̽��ֱ�� of Cambridge - Department of Health

Rare genetic variants confer largest increase in type 2 diabetes risk seen to date

cjb250 — Wed, 07 Jul 2021 11:10:25 +0000

Type 2 diabetes is thought to be driven in part by inherited genetic factors, but many of these genes are yet unknown. Previous large-scale studies have depended on efficient ‘array genotyping’ methods to measure genetic variations across the whole genome. This approach typically does a good job at capturing the common genetic differences between people, though individually these each confer only small increases in diabetes risk.

Recent technical advances have allowed more comprehensive genetic measurement by reading the complete DNA sequences of over 20,000 genes that code for proteins in humans. Proteins are essential molecules that enable our bodies to function. In particular, this new approach has allowed for the first time a large-scale approach to study the impact of rare genetic variants on several diseases, including type 2 diabetes.

By looking at data from more than 200,000 adults in the UK Biobank study, researchers from the Medical Research Council (MRC) Epidemiology Unit at the ̽��ֱ�� of Cambridge used this approach to identify genetic variants associated with the loss of the Y chromosome. This is a known biomarker of biological ageing that occurs in a small proportion of circulating white blood cells in men and indicates a weakening in the body’s cellular repair systems. This biomarker has been previously linked to age-related diseases such as type 2 diabetes and cancer.

In results published today in Nature Communications, the researchers identified rare variants in the gene GIGYF1 that substantially increase susceptibility to loss of the Y chromosome, and also increase an individual’s risk of developing type 2 diabetes six-fold. In contrast, common variants associated with type 2 diabetes confer much more modest increases in risk, typically much lower than two-fold.

Around 1 in 3,000 individuals carries such a GIGYF1 genetic variant. Their risk of developing type 2 diabetes is around 30%, compared to around 5% in the wider population. In addition, people who carried these variants had other signs of more widespread ageing, including weaker muscle strength and more body fat.

GIGYF1 is thought to control insulin and cell growth factor signalling. ̽��ֱ��researchers say their findings identify this as a potential target for future studies to understand the common links between metabolic and cellular ageing, and to inform future treatments.

Dr John Perry, from the MRC Epidemiology Unit and a senior author on the paper, said: “Reading an individual’s DNA is a powerful way of identifying genetic variants that increase our risk of developing certain diseases. For complex diseases such as type 2 diabetes, many variants play a role, but often only increasing our risk by a tiny amount. This particular variant, while rare, has a big impact on an individual’s risk.”

Professor Nick Wareham, Director of the MRC Epidemiology Unit, added: “Our findings highlight the exciting scientific potential of sequencing the genomes of very large numbers of people. We are confident that this approach will bring a rich new era of informative genetic discoveries that will help us better understand common diseases such as type 2 diabetes. By doing this, we can potentially offer better ways to treat – or even to prevent – the condition.”

Ongoing research will aim to understand how the loss of function variants in GIGYF1 lead to such a substantial increase in the risk of developing type 2 diabetes. Their future research will also examine other links between biomarkers of biological ageing in adults and metabolic disorders.

̽��ֱ��research was funded by the Medical Research Council. UK Biobank is supported by Wellcome, the Medical Research Council, British Heart Foundation, Cancer Research UK, the UK Department of Health, Northwest Regional Development Agency and the Scottish Government.

Reference
Zhao, Y et al. GIGYF1 loss of function is associated with clonal mosaicism and adverse metabolic health. Nature Communications 2021; 07 Jul 2021; DOI: 10.1038/s41467-021-24504-y

Scientists at the ̽��ֱ�� of Cambridge have identified rare genetic variants – carried by one in 3,000 people – that have a larger impact on the risk of developing type 2 diabetes than any previously identified genetic effect.

For complex diseases such as type 2 diabetes, many variants play a role [in disease risk], but often only increasing our risk by a tiny amount. This particular variant, while rare, has a big impact on an individual’s risk

John Perry

qimono

DNA jigsaw

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Drug-resistant hospital bacteria persist even after deep cleaning, genomic study reveals

cjb250 — Mon, 26 Oct 2020 16:00:20 +0000

Enterococcus faecium is a bacterium commonly found in the gastrointestinal tract, where it usually resides without causing the host problems. However, in immunocompromised patients, it can lead to potentially life-threatening infection.

Over the last three decades, strains have emerged that are resistant to frontline antibiotics including ampicillin and vancomycin, limiting treatment options – and particularly worrying, these strains are often those found in hospital-acquired E. faecium infections.

A team of scientists at the ̽��ֱ�� of Cambridge and the London School of Hygiene and Tropical Medicine has pioneered an approach combining epidemiological and genomic information to chart the spread of bacteria within healthcare settings. This has helped hospitals identify sources of infection and inform infection control measures.

In a study published today in Nature Microbiology, the team has applied this technique to the spread of drug-resistant E. faecium in a hospital setting.

Dr Theodore Gouliouris from the Department of Medicine at the ̽��ֱ�� of Cambridge, and joint first author on the study, said: “We’ve known for over two decades that patients in hospital can catch and spread drug-resistant E. faecium. Preventing its spread requires us to understand where the bacteria lives – its ‘reservoirs’ – and how it is transmitted.

“Most studies to date have relied on culturing the bacteria from samples. But as we’ve shown, whole genome sequencing – looking at the DNA of the bacteria – combined with detailed patient and environmental sampling can be a powerful tool to help us chart its spread and inform ways to prevent further outbreaks.”

̽��ֱ��team followed 149 haematology patients admitted to Addenbrooke’s Hospital, Cambridge ̽��ֱ�� Hospitals NHS Foundation Trust, over a six-month period. They took stool samples from the patients and swabs from the hospital environment and cultured them for E. faecium.

Genomic analysis of the bacteria was much more effective at identifying hospital-acquired E. faecium: out of 101 patients who could be followed up, genomic analysis identified that two thirds of patients acquired E. faecium, compared to less than half using culture methods alone.

Just under half (48%) of the swabs taken from the hospital environment were positive for vancomycin-resistant E. faecium. This included 36% of medical devices, 76% of non-touch areas such as air vents, 41% of bed spaces and 68% of communal bathrooms tested.

̽��ֱ��researchers showed that even deep cleaning could not eradicate the bacteria. ̽��ֱ��hospital undertook deep cleaning on one ward over a three-day period during the study, when patients were moved elsewhere; however, when the team sampled locations prior to patients returning to the ward, they found that 9% of samples still tested positive for the bacteria. Within three days of patients returning to the ward, around half of the sampled sites tested positive.

Three-quarters (74%) of the patients (111/149) were carriers of the A1 clade – a multi-drug resistant strain of E. faecium commonly seen in hospitals that is resistant to the antibiotic ampicillin and which frequently acquires resistance to vancomycin. Of these 111 patients, 67 had strong epidemiological and genomic links with at least one other patient and/or their direct environment.

“ ̽��ֱ��fact that these cases were all linked to another patient or their environment suggests strongly that they had picked up the multi-drug resistant bacteria while in the hospital,” said Dr Francesc Coll from the London School of Hygiene and Tropical Medicine, joint first author.

Further genomic analysis showed that within this multi-drug resistant strain were several subtypes (defined by how genetically-similar they were). However, it was not uncommon for a patient to be carrying more than one subtype, which – without detailed genomic analysis – could confound attempts to identify the route of transmission of an infection. Notably, despite the circulation of as many as 115 subtypes, 28% of E. faecium acquisitions were caused by just two superspreading subtypes. ̽��ֱ��authors found no evidence of resistance or tolerance to common disinfectants to explain the success of these subtypes.

Six study patients contracted an ‘invasive infection’, meaning that they had been carrying E. faecium asymptomatically in their gut, but subsequently developed a symptomatic infection. Comparing the genomes of the infecting and gut strains the authors determined that invasive E. faecium infections originated from the patients’ own gut.

“Our study builds on previous observations that drug-resistant strains of E. faecium can persist in the hospital environment despite standard cleaning – we were still surprised to find how short-lasting was the effect of deep cleaning,” added Dr Gouliouris.

“We found high levels of hospital-adapted E. faecium despite the use of cleaning products and procedures that have proven effective against the bug. It highlights how challenging it can be to tackle outbreaks in hospitals.”

Senior author Professor Sharon Peacock from the Department of Medicine at the ̽��ֱ�� of Cambridge added: “ ̽��ֱ��high rates of infection with drug-resistant E. faecium in specific vulnerable patient groups and its ability to evade cleaning measures pose an important challenge to infection control. Patient screening, adequate provision of isolation and ensuite toilet facilities, improved and more frequent cleaning procedures, and stricter health-care worker hygiene practices will all be needed to curtail this global epidemic.

“But this is also a sign of how urgently we need to tackle inappropriate use of antibiotics worldwide, which is widely recognised as posing a catastrophic threat to our health and our ability to control infections.”

̽��ֱ��research was funded by the Department of Health and Wellcome.

Reference
Gouliouris, T, Coll, F et al. Quantifying acquisition and transmission of Enterococcus faecium using genomic surveillance. Nature Microbiology; 26 Oct 2020; DOI: 10.1038/s41564-020-00806-7

Scientists have used genome sequencing to reveal the extent to which a drug-resistant gastrointestinal bacterium can spread within a hospital, highlighting the challenge hospitals face in controlling infections.

Our study builds on previous observations that drug-resistant strains of E. faecium can persist in the hospital environment despite standard cleaning – we were still surprised to find how short-lasting was the effect of deep cleaning

Theodore Gouliouris

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Hospital ward

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Tackling COVID-19: Karl Wilson

Anonymous — Wed, 20 May 2020 23:27:00 +0000

On Friday 20 March, Karl Wilson, received a phone call which would turn his life upside-down for the next six weeks.

“After a hectic week of closing down labs across the ̽��ֱ��, I was adjusting to my first day of working from home,” remembers Wilson. “I’d managed a couple of hours work in my spare room (having just set up my new desk with the ‘help’ of my four year old daughter), when I received a call to say that the ̽��ֱ�� would be partnering with pharmaceutical giants AstraZeneca and GSK to set up a testing centre for Covid-19, in the newly built Anne McLaren Building.

“I knew it would be a huge undertaking but there was no question in my mind about it. It was just a case of ‘yes, let’s do this.’”

An hour later Wilson found himself at the lab discussing floor plans, safety cabinets and sample-prepping-robots. “It’s been a whirlwind ever since,” he says.

A project of this scale would ordinarily take around six months to complete but incredibly the lab was ready to begin trialling tests in just three weeks. Wilson explained that this phenomenal feat was testament to the positive approach of everyone involved in the project. “There’s never been any hesitation, never a question of ‘what’s in it for me?’ It’s always just been a case of ‘how can I help?’”

It’s the small snippets of personal stories which demonstrate the dedication to the project of every individual involved. Wilson shares about a Programme Manager who left his family to move temporarily to Cambridge, to set up the IT infrastructure key to running the robotics. In another instance of generosity, two building firms, Mace and Mick George worked together to create a vital walkway to the test centre at short notice, and then waived fees of approximately £20,000. And from the very moment the project began, manufacturers have developed and supplied complex scientific equipment in a fraction of the time it would usually have taken them to do so.

Wilson says that the timely completion of the test centre was only possible through teamwork, collaboration, flexibility and the sheer number of hours put in by employees. It’s been estimated that 2292 hours have been worked overall to get us to this stage.

Wilson describes the feeling on site as being “very much a ‘camp vibe.’” He says, “You're thrusting a lot of people who don't know each other into a new situation, under very unusual circumstances. We were typically on site 13 hours a day – working together, talking together, eating together and taking time-out together. We all really bonded – you’d never have known we’d met for the first time just a few weeks before – it now feels like we’ve been friends for years.”

When days were tough it was the ‘why’ that kept the teams going. “We were just thinking ‘the quicker we get the centre open, the sooner we can help the country move forward, get out of lockdown, and hopefully return to some semblance of normality,” says Wilson.

With the project nearing completion Wilson is finally able to catch his breath and begin to reflect on what has been both the greatest challenge and most rewarding venture of his career to date. He credits the success of the project to every individual involved who “just wanted to do a great job.”

“Everyone took real ownership of their roles and such pride in their work,” he says. “I think everyone is really pleased with what we’ve accomplished.

“We’re excited to see the lab in action and, in a sense, see the fruits of our labour. And one day, hopefully in the not too distant future, we’re all looking forward to going out together, to raise a toast to the success of a job well done.”

This article is part of a series in which we speak to some of the many Cambridge researchers tackling COVID-19. For other articles about our latest COVID-19-related research, click here.

Operations Director Karl Wilson has helped lead a herculean effort to transform a standard laboratory into a bespoke testing centre, to aid the national response against COVID-19. For him, there was never any question about whether we should - or could - do this.

Everyone took real ownership of their roles and such pride in their work. I think everyone is really pleased with what we’ve accomplished

Karl Wilson

Yes

Widely-available antibiotics could be used in the treatment of ‘superbug’ MRSA

cjb250 — Mon, 24 Jun 2019 11:33:23 +0000

Since the discovery of penicillin, the introduction of antibiotics to treat infections has revolutionised medicine and healthcare, saving millions of lives. However, widespread use (and misuse) of the drugs has led some bacteria to develop resistance, making the medicines less effective. With few new antibiotics in development, antibiotic resistance is widely considered a serious threat to the future of modern medicine, raising the spectre of untreatable infections.

One of the most widely used and clinically important groups of antibiotics is the family that includes penicillin and penicillin derivatives. ̽��ֱ��first type of penicillin resistance occurred when bacteria acquired an enzyme, known as a beta-lactamase, which destroys penicillin. To overcome this, drug manufacturers developed new derivatives of penicillin, such as methicillin, which were resistant to beta-lactamase.

In the escalating arms race, one particular type of bacteria known as Methicillin-resistant Staphylococcus aureus – MRSA – has developed widespread resistance to this class of drugs. MRSA has become a serious problem in hospital- and community-acquired infections, forcing doctors to turn to alternative antibiotics, or a cocktail of different drugs which are often less effective, and raises concerns that even these drugs will in time become ineffective.

In previous research, a team of researchers in Cambridge identified an isolate of MRSA (a sample grown in culture from a patient’s infection) that showed susceptibility to penicillin in combination with clavulanic acid. Clavulanic acid is a beta-lactamase inhibitor, which prevents the beta-lactamase enzyme destroying penicillin; it is already used as a medicine to treat kidney infections during pregnancy.

In a study published today in Nature Microbiology, a team of scientists from the UK, Denmark, Germany, Portugal, and USA used genome sequencing technology to identify which genes make MRSA susceptible to this combination of drugs. They identified a number of mutations (changes in the DNA sequence) centred around a protein known as a penicillin-binding protein 2a or PBP2a.

PBP2a is crucial to MRSA strains as it enables them to keep growing in the presence of penicillin and other antibiotics derived from penicillin. Two of these mutations reduced PBP2a expression (the amount of PBP2a produced), while two other mutations increased the ability of penicillin to bind to PBP2a in the presence of clavulanic acid. Overall the effect of these mutations means that a combination of penicillin and clavulanic acid could overcome the resistance to penicillin in a proportion of MRSA strains.

̽��ֱ��team then looked at whole genome sequences of a diverse collection of MRSA strains and found that a significant number of strains – including USA300 clone, the dominant strain in the United States – contained both mutations that confer susceptibility. This means that one of the most widespread strains of MRSA-causing infections could be treatable by a combination of drugs already licensed for use.

Using this knowledge, the researchers used a combination of the two drugs to successfully treat MRSA infections in moth larvae and then mice. Their next step will be to conduct the further experimental work required for a clinical trial in humans.

Dr Mark Holmes from the Department of Veterinary Medicine at the ̽��ֱ�� of Cambridge, a senior author of the study, says: “MRSA and other antibiotic-resistant infections are a major threat to modern medicine and we urgently need to find new ways to tackle them. Developing new medicines is extremely important, but can be a lengthy and expensive process. Our works suggests that already widely-available medicines could be used to treat one of the world’s major strains of MRSA.”

First author Dr Ewan Harrison, from the Wellcome Sanger Institute and the ̽��ֱ�� of Cambridge, adds: “This study highlights the importance of genomic surveillance – collecting and sequencing representative collections of bacterial strains. By combining the DNA sequencing data generated by genomic surveillance with laboratory testing of the strains against a broad selection of antibiotics, we may find other unexpected cracks in the armour of antibiotic-resistant bacteria that might give us new treatment options.”

̽��ֱ��research was funded by the Medical Research Council (MRC), Wellcome and the Department of Health.

Dr Jessica Boname, Head of Antimicrobial Resistance at the MRC, says: “This study demonstrates how a mechanistic understanding of resistance and access to clinical data can be used to find new ways to contain and control infections with existing resources.”

Reference
Harrison, EM et al. Genomic identification of cryptic susceptibility to penicillins and β-lactamase inhibitors in methicillin-resistant Staphylococcus aureus. Nature Microbiology; 24 June 2019; DOI: 10.1038/s41564-019-0471-0

Some MRSA infections could be tackled using widely-available antibiotics, suggests new research from an international collaboration led by scientists at the ̽��ֱ�� of Cambridge and the Wellcome Sanger Institute.

MRSA and other antibiotic-resistant infections are a major threat to modern medicine and we urgently need to find new ways to tackle them

Mark Holmes

NIAID

Scanning electron micrograph of a human neutrophil ingesting MRSA (yellow)

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Children from disadvantaged backgrounds and certain ethnic minorities do less vigorous physical activity

cjb250 — Tue, 28 May 2019 08:55:20 +0000

̽��ֱ��patterns mirror inequalities seen in levels of childhood obesity, suggesting a need for a greater focus on the promotion of vigorous physical activity, particularly for those children from more disadvantaged backgrounds.

Over the past four decades, the global prevalence of childhood obesity has increased tenfold. Obesity in childhood is associated with illness and early death in adulthood, so tackling childhood obesity is increasingly a public health priority for governments.

There are also widening inequalities in obesity prevalence. By age 11, UK children from disadvantaged families are three times as likely to be obese than more advantaged children. There are also stark ethnic and racial differences in levels of childhood obesity, with higher rates of obesity within certain ethnic minorities including children from Black African, Black Caribbean, Pakistani and Bangladeshi backgrounds.

Evidence suggests that more vigorous intensity activity – such as running or swimming – is more strongly linked with reduced waist circumference and body fat than moderate intensity activity. International guidelines say that children should engage in moderate-to-vigorous intensity activity for at least 60 minutes per day.

“When we look at overall physical activity we don’t see clear differences between children from different backgrounds despite clear inequalities in obesity,” says Rebecca Love, a Gates Cambridge Scholar at the Centre for Diet and Activity Research (CEDAR) in the MRC Epidemiology Unit at the, ̽��ֱ�� of Cambridge. “To investigate this further, we looked at whether overall physical activity was hiding inequalities in the intensity with which that activity is performed that might explain these patterns.”

̽��ֱ��researchers studied data from almost 5,200 children aged 7 years who were part of the Millennium Cohort Study, a longitudinal study of children born in the UK between September 2000 and January 2002. ̽��ֱ��children were given accelerometers and their activity measured for a minimum of ten hours for three days. ̽��ֱ��results are published today in the journal BMJ Open.

̽��ֱ��team found that the higher the level of education attained by the mother, the more minutes of vigorous intensity activity her child was likely to have, accounting for time spent in moderate physical activity. Children with mothers with high levels of education accumulated three minutes more vigorous activity per day then those with low levels of education. Similarly, the team found significantly more time spent in vigorous intensity activity incrementally with increasing household income.

Intensity differences were also apparent by ethnicity. White British children perform on average more than three minutes more daily vigorous physical activity in comparison to children from Pakistani and Bangladeshi backgrounds. Children from ‘other ethnic groups’ also accumulated 2.2 minutes fewer daily vigorous intensity activity overall.

It is suggested these differences are relevant on a population level and changes to reduce differences in vigorous physical activity could have population implications for inequalities in adiposity in UK children. ̽��ֱ��differences were consistent in both boys and girls.

“There are clear differences in the amount of vigorous physical activity a child does depending on their socioeconomic and ethnic background,” explains senior author Dr Esther van Sluijs. “Although individually, these differences are small, at a population level they are likely to make a difference. Changes to reduce existing gaps in vigorous intensity activity could help reduce existing inequalities in levels of obesity in children.”

̽��ֱ��team say that there are many factors that might explain the differences, including access to or the cost of participating in sports activities, and a parent working longer, inconsistent work hours within a low-income job. There may also be differences in home and family support for physical activity between ethnic groups.

“Children from different backgrounds can face a number of barriers preventing them from participating in sports or other types of vigorous physical activity,” adds Dr Jean Adams. “We need to find more ways to provide opportunities for all children to get involved in vigorous activity.”

̽��ֱ��research was funded by the British Heart Foundation, Department of Health, Economic and Social Research Council, Medical Research Council, and Wellcome. Additional support was provided by Gates Cambridge.

Reference
Love, R et al. Socio-economic and ethnic differences in children’s vigorous intensity physical activity: a cross-sectional analysis of the UK Millennium Cohort Study. BMJ Open; 28 May 2019

Children from disadvantaged backgrounds and certain ethnic minority backgrounds, including from Pakistani and Bangladeshi backgrounds, have lower levels of vigorous physical activity, according to researchers at the ̽��ֱ�� of Cambridge.

Children from different backgrounds can face a number of barriers preventing them from participating in sports or other types of vigorous physical activity

Jean Adams

Margaret Weir

Children playing

Researcher profile: Rebecca Love

Rebecca Love, a PhD student at the Centre for Diet and Activity Research (CEDAR) researches the factors that drive obesity, particularly among children from different economic and social backgrounds.

It is perhaps ironic, then, that she has spent most of her PhD “sitting at a computer in the CEDAR offices at Addenbrooke’s [Hospital] – not quite the picturesque Cambridge working environment I had imagined”!

Rebecca grew up in Canada. As part of her undergraduate degree at Queen’s ̽��ֱ�� in Kingston, Ontario, she spent a year in Trinidad and Tobago working alongside the Caribbean Sport and Development Agency on a project to implement educational programming and change policy structures to protect the rights of children. It was through these experiences that she gained an interest in the evaluation of interventions and in understanding how to identify what works within a given context.

Rebecca is currently finishing her PhD, supported by Gates Cambridge. Her work has involved examining population cohort studies from a range of countries to understand whether differences in patterns of physical activity behaviour between children help to explain the rising and widening obesity disparities seen within many countries. She is now investigating whether school-based interventions are effective at improving physical activity behaviour – and if this effect is the same in children from advantaged and disadvantaged backgrounds and between girls and boys.

“I’m fascinated by the complexity of influences driving the worsening epidemic of obesity globally,” explains Rebecca. “If we’re going to find effective solutions, we’ll need an interdisciplinary approach involving collaboration from a wide range of stakeholders and institutions.”

Fortunately, Rebecca’s research does sometimes get her out ‘into the field’. In 2017, she visited the ̽��ֱ�� of the Witwatersrand in Johannesburg, South Africa to investigate physical activity and obesity within the Birth to Twenty Cohort. This is Africa’s largest and longest running cohort of adolescent health and development, which has followed a cohort of children born in 1990 in Soweto, South Africa.

“Two months of warmth in exchange for the UK winter and cold bike rides to Addenbrooke’s came at a welcome time in my PhD! There, I had the opportunity to visit childcare centres and schools in townships surrounding Johannesburg and Cape Town, across which rates of childhood overweight and obesity are rising. Listening and learning from the experiences and perspectives of individuals working across these settings was thought-provoking.”

Rebecca describes CEDAR as “an extremely supportive and welcoming community. ̽��ֱ��opportunity to constantly be exposed to innovative research and conversations has been really influential and a central part of my learning experience”.

She is currently a PhD student at King’s College. This, together with her Gates Cambridge scholarship, has allowed her to meet students and researchers from a wide range different backgrounds and disciplines, developing friendships and learning from perspective of peers from all corners of the world.

“Constant events, lectures and opportunities make Cambridge an exciting and stimulating place to be a graduate student. It can be quite distracting at times – but to me that is one of the best parts about being here!”

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Labelling alcoholic drinks as lower in strength could encourage people to drink more, study suggests

cjb250 — Wed, 25 Apr 2018 23:58:10 +0000

Alcohol is the fifth leading cause of disease and premature death both in the UK and globally. Reducing consumption of alcohol is a public health priority in many countries. In the UK, as part of a range of steps to reduce overall alcohol consumption, policymakers are currently interested in allowing industry to label a wider range of alcohol products as lower in alcohol.

Proposed legislative changes include extending the variety of terms that could be used to denote lower alcohol content, and extending the strength limit to include products lower than the current average on the market (12.9% ABV for wine and 4.2% ABV for beer*).

“For lower strength alcohol products to reduce consumption, consumers will need to select them in place of equal volumes of higher strength products,” says Dr Milica Vasiljevic from the ̽��ֱ�� of Cambridge. “But what if the lower strength products enable people to feel they can consume more?”

In this study, two-hundred and sixty-four weekly wine and beer drinkers – sampled from a representative panel of the general population of England – were randomised to one of three groups to taste test drinks in a laboratory designed to mimic a bar environment. ̽��ֱ��drinks varied only in the label displayed. In one group participants taste-tested drinks labelled ‘Super Low’ and ‘4%ABV’ for wine or ‘1%ABV’ for beer. In another group the drinks were labelled ‘Low’ and ‘8%ABV’ for wine or ‘3%ABV’ for beer. In the final group participants taste-tested drinks labelled with no verbal descriptors of strength, but displaying the average strength on the market – wine (‘12.9%ABV’) or beer (‘4.2%ABV’).

̽��ֱ��results showed the total amount of drink consumed increased as the label on the drink denoted successively lower alcohol strength. ̽��ֱ��mean consumption of drinks labelled ‘Super Low’ was 214ml, compared with 177ml for regular (unlabelled) drinks. Individual differences in drinking patterns and socio-demographic indicators did not affect these results.

“Labelling lower strength alcohol may sound like a good idea if it encourages people to switch drinks, but our study suggests it may paradoxically encourage people to drink more,” says Professor Theresa Marteau, senior author and Director of the Behaviour and Health Research Unit.

While this study shows that people may drink more if drinks are labelled as lower in strength, the researchers do not yet know if this effect is sufficient to result in the consumption of more units of alcohol overall from lower strength alcohol drinks. Furthermore, participants in this study were tested in a bar-laboratory setting. To learn more about the impact of lower strength alcohol labelling, research in real-world settings is needed.

̽��ֱ��study was funded by the Department of Health.

*ABV denotes alcohol by volume, the standard measure of how much alcohol is contained in a given volume of an alcoholic drink.

Reference
Vasiljevic M, Couturier DL, Frings D, Moss AC, Albery IP, Marteau TM. Impact of lower strength alcohol labeling on consumption: A randomized controlled trial. Health Psychology. DOI: 10.1037/hea0000622

Wines and beers labelled as lower in alcohol strength may increase the total amount of alcoholic drink consumed, according to a study published in the journal Health Psychology. ̽��ֱ��study was carried out by the Behaviour and Health Research Unit at the ̽��ֱ�� of Cambridge in collaboration with the Centre for Addictive Behaviours Research at London South Bank ̽��ֱ��.

For lower strength alcohol products to reduce consumption, consumers will need to select them in place of equal volumes of higher strength products

Milica Vasiljevic

PatternPictures

Beer foam bubbles

Researcher profile: Dr Milica Vasiljevic

On the face of it, e-cigarettes and low alcohol seem to be a step in the right direction towards reducing the health impacts of smoking and drinking. But are things really so clear cut? This is one of the questions that social psychologist Dr Milica Vasiljevic is asking.

Vasiljevic investigates the impact that environmental cues have on health behaviours, and how this knowledge can be translated into effective interventions to change our behaviour to improve health and reduce inequalities. “ ̽��ֱ��bulk of my work to date has looked at how cues such as labelling and advertising encourage people to eat unhealthily, drink alcohol, and/or smoke tobacco,” she says.

Her work is of particular interest to policymakers and has informed national and international policies. “My recent work on the impact of e-cigarette adverts on perceived harm of tobacco smoking amongst children has been discussed at the US Food & Drug Administration, the German Bundestag, and the UK House of Lords in relation to legislative changes surrounding the marketing of e-cigarettes,” she explains.

Similarly, her work on lower strength alcohol labelling is currently used by the Department of Health to inform legislative changes to national alcohol labelling rules in England, which are due to come into force after 2018.

̽��ֱ��Behaviour and Health Research Unit, where she works, is a multidisciplinary policy research unit including psychologists, economists, medics, sociologists, social scientists, and statisticians.

“This diverse mix is very enriching, and on many occasions has spurred creative solutions to research problems that we have been grappling with. But, most importantly, being in such close contact with stellar researchers with diverse training backgrounds is fun and inspirational; and has helped me develop my research skills and communication style.”

Vasiljevic is a keen communicator, as is appropriate for someone whose work has relevance to all of our lives. “ ̽��ֱ��most interesting days I’ve had so far are the Cambridge Science Festival days and also the days when I have carried out outreach work in schools,” she says. “These events are always lots of fun, and are an excellent opportunity for children and adults from the local communities to get involved in our research, learn more about what we do, and of course help us shape some of our future studies.”

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. For image use please see separate credits above.

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Young people exposed to vaping ads less likely to think occasional smoking is bad for health

cjb250 — Mon, 05 Sep 2016 21:21:41 +0000

Estimates suggest that among children who try smoking, between one third and one half are likely to become regular smokers within two to three years. However, young people are now more likely to experiment with e-cigarettes than they are with tobacco cigarettes. For example, a 2014 study found that 22% of children aged 11-15 in England had experimented with e-cigarettes, compared to 18% for tobacco cigarettes.

There is concern that the increasing exposure of children to e-cigarette adverts could be contributing to high rates of experimentation; in the US, adolescents’ exposure to e-cigarette adverts on TV more than trebled between 2011 to 2013. E-cigarette brands often market themselves as helping people quit smoking and as healthier and cheaper alternatives to tobacco cigarettes.

In this study from researchers at the Behaviour and Health Research Unit, ̽��ֱ�� of Cambridge, and the ̽��ֱ�� of North Carolina Gillings School of Global Public Health, and published today in the journal Tobacco Control, more than 400 English children aged 11-16 who had never smoked or ‘vaped’ previously were recruited and randomly allocated to one of three groups. One group was shown ten adverts that depicted e-cigarettes as glamorous, a second group was shown ten adverts that portrayed them as healthy, and a third control group was shown no adverts.

̽��ֱ��children were then asked a series of questions aimed at determining their attitudes towards smoking and vaping. Children shown the adverts were no more or less likely than the control group to perceive tobacco smoking as appealing and all three groups understood that smoking more than ten cigarettes a day was harmful. However, both groups of children exposed to the e-cigarette adverts, both healthy and glamorous, were less likely to believe that smoking one or two tobacco cigarettes occasionally was harmful.

Dr Milica Vasiljevic from the Department of Public Health and Primary Care at the ̽��ֱ�� of Cambridge says: “While we can be optimistic that the adverts don’t seem to make tobacco smoking more appealing to young people, they do appear to make occasional smoking seem less harmful. This is worrying, as we know that even occasional tobacco smoking is bad for your health, and young people who smoke occasionally believe they are somehow immune to its effects and do not feel the need to quit.”

̽��ֱ��group of children that were shown adverts depicting e-cigarettes as glamorous also believed e-cigarette vaping to be more prevalent than did the other two groups.

Professor Theresa Marteau, Director of the Behaviour and Health Research Unit and a Fellow of Christ’s College, ̽��ֱ�� of Cambridge, adds: “E-cigarette marketing across Europe is regulated under the new EU Tobacco Products Directive, which came into effect on the 20th May this year. ̽��ֱ��Directive limits the exposure of children to TV and newspaper e-cigarette adverts. However, it does not cover advertising in the form of posters, leaflets, and adverts at point of sale, nor does it cover the content of marketing materials depicting e-cigarettes as glamorous or healthy. ̽��ֱ��findings from our study suggest these omissions could present a threat to the health of children.”

̽��ֱ��study was funded by the Department of Health.

Reference
Petrescu, D, Vasiljevic, M, Pepper, JK, Ribisl, KM, Marteau, TM . What is the impact of e-cigarette adverts on children’s perceptions of tobacco smoking? An experimental study. Tobacco Control; 6 Sept 2016; DOI: 10.1136/tobaccocontrol-2016-052940

Exposure to advertisements for e-cigarettes may decrease the perceived health risks of occasional tobacco smoking, suggests new research from the ̽��ֱ�� of Cambridge, prompting concern that this may lead more young people to experiment with smoking.

While we can be optimistic that the adverts don’t seem to make tobacco smoking more appealing to young people, they do appear to make occasional smoking seem less harmful.

Milica Vasiljevic

Vaping360

E-cigarette

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Larger wine glasses may lead people to drink more

cjb250 — Mon, 06 Jun 2016 23:01:48 +0000

Alcohol consumption is one of the leading risk factors for disease and has been linked to conditions such as type 2 diabetes, cancer and liver disease. ̽��ֱ��factors that influence consumption are not clear; a recent Cochrane review published by the Behaviour and Health Research Unit (BHRU) at the ̽��ֱ�� of Cambridge found that larger portion sizes and tableware increased consumption of food and non-alcoholic drinks, but found no evidence relating to consumption of alcohol.

To examine whether the size of glass in which alcohol is served affects consumption, the team at the BHRU, together with Professor Marcus Munafo from the ̽��ֱ�� of Bristol, carried out a study in ̽��ֱ��Pint Shop in Cambridge from mid-March to early July 2015. ̽��ֱ��establishment has separate bar and restaurant areas, both selling food and drink. Wine (in 125ml or 175ml servings) could be purchased by the glass, which was usually a standard 300ml size.

Over the course of a 16-week period, the owners of the establishment changed the size of the wine glasses at fortnightly intervals, alternating between the standard (300ml) size, and larger (370ml) and smaller (250 ml) glasses.

̽��ֱ��researchers found that the volume of wine purchased daily was 9.4% higher when sold in larger glasses compared to standard-sized glasses. This effect was mainly driven by sales in the bar area, which saw an increase in sales of 14.4%, compared to an 8.2% increase in sales in the restaurant. ̽��ֱ��findings were inconclusive as to whether sales were different with smaller compared to standard-sized glasses.

“We found that increasing the size of wine glasses, even without increasing the amount of wine, leads people to drink more,” says Dr Rachel Pechey from the BHRU at Cambridge. “It’s not obvious why this should be the case, but one reason may be that larger glasses change our perceptions of the amount of wine, leading us to drink faster and order more. But it’s interesting that we didn’t see the opposite effect when we switched to smaller wine glasses.”

Professor Theresa Marteau, Director of the Unit, adds: “This suggests that avoiding the use of larger wine glasses could reduce the amount that people drink. We need more research to confirm this effect, but if it is the case, then we will need to think how this might be implemented. For example, could it be an alcohol licensing requirements that all wine glasses have to be below a certain size?”

̽��ֱ��research was funded by the Department of Health.

Reference
Pechey, R et al. Does wine glass size influence sales for on-site consumption? A multiple treatment reversal design. BMC Public Health; 7 June 2016; DOI: 10.1186/s12889-016-3068-z

Selling wine in larger wine glasses may encourage people to drink more, even when the amount of wine remains the same, suggests new research from the ̽��ֱ�� of Cambridge. In a study published today in the journal BMC Public Health, researchers found that increasing the size of wine glasses led to an almost 10% increase in wine sales.

It’s not obvious why this should be the case, but one reason may be that larger glasses change our perceptions of the amount of wine, leading us to drink faster and order more

Rachel Pechey

BMC Public Health

Wine glasses at ̽��ֱ��Pint Shop

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