Nigel Unwin
Biographic Data
| ID | 169811 |
|---|---|
| NAME | Nigel Unwin |
| GIVEN NAMES | Nigel |
| FAMILY NAME | Unwin |
| SIGNATURE | UNWIN N |
| AFFILIATIONS | Newcastle University |
| ORCID | 0000-0002-1368-1648 |
| VERIFIED | Yes |
| TOTAL WORKS | 56 |
| TOTAL CITATIONS | 15 |
| WORKS AS AUTHOR | 56 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 1996 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
The value of adding ‘grey literature’ in evidence synthesis for equity-driven global health
Grey literature, defined as evidence ‘not controlled by commercial publishers’, can enhance the comprehensiveness, timeliness and balance of evidence reviews. It may be particularly important in global health research, where funding inequities and under-representation of local expertise in peer-reviewed research articles—often published by commercial publishers for substantial fees—can lead to evidence gaps in systematic reviews. However, searchi…
Examining food sharing practices in Caribbean Small Island Developing States and their potential for improving health outcomes, through a system-informed lens
Food sharing is an important part of food practices in many settings and contributes to food access and diversity. Food sharing has long been embedded in Caribbean culture, reflecting values of community, care, and social cohesion. These practices are undergoing shifts influenced by various socio-political, economic, and environmental factors. Contemporary trends suggest a decline in food sharing, with increased sharing of convenience-oriented fo…
An exploratory case study of food sharing practices in Caribbean countries through a transition lens using intergenerational dyad interviews
BACKGROUND: Caribbean populations face complex health issues related to diet and food security as they undergo a rapid nutrition transition, resulting in some of the world's highest number of premature deaths from noncommunicable diseases (NCDs). Despite policy efforts to promote local and regional food consumption, reliance on food imports remains high with many Caribbean countries importing more than 80% of their food from larger economies. Pre…
Understanding the links between human health, ecosystem health, and food systems in Small Island Developing States using stakeholder-informed causal loop diagrams
Globalized food systems are a major driver of climate change, biodiversity loss, environmental degradation, and the increasing prevalence of overweight and obesity in society. Small Island Developing States (SIDS) are particularly sensitive to the negative effects of rapid environmental change, with many also exhibiting a heavy reliance on food imports and high burdens of nutrition-related disease, resulting in calls to (re)localize their food sy…
Situating commercial determinants of health in their historical context
BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of mortality across the Caribbean and similar regions. Structural determinants include a marked increase in the dependency on food imports, and the proliferation of processed foods, including sugar-sweetened beverages (SSBs). We focused on Jamaica as a case study and the health challenge of SSBs, and situated contemporary actions, experiences and policies within their historical c…
Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model
Diabetes and obesity present a high and increasing burden of disease in the Caribbean that have failed to respond to prevention policies and interventions. These conditions are the result of a complex system of drivers and determinants that can make it difficult to predict the impact of interventions. In partnership with stakeholders, we developed a system dynamics simulation model to map the system driving diabetes and obesity prevalence in the …
Evidence of a health risk ‘signalling effect’ following the introduction of a sugar-sweetened beverage tax
Consuming sugar-sweetened beverages (SSBs) has been associated with increased rates of obesity and type 2 diabetes, making SSBs an increasingly popular target for taxation. In addition to changing prices, the introduction of an SSB tax may convey information about the health risks of SSBs (a signalling effect). If SSB taxation operates in part by producing a health risk signal, there may be important opportunities to amplify this effect. Our aim …
"We used to get food from the garden." Understanding changing practices of local food production and consumption in small island states
The global diet and activity research (GDAR) network
Implications of Covid-19 control measures for diet and physical activity, and lessons for addressing other pandemics facing rapidly urbanising countries
At the time of writing, it is unclear how the COVID-19 pandemic will play out in rapidly urbanising regions of the world. In these regions, the realities of large overcrowded informal settlements, a high burden of infectious and non-communicable diseases, as well as malnutrition and precarity of livelihoods, have raised added concerns about the potential impact of the COVID-19 pandemic in these contexts. COVID-19 infection control measures have b…
Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045
Tuberculosis and diabetes
BACKGROUND: Many studies have found an increased risk of pulmonary tuberculosis (PTB) among those with diabetes mellitus (DM). However, evidence on whether the association is bidirectional remains sparse. This study investigates DM rates among those with and without prior tuberculosis (TB) disease as well as the reverse. METHODS: Data on a UK general practice population, between 2003 and 2009, were obtained from The Health Improvement Network dat…
Sodium and potassium excretion in an adult Caribbean population of African descent with a high burden of cardiovascular disease
In this first nationally representative study with objective assessment of sodium and potassium excretion in a Caribbean population in over 20 years, levels of sodium intake were high, and potassium intake was low. Younger age and lower educational level were associated with the highest sodium-to-potassium ratios. These findings provide baseline values for planning future policy interventions for non-communicable disease prevention
Regulatory measures to fight obesity in Small Island Developing States of the Caribbean and Pacific, 2015 – 2017
This report examines the experiences of Small Island Developing States in the Caribbean- Barbados, Dominica, Jamaica, and in the Pacific- Fiji, Nauru, and Tonga with specific governmental regulatory measures to reduce the risk of obesity and associated diet-related chronic noncommunicable diseases (NCDs), as well as the obstacles and opportunities encountered. Guided by the diet-related indicators of the World Health Organization (WHO) Noncommuni…
Increased taxation on cigarettes in Grenada
In Grenada, consumption can be reduced alongside growth in government revenues, making available additional resources for health. This aligns with the literature, which indicates that taxation can be effective in pursuing the public health objective of reduced incidence of smoking-related illnesses via reduced consumption
Health and other impacts of community food production in Small Island Developing States
Evidence of impacts of CPFIs in Small Island Developing States is limited and the approaches taken are inconsistent. This review demonstrates the need and provides a basis for developing a coherent body of methods to examine the impacts of CFPIs and provide evidence to guide policy, especially as it relates to health
An updated systematic review and meta-analysis on the social determinants of diabetes and related risk factors in the Caribbean
Validating the self-reported annual monitoring grid for the 2007 Caribbean Community Declaration of Port-of-Spain on noncommunicable diseases
In general, the monitoring grid accurately assessed the national situation, but with a possible tendency to overstate performance in some areas. These findings contributed to the design of a new, 50-indicator monitoring grid in 2016. Alongside these improvements, CARICOM countries face a substantial burden from having to complete many other required NCD reports, mainly for the Pan American Health Organization and the World Health Organization
The 2007 Caribbean Community Port-of-Spain Declaration on noncommunicable diseases
Priorities for further implementation of the mandates from the Port-of-Spain Declaration include establishing throughout the CARICOM member countries and territories fully functioning national bodies to support multisectoral action for NCD prevention; greater regional support in policy development and implementation for smaller countries; and greater targeted use of taxes on tobacco and alcohol to support NCD control and prevention
Evaluating policy responses to noncommunicable diseases in seven Caribbean countries
Regional collaboration and political support across sectors are essential to accelerating the pace of action to support healthy eating and active living environments. Policy "blueprints" could accelerate the process of development. Regional "NCD champions" could spearhead such responses and approaches
Premature mortality from cardiovascular disease and diabetes in the Caribbean and associations with health care expenditure, 2001 − 2011
Findings suggest that progress has been made to reduce premature CVD-DM related mortality in a number of Caribbean countries. Differences between countries may be partly related to differences in health care system performance, although further research that considers confounders is needed
Prevalence and phenotype of diabetes and prediabetes using fasting glucose vs HbA1c in a Caribbean population
BACKGROUND: Both fasting plasma glucose (FPG) and HbA1c are recommended for the diagnosis of diabetes and prediabetes by the American Diabetes Association (ADA), and for diabetes by the World Health Organization. The ADA guidance is influential on clinical practice in many developing countries, including in the Caribbean and Latin America. We aimed to compare the prevalence and characteristics of individuals identified as having diabetes and pred…
Do cardiometabolic, behavioural and socioeconomic factors explain the ‘healthy migrant effect’ in the UK? Linked mortality follow-up of South Asians compared with white Europeans in the Newcastle Hear…
BACKGROUND: Immigrants are sometimes found to have better health than locally born populations. We examined the mortality experience of South Asian origin and white European origin individuals living in Newcastle upon Tyne, UK. METHODS: A linked 17-21 year mortality follow-up of a cross-sectional study of European (n=825) and South Asian (n=709) men and women, aged 25-74 years, recruited between 1993 and 1997. Poisson regression was used to estim…
An epidemiological study of rates of illness in passengers and crew at a busy Caribbean cruise port
The predominant illnesses reported were gastroenteritis and influenza similar to previous published reports from around the world. This study is the first of its type in the Caribbean and the data provide a baseline for future surveillance and for comparison with other countries and regions
A cross-sectional study of physical activity and sedentary behaviours in a Caribbean population
The use of both objective and self-report methods to assess PA and sedentary behaviour provides important complementary information to guide public health programmes. Our results emphasize the urgent need to increase PA and reduce sedentary time in this developing country population. Women and those with higher social economic position are particularly at risk from low levels of physical activity
Evidence of a health risk ‘signalling effect’ following the introduction of a sugar-sweetened beverage tax
Consuming sugar-sweetened beverages (SSBs) has been associated with increased rates of obesity and type 2 diabetes, making SSBs an increasingly popular target for taxation. In addition to changing prices, the introduction of an SSB tax may convey information about the health risks of SSBs (a signalling effect). If SSB taxation operates in part by producing a health risk signal, there may be important opportunities to amplify this effect. Our aim …
Body mass index, waist circumference, waist-hip ratio, and glucose intolerance in Chinese and Europid adults in Newcastle, UK
OBJECTIVE: To compare the prevalence of glucose intolerance (impaired glucose tolerance and diabetes), and its relationship to body mass index (BMI) and waist-hip ratio in Chinese and Europid adults. DESIGN: This was a cross sectional study. SETTING: Newcastle upon Tyne. SUBJECTS: These comprised Chinese and Europid men and women, aged 25-64 years, and resident in Newcastle upon Tyne, UK. MAIN OUTCOME MEASURES: Two hour post load plasma glucose c…
Social networks and coronary heart disease risk factors in South Asians and Europeans in the UK
The results provided only partial support for the hypothesis that South Asians in the UK are socially isolated, and suggest that South Asians and Europeans in the UK utilise different sources of social support. Future work should acknowledge variation in sources of social support between ethnic groups, and should explore the possibility that different mechanisms link social support and health in different ethnic groups
"We used to get food from the garden." Understanding changing practices of local food production and consumption in small island states
Increased risk of tuberculosis disease in people with diabetes mellitus
BACKGROUND: The authors aimed to determine whether, and by how much, diabetes mellitus (DM) increases the risk of tuberculosis (TB) and conversely whether TB increases the risk of DM. METHODS: Retrospective cohort analyses using data from two Oxford Record Linkage Study (ORLS) datasets, containing information on hospital admissions and day-case care between 1963 and 1998 (ORLS1) and between 1999 and 2005 (ORLS2), were carried out. The rate ratio …
Self-Reported Work Strain is Lower in South Asian than European People
In a representative population sample the overall balance of job demand and control was similar in South Asian and European people, though South Asian people tended to be in jobs characterised by low skill and high decision latitude. These findings do not support the suggestion that increased work strain contributes to the increased risk of CHD in UK South Asian people
Agreement between the Takeda UA-731 automatic blood pressure measuring device and the manual mercury sphygmomanometer
STUDY OBJECTIVE: To assess agreement between two Takeda UA-731 automatic blood pressure measuring devices (referred to as machines A and B) and two manual mercury sphygmomanometers. DESIGN: A 'Y' connector attached each Takeda UA-731 to a manual mercury sphygmomanometer. Simultaneous measurements were made on adult subjects. SETTING: A population based cardiovascular disease survey in Newcastle upon Tyne, UK. PARTICIPANTS: Measurements on machine…
Body mass index, waist circumference, waist-hip ratio, and glucose intolerance in Chinese and Europid adults in Newcastle, UK
OBJECTIVE: To compare the prevalence of glucose intolerance (impaired glucose tolerance and diabetes), and its relationship to body mass index (BMI) and waist-hip ratio in Chinese and Europid adults. DESIGN: This was a cross sectional study. SETTING: Newcastle upon Tyne. SUBJECTS: These comprised Chinese and Europid men and women, aged 25-64 years, and resident in Newcastle upon Tyne, UK. MAIN OUTCOME MEASURES: Two hour post load plasma glucose c…
Low levels of cardiovascular risk factors and coronary heart disease in a UK Chinese population
OBJECTIVE: To compare the prevalence of cardiovascular risk factors and coronary heart disease in Chinese and Europid adults. DESIGN: Population based, cross sectional survey. SETTING: Newcastle upon Tyne, UK, 1991-93. SUBJECTS: Altogether 380 Chinese and 625 Europid adults, aged 25-64 years. MAIN OUTCOME MEASURES: Fasting lipid levels, blood pressure, body mass index (BMI), the proportions who smoked, and the prevalence of coronary heart disease…
Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations
OBJECTIVE: To compare coronary risk factors and disease prevalence among Indians, Pakistanis, and Bangladeshis, and in all South Asians (these three groups together) with Europeans. DESIGN: Cross sectional survey. SETTING: Newcastle upon Tyne. PARTICIPANTS: 259 Indian, 305 Pakistani, 120 Bangladeshi, and 825 European men and women aged 25-74 years. MAIN OUTCOME MEASURES: Social and economic circumstances, lifestyle, self reported symptoms and dis…
Tobacco smoking in Tanzania, East Africa
The data suggest: (1) high rates of smoking among men in an urban area of East Africa; and (2) the importance of validating self reports of smoking status, particularly among women
Social networks and coronary heart disease risk factors in South Asians and Europeans in the UK
The results provided only partial support for the hypothesis that South Asians in the UK are socially isolated, and suggest that South Asians and Europeans in the UK utilise different sources of social support. Future work should acknowledge variation in sources of social support between ethnic groups, and should explore the possibility that different mechanisms link social support and health in different ethnic groups
Is It Time to Reassess the Categorization of Disease Burdens in Low-Income Countries
The classification of disease burdens is an important topic that receives little attention or debate. One common classification scheme, the broad cause grouping, is based on etiology and health transition theory and is mainly concerned with distinguishing communicable from noncommunicable diseases. This may be of limited utility to policymakers and planners. We propose a broad care needs framework to complement the broad cause grouping. This alte…
Self-Reported Work Strain is Lower in South Asian than European People
In a representative population sample the overall balance of job demand and control was similar in South Asian and European people, though South Asian people tended to be in jobs characterised by low skill and high decision latitude. These findings do not support the suggestion that increased work strain contributes to the increased risk of CHD in UK South Asian people
Sex hormone-binding globulin and androgen levels in immigrant and British-born premenopausal British Pakistani women
In women, raised insulin levels are associated with low sex hormone-binding globulin (SHBG) and high androgen levels, which are in turn linked to infertility. Since insulin resistance and hyperinsulinemia are major health problems for South Asians living in Western countries, we predicted that British Pakistani women would have low SHBG and raised androgen levels compared to European women. Given low birth weights in Pakistan, and known links bet…
Anthropometry measures and prevalence of obesity in the urban adult population of Cameroon
The study provides current data on anthropometric measurements and obesity in urban Cameroonian populations, and found high prevalences of overweight and obesity particularly over 35 years of age, and among women. Prevalence varied according to the measure used. Our findings highlight the need to carry out further studies in Cameroonian and other Sub-Saharan African populations to provide appropriate cut-off points for the identification of peopl…
Diabetes and tuberculosis
Diabetes makes a substantial contribution to the burden of incident tuberculosis in India, and the association is particularly strong for the infectious form of tuberculosis. The current diabetes epidemic may lead to a resurgence of tuberculosis in endemic regions, especially in urban areas. This potentially carries a risk of global spread with serious implications for tuberculosis control and the achievement of the United Nations Millennium Deve…
Differences in body composition and cardiovascular and Type 2 diabetes risk factors between migrant and British‐born British Pakistani women
There is a high prevalence of cardiovascular disease and Type 2 diabetes in people of South Asian origin living in affluent western countries. We do not know whether or how risk factors for these diseases change in subsequent generations born in the west. Findings that birth‐weight is inversely associated with abdominal obesity and risk of cardiovascular disease and Type 2 diabetes in later life suggest that those born in the west may have lower …
Total estradiol levels in migrant and British‐born British Pakistani women
The purpose of this study was to test the hypothesis that women who grow up in energetically stressed environments have later menarche and lower total estradiol levels during their reproductive years than do women who grow up in less energetically stressed environments. We assessed total estradiol in a serum sample taken 9-11 days after the start of the menstrual cycle in 26 women who grew up in Pakistan and migrated to the UK as adults, in 28 Br…
Obesity" and "Clinical Obesity" Men's understandings of obesity and its relation to the risk of diabetes
Men in this study had a complex understanding of the interlinked importance of weight and fitness in relation to health. Obesity is understood as a description of people with centrally distributed fat, in association with low fitness levels. There is a need to increase understanding of the causes and consequences of diabetes. Discussion of increased health awareness by men round the age of 40 may indicate a window of opportunity to intervene at t…
A review of co-morbidity between infectious and chronic disease in Sub Saharan Africa
BACKGROUND: Africa is facing a rapidly growing chronic non-communicable disease burden whilst at the same time experiencing continual high rates of infectious disease. It is well known that some infections increase the risk of certain chronic diseases and the converse. With an increasing dual burden of disease in Sub Saharan Africa the associations between diseases and our understanding of them will become of increased public health importance. A…
Quantifying the association between tuberculosis and diabetes
Tuberculosis (TB) remains a major global health problem. A possible risk factor for TB is diabetes (DM), which is predicted to increase dramatically over the next two decades, particularly in low- and middle-income countries, where TB is widespread. This convergence of two epidemics has highlighted the need for a better understanding of the possible association between the two diseases, and its potential significance for public health. This study…
Metabolic health changes in migrants moving from a rural to an urban environment in Tanzania
before achieving LTC, and 49% achieved LTC. The relative hazard of death before achieving LTC compared to surviving without achieving LTC decreased for those with a history of opiate substitution therapy (OST) (HR 0.19, CI 0.10 to 0.34) and increased for HIV positive participants (HR 6.2, CI 3.6 to 10.6), those who started injecting after 1985 (HR 2.5, CI 1.3 to 4.8), those aged over 18 years at first injection (HR 2.2, CI 1.4 to 3.6), and those …
Lifecourse predictors of adult fibrinogen concentrations
characteristics interact so that combinations of factors carry cumulative risk for CVD? (iii) are associations explained by early life predictors of CVD risk.Design: Birth cohort.Setting: England, Scotland and Wales.Participants: 7916 men and women in the 1958 British birth cohort who were in paid employment at 45 y.Main Outcome Measures: Body mass index (BMI), waist circumference (WC), blood pressure (BP), triglycerides, total and high density l…
Tackling Africa's chronic disease burden
Rural to urban migration and changes in cardiovascular risk factors in Tanzania
High levels of rural to urban migration are a feature of most African countries. Our aim was to investigate changes, and their determinants, in cardiovascular risk factors on rural to urban migration in Tanzania. Men and women (15 to 59 years) intending to migrate from Morogoro rural region to Dar es Salaam for at least 6 months were identified. Measurements were made at least one week but no more than one month prior to migration, and 1 to 3 mon…
Do obese but metabolically normal women differ in intra-abdominal fat and physical activity levels from those with the expected metabolic abnormalities? A cross-sectional study
A sub-group of women exists who are metabolically normal despite being very obese. Differences in fat distribution, insulin resistance, and physical activity level are associated with metabolic differences in these women, but account only partially for these differences. Future work should focus on strategies to identify those obese individuals most at risk of the negative metabolic consequences of obesity and on identifying other factors that co…
A policy effectiveness-feasibility loop? Promoting the use of evidence to support the development of healthy public policy
Background Historically, policy initiatives have made variable contributions to improvements in public health. Today there is a growing interest in translating evidence from health research into healthy public policy. Although research evidence may be a component of policy development, it is rarely enough, because policy makers are subject to a wide range of influences. Furthermore, researchers and policy makers usually work within different time…
Forecasting diabetes prevalence using a simple model
Mice with a mutation of the ζ-associated protein of 70 kDa gene ( skg mutation) are genetically prone to develop autoimmune arthritis, depending on the environment. In a set of mice with the mutation, the amount of ζ-associated protein of 70 kDa protein as well as its tyrosine phosphorylation upon TCR stimulation decreased from +/+, skg /+, skg / skg , to skg /− mice in a stepwise manner. The reduction resulted in graded alterations of thymic pos…
P1-99 A policy effectiveness-feasibility loop for evidence-based public health policy
Introduction While public health policy could profoundly effect health status 1 , research informing policy-making and implementation is underutilised. 1–5 A range of evidence types are required to support policy-making, and involving policy makers in generating and evaluating evidence is important. This work aims to develop, implement and evaluate an interactive approach to informing policy for preventing and managing cardiovascular disease (CVD…
O1-5.6 Forecasting Diabetes Prevalence
Introduction Current projections of diabetes prevalence are mostly based on demographic change. Explicitly including trends in obesity and other risk factors could improve the accuracy of the projections and assist in evaluating policy options for prevention. Methods The model integrates population, obesity and smoking trends to estimate future diabetes prevalence using a Markov approach. Model parameters were derived from the literature, except …
Medicine (48 works) · Environmental health (31 works) · Internal Medicine (22 works) · Global Public Health Policies and Epidemiology (21 works) · Population (20 works) · Demography (19 works) · Diabetes mellitus (17 works) · Political science (17 works) · Endocrinology (15 works) · Gerontology (15 works)