Whilst my group’s research covers broad aspects of paediatric nutrition, the main focus of the current programme is to develop nutritional interventions in infancy and childhood to reduce the long-term risk of obesity and cardiovascular disease. This work is a based on 2 main themes: 1) investigating the effects of nutrition in infancy on long-term health and the underlying mechanism involved; and 2) development and evaluation of nutritional interventions to prevent and treat childhood obesity.

Theme 1 tests the concept that nutrition in infancy influences, or programmes, long-term cardiovascular disease and its risk factors. This concept, although well recognized in animal studies, has in the last 10 years, been shown by us and others to apply to humans. Importantly, our group was the first to demonstrate this concept in experimental studies that support a causal link between infant nutrition and later health. In these studies infants were randomly assigned to different diets after birth and then reviewed at later ages. For instance, we showed that nutrition and the pattern of growth in infancy had a major impact on development of obesity, high cholesterol concentration, high blood pressure, and risk of diabetes in young adults. This concept has now been supported by many studies worldwide and led to changes in nutrition practice. Our aim is to further this work by developing health interventions that have a direct impact on both clinical and public health policy. Our current research involves follow-up of children and adults who participated in randomized controlled trials of different nutritional interventions in infancy as well as the initiation of new large-scale intervention trials.

Theme 2 aims to develop and evaluate public health interventions to prevent and treat childhood obesity and to understand the mechanisms by which early obesity contributes to long-term cardiovascular health. This research is based on the evidence that obesity in childhood adversely affects adult cardiovascular disease risk, independently of risk factors in adults. However, as highlighted by a Cochrane systematic review, there are few evidence based treatments of childhood obesity on which to base national strategies, and the effect of any such interventions on long-term CVD risk under-researched. Our work in this area is based on two interventions for the prevention and treatment of paediatric obesity: i) The MEND programme is a community based, lifestyle intervention for adolescent obesity that has been successfully used in over 70, 000 children in the UK and Internationally. ii) TRIMTOTS’. Whilst MEND is a intervention for adolescents, the fastest increase in childhood obesity in the UK has occurred in preschool children. To address this major area of unmet need, we have developed an intervention for children aged 1-5 years which includes components of nutrition education, physical activity and behaviour change with an emphasis on family involvement and learning through art and play. Recently, our pilot randomised study, has shown that this intervention was acceptable to families, children and Sure Start Centre staff, and resulted in a significant lowering of obesity risk up to 2 years after the start of the programme.