I lead research on nutrition, metabolic, and reproductive health. My research program investigates how different maternal diet and lifestyle exposures associate with pregnancy complications, particularly gestational diabetes, clinical reproductive health outcomes, and offspring health. My research program has contributed to important findings on the relationship between pre-pregnancy nutrition, metabolic syndrome, and pregnancy outcomes.

Research projects 2024/2025, Honours, Masters and PhD

Nutrition, metabolic, and reproductive health group:

1) Maternal diet and lifestyle exposures and offspring health.

Supervisor: Dr Jessica Grieger

Skills learned during this project: Dietary analysis; quantitative analysis; increased knowledge on pregnancy complications, developmental origins of health and disease.

Project available for: Honours and HDR

Location: SAHMRI, North Terrace

Research project start: Any time.

2) Nutrition and fertility

Supervisors: Dr Jessica Grieger, Dr Leanne Pacella-Ince

Skills learned during this project: Nutritional intake assessment/analysis; data entry; literature searching; increased knowledge on nutrition and reproductive health.

Project available for: Honours and HDR

Location: SAHMRI, North Terrace

Research project start: Any time.

3) Qualitative research projects (nutrition, reproductive health)

Supervisors: Dr Jessica Grieger

Skills learned during this project: Qualitative methods, data transcription, interviews, focus groups, data coding, thematic analysis.

Project available for: Honours

Location: SAHMRI, North Terrace

Research project start: Any time.

Research communication

Women's Health Week 2020: https://www.youtube.com/watch?v=a8WJyfKQGWw&feature=youtu.be

The Discovery Pod Episode 3: Nutrition https://fb.watch/25KJpYR5Tl/

Selection of my research highlights

1. Precision Diabetes Medicine Initiative: Gestational Diabetes

Our ability to sustain human health and mitigate disease is being transformed by precision medicine. Precision medicine is part of the logical evolution of contemporary evidence-based medicine that seeks to reduce errors and optimize outcomes when making medical decisions and health recommendations. Key components of precision medicine are diverse data types and intelligent analysis procedures to improve precision and accuracy when predicting individual health outcomes. There are hundreds of millions of people with diabetes worldwide, many who will develop life-threatening complications and die prematurely. Precision medicine has potential to address this enormous problem by accounting for the heterogeneous etiology, clinical presentation, and pathogenesis of common forms of diabetes, risk of complications, and related conditions.

The PMDI was established in 2018 by the American Diabetes Association (ADA) in partnership with the European Association for the Study of Diabetes (EASD) to address the untenable health and economic burdens of diabetes prevention and care.

Our 1st systematic review and meta-analysis examined participant characteristics associated with responses to interventions in gestational diabetes mellitus (GDM) prevention. Combined diet and physical activity interventions resulted in greater GDM reduction in participants without polycystic ovary syndrome (PCOS) than those with PCOS (0.62 [0.47, 0.82] vs 1.12 [0.78-1.61]) and in those without a history of GDM than those with unspecified GDM history (0.62 [0.47, 0.81] vs 0.85 [0.76, 0.95]). Metformin interventions were more effective in participants with PCOS than those with unspecified status (0.38 [0.19, 0.74] vs 0.59 [0.25, 1.43]), or when commenced preconception than during pregnancy (0.21 [0.11, 0.40] vs 1.15 [0.86-1.55]). Future research should include trials starting in the preconception period, and provide results stratified by participant characteristics to better target GDM prevention interventions.

Commun Med (Lond). 2023; 3: 137: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/37794119/

Our 2nd systematic review and meta-analysis evaluated intervention components to inform the implementation of GDM prevention interventions. 

Greater reductions in the incidence of GDM were found in group-based physical activity interventions (RR 0.66; 95% CI 0.46, 0.95) compared with individual or mixed (individual and group) delivery format (subgroup p-value=0.04). Physical activity interventions delivered at healthcare facilities were associated with a greater risk reduction of GDM (RR 0.59; 95% CI 0.49, 0.72) compared with home-based interventions (subgroup p-value=0.03). Future individual studies should improve the reporting on these characteristics to enable further elucidation of optimal duration, frequency and dietary type of interventions in preventing GDM.

2. Nutrition and fertility

Preconception diet is a proposed modifiable risk factor for infertility. However, there is no official guidance for women or men in the preconception period as to which dietary approaches may improve fertility. For female fertility, a total of 36 studies were eligible for inclusion (31 prospective, 3 cross-sectional, and 2 case-control studies). Increased adherence to the Mediterranean diet displayed the strongest and most consistent association with improved clinical pregnancy rates. Reducing trans fatty acids, saturated fatty acids, and discretionary food intake (fast food and sugar-sweetened beverages) were associated with improvements in live birth, clinical pregnancy rates, and related ART outcomes. 

Human Reproduction Update 2023: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/37467045/

For male fertility, 37 studies were eligible, including one RCT and 36 observational studies (four studies in non-ART populations) published between 2008 and 2023.The RCT did not assess clinical outcomes but found that tomato juice may benefit sperm motility. In observational studies, some evidence suggested that increasing fish or reducing sugar-sweetened beverages, processed meat or total fat may improve fecundability. Healthy diet patterns in general were shown to improve sperm health.

Human Reproduction Update 2024: https://academic.oup.com/humupd/advance-article/doi/10.1093/humupd/dmad035/7571335?login=false

3. Metabolic syndrome and pregnancy and offspring health:

Obesity increases the risk for developing gestational diabetes mellitus (GDM) and preeclampsia (PE), which both associate with increased risk for type 2 diabetes mellitus and cardiovascular disease (CVD) in women in later life. In the general population, metabolic syndrome (MetS) associates with T2DM and CVD.  I initiated and led the analysis from over 5500 women throughout their first pregnancy to investigate whether MetS was associated with risk for pregnancy complications. Overall, 12.3% (n=684) had MetS. These women were at a higher risk for developing GDM and PE by 2-4 times. Increasing body mass index in combination with having MetS further increased the likelihood for developing GDM (PLOS Medicine 2018). We then demonstrated that physical activity did not modify the association between MetS and risk for GDM (Acta Diabetol 2021). My research program was also the first to show that MetS in pregnancy was associated with shorter telomere length, a biomarker of aging, in children aged 8-10 years of age (Diabetologia 2020).

Research article: https://www.ncbi.nlm.nih.gov/pubmed/30513077

Media links: https://blogs.adelaide.edu.au/robinson-institute/2018/12/14/media-release-metabolic-syndrome-increases-risk-of-pregnancy-complications/?fbclid=IwAR1rPPqZXiIxTPEg-PxgzFk7b3JOzZNZBtctIYJUSaD0Ffopo7A0FtqRsaQ

Research article: https://pubmed.ncbi.nlm.nih.gov/33743081/

Research article: https://pubmed.ncbi.nlm.nih.gov/32728890/

Diet and lifestyle factors associated with infertility:

Time to pregnancy (TTP) is a measure of how long a couple takes to conceive, and infertility is the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. Several lifestyle factors, such as smoking and obesity, have consistently been associated with a longer TTP or infertility, but the role of preconception diet in women remains poorly studied. Healthier foods or dietary patterns have been associated with improved fertility, however, these studies focused on women already diagnosed with or receiving treatments for infertility, rather than in the general population. Our multi-centre SCOPE cohort study (n=5598 pregnant women), was the first to show that a lower intake of fruit and higher intake of fast food in the preconception period were both associated with a longer TTP. In women with the lowest intake of fruit, the risk of infertility increased from 8% to 12%, and in those who ate fast food four or more times a week, the risk of infertility increased from 8% to 16%. These findings underscore the importance of considering preconception diet for fertility and preconception guidance.

Research article: https://www.ncbi.nlm.nih.gov/pubmed/29733398

Media links: https://blogs.adelaide.edu.au/robinson-institute/2018/05/04/media-release-women-who-eat-fast-food-take-longer-to-become-pregnant/