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APCAPS

The Andhra Pradesh Children and Parents’ Study (APCAPS) is a prospective inter-generational cohort that has been incrementally built through long-term follow-up of a nutrition trial (1987-90) in Telangana, south India.

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About

The Andhra Pradesh Children and Parents’ Study (APCAPS) is a large prospective, intergenerational cohort study with in-depth health information from around 7000 adults in 29 rural and peri-urban villages in Telangana state, South India.

Research

In-depth health information related to cardiovascular and other chronic diseases has been collected for APCAPS cohort members at multiple time-points between 2003-05 and 2022-23. A number of nested chronic disease studies have also been conducted with the cohort and wider community.

Team

APCAPS is a collaborative multi-institutional study, currently led by researchers from the London School of Hygiene and Tropical Medicine (UK), Indian Council of Medical Research (ICMR) - National Institute of Nutrition, Public Health Foundation of India, and Indian Institute of Public Health Gandhinagar (India).

Collaboration

We strongly encourage researchers to use existing APCAPS data for their research, and to apply to collaborate with us for further data collection in the cohort.

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What is APCAPS?

The Andhra Pradesh Children and Parent Study (APCAPS) is an intergenerational, community-based, cohort study in southern India that began in 2004 with long-term follow-up of children of the Hyderabad Nutrition Trial (1987-1990) (please see background to the cohort for more information). Since then, it has grown to become one of the largest, longest running and most deeply phenotyped studies of chronic disease in India. Research from APCAPS has contributed fundamentally to our understanding of the early life origins of cardiovascular disease, as well as the role of societal, lifestyle and biological determinants of common chronic conditions in Indians. Today, priority research aims for APCAPS include: pioneering the analysis of digital data with artificial intelligence to characterise disease more deeply and at lower cost; discovery of disease mechanisms and biomarkers through integrating -omics with high-resolution phenotype data; and investigation of the causes and consequences of the multimorbidity of chronic conditions. Our research has been funded by grants from multiple government and charitable funding agencies and is the product of long-standing collaboration between a network of leading Indian and global research institutes.

Background to the cohort 

Conducted in 1987-90, the Hyderabad Nutrition Trial evaluated the Integrated Child Development Services (ICDS) scheme, a national program that provides a daily food supplement to pregnant women and children under 6 years of age. The food supplement consisted of a cereal based meal providing roughly 2.09 MJ and 20-25 g protein to pregnant/lactating women and 1.25 MJ and 8-10 g protein to children up to 6 years. The Trial used a controlled stepped wedge design, recruiting pregnant women from 29 villages in Ranga Reddy district (then Andhra Pradesh, now Telangana state); 15 intervention villages that received the ICDS during the trial period (1987-90) and 14 control villages where the ICDS had not yet been implemented.

The Hyderabad Nutrition Trial aimed to understand the effect of food supplementation during pregnancy on birthweight of offspring. In 2003-05, with the aim of examining the long-term effect of early-life undernutrition on cardiovascular disease risk, families with at least one child born during the Hyderabad Nutrition Trial period were re-traced (1815 families, 2601 trial children). The re-traced individuals, who were born during the Hyderabad Nutrition Trial, formed the core of the APCAPS cohort.

In-depth chronic disease risk-factor and outcome data for children born during the Hyderabad Nutrition Trial (aka the APCAPS “index children”) has been collected at multiple time-points (2003-05, 2009-10, 2010-12, 2022-23). In 2010-12, similar data was also collected for their parents and siblings to develop APCAPS into an intergenerational cohort. In 2022-23, data collection was expanded to examine multimorbidity and age-related conditions (e.g., frailty) in the parents’ generation of the cohort who were reaching older ages (~59 years in 2022-23).

In addition to repeated rounds of data collection in the prospective APCAPS cohort, the environment of the study villages has been profiled in detail and several chronic disease related studies have been undertaken in the wider community of the APCAPS villages. 

Learn more on the Research page.

Key research themes 

The cohort is uniquely placed to answer questions and suggest solutions for the cardiovascular and wider chronic disease epidemic occurring in India and other rapidly developing settings.

Please see below for a non-exclusive list of chronic disease related research themes that could be examined with APCAPS data and the Collaborate page for details of available data. We encourage researchers to apply to use APCAPS data to answer research questions of their interest, regardless of whether they fall within the highlighted themes.

Key research themes

  • Early life undernutrition – Rich chronic disease risk-factor and outcome data is available for adults born during a controlled trial of a food supplement for pregnant women/infants in rural India (Hyderabad Nutritional Trial, 1987-90). Please see here for a research example.
  • Digital health and artificial intelligence – Simple digital biomarkers (e.g., photographs) contain rich health information and can be collected at low cost, potentially transforming epidemiological research as well as primary care. Rich digital biomarker data is available from the APCAPS follow-up 4 (2021-23).
  • Healthy Ageing – Data on ageing related phenotypes such as cognitive function, frailty, stature/movement, sarcopenia, functioning and sensory impairments is available for older APCAPS cohort members, which can be used to explore the lifecourse determinants of healthy ageing. Please see here for a research example.
  • Multimorbidity – Data for a range of non-communicable, infectious and mental health conditions is available, alongside information on potential causes (e.g. lifestyle, environmental, biological) and consequences (e.g. quality of life, healthcare use, disability) of multimorbidity. Please see here for a research example.
  • Biological mechanisms of chronic disease – Data on a range of cardiovascular, inflammatory, liver, bone and kidney biomarkers is available and blood and urine samples are banked for future assays. Collaborations with leading laboratories in India to generate metabolomics and genetics data are underway. Please see here for a research example.
  • Triangulation for aetiological epidemiology – Distribution of some health-related characteristics (e.g., BMI) in the APCAPS population contrast to populations in urban, high-income settings. Evidence from the APCAPS cohort can be triangulated with different populations to strengthen casual inference. Please see here for a research example.
  • Urbanisation – The environment of the 29 APCAPS villages, which are at varying degrees of urbanisation, has been profiled in detail (e.g., geotagging of local health facilities, food/alcohol/tobacco vendors and participant households, modelling of ambient air pollution). Please see here for a research example.
  • Trans-generational risk – APCAPS is composed of adult children and their parents and can be used to explore the trans-generational effects of environmental and genetic risk factors. Please see here for a research example.
  • Health-related behaviours – Detailed information on key health-related behaviours (e.g., diet, physical activity, alcohol and tobacco use, sleep) at multiple time-points is available. Please see here for a research example.
APCAPS study site 

APCAPS is located in 29 villages in Ranga Reddy district of Telangana state, South India. Ranga Reddy was located in Andhra Pradesh state until 2014 when Andhra Pradesh was divided into two states: Telangana and Andhra Pradesh. Telangana is the 11th most populous Indian state, with a population of approximately 35 million. The official language of the state is Telugu. Telangana’s capital, and largest city, Hyderabad is located between 29 and 66 km from the closest and furthest APCAPS villages respectively. 

The APCAPS villages are undergoing urbanisation at uneven rates, the smallest village has a population of 500 while the largest has over 11,000 inhabitants, which is changing local environments and lifestyles. 

Chronic disease in India 

India is undergoing major social and economic changes leading to an epidemic of chronic diseases including cardiovascular disease and diabetes, and increasingly multimorbidity of chronic conditions within one individual. Lifestyle changes resulting from rapid urbanisation and economic development, compounded by predisposition arising from adverse socio-economic conditions in early life, are thought to be responsible. However, the consequences of historical disadvantage overlaid by rapid economic development are unknown. Also unknown are the biological and social mechanisms by which these upstream social determinants, acting over an individual’s life course, lead to downstream physiological changes and disease.

Some information about chronic diseases in India:

  • The Global Burden of Disease Study estimated that cardiovascular disease was responsible for 26.6% (25.3%–27.4%) of all deaths and 13.6% (12.5%–14.6%) of total disability-adjusted life years (DALYs) in India in 2017. This represents a notable increase compared with 15.2% (13.7–16.2) and 6.9% (6.3–7.4), respectively, in 1990.
  • In 2017, the age-standardized DALY rate of ischaemic heart disease in India was 1.6 times higher than the global average.
  • It has been estimated that 62% of all cardiovascular deaths in Indian populations are premature.
  • There were an estimated 72.9 million people with diabetes in India in 2015 (International Diabetes Federation), and 207 million with hypertension in 2014 (Fourth District-Level Household Survey)
  • The World Economic Forum and Harvard School of Public Health in 2014 estimated that India would suffer economic losses of $2.17 trillion between 2012 and 2030 due to cardiovascular diseases.

(Reference: Kalra et al 2023, https://doi.org/10.1016/j.lansea.2023.100156

 

Research
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Chai vendor

Summary

APCAPS research falls into the below categories:

  1. Research conducted with the prospective APCAPS cohort (APCAPS follow-ups 1-4).
  2. Research conducted with the wider community residing in the 29 APCAPS villages in Ranga Reddy district, Telangana.
  3. Profiling of the environment of the APCAPS villages for examining environmental risk-factors of chronic disease.
  4. Intervention development and evaluation in the APCAPS villages.
  5. Qualitative studies to inform APCAPS research and guide intervention development.
  6. Methodological studies to improve research quality.
  7. Related studies.

Studies with the APCAPS cohort

While the primary aim of each APCAPS cohort follow-up differed, chronic disease risk factor and outcome data is largely comparable across follow-ups and can be used to answer research questions outside of the original primary aims. Participant eligibility (index children, mothers, fathers, siblings) varied across the follow-ups. Learn more about data availability in the APCAPS cohort.

APCAPS Follow-up 1 (2003-05) 

Background

Undernutrition in early life may contribute to the cardiovascular disease epidemic in India and other low- and middle-income countries. The primary aim of APCAPS follow-up 1 was to examine the prevalence of risk factors for cardiovascular disease in adolescents born during the Hyderabad Nutrition Trial (1987-90) (aged 13-17 in 2003-05) which evaluated the impact of food supplements for pregnant women on birthweight of their kin.

Learn more about the Hyderabad Nutrition Trial on the 'About' page (click the 'background to the cohort' panel to read more).

Methods

Mothers who participated in the Hyderabad Nutrition Trial (both intervention and control villages) were retraced. All individuals born during the Hyderabad Nutrition Trial period (1987-90) were eligible to participate (“APCAPS index children”). However, due to resource constraints of the study, only a sub-sample of individuals were invited to participate. An interviewer-administered questionnaire and clinical examination of the index children was carried out at clinics in the study villages, and a brief questionnaire and clinical examination was undertaken on their mothers.

Learn more about data available from APCAPS follow-up 1.

Key findings

Results of the primary analysis suggested a lower risk of cardiovascular disease (as evidenced by arterial stiffness and insulin resistance) in adolescents from the intervention villages in comparison to controls.

Results of further analyses indicated that (1) lower socio-economic position was associated greater central adiposity and higher triglyceride levels, but not other cardiovascular risk factors, (2) relative leg length was not associated with nutritional supplementation, challenging the use of leg length as a biomarker for early childhood nutrition which has been based mainly on observational data, and (3) school enrolment, and potentially schooling grades, were higher in adolescents from intervention villages, though test scores were not associated.

Funding

The Eden Fellowship in Paediatrics, Royal College of Physicians, UK to Dr Sanjay Kinra

APCAPS Follow-up 2 (2009-10) (also known as the Hyderabad DXA study) 

Background

APCAPS follow-up 2 primarily aimed to examine the effect of early life undernutrition on amount and distribution of body fat, diabetes and cardiovascular disease risk, as well as the association between body fat and diabetes and cardiovascular disease risk, in the index children of the APCAPS cohort (aged ~18-21 years in 2009-10).

Methods

All children born during the Hyderabad Nutrition Trial period (1987-90) (“APCAPS  index children”) were eligible and invited to participate in the study, irrespective of (non-) participation in APCAPS follow-up 1. An interviewer-administered questionnaire and clinical examination (including Dual-energy X-ray absorptiometry (DXA), anthropometrics, vascular measures) of the index children in young adulthood was carried out in clinics in the National Institute of Nutrition, Hyderabad. In addition, around 918 people from a related study, the Indian Migration Study, who mostly lived in Hyderabad or different areas of the district, were surveyed at the same time with the same protocols and data collection instruments (for more details see this paper or enquire with the study team).

Learn more about data available from APCAPS follow-up 2.

Key findings

Results indicated lack of a long-term association between early life undernutrition and adult lean body mass or muscle strength. Further results indicated (1) current lean mass and weight-bearing physical activity were more important determinants of bone mass than early-life undernutrition, (2) the postulated link between Vitamin D and cardiovascular risk may be attributable to confounding by lifestyle factors such as obesity and physical inactivity in studies conducted in high-income settings, and (3) no strong evidence that DXA or waist-to-hip ratio (a measure of abdominal adiposity) were better at predicting cardiometabolic risk in comparison to BMI.

Funding

The Wellcome Trust, UK

APCAPS Follow-up 3 (2010-12) 

Background

APCAPS follow-up 3 primarily aimed to explore the trans-generational effects of environmental and genetic risk factors on cardiovascular and other chronic diseases and to continue examining the effect of early life undernutrition on cardiometabolic risk in the APCAPS index children.

Methods

Parents and siblings of the APCAPS index children were invited to participate, as were the APCAPS index children, resulting in close timing of APCAPS follow-up 2 and 3. An interviewer-administered questionnaire and clinical examination of the index children, their siblings and parents was carried out in clinics in the National Institute of Nutrition, Hyderabad.

Learn more about data available from APCAPS follow-up 3.

Key findings

Results indicated lack of association between early life undernutrition and cardiovascular risk in the APCAPS index children in early adulthood. Further results indicated (1) lack of evidence of an inverse association between parental childhood socioeconomic conditions or stature and offspring’s risk of cardiovascular disease, (2) women were four times as likely to be anaemic as men and were particularly vulnerable to co-occurring anaemia and cardiometabolic risk, and (3) exposure to supplementary nutrition in utero and during the first three years of life was associated higher ages at menarche, first cohabitation with partners and first pregnancies among the women.

Funding 

The Wellcome Trust, UK

APCAPS Follow-up 4 (2021-23)

Background

Evidence on the burden, risk-factors, outcomes, and care of multimorbidity (co-occurrence of two-plus chronic conditions in an individual) in rural and urbanising India is limited, in part due to a lack of longitudinal and objectively measured data on chronic conditions. APCAPS follow-up 4 primarily aimed to develop APCAPS into a data resource for examining the epidemiology, and improving the prevention and care, of multimorbidity in rural/urbanising India.

Methods

All APCAPS members aged ≥40 years old were invited to participate. An interviewer-administered questionnaire and clinical examination was conducted to screen locally prevalent non-communicable and infectious diseases, mental health conditions, cognitive impairments, and functional deficits and frailty, using a combination of self-reported clinical diagnoses, symptom-based questionnaires, physical examinations, and biochemical assays. 

Read the study protocol for APCAPS follow-up 4.

Learn more about data available from APCAPS follow-up 4.

Key findings

Study ongoing.

Funding

Medical Research Council, UK

Studies within the APCAPS study villages

Village-wide Household Survey (2011-14) 

Summary

In 2011-14, all households in the 29 APCAPS villages were surveyed and geotagged. Health and development data were collected for each coresident child under 6 years of age, comprising information on infant feeding (colostrum intake, total duration of breastfeeding and age of onset of weaning), immunisation and anthropometric measurements. Data were collected from 23,314 households which contained ~91,000 individuals, including ~9,000 children under 6 years.

Learn more about data available from APCAPS household survey.

Key findings

Study results indicated that early stage village urbanicity was associated with shorter duration of breastfeeding.

Funding

The Wellcome Trust, UK

Explaining the Differential Severity of COVID-19 between Indians in India and the UK (DiSeCT) (2020-2024) 

Summary

Limited data suggest a greater severity of COVID-19 (COVID hospitalisation/mortality and Long COVID) in Indians living in the UK than in Indians living in India. The DiSECT study aims to determine whether differences in A) the rate of COVID-19 mortality and B) prevalence of long-term symptoms of COVID-19, between Indian populations in India compared to the UK, are explained by differences in demographic composition (age, sex) and non-communicable diseases (diabetes, hypertension, obesity).

Key findings

Study ongoing.

Funding

Department of Biotechnology, India (India data collection/analyses), Medical Research Council, UK, (UK analyses).

Profiling the environment of the APCAPS study villages

Urbanicity Index (2010-12) 

Summary

There is extensive evidence that level of urbanisation (“urbanicity”) is a key determinant of health status. A measure of urbanicity utilising remote sensing night-time light intensity (NTLI) data, acquired through the USA's Defence Meteorological Satellite Programme's Operational Linescan System, was developed.

Key findings

Since the first survey wave in 2003–2005, the 28 APCAPS villages had changed from rural agricultural communities with similar NTLI levels to represent a continuum of NTLI levels with growing differentiation at higher levels. The variation in night-time intensity has also increased over the past twenty years, suggesting the presence of uneven rates of urbanization. Studies using the NTLI estimates indicate that early stage village urbanicity was associated with shorter duration of breastfeeding and that moderate increases in urbanisation levels were associated with cardiovascular risk-factors.

Funding

The Wellcome Trust Strategic Award, UK

Built Environment Survey (2016) 

Summary

All non-residential places in the 29 APCAPS villages were surveyed and geotagged, including food shops and outlets, health facilities, educational facilities, and local parks/open spaces used for physical activity. Households of the prospective APCAPS cohort were also geotagged, allowing exploration of how environmental risks impact chronic disease risk in a rapidly urbanising setting.

Learn more about data available from APCAPS built environment survey.

Key findings

Study results have indicated that higher density of fruit and vegetable vendors is associated with lower blood pressure while higher density of highly processed and take-away food vendors was associated with higher blood pressure and BMI/waist circumference. See the findings of this study.

Study results have also indicated that living a greater distance from the nearest alcohol outlet is associated with lower daily alcohol intake, waist circumference and blood pressure. There is also an association between the number of alcohol outlets within a 400m area and waist circumference and blood pressure. See the findings of this study.

Funding

The Wellcome Trust, UK

Cardiovascular Health Effects of Air pollution in Telangana, India (CHAI) Study (2015-18) 

See “Related Studies” for details.

Intervention development and evaluation

A financial incentive scheme to increase fruit and vegetable purchasing from unorganised retailers in rural India (2019-2021) 

Summary

Intake of fruits and vegetables in India is amongst the lowest in the world, with intake in rural areas even lower. Attempts to increase the intake of fruits and vegetables through nutrition education programs have had limited success globally. The aim of the study was to determine the effectiveness of a financial incentive scheme offering a ~20% cashback on the purchase of fruits & vegetables from unorganized retailers in rural India. The intervention was informed by behavioural economics and developed through consultation with the local stakeholders and community. The study used a cluster-randomized controlled trial design and ran for three months in three of the six trial villages.

Key findings

After the scheme was over, the weekly household purchase of fruits and vegetables was ∼28% higher for intervention villages compared to control villages (corresponding to ∼1.5 portions of fruit and vegetables per person per day). The findings confirm the feasibility of using such interventions in unorganised food retail environments and suggest that such interventions may be effective in influencing food purchasing (findings here).

Funding

The Drivers of Food Choice (DFC) Competitive Grants Program

Qualitative studies

APCAPS qualitative studies

Summary

Qualitative studies have been conducted within the APCAPS villages to explore a range of topics including: community members’ and key stakeholders’ (e.g., healthcare providers, local administrators) perceptions of chronic disease and its influences, changes occurring to the local environment, needs of local populations, and views and suggested priorities of the APCAPS study.

Key findings

Results of a study conducted with community members in 2013 indicated that participants believed their communities were currently less healthy, more polluted, less physically active, had poorer access to nutritious food and shorter life expectancies than previously. Another study used a novel qualitative geographical information systems approach to identify prices, vendor and product properties, and social capital as drivers of food acquisition practices in adults in the APCAPS villages.

Methodological studies

Cardio-metabolic effects of meat intake in Indians (2021-23) 

Summary

The double burden of undernutrition and cardio-metabolic diseases have impacted India for several decades following expanded urbanisation. Meat provides a dense source of essential amino acids and contains many micronutrients to potentially combat undernutrition. However, its uptake in diet is limited due to concerns about increased risk of cardio-metabolic disease. The study aims to identify risks of cardio-metabolic disease associated with meat consumption. Metabolite data has been collected from a sub-sample of the prospective APCAPS cohort. Urinary and blood metabolite samples will be processed and analysed to identify both short-term and long-term markers of meat intake and metabolism. This study further aims to more improve nutritional metabolomics and integrative epidemiology capacity in India.

Key findings

Study ongoing.

Funding

Medical Research Council, UK

Digital Biomarker Development (2021-2023) 

Summary

Recent developments in machine learning, particularly in deep learning, could be used to identify novel health-related phenotypes using digital data (e.g., images, audio). This has the potential to reduce participant burden and risk of exposure to infectious disease (e.g., COVID-19) in comparison to traditional methods of epidemiological studies (e.g., lengthy questionnaires). With participant approval, image (e.g., body shape (clothed)), video (e.g., participants walking a 6-meter course), and audio data (e.g., recordings of participants breathing) was collected on a subset of participants during APCAPS follow-up 4. We will use machine learning methods to identify biomarkers with the aim of developing novel screening methods.

Results

Study ongoing.

Other methodological studies 

Other methodological studies have: developed and evaluated a questionnaire tool for accurately measuring diet and physical activity in India, compared the validity of two reference methods for estimating body composition (dual-energy X-ray absorptiometry and isotope dilution technique), and developed and evaluated anthropometric prediction equations for estimating lean body mass and appendicular lean soft tissue in the Indian population (using standard anthropometric indices).

Related studies

Indian Migration Study (2005-07) 

Summary

The Indian Migration Study (IMS) aimed to investigate the effects of rural-urban migration on chronic disease risk in India. It used a sibling pair design, comparing chronic disease risk factors in migrant urban factory workers and their spouses with that of their siblings who still lived in rural areas (non-migrants). Urban participants were recruited from factories in Lucknow, Nagpur, Hyderabad and Bangalore. Their rural-dwelling siblings came from 18 of the 28 states in India. A sample of workers who had always lived in urban areas and their urban-dwelling siblings were also recruited. All participants (6,510 in total) answered questions about their diet and physical activity, had anthropometric measurements taken and gave blood samples. Protocols and data collection instruments of APCAPS and the IMS are largely aligned, allowing joint analysis.

Key findings

A study combined APCAPS and IMS data to examine the association between childhood socioeconomic circumstances and cardiovascular risk; results indicated an inverse association between standard of living in childhood and blood pressure in adulthood, independent of socioeconomic circumstances in adulthood. Results of other IMS studies have suggested that body fat increases rapidly when individuals first move to an urban environment, whereas other cardiometabolic risk factors evolve gradually.

Read the study protocol for the Indian Migration Study.

Data access

The data are available to researchers to access following an approval process – see ‘collaborate’ for further information.

Funding

The Wellcome Trust, UK

Cardiovascular Health Effects of Air pollution in Telangana, India (CHAI) Study (2015-18)

Summary

While there is convincing evidence that fine particulate matter (PM2.5) causes cardiovascular mortality and morbidity, very little of this evidence is based on populations of low- and middle-income countries. There are large knowledge gaps regarding the health effects of such exposures in India. The Cardiovascular Health effects of Air pollution in Telangana, India aimed to 1) characterize the exposure of particulate air pollution from household and outdoor sources, 2) to integrate information from GPS, wearable cameras, and continuous measurements of personal exposure to particles to understand where and through which activities people are most exposed and 3) quantify the association between particles and markers of atherosclerosis. CHAI participants were randomly sampled, stratified by village from participants in APCAPS third follow up, who were still resident of APCAPS villages and 18 years or older. Three stationary monitoring stations within the study area were established to characterize ambient concentrations of PM2.5 and their temporal variability. We measured 24-h integrated gravimetric PM2.5 for 21 days over two seasons at 23 sites which were located within 16 of the area villages. Please see CHAI website for further information.

Results

The CHAI study developed land-use regression models for predicting exposure to PM2.5 and black carbon and examining the relationship between air pollution and chronic disease. CHAI study findings indicate a positive association between ambient PM2.5 and household air pollution with carotid intima-media thickness in the APCAPS cohort, a positive association between PM2.5 and blood pressure for women, and lack of an association between PM2.5 and blood pressure for men or black carbon for either gender, and lack of an association between PM2.5 or black carbon with blood glucose or diabetes status.

Data access

Data on predicted PM2.5 and black carbon exposure (personal and ambient) is available for APCAPS follow-up 3 and can be accessed with the usual approval process – see ‘collaborate’ for further information. Land-use regression models for predicting exposure to PM2.5 and black carbon are published (please see above) and can be used to predict PM2.5 and black carbon exposure for other APCAPS follow-ups.

Funding

The European Research Council

Nagasaki Islands Study 

Summary

The Nagasaki Islands Study has been conducted under a population-based open cohort design in Goto city, located in the remote islands of Nagasaki prefecture, Japan. This study aims to assess environmental and genetic factors associated with non-communicable diseases in the community, as well as to prevent, diagnose, and treat such diseases effectively.

Similar protocols and data collection instruments have been used in APCAPS and the Nagasaki Islands Study, allowing cross-contextual analyses.

Key findings

A study combined APCAPS and Nagasaki Islands Study data to examine the association between atherosclerosis and handgrip strength in non-hypertensive populations.

Data access

An anonymous dataset supporting the findings of Nagasaki Islands Study is available upon reasonable request. Please see the Nagasaki Island Study website for the application form and letter of pledge and send it to the Nagasaki Islands Study team.

Collaborate
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We strongly encourage researchers to use APCAPS cohort data and invite ideas for papers, grant proposals and data collection.

If you are interested in collaborating on APCAPS, please fill in the APCAPS Collaborator Form and send back to the APCAPS research coordinator (apcaps.crf@gmail.com). We will endeavour to review your form and inform you of the outcome within 4 weeks.

Please refer to the full terms and conditions of using APCAPS (and related studies’) data, found at the end of the APCAPS Collaborator Form.

If you are interested in accessing data of studies not listed below (e.g., qualitative, methodological, intervention development and evaluation) please get in touch with the APCAPS research coordinator (apcaps.crf@gmail.com).

Available data

Extensive data have been collected on: socio-demographics; social position; lifestyle (diet, physical activity, tobacco and alcohol, sleep); household characteristics; general health, medical and family history; anthropometric and body composition measures (TANITA and DXA); vascular physiology (BP, arterial stiffness, carotid intima-media thickness), lung function, and fasting biomarkers (e.g., glucose, lipids and insulin). Blood samples and DNA have also been banked.

Identification of duplicate index children during later waves of data collection are the primary reason for slightly different participant numbers in existing APCAPS publications. Where possible, collaborators should aim to be consistent with the numbers presented in this document. If you intend to present a different sample size, please discuss with the APCAPS team in advance of your analysis.

Access a table of available data from APCAPS, by domain.

Diagram summary APCAPS follow-ups and participants - ongoing.

Questionnaires

Copies of the questionnaires from all follow ups of the prospective APCAPS cohort, and the village-wide household survey, are available for download here.

First Follow Up (2003-2005)

 

Second Follow Up (2009-2010) (also referred to as the Hyderabad DXA study)

 

Third Follow Up (2010-2012)

 

Fourth Follow Up (2021-23)

 

Household Survey (2012-2013)

 

APCAPS Built Environment Audit (2016)

 

Cardiovascular Health Effects of Air pollution in Telangana, India (CHAI) Study (2015-18)

Please see CHAI website for further information.

Indian Migration Study (2005-8)

View the Indian Migration Study Questionnaire. We are willing to share Indian Migration Study data with bona fide researchers. Please complete and submit the IMS Collaborator Form to the APCAPS research coordinator (apcaps.crf@gmail.com).

Protocols
Team
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APCAPS executive committee and APCAPS follow-up 4 field research team
Members of the APCAPS executive committee and APCAPS follow-up 4 field research team
Executive Committee

Roles

  1. Oversee day-to-day operational and scientific management of study, constitute ad hoc working groups as necessary
  2. Consider data collaboration requests
  3. Consider proposals for collaborative projects
  4. Meet by teleconference twice per month

Membership

  • Dr Sanjay Kinra, Professor, London School of Hygiene and Tropical Medicine, London, UK
  • Dr Santosh Kumar, Scientist D, National Institute of Nutrition, Hyderabad
  • Dr Bharati Kulkarni, Scientist G, National Institute of Nutrition, Hyderabad
  • Dr Poppy Mallinson, Research Fellow, London School of Hygiene and Tropical Medicine, London, UK
  • Dr Judith Lieber, Research Fellow, London School of Hygiene and Tropical Medicine, London, UK
  • Santhi Bhogadi, Project Coordinator, APCAPS, Hyderabad
  • Srivalli Addanki, Medical Officer, APCAPS, Hyderabad
  • Dr Hemant Mahajan, Scientist D, National Institute of Nutrition, Hyderabad
  • Dr Anoop Shah, Associate Professor, London School of Hygiene and Tropical Medicine, London, UK
  • Dr Komal Shah, Associate Professor, Indian Institute of Public Health Gandhinagar
Field research team
  • Prasad Undrajavarapu
  • Sandeep Gyara
  • Sridevi Nallana
  • Amaravathi Mora
  • Praveen Rao Dadigala
  • Prashanthi Silvery
  • Subhash Masapeta

Academic Investigators

APCAPS follow-up 1 (2003-2005)

Dr Sanjay Kinra
Professor in Clinical Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM)
Expertise: Paediatrics, Epidemiology and Public Health
Research interests: Epidemiology of non-communicable diseases in India; early life influences on adult health; food, nutrition and health; prevention and management of childhood obesity and its health consequences; traditional/complementary therapies and their integration with western medicine.
Sanjay.kinra@lshtm.ac.uk

Dr Yoav Ben-Shlomo
Professor of Clinical Epidemiology, University of Bristol
Expertise: Clinical epidemiology; health services research
Research interests: Life course determinants of chronic diseases; the impact of migration and urbanisation on health
y.ben-shlomo@bristol.ac.uk

Professor George Davey Smith
Professor of Clinical Epidemiology, University of Bristol
Expertise: Health inequalities, life course approach to epidemiology, Mendelian randomization
Research interests:
Kz.davey-smith@bristol.ac.uk

Dr Rameshwar Sarma Kramadhati Venkata
Scientist F, (Retd), National Institute of Nutrition (NIN)
Expertise: Applied nutrition, disease prevention
Research interests: Preventive medicine, clinical nutrition, malnutrition

Dr Ghafoorunnisa

Dr M Vishnuvardhan Rao

Dr B Sivakumar

APCAPS follow-up 2 (2009-2010)

Professor Hannah Kuper
Professor of Epidemiology, LSHTM
Expertise: Ageing, Health inequalities, disability inclusive development programmes
Research interests: Disability in low- and middle-income countries, with a particular interest in older people
Hannah.Kuper@lshtm.ac.uk

Dr Radha Krishna K. V.
Consultant, Deputy Director (Retd), NIN
Expertise: Maternal and child health, growth and development
Research interests: Micro nutrients, early life nutrition and adult chronic diseases, body composition

Professor Shah Ebrahim
Honorary professor of Public Health, LSHTM & SANCD, PHFI
Expertise: Primary care, geriatric medicine and public health; chronic disease in India.
Research interests: Prevention and management of chronic diseases in low- and middle-income countries
Shah.ebrahim@lshtm.ac.uk

Dr Veena Shatrugna
Medical Scientist, (Retd), NIN
Expertise: Nutritional epidemiology, body composition
Research interests: Micronutrients, early life nutrition and growth

Dr Sanjay Kinra and Dr Yoav Ben Shlomo (details provided under follow-up 1)

APCAPS follow-up 3 (2010-12)

Dr Poornima Prabhakaran
Director, Centre for Environment and Health, PHFI
Expertise: Medicine and chronic disease epidemiology
Research interests: Early life influences and life course approach to the study of chronic diseases; transgenerational studies looking at socio-environmental and genetic determinants of cardiometabolic risk
poornima.prabhakaran@phfi.org

Dr Vipin Gupta
Associate Professor, Department of Anthropology, University of Delhi
Expertise: Biological anthropology; genetic epidemiology of non-communicable chronic diseases (type 2 diabetes, CVD and COPD), their measures and risk factors.
Research interests: Genomics/epigenomic epidemiology; public health
udaiig@gmail.com

Dr Aastha Agrawal
Assistant Professor, SANCD, PHFI
Expertise: Biological anthropology; population genetics
Research interests: Genetics; epigenetic epidemiology
aastha.aggarwal@phfi.org

Dr Gagandeep Kaur Walia
Assistant Professor, SANCD, PHFI
Expertise: Biological anthropology; genetic epidemiology
Research interests: Genetic and epigenetic epidemiology
Gkaurw@gmail.com

Dr Radha Krishna K. V.
Consultant, Deputy Director (Retd), NIN
Expertise: Maternal and child health, growth and development
Research interests: Micro nutrients, early life nutrition and adult chronic diseases, body composition

Dr Prabhakaran Dorairaj
Professor of Public Health, PHFI
Expertise: Large population cohorts in India, chronic disease health research
Research interests: Clinical cardiology, cardiovascular epidemiology
dprabhakaran@phfi.org

Professor Shah Ebrahim (details provided under follow-up 1)

Dr Sanjay Kinra (details provided under follow-up 1)

Dr Yoav Ben-Shlomo (details provided under follow-up 1)

Professor George Davey Smith (details provided under follow-up 1)

APCAPS follow-up 4 (2021-23)

Dr Sanjay Kinra (details provided under follow-up 1)

Dr Santhosh Kumar
Scientist D, NIN
Expertise: Preclinical toxicology, clinical trials, clinical nutrition, public health and patient safety
Research interests: Antimicrobial resistance in relation to nutrition in paediatric population, preclinical safety/efficacy evaluation of biopharmaceuticals products, Nutra vigilance, pharmacovigilance, clinical trials, heavy metal analysis
santosh.kumar@icmr.gov.in 

Dr Bharati Kulkarni
Scientist G, NIN  
Expertise: Nutritional epidemiology, paediatrics, public health  
Research interests: Developmental origins of adult health and disease, body composition  
dr.bharatikulkarni@gmail.com 

Dr Hemant Mahajan
Scientist D, NIN
Expertise: Community-based large observational and experimental studies in both high- and low-income countries
Research interests: Applied epidemiology, quantitative methods, research design  
hemant.mahajan.84@gmail.com 

Dr Gowri Iyer
Assistant Professor, PHFI
Expertise: Mental health, ageing, social determinants of health, disability, research methods, behaviour change
Research interests: Role of cognitive & behavioural sciences in public health, public mental health, ageing research with special focus on dementia and efforts at dementia prevention and rehabilitation
gowri.iyer@iiphh.org 

Dr Suresh Kumar Kamalakannan
Assistant Professor, PHFI
Expertise: Mainstreaming disability within the agenda for health especially in low- and middle-income countries.
Research interests: Occupational therapy, disability, public health, program management, epidemiology
suresh.kumar@iiphh.org 

Dr Om Kurmi
Associate Professor, Coventry University
Expertise: Chronic diseases, epidemiology, program evaluation
Research interests: Respiratory medicine, air pollution, public health, lung diseases
O.kurmi@icloud.com

Dr Judith Lieber
Research Fellow, LSHTM
Expertise: Ageing, demography, social and structural determinants of health
Research interests: Health and well-being of older individuals, mixed-methods research, routine and secondary data
Judith.Lieber1@lshtm.ac.uk 

Dr Poppy Mallinson
Assistant Professor, LSHTM
Expertise: Ageing, life-course epidemiology, health inequalities
Research Interests: The aetiology and prevention of cardiovascular pathologies in Low- and Middle-Income Countries, structural and behavioural interventions
Poppy.Mallinson1@lshtm.ac.uk 

CHAI Study (2015-18) 

Professor Cathryn Tonne

Research Professor, ISGlobal, Spain
Expertise: Air Pollution, Urban Planning, Environment and Health
Research interests: Health effects of air pollution from outdoor and household sources and their intersection with sustainable development; in particular, exposure patterns and health effects of air pollution in high- as well as low- and middle-income countries, as well as the health co-benefits of climate change mitigation.
cathryn.tonne@isglobal.org 

Publications
Publications APCAPS 2 columns
Publications APCAPS 2 columns left paragraph
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ICMR-National Institute of Nutrition
ICMR-National Institute of Nutrition, Hyderabad, India
2024

Mahajan H, Mallinson PAC, Lieber J, Bhogadi S, Banjara SK, Reddy VS, Reddy GB, Kulkarni B, Kinra S. The Association of Total Meat Intake with Cardio-Metabolic Disease Risk Factors and Measures of Sub-Clinical Atherosclerosis in an Urbanising Community of Southern India: A Cross-Sectional Analysis for the APCAPS Cohort. Nutrients. 2024; 16(5):746. https://doi.org/10.3390/nu16050746

Mahajan H, Lieber J, Mallinson PA, Bhogadi S, Banjara SK, Kinra S, Kulkarni B. The higher dietary inflammation is associated with a higher burden of multimorbidity of cardio-metabolic and mental health disorders in an urbanizing community of southern India: A cross-sectional analysis for the APCAPS cohort. Human Nutrition & Metabolism. 2024 Feb 15:200254.

2023

Lieber J, Kinra S, Addanki S. Process evaluation of a financial incentive scheme to increase fruit and vegetable purchasing from unorganised retailers in rural Telangana, India. 2023; Pre-print. Open Science Foundation. Published online Sept 7. DOI:10.31219/osf.io/tv6q3. 

Kinra, S., Mallinson, P.A., Debbarma, A., Walls, H.L., Lieber, J., Bhogadi, S., Addanki, S., Pande, R., Kurpad, A.V., Kannuri, N.K. and Aggarwal, S., 2023. Impact of a financial incentive scheme on purchase of fruits and vegetables from unorganised retailers in rural India: a cluster-randomised controlled trial. The Lancet Regional Health-Southeast Asia.

Ranatunga, S., Kulkarni, B., Kinra, S., Ebeling, P.R. and Zengin, A., 2023. Sex-specific associations between markers of arterial stiffness and bone mineral density in Indian men and women. Bone, 169, p.116686. 

Lieber J, Banjara SK, Mallinson PA, Mahajan H, Bhogadi S, Addanki S, Birk N, Song W, Shah AS, Kurmi O, Iyer G. Burden, determinants, consequences and care of multimorbidity in rural and urbanising Telangana, India” protocol for a mixed-method study within the APCAPS cohort. BMJ open. 2023 Nov 27;13(11):e073897.

2022

Li Y, Mallinson PAC, Aggarwal A, Kulkarni B, Kinra S. Association of Neighborhood Alcohol Environment With Alcohol Intake and Cardiovascular Risk Factors in India: Cross-Sectional Evidence From APCAPS. Front Cardiovasc Med. 2022 Apr 29;9:844086. doi: 10.3389/fcvm.2022.844086 

Turner C, Bhogadi S, Walls H, Surendran S, Kulkarni B, Kinra S, Kadiyala S. Drivers of food acquisition practices in the food environment of peri-urban Hyderabad, India: A qualitative investigation. Health Place. 2022 Mar;74:102763. doi: 10.1016/j.healthplace.2022.102763 

Gandham A, Scott D, Bonham MP, Kulkarni B, Kinra S, Ebeling PR, Zengin A. Sex Differences in Bone Health Among Indian Older Adults with Obesity, Sarcopenia, and Sarcopenic Obesity. Calcif Tissue Int. 2022 Aug;111(2):152-161. doi: 10.1007/s00223-022-00981-1

2021 

Mallinson PAC, Kulkarni B, Bhogadi S, Kinra S. Association between parents' socioeconomic conditions and nutritional status during childhood and the risk of cardiovascular disease in their adult offspring: an intergenerational study in south India. J Epidemiol Community Health. 2021 Nov;75(11):1091-1097. doi: 10.1136/jech-2020-216261. 

Matsuzaki M, Birk N, Bromage S, Bowen L, Batis C, Fung TT, Li Y, Stampfer MJ, Deitchler M, Willett WC, Fawzi WW, Kinra S, Bhupathiraju SN. Validation of Global Diet Quality Score Among Nonpregnant Women of Reproductive Age in India: Findings from the Andhra Pradesh Children and Parents Study (APCAPS) and the Indian Migration Study (IMS). J Nutr. 2021 Oct 23;151(12 Suppl 2):101S-109S. doi: 10.1093/jn/nxab217. 

Bromage S, Batis C, Bhupathiraju SN, Fawzi WW, Fung TT, Li Y, Deitchler M, Angulo E, Birk N, Castellanos-Gutiérrez A, He Y, Fang Y, Matsuzaki M, Zhang Y, Moursi M, Gicevic S, Holmes MD, Isanaka S, Kinra S, Sachs SE, Stampfer MJ, Stern D, Willett WC. Development and Validation of a Novel Food-Based Global Diet Quality Score (GDQS). J Nutr. 2021 Oct 23;151(12 Suppl 2):75S-92S. doi: 10.1093/jn/nxab244. 

2020 

Mallinson PAC, Lieber J, Bhogadi S, Kinra S. Childhood socio-economic conditions and risk of cardiovascular disease: results from a pooled sample of 14 011 adults from India. J Epidemiol Community Health. 2020 Oct;74(10):831-837. doi: 10.1136/jech-2020-214016 

Surendran S, Selvaraj K, Turner C, Addanki S, Kishore Kannuri N, Debbarma A, Kadiyala S, Kinra S, Walls H. Characterising the fruit and vegetable environment of peri-urban Hyderabad, India. Global Food Security. 2020. doi:10.1016/j.gfs.2019.100343. 

Kinra S, Gregson J, Prabhakaran P, Gupta V, Walia GK, Bhogadi S, Gupta R, Aggarwal A, Mallinson PAC, Kulkarni B, Prabhakaran D, Davey Smith G, Radha Krishna KV, Ebrahim S, Kuper H, Ben-Shlomo Y. Effect of supplemental nutrition in pregnancy on offspring's risk of cardiovascular disease in young adulthood: Long-term follow-up of a cluster trial from India. PLoS Med. 2020 Jul 21;17(7):e1003183. doi: 10.1371/journal.pmed.1003183

Milà C, Ranzani O, Sanchez M, Ambrós A, Bhogadi S, Kinra S, Kogevinas M, Dadvand P, Tonne C. Land-Use Change and Cardiometabolic Risk Factors in an Urbanizing Area of South India: A Population-Based Cohort Study. Environ Health Perspect. 2020 Apr;128(4):47003. doi: 10.1289/EHP5445.

Ranzani OT, Milà C, Sanchez M, Bhogadi S, Kulkarni B, Balakrishnan K, Sambandam S, Sunyer J, Marshall JD, Kinra S, Tonne C. Personal exposure to particulate air pollution and vascular damage in peri-urban South India. Environ Int. 2020 Jun;139:105734. doi: 10.1016/j.envint.2020.105734. Epub 2020 Apr 30. 

2019 

Cecelja M, Sriswan R, Kulkarni B, Kinra S, Nitsch D. Association of pulse wave velocity and intima-media thickness with cardiovascular risk factors in young adults. J Clin Hypertens (Greenwich). 2020 Feb;22(2):174-184. doi: 10.1111/jch.13812 

Ranzani OT, Milà C, Sanchez M, Bhogadi S, Kulkarni B, Balakrishnan K, Sambandam S, Sunyer J, Marshall JD, Kinra S, Tonne C. Association between ambient and household air pollution with carotid intima-media thickness in peri-urban South India: CHAI-Project. Int J Epidemiol. 2019 Oct 11. pii: dyz208. doi: 10.1093/ije/dyz208. 

Pomeroy E, Mushrif-Tripathy V, Kulkarni B, Kinra S, Stock JT, Cole TJ, Shirley MK, Wells JCK. Estimating body mass and composition from proximal femur dimensions using dual energy x-ray absorptiometry. Archaeol Anthropol Sci. 2019;11(5):2167-2179. doi: 10.1007/s12520-018-0665-z.

Li Y, Mallinson PAC, Bhan N, Turner C, Bhogadi S, Sharma C, Aggarwal A, Kulkarni B, Kinra S. Neighborhood physical food environment and cardiovascular risk factors in India: Cross-sectional evidence from APCAPS. Environ Int. 2019 Nov;132:105108. doi: 10.1016/j.envint.2019.105108. 

Curto A, Ranzani O, Milà C, Sanchez M, Marshall JD, Kulkarni B, Bhogadi S, Kinra S, Wellenius GA, Tonne C. Lack of association between particulate air pollution and blood glucose levels and diabetic status in peri-urban India. Environ Int. 2019 Oct;131:105033. doi: 10.1016/j.envint.2019.105033. 

Sanchez M, Milà C, Sreekanth V, Balakrishnan K, Sambandam S, Nieuwenhuijsen M, Kinra S, Marshall JD, Tonne C. Personal exposure to particulate matter in peri-urban India: predictors and association with ambient concentration at residence. J Expo Sci Environ Epidemiol. 2019 Jul 1. doi: 10.1038/s41370-019-0150-5.

Curto A, Wellenius GA, Milà C, Sanchez M, Ranzani O, Marshall JD, Kulkarni B, Bhogadi S, Kinra S, Tonne C. Ambient Particulate Air Pollution and Blood Pressure in Peri-urban India. Epidemiology. 2019 Jul;30(4):492-500. doi: 10.1097/EDE.0000000000001014. 

Nandi A, Behrman JR, Black MM, Kinra S, Laxminarayan R. Relationship between early-life nutrition and ages at menarche and first pregnancy, and childbirth rates of young adults: Evidence from APCAPS in India. Matern Child Nutr. 2019 May 29:e12854. doi: 10.1111/mcn.12854. 

2018 

Shridhar K, Kinra S, Gupta R, Khandelwal S, D P, Cox SE, Dhillon PK. Serum Calcium Concentrations, Chronic Inflammation and Glucose Metabolism: A Cross-Sectional Analysis in the Andhra Pradesh Children and Parents Study (APCaPS). Curr Dev Nutr. 2018 Oct 25;3(3):nzy085. doi: 10.1093/cdn/nzy085. 

Milà C, Salmon M, Sanchez M, Ambrós A, Bhogadi S, Sreekanth V, Nieuwenhuijsen M, Kinra S, Marshall JD, Tonne C. When, Where, and What? Characterizing Personal PM(2.5) Exposure in Periurban India by Integrating GPS, Wearable Camera, and Ambient and Personal Monitoring Data. Environ Sci Technol. 2018 Nov20;52(22):13481-13490. doi: 10.1021/acs.est.8b03075.

Salmon M, Milà C, Bhogadi S, Addanki S, Madhira P, Muddepaka N, Mora A, Sanchez M, Kinra S, Sreekanth V, Doherty A, Marshall JD, Tonne C. Wearable camera-derived microenvironments in relation to personal exposure to PM(2.5). Environ Int. 2018 Aug;117:300-307. doi: 10.1016/j.envint.2018.05.021.

Pomeroy E, Mushrif-Tripathy V, Wells JCK, Kulkarni B, Kinra S, Stock JT. Stature estimation equations for South Asian skeletons based on DXA scans of contemporary adults. Am J Phys Anthropol. 2018 Sep;167(1):20-31. doi: 10.1002/ajpa.23596. 

Yamanashi H, Kulkarni B, Edwards T, Kinra S, Koyamatsu J, Nagayoshi M, Shimizu Y, Maeda T, Cox SE. Association between atherosclerosis and handgrip strength in non-hypertensive populations in India and Japan. Geriatr Gerontol Int. 2018 Jul;18(7):1071-1078. doi: 10.1111/ggi.13312. 

Nandi A, Behrman JR, Kinra S, Laxminarayan R. Early-Life Nutrition Is Associated Positively with Schooling and Labor Market Outcomes and Negatively with Marriage Rates at Age 20-25 Years: Evidence from the Andhra Pradesh Children and Parents Study (APCAPS) in India. J Nutr. 2018 Jan 1;148(1):140-146. doi: 10.1093/jn/nxx012. 

2017

Oakley L, Baker CP, Addanki S, Gupta V, Walia GK, Aggarwal A, Bhogadi S, Kulkarni B, Wilson RT, Prabhakaran D, Ben-Shlomo Y, Davey Smith G, Radha Krishna KV, Kinra S. Is increasing urbanicity associated with changes in breastfeeding duration in rural India? An analysis of cross-sectional household data from the Andhra Pradesh children and parents study. BMJ Open. 2017 Sep 21;7(9):e016331. doi: 10.1136/bmjopen-2017-016331. 

Bhan N, Madhira P, Muralidharan A, Kulkarni B, Murthy G, Basu S, Kinra S. Health needs, access to healthcare, and perceptions of ageing in an urbanizing community in India: a qualitative study. BMC Geriatr. 2017 Jul 19;17(1):156. doi: 10.1186/s12877-017-0544-y.

Sanchez M, Ambros A, Salmon M, Bhogadi S, Wilson RT, Kinra S, Marshall JD, Tonne C. Predictors of Daily Mobility of Adults in Peri-Urban South India. Int J Environ Res Public Health. 2017 Jul 14;14(7). pii: E783. doi: 10.3390/ijerph14070783. 

Tonne C, Salmon M, Sanchez M, Sreekanth V, Bhogadi S, Sambandam S, Balakrishnan K, Kinra S, Marshall JD. Integrated assessment of exposure to PM(2.5) in South India and its relation with cardiovascular risk: Design of the CHAI observational cohort study. Int J Hyg Environ Health. 2017 Aug;220(6):1081-1088. doi: 10.1016/j.ijheh.2017.05.005. 

Aleksandrowicz L, Tak M, Green R, Kinra S, Haines A. Comparison of food consumption in Indian adults between national and sub-national dietary data sourcesBr J Nutr. 2017 Apr;117(7):1013-1019. doi:10.1017/  S0007114517000563. 

Matsuzaki M, Kulkarni B, Kuper H, Wells JC, Ploubidis GB, Prabhakaran P,Gupta V, Walia GK, Aggarwal A,Prabhakaran D, Davey Smith G, Radhakrishna KV, Ben-Shlomo Y, Kinra S. Association of Hip Bone Mineral Density and Body Composition in a Rural Indian Population: The Andhra Pradesh Children and Parents Study (APCAPS)PLoS One. 2017 Jan 6;12(1):e0167114. doi:10.1371/journal.pone.0167114. 

2016

Nandi A, Ashok A, Kinra S, Behrman JR, Laxminarayan R. Early Childhood Nutrition Is Positively Associated with Adolescent Educational Outcomes: Evidence from the Andhra Pradesh Child and Parents Study (APCAPS)J Nutr. 2016 Mar 9. pii: jn223198. 

Matsuzaki M, Sullivan R, Ekelund U, Radha Krishna KV, Kulkarni B, Collier T, Ben-Shlomo Y, Kinra S, and Kuper H. Development and evaluation of the Andhra Pradesh Children and Parent Study Physical Activity Questionnaire (APCAPS-PAQ): a cross-sectional study. BMC Public Health 2016 Jan 19;16(1):48. doi: 10.1186/s12889-016-2706-9. 

Jones AD, Hayter AK, Baker CP, Prabhakaran P, Gupta V, Kulkarni B, Smith GD, Ben-Shlomo Y, Krishna KV, Kumar PU, Kinra S. The co-occurrence of anemia and cardiometabolic disease risk demonstrates sex-specific sociodemographic patterning in an urbanizing rural region of southern IndiaEur J Clin Nutr. 2016 Mar;70(3):364-72. doi: 10.1038/ejcn.2015.177. 

2014

Kuper H, Taylor A, Krishna KV, Ben-Shlomo Y, Gupta R, Kulkarni B, Prabhakaran D, Davey Smith G, Wells J, Ebrahim S, Kinra S. Is vulnerability to cardiometabolic disease in Indians mediated by abdominal adiposity or higher body adiposityBMC Public Health. 2014 Dec 1;14:1239. doi: 10.1186/1471-2458-14-1239. 

Kulkarni B, Kuper H, Taylor A, Wells JC, Radhakrishna KV, Kinra S, Ben-Shlomo Y, Smith GD, Ebrahim S, Kurpad AV, Byrne NM, Hills AP. Assessment of body composition in Indian adults: comparison between dual-energy X-ray absorptiometry and isotope dilution techniqueBr J Nutr. 2014 Oct 14;112(7):1147-53. doi: 10.1017/S0007114514001718. 

Bhattacharya S, Smith GD, Shah SH, Ben-Shlomo Y and Kinra S, Anthropometric Measures and Insulin Resistance in Rural Indian AdolescentsJournal of Biosafety and Health Education 2014: doi: 10.4172/2332-0893.1000116. 

Kinra S, Johnson M, Kulkarni B, Rameshwar Sarma KV, Ben-Shlomo Y, Smith GD, Socioeconomic position and CVD risk in rural Indian adolescents: Evidence from the Andhra Pradesh Children and Parents Study (APCAPS)Public Health 2014;128:852-9. 

Kulkarni B, Kuper H, Radhakrishna KV, Hills AP, Byrne NM, et al. The association of early life supplemental nutrition with lean body mass and grip strength in adulthood: evidence from the APCAPSAmerican Journal of Epidemiology 2014;179:700-9.

Matsuzaki M, Kuper H, Kulkarni B, Radakrishna KV, Viljakainen H, Taylor AE, et al. Life course determinants of bone mass in young adults from a transitional rural community in India: the Andhra Pradesh Children and Parents Study (APCAPS)American Journal of Clinical Nutrition 2014;1450-9. 

2013

Kinra S, Radhakrishna KV, Kuper H, et al. Cohort Profile: Andhra Pradesh Children and Parents Study (APCAPS)International Journal of Epidemiology 2013:1-8, doi: 10.1093/ije/dyt128. 

Kulkarni B, Kuper H, Taylor AE, Hills AP, Byrne NM, Taylor AE, et al. Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and womenJournal of Applied Physiology 2013. Published online before print August 15, 2013.

2012 

Molinari F, Meiburger KM, Zeng G, Saba L, Rajendra Acharya U, Famiglietti L, et al. Automated carotid IMT measurement and its validation in low contrast ultrasound database of 885 patient Indian population epidemiological study: results of AtheroEdge SoftwareInternational Angiology 2012;31:42-53. 

Taylor AE, Kuper H, Varma RD, Wells JC, Bell JD, Radakrishna KV, et al. Validation of dual energy X-ray absorptiometry measures of abdominal fat by comparison with magnetic resonance imaging in an Indian population. PLoS One 2012;7:e51042. 

2011 

Kinra S, Sarma KV, Hards M, Smith GD, Ben-Shlomo Y. Is relative leg length a biomarker of childhood nutrition? Long term follow-up of the Hyderabad Nutrition TrialInternational Journal of Epidemiology 2011;40:1022-9. 

2008 

Kinra S, Rameshwar Sarma KV, Ghafoorunissa, Mendu VV, Ravikumar R, Mohan V, et al. Effect of integration of supplemental nutrition with public health programmes in pregnancy and early childhood on cardiovascular risk in rural Indian adolescents: long term follow-up of Hyderabad nutrition trialBMJ 2008;337:a605.

PhD Theses 

Poppy Mallinson, London School of Hygiene and Tropical Medicine, 2021. Thesis title: Life course socioeconomic influences on risk of cardiovascular disease in low- and middle-income countries., London School of Hygiene and Tropical Medicine, 2021.

Christopher Turner, London School of Hygiene and Tropical Medicine, 2019. Thesis title: Investigating food environments and drivers of food acquisition in low- and middle-income countries: The case of peri-urban Hyderabad, Telangana, India.

Tina Sorensen, London School of Hygiene and Tropical Medicine, 2019. Thesis title: Influences of place of residence on risk factors for atherosclerotic cardiovascular diseases in South India.

Mika Matsuzaki, London School of Hygiene and Tropical Medicine, 2016. Thesis title: Lifecourse determinants of bone mass accrual in a transitional rural community in South India: the Andhra Pradesh Children and Parents Study (APCAPS).

Bharati Kulkarni, Queensland University of Technology, 2014. Thesis title: Determinants and measurement of lean body mass in Indian adults.

Amy Taylor, University of Bristol, 2012. Thesis title:

Ruth Sullivan, London School of Hygiene and Tropical Medicine, 2012. Thesis title: Physical activity and rural-urban migration in India.

Poornima Prabhakaran, University of Bristol, 2012. Thesis title: Associations between parental height and cardiometabolic outcomes in the offspring: an intergenerational study in a birth cohort in Andhra Pradesh, India.

Sanjay Kinra, University of Bristol, 2007. Thesis title: The effect of supplemental nutrition in pregnancy and early childhood on future risk of cardiovascular disease: long term follow up of a community trial.