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Research by Professor Elliott and colleagues at Imperial College on worldwide salt and potassium intakes, their relationships to blood pressure, and co-authored systematic reviews and meta-analyses of their effects in adults and children on blood pressure and cardiovascular disease — and potential adverse effects — has played an instrumental role in developing international guidelines and public policy on sodium reduction strategies. Furthermore, published primary research has influenced US Centers for Disease Control and Prevention (CDC) strategies for population-wide monitoring of sodium intakes in the USA. This work has thus had impact on policies for sodium reduction and monitoring of sodium intakes worldwide.
Many research groups around the world have produced evidence that cardiovascular disease (CVD) can be prevented by dietary salt reduction. The specific contribution of the University of Warwick consists of primary research carried out between 2005 and 2013 by Professor Francesco Cappuccio, who has demonstrated that lower salt intake can lead to a reduction in strokes and total cardiovascular events. These results have informed public health awareness and policy- making both nationally and globally. The research contributed directly to the development of a national policy for salt reduction by the UK National Institute for Health and Care Excellence (NICE) in 2010 by indicating the likely health gains of a population strategy. The research also influenced global policies set out by the World Health Organization (WHO) in 2007, 2010 and 2012. Population-wide reductions in dietary salt are now the second priority after tobacco control set by the United Nations in 2011 for the prevention of non-communicable disease worldwide.
MacGregor and colleagues working at St George's have provided extensive clinical and epidemiological evidence that has changed UK government policy on recommendations for salt intake. In 2011 NICE recommended continued reduction in dietary salt intake in the UK. A 3 gm reduction in daily salt intake is calculated to result in 14-20,000 fewer deaths from cardiovascular disease annually, a saving of approximately £350 million in healthcare costs, and the gain of 130,000 quality-adjusted life years. The global benefits of this policy have been recognised with the WHO making recommendations for similar levels of salt reduction worldwide.
Our impact has been to protect the public by informing and influencing both the international policy debate on health claims associated with soy consumption, and the relevant regulatory risk assessment authorities.
Our research formed a key component of dossiers that resulted in the rejection of health claims by the European Food Safety Authority (EFSA, the EU agency responsible for the scientific substantiation of health claims) relating to soy isoflavones and a number of health endpoints including bone health, heart health and menopausal symptoms. Earlier work had underpinned decisions on comparable health claims in the US and UK.
Our soy isoflavone research also provided key scientific data on the absorption of isoflavones by the body (and dependence on age and food source) to the UK Government Committee on Toxicity (COT) policy review on the toxicity of chemicals with a specific focus on soy infant formula. This expands on COT advice in 2003, which used earlier Cassidy research and helped to inform the UK government's (Food Standards Agency) research programme on phytoestrogens /isoflavones.
Changing global patterns of agricultural production, food availability and processing are having profound impacts on individual food consumption and population health. Thus accurate data on individual food consumption are fundamental for effective planning of agricultural investments and for the implementation of sound public health nutrition policy. Research undertaken at the University of Ulster has demonstrated that mis-reporting in dietary surveys is pervasive and consequently is obscuring diet-health associations. This research has prompted a major paradigm shift in the way public health policy makers interpret dietary intake data.
The main impact of this work has been to provide an evidence base to inform practice and policy in relation to nutrition and diet. Through our contribution to the international EURRECA Network of Excellence, we have developed resources accessible to international expert panels as they review micronutrient recommendations. In addition, this work has had a significant impact on the formation of two major new initiatives; BOND and Zinc-Net, both of which address global issues relating to zinc deficiency and human health. Our pioneering research activities in Pakistan are helping to transform nutrition support and quality of life in marginalised communities.
Around 25% of UK adults have high blood pressure (hypertension), accounting for more than half of all strokes and heart disease. The pressure that the heart and brain senses that leads to these diseases is central aortic pressure. The Unit's research developed and evaluated methods for the non-invasive assessment of central aortic pressure, demonstrating its important relationship to clinical outcomes. The work has contributed to improvements in the way high blood pressure is treated for millions of people, nationally and worldwide, by (i) providing a rationale for one of the biggest-ever changes in treatment guidance in 2006; (ii) stimulating major growth in medical devices for the non-invasive measurement of aortic pressure with a simple, easy-to-use wristwatch invention; (iii) and developing central aortic pressure as a better biomarker for pharmaceutical companies to develop new drugs to treat hypertension.
Novel research into the cardiovascular and other health benefits of consuming flavanol-containing foods at the University of Reading prompted a multi-national food and confectionary producer, Mars Incorporated, to invest over £1.1 million in research into the absorption, metabolism and health effects of cocoa-derived flavanols in humans. This research informed the development of a cocoa-extract supplement drink and supplement extract, both widely available in the US since 2010. This in turn sparked interest from other multinational corporations looking to market flavanol- and other flavonoid-containing health products, resulting in an additional £917K investment by industry. Mars' cocoa-extract supplements currently hold a 1% share of all food and drinks marketed on a cardiovascular health platform in the US; a market worth US$3.1 billion in 2012. Research by Reading and others has provided evidence that consumption of these products can improve memory and cognition, cardiovascular health and digestive health for consumers. These and other research findings have been widely disseminated to the general public by the Reading researchers.
Cardiovascular disease is the largest killer in the developed world, with 50% of people affected during their lifetime. While the link between raised plasma cholesterol and cardiovascular disease is well established, heart-health policy to limit dietary cholesterol intake was based on the unsupported belief that dietary cholesterol was a key determinant of plasma cholesterol.
Researchers at Surrey were central to demonstrating no direct correlation between cholesterol-rich food and plasma cholesterol. This research led to multiple impacts: alteration of national and international dietary guidelines; better public perception of cholesterol control; and commercial impact through the increased consumption of cholesterol-containing foods.
Research at the University of Nottingham (UoN) has had influence on development of health policy in the UK and internationally. It is recognised that the risk of diseases related to obesity and insulin resistance, is partly determined by the nutritional environment experienced during early life. Against a background of scepticism researchers at the UoN have generated data that has been critical in demonstrating the biological plausibility of such associations. This has influenced expert panels and non-governmental organisations in framing their current recommendations for nutrition in pregnancy and infancy, which benefit women and children worldwide.