WHO? Ghattu V. Krishnaveni, 44
WHAT? Epidemiologist
WHERE? CSI Holdsworth Memorial Hospital, Mysuru
Photographed by Rahul M
A young woman anxiously narrated how she and her friends escaped a group of hooligans during a night trek in the hills of Mysuru. Two people faced the woman, maintaining neutral expressions as she recounted the incident. Meanwhile, GV Krishnaveni and two of her colleagues gauged the young woman’s mental state by examining her cardiovascular parameters through an apparatus connected to her left wrist.
A stressed subject, sharing a stressy situation she made up. She is participating in an experiment conducted by Krishnaveni (standing behind her) that will help ascertain “the role of psychological stress in the development of adult chronic diseases.”
GV Krishnaveni is India’s leading expert on investigating how improper nutrition in the womb leads to non-communicable diseases. She has recently expanded her research to include stress in young adults.
The participant’s saliva is collected prior to the experiment and stored in the lab’s refrigerator before being tested for cortisol levels – the stress hormone.
The saliva would be stored in these containers in the lab’s refrigerator before being tested for amounts of cortisol in Saliva.
Saliva from the previous pilot tests.
Krishnaveni tethers the monitor of an apparatus to their subject’s left wrist to collect the cardiovascular parameters of the participant during the stress test.
Krishnaveni was trying out the Trier social stress test, a test designed in 1993 in Germany’s University of Trier, to induce and understand stress levels in individuals. “In this test, we ask them to perform in front of strangers. If there are repeated stressful situations, cortisol levels become high and keeps rising as long as they are stressed,” the 44-year-old Krishnaveni explained. “If cortisol remains consistently high, people are likely to develop [non-communicable] diseases — both mental and physical — in the future. This is the hypothesis we are testing now.” Krishnaveni’s research problem is “to look at the role of psychological stress in the development of adult chronic diseases.”
Krishnaveni discussing the test with her colleagues who had come in as the judges through the test.
Mentored into public health
The young woman we met at the beginning (who was narrating the story of the trek) is one of the volunteers in a series of “pilot” experiments that Krishnaveni’s team has been conducting on young adults. Once the test is finalised, it will be used to understand stress levels among around 600 young adults Krishnaveni has been studying for the last two decades.
Krishnaveni in a storage room where the data of the birth cohort is preserved.
Progress log of one of the birth cohorts
Krishnaveni’s relationship with these (approximately) 600 boys and girls started when they were still in the wombs of their mothers. In 1997, she had just passed out of Mysore Medical College, when she saw an advertisement for a research position in Mysuru’s Holdsworth Memorial Hospital. Professor Caroline HD Fall, an epidemiologist from University of Southampton, had been doing research at the hospital since 1993, and was looking for someone to assist her. Krishnaveni applied for the position and soon joined Fall in her investigations.
Krishnaveni with one of the participants from the birth cohort, now a 20-year-old. She has come after a few years, to record the sugar levels in her blood. At least six of her friends come to the center for the study. Their mothers too have volunteered to be part of the study. For the mothers and children participating in the study, these regular check-ups also mean an efficient way to track their health-status regularly.
Fall was studying the “early origins of adult disease hypothesis” which was originally put forward by her colleagues in the UK. According to this hypothesis, environmental factors, particularly nutrition, influence an individual’s risk of adverse health in adult life. Barker’s experiments conducted in the mid-1980s showed that low birthweight and small body-size (which were used as proxies to indicate how well nourished the mother was while pregnant) at the time of birth were associated with a greater risk of non-communicable diseases such as heart disease and diabetes in later life.
Fall set up a unit for her research in Mysuru’s Mission Hospital (as CSI Holdsworth Memorial Hospital is commonly known) because this hospital had records with details about the birth weight, birth length and head circumference of the infants born at the hospital from 1934. With these details it was possible to repeat Barker’s experiments in India. Fall began this in 1993 and was joined by Krishnaveni in 1997.
Medical case studies: From birth to death
When Krishnaveni took up the job she was just out of medical college, where the norm she remembered was to “read a lot, memorise and reproduce,” she said. This routine did not excite her at all. “That was not my way. I wanted to understand things and interpret them,” she said. Under Fall, she expanded her horizons and was brought closer to research. The duo gradually set up the the Mysore Parthenon Birth Cohort consisting of 600-odd subjects.
According to a paper titled “Cohort Profile: Mysore Parthenon Birth Cohort” published in International Journal of Epidemology in 2014 which Krishnaveni co-authored, “The cohort was established to examine the long-term effects of maternal glucose tolerance and nutritional status on cardiovascular disease risk factors in the offspring.”
One of the mothers of the birth cohort showing Krishnaveni documents related her to her son’s recent illness.
Within a few years of working with Fall, Krishnaveni deepened her expertise by going on to do a PhD at University of Southampton where Fall taught. There, she studied the long-term implications of maternal undernutrition and overnutrition for offspring cardio-metabolic risk.
During her research in Mysore, she noticed a public health trend unique to India. “Unlike in the UK, here there were babies born with more fat — chubby babies, short and fat babies — who went on to develop diabetes,” explained Krishnaveni.
Krishnaveni and team have been very resourceful during the study of this cohort. “We had to trace people who were born in the hospital,” recounts Dr K Kumaran, a senior scientist at the unit and Krishnaveni’s colleague in the research unit. “At that time there were many places here which didn’t have proper door numbers. So when we went, we would draw a map of the area, come back and transcribe to a large scale map here and basically mark where we had found people who said they were born in the hospital.” Interestingly, and with efficiency, Kumaran’s team had used various colours and sizes of bindis to mark details on these maps. Once they narrowed down on the people they wanted to study from the area, they persuaded them to volunteer in their research over the next few years.
Apart from some hindrances while travelling, Krishnaveni said that her gender has not affected her work. “At least in this research unit, we have more women researchers than males.” She is unmarried, not because there was too much work, but because “it just didn’t happen,” she said.
Krishnaveni believes that her work will provide important leads for next-generation preventive strategies for non-communicable disease in susceptible individuals across the world. She also plans to develop multi-faceted interventions for future use among vulnerable youth to manage stress.
Krishnaveni and her team discussing how to make sure teenagers in the cohort tell them truth about their recently-picked up smoking and drinking habits, to incorporate these variables into their study.
Apart from some hindrances while travelling, Krishnaveni said that her gender has not affected her work. “At least in this research unit, we have more women researchers than males.” She is unmarried, but not because there was too much work, but because “it just didn’t happen,” she said.
Krishnaveni and team have been very resourceful during the study of this cohort. “We had to trace people [between 40-60 old] who were born in the hospital” remembers Dr.K.Kumaran, a senior scientist at the unit and Krishnaveni’s colleague in the research unit. “At that time there were many places here which didn’t have proper door numbers. So when we went we would draw map of the area, come back and transcribe to a large scale map here and basically mark where we had found people who said they were born in the hospital.” Interestingly, and with efficiency, Kumaran’s team had used various colours and sizes of Bindis to mark details on these maps. Once they have narrowed down on the people they wanted to study from the area, they started persuading them to volunteer in their research over the next few years.
Krishnaveni with Kumaran, a senior scientist at the unit. He was one of the founding members of the unit in 1993.
One of the first maps of a part of 2-square- kilometer radius around Mysore’s Mission hospital. Kumaran and around 7 others in his team chalked these maps out by knocking doors of people born in this hospital 40-60 years ago. “At that time there were many places here which didn’t have proper door numbers. So when we went we would draw map of the area, come back and transcribe to a large scale map here and basically mark where we had found people who said they were born in the hospital.” Interestingly, and with efficiency, Kumaran’s team had used various colours and sizes of Bindis to mark details on these maps. Once they have narrowed down on the people they wanted to study from the area, they started persuading them to volunteer in their research over the next few years.
Various colours and shapes bindis were used to mark feedback Kumaran’s team got while preparing a database of people to run Barker’s experiments in Mysore.
Editor’s note: All the individuals seen in the photographs have consented to appear in the photographs in this essay.
This is the first piece in a series of 30 profiles on the life of science of Indian women scientists whose research has been funded by Wellcome Trust/DBT India Alliance. We are thankful for a grant from India Alliance towards this series that has allowed us to invite voices of fellow science writers on this project.
