Public Health Practice

Engagement with Professional Bodies/ Government

International

  • Regional Representative LMIC, International Society for Developmental Origins of Health and Disease [DOHaD]
  • International Practitioner Member, Faculty of Public Health, Royal Colleges of Physicians, U.K.
  • Member, Chartered Class, National Board of Public Health Examiners, USA.
  • Member, Society for Development Origins of Health and Disease [DOHaD]
  • Member, Royal Society of Tropical Medicine and Hygiene, [RSTMH]
  • Life Member, International Epidemiology Association [IEA]
  • Member, Society for Epidemiological Research, USA [SER]
  • Member, American College of Epidemiology
  • Life Member, Indian Public Health Association [IPHA]
  • Indian Medical Association [IMA]

National Level

  • Investigator in the National Seroprevalence Survey, India, ICMR
  • Member of Epidemiology, Surveillance, & Research group, ICMR National Task Force for COVID-I9, India.
  • Member, NCD Core Technical Group, Ministry of Health & Family Welfare, Government of India
  • Member, Nursing Council of India, Core group for curriculum for Nursing Health Practitioner

Regional

  1. Member, State Vision Group, Karnataka State Government
  2. Co-Chair, BBMP Taskforce on COVID-19 Public Health Response, Bruhat Bengaluru Mahanagara Palike, Bengaluru.
  3. Member, Karnataka State Government Expert Committee for COVID19
  4. Member, Bruhat Bengaluru Mahanagara Palike, Expert Committee for COVID19
  5. Member, Karnataka State Government Technical Analysis Committee: COVID19
  6. Consultation to State Governments of Andhra Pradesh, Uttar Pradesh, Maharashtra, Punjab & Telangana
  7. Initiated and was the founding member of Karnataka State Core Group on Routine Immunization.
  8. Member, Committee to create Public health department and cadre in the state of Karnataka.
  9. Member, of the Board of Studies, Department of Public Health, Manipal University
  10. Member, Public Health Cadre and Department reorganization, Government of Karnataka.
  11. Member, Executive Committee of Karnataka State Health System Resources Centre, Bangalore.
  12. Committee member, Karnataka Public Health (Act) Committee, Govt. of Karnataka
  13. Member, Karnataka Private Establishments Act amendment, Government of Karnataka
  14. Member, Technical Group, Rolling out Universal Health Coverage, Karnataka
  15. Member, State level core committee for prevention of blindness and diabetic retinopathy, Govt. of Karnataka
  16. Member, District level core committee for prevention of blindness and diabetic retinopathy, Govt. of Karnataka
  17. Member, State level committee for review and amendment of Karnataka Private Establishment Act, Govt. of Karnataka
  18. Coordinator, Sub-committee on strengthening primary care for health task force, knowledge commission, Govt. of Karnataka
  19. Advisory Committee Member of Nutrition project, Ashoka Innovators for the public, Bengaluru

Community Service

  • Used Social media to effectively disseminate information regarding public health issues. Nominated for Best on Twitter by Health System Global awards for Social Media, 2014. I run two papers termed as “Epi Times” (paper.li/epigiri/1343539842) and Public health times, which are aggregator newsletters to regularly collects epidemiology-related news from around the world
  • Use of Social Media in Public Health: Experience with Public Health in India- A Facebook group.
  • Blogs on Public Health Global Network Link: http://goo.gl/8oje3 Published on Nov 17, 2011
  • Regular articles in Media regarding the use of public health principles in promoting human health. link to detailed articles can be found here.

Awards and Accolades

  • Led the efforts to stop wild poliovirus transmission in Karnataka state.
  • Awarded by Rotary International for outstanding contribution to Polio eradication activities.
  • Advocacy for Measles surveillance in India, which led to Multi-Year Plan for Measles elimination in India

Consultations

  1. Consulted to World Health Organization for Reprioritization of Diseases under India Surveillance Program
  2. Represented and contributed at National level consultation. “Prioritising Newborn and Child Health: A Policy Advocacy Initiative to Build Informed Consensus and Mobilise Support by Translating Evidence to Action”. 23-24 November, 2010, New Delhi
  3. Consultation provided to proposed Karnataka Public Health Act
  4. Consultancy to WHO SEARO, for finalization of “Handbook on Public Health Programs at the District Level”, for South East Asia Regional Office-WHO (SEARO) to be implemented by all the SEARO countries.
  5. Task Force for developing Karnataka Public Health Policy (KPHP) Karnataka Jnana Aayoga

External Academic service

  1. External Examiner, Ph.D. Examiner to New South Wales (Sydney), Australia
  2. External Examiner, PGDPHM, JIPMER, Pondicherry
  3. External Examiner, Department of Public Health, Manipal University.

 Keynote Address

  1. “COVID 19: MUTANTS AND VACCINES” Sri Devaraj Urs Academy of Higher Education and Research, 02nd February 2021
  2. “COVID–19 Vaccine Rollout: Executing an Effective and Equitable Strategy in Karnataka” Webinar 1-Public Policy Dialogue, Policy Engagement & Communication and Training, 22nd January 2021
  3. Holistic Health for Primary care Physicians By AHPI, 28th December 2020
  4. Panel discussion on Covid19 response: The journey so far- Initial reflections and future directions, KACHCON 2020 S. Ramaiah Medical College, 21th December 2020
  5. Panel Discussion – Smart Green urban Living, IOTFOrum India, IOTMatrix 2020, 11th December 2020
  6. “COVID -19, Has the world done enough? and Future perspectives” with focus on India Invited talk for Academic Society, JSS Medical College, Mysuru 10th December 2020
  7. “Introduction to Epidemiology” for MA Development students at Azim Premji University, 26th November 2020.
  8. Vaccines- The potential in India to go beyond manufacturing into discovery and development, Virtual Conference of Bengaluru Tech Summit 2020, Department of Electronics, Information Technology, Biotechnology and Science & Technology  Government of Karnataka  21st November 2020
  9. Panel Discussion in Workshop entitled “Challenges in Scientific Research and Education during unprecedented COVID-19 times” 13th International Symposium on Biomathematics and Ecology Education and Research (BEER), 13th November 2020
  10. CII Karnataka CSR Conclave 2020 is ” Creating Shared Value”, Confederation of Indian Industry, 3rd November 2020.
  11. Good practices in planning strategies and implementation of containment measures in urban and rural, IIPH Gandhi Nagar, 25 November 2020 Link
  12. Epidemiology of Covid- 19 in India: Learnings and Way Forward, Meet the Scholar university of Kerala, 30th October 2020
  13. A webinar and panel discussion on COVID-19 Pandemic & Health Care Ethics on 29th October 2020 Link
  14. Covid-19 Pandemic Health Care Ethics, Nitte Unevercity 28th October 2020
  15. Plenary Talk in the Virtual Symposium on Society, Economy and Development during Covid-19 Crisis: Lessons For Emerging Economies, Centre for Happiness, Central University of Tamil Nadu, 10th October 2020.
  16. International Webinar on Understanding covid-19 pandemic an integrated approach, NIUM 7th October 2020
  17. National Webinar On Horticultural Resources and Their Role In Boosting Immunity Against Covid-19  situation in India: A Public Health Perspective, Sri Devaraj Urs Academy of Higher Education and Research, 4th September, 2020
  18. VCN Doctors: Management of Covid 19 and support to health care, VCN Doctor Welfare Association 05th July 2020
  19. The Covid-19 Pandemic & The Emerging World Order, KPSA Mysore 13th June 2020 Link
  20. ISRC online symposium on CoVid19 India data analysis, IndSciCovid, 6th June 2020   Link
  21. Post COVID 19 Impact of Healthcare Services -Prevention, Practices and Processes, Confederation of Indian Industry, 30th May 2020 Link
  22. Corona in India: Doubling rate, Post lockdown Syndromic Surveillance and Antibody Tests, 25th May 2020 – Link
  23. International Covid-19 Conference, Stanford Medicine, 15th May 2020
  24. Preparedness for Pandemic –Indian Chamber of Commerce, 11th May, 2020, Link
  25. Beyond the pandemic: What Should Doctors and Hospital Do, Nature India, 03rd May 2020 Link
  26. The Twelfth (12th) online weekly meeting of all State Presidents and Secretaries, Emerging Data Trend and Pattern- National and State wise Analysis. Part of Project: Jeevanrakshe, a Public-Private Partnership initiative supported by Indian Medical Association, June 28 2020
  27. Panel Discussion -Science and Solidarity Must Guide Social Response to Covid-19, Sphere India Covid-19 Academy,  28th April 2020 Link
  28. Valedictory Address in Institute for Social and Economic Change (ISEC), Bengaluru January 23 2020.
  29. Management of Human Resource, State Institute of Health and Family Welfare, Magadi Road, Bengaluru January 07 2020.
  30. Guest speaker in a plenary session, ISMSCON2019 to be held at All India Institute of Medical Sciences, Patna, Bihar from 5th to December 07 2019.
  31. Grant Writing Workshop, Ramaiah Medical College, Bengaluru, September 24 2019.
  32. “Life course Epidemiology Projects” St. Joseph’s College, Autonomous, Bengaluru September 13 2019.
  33. “Early Childhood Development: Early Moments Matter “. IIPH Hyderabad, on 30th and 31st July, 2019.
  34. “Career in Public Health Sciences” during the launch of “Build India Movement” at Bengaluru Medical College on January 12 2019.
  35. Life course trajectory of under nutrition, Nutrition Awareness Activity at Mount Carmel College, Bengaluru September 06 2018
  36. Epidemiology and Health Promotion, State Institute of Health and Family Welfare, Magadi Road, Bengaluru April 11 2018
  37. Ethics in Public Health Practice. Wipro Learning Centre, Sarjapur Road, Bengaluru February 08 2018
  38. Writing a Good Manuscript for Publication – An Editor’s Perspective, Medical Communication Workshop, Indian Society for Clinical Research (ISCR) in collaboration with the International Society for Medical Publication Professionals (ISMPP), November 13, 2016
  39. National conference on health, safety & well-being of the workers in unorganized sector/informal economy, Pro-VC Hall, Central University of Tamil Nadu 23rd March 2017
  40. Hygiene Matters, Multi-specialty National Conference NIMHANS Convention Center, Bengaluru 25th March 2017
  41. Environmental Health and Sustainable Development: International conference of the Public Health Foundation of India and the Pacific Basin Consortium 15th November 2017
  42. Speaker at “Household Air Pollution and NCDs”, Faculty for World NCD Congress, Chandigarh, India, 4-6 November 2017
  43. Public health aspects of Disaster Management, Bengaluru University. March 09 2017.
  44. Hygiene Matters, Multi-specialty National Conference, NIMHANS, Bengaluru, 25 & 26 March 2017
  45. Epidemiology and Public Health in India, Bengaluru University, July 14, 2016
  46. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin. Health in Slums Symposium by Zuyd University of Applied Sciences, Maastricht University, Bengaluru, Baptist Hospital, and Manipal University. 30th April, 2016
  47. Training and research opportunities in Diabetes at Beat diabetes stay super; – world health CME by Department of Community Medicine and Endocrinology, M.S. Ramaiah Medical College. 16th April 2016.
  48. Social Determinants of Health, Right to Health & Health Equity. International conference on Global Public Health and Social work- DYUTI 2013. January 05 2013
  49. Keynote address on scope of public health and social work in India. Public Health and Social work in International settings. International conference on Global Public Health and Social work- DYUTI 2013. January 04 2013
  50. Analysis of Universal Health Coverage and Pointers for Future”. 24th Annual Conference of KACH. Karnataka Association of Community Health Professionals. Bagalkote, India 3rd November 2012.
  51. Public Health Cadre in the state of Karnataka, Indian Public Health Association Annual Conference, Kochi, 13-14th February, 2012.

Public Health Practice

Engagement with Professional Bodies/ Government

International

  • Member of Chartered Class, National Board of Public Health Examiners, USA.
  • Certified in Public Health, National Board of Public Health Examiners, USA (Currently valid)
  • Member, NCD Technical group, World Health Organization & CCDC, India

National Level

  • Member, NCD Core Technical Group, Ministry of Health & Family Welfare, Government of India
  • Member, Nursing Council of India, Core group for curriculum for Nursing Health Practitioner

Regional

  1. Initiated and was the founding member of Karnataka State Core Group on Routine Immunization.
  2. Member, Committee to create Public health department and cadre in the state of Karnataka.
  3. Member, of the Board of Studies, Department of Public Health, Manipal University
  4. Member, Public Health Cadre and Department reorganization, Government of Karnataka.
  5. Member, Executive Committee of Karnataka State Health System Resources Centre, Bangalore.
  6. Committee member, Karnataka Public Health (Act) Committee, Govt. of Karnataka
  7. Member, Karnataka Private Establishments Act amendment, Government of Karnataka
  8. Member, Technical Group, Rolling out Universal Health Coverage, Karnataka
  9. Member, State level core committee for prevention of blindness and diabetic retinopathy, Govt. of Karnataka
  10. Member, District level core committee for prevention of blindness and diabetic retinopathy, Govt. of Karnataka
  11. Member, State level committee for review and amendment of Karnataka Private Establishment Act, Govt. of Karnataka
  12. Coordinator, Sub-committee on strengthening primary care for health task force, knowledge commission, Govt. of Karnataka
  13. Advisory Committee Member of Nutrition project, Ashoka Innovators for the public, Bengaluru

Community Service

  • Used Social media to effectively disseminate information regarding public health issues. Nominated for Best on Twitter by Health System Global awards for Social Media, 2014. I run two papers termed as “Epi Times” (paper.li/epigiri/1343539842) and Public health times, which are aggregator newsletters to regularly collects epidemiology-related news from around the world
  • Use of Social Media in Public Health: Experience with Public Health in India- A Facebook group.
  • Blogs on Public Health Global Network Link: http://goo.gl/8oje3 Published on Nov 17, 2011
  • Regular articles in Media regarding the use of public health principles in promoting human health. link to detailed articles can be found here.

Awards and Accolades

  • Led the efforts to stop wild poliovirus transmission in Karnataka state.
  • Awarded by Rotary International for outstanding contribution to Polio eradication activities.
  • Advocacy for Measles surveillance in India, which led to Multi-Year Plan for Measles elimination in India

Consultations

  1. Consulted to World Health Organization for Reprioritization of Diseases under India Surveillance Program
  2. Represented and contributed at National level consultation. “Prioritising Newborn and Child Health: A Policy Advocacy Initiative to Build Informed Consensus and Mobilise Support by Translating Evidence to Action”. 23-24 November, 2010, New Delhi
  3. Consultation provided to proposed Karnataka Public Health Act
  4. Consultancy to WHO SEARO, for finalization of “Handbook on Public Health Programs at the District Level”, for South East Asia Regional Office-WHO (SEARO) to be implemented by all the SEARO countries.
  5. Task Force for developing Karnataka Public Health Policy (KPHP) Karnataka Jnana Aayoga

External Academic service

  1. External Examiner, Ph.D. Examiner to New South Wales (Sydney), Australia
  2. External Examiner, PGDPHM, JIPMER, Pondicherry
  3. External Examiner, Department of Public Health, Manipal University.

 Keynote Address

  1. Giridhara R Babu, National Conference on Health, Safety & Well Being of the workers in Unorganized sector/informal economy, Central University of Tamilnadu, 23rd March 2017
  2. Giridhara R Babu, Analysis of Universal Health Coverage and Pointers for Future”. 3rd November 2012. 24th Annual Conference of KACH. Karnataka Association of Community Health Professionals. Bagalkote, India.
  3. Giridhara R Babu, Keynote address on scope of public health and social work in India. Public Health and Social work in International settings. International conference on Global Public Health and Social work- DYUTI 2013. 4 January 2013
  4. Giridhara R Babu, Social Determinants of Health, Right to Health & Health Equity. International conference on Global Public Health and Social work- DYUTI 2013. 5 January 2013

Activities

Courses

Each year, I offer several courses in the areas of Basic Epidemiology, Advanced Epidemiology, Applied Epidemiology (Non-communicable diseases, communicable diseases, and Surveillance), and Introduction to Public Health, Universal Health Coverage for

  • Diploma Students
  • Masters Students and
  • Doctoral Students

Furthermore, I regularly offer short courses and visiting lectures, which allow students to complete required learning in their flexible time. This is part of the capacity building for public health professionals.

For the current list of courses for the current year: Please write to us. E-mail

Bachelor and Master’s Theses

For all students with an interest in Life course Epidemiology, I offer a wide range of research areas out of which a topic for a Bachelor- or Master thesis can be chosen. If you are interested, just write to my project staff and arrange an appointment to discuss. We will be available for presenting you interesting topics for a thesis in the area of Life course epidemiology. Concerning questions on theses, you might of course also contact one of our research staff.

Internships and Ph.D. opportunities

If you are interested in internships or Ph.D., we welcome outstanding graduate students to our institution, to participate in research on a wide range of national and international public health issues. The core research areas include:

  • PhDs will have to major in Epidemiology (with specific areas of interest from the list below) or other areas listed.
    • Health of Children and Families
    • Social Determinants of Health
    • Clean Energy and Health
    • Environmental health
    • Noncommunicable Diseases
  • Universal Health Coverage
  • Global Health
  • Public Health Legislations and Ethics
  • Surveillance, Health Security & International regulations
  • Role of Technology in health

Some of the profiles of interns are listed here: Interns

Click here for currently enrolled Ph.D. students: Ph.D. fellows

For eligibility and application process, please contact our project staff.

Research

The focus of my research is through the realization of the following objectives. (1) Generating evidence regarding the parental and psychosocial environment of NCDs; (2) Exploring the appropriate interventions through pilot projects; and (3) Ensuring evidence-based public health policy planning and implementation. Objectives (1) and (2) help in identification and prioritization of parental determinants of childhood susceptibility to NCDs. The evidence available in the next three years will aid in the generation of rigorous, feasible, and contextually specific population-based pilot interventions. The objective (3) will be achieved through the implementation of pilot interventions based on objectives (1) and (2). The three objectives together will contribute to logical and empirically grounded choices of public health interventions.

The role of psychosocial environment in NCDs: The role of psychosocial and environmental risk factors and their associations with hypertension was unclear, as the findings from observational studies were largely inconsistent. Earlier evidence had indicated the poor association between psychological stress and coronary heart disease (CHD). This indicated that the impact of job strain on CHD is lower than that of other established risk factors, such as smoking, abdominal obesity, and physical inactivity. I hypothesized that job strain does not directly result in CHD, and affects CHD only by initiating hypertension. I led a systematic review and meta-analysis and found that job strain and hypertension were positively associated. Based on this finding, the effect of job strain in the etiology is confirmed for the first time. In continuation of this information, I am investigating the role of maternal psychosocial stressors in identifying the early markers of NCDs. We have found the high burden of psychosocial stressors in pregnant women, and are in advanced stages of investigation to know the outcome of their children.

Hyperglycemia in Pregnancy and risk of chronic diseases: The carbohydrate ‘fuel’ metabolism in a pregnant woman could have a long-term impact on the development of her offspring (‘fuel-mediated teratogenesis’ hypotheses).(1) In-utero exposure to maternal hyperglycemia can result in fetal hyperinsulinemia. The consequential increase in fetal fat cells can initiate a feed-forward loop of rising adiposity and hyperinsulinemia throughout childhood, leading to obesity and T2DM in later life. (2) Earlier studies demonstrated that the effect of maternal glucose concentrations on weight in children was “U- shaped”.(3) Our ongoing cohort study sets to advance this knowledge by looking at measures of infant and child adiposity with continuous levels of maternal glucose and connecting towards the evolution of NCD’s.(4) I am the P.I of the birth cohort in India, which is currently recruiting participants from public health facilities in India. This is the first birth cohort in India, which is examining the role of psychosocial and nutritional antecedents in pregnant women with early markers of NCDs in their children.

Ongoing Research Projects

  1. Giridhara R Babu (PI) Wellcome Trust-DBT India Alliance. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI). An Intermediate Fellowship. Hyperglycemia in Pregnancy and risk of chronic diseases. The aim of this study is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. More information
  2. Giridhara R Babu (PI). Department of Science and Technology. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India. The aim of this study is to prospectively assess the effects of ambient and indoor air pollutant levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the risks of chronic diseases in infants. More information
  3. Giridhara R Babu (PI), Department of Women and Child/UNICEF,  Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL). The aim of the state level intervention study is to study the impact of hot fully cooked meals provided to pregnant women in improving pregnancy and infant outcomes. More information

Some of the Completed Research Projects

  1. Giridhara R Babu (PI), Wellcome Trust-PHFI collaboration, 09/24/12 to 03/23/15. A Pilot Study to test the feasibility of a larger cohort study. To evaluate the feasibility of examining the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the risk of chronic diseases in infants.
  2. Giridhara R Babu (PI). The World Bank. 03/18/13 to 11/31/13. Development of Manual for health professionals- Non-Communicable Diseases and Standard Treatment Guidelines for Karnataka. The goal was to develop the guideline for health workers at different levels in the Karnataka State Health System.
  3. Giridhara R Babu (Co-PI), Government of Karnataka, 03/18/13 to 11/31/13, Human Resources in Health for Karnataka state. The goal was to provide the roadmap for management of health systems and reorganization of human resources required for the Karnataka State Health System.
  4. Giridhara R Babu (Co-PI), Government of Karnataka, 01/05/13 to 04/05/ Universal Health Coverage in Karnataka, Visioning UHC, Government of Karnataka. The goal of this study was to provide technical consultancy and assistance for rolling out of Universal Health Coverage in the pilot districts of Karnataka.
  5. Giridhara R Babu (PI), Ashoka Innovators for the Public, 06/01/13 to 11/31/13. Nutritional status in Karnataka. A state of the art review. The goal of this study is to review of existing national and state-specific program guidelines for conceptualization, designing, development and review the status of nutrition programs in Karnataka
  6. Giridhara R Babu (Co-I), World Health Organization. Participation for local action; Implementation research with indigenous communities in southern India for local action on improving maternal health services. The goal of the study is to facilitate contextualization of the safe motherhood program in remote areas with the indigenous population by bringing together various stakeholders to achieve inclusive and locally adapted implementation at the end of one year.

A list of projects is provided in this link

Public Health Practice

Activities

Teaching

Each year, I offer several courses in the areas of Basic Epidemiology, Advanced Epidemiology, Applied Epidemiology (Non-communicable diseases, communicable diseases, and Surveillance), and Introduction to Public Health, Universal Health Coverage for

  • Diploma Students
  • Masters Students and
  • Doctoral Students

Furthermore, I regularly offer short courses and visiting lectures, which allow students to complete required learning in their flexible time. This is part of the capacity building for public health professionals.

For the current list of courses for the current year: Please write to us. E-mail

Bachelor and Master’s Theses

For all students with an interest in Life course Epidemiology, I offer a wide range of research areas out of which a topic for a Bachelor- or Master thesis can be chosen. If you are interested, just write to my project staff and arrange an appointment to discuss. We will be available for presenting you interesting topics for a thesis in the area of Life course epidemiology. Concerning questions on theses, you might of course also contact one of our research staff.

Internships and Ph.D. opportunities

If you are interested in internships or Ph.D., we welcome outstanding graduate students to our institution, to participate in research on a wide range of national and international public health issues. The core research areas include:

  • PhDs will have to major in Epidemiology (with specific areas of interest from the list below) or other areas listed.
    • Health of Children and Families
    • Social Determinants of Health
    • Clean Energy and Health
    • Environmental health
    • Noncommunicable Diseases
  • Universal Health Coverage
  • Global Health
  • Public Health Legislations and Ethics
  • Surveillance, Health Security & International regulations
  • Role of Technology in health

Some of the profiles of interns are listed here: Interns

Click here for currently enrolled Ph.D. students: Ph.D. fellows

For eligibility and application process, please contact our project staff.

Research

The focus of my research is through the realization of the following objectives. (1) Generating evidence regarding the parental and psychosocial environment of NCDs; (2) Exploring the appropriate interventions through pilot projects; and (3) Ensuring evidence-based public health policy planning and implementation. Objectives (1) and (2) help in identification and prioritization of parental determinants of childhood susceptibility to NCDs. The evidence available in the next three years will aid in the generation of rigorous, feasible, and contextually specific population-based pilot interventions. The objective (3) will be achieved through the implementation of pilot interventions based on objectives (1) and (2). The three objectives together will contribute to logical and empirically grounded choices of public health interventions.

The role of psychosocial environment in NCDs: The role of psychosocial and environmental risk factors and their associations with hypertension was unclear, as the findings from observational studies were largely inconsistent. Earlier evidence had indicated the poor association between psychological stress and coronary heart disease (CHD). This indicated that the impact of job strain on CHD is lower than that of other established risk factors, such as smoking, abdominal obesity, and physical inactivity. I hypothesized that job strain does not directly result in CHD, and affects CHD only by initiating hypertension. I led a systematic review and meta-analysis and found that job strain and hypertension were positively associated. Based on this finding, the effect of job strain in the etiology is confirmed for the first time. In continuation of this information, I am investigating the role of maternal psychosocial stressors in identifying the early markers of NCDs. We have found the high burden of psychosocial stressors in pregnant women, and are in advanced stages of investigation to know the outcome of their children.

Hyperglycemia in Pregnancy and risk of chronic diseases: The carbohydrate ‘fuel’ metabolism in a pregnant woman could have a long-term impact on the development of her offspring (‘fuel-mediated teratogenesis’ hypotheses).(1) In-utero exposure to maternal hyperglycemia can result in fetal hyperinsulinemia. The consequential increase in fetal fat cells can initiate a feed-forward loop of rising adiposity and hyperinsulinemia throughout childhood, leading to obesity and T2DM in later life. (2) Earlier studies demonstrated that the effect of maternal glucose concentrations on weight in children was “U- shaped”.(3) Our ongoing cohort study sets to advance this knowledge by looking at measures of infant and child adiposity with continuous levels of maternal glucose and connecting towards the evolution of NCD’s.(4) I am the P.I of the birth cohort in India, which is currently recruiting participants from public health facilities in India. This is the first birth cohort in India, which is examining the role of psychosocial and nutritional antecedents in pregnant women with early markers of NCDs in their children.

Ongoing Research Projects

  1. Giridhara R Babu (PI) Wellcome Trust-DBT India Alliance. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI). An Intermediate Fellowship. Hyperglycemia in Pregnancy and risk of chronic diseases. The aim of this study is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. More information
  2. Giridhara R Babu (PI). Department of Science and Technology. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India. The aim of this study is to prospectively assess the effects of ambient and indoor air pollutant levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the risks of chronic diseases in infants. More information
  3. Giridhara R Babu (PI), Department of Women and Child/UNICEF,  Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL). The aim of the state level intervention study is to study the impact of hot fully cooked meals provided to pregnant women in improving pregnancy and infant outcomes. More information

 

Related Publications

  1. Thakur, M., Boudewijns, E.A., Giridhara R. Babu., Winkens, B., de Witte, L.P., Gruiskens, J., Sushama, P., Ghergu, C.T. and van Schayck, O.C., 2017. Low-smoke chulha in Indian slums: study protocol for a randomised controlled trial. BMC Public Health, 17(1), p.454.
  2. Giridhara R Babu, Nolita Saldanha , Anita Nath, Mohanbabu Rathnaiah, Deepa R, GVS Murthy, GM Vatsala, Anura V Kurpad, Sarah Benjamin Neelon ,Sanjay Kinra Determinants of Mental Health in Pregnant Women attending Public Health Facilities in Bangalore, India. (Under review)
  3. Giridhara R Babu, GVS Murthy, Deepa R, Yamuna, Nolita Saldanha, Prafulla, Maithili Karthik, Keerti Deshpande, Vatsala G, Sara E Benjamin Neelon, Anura Kurpad, Sanjay Kinra. Screening for Gestational Hyperglycemia in Public Health Facilities: Baseline Results from a Pilot Cohort Study. (Under review)
  4. Giridhara R Babu, GVS Murthy, Yamuna, Prital Patel, Deepa R, Sara E Benjamin Neelon, Sanjay Kinra , K Srinath Reddy. Association of Obesity with hypertension and Type-2 Diabetes Mellitus in India, A meta-analysis of observational studies. (Under review)
  5. Checkley, William, Suzanne L. Pollard, Trishul Siddharthan, Giridhara R. Babu, Megha Thakur, Catherine H. Miele, and Onno CP Van Schayck. “Managing threats to respiratory health in urban slums.” The Lancet Respiratory Medicine 4, no. 11 (2016): 852-854.
  6. Giridhara R. Babu, Murthy GVS, Deepa R, Yamuna, Prafulla, Kumar HK, Karthik M, Deshpande K, Benjamin Neelon SE, Prabhakaran D, Anura Kurpad, Sanjay Kinra. Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI):: a prospective cohort study. BMC Pregnancy and Childbirth 2016, 16(1):311.

Some of the Completed Research Projects

  1. Giridhara R Babu (PI), Wellcome Trust-PHFI collaboration, 09/24/12 to 03/23/15. A Pilot Study to test the feasibility of a larger cohort study. To evaluate the feasibility of examining the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the risk of chronic diseases in infants.
  2. Giridhara R Babu (PI). The World Bank. 03/18/13 to 11/31/13. Development of Manual for health professionals- Non-Communicable Diseases and Standard Treatment Guidelines for Karnataka. The goal was to develop the guideline for health workers at different levels in the Karnataka State Health System.
  3. Giridhara R Babu (Co-PI), Government of Karnataka, 03/18/13 to 11/31/13, Human Resources in Health for Karnataka state. The goal was to provide the roadmap for management of health systems and reorganization of human resources required for the Karnataka State Health System.
  4. Giridhara R Babu (Co-PI), Government of Karnataka, 01/05/13 to 04/05/ Universal Health Coverage in Karnataka, Visioning UHC, Government of Karnataka. The goal of this study was to provide technical consultancy and assistance for rolling out of Universal Health Coverage in the pilot districts of Karnataka.
  5. Giridhara R Babu (PI), Ashoka Innovators for the Public, 06/01/13 to 11/31/13. Nutritional status in Karnataka. A state of the art review. The goal of this study is to review of existing national and state-specific program guidelines for conceptualization, designing, development and review the status of nutrition programs in Karnataka
  6. Giridhara R Babu (Co-I), World Health Organization. Participation for local action; Implementation research with indigenous communities in southern India for local action on improving maternal health services. The goal of the study is to facilitate contextualization of the safe motherhood program in remote areas with the indigenous population by bringing together various stakeholders to achieve inclusive and locally adapted implementation at the end of one year.

A list of projects is provided in this link

Public Health Practice

A detailed page about Public Health Practice can be found in this link. Only selected exerpts are listed here.

Media articles and Mentions

A detailed page about articles in Media and mentions can be found in this link. Only selected exerpts are listed here.

Conferences and Workshops

  1. Giridhara R Babu, Association of quality of life and job stress in occupational workforce of India: A cross sectional study in software professionals. IEA regional Conference, Pokhara, Nepal.
  2. Giridhara R Babu, Tanmay Mahapatra, Roger Detels. Job Stress and Hypertension in Young Software professionals. South-East Asia Regional Public Health Conference. IPHACON 2013, Kolkotta. 1st-3rd February 2013
  3. Giridhara R Babu, Tanmay Mahapatra, Roger Detels. Sexual behaviour and association with occupational stress among software professionals of Bengaluru, India. Southeast Asia Regional Public Health Conference. IPHACON 2013, Kolkotta. 1st-3rd February 2013
  4. Giridhara R Babu, Jotheeswaran A Thiagarajan, Tanmay Mahapatra, Sanchita Mahapatra, Roger Detels. Job stress and hypertension: A systematic review and meta-analysis of observational studies. South-East Asia Regional Public Health Conference. IPHACON 2013, Kolkotta. 1st-3rd February 2013
  5. Giridhara R Babu. Job stress and hypertension: A systematic review and meta-analysis of observational studies. PHFI Research symposium, 5th January 2013.
  6. Giridhara R Babu. Sexual behaviour and association with occupational stress among software professionals of Bengaluru, India. PHFI Research symposium, 4th -5th January 2013.
  7. Giridhara R Babu. Job Stress and Hypertension in Young Software professionals’ PHFI Research symposium, 4th -5th January 2013.
  8. Giridhara R Babu, Keynote address on scope of public health and social work in India. Public Health and Social work in International settings. International conference on Global Public Health and Social work- DYUTI 2013. 4 January 2013
  9. Giridhara R Babu, Social Determinants of Health, Right to Health & Health Equity. International conference on Global Public Health and Social work- DYUTI 2013. 5 January 2013
  10. Giridhara R Babu, Analysis of Universal Health Coverage and Pointers for Future”. 3rd November 2012. 24th Annual Conference of KACH. Karnataka Association of Community Health Professionals. Bagalkote, India.
  11. Giridhara R Babu, Public Health Cadre in the state of Karnataka, Indian Public Health Association Annual Conference, Kochi, 13-14th February, 2012.
  12. Ghosh, P, Arah, OA, Talukdar, A, Sur, D, Giridhara R Babu, Sengupta, P, Detels, R. Factors associated with HIV infection among Indian women. In: Translation Research on HIV and AIDS in India (TRAI); 2011, 13th – 14th January; Panaji, India.
  13. Giridhara R Babu, Strengthening Public Health Education in India – Epidemiology Training, organized by Public 
health foundation of India and Deakin University, IIPH-Delhi.
  14. Giridhara R Babu Public Health Foundation of India. 7th March 2011. Preliminary results on
study of Job Stress and Hypertension in IT professionals. Research symposium, Hyderabad, 2012.

Education

  • Core Discipline

    • Ph.D. (Epidemiology), University of California (UCLA), Los Angeles.
    • MPH: Masters in Public Health (Epidemiology), University of California (UCLA).
    • MBBS: Bachelor of Medicine and Bachelor of Surgery, Kasturba Medical College, Manipal
  • Other 

  • MBA: (Hospital and health Administration), IBMR, TASMAC, Pune.
  • PGMLE: Post Graduate Diploma in Medical Law & Ethics, National Law School of India University, Bangalore

 

Education

  • Ph.D. (Epidemiology), University of California (UCLA), Los Angeles.
  • MPH: Masters in Public Health (Epidemiology), University of California (UCLA).
  • MBA: (Hospital and health Administration), IBMR, TASMAC, Pune.
  • PGMLE: Post Graduate Diploma in Medical Law & Ethics, National Law School of India University, Bangalore
  • MBBS: Bachelor of Medicine and Bachelor of Surgery, Kasturba Medical College, Manipal

 

Research

Statement of Research Interests 

In Asia, there is an imperative need to implement the practice of evidence-based public health policy, planning, and spending. My earlier and ongoing research provides the appropriate evidence, which can guide the formulation of policy to bring in positive change that we can see in our lifetime. I am focused shaping my career towards independence and in building a long-term career in academic public health. Therefore, my future research plan is dedicated to exploring the impact of tackling determinants in the maternal and psychosocial environment and thereby promote positive health in populations through appropriate interventions.

The focus of my research is through the realization of the following objectives.

  1. Generating evidence regarding maternal and psychosocial environment of NCDs
  2. Explore the appropriate interventions through pilot projects
  3. Ensuring evidence-based public health policy planning and implementation

Objectives (a) and (b) help in identification and prioritization of maternal determinants of childhood obesity (and subsequent risk of diabetes and hypertension) in Asia.  The evidence available in the next three years will aid in the generation of rigorous, feasible and contextually specific population-based pilot interventions. The objective (c) will be achieved through the implementation of pilot interventions based on objectives (a) & (b). The three objectives together will contribute to logical and empirically grounded choices of public health interventions.

In the next few years, I want to pilot the interventions based on the results of the research on the role of the maternal and psychosocial environment of NCDs in different populations. The overall results from testing the interventions will result in the implementation of evidence-based public health. In the next 5 years, I wish to inculcate the evidence into policy formulations at the national and international level to influence policymakers to bring positive changes with respect to NCD prevention and control. Due to demographic transition and lifestyle changes, the aging Asian populations continually are affected by NCDs. My engagement of research and advocacy in NCDs will aid in improving the health of an aging population and improve productivity. I am uniquely positioned to study the effects from an intergenerational perspective and earnestly believe that the positive changes will see the transformation of societies in the next two decades. Therefore, my long-term goal is to ensure healthy populations are sustained through integrated technical and advocacy efforts. My track record of working in public health over 17 years has provided a clear resolve for the achieving the objectives listed above.

Ongoing Research Projects.

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance: Link1 Link2 Link3
  2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 
  3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

Details of the Ongoing Research Projects

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance: Link1 LinkLink3

India is experiencing an epidemic of obesity-hyperglycaemia, which can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, Currently, we are recruiting women in a birth cohort since April 2016. The protocol of the study documents the processes which aim at advancing the available knowledge, linking several steps in the evolution of obesity led hyperglycemia.

Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) is a cohort study in the public health facilities in Bangalore, India. The objective of MAASTHI is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. The primary objective of the proposed study is to investigate the effect of glucose levels in pregnancy on skinfold thickness (adiposity) in infancy as a marker of future obesity and diabetes in offspring. The secondary objective is to assess the association between the psychosocial environment of mothers and adverse neonatal outcomes including adiposity. The study aims to recruit 5000 pregnant women and follow them and their offspring for a period of 4 years.

The carbohydrate ‘fuel’ metabolism in a pregnant woman may have a long-term impact on the development of her offspring (‘fuel-mediated teratogenesis’ hypothesis) including in utero exposure to maternal hyperglycemia leading to fetal hyperinsulinemia, and the consequent increase in fetal fat cells. Therefore, a feed-forward loop can exist of rising adiposity and hyperinsulinemia throughout childhood, perhaps leading to obesity and diabetes in later life. There is a need for prospective examination of body fat distribution in children born to mothers with different glycemic levels to understand the plausible association between glucose metabolism and future risk of diabetes in offspring.

We published detailed protocols of the study and pilot in open access peer-reviewed journals. (BMC,  BMJOpen)  In order to extend the recruitment, complete the follow-up and create a bio-repository, I have been awarded intermediate fellowship from Wellcome trust-DBT India alliance. With the funding support of WT-DBT India alliance, I am currently expanding the cohort study to aim to recruit more than 3000 pregnant women. Extending the study to multiple centers will provide the robust data for valid inferences.

Accomplishments

  • The knowledge from this study may be extremely important for developing an effective strategy for the control of the obesity-hyperglycaemia epidemic in low-income and middle-income countries. The results from our study can provide insights into the relation of adiposity during infancy and childhood into adult adiposity and Type 2 Diabetes Mellitus (T2DM).
  • We have been able to recruit more than 700 pregnant women. All women have undergone Hb and OGTT (Fasting and 2 Hr PPBS with 75g glucose).
  • Additional funding requests are underway for expansion of the birth cohort and for testing the additional hypotheses.

Publications from this project are as follows:- (also visit, publications)

  • Babu, G. R., Garadi, L., Murthy, G. V. S., & Kinra, S. (2014). Effect of hyperglycemia in pregnancy on adiposity in their infants in India: a protocol of a multicentre cohort study. BMJ open, 4(6), e005417.
  • Babu, G R., B. Tejaswi, M. Kalavathi, G. M. Vatsala, G. V. S. Murthy, Sanjay Kinra, and Sara E. Benjamin Neelon. “Assessment of screening practices for gestational hyperglycemia in public health facilities: a descriptive study in Bangalore, India.” Journal of Public Health Research 4, no. 1 (2015).
  • Babu GR, Murthy GV, Deepa R, Kumar HK, Karthik M, Deshpande K, Neelon SE, Prabhakaran D, Kurpad A, Kinra S. Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study. BMC pregnancy and childbirth. 2016 Oct 14;16(1):311.
  • Giridhara R Babu, GVS Murthy, R Deepa, A Yamuna, Nolita Saldanha, Prafulla Shriyan, Maithili Karthik, Keerthi Deshpande, Sara E Benjamin Neelon, Anura Kurpad, Sanjay Kinra. Screening for Gestational Hyperglycemia in Public Hospitals: Baseline Results from piloting MAASTHI, a Cohort Study. BMC Pregnancy and Childbirth (In Press)
  • “Association of Obesity with hypertension and Type-2 Diabetes Mellitus in India A meta-analysis of observational studies”  (In Peer review)
  • Two more papers in review

2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 

Understanding the relation between maternal nutrition and birth outcomes provides a basis for developing nutritional interventions that will improve- birth outcomes, childhood growth and development long-term quality of life and reduce mortality, morbidity, and health-care costs. To address the issue of maternal undernutrition and consequential adverse effects on birth outcomes or growth of children, Department of Women and Child Development, Government of Karnataka is piloting a new strategy on the provision of One full meal served to Pregnant and Lactating mothers at AWC along with IFA supplement in order to ensure consumption the food meeting 40% of the day’s nutrient requirement. This initiative provides a unique opportunity to understand the impact of nutritious food on pregnancy outcome and child development.

 Primary Objective The overall aim of the intervention study is to study the impact of hot fully cooked meals provided to pregnant women in improving pregnancy and infant outcomes.

Secondary Objectives

  • To estimate the impact of the intervention on change in mean Hb% in the intervention arm compared to control arm.
  • To estimate the impact of the intervention on weight for length in the intervention arm compared to control arm.

3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

*Under Development*

Details of Earlier Research

[2009-2012, University of California Los Angeles]

Summary: Hypertension is a major contributor to the worldwide epidemic of cardiovascular disease (CVD).[1,2] It is estimated that hypertension causes 7.5 million deaths worldwide amounting to 12.8% of the total of all annual deaths.[3] Many risk factors leading to hypertension are modifiable and therefore provide an opportunity for preventive efforts.[4] There is an imperative need for population-based research to understand the modifiable factors such as job stress in leading to Hypertension.[4] I chose workplace settings for the research as they provide opportunities to explore determinants of these negative behaviors and are amenable to interventions.[1]

I led a moderately large study (N = 1071) in the software professionals in Bangalore, India employed at 27 different IT companies. The focus of our study was to study the association of Job stress and Hypertension as well as understanding the on the age gradient of hypertension prevalence. The research established a higher prevalence of hypertension in the younger age cohort, affecting 31% professionals with 5% having malignant levels of hypertension. It was known earlier that south Asians are predisposed to be hypertensive a decade earlier compared the developed countries.[6] Our research suggested that hypertension in IT/ITES professionals occurs a decade earlier compared to the rest of India and two decades earlier compared to developed countries.[7] This suggests that if untreated, these professionals would go on to develop cardiovascular diseases (CVD) at an early age. The results also indicated that 46% of professionals were in pre-hypertension. In addition, I found that the dimensions of workplace autonomy and workplace environment are associated with hypertension.

Accomplishments

  1. The earlier understanding was that the association between job strain and coronary heart disease (CHD) is weak, with job strain slightly increasing the risk of coronary diseases by 3.4% in the general population.[9] Our meta-analysis showed statistically significant associations with 30% higher risk of hypertension for those with job strain. This proves that job strain might be affecting the CHDs through hypertension. The paper on the meta-analysis of job stress and hypertension, therefore, is a significant contribution to the body of literature and would influence future research delineating the effects of stress on CHDs. As a testimony to the impact of the paper, the original paper by us was republished by the BMJ group in their postgraduate medical journal.
  2. It is important that individuals with higher stress have to change their lifestyle to prevent a progressive rise in BP using the recommended lifestyle modifications. [8] As a result of the findings from the study, the software companies have approached us and have requested to engage with them for improving health outcomes. I am in discussion with a major IT company to finalize the details of engagement towards improving the health of the employees.
  3. I have published extensively on this work. The Publications from this project are as follows.
    1. Babu, Giridhara R., et al. “Republished: Is hypertension associated with job strain? A meta-analysis of observational studies.” Postgraduate Medical Journal 90.1065 (2014): 402-409.
    2. Giridhara R Babu, T. Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
    3. Babu GR, Jotheeswaran A, Mahapatra T, Mahapatra S, Kumar A SR, Detels R, Pearce N. Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med. 2014 Mar; 71(3):220-7. doi: 10.1136/oemed-2013-101396. Epub 2013 Sep 24.
    4. Babu GR, Mahapatra T, Mahapatra S, Detels R. Sexual behavior and job stress in software professionals, Bengaluru – India. Indian J Occup Environ Med. 2013 May; 17(2):58-65. doi: 10.4103/0019-5278.123165.
    5. Babu GR, Mahapatra T, Detels R. Application of mixed methods for exploration of the association of job stress and hypertension among software professionals in Bengaluru, India. Indian J Occup Environ Med. 2013 May; 17(2):41-7. doi: 10.4103/0019-5278.123160.
    6. Babu GR. Prevalence of Job Stress, General Health Profile, and Hypertension Among Professionals in the Information Technology Sector in Bengaluru, India. Los Angeles: University of California, Los Angeles; 2012.
    7. Babu GR, Detels R. Prioritizing Social Actions And Involving Community For Prevention Of The Non-Communicable Diseases. The Internet Journal of Epidemiology. 2011;9(2).
    8. Giridhara R Babu, Sathyanarayana T N, Snehendu B Kar, Roger Detels. Perceived occupational stressors and the health of Software Professionals in Bengaluru, India. The Qualitative Report.
  4. Subsequent to the study in software professionals, we have now conducted the study in schoolteachers and employees of the health department. These studies are helping us to collate evidence on the worksite-based burden of NCDs and are helpful in designing the appropriate interventions. A series of papers are pending for publications on the burden of the diseases in different workgroups.
    1. Parimala, Giridhara R Babu, The Burden of Diabetes And Hypertension in the staff working in Directorate Of Health And Family Welfare Services, Bengaluru, Karnataka. [In press]
    2. Manjula, Sarin S, Giridhara R Babu. Prevalence of Diabetes Mellitus in School teachers of Bengaluru. [In press]
    3. Sudha BK, Sarin S, Giridhara R Babu Prevalence of Hypertension in School teachers of Bengaluru. [In press]

References for Details of Earlier Research:

  1. Giridhara R Babu, Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
  2. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365:217–23.
  3. World Health Organization. Global Health Risks: mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization, 2010; 2009.
  4. Srinath RK. Protecting the heart of global development. Heart Beat, The World Heart Federation Newsletter. 2005. Jun, [Last accessed on 2014 Jan 10].
  5. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104:2855–64.
  6. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436–42.
  7. Reddy KS. India wakes up to the threat of cardiovascular diseases. J Am Coll Cardiol. 2007;50:1370–2.
  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.
  9. Kivimäkii M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary 
heart disease: a collaborative meta-analysis of individual participant data. Lancet 
2012;380:1491–7.

The research publications are listed in this link: Publications

Advocacy is provided in this link: Links

Professional Memberships

 

Research

Summary of the Current Research

Research Focus

In Asia, there is an imperative need to implement the practice of evidence-based public health policy, planning, and spending. My earlier and ongoing research provides the appropriate evidence, which can guide the formulation of policy to bring in positive change that we can see in our lifetime. I am focused shaping my career towards independence and in building a long-term career in academic public health. Therefore, my future research plan is dedicated to exploring the impact of tackling determinants in the maternal and psychosocial environment and thereby promote positive health in populations through appropriate interventions.

The focus of my research is through the realization of the following objectives.

  1. Generating evidence regarding maternal and psychosocial environment of NCDs
  2. Explore the appropriate interventions through pilot projects
  3. Ensuring evidence-based public health policy planning and implementation

Objectives (a) and (b) help in identification and prioritization of maternal determinants of childhood obesity (and subsequent risk of diabetes and hypertension) in Asia.  The evidence available in the next three years will aid in the generation of rigorous, feasible and contextually specific population-based pilot interventions. The objective (c) will be achieved through the implementation of pilot interventions based on objectives (a) & (b). The three objectives together will contribute to logical and empirically grounded choices of public health interventions.

In the next 2-3 years, I want to pilot the interventions based on the results of the research on the role of the maternal and psychosocial environment of NCDs in different populations. The overall results from testing the interventions will result in the implementation of evidence-based public health. In the next 5 years, I wish to inculcate the evidence into policy formulations at the national and international level to influence policymakers to bring positive changes with respect to NCD prevention and control. Due to demographic transition and lifestyle changes, the aging Asian populations continually are affected by NCDs. My engagement of research and advocacy in NCDs will aid in improving the health of an aging population and improve productivity. I am uniquely positioned to study the effects from an intergenerational perspective and earnestly believe that the positive changes will see the transformation of societies in the next two decades. Therefore, my long-term goal is to ensure healthy populations are sustained through integrated technical and advocacy efforts. My track record of working in public health over 17 years has provided a clear resolve for the achieving the objectives listed above.

Ongoing Research Projects [PHFI, Bengaluru campus]

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance : Link1 Link2 Link3
  2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 
  3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

Details of the Ongoing Research Projects

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance Link1 LinkLink3

India is experiencing an epidemic of obesity-hyperglycaemia, which can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, Currently, we are recruiting women in a birth cohort since April 2016. The protocol of the study documents the processes which aim at advancing the available knowledge, linking several steps in the evolution of obesity led hyperglycemia.

Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) is a cohort study in the public health facilities in Bangalore, India. The objective of MAASTHI is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. The primary objective of the proposed study is to investigate the effect of glucose levels in pregnancy on skinfold thickness (adiposity) in infancy as a marker of future obesity and diabetes in offspring. The secondary objective is to assess the association between the psychosocial environment of mothers and adverse neonatal outcomes including adiposity. The study aims to recruit 5000 pregnant women and follow them and their offspring for a period of 4 years.

The carbohydrate ‘fuel’ metabolism in a pregnant woman may have a long-term impact on the development of her offspring (‘fuel-mediated teratogenesis’ hypothesis) including in utero exposure to maternal hyperglycaemia leading to fetal hyperinsulinaemia, and the consequent increase in fetal fat cells. Therefore, a feed-forward loop can exist of rising adiposity and hyperinsulinaemia throughout childhood, perhaps leading to obesity and diabetes in later life. There is a need for prospective examination of body fat distribution in children born to mothers with different glycemic levels to understand the plausible association between glucose metabolism and future risk of diabetes in offspring.

We published detailed protocols of the study and pilot in open access peer reviewed journals. (BMC,  BMJOpen)  In order to extend the recruitment, complete the follow-up and create a bio-repository, I have been awarded intermediate fellowship from Wellcome trust-DBT India alliance. With the funding support of WT-DBT India alliance, I am currently expanding the cohort study to aim to recruit more than 3000 pregnant women. Extending the study to multiple centres will provide the robust data for valid inferences.

Accomplishments

  • The knowledge from this study may be extremely important for developing an effective strategy for the control of the obesity-hyperglycaemia epidemic in low-income and middle-income countries. The results from our study can provide insights into the relation of adiposity during infancy and childhood into adult adiposity and Type 2 Diabetes Mellitus (T2DM).
  • We have been able to recruit more than 700 pregnant women. All women have undergone Hb and OGTT (Fasting and 2 Hr PPBS with 75g glucose).
  • Additional funding requests are underway for expansion of the birth cohort and for testing additional hypothesis.

Publications from this project are as follows:- (also visit, publications)

  • Babu, G. R., Garadi, L., Murthy, G. V. S., & Kinra, S. (2014). Effect of hyperglycaemia in pregnancy on adiposity in their infants in India: a protocol of a multicentre cohort study. BMJ open, 4(6), e005417.
  • Babu, G R., B. Tejaswi, M. Kalavathi, G. M. Vatsala, G. V. S. Murthy, Sanjay Kinra, and Sara E. Benjamin Neelon. “Assessment of screening practices for gestational hyperglycaemia in public health facilities: a descriptive study in Bangalore, India.” Journal of Public Health Research 4, no. 1 (2015).
  • Babu GR, Murthy GV, Deepa R, Kumar HK, Karthik M, Deshpande K, Neelon SE, Prabhakaran D, Kurpad A, Kinra S. Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study. BMC pregnancy and childbirth. 2016 Oct 14;16(1):311.
  • Giridhara R Babu, GVS Murthy, R Deepa, A Yamuna, Nolita Saldanha, Prafulla Shriyan, Maithili Karthik, Keerthi Deshpande, Sara E Benjamin Neelon, Anura Kurpad, Sanjay Kinra. Screening for Gestational Hyperglycemia in Public Hospitals: Baseline Results from piloting MAASTHI, a Cohort Study. BMC Pregnancy and Childbirth (In Press)
  • “Association of Obesity with hypertension and Type-2 Diabetes Mellitus in India A meta-analysis of observational studies”  (In Peer review)
  • Two more papers in review

2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 

*Under Development*

3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

*Under Development*

Details of Earlier Research

[2009-2012, University of California Los Angeles]

Summary: Hypertension is a major contributor to the worldwide epidemic of cardiovascular disease (CVD).[1,2] It is estimated that hypertension causes 7.5 million deaths worldwide amounting to 12.8% of the total of all annual deaths.[3] Many risk factors leading to hypertension are modifiable and therefore provide an opportunity for preventive efforts.[4] There is an imperative need for population-based research to understand the modifiable factors such as job stress in leading to Hypertension.[4] I chose workplace settings for the research as they provide opportunities to explore determinants of these negative behaviors and are amenable to interventions.[1]

I led a moderately large study (N = 1071) in the software professionals in Bangalore, India employed at 27 different IT companies. The focus of our study was to study the association of Job stress and Hypertension as well as understanding the on the age gradient of hypertension prevalence. The research established higher prevalence of hypertension in the younger age cohort, affecting 31% professionals with 5% having malignant levels of hypertension. It was known earlier that south Asians are predisposed to be hypertensive a decade earlier compared the developed countries.[6] Our research suggested that hypertension in IT/ITES professionals occurs a decade earlier compared to the rest of India and two decades earlier compared to developed countries.[7] This suggests that if untreated, these professionals would go on to develop cardiovascular diseases (CVD) at an early age. The results also indicated that 46% of professionals were in pre-hypertension. In addition, I found that the dimensions of workplace autonomy and workplace environment are associated with hypertension.

 

Accomplishments

  1. The earlier understanding was that the association between job strain and coronary heart disease (CHD) is weak, with job strain slightly increasing the risk of coronary diseases by 3.4% in the general population.[9] Our meta-analysis showed statistically significant associations with 30% higher risk of hypertension for those with job strain. This proves that job strain might be affecting the CHDs through hypertension. The paper on the meta-analysis of job stress and hypertension, therefore, is a significant contribution to the body of literature and would influence future research delineating the effects of stress on CHDs. As a testimony to the impact of the paper, the original paper by us was republished by the BMJ group in their postgraduate medical journal.
  2. It is important that individuals with higher stress have to change their lifestyle to prevent a progressive rise in BP using the recommended lifestyle modifications. [8] As a result of the findings from the study, the software companies have approached us and have requested to engage with them for improving health outcomes. I am in discussion with a major IT company to finalize the details of engagement towards improving the health of the employees.
  3. I have published extensively on this work. The Publications from this project are as follows.
    1. Babu, Giridhara R., et al. “Republished: Is hypertension associated with job strain? A meta-analysis of observational studies.” Postgraduate Medical Journal 90.1065 (2014): 402-409.
    2. Giridhara R Babu, T. Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
    3. Babu GR, Jotheeswaran A, Mahapatra T, Mahapatra S, Kumar A SR, Detels R, Pearce N. Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med. 2014 Mar; 71(3):220-7. doi: 10.1136/oemed-2013-101396. Epub 2013 Sep 24.
    4. Babu GR, Mahapatra T, Mahapatra S, Detels R. Sexual behavior and job stress in software professionals, Bengaluru – India. Indian J Occup Environ Med. 2013 May; 17(2):58-65. doi: 10.4103/0019-5278.123165.
    5. Babu GR, Mahapatra T, Detels R. Application of mixed methods for exploration of the association of job stress and hypertension among software professionals in Bengaluru, India. Indian J Occup Environ Med. 2013 May; 17(2):41-7. doi: 10.4103/0019-5278.123160.
    6. Babu GR. Prevalence of Job Stress, General Health Profile, and Hypertension Among Professionals in the Information Technology Sector in Bengaluru, India. Los Angeles: University of California, Los Angeles; 2012.
    7. Babu GR, Detels R. Prioritizing Social Actions And Involving Community For Prevention Of The Non-Communicable Diseases. The Internet Journal of Epidemiology. 2011;9(2).
    8. Giridhara R Babu, Sathyanarayana T N, Snehendu B Kar, Roger Detels. Perceived occupational stressors and the health of Software Professionals in Bengaluru, India. The Qualitative Report.
  4. Subsequent to the study in software professionals, we have now conducted the study in schoolteachers and employees of the health department. These studies are helping us to collate evidence on the worksite-based burden of NCDs and are helpful in designing the appropriate interventions. A series of papers are pending for publications on the burden of the diseases in different workgroups.
    1. Parimala, Giridhara R Babu, The Burden of Diabetes And Hypertension in the staff working in Directorate Of Health And Family Welfare Services, Bengaluru, Karnataka. [In press]
    2. Manjula, Sarin S, Giridhara R Babu. Prevalence of Diabetes Mellitus in School teachers of Bengaluru. [In press]
    3. Sudha BK, Sarin S, Giridhara R Babu Prevalence of Hypertension in School teachers of Bengaluru. [In press]

References for Details of Earlier Research:

  1. Giridhara R Babu, Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
  2. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365:217–23.
  3. World Health Organization. Global Health Risks: mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization, 2010; 2009.
  4. Srinath RK. Protecting the heart of global development. Heart Beat, The World Heart Federation Newsletter. 2005. Jun, [Last accessed on 2014 Jan 10].
  5. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104:2855–64.
  6. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436–42.
  7. Reddy KS. India wakes up to the threat of cardiovascular diseases. J Am Coll Cardiol. 2007;50:1370–2.
  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.
  9. Kivimäkii M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary 
heart disease: a collaborative meta-analysis of individual participant data. Lancet 
2012;380:1491–7.

 

The research publications are listed in this link: Publications

Advocacy is provided in this link: Links

Professional Memberships

Statement of Research Interests 

In Asia, there is an imperative need to implement the practice of evidence-based public health policy, planning, and spending. My earlier and ongoing research provides the appropriate evidence, which can guide the formulation of policy to bring in positive change that we can see in our lifetime. I am focused shaping my career towards independence and in building a long-term career in academic public health. Therefore, my future research plan is dedicated to exploring the impact of tackling determinants in the maternal and psychosocial environment and thereby promote positive health in populations through appropriate interventions.

The focus of my research is through the realization of the following objectives.

  1. Generating evidence regarding maternal and psychosocial environment of NCDs
  2. Explore the appropriate interventions through pilot projects
  3. Ensuring evidence-based public health policy planning and implementation

Objectives (a) and (b) help in identification and prioritization of maternal determinants of childhood obesity (and subsequent risk of diabetes and hypertension) in Asia.  The evidence available in the next three years will aid in the generation of rigorous, feasible and contextually specific population-based pilot interventions. The objective (c) will be achieved through the implementation of pilot interventions based on objectives (a) & (b). The three objectives together will contribute to logical and empirically grounded choices of public health interventions.

In the next few years, I want to pilot the interventions based on the results of the research on the role of the maternal and psychosocial environment of NCDs in different populations. The overall results from testing the interventions will result in the implementation of evidence-based public health. In the next 5 years, I wish to inculcate the evidence into policy formulations at the national and international level to influence policymakers to bring positive changes with respect to NCD prevention and control. Due to demographic transition and lifestyle changes, the aging Asian populations continually are affected by NCDs. My engagement of research and advocacy in NCDs will aid in improving the health of an aging population and improve productivity. I am uniquely positioned to study the effects from an intergenerational perspective and earnestly believe that the positive changes will see the transformation of societies in the next two decades. Therefore, my long-term goal is to ensure healthy populations are sustained through integrated technical and advocacy efforts. My track record of working in public health over 17 years has provided a clear resolve for the achieving the objectives listed above.

Ongoing Research Projects [PHFI, Bengaluru campus]

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance: Link1 Link2 Link3
  2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 
  3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

Details of the Ongoing Research Projects

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance: Link1 LinkLink3

India is experiencing an epidemic of obesity-hyperglycaemia, which can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, Currently, we are recruiting women in a birth cohort since April 2016. The protocol of the study documents the processes which aim at advancing the available knowledge, linking several steps in the evolution of obesity led hyperglycemia.

Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) is a cohort study in the public health facilities in Bangalore, India. The objective of MAASTHI is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. The primary objective of the proposed study is to investigate the effect of glucose levels in pregnancy on skinfold thickness (adiposity) in infancy as a marker of future obesity and diabetes in offspring. The secondary objective is to assess the association between the psychosocial environment of mothers and adverse neonatal outcomes including adiposity. The study aims to recruit 5000 pregnant women and follow them and their offspring for a period of 4 years.

The carbohydrate ‘fuel’ metabolism in a pregnant woman may have a long-term impact on the development of her offspring (‘fuel-mediated teratogenesis’ hypothesis) including in utero exposure to maternal hyperglycemia leading to fetal hyperinsulinemia, and the consequent increase in fetal fat cells. Therefore, a feed-forward loop can exist of rising adiposity and hyperinsulinemia throughout childhood, perhaps leading to obesity and diabetes in later life. There is a need for prospective examination of body fat distribution in children born to mothers with different glycemic levels to understand the plausible association between glucose metabolism and future risk of diabetes in offspring.

We published detailed protocols of the study and pilot in open access peer-reviewed journals. (BMC,  BMJOpen)  In order to extend the recruitment, complete the follow-up and create a bio-repository, I have been awarded intermediate fellowship from Wellcome trust-DBT India alliance. With the funding support of WT-DBT India alliance, I am currently expanding the cohort study to aim to recruit more than 3000 pregnant women. Extending the study to multiple centers will provide the robust data for valid inferences.

Accomplishments

  • The knowledge from this study may be extremely important for developing an effective strategy for the control of the obesity-hyperglycaemia epidemic in low-income and middle-income countries. The results from our study can provide insights into the relation of adiposity during infancy and childhood into adult adiposity and Type 2 Diabetes Mellitus (T2DM).
  • We have been able to recruit more than 700 pregnant women. All women have undergone Hb and OGTT (Fasting and 2 Hr PPBS with 75g glucose).
  • Additional funding requests are underway for expansion of the birth cohort and for testing the additional hypotheses.

Publications from this project are as follows:- (also visit, publications)

  • Babu, G. R., Garadi, L., Murthy, G. V. S., & Kinra, S. (2014). Effect of hyperglycemia in pregnancy on adiposity in their infants in India: a protocol of a multicentre cohort study. BMJ open, 4(6), e005417.
  • Babu, G R., B. Tejaswi, M. Kalavathi, G. M. Vatsala, G. V. S. Murthy, Sanjay Kinra, and Sara E. Benjamin Neelon. “Assessment of screening practices for gestational hyperglycemia in public health facilities: a descriptive study in Bangalore, India.” Journal of Public Health Research 4, no. 1 (2015).
  • Babu GR, Murthy GV, Deepa R, Kumar HK, Karthik M, Deshpande K, Neelon SE, Prabhakaran D, Kurpad A, Kinra S. Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study. BMC pregnancy and childbirth. 2016 Oct 14;16(1):311.
  • Giridhara R Babu, GVS Murthy, R Deepa, A Yamuna, Nolita Saldanha, Prafulla Shriyan, Maithili Karthik, Keerthi Deshpande, Sara E Benjamin Neelon, Anura Kurpad, Sanjay Kinra. Screening for Gestational Hyperglycemia in Public Hospitals: Baseline Results from piloting MAASTHI, a Cohort Study. BMC Pregnancy and Childbirth (In Press)
  • “Association of Obesity with hypertension and Type-2 Diabetes Mellitus in India A meta-analysis of observational studies”  (In Peer review)
  • Two more papers in review

2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 

*Under Development*

3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

*Under Development*

Details of Earlier Research

[2009-2012, University of California Los Angeles]

Summary: Hypertension is a major contributor to the worldwide epidemic of cardiovascular disease (CVD).[1,2] It is estimated that hypertension causes 7.5 million deaths worldwide amounting to 12.8% of the total of all annual deaths.[3] Many risk factors leading to hypertension are modifiable and therefore provide an opportunity for preventive efforts.[4] There is an imperative need for population-based research to understand the modifiable factors such as job stress in leading to Hypertension.[4] I chose workplace settings for the research as they provide opportunities to explore determinants of these negative behaviors and are amenable to interventions.[1]

I led a moderately large study (N = 1071) in the software professionals in Bangalore, India employed at 27 different IT companies. The focus of our study was to study the association of Job stress and Hypertension as well as understanding the on the age gradient of hypertension prevalence. The research established higher prevalence of hypertension in the younger age cohort, affecting 31% professionals with 5% having malignant levels of hypertension. It was known earlier that south Asians are predisposed to be hypertensive a decade earlier compared the developed countries.[6] Our research suggested that hypertension in IT/ITES professionals occurs a decade earlier compared to the rest of India and two decades earlier compared to developed countries.[7] This suggests that if untreated, these professionals would go on to develop cardiovascular diseases (CVD) at an early age. The results also indicated that 46% of professionals were in pre-hypertension. In addition, I found that the dimensions of workplace autonomy and workplace environment are associated with hypertension.

 

Accomplishments

  1. The earlier understanding was that the association between job strain and coronary heart disease (CHD) is weak, with job strain slightly increasing the risk of coronary diseases by 3.4% in the general population.[9] Our meta-analysis showed statistically significant associations with 30% higher risk of hypertension for those with job strain. This proves that job strain might be affecting the CHDs through hypertension. The paper on the meta-analysis of job stress and hypertension, therefore, is a significant contribution to the body of literature and would influence future research delineating the effects of stress on CHDs. As a testimony to the impact of the paper, the original paper by us was republished by the BMJ group in their postgraduate medical journal.
  2. It is important that individuals with higher stress have to change their lifestyle to prevent a progressive rise in BP using the recommended lifestyle modifications. [8] As a result of the findings from the study, the software companies have approached us and have requested to engage with them for improving health outcomes. I am in discussion with a major IT company to finalize the details of engagement towards improving the health of the employees.
  3. I have published extensively on this work. The Publications from this project are as follows.
    1. Babu, Giridhara R., et al. “Republished: Is hypertension associated with job strain? A meta-analysis of observational studies.” Postgraduate Medical Journal 90.1065 (2014): 402-409.
    2. Giridhara R Babu, T. Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
    3. Babu GR, Jotheeswaran A, Mahapatra T, Mahapatra S, Kumar A SR, Detels R, Pearce N. Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med. 2014 Mar; 71(3):220-7. doi: 10.1136/oemed-2013-101396. Epub 2013 Sep 24.
    4. Babu GR, Mahapatra T, Mahapatra S, Detels R. Sexual behavior and job stress in software professionals, Bengaluru – India. Indian J Occup Environ Med. 2013 May; 17(2):58-65. doi: 10.4103/0019-5278.123165.
    5. Babu GR, Mahapatra T, Detels R. Application of mixed methods for exploration of the association of job stress and hypertension among software professionals in Bengaluru, India. Indian J Occup Environ Med. 2013 May; 17(2):41-7. doi: 10.4103/0019-5278.123160.
    6. Babu GR. Prevalence of Job Stress, General Health Profile, and Hypertension Among Professionals in the Information Technology Sector in Bengaluru, India. Los Angeles: University of California, Los Angeles; 2012.
    7. Babu GR, Detels R. Prioritizing Social Actions And Involving Community For Prevention Of The Non-Communicable Diseases. The Internet Journal of Epidemiology. 2011;9(2).
    8. Giridhara R Babu, Sathyanarayana T N, Snehendu B Kar, Roger Detels. Perceived occupational stressors and the health of Software Professionals in Bengaluru, India. The Qualitative Report.
  4. Subsequent to the study in software professionals, we have now conducted the study in schoolteachers and employees of the health department. These studies are helping us to collate evidence on the worksite-based burden of NCDs and are helpful in designing the appropriate interventions. A series of papers are pending for publications on the burden of the diseases in different workgroups.
    1. Parimala, Giridhara R Babu, The Burden of Diabetes And Hypertension in the staff working in Directorate Of Health And Family Welfare Services, Bengaluru, Karnataka. [In press]
    2. Manjula, Sarin S, Giridhara R Babu. Prevalence of Diabetes Mellitus in School teachers of Bengaluru. [In press]
    3. Sudha BK, Sarin S, Giridhara R Babu Prevalence of Hypertension in School teachers of Bengaluru. [In press]

References for Details of Earlier Research:

  1. Giridhara R Babu, Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
  2. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365:217–23.
  3. World Health Organization. Global Health Risks: mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization, 2010; 2009.
  4. Srinath RK. Protecting the heart of global development. Heart Beat, The World Heart Federation Newsletter. 2005. Jun, [Last accessed on 2014 Jan 10].
  5. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104:2855–64.
  6. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436–42.
  7. Reddy KS. India wakes up to the threat of cardiovascular diseases. J Am Coll Cardiol. 2007;50:1370–2.
  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.
  9. Kivimäkii M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary 
heart disease: a collaborative meta-analysis of individual participant data. Lancet 
2012;380:1491–7.

 

The research publications are listed in this link: Publications

Advocacy is provided in this link: Links

Professional Memberships

Research

Statement of Research Interests 

In Asia, there is an imperative need to implement the practice of evidence-based public health policy, planning, and spending. My earlier and ongoing research provides the appropriate evidence, which can guide the formulation of policy to bring in positive change that we can see in our lifetime. I am focused shaping my career towards independence and in building a long-term career in academic public health. Therefore, my future research plan is dedicated to exploring the impact of tackling determinants in the maternal and psychosocial environment and thereby promote positive health in populations through appropriate interventions.

The focus of my research is through the realization of the following objectives.

  1. Generating evidence regarding maternal and psychosocial environment of NCDs
  2. Explore the appropriate interventions through pilot projects
  3. Ensuring evidence-based public health policy planning and implementation

Objectives (a) and (b) help in identification and prioritization of maternal determinants of childhood obesity (and subsequent risk of diabetes and hypertension) in Asia.  The evidence available in the next three years will aid in the generation of rigorous, feasible and contextually specific population-based pilot interventions. The objective (c) will be achieved through the implementation of pilot interventions based on objectives (a) & (b). The three objectives together will contribute to logical and empirically grounded choices of public health interventions.

In the next few years, I want to pilot the interventions based on the results of the research on the role of the maternal and psychosocial environment of NCDs in different populations. The overall results from testing the interventions will result in the implementation of evidence-based public health. In the next 5 years, I wish to inculcate the evidence into policy formulations at the national and international level to influence policymakers to bring positive changes with respect to NCD prevention and control. Due to demographic transition and lifestyle changes, the aging Asian populations continually are affected by NCDs. My engagement of research and advocacy in NCDs will aid in improving the health of an aging population and improve productivity. I am uniquely positioned to study the effects from an intergenerational perspective and earnestly believe that the positive changes will see the transformation of societies in the next two decades. Therefore, my long-term goal is to ensure healthy populations are sustained through integrated technical and advocacy efforts. My track record of working in public health over 17 years has provided a clear resolve for the achieving the objectives listed above.

Ongoing Research Projects .

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance: Link1 Link2 Link3
  2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 
  3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

Details of the Ongoing Research Projects

  1. Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI): a prospective cohort study. Funded by Wellcome Trust DBT India Alliance: Link1 LinkLink3

India is experiencing an epidemic of obesity-hyperglycaemia, which can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, Currently, we are recruiting women in a birth cohort since April 2016. The protocol of the study documents the processes which aim at advancing the available knowledge, linking several steps in the evolution of obesity led hyperglycemia.

Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) is a cohort study in the public health facilities in Bangalore, India. The objective of MAASTHI is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. The primary objective of the proposed study is to investigate the effect of glucose levels in pregnancy on skinfold thickness (adiposity) in infancy as a marker of future obesity and diabetes in offspring. The secondary objective is to assess the association between the psychosocial environment of mothers and adverse neonatal outcomes including adiposity. The study aims to recruit 5000 pregnant women and follow them and their offspring for a period of 4 years.

The carbohydrate ‘fuel’ metabolism in a pregnant woman may have a long-term impact on the development of her offspring (‘fuel-mediated teratogenesis’ hypothesis) including in utero exposure to maternal hyperglycemia leading to fetal hyperinsulinemia, and the consequent increase in fetal fat cells. Therefore, a feed-forward loop can exist of rising adiposity and hyperinsulinemia throughout childhood, perhaps leading to obesity and diabetes in later life. There is a need for prospective examination of body fat distribution in children born to mothers with different glycemic levels to understand the plausible association between glucose metabolism and future risk of diabetes in offspring.

We published detailed protocols of the study and pilot in open access peer-reviewed journals. (BMC,  BMJOpen)  In order to extend the recruitment, complete the follow-up and create a bio-repository, I have been awarded intermediate fellowship from Wellcome trust-DBT India alliance. With the funding support of WT-DBT India alliance, I am currently expanding the cohort study to aim to recruit more than 3000 pregnant women. Extending the study to multiple centers will provide the robust data for valid inferences.

Accomplishments

  • The knowledge from this study may be extremely important for developing an effective strategy for the control of the obesity-hyperglycaemia epidemic in low-income and middle-income countries. The results from our study can provide insights into the relation of adiposity during infancy and childhood into adult adiposity and Type 2 Diabetes Mellitus (T2DM).
  • We have been able to recruit more than 700 pregnant women. All women have undergone Hb and OGTT (Fasting and 2 Hr PPBS with 75g glucose).
  • Additional funding requests are underway for expansion of the birth cohort and for testing the additional hypotheses.

Publications from this project are as follows:- (also visit, publications)

  • Babu, G. R., Garadi, L., Murthy, G. V. S., & Kinra, S. (2014). Effect of hyperglycemia in pregnancy on adiposity in their infants in India: a protocol of a multicentre cohort study. BMJ open, 4(6), e005417.
  • Babu, G R., B. Tejaswi, M. Kalavathi, G. M. Vatsala, G. V. S. Murthy, Sanjay Kinra, and Sara E. Benjamin Neelon. “Assessment of screening practices for gestational hyperglycemia in public health facilities: a descriptive study in Bangalore, India.” Journal of Public Health Research 4, no. 1 (2015).
  • Babu GR, Murthy GV, Deepa R, Kumar HK, Karthik M, Deshpande K, Neelon SE, Prabhakaran D, Kurpad A, Kinra S. Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study. BMC pregnancy and childbirth. 2016 Oct 14;16(1):311.
  • Giridhara R Babu, GVS Murthy, R Deepa, A Yamuna, Nolita Saldanha, Prafulla Shriyan, Maithili Karthik, Keerthi Deshpande, Sara E Benjamin Neelon, Anura Kurpad, Sanjay Kinra. Screening for Gestational Hyperglycemia in Public Hospitals: Baseline Results from piloting MAASTHI, a Cohort Study. BMC Pregnancy and Childbirth (In Press)
  • “Association of Obesity with hypertension and Type-2 Diabetes Mellitus in India A meta-analysis of observational studies”  (In Peer review)
  • Two more papers in review

2. Full meal supplementation: Evaluation of Effect in Pregnant and Lactating women (FEEL): Funded by Department of Women and Child, Government of Karnataka 

*Under Development*

3. Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in Infants (APPLE); A cohort study in South India.  Funded by Department of Science & Technology, Government of India

*Under Development*

Details of Earlier Research

[2009-2012, University of California Los Angeles]

Summary: Hypertension is a major contributor to the worldwide epidemic of cardiovascular disease (CVD).[1,2] It is estimated that hypertension causes 7.5 million deaths worldwide amounting to 12.8% of the total of all annual deaths.[3] Many risk factors leading to hypertension are modifiable and therefore provide an opportunity for preventive efforts.[4] There is an imperative need for population-based research to understand the modifiable factors such as job stress in leading to Hypertension.[4] I chose workplace settings for the research as they provide opportunities to explore determinants of these negative behaviors and are amenable to interventions.[1]

I led a moderately large study (N = 1071) in the software professionals in Bangalore, India employed at 27 different IT companies. The focus of our study was to study the association of Job stress and Hypertension as well as understanding the on the age gradient of hypertension prevalence. The research established higher prevalence of hypertension in the younger age cohort, affecting 31% professionals with 5% having malignant levels of hypertension. It was known earlier that south Asians are predisposed to be hypertensive a decade earlier compared the developed countries.[6] Our research suggested that hypertension in IT/ITES professionals occurs a decade earlier compared to the rest of India and two decades earlier compared to developed countries.[7] This suggests that if untreated, these professionals would go on to develop cardiovascular diseases (CVD) at an early age. The results also indicated that 46% of professionals were in pre-hypertension. In addition, I found that the dimensions of workplace autonomy and workplace environment are associated with hypertension.

 

Accomplishments

  1. The earlier understanding was that the association between job strain and coronary heart disease (CHD) is weak, with job strain slightly increasing the risk of coronary diseases by 3.4% in the general population.[9] Our meta-analysis showed statistically significant associations with 30% higher risk of hypertension for those with job strain. This proves that job strain might be affecting the CHDs through hypertension. The paper on the meta-analysis of job stress and hypertension, therefore, is a significant contribution to the body of literature and would influence future research delineating the effects of stress on CHDs. As a testimony to the impact of the paper, the original paper by us was republished by the BMJ group in their postgraduate medical journal.
  2. It is important that individuals with higher stress have to change their lifestyle to prevent a progressive rise in BP using the recommended lifestyle modifications. [8] As a result of the findings from the study, the software companies have approached us and have requested to engage with them for improving health outcomes. I am in discussion with a major IT company to finalize the details of engagement towards improving the health of the employees.
  3. I have published extensively on this work. The Publications from this project are as follows.
    1. Babu, Giridhara R., et al. “Republished: Is hypertension associated with job strain? A meta-analysis of observational studies.” Postgraduate Medical Journal 90.1065 (2014): 402-409.
    2. Giridhara R Babu, T. Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
    3. Babu GR, Jotheeswaran A, Mahapatra T, Mahapatra S, Kumar A SR, Detels R, Pearce N. Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med. 2014 Mar; 71(3):220-7. doi: 10.1136/oemed-2013-101396. Epub 2013 Sep 24.
    4. Babu GR, Mahapatra T, Mahapatra S, Detels R. Sexual behavior and job stress in software professionals, Bengaluru – India. Indian J Occup Environ Med. 2013 May; 17(2):58-65. doi: 10.4103/0019-5278.123165.
    5. Babu GR, Mahapatra T, Detels R. Application of mixed methods for exploration of the association of job stress and hypertension among software professionals in Bengaluru, India. Indian J Occup Environ Med. 2013 May; 17(2):41-7. doi: 10.4103/0019-5278.123160.
    6. Babu GR. Prevalence of Job Stress, General Health Profile, and Hypertension Among Professionals in the Information Technology Sector in Bengaluru, India. Los Angeles: University of California, Los Angeles; 2012.
    7. Babu GR, Detels R. Prioritizing Social Actions And Involving Community For Prevention Of The Non-Communicable Diseases. The Internet Journal of Epidemiology. 2011;9(2).
    8. Giridhara R Babu, Sathyanarayana T N, Snehendu B Kar, Roger Detels. Perceived occupational stressors and the health of Software Professionals in Bengaluru, India. The Qualitative Report.
  4. Subsequent to the study in software professionals, we have now conducted the study in schoolteachers and employees of the health department. These studies are helping us to collate evidence on the worksite-based burden of NCDs and are helpful in designing the appropriate interventions. A series of papers are pending for publications on the burden of the diseases in different workgroups.
    1. Parimala, Giridhara R Babu, The Burden of Diabetes And Hypertension in the staff working in Directorate Of Health And Family Welfare Services, Bengaluru, Karnataka. [In press]
    2. Manjula, Sarin S, Giridhara R Babu. Prevalence of Diabetes Mellitus in School teachers of Bengaluru. [In press]
    3. Sudha BK, Sarin S, Giridhara R Babu Prevalence of Hypertension in School teachers of Bengaluru. [In press]

References for Details of Earlier Research:

  1. Giridhara R Babu, Mahapatra, and R. Detels. “Job stress and hypertension in younger software professionals in India.” Indian Journal of Occupational and Environmental Medicine 17.3 (2013): 101.
  2. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365:217–23.
  3. World Health Organization. Global Health Risks: mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization, 2010; 2009.
  4. Srinath RK. Protecting the heart of global development. Heart Beat, The World Heart Federation Newsletter. 2005. Jun, [Last accessed on 2014 Jan 10].
  5. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part II: Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation. 2001;104:2855–64.
  6. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349:1436–42.
  7. Reddy KS. India wakes up to the threat of cardiovascular diseases. J Am Coll Cardiol. 2007;50:1370–2.
  8. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–52.
  9. Kivimäkii M, Nyberg ST, Batty GD, et al. Job strain as a risk factor for coronary 
heart disease: a collaborative meta-analysis of individual participant data. Lancet 
2012;380:1491–7.

 

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