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This month we speak to Dr Oliver Mytton to find out how his research on obesity prevention is improving the health of the public.
What is your role and what does it involve?
I am a public health physician and academic. I work at the interface of research with public health practice and policy. Part of my role is developing the evidence base to inform policy and practice. Part of my role is explaining research findings to policy makers, as well as advocating for good evaluation and research.
A lot of my work focuses on obesity prevention - supporting children and adults to be active and to eat healthily. My work spans from individual approaches to government policies. I am particularly interested in government policies (national and local) that have wide reach, often termed population-level approaches. My work to inform the introduction and then evaluation of the soft drinks industry level, being one example.
In a typical week, I wear several different hats. I hold a UKRI Future Leaders Fellowship, exploring local authority’s roles in the prevention of childhood obesity. I am a co-investigator a the NIHR Obesity Policy Research Unit, responsible for providing research to inform government policy in this area. I am also a public health consultant working at Milton Keynes City Council and Milton Keynes University Hospital.
How are you improving the health of the public?
For the last 18 months in Milton Keynes, I have headed up a new team that works closely with other areas of the council (housing, transport, planning) to improve people’s health. Our hope being that by working with others in the Council we can have a positive influence on people’s health through acting on some of the wider determinants or building blocks of people’s health.
For example, at a policy level, the Council is making health one of the core themes in their next local plan, which means the proposed policies are tested in terms of their impact on people’s health. At a practice level, we have put systems in place to check plans brought forward for developers. This means we can catch and amend developments brought forward that have not taken adequate account of people’s health: for example, a new development of flats without any play facilities for children; or improving the heat resilience of flats with south facing windows (overheating in urban areas being an increasing area of concern, as we saw last summer).
At an individual level, for people living in social housing, we are now embedding smoking cessation advice alongside advice on managing debt. The financial benefits of quitting smoking are an immediate and important motivator for people to quit smoking.
What do you find most interesting or enjoyable about your work?
My work is hugely varied, and I enjoy most aspects of my work. I particularly enjoy working in multi-disciplinary teams, enabling teams to come together and produce something that no one individual could produce is always special. I also enjoy communicating research to policy makers, seeing that ‘light bulb moment’, when a policy maker learns to see something differently or grasps a new concept.
How have cross-disciplinary collaborations shaped your work?
I started out as an aspiring epidemiologist, but I quickly came to realise there was more to preventing disease than cohort studies. From quite an early stage in my career, I became interested in levers for improving health outside the realm of the health service. I started working with an economist to look at the role of taxing food on people’s health. We saw an opportunity to combine a good economic evidence base (about how price affects purchasing) with a good health evidence base (the relationship between food consumption and health) to simulate the impact of price changes (taxes and subsidies) on food. That led me into the field of NCD (non-communicable disease) public health modelling as it was just emerging. As we saw in the pandemic there is a lot of expertise in the field of communicable (infectious disease) modelling, but it is much less developed for non-communicable diseases.
Working with economists and others (notably Members of Parliament when I worked for the Health Select Committee) has also helped me reflect on public health, and realise it offers a particular perspective on a problem. Understanding and, better still, bringing together different perspectives offers much richer insights and (hopefully) better solutions for policy makers. One of the exciting things for me about moving to UCL is the breadth of expertise in areas that are hugely important for public health: transport, climate change, and the built environment.
What advice would you offer to others interested in developing cross-disciplinary work?
First, it is a great area to work in. There is increasing recognition that the really challenging problems that society faces, climate change, obesity, and poor mental health, cannot be solved by working within the traditional disciplinary silos. Funders are starting to create mechanisms and incentives to enable better cross-disciplinary work.
Second, you need to be comfortable with not being an expert and learn how to work in teams. You will not have all the answers, but neither will any one of your colleagues. The real strength comes from bringing together different methods and perspectives to provide a more holistic approach to a problem.
Third you need a lot of patience. It takes time to develop collaborations and trust. It takes time to understand different disciplinary practices and languages. It takes time to find and agree the research questions.
What's next on the research horizon for you?
We are trialling a digital incentive scheme to support adults with type 2 diabetes to be physically active in Milton Keynes. This combines financial incentives (vouchers), physical activity monitoring (a watch) and a mobile phone app that links the two. Each of the different components has been shown to increase physical activity but their use together in the NHS is new. I am really pleased that we will be evaluating its use robustly (using an RCT with waitlist controls), whilst also taking a pragmatic approach to minimize the research burden for participants and primary care staff, leaning on and developing the local R&D infrastructure to deliver the trial. As Chief Investigator, it will be my first major experience of primary data collection.
If you could make one change in the world today, what would it be?
I would like to see much greater legal recognition of the impact of food on people’s health. There are quite stringent rules when it comes to food safety, keeping microbes (and harmful chemicals) out of food. In the UK, food poisoning now accounts for around 500 deaths per year, 0.1% of all deaths. In contrast, the Global Burden of Disease estimates that poor quality diets, which contribute to many preventable diseases (heart disease, type 2 diabetes, dementia and some cancers), account for 15% of all deaths. Changes in food supply and food environment appear to be the dominant reason behind the dramatic rise in childhood obesity since the 1980s.
There is a Clean Air Act and a Food Safety Act. I think we need a Food and Health Act to respond to the proliferation of marketing and over-selling of cheap highly palatable foods high in sugar, fat and salt. Protection of children and young people is particularly important.