Diabetes and prevention strategies in South Asian peoples (completed)
GIFTS - Genomic and lifestyle predictors of foetal outcome relevant to diabetes and obesity and their relevance to prevention strategies in South Asian peoples.
Mother and Child taking part in Research in GIFTS - Pakistan. Photo: Dr. Fareeha Sheikh
About the project
GIFTS is an ambitious project targeting early life programming as an opportunity for the prevention of diabetes and obesity in people of South Asian origin.
Gifts will enhance diabetes prevention strategies and understanding in this field by:
- Improving understanding of the nutritional and lifestyle factors affecting early life programming
- Elucidating the role of genomics in the development of diabetes
- Modification of diabetes prevention education by incorporation of results and learning generated by GIFTS into the curriculum
Furthermore, by putting these key early life influences into context of an increasingly divergent postnatal life in home and emigrant populations, this collaborative programme will strike at the heart of adult metabolic disease susceptibility and tailored prevention strategies.
GIFTS bring together a unique group of investigators from Europe and South Asia, with wide-ranging expertise, to study diabetes in people from South Asian origin, both in their native countries and Europe. Results will be used ot inform public health policy, through guideline development.
- The main object will be to combine the knowledge gained from pilot studies (and work packages performed within the project) regarding liftestyle, nutrition, mental health and genetics and how these affect the risk of developing diabetes type II, so that we can develop targeted interventions to improve public health.
- Try to undertand the determinants early in life (genetic, lifestyle and environmental factors) that can lead to diabetes type II, obesity and related metabolic diseases in the South Asian population group in Europe and in their countries of origin.
- To establish a strong international consortium to understand early life determinants of diabetes and metabolic disease. This will be achieved through close cooperation between a number of institutions and researchers in Europe and Asia.
Additional main objective for the Oslo-Norway part:
- To explore the nutritional status and prevalence of depression in pregnant women of Pakistani origin as indicators for developing diabetes type II and cardio-matabolic risk
Diabetes and obesity are multi-factorial diseases. Despite a strong genetic component, the rapidly rising prevalence of these disorders is due to adaptation to a changing environment. The epicentre of the ‘diabetes epidemic’ is in South Asia where, for example, 1 in 4 of all Indians above 20 years of age has either diabetes or impaired glucose regulation. Importantly, similar increases in diabetes are also seen in South Asian communities living in Europe with the prevalence of diabetes 3-6 fold higher than the European average.
Current diabetes/obesity prevention strategies are focused on adult life and target over-nutrition with interventions designed to reduce obesity in high-risk adults. However, for many population groups across the globe, these strategies ignore many key principles that underlie the increasing global prevalence of these diseases.
A substantial portion of the South Asian people, living in their home countries experience nutrition deprivation, while after migration to Europe, may encounter nutritional abundance resulting in imbalance during their lifecourse. These conditions are of particular importance during foetal and early developmental stages where environmental insults may interact with genetic risk to induce ‘foetal programming’ of adult metabolic disease.
An increasing contextual understanding of South Asian populations in home and emigrant populations highlights the existence of these adverse conditions during these developmental stages, further compounded by extreme environmental and social deprivation.
Key examples include the poor uptake of pre- and peri-conceptual pregnancy planning, and low uptake of routine folic acid supplementation in women of South Asian origin. Fetal growth during pregnancy may be also restricted or excessive, due to genetic factors, exposure to maternal undernutrition, weight gain or dysglycaemia.
Mothers from some South Asian groups are also less likely to breastfeed and more likely to introduce solid foods earlier than recommended, increasing the risk of rapid postnatal catch-up growth and childhood obesity.
Although a new WHO guideline has begun to address these complex issues it still leaves a significant knowledge gap with regard to ideal weight during pregnancy, notably for South Asian women who are between the extremes of underweight or overweight, or for specific nutritional guidelines for key developmental regulators such as vitamin D and one-carbon metabolites (folate and vitamin B12 in particular). More notable is the absence of clear international guidance on how to achieve optimal conditions during this reproductive and early childhood period.
- EU (FP7-HEALTH-2011)
- Queen Mary and Westfield College, University of London
- King Edward Memorial Hospital Research Centre
- Baqai Medical University
- Bangladesh Institute of Health Sciences
- Public Health Foundation of India
- University of Southampton
- London School of Hygiene and Tropical Medicine
- University of Bristol
- University of Exeter
- Centre for Cellular and Molecular Biology
- Technische Universitat Dresden
- University of Helsinki
- University of East London
- University College London
- INSTRUCT AG
- BAP Health Outcomes
Start - Finish
Sanna Zaman, Melissa Trout, Salih Bisme, Line Løw and Shaheen Asghar. Photo: Anbjørg Kolaas