various intervention studies based at least in part on SWS findings, with the aim of improving preconception and pregnancy health behaviours, body composition and health in parents. A particular interest is in adolescent health as teenagers will become parents of the next generation.
RESPONSIBILITIES
President of the Society of Social Medicine | 2019-2020 |
Vice Chancellor’s Award for International Engagement – EpiGen Global Research Consortium | 2017 |
Vice Chancellor’s Award for Collegiality – LifeLab team | 2016 |
Honorary Life Membership of the Society of Social Medicine | 2016- |
Honorary Fellow of the Faculty of Public Health | 2009- |
Member of MRC/ESRC/Wellcome Trust Population Research Resource Steering Group | 2019- |
Member of the Strategic Advisory Board for the Centre for Longitudinal Studies (CLS) | 2019- |
Member of MRC’s Multimorbidity Panel | 2019 |
Co-opted member of the Wellcome Trust Expert Review Group on Population Health | 2018-2019 |
Member of MRC’s Nutrition Research Partnership Collaborative Awards Expert Review Panel | 2018-2019 |
Invited member of the MRC-PHE Centre International Scientific Advisory Board | 2018 |
President Elect of the Society of Social Medicine | 2018 |
Chair – International Scientific Advisory Board for the COSMOS Study | 2016- |
Chair International Scientific Advisory Committee for the MRC Biostatistics Unit | 2016 |
Chair of ESRC/MRC Life Study Audit Panel | 2015 |
Member of Scientific Steerting Committee, CDC Ebola Prevention Vaccine Trial | 2015-2017 |
Member of the CLOSER leadership team | 2013- |
Deputy chair – MRC’s Population and Systems Medicine Board | 2013-2017 |
Chair – ENABLE London Steering Committee | 2013-2018 |
Member of the ARUK Clinical Studies Subcommittee | 2012-2016 |
Acting vice-chair of the NIHR Clinician Scientist Panel | 2011 |
Member of the MRC’s Cohort Strategy Review Group | 2011-2017 |
Member of the MRC’s Population and Systems Medicine Board | 2011-2017 |
Member of the Arthritis Research UK Trials Progress Review Committee | 2009-2012 |
International Editorial Board member Journal of Developmental Origins of Health and Disease | 2009- |
Member of Southampton Children and Young People’s Trust Board | 2008-2012 |
Member of MRC’s Clinical Training and Career Development Panel | 2007-2011 |
Member of the NHS South Central Research for Patient Benefit Committee | 20016-2011 |
Member of MRC’s Consultation on Personal Data Steering Group | 2006-2010 |
Member of the Investment Subcommittee for the MRC Pension Trust | 2006-2013 |
Director of the MRC Pension Trust(appointment renewed by MRC Council 2006, 2011) | 2001-2016 |
Statistical advisor for the British Medical Journal | 1999-2008 |
CONTACT
Professor Hazel Inskip
MRC Lifecourse Epidemiology Unit,
University of Southampton,
Southampton General Hospital,
Southampton SO16 6YD
Room Number: SGH/MRC/MP95/310
Telephone: (023) 8076 4044
Facsimile: (023) 8070 4021
Email: hmi@mrc.soton.ac.uk
Twitter: @HazelInskip
Karen graduated from the University of Reading in 2004 with an MSc in Biometry, having previously obtained a BSc (Hons) in Applied Statistics from the University of Plymouth.
She joined the MRC Lifecourse Epidemiology Unit in 2006 as a statistician and largely works in the area of musculoskeletal research using a variety of data resources including the Hertfordshire Cohort Study.
I completed my degree in psychology at De Montfort University, Leicester, during which I discovered the field of health psychology and became particularly interested in the psychology of diet and nutrition. I then went on to do the MSc Health Psychology course at the University of Southampton, during which I joined the MRC LEU as a part-time research assistant to gain some experience in the field. After working part-time throughout my MSc, I was awarded a full-time position as a research assistant working on both the EACH-B adolescent intervention trial, and an ARC Wessex funded experimental psychology study with Janis Baird and Christina Vogel.
I am in the process of applying for funding to do a PhD in the area of adolescent wellbeing, focusing on the interactions between social and health psychology. My primary supervisor will be Sofia Strommer, and I will look at how the process of identity formation relates to dietary choices in adolescence and how this information can be harnessed to improve adolescent health.
I am a Public Health Nutritionist with an interest in global health and the determinants of diet and physical activity. I completed my BSc in Physiology and Psychology and my MSc in Public Health Nutrition, both at the University of Southampton.
I joined the MRC LEU in 2006 and have since worked on nutritional aspects of cohort and intervention studies investigating the developmental origins of chronic disease in India. This has included dietary and physical activity assessment, diet patterns analysis, systematic reviews, development of a micronutrient-rich snack and micronutrient status assessment. I completed my PhD in 2013 which I undertook on a part time basis over a four year period. My thesis was entitled ‘The effect of a micronutrient-rich food supplement on women’s health and nutrient status’.
In 2015-2017, I led a qualitative study in rural Maharashtra, India which aimed to identify constraints to fruit and vegetable consumption among women of reproductive age. We investigated both supply and demand factors by holding focus group discussions and interviews with consumers, vendors, wholesalers and farmers. We also engaged with policy makers and other stakeholders to understand their priorities in terms of improving nutrition and health in these communities.
My current research focuses on determinants of dietary habits and associated cardiometabolic health outcomes in low-income settings in India and Sub-Saharan Africa, and aims to identify and implement interventions to improve nutritional status across the lifecourse.
I am Scientific Coordinator for the NIHR Global Health Research Group INPreP (Improved Nutrition Preconception, Pregnancy and Postnatally). This project aims to identify and pilot interventions to improve maternal and child nutritional status in in Burkina Faso, Ghana and South Africa.
I am a member of the TALENT (Transforming Adolescent Lives through Nutrition) Research group which aims to develop and implement interventions in India and Sub-Saharan Africa to optimise diet and increase physical activity among adolescents.
After completing my undergraduate medical degree in India, I was involved in the collaborative studies on the fetal origins of adult disease between the MRC Environmental Epidemiology Unit, Southampton and Holdsworth Memorial Hospital, Mysore between 1994 and 1998. I obtained a DM from the University of Southampton based on the work in Mysore. The success of the Mysore projects attracted funding for developing a new purpose built research centre. My interest in translating research into practice led me to undergo formal training in public health in the UK between 1999 and 2004. During this period, I obtained an MSc in Public Health, a postgraduate certificate in clinical education and the membership of the Faculty of Public Health, UK.
Between October 2004 and March 2012, I worked at consultant level in the UK for the Health Protection Agency, NHS Somerset and the Peninsula Medical School where my portfolio included clinical, management and teaching roles. I led on public health intelligence and clinical governance arrangements. I was involved in the development and delivery of undergraduate and postgraduate public health teaching, and am an accredited service and academic public health trainer.
In 2012, I took up a post with the MRC Lifecourse Epidemiology Unit, Southampton to be based mainly in India and work across the MRC and various Indian teams on collaborative projects relating to the developmental origins of health and disease. My role is to provide support to the setting up and management of teams for ongoing and future projects, and contribute to the development of future research strategy, acquisition of funding and translation of research evidence into public health practice and policy. I have since been closely involved in supporting a community-based pre-conceptional micronutrient supplementation trial to influence programming of diabesity in the next generation in Pune, and in the follow-up of children born in a pre-conceptional community-based supplementation trial of micronutrient rich food among slum dwellers in Mumbai. I am also the co- leader of a successful bid for a centre of excellence in Pune focussing on the ‘omics’ of fetal programming. In Mysore, I am involved in a multi-centre study examining environmental and genetic factors influencing externalising disorders, and in examining programming of stress responses in young adults. I am the Indian principal investigator of a multi-country longitudinal multi-faceted intervention study (the Healthy Life Trajectories Initiative), which involves nutrition, behavior change, hygiene and psychosocial interventions. My long-term interests include the application of multi-faceted, evidence-based population level interventions to improve fetal growth and long-term health using a lifecourse approach, and teaching and training initiatives.
I undertook my undergraduate medical training at Aristotle University of Thessaloniki, graduating in 2011. I then started my medical training in France where I lived for a year. I then moved to the UK and completed my core medical training at East of England Deanery and gained an Academic Clinical Fellowship in the Wessex Rheumatology Specialist Training programme in 2018.
I am now undertaking my higher degree at the University of Southampton (supervisors: Prof Elaine Dennison, Prof Cyrus Cooper and Dr Harnish Patel) and I am a Senior Research Fellow, supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. My research is based on the relationship between bone and muscle in older adults and my aim is to understand the interrelationships and factors that contribute to osteoporosis and sarcopenia.
Dr Wendy Lawrence is Associate Professor of Health Psychology at the University of Southampton.
I am a Chartered Psychologist, a member of the British Psychological Society and the European Health Psychology Society, and HCPC-registered. My research interests cover all aspects of health improvement including lifestyle behaviours such as diet and physical activity, with a particular focus on translating research observations into activities to bring about behaviour change to improve population health. I contribute qualitative expertise and skills to a range of projects.
I am the global lead of “Healthy Conversation Skills” (HCS), a training intervention developed in Southampton which equips front-line practitioners with additional skills to enable them to better support people to make sustainable health behaviour changes. The training has been commissioned by organisations both in the UK and internationally to support workforce development and improvements in population health. It is being used as one mechanism of delivery of Health Education England’s work to meet the UK government’s Making Every Contact Count agenda, which is now part of all NHS contracts, with me providing consultancy to Health Education England (Wessex). I also contribute to the Faculty of Medicine’s LifeLab programme, as I describe in this video on LifeLab.
Evaluation of the impact of HCS in different contexts and populations is a key focus of my work. Funded by the New Zealand Ministry of Health I supported the delivery, roll-out and evaluation of training across New Zealand to the maternal and child health workforce (with over 3,000 trained up to 2020) Healthy Conversation Skills Training web page.
As part of ongoing international collaborations, I have trained fieldworkers, researchers and practitioners in South Africa, China, Australia and Canada.
I am the Faculty of Medicine’s BM6 Y0 Senior Tutor and Deputy Module Lead for the BM6 Professional Practice modules, working closely with students & staff to provide high quality learning and development experiences.
I have worked with University Hospitals Southampton NHS Foundation Trust colleagues to support the COVID-ZERO campaign, and have run public consultations with the Southampton Biomedical Research Centre to further our understanding of young people’s attitudes towards Covid-19 trials.