The Interconnect Project-Global Data for Diabetes and Obesity Research
The global variation in risk of type 1 and type 2 diabetes between populations is well described and the pattern suggests a complex but distinct interaction between genetic and environmental risk factors across the life course. Considerable progress has been made in understanding the relationship between lifestyle behavioural factors and the incidence of type 2 diabetes and also in the identification of genetic factors for type 1, type 2 and obesity.
This has made the study of gene-environment interactions possible but most studies of interaction have sought to explain variation within populations. Although studying variation in risk within populations is important, the next critical step is to attempt to move beyond within-population examination of gene-environment interaction to the examination of it between-populations.
InterConnect, a new international research initiative on gene-environment interaction in diabetes and obesity, is enabling this work. Supported by the European Union FP7 grant, the project is changing the way that data are used in population research into the causes of diabetes and obesity. It is supporting decentralized surveillance and data analysis of shared global results that is secure, scalable and sustainable.
The aims of this study were to validate feasible methods for measuring physical activity in population-based studies in Africa and to describe the physical activity levels and its determinants in an urban and a rural Cameroonian population. A follow-up study funded by the Wellcome Trust is nearing completion in the same locations in which detailed information on the determinants of physical activity is being collected.
Evaluation of NCD prevention and control policies in the Caribbean
The University of the West Indies (UWI) with the Support from Dr Cornelia Guell at the Centre for Diet and Activity Research is leading to an evaluation of a major Caribbean policy initiative on the prevention and control of non-communicable diseases (NCDs). The initiative is the 2007 Port of Spain Declaration, in which the 20 Heads of Government of the Caribbean Community committed to a range of actions on NCDs. The Caribbean summit was a forerunner to the 2011 United Nations High Level Meeting on NCDs.
Objective assessment of physical activity, and the contribution of inactivity to the NCD risk.
This study is the first objective assessment, using combined heart rate monitoring and accelerometry, of levels and patterns of physical activity in a population based sample of adults in the Caribbean. This work is nested in a population based survey in Barbados of diabetes, cardiovascular disease, and their social, biological and behavioural risk factors. Three hundred and eighty adults aged 25 to 54 participated in the objective assessment of physical activity. Data analysis is in progress, and will address levels, patterns and predictors of physical activity. The data will enable estimates of the contribution of physical inactivity to the risk of diabetes and cardiovascular disease. The collaboration is supporting the development at UWI of expertise in state of the art physical activity assessment, and the joint supervision of a UWI PhD candidate. This work is largely funded by the Ministry of Health of Barbados, with the MRC Epidemiology Unit providing the hardware and software for the assessment of physical activity, and ongoing expert guidance. Dr Soren Brage and Ms Kate Westgate in MRC Epidemiology Unit at Cambridge are assisting in the study.
Assessment of sodium intake and dietary quality
High levels of hypertension in the Caribbean are thought to be related in part to high levels of salt consumption. However, objective data on sodium intake in the Caribbean are rare, as are robust dietary data to indicate sources of sodium in the diet and overall dietary quality. The Ministry of Health in Barbados has funded a study in which a representative sample of 400 adults, aged 25 to 64 years, are providing 24 hour urine samples for the measurement of sodium and potassium. In addition, detailed dietary data are being collected on all participants, using repeated 24 hour recalls. The MRC Epidemiology Unit is providing expert guidance on the analysis and interpretation of these data, and contributing to the joint supervision the UWI PhD candidate on this topic. Dr Nita Forouhi of the MRC Epidemiology Unit at Cambridge is supporting the assessment.