Year: 2025
Type: article
Abstract: All correspondence relating to this paper should be sent to: [email protected] Andrew Agbaje is an associate professor of clinical epidemiology and child health at the University of Eastern Finland. Born in Nigeria, he earned his medical degree from the University of Benin before completing clinical research training at Harvard University, USA, and his PhD from the University of Portsmouth, UK. He leads the UndeRstanding FITness and Cardiometabolic Health In Little Darlings (urFIT-child) and has received the European Society of Cardiology Top Reviewer award for three consecutive years work on the European Journal of Preventive Cardiology (Figure 1A). A, Professor Andrew Agbaje MD, MPH, PhD at the American Society of Nutrition, 2025 Flemming Quaade Award lecture for innovation in childhood obesity, Orlando, USA. B, Joint ESC/EASO 2025 Session, Malaga Spain, L-R, Professors Gijs Goossens (Netherlands); Naveed Sattar (UK); Annika Rosengren (Sweden); Andrew Agbaje (Finland); Gema Frühbeck (Spain); and Jean Michel Oppert (France). C, Fellow of ESC convocation at ESC congress 2024, Excel London, UK Can you tell us about your background and the path to your current role? About two years before graduating medical school, I believe God showed me a vision that I would contribute significantly to paediatric research, especially in cardiovascular and metabolic health. This seemed strange and unbelievable since I had struggled with undergraduate epidemiology and biostatistics—courses my medical colleagues and I considered necessary distractions from clinical studies. While working as a physician at a tertiary hospital in Nigeria, I noticed that many cases we treated were preventable and began thinking about preventive medicine in paediatrics, though I had limited knowledge of how to proceed. Coincidentally, in 2015, I found a free online course, Introduction to the Principle and Practice of Clinical Research, from the National Institutes of Health, USA. I passed this with flying colours, and this inspired me to apply for a master’s degree in public health with a specialization in epidemiology. Any mentors or key influences that helped shape your career? Interestingly, I don’t have a specific mentor. My rapid development into an internationally recognized researcher within seven years of my post-master’s degree stems from reviewing manuscripts for major cardiology journals—usually one to two per week. Reading unpublished work from cardiovascular leaders and their responses to reviewers became my private school, significantly advancing my research processes and creativity. Consistently attending European Society of Cardiology (ESC) and American Heart Association (AHA) congresses led to a research collaboration with a past president of the AHA. How did your research career evolve? A pivotal event was experiencing 21 rejections of a single manuscript over two years. Based on the ALSPAC (Avon Longitudinal Study of Parents and Children) cohort that gave us dual-energy X-ray absorptiometry (DXA) measurements of lean and fat mass from childhood to young adulthood, I longitudinally related body composition to vascular changes. I discovered that lean, not fat mass, drove arterial changes. When body mass index (BMI) predicted vascular changes in nearly 4000 children over 15 years, I initially considered this to be obesity-induced pathology, but it appeared to be lean mass-induced remodelling. Initially some editors disputed the results, saying it challenged medical school teaching, but following six further re-analysis attempts I concluded that BMI may misdiagnose children who have nearly four times more muscle than fat. Later, I investigated cheap, accurate BMI alternatives and discovered waist-to-height ratio (WHtR) had a ninety per cent agreement with DXA-measured body fat and trunk mass, with cut points I developed being externally validated as predictors of Type 2 diabetes, liver steatosis, cirrhosis, and bone fractures. The European Heart Journal (EHJ) recently published a randomized controlled trial showing WHtR significantly outperforms BMI in predicting heart failure and hospitalization across multi-racial populations while refuting the ‘obesity paradox’. During those two years of rejections, I tested whether arterial stiffness preceded cardiometabolic alterations and found that it independently predicts hypertension, insulin resistance, metabolic syndrome, and cardiac damage in young adults—results confirmed by others using Mendelian randomization. Consequently, ScholarGPS ranked me third globally in the speciality of arterial stiffness in March 2025. To educate the public on WHtR’s usefulness in detecting excess fat, I gave a TEDx talk titled ‘Tailor’s tape to the rescue’ and published a free online WHtR calculator. These discoveries earned me the 2024 European Association for the Study of Obesity New Investigator Award and the prestigious 2025 American Society for Nutrition Foundation Flemming Quaade Award, among others. In May 2025, ESC leaders appointed me Chair for the official ESC/EASO Joint session at the European Congress on Obesity in Spain—I was the youngest on the podium (Figure 1B). What are you working on now? My research identifies critical risk factors for early cardiovascular damage, I’ve discovered that childhood physical inactivity, smoking, and adolescent metabolic dysfunction cause irreversible heart damage by the mid-twenties—a finding recognized as a cardiovascular research advance by the AHA in 2024.1–3 I now recommend starting cardiometabolic assessments before age 40—waiting too long misses the window to prevent permanent damage. Currently, I’m investigating longitudinal relationships between DXA-measured fat/lean mass from childhood through young adulthood and cardiac changes. This evidence will better identify earliest adiposity-induced cardiac alterations than BMI. My team has a manuscript under review validating WHtR as superior to BMI for predicting hypertension across multiracial populations. What are your future research or career ambitions? Through editorial roles and reviewing for over 50 journals, I’m optimistic that I can expand my impact. Speaking engagements and clinical guideline contributions all help raise your professional profile, and as an ESC Fellow, chairing sessions and presenting at the 2025 Madrid congress helps engage early career researchers. I’m speaking at the Nigerian Cardiac Society congress on Reprogramming Cardiovascular Risk Profile at Adolescence and developing manuscript writing training for Nigerian clinicians. I’m also strengthening African collaborations, mentoring a clinical professor who will train resident doctors in European research methods (Figure 1C). Which part of your work do you enjoy the most and how do you find a balance? Challenging the status quo by asking questions and testing counterfactual hypothesis in order to unravel new knowledge, translating scientific research into layman’s language through public speaking, interviews with health journalists, and writing press releases are all critical to my research. It is important to mentor the next generation which I do through several editorial and academic roles. I collaborate extensively with clinicians, epidemiologists, public health experts, and exercise physiologists across the globe to improve the translational outlook of my research findings. I am not distracted by social media, and I maintain a disciplined timetable on and off work. Apart from research, I spend several hours weekly in prayer and bible studies because this is how I receive inspiration, peace, and joy integral to my work. What advice would you give to early-career cardiologists or researchers? Perseverance and resilience are key to turning manuscript rejections into innovative discoveries. Never give up. Rebel against the scientific status quo—this is your window to attain greatness. If you don’t rebel, you’ll become part of what you cannot dismantle. Be curious, ask questions, attend conferences, find like-minded researchers for collaboration. Stay current with research, read systematic reviews, identify knowledge gaps, and apply for all awards. Learn rigorous statistical methods, pay attention to methodological details, investigate counterfactual hypotheses, and use multiple designs to confirm findings. Don’t take easy routes—enjoy rigor! Publish quality papers in high-impact journals. Always consider the public, write press releases, simplify jargon for laypeople, educate everyone including children. All authors declare no disclosure of interest for this contribution.
Source: European Heart Journal
Author: Judith Ozkan
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4416190239