2025-26 Project (Critchley & Donin & Doyle)

Nutrition and cardiovascular risk reduction for youth in Zimbabwe

SUPERVISORY TEAM

Supervisor

Professor Julia Critchley at City St George’s
Email: jcritchl@sgul.ac.uk

Co-Supervisor

Dr Angela Donin at City St George’s
Email: adonin@sgul.ac.uk

Co-Supervisor

Dr Aoife Doyle at LSHTM
Email: aoife.doyle@lshtm.ac.uk

PROJECT SUMMARY

Project Summary

This project aims to explore the main dietary risk factors for cardiovascular disease in a population of young people in Zimbabwe, and to explore key areas to target for prevention.  Poor diet is associated with increased risk markers such as elevated BP, hyperglycaemia and overweight/obesity, all of which are rising rapidly in Sub Saharan Africa.   

The project will involve adapting dietary data collection tools tailored for a sub-Saharan African context.  Dietary associations with key health measures, including BP, HbA1c, and anthropometric measures will be investigated, analyses will provide several opportunities to publish in peer reviewed Journals and present at relevant scientific conferences.  Finally, nutritional prevention strategies will be proposed with a view to reducing future cardiovascular risk.

Nested within the SHEAR Zim study, the project will provide a unique dataset in this under-researched young population. The project is London-based, and might suit students considering careers in global health.

Project Key Words

Diet, cardiovascular risk, youth, prevention

MRC LID Themes

  1. Global Health

Skills

MRC Core Skills

  1. Quantitative skills
  2. Interdisciplinary skills

Skills we expect a student to develop/acquire whilst pursuing this project

Critical review of scientific literature 
Epidemiology and statistical analysis skills 
Field epidemiology skills including population based dietary data collection in LMIC setting  
Dietary data analysis using appropriate Food Composition Tables 
Inter-disciplinary research skills and international experience

Routes

Which route/s are available with this project?

  • 1+4 = No
  • +4 = Yes

Possible Master’s programme options identified by supervisory team for 1+4 applicants:

  • Not applicable

Full-time/Part-time Study

Is this project available for full-time study? Yes
Is this project available for part-time study? Yes

Location & Travel

Students funded through MRC LID are expected to work on site at their primary institution, meeting – at the minimum – the institutional research degree regulations and expectations. Students may also be required to travel for conferences (up to 3 over the duration of the studentship), and for any required training (for research degree study). Other travel expectations and opportunities highlighted by the supervisory team are noted below.

Primary location for duration of this research degree: City St George’s, London

Travel requirements for this project: There are potentially up to two field visits to Zimbabwe (both 2 week visits).

Eligibility/Requirements

Particular prior educational requirements for a student undertaking this project

  • Minimum City St George’s institutional eligibility criteria for doctoral study.
  • MSc in public health field (e.g., Public Health, Epidemiology, Nutrition)

Other useful information

  • Potential Industrial CASE (iCASE) conversion? = No
  • Following upgrading, the project supervisory team will change (pending approval from City St George’s RD Committee). It is envisaged that at that time Dr Donin will become Primary Supervisor, with Dr Doyle and Dr Kalpana Sabapathy as Co-Supervisors.

PROJECT IN MORE DETAIL

Scientific description of this research project

Cardiovascular disease (CVD) is a leading cause of death worldwide; with mortality from stroke and heart disease increasing significantly over the last few decades.  A large proportion of the burden is now occurring in low- and middle-income countries (LMICs) (WHO, 2019). Recent population-based studies in Sub-Saharan Africa (SSA) suggest this could be driven by a high prevalence of hypertension and other key cardiovascular risk factors (e.g., diabetes, obesity).  Poor diet is an important determinant of CVD and is a key modifiable risk factor for predisposing conditions such as elevated blood pressure (BP), hyperglycaemia and overweight/obesity.  A recent analysis of approximately 17,000 Zimbabwean youth (18-24y), found prevalence of elevated BP (≥120mmHg and/or ≥80mmHg) of 19.6%, suggesting that preventive interventions early in the life-course are essential.   

This PhD project aims to investigate the dietary determinants of elevated BP, and other cardiovascular risk markers in young people in Zimbabwe. 

The project will be nested within a cross-sectional study of young people (SHEAR Zim study- Significance of Hypertension in Early Adulthood Research in Zimbabwe – Wellcome Trust), which will collect a range of socio-demographic, behavioural, and biological markers associated with increased cardiovascular risk.  This PhD project will involve the addition of detailed dietary assessment for a subset of participants, creating a unique dataset in this under researched population through which the relationships between current dietary patterns and emerging chronic disease risk can be explored.   

Objectives 
1. To review existing dietary measurement tools and identify an acceptable and feasible tool to assess key food item consumption relevant to the local context   2. To examine associations between dietary intakes and cardiovascular risk markers in a population of young adults in Zimbabwe (nested within SHEAR Zim study). 
3. To co-create recommendations and identify potential nutritional prevention strategies suitable for the Zimbabwean setting to reduce the risk of cardiovascular disease.   

Techniques   
1. Questionnaire and dietary data collection tool development. 
2. Dietary data collection through a population-based study
3. Dietary data analysis, including use of relevant software linked to Food Composition Tables, using appropriate quantitative statistical models 
4. Stakeholder engagement and participatory approaches to intervention design    

To allow the additional dietary data to be collected within the SHEAR data collection period (Jan-Dec 2026), and to increase efficiency, modest support has been costed to support data collection.    

Availability of databases 
1. Review of openly available literature and literature available through LSHTM and SGUL licences 
2. Participant data will be available on a range of cardiovascular risk markers (including BP, anthropometry, blood lipids and glucose), permission to use the SHEAR data for the purposes of this PhD analysis has been provisionally agreed by study PI Dr Sabapathy (who is part of the supervisory team) and the student will make a formal request for data use during year 1. 

Potential risks  
The main potential risk is that the primary data collection (objective 2) cannot take place due to political unrest and/or other unforeseen circumstances. In such a situation, an additional secondary analysis component of the PhD would be introduced e.g. based on existing data from national surveys (e.g., Food and Nutrition Council), explore the impact of climate shocks on nutritional intakes, Ultra Processed Food (UPF) intakes and nutritional status.

Further reading

Relevant preprints and/or open access articles:
(DOI = Digital Object Identifier)

Additional information from the supervisory team

The supervisory team has provided a recording for prospective applicants who are interested in their project. This recording should be watched before any discussions begin with the supervisory team.

Critchley-Donin-Doyle recording

MRC LID LINKS

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