Early INterventions to Support Trajectories for healthy lifE in INdia (EINSTEIN)
Our HeLTI – India proposal has been approved by CIHR


Background


The health and economic burden of non-communicable diseases (NCDs) is increasing rapidly globally and falls disproportionally on low- and middle-income countries (LMICs). In India, an estimated 65 million people have diabetes and a further 77 million are pre-diabetic. Unchecked, the population with diabetes is expected to reach 109 million by 2035. The rising burden of cardiometabolic disease is accompanied by a growing burden of mental health disorders; 13% of young people aged 1-16 years in India experience mental health disorders.

Undernutrition remains a significant problem in India.

In children under 5, the prevalence of: stunting is ~48%; wasting ~20%; underweight ~43%, anaemia ~69%. In women aged 15-49 years: 33% are underweight while ~55% are anaemic. These factors are reflected in a high prevalence of low birth weight (<2500g) in ~25% of babies born in India each year. Low birth weight (LBW), poor infant nutrition, and rapid childhood weight gain and obesity are well-established risk factors for poor health trajectories and development of NCDs in later life. Rates of obesity in children and adults are also increasing in India; 19% of children and adolescents and 15% of women of reproductive age are overweight or obese.

How it works?
An impressive interdisciplinary team has been assembled for the EINSTEIN Project. Our Indian team brings together researchers from 11 Institutions, further developing a national resource in DOHaD research, intervention cohorts, longitudinal studies, data management and knowledge translation/policy development. The Canadian team brings together investigators with complementary expertise from 7 Universities. Our team includes knowledge users, and sex and gender champions, in both India and Canada.

Where?
The study is a community-based, cluster randomized intervention with three arms (pre-conception, pregnancy and control) set in rural Mysore, South India, with individual villages forming the basis for the cluster.


Hypothesis
A multifaceted integrated intervention programme starting pre-conceptionally and continuing through pregnancy and infancy, comprising measures to improve maternal mental health and nuturing skills, and prevent infant infection, will improve child growth and development (in the short term) and reduce the burden of non-communicable disease and optimize human potential (in the longterm).

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