Health and Lifestyle
Our research focuses on identifying modifiable lifestyle risk factors for common and serious diseases- cancers, heart disease, stroke and blood clots (venous thromboembolism), fractures and dementia. How does lifestyle – smoking, diet, exercise, medications, work, social life – influence risk of disease, especially in middle and old age, and what aspects of lifestyle might individuals and society consider most important for disease prevention and public health?
In the UK, smoking remains the leading preventable cause of death, and is a major cause of cancer and cardiovascular disease. In the Million Women Study, we are investigating the full effects of smoking and of stopping smoking at various ages on a number of health outcomes, in a cohort who were the first generation of women to have smoked substantial numbers of cigarettes from a young age into later middle-age. We have shown that even after a lifetime of smoking, women who stop smoking in middle age can still substantially reduce their risk of dying prematurely from a smoking-related disease (Pirie et al, 2013).
Obesity continues to be a major factor influencing the burden of disease globally. In the UK and other countries, we investigate the impact of obesity on health and on the healthcare system across a range of major diseases, including cancer, heart disease and fractures. In the Million Women Study, we found that overweight and obesity have a major impact on rates of hospital admission for a wide range of conditions including joint replacements, heart disease - and some less obvious diseases such as carpal tunnel syndrome (Reeves et al, 2014). Obesity is also closely related to other topics of interest in the Unit, such as diet, physical activity, hormones and childhood growth.
The effect of diet on cancer risk is the focus for the EPIC cohort, and we are also looking at diet and disease risk in the Million Women Study (Crowe et al, 2014) and in UK Biobank. These studies, particularly for prostate cancer, include measures of hormones such as IGF-1, and of biochemical and genetic factors which may mediate or interact with the effects of diet.
We are using the Million Women Study dataset to consider questions of interest in physical activity epidemiology - such as the different effects of activity on risk of fracture at different sites (Armstrong et al, 2012).
We continue to study the risks and benefits associated with hormonal factors, including use of hormone replacement therapy (Sweetland et al, 2012; Collaborative Group on Hormonal factors in Breast Cancer, 2012), and of oral bisphosphonates (Green et al, 2010).
environmental and genentic factors
We have a programme of research on social factors, such as marital status and social participation (Floud et al 2015). Our work on lifestyle (environmental) factors gives part of the picture - for many conditions we are also studying genetic influences (eg for prostate cancer and breast cancer), (Travis et al,2010; Reeves et al, 2010) as well as biochemical factors (Schmidt et al., 2015) which may help to explain how lifestyle and genes affect development of disease.