Environmental temperature and child growth in sub-Saharan Africa and Asia - NU/LSHTM project

Title of PhD project / theme

Environmental temperature and child growth in sub-Saharan Africa and Asia

Supervisory team


Dr Lucy Tusting (Assistant Professor) – LSHTM

Professor Sharon Cox (Professor of Epidemiology & Nutrition) – NU

Professor Steve Lindsay (Honorary Chair, LSHTM and Professor of Public Health Entomology, Durham University)

Advisory panel:

Dr Chris Fook Sheng Ng (Associate Professor – Biostatistics, Environmental Epidemiology) – NU

Dr Ana Bonell (Clinical Research Fellow) – LSHTM

Brief description of project / theme

Child growth faltering persists in sub-Saharan Africa and Asia despite the scale-up of nutrition, water, and sanitation interventions over the past two decades.1 High temperatures are hypothesised to contribute to underweight and wasting via an adaptive response to heat, reduced appetite, and the energetic cost of thermoregulation.2,3,4 In contrast, preliminary data suggests that stunting prevalence may decrease with higher temperatures, possibly due to a heat effect on bone elongation.2,5

The aim of this PhD is to further explore the hypothesis that environmental temperature is linked to child growth faltering in sub-Saharan Africa and Asia, with the following specific objectives:

  1. To build on previous research2 to collate existing anthropometric data (e.g. from national surveys and DSS sentinel sites) and link this with contemporary and historical climate data (e.g. remotely-sensed and weather stations) to explore associations between temperature and child growth across Asia and sub-Saharan Africa, controlling for covariables such as household socioeconomic position and access to food.
  2. To explore potential biological mechanisms underlying the hypothesis that child growth is linked with environmental temperature, through an observational study. Potential mechanisms may include the relationship between daily and seasonal changes in temperature and childrens’ activity, appetite, or metabolism. 
  3. Explore the potential relevance of evolutionary responses to heat stress for international child growth standards.

This research topic is novel, and largely unstudied, yet highly relevant in the context of anthropogenic climate change. At a pivotal time, this PhD will help address an urgent need to improve our understanding of the relationship between temperature increases and human physiology. The PhD will not attempt to determine causality, but through collection of preliminary data will help lay the foundation for a new branch of research in this important area. 


  1. Husseini, M., et al., Thresholds of socio-economic and environmental conditions necessary to escape from childhood malnutrition: a natural experiment in rural Gambia. BMC Med, 2018. 16: 199.
  2. Tusting LS, Bradley J, Bhatt S, et al. Environmental temperature and growth faltering in African children: a cross-sectional study. Lancet Planetary Health 2020; 4: e116-e23.
  3. Wells, J.C., Environmental temperature and human growth in early life. J Theor Biol, 2000. 204: 299-305.
  4. Foster, F. and M. Collard, A reassessment of Bergmann's rule in modern humans. PLoS One, 2013. 8: e72269.
  5. Serrat, M.A., Environmental temperature impact on bone and cartilage growth. Compr Physiol, 2014. 4: 621-55.

The role of LSHTM and NU in this collaborative project

The student will be based at LSHTM (London) with fieldwork in one or two sites in sub-Saharan Africa and Asia: Potential sites include Keneba, The Gambia, West Africa, and the APCAPS study site, Deccan Plateau, Hyderabad, India or Manila, Philippines. The supervisory team has strong links with research teams at these settings as well as experience accessing relevant datasets (e.g. DHS surveys). The supervisory team will also provide expertise in analysis of large datasets, designing and implementing the observational study, statistical analyses and translation of research into peer-reviewed publications. With a track record of experience in nutrition, health & the environment, the supervisory team is ideally placed to guide the student to successful completion. In addition, specialist support in use of remotely sensed data will be provided by Nagasaki University via the advisory panel. Adding to this, epidemiological and statistical expertise at LSHTM will also be brought in through selection of advisory panel members in conjunction with the student.

Particular prior educational requirements for a student undertaking this project

The ideal candidate will have a background in biomedical sciences, hold a master’s degree and have a passion for global health, particularly the links between health and the environment. Training in epidemiology, public health nutrition, basic medical statistics and spatial epidemiology is desirable. Experience working in an African/Asian setting is advantageous.

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

The student will gain practical experience of designing and implementing data collection, data cleaning and analysis and use of remotely-sensed data, as well as expertise in child nutrition, growth physiology and the environment. Importantly, the student will gain experience in the design and conduct of fieldwork in extreme environments and working with communities and vulnerable populations. The candidate will be expected to disseminate their research findings through submission to peer-reviewed journals and conferences and through public engagement.