Taking fish oil supplements might be better than eating oily fish for improving heart health, according to an award-winning research paper. Southampton researchers Professor Philip Calder and Dr Helena Fisk are co-authors for the study, which has been named the British Journal of Nutrition’s Paper of the Year. They are both part of our NIHR Southampton Biomedical Research Centre’s nutrition, lifestyle and metabolism theme. Preventing blood clots The study was led by Professor Parveen Yaqoob at the University of Reading, in collaboration with researchers in Southampton and Liverpool. The study aimed to find out whether eating oily fish or taking fish oil supplements is better for heart and blood vessel health. Both are a source of EPA, a type of omega-3. To do this, the team looked at extracellular vesicles in the blood of 42 adults. They either ate oily fish like salmon or mackerel, took fish high-dose oil supplements, or continued with their normal diet (the control group) for 12 weeks. Extracellular vesicles are tiny ‘packages’ that help cells to communicate. However, too many can raise the risk of blood clots, a factor linked to cardiovascular disease. Supplements more effective Only participants who took high-dose fish oil supplements had a significant reduction in the number of extracellular vesicles in their blood. Participants who ate oily fish had no change. Supplements also reduced how strongly the vesicles triggered the production of thrombin, a key protein involved in blood clotting. Again, this was not seen in those who ate oily fish. The research shows that eating oily fish is not enough to give cardiovascular benefits related to extracellular vesicles. However, high-dose fish oil supplements could help. The Paper of the Year award recognises an outstanding piece of research published in the British Journal of Nutrition. The winning paper needs to demonstrate exceptional scientific rigour, originality, and significance in the field of nutritional science.

A research-based initiative to prepare cancer patients for surgery is coming to leisure centres across Southampton. Researchers at University Hospital Southampton (UHS) developed the programme with Wessex Cancer Alliance. It was first introduced at Bournemouth’s BH Live Active Littledown Centre in 2018 as part of the WesFit trial. The scheme has already improved the post-surgery experience for hundreds of patients across Bournemouth and Portsmouth. Now, it is being expanded to support people with cancer in Southampton. Based on evidence from research Patients who are physically fit are more likely to have better outcomes from surgery. Prehabilitation, or prehab, uses exercise to support patients to improve their fitness beforehand. WesFit aimed to see if prehab in leisure centres improved surgery outcomes for patients with cancer. The trial showed patients' physical fitness returned to pre-chemotherapy levels before their surgery. They also had shorter hospital stays and fewer complications afterwards. Wesfit was part of years of prehabilitation research led in Southampton by Professor Sandy Jack. Her research forms part of the NIHR Biomedical Research Programme’s perioperative and critical care theme. Improving cancer patients’ outcomes The programme is aimed at people aged 18 and over with stage 3 and 4 cancer who are preparing for surgery. People are referred onto the scheme via their NHS health practitioner. They receive a personalised exercise plan to improve their fitness before their surgery. Activities include one-to-one personal training. They also include group exercise classes such as cycling, yoga, Pilates and swimming. Benefits include fewer post-treatment complications and reduced length of stay in hospital. People also report better fitness levels, confidence and quality of life. Expanding this 'life-changing support' The scheme is now available at BH Live Active centres in Bitterne, Chamberlayne and The Quays. These are owned by Southampton City Council and operated in partnership with BH Live. Professor Sandy Jack, co-lead of the prehabilitation service at UHS, said: "Expanding the offering of prehabilitation in our city is a really positive step in helping people prepare both physically and mentally for cancer treatment, improving recovery and long-term health outcomes." Sally Rickard, Managing Director at Wessex Cancer Alliance, said: "We are really pleased that this partnership is continuing to support people with cancer across Wessex." Karen Tillyer, Southampton Health and Wellbeing Manager at BH Live, said: “Expanding the PREHAB Cancer programme across our BH Live Active centres is an important step in supporting people through a challenging stage of their cancer journey. “We’ve already seen how personalised prehabilitation can boost patients’ confidence, fitness and overall recovery. “Working with University Hospital Southampton and Wessex Cancer Alliance, we’re proud to bring this life‑changing support to even more people in our community.”

Image credit: World Obesity Federation A new analysis of global obesity trends since the 1980s challenges the idea of a ‘global epidemic’ of obesity. The research reveals rising levels of obesity have slowed, stabilised and possibly even reversed in many nations. The global report was put together by a collaboration of researchers, including from Southampton. It has now been published in the journal Nature. A more optimistic picture The analysis was led by researchers from Imperial College London, via the NCD Risk Factor Collaboration (NCD-RisC). The research looked at more than four decades of health data from 200 countries and territories, covering the period from 1980 to 2024. The findings come as experts from around the world meet at the European Congress on Obesity (ECO 2026) in Istanbul this month. They provide a more optimistic picture of progress than previously reported. The research shows that the increase in obesity rates has slowed or levelled off in most high-income countries. This is despite rapid rises at the end of the 20th Century. In some high-income countries rates may have even begun to decline. This includes France, Italy and Portugal. The researchers say these results suggest previous claims of a ‘global epidemic’ of obesity are likely to be an oversimplification. They say these claims mask the huge diversity seen across countries. This can be driven by a range of factors, especially the availability and affordability of healthy food. However, obesity prevalence continues to rise in many low‑ and middle‑income countries. This includes Africa, Asia, Latin America, and Pacific and Caribbean island nations. The researchers suggest we should focus on the pace of change in obesity over time, rather than just the prevalence. By doing so, they say we can learn where urgent action is needed. This includes robust health and food policies to help nations adapt and manage public health during economic, technological and nutritional transitions. Professor Majid Ezzati, from the School of Public Health at Imperial College London, led the analysis. He said: “We now need to find out why some countries are doing so much better than others, and apply the lessons to stop obesity from increasing. “Ultimately, this analysis shows that the trend towards obesity is not inevitable, and that it is possible for policy makers to intervene to stop and even reverse growing obesity.” Children improving first Obesity rates in high-income countries slowed first in school-aged children and adolescents. Adults followed the same pattern about a decade later. In most high-income western countries, the rise in obesity among children occurred before the millennium. This trend slowed, plateaued and even reversed slightly after the year 2000. Denmark experienced the earliest documented slowdown, around 1990. This was followed by other European countries during the 1990s. These included Iceland, Switzerland, Belgium and Germany. By the mid-2000s, growing obesity rates among school-aged children and adolescents in most high-income countries started to stabilise. In some, they even started to decline. The exceptions were among children in Australia, Finland and Sweden. There, obesity increased steadily or accelerated. However, the levelling off has happened at very different national prevalences across countries. In many western European countries and Japan, obesity growth plateaued or reversed when prevalence was below 10% of the school-age population. This meant fewer than one in ten children had obesity. By comparison, in the USA and New Zealand, obesity stabilised when levels were much higher, at 19-23% of the school-age population. This meant as many as one in four school children had obesity. The same trend was seen in adults. In the UK, the research showed the rise in obesity has slowed or plateaued for both children and adults. However, this has happened at moderately high prevalence. 10-12% of children and 27-30% of adults had obesity in 2024. The UK remains mostly in the top 10 countries among high-income western countries for obesity rates. Professor Keith Godfrey from the NIHR Southampton Biomedical Research Centre and the University of Southampton contributed to the research. He said: “In England, the most recent National Child Measurement Programme data show that 10.5% of school children in reception and 22.2% of year 6 children were living with obesity. “Excluding the 2020 to 2021 peak during the COVID pandemic, this is the highest obesity prevalence seen in reception since the measurement programme began in 2006. “At national, regional and local levels, there are large and widening variations in obesity prevalence in young children, associated with persistent inequalities by ethnic group and deprivation. “The findings are encouraging in showing that obesity rates have stabilised or even started to decline in several European countries. “They give hope that concerted action to improve our national food system could likewise start to reduce the wide disparities in child obesity in the UK.” Global obesity trends Previous reports on the global state of obesity have typically compared prevalence of obesity over decades. This includes those conducted by NCD-RisC in collaboration with the World Health Organization (WHO). This approach can provide valuable insights. However, it can make it difficult to track progress in controlling obesity. This is especially true for recent changes that reflect policy innovation. In the latest analysis, researchers used velocity of obesity as a key measure. This is calculated as the annual absolute change in prevalence of obesity. It is reported in percentage-points-per-year. Using this method, they were able to provide a clearer picture of where increases in obesity are accelerating, stabilising, or reversing. The team analysed weight and height measurements from over 232 million people. This included 70 million people aged five to 19 years, and 162 million aged 20 years or above. The analysis covered 200 countries and territories. More than 1,900 researchers contributed to the study. It looked at body mass index (BMI) to understand how obesity rates have changed worldwide from 1980 to 2024. Obesity was defined as a BMI of 30 kg/m2 or above for adults. It was defined as a BMI over two standard deviations above the median of the WHO growth reference for children and adolescents. Estimates of obesity were adjusted for differences in how the population was distributed in different ages. This was done through a process called age standardisation. Growing gap between countries The analysis shows that obesity continues to rise, and is even accelerating, in most low- and middle-income countries. This divergence from high-income nations highlights growing global inequalities in nutrition and health. The researchers recommend tailored public health policies to address the growing gap. These could include policies focused on the availability and affordability of healthy foods for countries and communities who cannot currently afford and access them. Over the last decade, new obesity medications have become widely available. These include GLP-1 receptor agonists. The researchers state that the introduction of these drugs does not yet explain the changes seen in their study. However, they say these are likely to play an important role in future trends, especially if access and affordability are improved. Professor Ezzati explained: “At this stage it’s probably too early to say whether GLP-1 drugs have had a direct impact in entire populations, even though they are beneficial for patients who use them. The focus should be on making them more affordable to all who need them around the world.” The authors highlight a number of limitations to the study, including the amount of data available, which varied by region. The research was funded by the UK Medical Research Council and UK Research and Innovation. It was supported by funding through the European Union.

Tree bark is being tested by researchers at the University of Southampton as a new way to trace harmful air pollution in local communities. Particulate matter – tiny particles of dust too small for the eye to see – is considered to be one of the most harmful types of air pollution for our health. However, it can be difficult to measure what people are exposed to, and establish where it has come from. A new approach being trialled at the University and the NIHR Southampton Biomedical Research Centre is seeing if tree bark could hold the answer. The study is being led by Dr Natasha Easton through an Early Career Colleague Fellowship with the University’s Sustainability and Resilience Institute. She is supported by BRC Air Pollution lead Prof Matt Loxham and Interstitial Lung Disease lead Prof Mark Jones. Harmful to health Particulate matter can be breathed deep into the lungs, and the very smallest particles can even enter the bloodstream. Long-term exposure to particulate matter has been associated with increased risk of a wide range of health conditions. These include asthma, interstitial lung disease, lung cancer, cardiovascular disease, stroke and dementia. This dust comes from both man-made and natural sources. Man-made sources include burning fuels, for example in vehicle engines, industrial emissions, as well as tyre and brake wear. These sources leave behind a chemical fingerprint. This can be used to work out where the pollution came from. Dr Easton said: “Air pollution doesn’t affect every area in the same way, so it’s really important that we build a clearer picture of what’s happening in our local environments. “By looking at what’s captured in tree bark, we hope to uncover these hidden fingerprints to pinpoint sources of pollution and guide strategies to ultimately support healthier communities.” Analysing tree bark Particulate matter can become trapped in tree bark. The research team therefore aims to measure the levels of this type of air pollution using the bark from local trees. The project will collect bark samples from trees across two cities. It is being conducted in partnership with Southampton and Winchester City Councils. The researchers will then analyse these samples to determine how the composition and sources of particulate matter vary across our region, and by how much. This will allow them to identify who is most likely to be exposed to each of the different sources. This new approach to monitoring air quality will give a detailed picture of real-world particulate matter distribution. The project will help to identify which sources contribute the most to local air pollution and how our different communities are differentially exposed. This knowledge could steer strategies to improve air quality and inform future studies to relate individual sources to impacts on health.

Teenagers are embracing ‘food swaps’ after demystifying ultra-processed foods in a project funded by the National Institute for Health and Care Research (NIHR). Young people quizzed academic, doctor and broadcaster Chris van Tulleken as they finished the work exploring the health effects of ultra processed foods. The star of CBBC’s Operation Ouch! and author of Ultra Processed People was visiting the South to speak at an open day for the NIHR Southampton Biomedical Research Centre (BRC). Ultra processed foods are now so common in the UK that they can be difficult to avoid, and teenagers are eating a lot of them. This can have serious consequences for their health. These foods include sugary cereals, crisps, chocolate bars, fizzy drinks and ready meals. Collaborative ‘Youth Panel’ Seven young people, aged between 14 and 17 years, worked with researchers on the REACH study as part of a Youth Panel hosted by LifeLab. LifeLab is a collaboration between the University of Southampton, University Hospital Southampton (UHS) and the NIHR Southampton BRC, and is based at UHS. Over 12 weeks, the Youth Panel explored ultra processed foods and their effects on children and young people’s health. They discussed food environments, marketing, misinformation and behaviour change. In the final sessions, they used their new knowledge and understanding to design solutions, working in partnership with the researchers. These included ideas such as ‘food swaps’, which provide a healthier choice that young people could use to replace an ultra-processed food in their diet. Youth panellist Meriel Armstrong said: “This has made me discover there are a lot of foods involved that you wouldn’t expect to be ultra processed. I’m definitely more conscious now of what I eat and the choices I make, and I have changed to eat more Greek yoghurt and fruit for breakfast.” Fellow panellist Chichi Anozie added: “I didn’t previously realise the magnitude of how much this issue involves young people and the effect it can have on our health in the long term. This whole process has been very insightful and collaborative, and it’s got me talking to my friends to expand the conversation.” Ultra-processed health risks In the UK, ultra-processed foods now make up over half the calories in our diet. For teenagers, this is even higher, making up almost two-thirds of the calories they eat. They are cheap, tasty and have a long shelf life, meaning they have become a staple of the UK diet. These foods are industrially produced. They are often high in sugar, fat and salt, and contain additives, preservatives and emulsifiers not used in home cooking. However, a diet high in UPFs has been linked to numerous health conditions, including obesity, type 2 diabetes and cancer. It is also associated with poor sleep, anxiety and depression. Professor van Tulleken is well aware of these health implications, both in his professional life and through personal experience helping his twin brother, Xand, find ways to reverse his weight gain. His address at the NIHR Southampton BRC open day at St Mary’s Stadium highlighted his efforts to bring public attention to the health effects of ultra-processed foods. Following the talk, he spent an hour with the LifeLab Youth Panel and pupils from Mount Pleasant Junior School in Southampton. The teenagers presented him their findings and put their questions to him about the foods. Professor van Tulleken said: “Young people can have an incredibly powerful and informed voice on ultra‑processed foods, and they are often the ones most affected by the food environments we’ve created. “Meeting children and young people who are so engaged, curious and solutions‑focused on this issue has been genuinely inspiring, and it reinforces why they must be part of the conversation.” Finding ‘solutions together’ LifeLab set up Youth Panels in 2022 to provide a space for young people to discuss health issues that concern them. They are employed as equal partners on projects, allowing them to create and implement solutions to improve their own health and the health of other young people. The REACH study is funded by the NIHR Wessex Experimental Medicine Network. The network is hosted by the NIHR Southampton BRC and supported by Wessex Health Partners. Dr Caroline Anderson, a Clinical Academic Paediatric Dietitian at UHS, led the REACH study. Her research has been supported by UHS through a Research Leaders Programme award and more recently the NIHR SCPRA (Senior Clinical Practitioner Research Award). “Ultra processed foods are a growing concern for young people, particularly those with long term conditions. Yet most conversations about UPFs happen about young people, not with them,” she said. “The REACH study aims to change that. We’ve worked in partnership with them to hear their views and come up with solutions together.” Professor Kath Woods-Townsend, REACH study co-lead and LifeLab Programme Director, said: "I am always amazed by the depth of engagement and insight we see from our LifeLab Youth Panels when they're given the space to explore health issues that matter to them. "Our research shows that despite school food standards intended to restrict foods high in fat, salt and sugar, young people often find their canteen looks more like a fast-food outlet than a healthy eating environment - making ultra-processed foods feel like the only realistic option. "That's the context in which these young people are navigating their food choices, and it's exactly why their voices need to be part of the solution."

A pioneering trial is testing whether exercising before heart surgery can help patients recover faster and improve long-term outcomes. The CardioFit trial is delivered through the NIHR Southampton Biomedical Research Centre (BRC). It is supported by the Heartbeat charity. Patients with cancer are already routinely offered ‘prehabilitation’ at University Hospital Southampton (UHS). The hospital is now breaking new ground by investigating its impact on patients with heart conditions. Structured exercise programme Patients with active cardiac conditions are currently told to avoid strenuous exertion in the weeks before surgery. However, in this new study, patients with severe aortic stenosis awaiting surgery will follow a structured exercise programme. The team will evaluate the safety, feasibility and benefits of the trial to establish if it boosts recovery and success of the procedure. The trial is being led by Professor Sandy Jack and Professor Denny Levett. They are clinical academics in the Southampton NIHR BRC and co-leads of the prehabilitation service at UHS. Critical heart condition Severe aortic stenosis occurs when the aortic valve thickens or stiffens and doesn’t open properly. Around 300,000 people aged over 55 are estimated to be living with the condition in the UK. Participants on the trial complete up to six weeks of exercise training at the hospital’s NIHR Southampton Clinical Research Facility. They will be guided by clinicians and tailored to their individual fitness levels. Each session is carefully monitored with heart and oxygen sensors. This ensures safety and assesses each individual’s response. “This is one of the first times prehabilitation has been applied to patients with heart valve disease,” explained Professor Jack. “We know from our earlier work that being fitter before surgery can make a real difference to how quickly patients recover. We want to bring those benefits to people undergoing cardiac surgery. “Prehabilitation has also been shown to reduce the number of cancellations on the day of surgery. This can lead to important cost savings for the NHS.” Charity financial support Donors, supporters and trustees of Heartbeat have long envisioned the charity actively promoting heart health. The charity's financial support for Cardiofit, is the first such research venture. It capitalises on the expertise the team at UHS has in the field of prehabilitation medicine. Mark Ind, Chief Executive of Heartbeat, said: “I am delighted that Heartbeat has been able to provide funding and support for this important research for Cardiofit. This would, in time, enable so many cardiac patients to undergo their surgery with a greater level of physical and mental wellbeing. “With the appropriate level of exercise, good diet and psychological support, patients should recover quicker and reduce the risk of further procedures. In some cases, they may have a greater likelihood of increased life expectancy. To be now at the patient trial stage of the process is an excellent milestone. I am excited by the prospect of further participants in the coming months.” Professor Mike Grocott, Director of the NIHR Southampton BRC, said: “In the last few years, research has shown us just how much preparing for surgery through supervised exercise can improve people’s recovery and overall health. We’re seeing those benefits reach more patients and helping the NHS by reducing complications and speeding up recovery times. I hope this new research continues to grow that impact so even more people can benefit in the future.” Taking part in the trial Graeme Harrison, 60, from Southampton, is preparing for surgery by taking part in the CardioFit trial this spring. “I was first aware there might be a problem with my heart toward the end of 2024,” he explained. “I noticed things were starting to be a physical struggle. Regular activities like walking to the station were becoming harder and harder.” Graeme ended up with chest pains and was admitted to hospital for a couple of days. He was diagnosed aortic stenosis. The heart condition will require surgery this year. “I received a call out of the blue from the hospital about the opportunity to take part in the research trial,” he said. “I was told prehabilitation has been beneficial for others and it seemed a sensible option to take up. “It’s been a very interesting experience and not as hard work as I thought it was going to be. If I can help others in the future by being part of this study, then that would be a great outcome.” The trial is being driven forward by a team including Dr James Otto, Lesley Hawkins, Gurinder Rayat and former trial manager Samatha Leggett. Over a decade of research Southampton is internationally recognised for its pioneering prehabilitation research. Over 15 years, these trials have helped thousands of patients recover faster, reduce complications and improve quality of life. This led to UHS launching the UK’s first NHS-funded Prehabilitation Medicine Service in 2023. The service has improved patient outcomes and reduced delays to surgery due to improved fitness levels. It also inspired the creation of Prehab4Life. This Southampton-led national spinout company will manage and deliver the production of repeatable and scalable prehabilitation services across the NHS. Prof Jack added: “CardioFit marks another exciting step forward in Southampton’s prehabilitation programme. We believe it could improve outcomes for this group of cardiac patients across the UK.”

Deliberately infecting volunteers to test new whooping cough vaccines has been shown to be safe in research. A team at University Hospital Southampton has developed a safe method of ‘controlled human infection’, where volunteers are infected with whooping cough bacteria without causing any illness. This can be used to study the infection in detail and to help develop and test new and improved vaccines. The researchers have shown that the method was safe, even when volunteers went home while infected with the bacteria that causes the disease. The results have now been published in the Lancet Microbe. Led by Southampton’s Professor Robert Read, the discovery marks a major step forward for whooping cough vaccine development. It shows trial participants do not need to stay for weeks in hospital. This takes away a major barrier to developing a new, potentially life-saving vaccine. The findings will speed up the testing of new vaccines for whooping cough and has international importance. In light of this evidence, the US government’s Food and Drug Administration has now stated that controlled infection studies can be used to assess the efficacy of new whooping cough vaccines. The study was delivered through the NIHR Southampton Biomedical Research Centre (BRC). Protecting babies Whooping cough is estimated to cause 160,000 deaths worldwide each year. Half of these are in babies less than a year old. Caused by the bacteria Bordetella pertussis, it is highly infectious and is spread through coughs and sneezes. The bacteria can infect the upper airway without causing disease symptoms, so adults can spread it without knowing they have it. While infected adults can have mild cold-like symptoms or none at all, whooping cough can cause persistent coughing and breathing difficulties in babies under six months. This can be severe and even life-threatening. A vaccine for whooping cough is currently offered to all babies in the UK. However, it does not offer lifelong protection, or prevent people from getting infected or spreading the disease. We therefore need a better whooping cough vaccine to be developed. Avoiding weeks in hospital To investigate whether a whooping cough vaccine protects people against being infected or spreading it, you need to know people will be exposed to Bordetella pertussis. Since this is unlikely to happen by chance in the UK, researchers are investigating whether trial participants can be deliberately infected under controlled conditions. This is known as a ‘human challenge trial’. Previously, healthy volunteers deliberately infected with Bordetella pertussis were required to stay in isolation at hospital for around two weeks, before being given antibiotics to clear it. Now, these new results show this may not be necessary. In this study, participants were treated as outpatients, meaning they were allowed to return home after being infected at the NIHR Southampton Clinical Research Facility. Of the 51 adults who took part, the bacteria did grow in 23 of their noses. None developed symptoms of whooping cough and there were no serious side effects reported. The study also tested 14 people who shared a bedroom with one of the participants. None of them became infected, showing the participants did not spread the bacteria. Professor Read is senior author on the paper. He leads the NIHR Southampton BRC’s microbiology, immunology and infection theme. “Our results show this new way of infecting healthy volunteers is safe and effective,” he said. “Isolating participants in hospital for weeks at a time is expensive, and prevents many people from being able to take part. “We hope this new discovery will remove this barrier, enabling the development of a new vaccine that will better protect babies.”

Antibiotics play an essential role in healthcare, but infections resistant to them are on the rise. Antibiotic resistant infections are difficult to treat. This is because bacteria develop defences that mean they can no longer be killed with commonly used antibiotics. Overprescribing of antibiotics is one the main factors driving the rise in antibiotic resistant infections. Avoiding unnecessary prescribing and use of antibiotics will help ensure they continue to work. Nour Odeh is a postgraduate researcher at the NIHR Southampton Biomedical Research Centre. Based at the University of Southampton’s Primary Care Research Centre, she’s investigating why patients with asthma are more likely to be prescribed antibiotics for acute respiratory symptoms. She shares her hopes for the project, and why she decided to pursue a career in research.   How did you become interested in research? My interest in research developed while completing my master’s degree at a university in London. I conducted a research project exploring the embodiment of prosthetic limbs following amputation. Having left Syria only a few years earlier due to the war, I was particularly aware of how health challenges can profoundly affect people’s lives. This experience helped me recognise the potential of research to improve healthcare and support individuals facing complex physical and psychological changes. Motivated by this, I pursued a career in clinical research delivery. I worked as a registered Clinical Research Practitioner in a primary care setting. In this role, I contributed to the delivery of several studies with researchers at the University of Southampton. This experience strengthened my appreciation of the vital role of primary care in healthcare and research. By 2024, I felt ready to begin my own doctoral journey under the guidance of an excellent team of researchers. What is the healthcare challenge that you are seeking to address? I aim to address the overprescribing of antibiotics in people with asthma. Around 80% of antibiotics are prescribed in primary care. Chest infections are the most common reason. Evidence suggests that people with asthma are more likely to receive antibiotics for chest symptoms. This is compared to those without asthma. The reasons for this higher prescribing rate remain unclear. The PAUSE study will explore views and experiences on antibiotic prescribing for chest symptoms. These will come from healthcare professionals, adults with asthma, and parents of children with asthma. The project will help understand the factors that influence prescribing decisions and patient expectations. It aims to identify key drivers of potentially inappropriate antibiotic use in this population. The findings will inform the development of an intervention. This intervention will support more appropriate antibiotic prescribing. This will help reduce unnecessary antibiotic use in people with asthma. What do you hope to achieve in your research at the BRC? I aim to better understand why antibiotics are prescribed to people with asthma who present with chest symptoms in primary care. This research will explore factors that influence prescribing decisions. I aim to identify the key drivers of antibiotic prescribing in this population. I hope to generate evidence that can inform more effective approaches to antibiotic stewardship. Ultimately, this research aims to reduce unnecessary antibiotic prescribing and improve asthma management. It will also support wider efforts to tackle antimicrobial resistance in primary care. This project aligns closely with the BRC themes of Microbiology, Immunology and Infection and Respiratory and Allergy. I am very grateful to be supported by leading experts in the field. These include Nick Francis, Kay Wang, Kate Lippiett, Rosie Essery and Ingrid Muller. How would you sum up your research in three words? 'Think long term' When prescribing antibiotics, it can be easy to focus on the potential short-term benefits. This can mean we overlook the long-term consequences of antibiotic resistance. Antibiotics are a precious and finite resource, and their effectiveness depends on how responsibly we use them. None of us want to face a future where common infections become difficult to treat, because bacteria are resistant to available treatments. By prescribing and using antibiotics only when they are truly needed, we can help protect their effectiveness. This includes for ourselves, our loved ones and future generations. What is it like to be an early career researcher in Southampton? Being an early career researcher in Southampton has been a great experience, full of opportunities. I am in my third year of a four-year PhD and have hugely benefited from being part of the university’s strong academic community. There are many training opportunities that help build both methodological and professional skills. There are also workshops that support career development. I have had access to bursaries specifically aimed at early career researchers. I have also had opportunities to attend national and international conferences. In addition, I’ve been involved in facilitation experiences. These have helped me to build confidence in teaching and communication. Networking events have also been really valuable for connecting with other researchers at similar stages. What advice would you give to other early career researchers? As I’m still an early career researcher myself, I’d probably frame this for anyone just starting on this journey. It’s a really exciting opportunity to grow not only as a researcher, but also as a person. You’ll discover strengths you didn’t know you had, but you’ll also face challenges that test your resilience and patience. One of the most important things is to surround yourself with supportive, like-minded people. They can help you see the positives even when things feel tough. Don’t be afraid to ask for help when you need it - that’s part of growing, not a weakness. And just as importantly, make time for things outside of research that you enjoy. Protecting your well-being and noticing when you’re becoming stressed or overloaded really does make a difference in the long run. Take it from someone who had a couple of colds in a few months before realising it’s sometimes a sign to give your body a proper reset, take a step back, and come back refreshed!

Researchers have delivered the UK’s first dose in a new trial using an investigational mRNA vaccine to protect people against potential influenza pandemics such as avian flu (also known as ‘bird flu’). The research will assess the safety and immune response of an investigational mRNA-based A(H5) pandemic influenza vaccine candidate, mRNA-1018, commonly circulating in birds, with pandemic potential. The study is supported by the National Insititute for Health and Care Research (NIHR) and sponsored by Moderna. It is part of its UK government strategic partnership, managed by the UK Health Security Agency (UKHSA). For more information on this new A(H5N1) vaccine trial, visit the NIHR’s Be Part of Research service. ‘Strengthening reslience’ The study is being led in Southampton by Professor Saul Faust, Director of the NIHR Southampton Clinical Research Facility (CRF) and co-theme lead at the NIHR Southampton Biomedical Research Centre. The delivery of the study in Southampton, Bournemouth and Weymouth is being supported by expertise from the CRF. Prof Saul Faust said: “By launching this bird flu vaccine trial, we are strengthening the resilience of the NHS in our region, and our national and international readiness.” Dr Patrick Moore, Co‑Director, NIHR Wessex Commercial Research Delivery Centre (CRDC), added: “Bird flu is no longer a distant problem – it’s a fast‑evolving virus with the potential to spark the next pandemic. This trial gives local people the chance to be part of cutting‑edge research that could protect our own community and people across the world.” Providing crucial evidence This large-scale, phase 3 trial will involve around 4,000 adult volunteers aged 18 and over in the UK and USA. 3,000 patients (75%) recruited will be in the UK. Bird flu is currently transmitted between affected birds and various mammals. Whilst the virus does not easily spread to humans, and transmission between people is very rare, there is a risk that the virus could adapt. This could make it more transmissible to or between humans. Since 2024, there have been 116 confirmed human cases across the world. Almost all are linked to close contact with infected animals. This study aims to provide crucial evidence on whether the investigational vaccine can generate strong immune responses to protect against currently circulating and emerging strains of H5N1. This will help the UK prepare for future pandemics and apply system-wide learnings from COVID-19. There will be 26 sites across the UK administering the vaccine. In line with the government's hospital-to-community shift, the study is being delivered at various community clinics across England and Scotland. This trial forms part of a wider response to tackling bird flu. Vaccine trials have already started to help protect poultry in the UK, following the recent outbreaks. ‘Improving pandemic preparedness’ Dr Rebecca Clark, is the trial’s National Co-ordinating Investigator based at Layton Medical Centre, Blackpool. She said: "We know that the A(H5N1) strain is evolving and spreading across animal species, and though it does not yet move easily between humans, we have to treat human-to-human transmission as a real possibility. This trial is our proactive attempt to shield against that possibility, and any future pandemic that could emerge from it. "With recruitment sites across the country, we have shifted from traditional hospital settings into the heart of our communities, helping ensure the research can be carried out across a range of locations and populations. “This work is an important part of strengthening our understanding of how we can respond to emerging public health threats and improve pandemic preparedness for the future.” Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care (DHSC) and Chief Executive Officer of the NIHR, said: "This important trial is a testament to the power of the UK’s strategic partnership with Moderna. By combining world-leading technology with the UK’s unparalleled research infrastructure, we are bolstering our pandemic resilience. "Central to this effort is the NIHR's Be Part of Research registry, which offers people a quick and easy way of taking part in some of the UK's most exciting research. With over 700,000 people signed up so far, it is a key pillar of the UK's research landscape." "This trial proves that when the public, the government, and industry collaborate through the NIHR, we can accelerate the journey from laboratory to clinic - protecting public health both in the UK and across the world." Vaccine innovation mRNA forms part of every human cell. It is the way in which the instructions in our genes (DNA) are used to make certain specific proteins. When used in vaccines, mRNA delivers the instructions for replicating proteins identical to those found in a particular virus. In this case, bird flu. Once replicated, it is hoped that our immune system will recognise it as a foreign body and produce antibodies that will attack the protein if they encounter it in an actual virus. The study is being run as part of the UK Vaccine Innovation Pathway - a UK-wide Clinical Trial Accelerator. This expedites vaccine trial set-up and delivery and takes vaccine trials closer to where people live. The first participant was enrolled into the trial in less than half the time of the government's 150 day study set-up goal. The trial is supported by the NIHR’s Agile Research Delivery Team, who play a key role in delivering research in communities. It is also supported by Moderna's collaboration with the Coalition for Epidemic Preparedness Innovations (CEPI).

Interstitial lung disease (ILD) is a group of conditions that cause inflammation and scarring in the lungs, making it harder to breathe. The most common form has a life expectancy of three to five years from diagnosis, with limited treatment options. Dr Sophie Fletcher, Consultant Respiratory Physician at University Hospital Southampton (UHS), has dedicated her research career towards improving care for these patients. However, she is aware that she cannot do this alone. The UHS Research Leaders Programme (RLP) has allowed her to mentor and support others, as well as develop new collaborations.  Creating more opportunities Over the last three years, the RLP has enabled Sophie to develop her research. “What it's done for me, personally, is it's allowed me to grow a portfolio of national and global clinical trials in interstitial lung disease,” she says, “which I’ve led as Principal Investigator and Chief Investigator.” She’s focussed mainly on commercial studies, as they provide opportunities for patients to access novel treatments sponsored by the pharmaceutical industry. Commercial studies provide an income stream that allows expansion of the research team that facilitates the work of others with the Respiratory group. These studies also cover care costs for patients in the ‘standard care’ arm of treatment. “My research team has got bigger,” she says. “As I’ve taken on more studies, the income has grown, and our team has grown.” This has increased opportunities for patients with ILD at UHS to take part in research, allowing them to gain early access to new drugs. Embedding research culture Sophie has long been committed to supporting others to follow in her footsteps. Her RLP has accelerated this work, allowing her to recruit, supervise and mentor eight clinical fellows. These are doctors undertaking a fixed-term role that includes research. She has also supervised five NIHR Associate Principal Investigators. This six-month training opportunity aims to develop health and care professionals to become the Principal Investigators of the future. Sophie says the research experience the fellows gain is still valuable, even if they decide not to pursue a career in research. “Research should be part of clinical care,” she says. “If that’s something introduced to you at an early part of your career, you’re more likely to carry on doing it. It’s about embedding good practice, with research as part of your everyday clinical care.” Forging new collaborations Sophie also works closely with her colleagues, and has created new working relationships with other respiratory researchers. One example is with Dr Aisha Fazleen, a newly appointed consultant investigating Alpha-1 antitrypsin deficiency. This genetic condition increases the risk of lung diseases. “She started up her research portfolio from scratch, and didn’t have a research fellow, so I lent her mine,” says Sophie. “I’ve become her mentor, as well as providing her with practical support.” Sophie also works closely with asthma researcher and RLP awardee Dr Hitasha Rupani. Hitasha didn’t have enough funding for a fellow one year, so Sophie suggested they each fund half of a joint role. “It’s all about collaborative work to find a solution,” she says.

Southampton researchers have revealed new insights into age-related muscle loss and potential contributors to a statin-associated side effect on muscle. The discoveries could enable new treatments to be developed for older people. These could help reduce this side effect of statins and protect muscle health in later years. The two studies were led by experts at the NIHR Southampton Biomedical Research Centre. Looking at the underlying biology We naturally lose muscle mass and strength as we age. However, the rate at which this occurs is not the same for everyone. This means some people become weaker at a younger age, increasing the risk of falls and loss of independence in older adults. New research could shine a light on why this process differs from person to person. It has been published in the Journal of Cachexia, Sarcopenia and Muscle . Drs Mark Burton and Emma Garratt are first authors on the paper. The results reveal differences in muscle cell populations from 132 participants aged between 72 and 83 years from the Hertfordshire Cohort Study. Muscle cell populations were found to exist in different states which were linked to measures of muscle health. This finding increases our understanding of what may go wrong in muscle disease. Investigating statin side effects Statins are commonly prescribed to reduce the risk of cardiovascular disease. However, they are known to have side effects that affect muscle health. These include muscle pain, weakness and reduced function. Collectively, they are referred to as statin-associated muscle symptoms (SAMS). This could accelerate age-related muscle loss, meaning older people become weaker at a younger age. The second Southampton paper has been published in JCSM Communications . This aimed to investigate the underlying mechanisms that cause SAMS. PhD researcher Maisha Chaudhery was first author, with Dr Emma Garratt a senior author. The researchers used muscle biopsies from 11 older women and grew muscle cells from them in the laboratory. They added different amounts of the most commonly prescribed statin, atorvastatin, to these cells. Muscle cells exposed to higher doses of atorvastatin showed more signs of ageing and reduced growth. The researchers found many key gene regulatory pathways involved in muscle maintenance, function, and health were disrupted in these cells. These pathways could provide a key target for future treatments to reduce the muscle side effects of statins and protect older people’s muscle health for longer. “Age-related muscle loss can mean older people become frail and lose the ability to be independent,” said Dr Burton, who was an author on both papers. “Loss of muscle not only affects movement and strength but also changes metabolism, which is key for overall health. “These studies reveal new insights that could aid in the development of future treatments, which could enable people to live independently for longer as they age.”

Placing fruit and vegetables near supermarket entrances can improve sales and diet quality, new research shows. The study found the placement led to thousands more fruit and vegetables being bought at each store every month. The results have now been published in the journal PLOS Medicine . Professor Christina Vogel at City St George’s, University of London and the University of Southampton was lead author. Her research is part of the NIHR Southampton Biomedical Research Centre's nutrition, lifestyle and metabolism theme. Bucking the trend The WRAPPED study was carried out between March 2018 and May 2022. This coincided with the COVID-19 pandemic and cost of living crisis. During this time, the UK population's fruit and vegetable purchasing and intake declined. Household purchasing of fruit fell by 7.2 percent and of vegetables by 5.3 percent. On average, households were buying fewer than four portions per day for the whole family. The study was conducted in 36 stores of a discount supermarket chain in England. Half introduced the new layout, with fruit and vegetables near the entrance. The other half kept their existing layout for comparison. The researchers found a big difference in fruit and vegetable sales in the group with the new layout. Compared to predicted sales without the change, they sold the equivalent of around 2,525 extra portions per store each week. Calling for change The researchers are now calling on the Government to account for these results in their regulations. They say this could boost fruit and vegetable sales and improve the nation’s diet. They recommend making it a requirement for fruit and veg to be positioned near entrances in all large food stores. They also suggest limiting unhealthy foods at checkouts, aisle-ends and entrances. The study was led by researchers from the MRC Lifecourse Epidemiology Centre at the University of Southampton with the Centre for Food Policy at City St George’s, alongside others. Professor Vogel said: “The food industry and the public are trapped in a ‘junk food cycle’, where unhealthy foods are cheap to make, profitable to market, appealing to eat and affordable to buy. “To counter this, our study shows that placing fruit and vegetables at the entrances of discount supermarkets increased fresh fruit and vegetable sales.” The study was funded by the National Institute for Health and Care Research (NIHR). Professor Adam Briggs is Director of NIHR's Public Health Research Programme. He said: “Poor diet remains a leading cause of ill health and inequalities in the UK and tackling this requires action across a range of policy areas. “WRAPPED's promising results show how small changes in our supermarket layouts can impact our shopping habits and encourage healthier diets that can help prevent obesity and diet-related disease. “It’s a great example of how carefully involving retailers in research can help deliver practical real-world insights.”