Innovative lung research is driving discoveries that could help develop new ways to prevent or treat respiratory disease. Southampton researchers are collaborating with AstraZeneca to help uncover the biological processes of the lungs using a technique called ‘multiomics’. This winter, Dr Alastair Watson has been awarded the British Thoracic Society (BTS) 2021 Medical Student Award for his role in the respiratory research. Chronic obstructive pulmonary disease (COPD) is caused by air pollutants and smoking. It leads to more than three million deaths per year worldwide and is a major cause of hospital admissions and GP visits. New treatments are desperately needed to improve outcomes for patients. In the latest study, published in the BMJ Thorax journal, researchers studied differences in the lungs of patients with and without COPD. This has improved understanding of processes that are different in COPD and may lead to the disease. Scientists took samples from the lungs of patients using a procedure called bronchoscopy. This involves inserting a small flexible tube through the nose or mouth into the lung. These samples were then analysed using mass spectrometry-based multiomics. Studying surfactant in the lungs Human lungs have a liquid called ‘surfactant’ that contains fat molecules - called lipids - and proteins. This liquid is essential for breathing as it stops the lungs from sticking together and collapsing. The proteins in the liquid also have extra roles to prevent the lungs from infections and inflammation. The new research found that patients with COPD had lower levels of surfactant lipids and proteins in their lungs. These patients also had higher levels of enzymes that breakdown surfactant proteins, which could contribute to there being less in the lungs. “This decrease in surfactant in patients with COPD could be a consequence of the disease or could contribute to its development,” Dr Watson explains. “The lack of surfactant proteins could also contribute to the increased risk that these patients have of developing serious lung infections, which leads to COPD getting worse.” “Surfactant drugs are currently being tried in patients with COVID-19 and developed for premature babies with lung disease. Therefore, there may be a possibility to develop surfactant-based drugs for patients with COPD in the future.” Identifying targets for new drugs The project stems from a longstanding collaboration between Southampton NIHR Biomedical Research Centre researcher Professor Tom Wilkinson and AstraZeneca, who funded this study. Further work is exploring other differences identified in the lungs of patients with COPD and how these could contribute to disease and infection. This may enable scientists to identify targets that allow new drugs to be developed. Dr Watson completed his PhD and postdoctoral research fellowship at the University of Southampton. He has since been retraining to be a doctor, whilst continuing his research work in Southampton. “I am delighted to win the BTS Medical Student Award and to have presented this work at the BTS winter meeting,” he says. “It is incredible recognition of this important continuing collaborative work. I thoroughly enjoyed working on this project and am excited by the impact that this continuing research may have on our understanding of COPD and the lives of patients with COPD in the future.” Image: Dr Alastair Watson has been awarded the British Thoracic Society (BTS) 2021 Medical Student Award.

Patients having emergency bowel surgery at 15 UK hospitals will be offered a new pain relief technique in a trial to help ease recovery and improve outcomes. Dr Mark Edwards, consultant anaesthetist and researcher at the NIHR Southampton Biomedical Research Centre, will jointly lead the trial with Dr Ronelle Mouton from the University of Bristol. Major surgery Around 30,000 people need emergency bowel surgery each year in the UK. The surgery is performed for many different reasons, including bowel cancer complications or infection. These are major operations for patients who tend to be elderly and often have additional health problems. After surgery, patients are usually cared for within intensive care units, but around one in 10 do not survive the immediate effects of surgery. The surgery typically requires a large cut to be made straight down their middle. This leaves patients in considerable pain in the days following surgery. This pain can cause them to avoid deep breaths, sometimes resulting in lung infections. In rare cases, patients may also go on to develop long-term pain which is difficult to treat. Improving pain relief The trial will give patients a new pain relief method, known as rectus sheath catheters. The catheters are inserted just under the rectus abdominis muscles, which run vertically down the centre of the belly. These abdominal muscles are what give people a six-pack. Local anaesthetic will be slowly pumped through two of these catheters for three days after surgery. They will be given in addition to pain relief currently available to these patients, such as painkillers like morphine. A control group will also have the catheters, but they won’t be inserted and will instead rest on the top of the skin. Patients will not be told which group they are in during the trial. The researchers hope the trial will show rectus sheath catheters, compared with standard care, are a cost-effective way to improve pain relief for these patients. They plan to start the trial next summer, with 750 patients taking part across 15 UK hospitals where the treatment is not already routinely in use.

New research led by the University of Southampton shows supporting women to eat a healthy diet pre-pregnancy could reduce risk of obesity for their children. Rates of childhood obesity are increasing worldwide. In the UK, nearly a quarter of under-fives are overweight or obese. This increases to more than a third by the time children start secondary school. Children who are obese are more likely to be obese adults, with long-term consequences for their health. Unhealthy diets are an important factor that contribute to this. New research, led by Southampton’s Dr Sarah Crozier, has found children aged eight or nine were more likely to be obese if their mother had a poor diet during – and before – pregnancy. The research identifies these as critical times, when initiatives to reduce childhood obesity may be more effective. Long-term analysis The researchers analysed data on the diets of 2,963 mother-child pairs who were part of the UK Southampton Women’s Survey – a long-running study that tracks the health of mothers and their children. Women joined it before pregnancy when they were first considering having a baby. As part of the survey, the women were interviewed and their answers used to fill in questionnaires on their diet and that of their child. The researchers asked about the mother’s diet before they became pregnant and when they were 11 and 34 weeks pregnant. They also asked about what the child ate at six months, one year, three years, six to seven years, and eight to nine years of age. The dietary information collected was used to give each mother-child pair a combined diet quality score. They used these scores to divide them into five groups: poor, poor-medium, medium, medium-better and best. Long-term effects Mothers who were younger, had attained fewer academic qualifications, smoked and had a higher body mass index (BMI) before pregnancy tended to be in a worse diet group with their child. When the children were eight to nine years old, the researchers assessed the amount of fat tissue in their bodies using a dual-energy X-ray absorptiometry (DXA) scan. They also calculated the child’s BMI, adjusting this to account for their age and sex. The results, published in the International Journal of Obesity, showed that if a mother-child pair was in a lower diet quality group, this was associated with child having a higher DXA percentage body fat and BMI at age eight or nine. Dr Crozier, Associate Professor of Statistical Epidemiology at the University of Southampton, said: “Childhood obesity is a significant and growing issue in the UK, causing long-lasting health problems that extend well into adulthood. This research shows the importance of intervening at the earliest possible stage in a child’s life, in pregnancy or even before conception, to enable us to tackle it.” This work was funded by grants from the Medical Research Council, project EarlyNutrition, and the European Union’s Seventh Framework and Horizon 2020 programmes. It was also supported by the National Institute for Health Research Southampton Biomedical Research Centre, the University of Southampton and University Hospital Southampton NHS Foundation Trust.

Southampton researchers have opened a study working with young people to better understand how COVID-19 restrictions are affecting them and how best to support them. Professor Mary Barker from our NIHR Biomedical Research Centre (NIHR BRC), is leading conversations with young people in and around Southampton about the impact of COVID-19, and building resources to lessen this during the pandemic. Young people’s perspective Widespread criticism of teenagers and young people has centred on the belief that they are taking less notice of the current lockdown than others, endangering themselves and the wider population. However, early research interviews by Prof. Barker and the Lifelab Southampton team indicated that a lack of purpose is influencing many, leaving them anxious and lost under the stay-at-home directives. Year 11 and 13 students appear particularly affected. The sudden suspension of their education and cancellation of national exams is taking away a central focus of their lives, leaving them facing a long summer – or longer – with nothing to do. Finding their own solutions Yet when asked, participants had some clear ideas for ways to support constructive activities, including structured opportunities to support their local communities, access to free mobile data or courses to learn new skills, and work packages to prepare for upcoming A-level or university courses. “Lockdown for young people is clearly a very difficult experience. They may also be amongst the least adherent presumably because they perceive themselves to be least at risk,” comments Professor Mary Barker. “It is beholden to us to listen to their voices and with them to find ways of minimising the long-term negative impact on them of this extraordinary, unprecedented experience. In our conversations with young people, we have found them to be well-informed, articulate and very clear about the support they need.” Prof. Barker concludes. Developing their own solutions for the duration – and beyond Prof. Barker and the Lifelab team are working with two groups of young advisors to conduct a more in-depth study over the next few months. Together, they will follow the impact of the pandemic experience on a number of young people in Southampton and surrounds, through remote focus group discussions, social media diaries and self-reporting of their diet, physical activity, mental health and well-being. At the same time discussions with local services and volunteering organisations are developing resources and opportunities for young people to help out and gain valuable experience. Professor Keith Godfrey, BRC Nutrition theme lead underlined how the impact on young people at such a critical time in their lives must be taken seriously, as society strives to protect older people, those with chronic conditions and the NHS. “The global climate movement has demonstrated how young people can drive the global policy agenda in positive ways, and there are similar opportunities for the world to benefit from their vision in relation to COVID,” he commented. “Moreover, wider society will be permanently changed by the emergency and the views of young people will be critical in shaping the post-COVID world." Prof. Godfrey concludes.

Valneva’s inactivated whole virus COVID-19 vaccine is scheduled to enter large scale trials later this month after it was shown to be safe, inducing a strong immune response in its first trials involving 153 people. The specialist vaccine company Valneva has announced promising results for the first of two parts of its phase 1/2 trial of a COVID-19 vaccine, with two injections of the highest dose generating levels of virus-neutralizing antibodies higher than those seen in patients recovering from COVID-19 infection. “Again, the people of Southampton have stepped up and contributed to these results that open the way to yet another effective coronavirus vaccine. Having a range of vaccines is vital to tackling COVID-19 now and over the next few years – these latest results are great news, indicating outstanding efficacy for a completely different type of vaccine. “I want to thank the people of our city and region for their continuing commitment and contribution to these trials,” comments Prof Saul Faust, Southampton lead for the VLA2001 trial and Director of the NIHR Southampton Clinical Research Facility. Using the whole virus The Valneva vaccine VLA2001 is different to the other Sars-COV2 vaccines currently in use or in trials. Whilst those vaccines, including Oxford/AstraZeneca, Moderna and Pfizer target the virus’ characteristic spike proteins that help it attach to and enter cells, VLA2001 uses inactivated whole virus. One of the most established and oldest vaccine technologies, whole virus inactivation has been successfully used in a range of infectious diseases, including polio, hepatitis, rabies and influenza. To boost performance, Valneva used a strain of SARS-CoV-2 rich in spike protein to make VLA2001, and combined this with two adjuvants (alum and CpG 1018) compounds that enhance the immune reaction. 153 healthy adults aged 18 to 55 years were given two injections of the vaccine three weeks apart. They were split into three groups to compare the effects of low, medium and high doses. The trial is being conducted in two parts, Part A (Day 1 to Day 36) and Part B (Day 37 to Day 208).These results are only for Part A of the trial, with the results from Part B yet to be announced, and the results have not yet been formally peer reviewed. Strong immune response More than 90% of all study participants produced significant levels of antibodies to the SARS-CoV-2 virus spike protein. No concerning side effects were found, with the majority of side effects either mild or moderate. The high dose group showed the best immune response, with similar levels of neutralising antibodies to those seen in people recovering from the virus. This dose will therefore be used in the next larger scale phase 3 trial. Why do we need more vaccines? More COVID-19 vaccines will help to boost supply and accelerate the vaccine roll-out across the UK, give options for tackling new variants, and prepare for the likely need for regular booster vaccinations. A Phase 3 trial, involving thousands of people from a greater spread of ages, is expected to start later this month, with the results announced in the Autumn. Success in that trial would pave the way for approval by the UK medicines regulator, the MHRA, and use of the vaccine in the NHS vaccination programme. VLA2001 would also provide some protection from import and supply chain challenges, due to its production at a new site in Livingstone, Scotland.

Researchers at University Hospital Southampton are looking for volunteers with COVID-19 symptoms to take part in a new trial of a potential treatment that uses the immune system to fight COVID-19. The trial is part of the national AGILE drug testing platform, which aims to rapidly identify therapies that have the potential to treat COVID-19 and bring them into early phase clinical trials. The researchers hope the drug in this trial – an antibody – will not only neutralise the SARS-CoV-2 virus, meaning patients are less likely to be admitted to hospital with severe symptoms, but also trigger a long-lasting immune response to the virus. Do we still need COVID-19 treatments? With the UK’s COVID-19 vaccination programme helping to bring down the number of cases in the community and in hospitals, you may think there is no longer a need to develop new treatments. However, vaccines will not eradicate COVID-19 infections entirely and the virus will continue to circulate at lower levels. We therefore still need to find treatments for those who do contract the virus to prevent them from developing the most severe symptoms. Discovering new COVID-19 treatments faster The trial is being run at the NIHR Southampton Clinical Research Facility as part of the AGILE drug testing platform, which enables rapid evaluation of early stage clinical trials (phase 1 and 2a) to identify promising new treatments for COVID-19. Whereas other COVID-19 trials seek to repurpose existing drugs already prescribed for other conditions, AGILE will test completely new drugs that are not yet approved for use in patients. The innovative design of the trial means that multiple potential treatments can be evaluated in parallel, allowing important testing stages to be safely completed in months rather than years. Treatments shown to be beneficial in AGILE will be rapidly considered for advancement into later phase clinical trial platforms, such as PRINCIPLE and RECOVERY, where the effectiveness of these treatments can be assessed in larger numbers of patients. AGILE is led by researchers at the University of Southampton’s NIHR Southampton Clinical Trials Unit, in collaboration with the University of Liverpool and the UK Clinical Research Facility network. Taking part The research team are currently looking for people with COVID-19 symptoms to take part in the trial. To be eligible they must: be aged 18-55 have symptoms of COVID-19 within the last 4 days have not had a COVID-19 vaccine not be hospitalised for COVID-19 Participants will be reimbursed for their time and travel. For more information, please email UHS.SouthamptonCRF@nhs.net or call 07469 565 895.

Children with weakened immune systems have not shown a higher risk of developing severe COVID-19 infection despite commonly displaying symptoms, a new study suggests. During a 16-week period which covered the first wave of the pandemic, researchers from the University of Southampton and University Hospital Southampton carried out an observational study of nearly 1500 immunocompromised children – defined as requiring annual influenza vaccinations due to underlying conditions or medication. The children, their parents or guardians completed weekly questionnaires to provide information about any symptoms they had experienced, COVID-19 test results and the impact of the pandemic on their daily life. No severe COVID-19 cases The results, published in BMJ Open, showed that symptoms of COVID-19 infection were common in many of the children – with over two thirds of participants reporting at least one symptom and one third experiencing three or more symptoms simultaneously. One hundred and ten patients with symptoms undertook viral PCR tests, none of whom tested positive. Dr Hans de Graaf, who led the research, said, “Whilst we cannot be certain of the prevalence of COVID-19 amongst the children who took part because testing was only done when patients were admitted and these children were told to adhere to strict shielding measures, we can assume that any infections would have been mild cases since none of these high risk patients required hospital admissions.” High levels of anxiety More than half of the patients or parents reported high levels of anxiety at the start of the study and despite the absence of severe symptoms, these scores remained consistently high throughout the study period. The report concludes that the continuous high level of anxiety among participants highlights the need to clearly define and communicate the risk of COVID-19 in children and young people, particularly as lockdown restrictions ease. Symptom screening not useful The researchers believe that these results show that widespread symptom screening for early detection of COVID-19 is not going to be useful for children in these circumstances. Dr de Graaf continued, “This study was the first to observe the impact of the pandemic on children with compromised immune systems. During the first wave of the pandemic, many may have been shielding, so our results suggest that either the shielding measures were effective or that immunocompromised children are less affected by COVID-19 than adults, just like healthy children.”

Volunteers from the Southampton area are being asked to sign up to the latest COVID-19 vaccine study to be rolled out across the UK. The National Institute for Health Research (NIHR)-supported Valneva Phase 2/3 study, will be run at University Hospital Southampton, and is open to healthy adults who have not had a previous COVID-19 vaccine. 4,000 participants will be recruited across the UK, and everyone involved in the study will receive two active vaccine doses, administered in a four-week interval. Those enrolled in the study over the age of 30 will be randomised to receive two doses of either the Valneva vaccine, or the approved Oxford/AstraZeneca vaccine. Participants aged 18 - 29 can be enrolled into the study to receive the Valneva vaccine and will not be offered the approved Oxford/AstraZeneca vaccine. Developed by the specialty vaccine company Valneva, the vaccine is being manufactured at the company’s site in Livingston, West Lothian, and is the only inactivated, adjuvanted (an ingredient to create a stronger immune response) COVID-19 vaccine in clinical development in Europe. Volunteers for the study will be vaccinated at the beginning of May, and a proportion of potential participants will be identified through the NHS COVID-19 Vaccine Research Registry, which currently has over 480,000 sign ups. Subject to successful Phase 2/3 data, Valneva aims to make regulatory submissions for initial approval in the autumn of 2021. If Valneva’s vaccine is shown to be safe and effective, up to 250 million vaccine doses could be supplied to the UK and other countries around the world. As part of the UK government’s vaccine procurement approach, up to 100 million doses of this vaccine have been secured. Find out more by visiting the Valneva study website - https://www.ukcovid19study.com/. Professor Adam Finn, Chief Investigator for the Valneva study said: “Following very encouraging safety and immune response results from our phase 1 study, along with my investigator colleagues, I am really looking forward to starting on this important next stage of the clinical development of this important new vaccine. “We definitely need more vaccines to help us out of this pandemic and this one is a very promising candidate.” Professor Saul Faust, Director of the NIHR Southampton Clinical Research Facility and local investigator for the trial, said: “Clinical studies into COVID-19 vaccines remain critical to help find several safe and effective candidates to help protect us all. Volunteers in Southampton are still needed to help carry out these studies. Visit nhs.uk/researchcontact to sign up to be contacted about taking part in COVID-19 vaccine studies.” Professor Andrew Ustianowski, National Clinical Lead for the UK NIHR COVID Vaccine Research Programme, said: “Off the back of positive early study data, it is great to see the final stage of the Valneva study begin across the UK, coordinated by the NIHR Clinical Research Network. Evaluating an additional vaccine candidate to help protect the population against COVID-19 is vital in our efforts to ensure that we have effective vaccines that work for everybody. "Each and every one of the participants involved in the study are key to helping us gain a detailed understanding of how the vaccine will perform in a large population.” Thomas Lingelbach, Chief Executive Officer of Valneva, said: “As COVID-19 continues to impact people’s daily lives, Valneva remains fully focused on developing another safe and efficacious vaccine solution. The world needs multiple vaccines and we believe that ours has an important role to play - including boosters or potential modifications to address variants. “The initiation of this trial marks a significant milestone in the development of the only inactivated vaccine candidate against COVID-19 in clinical trials in Europe. We are grateful to the NIHR for its continued support and to everyone who volunteers to make clinical trials possible.”

A Southampton study has shown that use of a nutritional supplement before and during pregnancy did not influence the mother’s blood sugar levels or birthweights of the 585 babies born, but was associated with lower rates of preterm births. Researchers from the NIHR Southampton Biomedical Research Centre and the international EpiGen Global Research Consortium, an academic group of clinicians and scientists led by Professor Keith Godfrey, have shown that taking a new supplement before and during pregnancy may help to reduce the number of babies born early. Starting before pregnancy The Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health (NiPPeR) study aimed to understand whether early use of nutritional supplements could help in maintaining healthy blood sugar levels in pregnancy and sustaining a healthy pregnancy and delivery. Between 2015 and 2017 the study recruited 1,729 women aged 18–38 from the UK, Singapore, and New Zealand who were planning to get pregnant in the next six months. The women were split into two groups, drinking two different powdered supplements dissolved in water twice a day, from before pregnancy through to birth. The first group took an enhanced supplement containing myo-inositol, probiotics, vitamins D, B6, B12, riboflavin and zinc formulated to aid in maintaining healthy blood sugar levels in pregnancy and sustaining a healthy pregnancy and delivery. The second group took a standard pregnancy supplement for comparison. 585 women became pregnant within a year. No effect on mother’s blood sugar levels, but benefits for reducing preterm birth As published in the journal Diabetes Care, their results showed no significant difference between the two groups in their response to an oral glucose challenge test during pregnancy. However, they did find that fewer babies were born early (before 37 weeks of pregnancy) in the group who took the enhanced supplement compared, with a particular reduction in births associated with preterm pre-labour rupture of membranes. These results suggest that one or more of the components within the enhanced supplement might help to prevent preterm births, as supported by previous trials of myo-inositol supplements in pregnancy which also showed a reduction in preterm births. “Preterm delivery is a serious, common and costly public health problem worldwide that continues to increase in incidence,” said Professor Keith Godfrey, Professor of Epidemiology and Human Development at the University of Southampton and NIHR Southampton Biomedical Research Centre Nutrition Lead, who was chief investigator of the research. “Preterm pre-labour rupture of membranes is a major cause of preterm birth. Our study presents for the first time a clinical trial of a novel non-pharmacological approach that started preconception and extended throughout pregnancy, through the innovative use of a combination of nutritional ingredients. The study findings highlight the potential value of the mix of nutrients and probiotics in reducing the risk of preterm birth and supporting a timely delivery.”

A new study has shown that most patients discharged from hospital after experiencing severe COVID-19 infection appear to return to full health, although up to a third do still have evidence of effects upon the lungs one year on. COVID-19 has infected millions of people worldwide. People are most commonly hospitalised for COVID-19 infection when it affects the lungs – termed COVID-19 pneumonia. Whilst significant progress has been made in understanding and treating acute COVID-19 pneumonia, very little is understood about how long it takes for patients to fully recover and whether changes within the lungs persist. In this new study, published in The Lancet Respiratory Medicine, researchers from the NIHR Southampton Biomedical Research Centre worked with collaborators in Wuhan, China, to investigate the natural history of recovery from severe COVID-19 pneumonia up to one year after hospitalisation. Tracking lung recovery 83 patients were recruited after they were discharged from hospital following severe COVID-19 pneumonia and were followed up after three, six, nine and twelve months. At each time point they underwent clinical assessment as well as measures of how well the lungs function, a CT scan of their chest to take a picture of the lungs, and a walking test. Over 12 months in most patients there was an improvement in symptoms, exercise capacity, and COVID-19 related CT changes. By 12 months the majority of patients appeared to have fully recovered although about 5% of patients still reported breathlessness. Lung changes still found a year later A third of patients’ measures of lung function were still reduced – in particular how efficiently oxygen is transferred in the lungs into the blood - and this was more frequently found in women than in men. In around a quarter of patients CT scans showed there were still small areas of change in the lungs, and this was more common in patients with more severe lung changes at time of hospitalisation. Dr Mark Jones, Associate Professor in Respiratory Medicine at the University of Southampton and NIHR Southampton Biomedical Research Centre who co-led the study said, “The majority of patients with severe COVID-19 pneumonia appeared to fully recover, although for some patients this took many months. Women were more likely to have persistent reductions in lung function tests and further investigation is needed to understand if there is a sex specific difference in how patient’s recover. We also don’t yet know what happens beyond 12 months and this will need ongoing study.” Important implications for treatment The researchers acknowledged that this study only involved a small number of patients and the findings will require confirmation in additional studies, however they have identified a number of important implications. Dr Yihua Wang, Lecturer in Biomedical Sciences at the University of Southampton and NIHR Southampton Biomedical Research Centre who co-led the study explained, “Firstly, our research provides evidence that routine respiratory follow-up of patients hospitalised with COVID-19-pneumonia is required. “Secondly, given the length of time it takes for some patients to recover, it suggests that research into whether exercise programmes help patients recover more quickly is required. Finally, it highlights the need for treatment strategies to prevent the development of long term COVID-19 related lung changes."

A study by the University of Southampton has shown its LifeLab programme, aimed at improving adolescent health through hands-on learning, significantly increases young people’s understanding of what it means to lead a healthy lifestyle. Led by a team from both the Faculty of Medicine and Education School at the University of Southampton, the LifeLab programme aims to encourage engagement with the science behind public health messages, to support development of health literacy alongside decision-making skills and promotion of adolescents’ sense of control over their lives and futures. Based at University Hospital Southampton (UHS) NHS Foundation Trust, LifeLab is a state-of-the-art teaching laboratory dedicated to improving adolescent health through science engagement. Improving health literacy at a critical time Latest research, published in the journal PLoS One and funded by the British Heart Foundation, has found that participation in LifeLab was associated with an increase in students’ health literacy 12 months later. There was also evidence that participants subsequently judged their own lifestyles more critically than students who had not taken part in the programme. Health literacy can be described as having the knowledge, skills, understanding and confidence to use health and care information and services and to apply these to lifestyle choices. Increasing evidence suggests that adolescence is a critical developmental stage during which lifelong health literacy can be established, offering a potential window of opportunity during which improvements in health literacy could benefit long-term health, and enable preparation for parenthood – passing on good health prospects to future children. Professor Keith Godfrey, a co-investigator on the study from the National Institute for Health Research Southampton Biomedical Research Centre, commented: “Interventions during adolescence have the potential for a ‘triple dividend’ of benefits now, into future adult life and for the next generation of children. The LifeLab programme paves the way for enabling young people to access, understand and reflect on what they need to do to live healthier lives.” Working with schools across England The randomised controlled trial was conducted in 38 secondary schools in England, drawing on principles of education, psychology and public health to engage students with science for health literacy, focused on the message ‘Me, my health and my children’s health’. The programme comprised a professional development day for teachers, a two to three week module of work for 13-14-year-olds and a ‘hands-on’ practical health science day visit to a dedicated facility in a university teaching hospital. Information was collected from 2929 adolescents aged 13-14 years, at baseline and 2487 at follow-up 12-months later. “Experiencing LifeLab led to improved health literacy in adolescents and a move towards a more critical judgement of health behaviour 12 months after the intervention,” said Dr Kath Woods-Townsend, who leads the LifeLab programme. “By providing opportunities linked to the National Curriculum, and which meet schools’ needs, we have shown that students can be successfully engaged with the science behind the health messages, with lasting benefits for their health literacy.” Sharing her thoughts, Professor Hazel Inskip, principal investigator on the study from the Medical Research Council Lifecourse Epidemiology Unit at the University of Southampton, said: “The importance of health literacy in young people is being increasingly recognised, but there are very few randomised controlled trials seeking to assess interventions that promote health literacy through working in partnership with schools. It is an exciting step forwards to show that such a programme can engage adolescents with science, leading to sustained changes in health literacy and more critical judgement of their own behaviour.”

Diet in pregnancy has significant impact on baby’s development and lifelong health. Pregnant teenagers’ diets are amongst the least healthy of any group in the UK, making healthy eating support a key target for improving their health and their child’s health. A new study, led by Prof Mary Barker, has found very young mothers need more diet support from their midwives, who in turn feel the need for allocated time and more resources to do so. The babies, eating, and lifestyle in adolescence (BELLA) study aimed to identify barriers preventing teenage mothers from eating healthily during their pregnancy, and find ways to overcome these. The study team spoke to young mothers and their midwives, revealing challenges for both groups in discussing diet and food. Different perspectives Researchers interviewed 20 midwives and 106 young women who were teenagers when they gave birth to their first child, in Manchester, Doncaster, and Southampton, asking them questions about their diet and lifestyle during pregnancy, as well as what support would be helpful. At the point of interview a fifth of participants were pregnant, with 67% still teenagers and the remaining 43% in their early twenties. The results, published in Social Science and Medicine, show that while young women trusted their midwives’ advice and wanted more support with healthy eating during pregnancy, the midwives felt they did not have the time, confidence, or enough knowledge to discuss it. Improving support The young women interviewed said they found it difficult to prioritise healthy eating, often feeling isolated and lacking control in their own lives, and wanted advice and support from their midwife. Yet while the midwives felt it was part of their role to provide health eating support, they were anxious about starting a conversation about diet and health and felt that they lacked clear guidance on what to recommend. Improving the guidance for midwives could therefore help to give midwives the confidence and knowledge to start these conversations, and in doing so enable them to better support teenage girls to eat well in pregnancy. Dr Sofia Strommer, Chartered Psychologist and a Research Fellow in Behavioural Science managing the study, said: “These results show that better support for midwives could empower them talk about healthy eating with pregnant teenagers, helping to improve lifelong outcomes for young women and their babies.”