Cardiac, vascular and cerebrovascular health in the prevention of cardiovascular disease
The primary focus is the assessment of cardiac, vascular and cerebrovascular anatomy and function after exposure to exercise, acquired or inherited diseases or a combination of these factors. Related to the heart, a series of unique studies have been performed that examined evidence for sport-specific remodelling of the heart (athlete’s heart), and how novel technology can help in the (early) detection of cardiac abnormalities.
Our group has provided novel insight into the phenomenon of exercise-induced cardiac fatigue and the release of cardiac troponin in response to exercise (and its potential clinical relevance). Cardiac pre-participation screening has gained significant media coverage due to the occurrences of (aborted) sudden cardiac death incidents in elite athletes and was the focus of an Impact Case Study (4* world leading) at REF2021. Related to vasculature, our group has contributed to the evidence for remodelling of the vascular system from exercise training, with alterations in hemodynamics representing a key stimulus, and subsequently explaining part of the cardioprotective effects of exercise training. Within this work on the vasculature, we focus on peripheral conduit, resistance and microvessels (including the skin), but also cerebrovascular health. Our work highlights the strong variability in how these different arteries respond to a physically active lifestyle. Through better understanding of the underlying mechanisms, our group has introduced new strategies (e.g. preconditioning) and explores novel types (e.g. high-intensity training), timing (pre-habilitation) of exercise to optimise and explores novel technology to personalise the benefits of exercise training and enhance adherence. Importantly, one focus of our group is improving the way exercise is prescribed and delivered as part of the prevention, treatment and long-term management of acute, sub-acute, chronic and complex conditions across healthcare settings from hospital to community.
As part of a Research England funded project, aimed at learning from the Australian allied health professional system that has clear economic benefit, our group (with colleagues across the UK and Australia) is advocating and promoting a University trained and accredited Exercise Specialist within the UK health care system (i-CARDIO project).
Sedentary behaviour and cardiovascular disease
Over the last decade, a link between sedentary behaviour (when a person is sitting or lying down) and cardiovascular disease risk has become apparent. The group aim to advance the mechanistic understanding of this relationship by interrogating cardiovascular responses to behavioural manipulation.
Previous projects have aimed to determine the acute cerebro- and conduit vascular responses to prolonged sitting bouts, and have examined activity break strategies that could be utilised to prevent the detrimental effects of prolonged sitting. Furthermore, our group, in collaboration with the Physical Activity Exchange, have implemented novel and complex, long term interventions to reduce sitting time in highly sedentary workers, including office and call centre staff, in order to improve workers cardiovascular health, mental wellbeing and overall performance.
Current studies have expanded this work to investigate people living with long term conditions, such as rheumatoid arthritis. Specifically, projects aim to better understand how prolonged periods of sedentary behaviour may exacerbate clinical symptoms and accelerate the disease process. Another ongoing study is examining the effects of prolonged sitting on cardiovascular and metabolic health during pregnancy.
Whole body and skin thermoregulation
Our group focuses on thermoregulatory physiology; the ability to control body temperature, in both healthy and diseased individuals through collaborative and innovative work. The group provides novel insight into the control of cutaneous (skin) vascular (blood flow) and sudomotor (sweating) function and structure in response to various stressors, for example, exercise and environmental extremes, as well as apply research to the practical needs of various populations, e.g., athletes, patients and commercial/industry partners. Furthermore, using novel and intricate techniques we are able to examine the function (laser Doppler flowmetry) and structure (skin and muscle biopsies) of blood vessels and sweat glands in both healthy individuals and populations with microvascular/sudomotor dysfunction.
Our aim is to better understand how we regulate body temperature via changes in skin blood flow and sweating as well as further understand the role of microvascular dysfunction in cardiovascular disease. Using our expertise and techniques we also work with industry to understand technology and/or interventions that aim to modulate microvascular, sudomotor and temperature responses to exercise and environmental stressors.
Women’s health and cardiovascular disease
Members of our group have a research interest in female physiology and promoting physical activity and exercise across the lifespan. Understanding the impact and consequences of sex hormones on the cardiovascular system (e.g. polycystic ovary syndrome) as well as exploring the health consequences of life events specific to females (e.g. conception, pregnancy, post-partum and pre, peri, post-menopause) provides important insight for the design and implementation of novel non-pharmacological interventions, that are specific to females. For example, one previous research project examined the impact of pregnancy on cardiovascular health and explored whether increasing physical activity can positively impact vascular health of the mother and baby. Active current studies are examining the influence of activity status on metabolic and cardiovascular health during pregnancy (including healthy pregnancy and those with gestational diabetes); the impact of body composition and habitual lifestyle on fertility status of females as well as the mechanisms of the menopausal hot flushes.
Nutrition and cardiometabolic health
Our primary focus is how existing and modified diets and nutrition can ameliorate cardiometabolic risk in primary and secondary prevention of cardiovascular disease (CVD). We have conducted a range of studies including, systematic review/meta-analysis, observational, method development, and randomised controlled trials in our specialist areas of nutrition. These include but are not limited to, omega-3 (plant and marine-based), carbohydrate restriction, plant based/vegan, higher protein diets, and takeaway/fast-food consumption. We also perform combined nutrition and exercise studies. Our previous projects include the bioavailability of plant-based omega-3 fatty acid nanoemulsions, low carbohydrate diets, and our work on low density lipoprotein discordance.
Our research outcomes focus on the circulating lipids and lipoproteins traditional and advanced lipidomics, metabolomics, indices of strength and muscle mass, omega-3 index, insulin resistance, non-invasive measures, and inflammation all as marker/measures of CVD and related conditions.
Our current projects include:
- Plant-based omega-3 supplementation to alleviate cardiometabolic markers in populations at risk of cardiovascular disease.
- Higher protein Mediterranean diet plus resistance training in a cardiac rehabilitation population.
- The effect of omega-3 on indices of strength and muscle mass.
- The impact of high protein diets on the microbiome.
- The metabolomics and proteomics of low- and high-density lipoproteins.