What are the most popular foods and drinks at TwinsUK?

6th April 2022 – By Aaruthy Suthahar

Birds eye view of table with food (toast and chocolates) and beverages (tea).

New research has found that black tea and semi-skimmed milk are the most consumed items by TwinsUK members. The study, which aimed to understand eating patterns, also identified the top paired food items that were most consumed by twins were tomatoes and lettuce.

Researchers found that eating breakfast was not linked to an individual having a lesser or greater BMI (Body Mass Index) status or weight, even though they had a higher calorie intake. However, the team also found that individuals with a longer eating window were strongly associated with an increased BMI and weight. Diet has lots of complexities and variability, with a major effect on human health. It is not only what someone eats that can have ramifications for their health but also how and when. TwinsUK researchers have therefore been investigating the relationship between diet and disease. One key element is to understand individuals typical eating patterns and intake of nutrients. 

An EFR (Estimated Food Record) is a type of food questionnaire that allows researchers to understand eating behaviours in individuals by collecting data about all foods consumed in participants over a period. The open-ended style of an EFR means that it can more effectively identify how complex and variable individual diets are compared to methods which are more structured, including further understanding into, for example, eating patterns and of co-occurring foods.  

The researchers included 2,184 participants from our TwinsUK cohort between 2012 and 2017 and collected 2343 EFR’s from them. Twins were asked to provide information on the size of their portions, time of their meals, details of food type they consumed, date and a yes/no answer to whether they considered it a standard day’s intake. 

The team also found that twins who skipped their breakfast were reported to have a longer eating window than individuals who had breakfast, which could partly explain the lack of consistency in weight and BMI status between the individuals who had breakfast and those who skipped it. Also, time-restricted consumption, like consuming food daily within an 8-to-10-hour window, has been shown to improve glucose tolerance, although further research needs to be carried out in humans.  

One limitation of the research is that the study looked at data mostly from women. This means it is difficult to make an accurate conclusion without further clinical studies which include participants more representative of the diversity of the population in the UK.  

100 most frequently consumed food items, and food co-occurrence network of food pairings consumed within a food record

100 most frequently consumed food items, and food co-occurrence network of food pairings consumed within a food record; A 100 most frequently appearing word within food item descriptions, with the font size and colour depicting the importance of the food item B 100 most frequently appearing food item description

Can gut bacteria be linked to greenspace composition in the UK?

22nd March 2022 – By Aaruthy Suthahar

Hills and trees

The bacteria in your gut is linked to the environment around you, according to latest research from TwinsUK.  

Exposure to natural environments, also known as greenspace, has been shown to have a positive influence on our health, but the mechanisms as to why are still not clear. We know from previous research that gut bacteria is linked with inflammatory illnesses; inflammatory illnesses are also more prevalent in urban areas and in individuals who have lower levels of exposure to greenspace. Therefore, gut bacteria could act as one of the links between greenspace and health.  

The team studied 2,443 participants from the TwinsUK cohort to see if there was a difference in gut bacteria in individuals living in rural and urban environments. The researchers looked at the amount of greenspace at three different distances from a participant’s home: 800 m, 3000 m, and 5000 m. The aim was to understand if there was any evidence of bacteria differing with the amount of greenspace. 

The team found there were differences in bacteria between different greenspace areas and when comparing rural versus –urban microbes. One hypothesised reason could be that people are exposed to a range of microorganisms and therefore have a stronger immune system as they are exposed to a wider range of bacteria. Levels of bacteria associated with disease were higher in individuals living in more urban environments compared to rural environments. 

A limitation of the study was the broad interpretation of “greenspace” as being any area in a non-urban environment. This meant that factors like the accessibility of land or the type and quality of habitats that were present could not be considered. Further work could design experiments to understand this further by comparing urban areas with high, accessible greenspace with urban areas of low, accessible greenspace. 

The different microrganisms residing along the human digestive tract, along with the things these microbes produce is collectively called the human gut microbiome. It has a crucial role as it interacts with the immune system, is vital for processing nutrients and protects individuals against pathogens.  

First author Ruth Bowyer said: 

“The results show that there are geographical patterns in the composition of the microbiota which does not appear to be explained by diet, BMI (Body Mass Index), and health deficit. Therefore, the results bring to light the potential importance of considering non-lifestyle factors that could affect microbiota composition.” 

Genomic regions discovered that could help understand obesity

16th February 2022 – By Guy’s and St Thomas’ NHS Foundation Trust

DNA molecule

A new study has helped to shine light on the genetic pathways underlying obesity. The findings could help develop more personalised ways to help people maintain a healthy weight.

The work is the largest study of its kind looking at genomics and levels of metabolites – the molecules produced when the body breaks down food. It reports 74 previously unknown genomic regions that influence how people’s bodies break down food into energy.

The work was supported by the National Institute for Health Research (NIHR) Guy’s and St Thomas’ Biomedical Research Centre. The team behind the study were from the Department of Twin Research and Genetic Epidemiology, King’s College London and the NIHR BioResource.

The study involved 8,809 people who had joined the NIHR BioResource. The BioResource is a bank of individuals who consented to be contacted about research projects.

The team looked at blood samples to measure levels of 722 metabolites. These provide a snapshot of an individual’s wellbeing and the mechanisms that control key physiological processes. Metabolite levels can be affected by nutrition, drugs and the gut microbiome. However, the way the body breaks down food is known to be strongly driven by a person’s genetics.

From analysing these alongside whole genome sequencing, the team identified 202 unique genomic regions whose variations are associated with the levels of 478 different metabolites. These included 74 genomic regions not associated with any metabolites in previous works. They confirmed the findings in an independent cohort of 1,768 people.

Senior author Dr Cristina Menni from the Department of Twin Research and Genetic Epidemiology, King’s College London said:

“These results could have many practical implications. Human metabolism underlies a lot of different areas of human health and disease. Our findings could help understand certain diseases.”

“Some of the metabolites we looked at are linked to BMI and could give us an insight into obesity in some individuals. It is very early research, but in the future these findings could help to develop approaches to maintaining a healthy weight which take into account a person’s genetic profile.”

Dr Massimo Mangino, senior bio-informatician from the NHIR Guy’s and St Thomas’ Biomedical Research Centre and lead author of the study, said:

“Obesity is one of the most common conditions, and yet there’s still so much we need to understand about its biological mechanisms. Our latest findings may help to unravel some of them. Genetic studies hold real promise in helping us find new treatments for obesity. By teasing out the complex relationships between different genes, we have a huge opportunity to turn the tide against this condition.”

Dr Pirro Hysi from the Department of Twin Research and Genetic Epidemiology added:

“This study is the largest scale study of its kind of metabolite levels to date and its results enhance our knowledge of genetic mechanisms controlling human metabolism. The NIHR BioResource is a unique UK resource made possible by the amazing collaboration between doctors and researchers in the NHS. It’s because of collaborations like this that large scale studies like ours are possible.”

The World Health Organisation estimates that over four million people die each year as a result of being overweight or obese.

Study finds potential predictor for perimenopause

11th February 2022 – By King’s College London

A new study has found women ‘age’ significantly faster in the perimenopausal period, based on analysis of the IgG glycome. This finding indicates the potential of using the IgG glycome composition as an early predictor for perimenopause.

780x450 Pills

The study, published in iScience and led by a team of researchers from the Genos Glycoscience Research Laboratory in Zagreb, Croatia, Newson Health Menopause & Wellbeing in Stratford upon Avon and King’s College London followed nearly 2000 women for 15 years and analysed their IgG glycans several times during that period. IgG glycans, otherwise known as immunoglobulin G glycome, is an abundant antibody and has been shown to be a biomarker of an individual’s health.

Researchers analysed IgG glycome composition in 5,080 samples from 1,940 females during their transition from before menopause (premenopause) to postmenopause. Many of these samples were taken from TwinsUK which is the largest twin registry in the UK and led by researchers from King’s College London.

Analysis of the IgG glycome in multiple samples from the same individuals was able to show the association between perimenopause and the changes in the IgG glycome composition. This period showed the IgG glycome changing from an inflammation-suppressive to proinflammatory. While this is common as we age, researchers saw this change happen rapidly as women transitioned from a regular cycle to menopause.

This change in IgG glycans is associated with many health risks that accompany menopause. In some diseases like rheumatoid arthritis and cardiovascular diseases, this change can occur years before disease onset. This suggests glycans and chronic inflammation is linked and the transformation of IgG glycans plays a part in developing the disease.

Perimenopause can last up to 15 years and is challenging to diagnose due to highly irregular hormonal cycles. As a result of poor awareness and inappropriate use of hormonal tests, women are often misdiagnosed with conditions such as fibromyalgia, migraines, depression, or chronic fatigue syndrome and are frequently prescribed antidepressants despite the lack of evidence to support their use to improve the low mood associated with perimenopause or menopause. This study shows it may be possible to use IgG glycans to predict perimenopause.

Senior author Dr. Cristina Menni from King’s College London said:

“Perimenopause is poorly diagnosed due to highly irregular hormonal cycles and symptoms that can last for as long as 15 years. Currently, there is no accurate diagnostic test for perimenopause. Adding an easily quantifiable novel early biomarker of perimenopause could be a valuable improvement to current clinical praxis.”



What does Long Covid mean to you?

4th February 2022

Woman lying in bed with mug

Since the pandemic began, people have been reporting that they have continued to experience symptoms for weeks or even months after infection. This can range from mild symptoms all the way to debilitating symptoms that have a major impact on people’s lives. This condition is now described as ‘Long Covid’ – but there is currently no set definition of what constitutes Long Covid, even as more and more people develop the condition.

TwinsUK is part of a multi-university study called CONVALESCENCE, which aims to understand, define and improve diagnosis of Long Covid. There are many parts to this project, and more information is available here.

As part of this research, we want to hear what Long Covid means to you. To facilitate this, the CONVALESCENCE team have created an online discussion forum. The aim of the forum is to ensure that a wider cross section of public and patient perspectives are included in discussions about how to define Long Covid and in the broader research. 

The forum is hosted on the People in Health West of England (PHWE) Discourse Platform. The platform works in a similar way to social media you may be familiar with such as Facebook. Your input will help in shaping how we progress the research going forward.  

The Long Covid forum space is public. Public forum areas on the Discourse platform can be viewed by anyone, but only people that have created an account can reply. 

If you would like to contribute to the development of this research as a public contributor, you are welcome to join the conversation by creating an account.  

Click on this link to view the public forum space dedicated to discussing how we should define Long Covid, and register for an account if you would like to participate in the conversation. Click here for a short guide to the forum. 

Could bacterial infection contribute to low back pain?

3rd February 2022 – By Aaruthy Suthahar

women sat in an office touching lower back due to back pain

Infection of the disc may be a factor in spinal disc degeneration and lower back pain, according to the latest TwinsUK research.  

Back pain, specifically low back pain, is now the world’s leading cause of disease. It is a huge problem globally and is associated with intervertebral disc degeneration, which is the breakdown of one or more of the cushioned discs that separate the bones of the spine. This causes pain in the back or neck and frequently in the legs and arms.  

In some cases, doctors see on scans bone marrow lesions known as ‘Modic change’, which may be associated with low back pain. The aim of this study was to identify whether there is an association between discs next to Modic change and bacterial reproduction. Previous studies have found the growth of bacteria following the removal of degenerated discs after spine surgery.  

The TwinsUK team carried out a review of existing research papers, looking at 36 research articles published between 2001 and 2021 reporting human studies which examined the role of bacteria in disc degeneration or Modic change in the bones which form the backbone. 

They found that a specific type of bacteria, Cutibactierum acnes, was commonly identified, although this may be because, in many of these studies, researchers have looked for and studied specific bacteria, which means they may have missed other bacteria that were present. 

Although several studies in this review reported that the presence of bacteria might be due to infection in the disc, other studies also suggested that contamination may have played a role during study procedures. Some research concluded that bacteria found in the disc may be due to contamination, meaning that the bacteria has come from the air or from the surgical team even though they were scrubbed up and wearing gloves.  

Further work is therefore needed to determine whether these bacteria are a result of contamination or represent a real infection of the spine, which contributes to chronic low back pain. This could be done by having a new method approach to look at all the bacteria present, rather than looking for specific bacteria. Researchers will also need to implement a suitable control to test how bacteria could be getting into the disc. 

First author, Isabelle Granville Smith, said: 

“It is exciting that we might have found contributing factors to disc degeneration as there is not much research on it. We now need to find a way to be able to extract as much information as possible of all the bacteria present rather than looking for specific bacteria.” 

Granville Smith et al. 2021. Evidence for infection in intervertebral disc degeneration: a systematic review. European Spine Journal.

Have your say on TwinsUK research

27th January 2022

We are looking for new members of our TwinsUK Volunteer Advisory Panel (VAP) and eVAP, to replace our outgoing panel.

The VAP meet twice a year, either in person or by video call, and the eVAP provide input by email only. 

To apply to be a member, please complete the short online application below by Monday 7th March 2022 (extended from 14th February 2022). 

What are the VAP and eVAP? 

The VAP and eVAP provide feedback on new research protocols, pilot our questionnaires, review newsletters and participant information materials, discuss ethical issues, and provide advice on a variety of topics. 

We set up the VAP and eVAP in 2009 to ensure that we take the opinions and views of our volunteers on board during the development and running of research programmes at TwinsUK.

Membership lasts for three years.

The panel consists of: 

  • 12 VAP members who meet twice a year, either in person at St Thomas’ Hospital, London, or over video call. We also email VAP members approximately 4-6 times a year for their views. 
  • 12 eVAP members who are consulted by email only (approximately 4-6 times a year). 

How do I apply? 

There are no qualifications needed and everyone can apply, although only one twin in a pair can be on the panel at any one time – so please discuss with your twin before you volunteer! We also ask that you do not apply if you have previously been a VAP or eVAP member. 

Both panels will be selected to represent the diversity of TwinsUK in terms of zygosity, age and gender of the twins. 

If you would like to apply to become a member of the VAP or the eVAP, please click on the link below to complete the short form by Monday 14th February 2022. We will email you the outcome of your application by within a month of the closing date.  

Apply to join today

To apply, click on the link below and fill out the short form:

VAP application form

If you have any questions, please do get in touch with the Chair of the VAP, Paz García, on paz.garcia@kcl.ac.uk. 

Feedback from 2018-2021 VAP members

“I’ll really miss being part of VAP.  Throughout my time in lockdown, it really gave me a sense of purpose and a feeling that I was part of a team making a valuable contribution in the fight against Covid. The VAP enabled me to contribute some diverse and commercial risk management skills in a very different environment. Our VAP formed a great team where everyone was listened to and their views were respected.” 

“I was wary that the level of scientific explanations might be beyond me at times but I always felt that things were pitched in an appropriate way for us…. so don’t let people be put off by this.”

“I am very grateful to you all at the DTR for making my three years as part of the panel such an enjoyable and worthwhile experience.  It has been especially good to have been able to contribute to your vital work during the pandemic which was such a pressured time for you all.  Thank you so much.” 

Do identical twins have identical antibody responses?

27th January 2022 – By King’s College London

virus, pathogen, antibody

New research has demonstrated the heritability of anti-viral antibody selection among a cohort of identical twins.

The study, published today in Cell Press and led by researchers from King’s College London in collaboration with the John Hopkins University, investigated for the first time whether epitope selection – the part of the antigen molecule which an antibody attaches itself – is heritable.

There is a high degree of variability in human immune responses to viral infections. The genetic factors that influence this variability are not well explored. TwinsUK is the UK’s largest adult twin registry consisting of identical twins. Identical (monozygotic) twins come from a single fertilised egg that splits in two and share most of their genetic material. As such, most of their differences (either physical or behavioural) are likely to be the results of environmental factors.

Researchers from TwinsUK compared samples from identical twins with fraternal twins to measure the heritability of the antibody repertoire and identify genetic loci driving antibody responses in humans.

They used VirScan, a virome-wide antibody profiling technology, to measure the heritability of epitope selection.

The results found epitope selection is a heritable trait. They also utilised genome-wide association analysis to identify genetic loci linked to Epstein-Barr Virus (EBV) antibody epitope selection and identified a key role for HLA-DR (MHC-II) in selecting certain dominant EBV epitopes.

First author Dr. Massimo Mangino from King’s College London said:

“Our study represents the first comprehensive investigation of the contributions of genetic and environmental factors to the variation in the antibody responses to viral infections. It highlights the complex relationship between genetic and environment and may provide a novel framework for identifying genes important for pathogen immunity.”

Could the DASH diet help reduce high blood pressure?

11th November 2021 – By Aaruthy Suthahar

photo of vegetables, fruits and nuts

In a recent study, TwinsUK researchers found that following the DASH diet was linked with reduced blood pressure and that this may be as a result of a simultaneous reduction in weight.  

High blood pressure is a very common although adaptable risk factor for heart disease and deaths worldwide. Risk factors for high blood pressure include both genetic predisposition and environmental or lifestyle factors, such as diet, alcohol use, and inactive behaviour. The DASH diet – which stands for Dietary Approaches to Stop Hypertension – consists of foods like fruits, vegetables, whole grains, nuts, and low-fat dairy products, and aims to reduce the consumption of red meats and full-fat dairy products.

The DASH diet was developed to combine the effects of many foods and nutrients that have been shown to help lower blood pressure and has been supported by several successful clinical trials. Some countries, including the USA and many European countries, advocate the DASH diet as a suitable nutritional approach for preventing high blood pressure. 

In this present study, the TwinsUK researchers found that body mass index (BMI) is the link between the DASH diet and changes in high blood pressure. The team also identified six molecules in the blood linked with the DASH diet and BMI, indicating shared metabolic pathways.  

The researchers included 2,424 female participants from the TwinsUK cohort with blood pressure and BMI measurements and food intake data. The team investigated the relationship between adherence to a DASH diet and blood pressure in the volunteers.  

One limitation of the research is that the study looked at data only from women and at one specific time point. This means it is difficult to make an accurate conclusion about whether or how the DASH diet reduces blood pressure without further clinical studies.  

First author Panayiotis Louca said: 

“Our study presents novel insights into the relationship between the DASH diet, high blood pressure, and BMI. Further studies should be done to look into the underlying molecular mechanisms to improve our understanding of how to treat high blood pressure.” 

Senior author Cristina Menni said: 

“The team highlight that the findings further our knowledge of the molecular mechanisms at play and may be relevant in developing dietary guidelines for preventing high blood pressure, for future global health.” 

Louca et al. 2021. Body mass index mediates the effect of the DASH diet on hypertension: Common metabolites underlying the association. The Journal of Human Nutrition and Dietetics 

Is a love of nature in your genes?

3rd November 2021 – By Aaruthy Suthahar

Identical twins are consistently more similar to each other in their concern for nature, environmental movement activism, and personal conservation behaviour than non-identical twins, suggesting there are genetic influences on these traits.  

The study, led by a team from the University of Singapore, found that all three characteristics were somewhat heritable, and the genetic correlations were high among them.  

This highlights that the genetic foundation of concern for nature, protecting the environment, and conservation behaviour partially overlap. The genetic correlations amongst the traits could help explain why people who show more concern for nature generally make pro-environmental decisions. 

Although results from the study revealed that genetic effects can have a contribution to sustainable behaviours, the researchers explain in their paper that external factors such as education and making conservation behaviours more convenient remain key to encouraging more people towards sustainability.  

The researchers used data from the TwinsUK cohort to look at the external and genetic influences that drive individual differences via an online survey on concern for nature, environments, and personal conservation behaviours. They analysed responses from 1,165 twin pairs who participated in the study. The survey results of identical twins were then compared with those of non-identical, who share fewer genes. 

One limitation of the study however is that it only surveyed TwinsUK members and at one time-point. Our understanding of a person’s evolving concern for nature and pro-environmental behaviour can be improved by conducting long-term repeated measurements (e.g., looking from child to adult stage of life). Future research studies could therefore carry out repeated measures with a more diverse group of participants to address this. 

As the earth is undergoing an environmental crisis due to the negative impacts made on nature by humans, several policies have been proposed in an attempt towards a more sustainable future. The researchers highlighted in their paper that such recommendations have often been disregarded, due to the lack of public support and concern about the crisis. Therefore, a better understanding of people’s support or lack thereof for pro-environmental policies is essential if we want to achieve environmental sustainability. 

Chang et el. 2021. Genetic Contribution to Concern for Nature and Proenvironmental Behavior. BioScience 

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