CSI Holdsworth Memorial Hospital, Mysore, India; MRC Lifecourse Epidemiology Centre, Southampton General Hospital, University of Southampton, Southampton, UK.
SickKids Research Institute, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.
Lancet Glob Health. 2023 Mar;11 Suppl 1:S15. doi: 10.1016/S2214-109X(23)00098-0.
Interactions between genes and early-life exposures during conception, fetal life, infancy, and early childhood have been shown to affect an individual's health later in life. Maternal undernutrition and obesity, gestational diabetes, and impaired growth in utero and in early life are associated with adiposity and overweight and obesity in childhood, which are risk factors for poor health trajectories and non-communicable diseases. In Canada, China, India, and South Africa, 10-30% of children aged 5-16 years are overweight or obese.
The application of developmental origins of health and disease principles offers a novel approach to prevention of overweight and obesity and reduction of adiposity by delivering integrated interventions across the life course, starting before conception and continuing through early childhood. The Healthy Life Trajectories Initiative (HeLTI) was established in 2017 through a unique collaboration between national funding agencies in Canada, China, India, South Africa, and WHO. The aim of HeLTI is to evaluate the effect of an integrated four-phase intervention starting preconceptionally and continuing through pregnancy, infancy, and early childhood on reducing childhood adiposity (fat mass index) and overweight and obesity, and optimising early child development, nutrition, and other healthy behaviours.
Approximately 22 000 women are being recruited in Shanghai (China), Mysore (India), Soweto (South Africa), and across various provinces of Canada. Women who conceive (an expected 10 000) and their children will be followed up until the child reaches the age of 5 years.
HeLTI has harmonised the intervention, measures, tools, biospecimen collection, and analysis plans for the trial to be run across four countries. HeLTI will help establish whether an intervention aimed at addressing maternal health behaviours, nutrition, and weight; providing psychosocial support to reduce maternal stress and prevent mental illness; optimising infant nutrition, physical activity, and sleep; and promoting parenting skills can reduce the intergenerational risk of excess childhood adiposity and overweight and obesity across diverse settings.
Canadian Institutes of Health Research; National Science Foundation of China; Department of Biotechnology, India; and South African Medical Research Council.
已有研究表明，个体在受孕、胎儿期、婴儿期和幼儿期的基因与早期生活暴露之间的相互作用会影响其以后的健康。母体营养不足和肥胖、妊娠期糖尿病以及宫内和幼儿期生长受损与儿童期肥胖和超重有关，而肥胖和超重是不良健康轨迹和非传染性疾病的风险因素。在加拿大、中国、印度和南非，10-30%的 5-16 岁儿童超重或肥胖。
健康起源与疾病原理的应用为通过在整个生命过程中提供综合干预措施来预防超重和肥胖以及减少肥胖提供了一种新方法，这些措施从受孕前开始，并持续到幼儿期。健康生活轨迹倡议（HeLTI）于 2017 年通过加拿大、中国、印度、南非和世卫组织国家资助机构之间的独特合作建立。HeLTI 的目的是评估从受孕前开始并持续到怀孕、婴儿期和幼儿期的综合四阶段干预措施对降低儿童肥胖（脂肪质量指数）和超重及肥胖的效果，并优化儿童早期发育、营养和其他健康行为。
上海（中国）、迈索尔（印度）、索韦托（南非）和加拿大各省份正在招募约 22000 名妇女。预计将有 10000 名受孕的妇女及其子女将接受跟踪调查，直到孩子年满 5 岁。
HeLTI 协调了干预措施、措施、工具、生物样本收集和分析计划，以便在四个国家进行试验。HeLTI 将有助于确定一项旨在解决母亲健康行为、营养和体重问题的干预措施；提供社会心理支持以减少母亲压力和预防精神疾病；优化婴儿营养、身体活动和睡眠；并促进育儿技能是否可以减少不同环境中儿童超重和肥胖的代际风险。
加拿大卫生研究院；中国国家自然科学基金会；印度生物技术部；和南非医学研究理事会。
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