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Publications
arising from the Newcastle Thousand Families Study
The 1000 Families study is very much 'work in progress' and further publications are planned using existing data from the cohort in addition to planning new follow-ups. The results outlined below relate to work completed since the follow-up at age 50 years took place. These pages will be updated as and when new results are published. Full details of the publications referred to on this page are given at the end of the page, with links to the journal articles (some of which may be restricted to password holders for the particular journal). Health and Development in Childhood The results at the end of the first year of the study suggested that poverty, family structure and maternal education all played an important role in influencing the health of the infants, particularly ‘mothering skills’. However, a later reanalysis of the data with modern multivariable statistical techniques demonstrated that living in an economically deprived household was the greatest risk factor, and that even those mothers scoring highly in terms of mothering skills could do little to mitigate the effects of poverty (Parker et al.,1999 Analyses in childhood continued to show strong socio-economic gradients in health, growth and school achievement. Childhood growth was also positively associated with earlier menarche (Blell et al, 2008). Three books have been written detailing the findings of the childhood phase of the Thousand Families Study. Age 50 follow-up The follow-up of study members at age 50 was prompted by a change in the focus of chronic disease epidemiology to investigate the role of fetal growth, socio-economic circumstances and experience and behaviour throughout life. Regaining contact with study members and adding detailed information on their health and lifestyle during adulthood to the existing information from earlier in life provided a unique opportunity to investigate lifecourse determinants of disease in middle age. A large amount of information was collected on study members at the age of 50 years. Work has been (and still is) ongoing to analyse these data in relation to the other information collected at different stages of life, considering a wide range of health outcomes. The remainder of this section provides a summary of the progress made on each component within the study. Cardiovascular disease and the central metabolic syndrome The raising of the hypothesis that poor fetal growth increases the risk of cardiovascular disease and central metabolic syndrome was a key reason for resurrecting the Thousand Families Cohort study in the mid 1990's. Our results for carotid artery-intima media thickness (which was estimated by ultrasound), suggest that, in this cohort, adult lifestyle is the main influence on cardiovascular health, as opposed to factors in early life, including birth weight (Lamont et al., 2000). Central metabolic syndrome (CMS) is the 'clustering' of certain cardiovascular disease risk factors and is associated with an increased risk of both diabetes and cardiovascular disease. The risk factors included within this 'cluster' include obesity, high blood pressure and insulin resistance. In this cohort we showed an effect of childhood catch-up growth on CMS risk at age 50 in men, but that for both men and women the most important factors in preventing CMS appear to be a healthy adult lifestyle (Parker et al., 2003). Parental diabetes was reported in the self-completion questionnaires at age 50. A subsequent paper reported no association between the birth weight of study members and whether their parents had ever been diagnosed with diabetes (Adams et al., in press). We were also able to investigate the hypothesis that diarrhoeal episodes in infancy may be related to later blood pressure. While we did not find evidence to support this particular hypothesis, our results did suggest that early such episodes may be linked to salt preference in later life (Pearce et al, 2008). Helicobacter pylori Cohort members were assessed for H. pylori (a common bacterial infection) seropositivity at age 50 using an ELISA method. The data generated were used to compared IgG subclass responses in four populations (Thousand Families Study members, an adult Gambian population and two paediatric populations, one from the UK and one from the Gambia) (Campbell et al., 2004a). We found that the response among the Thousand Families Study members was different to that seen in the other groups. The data suggest that the Gambian response remains the same throughout life, whereas the response in the UK appears to change between childhood and adulthood. The H. pylori results were also used as control data in an investigation of IgG subclass responses in relation to duodenal ulcers in children (Campbell et al., 2004b) Children with H. pylori were found to produce predominantly an IgG1 response to whole cell antigens, suggesting a Th2 mucosal response. There was no evidence of a Th1 response in children with duodenal ulcer, in contrast to previous observations among adults. These results provide evidence that there be a different mechanism of disease causation among children with H. pylori associated duodenal ulceration. In a further publication, H. pylori was also investigated with respect to tooth loss by the age of 50 years. Our findings suggest that the proposed relationship between the two outcomes may be simply due to confounding by social class (Pearce et al., 2005a). Bone Health Study members had their bone mineral density assessed using DXA scanning at age 50. Four papers have been published using these data. The first, also used DNA collected at age 50, suggested a weak association between the vitamin D receptor gene and lumbar spine bone mineral density (Kanan et al., 2000). The methods used to measure bone health, and in particular femoral geometry were presented alongside a demonstration of the gender differences in bone health at age 50 (Tuck et al., 2005) . Self-reported height loss was shown to be inaccurate when compared to actual height differences, with implications for clinical practice (Birrell et al., 2005). Finally an investigation of the lifecourse determinants of bone health suggested a limited impact of early life on bone mineral density and that any such impact is likely to be mediated through achieved adult height. We did however find an association between size at birth and bone area in adulthood (Pearce et al., 2005b). Oral Health Two papers have been published so far from the oral health component of the study, one linking with the H. pylori component as described earlier (Pearce et al., 2005a). The second paper investigated lifecourse influences on tooth retention at age 50 and received worldwide media attention. Little effect of early life was shown, with the major factor in tooth retention being adult socio-economic position and lifestyle (in particular cigarette smoking) (Pearce et al., 2004). This work formed part of a BMedSci thesis submitted by Justine Mason. Justine presented her work at the annual British Dental Research Conference in 2004, was awarded the Colgate prize for best student presentation. Mental Health and Cognition Adult mental health A study using data from a follow-up of a subset of the cohort at age 33 years had concluded that ‘social and family (especially multiple family) disadvantage during childhood predispose individuals to an increased risk of major depression in adulthood’ (Sadowski et al., 1999). Using data from the age 50 follow-up, self-reported mental health at age 50 was shown to be associated with socio-economic mobility across the lifecourse. In particular, a downward social trajectory was associated with poorer self-reported mental health in men, but not in women. [29] Again in men, lower current income and a downward social trajectory across the lifecourse were associated with a negative perception of family functioning. [30] Childhood cognition A programme of research has been developed using the childhood IQ data in relation to both early and later life. The first paper to result from this collaboration presented the results of an investigation into birth weight and childhood growth and how this may affect IQ scores at the age of 11 (Pearce et al., 2005). Although no effect was found for birth weight, a significant effect was found for childhood growth, implying that postnatal growth may be more important in terms of childhood cognition than fetal growth. Growth and obesity Obesity and health has become a key research question in modern times. The Thousand Families Study has enabled us to look back and see the effect of being thin or fat in childhood on health in later life (Wright et al., 2001). It was found that fat children do not become fat adults – and indeed, being thin in childhood does not lead to a slim adulthood. Surprisingly it was also found that it is the thinnest children that tend to have the highest adult risk of obesity. The Thousand Families Study data was also considered alongside a younger cohort, again from Newcastle upon Tyne, to assess whether the effects of deprivation on height and weight had changed over a forty year period (Wright & Parker, 2004). No evidence of a change in the influence of deprivation on growth during childhood was found, despite increases in average height over the same time period. Respiratory health Adult lung function was showed to be influenced, both directly and indirectly, by a range of factors during an individual’s lifetime. As expected, sex, achieved adult height and smoking were the most influential predictors, but birth weight, duration breast-fed and childhood lower respiratory tract infections also contributed significantly. [31] Telomere length In our studies to date on telomere length, as a putative marker of biological ageing, we have shown no association with markers of socio-economic status, but did find longer telomeres in men than women. [35] Validation of self-reported smoking The self-completion questionnaire included questions on cigarette smoking. As part of the clinical examination, exhaled carbon monoxide was measured, which can be used as a validation method for self-reported smoking surveys. The data were combined with similar data from the Newcastle Heart Project and produced results suggesting that the specificity of such validation methods may depend on factors such as ethnicity, in addition to which level is chosen at the cut-off level (Pearce & Hayes, in press). Social Inequalities and adult health We reported on the tracking of socio-economic indicators and the subsequent influence of socio-economic mobility on adult health (Adams et al., 2004). Socio-economic position at different stages of life were associated with self-reported limiting long-standing illness in men, but no such associations were seen for women. References 1. Lamont DW, Parker L, Cohen MA, White M, Bennett SM, Unwin NC, Craft AW, Alberti KGMM. Early life and later determinants of adult disease: a 50 year follow-up study of the Newcastle Thousand Families cohort. Public Health 1998; 112: 85-93. 2. Parker L, Lamont DW, Wright CM, Cohen MA, Alberti KGMM, Craft AW. Mothering skills and health in infancy: the Thousand Families study revisited. Lancet 1999; 353: 1151-2. 3. Sadowski H, Ugarte B, Kolvin I, Kaplan C, Barnes J. Early life family disadvantages and major depression in adulthood. British Journal of Psychiatry 1999; 174: 112-20. 4. Lamont D, Parker L, White M, Unwin N, Bennett SMA, Cohen M, Richardson D, Dickinson HO, Adamson A, Alberti KGMM, Craft AW. Risk of cardiovascular disease measured by carotid intima-media thickness at age 49-51: lifecourse study. British Medical Journal 2000 320: 273-8. 5. Parker L, Lamont DW, Unwin N, Pearce MS, Bennett SMA, Dickinson HO, White M, Mathers JC, Alberti KGMM, Craft AW. A lifecourse study of risk for hyperinsulinaemia, dyslipidaemia and obesity (the central metabolic syndrome) at age 49-51 years. Diabet Med 2003;20:406-415. 6. Kanan RM, Varanasi SS, Francis RM, Parker L, Datta HK. Vitamin D receptor gene start codon polymorphism (FokI) and bone mineral density in healthy male subjects. Clinical Endocrinology 2000; 53: 93-8.
8. Craft AW. Fetal programming or adult lifestyle. Lessons from the Newcastle 1000 Families Study. Hong Kong J Paediatr 2003;8:346-353. 9. Adams J, Pearce MS, White M, Unwin N, Parker L. No consistent association between birth weight and parental risk of diabetes and cardiovascular disease. Diabetic Medicine 2003; 20: 406-15. 10. Adams J, White M, Pearce MS, Parker L. Lifecourse measures of socio-economic status and self reported health at age 50: prospective cohort study. Journal of Epidemiology and Community Health 2004; 58: 1028-9. 11. Campbell DI, Sullivan PB, Pearce MS, Dale A, Parker L, Thomas JE. IgG subclass responses to Helicobacter pylori vary with age in populations with different risk of gastric carcinoma. Clin Diag Lab Immunol 2004;11:631-633. 12. Campbell DI, Pearce MS, Parker L, Thomas JE. IgG subclass responses in childhood Helicobacter pylori duodenal ulcer: Evidence of T-helper cell type 2 responses. Helicobacter 2004b; 9: 289-92 13. Pearce MS, Steele JG, Mason J, Walls AWG, Parker L. Do circumstances in early life contribute to tooth retention in middle age? Journal of Dental Research 2004; 83: 562-6.
15. Pearce MS, Steele JG, Campbell DI, Thomas JE. Tooth loss and Helicobacter pylori seropositivity: The Newcastle Thousand Families cohort study at age 49-51 years. Helicobacter 2005a; 10: 90-4
19. Birrell F, Pearce MS, Francis R, Parker L. Self-report overestimates true height loss. Clin Rheumatol 2005;24:590-592.
22. Pearce MS, Unwin NC, Relton CL, Alberti KGMM, Parker L. Lifecourse determinants of fasting and post-challenge glucose at age 49-51 years: The Newcastle Thousand Families Study. European Journal of Epidemiology. 2005; 20: 915-923. 23. Tiffin PA, Pearce MS, Parker L. Social mobility over the lifecourse and self-reported mental health at age 50: prospective cohort study. J Epidemiol Comm Health 2005;59:870-872. 24. Pearce MS, Thomas JE, Campbell DI, Parker L. Does increased duration of exclusive breast feeding protect against Helicobacter pylori infection: The Newcastle thousand families cohort study at age 49-51 years. J Pediatr Gastroenterol Nutr 2005;41:617-620. 25. Pearce MS, Unwin NC, Parker L, Alberti KGMM. Lifecourse determinants of insulin secretion and sensitivity at age 49-51 years: The Newcastle Thousand Families Study. Diabetes Metab Res Rev 2006;22:118-125. 26. Mason J, Pearce MS, Walls AWG, Parker L, Steele JG. How do factors at different stages of the lifecourse contribute to Oral Health Related Quality of Life in middle age for men and women? Journal of Dental Research 2006;85:257-261. 27. McIntyre EA, Parker L, Pearce MS, Gerrard J, Sattar N, Craft AW, Walker M. Birth weight does not predict cardiovascular risk estimated by circulating markers of endothelial dysfunction in middle life. Heart 2006;92:679-680. 28. Hayes L, Pearce MS, Unwin NC. Why are some overweight individuals ‘metabolically normal’? Predictors of metabolic parameters in overweight and obese adults from the Newcastle Thousand Families Study. International Journal of Obesity 2006;30:970-976. 29. Pearce MS, Deary IJ, Young AH, Parker L. Childhood IQ at age 11 years and deaths up to middle age: The Newcastle Thousand Families Study. Public Health 2006;120:1020-1026 30. Adams J, Martin-Ruiz C, Pearce MS, White M, , Parker L, von Zglinicki T. No association between socio-economic status and white blood cell telomere length. Ageing Cell 2007;6:125-128 31. Tiffin PA, Pearce MS, Kaplan C, Fundudis T, Parker L. Recollections of parental style and perceptions of current family functioning at age 50. Journal of Family Therapy 2007;29:169-182. 32. Tiffin PA, Pearce MS, Kaplan, K, Fundudis T, Parker L. The impact of socioeconomic status and mobility on perceived family functioning. Journal of Family and Economic Issues 2007; 28: 653-667 33. Blell MT, Pollard TM, Pearce MS. Predictors of age at menarche in the Newcastle Thousand Families study. Journal of Biosocial Science 2008; 40:563-575 34. Tennant PWG, Gibson GJ, Pearce MS. Lifecourse predictors of adult respiratory function: results from the Newcastle Thousand Families Study. Thorax 2008; 63;823-830 35. Owen CG, Whinchup PH, Kaye SJ, Martin RM, Smith GD, Cook DG, Bergstrom E, Black S, Wadsworth MEJ, Fall CH, Freudenheim JL, Nie J, Huxley RR, Kolacek S, Leeson CP, Pearce MS, Raitakari OT, Lisinen I, Viikari JS, Ravelli AC, Rudnicka AR, Strachan DP, Williams SM. Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence. American Journal of Clinical Nutrition 2008;88:305-14. 36. MS Pearce, CL Relton, NC Unwin, AJ Adamson and G Davey Smith. The relation between diarrhoeal episodes in infancy and both blood pressure and sodium intake in later life: The Newcastle Thousand Families Study. Journal of Human Hypertension 2008 Aug;22(8):582-4 37. Starr JM, Shiels PG, Harris SE, Pattie A, Pearce MS, Relton CL, Deary IJ. Oxidative stress, telomere length and biomarkers of physical aging in a cohort aged 79 years from the 1932 Scottish Mental Survey. Mechanisms of Ageing and Development (In Press) 38. Pearce MS, Unwin NC, Parker L, Craft AW. Cohort profile: The Newcastle Thousand Families Study. International Journal of Epidemiology (In Press)
       
Newcastle Thousand Families Study,
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