Identification of nutritionally modifiable hormonal and epigenetic drivers of positive and negative growth deviance in rural African fetuses and infants

In collaboration with Dr Robin Bernstein from the University of Colorado at Boulder, and with funding from the BMGF (Health Growth), this study aims to elucidate the key hormonal and epigenetic correlates of positive and negative growth deviance in rural Gambian children. Healthy growth is orchestrated by a small number of interacting hormonal pathways that are sensitive to nutritional and infectious insults. This project seeks to understand how and why these critical hormonal axes are down-regulated in children from The Gambia. This exploratory study will compare the best versus worst growth patterns for fetal, infant and early childhood growth. Through this study, will generate new knowledge on: a) critical periods within the first 1000 days when growth faltering is determined and can be modified; b) epigenetic correlates of positive and negative growth deviance (which may point to critical windows and pathways); c) the components of post-natal growth (regular, acute faltering, acute recovery) most affected; d) the role of body fat in protecting against faltering; and e) the hormonal pathways affected by malnutrition/stress/infection, their role in determining growth delay/failure, and their relationship to enteropathy as indexed by intestinal permeability measurements.

Starting in 2014, this study will prospectively recruit 200 mother-infant pairs from rural Gambia into our most ambitious study on growth to date. Key collaborators on this project are: Dr Ken Ong and Professor David Dunger, from the Department of Paediatrics, University of Cambridge and Professor Nabeel Affara and colleagues, from the Department of Pathology, University of Cambridge.

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