Previous research

Published: 13 June 2014


November 2015 Research from the Family Study showed highest heritability estimates were observed in women when their parents’ body mass index values were either below 25 or above 30 kg/m2. Obesity risk was increased in families with a history of cigarette smoking, with specific maternal influences on increased risk of increased waist circumference in daughters. Parental obesity increased offspring coronary heart disease and metabolic syndrome even after adjusting for confounding factors including offspring and parental age, smoking habit and social class. At the time of questionnaire completion, the ages of offspring (mean 45, SD 6 years) meant that prevalence of cardiovascular disease was still relatively low, particularly in women, so conclusions could only be drawn for early onset coronary heart disease, and true associations with coronary heart disease may still exist.

Paper. Han TS, Hart CL, Haig C, Logue J, Upton MN, Watt, GCM, Lean MEJ. Contributions of maternal and paternal adiposity and smoking to adult offspring adiposity and cardiovascular risk: the Midspan Family Study. 
BMJ Open 2015;5:e007682.doi:10.1136/bmjopen-2015-007682

10 May 2015 Research from the Family study investigated which groups of risk factors contributed most to all-cause mortality and cardiovascular disease. While mid-life biological and behavioural factors were the strongest factors for both all-cause mortality and cardiovascular disease, the second most important group for all-cause mortality was mid-life socioeconomic factors, but early-life socioeconomic factors was the second most important group for cardiovascular disease. Parental lifespan was the weakest predictor and parental risk factors were intermediate.

Paper. Hart C L, McCartney G, Gruer L Watt GCM. Journal of Epidemiology and Community Health 2015 Oct;69(10):950-7. doi: 10.1136/jech-2014-205242

6 Mar. 2015 It is important for health policy and expenditure projections to understand the relationship between age, death and expenditure on health care. Previous research has shown that older age groups incur lower hospital costs than previously anticipated and that remaining time to death was a much stronger indicator for expenditure than age. How health behaviour or risk factors impact on health care utilisation and costs at the end of life is relatively unknown. This recent paper addressed this evidence gap utilising the Renfrew & Paisley study. We estimated whether health risks and health status measures that were obtained at baseline had an impact on hospital costs later in life. Despite the relatively small size of the effect we concluded that health risk measures obtained at baseline provide a good indication of individuals’ probability of needing medical attention later in life and incurring costs.

Paper. Geue C, Lorgelly P, Lewsey J, Hart C, Briggs A. PLoS ONE 2015;10(3): e0119035 (doi:10.1371/journal.pone.0119035)

29 Oct. 2014 Using data from women in the Renfrew & Paisley study who survived to age 80, general hospital admissions after the age of 80 were not socially patterned. However, lower occupational class was associated with higher rates of coronary heart disease and stroke admissions, and with lower rates of cancer admissions. Bed-day use was higher in lower classes, especially for stroke. For mental health, lower occupational class was associated with higher rates of admissions, especially dementia. The associations remained after adjusting for baseline risk factors. 

Paper. Hart C L, McCartney G, Watt GCM. Age Ageing (2015) 44 (3): 515-519. doi: 10.1093/ageing/afu184

13 Feb. 2013 A recent long-term study of working men in Israel showed that smokers who reduced their cigarette consumption had lower mortality rates compared with those who maintained the same level. Two of the Midspan studies were analysed to see if these results could be replicated in similar cohorts. There was no evidence of lower mortality in reducers compared with maintainers in either the Collaborative or Renfrew & Paisley cohorts, but clear evidence of lower mortality in quitters.  Just reducing the number of cigarettes smoked is not a reliable way of improving health in the long term. However, it may have a valuable role as a step toward giving up altogether.

Paper. Hart C, Gruer L, Bauld L.  Does smoking reduction in midlife reduce mortality risk? Results of 2 long-term prospective cohort studies of men and women in Scotland. American J Epidemiol. 2013; 178(5):770-779 doi: 10.1093/aje/kwt038

19 Oct. 2012 A recent investigation of the Family Study suggested that parental height may affect a child's risk of developing heart disease in adulthood, particularly for mothers. Previous research has shown that taller people are at lower risk of heart disease but the effect of parental height has not previously been investigated in detail. The stronger link with mother’s height could be explained by stronger associations between health behaviours of mothers and their children, or the mother’s womb being affected by her own early life circumstances.

Paper. Gray L, Davey Smith G, McConnachie A, Watt G C M, Hart C L, Upton M N, Macfarlane P W, Batty G D. Parental height in relation to offspring coronary heart disease: examining transgenerational influences on health using the west of Scotland Midspan Family Study Int J Epidemiol 2012;41(6):1776-1785; doi:10.1093/ije/dys149

4 Sept. 2012 A new study of the men in the Collaborative cohort suggested that heavy coffee drinkers (three or more cups per day) were less likely to develop aggressive prostate cancer. Most previous research has shown no relationship with prostate cancer for coffee except for one recent study which suggested some preventive effect for aggressive prostate cancer. Our findings further strengthen the recent findings of preventive effect of coffee on aggressive prostate cancer.

Paper Shafique K, McLoone P, Qureshi K, Leung H, Hart C, Morrison D. Coffee consumption and prostate cancer risk: further evidence for inverse relationship Nutrition Journal 2012;11:42 doi:10.1186/1475-2891-11-42

11 July 2012 A new study comparing male mortality in the Scottish Collaborative and Renfrew & Paisley studies with that in the Whitehall I cohort of civil servants in south-east England found that mortality was much higher in the Scottish studies. The higher all-cause, respiratory, and lung cancer mortality in the Scottish cohorts was almost entirely explained by social class differences and higher prevalence of known risk factors, but reasons for the excess mortality from stroke, alcohol-related causes, accidents and suicide remained unexplained.

Paper McCartney G, Shipley M, Hart C, Davey Smith G, Kivimäki M, Walsh D, Watt G C, Batty G D. Why do males in Scotland die younger than those in England? Evidence from three prospective cohort studies. PloS ONE 2012;7(7):e38860 (doi:10.1371/journal.pone.0038860)

19 June 2012 A new study of over 6,000 men in the Collaborative cohort suggested that heavy tea drinkers (seven or more cups per day) were 50% more likely to develop prostate cancer than those drinking between none and three cups. Most previous research has shown either no relationship with prostate cancer for black tea or some preventive effect of green tea. We don’t know whether tea itself is a risk factor or if tea drinkers are generally healthier and live to an older age when prostate cancer is more common anyway.

Paper Shafique K, McLoone P, Quershi K, Leung H, Hart C, Morrison D S. Tea consumption and the risk of overall and grade specific prostate cancer: a large prospective cohort study of Scottish men Nutrition and Cancer 2012 (online) doi:10.1080/01635581.2012.690063

26 Jan. 2012 A new study of the men in two Midspan cohorts suggested that plasma cholesterol was positively associated with increased risk of aggressive prostate cancer but not with overall risk of developing the prostate cancer. This study also highlighted that greater height has a strong relationship with increased risk of prostate cancer regardless of socioeconomic status. Given the lack of known modifiable risk factors for prostate cancer these findings are important and interventions to minimise metabolic risk factors may have a role in reducing incidence of aggressive prostate cancer.

Paper. Shafique K, McLoone P, Quershi K, Leung H, Hart C, Morrison D. Cholesterol and the risk of grade-specific prostate cancer incidence: evidence from two large prospective cohort studies with up to 37 years’ follow up BMC Cancer 2012;12:25 (doi:10.1186/1471-2407-12-25)

28 June 2011 A new study of the women in the Renfrew and Paisley study who had never smoked showed that lower social position was associated with higher mortality rates from cardiovascular disease (but not cancer) and higher rates of obesity. Women who had never smoked and were not obese had relatively low mortality rates regardless of their occupational position, but obese women from the lowest classes had the highest mortality rates. In populations like this one, where obesity is social patterned, it may contribute to health inequalities.

Paper. Hart C L, Gruer L, Watt G C M. Cause specific mortality, social position, and obesity among women who had never smoked: 28 year cohort study. BMJ 2011;342:d3785 doi: 10.1136/bmj.d3785

24 Dec. 2010 A new study investigated the combined effects of both smoking and consuming alcohol on cause-specific mortality. Men from the Collaborative study were divided into nine groups according to their smoking status (never, ex or current) and reported weekly drinking (none, 1-14 units and 15 or more).

  • Men who both smoked and drank 15+ units/week had more than double the risk of all-cause mortality compared with never smokers who did not drink.
  • Premature mortality was particularly high in smokers who drank 15+ units/week, with a quarter of the men not surviving to age 65.

Paper Hart C L, Davey Smith G, Gruer L, Watt G C M. The combined effect of smoking tobacco and drinking alcohol on cause-specific mortality; a 30 year cohort study. BMC Public Health 2010;10:789


11 Mar. 2010 New research assessing the link between body mass index (BMI), alcohol and liver disease in men using data from two Midspan studies (Main & Collaborative), has found:


  • Raised BMI and alcohol consumption were both individually related to liver disease mortality.
  • The combined effect of raised BMI and alcohol consumption was greater than the sum of their separate effects.
  • Obese men drinking 15 or more units a week had almost 19 times higher risk of dying of liver disease than underweight/normal weight non-drinkers.
  • Joint strategies to reduce both alcohol consumption and raised BMI in populations could have an impact on liver disease levels.

BMJ article BMJ 2010;340:c1240


25 Feb. 2010 New research using data from two of the Midspan studies (Main & Collaborative) of participants aged 35 years and under, has shown


  • that levels of cigarette smoking and alcohol consumption, and low lung capacity, in early adulthood, were found to predict deaths from heart disease.
  • Obesity and social disadvantage were additionally implicated in deaths from any cause.

European Journal of Cardiovascular Prevention & Rehabilitation. 17(1):106-112, February 2010


9 Feb. 2010 Research using data from three of the Midspan studies (Main, Collaborative & Renfrew/Paisley) has shown

  • Body mass index (BMI) was strongly related to death from liver disease in men. Obese men had more than three times the rate of liver disease mortality compared with underweight or normal weight men.
  • BMI was also related to liver disease (fatal or non-fatal) in men, with some evidence of a relationship in women.
  • The current rise in overweight and obesity may lead to a continuing epidemic of liver disease.

Abstract International Journal of Obesity Hart C L, Batty G D, Morrison D S, Mitchell R J, Davey Smith G. Obesity, overweight and liver disease in the Midspan prospective cohort studies. 2010; doi: 10.1038/ijo.2010.20


1 July 2009 Research using data from the Collaborative study has shown

  • Amount of alcohol consumed has a substantial effect on hospital admissions and length of stay. Men consuming 22 or more units/week had a 20% higher rate of admissions than non-drinkers.
  • Length of stay was particularly high for men consuming 35 or more units/week - 58% higher for acute admissions and three times higher for mental health admissions, compared with non-drinkers.
  • Alcohol has a notable effect on health service usage and this will significantly impact on NHS costs

Abstract J Epidemiol Community Health Hart C L, Davey Smith G. Alcohol consumption and use of acute and mental health hospital services in the West of Scotland Collaborative prospective cohort study 2009;63:703-707;doi:10.1136/jech.2008.079764


18 Feb. 2009 A long-term study of men and women from the Renfrew/Paisley study has shown

  • Never smokers in the lowest social positions survived longer than all smokers, even those from the highest social positions
  • Smoking was a greater source of health inequality than social position.
  • Reducing health inequalities may be limited unless smokers in lower social positions can be encouraged to give up.


BMJ article. Gruer L, Hart C L, Gordon D S, Watt G C M. Effect of tobacco smoking on survival of men and women by social position: a 28 year cohort study. BMJ 2009;338:b480

First published: 13 June 2014