MRC Integrative Epidemiology Unit (IEU) Seminar Series

Title: Preconception health and healthy life trajectories (HeLTI study)

Abstract: 

The focus of the seminar will to summarise evidence of preconception health interventions to offset child obesity, and to share information on a global health programme to optimise preconception health of women to offset health-risk and setup healthier trajectories in the offspring.

Obesity is a leading cause of poor lifelong health across the world. In South Africa, one in four girls age two to fourteen years, and one in six boys in the same age group, are either overweight or obese. The Birth to Twenty Plus cohort, South Africa’s longest running study of child health and development that started in 1990 in Soweto-Johannesburg, showed that by early adulthood 40% of girls were either overweight or obese. Also, if a girl was obese by age 5 years, she had a 42 times greater risk of being an obese adult.

Nicola Heselhurst and colleagues from Newcastle University (UK) after reviewing many studies from around world, found that when mothers were obese before they became pregnant, their children had a 26 times greater risk of also being obese.  Findings from the urban Soweto First 1000 Days cohort reported that 67% of women presenting at their first antenatal clinic visit was either overweight or obese. Observational evidence from several countries around the world suggests that possibly interventions that support women to optimise their health and manage their weight even before they become pregnant, that is preconception, will not only benefit their own health but may also combat intergenerational obesity.

Given the public health concern around child obesity, the South African Medical Research Council partnering with World Health Organisation and the Canadian Institutes of Health Research has launched the Healthy Life Trajectories Initiative (HeLTI) in South Africa. This initiative aims to establish a programme of research to generate evidence that will inform national policy and decision-making to combat child obesity. This programme is also rolling out in Canada, China and India. Indeed, the science teams from these four countries are working together in a coordinated way to ensure the collection of high-quality data and biological samples to better understand the mechanisms underlying child obesity. In South Africa, the study is called Bukhali. This clinical trial will examine the effects of a complex intervention aimed to optimise the health of women before their conceive a child, during pregnancy and post-delivery, and support the growth and development of their children to reduce obesity-risk at age 4-5 years. Similar, but context-adapted, trials will be launching in Canada, China and India soon.

Despite the study having several more years to go, the scientific teams are committed in publishing and disseminating their learning as they progress, and making the resource accessible to scientists across South Africa and internationally. Obesity is a complex public health challenge that will take multiple initiatives to help reverse, and it is hoped that HeLTI will provide some of the insight necessary for us to successfully curb the rising obesity levels in children.

Biography:

Shane Norris is a Research Professor in the Department of Paediatrics at the University of the Witwatersrand, Johannesburg, South Africa. Shane Directs the MRC/Wits Developmental Pathways for Health Research Unit and DST/NRF Centre of Excellence in Human Development. He has extensive research experience in longitudinal cohort studies and epidemiology and his research expertise and interest includes: (i) maternal and child health, and (ii) intergenerational transmission and developmental origins of obesity and metabolic disease risk

All welcome