Sithara Vivek named BIRCWH Scholar to advance research on sex differences in cardiovascular and kidney health

LMP assistant professor Sithara Vivek has been named a Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Scholar.  

A National Institutes of Health training grant program created by the Office of Research on Women’s Health (ORWH), BIRCWH “fosters mentored research career development of junior faculty of any gender who are engaged in interdisciplinary women’s health or sex differences research.”  She will receive $30,000 in research support and 75 percent salary support for 2026-2027 with the possibility of extension.  Sithara's research project examines how cardiovascular kidney metabolic syndrome develops differently in women and men across the life course. 

How important is the BIRCWH award to her career?

"The BIRCWH award is an important step in my development as an independent investigator," Sithara said.  "It provides protected research time, interdisciplinary mentorship, and advanced training at a critical stage of my career. My background is in epidemiology, computational biology, and biomarker research, and BIRCWH will allow me to build deeper expertise in cardiovascular and kidney epidemiology, women’s health, nutritional biomarkers, and longitudinal methods."

The BIRCWH award gives her "the opportunity to establish an independent research program focused on understanding why cardiovascular and kidney disease develop differently in women and men, and how modifiable nutritional and biological aging pathways may contribute to those differences," she said.  Her long-term goal is to identify biomarkers and modifiable pathways that can support earlier, more precise prevention of cardiovascular and kidney disease, particularly in women, and use this work as a foundation for future independent NIH funding.

How will the award advance her research interests?

Using more than 35 years of data from the CARDIA (Coronary Artery Risk Development in Young Adults) study, she will investigate Cardiovascular-Kidney-Metabolic (CKM) syndrome, a framework that recognizes the interconnected nature of metabolic, kidney, and cardiovascular health.   She will focus on transitions through CKM stages from young adulthood into midlife, and identify periods when women and men begin to converge / diverge in risk. 

Sithara will then investigate whether modifiable nutritional factors, particularly folate (vitamin B9), vitamins B12 and B6, and homocysteine, a common amino acid produced when the body breaks down another amino acid called methionine, are associated with CKM progression and whether epigenetic aging and chronic inflammation may represent biological pathways linking micronutrients to later cardiometabolic and kidney health.  

"My BIRCWH project takes advantage of one of CARDIA’s greatest strengths, more than 35 years of follow-up beginning in young adulthood," Sithara said.  "The first aim will characterize how women and men move through cardiovascular kidney metabolic, or CKM syndrome stages across adulthood and identify whether the timing and patterns of progression differ by sex. This is especially timely because the new 2026 American Heart Association CKM guidelines emphasizes identifying individuals at risk earlier and preventing progression." 

The second aim of Sithara's research project focuses on potentially modifiable nutritional factors. "We will study biomarkers of one-carbon metabolism, including folate, vitamin B12, vitamin B6, and homocysteine, to determine whether micronutrient status in midlife is associated with later CKM stage and progression, and whether these associations differ between women and men," she said. "We will also examine whether biological aging processes, particularly epigenetic aging and chronic inflammation, may help explain these associations." 

By combining long-term CKM staging with nutritional biomarkers and measures of biological aging, Sithara said her project moves beyond simply describing sex differences to ask what may be driving them. "Ultimately, I hope this work can help identify earlier and more precise opportunities to prevent cardiovascular and kidney disease, particularly in women." 

The one-carbon metabolism component builds directly on Sithara's recent work published in GeroScience. In a nationally representative study of adults aged 60 years and older in India, Sithara and her colleagues, including LMP professor and chair Bharat Thyagarajan, reported that higher folate was associated with slower biological aging, while higher homocysteine was associated with faster aging.  "Changes in these nutritional biomarkers over about 4.5 years also tracked with changes in biological and epigenetic aging," Sithara said. "These findings suggest that one-carbon metabolism may be a potentially modifiable nutritional pathway related to healthy aging. My BIRCWH project now brings this question earlier in the life course, asking whether these same pathways in midlife are related to the development and progression of cardiovascular, kidney, and metabolic disease."

A complementary CARDIA study from her research program is examining vitamin B6 deficiency in relation to hallmarks of aging.  She and fellow investigators found that vitamin B6 deficiency in midlife was associated with accelerated epigenetic aging, higher levels of inflammation, and greater oxidative stress.  She will present this work at the 2026 Biomarkers of Aging Conference in Boston next month.

"Together, these studies are helping me build a research program focused on how modifiable nutritional factors may contribute to biological aging and the development of cardiovascular and kidney disease across the life course, with the long-term goal of identifying opportunities for earlier and more precise prevention," Sithara said.