Preconception health and healthy life trajectories (HeLTI study)

Speaker:  Professor Shane Norris, Department of Paediatrics, University of the Witwatersrand, South Africa

Join Professor Shane Norris as he explores health interventions before conception, which are proving to help offset child obesity. He will also talk about how to optimise the preconception health of women in order to offset health risks and set up healthier trajectories for their offspring.

*If you are external to King’s and would like to attend this event, please ensure you contact the event organiser.

Obesity is a leading cause of poor lifelong health across the world. In South Africa, one in four girls aged 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, 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. 

Meanwhile, findings from the urban 'Soweto First 1000 Days' cohort reported that 67% of women presenting at their first antenatal clinic visit were either overweight or obese. Observational evidence from several countries around the world suggests that 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 ages 4-5 years. Similar, but context-adapted, trials will soon be launching in Canada, China and India.

Despite the study having several more years to go, the scientific teams are committed to publishing and disseminating their learning as they progress, and are 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.

Shane Norris is the Director of the South African Medical Research Council’s Developmental Pathways for Health Research Unit (DPHRU), and Director of the South African Department of Science and Technology and National Research Council’s Centre of Excellence in Human Development (CoE-HUMAN).

He has extensive research experience in longitudinal cohort studies and epidemiology. His research expertise and interest includes maternal and child health, and intergenerational transmission and developmental origins of obesity and metabolic disease risk.