Grant: Team Grant: Healthy Life Trajectories Initiative (HeLTI) - China

The obesity epidemic in China has become a major public health concern. There is growing evidence to support the role of adverse factors before conception, during pregnancy and at early life, in the vulnerability to obesity. Reducing the risk of overweight and obesity (OWO) in the whole early life course can yield substantial benefits towards decreasing the population-wide burden of diseases associated to OWO. Our transdisciplinary Sino-Canadian team is conducting a community-based, multi-centre research study to test the impact of an evidence-based package of interventions on childhood OWO rates in 5-year-old children in China. A total of 36 community health centres, linked to 4 regional obstetric care hospitals, have been allocated at random into intervention or control (routine care) sites. The interventions account for the multi-faceted nature of early-life trajectories, are community-family-parent-child oriented, and are incorporated into the routine child care systems at pre-conception, prenatally and postnatally. We are examining the impact of the intervention on children's OWO rates, fat mass, indicators of metabolic dysfunction, child cerebral development/functioning, and modifiable parental or family risk factors for OWO (i.e., behaviours and parenting/caregiver practices). We are also studying some fundamental mechanisms that may underlie the development of OWO. We have reached 87% of the initial targeted recruitment (n=3,922) between January 2019 and October 31th, 2021. Our retention rate is 85% (n=3,327) and the participation rate for biobank samples so far surpasses 80%. During the next 5-year phase of the project, our goal is to complete intervention delivery and data-collection, conduct the statistical analyses, foster partnerships with stakeholders and develop strategies for transforming the knowledge obtained in this study into regional and national policy.