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Parents should monitor their child’s weight from the age of two

Wed, 27 Mar 2019 14:29:05 +0000

One in five children in England by the time they start primary school. Nationally, children are , aged four to five, during their first year of school. But findings from our new study suggest that to prevent obesity parents should keep an eye on their children’s weight from as early as age two.

Our team conducted a internationally that reported child height and weight measurements taken since 2000. Pooling data from over 700,000 children, we plotted typical body mass index (BMI) growth curves for boys and girls between the ages of four and 11 years old, showing the predicted trajectories for subsets of children with higher and lower BMI values.

We also examined the findings of eight studies that followed up the same children over time to identify individual growth patterns and pinpoint when these diverged. We found that most studies agreed on four distinct patterns of growth, including subsets of children with increasing higher than normal BMIs. As some of these studies measured children from before the age of four (some even from birth), certain “early increasing” growth patterns associated with higher risks of obesity in later life were detectable as early as the age of two.

Meanwhile, 5-19% of children fell into a “late increasing” class, which only separated from other groups of children at age five to six years. This means that relying on the current practice of measuring children twice (on entering and leaving primary school) may fail to spot many children who have a normal weight when they start school but develop weight problems in subsequent years.

Part of the problem of measuring infrequently is that the four-to-11 age range encompasses peaks and troughs in growth. The timing of these growth spurts are critical to child development and can predict a later risk of obesity and certain diseases in adulthood, including , and . One-off measures of height and weight may not be enough to identify the shape of these patterns and pick out those children on higher risk trajectories. Based on our findings, we would recommend annual measurements from at least the age of two.

Children only have their BMI measured twice in primary school.

What is ‘normal’?

You might think it would be easy to spot overweight children by looking at them, but that isn’t necessarily the case. Obesity is becoming more commonplace at younger ages, so in their own children. One found while few parents overestimated the weight of their child, a third believed them to be a healthy weight when they were overweight according to commonly used growth reference standards.

BMI in children is calculated in the same way as for adults (weight in kilograms divided by height in meters squared), but the way thresholds are used to identify underweight, overweight and obese children is more complex. In the UK, this is commonly done by making comparisons to children that were measured during the 1990s, before the obesity epidemic emerged. Globally, there is a lot of debate about which growth reference charts we should use, with the World Health Organisation, International Obesity Task Force and the US Centers for Disease Control and Prevention each having its own chart.

For our review, we focused on BMI as the most widely used measure globally, but we recognise that there is an ongoing debate about the most appropriate ways to measure children and the . For example, one of the is that it does not take muscle-to-fat ratio into account.

Also, thresholds may not be equally relevant to different populations around the world. We could not find recent data for many nations with high rates of adult obesity, so we don’t have as full a picture of the global situation as we would like. Having said that, we found unprecedentedly high BMI levels in children aged four to 11 years in Kuwait, Pakistan, the US, Spain, Greece and a Pacific Island community in New Zealand.

Stitch in time

If being overweight has become more commonplace, merely watching children grow up won’t cut it. Parents and carers need simple, regular feedback about their children’s growth from an early age so that they intervene early enough to prevent later health problems. Most times, feedback about BMI alone – while valuable – may not be enough to prompt changes in lifestyles. Policymakers also need to recognise and act on the influence of the – including access to health services, living and working conditions, and social norms – if we are to find the most effective ways of helping families lead healthier lifestyles.

, Research fellow,

This article is republished from under a Creative Commons license. Read the .

Regular height and weight checks from early age critical in child obesity fight

Tue, 26 Mar 2019 06:53:17 +0000

Children monitored regularly for height and weight are less likely to be overweight according to research by University of Manchester and Oxford experts.

Publishing in the journal Preventive Medicine Reports today, the researchers say current practice may fail to spot a large number of children who are a normal weight on school entry but develop obesity in later in their lives.

Typically, a single measurement is taken when children start school, which may not be repeated until they are aged 11; only children who are obese from a very young age are easily identified for support.

The data allowed them to plot population-level and individual-level growth curves for girls and boys and find typical patterns.

The study reviewed the literature and pooled data from 54 studies and over 750,000 children worldwide.

According to Dr Heather Robinson who conducted the research while at The University of Manchester, the research shows that children should be measured regularly from a young age to help prevent obesity in later life.

According to the review, since 2000 late increasing children have made up 5-19 percent of children in the UK, USA and Australia.

She said: “Adult BMI starts to be predictable from child growth patterns from as early as age 2 years in some children so we should be measuring them from that age.

“However, as most measurement programmes are linked to schools as a way of accessing large groups of children, we can still achieve much by making the most of these observations between 4 and 11 years of age.

“Continuing closures of Sure Start centres which measure UK babies could mean the few early years measurements parents get could soon be lost.

“Each year a number of parents indicate that the current format of the National Child Measurement Programme, which informs parents of children's underweight and overweight at age 4-5 and 10-11, is unhelpful.

“Our work reiterates that not only are a minority of children identified as obese when they are following healthy growth pathways, but a group of children who become obese later have BMIs in the normal range at 4-5 years, so are missed.”

Previous studies have shown that many health problems are linked to how trajectories of weight and height in early childhood.

This includes including adult obesity, metabolic syndrome, non–alcoholic fatty liver disease and type 1 diabetes.

The research also shows that children adopt distinctive growth patterns before or within the 4-11 year age range.

Dr Matt Sperrin, from The University of Manchester added: “The trajectories we discovered can be classified into types which can be used to predict later life health outcomes.

“High risk growth trajectories predisposing adult obesity diverge from less harmful trajectories by approximately age 5.

“So we therefore argue that children and their parents should be targeted for healthy lifestyles considerably before this point.”

Dr Rinita Dam, from the University of Oxford, said: “We need to find effective ways of communicating issues related to children’s growth to their parents.

“We feel that by proactively encouraging and supporting parents and children to talk about this sensitive subject in a non-judgemental environment, much can be achieved.”

Dr Matt Sperrin, from The University of Manchesteradded: “The trajectories we discovered can be classified into types which can be used to predict later life health outcomes.

“High risk growth trajectories predisposing adult obesity diverge from less harmful trajectories by approximately age 5.

“So we therefore argue that children and their parents should be targeted for healthy lifestyles considerably before this point.”

Dr Rinita Dam, from the University of Oxford, said: “We need to find effective ways of communicating issues related to children’s growth to their parents.

“We feel that by proactively encouraging and supporting parents and children to talk about this sensitive subject in a non-judgemental environment, much can be achieved.”

High blood sugar during pregnancy ups risk of mother’s type 2 diabetes and child’s obesity

Tue, 11 Sep 2018 16:00:00 +0100

Research conducted in part at The University of Manchester has found that mothers with elevated blood glucose during pregnancy – even if not high enough to meet the traditional definition of gestational – were significantly more likely to have developed type 2 diabetes a decade after pregnancy than their counterparts without high blood glucose.

For children born to mothers with elevated or normal glucose, researchers found no statistically significant difference between the two groups of children in terms of their combined overweight and obesity, the study’s primary outcome. However, when obesity was measured alone, children of mothers with elevated blood glucose were significantly more likely to be obese.

The results are part of a published Sept. 11 in the Journal of the American Medical Association. Funded primarily by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institute of Health, and conducted at ten study sites, including The University of Manchester the or HAPO-FUS, followed mothers and their children 10-14 years after birth.

Professor Peter Clayton, who led the 91ֱ�� research team, said: “Here in 91ֱ��, we recruited more than 500 mother-child pairs from the original HAPO study, conducted when the children were born. Many of the mothers and their children had also helped us with studies through childhood, as part of the 91ֱ�� Heart and Growth study.

“The work was carried out by our research team, which included Avni Vyas, Aysha Khan, Fiona Pritchard, Jane Howell and Andy Whatmore (from Developmental Biology & Medicine in the School of Medical Sciences), supported by the NIHR 91ֱ�� Clinical Research Facility and the Greater 91ֱ�� Clinical Research Network”.

The original HAPO study found that even modestly elevated blood glucose levels increased the risks of complications for the baby both before and shortly after birth. Based on these results many, but not all, organizations adopted a new definition of , a type of diabetes that occurs during pregnancy.

HAPO-FUS compared the long-term effects of blood glucose levels in mothers who would have met the new definition of gestational diabetes with those who did not. Researchers aimed to learn if modest increases in blood glucose increased the mother’s risk of developing type 2 diabetes or prediabetes and the risk of obesity in the mother’s offspring at least a decade after giving birth.

The study found the harms of even modestly elevated blood glucose for both mother and child extend more than a decade. Among women with elevated blood glucose during pregnancy, nearly 11 percent had at the follow-up study visit 10-14 years after childbirth and about 42 percent had . Of their counterparts who did not have elevated blood glucose during pregnancy, about 2 percent had type 2 diabetes and about 18 percent had prediabetes. The study examined 4,697 mothers for type 2 diabetes, prediabetes and other disorders of glucose metabolism.

Researchers analyzed 4,832 children for overweight and obesity, collecting data using body mass index (BMI), body fat percentage, skin fold thickness and waist circumference. They found that these measures all showed that children born to mothers with elevated glucose levels were more likely to be obese. For example, using BMI, 19 percent of children born to mothers with elevated blood glucose were obese, compared with 10 percent for children of mothers with normal glucose.

Adjusting for the mother’s BMI reduced – but did not eliminate – the differences between the groups.

“The differences in mothers and their children due to the mother’s higher blood glucose are very concerning. Even accounting for the mother’s weight, glucose had an independent effect,” said Dr. Barbara Linder, a study author and senior advisor for childhood diabetes research at the NIDDK. “Our findings add to the motivation to find ways to help women at high risk for gestational diabetes who are or plan to get pregnant to take steps to reduce their risk.”

The looked at 23,316 mother-child pairs and found that a mother’s blood sugar levels, even short of diabetes, were associated with her newborn’s birth weight and body fat. HAPO results led an international panel of experts to recommend new diagnostic criteria for gestational diabetes in 2010. However, not all professional groups adopted these proposed criteria.

“HAPO helped redefine gestational diabetes, and now its follow up continues to raise important alarms about the long-term danger of high blood glucose levels during pregnancy,” said study chair Dr. Boyd Metzger, emeritus Tom D. Spies Professor of Nutrition and Metabolism at the Northwestern University Feinberg School of Medicine, Chicago. “This study shows that both mothers with elevated blood glucose levels and their offspring are at higher risk for adverse health effects later in life. More research is needed to find interventions to help both these women and their children.” None of the women in HAPO-FUS were diagnosed with or treated for gestational diabetes during their pregnancy. HAPO recruited an international, racially and ethnically diverse group. Limitations of the data in HAPO include that body mass index was obtained during pregnancy, not before. As well, HAPO-FUS did not collect data on the women or children’s lifestyles to evaluate other factors that could contribute to obesity or type 2 diabetes.

The results build on findings from other studies showing that type 2 diabetes in mothers during pregnancy is associated with obesity in that mother’s offspring and that elevated blood glucose increases risk of type 2 diabetes in the woman after pregnancy.

“HAPO and its follow-up study have shown the detrimental long-term effects of elevated blood glucose on both mother and child and the importance of early intervention for women at risk for gestational diabetes,” said NIDDK Director Dr. Griffin P. Rodgers. “We hope these results will be used to improve the health of generations to come.”

HAPO-FUS was conducted at 10 clinical centers around the world

Research reveals why obese mothers less likely to breastfeed

Tue, 27 Mar 2018 14:00:00 +0100

Obese women are less likely to breastfeed according to a review of 20 research papers by health psychologists and midwives from The University of Manchester.

PhD student and trainee health psychologist Stephanie Lyons from The University of Manchester says women with a Body Mass Index of over 30kg/m² - the medical definition for obesity- are also more likely breastfeed for shorter durations than other women.

The review identified psychological factors which can hold back these women from breastfeeding their babies.

The women tend to have social networks where friends and family members do not breastfed their babies.

The research team also hope measures to encourage women to breastfeed may help tackle rising obesity rates in children as non-breastfeeding mothers are more likely to have obese children.

The research was funded by the Economic and Social Research Council , as part of Stephanie Lyons’ PhD programme.

Factors holding obese women back from breastfeeding included: lack of breastfeed planning, low belief in breastmilk’s nutritional adequacy and sufficiency, poor body image and lack of social knowledge.

The fifth factor highlighted a belief that close friends or family members preferred them not to breastfeed.

The team recommend that clinicians should proactively support medically obese women to breastfeed by providing accurate information and practical advice for latching and positioning.

And women, they add, should be signposted to breastfeeding support groups to receive advice from peers and be in social situations with other breastfeeding mothers.

Stephanie Lyons said: “Breastfeeding is associated with many health benefits for both mother and child and can play a key role in the reduction of long term obesity for mothers and prevention of obesity in children.

“The World Health Organisation recommends all mothers should exclusively breastfeed their infants until they reach six months of age, and continue with complementary breastfeeding until they are at-least two years of age.

“But medically obese women are less likely to breastfeed- and they will be held back by a number of psychological factors.”

She added: “Our results suggest having poor body image and lacking belief in breastmilk’s nutritional adequacy and sufficiency may create barriers to breastfeeding.

“Many of the women with higher BMIs had poorer body image, and lacked belief in their breastmilk’s nutritional adequacy and sufficiency.

“We therefore urge, clinicians and associated professionals to proactively work with women with a BMI of 30kg/m² or more to encourage, educate and support them.”

“The association between psychological factors and breastfeeding behaviour in women with a body mass index (bmi) ≥30kg/m2: a systematic review” is published in

New role for immune cells in preventing diabetes and hypertension

Fri, 17 Mar 2017 10:00:00 +0000

Immune cells which are reduced in number by obesity could be a new target to treat diseases such as type 2 diabetes and hypertension that affect overweight people, according to a collaborative study between The University of Manchester, Lund University and the University of Salford.

In a study published in the journal Scientific Reports, the researchers from immunology and cardiovascular backgrounds investigated a type of immune cell called eosinophils. Eosinophils are present in a layer of fat tissue called the perivascular adipose tissue (PVAT), which surrounds blood vessels and helps to maintain normal blood vessel function by reducing artery contraction.

The current research by the researchers found that eosinophils were considerably reduced in the PVAT in obesity in mice, and that the PVAT function was severely impaired, contributing to type 2 diabetes and hypertension. This is not something that has previously been observed.

, the lead researcher on -funded study, said: “This type of immune cell is present in many parts of the body and was once thought to just act in parasitic infections and allergies, but it’s fast becoming clear that they have a significant effect on lots of aspects of health and immunity.

“Our study showed that in fact the secretions from eosinophils have a profound effect on how the blood vessels operate and when they are missing, as in obesity, serious health problems can start to develop.”

The role of the eosinophils also opens up new opportunities to investigate treatments for type 2 diabetes and hypertension.

PVAT from fat that lack eosinophils could quickly be rescued by addition of eosinophils, demonstrating that there is the potential for a treatment based on restoring this function.

The researchers observed that the eosinophils influenced the release of nitric oxide and a protein called adiponectin, which control healthy PVAT function. This appears to be a unique function of these immune cells. The researchers are particularly excited by how quickly the eosinophils could restore PVAT function, showing just how potent they may be.

Dr Cruickshank added: “These immune cells have been traditionally overlooked but this study shows for the first time that they have a direct role to play in processes in the body beyond the immune system.

“They seem to be incredibly important in a number of processes and this presents us with an exciting new area to investigate for a whole range of illnesses.”

The paper ‘’ was published in Scientific Reports. doi:10.1038/srep44571

Genetics links sleep disturbance with restless legs syndrome, schizophrenia, and obesity

Mon, 19 Dec 2016 17:00:00 +0000

A team of American and British scientists have for the first time discovered genetic connections between sleep disturbance and a range of medical disorders including obesity.

Lead author Dr Jacqueline Lane, postdoctoral fellow at Massachusetts General Hospital (MGH) and joint senior authors Richa Saxena, Assistant Professor of Anaesthesia at the MGH and Harvard Medical School and Dr Martin K Rutter, Senior Lecturer in Cardiometabolic Medicine from The University of Manchester, publish their ground-breaking research in Nature Genetics today.

The study looked at the biological controllers of sleep duration, insomnia and excessive daytime sleepiness, and how they linked to the health and life histories of more than 112,000 people taking part in the world-leading UK Biobank study.

91ֱ�� participants reported their sleep duration, the degree of insomnia and daytime sleepiness, and then had their genes mapped. Other information about them such as their weight and any diseases they suffered from was also collected.

The researchers identified for the first time areas of the genome that are associated with sleep disturbance including insomnia and excessive daytime sleepiness and also discovered novel genetic links with several medical conditions including restless legs syndrome, schizophrenia and obesity.

The strongest genetic association for insomnia symptoms fell within a gene previously linked to restless legs syndrome – a nervous system disorder affecting around 1 in 20 people that leads to a strong urge to move one's legs which is often worse at night. Other gene regions were important for insomnia but selectively in either men or women.

The team also identified genetic links between longer sleep duration and schizophrenia risk and between increased levels of excessive daytime sleepiness and measures of obesity (body mass index and waist circumference).

The research also suggested that insomnia has shared underlying biology with major depression and abnormal glucose metabolism.

Funded by the US National Institutes of Health and The University of Manchester’s Research Innovation Fund, the study marks a major advance in our understanding of the biology of sleep.

One in four British adults are obese, according to the UN Food and Agriculture Organisation, prompting fears that the UK has become the "fat man of Europe". And at any one time about 280,000 people are being treated for schizophrenia by the NHS. Sufferers have a 1 in 10 chance of dying by their own hand within ten years of diagnosis.

Dr Rutter said: “This clinical science is an important step forwards in understanding the biological basis for these conditions so it’s very exciting.”

“Scientists have long observed a connection between sleep disorders and these conditions in epidemiological studies. But this is the first time these biological links have been identified at a molecular level.”

UK Biobank aims to improving the prevention, diagnosis and treatment of a wide range of serious and life-threatening illnesses.

Dr Lane said, ”We’re particularly pleased to be able to use UK Biobank data in this way; it’s an amazing resource for scientists.”

Dr Saxena said: “It’s important to remember there is no molecular targeting available for conditions which affect sleep: all we really have are sedatives.”

“So we hope that this research will enable scientists to develop new ways to intervene on a range of conditions in a much more fundamental way.”

“We do acknowledge these findings will need further study, but believe this knowledge amounts to a key advance in our understanding of the biology behind sleep - a major influence on our health and behaviour.”

The University of Manchester, a member of the prestigious Russell Group of British universities, is the largest and most popular university in the U.K. It has 20 academic schools and hundreds of specialist research groups undertaking pioneering multi-disciplinary teaching and research of worldwide significance including a major programme of work in biological timing. The University of Manchester is one of the country’s major research institutions, rated fifth in the U.K. in terms of ‘research power’ (REF 2014), and has had no fewer than 25 Nobel laureates either work or study there. The University had an annual income of £886 million in 2013-14.

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The conducts the largest hospital-based research program in the nation, with an annual research budget of more than $800 million and major research centers in HIV/AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, photomedicine and transplantation biology. The MGH topped the 2015 Nature Index list of health care organizations publishing in leading scientific journals and earned the prestigious 2015 Foster G. McGaw Prize for Excellence in Community Service. In August 2016 the MGH was once again named to the Honor Roll in the U.S. News & World Report list of "America’s Best Hospitals."

Cancer: A year of Manchester solutions to a global problem

Thu, 15 Dec 2016 01:00:00 +0000

This year is ending on a high note for researchers working in the field here in 91ֱ��. With today’s announcement of more than £42m of investment from Cancer Research UK, the city is now firmly established among the world’s elite for finding new treatments and prevention strategies for this disease.

But this isn’t the only achievement made by cancer researchers here in the city this year.

New treatments and insights

We’ve made a number of breakthroughs in 2016 – helping to develop new treatments and gain greater understanding of how cancer works.

In August we revealed findings which could lead to a new test for a common , we also identified drugs to target the ‘Achilles heel’ and another study earlier in the year also identified another possible for this form of the disease.

We have also made advances in the treatment of breast cancer, with exciting findings that a combination of two drugs . We also discovered how breast cancer cells to different parts of the body.

These kinds of insights are important for developing new treatments further down the line and findings that shed light on with each other have this potential to lead to future cures. Another study turned the idea that on its head.

We’re also refining existing treatments with one trial finding that and is equally good at treating small cell lung cancer. We’ve also studied how the can be averted by personalising treatment.

Prevention and early detection

Catching cancer early or developing ways to change people’s behaviour are among the most effective ways of combatting the disease. That’s why the statistical analysis we released last month, which shows that in men by 50 percent and in women by almost 20 percent is important.

In September we announced to diagnose cancers early, potentially saving many lives and saving the NHS millions of pounds. And other funds will help us devise .

Funds and facilities to fight the disease

Coupled with today’s £42m announcement we’ve also been working hard to attract new funds and build world class facilities to support our research. The news that 91ֱ�� was selected by government to be a with £28.5m funding attached will help support many more of the projects described above.

We’ve also opened dedicated to finding the markers that enable quick diagnosis of diseases including cancer and more funding will .

One of the major scientific discoveries of the last few years, graphene, also has applications for cancer research and could potentially develop targeted drug delivery systems to attack cancer cells.

We’re also working across the world, in one of the first international collaborations inspired by US Vice-President Joe Biden’s Cancer Moonshot.

In the community

That’s not the only way we’ve been working with our global partners. In July 91ֱ�� hosted as part of the city being designated European City of Science. We’ve also been working in our community, which were exhibited to highlight the achievements the city has made in battling the disease.

91ֱ��’s place in fighting cancer

will enable 91ֱ�� to train 46 of the brightest minds in cancer science, support treatments based around the concept of precision medicine and run even more trials to test the effectiveness of treatments.

As Professor Dame Nancy Rothwell, President and Vice-Chancellor of The University of Manchester, said: “91ֱ�� is now one of the world’s leading research centres for cancer and this funding represents an important step forward in finding new treatments, carrying out more trials and training the brightest minds to continue this work. Working with our partners at The Christie and Cancer Research UK gives us great strength, bringing together researchers and doctors to make new discoveries that benefit of people here and around the world."

is one of The University of Manchester’s - examples of pioneering discoveries, interdisciplinary collaboration and cross-sector partnerships that are tackling some of the biggest questions facing the planet. #ResearchBeacons

Find our more about .

Adult weight gain could increase cancer risk

Mon, 07 Nov 2016 14:03:00 +0000

Substantial weight gain over many years increases the risk of obesity-related cancers in men by 50 percent and in women by almost 20 percent, according to new research presented at the National Cancer Research Institute’s (NCRI) Cancer Conference in Liverpool, today (Monday).

Researchers at The University of Manchester and , looked at weight gain over many years and assessed the risk of developing obesity-related cancers.

This is a new way of looking at the long-term impact of being obese throughout a person’s life and the link to developing cancer.

In the study of approximately 300,000 people in America, including around 177,500 men and 111,500 women, researchers categorised the population into five different lifetime weight trajectories. They looked at changes in BMI between the ages of 18 and 65.

Some people gained a little weight between the ages of 18 and 65 years, while others became morbidly obese.

The population was then followed up for an average of 15 years to see who went on to develop obesity-related cancers.

It found that men who went from a BMI of around 22 to 27 had a 50 percent increased risk of developing obesity-related cancer compared to a man who stayed within a healthy weight range. And in men who went from being overweight to morbidly obese, the risk went up by 53 percent compared to the same group.

Women who went from a BMI of 23 to around 32, had a 17 per cent increased risk in comparison to women whose weight started off in the healthy bracket and remained stable.

Of the 300,000 people in the study, there were around 9,400 women and 5,500 men who were diagnosed with obesity-related cancers after the age of 65.

Being overweight or obese is the second biggest preventable cause of cancer in the UK after smoking and contributes to around 18,100 cases of cancer every year. It is linked to a range of cancer types including bowel, breast, and pancreatic.

Several of the obesity-related cancer types can only affect women – for example, womb cancer and ovarian cancer.

, lead author and researcher at The University of Manchester, said: “This research shows how important it is to look at weight gain over a person’s lifetime – to give a clearer picture of cancer risk through life compared to assessing someone’s BMI at a single point.

“This study could also be really useful in public health. It could help identify people who would benefit the most from taking action to control their weight before any health problems arise – including a cancer diagnosis.”

Sir Harpal Kumar, 's chief executive said: “This is a really interesting way to look at lifetime risk of obesity-related cancers and helps us understand the effects of weight gain over time.

“It’s important that people are informed about ways to reduce their risk of cancer. And while there are no guarantees against the disease, keeping a healthy weight can help you stack the odds in your favour and has lots of other benefits too. Making small changes in eating, drinking and taking exercise that you can stick with in the long term is a good way to get to a healthy weight – and stay there.”

Dr Karen Kennedy, Director of the , said: “This study provides a deeper understanding of the health implications caused by the obesity epidemic. It helps paint the picture of how risk could accumulate over time for different people, and could provide health professionals with a means to asses an individual’s risk.”

This work is funded by Cancer Research UK as part of the National Awareness and Early Diagnosis Initiative (NAEDI). Supported by and linked with the new Cancer Prevention and Early Detection theme.

View the abstract here: ‘.’

is one of The University of Manchester’s - examples of pioneering discoveries, interdisciplinary collaboration and cross-sector partnerships that are tackling some of the biggest questions facing the planet. #ResearchBeacons

Natural births after caesarean more likely if you call the midwife

Wed, 20 Apr 2016 16:41:09 +0100

Although caesarean sections are safe, research is increasingly showing that vaginal birth and labour protects against long term-risks
There is a growing emphasis placed by health authorities on promoting vaginal birth after caesarean

Women who had a caesarean section in a previous pregnancy are much more likely to have a vaginal birth if their antenatal care is led by a midwife, according to a new study from a University of Manchester researcher, which was carried out in Southampton.

Although caesarean sections are safe, research is increasingly showing that vaginal birth and labour protects against long term-risks such as impaired immune response, asthma, obesity and type 2 diabetes in the baby. As a result there is a growing emphasis placed by health authorities on promoting vaginal birth after caesarean (VBAC) where it is safe to do so.

The new study, published in the journal Birth, is the first to evaluate the influence on VBAC rates of midwife-led antenatal care as opposed to care led by an obstetrician.

Using patient records, 405 women giving birth at one hospital after a previous caesarean were examined in two groups. The first group was from 2008 when antenatal care was led by obstetricians and, following a change in hospital policy in 2009-2010, the second group was drawn from women who had received midwife-led antenatal care in 2011.

The number of women who intended to give birth by VBAC in 2011 was 90.3 percent, against 77 percent in 2008. Those who actually achieved VBAC was also higher in the midwife-led group with 61.2 percent instead of 46.9 percent. Both represented significant increases in VBAC when antenatal care was led by a midwife.

, a midwifery lecturer in the University’s , carried out the research at the University of Southampton. She said: “There were few differences between the two groups of women we studied, so the main variance was the professional responsible for their care.

“Where it can be achieved safely, vaginal birth is preferable, but there’s a real issue with women who have had a caesarean once, opting for the same again. There aren’t many initiatives out there to break this cycle so this finding is important for providing evidence that midwives are best placed to promote vaginal birth.”

The authors of the study are not proposing that women should reject caesarean birth when they are advised to do so, but suggest that midwives are important figures in promoting VBAC in suitable women.

There is a three year gap between the two groups of women but in terms of age, socio-economics, ethnic group and other variables, the groups are similar. The only significant change was the change in policy to midwife led care in the hospital. The results are also unlikely to be due to cultural changes over time as the VBAC rates across England more generally did not change during the study period.

Dr White added: “The more we understand the role of the microbes living in the vagina, the more we are uncovering the protective effects of labour and natural birth against conditions such as diabetes and obesity.

“Midwife led care is cost-effective and, if it safely reduces the number of repeat caesarean sections, then it’s even more beneficial for mothers and babies.”

The paper ‘’, was published in the journal Birth.

Expert reaction: WHO warning on diabetes’ ‘unrelenting march’

Fri, 08 Apr 2016 10:15:29 +0100

As the World Health Organization warns of an ‘’ with 422 million cases in 2014, an experts from The University of Manchester have reacted to the problem and suggest some ways to address the obesity epidemic that fuels it.

, Reader in Behavioural Medicine/Health Psychology said: “We are living with an obesity epidemic. People with the least resources; lower socio-economic groups; socially unstable groups; and those with mental health problems are most affected by obesity. Parents who are obese are more likely to have overweight children, who are also more likely to be inactive, perpetuating a cycle of obesity and inactivity which increases the future risk of illness.

“In addition, we live in a society where food companies bombard people with images of high fat, high sugar food and drinks. Subtle psychological messages are paired with images of food and drink and people are sold a lifestyle that is inconsistent with the foods being advertised. The amount of spend on research and services to manage obesity compared with the cost to the tax-payer of living with the associated health problems is very small. This needs to change.

“The answer lies in a strategy that addresses food regulation and legislation so that healthy food messages are as common as unhealthy images and messages; the influence of ‘social norms’ by changing what is acceptable in specific social groups; the individual person – supporting people to change.

“Health psychologists and behavioural medicine practitioners have such expertise and should be incorporated into existing weight management services which should be expanded to address this ongoing epidemic.”

is director of and the 91ֱ�� Urban Collaboration on Health (), as well as a Senior Lecturer in Public Health.

“Prevention strategies that will halt the obesity epidemic are key to reducing the burden of diabetes in our populations. Public health professionals across the globe have been advocating for better regulation of sugar in foods, drinks and junk food in general. Mexico is leading the way with increased taxes and which is so badly needed here in the UK.

“The National Institute of Health and Care Excellence (NICE) has published many on the prevention of diseases. Making the healthy choice the easy choice is a population-based approach which will ultimately lead to reducing the large inequalities seen in the UK. Obesity and diabetes alone costs £5 billion every year and will rise to £50 billion by 2050.

“Our lifestyles, eating and drinking habits are costing society, the NHS and social care a burden that cannot be sustained. How much of our ‘free will’ has been decided for us by large multinational companies and their advertising agencies? Many people see this as yet another attack on making personal choices and the ‘nanny state’ but the evidence is clear on the impact of unhealthy diets and lifestyles causing diseases like diabetes.

“Our recent survey comparing 26 cities across Europe showed Greater 91ֱ�� had significantly higher rates of overweight and obesity in adults, especially men aged over 65 years (source EURO-URHIS 2 project )

“Better designed cities can also help with the fight against diabetes. Making walking, cycling and recreational activities safe, fun and exciting for urban dwellers, exploring with employers how to maximise physical activity at work, nutritional foods in schools and workplaces will all help.”

New syndrome which causes obesity and intellectual disability identified

Wed, 03 Feb 2016 09:45:00 +0000

Syndrome has an effect on sthe hypothalamus that produce a hormone called oxytocin
Researchers hope that the findings will help uncover how the hypothalamus works

Scientists at The University of Manchester have discovered a new genetic syndrome of obesity, over-eating, mental and behavioural problems in six families, from across the world.

, Clinical Senior Lecturer at , who led the study, explained: “Our team has identified that this new syndrome is caused by a small deletion on chromosome 6 that affects the function of hypothalamus, a region of the brain that plays a number of important roles in the body.”

Working in collaboration with Dr Eric Glasgow of the Georgetown University Medical Center in Washington D.C., the two teams used zebrafish models to study the consequences of chromosome 6 deletion and showed that the deletion has an effect on specific cells in the hypothalamus that produce a hormone called oxytocin.

This explains why sufferers are often severely obese, find it difficult to control their appetites and are prone to mood swings and being withdrawn.

The study, published in the latest issue of the American Journal of Human Genetics represents an important step in our understanding of how the hypothalamus and oxytocin control appetite and behaviour. Dr Banka, who is also a Consultant Clinical Geneticist at , said: “This finding demonstrates the power of human genetic study of rare conditions.”

Although at an early stage, the researchers hope that the findings will help form part of a picture of how the hypothalamus works and may lead to new treatments in the future.

The paper, .

DOI: 10.1016/j.ajhg.2015.12.014

Slow progress in stillbirth prevention highlighted by landmark research series

Tue, 19 Jan 2016 14:14:19 +0000

More than 2.6 million stillbirths continue to occur globally every year
Major new research series highlights scale and potential solutions

More than 2.6 million stillbirths continue to occur globally every year with very slow progress made to tackle this ‘silent problem’, according to new research published in The Lancet, and co-authored by from the Stillbirth Research Centre at and The University of Manchester.

Despite significant reductions in the number of maternal and child deaths, there has been little change in the number of stillbirths (in the third trimester of pregnancy) even though the majority are preventable.

states the annual rate of reduction for stillbirths is 2.0%, much slower than progress made for maternal (3.0%) and child deaths (4.5%). It also reveals the hidden consequences of stillbirth, with more than 4.2 million women living with symptoms of depression, often for years, in addition to economic loss for families and nations.

Series co-lead, Professor Joy Lawn from the London School of Hygiene & Tropical Medicine, said: “We must give a voice to the mothers of 7,200 babies stillborn around the world every day. There is a common misperception that many of the deaths are inevitable, but our research shows most stillbirths are preventable.

“We already know which existing interventions save lives. These babies should not be born in silence, their parents should not be grieving in silence, and the international community must break the silence as they have done for maternal and child deaths. The message is loud and clear – shockingly slow progress on stillbirths is unacceptable.”

Video courtesy of the Faculty Fellowship Academy

New estimates of stillbirth rates for 195 countries developed by the London School of Hygiene & Tropical Medicine with the World Health Organization and UNICEF reveal huge inequalities around the world. Ten countries account for two-thirds of stillbirths* with India having the highest number, estimated at 592,100 in 2015. The highest rates are in Pakistan (43.1 per 1,000 total births) and in Nigeria (42.9). The lowest rates are in Iceland (1.3), Denmark (1.7), Finland (1.7) and the Netherlands (1.8). Netherlands is also making the fastest progress, reducing stillbirths by 6.8% per year. The United States is one of the slowest progressing countries with a reduction of 0.4% per year.

The new research includes the first global analysis of risk factors associated with stillbirth, underlining that many deaths can be prevented by:

Treating infections during pregnancy – 8.0% of all stillbirths are attributable to malaria, increasing to 20.0% in sub-Saharan Africa, and 7.7% of all stillbirths are associated with syphilis, increasing to 11.2% in sub-Saharan Africa.
Tackling the global epidemics of obesity and non-communicable diseases, notably diabetes and hypertension – at least 10% of all stillbirths are linked to each of these conditions.
Strengthening access to and quality of family planning services – especially for older and very young women, who are at higher risk of stillbirth.
Addressing inequalities – in high-income countries, women in the most disadvantaged communities face at least double the risk of stillbirth.

The research also highlights the underappreciated psychological, social and economic impacts of stillbirth on parents, families, caregivers, and countries. New estimates suggest at least 4.2 million women around the world are living with symptoms of depression due to stillbirth, suffering psychological distress, stigma and social isolation, as well as increased risk of family breakdown, and even abuse and violence.

Christina Sapulaye from Malawi, who experienced a stillbirth last year, said: “It was a very painful situation to me and I never knew what to do… I am being stigmatised by my own people and was divorced due to the stillbirth, and now I am by myself with my little kids.

Fathers also commonly report suppressing their grief, and almost half of 3,503 parents surveyed in high-income countries felt society wanted them to forget their stillborn baby and try to have another child.

The economic impact of stillbirth for families ranges from funeral costs for their baby to loss of earnings due to time off work, with data suggesting 10% of bereaved parents remain off work for six months. The direct financial cost of stillbirth care is 10-70% greater than for a live birth, with additional costs to governments due to reduced productivity of grieving parents and increased welfare costs.

Dr Alexander Heazell, co-author from the Tommy’s Stillbirth Research Centre at St Mary’s Hospital and The University of Manchester, said: “The consequences of stillbirth have been hugely underestimated. Our research suggests that grief and symptoms of depression after stillbirth often endure for many years.

“It is vital we, as carers, see the loss through the eyes of those parents affected to provide sensitive and respectful bereavement care. We know that something as simple as supporting parents to see and hold their baby and providing bereavement support can reduce the long-term negative impact of stillbirth.

“Dealing with stillbirth can also have a psychological impact on health workers; consequently, better training and provision of support for those looking after affected families should also be a priority.”

The Ending Preventable Stillbirth Series was developed by 216 experts from more than 100 organisations in 43 countries and comprises five papers. The research provides compelling evidence of the preventability of most stillbirths, forming the basis for action from parents, health care professionals, and politicians. It follows the research group’s 2011 series on stillbirths also published in The Lancet.

Rising risk of obesity among China’s ‘left behind children’

Wed, 09 Dec 2015 11:09:41 +0000

The study of 975 children from 140 rural villages in nine provinces carefully analysed nutritional intake
'Left behind’ boys in particular consumed more fat and less protein than those from complete families

Some 61 million rural children left behind by parents moving to China’s booming urban centres are at risk from increased fat and reduced protein in their diets, research from The University of Manchester, published in Public Health Nutrition suggests.

The study of 975 children from 140 rural villages in nine provinces carefully analysed nutritional intake and showed a particular risk to boys who were left behind in the care of grandparents or one parent while a mother or father sought work away from home.

The research was led by Nan Zhang from the University’s . She said: “There are sound financial reasons why so many people move from rural to urban areas in China, but the benefits that more money brings to a family can often be at the expense of child nutrition.

“The Chinese government needs to recognise this growing problem among rural communities and this research provides some evidence to target health policies on encouraging a balanced diet.”

The study found that ‘left behind’ boys in particular consumed more fat and less protein than those from complete families, which leaves them at increased risk of obesity and stunted growth. This finding has important policy implications in a specific cultural context where ‘son preferences’ are powerful.

Although the findings don’t provide reasons for this change in diet, the researchers speculate that mothers moving away from home generally earn less, and that these lower earnings act in combination with grandparents’ poorer dietary knowledge or willingness to spend more on food. Another academic paper led by Nan Zhang has explored the intergenerational differences in beliefs about healthy eating for left-behind children among grandparents and parents and was published in Appetite.

Another factor at work could be that prices of protein-based foods such as eggs and meat have increased faster than many households’ incomes – meaning that even though money is being sent home from one or both parents, nutrition doesn’t always improve.

Nan Zhang said: “The process of parental migration is complex and the reasons for problems in boys’ nutrition are not straightforward, however we can see that both parents and grandparents in rural areas need to be educated about good diet.

“Because raising children can fall on all members of the family, good care-giving practice needs to become more widespread.”

The paper, ‘ was published in the journal, Public Health Nutrition.

Funding came from an Economic and Social Research Council (ESRC) Postgraduate Scholarship

Deal to create world-class health innovation

Wed, 02 Sep 2015 16:37:01 +0100

Leaders across healthcare research, academia and industry have today, Wednesday 2 September, come together to launch a unique partnership.

Health Innovation 91ֱ�� will speed up the discovery, development and delivery of innovative solutions to help improve the health of the almost three million people in Greater 91ֱ��, and beyond.

The new approach, which is the latest landmark in the region’s devolution of health and social care, builds on the existing expertise and assets in the area to address a nationwide issue of delays between research innovation and health and economic benefits being realised on the ground.

It will harness the partner organisations’ collective expertise to develop the infrastructure needed for clinical trials and health informatics.

The partnerships aims and ambitions are enshrined in a Memorandum of Understanding which will be signed today by key partners from across the system including , , , and .

Health priorities in Greater 91ֱ�� include cardiovascular disease, cancer, diabetes, drug and alcohol misuse and the high prevalence of obesity among adults and children.

The early priorities identified for Health Innovation 91ֱ�� are:

Build on groundbreaking work on integrated health data systems to extend it to the whole of Greater 91ֱ��. This will enable better care (by providing more joined-up information to GPs and hospitals) and potentially help identify new ways of treating diseases.
Improve the ability to use personalised medicine, with more targeted treatments for those who will benefit most from them. For example, this could involve developing new medicines to treat specific groups of patients or targeting existing treatments more effectively.
Enhance the testing of new medicines or treatments to enable those with the biggest positive impact to be identified and introduced into routine clinical practice across the whole of Greater 91ֱ�� as quickly as possible, maximising the patient benefits.

These priorities will be underpinned by engagement with cutting-edge businesses to ensure effective collaborations which will help make Greater 91ֱ�� a magnet for innovative life science companies.

The partnership will also be able to have new innovations tested and validated for use across all NHS sites in the region – and then share data, learning and costs to improve diagnosis and ensure that patients get the most appropriate treatment. This will then have an impact on the region’s industry from research and development through to manufacturing.

Clive Morris, Director of Health Innovation 91ֱ��, said: “Greater 91ֱ�� already benefits from a strong history of research and innovation in health. It is an important life sciences cluster and an eco-system with significant growth potential.

“However, we know that it can take many years for a new innovation to reach routine adoption across the NHS, and that we don’t leverage our skills and capabilities across the whole of the region and across different diseases.

“Our ambition is to solve this by harnessing and building on the collective expertise we have, and working together to develop the very best approaches to address the health needs of Greater 91ֱ��. By working collectively across healthcare providers, academia and industry – more closely than ever before – we can see the potential to accelerate the discovery and development of new innovations and transform the health of our population.”

Councillor Cliff Morris, lead on health for (GMCA), said: “This approach complements and supports our devolution objectives and ambitions around integrated health and social care – allowing people to have more control of their own health – while taking pressure off hospitals and boosting work in the community.”

Sir Richard Leese, lead on growth for GMCA, said: “All these developments are based on firm foundations. Greater 91ֱ�� is already recognised as being in the top three UK life science clusters with almost 11,500 people working in pharmaceutical, biotechnology and medical technology businesses.

“World-class strengths include a strong research-led university base, six major teaching hospitals, a successful record of clinical trials, rich history of innovation and a wide industrial base. It also has the only accredited Academic Health Science Centre in the UK outside the South East, which is a powerful platform to widen Greater 91ֱ��’s business base and growth.”

Professor Dame Nancy Rothwell, President and Vice-Chancellor of The University of Manchester, said: “This partnership will allow new medical discoveries by University of Manchester researchers to have patient benefit much faster, something which is of critical importance to the major health challenges we face as a city. We already work closely with our NHS and industry partners, but HIM means that ideas can move much more quickly from the lab to having an impact on people in Greater 91ֱ��, and ultimately around the world.”

NHS chief executive Simon Stevens said: "91ֱ�� has a proud history of world-leading breakthroughs in medicine and science and this approach will accelerate future gains for patients, hospitals, universities and employers across the region."

World Health Organization recognition for public health centre

Tue, 09 Jun 2015 17:30:00 +0100

A University of Manchester research centre has been awarded World Health Organisation Collaborating Centre status for its work on improving the health of people across Europe and in the Greater 91ֱ�� area.

Following a launch event yesterday (8 June), The 91ֱ�� Urban Collaboration on Health () will now be working with to shape the co-ordination of health information across Europe, building on long-standing ties.

who leads the Centre said: “Essentially what we do is provide guidance, based on research, which lets countries use the best methods possible for improving health in their populations.

“The most vulnerable often have the worst health and well-being outcomes. By using information better, we can understand how to reduce the inequalities that have been steadily growing across Europe.

“This includes understanding the patterns to work out why we see the differences in health and well-being across our communities, improve the uptake of vaccinations, help improve people’s knowledge of why early diagnosis and cancer screening is important, and promoting healthy lifestyles to combat obesity.

“WHO Collaborating Centre status places us in a much stronger position to carry out this work, so we’re delighted to have received it.”

MUCH is an important element for the implementation of the WHO’s strategy to significantly improve the health and well-being of populations, reduce health inequalities, and strengthen public health in Europe.

Dr Verma is part of the steering group for the project, and the WHO Collaborating Centre will be able to work more closely with the WHO on what will make a difference to the health information that is all around us being used to help the most vulnerable.

As well as working at the European level, MUCH also works with NHS and local authority figures in Greater 91ֱ�� on health initiatives such as reducing blood-borne diseases and creating better links between health workers across the region.

One result of this work has been , held in 91ֱ�� for the last three years and next taking place on 2 July.

The Festival attracts hundreds of delegates and leading NHS and government figures to debate everything from the smoking ban to obesity and this year features addresses by Natalie Bennett, leader of the Green Party and Baron O'Neill of Gatley, retiring Chairman of Goldman Sachs Asset Management.

The launch event was attended by the University’s President and Vice-Chancellor, Professor Dame Nancy Rothwell, Professor Martin Tickle, Director of and leading figures from the WHO.

One of these, Dr Claudia Stein, Director of the Division of Information, Evidence, Research and Innovation, World Health Organization, Regional Office for Europe, said: “We are delighted to welcome the Urban Collaboration on Health on board as the newest of our collaborating centres.

“This is a significant step towards realising the objectives of the European Health Information Initiative, through which we want to improve the information that underpins health policy and ultimately improve the health of the people of the European Region.

“The 91ֱ�� Urban Collaboration on Health is a power house of expertise and talent and we very much look forward to standing shoulder to shoulder to take health in Europe into a new era.”

MUCH has become the second WHO Collaborating Centre at the University after last year.

Notes for editors

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Research unlocks critical early nutrient supply for embryos

Thu, 30 Apr 2015 11:38:00 +0100

The mechanism by which embryos receive nutrition during the first 11 weeks of pregnancy has been revealed by University of Manchester scientists.

Writing in this month’s edition of the journal Placenta, they show how glucose and other nutrients are delivered in the early stages of pregnancy before the foetus is large and developed enough to receive a direct blood supply from the mother.

This stage is crucial for the implantation of the embryo onto the wall of the placenta and a successful pregnancy, and as previous studies have shown, nutritional problems at this stage can affect the child’s health for the rest of its life.

The scientists discovered that gland cells in the lining of the uterus store glucose in the form of glycogen. This is then delivered to the placenta together with glycoproteins to be used for energy and converted into the amino acids which are the building blocks for further growth of the embryo.

Once a direct blood supply from the mother’s circulation to the placenta is established after 11 weeks, the supply from the gland cells tails off.

, from the University’s , led the study with . Professor Aplin said: “A newly created embryo could not survive the full force of arterial blood from the mother. Although it has been known for some time that uterine secretions nurture the tiny embryo, the mechanism whereby the nutrients leave maternal cells and are delivered to the placenta has not been understood.

“The discovery of this mechanism represents a leap forward in what we understand about how nutrients get from mother to child in the womb.”

An earlier study of Dutch women who were in the first three months of pregnancy at the time of a famine at the end of World War Two showed that their children were more susceptible to diabetes, obesity, cardiovascular disease and other health problems than those who had enjoyed the good diet to which the people of Holland usually have access.

The new study explains some of how this crucial stage of development operates, suggesting not just that a healthy diet during the first 11 weeks of pregnancy is essential, but that as nutrients are stored in the gland cells before pregnancy, it is also important to get this right before conception.

Professor Aplin added: “Not much research has been carried out on the very early stages of pregnancy and we’re only just beginning to understand the process of nutrient supply, so we’re not in a position to talk about specific diets which will have an impact beyond the advice given to women in general.

“However, as the study shows, the mechanism for nutrient delivery is quite different at this stage of development and making sure that a good supply of energy is in the gland cells is an important part of ensuring a healthy embryo.”

The paper, ‘’, was published in the journal, Placenta.

Notes for editors

Media enquiries to:
Jamie Brown
Media Relations Officer
The University of Manchester
Tel: 0161 2758383
Email: jamie.brown@manchester.ac.uk

Have a say in the national direction of womb cancer research

Mon, 23 Mar 2015 11:49:00 +0000

A national group of researchers, medical bodies and charities, led by The University of Manchester is looking for help in setting the top priorities for fighting womb cancer, with a survey launched today (23 March 2015).

, a consortium of 12 leading organisations, is surveying women at risk, patients, family members and healthcare workers to find the best ways to direct research funds into the fourth most common cancer affecting British women.

Womb (or uterine) cancer is rising in incidence and more women than ever before are now dying from the disease, despite improvements in overall survival. The reasons behind this are not fully understood, but may include:

An ageing population
Fewer hysterectomies
Breast cancer survivors treated with tamoxifen
The obesity epidemic

Women are at increased risk if they experience abnormal vaginal bleeding, that is, bleeding after the menopause or between periods. Women with these symptoms should see their GP without delay.

from The University of Manchester’s is one of the members of the Alliance. She said: “Womb cancer is a growing research priority and understanding the causes is just one part of what we need to address.

“We want the views of the people most affected by this disease to help us find the right way forward in preventing, treating and curing this cancer.”

The survey will address these questions by using the responses to create a top ten list of priorities. This will enable funds to be found to provide answers and solutions.

Daloni Carlisle, aged 51, was diagnosed with womb cancer in February 2014. She is a mother of two and is now recovering after surgery, chemotherapy and radiotherapy. She said: "When I was diagnosed with womb cancer a year ago, I had never heard of it. I know I'm not alone. I'm in contact with a wide group of women affected by womb cancer through social media and we all say the same.

"It's not just that we hadn't heard of it. We didn't know the tell-tale signs, we didn't know the risk factors and we certainly weren't aware of just how common it is. Not a single woman I know is involved in a clinical trial.

"This initiative from the Womb Cancer Alliance to set out the research priorities is a great first step to addressing a huge knowledge gap."

Dr Emma Crosbie added: “The more responses we get to this survey, the stronger our mandate will be to secure funds for research. This could make a real difference in saving lives for a few minutes of someone’s time.”

The survey is open until 31 May 2015 and can be completed online .

The Womb Cancer Alliance is a group of healthcare professionals, patients and charity representatives who are interested in promoting womb cancer research.

It is led by The University of Manchester and includes: , , , , , , , , , and .

Cancer is one of - examples of pioneering discoveries, interdisciplinary collaboration and cross-sector partnerships that are tackling some of the biggest questions facing the planet.

Notes for editors

The survey is open until 31 May 2015 and can be completed online .

Media enquiries to:
Jamie Brown
Media Relations Officer
The University of Manchester
Tel: 0161 2758383
Email: jamie.brown@manchester.ac.uk

University welcomes integration of health and social care in Greater 91ֱ��

Fri, 27 Feb 2015 10:08:00 +0000

The University of Manchester has welcomed the news of proposals for the integration of health and social care services in Greater 91ֱ��, providing more opportunities for the benefit of local people.

President and Vice-Chancellor, said: “A distinctive feature of Greater 91ֱ��’s way of working is the close co-operation between local authorities, universities and healthcare providers.

“For a long time people, including many of the leading researchers at the University, have been calling for health systems in the UK to be more joined up – ensuring that the care given is more effective and an efficient use of resources. This proposal appears to open up this possibility for our region.

“While there is much yet to be done, this presents new opportunities for us to work with our partners to improve health for the people of Greater 91ֱ��, identify new avenues of research and provide new opportunities for our students and graduates.”

Greater 91ֱ�� has some of the poorest health outcomes in England with low life expectancy, and high rates of obesity, heart disease and cancer. The University is active in addressing all of these issues, with researchers developing new treatments, influencing policy and practise and conducting public awareness campaigns.

As part of this, the University is a member of the – alongside six NHS organisations – which aims to effectively link researchers across the city-region with patients and healthcare providers to deliver the latest research effectively.

The University also works with leading charitable funders of research, such as Cancer Research UK, to deliver cutting-edge research into issues like , which are major global health priorities.

Dame Nancy believes that the devolution proposals for Greater 91ֱ�� could allow this integrated process to flourish further. She said: “Clearly there is a lot more work to be done on how this new system would look and how it will operate in practise, but if all of the organisations involved continue to work together as closely as they do now, then Greater 91ֱ�� has the opportunity to be one of the country’s best providers of joined-up care.”

Notes for editors

Media enquiries to:
Jamie Brown
Media Relations Officer
The University of Manchester
Tel: 0161 2758383
Email: jamie.brown@manchester.ac.uk

Hitachi, Salford Royal FT, Salford CCG, and NWEH partnership to target diabetes

Fri, 05 Dec 2014 10:56:00 +0000

Treating type 2 diabetes costs the NHS £8.8bn each year and despite being largely preventable its prevalence continues to increase. In Salford, one in ten men over the age of 60 has diabetes. A major driver for the development of diabetes is obesity, which markedly increases the risk of developing the disease.

In partnership with , , and (CCG), is set to deliver a game-changing telecare service across the Salford area that will target people at the pre-diabetes stage, when they present with impaired glucose regulation (IGR).

NorthWest EHealth is itself a partnership made up of the University of Manchester, Salford Royal FT, and Salford CCG.

Following on from a proof of concept trial, the study will allow both diabetes specialist nurses and patients to view their progress implementing small lifestyle modifications. Changing people’s attitudes and habits around portion size, exercise and alcohol consumption can add up to make a huge difference to lowering their risk – advises that every kilogram of weight lost can reduce risk by up to 15%.

Using Salford’s integrated electronic records system, and this new online interface, people at greatest risk of developing type 2 diabetes can be identified and supported to work towards healthy lifestyle goals.

As well as reducing the risk of developing diabetes, the project has the potential to improve patient health overall, and limit their risk of developing other chronic illness like heart disease and cancer. It could also provide a model which can be used to remotely treat a broad range of different disease across the UK.

Notes for editors

For media enquiries:

Jamie Brown
Media Relations Officer
The University of Manchester
Tel: 0161 2758383
Email: jamie.brown@manchester.ac.uk

Body clock link could aid obesity treatments

Thu, 04 Sep 2014 01:00:00 +0100

Scientists at The University of Manchester have discovered that the body clock plays an important role in body fat. Their findings are helping develop new ways of treating obesity and the fatal diseases linked to being overweight.

The researchers, led by Professor David Ray, not only looked at the role of the clock in fat tissue in mice, but also collected samples from patients undergoing weight loss surgery. Fat and blood samples taken both before and after surgery allowed the researchers to compare their biochemistry. The results are published in the journal Diabetes today (Thursday 4 September).

Professor Ray explains what they found: “Essentially we discovered that the circadian clock, protein REVERB plays an important role in the safe accumulation of body fat. Usually as fat accumulates there is inflammation in the body which leads to diabetes and heart disease. Our research shows that this process is linked to the body clock.”

The team found that REVERB affects obesity-related inflammation by regulating both a hormone that comes from fat, adiponectin, and a master regulator of inflammation A20. Mice lacking REVERB had enhanced fat storage but without the expected inflammation. They also registered higher levels of the hormone adiponectin, suggesting the hormone has an anti-inflammatory role.

Dr David Bechtold was one of the key researchers and says: “Our work demonstrates that it could be possible to switch unhealthy fat to a healthier form by tapping into one of the elements which we discovered. We hope that would mean fewer obese people go on to develop more severe metabolic complications such as type 2 diabetes and heart disease.”

As part of the study the researchers took fat and blood samples from morbidly obese patients both before and after weight loss surgery. After the surgery these people had both an increase in the hormone adiponectin in the circulation, but also the inflammation regulator A20 in fat itself. At the same time body fat was healthier, with less of the inflammation linked to diabetes and heart disease.

Professor Ray explains their findings: “Our analysis showed that in morbidly obese people who have undergone weight loss surgery the same pathway from the body clock to inflamed fat is activated. This helps explain why surgery results in rapid health improvements for obese people.”

He continues: “We believe our research could open up a novel way to treat obesity without surgery. There is the potential for drug development that could stop so many people dying of obesity related diseases.”

A clinical research study is now taking place at The University of Manchester, and Central 91ֱ�� University Hospitals NHS Foundation Trust led by Dr Martin Rutter to take this research further. The clinical research study is taking place at the National Institute for Health Research (NIHR)/Wellcome Trust 91ֱ�� Clinical Research Facility and The 91ֱ�� Diabetes Centre, the first centre to be established in the UK to provide specialist care and education for diabetes patients in the North West.

It is using “clock logic” to treat diabetes. Patients eat, sleep and take medication at times that fit with their body clock in a bid to control the disease. It’s hoped the study will demonstrate that strengthening our internal body clock by changing behaviour can be used to treat a condition in a similar way to drugs and surgery.

Notes for editors

The paper will be published in the journal Diabetes on Thursday 4 September 2014. Doi: 10.2337/db13-1835/-/DC1

For interview requests please contact:

Morwenna Grills Mob: 07920 087466 / Alison Barbuti Mob. 07887 561 318

Media Relations Office | The University of Manchester

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The University of Manchester

The University of Manchester, a member of the prestigious Russell Group of British universities, is the largest and most popular university in the UK. It has 20 academic schools and hundreds of specialist research groups undertaking pioneering multi-disciplinary teaching and research of worldwide significance. According to the results of the 2008 Research Assessment Exercise, The University of Manchester is one of the country’s major research institutions, rated third in the UK in terms of ‘research power’, and has had no fewer than 25 Nobel laureates either work or study there. The University had an annual income of £807 million in 2011/12.

Central 91ֱ�� University Hospitals NHS Foundation Trust (CMFT) is a leading provider of specialist healthcare services in 91ֱ��, treating more than a million patients every year. Its eight specialist hospitals (91ֱ�� Royal Infirmary, Saint Mary’s Hospital, Royal 91ֱ�� Children’s Hospital, 91ֱ�� Royal Eye Hospital, University Dental Hospital of Manchester and Trafford Hospitals) are home to hundreds of world class clinicians and academic staff committed to finding patients the best care and treatments.

The NIHR/Wellcome Trust 91ֱ�� Clinical Research Facility (MCRF) is a purpose-built unit focused on supporting experimental medicine research helping to bring new drugs and medical devices into patient care. The facility is based at Central 91ֱ�� University Hospitals NHS Foundation Trust and receives funding from the National Institute for Health Research (NIHR). The MCRF offers state-of-the-art equipment and facilities for adult and children's studies, and has a team of specialist research nurses and support staff. A satellite unit the Children’s CRF in the Royal 91ֱ�� Children’s Hospital is at the cutting edge of research into inherited renal, metabolic, and hearing disorders. For further information see: www.wtcrf.nhs.uk and www.childrenscrf.org

is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.

Current way of diagnosing type-2 diabetes needs to be revised, study shows.

Thu, 04 Sep 2014 01:00:00 +0100

The current way of diagnosing type-2 diabetes using blood glucose levels needs to be urgently revised, research by scientists from The University of Manchester and King’s College London suggests.

The findings, published in the journal PLOS ONE today (3 September), show the current method of diagnosis - using blood glucose levels - means patients are diagnosed too late so that their blood vessels may already be damaged.

Type 2 diabetes, which affects over 90% of all adults with diabetes, often leads to heart damage and blood vessel problems in the brain, eyes and kidneys. It is closely linked to increasing levels of obesity, lack of exercise, unhealthy diets and our aging population.

The study focused on young, previously pregnant women followed up in Greater 91ֱ�� after being identified as at increased, intermediate and low risk of developing type-2 diabetes. Researchers examined biochemical markers in the blood before glucose became elevated – so before the patients reached the pre-diabetes stage.

Their findings show that changes in types of blood fat metabolites - naturally occurring particles that come from and make up fats in the blood - appear to be good indicators of developing type-2 diabetes. The changes in these particles were detectable well before changes in blood glucose that now define type-2 diabetes or pre-diabetes.

Professor Kennedy Cruickshank, lead author of the study and Professor of Cardiovascular Medicine and Diabetes, in the Division of Diabetes and Nutritional Sciences at King’s College London, formerly at The University of Manchester, said his team’s findings could be important for future diagnosis and, in turn, treatments.

Professor Cruickshank said: “We found that several groups of fat metabolites, also linked to body fat, were changed in the blood, as were others including some amino acids and to some extent vitamin D, before glucose levels increased.

“Blood vessels become damaged as part of the condition, but problems in the vessels arise before high blood sugar sets in during a ‘pre-diabetes’ period.

“The current method of categorising type-2 diabetes solely by a patient’s glucose level means that many will already have suffered blood vessel damage and will experience poorer outcomes.

“Our study overall adds weight to the argument that type-2 diabetes should not be classified as ‘diabetes’ as we currently understand it from just measuring blood glucose.”

The authors argue that rather than concentrating purely on glucose-directed treatments, which do not improve blood vessel health, a new, quite different definition of type-2 diabetes is required, partly based on the distribution of fat metabolites in the blood in the pre-diabetes stage.

Dr Simon Anderson, co-author of the study and National Institute for Health Research Clinical Lecturer in Cardiology from The University of Manchester, said: “This long-term study of women in Greater 91ֱ�� adds to growing evidence about the major role that fats and fat metabolites play in the health of blood vessels, and in diabetes per se.

“To help clarify the metabolic conditions that lead to the development of type-2 diabetes, further assessment of the total chemicals in the blood – the metabolome - is necessary.

“In the long-term we aim to identify a biomarker or a disorder in a chemical pathway that is linked to blood vessel health and subsequent diabetes.

“Ultimately this might translate into a specific blood test to identify people at risk of type-2 diabetes early on but most importantly, it may allow advice on lifestyle modification at an earlier stage to reduce the long-term impact of diabetes.”

The team say more work is now needed to validate this alternative approach to diagnosing, treating and preventing diabetes.

Work is now ongoing at King’s to establish earlier treatments for blood vessels and the heart in people at risk of diabetes, while researchers in 91ֱ�� are looking at the risk of developing diabetes for children born from mothers with gestational diabetes and varying degrees of fatness.

Notes for editors

Link to PLOS ONE article: http://dx.plos.org/10.1371/journal.pone.0103217

For further information or to request the paper, please contact the Media Relations Office.

Interviews with Professor Kennedy Cruickshank:

The Press Office | King’s College London │Tel: +44 020 7848 3202 and pr@kcl.ac.uk

Interviews with Dr Simon Anderson

Alison Barbuti | Media Relations Officer | Faculty of Medical and Human Sciences |

The University of Manchester Tel: +44 (0)161 275 8383 / Mob. +44 (0)7887 561 318 alison.barbuti@manchester.ac.uk

Scientists discover clues why weight-loss surgery cures diabetes

Thu, 10 Jul 2014 01:00:00 +0100

Scientists at The University of Manchester are a step closer to understanding why diabetes is cured in the majority of patients that undergo gastric bypass surgery.

The research, published in the journal Endocrinology, shows the cure is likely to be explained by the actions of specialised cells in the intestine that secrete a cocktail of powerful hormones when we eat.

During the research, the team showed that gut hormone cells previously thought to contain just one hormone, had up to six hormones including the hunger hormone ghrelin.

91ֱ�� team leader, Dr Craig Smith, a Senior Lecturer in Molecular Cell Physiology, said: “Our research centred on enteroendocrine cells that ‘taste’ what we eat and in response release a cocktail of hormones that communicate with the pancreas, to control insulin release to the brain, to convey the sense of being full and to optimize and maximize digestion and absorption of nutrients.”

“Under normal circumstances these are all important factors in keeping us healthy and nourished. But these cells may malfunction and result in under or over eating.”

75% of people suffering from obesity who also have diabetes are cured of diabetes after receiving a gastric bypass and Dr Smith says that understanding how bypass surgery cures diabetes is the crux of his team’s research.

Dr Smith: “This is where things start to get really interesting because the most common type of gastric bypass actually also bypasses a proportion of the gut hormone cells. It is thought that this causes the gut hormone cells to change and be reprogrammed. For us, understanding how these cells change in response to surgery is likely to hold the key to a cure for diabetes.”

In the UK, approximately 2.9 million people are affected by diabetes and the most common form of the disease is Type 2 diabetes which is linked to genes, ethnicity, obesity and diet.

“Understanding the messages the gut sends out when we eat food and when things go wrong, as is the case in diabetes, is our next challenge and hopefully one that will result in the development of drugs which could be used instead of surgery to cure obesity and prevent diabetes,” said Dr Smith.

The research team also comprised John Mclaughlin who is Professor of Gastroenterology and Nutrition at The University of Manchester as well as Professor Robert Fenton’s team based at the University of Aarhaus in Denmark.

Notes for editors

High resolution images are available on request.

Dr Craig Smith from The University of Manchester is available for interview.

The paper ‘I cells contain multiple key gut hormones’ by Alexandros G. Sykaras, Claire Demenis, Lei Cheng, Trairak Pisitkun, John T Mclaughlin, Robert A. Fenton and Craig P. Smith is available upon request

For media enquiries contact Kath Paddison, University of Manchester Press Office +44(0)161 275 2111 or kath.paddison@manchester.ac.uk

Two major arthritis research centres launched in 91ֱ��

Wed, 14 May 2014 01:00:00 +0100

Two major new research centres at The University of Manchester aimed at improving the lives of people with arthritis are to be officially launched on May 19.

Leading medical research charity Arthritis Research UK is investing almost £5m over the next five years into the centres of genetics and genomics, and epidemiology.

The event will also be a celebration 60 years of epidemiological research at the university – funded largely by the charity – which has made a huge contribution to finding the causes of inflammatory arthritis and the factors that increase the risk of developing it.

The Arthritis Research UK Centre for Genetics and Genomics aims to capitalise on the exciting expanding knowledge in genetics and apply that to patients with inflammatory arthritis, including rheumatoid arthritis, by increasing the understanding of genetic factors that determine the risks of developing the disease, and identifying better target treatments based on genetic profiles.

The Arthritis Research UK Centre for Epidemiology will investigate non-genetic factors which influence the onset and progress of inflammatory arthritis, such as rheumatoid arthritis and osteoarthritis. The combined work of the two centres will lead to better strategies for preventing these diseases and reducing their severity. A specific focus will be to identify which treatment should be given to which patient. Both centres will be based within the Faculty of Medical and Human Sciences’ Institute for Inflammation and Repair at the university’s Stopford Building on Oxford Road.

Osteoarthritis affects more than eight million people in the UK, and occurs when cartilage at the ends of bones wears away leaving leading to stiff, painful joints. Rheumatoid arthritis is a chronic, inflammatory condition in which the body’s immune system attacks the joints, causing swelling, pain and disability in around 380,000 people in the UK.

Researchers based at the new centres have already made a number of important findings that have had a big impact on arthritis treatment including:

• establishing that smoking, obesity, eating lots of red meat and insufficient quantities of fresh fruit and vegetables are risk factors for inflammatory arthritis ;

• helping to establish that biological therapies used to treat inflammatory arthritis can reduce heat attacks by lowering inflammation in the body;

• tracking down large numbers of genes that predispose people to developing inflammatory arthritis, including arthritis in children

• discovering that depression is much more common in people with rheumatoid arthritis than previously reported.

Professor Jane Worthington, director of the centre for genetics and genomics, said: “We’ve already discovered a considerable amount about the genetic risk factors for inflammatory arthritis, and we now want to combine this knowledge with information on non-genetic risk factors in order to develop methods to predict who will get arthritis, when, and how severely, and to make it easier to choose the right treatment first time.

Professor Deborah Symmons, director of the centre for epidemiology added: “These two new centre awards will enable us to continue to find better, more targeted therapies, highlight possible side-effects, with a view to improving the lives of the millions of people suffering from these painful conditions.”

Medical director of Arthritis Research UK Professor Alan Silman said: “Within these two centres there are some fantastically talented people engaged in very exciting, cutting-edge research that will make a real practical difference to arthritis patients. The more we know about the specific risk factors for groups and individuals, the more we can tailor treatments to meet their particular needs. We’re very happy to be supporting this research in 91ֱ��.”

Arthritis Research UK is the leading authority on arthritis in the UK, conducting scientific and medical research into all types of arthritis and related musculoskeletal conditions. It relies on the generosity of the pubic to fund its research programme and other charitable activities."

ENDS

Notes for editors

For more details or to speak to Professor Jane Worthington, please contact Jane Tadman in the Arthritis Research UK press office on 01246 541107 or j.tadman@arthritisresearchuk.org or Alison Barbuti in The University of Manchester press office on 0161 275 8383 or alison.barbuti@manchester.ac.uk

North West’s first Florence Nightingale Foundation Chair appointed

Wed, 09 Apr 2014 01:00:00 +0100

Patients in 91ֱ�� are to benefit from a new Florence Nightingale Foundation Chair in Clinical Nursing Practice Research to follow the celebrated social reformer’s role reviewing and developing evidence to deliver the highest quality care to patients.

The appointment made by the Florence Nightingale Foundation in partnership with The University of Manchester and Central 91ֱ�� University Hospitals NHS Foundation Trust will see Professor Angela Tod become the first Florence Nightingale Foundation Chair in Clinical Nursing Practice Research in the North West.

The chair is one of several prestigious appointments across the UK and follows appointments in Cardiff, Cambridge and London.
Professor Tod, currently Professor in Health Services Research at Sheffield Hallam University, has many years’ experience of clinical nursing practice and practice development. She has specialised in research to capture patient experience and evaluate the accessibility and effectiveness of health services in clinical areas including cardiology and obesity. Her research has looked at how people experience diagnosis, treatment and recovery from conditions such as a heart attack and lung cancer, including health inequalities and developing and evaluating health care services.

Other recent research topics include health inequalities, fuel poverty and how cold weather and cold homes impact on health. Additional evaluations are of a smoke free homes initiative, nutrition for oncology patients and the nurse's role and experience of breaking bad news.

Professor Karen Luker, Head of the School of Nursing, Midwifery and Social Work at The University of Manchester, said: “The Florence Nightingale Chair appointment recognises the important role nurses continue to play in developing new evidence-based techniques through research to improve the care of patients. We are delighted to have Professor Tod on board and her wealth of experience will be a huge benefit helping to translate new treatment approaches directly into hospitals. The role will help to support innovation and improve patient care through excellent academic leadership.”

Gill Heaton, Director of Patient Services/Chief Nurse at Central 91ֱ�� University Hospitals NHS Foundation Trust, said: “We are delighted to have jointly appointed a Chair in Clinical Nursing Practice Research in partnership with The University of Manchester School of Nursing, Midwifery and Social Work. Supported by the Florence Nightingale Foundation, the Chair will work closely with our nursing teams at Central 91ֱ�� University Hospitals NHS Foundation Trust to further enhance the quality of nursing care delivered to our patients through the application and advancement of nursing research.”

Professor Elizabeth Robb, Chief Executive of the Florence Nightingale Foundation, said: “Professor Tod’s appointment reflects our aim to support the creation of chairs in clinical nursing practice research and to work closely with academic bodies and healthcare organisations to develop evidence based practice. This appointment adds to our network of Chairs around the country ensuring that the standards and values laid down by Florence Nightingale continue to resonate in nursing today.”

Professor Tod was principal investigator for a National Institute for Health Research (NIHR) Research for Patient Benefit project to explore factors influencing Keeping Warm in Later Life and is currently developing research on other aspects of fuel poverty, cold weather and health, including households with children with asthma. She is part of a large five year NIHR Programme study on the Design, Development, Commissioning and Evaluation of Patient Focused Vascular Services which she will continue to work on in 91ֱ��.

A widely published author and speaker at national and international forums, Professor Tod is also chair of the National Lung Cancer Forum for Nurses Research Interest Group.

Professor Tod said she was both excited and honoured to take on the role.

Professor Tod said: “It is a huge honour to be appointed to the Florence Nightingale Chair in Clinical Nursing Practice Research. I am tremendously excited to be working in this innovative post supported by three outstanding organisations, the University of Manchester School of Nursing, Midwifery and Social Work, the Florence Nightingale Foundation and Central 91ֱ�� University Hospitals NHS Foundation Trust. Throughout my career I have been committed to conducting research of applied use to patient care, nursing and health care organisations. This post offers a unique opportunity to expand on this research programme in a way that reflects the nursing priorities of patients in 91ֱ�� and the North West.”

Ends

Notes for editors

Professor Tod is available for interview today only.

For further information, please contact: Alison Barbuti | Media Relations Officer

Faculty of Medical and Human Sciences | The University of Manchester

91ֱ�� Academic Health Science Centre (MAHSC)

Tel: +44(0)161 275 8383 | Email: alison.barbuti@manchester.ac.uk

Research shows gastric surgery halves risk of heart attack in obese people

Wed, 02 Apr 2014 01:00:00 +0100

Obese people who have stomach surgery to help them lose weight will halve their risk of heart attack according to new research from a team of doctors at The University of Manchester, University of East Anglia and University of Aberdeen.

The procedures, known as bariatric surgery, involve techniques such as gastric banding, which are available on the National Health Service (NHS), UK for selected patients.

New research published today in the International Journal of Cardiology reviewed data from 14 studies involving more than 29,000 patients who underwent bariatric surgery. It reveals that death rates were reduced by 40 per cent, and that heart attacks in particular were reduced by half – compared to obese people who did not have surgery.

The research is the first comprehensive review of the impact of surgery on heart disease, stroke disease and death.

Senior author Dr Yoon Loke from UEA’s Norwich Medical School said: “Obesity is a worldwide problem with significant consequences on individuals and society. It is associated with heart disease, type 2 diabetes, many cancers, and a shorter life expectancy.

“The latest government figures from 2011 show that obesity affects about one in four people in the UK and this figure is growing. During 2011-12, the NHS reported 11,736 hospital admissions due to obesity, which represents an 11-fold increase compared to the 1019 admissions in 2001-02.

“We looked at the outcomes for patients who undergo bariatric surgery, and compared them to figures for obese people who had not received surgery. We saw that surgery was potentially life-saving and could lower the risk of having a heart attack and stroke by almost 50 per cent.

“These findings suggest that surgery should be seriously considered in obese patients who have a high risk of heart disease. This is the right time for a large, high-quality trial of bariatric surgery in the NHS to confirm the potential benefits.”

Dr Mamas Mamas, Clinical Senior Lecturer and honorary consultant cardiologist in the Institute of Cardiovascular sciences, based at The University of Manchester, who co-led the research added that bariatric surgery represents an important opportunity to reduce the cardiovascular disease burden in morbidly obese individuals who are at very high risk of future cardiovascular events. "The current analysis suggests that weight loss through bariatric surgery can halve the risk of mortality, myocardial infarction and stroke in such a high risk population representing an important breakthrough in the treatment of obese patients. Future research should focus on mechanisms through which weight loss mediated by bariatric surgery can produce these benefits."

Professor Bernard Keavney British Heart Foundation (BHF) Professor of Cardiovascular Medicine and Director of the Institute of Cardiovascular Sciences at The University of Manchester, Dr Simon Anderson, National Institute for Health Research (NIHR) Academic Clinical Lecturer in Cardiology and Dr Chun Shing Kwok, honorary research fellow, both based at The University of Manchester’s Institute of Cardiovascular Sciences, also worked on the research.

The mean age of participants was 48 years old, and 30 per cent of participants were male. The original studies were carried out the North America, Europe and Australia, and patients were followed-up from two years to 14 years, including Greater 91ֱ��?

‘Bariatric surgery and its impact on cardiovascular disease and mortality: A systematic review and meta-analysis’ was published in the on March 28.

ENDS

Notes for editors

To interview Dr Mamas Mamas from The University of Manchester and for more information about the University of Manchester involvement, please contact Alison Barbuti, 0161 275 8383 or email alison.barbuti@manchester.ac.uk

Image courtesy of Michelle Meiklejohn FreeDigitalPhoto.net

Research produces strong evidence for new class of antidepressant drugs

Wed, 26 Mar 2014 00:00:00 +0000

Scientists have shown for the first time that a chemical in the brain called galanin is involved in the risk of developing depression.

And the research, undertaken by a European research team, points to a strong reason to develop drugs that modify galanin functioning as a new class of antidepressant drug.

Galanin is a neuropeptide (a small protein) that was discovered and investigated over 30 years ago by various groups including the Swedish scientist Tomas Hokfelt. He is one of the senior authors of the paper published in the journal PNAS.

Professor Hokfelt and others made the fundamental discovery that neurones can release peptides alongside their classical transmitters and that galanin and noradrenaline are one such pair. Both have long been implicated in pain and stress and therefore depression but in the past it had been difficult to study peptides in humans.

The new research by scientists from Sweden, Hungary and the UK demonstrates that galanin is an important stress mechanism in the human brain that influences how sensitive or resilient people are to psychosocial stress.

Lead author Gabriella Juhasz, who is a Research Fellow at the University of Manchester and the Semmelweis University in Budapest, said: “Our research shows that some versions of the gene coding for galanin protect against the risk of depression and anxiety but only in people who have experienced early life neglect or trauma, or recent adverse events.

“Furthermore, the three genes for the three receptors through which galanin acts also influence the risk of depression in people experiencing early or recent life adversity. Crucially, all the galanin related genes are widely separated on different chromosomes and the odds are stacked against four random genes acting in the same way by chance.”

Results from the research indicate that although the results are statistically reliable, galanin effects modify the substantial effects of stress by only a few percent. Indeed the moderate overall genetic influence (about 35%) on depression is likely to be mediated by many small genetic effects interacting with each other and with psychosocial factors converging on stress mechanism in brain.

Co-author Professor Bill Deakin, from the University of Manchester, said: “The findings provide a strong reason to develop drugs that modify galanin functioning as a new class of antidepressant drug. And new drugs are badly needed as almost all commonly prescribed antidepressants act on serotonin and they are often not very effective.

“Our research confirms what previous reports have shown about the variation in the serotonin ‘transporter’ gene and how it influences the risk of depression. We found that the galanin effects are substantially greater than the effects of serotonin.”

The research team also say there is increasing evidence suggesting that depression, obesity, diabetes and Alzheimer’s disease may be varying manifestations of shared underlying abnormalities of body metabolism.

“Galanin may be part of this general vulnerability since it has a significant role in appetite and obesity,” added Professor Deakin.

Ends

Notes for editors

The paper, ‘Brain galanin system genes interact with life stresses in depression-related phenotypes,’ by Gabriella Juhasz, Gabor Hullam, Nora Eszlari, Xenia Gonda, Peter Antal, Ian Anderson, Tomas Hökfelt, Bill Deakin and Gyorgy Bagdy is published in PNAS and available to view as a PDF .

Background:

Depressive illness is often triggered by life stresses and adverse events in early childhood such as neglect and abuse make people more vulnerable to later depression. Depressive illness also runs in families and variation in genes (DNA) accounts for about a third of the risk of developing Depressive illness.

Despite the application of advanced DNA mapping techniques spanning the whole genome to large numbers of people with and without depression, no definite evidence has been found for any genes whose variation is associated with depression. This is because such studies are too big to record psychosocial stress on every individual and so genetic factors that work through modifying response to stress cannot be detected.

This study used a novel Bayesian network-based analysis to calculate the relevance of gene – stress interactions in depression. Bayes was an English vicar who proposed his famous theorem in the early 18^th century. It was neglected for a century or more and its elaborations are still expanding into to many aspects of understanding risk. The Bayesian approach offers an efficient new way to identify genetic effects in disorders with a strong environmental component.

The study was carried out in two populations, in 91ֱ�� and in Budapest, each with more than a thousand people. They provided blood for DNA and information about their psychosocial experiences and psychiatric symptoms. We confirmed the reliability of self-reported experiences and symptoms by interviewing a subset of 260 participants. The fact that the galanin system findings were the same in both countries and the same in men and women confirms their reliability.

For further information contact:

Kath Paddison
Media Relations Officer
The University of Manchester

Tel: 0161 275 2111
Email: kath.paddison@manchester.ac.uk

Scientists find mechanism to reset body clock

Fri, 21 Mar 2014 00:00:00 +0000

Researchers from The University of Manchester have discovered a new mechanism that governs how body clocks react to changes in the environment.

And the discovery, which is being published in Current Biology, could provide a solution for alleviating the detrimental effects of chronic shift work and jet-lag.

The team’s findings reveal that the enzyme casein kinase 1epsilon (CK1epsilon) controls how easily the body’s clockwork can be adjusted or reset by environmental cues such as light and temperature.

Internal biological timers (circadian clocks) are found in almost every species on the planet. In mammals including humans, circadian clocks are found in most cells and tissues of the body, and orchestrate daily rhythms in our physiology, including our sleep/wake patterns and metabolism.

Dr David Bechtold, who led The University of Manchester’s research team, said: “At the heart of these clocks are a complex set of molecules whose interaction provides robust and precise 24 hour timing. Importantly, our clocks are kept in synchrony with the environment by being responsive to light and dark information.”

This work, funded by the Biotechnology and Biological Sciences Research Council, was undertaken by a team from The University of Manchester in collaboration with scientists from Pfizer led by Dr Travis Wager.

The research identifies a new mechanism through which our clocks respond to these light inputs. During the study, mice lacking CK1epsilon, a component of the clock, were able to shift to a new light-dark environment (much like the experience in shift work or long-haul air travel) much faster than normal.

The research team went on to show that drugs that inhibit CK1epsilon were able to speed up shift responses of normal mice, and critically, that faster adaption to the new environment minimised metabolic disturbances caused by the time shift.

Dr Bechtold said: “We already know that modern society poses many challenges to our health and wellbeing - things that are viewed as commonplace, such as shift-work, sleep deprivation, and jet lag disrupt our body’s clocks. It is now becoming clear that clock disruption is increasing the incidence and severity of diseases including obesity and diabetes.

“We are not genetically pre-disposed to quickly adapt to shift-work or long-haul flights, and as so our bodies’ clocks are built to resist such rapid changes. Unfortunately, we must deal with these issues today, and there is very clear evidence that disruption of our body clocks has real and negative consequences for our health.”

He continues: “As this work progresses in clinical terms, we may be able to enhance the clock’s ability to deal with shift work, and importantly understand how maladaptation of the clock contributes to diseases such as diabetes and chronic inflammation.”

Notes for editors

The paper, ‘A novel mechanism controlling re-setting speed of the circadian clock to environmental stimuli' by Violetta Pilorz, Peter Cunningham, Anthony Jackson, Alexander West, Travis T Walton, Andrew A.S.I. Loudon and David A Bechtold is available on request.

Kath Paddison
Media Relations Officer
Faculty of Life Sciences
The University of Manchester

Tel. +44 (0)161 275 2111
Email: kath.paddison@manchester.ac.uk

About Biological Sciences Research Council

The Biotechnology and Biological Sciences Research Council (BBSRC) invests in world-class bioscience research and training on behalf of the UK public. Our aim is to further scientific knowledge, to promote economic growth, wealth and job creation and to improve quality of life in the UK and beyond.

Funded by Government, and with an annual budget of around £467M (2012-2013), we support research and training in universities and strategically funded institutes. BBSRC research and the people we fund are helping society to meet major challenges, including food security, green energy and healthier, longer lives. Our investments underpin important UK economic sectors, such as farming, food, industrial biotechnology and pharmaceuticals.

For more information about BBSRC, our science and our impact see:

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Health leaders set to brainstorm best practice in 91ֱ��

Wed, 26 Feb 2014 00:00:00 +0000

Health experts from around the world will be descending on 91ֱ�� next month to discuss ways to improve the health of people who live in cities.

The city has been chosen to host The 11th International Conference on Urban Health following in the footsteps of Toronto, New York, Amsterdam, Nairobi and Vancouver which provides a platform for policymakers and researchers to brainstorm best-practice.

The proportion of people living in cities is projected to increase to 70 per cent by 2050 and the conference aims to help decision makers and medics respond to the large-scale health challenges affecting countries and communities worldwide. The theme for the conference is “Crossing boundaries: partnerships for global urban health” where health experts have invited professionals and citizens from across the globe to discuss how working together improves the wellbeing of urban residents.

Keynote speakers at the conference organised by The University of Manchester and 91ֱ�� Academic Health Science Centre (MAHSC) include United States Assistant Secretary for Health Dr Howard Koh.

Professor Sir Michael Marmot, Director of UCL Institute of Health Equity, will be discussing inequities and Professor Martin McKee CBE, Chair of the International Scientific Committee, will ask why are we remaining silent when there are “wicked” problems that need solving in urban public health. Professor John Watson, Deputy Chief Medical Officer for England, will discuss the problems we are now facing when drugs fighting TB do not work anymore.

Keynote speakers from the World Health Organisation include Dr Marie-Paul Kierny speaking on health services for all and Mr Alex Ross will reflect on the past for lessons cities need to learn for future progress.

Other topics on the agenda at the three-day event include: policymaking and political leadership; humanitarian conflict and response, mental health, climate change, urban planning and architecture, stress in the city, healthy cities – including reducing use of cars and promoting active travelling such as cycling and walking, lifestyle and wellbeing - cancer, obesity and diabetes; stratified medicine (identifying and developing treatments that are effective for particular groups of patients), drugs; and engaging with the public about how to look after your health.

The conference runs from March 4-7 at 91ֱ�� Central Convention Centre and comes hot on the heels of the city hosting the NHS Health and Care Innovation Expo 2014, the first time the event has ever been held outside London. The NHS Expo will culminate with a dinner hosted by University of Manchester Vice-President and MAHSC Director Professor Ian Jacobs at 91ֱ�� Museum’s Living Worlds Gallery expected to be attended by UK Government health ministers.

Professor Jacobs said: “These two high-profile events show that 91ֱ�� is helping to lead the way in shaping health policy and improving treatments for patients. The conference will bring people together from across the world to consider the challenges that we face in urban health and in many other aspects of health and to come up with new ideas and work collaboratively. I hope that the many ideas that we have developed and applied here in 91ֱ�� will be relevant to the influential experts who attend the conference and that we will learn a lot from what is being done in other parts of the world too.

“I am delighted that Dr Koh will be attending the meeting and adding such high level US government and healthcare involvement. This reflects the outstanding quality of the programme and the importance of the range of topics in public and urban health which will be addressed. The conference fits perfectly with the objective of MAHSC (91ֱ�� Academic Health Science Centre) to have a major impact on health science, education and care both regionally and internationally.”

Dr Koh said he was looking forward to attending the conference and sharing solutions with his counterparts in 91ֱ��. "Health starts in the community where people live, labour, learn, pray, and play,” said Dr Koh. “By adopting a health in all policies approach, we can ensure residents will be able to achieve their full potential for health.”

Sir Howard Bernstein, Chief Executive of Manchester City Council and Chair of MAHSC, said 91ֱ�� offered the perfect platform for the high-profile global conference with both a rich public health history - 91ֱ�� was the birthplace of public health pioneer, Edwin Chadwick in 1800 - and a bright, exciting and vibrant future in terms of the innovation and opportunities for the city's residents, businesses, employers and visitors.

Sir Howard, who will officially open the conference with Professor Jacobs and conference-founder David Vlahov, said: “It is a great pleasure for the city to host this conference. I think it is particularly important that we do debate public health at conferences like this. We face some big challenges throughout the world, more and more people wanting to live in cities and what all of that represents in terms of challenges around sustainability and how we all respond to being a low carbon economy and more particularly what all of that means to health generally and public health in particular.”

Conference organiser Dr Arpana Verma, from The University of Manchester’s Institute of Population Health, said: “How we live, work and play in our cities is dependent on us all working together, crossing boundaries. More so now than ever before urban residents, workforce and employers are leading research, policy and interventions. Healthier cities can be achieved where wellbeing, equity and prosperity grows. Effective policies are at the heart of making cities better for citizens. The “public” are so often ignored from public health but ICUH 2014 will showcase the excellent work happening in our cities at international, national and local level.”

For more information about the conference, please visit: https://www.icuh2014.com/

ENDS

Notes for editors

The 11th International Conference on Urban Health takes place at The 91ֱ�� Central Convention Complex, opening hours: 9.00am-5.30pm GMT
Ticket prices start from £350
The event is part funded through the generous support of the Hallsworth conference fund and cities@manchester. ICUH 2014 was co-organized with and supported by the World Health Organization Centre for Health Development (WHO Kobe Centre). It is sponsored by The University of Manchester, 91ֱ�� Academic Health Science Centre (MAHSC), Public Health England, European Public Health England and Visit 91ֱ��.

History of ICUH

ICUH was founded in 2002 and is sponsored by The International Society for Urban Health (ISUH). The first ever ICUH was held in Toronto, Canada and was held annually in various cities around the world for 9 years, since 2011, however the event has taken place every other year. ISUH's aim is to hold the conference in a different global city every other year in order to broaden the reach of the society and the impact of its efforts.

The conference was started by David Vlahov, the founder of the International Society of Urban Health.

ICUH provides the ideal forum for knowledge exchange for urban health stakeholders attracting multidisciplinary scientists, practitioners, development partners and various national and regional senior policymakers from around the world. With the ultimate goal to mobilise and energise like-minded professionals, ICUH will address the effects of urbanisation and urban environments on the health of urban populations.

MAHSC (the 91ֱ�� Academic Health Science Centre) is a partnership between the University of Manchester and six NHS organisations. Our NHS partners are some of the most highly rated NHS Trusts in the country, and The University of Manchester is one of the top three UK research universities (RAE 2008). We are proud to be one of only five centres in the country designated as an AHSC. AHSC designation recognises excellence across research, innovation, education and patient service, and in particular the potential to excel in translational medicine. Through partnership with the GM AHSN, MAHSC acts as a beacon within the local health system, providing clinical leadership and helping health care organisations reap the benefits of research and innovation to drive improvements in care.

The MAHSC partners are:

The University of Manchester
Central 91ֱ�� University Hospitals NHS Foundation Trust
91ֱ�� Mental Health and Social Care Trust
Salford CCG (formerly NHS Salford) as lead representative for GM CCGs
Salford Royal NHS Foundation Trust
The Christie NHS Foundation Trust
University Hospital of South 91ֱ�� NHS Foundation Trust

Alcohol-breakdown molecule may play a role in breast cancer development

Wed, 12 Feb 2014 00:00:00 +0000

New research looking at the biological process involved in breast cancer development has strengthened the argument for a potential link between alcohol consumption and the disease.

Scientists from The University of Manchester – part of the 91ֱ�� Cancer Research Centre – looked at a particular enzyme, a biological molecule that accelerates chemical reactions - known as CYP2E1.

Their findings offer a possible target to improve outcomes for patients in the later stages of the disease.

Dr Costas Demonacos, based at The University’s 91ֱ�� Pharmacy School who led the research, said: “This enzyme, known as CYP2E1, has been implicated in various liver diseases linked to alcohol consumption (Alcoholic Liver Disease (ALD), as well as diabetes, obesity and cancer.

“We wanted to understand why an enzyme known to function mainly in the liver was found to be heavily present in some types of breast cancer tissues. We also wanted to explore what other activities this enzyme might have that control the development of breast cancer.”

The enzyme breaks down various molecules within cells, including alcohol. The by-products of this metabolism include reactive oxygen species (ROS), resulting in something called oxidative stress - in normal physiological conditions this aids cellular functions, whereas when concentrations of ROS are high or oxidative stress becomes chronic, cells can be seriously damaged.

Previous studies have shown that the enzyme is most strongly expressed in early-stage breast tumours rather than more developed tumours and scientists believe that it contributes to the progression of breast cancer. The 91ֱ�� team looked at the role it plays in various cellular functions in breast cancer cells.

The study, published in Breast Cancer Research, found that depending on the stage of the breast cancer, high levels of the enzyme can help cells survive during stress.

They also found that inhibiting the activity of the enzyme in cells with high migratory potential promoted cell migration – a process linked to cancer spreading – known as metastasis.

Dr Demonacos said: “Now that we have a clearer picture of the role played by this enzyme in breast cancer development, scientists could use it as a target in the later stages of the disease, to slow down the spread of cancer as well as to personalise anti-cancer therapy.

“Since CYP2E1 is involved in alcohol metabolism too, our findings should allow new insight on the potential link between chronic alcohol consumption and breast cancer, by showing how alcohol influences the progression of cancer.”

ENDS

Notes for editors

For a copy of the paper or to request an interview, please contact: Alison Barbuti, Media Relations Officer

Faculty of Medical and Human Sciences | The University of Manchester

91ֱ�� Academic Health Science Centre (MAHSC)

Tel: +44(0)161 275 8383

Email: alison.barbuti@manchester.ac.uk

Childhood obesity can only be tackled with broad public health interventions

Tue, 21 Jan 2014 00:00:00 +0000

Public health researchers from The University of Manchester have found single dietary interventions are not effective at increasing fruit and vegetable consumption among overweight children and will not halt the global epidemic in childhood obesity.

The team from , based at the University, say broader public health strategies are needed instead as obesity figures continue to rise.

Obesity has now become a global epidemic affecting children, adolescents and adults alike.
The 91ֱ�� team reviewed of studies looking at dietary interventions to tackle the condition as latest figures now show in the UK 31% of boys and 28% of girls aged 2–15 are classed as either overweight or obese.

Dr Paula Whittaker, Clinical Lecturer in Public Health at The University of Manchester, said: “We conducted a systematic review of literature of interventions to increase fruit and/or vegetable consumption in overweight or obese children. We found narrow interventions focusing on single aspects of behaviour are unlikely to achieve long-term change.”

Michael Bourke, a fourth year medical student at The University of Manchester who worked on the study, said: “We need to take a holistic approach and target behaviour change in multiple aspects of children’s lifestyles and their surroundings, including nutritional education, parental support and physical activity.”

Obese children are at increased risk of becoming obese adults, and therefore they are at risk of numerous other medical conditions in later life related to obesity. They are at risk of having a reduced life expectancy and the longer medical conditions are present, the greater the risk of complications and associated morbidity, resulting in more days away from work and education.

The research findings come ahead of world-leading speakers from across the globe descending on 91ֱ�� for the International Conference in Urban Health for 91ֱ�� Academic Health Sciences Centre in March.

Dr Arpana Verma, Director of MUCH at The University of Manchester, said: “Public health interventions helping global, national and local policy makers to make the right decisions for evidence-based policy is vital. Narrowing inequalities and inequities by helping children get the best start in life with policies that work is our best way of tackling the global epidemic in obesity.
“Our international conference will highlight what works from world-leading speakers across the globe.”

The rising prevalence of overweight and obese children is the result of multiple factors, such as increased consumption of energy dense foods and a decrease in physical activity participation, Dr Verma added. “Changes in eating habits such as increased consumption of sugar sweetened beverages and high-fat foods accompanied by a decreased consumption of fruit and vegetables are associated with an increasing number of overweight children.
“Targeting children, particularly overweight children, with nutritional education is important as it helps children form healthier long-term eating habits.”

ENDS

Notes for editors

To interview Dr Verma, please contact Alison Barbuti | Media Relations Officer | Faculty of Medical and Human Sciences |The University of Manchester | 91ֱ�� Academic Health Sciences Centre (MAHSC) Tel. +44 (0)161 275 8383 | Mobile 07887 561 318 |Email: alison.barbuti@manchester.ac.uk
The study entitled ‘Are dietary interventions effective at increasing fruit and vegetable consumption among overweight children? A systematic review’ has just been published by Journal of Epidemiology and Community Health: http://jech.bmj.com/cgi/content/full/jech-2013-203238
To read fourth year medical student Michael Bourke’s blog on the subject, please click here:

The International Conference on Urban Health for 91ֱ�� Academic Health Sciences Centre runs from 4th to 8th March 2014 (www.icuh2014.com) and will highlight work by world leading speakers across the globe.
For more information about the International Conference in Urban Health, please email: info@icuh2014.com.

Midwifery training includes teaching about women over 40 having a baby

Thu, 09 Jan 2014 00:00:00 +0000

The Royal College of Midwives State of Maternity Services Report 2013, out this week, shows an increase in the number of older and obese mothers and a baby boom in 2012. Dr Tracey Mills, from The University of Manchester’s School of Nursing, has provided the following reaction to the findings.

Dr Mills said: “The numbers of women having babies later in life has increased dramatically in the last 10 to 20 years and the number of women over the age of 40 having a baby has almost trebled.

“The problem is that birth at advanced maternal age is associated with higher rate of still birth and major pregnancy complications such as hypertension.

“What we don’t really know for definite is whether this is due to age itself and the aging reproductive system or whether it is also that as women get older they are more likely to have co-existing medical conditions such as diabetes, obesity or other chronic diseases.

“Older women have more time to develop poor health and are more likely to have co –existing health problems.

“When a woman is having a baby in her 40s there is often a feeling represented in the media or among women that if she is slim, healthy and exercises then she’ll be fine but the studies which have been done suggest that this might not be the case because body system, blood vessels, heart, joints and so on have all still aged.”

Midwifery training has changed to reflect these changes, Dr Mills added. “The demographic of women using maternity services has changed and so when we train midwives we are now making them more aware of the impact of age on pregnancy outcomes both in terms of things to look out for and for the women to look out for themselves.

“Here at The University of Manchester, we’ve increased our emphasis on public health issues such as advanced maternal age and obesity in pregnancy to respond to the changes we are witnessing. When I trained as a midwife 20 years ago you didn’t really have to think about obesity in pregnancy but now it is seen more often. We do sessions about recognising the risk factors and the additional risk factors for women over 35. However when women come to midwives they’ve got over one of the major risks of aging and pregnancy which is infertility just by getting pregnant. I think it is important to make people aware of the risks associated with pregnancy later in life as not managing to get pregnant can result in psychological health issues too.”

The increase in the number of births in the UK needed to be addressed generally in the health system, she added.

“The rise in births places additional pressures on the system when midwives are trying to offer improved services and have more technology around to use. There are lots of demands on the system including the increasing diversity of the ethnic and cultural population which services have to respond to on the frontline. We have an aging midwife population with many coming up for retirement and it is about having enough to replace those who leave.”

Notes for editors

Researchers explore how mothers’ blood sugar levels influence child fat

Fri, 13 Dec 2013 00:00:00 +0000

Researchers from 91ֱ�� have begun a new study to determine whether blood sugar levels during pregnancy, lower than the level used to diagnose gestational diabetes, influences later levels of body fat in children and development of diabetes in mothers after giving birth.

The team from The University of Manchester and Central 91ֱ�� NHS Foundation Trust are trying to trace mothers and children who took part in an earlier research project 12 years ago.

The original study, the Hyperglycemia and Pregnancy Outcomes (HAPO), looked at 2400 mothers from 91ֱ�� who were part of 23,316 mother-child pairs worldwide. They found that a mother’s blood sugar levels, even short of diabetes, were associated with how heavy or fat her baby was.

Avni Vyas, from The University of Manchester’s Institute of Human Development, said: “We know that heavy babies are more likely to become overweight as children. The medical world has known for over a decade that obesity is rising at an alarming rate. However, we are still surprised when we see the above figures headlining in newspapers on a regular basis. Increasing tax on unhealthy foods and now sweet drinks- is not the way forward. The problem stems from people not believing in the increased risk of ill health and early death from obesity and secondly not knowing or not wanting to know if they are at risk.

“We know that mothers with poor health and early signs of diabetes in pregnancy are at increased risk of having adverse outcomes at delivery such as; shoulder dystocia, caesarean sections and babies that are overweight and possibly hyperglycaemic. These children then go on to become unhealthy in later life and the cycle is perpetuated.”

The 91ֱ�� researchers join experts funded by the National Institute of Health in the United States led by Professor Boyd Metzger, who plan to determine whether elevated blood sugar during pregnancy, a less severe condition than gestational diabetes, influences later levels of body fat in children and development of diabetes in mothers after giving birth. The research will also take place in the United States, Toronto, Barbados, Hong Kong, Israel and Belfast.

Known as the HAPO-Follow-up 91ֱ�� (HAPO-FUS), they seek to recruit 800 of the original HAPO mothers and their children from 91ֱ�� for a single visit to the Wellcome Trust Clinical Research Facility. Mothers and their children (now aged 8 to 12 years) will have their height, weight, blood pressure, body fat, blood sugar, insulin, and blood fats measured.

Dr Michael Maresh, Obstetrician at St Mary’s Hospital, 91ֱ��, said: “The original study has helped us to better understand the relationship between blood sugar levels in pregnancy and whether they are related to increased risk for the mother having complications during delivery or her baby having problems. As a result of this important study, medical and public health opinion regarding healthy blood sugar levels in pregnancy is changing. It is now becoming common practice to aim to have lower blood sugar levels during pregnancy than was originally accepted.”

Professor Peter Clayton, Paediatric Endocrinologist at the 91ֱ�� Children’s Hospital and Professor of Child Health and Paediatric Endocrinology at The University of Manchester, added: “If we can determine risk factors for obesity early in life, then we have the opportunity to do something about it. This could help to prevent some of the later life consequences of obesity, such as heart disease and diabetes.

The US funded original HAPO study was initially conducted at 15 centres across nine countries between 2000 and 2006. HAPO sought to determine whether high sugar levels, less severe than diabetes, were associated with adverse pregnancy and birth outcomes. The women underwent an oral glucose tolerance test between 24 and 32 weeks of pregnancy.

In the original HAPO study, researchers found that women with higher glucose levels also had an increased risk of needing a caesarean section. These results were found across all the clinical centres and led an international panel of experts to recommend new diagnostic criteria for gestational diabetes (2010), a form of diabetes that develops during pregnancy.

ENDS

Notes for editors

To prevent diabetes, the UK NICE guidelines encourages women who have had gestational diabetes to be tested for diabetes six weeks after their baby is born; eat smaller amounts of food to reach and stay at a healthy weight, and be active each day. Women with the following risk factors are more likely to develop gestational diabetes:

Overweight or obese

A strong family history of diabetes

A previous diagnosis of gestational diabetes

Coming from a South Asian or African Caribbean background.

For further information or advice about diabetes please contact:

Diabetes Midwifes at St Mary’s Hospital on- 0161 276 6408 or visit the Diabetes UK website - www.diabetes.org.uk

Image courtesy of adamr/FreeDigitalPhotos.net

91ֱ�� scientists turning unwanted goods into life-saving research

Fri, 20 Sep 2013 01:00:00 +0100

Heart researchers in 91ֱ�� have been awarded a prestigious grant of more than £180,000 by the British Heart Foundation (BHF).

The BHF is announcing the awards to coincide with the Great British Bag-athon, BHF shops biggest stock donation appeal which aims to raise 1 million bags of unwanted things in September, raising vital funds in the fight against heart disease. Last year’s Great British Bag-athon raised over £4 million helping the BHF to support this new research at the University of Manchester.

Professor Jeremy Pearson, Associate Medical Director at the BHF said: “Treatments for heart disease have come on leaps and bounds over the past 50 years. Through funding groundbreaking research, the BHF has played a major part in that. But there is still much more to be done and this pioneering research project is helping to advance our fight against heart disease.

“Thanks to generous donations to our 91ֱ�� shops, the people of Manchester have helped us fund this cutting-edge research. They can help us to fund more research at the University of Manchester by having a clear out and donating even more this year. Every bag you fill is a bag full of life saving research.”

This September is the Great British Bag-athon. BHF shops are aiming to raise 1 million bags of unwanted things, raising vital funds in the fight against heart disease. Visit bhf.org.uk/bagathon for more information.

The grant announced today will help to provide state-of-the-art equipment for heart researchers in 91ֱ�� that may reveal the changes that occur in small blood vessels when people are obese.

The BHF has awarded a grant to BHF Professor David Eisner and colleagues Dr Adam Greenstein and Professor Mark Boyett in The University of Manchester's Institute of Cardiovascular Sciences who are looking at conditions like diabetes, obesity and high blood pressure. These conditions affect the health of small arteries in the body – if they become damaged or diseased, a condition called microvascular disease can develop. The 91ֱ�� scientists are working out how this happens, and their work may reveal new ways to keep blood vessels healthy.

The BHF has awarded £187,000 towards this state-of-the-art equipment, which is half of the total cost. The new equipment - a high-speed spinning disc confocal microscope and a dynamic retinal vessel analyser - will enable Professor Eisner and his colleagues to study samples from healthy and obese patients in greater detail than ever before. Their work will give unique insight into how human obesity causes blood vessel damage, which cannot be gleaned from animal models.

Confocal microscopy is a specialised form of microscopy that allows scientists to visualise cells and tissues in intricate detail, in three dimensions. Retinal vessel analysers enable researchers to visualise and measure the small blood vessels at the back of the eye, revealing clues about blood vessel health. Contraction or relaxation of a small artery depends on calcium release within individual cells. Alongside other equipment, both machines will allow the 91ֱ�� researchers to study small artery function in incredible detail, in a more inclusive way than ever before - even measuring calcium within individual cells and heart tissue.

This state-of-the-art equipment combination and the samples they will study means they they will have the capacity to study human arteries using a ‘bedside to bench’ approach, which will attract talented researchers to work at the university. Ultimately, their work will reveal more about microvascular disease in obesity and new ways to treat it in the future.

ENDS

Notes for editors

For more information please call the BHF press office on 020 7554 0164 or 07764 290381 (out of hours) or email newsdesk@bhf.org.uk.

Coronary heart disease is the UK’s single biggest killer. For over 50 years we’ve pioneered research that’s transformed the lives of people living with heart and circulatory conditions. Our work has been central to the discoveries of vital treatments that are changing the fight against heart disease. But so many people still need our help. From babies born with life-threatening heart problems to the many Mums, Dads and Grandparents who survive a heart attack and endure the daily battles of heart failure. Every pound raised, minute of your time and donation to our shops will help make a difference to people’s lives.

New project with Hitachi and NHS will utilise informatics to improve healthcare

Thu, 19 Sep 2013 01:00:00 +0100

Hitachi and NHS Greater 91ֱ�� - with input from The University of Manchester and 91ֱ�� Academic Health Science Centre - to Start Proof of Concept Projects for the Use of Informatics to Improve Healthcare.

The NHS and Hitachi Ltd have announced that they have agreed to start Proof of Concept projects (POC) for the use of informatics to improve healthcare working with partners including The University of Manchester.

NHS Greater 91ֱ�� and Hitachi have been planning activity to leverage IT and informatics technology in improving the quality of healthcare since April 2013. It will be used together with the , a partnership between The University of Manchester and six leading NHS Trusts in Greater 91ֱ��; , Hitachi Consulting Co. Ltd and Eagle Matrix Consulting Co. Ltd.

To realise and deliver the projects planned over the past six months, starting from October 1, Hitachi and the NHS Greater 91ֱ�� will be starting two proof of concept in 91ֱ�� and Salford. The first is around developing a federated data platform to facilitate the collaboration of medical information in order to enable the provision of any number of new services that leverage the highest levels of privacy and security. The second is around diabetes care in the form of a lifestyle improvement programme enhancing a programme that is already being tested in the 91ֱ�� and Salford. The aim is to by way of this proof of concept is to build upon the current programme more efficient, more effective and more accessible by utilising of IT.

Going forward, as part of this project, the NHS Greater 91ֱ�� and Hitachi will be working together in developing an informatics platform that enables security and analytics technologies to deliver several new high quality healthcare services, including lifestyle improving programmes targeted towards tackling diabetes, further enhancing the quality of life and population health in 91ֱ��.

Furthermore, by providing comprehensive solutions to healthcare problems within Greater 91ֱ��, Hitachi will be looking to leverage this partnership into developing a new informatics ecosystem by expanding similar services to other regions around Greater 91ֱ�� and eventually to the rest of England.

Dr Mike Burrows, Director of the NHS Greater 91ֱ��, said: “In Greater 91ֱ�� we share many of the healthcare challenges faced in Japan and other parts of the world, namely, an ageing population and an increase in lifestyle and poverty associated healthcare problems such as obesity leading to increase in diabetes.

"This is against a backdrop of increasing demand, increasing costs of provision, finite resources and a system of providing healthcare that is reactive to healthcare problems when they emerge rather than pre-empting them. Generally, this is combined with disparate healthcare records, lots and lots of data with limited integration and imperfect information and patients who are disempowered from the healthcare processes. By working with Hitachi, which has world class technology and a track record of innovation, we can accelerate and expand our work for the benefit of our patients and population.”

Dr David Dalton, Chief Executive, Salford Royal NHS Foundation Trust, said: “In Greater 91ֱ�� we have the potential and the commitment to address our healthcare challenges most notably because we have a cohesive healthcare system and, in NorthWest EHealth (a collaboration between Salford Royal, Salford Clinical Commissioning Group and The University of Manchester, all part of the larger 91ֱ�� Academic Health Science Centre -MAHSC), we have in place a proof of concept integrated record that now has the potential to extend further. The benefits are improved clinical decision making, planning information and research tools. In our work with Hitachi to date we have seen a great willingness to collaborate and gain extensive understanding of the health ecosystem as well as a significant commitment already demonstrated to Greater 91ֱ��. Our complementary skills and knowledge augur well for future partnership.”

Masaya Watanabe, Vice President and Executive Officer of Hitachi, Ltd., who is also the Chief Strategy Officer and Chief Innovation Officer of Hitachi’s Information and Telecommunication Systems Company, said: “Thanks to the cooperation of the NHS Greater 91ֱ�� and all related organisations in 91ֱ��, we have been able to successfully take this positive leap forward, from planning projects over the past six months to entering this new phase of real action in the form of proof of concept.

"Moving forward we want to continue to focus on the needs of the patients and staff alike within the NHS and continue to deliver successes through our invaluable partnerships. Through these proof of concept projects we want to further explore the impact that innovative technologies and services can have on the improvement of quality in healthcare and eventually expand the model to other regions within England and even bring what we learn and develop back to Japan. It’s about consolidating the strengths of the Hitachi Group and directly contributing to the advancement and improvement of healthcare and people’s quality of life in both England and Japan.”

ENDS

Notes for editors

For further information, please contact: Paul Thorpe, Head of Communications, Northwest EHealth
+44-161-291-5816 paul.thorpe@manchester.ac.uk

Hitachi, Ltd. (TSE: 6501), headquartered in Tokyo, Japan, is a leading global electronics company with approximately 326,000 employees worldwide. The company’s consolidated revenues for fiscal 2012 (ended March 31, 2013) totaled 9,041 billion yen ($96.1 billion). Hitachi is focusing more than ever on the Social Innovation Business, which includes infrastructure systems, information & telecommunication systems, power systems, construction machinery, high functional material & components, automotive systems and others.

About The NHS Greater 91ֱ��
NHS England (Greater 91ֱ��) commissions primary care and specialist care in the region. The Greater 91ֱ�� Clinical Commissioning Groups (CCGs) commission health services from the providers including the MAHSC NHS members (Central 91ֱ�� University Hospitals NHS Foundation Trust, The Christie Hospital NHS Foundation Trust, 91ֱ�� Mental Health and Social Care Trust, Salford Royal NHS Foundation Trust, University Hospital South 91ֱ�� NHS Foundation Trust, and Salford CCG). The newly formed Greater 91ֱ�� Academic Health Science Network (‘GM AHSN) includes all MAHSC members, all other NHS organisations in Greater 91ֱ�� plus part of East Cheshire and Lancashire in addition to three other Higher Education Institutions - The University of Salford, The 91ֱ�� Metropolitan University and The University of Bolton.

Slow-down in the rising weight of most English adults

Tue, 03 Sep 2013 01:00:00 +0100

The trend of increasing body mass index (BMI) may be slowing down in most English adults, according to research published by researchers from The University of Manchester online in the International Journal of Obesity this week.

Around two thirds of women and three quarters of men may be relatively resistant to further rises in BMI, the study suggests.

Professor Andrew Renehan, from 91ֱ�� Cancer Research Centre, a partnership between The University, The Christie NHS Foundation Trust and Cancer Research UK, and colleagues from The University of Manchester’s Faculty of Medical and Human Sciences and Faculty of Humanities, used a mixture modelling method to analyse BMI data collected from the Health Surveys for England between 1992 and 2010.

Mixture modelling can find clusters of people in a diverse population. This work found two main clusters: 164,166 adults were categorised as either ‘normal BMI’ or ‘high BMI’, and possible influencing factors such as smoking, education and income were taken into account.

Both men and women from the high-BMI group showed rising weight in early and middle adulthood, with falls in later life. However, in the normal-BMI group, the mean BMI of females steadily increased throughout early and middle adulthood, while the mean BMI of males increased the most in early adulthood.

Professor Renehan and co-authors suggest that this constant sub-population of normal-BMI individuals who seem to be resistant to further BMI increases may off-set the BMI increases experienced by the high-BMI individuals who are getting fatter.

Professor Renehan, Professor of Cancer Studies and Surgery at The University of Manchester and Consultant Colorectal Surgeon at The Christie NHS Foundation Trust, said: “The findings support the need for smarter targeting of policies to tackle the determinants of obesity.”

Professor Iain Buchan, Professor of Public Health Informatics at The University of Manchester, and Co-director of the national Farr Institute for Health Informatics Research, said: “This research shows the importance of health surveys and their detailed analysis – previous projections of rising obesity have made bold assumptions rather than listening to the data.

“Despite the slowing down in the rise of excess weight, there is no room for complacency as society still has to deal with the cumulative consequences of the obesity epidemic – affecting a minority of people more than others, but still everybody’s problem in finding a sustainable solution.”

Notes for editors

Image courtesy of Michelle Meiklejohn / FreeDigitalPhotos.net

The research was published in the International Journal of Obesity this week.

The research team also includes Dr Alan Marshall and Vanessa Higgins from the School of Social Sciences, University of Manchester

For further information or to request an interview with one of the report authors, please contact: Alison Barbuti | Media Relations Officer | Faculty of Medical and Human Sciences |The University of Manchester | 91ֱ�� Academic Health Sciences Centre (MAHSC)
Tel. +44 (0)161 275 8383 | Mobile 07887 561 318 |Email: alison.barbuti@manchester.ac.uk

New research links body clocks to osteoarthritis

Wed, 12 Jun 2013 01:00:00 +0100

Scheduled exercise, regular meals and the periodic warming and cooling of joints could be used to relieve the symptoms of osteoarthritis according to scientists at The University of Manchester. Their research may also help explain why older people are more prone to developing this common joint disorder.

The team in the Faculty of Life Sciences has established for the first time that cartilage cells have a functioning body clock that switches on and off genes controlling tissue function. The rhythm of the cartilage clock perhaps goes some way to explain why osteoarthritis sufferers find the symptoms of the disease worse at certain times of the day.

When Dr Qing-Jun Meng and his team studied cartilage tissue in older mice they found that the tissue’s body clock was 40% weaker than in younger mice. This suggested that clock deterioration could contribute to an increased risk of developing osteoarthritis in later life. The researchers then looked at cartilage cells affected by damage similar to osteoarthritis and found that components of the body clock are altered during the early stages of the disease.

Following these discoveries the researchers tested what would happen to cartilage tissue in mice and human cartilage cells if they imposed an artificial rhythm mimicking daily changes of body temperature. By raising the temperature by two degrees at 12 hour intervals they found that after three applications the body clock in the cells had been reset and was working in a more robust state. This change lasted for between five and seven days even after the temperature cycles were removed. Further study may show the change continues for longer.

Dr Meng says: “By imposing a rhythm to boost the internal rhythm in cartilage, our data suggests the aged cartilage clock might be re-tuned. This could be done using systemic approaches such as scheduled exercise, restricted meal times or by targeting the joint itself with scheduled warming and cooling. We believe imposing a rhythm could have a significant impact on the future management of joint diseases and with further study it could relieve sufferers’ symptoms.”

This ground breaking research also suggests that taking drug treatments for joint diseases according to the cartilage clock time could increase their effectiveness, which would allow a lower dosage and consequently reduce side effects.

Dr Meng, a Medical Research Council (MRC) Fellow, has been studying body clocks for a number of years: "Mounting evidence suggests that disruption to body clocks by changes like shift work or jet lag contribute to a number of conditions such as obesity, cardiovascular diseases, cancer and mood disorders. Our next step is to test our theory that body clock disruption also contributes to osteoarthritis."

The research has been published in the journal Arthritis and Rheumatism. Osteoarthritis is the most common joint disorder, affecting around 6 million people in the UK. However, the mechanisms behind the disease are poorly understood and treatment options are limited.

Professor Ray Boot-Handford from the Wellcome Trust Centre for Cell Matrix Research, which is based at the university, has been studying cartilage and osteoarthritis for more than 20 years. He worked with Dr Meng on this research and says: “Osteoarthritis is a complex disease caused by multiple factors, although it’s well known that one of the major risk factors is aging. Our findings that the cartilage cells show circadian rhythm and that this rhythm is weakened with age is exciting and may help explain how osteoarthritis develops as we get older. Future research will directly examine the link between cartilage clock changes and osteoarthritis and highlight potential new avenues for treating this disease.”

One of the key aspects of this research was the identification of the rhythmic genes that are expressed in cartilage tissue. The scientists found that 615 genes, or 4% of the genes in cartilage, were time-dependently expressed with peaks every 24 hours. They also found that many of the genes have previously been linked to osteoarthritis.

Nicole Gossan worked on the study as part of her PhD. She says: “This research has been incredible to work on. It is the first to show a functioning clock in mouse and human cartilage cells and identify its genome-wide targets. Disruption of these targets during ageing could seriously impact joint health and we are the first to establish a link between clock disruption and osteoarthritis.”

Dr Meng and his team have now been awarded an MRC grant of half a million pounds to establish the causal relationship between clock disruptions and the onset and severity of osteoarthritis as well as identifying novel therapeutic targets. This will include the targeting of clocks by imposing an artificial rhythm as well as the timed delivery of drugs. It’s hoped the research will ultimately lead to better treatments for osteoarthritis.

Notes for editors

Dr Meng is available for interviews and an image of him can be obtained from the press office.

The paper has been published in the journal Arthritis and Rheumatism. The full title is: “The circadian clock in chondrocytes regulates genes controlling key aspects of cartilage homeostasis”. A copy of the paper can be obtained from the press office.

The research was carried out using experimental models on mice as well as human cartilage cells in vitro.

The research was supported by the Medical Research Council (UK) - which provided a five year Career Development Award for Dr Meng, the PIN Award (Promoting Interface Networking) from the Faculty of Life Sciences and the Wellcome Trust(UK) which provides the core funding to the Wellcome Trust Centre for Cell-Matrix Research.

For interview requests please contact:

Morwenna Grills

Media Relations Officer

Faculty of Life Sciences

The University of Manchester

Tel: 0161 275 2111

Mob: 07920 087466

Email: Morwenna.Grills@manchester.ac.uk

Research find links between lifestyle and developing rheumatoid arthritis

Mon, 18 Mar 2013 00:00:00 +0000

Researchers in 91ֱ�� have found a link between several lifestyle factors and pre-existing conditions, including smoking cigarettes and diabetes, and an increased risk of developing rheumatoid arthritis.

Rheumatoid Arthritis (RA) is a chronic disease which affects around 0.8% of the population; and its causes are of great interest to the medical world. Research led by Professor Ian Bruce, NIHR Senior Investigator and Professor of Rheumatology at The University of Manchester and consultant at Central 91ֱ�� University Hospitals NHS Foundation Trust, looked into the association between lifestyle factors and the risk of developing RA.

The research group at the Arthritis Research UK Epidemiology, which is part of the National Institute of Health Research 91ֱ�� Musculoskeletal Biomedical Research Unit, looked at a sample of over 25,000 people, aged 40-79 years old who have been followed over a number of years to discover if lifestyle factors had an affect on developing the disease.

When they compared 184 participants who went on to develop arthritis to those who did not, they found that smoking, obesity and having diabetes all increased the risk. It was also found that drinking a small amount of alcohol and being in a higher social class were associated with a reduced risk of developing the disease.

The study, funded by Arthritis Research UK, also examined gender specific factors and found women who had more than two children and breastfed for a shorter amount of time also had a higher risk of developing RA.

The research team also conclude that this information could be used to develop a simple screening tool, used by GPs and primary care workers, to identify patients with a higher risk of developing RA who could be offered advice to reduce their risk.

Professor Ian Bruce said: “The factors we studied give us vital clues to the early events in the process that ends in someone developing RA. They are also simple to ask about and can be used as part of a prevention programme. Our new wave of funding from the Medical Research Council and National Institute of Health Research has allowed us to move forward to the next stage in our attempt to prevent the development of this distressing condition.”

This research is supported by the 91ֱ�� Biomedical Research Centre.

Ends

Notes for editors

The paper associated with this press release was published in the Annals of the Rheumatic Diseases (ARD) on 17 March 2013.

The National Institute of Health Research 91ֱ�� Musculoskeletal Biomedical Research Unit and 91ֱ�� Biomedical Research Centre are both partnerships between Central 91ֱ�� University Hospitals NHS Foundation Trust and The University of Manchester.

For further information please contact:

Alison Barbuti

Media Relations Officer

Faculty of Medical and Human Sciences

University of Manchester

0161 725 8383

alison.barbuti@manchester.ac.uk

Emma Smith

CMFT

0161 701 2679 / 0782 514 2219

Emma.smith@cmft.nhs.uk

Biggest European health study identifies key priorities in 26 cities

Mon, 17 Sep 2012 01:00:00 +0100

Researchers have announced the results of the largest ever health and lifestyle survey of cities and conurbations across Europe – including five British urban centres.

The research examined and compared the health, life expectancy and lifestyles of the populations of 26 European cities (the Euro-26) and found major differences, not only between cities, but within individual urban areas too.

The pan-European study, led in the UK by the Universities of Manchester and Liverpool, identified key priority areas for each city studied that the researchers hope policymakers will address.

In England’s Greater 91ֱ�� and Merseyside, for example, depression and anxiety were identified as problem areas, along with cancer and respiratory disease – both of which were higher in these conurbations than the Euro-26 average. Obesity among 91ֱ�� and Liverpool’s populations was also higher than the average of those cities studied, as was heavy drinking among the population’s youth and binge drinking among adults.

It wasn’t all bad news for 91ֱ�� though: Mancunians ate considerably more fruit and vegetables than the average Euro-26 city; they had more green spaces to enjoy, and ate breakfast more frequently than their European counterparts. Liverpudlians smoked less than the European average but had a lower-than-average perception of their own wellbeing.

Birmingham, Cardiff and Glasgow were the other British cities analysed. Death from respiratory disease in Birmingham was substantially higher than the Euro-26 average, although the incidence of male cancers was significantly lower. Heavy drinking and smoking among young Brummies was also well below the Euro-26 average.

In Cardiff, male cancers and deaths among women from circulatory diseases were much lower than in the other European cities studied, but depression and anxiety among adults in the Welsh capital, as well as binge drinking, were higher than the Euro-26 average. Mortality from cancers and respiratory diseases were seen as key concerns in Scotland’s largest conurbation, but drinking and smoking among young Glaswegians was on par with the Euro-26 average.

The study, known as the European Urban Health Indicator System (EURO-URHIS 2) project and co-funded through the European Union’s Seventh Framework Programme, provides an in-depth health and lifestyle analysis, as well as key policy recommendations, for each of the 26 European cities and beyond.

The 26 cities and conurbations are: Amsterdam, Birmingham, Bistrita, Bordeaux, Bratislava, Cardiff, Craiova, Glasgow, Greater 91ֱ��, Iasi, Kaunas, Koln, Kosice, Liepaja, Ljubljana, Maribor, Merseyside, Montpellier, Oberhausen, Oslo, Riga, Siauliai, Skopje, Tetova, Tromso and Utrecht. (A link to the findings for all cities is provided in the notes below.)

Project coordinator Dr Arpana Verma, from The University of Manchester, said: “The gap between the rich and poor living in urban areas across the world is widening. The urban poor are now worse off than the rural poor. Health inequalities are a greater issue than ever before and it’s becoming increasingly important for policymakers to take the valuable information that we have to offer and translate into policies that can help improve our health.

“The European Urban Health Conference highlights these disparities and demonstrated effective tools that policymakers can use to improve health for all. Comparison within cities and between cities is becoming an area of interest to researchers, policymakers and the populations they serve. We will shortly launch our website with our preliminary results, including the differences we have seen. By highlighting these differences, we can learn from each other to make our cities healthier, and empower the citizens of Europe.”

Dr Erik van Ameijden, from Utrecht Municipal Health Service, Netherlands, said: “The monitoring of health information is vital to bring about evidence-based health gain in urban populations. With the help of our partners, my team in Utrecht has been able to analyse and present data in easy-to-use profiles, as well as demonstrate the key differences seen between cities and countries.

“We are proud to launch our health profiles for 26 cities across Europe where we describe differences in the health status of our urban citizens. These differences may be explained by the variation in social, demographic and economic conditions both within and between cities. We are concerned that the European north/south divide in health outcomes previously reported at national and regional level is happening in our cities.”

Dr Christopher Birt, from the University of Liverpool, said: “Networks and public health advocacy is vital if we are to make our urban areas work for our populations in the future. Policy makers and researchers need to work together, with the best evidence, to reduce inequalities and improve health.”

Dr Daniel Pope, also from the University of Liverpool, said “The results of our research show that policy makers are keen to use and learn about the tools we have created such as the profiles, healthy life expectancy and future trends, tools to help prioritise policies, urban health impact assessment and screening tools.”

Professor Arnoud Verhoeff, from the Amsterdam Municipal Health Service, Netherlands, and chair of the local organising committee, added: “We enjoyed welcoming our esteemed speakers, guests and delegates to what proved to be the most popular venue for urban health researchers, policy makers and lay people to mix and share ideas. The main outputs of the conference will be the launch of the results of EURO-URHIS 2 and a new website which will offer a resource for all people interested in urban health.”

Ends

Notes for editors

The key findings for each individual city involved in the research can be accessed here:

The findings of the research were presented at the European Urban Health Conference, which took place at the Felix Meritis on the Keizersgracht, Amsterdam, The Netherlands, between September 12 and 14. The results will shortly be published on the URHIS website.

The conference attracted more than 200 registered researchers, policy makers and other professionals from across Europe and beyond. Visit for more details.

Key organisations that took part in the conference included the European Commission, the World Health Organisation (WHO), European Public Health Association (EUPHA), European Public Health Alliance (EPHA), International Society of Urban Health (ISUH), USAID, health services, individuals and universities with a special interest in urban health.

Keynote speakers at the conference included:

Barbara Kerstiëns, European Commission, DG Research and Innovation
Megumi Kano, World Health Organisation, Kobe Centre, Japan
Amit Prasad, World Health Organisation, Kobe Centre, Japan
Waleska Teixeira Caiffa, Federal University of Minas Gerais, Brazil
Mark McCarthy, University College London, UK
Richard Rothenberg, Georgia State University, United States
Carlos Castillo-Salgado, Johns Hopkins Bloomberg School of Public Health, USA
Don Brand, Winthrop University Hospital, New York, USA
Arpo Aromaa, Leader of ECHIM, Finland

Media enquiries to:

Aeron Haworth
Media Relations
The University of Manchester

Tel: +44 (0)161 275 8383
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Email: aeron.haworth@manchester.ac.uk

Electronic health research centre awarded to 91ֱ��

Thu, 02 Aug 2012 01:00:00 +0100

A new multimillion-pound centre of excellence in electronic health data research to improve patient care and public health across a wide range of conditions has been awarded to a consortium led by The University of Manchester.

The Medical Research Council () announced today (Thursday) that (HeRC) will be set up in 91ֱ�� in partnership with the Universities of Lancaster, Liverpool and York.

HeRC will research new ways of harnessing electronic health data to improve care for patients and communities. The consortium brings together partners from academia, the NHS, local authorities and industry in a five to 10-year programme.

The Centre, led by , will produce new computer-based methods and tools, and apply them to five areas of innovation:

Helping patients to monitor their own health in daily life using mobile technologies such as smartphones, alongside records shared with GPs;
Helping the NHS to examine complex flows of patients in order to spot missed opportunities for earlier or better targeted care;
Giving researchers more powerful tools for identifying sub-groups of people who have different patterns of health that might illuminate new targets for treatment or prevention;
Enabling different research teams to collaborate across different organisations to produce more powerful and timely analyses of anonymised healthcare records;
Making clinical trials more efficient and more relevant to patients.

In addition to generating world-leading methodology, HeRC will train a new cadre of professionals in the underpinning discipline of Health Informatics.

The MRC, along with nine other government and charity funders, are investing £4.5 million in HeRC over the next five years, and the total activity with investments from industry and academia will be around £18 million.

Three other e-health research Centres will be established in London, Dundee and Swansea. The four Centres will investigate a wide range of conditions that place a huge burden on the UK population, including diabetes and obesity, cardiovascular disease, cancer and child and maternal health.

Maximising the unique value of the NHS, the Centres will undertake cutting edge research that links e-health records with other forms of research and routinely collected data, which will lead to patient and public benefit and ensuring the UK remains at the forefront of global medical research.

By combining clinical, social and research data, researchers aim to identify more effective treatments, improve drug safety, assess risks to public health and study the causes of diseases and disability.

The four Centres will make use of patient data sets available through the Clinical Practice Research Datalink, a £60 million service recently announced by the Medicines and Healthcare Products Regulatory Agency and the National Institute for Health Research. The public and charitable funding for these Centres builds on this important commitment from the Government and on similar bodies that link patient records in Scotland and Wales.

Ends

Notes for editors

For further information contact:

Aeron Haworth
Media Relations
Faculty of Medical and Human Sciences
The University of Manchester

Tel: 0161 275 8383
Mob: 07717 881563
Email: aeron.haworth@manchester.ac.uk

New stroke treatments becoming a reality

Thu, 26 Jul 2012 01:00:00 +0100

Scientists led by the President of The University of Manchester have demonstrated a drug which can dramatically limit the amount of brain damage in stroke patients.

Professor Dame Nancy Rothwell, Professor Stuart Allan and their team have spent the last 20 years investigating how to reduce damage to the brain following a stroke.

They have been testing the effectiveness of the drug Anakinra (IL-1Ra), which is already used for rheumatoid arthritis in experimental studies of stroke.

This new study builds on previous research, although the big difference is that rats with stroke risk factors such as obesity, insulin resistance and atherosclerosis were used alongside healthy rats and older ones. It means the findings have a far greater chance of being replicated in human stroke patients.

Researchers induced a stroke in the rats and the drug IL-1Ra, or a placebo for comparison, was injected under the skin. The researchers did not know which animals had been given which drug. This is a similar process to what happens in clinical trials of medicines.

The results were startling. MRI scans revealed that the rats that were given IL-1Ra up to three hours after the stroke had only about half the brain damage of the placebo group.

Professor Rothwell said: “This is the first time that we are aware of a potential new treatment for stroke being tested in animals with the same sort of diseases and risk factors that most patients have. The results are very promising and we hope to undertake further clinical studies in stroke patients soon.”

IL-1Ra works by blocking the naturally occurring protein interleukin 1. Researchers at The University of Manchester have identified that it is a key cause of brain injury following a stroke.

Interleukin 1 encourages inflammation in the area of the brain affected by stroke. This sends out signals to attract white blood cells and to switch on microglia cells in the brain. Because the barrier surrounding the brain has been weakened by the stroke the white blood cells find it easier to enter the brain. But instead of helping the inflamed area they actually kill nerve cells and worsen the injury. The increasing presence of these cells also explains why the damage in the brain gets worse over time following a stroke.

IL-1Ra also reduces the amount of damage to the blood-brain barrier following a stroke so the harmful cells can’t enter the brain. In the recent experiments IL-1Ra reduced the damage to the blood-brain barrier by 55% in healthy rats and 45% in rats with underlying health conditions. In all types of rats the drug reduced the amount of activated microglia cells by 40% compared to the placebo group.

The only drug treatment currently available for stroke patients is Tissue Plasminogen Activator (tPA). However, this can only be administered to patients who suffer from a blood clot (ischaemic stroke) rather than bleeding. A brain scan is required to assess which type of stroke a patient has suffered which is why it is essential to get them to hospital as quickly as possible. tPA also has to be administered within a few hours of a stroke to be effective.

Professor Stuart Allan at The University of Manchester hopes that IL-1Ra could be used for both forms of stroke, meaning it could be administered immediately.

He said: “This drug has real potential to save lives and stop hundreds of thousands of people being seriously disabled by stroke. This really could be the treatment for stroke that we’ve been looking for over the past two decades.”

A phase 2 trial with a small number of patients has yielded encouraging results. It’s hoped a much larger clinical trial will demonstrate the effectiveness of IL-1Ra in reducing brain damage in stroke patients and that eventually it will become the standard treatment.

Notes for editors

Stroke is the third most common cause of death and the leading cause of adult disability in the western world. More than 100,000 people have a stroke in the UK each year. Nearly a fifth of people still die within 30 days of diagnosis. Those who survive are often seriously disabled.

The most common cause of stroke is ischaemia (blood clot causing damage) whilst 15% of strokes are due to primary haemorrhage (direct bleeding into the brain). The induced stroke used in this study was an ischaemia.

The animals were randomized for all the experiments, assessments were performed in a blinded manner and analysis was confirmed by two independent researchers.

The research from these experiments was published in the Journal of Cerebral Blood Flow and Metabolism on the 11 July 2012.

Professor Stuart Allan is available for interviews and images can be obtained from the press office.

Please contact:

Morwenna Grills
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The University of Manchester

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Major new study finds clues to the genetic causes of osteoarthritis

Tue, 03 Jul 2012 01:00:00 +0100

UK scientists have discovered more genetic regions associated with the cause of osteoarthritis. Researchers from nine institutions across the UK have described the findings as a significant breakthrough in understanding the genetic risk factors that cause the disease.

Publishing their findings in The Lancet today, the Arthritis Research UK-funded arcOGEN consortium has highlighted eight genetic regions linked to the development of osteoarthritis. Previously, only three osteoarthritis genetic regions had been identified.

Several of the genetic regions encompass genes that are known to regulate how joints are made and then maintained, making them excellent osteoarthritis candidate genes. Another genetic region contains a gene involved in the regulation of body weight, which is a strong risk factor for osteoarthritis.

The £2.2million project is the world’s biggest ever-genome wide study into osteoarthritis, comparing the genetic differences of 7,400 patients with severe osteoarthritis with 11,000 healthy volunteers. The results were then replicated in over 7,000 OA individuals and 43,000 control individuals, from four European collaborating partners.

Osteoarthritis affects about 40 per cent of people over the age of 70, a total of 8 million people in the UK, causing pain and disability. There is currently no cure for the condition. Treatments for early osteoarthritis are limited to non-surgical options such as pain killers and physiotherapy until joint replacement becomes a viable option. Osteoarthritis is a complex disorder with both environmental and genetic causes. It is estimated that about 50 per cent of an individual’s risk of developing osteoarthritis is due to inherited genetic factors.

Professor Bill Ollier, from the University of Manchester’s Centre for Integrated Medical Research (CIGMR), said: “Osteoarthritis is one the most common conditions affecting adults and is responsible for causing much pain and suffering for a large proportion of the population. Unfortunately, this is becoming a larger health problem as we live longer. We are only now just beginning to identify the genetic and lifestyle factors involved in OA and work out how they interact to allow the disease to develop. Only by doing this will we be able to develop treatments to tackle the disease at an early stage and avoid surgical replacements of joints. This landmark study, supported by the Alzheimer's Research UK, has brought together the major research groups working on OA in collaboration, rather than being in competition. This important study opens up a number of exciting new avenues for tackling this common condition.”

Two of the novel regions are close to genes that immediately suggest clinical implications for osteoarthritis. One, CHST11, affects cartilage proteoglycan (proteins in the cartilage modified with sugar chemicals) and changes in proteoglycan are an active area of development of new treatments for osteoarthritis. A second gene, PTHLH, is the basis for recently developed parathyroid hormone-based treatments for osteoporosis. The research team suggest a next step would be to explore whether these compounds may also be effective in osteoarthritis.

Gillian Wallis, Professor of Genetics in 91ֱ��’s Wellcome Trust Centre for Cell-Matrix Research, said: “It is very exciting that many of the chromosomal regions associated with osteoarthritis contain genes that are involved in the development, production and maintenance of healthy cartilage. This makes sense because cartilage is one of the tissues of the joint that is degraded by the osteoarthritic disease process. Knowing which genes contribute to osteoarthritis susceptibility provides a firm starting point for research into the causes of this complex disease which may identify new targets for drug development.”

Principal investigator of arcOGEN John Loughlin, Professor of Musculoskeletal Research at Newcastle University, said: “We know that osteoarthritis runs in families and that this is due to the genes that people pass on, rather than their shared environment. In this study we were able to say with a high degree of confidence which genetic regions are the major risk factors for developing osteoarthritis: the first time that this has been possible for this common yet complex disease. It’s an important first step.”

Medical director of Arthritis Research UK Professor Alan Silman added: “There is no cure for osteoarthritis yet it affects millions of people around the world. For 60 years we have known that you are twice as likely to have osteoarthritis if your parents have the disease, yet we haven’t known why.

“Until we understand the cause of this complex disease, we cannot hope to find a cure. This is a major breakthrough in our understanding of osteoarthritis which we hope will help us to unlock the genetic basis of the disease.”

Further work is now needed to pinpoint the actual DNA changes within the genetic regions to establish exactly how these changes lead to osteoarthritis.

Professor Loughlin said that they were not yet able to use their discoveries as a tool to predict who was more or less likely to develop the disease, or to predict the degree of osteoarthritis severity, based on the genes they have inherited. Far more genes are involved in causing disease susceptibility than was previously thought, and there are still many left to find.

He added: “However, what we are able to do is to use our genetic discoveries to identify key biological pathways that can now be exploited to develop new treatments.”

Ends

Notes for editors

About arcOGEN:The arcOGEN project was a major collaboration bringing together 16 academic investigators from across the UK, and at a cost of £2.2million was the biggest-ever single grant funded by Arthritis Research UK. The investigators were Professor Loughlin, Professor Andrew McCaskie and Dr Fraser Birrell from Newcastle University, Professor Nigel Arden, Professor Andrew Carr and Dr Kay Chapman from the University of Oxford, Professor Tim Spector and Dr Anna Valdes from King’s College London, Professor Michael Doherty from the University of Nottingham, Professor Mark Wilkinson from the University of Sheffield, Professor Bill Ollier and Professor Gillian Wallis from The University of Manchester, Professor Ashok Rai from the University of Worcester, Professor Stuart Ralston from the University of Edinburgh, and Dr Panos Deloukas and Dr Ele Zeggini from the Wellcome Trust Sanger Institute. For more information about the arcOGEN project go to

About osteoarthritis:Osteoarthritis is the most common form of arthritis, affecting around 40 per cent of people over the age of 70. It is a complex disease of the musculoskeletal system with both genetic and environmental risk factors.

Osteoarthritis is characterised by cartilage degeneration in the joints that can cause pain, stiffness and swelling. It is one of the leading causes of chronic disability and impaired quality of life in the developed world.

Osteoarthritis represents a substantial public health burden in the UK and is the primary cause for total joint replacement (TJR) surgery (accounting for 80 per cent of TJR). Prevalence is increasing, in keeping with epidemiologically established risk factors in the population, i.e. age and obesity.

Heritability studies in twins, sibling-pairs and families have estimated that genetic factors account for approximately 50 per cent of the risk of developing osteoarthritis in the hip or knee, although precise estimates vary depending on sex, affected site, and severity of disease.

About Arthritis Research UK: Arthritis Research UK is the leading authority on arthritis in the UK, conducting scientific and medical research into all types of arthritis and musculoskeletal conditions. It is the UK’s fourth largest medical research charity and the only charity solely committed to funding research into the cause, treatment and cure of arthritis. For more information please visit:

For further information contact:

Aeron Haworth
Media Relations
Faculty of Medical and Human Sciences
The University of Manchester

Tel: 0161 275 8383
Mob: 07717 881563
Email: aeron.haworth@manchester.ac.uk

Female fat prejudice persists even after weight loss, study finds

Wed, 30 May 2012 01:00:00 +0100

Overweight women may never escape the painful stigma of obesity – even after they have shed the pounds, new research suggests.

The study, by the University of Hawaii at Mānoa, The University of Manchester, and Monash University, examined whether anti-fat prejudice against women persisted even after they had lost significant weight and were now thin.

The researchers asked young men and women to read vignettes describing a woman who had either lost weight (70 pounds/32 kilograms) or had remained weight stable, and who was either currently obese or currently thin. Participants were then asked their opinions about this woman on a number of attributes, such as how attractive they found her, and their overall dislike for fat people.

The team found that participants in the study – published in the journal Obesity – expressed greater bias against obese people after reading about women who had lost weight than after reading about women who had remained weight stable, regardless of whether the weight-stable woman was thin or obese.

“We were surprised to find that currently thin women were viewed differently depending on their weight history,” said Dr Janet Latner, study lead at the University of Hawaii at Mānoa, US. “Those who had been obese in the past were perceived as less attractive than those who had always been thin, despite having identical height and weight.”

One of the more disturbing findings from the study, the researchers noted, was that negative attitudes towards obese people increase when participants are falsely told that body weight is easily controllable.

Co-author, Dr Kerry O’Brien, from the University of Manchester’s School of Psychological Sciences and Monash University in Melbourne, Australia, said: “The message we often hear from society is that weight is highly controllable, but the best science in the obesity field at the moment suggests that one’s physiology and genetics, as well as the food environment, are the really big players in one’s weight status and weight-loss.

“Weight status actually appears rather uncontrollable, regardless of one’s willpower, knowledge, and dedication. Yet many people who are perceived as ‘fat’ are struggling in vain to lose weight in order to escape this painful social stigma. We need to rethink our approaches to, and views of, weight and obesity.”

The findings, say the authors, demonstrate that residual obesity stigma persists against individuals who have ever been obese, even when they have lost substantial amounts of weight. Obesity stigma is so powerful and enduring that it appears to even outlast the obesity itself.

Dr Latner added: “Descriptions of weight loss, such as those often promoted on television, may significantly worsen obesity stigma. Believing that obese people can easily lose weight may make individuals blame and dislike obese people more.

“The findings demonstrate that residual obesity stigma persists against individuals who have ever been obese, even when they have lost substantial amounts of weight. Obesity stigma is so powerful and enduring that it may even outlast the obesity itself. Given the great number of people who may be negatively affected by this prejudice, obesity discrimination clearly needs to be reduced on a societal level.”

Ends

Notes for editors

A copy of the paper, ‘'Residual Obesity Stigma: An Experimental Investigation of Bias against Obese and Lean Targets Differing in Weight-Loss History,’ is available on request.

For further information contact:

Aeron Haworth
Media Relations
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The University of Manchester

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Email: aeron.haworth@manchester.ac.uk

Obesity affects job prospects for women, study finds

Mon, 30 Apr 2012 01:00:00 +0100

Obese women are more likely to be discriminated against when applying for jobs and receive lower starting salaries than their non-overweight colleagues, a new study has found.

The study, led by The University of Manchester and Monash University, Melbourne, and published in the International Journal of Obesity, examined whether a recently developed measure of anti-fat prejudice, the universal measure of bias (UMB), predicted actual obesity job discrimination. The researchers also assessed whether people’s insecurity with their own bodies (body image) and conservative personalities such as, authoritarianism, and social dominance orientation were related to obesity discrimination, as they are related to homophobia and racism.

Psychologist and lead researcher Dr Kerry O’Brien said the nature of the study was initially concealed from the participants to avoid biased results, and simply advertised as a study on whether some people are better at personnel selection than others.

“Participants viewed a series of resumes that had a small photo of the job applicant attached, and were asked to make ratings of the applicants suitability, starting salary, and employability,” said Dr O’Brien. “We used pictures of women pre- and post-bariatric surgery, and varied whether participants saw either a resume, amongst many, that had a picture of an obese female (BMI 38-41) attached, or the same female but in a normal weight range (BMI 22-24) following bariatric surgery.

“We found that strong obesity discrimination was displayed across all job selection criteria, such as starting salary, leadership potential, and likelihood of selecting an obese candidate for the job.”

The higher a participant’s score on the measure of anti-fat prejudice, the more likely they were to discriminate against obese candidates, while those with a more authoritarian personality also displayed discrimination.

Dr O’Brien and co-authors Dr Janet Latner, from the University of Hawaii, and Dr Jackie Hunter, from Otago University, noted that one of the particularly interesting and new findings was that the participants’ ratings of their own physical appearance (body image) and importance of physical appearance were also associated with obesity discrimination.

”The higher participants rated their own physical attractiveness and the importance of physical appearance, the greater the prejudice and discrimination,” said Dr O’Brien. “One interpretation of this finding might be that we feel better about our own bodies if we compare ourselves and discriminate against ‘fat’ people, but we need to test this experimentally.”

The study is the first to show a relationship between explicit self-report measures of obesity prejudice and obesity job discrimination. In addition, the results suggest that a belief in the superiority of some individuals over others is related to the perception that obese individuals deserve fewer privileges and opportunities than non-fat individuals.

Dr O’Brien added: “Our findings show that there is a clear need to address obesity discrimination, particularly against females who tend to bear the brunt of anti-fat prejudice. Prejudice reduction interventions and policies need to be developed. It’s also becoming clear that the reasons for this prejudice appear to be related to our personalities, how we feel about ourselves, with attributions, such as, obese people are lazy, gluttonous etc merely acting as justifications for our prejudice.”

Ends

Notes for editors

A copy of the paper, ‘Obesity discrimination: the role of physical appearance, personal ideology, and anti-fat prejudice,’ published in the International Journal of Obesity, is available on request or .

For further information contact:

Aeron Haworth
Media Relations
Faculty of Medical and Human Sciences
The University of Manchester

Tel: 0161 275 8383
Mob: 07717 881563
Email: aeron.haworth@manchester.ac.uk

Babies’ brains are programmed by what mums eat

Mon, 02 Apr 2012 01:00:00 +0100

Women who fall pregnant while dieting are more likely to have a child that could become obese or diabetic in later life, new research suggests.

While the study was carried out in sheep, University of Manchester scientists suspect the findings may hold true for humans as well. The research, carried out with colleagues in New Zealand and Canada, may also have found a reason why human twins are more likely to develop type-2 diabetes in adulthood after the team studied twin lambs.

The study investigated twin pregnancies in sheep, as well the pregnancies of ewes that received less food around the time the lamb was conceived. The researchers then looked at tissues from the brains of the unborn lambs. This was to see if there were changes in the structure of the DNA that would alter genes involved in food intake and glucose levels after birth.

“We found that unborn twin lambs had changes in the structure of DNA in the region of the brain that regulates food intake and glucose that resulted in an increased chance of diabetes in adulthood,” said study lead Anne White, Professor of Endocrine Sciences.

“Our findings provide a reason why twins are more likely to get diabetes but we have also shown that mothers who don’t have enough food around the time of conception may have a child who grows up with an increased risk of obesity.”

Although the study, published in the Journal of the Federation of American Societies for Experimental Biology, was conducted in sheep, the researchers believe their findings are relevant to humans too, as they reveal a non-genetic, or ‘epigenetic’, way in which the DNA of offspring can be altered.

Professor White, from 91ֱ��’s Faculties of Medical and Human Sciences and Life Sciences, continued: “This is not an inherited change in the genes but a change in the structure of the DNA that affects the genes, and therefore much more unusual.

“What is significant is that the changes we have found are in genes that control food intake and glucose levels and alterations in these genes may lead to obesity and diabetes.”

More and more people are becoming obese and getting diabetes, while rates of twins are steadily increasing as women have babies at older ages and rates of conception using artificial reproductive technologies increase. Dieting in young women is also very common and can occur in women who may not know they are pregnant. The team’s findings in sheep, if replicated in humans, suggest that obesity and diabetes could be more likely in twins and in children from mothers who aren’t eating properly, or dieting, around the time of conception.

Professor White added: “Our study is important because it shows that factors in the brain can be altered by non-hereditary mechanisms and this results in changes in the body, which could make people obese.

“The findings may provide a new understanding of why twins can develop diabetes and also suggests that dieting around the time a baby is conceived may increase the chance of the child becoming obese later in life.”

While the study doesn’t have implications for the treatment of diabetes or obesity, the researchers say it could be important for disease prevention regimes whereby advice on eating is given to women who are planning a family that could reduce future health risks for their children.

Ends

Notes for editors

A copy of the paper, ‘Epigenetic changes in fetal hypothalamic energy regulating pathways are associated with maternal undernutrition and twinning,’ is available on request.

For further information contact:

Aeron Haworth
Media Relations
Faculty of Medical and Human Sciences
Faculty of Life Sciences
The University of Manchester

Tel: 0161 275 8383
Mob: 07717 881563
Email: aeron.haworth@manchester.ac.uk

Scientists find natural way to curb your greed

Mon, 05 Jul 2010 01:00:00 +0100

University of Manchester scientists have discovered a naturally-occurring appetite suppressant that could be used to make a diet drug without side effects.

Professor Simon Luckman and Dr Garron Dodd believe the peptide hemopressin, which affects the reward part of the brain responsible for hedonistic behaviour, might treat some aspects of alcohol and drug abuse.

Dr Dodd, co-author of the findings published in the Journal of Neuroscience, explains: “It has long been known that the rewarding aspects of feeding behaviour influence our appetite, so that sometimes we eat for pleasure rather than hunger. This is because the cannabinoid system in the brain – a component of the naturally-existing circuitry responsible for reward – is affected by chemicals that are termed ‘agonists’ which bind to its receptors and increase the reward from feeding.

“One such agonist is cannabis – it hijacks the cannabinoid system and leads to what is colloquially referred to as ‘the munchies’. Similarly, when you fast, the brain causes an increase in naturally-occurring agonists. This results in increased hedonic impact so that when you do eat, food tastes better.

“Conversely when ‘antagonists’ bind to the receptors of the cannabinoid system, it decreases the reward from feeding. By reducing hedonistic feeding, it is possible to help people lose weight by quenching the desire to eat.”

A synthetic antagonist, Rimonabant, was developed six years ago and marketed as an anti-obesity treatment. As well as acting in the brain to reduce feeding it also acted in peripheral tissues to reduce fat deposition. However, despite its efficiency at reducing body weight in humans, it was later withdrawn from the market due to undesirable side effects such as depression and increased suicidal thoughts. Dr Dodd believes that naturally-occurring hemopressin may not cause such side effects.

The scientists in the Faculty of Life Sciences, gave mice hemopressin and monitored feeding and other behaviours. They found that while feeding behaviour decreased, importantly, other behaviours were not affected by the natural antagonist. With the synthetic antagonist, feeding behaviour decreased, but other non-specific behaviours, such as grooming and scratching increased. This shows that, unlike the synthetic antagonists, hemopressin specifically affected feeding, acting to potentially reduce hedonistic behaviour without some of the “off-target” effects.

“We now plan to investigate this further,” Dr Dodd adds.

“This is a newly discovered peptide and we do not know yet exactly where it is expressed in the brain. We also need to find out whether it has prolonged actions on body weight. Finally, while our findings are an indication of safety, this cannot be immediately extrapolated to humans. This discovery does however offer new insights into how the brain controls appetite, and opens new avenues by which to manipulate this brain circuitry and aid the development of anti-obesity treatments.

“The existence of naturally-occurring agents, such as hemopressin, provides attractive targets for drug companies as they may be ‘safer’ in the long term. In addition, as peptides are modified quite easily there is the potential to target their uptake by the body to reduce undesirable side effects.”

Notes for editors

The paper ‘The Peptide Hemopressin Acts through CB1 Cannabinoid Receptors to Reduce Food Intake in Rats and Mice’ is available.

For more information or an interview with Dr Garron Dodd, contact Media Relations Office Mikaela Sitford on 0161 275 2111, 07768 980942 or Mikaela.Sitford@manchester.ac.uk.

Researchers unzip symptoms of the ‘male menopause’

Thu, 17 Jun 2010 01:00:00 +0100

Scientists have for the first time identified the symptoms associated with what has been termed late-onset hypogonadism or ‘male menopause’ caused by a reduction in testosterone production in ageing men.

But the researchers say that unlike the female menopause, which affects all women, the male menopause is relatively rare, affecting only 2% of elderly men, and is often linked to poor general health and obesity.

The findings, published in the New England Journal of Medicine, should provide new guidance to physicians prescribing male testosterone therapy, a practice that has increased by 400% in the United States, though not elsewhere, since 1999.

The University of Manchester researchers, working with colleagues at Imperial College London, UCL (University College London) and other European partners, measured the testosterone levels of 3,369 men between the ages of 40 and 79 years from eight European centres and asked details about their sexual, physical and psychological health.

The team found that only nine of the 32 candidate symptoms were actually associated with low testosterone levels, the most important being the three sexual symptoms – decreased frequency of morning erection, decreased frequency of sexual thoughts (sex drive), and erectile dysfunction.

The study concluded that the presence of all three sexual symptoms, together with low testosterone levels, was required to establish a diagnosis of late-onset hypogonadism, although other non-sexual symptoms may also be present.

These other symptoms included three physical symptoms – an inability to engage in vigorous activity, such as running or lifting heavy objects, an inability to walk more than 1km, and an inability to bend, kneel or stoop – and three psychological symptoms – loss of energy, sadness, and fatigue. However, these non-sexual symptoms were only weakly related to low testosterone.

Additional symptoms often said to be associated with the male menopause but which the study was able to discount as not being testosterone related included changes in sleeping pattern, poor concentration, feeling worthless, nervousness or anxiety and difficulty getting up from a chair.

“The diagnosis of classical hypogonadism is corroborated by underlying diseases affecting the testes or pituitary gland, which controls testicular function, but this well-practiced diagnostic approach is frequently found wanting when dealing with the age-related decline of testosterone in elderly men who are prone to have a significant background of non-hormone-related complaints,” said lead author Professor Fred Wu, from The University of Manchester’s School of Biomedicine.

“Our findings have for the first time identified the key symptoms of late-onset hypogonadism and suggest that testosterone treatment may only be useful in a relatively small number of cases where androgen deficiency is suspected, since many candidate symptoms of classic hypogonadism were not associated with decreased testosterone levels in older men.”

The research, part of the European Union-funded European Male Ageing 91ֱ��, also identified the thresholds of testosterone below which certain symptoms become increasingly prevalent. Documentation of levels of testosterone below these thresholds is required to confirm the diagnosis of hypogonadism in symptomatic elderly men.

However, even with the nine rigorously selected symptoms, differences in testosterone levels between symptomatic and non-symptomatic men were marginal, highlighting the weak overall association between symptoms and testosterone levels.

Professor Wu added: “The long list of nonspecific symptoms that have a potential association with testosterone deficiency makes it difficult to establish a clear diagnosis of late-onset hypogonadism. This situation is further complicated when you consider that even the most specific sexual symptoms of androgen deficiency was relatively common among men with normal testosterone levels.

“It is therefore important to specify the presence of all three sexual symptoms of the nine testosterone-related symptoms we identified, together with low testosterone, in order to increase the probability of correctly diagnosing late-onset hypogonadism. The application of these new criteria should guard against the excessive diagnosis of hypogonadism and curb the unwise use of testosterone therapy in older men.”

Ends

Notes for editors

A copy of the paper ‘Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men’ is available on request.

For further information contact:

Aeron Haworth
Media Relations
Faculty of Medical and Human Sciences
The University of Manchester

Tel: 0161 275 8383
Mob: 07717 881563
Email: aeron.haworth@manchester.ac.uk

Scientists find important new step in protein production

Fri, 21 May 2010 01:00:00 +0100

Scientists at the University of Manchester have identified an extra step in protein production, a major activity of all cells, which they believe impacts particularly on how our cells respond to stresses such as starvation and virus attack.

Drs Graham Pavitt and Martin Jennings, whose findings are published in Nature today (20 May 2010), have found a new function for a protein, called eIF5, which is critical for appropriate and normal control of the protein production process.

Protein production (or synthesis) takes place within ribosomes - complex structures made of RNA and proteins - and is facilitated by a number of accessory factors that enhance its rate and tightly control the whole process, which is central to all cell activities. In experimental models, changes that alter protein synthesis control can lead to obesity, diabetes and even altered memory functions within the brain. In addition when many viruses attack, they use our protein synthesis pathways to produce more viruses. There is a war inside the infected cells, which fight back to try to shut down protein synthesis and prevent production of new infectious virus.

The new findings show that the protein synthesis factor eIF5 not only promotes protein synthesis by activating a second factor (called eIF2), it also has a second function which locks eIF2 in a 'switched-off' state; that is, it regulates the overall process as well as activating it. This second function is necessary for control of protein production in times of stress.

Dr Pavitt, at 91ֱ��'s Faculty of Life Sciences, said: "We investigated how simple yeast cells sensed and responded to changes in their nutrition, specifically to starvation for amino acids, which are essential building blocks for proteins. Now we know there is another important step in this process, one that is particularly important in the cellular response to stress."

He added: "Although we used yeast cells in our study, there is sufficient similarity in the mechanism across all cells to suggest that the new regulatory function operates in a similar or identical manner in mammalian cells, including man.

"Further work is now required to determine if these new findings will have consequences for our deeper understanding of human health and disease."

Notes for editors

The paper 'eIF5 has GDI activity necessary for translational control by eIF2 phosphorylation' is available from the Nature website.

For more information or an interview with Dr Graham Pavitt, contact Media Relations Officer Mikaela Sitford on 07768 980942 or Mikaela.Sitford@manchester.ac.uk.

Better training needed to curb ‘fatism’ within health professions

Fri, 16 Apr 2010 01:00:00 +0100

Prejudice towards obese people is rife among trainee health professionals, but can be modified, new research has found.

The study, published in the journal Obesity, says weight-based discrimination by the public has increased by 66% over the past decade with anti-fat prejudice among health professionals found to be high in western nations, and often exceeding that found within the general population.

The research, by scientists at the Universities of Manchester and Hawaii and Yale University, suggests that medical and allied health professions need to present a balanced view of the causes of, and treatment for, obesity when training young professionals in order to reduce the strong prejudice towards obese people.

The team found that the prejudice could be either increased or decreased depending on the type of obesity training pre-service, health-professional students received.

Health profession trainees from Australia were randomly assigned to one of three intensive, seven-week tutorial courses as part of their degree. One tutorial course educated students about the role of diet and physical activity as the primary cause of, and treatment for, obesity. A second tutorial course focused instead on educating students about the uncontrollable causes of obesity, such as the contribution of genes and environmental factors, like junk-food marketing and pricing. Finally, a third control group of students attended a tutorial course that addressed alcohol use in young people.

Measures of obesity prejudice were taken before the courses and then two weeks after completion. Significant reductions in obesity prejudice of 27% and 12% were found on two forms of prejudice for the course delivering material on genetic and environmental factors, while students on the course focusing on diet and physical activity showed a 27% increase in obesity prejudice.

Lead author Dr Kerry O’Brien, from The University of Manchester, UK, said: “One reason for the high levels of obesity prejudice is that people only hear that obesity is due to poor diet and lack of exercise, which implies that obese people are just lazy and gluttonous, and therefore deserve criticism. But, uncontrollable factors, such as genes, the environment and neurophysiology, play an important role.

“Weight status is, to a great extent, inherited. It’s crucial that health professionals, such as nurses, doctors, dieticians and physical educators, are aware of these other influences, as well as their own potential prejudices, and don’t just blame the individual for their weight status.

“Those tasked with providing health services to obese people may become frustrated with patients when they do not lose weight following counselling and treatment, but the research shows that weight loss is extremely difficult to maintain long term. Obese people are constantly fighting their physiology and the environment. If professionals keep this in mind it may help in not stigmatising their clients.”

Reviews of both adult and child obesity stigma research by study co-authors Dr Rebecca Puhl, from Yale University, and Dr Janet Latner, from the University of Hawaii, have shown that weight-related teasing and obesity stigma have serious psychological, physical and social consequences.

People with obesity also report receiving poorer treatment and stigma from health professionals and are less likely to seek treatment for certain conditions because of a fear of being stigmatised.

Dr Puhl said: “Unfortunately, weight stigma towards obese patients is very common in health care settings and efforts are clearly needed to reduce biased attitudes among health professionals and to improve quality of health care towards this patient population.”

Dr O’Brien added: “We were surprised by how few efforts to reduce obesity prejudice or weight stigma had been made, particularly within health professionals who are tasked with treating overweight and obese patients. Perhaps this represents a tacit acceptance that obesity prejudice is somehow okay.”

The authors suggest the results should not be interpreted as providing justification for reducing the emphasis on diet and exercise as cornerstones of obesity prevention. Instead, they say health educators should ensure that balanced information on the causes of obesity is delivered in a convincing manner.

The study adopted a model of persuasion often used in advertising, but also provided motivation for students to process course material in depth, with related assignments contributing 10% to course grades. This may be a valuable component for other stigma-reduction strategies. By assigning a tangible value to the information presented, the curriculum reinforces the importance and credibility of that information to students.

Ends

Notes for editors

O’Brien K.S., Puhl R., Latner J., Mir A., Hunter J. Reducing anti-fat prejudice in pre-service health students: A randomized trial. Obesity (advanced online access) 2010.

For a copy of the article or to arrange an interview contact:

Aeron Haworth
Media Relations
Faculty of Medical and Human Sciences
The University of Manchester

Tel: 0161 275 8383
Mob: 07717 881563
Email: aeron.haworth@manchester.ac.uk

“91ֱ�� Group” of researchers honoured

Wed, 14 Apr 2010 01:00:00 +0100

An influential group of University of Manchester anthropologists who pioneered a method which helps us understand the way things catch on through connections are being recognised at a special event this week.

The ideas of the ‘91ֱ�� Group’ have been influential in the study of the spread of things such as friendship, obesity, terrorism, disease and even musical genres.

In the 1950s and 60s, University of Manchester anthropologists pioneered the method - called social network analysis - led by Clyde Mitchell.

Mitchell’s former 91ֱ�� colleagues Professors John Barnes and Bruce Kapferer together with Elizabeth Bott – now in their eighties - will receive an award in recognition for the work.

They will also launch the University’s Mitchell Centre for Social Network analysis - named after the researcher who died in 1995.

The new centre will bring together the latest generation of Manchester researchers who are currently examining areas as diverse as Punk Rock, mobile phone networks, disease and crime.

The Director of the Centre, Professor Martin Everett, was supervised by Mitchell for his DPhil.

He said: “Social Network Analysis is a relatively new and interdisciplinary field in which 91ֱ�� played an important foundational role.

“It provides the tools to map and analyze the patterns of relations that link individuals or groups and so helps us uncover and understand how the people we are connected to influence our behaviour, attitudes and beliefs.

“When Mitchell left 91ֱ�� he went to Oxford and continued his work but the subject did not take off in the UK; though major developments continued in mainland Europe and the USA.

“But since then the subject has grown exponentially and we are now in the process of re-establishing 91ֱ��’s international credentials in this important interdisciplinary field.”

Notes for editors

The sixth UK Social Networks Conference is from Wednesday 14 to Friday 16 April in the Alan Turning Building.

Keynote speakers include

Professor Linton Freeman, University of California.
Professor Russell Bernard, University of Florida
Professor Patrick Doreian, University of Pittsburgh, University of Ljubljana

For media enquires contact:

Mike Addelman
Media Relations
Faculty of Humanities
The University of Manchester
0161 275 0790
07717 881567
michael.addelman@manchester.ac.uk