University of Southampton, United Kingdom
MRC Lifecourse Epidemiology Unit, University of Southampton, United Kingdom
CSI Holdsworth Memorial Hospital, Mysuru, Karnataka
While doing MBBS at Mysore Medical College, I frequently thought about pursuing a career in public health. However, I had never imagined that one day I would be a research scientist. My entry into the research field was purely by chance. Immediately after completing my internship I took up a medical officer’s job for a research project at Holdsworth Memorial Hospital (HMH) in Mysore to get some work experience before further studies. I did not know at that time that I had joined one of the first research groups in India working on the “developmental origins” hypothesis. For the first time I was introduced to the concept of early origins of adult disease, which proposed that nutrition during fetal development affects an individual’s susceptibility to adult non-communicable diseases (NCD). I found this immensely interesting and very relevant to the current Indian NCD scenario in the context of widespread maternal and fetal undernutrition in the country. Soon I realised that the research field encouraged me to think critically, to question the existing theories and develop my own ideas and concepts. This itself was a refreshing change from the traditional system of believing whatever was in the textbooks. It was during this time that I met my mentor Prof. Caroline Fall from the University of Southampton, UK. This was the turning point of my life and career. Her association further increased my interest towards research in general, and the “developmental origins” concept in particular. I obtained a PhD from the University of Southampton studying the long-term implications of maternal undernutrition and overnutrition (gestational diabetes) for offspring cardiometabolic risk. Continued support from Prof. Fall and from my institution, particularly our director Dr. SC Karat helped me to pursue my research interest in India after PhD. I have not looked back since then.
Over the years, I have been convinced that the “developmental origins” paradigm provides a promising lead for understanding the reason behind the unprecedented rise of non-communicable disease in India, and a means for developing sustainable public health solutions for its mitigation. My special interest all along has been to investigate the long-term associations of maternal gestational diabetes (GDM) on offspring cardio-metabolic and psychological risks. I led studies that produced some of the best longitudinal data on the offspring of GDM mothers. We showed associations of maternal diabetes and micronutrient status, and offspring birthweight and postnatal growth on their risk outcomes during childhood and adolescence. These findings suggested that both overnutrition (GDM) and specific nutritional deficiencies co-exist in Indian mothers and have adverse impact on offspring long-term health.
Recently, I developed interest in the role of psychological stress in the development of adult chronic diseases. Stress is ubiquitous particularly in adolescents and young adults in modern societies. This may trigger several physiological, psychological and lifestyle changes that will set in motion a cascade of risk factors for future disease development. With the help of a Wellcome Trust Intermediate fellowship I explored a possible mechanistic link between the early exposures and adolescent offspring’s chronic disease risk markers by studying the cortisol and cardiovascular stress responses in the adolescents from the Parthenon cohort which I had helped to set up in Mysore. My proposed research for the current fellowship aims to understand the various early life and current factors that determine variations in stress reactivity among young population, and how this relates to their future disease risk. Through this research I also propose to develop multi-faceted interventions for future use among vulnerable youth to manage stress. I consider this study as a first step for me towards translational research. I believe that the mechanistic studies proposed in my research will provide important leads for NextGen preventive strategies for non-communicable disease in susceptible individuals.
I am very glad that the Wellcome Trust/DBT India Alliance has provided a perfect platform for researchers like me to work towards their vision for improving global health scenario.