Roham Sadeghimakki

Researcher and London Met graduate Roham Sadeghimakki recently contributed his research findings to Public Health England (PHE), which may prove vital in investigating links between obesity and COVID-19. His extensive PhD work on body composition and respiratory function has put him at the forefront of the research against coronavirus. He has presented his research at various major conferences, including the UK Congress on Obesity, the European Obesity Summit and the European Congress on Obesity. He was conferred as a Fellow of the International Society of Hypertension (ISH) in 2018, and has had his peer-reviewed research published in the Annals of Human Biology.

Roham’s educational journey began in Iran as a medical student before studying an Obesity and Weight Management MSc (now Human Nutrition (Public Health / Sports) MSc) and then completing his PhD in Nutrition and Cardiorespiratory Function at London Met.

Can you tell us a bit about your background and what led you to London Met?

Before moving to the UK, I practiced in Iran as a GP for seven years with special interests in cardiology, diabetes, endocrinology and musculoskeletal conditions.

I was aware of the ascent in the prevalence of obesity and lifestyle-related diseases, including diabetes, cardiovascular diseases and respiratory problems. I could see the negative impact that obesity and nutritional imbalance exerted on the underlying conditions and quality of life of many patients.

When I realised that a postgraduate course on obesity and weight management was available at London Met, I decided to study this course to improve my knowledge and skills in the assessment and treatment of patients with excessive weight and malnutrition.

What was your favourite project or work experience on the MSc or PhD?

I totally enjoyed working on my MSc dissertation as for the first time, I analysed large-scale health and nutrition data to explore the effect of insulin resistance on the link between obesity and asthma in adults living in the US.

Then, I was given the amazing opportunity of teaching postgraduate public health and nutrition modules as an associate lecturer. It was so rewarding because I could engage in a teaching role whilst I was conducting research. It was a fascinating journey as I was learning how to communicate interactively with students and colleagues.

In parallel, my interdisciplinary PhD project on the connections between body composition, respiration and haemodynamic stability unlocked many doors to the wide network of metabolic and nutrition research. It led to a series of pleasantly unexpected findings that I hope could form a basis for future breakthroughs in sarcopenia and obesity research.

What have been the most interesting findings from your PhD?

To the best of my knowledge, this is the first study which demonstrates the significant role of body composition phenotyping in assessing respiratory function among young to middle-aged adults. 

The most interesting finding from my research was the connection between systemic blood pressure, body composition and lung function. It indicated that excessive fat tissue in trunk and limbs could have a greater impact on limiting respiratory capacity and/or flow rate when accompanied by larger muscle tissue.

For the first time, this study shows that free-living healthy adults who have limited respiratory capacity and/or narrower airways may have higher systolic and diastolic blood pressure. This association is also observed in the reverse direction. Adults with increased systolic and diastolic pressure are more likely to have reduced lung capacity and/or increased airway resistance.

Interestingly, this study revealed that metabolic imbalance at whole-body and segmental levels plays a significant role in the crosstalk between respiratory and vascular systems. In individuals whose overall lean mass was greater than their total fat mass, high diastolic blood pressure impaired the respiratory function to a larger extent than in those with a more balanced whole-body metabolic status or even metabolic overload. On the contrary, high systolic blood pressure had a deleterious impact on lung function only in individuals with whole-body metabolic overload, ie, those with the predominance of fat over lean mass.

These findings may have important implications for the risk stratification and the management of patients affected by COVID-19 and other respiratory disorders.

Since individuals with obesity and hypertension are generally at increased risk of adverse outcomes from COVID-19, the identification of high-risk subgroups of this population based on their body composition phenotype, together with the specific alterations in their systolic and diastolic blood pressure, would enable the clinical team to individualise supportive measures more accurately and allocate life-saving modalities to patients whose combined metabolic and haemodynamic profile gives them a higher risk of COVID-related complications.

How do you think your study at London Met prepared you for your work today?

Studying at London Met was an exceptional opportunity to develop skills that I would have never achieved. Over the course of five years, the incredible guidance, support and encouragement that I received from my supervisors, Professor David McCarthy and Dr Dee Bhakta, and my senior colleagues, Afshan Aghili, Dr Abdollah Ghavami, Dr Simon Dryden and Sarah Illingworth allowed me to discover new areas of research and work.

Before partaking to this wonderful experience, I had limited understanding of nutrition science, weight management, statistics, high-quality research and teaching at higher education. Now, thanks to this fruitful journey, I am a physician, obesity specialist, nutritionist, data analyst and lecturer.

Did you use the Superlab at all?

I used the Superlab several times for dietary assessment – to compare the energy and macronutrient intake estimated by a food diary against the criterion method of bomb calorimetry. Also, I analysed a 24-hour urinary sodium excretion there as part of my study on the association between salt intake and systemic blood pressure in postgraduate students.

The distinguishing feature of London Met’s Superlab is the wide range of the state-of-the-art equipment which makes it possible to carry out a large variety of multidisciplinary research and educational projects concomitantly; it accommodates the academic and productive purposes of scientists and other stakeholders from all areas of life sciences.

What was your favourite spot at the University and why?

I formed an especially satisfying bond with the cosy space of the Science Centre’s nutrition physiology lab, where I literally spent four years of my academic life. I performed every single stage of my PhD research in that nutrition lab. Owing to the commendably coordinated availability of my research tools, I was able to do all the tests in one place.

What were your lecturers like? And how have you found becoming a lecturer yourself?

I see my lecturers as vastly knowledgeable, inspirationally experienced, exemplary, supportive and remarkably welcoming. Without their pearls of wisdom, I would not have accomplished my goals.

The invaluable experience of creating a meaningful learning environment for undergraduate and postgraduate students has been one of my most precious achievements. I find it so pleasing when students think of me as a reliable companion who shows them how to do, not what to do. When students are empowered, they perform fantastically.

Were you in any clubs or societies at the Uni?

During my MSc, I was elected as the student academic representative (StAR), and as a member of London Met’s student council and postgraduate committee in 2014. From 2014 to 2016, I was also president of the Persian Met society. Persian Met ran a weekly radio show at Verve radio and organised several events both internally and externally.

Have you stayed in touch with friends or lecturers?

I am closely connected with my supervisors, colleagues and friends and continue to enjoy their advice, thoughts, suggestions and views.

Did anything surprise you about your course or London Met?

I was mostly surprised by the complexity of the obesity epidemic and the magnitude of its impact on global health and economy. It was a whole new topic for me. The variety of factors contributing to the development and progression of excessive adiposity was just unbelievable. The novelty of this subject gave me strong impetus and a firm reason to pursue study and research in such a steadfastly growing, multifaceted field of science.

If you could choose one word to describe your experience here, what would it be?

Marvellous. 

How would you describe the research culture at London Met?

Diverse, inclusive and forward-looking.

What’s next for your career?

I intend to expand my research interests to larger-scale clinical studies on the role of body composition phenotyping and metabolic homeostasis in improving the outcomes of patients with sarcopenia and/or adiposity-based chronic diseases.

My time at London Met has equipped me with the necessary research and management skills to undertake more effective high-quality research projects with measurable implications for healthcare services, including the NHS.

Any tips for students thinking about this subject here?

You just need to decide which subject would be the right choice for you. Make your choice knowingly based on what you expect to achieve and what you are ready to miss. 

Nutrition, dietetics and public health are popular and rapidly expanding areas in the unpredictably changing world we live in. So there will be plenty of opportunities for motivated graduates to make a difference in the quantity and quality of people’s lives.

Is there anything else you’d like to tell us about your time at London Met that isn’t covered above?

I would like to express my deepest gratitude to my exceptionally insightful supervisors, Professor McCarthy and Dr Bhakta, as well as my brilliant colleagues in the school of human sciences and the extended London Met family who helped me inscribe a worthwhile story in the fourth chapter of my book of life.

Image of Roham Sadeghimakki at a conference