Mechanisms for population strategies to prevent diet- and activity-related chronic disease
A population approach to disease prevention aims to shift the distributions of risk factors such as diet, physical activity and adiposity by changing the wider environments that influence everyone’s behaviour. This complements ‘high risk’ approaches targeting people at elevated risk of disease which have limited reach, may be costly and have the potential to exacerbate health inequalities.
The UK has made some progress in implementing population disease prevention strategies, but their impact has been modest and their evaluation is challenging. We lack a generalisable understanding of what makes for a successful strategy in different contexts. Just as high-risk approaches have benefitted from greater focus on behaviour-change theory, more effective and equitable deployment of population strategies depends on better understanding of how interventions work or do not work, and the extent to which findings are transferable between populations and contexts.
Evidence for population disease prevention strategies is often difficult or impossible to generate using randomised controlled trials, so we propose a more comprehensive approach. Building on the MRC translational framework for public health research, the goals of this programme are:
To develop and apply novel observational, natural experimental and evidence synthesis methods in combination
To produce new and stronger evidence for mechanistic pathways by which interventions that change environments lead to changes in (a) dietary and physical activity behaviours, (b) energy intake, energy expenditure, adiposity and other metabolic intermediaries, and (c) changes in NCD incidence and mortality
To identify key underlying intervention functions that can be implemented in different contexts
To specify more generalisable principles for the next generation of population disease prevention strategies in the UK and around the world.
We aim to triangulate a broad range of evidence ‘from epidemiology to evaluation’ to reduce critical uncertainties in causal mechanistic pathways for population disease prevention. Novel mechanism-focused systematic reviews of potential intervention strategies will form the pivot of the research programme (work package 1), both drawing on and feeding into mechanism-focused analyses of existing observational (WP2) and intervention study datasets (WP3).
David Ogilvie – University of Cambridge (Project Lead)
Jean Adams – University of Cambridge
Miriam Alvarado – University of Cambridge
Tom Burgoine – University of Cambridge
Leandro Garcia – Queen’s University Belfast
Louise Foley – University of Cambridge
David Humphreys – University of Oxford
Jenna Panter – University of Cambridge
Richard Patterson – University of Cambridge
Martin White – University of Cambridge
Status
In progress, April 2026 to September 2030
Unit role
Unit led study in collaboration with University of Oxford and Queen’s University Belfast
Funding
Medical Research Council programme grant UKRI1478
Data sharing
There are no data for sharing at present.
