MRC Epidemiology Unit

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MRC Epidemiology Unit

Obesity, type 2 diabetes and related metabolic disorders present a major and growing global public health challenge.

The MRC Epidemiology Unit investigates the individual and combined effects of genetic, developmental, behavioural & environmental factors that cause obesity, type 2 diabetes and to develop and evaluate strategies to prevent them and their consequences. These disorders result from a complex interplay between genetic, developmental, behavioural and environmental factors that operate throughout life. The mission of the MRC Epidemiology Unit is to investigate the individual and combined effects of these factors and to develop and evaluate strategies to prevent these diseases and their consequences. In this way, we are working to improve the health of people in the UK and around the world. We are a Medical Research Council Unit embedded as a department of the University of Cambridge School of Clinical Medicine. The Unit is part of the Wellcome – MRC Institute of Metabolic Science (IMS) on the Cambridge Biomedical Campus, where the principle offices and laboratories of the Unit are physically located. Unit Director Professor Nick Wareham is Co-Director of the IMS with Professor Sir Stephen O’Rahilly. Being embedded in the IMS is critical to our aspiration to follow up associations between exposures and metabolic disease outcomes to determine possible causality and mechanisms. The Unit is also a part of Cambridge Population Health Sciences, a three department partnership of the Department of Public Health and Primary Care and the MRC Biostatistics Unit. Collectively, the Partnership pursues a wide range of research across epidemiology, biostatistics, population health and primary care, and delivers the Masters courses in Population Health Sciences. We are delivering on our mission through eight High Level Objectives which connect all our research programmes and infrastructure.

- To investigate the causes of obesity, diabetes and related metabolic disorders
- To develop understanding of mechanisms identified by population-based studies
- To develop and evaluate individual level approaches to the prevention of diabetes, obesity and related metabolic disorders in children and adults
- To inform, develop and evaluate population-based approaches to improving health
- To develop new methods, resources and tools for epidemiological and public health research
- To investigate approaches to improving global health, particularly in low and middle income countries
- To build capacity for conducting, understanding and using local, national, and international epidemiology and public health research
- To contribute to the translation of research evidence into policy and practice

The main objectives of each individual research programme are mapped to one or more of these High Level Objectives, which therefore provide a unifying framework to illustrate and augment the cross-links and collaborations between programmes.

08/01/2026

People prescribed the new generation of weight loss drugs such as semaglutide and tirzepatid may not receive sufficient nutritional guidance to support safe and sustainable weight loss, leaving them vulnerable to nutritional deficiencies and muscle loss.

In a systematic review published today, the UCL and University of Cambridge team found a lack of robust evidence surrounding nutritional advice and support and the impact this has on factors such as calorie intake, body composition, protein adequacy, and patient experiences.

The researchers, Dr Marie Spreckley and Dr Cara Ruggiero at the MRC Epidemiology Unit, and Dr Adrian Brown at UCL, identified just 12 studies that looked at nutrition and diet alongside treatment with semaglutide or tirzepatide. Even then, as the trials varied widely in their approaches to dietary advice and nutritional assessment and lacked standardised protocols and reporting, it was difficult to reach robust conclusions to inform the optimal support for people taking weight loss drugs.

While there was insufficient evidence from the studies to recommend strict low-fat diets to complement the weight loss drugs, some studies found that people on the treatments often consumed excessive levels of total and saturated fat. This suggests that there might be a need for individualised fat intake guidance, aligned with broad national recommendations.

Dr Spreckley commented:

"If nutritional care is not integrated alongside treatment, there’s a risk of replacing one set of health problems with another, through preventable nutritional deficiencies and largely avoidable loss of muscle mass. This represents a missed opportunity to support long-term health alongside weight loss.”

Dr Spreckley leads the newly launched AMPLIFY study that seeks to understand how people experience next-generation weight loss therapies when used for weight management, to help identify the types of information and wrap-around support that are most meaningful and needed in real-world care.

The research was funded by the National Institute for Health and Care Research (NIHR), with additional support from the Medical Research Council and the NIHR UCLH Biomedical Research Centre.

Links to more information in the comments below.

05/01/2026

Our first Bradford Hill Seminar of 2026 is an in person event with Professor Clare Turnbull of the Institute of Cancer Research, who will join us to discuss:

Expanding testing of cancer susceptibility genes from the clinic to the population: exploring the evidence gaps

📅 Wed 14 January 1 PM (UK)

Info & registration: https://buff.ly/hZtYEKZ

18/12/2025

The 2025 issue 5 of the epigram newsletter is out now!

In this issue we're counting the cost of calories, looking back at our 2025 research successes, and sharing a veritable feast of podcasts.

Happy Christmas from us to you and yours.

16/12/2025

Have you noticed a school street closure in your neighbourhood?

Schemes restricting parking and access outside schools at drop-off and pick-up times, have proliferated across the UK. A team led by Professor Jenna Panter at the University of Cambridge, and involving the Walk Wheel Cycle trust, evaluated the impact of such schemes on travel to school, using data collected routinely at nearly 500 schools across England and Scotland.

They found that active travel to school in schools with schemes was 6% higher than comparative schools without. All active means of commuting – walking, cycling, scooting and skating – increased, with the greatest increase seen for “park and stride,” where people drive for some of the journey and walk for the rest.

This shift was driven largely by a decrease in use of motor vehicles, with a 5% decrease in the proportion of children travelling to school only by private car.

The authors suggest that school street closures are broadly successful and support the creation of schemes in areas where this is feasible.

Read more at: https://buff.ly/tNiPnUQ

16/12/2025

Watch a recording of the Bradford Hill Seminar "From Genes to Public Health: The Journey Continues" with Dr Muin J. Khoury, who until recently led the Office of Public Health Genomics at the CDC.

https://buff.ly/Xmqg2aI

Dr. Muin J. Khoury recently retired from the CDC after a 40-year public health career, including 26 years leading the Office of Public Health Genomics, which he formed in 1998. He contributed to the development of genetic epidemiology, public health genomics, and precision public health; fields that are vital for realising the population health benefits of genome discoveries.

The trajectory from genes to public health is still early but Dr Khoury believes the next 40 years promise to be even more exciting in applying these fields to save lives, prevent disease, and reduce health inequities. Dr Khoury warns that many of the advances in genomics translation and implementation could be unravelled because of the current turmoil and budget cuts in science and public health in the United States. This talk offers his perspective on the evolution and contributions of these fields, and recommendations for increasing their population health impact.

08/12/2025

Recruitment and data collection for Fenland phase 3 study is now complete. We are grateful to the more than 5,000 Fenland Study participants who took part in this phase of the study.

A total of 4,973 participants came for a clinical visit, provided questionnaire responses, and wore a physical activity monitor. A further 73 provided questionnaire data and wore a physical activity monitor without attending a visit.

We are working hard to make the Fenland 3 data available for release as soon as we can. Lab results, anthropometry variables, and raw questionnaire variables are now available for request. Liver ultrasound, medications, dietary intake and physical activity data will be made available over the next few months. Keep an eye on the Fenland Study Data Sharing page for updates on when we expect datasets to become available.

We are grateful to everyone who has participated in the Fenland Study, which marks its 20th anniversary this year and has contributed to more than 110 publications. We look forward to continuing to work with them in future, and to reporting back to them on the continued growth of the impact of the research that they have contributed to.

05/12/2025

Congratulations to Dr Cara Ruggiero, who was recently named runner-up for the British Nutrition Foundation Drummond Early Career Scientist Award 2025, which was presented at the BNF Annual Conference held at the Royal College of Physicians in central London on Tuesday, 25th November 2025.

04/12/2025

A new study led by Dr Robert Luben, utilizing data from studies including UK Biobank and EPIC-Norfolk, has identified genetic risk factors for primary angle-closure glaucoma (PACG) in European populations, shedding new light on the genetic underpinnings of this condition across different ancestry groups.

In PACG the eye's drainage angle becomes blocked, leading to increased pressure in the eye and damage to the optic nerve. It is a leading cause of blindness in older adults, and while most cases are reported in East Asian populations, an estimated 2.6 million people of European ancestry have PACG. Previous genome-wide association studies (GWAS) identified eight genetic loci associated with PACG risk in Asian populations. However, the extent to which these genetic risk factors apply to other populations has remained unclear.

In this new study, researchers conducted a discovery GWAS for PACG in European populations using data from the UK Biobank, identifying five genomic regions that were associated with PACG, including two loci previously identified in Asian populations. They successfully replicated their findings in six independent European populations and then compared these results with data from 14 Asian population cohorts.

The meta-analysis that statistically combined data from the combined European and Asian populationcohorts identified six additional novel loci, all previously associated with refractive error, a common eye condition where the eye cannot focus light properly on the retina, leading to blurred vision

Using Mendelian randomisation, the study provided strong evidence for a causal role of shorter axial length of the eye and hypermetropic (farsighted) refractive error in the development of PACG. Furthermore, a polygenic risk score derived from the European ancestry meta-analysis showed significant associations with quantitative ocular traits, such as a shallower anterior chamber and higher intraocular pressure, in the independent EPIC-Norfolk cohort.

In a subsequent multi-ancestry meta-analysis of 21 European and Asian cohorts, the researchers identified 12 additional novel loci. Most notably, the study showed that genetic factors associated with a darker iris eye axial length and hypermetropia confer risk for primary angle-closure glaucoma. Genetic factors associated with a darker iris were associated with PACG in European but not Asian populations, potentially reflecting the more homogeneous eye colour in Asian populations, and eye colour may be a surrogate for other genetic risk factors such as iris thickness.

This research not only advances our understanding of the genetic basis of PACG, opening up the possibility of targeted screening efforts for this blinding disease, but also highlights the importance of considering genetic diversity across populations in the study of complex diseases.

02/12/2025

"A key strength [of the guidance] is the emphasis on combining medication with behavioural support and on the need for equitable access, rather than presenting drugs as a stand-alone solution.

"It clearly recognises obesity as a chronic, progressive, and relapsing disease that requires long-term, integrated management rather than short-term treatment "

Dr Marie Spreckley comments on new WHO guidance on weight loss drugs in a Euronews article https://buff.ly/BEypph6

Dr Spreckley leads the AMPLIFY study, exploring the lived experiences of people using, or who have recently stopped, incretin-based weight loss therapies, to better understand how to support them with information and wrap-around support.

Find out more about Amplify at https://buff.ly/AxR0QqR

01/12/2025

Congratulations to Kelly Kokka and James Woodcock on being awarded funding for their project using articifial intelligence (AI) to help planners create healthier and more sustainable cities by analysing street camera images and travel patterns across 45 cities worldwide to create detailed neighbourhood maps showing how people move.

Theirs is one of 15 groundbreaking projects funded by the Accelerate Programme for Scientific Discovery and Cambridge Centre for Data-Driven Discovery that will use AI to tackle some of the most pressing challenges in science and society.

https://buff.ly/Hn8kZBY

01/12/2025

Join our next online Bradford Hill Seminar with Dr Muin J. Khoury, who until recently led the Office of Public Health Genomics at the CDC, and will discuss:

From Genes to Public Health: The Journey Continues!

📅 Wed 10 December, 1 PM (UK)

Info and registration - https://buff.ly/i1j3aoU

28/11/2025

The Unit has donated equipment to Medical Aid International. The social enterprise works to advance patient care in low and middle income countries (LMICs) through long-term, sustainable change.

We are proud to be able to help the enterprise’s work by donating manually operated clinical couches, automatic BP monitors, ECG machines and clinical trolleys.

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MRC Epidemiology Unit, University Of Cambridge School Of Clinical Medicine, Box 285 Institute Of Metabolic Science, Cambridge Biomedical Campus

CB2 0QQ

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+441223330315

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http://www.mrc-epid.cam.ac.uk/

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