I am a Paediatric Endocrinologist with a major research interest in the early life origins of disease. I qualified in medicine in 1991 at the University of Newcastle-upon-Tyne and obtained my PhD from the University of Edinburgh in 2004. I currently hold a Scottish Senior Clinical Fellowship based in the Centre for Cardiovascular Science. I also undertake clinics in Paediatric Endocrinology at the Royal Hospital for Sick Children in Edinburgh.
1. Early life programming and intergenerational effectsEpidemiological evidence suggests that early life events play an important role in determining the risk for common cardiovascular and metabolic disorders in adulthood. In particular, intra-uterine growth restriction (IUGR) is associated with a substantially greater incidence of adult hypertension, insulin resistance/type 2 diabetes and cardiovascular disease deaths. These observations have led to the concept of early life ‘programming’, involving the action of factors during a sensitive ‘window’ of development that alters the maturation, structure and function of specific tissues, producing effects that persist throughout life. The molecular mechanisms underlying the association between the early life environment and later disease are poorly understood but may include epigenetic effects including alterations in DNA methylation or histone modification. There is also growing evidence that ‘programming’ effects can be transmitted to subsequent generations and my research focuses on trying to understand the mechanisms by which this occurs. 2. Maternal obesity and the programming of offspring disease riskWhilst much of our research in the studies have focussed on the role of fetal overexposure to glucocorticoids in the programming of cardiovascular risk in offspring, there is now increasing interest in the link between maternal (and fetal) overnutrition and increased risk of obesity and cardiovascular disease in the offspring. This is of great importance given that the worldwide prevalence of obesity and related metabolic disorders such as insulin resistance, type 2 diabetes and dyslipidaemia has increased rapidly over recent years and some of our work is also aimed at understanding how factors such as maternal diet or obesity can affect the developing offspring. Much of my work in this area is being carried out within the Edinburgh Tommy’s Centre (http://www.tommys.org/Page.aspx?pid=367).3. Sex-specific effects of obesity on cardiovascular riskFinally, we are also exploring why obesity affects men and women differently in terms of cardiovascular risk.