Project 459698

The burden of non-communicable diseases in low- and middle- income countries is significant and increasing due to several risk factors including undernutrition at early age, sedentary behaviour, poor diet, and heredity. South Africa's (SA) evolving burden of diseases is particularly challenging due to persisting infant malnutrition that co-exists with high prevalence of obesity and rising rates of diseases such as type 2 diabetes. It is recognised that prevention of obesity in women of reproductive age is critical both for their health and for that of their children but efforts to address the paradoxical challenges of stunting in early childhood and escalating obesity have been largely unsuccessful. To date, interventions in overweight pregnant women have not produced impact on pregnancy and birth outcomes. This suggests that the pre-conception period may be a key window of opportunity to intervene to prevent obesity and contribute to the survival and wellbeing of newborns throughout their lives. This project started in 2017 and is laying the foundations for healthy trajectories by improving women's health prior to and during pregnancy and reinforcing optimal health in the infant. A team of experts from SA and Canada is implementing a longitudinal analysis of how exposures in the preconception period and during pregnancy, infancy and childhood impact life-long trajectories of health and development of children in SA. The research team is now nearing the end of recruiting 7000 women of childbearing age from Soweto, a historically disadvantaged urban area of Johannesburg, to evaluate the impact of a package of interventions developed during the first phase of the project, on their children's health, cognitive and behavioural outcomes. The team has engaged with community and policy makers to ensure that the information that will be generated can be applied to policies and practices in SA and potentially other countries to enhance the life-long wellbeing of children.