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Professor Caroline Fall MBChB, DM, FRCP, FRCPCH

Professor of International Paediatric Epidemiology

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Professor Caroline Fall is Professor of International Paediatric Epidemiology within Medicine at the University of Southampton.

As a paediatrician and epidemiologist, my research specialises in the developmental origins of health and disease. I focus on how a mother's diet and nutrition influence the long-term health of her children, and work mainly in developing and transitioning populations, especially India

Caroline Fall studied medicine at the University of Bristol, qualifying in 1978, followed by clinical training in General Medicine, General Practice and Paediatrics. She joined the MRC Lifecourse Epidemiology Unit (then the Environmental Epidemiology Unit) in 1989, to study the Hertfordshire birth cohort, and showed for the first time that low birthweight and infant weight were associated with an increased risk of insulin resistance and Type 2 diabetes in adult life. Since 1993, she has been working on the fetal origins of diabetes and other non-communicable diseases (NCDs), mainly in Indian populations, building up collaborations in several centres in India.

Caroline works with a team of epidemiologists, nutritionists and statisticians investigating the fetal origins of cardiovascular disease and Type 2 diabetes and the maternal factors influencing fetal growth. Her chief role is to lead a programme of research involving 7 centres in India. These studies include: 1) the follow-up of children and adults whose size at birth was recorded, 2) prospective cohort studies on the short and long-term effects on the offspring of maternal nutritional status and glucose/insulin metabolism during pregnancy, and more recently, 3) randomised studies of interventions to improve maternal nutrition, starting pre-conceptionally.

Caroline was the moving force and organising secretary for the First World Congress on the Developmental Origins of Health and Disease (DOHaD) held in Mumbai, India, February 2001, and has been a member of the scientific planning committees for subsequent DOHaD Congresses, held in Toronto (2005), Santiago, Chile (2009), Portland, Oregon (2011) and Capetown, S Africa (2013). She was secretary of the International DOHaD Society from 2003-2013, and continues to serve on its governing council and education sub-committee. She was awarded the David Barker Medal, the DOHaD society’s highest award for scientific achievement and leadership, in 2013.

Her clinical interests are in Paediatric Endocrinology and Diabetes, and she is a member of the UHS children’s diabetes team.

Committee Membership

 

Qualifications

BSc, Anatomy, Bristol University (1976)

MBChB, Medicine, Bristol University (1979)

MRCP, Medicine, (1983)

DCH, Child Health (1984)

DM, Epidemiology, University of Southampton (1999)

FRCP, Medicine (1999)

FRCPCH, Child Health (2000)

 

Appointments held

1979-1990 NHS Clinical Posts in Bristol, Bath and Southampton. House Officer, Senior House Officer and Registrar in Internal Medicine, General Practice and Paediatrics

1991-1993 MRC Environmental Epidemiology Unit, British Heart Foundation Research Fellow

1993-2006 MRC Environmental Epidemiology Unit, Clinical Research Fellow, Senior Lecturer, Reader

1989-present MRC Clinical Scientist, Professor of International Paediatric Epidemiology, MRC Lifecourse Epidemiology Unit, Honorary Consultant in Child Health, Southampton University Hospitals NHS Trust

Research interests

Professor Fall has over 230 original peer-reviewed research publications and 40 review articles.

Main research areas:

  • Developmental origins of type 2 diabetes, cardiovascular disease and metabolic syndrome
  • Developmental influences on cognitive function
  • Maternal nutrition and metabolism – effects on fetal growth and later health
  • Childhood growth patterns and later non-communicable disease risk

Research objective: Translating the Developmental Origins of Health and Disease (DOHaD) concept into interventions to improve human health and prevent disease in developing countries.

Professor Fall leads a programme of research within the Medical Research Council Lifecourse Epidemiology Unit on the Southampton General Hospital campus (Developmental determinants of cardiometabolic health in transitioning populations).

Most of her research takes place in India, where she has collaborations with research groups in Mumbai, Pune, Delhi, Mysore, Vellore and Hyderabad. Studies include birth cohort studies, prospective studies of maternal nutrition and metabolism in pregnancy, and intervention trials of nutritional supplementation before and during pregnancy. She is also interested in epigenetic changes (DNA methylation) as mediators of the link between early life nutrition and later heath. Visit the MRC LEU website for further details of individual projects.

Professor Fall also has wider collaborations in low- and middle-income countries (LMICs) outside India. She is a member of the COHORTS group, a consortium of large birth cohort studies in Brazil, Guatemala, India, The Philippines and South Africa. She leads the TALENT consortium (Transforming Adolescent Lives through Nutrition), which aims to fill knowledge gaps about adolescent diets, nutritional status and physical activity in India and sub-Saharan Africa, and develop interventions to improve the diet and activity of adolescents, in Ethiopia, Ivory Coast, The Gambia, South Africa and India. She also leads the EMPHASIS study (Epigenetic Mechanisms linking maternal Pre-conceptional micronutrient Supplementation with offspring health in India and Sub-Saharan Africa). She is part of the INPREP3 study, led by Professor Marie-Louise Newell, Global Health Research Institute, a collaboration with Burkina Faso, Ghana and S. Africa to develop interventions for mothers that are feasible within existing African health systems. She contributes data to the NCD-RisC collaboration which analyses trends in NCDs using data from >19 million people in >180 countries.



Main discoveries:

  1. The risk of type 2 diabetes, hypertension, cardiovascular disease and metabolic syndrome in adult life is increased following in utero exposure to maternal under-nutrition, maternal diabetes and low birthweight, and to poor infant weight gain, and rapid weight or BMI gain in childhood and adolescence
  2. The same early life exposures are associated with a more adverse cardiovascular risk profile even in childhood, and with endocrine disturbances such as reduce insulin secretion, insulin resistance and accentuated stress responses
  3. South Asian babies are born with a ‘muscle-thin-but-adipose’ body composition, which persists into childhood and adulthood and increases cardiometabolic risk
  4. Improvements in maternal diet quality and micronutrient status before and during pregnancy reduce the incidence of low birth weight. Studies are ongoing to determine whether they reduce cardiometabolic risk markers in the children

Department(s)

Human Development and Health

Affiliate Department(s)

Human Development and Physiology

Local responsibilities:

  • Deputy Director, Human Development and Health Division
  • PhD, DM and MSc supervisor in Paediatrics, DOHaD and nutrition, including international students
  • Supervisor for medical student Study in Depth/Research projects
  • Internal and external PhD and MD examiner
  • Personal tutor to under-graduate medical students

 

National and international responsibilities:

  • Regular reviewer for more than 20 international journals and national and international granting bodies.
  • Member, Advisory Group, CLOSER International, University College London. 2018-2020.
  • Member, Advisory group, NIHR Global Health Research Group (Improving outcomes in sub-Saharan African Diabetes through better diagnosis and treatment), PI Prof Andrew Hattersley, University of Exeter. 2018-2020.
  • Member, Medical Research Council Nutrition Research Partnership – a panel of nutrition scientists convened by MRC to develop and advise upon future strategy for UK nutrition research (2017-present).
  • Member, NIHR grant panel for Global Health Groups. 2018.
  • Member, MRC grant panel for Global Challenges Research Fund pump-priming awards (Confidence in Global Nutrition and Health). 2017.
  • Lead investigator, TALENT consortium (Transforming Adolescent Lives Through Nutrition) (2017-present).
  • Lead investigator, EMPHASIS study group (Epigenetic mechanisms linking pre-conceptional nutrition and health in India and sub-Saharan Africa) (2015-present).
  • Member, COHORTS collaboration (Consortium for Health-Orientated Research in Transitioning Societies), comprising birth cohort studies in India, Guatemala, Brazil, The Philippines and South Africa.
  • Member, 3rd British Nutrition Foundation Task Force on Diet and Cardiovascular Disease (2014-2019).
  • Member, HEFCE 2014 Research Excellence Framework sub-panel for Public Health, Health Services and Primary Care (2013-2014).
  • Former Secretary (2003-2013) and current member of Governing Council, International DOHaD Society.
  • Member, Public Health and Topical Medicine Committee (PHATIC), Wellcome Trust (2010-2015).
  • Chair, Research Committee (2012-2016) and Member (2010-2017) of the Public Health Foundation of India (PHFI) – UK consortium for capacity building for public health in India.
  • Member, GIFTS consortium (Genomic and lifestyle predictors of fetal outcome, diabetes and obesity in S Asian populations; PI: Graham Hitman, QMUL) (2011-2017).
  • Reviewer for international journals and granting bodies.
  • Member NCD-Risc consortium for global secular trends in cardio-metabolic risk markers (2009-present).
  • Member, Sneha-India (Indian Society for Natal Effects on Health in Adults) (1995-present), and co-organiser of 1st to 20th annual Sneha-India workshops on developmental origins of health and disease (1995-2017). 
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Professor Fall teaches medical students. She trains research teams in research methods, governance, epidemiology, and scientific writing. She teaches on developmental origins of health and disease on post-graduate diploma/Masters courses for various health professionals, internally and externally, and post-graduate courses designed for CME

Professor Caroline Fall
MRC Lifecourse Epidemiology Unit, Faculty of Medicine, University of Southampton, Southampton General Hospital, Tremona Road Southampton SO16 6YD.
Phone number: +44 2380 777624
E-mail: chdf@mrc.soton.ac.uk

Room Number: SGH/MRC/MP95

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